75–650 PDF

Calendar No. 193

107TH CONGRESS REPORT

1st Session " ! SENATE 107–84

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2002

OCTOBER 11, 2001.—Ordered to be printed

Mr. HARKIN, from the Committee on Appropriations,

submitted the following

REPORT

[To accompany S. 1536]

The Committee on Appropriations reports the bill (S. 1536) making appropriations for Departments of Labor, Health and Human

Services, and Education and related agencies for the fiscal year

ending September 30, 2002, and for other purposes, reports favorably thereon and recommends that the bill do pass.

Amount of budget authority

Total bill as reported to Senate ............................... $407,267,401,000

Amount of adjusted appropriations, 2001 .............. 364,816,166,000

Budget estimates, 2002 ............................................ 399,626,042,000

The bill as reported to the Senate:

Over the adjusted appropriations for 2001 ..... 42,451,235,000

Over the budget estimates for 2002 ................. 7,641,359,000
(2)

CONTENTS

Page

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

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

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

Bioterrorism Initiative ............................................................................................ 6

Rural Health Initiative ........................................................................................... 7

Aging Initiative ........................................................................................................ 11

Stem Cell Research .................................................................................................. 18

Youth Violence Prevention Initiative ..................................................................... 19

Reprogramming and Initiation of New Programs ................................................. 19

Transfer Authority ................................................................................................... 20

Title I—Department of Labor:

Employment and Training Administration .................................................... 21

Pension and Welfare Benefits Administration ............................................... 38

Pension Benefit Guaranty Corporation .......................................................... 38

Employment Standards Administration ......................................................... 38

Occupational Safety and Health Administration ........................................... 41

Mine Safety and Health Administration ........................................................ 42

Bureau of Labor Statistics ............................................................................... 43

Departmental management ............................................................................. 43

Office of Disability Policy ................................................................................. 46

Veterans Employment and Training ............................................................... 46

Title II—Department of Health and Human Services:

Health Resources and Services Administration ............................................. 49

Centers for Disease Control and Prevention .................................................. 82

National Institutes of Health .......................................................................... 119

Substance Abuse and Mental Health Services Administration .................... 188

Agency for Healthcare Research and Quality ................................................ 201

Centers for Medicare and Medicaid Services ................................................. 205

Administration for Children and Families ..................................................... 217

Administration on Aging .................................................................................. 235

Office of the Secretary ...................................................................................... 242

Title III—Department of Education:

Education for the disadvantaged ..................................................................... 254

Impact aid ......................................................................................................... 258

School improvement programs ........................................................................ 259

Indian education ............................................................................................... 295

Bilingual and immigrant education ................................................................ 296

Special education .............................................................................................. 297

Rehabilitation services and disability research ............................................. 301

Special institutions for persons with disabilities:

American Printing House for the Blind ................................................... 308

National Technical Institute for the Deaf ............................................... 308

Gallaudet University ................................................................................. 309

Vocational and adult education ....................................................................... 309

Vocational education ........................................................................................ 310

Adult education ................................................................................................. 311

State grants for incarcerated youth offenders ................................................ 312

Student financial assistance ............................................................................ 313

Federal family education loan program .......................................................... 315

Higher education .............................................................................................. 316

Howard University ........................................................................................... 333

College housing and academic facilities loans ............................................... 333

Historically black college and university capital Financing program .......... 334

Education research, statistics, and improvement .......................................... 334
Page

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Title III—Department of Education—Continued

Departmental management:

Program administration ............................................................................ 336

Office for Civil Rights ............................................................................... 337

Office of the Inspector General ................................................................ 337

General provisions ............................................................................................ 337

Title IV—Related agencies:

Armed Forces Retirement Home ..................................................................... 338

Corporation for National and Community Service ........................................ 338

Corporation for Public Broadcasting ............................................................... 340

Federal Mediation and Conciliation Service .................................................. 341

Federal Mine Safety and Health Review Commission .................................. 341

National Foundation of the Arts and the Humanities: Office of Library

Services: Grants and Administration .......................................................... 341

Medicare Payment Advisory Commission ...................................................... 345

National Commission on Libraries and Information Science ....................... 345

National Council on Disability ........................................................................ 346

National Education Goals Panel ..................................................................... 346

National Labor Relations Board ...................................................................... 346

National Mediation Board ............................................................................... 347

Occupational Safety and Health Review Commission ................................... 347

Railroad Retirement Board .............................................................................. 347

Social Security Administration ........................................................................ 348

U.S. Institute of Peace ..................................................................................... 353

Title V—General provisions .................................................................................... 354

Title VI—Mark-to-Market Extension Act of 2001 ................................................. 355

Budgetary impact of bill .......................................................................................... 356

Compliance with paragraph 7, rule XVI of the standing rules of the Senate .... 356

Compliance with paragraph 7(C), rule XXVI of the standing rules of the

Senate ................................................................................................................... 357

Compliance with paragraph 12, rule XXVI of the standing rules of the Senate .......................................................................................................................... 358

Comparative statement of new budget authority ................................................. 376
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SUMMARY OF BUDGET ESTIMATES AND COMMITTEE

RECOMMENDATIONS

For fiscal year 2002, the Committee recommends total budget au- thority of $407,267,401,000 for the Departments of Labor, Health

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

amount, $123,071,000,000 is current year discretionary funding.

ALLOCATION CEILING

Consistent with Congressional Budget Office scorekeeping, the recommendations result in full use of the $123,071,000,000 in discretionary budget authority pursuant to section 302(b) of the Congressional Budget Act of 1974, as amended.

OVERVIEW AND BILL HIGHLIGHTS

The Labor, HHS and Education and Related Agencies bill constitutes the largest of the 13 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 protection from illness and want; the

right to a basic education and job skills training; 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

Youth violence prevention initiative.—Building on last year’s efforts, the Committee bill includes $1,542,800,000 for currently authorized programs within the Departments of Labor, HHS and

Education. The initiative will focus resources on activities that

identify, prevent and help cope with violence among youth.

Job Training.—The Committee recommendation includes

$5,533,281,000 for job training programs, an increase of

$404,760,000 over the budget request.

Worker protection.—The Committee bill includes $1,422,356,000

to ensure the health and safety of workers, including $450,262,000

for the Occupational Safety and Health Administration and
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$256,093,000 for the Mine Safety and Health Administration. The

recommendation is an increase of $63,877,000 over the 2001 level.

Persons With Disabilities.—In addition to programs highlighted

individually and to promote independent living in home and community based settings, the Committee has included $1,275,976,000

for services to persons with disabilities. This includes $60,884,000

for programs authorized under the Assistive Technology Act, an increase of $19,772,000 over 2001. In addition, the recommendation

includes $43,263,000 for the Office of Disability Policy at the Department of Labor, and $70,000,000 for Real Choice Systems

Change Grants and Nursing Home Transition Grants through the

Center for Medicaid and Medicare Services.

National Institutes of Health.—A total of $23,695,260,000 is recommended to fund biomedical research at the 25 Institutes and

centers that comprise the NIH. This represents an increase of

$3,400,000,000 over the fiscal year 2001 level.

Embryo Adoption.—The Committee has included $1,000,000 for a

public awareness Campaign to educate Americans about the existence of spare embryos and adoption options.

AIDS.—The Committee bill includes $5,165,565,000 for AIDS research, prevention, and services. This includes $1,883,000,000 for

Ryan White programs, an increase of $75,391,000 and $781,213,000

for AIDS prevention programs at the Centers for Disease Control

and Prevention.

Bioterrorism initiative.—The Committee bill includes

$338,000,000 to fund efforts to address bioterrorism threats.

Medical Error Reduction.—The Committee recommendation includes $60,000,000 for activities of the Agency for Healthcare Research and Quality to reduce medical errors, an increase of

$10,000,000 over the administration’s request.

Health Centers.—The recommendation includes $1,343,723,000

for health centers, an increase of $51,000,000 over the budget request, and $175,111,000 over the fiscal 2001 enacted level.

Centers for Disease Control.—The Committee bill provides

$331,518,000 within the Centers for Disease Control and Prevention to combat the growing threat of infectious disease. The amount

recommended is an increase of $13,844,000 over the fiscal year

2001 amount.

Community services block grant.—The Committee bill includes

$675,000,000, an increase of $75,009,000 over the 2001 enacted

level. This program provides a wide range of services and activities

to alleviate causes of poverty in communities and to assist low-income individuals in becoming self-sufficient.

Head Start.—The Committee recommendation includes

$6,600,000,000 for the Head Start Program. This represents an increase of $400,188,000 over the 2001 enacted level.

Low-income home energy assistance.—The Committee recommends $2,000,000,000 for heating and cooling assistance for lowincome individuals and families. Of this amount, $300,000,000 supports additional energy assistance during emergencies.

Education for the Disadvantaged.—The Committee has provided

$11,879,900,000 in grants to enhance educational opportunities for

disadvantaged children. This includes an increase of
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$1,437,279,000 over the fiscal year 2001 amount for grants to local

education agencies, bringing the total to $10,200,000,000.

Teacher Quality.—The Committee recommends $3,039,834,000

for grants to improve teacher quality. This is an increase of

$931,834,000 above the appropriation for fiscal year 2001 and

$439,834,000 over the budget request.

Educational Technology.—The Committee recommends

$1,000,000,000 for educational technology, an increase of

$182,904,000 over the budget request.

After-School Programs.—The Committee recommends

$1,000,000,000 for 21st Century Community Learning Centers, an

increase of $154,385,000 over the fiscal year 2001 appropriation

and the budget request.

Student financial aid.—The Committee recommends

$12,284,100,000 for student financial assistance, an increase of

$1,610,100,000 over last year. This recommendation includes

$713,100,000 for the Federal Supplemental Educational Opportunity Grant Program, a $22,100,000 increase over last year. The

amount provided for the Pell Grant Program will allow the maximum grant to be raised to $4,000, an increase of $250 over the

2001 amount.

Higher education initiatives.—The Committee bill provides

$1,764,223,000 for initiatives to provide greater opportunities for

higher education, including $805,000,000 for Federal TRIO programs.

Education for individuals with disabilities.—The Committee bill

provides $7,339,685,000 to 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 $1,000,000,000 over the 2001 level. Included in this appropriation is an increase of $8,048,000 over last

year’s level for Personnel Preparation Services under Part D of

IDEA.

Rehabilitation services.—The bill recommends $2,481,383,000 for

rehabilitation services, an increase of $81,593,000 above the

amount provided in 2001. These funds are essential for families

with disabilities seeking employment.

Services for older Americans.—For programs serving older Ameri- cans, the Committee recommendation totals $2,786,477,000 including $202,547,000 for senior volunteer programs, $450,000,000 for

community service employment for older Americans, $366,500,000

for supportive services and centers, and $561,000,000 for senior nutrition programs. For the medical research activities of the National Institute on Aging, the Committee recommends

$909,174,000. The Committee recommendation includes

$15,000,000 for the Medicare insurance counseling program.

Public broadcasting.—The Committee bill provides $375,000,000

to support public radio and television, an increase of $15,000,000

over the previous year’s appropriation.

BIOTERRORISM INITIATIVE

The terrorist attacks of September 11, 2001 proved the willingness of America’s enemies to use new types of weapons of mass destruction to murder large numbers of civilians. Among these new
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weapons, the use of biological agents in acts of terrorism is considered a potential threat with extraordinarily grave consequences. An

act of bioterrorism could be perpetrated directly against the health

of Americans, or indirectly via an attack on the Nation’s food supply. The Appropriations Subcommittee on Labor, Health and

Human Services, Education and Related Agencies recognized the

seriousness of this threat and held a series of hearings, beginning

in 1998 and culminating on October 3, 2001, to assess the needs

of the civilian agencies responsible for responding to acts of bioterrorism. In these hearings, the subcommittee heard testimony from

Federal, State, and local officials that identified potential deficiencies in their response to an act of bioterrorism.

This year’s appropriation to the Department of Health and

Human Services for responding to bioterrorism totals over

$338,000,000, an increase of over $48,000,000 over last year which

represents almost a doubling of that budget since 1999. The Committee recognizes that the urgency of the threat requires more

funding, and will work with the administration to develop a supplemental appropriation bill that addresses the needs of Federal,

State, and local agencies and health departments to coordinate a

response, stockpile appropriate pharmaceuticals, and build our

public health infrastructure so that it may more quickly detect and

more effectively respond to an act of bioterrorism or any other

event that threatens the health of our citizens.

RURAL HEALTH INITIATIVE

There are more than 54 million Americans living in rural areas,

roughly 20 percent of the country’s population. Rural areas, however, face unique and longstanding problems in accessing and

maintaining adequate health care services. According to HHS’

Agency for Healthcare Research and Quality, almost one-third of

the adults living in rural America is in poor to fair health—in fact,

it is estimated that over 20 million rural Americans have inadequate access to health care services.

While there is great variability across rural areas, there are

some common threads. Typically, rural communities have small

populations spread out over large geographic areas. This causes

many rural residents to have to travel great distances to receive

care and in many communities the challenges are made even more

difficult by bad weather, poor roads and/or mountainous terrain.

Rural communities often face an aging infrastructure of older

hospitals and clinics, problems accessing capital improvement funding and a limited and often depressed economic base.

The serious lack of mental health and substance abuse professionals, community-based services, and infrastructure means that,

in rural areas, individuals with a mental or substance abuse disorder go untreated at disproportionately greater rates than Americans with similar health problems living in urban communities.

Rural Americans also are more likely to be poor, old, and experiencing poor health and disabilities than their urban counterparts.

They are less likely than their urban counterparts to have access

to an automobile or public transportation or to have a telephone.

Thus, while there are significant barriers to primary health care

for Americans living in all parts of the country, access to basic, yet
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essential, health care services is most problematic in rural communities.

Lack of health care clinicians

Although 20 percent of the population lives in rural areas, only

9 percent of physicians practice there. In 2000, rural areas contained 67 percent of the country’s primary care health professional

shortage areas.

While primary care providers are scarce in rural areas, specialized care is even more difficult to access. Internists, general surgeons, obstetrician-gynecologists and pediatricians and other medical specialists tend to be concentrated in bigger towns and cities.

Studies show that physicians trained in rural areas are more

likely to practice in those areas. Unfortunately, few rural training

opportunities exist. There are currently only 21 rural training

tracks in which the residents spend the majority of their time

training in rural areas under the 1∂2 model (1 year in a teaching

hospital with 2 years in a rural practice site).

Historically, the National Health Service Corps has been a key

provider of rural health professionals. In fiscal year 2000, 61.5 percent of the NHSC placements were in rural areas. Unfortunately,

due to limited funding, only 12.5 percent of the communities eligible for a primary care provider placement receive assistance.

Limited local health care services

Rural hospitals are the lifeblood of the rural health care delivery

system. The bulk of the 2,187 rural hospitals are primary care hospitals. Specialized hospital care, however, is limited.

—Of the 245 long-term care hospitals in the country, only 12 of

them are in rural areas.

—Of the 601 psychiatric hospitals in the country, only 81 of them

are in rural areas.

—Of the 208 rehabilitation hospitals in the country, only 21 of

them are in rural areas.

—All of the country’s 73 children’s hospitals are in urban areas.

Aging health care infrastructure

Rural areas are reliant on an aging infrastructure. Twelve percent of rural hospitals located in counties adjacent to urban areas

are using buildings and fixed equipment that is more than 20 years

old, compared to just 7 percent for hospitals in urban areas. For

those rural counties that are not adjacent to urban areas, the figure is even higher—15 percent are using aging building and equipment.

There are few sources of capital for rural hospitals. The existing

capital programs available through the U.S. Department of Housing and Urban Development are geared toward large urban facilities with substantial administrative requirements that are beyond

the reach of most small rural providers. The USDA’s Capital Facilities Loan program offers another opportunity for loans and grants

but it has limited resources and is open to all rural providers and

not targeted specifically to health care facilities.
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Access

Access problems for rural residents are most severe in the more

isolated areas, due primarily to lack of providers and greater distances needed to travel to receive care.

Forty-three percent of rural residents go without coverage of prescription drugs for the entire year compared to 27 percent of urban

residents. Fifty-two percent of rural elderly residents 85 and over

have no prescription drug coverage compared to 33 percent of their

urban counterparts.

Limited economic base

Rural areas are often adversely affected by poor economic conditions. Many of these communities may have a weak economic base,

which creates limited capacity to support modern health care delivery. The limited economic base also makes common capital improvements, such as air conditioning repairs, major obstacles or

sometimes completely unaffordable.

Reliance on Medicare

Medicare financing plays a critical role in supporting the rural

health care delivery system and continues to be the dominant

source of health care reimbursement in rural areas. Medicare patient expenses in 1998 accounted for 47 percent of total patient

care expenses for rural hospitals, compared to 36 percent of urban

hospitals. That makes rural hospitals particularly vulnerable to

Medicare payment policy changes.

Also, rural Medicare beneficiaries are typically treated in a feefor-service format and their provider base is heavily weighted toward primary care. Fifty-seven percent of the physicians in these

areas are generalists compared to 27 percent in urban areas.

Therefore, rural populations are significantly less likely to receive

specialized care, including timely EKGs for congestive heart failure

and transient ischemic attack, follow-up care after hospitalizations

for diabetes and gastrointestinal bleeding, timely gallbladder removal for symptomatic gallstones and screening mammography.

To address these inequities and barriers to access in rural communities, the Committee has provided increased funding for programs for this rural health initiative.

Access to Providers

National Health Service Corps.—To help train and retain primary care providers in rural areas, the Committee has provided

$154,400,000, an increase of over $25,000,000 over fiscal year 2001

for both recruitment and placement under the National Health

Service Corps. The Committee expects that a significant portion of

the additional funding will be used to minimize the disparity in the

supply of health care providers between rural and urban communities.

Quentin N. Burdick Program for Rural Interdisciplinary Training.—The Committee has increased funding for the Quentin N.

Burdick Program to ensure an appropriate increase in the distribution of health care professionals to rural areas by recruiting, training, and retaining teams of interdisciplinary professionals to work

in rural underserved areas.
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Access to health care facilities

Community Health Centers.—The Committee has provided the

largest single increase—over $175,000,000, for Community Health

Centers. These centers play an integral role in providing critical

health care services to underserved and uninsured people throughout America. The Committee expects that a portion of the additional funding provided in this bill will be used to expand access

to health care services to rural communities.

Support for rural hospitals

Rural Hospital Flexibility Grants.—The Committee has provided

full funding for this program to assist States to stabilize and improve access to health care services in rural communities.

Regulatory Relief for Rural Hospitals.—The Committee has pro- vided $15,000,000 for the Rural Hospital Improvement Program to

provide grants to small rural hospitals (those with fewer than 50

beds) and rural hospital networks to assist struggling rural facilities with the administrative burdens created by the Balanced

Budget Restoration Act and the Health Insurance Portability and

Accountability Act. While the Committee believes these regulatory

changes will ultimately improve the health care system by improving quality and reducing medical errors, it believes rural facilities,

because of their unique economic barriers, face unique hurdles and

deserve some relief.

Reducing health disparities

Rural Health Research.—The Committee has provided an increase for Rural Health Policy Development to improve and expand

the capacity of Rural Health Research Centers to develop and identity appropriate recommendations for improving the delivery of

health care services in rural communities.

State Offices of Rural Health.—The Committee has doubled funding for the State Offices of Rural Health from $4,000,000 to

$8,000,000. The additional funding will enable States to improve

rural health outreach and coordination and to better meet the specific rural health needs in each State. A portion of the new funding

will be used to fund rural health quality improvement grants

throughout America.

Improving Medicare Reimbursement Levels for Rural Providers.— The per-beneficiary reimbursement rate for providers is typically

much lower in rural States than in more heavily populated States.

The Committee has directed the Secretary to develop a proposal

that would increase the payment rates to Medicare providers who

are currently reimbursed at a rate below 95 percent of the national

average.

Rural Health Outreach.—The Committee has provided

$5,000,000 to improve access to automatic external defibrillators in

rural communities.

Medical errors initiative

Last year, the Committee provided funds to begin to address the

problem of injuries and deaths resulting from preventable medical

errors. The Institute of Medicine (IOM) estimates that medical errors are the fifth leading cause of death in the United States. With
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the $50,000,000 the Committee provided in fiscal year 2001, the

Agency for Healthcare Research and Quality (AHRQ) was able to

fund grants for 16 States to allow those States to begin collecting

comparable data on medical errors so that national trends can be

determined and analyzed. Also, AHRQ used a portion of the funds

appropriated to support a number of projects to determine innovative ways of reducing medical errors. This year, the Committee is providing a total of $60,000,000 to

continue and expand efforts to reduce medical errors. The Committee expects that AHRQ will use these funds to ensure that lessons learned and best practices will be shared among hospitals and

healthcare providers. The Committee directs AHRQ to work with

the Center for Medicare and Medicaid Services (CMS) to provide

such information to participating hospitals and healthcare facilities

so that they can begin implementing successful strategies. In an effort to reduce medical errors, the Committee also directs CMS to

prepare a comprehensive report on how current State requirements

are enforced. This report should include information detailing how

well the State licensing boards are meeting their target patient

safety goals.

The Committee further directs AHRQ to provide a report detailing the results of its efforts to reduce medical errors. Among other

things, the report should include how hospitals and other

healthcare facilities are reducing medical errors; how these strategies are being shared among healthcare professionals; how many

hospitals and other healthcare facilities record and track medical

errors; how medical error information is used to improve patient

safety; what types of incentives and/or disincentives have helped

healthcare professionals to reduce medical errors; a list of the most

common root causes of medical errors. The report should also provide data showing the effectiveness of State requirements in reducing medical errors. The report should also describe how AHRQ is

responding to some of the findings in the IOM’s report ‘‘To Err is

Human: Building a Safer Health System.’’ The Committee reiterates its position that there should be zero

tolerance for preventable medical mistakes and that the Congress,

the Administration, State licensing boards, and private healthcare

institutions and providers should work together to prevent further

unnecessary deaths and injuries.

AGING INITIATIVE

The decennial Census provides us with a snapshot of what our

society looks like today, reminds us how we have changed over the

years and offers a preview of the future composition of the United

States population. Last year, almost 46,000,000 Americans, or one

of every six, were 60 years of age or older. While the total population for the United States increased by 13 percent since 1990,

those in the age category 75–84 increased by twice that rate. Our

Nation’s most senior group—the population 85 years and older—increased by three times the rate of the overall population, making

it the second fastest growing age group. The largest increase occurred in the number of individuals age 45–54—members of the

baby boom generation—whose ranks increased by 50 percent since

1990. With improvements in health care supporting increasing life
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expectancy, it is this group that will add significant shades of grey

to the picture of the population of the United States.

These facts illustrate the trend of more people, living longer, but

that alone does not tell the entire story. Many Americans know

first hand that increases in age are accompanied often by the onset

of a disabling condition. Census data show that more than half of

the population 65 years of age and older report at least one disabling condition. Almost 25 percent of the Nation’s elders will experience multiple, chronic, disabling conditions that make it necessary for them to rely on others for their care and help with meeting basic needs. And for those age 80 and older, approximately 3

out of 4 are likely to experience at least one disabling condition,

and more than one in three will require some assistance with activities of daily living.

In recognition of these facts and the many, significant contributions that our Nation’s elderly have made and continue to make in

our society, the Committee has developed an aging initiative designed to increase the capacity of home- and community-based

services to support a high quality life for older Americans. The initiative is comprised of two components: guidance for the departments funded through the Labor, Health and Human Services, and

Education and Related Agencies appropriations bill to follow in

order to improve the administration of programs that serve seniors,

and additional resources to increase the capacity of programs to

meet their goals and objectives.

The Committee recognizes that the national aging network, comprised of State units on aging, area agencies on aging, and service

providers, is the foundation of supports and services for frail older

people, their families and caregivers. Programs and services administered by the aging network make it possible for frail older people

to live in their homes and receive care in the home or a community-based setting.

The Committee notes that many of the aging services programs

are administered at the Federal level by many different departments or agencies, which creates a number of barriers that make

State and local administration more cumbersome. Removing some

of these barriers and allowing more State and local flexibility will

improve the ability of the aging network to be responsive to the

needs of older people and their families and caregivers. The Committee believes that interagency cooperation and coordination

across different programs will help leverage the resources available

at the Federal level and establish a coordinated infrastructure of

home- and community-based services for older adults, thereby improving the availability and accessibility of these services at the

local level.

Therefore, The Committee directs the Secretary of the Department of Health and Human Services to set up an Interagency Task

Force on Aging Programs, comprised of the Departments of Health

and Human Services, Housing and Urban Development, Agriculture, Labor and Transportation. The Task Force’s efforts should

focus on coordinating activities to maximize the impact of existing

services, reducing and eliminating duplication in both service provision and the process for accessing such services, and minimizing

regulatory burdens and costs at the local level. The Committee also
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strongly urges that HHS increase the visibility and prominence of

elder issues within the Department and encourages the Department to provide the Administration on Aging with a more visible

and stronger leadership role within HHS. The Committee expects

to be briefed on a quarterly basis about the activities and accomplishments of the Task Force.

Strengthening the Aging Network

The Older Americans Act is the only piece of Federal legislation

that promotes comprehensive, coordinated systems of community

care, but it falls short of its promise due to the challenges of limited resources. The Committee recognizes that insufficient resources available to the aging network makes it difficult to serve

effectively the millions of Americans eligible for services. Therefore,

the Committee has increased funding for Older Americans Act programs by 10 percent over the fiscal year 2001 level. These additional resources will provide critical investments in nutrition, caregiver support, transportation and other supportive services. The

Committee believes that these investments in the aging network

are essential to maintaining a high quality of life for our Nation’s

elderly—in their homes and communities—and a key to preparing

for the needs associated with the aging of the baby boom generation.

Supportive Services and Senior Centers

The Committee has provided $366,500,000 for the supportive services and senior centers program, an increase of $41,425,000

over last year and the most significant investment in more than

two decades. The Committee recognizes the critical role that this

program plays in providing services to seniors that enable them to

continue living independently at home or in their community. For

example, transportation assistance provided to older Americans residing in rural areas allows them to make their doctor’s appointment, get vital prescriptions filled or shop for groceries. The Committee also is aware that funding for elderly case management is

essential to provide relief to community service providers and partners in the process who have historically provided support on a voluntary basis, but who now feel they are jeopardizing their ability

to provide services to all clients by stretching their resources and

organizations to the breaking point. Without adequate transportation assistance, adult day care, case management and in-home

services that this program provides millions of older Americans

could face avoidable hospital stays and unnecessary institutionalization.

Protection of Vulnerable Older Americans

The Committee recommendation includes $18,181,000 to defend

the basic rights of vulnerable older Americans and to help them

protect themselves from abuse, neglect and exploitation, an increase of $4,000,000 over last year. The Committee is aware of the

findings from the 1998 National Elder Abuse Incidence Study that

almost 450,000 individuals 60 years of age and older in domestic

settings experienced abuse, neglect, exploitation and/or self-neglect

during 1996. Less than 1 in 5 individuals actually reported these
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incidents to the appropriate agencies. In addition, approximately 3

million elderly and disabled individuals receiving care in nursing

homes, assistive living facilities and similar arrangements throughout the United States filed more than 200,000 complaints about

their care. The Committee notes that the Institute of Medicine report on Improving the Quality of Long-Term Care identified the

long-term care ombudsman program as ‘‘probably the best-known

advocacy effort in long-term care’’ and stated that ombudsmen and

long-term care professionals argue that ‘‘routine on-site presence of

ombudsmen establishes resident confidence, allows resident problems to be detected before they become serious and promotes positive working relationships with facility administration and staff.’’ The additional resources recommended by the Committee will support the hiring of additional ombudsmen and the publication and

dissemination of educational materials.

Family Caregiver Support Program

The Committee continues its investment in the critical long-term

care assistance delivered by the family and informal caregiving

support network by providing a $20,000,000 increase in the National Family Caregiver Support Program and an increase of

$1,000,000 for the Native American Caregiver Support Program.

The Committee recommends a total of $146,000,000 for caregiver

support programs. As the population of the United States continues

to age and average life spans continue to lengthen, more and more

Americans face the challenges of providing care to those who need

help because of chronic illness or disability. More than 12 million

adults have a disability that may require assistance from others to

carry out activities of daily living, such as bathing and feeding. The

Committee notes that if the work of the more than 7 million unpaid caregivers had to be replaced by paid home care staff, the estimated cost would be $94,000,000,000 per year. The significant increase the Committee recommends is not based on cost savings to

the Nation’s health care system alone, but instead reflective of the

important assistance and relief that caregiver support programs

offer for those providing unpaid services to loved ones, friends and

neighbors—our Nation’s elderly—to help them continue to live

independently in their community.

The Committee strongly urges the Assistant Secretary of the Administration on Aging and the Chief Executive Officer of the Corporation for National Service to coordinate activities under the National Family Caregiver Support program of the Older Americans

Act in a way that maximizes the ability of local communities to

meet the burgeoning need for home- and community-based care for

seniors and respite care for caregivers. The Committee notes that

the Senior Companion Program authorized under the Domestic

Volunteer Service Act has been providing in-home services to

homebound seniors, respite services to their families, and more for

three decades. Volunteers under the Retired and Senior Volunteer

Program provide hundreds of thousands of hours annually to homebound seniors and their families. The Committee understands that

coordination between area agencies on aging and these grantees,

particularly those sponsored by groups other than senior organizations, can serve to strengthen the infrastructure of support avail-
15

able in communities throughout the country and in doing so, provide seniors and their families greater access to much-needed services.

Nutrition Programs

The Committee has provided $561,000,000 for elderly nutrition programs, an increase of $30,588,000 over last year. This increase

includes an additional $25,000,000 for the home delivered meals

program. The Committee notes that nutrition programs are a critical component of the overall package of home- and communitybased services for elderly people. For seniors, nutrition can be especially important, because of their vulnerability to health problems

and physical and cognitive impairments. The last evaluation of the

elderly nutrition programs indicated program participants are

twice as likely to live alone and have physical impairments, but because of the services provided by the nutrition programs, experience higher daily intakes of key nutrients and more social contacts

per month than similar nonparticipants. Expenditures under the

nutrition program are highly leveraged by State, tribal, local, and

other Federal monies and services and are also augmented by donations from participants—making the nutrition programs a great

investment of Federal resources. Unfortunately, the evaluation

noted that 41 percent of service providers have waiting lists for

home-delivered meals. The increase provided by the Committee will

help address the critical need for additional nutrition services.

Alzheimer’s Disease Demonstrations

The Committee recommendation includes $13,000,000 for this

demonstration grant program, an increase of $4,038,000 over last

year. The Committee notes that an estimated 70 percent of individuals with Alzheimer’s disease live at home, where families provide

the preponderance of care. For these families, care giving comes at

enormous physical, emotional and financial sacrifice. The Alzheimer’s disease demonstration grant program currently provides

matching grants to 24 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. Given the programs proven record of success, the Committee

has provided a significant investment in order to expand the program to additional States.

Enhancing Employment and Training Services for Mature and

Older Workers

Recent Census data show that among individuals age 65 years

and older, 14 percent were in the civilian labor force. The Committee is aware that, prior to enactment of the Workforce Investment Act (WIA), the Federal job-training program targeted funds

specifically to older workers. Currently, WIA funds are not targeted

for training older workers, at a time when the number of older

workers is increasing significantly. To remain competitive in the

labor market, older workers must acquire or update their job skills.
16

While WIA is designed to meet the needs of all workers, the Committee is concerned that the One-Stop Career Centers, funded

under WIA, may not be adequately meeting the training and educational needs of older workers. The Committee therefore requests

that the Department of Labor (DOL) report within 180 days the

measures it can undertake to ensure training and related services,

appropriated under WIA, are available to older workers.

The Committee is pleased that both Senior Community Service

Employment Program (SCSEP) grantees and the DOL are interested in increasing unsubsidized placements of low-income older

workers participating in the SCSEP program. However, given the

decline in the national economy, the Committee is concerned that

any significant increase in the SCSEP unsubsidized placement

goal, absent the availability of national or local WIA occupational

skills training resources for SCSEP participants, will not be achievable. The Committee, therefore, could support a modest increase in

the SCSEP minimum unsubsidized placement goal only if it is implemented after the DOL has assured the Committee that the necessary WIA occupational skills training resources are available to

all SCSEP participants.

Health Care Support Structure

The Committee has provided $15,000,000 within the Centers for

Medicare and Medicaid budget to support grants for State Health

Insurance Counseling and Assistance programs (SHIPs), an increase of $5,000,000 over last year. SHIPs provide information,

counseling and decision support to people with Medicare. The 53

State and territorial programs are administered either by the State

unit on aging or the State department of insurance. The Committee

is aware that these programs provide a valuable service to people

with Medicare and require a stable source of funding. The CMS

shall use these resources to provide grants to States for SHIPs to

enable them to increase their capacity to serve Medicare beneficiaries, to operate a resource center and to administer special

projects that will help SHIPs continuously improve the quality of

service they provide. The Committee expects CMS to include, within its fiscal year 2003 congressional justification, a specific dollar

request for SHIPs, or to indicate that no resources are being requested for this activity.

The Committee is aware that many elderly individuals may be

eligible for payment of the cost of medicare cost-sharing under the

Medicaid program. The Committee notes that studies have estimated that 35 to 40 percent of the noninstitutionalized population

eligible for the Qualified Medicare Beneficiary program and Specified Low-Income Medicare programs are not receiving the financial

assistance available from these programs. Research has shown that

individuals likely to be eligible for this assistance tend to be relatively old, have lower income and resources than other Medicare

beneficiaries and are more likely to be in poor health and have

functional limitations. In order to increase awareness of and participation in these programs, the Committee has provided

$7,000,000 to the Social Security Administration (SSA) to enable

SSA to conduct outreach efforts to identify individuals who may be
17

eligible for payment of the cost of medicare cost-sharing under the

medicaid program.

Supporting Networks of Home and Community Based Care

The Committee strongly supports efforts to reduce barriers to

community living for all Americans. The Committee believes the

Department of Health and Human Services (HHS) should continue

to develop initiatives designed to reduce barriers to community living and ensure that the elderly disabled population is considered

in all initiatives designed to address barriers to community living.

The Committee notes that materials released by HHS since the

Olmstead decision and in response to the New Freedom initiative

have said little or nothing about the needs of the elderly disabled.

The Committee believes that greater attention needs to be paid to

the needs of older persons, to the role played by State Units on

Aging (SUAs) both as administrators of Medicaid waiver and other

home and community based services for the elderly and the unique

issues involved in the delivery of HCBS to older people. The Committee also encourages the Centers for Medicare and Medicaid

Services to focus increased attention on the issue of institutionalization, including the unique needs of the elderly. The Committee has included $50,000,000 within the Centers for

Medicare and Medicaid Services budget for Real Choice Systems

Change Grants to States to fund initiatives that establish specific

actions steps and timetables to achieve enduring system improvements and to provide long-term services and supports, including

community-based attendant care, to eligible individuals in the most

integrated setting appropriate. Grant applications should be developed jointly by the State and Consumer Task Force. The Task

Force should be composed of individuals with disabilities, including

the elderly, consumers of long-term care services and supports, and

those who advocate on behalf of such individuals. Grant funded activities should focus on areas of need as determined by the States

and the Task Force such as needs assessment and data gathering,

strategies to modify policies that unnecessarily bias the provision

of long-term care to institutional settings or health care professionals, strategies to ensure the availability of a sufficient number

of qualified personal attendants and training and technical assistance.

The Committee notes that the purpose of the Assistive Technology Act is to enhance access to assistive technology to empower

individuals with disabilities to have greater control over their lives

and more fully participate in their home, school, and work environments, and their communities. The Committee recognizes the high

priority of supporting individuals in their home or communitybased settings. To that end, the Committee encourages the Secretary of Education to give priority in providing technical assistance and planning for assistive technology to support community

living; provide States greater flexibility to set priorities under the

assistive technology program; and facilitate States’ ability to work

directly with lending institutions to make available to consumers

low cost loans to be used to purchase assistive technology that supports independent living. The Committee also has included bill language and sufficient resources within the Department of Edu-
18

cation’s Assistive technology program to continue all State projects

funded under title I of the Assistive Technology Act and maintain

the current program structure of the Alternative Loan Financing

program authorized under title III of the Act.

Investments in Biomedical Research

The Committee recommends a record $3,400,000,000 increase for

the National Institutes of Health over the fiscal year 2001 appropriation, for a total budget of $23,695,260,000. This investment in

medical research can foster improved health, longer life expectancy,

a better quality of life and lower health care costs. While the Committee does not earmark specific funding levels for individual diseases and conditions, a significant portion of this record increase

will go toward research on aging-related matters. For example,

funding for the National Institute of Aging will rise 15.7 percent,

from $786,056,000 in fiscal year 2001 to $909,174,000 in fiscal year

2002. Funding for the National Institute of Arthritis and Musculoskeletal and Skin Diseases will rise 16.5 percent, from

$394,968,000 to $460,202,000, and funding for the National Institute of Neurological Disorders and Stroke will rise 15.4 percent,

from $1,172,132,000 to $1,352,055,000.

STEM CELL RESEARCH

In November 1998, the world first learned that scientists had

successfully cultured human embryonic stem cells. Those researchers found that these cells, in their earliest stages, have the ability

to transform into any type of cell in the human body. In theory, a

stem cell implanted into a diseased heart, for example, would become a healthy heart cell; the same procedure could restore new

life to a damaged spinal cord, an insulin-deficient pancreas, or a

liver riddled by hepatitis. That theory gained more credence when

another team of researchers saw promising signs of movement

after injecting human embryonic stem cells into the spinal cords of

monkeys stricken with Lou Gehrig’s disease.

Since 1998, the Subcommittee on Labor, Health and Human

Services, and Education has held nine hearings on stem cell research. The subcommittee has heard more than 20 hours of testimony from preeminent scientists who have described the potential

of stem cells to cure the most common diseases afflicting Americans

today. It has heard from ethicists who have discussed the moral

and social implications of pursuing this line of research. It has listened to company executives recount their hopes for delivering

therapies to patients and patent attorneys discuss intellectual

property rights. But the most striking and most compelling testimony has come from patients who suffer from diseases and disabilities that could one day be treated or cured with the help of embryonic stem cells.

The Committee urges the NIH to move quickly to support all

types of stem cell research, including embryonic, adult, and cord

blood, and to keep the Committee informed of the research

progress.

The Committee understands that it may take several years to

translate research on these cells into therapies. Therefore, it directs the National Institutes of Health [NIH] to award grants for
19

human embryonic stem cell research as quickly as possible, in

strict compliance with ethical guidelines.

YOUTH VIOLENCE PREVENTION INITIATIVE

An estimated 3 million crimes a year are committed in or near

the Nation’s 85,000 public schools. Homicide is now the third leading cause of death for children age 10 to 14. For more than a decade it has been the leading cause of death among minority youth

between the ages of 15 and 24. The trauma and anxiety that violence begets in our children most certainly interferes with their

ability to learn and their teachers’ ability to teach: an increasing

number of school-aged children say they often fear for their own

safety in and around their classroom.

The Gun-Free Schools Act of 1994 requires states to pass laws

mandating school districts to expel any student who brings a firearm to school. A recent study indicates that the number of students

carrying weapons to school dropped from 26.1 percent in 1991 to

18.3 percent in 1997. While this trend is encouraging, the prevalence of youth violence is still unacceptably high.

Fault does not rest with one single factor. In another time, society might have turned to government for the answer. However,

there is no easy solution, and total reliance on government would

be a mistake. Youth violence has become a public health problem

that requires a national effort.

The Committee is aware of the controversy regarding the media’s

role in influencing youth violence. Despite disagreement over the

media’s role, the Committee is encouraged by historic efforts of various sectors of the entertainment industry to monitor and discipline

themselves and to regulate content. The industry’s self-imposed,

voluntary ratings system is a step in the right direction.

The Committee continues its commitment to provide adequate resources to address youth violence. Since fiscal year 1999, the Committee has devoted $2,900,000,000 for this prevention initiative.

This year, the Committee recommends $1,542,800,000 for this purpose. By reallocating funds from existing programs and coordinating efforts throughout the Departments of Health and Human

Services, Labor, Education and the Department of Justice, the

agencies have been able to target resources and address youth violence in a comprehensive fashion. This coordinated approach will

improve research, prevention efforts, education and treatment

strategies.

REPROGRAMMING AND INITIATION OF NEW PROGRAMS

Reprogramming is the utilization of funds for purposes other

than those contemplated at the time of appropriation enactment.

Reprogramming actions do not represent requests for additional

funds from the Congress, rather, the reapplication of resources already available.

The Committee has a particular interest in approving reprogrammings which, although they may not change either the total

amount available in an account or any of the purposes for which

the appropriation is legally available, represent a significant departure from budget plans presented to the Committee in an agency’s

budget justification.
20

Consequently, the Committee directs that the Departments and

agencies funded through this bill make a written request to the

chairman of the Committee prior to reprogramming of funds in excess of 10 percent, or $500,000, whichever is less, between programs, activities, or elements unless an alternate amount for the

agency in question is specified elsewhere in this report. The Committee desires to have the requests for reprogramming actions

which involve less than the above-mentioned amounts if such actions would have the effect of changing an agency’s funding requirements in future years, if programs or projects specifically cited

in the Committee’s reports are affected or if the action can be considered to be the initiation of a new program.

The Committee directs that it be notified regarding reorganization of offices, programs, or activities prior to the planned implementation of such reorganizations.

The Committee further directs that each agency under its jurisdiction submit to the Committee statements on the effect of this

appropriation act within 60 days of final enactment of this act.

TRANSFER AUTHORITY

The Committee has included bill language permitting transfers

up to 1 percent between discretionary appropriations accounts, as

long as no such appropriation is increased by more than 3 percent

by such transfer; however, the Appropriations Committees of both

Houses of Congress must be notified at least 15 days in advance

of any transfer. Similar bill language was carried in last year’s bill

for all three Departments.

Prior Committee notification is also required for actions requiring the use of general transfer authority unless otherwise provided

for in this act. Such transfers specifically include taps, or other assessments made between agencies, or between offices within agencies. Funds have been appropriated for each office funded by this

Committee; it is not the intention of this Committee to augment

those funding levels through the use of special assessments. This

directive does not apply to working capital funds or other fee-forservice activities.
(21)

TITLE I—DEPARTMENT OF LABOR

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2001 ............................................................................. $5,452,453,000

Budget estimate, 2002 ........................................................................... 5,128,521,000

Committee recommendation ................................................................. 5,533,281,000

The Committee recommends $5,533,281,000 for this account in

2002 which provides funding authorized primarily by the Workforce Investment Act [WIA]. This is $80,828,000 more than the

2001 level. This is $404,706,000 above 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 2002 will support the program from July

1, 2002, through June 30, 2003.

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.

Fiscal year 2000 was the first full year of operations under the

new Workforce Investment Act, beginning July 1, 2000 through

June 30, 2001. The new legislation is significantly enhancing employment and training services, consolidating, coordinating, and

improving programs utilizing a local level one-stop delivery system.

However, transition to the new legislative requirements has resulted in higher levels of unexpended funds than historical averages, allowing for continued expansion of job training services in

the budget year while maintaining formula grant funding at least

at current levels. The Committee recommendation rejects the cutbacks proposed in the President’s budget, recognizing the vital role

of the workforce system at a time of economic slowdown.

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

$950,000,000. This is the same as the 2001 comparable level and

$50,000,000 more than the budget request. This program is authorized by the Workforce Investment Act and 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 in-
22

tensive services, for unemployed individuals who are not able to

find jobs through core services alone.

Dislocated worker employment and training activities.—For Dislocated Worker Employment and Training Activities, the Committee recommends $1,549,000,000. This is an increase of

$136,460,000 over the 2001 comparable level. Of this amount,

$1,272,000,000 is designated for State formula grants, an increase

of $109,968,000 over the 2001 enacted level. This program, authorized by WIA, 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 $277,000,000 available to the

Secretary for activities specified in WIA, primarily to respond to

mass layoffs, plant and/or military base closings, and natural disasters across the country, which cannot be otherwise anticipated, as

well as technical assistance and training and demonstration

projects.

The Committee commends the administration for moving expeditiously to release emergency dislocated worker funding in response

to the recent terrorist attacks.

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. It also continues language modified to waive a 10 percent

limitation in the Workforce Investment Act with respect to the use

of discretionary funds to carry out demonstration and pilot projects,

multi-service projects and multi-State projects with regard to dislocated workers, and to waive certain other provisions in that Act.

The Committee recommends continuation of the following fiscal

year 2001 projects and activities in the fiscal year 2001 conference

agreement under the dislocated worker program: —Hawaii Department of Labor/Kauai Cooperative Extension

—Maui Women in High Tech Training

—JobLinks Program

—Pennyslvania Training Consortium

—Clayton College & State University GA-Virtual Ed & Training

Project

—Bethel Native Corp.—Alaska

These continuation grants are subject to project performance, demand for activities and services, and utilization of prior year funding.

The Committee is aware of the following projects that it encourages the Department to consider supporting:

—Good Faith Fund of the Arkansas Enterprise Group in

Arkadelphia, Arkansas

—Opportunities Industrialization Centers, International, services

to those who had transitioned from welfare to work but are

now out of work

—Cheiron Foundation, dislocated worker activities in rural, underserved areas

—Bloomington, Indiana job training program for dislocated workers, using resources of Indiana University
23

—Worker retraining for former tobacco workers, Idealliance

group in Winston-Salem, North Carolina —River Valley Growth Council, worker retraining for metal products industry —Chicago Youth and Adult Training Center, careers in the automobile industry —United Mineworkers of America career centers for retraining of

dislocated miners —Dexter Training Center to train and provide career counseling

to rural, dislocated workers —Training of dislocated and incumbent workers in plastics and

metals industries—Buncombe County Mountain Area Workforce Development Board —Workforce and related service requirements of migrant and

seasonal agricultural workers facing employment dislocation— La Cooperativa Compesina de California —Training services to both incumbent and dislocated workers— the Labor Institute of Training in Indianapolis, Indiana, and

the Indiana Department of Workforce Development —Workforce Training and Retraining for dislocated and incumbent workers in real manufacturing environment—University

of Albany, New York —Workforce Development project to retrain older incumbent

workers for Montana workforce—Montana State University,

Billings —Multi-State (Alabama, California, Connecticut, New Hampshire, Michigan, Ohio, and Vermont) Pilot of National Institute

for Metal Working Skills to retrain and certify dislocated workers and low wage workers as metalworkers —State of New Mexico—telecommunications job training for dislocated workers —Clemson University, retraining of tobacco farmers

—Oregon technology training program for incumbent and underemployed workers

—Central Oregon Community College, manufacturing and applied technology center

—South Central Wisconsin Workforce Development Board

—Recruiting for the Information Technology Age (RITA), to increase the capacity of Women Work!

—Opportunity Medical, Highland Park, Illinois, job training for

disabled persons

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

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

The Committee encourages efforts to make certain that dislocated workers in low pay, entry-level jobs can qualify for help

under the Dislocated Worker Program and get a fair share of the

funding.

The Committee has been advised that in some remote areas of

the country local personnel have received inadequate firefighting

training and in some cases lack even basic skills such as operation

of fire trucks and firefighting equipment. The Committee urges the

agency to work with local communities to develop basic firefighting

job training programs utilizing existing training facilities.
24

The Committee is aware of the substantial worker dislocation

brought on by the closure of all but two sugarcane plantations in

Hawaii and the rapidly increasing demand for food safety training

at all levels of food production. To meet these needs, the Committee

urges funding for the Hawaii Department of Labor and Industrial

Relations and the Hawaii Farm Bureau Federation to provide onfarm and off-farm food safety training for dislocated sugarcane

workers employed in the agricultural and food sector.

The Committee is aware of a collaborative effort between Kenosha County, Wisconsin, and Daimler Chrysler to retrain employees

and create a regional technology center through the dislocated

worker skills shortage demonstration program.

The Committee is aware of the severe worker dislocation brought

on by the closure of open-pit mines and the trend toward underground mining. Three decades of decline in underground operations

have caused the industry to lose much of the work force and skills

of underground mining. Few, if any, underground mechanics are

available that have adequate training in the technologies required

by the industry. The Committee encourages the Department to

support funding proposals in this area.

Youth activities.—For Youth Activities, the Committee recommends $1,127,965,000, the same as the 2001 comparable level

and $127,000,000 more than the budget request. Youth Activities,

authorized by WIA, consolidates the Summer Youth Employment

and Training Program under JTPA Title IIB, and Youth Training

Grants under JTPA Title IIC. In addition to consolidating programs, WIA also requires Youth Activities to be connected to the

One-Stop system as one way to link youth to all available community resources. The purpose of Youth Activities 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.

Youth opportunity grants.—For Youth Opportunity Grants, the

Committee recommends $250,000,000, the same as the 2001 comparable level and the budget request. Youth Opportunity Grants

are authorized in the Workforce Investment Act. These grants are

aimed at increasing the long-term employment of youth who live in

empowerment zones, enterprise communities, and other high-poverty areas. Surveys conducted by the Department of Labor have

found employment rates for out-of-school youth as low as 24 percent in selected high-poverty neighborhoods. Youth Opportunity

Grants will attempt to dramatically increase these employment

rates, and thus improve all aspects of life for persons living in

these communities.

Job Corps.—For Job Corps, the Committee recommends

$1,399,148,000. This is the same as the budget request and the

2001 comparable level. 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
25

businesses to ensure that student training meets current labor

market needs. Job Corps should continue its efforts to upgrade its

vocational offerings and curricula to reflect industry standards and

skill shortages. Job Corps, authorized by WIA, 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.

The Committee encourages Job Corps to strengthen working relationships with work force development entities, including employers, that will enhance services to students and increase students’ career opportunities. The Department is encouraged to continue its

efforts to meet industry standards in its occupational offerings

through a multi-year process to review, upgrade, and modernize its

vocational curricula, equipment, and programs in order to create

career opportunities for students in appropriate growth industries.

The Committee also encourages the Department of Labor’s Employment and Training Administration to encourage Job Corps centers

to coordinate with community-based organizations, such as substance abuse treatment centers, in innovative ways.

The Committee supports the goal of the Workforce Investment

Act of 1998 to integrate our Nation’s many diverse job training programs, and its approach of retraining the national character of the

Job Corps program within the new framework. The Committee encourages the Department to continue its work to develop national

partnerships with major regional and national employers to increase employment opportunities for Job Corps graduates. The Department should also continue to establish connections between Job

Corps and State workforce development programs, and between

Job Corps and other national and community partners, to provide

the most efficient, cost-effective services possible.

Responsible Reintegration for Young Offenders.—The Committee

recommends $55,000,000 for Responsible Reintegration for Young

Offenders, the same as the fiscal year 2001 level, to address youth

offender issues. This large scale WIA Pilot and Demonstration initiative will link offenders under age 35 with essential services that

can help make the difference in their choices in the future, such

as education, training, job placement, drug counseling, drug demand reduction activities, and mentoring, in order to reintegrate

them into the mainstream economy. Through local competitive

grants, this program would establish partnerships between the

criminal justice system and local workforce investment systems,

complementing a similar program in the Department of Justice

(DOJ). To maximize the impact of these initiatives, the DOL and
26

DOJ funds will be targeted to the same communities and populations. An estimated 13,750 youth will be served, and it is expected that 65 percent of program graduates will get jobs, re-enroll

in high school, or be enrolled in post-secondary education or training.

The Committee recognizes the Home Builders Institute’s Project

CRAFT (Community Restitution and Apprenticeship Focused

Training) program as a model intervention technique in the rehabilitation and reduced recidivism of accused and adjudicated juvenile offenders. The Committee also acknowledges the home building industry’s shortage of skilled workers and the role that Project

CRAFT plays in helping to address this need. As such, the Committee encourages the Department of Labor to work with the Justice Department to replicate such a project in order to offer at-risk

and juvenile offenders pre-apprenticeship training and job placement in the building industry.

Native Americans.—For Native Americans, the Committee recommends $57,800,000. This is $2,800,000 more than the 2001 comparable level. This program, authorized by WIA, is designed to improve the economic well-being of Native Americans (Indians, Eskimos, Aleuts, and Native Hawaiians) through the provision of training, work experience, and other employment-related services and

opportunities that are intended to aid the participants to secure

permanent, unsubsidized jobs. The recommendation includes

$1,711,000 for use under section 166(j)(1) of the Act, relating to assistance to American Samoans. The Department of Labor allocates

formula grants to Indian tribes and other Native American groups

whose eligibility for such grants is established in accordance with

Department’s regulations.

Migrant and seasonal farmworkers.—For Migrant and Seasonal Farmworkers, the Committee recommends $80,770,000. This is

$4,000,000 more than the 2001 comparable level. This program, authorized by WIA, 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.

The Committee recommendation includes bill language providing

$74,751,000 for State service area formula grants, $5,000,000 for

migrant and seasonal farmworker housing grants, and $1,019,000

for other discretionary purposes.

In its fiscal year 2001 appropriations report the Committee provided an additional $4,253,000 to the Department because of the

change in the formula used to allocate migrant and seasonal farmworker funds to grantees. These funds were used to restore grantees serving States with reduced allocations due to the formula

change to the 1998 funding level for those States. For fiscal year

2002, in addition to the $73,643,000 recommended for State service

area formula grants, the Committee is adding $1,108,000 to the

$4,253,000 provided in fiscal year 2001 to fund grantees in those

States impacted by the formula change at their comparable 1998

level.
27

The Committee believes that the Association of Farmworkers Opportunity Programs provide valuable technical assistance and

training to grantees and has distinguished itself as a tremendous

resource. Its Children in the Fields Campaign provides information, education, and technical assistance related to child labor in

agriculture. The Association also provides other assistance related

to employment and training (including pesticide and other worker

safety training for children and adults). The Department is encouraged to continue the services that the Association provides these

areas.

For migrant and seasonal farmworker housing, the Committee recommendation of $5,000,000 represents an increase of $1,000,000

over the fiscal year 2001 level. The Committee expects that these

funds will be made available to housing grantees receiving grants

in fiscal year 2000 to develop housing and related facilities.

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, the Women in Apprenticeship Program, as well as

the National Skills Standards Advisory Board.

Technical Assistance/Incentive Grants.—The Committee recommends $15,000,000 for the provision of technical assistance, staff

development, and replication of programs of demonstrated effectiveness; as well as incentive grants to each State that exceeds

State adjusted levels of performance for WIA State programs.

Pilots, Demonstrations, and Research.—The Committee recommends $35,000,000 for grants or contracts to conduct research,

pilots or demonstrations that improve techniques or demonstrate

the effectiveness of programs.

The Committee acknowledges changes under the Workforce Investment Act to develop and implement techniques and approaches, and demonstrate the effectiveness of specialized methods,

of addressing the employment and training needs of individuals.

The Committee encourages the Department to ensure that these

projects are coordinated with local boards. Appropriate time limits

are established for projects. Grant applications for over $500,000

are subject to peer review. The Committee encourages the Department of Labor to ensure that project performance is adequately

documented and evaluated.

The Committee recommends continuation of the following fiscal

year 2001 projects and activities under the pilot and demonstration

program:

—Job Corps Fellowship Training Program at Minot State University

—Training and Education Opportunities-University of Hawaii at

Maui

—Remote Rural Hawaii Job Training project for low-income

youth and adults

—Hawaii American Samoan Job Training

—Training and Education Opportunities—University of Hawaii

at Maui

—Ilasagvik College-Barrow, Alaska

—Kawerak, Inc. Vocational Training for Alaska Natives—Nome,

Alaska
28

—Alaska Federation of Natives Foundation

—Alaska Works, Construction Job Training—Fairbanks, Alaska

—Alaska Native Heritage Center, and Bishop Museum in Hawaii

—Peabody-Essex Museum in Salem, Massachusetts

—University of Missouri-St. Louis Regional Center for Ed and

Work

—Vermont Tech College-Tech Training Initiative

—Des Moines Community College-SMART Partners, Iowa

—American Indian Science & Eng. Society-Rural Computer Utilization Training

—Maui Economic Development Board-Rural Computer Training

—South Dakota Intertribal Skill Training Cooperative

—University of Colorado Health Sciences Center-Telehealth Distance Learning

These continuation grants are subject to project performance, demand for activities and services, and utilization of prior year funding.

The Committee is aware of the following projects that it encourages the Department to consider supporting:

—Expansion of Focus Hope Information Technology Center, Detroit

—Las Vegas Culinary Training Center

—Intertribal Bison Cooperative expansion

—Nevada Works demonstration projects

—Alexandria/Arlington Workforce Investment Board

—United Technologies Center—photonics curriculum for the purpose of training students

—Kennebec Valley Technical College—Precision Machining Technology Program

—New Hampshire Motor Transit Association Driver Training

School—public-private effort to recruit, train and retain truck

drivers

—City of Indianapolis—trades training initiative

—American Printing House for the Blind & Rehabilitation and

Research Training Center on Blindness at Mississippi State

University—national needs assessment of the Workforce Investment Act’s One-Stop Career Centers

—Honest Day Labor, Nashville, Tennessee—provides homeless

and poor individuals with the transportation and tools

—Total Action Against Poverty—Center for Employment Training skill training program model

—New Iowans Career Entry—address workforce needs

—Salt Lake City—Youth City Empowerment program

—Indiana Department of Workforce Development—Technology

Enhancement Certification for Hoosiers

—Ivy Tech State College of Indiana—Machine Tool Technology

Training Initiative

—Northeast Alabama Adult Education Program—adult education

program

—Chemeketa Community College—educational and support services to Woodburn

—Koahnic Broadcasting

—Yukon Kuskokwim Health Corporation
29

—Northwest Regional Miner-Training and Research Facility vocational training for miners, laborers, and mechanics, research

facilities for underground mining and related safety and environmental problems —Altoona Blair County Development Corporation—highly training workforce —Manufacturers Research Center & 3 Lehigh Valley community

colleges—workforce development system to train dislocated disadvantaged, incumbent and emerging workers —Ogontz Avenue Revitalization Corporation—community-targeted workforce development —Jobs for America’s Graduates—school-to-work projects for atrisk young people —National Court Reporters Association—recruit and train individuals to perform real-time captioning services —Court Reporting Institute of Dallas and Alvin Community College—train reporters and captioners —AIB College of Business—train reporters and captioners —Chattanooga State Community College—develop curriculum,

distance learning programs, job placements for training closed

captioners —Real Time Captioning at the University of Mississippi School

of Court Reporting —Lakeshore Technical College and Madison Area Technical College, Wisconsin—train reporters and captioners —Green River Community College—train reporters and

captioners —Community College of Allegheny County—train reporters and

captioners —Cuyahoga Community College—train reporters and captioners —Clark State Community College—train reporters and

captioners —Alfred State College—train reporters and captioners —St. Louis Community College—train reporters and captioners

—Southern Illinois University at Carbondale—train reporters

and captioners

—Midstate College—train reporters and captioners

—Sarasota County Technical Institute—train reporters and

captioners

—Gadsen State Community College—train reporters and

captioners

—Orleans Technical Institute in Pennsylvania—train reporters

and captioners

—Chicago Area Workers’ Rights Task Force, Center for Import

Research

—Region of Manufacturing Excellence (ROME)—a project to address the manufacturing workforce needs of northeast Ohio

—Northern Great Plains, Community eBusiness Service Center

—State of Alaska Rural Veterans Job Search and Job Preparation program

—State of Alaska rural summer youth employment and academic

enrichment program

—International Longevity Center, New York

—Center for Employment Training in San Jose, California
30

—Hood River Integrated Community/Community College Technology Training and Education program

—Vermont Telecommunications Application Center

—Cyber Skills Vermont Workforce Development Initiative

—Bay Area Workforce Development Board, Wisconsin

—Great Cities’ Universities Skills Enhancement Partnership,

Wisconsin

—Wisconsin Indianhead Technical College

—Douglas County Senior Center, Wisconsin

—Northern Wisconsin Concentrated Employment Program, Inc.

—Community Learning Center at Union County College, Elizabeth, New Jersey

—Nurse retention demonstration project, Washington Health

Foundation

—Model data plan for Washington State health workforce analysis and planning

—San Diego State University, high-tech training program

—Good Faith Fund, Arkansas Enterprise Group

—University of Arkansas Medical Sciences BioVentures

—University of Arkansas GENESIS Technology Incubator

—Working Partners, demonstration programs to help reduce substance abuse in the workplace

—Tanana Chiefs Conference and the Alaska Laborers Union, onthe-job skills training and employment opportunities for Alaska Natives

—Alaska Department of Labor and Workforce Development to

develop a training program for firefighters in remote villages

in Alaska

—Permian Basin Energy Education Project—petroleum technology training

—Lehigh University—developing innovative educational methods

—Collegiate Consortium—workforce training

—Cox Family Enterprise Center—helping individuals meet dramatic challenges of owning, operating, developing family businesses

—Good Shepherd Home in Lehigh County, the Re Place

—Compton Youth Succeed Initiative, Los Angeles County

—Federation of Southern Cooperatives

—Ready, Willing and Able

—Southern Arizona Institute of Advanced Technology, high-tech

training

—Mayville State University/Traill County Technology Center,

North Dakota

—Bishop Museum

—Pacific Basin Immigrant Job Training

—Maui Women Future Employment Opportunities

—School of the Building Arts to train students in the proper restoration of historic sites, Charleston, SC

—Retail Employee Link to Education, New Mexico Retailers Association

—Odyssey Maritime, school to work initiative in Washington

State
31

—Training for at-risk young people in occupations related to the

use of biometric technology in the security industry at Mississippi Valley State University —Alcorn Biotechnology Center, distance learning and business

training activities —Mississippi State University Nursery Assistance

—University of Mississippi Engineering Coalition

—Mississippi Delta Community College Business Services Center

—Harrisburg One-Stop project in Tupelo, Mississippi

—Creation of Southern NJ Regional Hospitality Workforce Development Consortium to coordinate training and develop career

ladder structure in hospitality and gaming industry —Gloucester County College, New Jersey

—Dream Center to provide job and training skills for new labor

market entrants or re-entrants—Los Angeles, California —North Country Career Center model education and training

program—Newport, Vermont —Vermont Department of Employment and Training employerled education and training partnerships initiative —Vermont Information Technology Center model information

technology training initiative—Champlain College, Burlington,

Vermont —Institute for Health Care Workforce Development, South Carolina —Lehigh University Job Training for hard to serve disadvantaged youth in manufacturing sector—Pennsylvania —Workplace Acclimation Program for Ex-Offenders to provide

pre-employment training and job placement assistance to

former offenders—Safer Foundation, Chicago, Ill —Remote 21st Century Rural Hawaii Job Training Project

—Remote Rural Alaska Job Training Project

—Model Community Jobs Initiative to train homeless persons,

San Francisco, CA —Collegiate Consortium for Workforce & Economic Development,

Philadelphia Naval Business Center

—Kirkwood Community College and ACT, Inc. for workforce

skills development in Iowa

—Community Self-Empowerment & Employment Program

(CSEEP) (PA)—comprehensive employment readiness, job development, job place, and case management for area low-income residents

—Western Alaska workforce training initiative

—Nevada Works

—UNLV Center for Workforce Development and Occupational

Research

—University of South Carolina College of Social Work, computer

training for low-income unemployed workers

—South Sumter Resource Center, South Carolina—comprehensive system of academic and skill training, leadership development, support services, case management, on-the-job training,

and cultural enrichment for at-risk youth

—Green Thumb, Inc.—conduct program for rural, low-income elders to develop entrepreneurial skills that utilize e-commerce

and IT
32

—California State Polytechnic University, technology workforce

training

—San Diego State University, high-tech workforce development

—Tlingit-Haida project—job training to unemployed natives in

southeast Alaska

—Mott Community College Workforce Development Institute for

Manufacturing Simulation

—Jefferson State Community College, Information Technology

workforce development

—Greater Columbus Ohio Chamber of Commerce Career Academies program—project to design and test programs in partnership with workforce development system

—Public/Private Ventures workplace mentoring program

—Urban League of Hudson County, New Jersey, Workforce Development Center

—Allegheny County, Pennsylvania, training of information technology workers

—Waukesha, Wisconsin, workforce training for economically disadvantaged youth and adults at La Casa de Esperanza

—Skill training for low-income and disadvantaged workers at the

Center for Employment Training in San Jose

—Covington Work Initiative Network, St Tammany Parish, Louisiana

—Job Challenge Pilot Program, Louisiana

—Southeastern Louisiana Economic and Workforce Development

Initiative

—Oregon Institute of Technology

—Minority-Owned Business Development and Training Initiative

of the Minority Business Roundtable

—Three Rivers Workforce Investment Board to train individuals

in information technology occupations to take them from entrylevel to mid-level skill positions in Allegheny County

—University Technology Park/Westchester University for the establishment of a Computer and Internet Training Center

—Opportunities Industrialization Center of Philadelphia, Inc. for

the OIC Hospitality Training Institute of Philadelphia to replicate the Philadelphia Opportunities Inn: Hospitality Training

Institute in five cities

—Southeastern Pennsylvania Chapter of the American Red Cross

to provide job counseling, training, and services for disaster

victims receiving extended care at the SEPA Chapter Red

Cross House

—National Student Partnerships for the opening of National Student Partnerships at Temple University, establishing staffed

offices at the University of Pennsylvania and the University of

Pittsburgh, and the continuation of NSP’s 18 current sites

—Nueva Esperanza for the administration of the Nueva

Esperanza Telework Center in Philadelphia, to provide technological jobs in a low-income area, provide technical job training

and aid in further career development

—Olde Kensington Redevelopment Corporation for the establishment of the North Philadelphia Senior Development Project by

the Olde Kensington Redevelopment Corporation
33

—Community Loan Fund Southwestern Pennsylvanian to expand

CLF’s ‘‘Family-Wage Job Initiative,’’ which will provide resources and create family wage jobs in nine Southwestern

Pennsylvania Counties

—The University of Louisville Center for Supply Chain Workforce Development

The Committee is aware that even the best employment and

training programs cannot serve those who lack the basic skills to

enter such programs. The Committee understands that programs

that help unskilled workers achieve the level of literacy necessary

to participate in Employment and Training Programs improves

their chances of successfully transitioning into full-time employment. The Committee encourages the Department to fund demonstration grants under Workforce Investment Act Title I National

Programs to increase the capacity of national networks of volunteer

adult literacy programs, library literacy programs and urban literacy coalitions to prepare the hardest-to-reach/hardest-to-teach

adults and out of school youth for the workforce.

Evaluation.—The Committee recommends $9,098,000 to provide

for the continuing evaluation of programs conducted under WIA, as

well as of federally-funded employment-related activities under

other provisions of law.

Women in Apprenticeship.—The Committee recommends

$1,000,000 to continue the current level of the Women in Apprenticeship and Nontraditional Occupations program. This activity

provides technical assistance to employers and unions to assist

them in training, placing, and retraining women in nontraditional

jobs and occupations.

National Skills Standards Advisory Board.—The Committee recommends the budget request of $3,500,000 for the Board, the same

amount provided in fiscal year 2001.

The Committee understands that the Board helped the Manufacturing Skill Standards Council (MSSC) develop the comprehensive

national manufacturing skill standards which were unveiled earlier

this year and believes that it should now help the MSSC develop

assessments and certifications to accompany these standards.

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2001 ............................................................................. $440,200,000

Budget estimate, 2002 ........................................................................... 440,200,000

Committee recommendation ................................................................. 450,000,000

The Committee recommends $450,000,000, an increase of

$9,800,000 over the budget request and the fiscal year 2001 appropriation 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 forwardfunded from July to June, and the 2002 appropriation will support

the program from July 1, 2002, through June 30, 2003. 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 detach-
34

ment from the labor force, older displaced homemakers, aged minorities, limited English-speaking persons, and legal immigrants.

The Committee is aware that, prior to enactment of the Workforce Investment Act (WIA), the Federal job-training program targeted funds specifically to older workers. Currently, WIA funds are

not targeted for training older workers, at a time when the number

of older workers is increasing significantly. To remain competitive

in the labor market, older workers must acquire or update their job

skills. While WIA is designed to meet the needs of all workers, the

Committee is concerned that the One-Stop Career Centers, funded

under WIA, may not be adequately meeting the training and education needs of older workers. The Committee therefore requests

that the Department report within 180 days the measures it can

undertake to ensure training and related services, appropriated

under WIA, are available to older workers.

The Committee is pleased that both senior Community Service

Employment Program grantees and the Department are interested

in increasing unsubsidized placements of low-income older workers

participating in the SCSEP program. However, given the decline in

the national economy, the Committee is concerned that any significant increase in the SCSEP unsubsidized placement goal, absent

the availability of national or local WIA occupational skills training

resources for SCSEP participants, will not be achievable. The Committee, therefore, could support a modest increase in the SCSEP

minimum unsubsidized placement goal only if it is implemented

after the Department has assured the Committee that the necessary WIA occupational skills training resources are available to

SCEP participants.

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2001 ............................................................................. $406,550,000

Budget estimate, 2002 ........................................................................... 415,650,000

Committee recommendation ................................................................. 415,650,000

The Committee recommends $415,650,000, the same as the budget request and an increase of $9,100,000 above the 2001 enacted

level for Federal unemployment benefits and allowances. These are

entitlement funds.

The trade adjustment line item has two activities totaling

$349,500,000 in fiscal year 2002.

The first activity, trade adjustment assistance benefits, provides

for special unemployment benefit payments to workers as authorized by the Trade Act of 1974, as amended. For this activity the

Committee recommends $255,000,000. This is the same as the

budget request and an increase of $7,000,000 above the 2001 comparable level. These funds will permit payment of benefits, averaging $239 per week, to 33,400 workers for 2002.

The second activity, trade adjustment assistance training, provides training, job search, and job relocation allowances to workers

adversely affected by imports. The funding for this activity is also

authorized under the Trade Act of 1974, as amended. The Committee recommends $94,500,000 for this activity, the same as the

budget request and an increase of $100,000 above the 2001 comparable level. These funds will provide services for an estimated

22,400 workers.
35

For NAFTA activities, $66,150,000 is provided in two components.

The first component, NAFTA transitional adjustment assistance

benefits, provides for weekly benefit payments to workers affected

by imports from Mexico and Canada. These payments are also authorized by the Trade Act of 1974, as amended as a result of the

signing of the North American Free Trade Agreement [NAFTA].

The Committee recommends $29,000,000 for this activity. This is

the same as the budget request and an increase of $2,000,000 over

the 2001 comparable level and represents the current services

funding level.

The second component, NAFTA transitional adjustment assistance training, provides funds for training, job search and job relocation to workers affected by imports from Mexico and Canada. The

fiscal year 2002 current services recommendation is $37,150,000,

the same as the fiscal year 2001 enacted level and the budget request.

Resources related to the Administration’s legislative proposals

will be considered upon enactment of the requested legislation.

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriations, 2001 ............................................................................. $3,380,210,000

Budget estimate, 2002 ........................................................................... 3,414,338,000

Committee recommendation ................................................................. 3,430,338,000

The Committee recommends $3,430,338,000 for this account.

This is $16,000,000 above the budget request and $50,128,000

above the 2001 comparable level. Included in the total availability

is $3,238,886,000 authorized to be drawn from the ‘‘Employment

Security Administration’’ account of the unemployment trust fund,

and $191,452,000 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

$2,413,923,000. This includes $2,403,923,000 for State Operations,

which is the same as the President’s request and $50,128,000

above the fiscal year 2001 level. The Committee expects the Department to manage these resources to ensure equitable funding to

States to handle total workload, which is estimated to be 2,622,000

average weekly insured unemployment (AWIU) claims. The Committee recommendation includes $10,000,000 for UI national activities, the same as the fiscal year 2001 level and the President’s request, which is directed to activities that benefit the State/Federal

unemployment insurance program. The bill continues to provide for

a contingency reserve amount should the unemployment workload

exceed an average weekly insured claims volume of 2,622,000. This

contingency amount would fund the administrative costs of unemployment insurance workload over the level of 2,622,000 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.
36

The Committee recommendation includes bill language which addresses the settlement of litigation relating to the acquisition of an

automated system for benefit payments under the unemployment

compensation program.

For the employment service, the Committee recommends $848,415,000 which includes $23,452,000 in general funds together

with an authorization to spend $824,963,000 from the ‘‘Employment security administration’’ account of the unemployment trust

fund.

Included in the recommendation for the employment service [ES] is $796,735,000 for Grants to States, available for the program year

of July 1, 2002, through June 30, 2003. This is the same as the

budget request and the 2001 comparable level. The recommendation includes $51,680,000 for national activities, an increase of

$2,000,000 over the budget request. The recommendation also includes $148,000,000 for one-stop career centers. This 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 $20,000,000 for the Work Incentives Grants program, the same as last year’s level and the President’s request, to help persons with disabilities find and retain jobs

through the One-Stop Career Center system mandated by the

Workforce Investment Act. Funding will support systems building

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

The Committee agrees that the work opportunity tax credit

[WOTC], and the welfare-to-work tax credit provide important resources to create new jobs, particularly for those Americans who

would otherwise be dependent on welfare. Therefore, the Committee recommendation includes $22,000,000 for the administration

of these initiatives, an increase of $2,000,000 over the 2001 level.

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2001 ............................................................................. $435,000,000

Budget estimate, 2002 ........................................................................... 464,000,000

Committee recommendation ................................................................. 464,000,000

The Committee recommends $464,000,000, an increase of

$29,000,000 above the 2001 comparable level, for this account. The

appropriation is available to provide advances to several accounts

for purposes authorized under various Federal and State unemployment compensation laws and the black lung disability trust

fund, whenever balances in such accounts prove insufficient. The

bill anticipates that fiscal year 2002 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

2002 are expected to be sufficient. Should the need arise, due to

unanticipated changes in the economic situation, laws, or for other
37

legitimate reasons, advances will be made to the needy 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, 2001 ............................................................................. $158,863,000

Budget estimate, 2002 ........................................................................... 161,078,000

Committee recommendation ................................................................. 161,078,000

The Committee recommendation includes $112,571,000 in general funds for this account, as well as authority to expend

$48,507,000 from the ‘‘Employment Security Administration’’ account of the unemployment trust fund, for a total of $161,078,000.

This is $2,215,000 greater than the 2001 comparable level.

The Committee recommendation includes $1,300,000 for the

management and oversight of the various pilot and demonstration

projects funded as part of this year’s appropriation and to support

those projects that continue to be implemented from previous year’s

appropriations. These funds will be used exclusively for financial,

technical, program and general administration provided by staff responsible for grant management, oversight, monitoring, guidance/

operation and reporting and evaluation for the earmark activities.

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, 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 is aware that citizens of Alaska suffer from high

unemployment rates due to a lack of available career and vocational job training, and that Alaska employers are often forced to

import labor, while leaving many untrained Alaskans unemployed.

The Committee encourages the Department to work with Alaska

Department of Labor and Workforce Development on a project to

conduct a comprehensive analysis of the State’s labor requirements

and the training facilities which would be required to meet those

needs, and to provide technical assistance, professional development and capacity building for existing vocational and technical

training, and to establish a statewide database of such programs.

The Committee continues to be concerned over the economic

plight of western Alaska, one of the poorest, most desolate areas

in the United States with unemployment rates ranging upwards of

80 percent in many villages, due in large part to the collapse of the

fishing industry there. The Committee urges the Department to

continue its contribution to the University of Alaska and the State

of Alaska’s major economic development initiative in western Alaska, including establishment of talent banks for employers, needs

assessments for employers, and training of unemployed workers for

available jobs.
38

The Committee supports the Vermont Department of Education’s

current efforts to assess the State’s vocational/technical education

infrastructure.

PENSION AND WELFARE BENEFITS ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2001 ............................................................................. $107,633,000

Budget estimate, 2002 ........................................................................... 107,988,000

Committee recommendation ................................................................. 112,418,000

The Committee recommendation provides $112,418,000 for this account, which is $4,785,000 above the 2001 comparable level.

This recommendation provides sufficient funding to offset the impact of inflation, preventing the reduction in full-time equivalent

staffing assumed in the budget request.

The Pension and Welfare Benefits Administration [PWBA] is responsible for the enforcement of title I of the Employee Retirement

Income Security Act of 1974 [ERISA] in both civil and criminal

areas. PWBA is also responsible for enforcement of sections 8477

and 8478 of the Federal Employees’ Retirement Security Act of

1986 [FERSA]. PWBA provides funding for the enforcement and

compliance; policy, regulation, and public services; and program

oversight activities.

PENSION BENEFIT GUARANTY CORPORATION

The Corporation’s estimate for fiscal year 2002 includes benefit payments of $1,079,000,000, multiemployer financial assistance of

$6,270,000, administrative expenses limitation of $11,690,000, and

services related to terminations expenses of $178,924,000.

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, collections 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 plans fail or go out of existence.

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2001 ............................................................................. $362,716,000

Budget estimate, 2002 ........................................................................... 284,434,000

Committee recommendation ................................................................. 377,145,000

The Committee recommendation includes $377,145,000 for this

account. This is $14,429,000 above the 2001 comparable level and

$92,711,000 above the ubdget request. The bill contains authority

to expend $1,981,000 from the special fund established by the

Longshore and Harbor Workers’ Compensation Act; the remainder

are general funds. In addition, an amount of $31,443,000 is available by transfer from the black lung disability trust fund. This is
39

the same as the request and $1,150,000 above the 2001 comparable

level.

This recommendation provides sufficient funding to offset the impact of inflation, preventing the reduction in full-time equivalent

staffing assumed in the budget request. It rejects the administration’s proposed legislation that would have established a surcharge

on the amount billed to Federal agencies for workers’ compensation

benefits to finance Labor Department administrative expenses of

$80,281,000.

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

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

the Family and Medical Leave Act, the Federal Employees’ Compensation Act [FECA], the Longshore and Harbor Workers’ Compensation Act, and the Federal Mine Safety and Health Act (black

lung).

The Committee supports expansion of the equal pay initiative,

which helps business improve the way they pay their employees,

and assists in education about the importance of equal pay.

SPECIAL BENEFITS

Appropriations, 2001 ............................................................................. $56,000,000

Budget estimate, 2002 ........................................................................... 121,000,000

Committee recommendation ................................................................. 121,000,000

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 recommendation includes $121,000,000, the same as the

budget request and an increase of $65,000,000 above the 2001 comparable level. This appropriation primarily provides benefits under

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

are prescribed by law.

The total amount to be available in fiscal year 2002 is

$3,267,514,000, an increase of $25,044,000 above the 2001 comparable level.

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. Costs will be charged to the FECA fund.

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 maximum 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
40

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 fair share

collections to fund capital investment projects and specific initiatives to strengthen compensation fund control and oversight.

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

PROGRAM

Appropriations, 2001 ............................................................................. $60,328,000

Budget estimate, 2002 ........................................................................... 136,000,000

Committee recommendation ................................................................. 136,000,000

The Committee recommends $136,000,000 for this account in

2002. This is the same as the President’s request and $75,672,000

above 2001.

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.

The Energy Employees Occupational Illness Compensation Program provides benefits authorized by the Energy Employees Occupational Illness Compensation Program Act. The Program went

into effect on July 31, 2001. 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 Committee is concerned that the Secretary’s planned implementation of the Energy Employees Occupational Illness Compensation Program will not result in sufficient services being provided to residents of West Texas who may qualify for benefits

under the law. As the number of potential beneficiaries residing

near the Pantex facility in Amarillo exceeds 12,000, a full-time resource center in that area is necessary to fully meet their needs.

The Committee therefore expects the Secretary to establish a fulltime resource center in West Texas and to provide the Committee

with a report within 90 days of enactment of the Act on the Department’s progress in this regard.

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2001 (Definite) ............................................................ $1,027,900,000

Budget Estimate, 2002 (Definite) ......................................................... 54,717,000

Budget Estimate, 2002 (Indefinite) ...................................................... 981,283,000

Committee recommendation (Definite) ................................................ 54,717,000

Committee recommendation (Indefinite) ............................................. 981,283,000

The Committee recommends $1,036,115,000 for this account in

2002, of which $54,832,000 is definite budget authority and

$981,283,000 is indefinite budget authority. In total, this is an increase of $8,215,000 over the 2001 comparable level and $115,000

more than the administration request. This represents a change in

the appropriation language beginning in fiscal year 2002 for the
41

Black Lung Disability Trust Fund. This change will eliminate the

need for drawdowns from the subsequent year appropriation in

order to meet current year compensation, interest, and other benefit payments. The appropriation language will continue to provide

definite budget authority for the payment of administrative expenses for the operation and administration of the Trust Fund.

The total amount available for fiscal year 2002 will provide $388,283 000 for benefit payments, and $54,832,000 for administrative expenses for the Department of Labor. Also included is

$407,343,000 for interest payments on advances. In fiscal year

2001, comparable obligations for benefit payments are estimated to

be $407,393,000 while administrative expenses for the Departments of Labor and Treasury, respectively, are $52,201,000 and

$356,000. In fiscal year 2001, the interest payments on advances

is estimated to be $568,000,000.

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 53,250 people will be receiving black lung

benefits financed from the trust fund by the end of the fiscal year

2002. This compares with an estimated 57,000 receiving benefits in

fiscal year 2001.

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

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

from reimbursement payments from mine operators for benefit payments made by the trust fund before the mine operator is found

liable, and advances. 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, 2001 ............................................................................. $425,886,000

Budget estimate, 2002 ........................................................................... 425,835,000

Committee recommendation ................................................................. 450,262,000

The Committee recommendation includes $450,262,000 for this

account. This is an increase of $24,427,000 over the budget request

and an increase of $24,376,000 above the 2001 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, preventing the reduction in full-time equivalent

staffing assumed in the budget request.

In addition, the Committee has included language to allow

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

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 pro-
42

visions 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 cut funding to help establish ongoing worker safety and

health training programs and has indicated that due to funding

cutbacks, such programs would be eliminated in fiscal year 2002.

The committee has provided $3,000,000 in additional funds to restore the institutional competency building training grants.

The Committee is concerned about the significant increase in

workplace fatalities among Hispanic and immigrant workers that

were reported in the 2000 BLS Census of Fatal Occupational Injuries. OSHA is urged to conduct an in-depth review of, and within

6 months, report to the Committee on the nature and causes of

workplace fatalities and injuries among Hispanic and immigrant

workers, the adequacy of existing standards, enforcement, compliance assistance, outreach and training programs that are directed

towards these high risk workers, and specific initiatives OSHA

plans to undertake to provide enhanced protection to these workers.

The Committee has provided funding to maintain the State consultation grant program and expects that this program will continue to be targeted to provide compliance assistance to small businesses. The Committee understands that OSHA has conducted a

study on the effectiveness of the State consultation program—the

first such evaluation of the program since it was initiated in

1977—and that a draft report has been prepared. The agency is

urged to finalize this report within the next 60 days and to provide

a copy to the Committee upon its completion.

The Committee is very pleased with OSHA’s efforts in placing

high priority on the voluntary protection programs (VPP) and other

voluntary cooperative programs. The agency’s work in expanding

participation in the programs, and promoting prompt review and

processing of applications is particularly noteworthy. In fiscal year

2002 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 continued to be funded as close as possible to its present level.

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2001 ............................................................................. $246,306,000

Budget estimate, 2002 ........................................................................... 246,306,000

Committee recommendation ................................................................. 256,093,000
43

The Committee recommendation includes $256,093,000 for this

account. This is $9,787,000 more than the 2001 comparable level.

This recommendation provides sufficient funding to offset the impact of inflation, preventing the reduction in full-time equivalent

staffing assumed in the budget request.

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.

The Committee is concerned that miners working in vermiculite,

talc, and taconite mines throughout the country are not being adequately protected from deposits of asbestos. The Committee is informed that in March of this year, the Inspector General of the Department of Labor issued an Evaluation of MSHA’s Handling of Inspections at The W.R. Grace & Company Mine in Libby, Montana.

The Committee urges MSHA to consider initiating rulemaking to

implement recommendations contained within the Inspector General’s evaluation as quickly as possible, and to provide an update

on this progress to the Committee within 6 months.

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriations, 2001 ............................................................................. $450,887,000

Budget estimate, 2002 ........................................................................... 476,000,000

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

The Committee includes $476,000,000 for this account, the same

as the budget request and $25,113,000 more than the 2001 comparable level. This includes $69,132,000 from the ‘‘Employment Security Administration’’ account of the unemployment trust fund,

and $406,868,000 in Federal funds. This funding level will cover

the agency’s built in increases.

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

The Committee has included bill language making $10,280,000 of

the BLS allowance for Occupational Employment Statistics available on a program year basis. This action is taken in order to maintain the funding stream established in the ETA State Unemployment Insurance and Employment Service Operations account,

through which the program was previously funded, thereby avoiding a programmatic disruption at the State level.

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriations, 2001 ............................................................................. $357,387,000

Budget estimate, 2002 ........................................................................... 329,765,000

Committee recommendation ................................................................. 361,834,000

The Committee recommendation includes $361,834,000 for this

account, which is $32,069,000 more than the budget request and

$4,447,000 above the 2001 comparable level. In addition, an
44

amount of $22,590,000 is available by transfer from the black lung

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

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

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 reflects major Committee priorities, including international labor affairs. The Committee recommendation includes $25,177,000 for Executive Direction, a 5 percent reduction from the request. The Committee recommends $10,186,000 for the Women’s Bureau, the same as the budget request and fiscal year 2001 level.

The Committee urges the Women’s Bureau to provide increased

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

technical assistance and training on programming for women in

transition.

The Committee recommends $147,982,000 for the Bureau of

International Labor Affairs, the same level of funding as provided

in fiscal year 2001.

Of this amount, the Committee’s recommendation includes

$82,000,000 in recognition of the U.S. commitment, pursuant to

adoption and ratification of ILO Convention #182, to provide additional resources on a sustained basis to assist developing countries

in removing the worst forms of child labor. Of that sub-total,

$45,000,000 constitutes the U.S. contribution to sustain and replicate the successful efforts of the ILO’s International Program for the Elimination of Child Labor (IPEC). The remaining $37,000,000

is for assistance to expand the program initiated in fiscal year 2001

to afford access to basic education for children removed from the

worst forms of child labor in impoverished nations where abusive

and exploitative child labor is most acute. While the Committee is

concerned by the slowness of the Department in obligating all of

the funds previously appropriated for this purpose, affording access

to basic education is the single most effective means to curb the

worst forms of child labor. Therefore, the Committee reaffirms its

support for this complementary work to international efforts and

expects the Department to collaborate more effectively with our

country’s labor attaches and labor reporting officers abroad, as well

as USAID and IPEC officials, in order to program these funds more

promptly where they can do the most good.

The Committee further recommends $20,000,000 for multilateral

technical assistance and $17,000,000 for bilateral technical assistance. These funds help developing countries implement core labor

standards, strengthen the capacities of Ministries of Labor to enforce national labor laws and protect internationally-recognized

worker rights. The Committee expects ILAB to use these bilateral

funds to further develop, improve, and expand its internal capacity

and to post staff in the field to provide top quality, professional expertise on a continuing basis. The Committee further expects ILAB
45

to provide a report to the Committee to explain the nature and

scope of the technical assistance already provided with the increased funding appropriated to the Department in recent years. In

this regard, the report should include efforts to improve the depth,

quality, and regularity of reporting, as part of a strategic plan for

ILAB activities, to be submitted to the Committee no later than

September 1, 2002. The Committee recommendation includes $10,000,000 for global

workplace-based HIV–AIDS education and prevention programs.

The Committee expects the Department to work through the ILO

to most effectively program the appropriated funds. The Committee recommendations further include $5,000,000 for

ILAB to build its own permanent capacity to monitor and report

regularly and in-depth to the Congress on the extent to which foreign countries with trade and investment agreements with the

United States respect internationally-recognized worker rights as

currently required under various U.S. laws and effectively promote

core labor standards as embodied in the ILO Declaration on Fundamental Principles and Rights at Work. In this regard, the Committee recognizes that it may be necessary, from time to time, for

the Department to tap private sector expertise from knowledgeable

employer, trade union, and non-governmental organizations with

their own presence or in-country partners on the ground in foreign

countries.

For other ILAB programs, including 125 FTE for Federal Admin- istration, the Committee recommends $13,982,000.

Finally, the Committee requests that ILAB undertake and complete a study by October 1, 2002 to firmly establish, if feasible,

amounts spent on military expenditures each year from 1990–2001

compared to expenditures on basic education in each of the foreign

countries with serious child labor problems as identified in the

prior seven ILAB studies on child labor. This study should also determine the underlying trends and specific amounts that the World

Bank and other international financial institutions have committed

to specifically combat abusive child labor and to improve access to

basic education in these problem countries every year since 1989.

The Committee requested a study by the Department in fiscal

year 1998 on the development of a methodology for the regular reporting of working conditions in the production of apparel imported

into the United States. The Committee expects this report to be

provided by December 31, 2001 along with corresponding recommendations for overcoming whatever deficiencies were identified.

Acknowledging the need to upgrade the information technology

capability in the Department of Labor, the Committee provides

$37,000,000 for the information technology fund. The total provided

includes support for cross-cutting investments such as common office automation suite implementation, and architecture requirements and web services.

The Committee is aware of the important work the U.S. Department of Labor’s Office of Policy is doing to encourage small businesses to develop alcohol-and drug-free workplace programs. The

Labor Department established the Working Partners Program, an

educational outreach initiative that has worked with numerous
46

businesses in creating prevention programs to promote a safe,

healthy and productive workforce. The Committee encourages the

Department to continue the Working Partners Program.

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.

OFFICE OF DISABILITY POLICY

Appropriations, 2001 ............................................................................. $22,969,000

Budget estimate, 2002 ........................................................................... 43,263,000

Committee recommendation ................................................................. 43,263,000

The Committee recommends $43,263,000 for this account in

2002. This is the same as the President’s request and $20,294,000

above 2001.

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 new office.

The ODEP mission, under the leadership of an Assistant Secretary, is to bring a heightened and permanent long-term focus to

the goal of increasing employment of persons with disabilities. This

will be achieved through policy analysis, technical assistance, and

development of best practices, as well as outreach, education, constituent services, and promoting ODEP’s mission among employers.

The increase includes: an expansion of one-stop accessability

grants, to support the process of implementing the ‘‘ticket to work’’ through One-Stop Career Centers; expanding the provision of

grants aimed at developing and implementing innovative programs

for moving youth with disabilities from school to work; and funding

an Olmstead grant program to assist persons with significant disabilities in making the transition from institutional settings to the

community and employment. The Committee recommendation includes $1,000,000 to fund a

minimum of three pilot programs to promote the employment of individuals with significant disabilities in Federal employment positions that can be performed from home-based work stations. Telecommunications technology makes it possible for properly equipped

individuals employed in customer service/call contact centers,

claims, loan or financial transaction processing operations to work

from home-based work stations. Each pilot program should identify

appropriate positions in a Federal agency, equip and train qualified

individuals with significant disabilities for such positions and, at

the end of 1 year, report to the Office of Disability Policy on the

results of the telecommuting project, including number of individuals with disabilities employed in telecommuting jobs, attrition

rates and performance of such individuals in comparison to the

general workforce, and the feasibility of employing more individuals with disabilities in other agency positions.

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2001 ............................................................................. $211,656,000

Budget estimate, 2002 ........................................................................... 211,703,000

Committee recommendation ................................................................. 213,703,000
47

The Committee recommendation includes $213,703,000 for this

account, including $26,800,000 in general revenue funding and

$186,903,000 to be expended from the ‘‘Employment Security Administration’’ account of the unemployment trust fund. This is

$2,000,000 more than the budget request and $2,047,000 above the

2001 comparable level.

For State grants the bill provides $81,615,000 for the Disabled

Veterans Outreach Program and $77,253,000 for the Local Veterans Employment Representative Program. These amounts are

the same as the budget request and the fiscal year 2001 enacted

level.

For Federal administration, the Committee recommends

$28,035,000, an increase of $47,000 over the fiscal year 2001 level.

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 an effective program. The Committee notes the budget request includes $2,000,000, the same as the fiscal 2001 level, 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 urges funding for the Institute be maintained, to

the extent possible, at the 2001 level.

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

Homeless veterans program, an increase of $1,500,000 over the

budget request and fiscal year 2001 level. Also included is

$7,800,000 for the Veterans Workforce Investment Program, an increase of $500,000 above the budget request and fiscal year 2001

level.

The recommendation also authorizes the Department of Labor to

permit the Veterans’ Employment and Training Service [VETS] to

also fund activities in support of the VETS’ Federal Contractor Program [FTP] from funds currently made available to States for veterans’ employment activities.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2001 ............................................................................. $54,683,000

Budget estimate, 2002 ........................................................................... 57,133,000

Committee recommendation ................................................................. 57,133,000

The bill includes $57,133,000 for this account, the same as the

budget request and $2,450,000 above the 2001 comparable level.

This funding will cover the agency’s built in increases. The bill includes $52,182,000 in general funds and authority to transfer

$4,951,000 from the ‘‘Employment Security Administration’’ account of the unemployment trust fund. In addition, an amount of

$328,000 is available by transfer from the black lung disability

trust fund.

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
48

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

efficiency, and effectiveness.

GENERAL PROVISIONS

General provision bill language is included to:

Prohibit the use of Job Corps funding for compensation of an individual at a rate in excess of Executive Level II (sec. 101).

Permit transfers of up to 1 percent between appropriations (sec.

102).
(49)

TITLE II—DEPARTMENT OF HEALTH AND HUMAN

SERVICES

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

Appropriations, 2001 ............................................................................. $5,570,177,000

Budget estimate, 2002 ........................................................................... 4,972,687,000

Committee recommendation ................................................................. 5,518,843,000

The Committee recommends an appropriation of $5,518,843,000

for health resources and services. This is $546,156,000 more than

the administration request and $51,334,000 less than fiscal year

2001.

Health Resources and Services Administration [HRSA] 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.

HEALTH CENTERS

The Committee provides $1,343,723,000 for the health centers,

which is $175,111,000 above the fiscal year 2001 level and

$51,000,000 above the administration request for this group of programs, which include community health centers, migrant health

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

service grants.

Community, migrant, public housing and homeless health centers will provide primary health care services to nearly 12 million

people this year. While the number of uninsured Americans decreased last year for the first time in a decade, the number of uninsured seeking care at health centers has increased dramatically. In

addition, millions of people who have health insurance coverage encounter serious difficulties in getting access to health care. For

many of these Americans, health centers are the only source of primary and preventive health care. Located in over 3,000 rural and

urban medically-underserved communities in all 50 States, health

centers have proven to be a cost-effective and efficient source of

care for the underserved. By providing access to basic health services, health centers annually save the health care system billions

of dollars in reduced use of costly emergency room, specialty, and

hospital inpatient care.

The Committee does not set aside any additional appropriations

for loan guarantee authority under Section 330(d) of the Public

Health Services Act. The Committee intends that unused loan

guarantee authority made available in fiscal year 1997 and fiscal
50

year 1998 continue to be available for guarantees of both loan principal and interest.

As in previous years, the Committee limits the amount available

for payment of claims under the Federal Tort Claims Act to

$5,000,000.

Community health centers

The community health centers provide comprehensive, case-managed primary health care services to medically indigent and underserved populations in rural and urban areas. Of the clients served

by community health centers, about 44 percent are children and 67

percent have incomes below the poverty line.

The Committee supports the administration request to eventually expand the program to double its service capacity. In addition,

the Committee notes that HRSA should distribute additional resources provided in this bill to increase the number of new and expanded sites by 1,200 over the next 5 years.

As part of its rural health initiative the Committee expects

HRSA to give priority consideration to creating new health centers

in underserved communities, especially rural communities. In addition, the Committee supports providing assistance to struggling

health centers to ensure their stability and quality of care and to

existing health centers to expand the scope of medical services

available to the community.

The Committee remains concerned about the affordability of prescription drugs for all Americans. To help address this concern, the

Committee encourages community health centers to utilize innovative approaches under their statutory Federal drug discount authority to reduce costs for those in greatest need, particularly the

elderly and lower income Americans.

The Committee continues to be concerned about how the Department distributes health center funds to States with large uninsured and underserved populations. The Committee requests the

Secretary to review the program to ensure that funds are distributed in an equitable and appropriate manner, and provide a report

to the Committee by June 30, 2002. The Department should explain how it intends to rectify any inequities in funds distribution

or if there is some rationale for these inequities.

Within the consolidated health center line, sufficient funds have

been provided to support the activities intended to reduce health

disparities among ethnic/racial groups with high rates of adverse

health outcomes.

The Committee applauds the agency for its initiative in Alaska,

the ‘‘Alaska Frontier Health Plan,’’ and encourages the agency to

continue and expand its efforts with this program.

School-based health centers

This program provides grants for comprehensive primary and

preventive health care services and health education to at-risk and

medically underserved children and youth. Grants are awarded to

public or private, nonprofit, community-based health care providers. Through agreements with a local school or school system,

the health care entity provides the services in the school building

or on school grounds.
51

The Committee is pleased with the achievements of the healthy

schools, healthy communities initiative which has been particularly

effective in providing comprehensive school-based, school-linked,

family centered, community based primary care to approximately

24,000 children.

Migrant health program

The program helps provide culturally sensitive comprehensive

primary care services to migrant and seasonal farm workers and

their families. Over 80 percent of the centers also receive funds

from the community health centers program.

Health care for the homeless

The program provides project grants for the delivery of primary

health care services, substance abuse services, and mental health

services to homeless adults and children. About one-half of the

projects are administered by community health centers. The other

one-half are administered by nonprofit coalitions, inner-city hospitals, and local public health departments.

Recognizing the adverse impact of residential instability and poverty on access to health care, the Committee urges the Department

to consider designating homeless persons, migrant and seasonal

farm workers, as medically underserved populations. The Committee further urges the Department to take steps to make health

services provided by the Department as fully accessible as possible

to persons experiencing homelessness.

Public housing health service grants

The program awards grants to community-based organizations to

provide case-managed ambulatory primary health and social services in clinics at or in proximity to public housing. More than 60

percent of the programs are operated by community health centers.

Native Hawaiian health care

The Committee again includes the legal citation in the bill for

the Native Hawaiian Health Care Program. The Committee has included 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 $7,000,000 be provided for these activities in fiscal year 2002.

The purpose of this activity is to improve the health status of native Hawaiians by making primary care, health promotion, and disease prevention services available through the support of Native

Hawaiian health systems. Services provided include health screening, nutrition programs, and contracting for basic primary care

services. This activity also supports a health professions scholarship program for native Hawaiians.

Other Native Hawaiian and Pacific Islander health issues

The Committee believes the Agency could establish a demonstration project in Hawaii to develop an integrated health and social

services model, to include traditional healing, prevention, and disease management, that addresses the disparities in health status
52

and barriers to accessing health and social services among native

Hawaiians and other minority populations at the Waimanalo

Health Center. The Committee requests inclusion of the Samoan

and other Pacific Island populations to partake in the traditional

healing, prevention and disease management opportunities in the

Waimanalo Health Center.

The Committee continues to support the concept of malama. This

innovative, culturally sensitive community partnership program

addresses the prenatal needs of minorities in rural Hawaii. The

Committee encourages the HRSA to support the replication of this

project to include teen pregnancies. The ever increasing epidemic

of teen pregnancy makes the maximum utilization of effective

strategies a necessity.

The Committee encourages the development of a Center of Excellence for Indigenous Health and Healing at the University of Hawaii and in other schools serving a large population of native peoples including American Indians, Alaska Natives, native Hawaiians

and Pacific Islanders to incorporate traditional medicine and healing practices into their training for medical, nursing, social work,

psychology, and public health students and pharmacy. The Committee encourages HRSA, CDC, and SAMSHA to support this effort

in their grants by including traditional practitioners as providers

of care where there are native and indigenous people residing in

the service area of the grantee. The Committee also supports the

creation of a Native Hawaiian Center of Nursing Excellence at the

University of Hawaii at Hilo.

The Committee understands that the Agency has funded the Hui

and encourages continued and increased support to address the

unique health care needs of Hawaii’s underserved population. Native Hawaiian indigenous populations continue to experience significant health problems, including asthma and diabetes. The Committee urges HRSA to implement a program under which the systematic utilization of native Hawaiian health expertise may effectively impact the health status in these populations. The Committee recommends that community health centers serve as a safety net for this program, utilizing nurse practitioners and psychologists as care providers for these underserved populations.

The Committee is also concerned that regulations and application procedures currently governing distribution of community

health center funds are preventing remote rural areas in States

like Alaska and Hawaii from applying for and receiving funding for

health centers despite severe shortages of health professionals and

great need. The Committee urges the agency to give appropriate

priority to locating new health centers in such remote communities

and to developing a flexible approach to working with Native

health providers and other similar groups to help meet the health

needs of low income persons living in extremely remote locations.

Currently the State of Hawaii and Pacific Basin Region are experiencing an acute shortage of Doctorally prepared Pharmacists and

there is no school of pharmacy in the State. Unique to Hawaii is

the fact much its population comes from the pacific basin region

and use health interventions that are unique to this part of the

world. Therefore the Committee urges HRSA to develop a pharmacy program at the University of Hawaii/ Hilo that includes as
53

part of the curriculum, strong clinical focus on pacific basin region

culture and traditional interventions. The University of Hawaii/

Hilo has a relationship with the National Tropical Botanical Gardens that would allow students in the school of pharmacy a rich

study in ethnobiology helping them to provide a broader background and cultural understanding of the Hawaiian population.

The Committee recognizes that providing health care in rural

areas is difficult, and the difficulties increase exponentially when

the location is a small island in the Pacific. However, Molokai General Hospital has been providing health care on this rural island

and has found that its environment provides opportunities to research outcomes of new interventions, evaluate culturally-relevant

health education, train health providers on care of ethnic populations, and facilitate the integration of non-Western health treatments. Molokai’s rural setting also encourages the collaboration

among diverse health professionals and necessitates the use of

technology advances, including telehealth, telemedicine, electronic

communication, and video consultation. Given Molokai’s General

Hospital’s ability to thrive in its isolated location, the Committee

believes that the Hospital could be designated a Center of Excellence that will focus on the provisions of health care in rural areas.

National Health Service Corps: Field placements

The Committee provides $49,511,000 for field placement activi- ties, which is $8,047,000 above the fiscal year 2001 level and

$7,000,000 more than the administration request. 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.

National Health Service Corps: Recruitment

The Committee provides $104,916,000 for recruitment activities,

which is $17,000,000 more than the fiscal year 2001 level and the

administration request. 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 shortage

area. The Committee reiterates its intention that funds support

multi-year, rather than single-year, commitments.

As part of its rural health initiative, the Committee is increasing

funding for field placements and recruitment to address growing

concerns about primary care provider shortages in rural and underserved areas. The Committee strongly supports these programs because of their success in recruiting, training, and retaining well

trained providers in these areas. The Committee is aware that providers who train in rural and underserved areas are more likely to

elect to practice in those areas.

The Committee is concerned by the declining percentage of placements of NHSC assignees at Community, Migrant, Homeless, and

Public Housing Health Centers. The program is intended to supplement efforts of other Federal programs, such as health centers,

that are targeted to underserved communities and vulnerable pop-
54

ulations, and the Committee remains supportive of efforts to place

practitioners in close coordination with this program.

The Committee applauds the efforts of the National Health Service Corps (NHSC) to place psychologists and other mental and behavioral health professionals in designated underserved areas including community and migrant health centers. Nevertheless, the

Committee believes greater emphasis should be placed on this priority to increase the number of these providers placed in Mental

(and Behavioral) Health Professional Shortage Areas. In addition,

the Committee is concerned that no psychologists are participating

in the Scholarship Program. The Committee, therefore, directs the

NHSC to take all necessary steps to increase the number of positions assigned to Mental Health Professional Shortage Areas (including for psychologists) and to begin including psychologists in

the Scholarship Program.

The Committee intends that $8,000,000 of the funds appropriated for this activity be used for State offices of rural health. As

part of its rural health initiative, the Committee is significantly increasing funding for the offices of rural health to allow States to

better coordinate care and improve support and outreach in rural

areas.

HEALTH PROFESSIONS

For all HRSA health professions programs, the bill includes

$352,927,000, which is the same as fiscal year 2001 and

$213,174,000 more than the administration request for these programs.

The health professions and nursing education programs under

Title VII and VIII of the Public Health Service Act provide support

to students, programs, departments, and institutions to improve

the accessibility, quality, and racial and ethnic diversity of the

health care workforce. In addition to providing unique and essential training and education opportunities, these programs help

meet the health care delivery needs of the over 2,800 Health Professions Shortage Areas in this country, at times serving as the

only source of health care in many rural and disadvantaged communities. Providers who were trained under Title VII and VIIIfunded programs are 3–5 times more likely to provide health care

in rural and underserved areas. The organizations representing

schools, programs, and institutions that benefit from this funding

have determined that these programs needs strong funding to educate and train a health care workforce that meets the public’s

health care needs.

The following clusters and their associated programs are included in this consolidated account:

A. Workforce information and analysis

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 work force

configurations.
55

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. The Committee reiterates its support for the three centers for

health professions research that are current grantees.

B. Training for diversity

Centers of excellence

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 the agency has refocused the minority centers of excellence program on providing

support to historically minority health professions institutions.

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 encourages the Centers of Excellence program to consider applications that are responsive to allied health professions which are experiencing shortages and high vacancy rates, such as laboratory

personnel.

The Committee urges the agency to consider establishing at least

one center for excellence focused on training Alaska Natives as

community health aides to serve as sole community health providers in remote Alaska Native villages across Alaska.

The Committee continues to be supportive of the work of the

American Foundation for Negro Affairs in providing early intervention training.

Health careers opportunity program

This program provides funds to medical and other health professions schools for recruitment of disadvantaged students and preprofessional school preparations. The Committee is pleased that

HRSA has given priority consideration for grants to minority

health professions institutions, and recommends that grant review

committees have proportionate representation from these institutions.

The Committee has been supportive of this program’s critical role

in improving the health status of minority and disadvantaged citizens by increasing available opportunities for those individuals

seeking a health professions career. The Committee understands

that minority providers are more likely to serve in underserved

areas. The program has recognized the contribution of historically

minority health professions schools, and have supported those in-
56

stitutions which have made the greatest contribution to increasing

the number of minorities in health professions careers.

The Committee is pleased that HRSA has given priority consideration for H–COP grants to minority health professions institutions,

and recommends that grant review committees have proportionate

representation from these institutions. The Committee encourages

the H–COP program to consider applications that are responsive to

allied health professions which are experiencing shortages and high

vacancy rates, such as laboratory personnel.

Faculty loan repayment

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

This program provides grants to health professions schools for

student scholarships to individuals who are from disadvantaged

backgrounds and are enrolled as full-time 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.

The Committee continues to intend that all health professions

disciplines made eligible by statute be able to participate in the

scholarship program.

The Committee continues to recognize the importance of training

greater numbers of psychologists and other health professionals

from disadvantaged backgrounds to participate on interdisciplinary

primary care teams addressing a range of behavioral and mental

health needs.

C. Training in primary care medicine and dentistry

The Committee recognizes that these programs play a critical

role in meeting the oral health care needs of Americans; especially

those who require specialized or complex care and represent vulnerable populations in underserved areas. Additionally, the Committee realizes that several States have fewer than 10 pediatric

dentists. The Committee notes that there is clearly a shortage of

dentists needed to address the oral health requirements of America’s children.

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.
57

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.

The Committee recognizes the need to increase the number of

dentists in rural and underserved areas, and particularly increase

the number of pediatric dentists in those areas. Rural States are

disproportionately underserved by pediatric dentists.

D. 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

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.

The Committee encourages the increase of residency training opportunities in dental public health so that Federal, State, and community-based programs have the leadership capabilities to prevent

dental disease, promote oral health, and improve treatment outcomes.

Health administration traineeships and special projects

This program provides 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.

E. Interdisciplinary, community-based linkages

The Committee recognizes the nationwide shortage of psychologists and other mental and behavioral health professionals, particularly among minorities and in underserved areas. Therefore,

the Committee urges the Bureau of Health Professions to increase

its efforts to meet the behavioral and mental health needs of underserved populations.
58

Area health education centers

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.

The Committee intends that adequate funding be provided to the

area health education centers grant program since AHEC’s are an

important component of the Federal/State partnership in addressing rural health issues.

It has been brought to the attention of the Committee that the

program has been emphasizing physical health needs, while more

could be done in addressing behavioral and mental health needs.

The Committee encourages the Bureau to train more behavioral

and mental health professionals in the AHEC program.

Health education and training centers

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

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 expects this program to continue to support

schools or programs with projects designed to plan, develop, or expand postbaccalaureate programs for the advanced training of allied health professionals; and provide traineeships or fellowships to

postbaccalaureate students who are participating in the program

and who commit to teaching in the allied health profession involved. This program also provides funds to expand existing training programs or develop new ones, recruit individuals into allied

professions with the most severe shortages or whose services are

most needed by the elderly, and increase faculty recruitment and

education, and research.

The Committee continues to encourage HRSA to give priority

consideration to those projects for schools training allied health

professionals experiencing shortages, such as medical technologists

and cytotechnologists. The Committee is concerned about high vacancy rates for these critical laboratory personnel and encourages

HRSA to redouble efforts to address these shortages.

Geriatric education centers and training

The Committee expects this program to continue to support

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

skill-base of health care professionals to care for our Nation’s grow-
59

ing elderly population. The Committee is concerned about the

shortage of trained geriatricians and urges the agency to give priority to building the work force necessary to care for the Nation’s

elderly.

The Committee recognizes the Des Moines University Osteopathic Medical Center for its development of a model program for

training and education in the field of geriatrics.

Quentin N. Burdick program for rural health interdisciplinary training

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. As part of its rural

health initiative, the Committee expects to significantly increase

funding for this program to help increase the number of health

care providers in rural areas. The Committee continues to be concerned about the lack of providers in rural areas and expects the

increased funding for this program will help alleviate this problem.

The Committee expects that this program will continue its current levels of support for addressing the issue of how the delivery

of chiropractic health care can be enhanced in rural areas, and how

more women and minorities can be recruited as chiropractic health

care practitioners in rural areas.

The Committee also expects the Bureau to expand its support for

telecommunications and telehealth initiatives for providing distance education and training for nurses and allied health professionals serving rural areas.

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

The 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 strongly 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 and funded at no less than

current levels.

F. Nursing workforce development

The Committee recognizes the current nursing shortage is creating a health care crisis in hospitals and skilled nursing facilities.
60

The lack of young people in nursing has resulted in a steady and

dramatic increase in the average age of U.S. nurses. Today, the average age of a working RN is 43 years old. According to recent surveys, one in five nurses plans to retire by 2006, exacerbating the

shortage. Another factor contributing to the nursing shortage is the

availability of nursing faculty. They, like nurses in healthcare delivery, are aging. Thus, for some schools, even if they could recruit

more students, they may not have faculty to teach them. The Committee believes that this is an area that requires critical attention.

Another reason for this shortage is the inability of nursing

schools to educate more nursing students, which is in turn largely

the result of a lack of qualified nursing faculty. Since the average

age of nurse educators today is 55, this shortage of educators will

continue to accelerate. The Committee is further aware of the success of the Troops-to-Teachers program at the Departments of Defense and Education in placing qualified military veterans into

teaching positions in America’s public schools through an expedited

certification process. The Committee therefore encourages HRSA to

establish a pilot program similar to the Troops-to-Teachers program to encourage qualified, active duty military nurses to become

nurse educators in certified nursing school programs. The program

should include career and placement assistance, transitional stipends for those who commit to teach in nursing schools, and cooperation with nursing schools to expedite the transition from the

military to civilian teaching.

To address the well documented nursing shortage, the Committee expects funding for advanced education nursing, basic nurse

education and practice, and nursing workforce diversity to be increased over the fiscal year 2001 funding level.

The Committee directs the Secretaries of the Departments of

Health and Human Services and Labor, in collaboration with the

American Nurses Association and American Colleges of Nursing, to

convene a national panel by March 1, 2002, to examine education

and training requirements for all nursing occupations. The panel is

encouraged to provide specific recommendations on education,

training, continuing education, retention, and professional development for all levels of nursing care providers. The Committee directs

the Department to fund this initiative and provide a report to the

Committee with specific recommendations within 1 year of the panel’s creation.

Advanced education nursing

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.

Nurse practitioner/nurse midwife education

This program supports programs preparing nurse practitioners

and nurse midwives to effectively provide primary health care in

settings such as the home, ambulatory, and long-term care facilities, and other health institutions. These professionals are in especially short supply in rural and underserved urban areas.
61

Professional nurse traineeships

Traineeships fund registered nurses in programs of advanced

nursing education, including preparation for teaching, administration, supervision, clinical specialization, research, and nurse practitioner and nurse midwife training.

Nurse anesthetist traineeships

Grants are awarded to eligible institutions to provide

traineeships for licensed registered nurses to become certified registered nurse anesthetists [CRNA]. The program also supports fellowships to enable CRNA faculty members to obtain advanced education.

Basic nurse education and practice

Authorized by Public Law 105–392, 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 basic nursing workforce and empower the workforce to

meet the demands of the current health care system.

The Committee is aware of a recent meeting of the Council on

Graduate Medical Education (COGME) and the National Advisory

Council on Nursing Education Program (NACNEP) where they determined to work together to develop educational programs to address concerns raised in the Institute of Medicine Report, ‘‘To Err

is Human.’’ Specifically, they have agreed to focus jointly on a new

initiative, ‘‘Training Physicians and Nurses Together to Improve

Patient Safety.’’ This promises to be a constructive and productive

effort and the Committee encourages HRSA to fund this initiative.

The Committee is aware of the University of Alaska Anchorage’s

program to recruit and retain Alaska Natives for basic and advanced training as nurses to serve in Native communities in Alaska, and notes that only 2 percent of the RN workforce in Alaska

is composed of Alaska Natives. There is also a severe shortage of

trained nursing professionals in rural Alaska. The Committee encourages the agency to consider continuing and expanding the University’s current program, including supportive services, stipends

for needy students, and distance delivery of educational components.

The Committee is aware of a need for more public health nurses,

public health aides and child health consultants in remote areas of

rural Alaska and encourages the agency to work with the Alaska

Department of Health and Social Services to help meet these

needs, particularly in early childhood education programs.

Nursing workforce diversity

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 nursing’s ability to provide quality health care services to

the increasingly diverse community it serves.
62

Children’s hospital graduate medical education program

The Committee recommends $243,442,000 for the Children’s Hospital Graduate Medical Education (GME) program. This is

$8,450,000 above the fiscal year 2001 level and $43,348,000 more

than the administration request.

The program provides support for health professions training in

children’s teaching hospitals that have a separate Medicare provider number (‘‘free-standing’’ children’s hospitals). 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.

The Committee believes Federal support for GME for children’s

hospitals is a sound investment in children’s health. Congress has

enacted expansions in children’s health coverage and increased

support for health programs devoted to children and biomedical research. Equitable funding for children’s hospitals GME is needed to

sustain the pediatric workforce, including an adequate supply of future pediatric researchers, and our pediatric research enterprise.

The Committee further recognizes that an inequity exists for

GME funding for children’s teaching hospitals because Medicare is

the largest single payer of GME, and free-standing children’s hospitals treat few Medicare patients. These funds provide essential,

equitable support for the teaching contributions of these institutions.

OTHER HRSA PROGRAMS

Hansen’s disease services

The Committee has included $18,391,000 for the Hansen’s Disease Program which is $501,000 more than fiscal year 2001 and

the same as the administration request. 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.

With the exception of about 40 long term residents who continue

to reside at Carville, the program has completed the move to leased

space in Baton Rouge. Other former long term residents have been

offered and elected to receive a living allowance from the program

and now live independently. The former Federal property at

Carville has been transferred to the State of Louisiana.

Over the next few years a long term facility will be developed in

the Baton Rouge area and offered to the current long term residents remaining at the Carville location as an alternative to remaining at the historic facility.

The program also conducts research focusing on the global elimination of Hansen’s Disease in laboratory facilities at Louisiana
63

State University in Baton Rouge. Research activities are directed

toward the development of new anti-leprosy drugs and short-term

more effective regimens; manufacture and distribution of lepromin

skin tests reagents through the World Health Organization; identification of host resistant mechanisms for potential use in vaccines

development; and application of state-of-the-art biotechnology to

develop simple lab techniques for case detection and diagnosis of

preclinical disease.

Maternal and child health block grant

The Committee recommends $719,087,000 for the maternal and

child health [MCH] block grant. This is $9,900,000 more than fiscal

year 2001 and $15,000,000 more than the administration request.

The Maternal and Child Health Block Grant program provides a

flexible source of funding that allows States to target their most urgent 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 Committee is aware that each State MCH program has just

completed a needs assessment that is conducted once every 5 years.

The assessment identified the need to expand programs in a variety of areas with the aim to assure access to quality health care;

prevent disease, disability and death; provide family-centered, community-based services for women, children, adolescents and their

families; and other priorities. The Committee has provided an increase in the MCH Block Grant to allow States to move forward

to address the unmet needs that they have identified.

The MCH block grant funds are provided to States to support

health care for mothers and children. According to statute, 12.75

percent of funds over $600,000,000 are used for community-integrated service systems [CISS] programs. Of the remaining funds,

15 percent is used for special projects of regional or national significance [SPRANS] while 85 percent is distributed on the same

percentage split as the basic block grant formula.

The Committee has expressed concerns in the past about MCH

plans to eliminate SPRANS funding for three thalassemia centers

that provide comprehensive services to patients and families. These

centers, located in Boston, New York and Oakland and serving a

broad geographical area, are the only source of support for many

patients. For this reason, the Committee is pleased to learn that

the Bureau has now agreed to continue funding all three centers

well into 2003. The Committee urges MCH to continue to work

closely with these centers and the Cooley’s Anemia Foundation to

assure that future changes in SPRANS funding will not have a

negative impact on the centers’ operations.

The Committee commends HRSA’s Maternal and Child Health

Bureau for its support of the Sudden Infant Death Syndrome Pro-
64

gram Support Center, and encourages the Maternal and Child

Health Bureau to continue its efforts in this important area of

service, and is pleased that the SIDS and Other Infant Death Support Center is collaborating with the National Institutes of Health

to address the disproportionately high incidence of SIDS among African Americans.

Partners in Program Planning for Adolescent Health (PIPPAH)

is a public-private initiative that promotes an adolescent health

care agenda among professional disciplines through funding from

the Office of Adolescent Health within the MCHB. The program

aims to improve access to health services for adolescents, including

access to mental health services. The Committee encourages the

bureau to continue using SPRANS funds for the PIPPAH program.

With sufficient funding, this programs could be expanded to involve

additional disciplines, including health care organizations such as

the American College of Obstetricians and Gynecologists.

The Committee recognizes that access to care through the hemophilia treatment center network is critical to the prevention and

treatment of the complications of hemophilia and other bleeding

disorders. The Committee believes that HRSA could strengthen

support for these centers and requests a report by March 31, 2002

on the steps it has taken to improve its services to persons with

hemophilia and other blood disorders, especially in underserved

areas.

Healthy start initiative

The Committee recommends $89,996,000 for the healthy start infant mortality initiative. This amount is the same as fiscal year

2001 and the administration request.

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.

Since 1990, the Maternal and Child Health Bureau has worked

in collaboration with the American College of Obstetricians and

Gynecologists (ACOG) to run the National Fetal and Infant Mortality Program. NFIMR is a national activity where professionals

review community fetal and infant mortality rates and work to address identified problems leading to mortality and establish systems of support for women and children. The public-private initiative also works to address problems with health disparities in minority health, as related to fetal and infant mortality rates. The

Committee believes NFIMR should continue to be supported

through MCH and notes that additional funds would allow more

communities to be served. Adequate funding has been provided for

NFIMR through the Healthy Start initiative. The Committee is

aware that in order to meet the demand of serving an expanded

number of communities, NFIMR must be able to continue its activities at an adequate funding level.

The Committee is aware of the excellent services provided by the

Northern Plains Healthy Start program to provide pre-natal care
65

to Native American women throughout South Dakota, Iowa, North

Dakota, and Nebraska.

The Committee is also aware of the high quality services provided to mothers and infants by Pee Dee Healthy Start in the Pee

Dee region of South Carolina.

Universal newborn hearing screening and early intervention

The Committee provides $10,000,000 for universal newborn hear- ing screening and early intervention activities, which is $2,001,000

above the fiscal year 2001 level and $3,419,000 more than the administration request. The Committee understands that screening

technology has enabled health providers to conduct accurate, costefficient newborn hearing screening prior to hospital discharge. By

detecting newborn hearing deficiencies, health providers can implement necessary treatment to the infant and advice to affected family members. This new program was begun last year and the response from States has been substantial. The Committee is aware

that HRSA received many more high quality applications for this

program than it was able to fund. Numerous studies have demonstrated that newborn hearing screening followed by early intervention services can greatly improve health and educational outcomes for children.

Funds provided will support grants to states to: develop and expand statewide screening programs; link screening programs with

community-based intervention efforts; monitor the impact of early

detection and intervention activities; and provide technical assistance.

Organ procurement and transplantation

The Committee provides $19,992,000 for organ transplant activi- ties. This is the same as the administration request and $5,000,000

more than the fiscal year 2001 appropriation.

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 encourages the

agency to establish linkages with state and Federal transportation

officials to improve coordination of donation following vehicular accidents, through the establishment of donor registries.

To increase the rate of organ donation, the Committee urges increased behavioral research to better target and increase the effectiveness of public awareness campaigns.

The Committee considers increasing the supply of organs, particularly livers, available from voluntary donations to be a top public health priority and expects that funds be committed to those activities having the greatest demonstrable impact on donation rates.

The Committee notes that in the last year while there were approximately 4,700 liver transplants performed, there were over

17,000 individuals on the list waiting for liver transplantations and

about 1,700 people died due to the lack of a donor liver. In view

of this continuing shortage of organ donors, the Committee is en-
66

couraged by the growing number of transplants using living donors

who contribute a portion of their liver to a recipient. In order to

increase the living donor liver transplantation, additional research

is needed to study the outcome of both donors and recipients, define the optimal surgical procedure and identify eligibility criteria.

National bone marrow donor program

The Committee has included $22,000,000 for the national bone

marrow donor program. This is the same as the administration request and $42,000 more than the fiscal year 2001 level. The National Bone Marrow Donor Registry is a network, operated under

contract, that 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.

Rural health outreach grants

The Committee recommends $57,921,000 for health outreach

grants. This amount is $293,000 less than the fiscal year 2001 level

and $20,058,000 more than the administration request. This program supports projects that demonstrate new and innovative models of outreach in rural areas such as integration and coordination

of health services. The Health Care Consolidation Act of 1996 authorized a new rural network development program intended to develop integrated organizational capabilities among three or more

rural health provider entities.

The Committee is aware of the importance of having trained staff

who have access to Automated External Defibrillators (AEDs), and

that the survival rate for someone experiencing sudden cardiac arrest drops 7 percent to 10 percent as each minute passes. The Committee therefore includes $5,000,000 to implement the Rural AED

Act of 2000 to provide grants to community partnerships to purchase equipment and provide training.

The Committee is aware of the difficulties small rural hospitals

have in complying with the new implementation requirements created by the Balanced Budget Act Refinement Act, the Health Insurance Portability and Accountability Act, and the Medicare, Medicaid, and S–CHIP Benefits Improvement and Protection Act.

Therefore, as part of the its rural health initiative, the Committee

includes $15,000,000 to assist rural hospitals through the Rural

Hospital Performance Improvement Program. Under this program,

grants would be provided to small rural hospitals (those with 50

beds or less), and networks of small rural hospitals (e.g., through

State Hospital Associations), that are essential access points for

Medicare and Medicaid beneficiaries. The program would target

those key service areas in greatest need. The grants would be used

to address the following critical areas of need:

—Improved Financial Performance: Many small rural hospitals

face financial struggles in an increasingly complex billing environment. These grants would assist these providers in upgrading and improving their billing practices, including technological upgrades (hardware and software, as well as staff training), reducing their accounts receivable, and ensuring a more

consistent financial foundation.
67

—Reduced Medical Errors/Quality Improvement: Improving

health quality and reducing medical errors in a rural environment requires an approach that recognizes the special circumstances faced by small rural hospitals that deal with low

patient volumes within a clinical focus that is dominated by

primary care. Rural communities are often heavily dependent

on retaining local health care dollars in order to remain financially viable. A loss of confidence in locally delivered care can

quickly escalate into a self-fulfilling prophecy of reduced quality, as patients are lost to distant urban providers. These

grants would allow small rural hospitals to develop locally

based and individualized quality improvement projects that

help retain local health care dollars in the community.

—Increased Organizational Capacity: The health care system is

undergoing rapid change and small rural hospitals are not immune to these changes. These grants would assist small rural

hospitals in their efforts to improve their local health care delivery system by improving clinical practices, re-organizing

their clinical pathways to better meet community needs and

modernizing their health technology infrastructure.

The Committee continues to be concerned about the enormous

chronic disease and public health burden faced by the Mississippi

Delta region and expects that HRSA continue to provide support to

the Delta Regional Authority (DRA) and that HRSA and DRA jointly administer this program. The Committee expects these resources

to be used to provide targeted, innovative health education, access

and research grants to existing Delta health-related educational institutions that have created comprehensive programs to improve

health outcomes in the Delta.

The Committee is aware of a number of rural health outreach

programs that, if funded by the Department, would improve access

to needed health care services in underserved rural areas. They include:

—The Community Health Aide program, which is the only provider of critical first-line health care in more than 200 remote

rural Alaska Native villages;

—The Center for Sustainable Health Outreach in developing

model health access programs, health-related jobs and the sustainability of community-based providers of health services in

rural and urban communities;

—The Maui Community College and Hana Community Health

Center to facilitate the training of nurses for adequate staffing

at the Hana Community Health Center, which is is one of the

most remote areas in the State of Hawaii;

—The Rural Family Diabetes and Mental Health Outreach program in New Mexico;

—Hispanic Community and Family Health programs in New

Mexico;

—The University of South Alabama initiative to establish a

model diabetes foot treatment center;

—LSU Health Science Center’s Minority and Rural Health Research and Outreach for the planning and development of improved rural health outreach;
68

—The Clakamas County, Oregon initiative to provide primary

health care to its chronically underserved population of rural

residents;

—The Oregon Health Sciences University Institute for Excellence

in Nursing to enhance nurse training and staff development for

practicing nurses throughout Oregon;

—The Northwest Health Center in Pascoag, Rhode Island to support health care services for 3,500 low income individuals in

rural Rhode Island;

—The Oregon Community Health Information Network program

to allow health centers throughout Oregon to better determine

patient eligibility for Medicaid and other health care programs;

—The diabetes lower extremity amputation preventive program

at the University of South Alabama, the Louisiana State University Medical School, the Roosevelt Institute for Rehabilitation, and the Jackson Medical Mall;

—The Littleton Regional Hospital in New Hampshire program to

allow the hospital to continue the paramedic services program

that is vital to that region’s residents;

—The Charles Cole Memorial Hospital proposal for Porter-Tioga

Mckear Pain Clinic to be a model pain management clinic for

rural areas;

—The Louisiana Public Health Institute Center for Community

Capacity Enhancement to promote community partnerships to

address health improvement priorities;

—A demonstration project in the rural Mississippi Delta area applying the Mississippi Medicaid disease State management

program to reduce the high prevalence and improve management of chronic diseases such as diabetes, asthma, hyperlipidemia, and cardiovascular disease in rural areas;

—The Children’s Health Fund in Mississippi to provide mobile

comprehensive medical care to uninsured and medically underserved children in the Mississippi Delta, particularly in Mississippi and Arkansas, along with the inner-city areas of New

York City;

—The comprehensive health initiative in the Mississippi Delta

and an initiative to promote basic and clinical research on the

prevention of the toxic effects of agricultural chemicals and the

prevention of agricultural related injuries. The collaboration

between Delta State University, the University of Mississippi

Medical Center, and the Mississippi State Department of

Health could promote coordinated consolidation of health and

human services that will positively impact the education,

health, and economics of this region;

—The North Idaho Rural Health Consortium, to extend and improve services to high-priority participants and rural areas;

—The Commun-I-Care program in South Carolina to provide

medications to the low-income, uninsured patients;

—The University of Montana Drug Information Service to provide health care professionals with access to specialized health

information in rural areas of Montana;

—The Bi-State Primary Care Association initiative to improve

the delivery of rural health care in Vermont;
69

—The University of Maine program to build a statewide database and access system that will allow more efficient tracking

and referral for intervention for infants and children at risk in

rural Maine settings;

—The Hunstman Cancer Institute in South Dakota pilot project

to develop a medical outreach program utilizing mobile clinics

equipped with Positron Emission Tomography (PET scan) to

educate Native Americans in rural areas on cancer risk, early

detection, prevention and treatment.

Rural health research

The Committee recommends $15,000,000 for the Office of Rural

Health Policy. This is $1,563,000 above the fiscal year 2001 level

and $8,901,000 more than the administration request. The funds

provide support for the Office as 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. As part of its rural health

initiative, the Committee is increasing funding for this program to

improve the delivery of health care services to rural communities.

The Committee is supportive of efforts to expand and integrate

the services of behavioral and mental health professionals, including psychologists, in underserved rural areas, particularly in areas

affected by the current farm crisis.

The Committee is supportive of continuing funds to the Children’s Health Fund to implement a rural health initiative that

would expand availability and accessibility of pediatric care to underserved rural communities.

The Committee is supportive of efforts by the Iowa Department

of Public Health to demonstrate the use of portable technology to

improve the delivery of health care in rural areas by public health

nurses.

The Committee is aware of rural health research programs that,

if supported by the Department, could have a positive impact on

the delivery of health care services to rural communities. They include:

—The Educational Mall in Beckley, West Virginia, to serve as a

coordinating and research location for rural initiative, especially in preventative medicine;

—The Center for Rural Health and Medicine at the University

of North Dakota to study nation’s the unique health care needs

of the rural elderly and special needs populations;

—The Secure Rural Imaging Network at Avera McKennan Hospital in Sioux Falls, South Dakota;

—The Center for Health Delivery at the University of Alaska

program to evaluate health care delivery and training needs

for health care workers to use this information to improve the

health status of Alaskans.

—The Rural Primary Care and Health Service Research Center

at the University of South Dakota School of Medicine to help

define the status of health and health care delivery in South

Dakota;
70

—The University of Texas Health Science Center at San Antonio’s Regional Academic Health Center program to research

and improve the diets of U.S. Hispanics, particularly those living along the United States/Mexico Border.

Telehealth

The Committee recommends $5,609,000 for telehealth activities.

This amount is $30,369,000 less than fiscal year 2001 and the

same as the administration request.

The telehealth program promotes the use of technologies to improve access to health services and distance education for health

professionals. The Committee recognizes the tremendous potential

that telehealth has for improving the delivery of quality health

care to rural underserved areas and for providing distance education to health care professionals. The Committee supports

HRSA’s numerous rural telehealth initiatives and encourages the

agency to work in partnership with medical librarians and other

health information specialists in the development and implementation of its telehealth projects.

The Committee believes that HRSA could establish a number of

regional centers for the advancement of telehealth. Such centers

could advance the cost-effective deployment of telehealth technologies and provide technical assistance to health care providers.

The centers could conduct research, evaluations, and assessments

to determine the appropriate application of telehealth technologies

that span healthcare disciplines, applications, and settings.

The Committee is supportive of HRSA’s efforts to include EMS

issues in its Telemedicine/Telehealth initiative and encourages the

Office of Rural Health Policy, the Office for the Advancement of

Telehealth and EMSC program to collaborate on projects to improve emergency medical service for children.

The Committee strongly supports HRSA’s numerous rural telehealth initiatives and encourages the agency to work in partnership with medical librarians, the National Library of Medicine, and

other health information specialists in the development and implementation of its telehealth projects.

The Committee is aware of HRSA’s increased commitment to

telehealth demonstration projects to serve as models for the efficient delivery of health care services to rural, underserved, and

hard to reach populations. For example, the Committee continues

to be concerned about the extraordinary adverse health status and

the limited access to health services of Alaska Natives and others

living in Southwestern Alaska, the region of Alaska with the highest poverty and unemployment rates, and encourages the agency to

continue and expand a project to develop infrastructure to support

a comprehensive health care delivery system in that region. The

Committee supports this purpose, but also urges an increased focus

on demonstration grants for providing behavioral and mental

health services and advanced training for providers in prisons and

other public institutions.

The Committee is aware of a number of Telehealth programs

that, with the support of the Department, could have positive

health impacts on people living throughout America. They include:
71

—The Mountaineer Doctor Television Program at West Virginia

University to allow health care providers at West Virginia University to provide medical care through telemedicine to rural

West Virginia communities; —The Clarion University and the Primary Care Council of Pennsylvania’s State System of Higher Education telecommunications network to help improve the health status of Pennsylvanians through increased community access and comprehensive care; —The Alaska Federal Health Care Access Network, which is

bringing telehealth services to remote villages and communities throughout Alaska, providing linkages between remote

and inaccessible locations with tertiary care facilities in Anchorage and Fairbanks. Continued funding will allow expanded

installation of telehealth stations and will support bringing

non-Federal partners into the project and will fund operations

of the Alaska Telemedicine Advisory Council; —The University of Pittsburgh Medical Center is developing and

deploying its state-of-the-art health care information technology system; —The Magee Womens Hospital in Pittsburgh is developing a

model to support coordinated and integrated care for women

with breast cancers by using new technologies for mammography imaging, ultrasound imaging, and pathology slides; —The Pennsylvania School of Optometry in Philadelphia is establishing a network of urban community-based satellite centers which give inner-city, underserved persons access to eye

care; —The Telehealth Education and Learning Center in Montana;

—The Four County Library System program to provide programming development and delivery to communities in need of primary health care and reference resources; —The Pennsylvania Association of Home Health Agencies plan to

conduct a multi-facility examination of telehomecare as a solution to the nursing shortage;

—The Midwest Center for Rural Health telehealth project in Indiana;

—The Union Hospital in Terre Haute, Indiana, telehealth demonstration project to improve accessibility to quality health

care for rural areas;

—The South Alabama Telemedicine Project to allow this project

to continue to serve the health needs of rural, poor, and medically underserved communities;

—Continued support to implement Phase II of the Telehealth Research Deployment Testbed (TRDT) program to increase

healthcare accessibility and quality in underserved areas;

—The Geisinger Stroke Care Partnership in rural Pennsylvania

to serve as an educational link for rural patients and their providers by establishing informational resources and outreach efforts;

—The West Tennessee/North Mississippi Telemedicine Project to

bridge the gap between the resource-rich metropolitan center

of Shelby County, Tennessee, with the medically underserved

counties in Tennessee and Mississippi;
72

—The Telehealth Project at the University of Tennessee to build

upon its infrastructure, expand the scope of clinical services

provided, and incorporate the upper region; —The New Mexico/Hawaii telehealth out reach for Unified Community Health (TOUCH), which provided much needed health

services to rural patients; —Valley Children’s Hospital E-Health and telehealth program in

California; —The Regional Telehealth Consortium’s Network in Lake

Charles, Louisiana; —North Dakota State University, College of Pharmacy Telepharmacy project; —The Healthy Mothers and Babies Technology Demonstration in

Minnesota to connect rural patients and their communities to

the specialty care available in Minneapolis/St. Paul; —The Samuel Merritt College nurse anesthesia education improvements through telehealth in California; —The University of Nevada Las Vegas ‘‘e-Health’’ initiative to

improve access to specialized and high quality health care in

rural Nevada; —Saint Vincent Hospital in Billings to establish a regional video

telecommunications network for healthcare providers; —The Deaconess Billings Clinic (DBC) Northwest Area Center

for Studies on Aging in Billings, Montana to address

healthcare problems associated with rural aging, and expand

access to specialty healthcare via telemedicine and video conferencing technology to a region where specialty healthcare

services are not currently available; —The Central Michigan University Telehealth Project to improve

health care access and quality to migrant and underserved

rural populations; —The La Crosse Medical Health Science Consortium to support

the development of a telecommunications-based, integrated

network of Virtual Population Health Centers in western Wisconsin;

—Continued support for Phase II of a telemedicine system to link

the research capabilities of the American Health Foundation

with patients served by the Beaufort-Jasper-Hampton Comprehensive Health Services;

—The Vermont Telemedicine Network to reduce disparities in

the clinical care and medical education of trauma in Vermont;

—The Susquehanna Health System plan to develop an electronic

medical information and physician access system for rural

areas;

—Expansion of the Children’s Hospital in Seattle, Washington

and University of Washington telemedicine program to improve access to health care services;

—Technology enhancements for federally Qualified Health Centers in the state of Oregon;

—Expansion of the Mississippi telemedicine network, which includes Mississippi Blood Services, Mississippi community colleges and universities, and local, State, and Federal agencies

in rural areas to eliminate health care disparities in access for

the underserved in rural areas including the Mississippi Delta;
73

—The Alcorn State University initiative to provide needed medical care and health education to residents of the lower Mississippi Delta; —The Idaho Telehealth Integrated Care Center at Idaho State

University; —The Rocky Mountain Technology Foundation (RMTF) in Billings, Montana, telehealth program, which has developed an

approach to solving problems of rural and frontier health providers; fragmentation of the health care delivery system; slow

diffusion of knowledge to rural providers of standardized advancements in diagnostic and therapeutic medical protocols;

and lack of strategic alliances and linkages between rural and

urban providers.

Native and rural Alaskan health care

The Committee has provided $20,000,000 for the Denali Commis- sion, which is $10,000,000 more than the fiscal year 2001 level and

$20,000,000 more than the administration request, to fund construction and renovation of health clinics, hospitals and social service facilities in rural Alaska as authorized by Public Law 106–113.

Provision of this funding will help remote communities in Alaska

develop critically needed health and social service infrastructure

for which no other funding sources are available so that health and

social services may be provided to Alaskans in remote rural communities as they are in other communities throughout the country.

Critical care programs

The Committee has grouped the following ongoing and proposed

activities: emergency medical services for children, the traumatic

brain injury program, trauma care/emergency medical services, and

poison control centers. The Committee provides $18,986,000 for emergency medical serv- ices for children. This is the same as the 2001 level and $3,412,000

more than the administration request. The program supports demonstration grants for the delivery of emergency medical services to

acutely ill and seriously injured children.

The Committee urges HRSA to consider EMSC a high priority,

and supports the efforts and purpose of the EMSC program to continue to work with States to improve the training and availability

of emergency medical services personnel who effectively treat children. The Committee also urges the Department to focus on the development of prevention and treatment programs and education of

emergency personnel in remote and rural areas throughout the

country, including Alaska and Hawaii, using telemedicine technology.

The Committee commends the Emergency Medical Services for

Children Program for the delivery of emergency medical services to

acutely ill and seriously injured children. The Committee also commends the Partnership for Children initiative which has provided

useful training and information to pediatric emergency care personnel.

The Committee supports the effective collaboration between

NHTSA and HRSA in the administration of the EMSC program.

The Committee urges the EMSC program to develop practice guide-
74

lines and other quality of care assessment and enhancement initiatives. The Committee encourages the EMSC program to continue

a research focus and to develop a means of collecting data to ensure accountability and to better track accomplishments and needs.

The Committee is supportive of HRSA’s efforts to include EMS

issues in its Telemedicine/Telehealth initiative and encourages the

Office of Rural Health Policy, the Office for the Advancement of

Telehealth and EMSC program to collaborate on projects to improve emergency medical service for children. The Committee provides $10,000,000 for the traumatic brain in- jury program, which is $5,000,000 more than the fiscal year 2001

level and the administration request. 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: pre-hospital care, emergency department care, hospital

care, rehabilitation, transitional services, education, employment,

and long-term support. The Committee includes $3,000,000 for protection and advocacy services, as authorized under section 1305 of

Public Law 106–310.

The Committee is extremely interested in the risk of head injury

in youth soccer participants associated with their lack of protective

head gear use. Therefore the Committee directs a study to determine the benefits of the use of protective head gear in decreasing

the incidence of head injury among youth soccer participants. The

Committee expects to receive the results of this survey by June

2002.

The Committee is aware that Mississippi leads the Nation in

both mortality and rates of incidences of traumatic brain injury.

The Committee encourages HRSA to implement programs to reduce the mortality and rate of incidences of traumatic brain injury

in Mississippi. The Committee provides $4,000,000 for trauma/emergency med- ical services. This is $1,000,000 more than fiscal year 2001 and

$1,533,000 more than the administration request. This program is

intended to improve the Nation’s overall emergency medical system, including the joint efforts between HRSA and the National

Highway Traffic Safety Administration to assess state systems and

recommend improvements to the current system.

The Committee provides $24,000,000 for poison control center activities, which is $4,004,000 more than fiscal year 2001 and

$7,579,000 above the administration request. The funds provided

will support the development and assessment of uniform patient

management guidelines and will support HRSA’s participation with

CDC and the joint CDC/HRSA advisory committee on planning efforts.

Black lung clinics

The Committee includes $7,000,000 for black lung clinics. This is

$1,000,000 above both the fiscal year 2001 amount and the administration request. This program funds clinics which treat respiratory and pulmonary diseases of active and retired coal miners.

These clinics reduce the incidence of high-cost inpatient treatment

for these conditions.
75

Nurse loan repayment for shortage area service

The Committee includes $15,000,000 for nurse loan payment for shortage area services. This is $12,721,000 more than fiscal year

2001 and the administration request.

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. The Committee views this program as a critical component of the rural health initiative outlined in this report, and intends that the majority of the increased funding be provided to increase the supply of qualified health care professionals in rural

areas.

Payment to Hawaii, Hansen’s disease treatment

The Committee includes $2,045,000 for Hansen’s disease services. This is the same as fiscal year 2001 and the administration

request.

Within the amount provided for Hansen’s disease services, the

Committee urges funding for the fiscal year 2002 payment to the

State of Hawaii for the medical care and treatment in its hospital

and clinic facilities of persons with Hansen’s disease at a per diem

rate not greater than the comparable per diem operating cost per

patient at Gillis W. Long National Hansen’s Disease Center. This

amount is the same as the administration request and the 2001

level.

The Committee appreciates the Institute of Medicine study of the

Pacific Basin health care delivery system, conducted in 1998. It is

the Committee’s understanding that the IOM cited findings for all

health indicators for the people residing in the freely associated

states, as being significantly worse than those for mainland Americans. The Committee, therefore, expects the Department to review

the IOM findings and initiate implementation of its recommendations which include: jurisdictional coordination by the Pacific Islanders Health Officers Association; use of Tripler Army Medical

Center and Guam Naval Hospital for care coordination, with emphasis on telehealth assessment and management; development of

and participation in a regional health information system for information tracking and storage; continuing education for all health

providers; and increased involvement in health care, particularly

womens’ health issues.

ACQUIRED IMMUNE DEFICIENCY SYNDROME

RYAN WHITE AIDS PROGRAMS

The Committee provides $1,883,000,000 for Ryan White AIDS

programs. This is $75,391,000 more than fiscal year 2001 and

$75,236,000 more than the administration request.

Recent advances in diagnosis, treatment, and medical management of HIV disease has resulted in dramatic improvements in individual health, lower death rates and transmission of HIV from

mother to infant. The Committee recognizes, however, that not all

HIV infected persons have benefitted from these medical advances

and expects that the Ryan White CARE Act programs provide so-
76

cial and other support services with the specific intent of obtaining

and maintaining HIV-infected individuals in comprehensive clinical

care.

The Department is encouraged to identify obstacles confronting

people with HIV/AIDS in receiving medical care funded through

the Ryan White programs and to develop strategies to address

these problems in light of the changing medical needs of a patient

population that is living longer with current therapies.

The Committee recognizes the recent advances in the treatment

and medical care of persons with HIV disease and the need for

early access to these interventions and services. Furthermore, the

Committee understands that disparities exist in accessing and

maintaining the benefits of these recent advances among communities highly impacted by HIV and AIDS.

The Committee encourages HRSA to assume a leadership role in

ensuring that the prevention, treatment, and management of HIV/

AIDS in correctional facilities is a high priority and that the care

rendered meets current medical standards for AIDS care. The Committee encourages HRSA to collaborate with the Federal Bureau of

Prisons, CDC, the White House Office on AIDS Policy, and other

entities of jurisdiction.

Emergency assistance—title I

The Committee recommends $620,000,000 for emergency assistance grants to eligible metropolitan areas disproportionately affected by the HIV/AIDS epidemic. This amount is $15,831,000

above the fiscal year 2001 and the administration request. These

funds are provided to metropolitan areas meeting certain criteria.

One-half of the funds are awarded by formula and one-half are

awarded through supplemental competitive grants.

The Committee encourages the Secretary, when awarding supplemental title I funds, to give priority as appropriate to EMA’s

whose applications increase services to women, adolescents, and

children with AIDS/HIV infection.

Comprehensive care programs—title II

The Committee has provided $950,000,000 for HIV health care

and support services. This amount is $39,031,000 above the administration request and the 2001 level. 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].

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

$610,000,000 for AIDS medications, compared to $589,000,000 provided for this purpose in fiscal year 2001. The Committee further

urges HRSA to encourage States to utilize Federal ADAP funding

in the most cost-effective manner to maximize access to HIV drug

therapies and to eliminate cost-shifting from Medicaid to the State

ADAP programs. States with ADAP funding should be allowed the
77

flexibility to purchase and maintain insurance policies for eligible

clients including covering any costs associated with these policies,

or continue to pay premiums on existing insurance policies that

provide a full range of HIV treatments and access to comprehensive primary care services, as determined by a State. Funds should

not be committed to purchase insurance deemed inadequate by a

State in its provision of primary care or in its ability to secure adequate access to HIV treatments.

It has been brought to the Committee’s attention that many

State HIV/AIDS programs seek increased flexibility to use some

ADAP resources to fund medical care, laboratory tests, and services

to enhance patient adherence to pharmaceuticals. The agency

should consider allowing States to redirect a reasonable portion of

ADAP funds, as determined in collaboration with the States, to

such services that enhance the ability of eligible people with HIV/

AIDS to gain access to, adhere to, and monitor their progress in

taking HIV-related medications. The agency should submit a report

to the Committee with details on the implications of such a change

prior to implementation.

The Committee is concerned about restrictions being placed on

the type and scope of targeted outreach, as authorized under the

Ryan White CARE Act, to identify underserved populations and

provide them needed medical care. The Committee urges the Secretary to provide States flexibility, where appropriate, in conducting comprehensive, targeted outreach to underserved and minority populations to improve access to CARE Act programs for underserved communities.

The Committee is concerned about the increasing prevalence of

hepatitis C–HIV co-infection. Co-infection of the hepatitis C virus

(HCV) in HIV infected patients has become the leading cause of

AIDS mortality in some parts of the country. The death rate is

higher and life expectancy shorter for co-infection patients than for

patients who have only HIV.

To address this growing problem, the Committee urges HRSA to

encourage State ADAPs to offer co-infected patients access to approved hepatitis C treatments as their resources allow, to ensure

that the Ryan White critical care funded programs (including Title

III & IV clinics) provide opportunities for training care givers and

clinicians to treat co-infected patients, and to ensure that AETCs

address the need for physician education on HCV/HIV co-infection.

The Committee is concerned that American Indians and Alaska

Natives are not participating in ADAP to the extent that these

services are needed. The burden of covering costs for AIDS-related

drugs is often falling on local Indian Health Service, tribal or

urban program providers, or on the families of American Indians

or Alaska Natives with AIDS. The Committee requests that HRSA

and IHS work together to ensure American Indians and Alaska Natives are participating proportionately in each State, and there are

not barriers to American Indians accessing the ADAP drugs due

solely to their status as American Indians.

Early intervention program—title III–B

The Committee recommends $195,000,000 for early intervention

grants. This is $9,121,000 above the 2001 level and the administra-
78

tion request. 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.

The Committee encourages HRSA to fairly allocate the increase

for title III–B between existing grantees and new providers. By

providing additional funds to current grantees, the Committee intends to strengthen the HIV care infrastructure already established in title III–B clinics. The Committee also supports expansion

of the number of communities receiving assistance from this title.

Priority should be placed on funding new projects in rural, medically underserved areas, and secondary cities outside of major metropolitan areas in order to build clinical capacity for the delivery

of HIV care among clinicians serving high-risk populations, minorities, and those who are unable to access clinical HIV care for economic reasons. In building capacity, the goal is to develop knowledgeable clinicians to improve access to quality HIV treatment

based upon the evolving HIV treatment guidelines of DHHS.

Women, infants, children, and youth—title IV

The Committee recommends $72,000,000 for title IV pediatric

AIDS, which is $7,005,000 above the administration request and

the 2001 amount. 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.

The Committee intends that at least 90 percent of total title IV

funding be provided to grantees. The Committee expects the agency

to provide at least 75 percent of the funding increase to existing

grantees to reflect the increases in the costs of providing comprehensive care, including the implementation of quality management programs. HRSA should use a significant portion of the remaining funds to expand comprehensive services for youth, both

through existing and new grantees. The Committee expects the

agency to expand efforts to facilitate ongoing communication with

grantees on the administration of the Title IV program. These expanded efforts should include collaboration with grantees on the

forthcoming determinations by the Secretary mandated in the

Ryan White CARE Act Amendments of 2000 on administrative expenses and HIV-related research access. The Committee also expects HRSA to collaborate with CDC to identify and eliminate barriers between HIV prevention and care.

Some 5 percent of the funds appropriated under this section may

be used to provide peer-based technical assistance. Within this

amount, sufficient funds are available to maintain and expand

work being done to create a national consumer and provider education center on the use of various strategies and planning in the

care of children, youth, women and families infected with or affected by HIV and AIDS.
79

AIDS dental services

The Committee provides $12,000,000 for AIDS dental services, which is $2,001,000 above the administration request and the 2001

level. 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.

The Committee recognizes the importance of oral health care providers in the diagnosis of HIV and in treating the painful and debilitating oral manifestations of this disease. The Committee supports this program as it improves access to oral health services for

low-income and uninsured people living with HIV and AIDS by

providing partial reimbursement to dental education institutions

for delivering care. The Committee recognizes that these dental

services are vital because they are often the only services available

to AIDS patients since many State Medicaid programs do not cover

adult dental services.

The Committee recognizes the effectiveness of this program in

training dentists and in assisting with the cost of providing unreimbursed oral healthcare to HIV patients. The Committee noted

last year the importance of providing adequate time and technical

assistance for grantees to comply with the new uniform reporting

requirements to better access outcomes and performance measures.

With that in mind, the Committee recommends that HRSA provide

a 1-year extension to its current deadline so that grantees can put

into place reporting mechanisms that meet the new requirements

in a manner consistent with State and institutional confidentiality

protections.

AIDS education and training centers

The Committee recommends $34,000,000 for the AIDS education

and training centers [AETC’s]. This amount is $2,402,000 more

than the 2001 level and the administration request. 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.

Emphasis should be placed on building clinical treatment capacity by reaching health professionals providing care to persons within medically underserved areas, minorities, the economically underprivileged, and rural populations. The goal is to provide clinical

education and consultation to increase knowledge and skills of the

targeted clinician group providing care to low or medium volume

of HIV patients thereby improving the early and ongoing access to

quality HIV treatment by clinicians within urban and rural medically underserved areas and secondary cities outside of major metropolitan areas.
80

Family planning

The Committee recommends $266,000,000 for the title X family planning program. This is $12,090,000 above the fiscal year 2001

level and $11,830,000 more than the administration request. Title

X grants support primary health care services at more than 4,000

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 preventative health services. This includes FDA-approved methods of contraception.

The Committee has increased funding for clinics receiving Title

X funds to address increasing financial pressures in their effort to

provide high-quality, subsidized family planning services to

4,400,000 each year, many of whom are uninsured. These pressures

include rising costs of newer and longer lasting contraceptive methods, pharmaceuticals, and screening and diagnostic technologies, as

well as a rising uninsured population.

The Committee remains concerned that programs receiving title

X funds ought to have access to these resources as quickly as possible. The Committee, therefore, again instructs the Department to

distribute to the regional offices all of the funds available for family

planning services no later than 60 days following enactment of this

bill.

The Committee intends that at least 90 percent of funds appropriated for Title X activities be for clinical services authorized

under section 1001 of the Act. All such funds for section 1001 activities are to be provided to the regional offices to be awarded to

grantees to provide family planning methods and services as specified by the Title X statute. The Committee further expects the Office of Family Planning to spend any remaining year-end funds in

section 1001 activities.

Health care facilities

The Committee provides $10,000,000 for health care facilities, which is $241,561,000 below the 2001 level and $10,000,000 above

the administration request. Funds are made available to public and

private entities for construction and renovation of health care and

other facilities.

The Committee includes funding, as authorized in section 3 of

Public Law 107–21, for the Paul D. Coverdell Building at the Institute of the Biomedical and Health Sciences at the University of

Georgia.

National Hansen’s Disease Program buildings and facilities

The Committee recommends $250,000 for buildings and facilities,

which is the same as fiscal year 2001 level and the administration

request.

Rural hospital flexibility grants

The Committee includes $25,000,000 for rural hospital flexibility

grants, which is $3,000 more than the administration request and

last year’s appropriation.
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This program administers the Rural Health Flexibility Program

previously administered by the Health Care Finance Administration. Under this program, eligible rural hospitals may convert

themselves into limited service facilities termed Critical Care 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.

National practitioner data bank

The Committee recommends $17,200,000 for the national practitioner data bank, which is the same as last year and the administration request. 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.

Traditional 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 recommends $8,000,000 for the health care integ- rity and protection data bank, which is $3,683,000 more than last

year and the same as the administration request. 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.

Healthcare access for the uninsured

The Committee provides $15,041,000 for this activity, which is $124,950,000 less than fiscal year 2001 and the same as the administration’s request. 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. These

funds will enable public, private, and non-profit health entities to

assist safety-net providers in developing and expanding integrated

systems of care and address service gaps within such integrated

systems.

Program management

The Committee recommends $135,991,000 for program manage- ment activities for fiscal year 2002. This is $3,000,000 less than fiscal year 2001 and $11,058,000 less than the administration request.

The Committee continues to recognize the important work of the

American Foundation for Negro Affairs of Philadelphia.

The Committee strongly urges, given its unique needs, filling of

the Public Health Services Senior Programmatic position in Hawaii.

MEDICAL FACILITIES GUARANTEE AND LOAN FUND

The Committee has not included funding for the Medical Facilities and Guarantee and Loan Fund. This fund was established in
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1972 under the Medical Facilities Construction Program in order to

make funds available for construction of medical facilities. The

fund is established in the Treasury without fiscal year limitation

to pay interest subsidies, make payments of principal and interest

in the event of default on a guaranteed loan, and repurchase, if

necessary loans sold and guaranteed. There are sufficient carryover

funds from prior years’ appropriations to pay defaults and interest

subsidy payments; therefore, no appropriation is required to cover

these payments.

HEALTH EDUCATION ASSISTANCE LOANS

The Committee recommends no additional guarantee authority

for new HEAL loans in fiscal year 2002, which is the same as the

President’s request.

The Committee recommends $10,000,000 to liquidate 1999 obligations from loans guaranteed before 1992, which is the same as

the administration request and the 2001 appropriation.

For administration of the HEAL Program including the Office of

Default Reduction, the Committee recommends $3,792,000, which

is $120,000 above the 2001 appropriation and the same as the administration request.

The HEAL Program insures loans to students in the health professions and helps to ensure graduate student access to health professions education, especially among minority, disadvantaged students, and those from behavioral and mental health fields. 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.

VACCINE INJURY COMPENSATION TRUST FUND

Appropriations, 2001 ............................................................................. $117,347,000

Budget estimate, 2002 ........................................................................... 117,847,000

Committee recommendation ................................................................. 117,847,000

The Committee recommends that $117,847,000 be released from

the vaccine injury compensation trust fund in fiscal year 2002, of

which $2,992,000 is for administrative costs. The total amount is

$500,000 more than fiscal year 2001 and the same as the administration request budget request.

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, 2001 ............................................................................. $4,118,319,000

Budget estimate, 2002 ........................................................................... 4,005,508,000

Committee recommendation ................................................................. 4,418,910,000
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For the Centers for Disease Control and Prevention [CDC], the

Committee provides $4,418,910,000 which is $300,591,000 above

the fiscal year 2001 level and $413,402,000 above the budget request.

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.

The Committee commends CDC for the agency’s immediate response to the recent New York City and Washington, DC, tragedies. CDC sent a total of 71 staff, including 49 epidemiologists, occupational health specialists, and other public health professionals

to supplement local efforts and provide expertise and assistance to

New York City hospitals as directed by State and local health officials. CDC’s Health Alert Network distributed information to

health officials in New York City and around the country regarding

incident response and technical issues.

It is also the Committee’s understanding that CDC used the National Pharmaceutical Stockpile by deploying a ‘‘push package’’ of

emergency materials that arrived in New York City within 7 hours

of being requested. These materials included pharmaceuticals, intravenous supplies, airway supplies, emergency medication, bandages and dressings, which included 84,000 bags of intravenous

fluid and other intravenous supplies, as well as 350 portable ventilators and 250 stationary ventilators and other materials to cover

a spectrum of medical needs.

Birth Defects, Developmental Disabilities, Disability and Health

The Committee recommends $88,748,000 for birth defects, developmental disabilities, disability and health which is $18,015,000

above the fiscal year 2001 level and $12,468,000 above the administration request.

Birth defects are the leading cause of infant death in the United

States. More than 150,000 infants are born with birth defects each

year in the United States. The Child Health Act of 2000 created

CDC’s National Center on Birth Defects and Developmental Disabilities. This new center will expand existing surveillance, epidemiological research, prevention programs, and require support for

a broad range of functions.

The Committee recognizes CDC as the Nation’s leader in assisting States in monitoring for birth defects and developmental disabilities and improving the health and wellness of people living

with a disability. The birth defects and developmental disabilities

monitoring programs collect, analyze, and make available data on

the incidence and causes of birth defects and developmental disabilities.

The Committee has included funding for further epidemiological

research into Duchenne and Becker muscular dystrophy in the

United States. More extensive data on this disease will inform re-
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search decisions, standards of care formation, prenatal and infant

screening and medical education.

The Committee is aware of the University of Louisville Health

Science Center’s work to improve the diagnosis, treatment, and

prevention of birth defects. The Committee believes CDC could consider this center to be designated as a CDC National Center on

Birth Defects Research.

The Committee continues to be supportive of funding for the Alabama Birth Defects Monitoring and Prevention Center to be located

at the University of South Alabama to implement the objectives

outlined by the United States Birth Defects Act of 1998.

Attention Deficit/Hyperactivity Disorder.—The Committee is

aware of the importance of early identification and proper treatment of Attention Deficit/Hyperactivity Disorder (AD/HD) in the

prevention of serious consequences, including school and work failure, depression, conduct disorder, and substance abuse. The Committee supports the recommendations by CDC to establish a resource center for accurate and valid information about AD/HD for

the public and professionals, including resource dissemination on

evidence-based interventions for the disorder and has included sufficient funding to establish such a center.

Autism.—The Committee is concerned about the lack of information available on the prevalence, cause or effective treatment of autism. Basic data collection and verification is integral to better understanding the incidence of autism, the factors that may be associated with a higher rate of incidence, and effective treatment. The

Committee commends CDC’s initial efforts to conduct epidemiological research on autism in select States and has included sufficient

funds to expand those activities.

Disabilities Prevention Programs.—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.

The Committee commends CDC for its work with the Christopher Reeve Paralysis Foundation to establish an information and

support center and to reduce secondary disabilities among people

with paralysis. Sufficient funds are provided to continue this important project which will do much to prevent secondary complications associated with paralysis, resulting in improved outcomes and

quality of life for people living with paralysis.

Fetal Alcohol Syndrome.—Fetal Alcohol Syndrome (FAS), the

country’s leading known cause of mental retardation and birth defects, devastates the lives of as many as 12,000 newborn children

and their families each year. The Committee has included sufficient funds for CDC to: (1) develop guidelines for the diagnosis of

FAS and other negative birth outcomes resulting from prenatal exposure to alcohol; (2) incorporate these guidelines into curricula for

medical and allied health students and practitioners, and seek to

have them fully recognized by professional organizations and accrediting boards; and (3) disseminate curricula to and provide

training for medical and allied health students and practitioners

regarding these guidelines. The Committee recommends that CDC

coordinate its efforts with the National Task Force on Fetal Alcohol
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Syndrome, existing federally-funded FAS prevention programs, and

appropriate non-governmental organizations.

The Committee continues to encourage the agency to work with

the State of Alaska to develop a comprehensive statewide strategy

to prevent, detect and treat fetal alcohol syndrome and notes that

Alaska has the highest rate of fetal alcohol syndrome in the Nation.

Newborn Screening.—Recent advances in genetic screening for

newborns allow identification at birth of underlying conditions

which can cause or contribute to disease, disabilities, and death.

The Committee supports further research and demonstration

projects to facilitate the translation of new scientific knowledge into

applied newborn public health screening programs, particularly in

the areas of Fragile X Syndrome and Cystic Fibrosis. The Committee urges CDC to coordinate with HRSA in translating the results of these efforts into guidance for public health programs, including State newborn screening programs.

Special Olympics Healthy Athletes Initiative.—The Committee is

concerned regarding the unmet health needs among persons with

mental retardation. On March 5, 2001, a field hearing was held in

Anchorage Alaska, during the World Winter Special Olympics

Games. At that hearing, numerous witnesses, including persons

with mental retardation, expressed their frustration in securing

needed health services and the severe consequences of not being

able to obtain such services in a timely and appropriate way. Persons with mental retardation have more health challenges and

poorer access to health care than the rest of the population. As a

result, their lives are unnecessarily shortened and the quality of

their lives is severely compromised.

To address the unmet health needs among its athletes, Special

Olympics has 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 Games competitions at

local, State, national, and international levels.

The Committee strongly urges the CDC to establish a Special

Olympics Healthy Athletes Initiative. The Committee further urges

the CDC to have lead responsibility for this initiative, in collaboration with the Health Resources and Services Administration, National Institutes of Health, Agency for Healthcare Research and

Quality, Center for Medicare and Medicaid Services. The agencies

could examine existing programs and resources to determine appropriate actions that they may take, including studies and demonstration projects, to address the health challenges to persons

with mental retardation. The initiative should help train health

professionals and sensitize health care systems and institutions, as

to the health needs of persons with mental retardation; establish

clinical and program standards of care that meet the needs of individuals with mental retardation; expand systems to make them accessible to persons with mental retardation; help identify the nature and scope of health challenges and health access barriers to

persons with mental retardation; and create and test models for

athlete health promotion at the local level.
86

Chronic Disease Prevention and Health Promotion

The Committee recommends $701,654,000 for chronic disease

prevention and health promotion, which is $48,119,000 below the

fiscal year 2001 level and $127,094,000 above the administration’s

request.

The leading causes of death and disability (e.g., heart disease

and stroke, cancer, diabetes, and arthritis) are among the most

prevalent, costly, and preventable of all health problems. Seven of

every 10 Americans who die each year, or more than 1.7 million

people, die of these chronic diseases. Heart disease and stroke and

cancer account for two-thirds of all deaths. The prolonged course of

illness and disability from such chronic diseases as diabetes and arthritis results in extended pain and suffering as well as in decreased quality of life for millions of Americans. A relative 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.

The Committee recognizes that a greater effort is needed to control the leading causes of death and disability through the prevention of risk factors. Further, this Committee which consistently

strives to insure that adequate resources are available for biomedical research is committed to insuring that applied research is

adequately funded.

Anemia.—The Committee notes that iron deficiency in children

can result in delayed or stunted intellectual and physical development, and is disturbed to learn that Alaska Native children in

rural areas have a high prevalence of iron deficiency anemia. Recent evidence suggests that treatment of H.pylori infection with

antibiotics might lead to resolution of the anemia in some children.

The Committee encourages the agency to give consideration to a

proposal by the State of Alaska to reduce unacceptably high anemia rates among the Alaska Native children of southwestern Alaska, which includes a clinical trial to evaluate the ability of triple

therapy with antibiotics to treat iron deficiency anemia among children 2 to 5 years of age in western Alaska.

Arthritis.—The Committee notes that Congress established the

CDC arthritis program in 1999 following the development of the

National Arthritis Action Plan (NAAP). The CDC activities form

the backbone of a multi-pronged response to the Nation’s leading

cause of disability. Prior to this initiative, there was no coordinated

public health strategy to prevent and appropriately treat the over

100 forms of this painful, debilitating disease. Grants to States are

a core component of the CDC arthritis program. These partnerships promote the development of a State-based network of local

activities to confront the burden of arthritis. This approach also encourages the formation of broadly-based coalitions with health care

providers, community-based organizations, and other stakeholders

to coordinate and leverage their resources. The Arthritis Foundation chapters across the country have led this external effort. The

Committee has been supportive of increased funding for the arthritis program. The Committee recognizes that there is a rising demand among States for these programs and that CDC’s desire to
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provide a minimum level of funding to each participating State has

produced a shortfall of funds.

Cancer Prevention and Control.—Cancer is the second leading

cause of death in the United States. Since 1990, 13 million new

cancer cases have been diagnosed—including over 1.2 million new

cases in 2000 alone. Cancer costs the Nation $107,000,000,000 annually in direct and indirect costs. Screening tests for breast, cervical and colorectal cancer reduce the number of deaths from these

diseases, and screening tests for cervical and colorectal cancer can

actually prevent the development of cancer through the early detection and treatment of pre-cancerous conditions.

The Committee commends CDC for its efforts to begin to build

a coordinated focus for cancer efforts at the State level, CDC funds

five States and an Indian health board to develop comprehensive

cancer control programs. These States are building the foundation

for a nationwide, comprehensive cancer control program. Comprehensive cancer programs integrate the full range of cancer prevention activities including research, evaluation, health education

and communication, program development, public policy development, surveillance, and clinical services.

The Committee has included increased funding for comprehensive cancer control programs. Particular attention should be paid to

raising public awareness and enhancing professional education on

cancers not currently addressed by a CDC program. For example,

CDC is encouraged to develop an awareness campaign to educate

patients and practitioners about the symptoms associated with

lymphoma and the challenges of correctly diagnosing this complicated cancer.

The Committee also urges CDC to plan and implement awareness programs for orphan cancers for patients and community

oncologists. Patients diagnosed with these cancers, such as esophageal, kidney, liver, multiple myeloma, pancreatic, and stomach,

currently have the lowest life expectancy rates of all diagnosed cancers, yet community oncologists generally lack specific knowledge

about these malignancies. The Committee also encourages CDC to

establish, with the States, high-risk registries for the digestive cancers and other cancers with significantly low survival rates following diagnosis.

The Committee is aware of a CDC project at Swope Parkway

Health Center in Kansas City that is successfully targeting African

American women who are at high risk for breast and cervical cancer. The project is a collaborative effort between the Health Center

and community groups in reaching out to this at-risk population

through the dissemination, access to free testing, and the implementation of a screening follow-up program. The Committee urges

the CDC to continue its support for this program.

Chronic Fatigue Syndrome (CFS).—The Committee is pleased

that CDC has restored funding for CFS research, and that these

funds are being used in substantive areas of research and education. In particular, the Committee would like to commend CDC

on its collaborations with prominent CFS clinicians, Emory University researchers, and CFS advocates. The Committee supports efforts to develop and test an empirically derived case definition and
88

initiate a national CFS survey to estimate sex-, age-, race/ethnic-, and socioeconomic-specific prevalence of CFS.

The Committee strongly encourages CDC to provide the funds

and the infrastructure to support other aspects of its ‘‘reinvigorated’’ CFS research plan, which includes surveillance projects on

children, adolescents, and minorities with CFS; a national CFS patient registry; studies of etiologic agents, diagnostic markers, natural history, and risk factors using specialized molecular epidemiology techniques and advanced surveillance methodologies; and

CFS public education programs with special emphasis on general

public service announcements and expanded efforts to educate primary care providers about the detection, diagnosis, and treatment

of CFS.

The Committee recognizes CDC’s support of the DHHS CFS Coordinating Committee (CFSCC) and expect that CDC will continue

its support as the CFSCC transitions from a coordinating committee to an advisory committee.

Community Health Centers.—The Committee strongly urges the

utilization of Community Health Centers as an integral part for

the provision of primary care in medically underserved populations.

The Committee urges CDC to contract directly with the Hawaiian

Community Health Centers to provide primary health care for its

underserved populations, this includes an approval for expansion of

the Community Health Centers to Kaui.

Cooley’s Anemia.—Patients with Cooley’s anemia, or thalassemia,

are the most frequently transfused of all patients receiving blood,

often every 2 weeks. This makes them an effective ‘‘early warning

system’’ for problems in the blood supply. The Committee is aware

that CDC has created a program outline for establishing a blood

safety surveillance program, modeled on the universal data collection program used in hemophilia. The Committee encourages CDC

to provide sufficient funds to establish this program, which will

make a major contribution to the safety of the blood supply for all

Americans.

Diabetes.—The Committee remains acutely concerned about the

high incidence of diabetes within the Native American, Native

Alaskan and Native Hawaiian populations. The Committee urges

the CDC to continue to develop a targeted prevention and treatment program for these culturally unique yet similar groups. The

Committee encourages the CDC to continue to work with Native

Americans and Native Hawaiians to incorporate traditional healing

and develop partnerships with community centers as a safety net

during program development. The Committee is pleased with

CDC’s efforts to work with the leadership of Native Hawaiian and

Pacific Basin Islander communities in these efforts.

The Committee is also aware of a proposal from the Standing

Rock Sioux Tribe and Cheyenne River Sioux Tribe to establish the

Dakota Plains Diabetes Center.

The Committee acknowledges that the The Texas Tech Institute

for Diabetes Prevention and Control has been very successful in addressing high incidence of diabetes in the Southwest, and supports

its continued activities.

The Committee continues to be supportive of the National Diabetes Prevention Center in Gallup, New Mexico.
89

Dental decay.—The Committee urges CDC to further enhance its

oral health activities to reduce the disparity in treatment of oral

health diseases including dental decay, tooth loss, oral cancers,

gum disease, and oral conditions associated with chronic diseases

such as diabetes and heart disease. The Committee urges the CDC

to work with eligible entities to implement the oral health prevention programs of the children’s Health Act of 2000. The Committee

has included sufficient funding to allow States to assist communities that are initiating water fluoridation projects to apply for appropriate assistance.

Epilepsy.—Although the CDC has developed public health strategies to address epilepsy, additional investment is required to effectively implement these initiatives. The Committee has provided increased funding for CDC to enhance its epilepsy efforts, with a

focus on expanding disease surveillance; increasing public awareness activities; public and provider education; prevention research;

and, importantly, to more aggressively address the stigma often associated with the disorder. Further, the Committee recognizes the

recent commitment by CDC to partner with a national voluntary

health organization dedicated to improving the lives of persons

with epilepsy and expects CDC to work with this organization and

other consumer groups in implementing this public health initiative.

Glaucoma.—The Committee has included funds for CDC to develop a model project to test the efficacy of glaucoma screening

using mobile units. The Committee further suggests the program

establish protocols to conduct outreach, identify staffing needs, implement glaucoma screenings, as well as address other eye conditions, provide patient education regarding the management of glaucoma, and make appropriate referrals to eye care professionals. The

program should also include a rigorous evaluation of the strategy

to conduct glaucoma screening using mobile units including measuring the number of screenings conducted and outcome measures

of the projects effectiveness. Alternate strategies to achieve similar

goals should be explored to determine the most effective methods

to deliver glaucoma screenings in various communities. Moreover,

the evaluation component should address the effectiveness of mobile units as a method to address populations most in need of glaucoma screenings.

Health Promotion.—The Committee has included sufficient funds

to continue the pilot program, begun in fiscal year 2000, for an

interdisciplinary approach to mind-body medicine and to assess the

preventive health impact.

Heart Disease and Stroke.—Heart disease and stroke are the

leading causes of death in the United States among men and

women and of all racial and ethnic groups. Challenges to combating

these diseases include persistent geographic, racial and ethnic disparities; the increasing prevalence of sedentary lifestyles and obesity among all sectors of the American population, the growing

number of people with these diseases as the population ages, and

the under use of established effective treatments for those already

afflicted by heart disease and stroke.

The Committee commends CDC for publishing and distributing

‘‘Women and Heart Disease: An Atlas of Racial and Ethnic Dispari-
90

ties in Mortality’’, the first publication to show heart disease death

rates among women aged 35 years or older, county-by-county,

throughout the United States.

The Committee has increased funding for the WISEWOMAN program to allow the program to expand to up to 20 States. The

WISEWOMAN program builds on the CDC’s National Breast and

Cervical Cancer Early Detection Program to also screen women for

heart disease, stroke and cardiovascular disease risk factors such

as high blood pressure, elevated cholesterol, lack of physical activity and obesity. CDC also delivers dietary and physical activity

counseling to these women to improve their health and to prevent

cardiovascular diseases, the leading cause of death of American

women. Currently in nine States, the program has screened more

than 10,000 low-income and uninsured women ages 40–64 for heart

disease and stroke risk factors. From 50 percent to 75 percent of

these women were found to have either high blood pressure or elevated cholesterol.

Stroke remains America’s No. 3 killer, a major cause of permanent disability and a key contributor to late-life dementia. This

year, nearly 600,000 Americans will suffer a stroke, costing Americans an estimated $45,000,000,000 in medical expenses and lost

productivity. Nearly 4.5 million Americans live with the consequences of stroke; many are permanently disabled. Currently, the

drug tPA, is the only approved emergency treatment for clot-based

stroke, yet less than 5 percent of those eligible for tPA receive it.

As a result, the Committee has included funding for the Paul

Coverdell National Acute Stroke Registry, established by Congress

last year and designed to track and improve the delivery of care

to patients with acute stroke. The Committee encourages CDC to

continue to work with the National Institute of Neurological Disorders and Stroke, and the National Heart, Lung, and Blood Institute at the National Institutes of Health, the Brain Attack Coalition, and other professional organizations, including hospitals, universities, State and local health departments, and other appropriate partners experienced in the treatment of stroke to further

implement this registry.

The Committee is impressed with the continued success of the

Michael E. DeBakey Institute for the Integrated Study of Cardiovascular Disease and Biomedical Devices. This Institute has supported the development of life-saving heart pumps and other devices and combines the world-class expertise of Baylor College of

Medicine with the engineering and veterinary medicine expertise of

Texas A&M University.

Hemophilia.—The Committee is appreciative of CDC’s efforts last

year to restore funding to meet the disease management, prevention, and outreach needs of persons with hemophilia and bleeding

disorders, and in particular, women with bleeding disorders. The

Committee expects CDC to continue working with the national hemophilia foundation to strengthen these programs and its blood

safety surveillance. The Committee also understands that geno-typing of the hemophilia population is needed to speed identification

of inhibitors and facilitate the rapid translation of gene therapy

technologies into treatment and prevention efforts.
91

Immunodeficiency Diseases.—The Committee has included sufficient funds to continue and expand the CDC’s national education

awareness campaign with regard to primary immunodeficiency diseases, in collaboration with NICHD, NIAID, NCI, and private entities, to serve as a model for other genetic diseases. At a minimum,

the campaign should include development and distribution of educational materials to health care professionals and others likely to

inter-act with undiagnosed patients, development and distribution

of culturally competent materials for patients and their families, as

well as physician and public education efforts. The Director of CDC

should submit a report to the Committee prior to next year’s appropriation hearings outlining the progress that has been made to

date. The Committee is pleased that CDC is working to establish

a competitively awarded primary immune deficiency diseases national surveillance program.

Micronutrients.—Deficiencies of micronutrients such as iron, iodine, and vitamin A, affect nearly one-third of the world’s population, and result in reduced mental and physical development of

children, poor pregnancy outcomes, diminished work capacity of

adults, and increased morbidity and premature mortality among

populations. Effective and inexpensive interventions such as dietary diversification, food fortification and supplementation have

eliminated most micronutrient deficiencies in developed countries.

The Committee has provided sufficient funding for CDC to increase its efforts to eliminate micronutrient malnutrition. The focus

of these efforts is to support a number of national and international efforts to assess mirconutrient status of populations and

to monitor and strengthen implementation of interventions as well

as to assess the impact of the interventions over time. CDC has extensive expertise in epidemiology, monitoring and assessment, and

laboratory science; and these efforts reflect the unique contribution

that CDC can make to eliminate micronutrient deficiencies.

Multiple Sclerosis.—The Committee commends the University of

Texas-Southwestern Medical Center for its preeminent Comprehensive Multiple Sclerosis Center of Excellence and its new National

Multiple Sclerosis Training Center. This center is providing neurologists across the United States with intensive training on the

management of MS.

Nutrition, Physical Activity and Obesity.—Physical inactivity and

unhealthy diet patterns account for at least 300,000 preventable

deaths each year among Americans and increase the risk for many

chronic diseases. Most Americans do not engage in recommended

behaviors for healthy eating and physical activity. More than 60

percent of adults do not engage in levels of physical activity necessary to provide health benefits, and daily participation in high

school physical education has dropped from 42 percent to 27 percent in the last 6 years. Obesity has reached epidemic proportions.

In the past 15 years, the prevalence of obesity has increased by

over 50 percent among adults and 100 percent in children and adolescents. The cost of diseases associated with obesity is almost

$100,000,000,000 per year.

The Committee is concerned about the alarming increase in

childhood obesity and has provided $950,000 to CDC to fund a

study by the Institute of Medicine to assess the nature of childhood
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obesity in the United States and develop an action plan to decrease

its prevalence that focuses on prevention. The study should assess

the primary factors responsible for the increasing prevalence of

childhood obesity and identify the most promising methods for prevention.

The Committee is aware of the report of the Evaluation Group

on the national 5-A-Day for Better Health Program and the findings that eating fruits and vegetables reduces the risk of cancer,

cardiovascular, and other diseases. Given these findings, the Committee urges the Centers for Disease Control and Prevention (CDC)

and the National Cancer Institute (NCI) to jointly develop a comprehensive plan to strengthen and expand the 5-A-Day program.

The plan should address the policy, environmental changes, communications, State and community programs, research and evaluation, and surveillance and program channels such as mass media,

restaurants, supermarkets, schools, and faith organizations. The

plan should also address how best to use already-developed technologies to promote healthy eating.

The Committee is aware that Alaska ranks in the top five in the

Nation in its proportion of people who are obese. The agency is encouraged to give consideration to a pilot program proposed by the

State of Alaska to prevent and control obesity through the promotion of increased physical activity and improved nutrition.

The Committee is aware of the Children’s Health Life Skills Initiative at the University of North Carolina at Greensboro, which is

a multi-university effort to address obesity and chronic disease

among children.

Pancreatic Cancer.—The Committee encourages the CDC to work

with the National Cancer Institute to determine possible areas of

collaboration in epidemiology, translational research, and awareness and registry programs for pancreatic cancer. A report to the

Committee on initiatives in these areas should be submitted prior

to next year’s appropriations hearing.

Prevention Centers.—The prevention centers form a nationwide

network of academic institutions that conducts applied research designed to develop and test innovative strategies for health promotion and disease prevention. The primary goals of the program

are to identify risk factors, and to identify barriers and facilitators

to behavior change to demonstrate the effectiveness of prevention

interventions, to increase collaboration among agencies and community partners, and to train public health professionals in creative ways for preventing chronic diseases and other health problems. The Committee has included sufficient funds to expand the

number of prevention centers funded by CDC.

The Committee encourages the continued support of center activities aimed at improving knowledge about the usefulness and effectiveness of 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.
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For example, the West Virginia University Prevention Research

Center (PRC) worked with the American Lung Association, schools,

and communities in West Virginia and across the United States to

develop and evaluate a smoking cessation program for teenagers.

Controlled studies showed that 20 to 30 percent of participants

were smoke-free by the end of the year and young people who did

not completely quit significantly reduced their cigarette smoking.

This program is currently being used in many States, and the U.S.

Army plans to use the program in military high schools across Europe.

Compared to the Nation, Mississippi Delta residents disproportionately suffer from heart disease, cancer, diabetes, and other

chronic illnesses. The Committee is aware that the University of

Mississippi Medical Center and Delta State University have formed

a partnership concentrating on improving the health, education,

and economic opportunities of Mississippi Delta residents.

Prostate Cancer.—The Committee is aware that prostate cancer

is the second leading cause of cancer death among men in the

United States, and that the CDC’s prostate cancer awareness campaign plays a key role in screening, outreach, education, and treatment of men with this disease, especially those at high risk. The

Committee is pleased with these efforts and encourages CDC to expand this program to include the broader at-risk male population.

The Committee recognizes that early detection of prostate cancer

by the prostate specific antigen (PSA) test is likely to reduce disease mortality and therefore believes it is important to accelerate

programs that can benefit Americans at special risk of this disease.

In particular, the Committee encourages CDC to improve outreach

for early detection to populations at special risk. The Committee requests that CDC prepare a report describing how it plans to accelerate opportunities for early detection of prostate cancer as well as

linkages to appropriate and accessible treatment for the medically

underserved. It is further expected that CDC will consult closely

with the research community, public health community, clinicians,

patient advocacy groups, and the Congress in preparation of this

report.

Pulmonary Hypertension.—The Committee continues to be interested in pulmonary hypertension, a rare, progressive and fatal disease that predominantly affects women, regardless of age or race.

Pulmonary hypertension 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 provided

funding for public and professional awareness of pulmonary hypertension in the fiscal year 2001 Conference Agreement, and expects

CDC to report on the progress made to initiate this program by December 31, 2001.

Safe Motherhood.—The Committee urges the National Center for

Chronic Disease Prevention and Health Promotion and the National Center for Health Statistics to work together to review the

Pregnancy Risk Assessment Monitoring Survey with the intent of

expanding this survey, and to explore the possibility of a mandatory reporting requirement to track the medical care and interventions that women receive during pregnancy and delivery.
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School Health.—The Committee supports CDC’s efforts to expand

coordinated school health programs that reduce chronic disease

risk factors including poor eating habits, physical inactivity, and tobacco use. The Committee recognizes that children are our most

valuable resource and schools represent an opportunity to provide

our children with valuable health skills. The Committee further

recognizes that significant research has demonstrated that tobacco

prevention programs in schools can lower smoking rates among

teenagers.

Sudden Infant Death Syndrome.—The Committee notes the work

of CDC, the National Institute of Child Health and Human Development and HRSA in developing model guidelines for death scene

protocol for Sudden Infant Death Syndrome. The Committee encourages CDC to implement projects to demonstrate the effectiveness of the death scene protocol in a variety of locales (urban, suburban, and rural) throughout the Nation. The Committee expects

CDC to be prepared to report on progress on this initiative during

the fiscal year 2003 budget hearings.

Tobacco Use.—Tobacco use is the single most preventable cause

of death and disease in the United States; it is responsible for more

than 430,000 deaths each year at an annual cost of nearly

$100,000,000,000. Every day 3,000 young people become regular

smokers, and it is anticipated that of today’s children, 5 million

will die prematurely if current smoking trends continue. In addition, the Committee recognizes the consequences of tobacco use

have become an issue of global concern far beyond the confines of

national boundaries. The global tobacco epidemic will become the

leading cause of preventable and premature death worldwide.

It has been brought to the Committee’s attention that Alaska Native teens use tobacco at rates much higher than the national average and begin using tobacco as early as age 5. The Committee encourages the agency to consider the ‘‘Challenge to Quit’’ program

operated by the Alaska Native Health Board which offers incentives for Alaska Native teenagers to quit using tobacco. The Committee is also disturbed to learn that tobacco use in the YukonKuskokwim delta region of Alaska is among the highest in the Nation, including more than 40 percent of pregnant women, and also

encourages the agency to work with the Alaska Native Health

Board in partnership with the Yukon-Kuskokwim Health Corporation, on a tobacco cessation program in the Yukon-Kuskokwim

delta region of Alaska.

Tourette Syndrome.—The Committee recognizes that Tourette

Syndrome is a commonly misdiagnosed disease, and has learned of

the Tourette Syndrome Association’s efforts to educate health care

professionals about this condition. The Committee supports these

efforts, and urges CDC to support these activities with a focus on

medically under served communities.

Youth Media Campaign.—The Committee has not included any

funding for the youth media campaign. The Committee is aware

that CDC is implementing the first year of a youth media campaign that uses principles of marketing and communications strategies to influence America’s children to develop habits that foster

good health over a lifetime—including physical activity, good nutrition, and the avoidance of illicit drugs, tobacco, and alcohol. CDC
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is working with marketing and media experts to design and implement a media campaign for cable or broadcast television programs

as well as on an interactive Web site.

Environmental Health

The Committee recommends $171,683,000 for environmental

health activities which is $34,584,000 above the fiscal year 2001

level and $35,180,000 above the administration 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. Pfiesteria piscicida, an organism implicated in major

fish kills at sites in the eastern United States, may cause a variety

of health problems as well as impact local economies. Outbreaks of

water-borne diseases such as cryptosporidium show the vulnerability of our water purification systems. 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 are harmful to humans, and at

what level of exposure. Many scientists estimate that about twothirds 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.—CDC’s asthma activities focus on three areas: tracking

the disease to improve the Nation’s ability to determine asthma

prevalence, severity, and management; assuring that interventions

are based on science; and working to address this problem through

partnerships including providing technical assistance to non-governmental organizations to carry out diverse community-based

childhood asthma control programs.

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, particularly inner city minorities, 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 minorities

populations in under served communities. The Committee also encourages CDC to work with other Public Health Service agencies

at NIH, HRSA, and the Office of the Surgeon General to develop

a PHS-wide plan to control asthma. The Committee has provided

sufficient funds to allow CDC to increase the numbers of States

covered by this program and to fund additional community-based

interventions that apply effective approaches demonstrated in research projects within the public health community.

As with the rest of the United States, there is an increase in the

prevalence, incidence, and severity of asthma throughout Hawaii,

especially in its medically underserved population. Because of this

the Committee urges the CDC to contract with Hawaiian Community Health Centers in order to provide proper health care in the

treatment of asthma throughout Hawaii.
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Childhood Lead Poisoning Prevention.—Since its inception in fiscal year 1990, the CDC program has expanded to approximately 40

project areas that encompass States, local areas, and numerous

communities and screens an estimated 1.75 million children annually. The program has developed its first Geographic Information

System (GIS) website using U.S. Census data on income, race, and

old housing to help State and local health departments identify

high-risk geographic areas. The availability of such information

will result in more efficient, targeted screening.

The Committee is aware of the portable, easy to use lead screening device developed with the support and participation of the

CDC. The Committee continues to believe that this device holds

great promise for increasing childhood screening rates in under

served communities and encourages CDC to support its further development for widespread application in community public health

settings.

The Committee notes the success that CLEARCorps/USA has

had in helping communities and families protect their children

from lead poisoning.

Childhood Leukemia.—The Committee is aware of the integral

role that CDC and ATSDR have played in helping the Nevada

State Health Division’s efforts to understand and address the outbreak of childhood acute lymphocytic leukemia (ALL) in Fallon, Nevada. CDC officials assisted the Health Division to develop a tool

to survey the families of Fallon children with ALL for any information suggestive of features, experiences, or exposures in common

among them. Officials from the centers also served on the Health

Division’s Expert Panel, a body that has provided the State with

guidance on advancing the investigation into the ALL outbreak.

More recently, CDC and ATSDR have been developing protocols for

the study of contaminants in human tissue, soil, air, and dust in

the Fallon community. It is anticipated that the study will be implemented later this summer. Given the limited resources available

to Nevada State health officials to continue the investigation into

the cause(s) of the Fallon childhood ALL outbreak, the Committee

strongly urges the CDC and ATSDR to continue to support Nevada

State health officials in their investigation.

Environmental Health Activities.—CDC’s environmental epidemiology activities include conducting national and international epidemiological studies on the association between health effects and

groundwater contamination; collecting and analyzing data on the

off-site migration of chemical contamination and resistant microbes

from concentrated animal feeding operations; providing consultation on pesticide use in vector-control programs; conducting human

pesticide exposure studies; developing sensitive biomarkers of pesticide exposure; and collaborating with EPA, academia, and State

and local health departments in several pesticide-related activities.

The genetics and disease prevention program is creating centers

for genomics and public health within schools of public health to

evaluate and disseminate information on gene-disease associations,

gene-environment interaction, and genetic tests and to provide

technical assistance and training for State and local public health

programs. CDC will incorporate genetic discoveries about human

disease into effective public health actions that identify ways to use
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this new knowledge in chronic and environmental disease prevention.

The Committee recognizes the need for scientific investigation of

the link between environmental contaminants and diseases in both

humans and ecosystems. The Committee is aware the University of

Mississippi Medical Center, in collaboration with University of Mississippi at Oxford, has a program focusing on the association between chemicals in the environment and the onset of disease

among residents living in the Mississippi River basin.

The Committee is supportive of the efforts of the University of

Montana, Missoula’s Center for Environmental Health Sciences.

The University is studying the impact of environmental factors

causing or exacerbating human health conditions in an effort to (1)

discover new or better treatments, (2) better assess the actual risks

caused by environmental agents, and (3) improve methods to reduce the adverse health impacts of these environmental agents.

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.

The Committee recognizes CDC for its commendable work in

analyzing toxic exposures throughout the United States. The Committee further recognizes that CDC’s environmental laboratory is

unprecedented in the world for measuring toxic exposures to humans and further commends CDC for publishing the National Report on Human Exposure to Environmental Chemicals, which provides information about the U.S. population’s exposure to 27 toxic

substances, including heavy metals and certain pesticides.

The Committee supports the CDC biomonitoring program and

study of environmental toxins and their relationship to chronic diseases, such as asthma, many birth defects, and cancer to increase

our understanding of the cause of many chronic diseases and conditions and to facilitate the development of effective prevention strategies. CDC should continue to pursue the development of a coordinated system among all the States to identify and track disease

and conditions caused by exposure to environmental toxins.

Health Tracking Network.—In fiscal year 2001, the Committee

requested that the Centers for Disease Control and Prevention

(CDC) develop a plan for a coordinated Nationwide Health Tracking Network among all States to identify and track chronic diseases and their related environmental factors. Across the Nation

there is a serious lack of trained personnel and modern technology

dedicated to responding to the very real health emergencies that

face our communities. State and local health departments need epidemiologists, environmental health specialists, chronic disease investigators, technical resources and regional laboratories to track

chronic disease and evaluate community exposures.

The Committee has included funding to develop pilot programs

in States as a first step in the development of a Nationwide Health
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Tracking Network. The pilot projects would include support for

State health departments to develop and operate a comprehensive

and coordinated State health tracking network, increased capacity

at regional environmental laboratories and State environmental

health investigators to lead rapid response teams when a disease

cluster or other health emergency is detected. Finally, these funds

would allow CDC, working in close coordination with State and

local public health officers, environmental specialists and other relevant parties, to begin to develop national standards and protocols

for tracking priority chronic disease as part of the Nationwide

Health Tracking Network.

Rural Health.—The Committee is greatly concerned about the

health status of the residents of rural communities. The Committee

encourages CDC to conduct an assessment of rural health problems, in particular, those that may be related to concentrated animal feeding operations. Potential health indicators should be identified and collected for selected areas that reflect the general health

status or well-being of the community. Analyses of the data should

be undertaken to identify potential causes of illnesses that may require further investigation. The Committee encourages the agency

to conduct the assessment in Iowa where rural communities reflect

many of the health problems suffered by rural residents nationwide.

World Trade Center and Pentagon Emergency Workers.—The

Committee has included funding for monitoring the health of workers directly involved in rescue and response efforts associated with

the terrorist attacks of September 11, 2001, at the World Trade

Center in New York City and the Pentagon, in Arlington, Virginia.

CDC should coordinate its efforts with the Federal Emergency

Management Agency, the Environmental Protection Agency, the

Department of Labor, the State of New York, the City of New York,

Arlington County and affected labor organizations. Such efforts

shall include baseline and long-term health monitoring of individuals directly involved in rescue and response efforts. The purpose

of this demonstration is to study the long-term health impacts associated with rescue and response efforts at the World Trade Center and the Pentagon.

Thyroid Cancer.—The Committee has included sufficient funds to

continue the next phase of a study on radioactive Iodine-131 and

thyroid cancer. This study will look at individuals exposed to fallout from the Nevada Nuclear Weapons Test Site.

Epidemic Services and Response

The Committee recommends $85,303,000 for epidemic services

and response which is $7,506,000 above the fiscal year 2001 level

and $5,000,000 over the administration’s request.

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 scientific basis of this program
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is applied epidemiology, in concert with other components of sound

public health practice. Findings from these disciplines enable

States, health organizations, foreign ministries of health, and others in the health field to make sound decisions and create effective

policy. Information derived from epidemiologic data and scientific

reasoning provide public health programs with an objective rationale to set priorities, apply interventions and policies, and evaluate

public health programs. Within the epidemic services and response

program, CDC carries out a variety of applied research and development activities. Areas of research include: social determinants of

health; aberration detection; burden of disease; injury, and death;

prevention effectiveness; and health care quality. The Committee

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.

Health Statistics

The Committee recommends $126,978,000 which is $5,012,000

above fiscal year 2001 and the same as the administration request.

CDC’s statistics give us context and perspective on which we can

base important public health decisions. By aggregating the experience of individuals, we gain a collective understanding of our

health, our 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 Committee urges CDC to continue to prioritize current

health information which is needed in all sectors of society as a

prerequisite for planning, action, and evaluation, and can lead to

improvements in health and quality of life. In this time of rapid

change in health and welfare policy, medical practice, and biomedical knowledge, it is important to make the investments necessary to monitor trends so that we can assess the impact of these

changes and guide policy.

The Committee is pleased that NCHS continues working with

the National Center for Infectious Diseases to implement a primary

immune deficiency national surveillance program.

HIV, STD, and TB Prevention

The Committee recommends $1,121,612,000 which is $77,463,000

above the fiscal year 2001 level and $53,160,000 above the administration request.

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
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collaboration with partners at community, State, national, and

international levels, applying well-integrated, multi-disciplinary

programs of research, surveillance, technical assistance and evaluation. These diseases are not vaccine preventable and must be controlled and prevented through identifying, diagnosing, and treating

infected persons; through provision of confidential, culturally competent counseling to identify and reach those who have been exposed to infection and who may not know it; and through individual and population level health promotion to reduce high risk

behaviors.

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.

The Committee urges that racial minorities be more fully targeted and included in HIV prevention efforts. The Committee urges

CDC to consider allocating increased resources to address the HIVrelated health disparities in ethnic and racial minority populations.

In particular, CDC should continue to target support for minority

community-based organizations and minority regional and national

organizations including education, technical assistance, infrastructure, capacity building, community development, and public health

initiatives.

According to the CDC, between 4 million and 5 million people in

the United States are at continued behavioral risk for HIV infection. The Committee recognizes that this is a low estimate due to

under-reporting by participants and the lack of inclusion of schools,

prisons, and the military. Communities must be better equipped

with local data to identify and direct resources to those most at

risk. They must have an array of effective interventions available

and the capacity to implement and evaluate them at the local level.

They must also be able not only to address barriers and deter risky

behavior but also to encourage health promotion behavior through

a variety of individual and group interventions, community-level

supports, and structural level changes. Because those at risk for or

living with HIV infection are often also at risk for other health

problems, HIV prevention must be integrated with other services

such as STD and TB screening and treatment, reproductive health

services, mental health services, and drug use prevention and

treatment. Therefore, the Committee urges CDC to give its HIV

Strategic Plan high priority, especially with regard to behavioral

research, development, implementation, and evaluation of prevention and intervention programs for at-risk subpopulations, such as

racial and ethnic minorities, adolescents, women, sex workers, substance abusers, and incarcerated individuals.

The Committee is concerned regarding the level funding received

by the HIV school health program during the last decade compared

to the increased funding for HIV activities. Significant increases in

the HIV epidemic in the United States during the same period disproportionately affect adolescents and young adults who can benefit from school and university based HIV prevention programs. Of

the increase provided for HIV/AIDS programs, the Committee di-
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rects CDC to increase school health HIV funding to a level that is

consistent with the increased cost of living since 1991.

Oral fluid testing is one of the newest and most revolutionary advances in diagnostic testing. Recent technological advances have resulted in a rapid oral fluid test, currently in FDA clinical trials,

that will indicate HIV/AIDS status within 20 minutes. The Committee is aware that, with some level of attention by the Centers

of Disease Control, this test could be adapted to a variety of infectious diseases, including those resulting from biological warfare or

bioterrorism.

The Committee is aware of the growing incidence of HIV/AIDS

along the United States-Mexico border and the greater difficulty

health providers have in identifying and treating individuals in

this region. The Committee understands that University of Texas

Health Sciences Center-Houston could establish a Center for HIV

Research and Education to better understand and respond to the

unique demographic characteristics and needs of this population to

help prevent the further spread of AIDS

Global HIV/AIDS.—CDC’s international work is conducted in

collaboration with USAID and other Federal agencies. In fiscal

year 2000 CDC began to implement prevention activities and programs in 15 countries, including India and 14 countries in Africa.

In fiscal year 2002, CDC will expand activities to Latin America

and other countries in Africa and Asia. The Committee has included bill language that will allow CDC to carry out international

health activities, including HIV/AIDS.

HIV/AIDS and other diseases such as hepatitis are spread in

sub-Saharan Africa by blood transfusion. Testing sub-Saharan African blood using FDA approved blood transfusion testing technologies is important. Since testing will deteriorate the available

blood supply in sub-Saharan Africa, funding for the development of

donor and transfusion facilities with trained staff would ensure an

adequate safe blood supply and safe transfusion practices. Funding

initiatives vis-a ́-vis blood testing must include the comprehensive

training of African nationals to staff testing laboratories and donor

facilities.

The Committee urges CDC to fund microbicide research and development within funds provided for global AIDS. These funds

could support clinical trials of microbicides as set forth in CDC’s

HIV Prevention Strategic Plan and its topical microbicides 5-year

research agenda.

Sexually transmitted diseases.—CDC’s strategy for STD prevention is to provide national and international leadership through research, surveillance, policy development, and assistance to States,

territories and local health departments in the delivery of services

to prevent and control the transmission of STDs and their complications. The Committee recognizes that this year, more than 15

million Americans will contract a STD. This epidemic will disproportionately affect adolescents, women, and people of color. The

epidemic will tally $8,400,000,000 in direct costs, along with immeasurable human costs in pain and suffering. National surveillance of syphilis, chlamydia, and gonorrhea is supported, and sentinel surveillance strategies are being developed for new viral

STDs, specifically, human papillomavirus. Prevention research is
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conducted to improve methods and delivery of prevention services

and to develop and refine interventions.

The Committee commends CDC in its work in this area and recognizes that STD prevention programs are highly effective. Two

major foci of national STD prevention efforts are syphilis elimination and prevention of STD-related infertility. CDC has undertaken an initiative to eliminate syphilis in the United States by

2005 which builds upon existing STD programs and takes advantage of the opportunity afforded by historic lows in syphilis rates.

Given the continuing high prevalence of chlamydia in the United

States and the need to expand screening and treatment efforts, the

Committee has included increased funding for this program and directs that this increase be used to provide services to all regions

of the country, with each region receiving the same percentage increase.

The Committee is concerned regarding the lack of adequate surveillance of HIV–STD among American Indian, Alaska Native, and

native Hawaiian populations, and encourages CDC to work in consultation with tribes, urban programs, and the Indian Health Service to develop a more effective surveillance strategy.

Tuberculosis Elimination.—CDC works with local, State, national, and international partners towards the goal of eliminating

TB. In addition to promoting the more effective use of existing tools

for combating TB, CDC is working with NIH and FDA to develop

new diagnostic and treatment tools as well as better vaccines.

The Committee commends CDC for its continued efforts to control tuberculosis (TB) in the United States, as demonstrated by the

eighth year of declining TB trends reported for 2000. However,

with the recent release of the Institute of Medicine’s report ‘‘Ending

Neglect: the Elimination of Tuberculosis in the United States,’’ the

Committee remains concerned about the threat of TB and multidrug resistant tuberculosis. The Committee is also concerned that,

until global control efforts are more effective and new treatments

and effective vaccines are developed, the global crisis on TB will

continue to directly impact the United States. Therefore, the Committee encourages CDC to continue to work with domestic partners

to maintain strong prevention and control programs. In addition,

the Committee encourages CDC to work with international partners to assure the success of international control programs, and

to encourage and support, when possible, the development of new

TB treatments and the development of a new effective TB vaccine.

The Committee is pleased with CDC’s program to control TB

along the United States-Mexico border. CDC is collaborating with

the Mexican National Public Health Laboratory Program and the

Association of State and Territorial Public Health Laboratory Directors to coordinate laboratory training between United States

and Mexican laboratorians. CDC also provides funding to State and

local health departments which supports several border health activities. The Texas-Mexico bi-national border projects are designed

to reduce TB by co-managing TB cases and their contacts.

The Committee is aware of the County of San Diego’s program

that provides treatment to multi-drug resistant TB patients along

the northern Mexico border with California and encourages CDC to

give full and fair consideration to this program.
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Immunization

The Committee recommends $637,145,000 for the program authorized under section 317 of the Public Health Service Act which

is $84,540,000 above the fiscal year 2001 level and $62,500,000

above the administration request.

The Omnibus Reconciliation Act [OBRA] of 1993 established a

new 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. Included in

the Medicaid estimate for fiscal year 2002 is $796,193,000 for the

purchase and distribution of vaccines, which when combined with

the section 317 discretionary funding totals $1,370,838,000.

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 the Maine Immunization Registry

Demonstration Project proposes a comprehensive, secure and detailed technological infrastructure to maintain databases that enroll children at birth and store information on each immunization;

consolidate scattered immunization records; and transfer immunization records confidentially to patients’ new providers to prevent

the costly and clinically inappropriate duplication of vaccine administration.

Global Immunization Activities.—Included in the amount for immunization are funds to continue CDC’s global immunization activities, which include additional funds for polio vaccine and sur-
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veillance to augment support for the highly successful, yet unfinished polio eradication efforts; support 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;

and establishing CDC’s program activities as a partner in the Global Alliance for Vaccines and Immunization (GAVI). Measles and

GAVIactivities should build on the global disease control and surveillance infrastructure developed for polio eradication.

Infectious Disease Control

The Committee recommends $331,518,000 for infectious disease

control which is $13,844,000 above the fiscal year 2001 level and

the same as the administration request.

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.

Infectious diseases are a leading cause of death worldwide, accounting for 1/4 to 1/3 of the estimated 54 million deaths in 1998.

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.

The Committee is aware that in 1995, in partnership with Federal, State, and local agencies, universities, private industry, foreign governments, the World Health Organization (WHO), and

many non-governmental organizations, CDC launched the first

phase of a nationwide program to revitalize national capacity to

protect the public from infectious disease threats. The second phase

of CDC’s effort, ‘‘Preventing Emerging Infectious Diseases: A Strategy for the 21st Century’’, published in 1998, continues these partnerships to build domestic and global capacity for recognizing and

responding to infectious diseases.

Approximately 11 million people live along the 2,000-mile Southwest border between the United States and Mexico in the States

of New Mexico, Texas, Arizona, and California. With rapid population growth, cross-border interchange, and low socio-economic

status in many border areas, public health and safety is an ongoing

concern. The Committee encourages CDC to expand its investment

in the Border Infectious Diseases Surveillance (BIDS) program to

provide increased personnel, equipment, training, and technical

support to better monitor public health conditions and safety along

the Southwest border.

The Committee recognizes the excellent work being done at the

University of Texas Medical Branch-Galveston and at the University of Texas Health Center-Tyler in the treatment and control of
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infectious disease, particularly along the United States/Mexico border.

The Committee is aware of the Center for Emerging Infectious

Diseases at the University of New Mexico and its work in biological

detection and intervention against emerging infectious diseases.

Antimicrobial Resistance Initiative.—The Committee is concerned

about the development of resistance in microbes to current antimicrobial therapies. Bacterial resistance to common antimicrobial

agents has become one of the most serious emerging infectious disease threats facing communities and the health care system in the

United States. To combat this national health threat, the Committee recognizes the need to discover and develop new pharmaceutical products to combat these drug resistant microbes. The

Committee notes that the University of Mississippi, a leader in

antimicrobial research and new compound discovery, has been

working with CDC on this issue and urges CDC to give consideration to continuing this partnership.

The Committee also recognizes the excellent work of Southern

Methodist University in modifying antibiotics to make them more

effective at combating human bacterial infection without causing

antibiotic resistance.

Bacterial Infections.—According to CDC, 65 percent of the bacterial infections treated by physicians in the developed world are

caused by biofilms. The Committee understands that the Center for

Biofilm Engineering at Montana State University is prepared to

undertake research in the etiology and control of middle ear infections and encourages CDC to give full and fair consideration to this

proposal.

Food Safety.—CDC established PulseNet in 45 State health departments. PulseNet is a national network of public health laboratories that performs DNA ‘‘fingerprinting’’ on bacteria that may be

foodborne. The PulseNet network has revolutionized foodborne disease surveillance by allowing near real-time comparison of these

‘‘fingerprint’’ patterns through an electronic database at CDC.

Matching patterns can indicate possible nationwide outbreaks and

provide an early warning for public health investigation and intervention. The Committee is pleased that CDC has developed and

implemented a state-of the art diagnostic and communications system to improve parasitic disease diagnoses in the United States.

This system, known as DPDx, uses Internet communication to rapidly exchange diagnostic images of parasites digitally captured

from microscopic slides. Using DPDx, public health laboratories can

obtain diagnostic assistance in real time, allowing for rapid identification of possible outbreaks.

The Committee is aware of concerns raised within and outside

Alaska about the safety of Alaskan wild foods. The Committee encourages the agency to give careful consideration to a State of Alaska program to monitor the safety of Alaskan wild foods, including

field studies of the effects of environmental chemical contaminants

and naturally occurring metals in Alaskan wild foods, measurement of PCB levels in remote arctic communities, documentation of

mercury levels in ancient humans, documentation of incidence of

childhood asthma, and development of public health recommenda-
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tions on Alaskan wild food consumption by subsistence users and

others.

Global Malaria Initiative.—The Committee continues to recognize the tremendous impact of malaria in the developing world,

and notes malaria’s increasing resistance to antimalarial drugs designed to counter its pervasive effects. New drugs must be developed, and the Committee urges the CDC to continue its efforts to

lead in new compound discovery. The Committee notes that the

University of Mississippi has been working collaboratively with the

CDC to address research in the area of malaria, along with TB and

HIV/AIDS. The Committee encourages CDC to give full consideration of these projects and to continue its important research in

this area.

Hawaiian Patients with End Stage Renal Disease.—The Committee is aware that many Native Hawaiian in rural Hawaii afflicted with End Stage Renal Disease (ESRD) and on dialysis have

a history of repeated infections that put them at greater risk for

frequent hospitalization. The Committee encourages CDC to consider a demonstration project in Hawaii to reduce the incidence of

infection in this patient population.

Hepatitis C.—The Committee encourages funding for the National Hepatitis C Prevention Strategy, a public health initiative to

control and reduce the incidence of Hepatitis C. This funding will

begin to develop State-based programs by funding public health

Hepatitis C coordinators in all 50 States, plus 15 large metropolitan areas and demonstrations in 15 States to learn the most feasible approach to integrating Hepatitis C and B screening, counseling and referral programs into the existing HIV–STD State programs. The Committee is pleased that the demonstrations include

funding for screening, counseling, and referral services, but is concerned that no such services are funded in the remaining States

and that even the demonstrations only provide the more comprehensive services in selected areas of the 15 demonstration

States. The Committee therefore requests that the CDC submit by

January 15, 2002 an implementation plan for a full response to the

need for Hepatitis C prevention.

The Committee continues to be highly interested in supporting

the Secretary’s ‘‘lookback’’ initiatives regarding screening and counseling for people who may have been infected with Hepatitis C

through blood transfusions before 1992. The Committee is aware

that CDC is supporting an evaluation of the adequacy of ongoing

efforts to screen and counsel these individuals and believes it is

critical that such an assessment be made at least quarterly and

made public. The Committee again calls on CDC to assure that

those potentially infected receive appropriate counseling and

screening and encourages CDC to develop a centralized national

screening program supported by a toll-free telephone number-based

operation, involving risk assessment, convenient screening and

counseling. Under this program, persons receiving lookback notification letters would be advised of the hotline service that provides

education and telephone counseling and coordinates convenient

testing.

Lyme Disease.—The Committee is deeply concerned about the

safety of the Lyme disease vaccine (LymeRix). Over 1,000 adverse
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event reports were filed with the Food and Drug Administration

from December 1998 to October 2000. The Committee encourages

CDC to work closely with the FDA to ensure that all adverse event

reports are thoroughly and expeditiously investigated to ensure

public safety as the vaccine is being distributed. Investigators

should pay particular attention to patients’ reports of arthritis

when evaluating these reports.

The Committee recognizes that the current state of laboratory

testing for Lyme disease is very poor. The situation has led many

people to be misdiagnosed and delayed proper treatment. The vaccine clinical trial has documented that more that one third (36 percent) of the people with Lyme disease did not test positive on the

most sophisticated tests available. The ramifications of this deficit

in terms of unnecessary pain, suffering and cost is staggering. The

Committee directs CDC to work closely with the Food and Drug

Administration to develop an unequivocal test for Lyme disease.

The Committee is distressed in hearing of the widespread misuse

of the current Lyme disease surveillance case definition. While the

CDC does state that ‘‘this surveillance case definition was developed for national reporting of Lyme disease: it is NOT appropriate

for clinical diagnosis,’’ the definition is reportedly misused as a

standard of care for healthcare reimbursement, product (test) development, medical licensing hearings, and other legal cases. The

CDC is encouraged to aggressively pursue and correct the misuse

of this definition. This includes issuing an alert to the public and

physicians, as well as actively issuing letters to places misusing

this definition.

The Committee recommends that the CDC strongly support the

re-examination and broadening of the Lyme disease surveillance

case definition by the Council of State and Territorial Epidemiologists. Voluntary and patient groups should have input into this

process. Currently there is just one definition (‘‘confirmed case’’) of

seven possible categories. By developing other categories while

leaving the current category intact, the true number of cases being

diagnosed and treated will be more accurately counted, lending to

improved public health planning for finding solutions to the infection.

The CDC is encouraged to include a broad range of scientific

viewpoints in the process of planning and executing their efforts.

This means including community-based clinicians with extensive

experience in treating these patients, voluntary agencies who have

advocacy in their mission, and patient advocates in planning committees, meetings, and outreach efforts.

Mosquito surveillance and research.—The Committee urges the

CDC and related State and local mosquito control agencies participating in CDC research into mosquito borne illnesses to utilize

emerging technologies, including counterflow technology, in the collection, trapping or surveillance of mosquitos used in connection

with such research. Emerging technologies developed for trapping

mosquitos offer environmentally sound alternatives that have the

potential to increase the productivity of personnel and enhance the

quality of specimens collected for this research.

Prevention Epicenter Program.—The Committee applauds CDC’s

support for the Prevention Epicenter Program and encourages CDC
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to continue and expand this program to address patient safety

issues.

Research and Development of Improved Vaccine Delivery Mechanisms.—Particularly in light of the recent terrorist attack, there is

a pressing need to improve the availability of vaccines. The Committee is aware of exciting new work by the Oral Vaccine Institute

to develop delivery mechanisms that allow vaccines currently only

administered by injection to be given orally. These and other potential improvements would significantly reduce costs, and improve

transportability and ease of storage. The Committee expects CDC

to expand its efforts in this area.

West Nile Virus.—The Committee is aware of CDC’s effort to

complete a national plan for West Nile virus response in the

United States. That includes developing a computerized national

surveillance system for West Nile virus and provides funds to 53

health departments to build national capacity to develop and implement effective surveillance, prevention, and control of West Nile

virus in the United States.

Injury Prevention and Control

The Committee recommends $146,655,000 for injury prevention and control which is $3,805,000 above the 2001 level and

$3,000,000 above the administration request.

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.

The Committee is aware that accidental injury is the leading

cause of death for Alaska children and teens. The injury fatality

rate for Alaskan children exceeds the national average by 60 percent. The Committee encourages the agency to give careful consideration to a proposal by the State of Alaska to collect and analyze

data on injury occurrence, scientifically examine childhood death,

and, working with the Alaska Injury Prevention Center, provide

targeted community-based interventions to reduce the incidence of

childhood injury and death.

Injuries Among the Elderly.—By 2020, one in six Americans will

be age 65 or older and every day, more than 100 older persons die

from an injury. The three leading causes of injury deaths among

older adults are falls (9,000 per year), motor vehicle collisions

(7,000 per year), and suicide (6,000 per year). In addition, hundreds

of thousands of older adults suffer non-fatal injuries every year

(350,000 from falls; 170,000 from motor vehicle crashes). Many if

not most of these are preventable. The Committee is pleased that

CDC and its public and private partners are making tremendous

progress in injury prevention and control. CDC’s strategy includes
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implementing successful safety programs into more States, communities, and businesses; communicating what works to safety organizations, health care providers, and the public; and conducting research to find out why people get injured, what works to prevent

injuries, and how to get people to use interventions that are successful.

Injury Control Research Centers.—The Committee recognizes the

need for an additional Injury Control Research Center in Federal

Region 7, and has included sufficient funds for an additional injury

control center in Iowa. Preference should be given to applicants

with proven injury center experience. The Committee is aware that

injury ranks as one of the Nation’s most pressing health problems

accounting for 150,000 deaths and 38 million emergency room visits per year. The Committee believes that rural populations have

special and underserved needs in injury control. These funds would

address the pressing needs to control morbidity, disability, death,

and costs associated with injury in rural populations.

National Violent Death Reporting System.—In fiscal year 2001,

Congress called for CDC to develop a system for more timely, complete, objective and accurate information about violent deaths and

injuries to inform and evaluate policy and program efforts. The

Committee is pleased that, during the past year, CDC has worked

with the Department of Justice and a variety of interested groups

to develop a model plan to implement a national violent death reporting system (NVDRS) that will enable State governments to understand more about the violence problem in their States. The

Committee urges CDC to begin initial implementation of the Plan

and has provided funds for that purpose.

The Committee is aware of the progress made by the University

of Pennsylvania, which sponsors injury reporting in Iowa and Ohio,

and efforts being made by the University of Maryland in establishing reporting systems. The Medical College of Wisconsin and

the Harvard School of Public Health are also developing injury reporting systems. The Committee urges the CDC to work with private health and education agencies as well as State agencies, when

developing an injury reporting system.

The Committee is pleased with the progress of the University of

Northern Iowa (UNI) in implementing the action steps described in

the National Action Plan for the Prevention of Playground Injuries

and encourages continued support of this project.

Residential Fire Deaths and Injuries.—Every 10 seconds in the

United States, a residential fire occurs, and every 23 minutes a residential fire injures a human being. In addition, 445,000 burn victims miss more than half a day of work or school and residential

fires cause $5,000,000,000 in direct property damage each year.

Yet, deaths from fires are preventable and CDC’s research indicates that installing smoke alarms and educating residents about

fire safety can reduce deaths by as much as 50–80 percent. The

Committee urges CDC to continue its efforts to increase the use of

smoke alarms especially among under served and minority populations.

Trauma Care.—The Trauma Information and Exchange Program

(TIEP) stands to serve as the first-ever national clearinghouse on

trauma statistics, enabling trauma physicians, emergency care co-
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ordinators and public health officials to determine and respond to

trauma trends such as geographical variations among injuries, agerelated injuries, and variations among rural versus urban/suburban

environments. A fully operational TIEP will enhance prevention,

amelioration, and treatment of injury and the reduction of injuryrelated disability and death across the Nation. The Committee continues to be supportive of the work of the American Trauma Society.

The Committee recognizes that the scope of the ‘‘National Study

on Costs and Outcomes of Trauma Care’’ has expanded since it was

initially designed, and encourages CDC to expand and complete

this effort. The expanded study would include greater analysis of

trauma care, critical examination of patient care outcomes, and a

broader range of patients analyzed, paying particular attention to

elderly populations.

The Committee is aware of the importance of the ongoing National Study on Costs and Outcomes of Trauma Care currently

being conducted by Harborview Medical Center in Seattle, Washington and John Hopkins University.

Youth Violence.—The Committee is acutely concerned about

school shootings and similar violent acts among our youth. The

Committee is also aware of the progress made by the agencies in

coordinating youth violence efforts and requests that the CDC coordinate their efforts with the Domestic Policy Council and continue to work with the National Institute of Child Health and

Human Development and the Substance Abuse and Mental Health

Services Administration to develop a collaborative program in this

regard. The Committee is pleased that the CDC focused a portion

of their research efforts to discover approaches to intervene and

prevent the complex behavior problems in children and youth

which utilize molecular neuroscience, brain mapping, and behavioral analysis.

Occupational Safety and Health

The Committee recommends $276,135,000 for occupational safety

and health programs which is $16,001,000 above the 2001 level

and $10,000,000 above the administration budget.

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 constructions sites to

coal mines.

The Committee encourages NIOSH to give full consideration to

establishing a center on environmental toxins at the University of

Hawaii at Hilo.

National Occupational Research Agenda.—The continuing need

for occupational safety and health research, both public and private, led NIOSH to work with the occupational safety and health

community to create the National Occupational Research Agenda
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(NORA) in 1996. Now in its 5th year, NORA has become the largest stakeholder-based research agenda in the United States, targeting 21 research priorities considered by the Nation’s occupational safety and health community as most essential for improving

the safety and health of the U.S. work force. Approximately 500 organizations and individuals outside of NIOSH provided input into

the development of the agenda. These efforts have led to the evolution of more efficient and effective ways to conduct research within NIOSH, the growth of NIOSH’s extramural programs, and the

expansion of occupational safety and health research in other government agencies.

The Committee is pleased that research conducted by NIOSH scientists is producing information of practical importance to millions

of workers and their employers. For example, recent laboratory

findings have confirmed the ability of common solvents to cause

hearing damage, revealed the mechanisms by which inhaled metal

dusts may be causing lung cancer, and determined the physical

characteristics of inhaled fibers that cause occupational lung diseases. Engineering research identified effective technology for protecting workers from chemical emissions in automobile repair, lifting injuries in nursing homes and beverage delivery, and hazardous dusts in construction and mining.

Aviation Safety.—The Committee continues to be pleased that

the National Transportation Safety Board has taken an aggressive

approach to address the recent rash of injuries and deaths from

aircraft accidents in Alaska. It supports continuation of the joint

interagency initiative which involves the Federal Aviation Administration, the NTSB, and the National Institute of Occupational Safety and Health. The Committee encourages NIOSH to continue to

implement the Board’s recommendations to improve aviation safety

in Alaska.

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. According to the Bureau of Labor Statistics, the rate of serious illnesses and injuries in construction has

dropped 32 percent from 1992 to 1997. The Committee is also

pleased by NIOSH’s new focus on active intervention to prevent occupational injury and illness in the construction industry, and the

National Occupational Research Agenda (NORA) for establishing

research priorities. However, the Committee is concerned with the

continued high fatality rate in the industry, and has included funds

to continue the program at no less than current levels.

The Committee is aware that the Construction Safety Alliance

(CSA), a consortium of universities that include the University of

Texas at Austin, the University of Florida at Gainesville, the University of Cincinnati in Ohio, and Purdue University in Indiana is

conducting research to develop and implement a national program

in construction safety and health. The Alliance will develop epidemiologic methods of studying injuries and illnesses and evaluating methods of prevention.

Education and Research Centers.—The Committee commends the

work of the 15 university-based Education and Research Centers

(ERC’s) and the smaller single discipline Training Project Grants
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(TPG’s). These regional centers are integral to the Nation’s efforts

to improve the health and safety of working men and women, and

important to the future efforts of NIOSH to implement the National Occupational Research Agenda (NORA). The Committee has

provided sufficient funding for the ERCs to expand research activities in support of implementation of the National Occupational Research Agenda (NORA).

Emergency Workers.—The Committee believes that significant

work must continue to protect emergency responders from biological and chemical terrorism exposures. Fire fighters, emergency

medical personnel, and other on-site workers need reliable personal

protective equipment, principally respirators, but also protective

clothing and detection devices to be able to effectively help victims

in case of exposure to biological and chemical terrorist agents. The

Committee urges the NIOSH to carry out research and related activities aimed at protecting workers, who respond to public health

needs in the event of a terrorist incident. The Committee further

urges NIOSH to move forward quickly with a chemical and biological respirator certification standard. The Committee requests CDC

to report to the Committee on its progress before next year’s budget

hearings.

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.

Maine Fishing Industry.—The Committee is aware of the loss of

life in Maine’s fishing industry in the last 18 months and urges

NIOSH to work with the State of Maine to address occupational

safety and health in the commercial fishing industry.

Mine Safety Research.—The fatality rate for the mining industry

continues to be excessive and is more than five times greater than

the national average for all industry segments. The primary causes

of mining fatalities are associated with ground falls, equipment operation and powered-haulage systems. The Committee recognizes

that the mine safety and health research programs address these

and other issues in the mining industry and continue as a high priority for NIOSH. The Committee is pleased with CDC’s recent accomplishment to develop a load rate warning system for mobile roof

supports. Retreat mining in underground coal mines is one of the

more hazardous operations and the adoption of this mining strategy has increased significantly following the development of mobile

roof supports. These supports replaced wooden timbers for roof support and have dramatically increased the productivity of the mining operation. The mobile roof supports may become overloaded depending upon the specific mining conditions and failure of the systems is often dramatic and catastrophic. The development of a

warning system has been adopted by the industry and is now commercially available by the major manufacturer of the systems.

Sleep Disorders.—The Committee is aware that sleepiness, as a

result of either untreated sleep disorders or simple sleep depriva-
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tion, has been identified as a causal factor in many chronic diseases as well as a growing number of vehicular and on-the-job injuries. Sleep deprivation is also a growing problem for high school

students, the largest at-risk group for fall-asleep car crashes, as

well as police officers and medical residents.

The Committee encourages CDC to develop and begin implementation of a 5-year sleep awareness action plan designed to develop

public health programs regarding sleepiness and sleep disorders

nationwide.

Workplace Violence.—The Committee recognizes that workplace

violence is a major national occupational priority and that it is the

second leading cause of workplace deaths among women workers.

The Committee further recognizes that several hundred workers

die each year as victims of workplace violence, that at least 2 million workers suffer from injuries that result from workplace violence, and that the health care costs, lost productivity and countermeasure costs run into the billions of dollars. The Committee has

included increased funding for NIOSH to develop an intramural

and extramural prevention research program that will target all

aspects of workplace violence and to coordinate its efforts with the

Departments of Justice and Labor.

Preventive Health and Health Services Block Grant

The Committee recommends $135,030,000 for the preventive

health and health services block grant which is the same as the

2001 level and the administration’s request.

The Preventive Health and Health Services Block Grant provides

States with funds for services to reduce preventable morbidity and

mortality to improve the quality of life. The Block Grant is the primary source of funding to States for health education and risk reduction activities; cholesterol, hypertension, and cancer screening;

and programs to prevent sex offenses. The strategy of the Block

Grant is to provide States with flexibility to tailor prevention and

health promotion programs to their health priority needs. Block

Grant funding enables States to provide money for developing new

programs; fund essential services that would otherwise go unfunded; and address urgent, rapidly developing health hazards

such as disease outbreaks or environmental disasters.

Public Health Improvement

The Committee recommends $114,910,000 for public health improvement which is $4,021,000 above the fiscal year 2001 level and

$5,000,000 above the administration request.

Our national public health system is the first line of defense

against preventable disease and disability. Virtually every health

problem in our communities—infectious disease outbreaks, chemical hazards, chronic diseases, and injuries—is first recognized by

local public health professionals, who must work in concert with

State and national officials to control these threats, prevent spread,

and save lives. Despite steady increases and shifts in the U.S. population there has been a decline in the number of public health

workers per capita in the past decade. Schools of Public Health and

Preventive Medicine report that the majority of graduates do not

seek employment in public health agencies. Only an estimated 44
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percent of the Nation’s current 448,000 public health practitioners

have had formal training in public health. One-half of all public

health nurses—the largest profession in public health—lack a baccalaureate nursing degree. The majority of public and private laboratory scientists lack access to continuing education and training

essential to using the cascade of new, high-technology laboratory

tests accurately and safely.

Minority Health Disparities.—This program is intended to help

racial and ethnic minority communities mobilize and organize their

resources to support effective and sustainable programs that will

contribute to the elimination of health disparities in the following

six target health areas: infant mortality, breast and cervical cancer

screening and management, cardiovascular disease, diabetes, HIV

infection and AIDS, and child and adult immunizations. REACH

2010 is a 2-phased, 5-year demonstration project. Phase I is a 12-

month planning phase to support planning and development of

demonstration programs. Phase II is a 4-year implementation and

evaluation phase. The Committee is pleased with CDC’s commitment to the REACH 2010 Program. The planning (Phase I) communities currently are establishing infrastructure to support community-level data collection, establishing collaborative partnerships,

establishing linkages with other state and local agencies, and working with Federal agencies and other partners to identify promising

prevention strategies that have the greatest potential for reducing

the health disparities in the target populations.

National Electronic Disease Surveillance System.—Accurate,

timely health information is a critical component of all effective

prevention and control efforts. Yet, only 55 percent of local health

departments have high-speed, continuous Internet access for finding the most recent health guidelines and recommendations. Only

56 percent can successfully receive broadcast health alerts. Only 50

percent have access to community health information critical for

setting priorities, taking effective actions, and tracking improvements in health status. The Committee is pleased with CDC’s work

to integrate disease detection and monitoring to ensure rapid reporting and follow-up.

Phytomedicines.—Millions of U.S. citizens consume dietary supplements regularly. But there is no formal mechanism for reporting

adverse events that may be associated with the use of such products, including events that may be linked to inappropriate use or

interactions with drugs or foods. The Committee recognizes that

development, implementation, and oversight of such a system must

necessarily involve expertise in pharmaceutical care, disease management, monitoring and surveillance, and the chemistry and biology of natural products.

Prevention Research.—The CDC Office of Extramural Prevention

Research sponsors peer-reviewed research conducted by academic

researchers who are linked with State and local health agencies to

develop improved interventions and services. Extramural investigators are located in leading schools of public health, medical schools,

State health departments, and other academic and practice-based

organizations. Translation of research findings into information,

guidelines, and tools for front-line public health practitioners are

an integral part of the program and will be facilitated through ex-
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isting and new partnerships between CDC’s Public Health Practice

Program Office and public health practice organizations. In addition to supporting high-priority prevention research projects, the

Office of Extramural Prevention Research is a focal point for CDC’s

extramural research partners, aids development of practice-oriented CDC prevention research agendas, promotes use of rigorous

peer-review processes for extramural research, and facilitates dissemination of research findings and translation of findings into action.

The Committee supports CDC’s efforts to expand prevention research. There are many areas of research that can pay dividends

in both improved health and reduced health care costs. The Committee expects more of these funds to be used to support research

on ways to prevent disease and disability in rural areas and to better utilize nurses and allied health professionals in prevention and

health promotion efforts.

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 is encouraged with CDC’s plans to initiate an expansion

of their effort in this area. Practice-based assessments and the

identification and study of promising and heavily used complementary and alternative therapies and practices should be undertaken

and results published. The Committee expects CDC to collaborate

with the National Center for Complementary and Alternative Medicine to assure that its efforts complement efforts by this Center.

The Committee has also included funds to research the antioxidant and anti-adhesion effects of Vaccinium proanthocyanidins

from native North American fruit for possible prevention or treatment of cardiovascular disease and diseases or conditions caused by

microbial pathogens such as ulcers, urinary tract infections and

various diseases of the ear, nose and throat.

Recognizing the importance of pediatric sleep disorders, last year

the Committee included language encouraging CDC to allocate increased funding for research on these problems. The Committee is

aware of Kosair Children’s Hospital’s Sleep Medicine Center and

the University of Louisville’s Multi-Disciplinary Early Childhood

Research Center’s research to improve the prevention, diagnosis,

and treatment of sleep disorders in children.

The Committee is aware of the social, economic, and health disparities in Mississippi and that health-related interventions and

programs should reflect the findings of individualized community

assessments, and that measurements of resulting outcomes must

evolve from a research design framed around the problem, the

intervention, and the appropriate evaluation methodologies. The

Committee recognizes that it is through research-based outcomes

that health care planners and policy makers can best respond to

the real needs of citizens. The Committee is aware of the development of the Research Center of Excellence located in Mississippi

and recommends the utilization of the Mississippi Research Center

of Excellence to offer its assessment and evaluation expertise to

identify community health care needs and wants.

The Committee is aware of the Tulane and Xavier Universities

request for funding for research on environmental signals and work
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on biosensors and biomarkers which will identify hazards in the

environment that may cause damage to humans.

The Committee is aware of the Vermont Oxford Network, located

in Burlington, Vermont, and it efforts to improve the quality of

health care available to children born prematurely through the reduction of medical errors.

The Committee urges CDC to give full and fair consideration to

these proposals.

Buildings and Facilities

The Committee recommendation includes $250,000,000 for the

planning, design, and construction of new facilities as well as the

repair and renovation of existing CDC facilities. This is

$75,000,000 above the fiscal year 2001 level and $100,000,000

above the administration request.

While making progress on addressing the many problems caused

by its buildings and facilities, CDC continues to carry out its mission with clearly inadequate laboratories, support facilities, and security infrastructure. As the Committee noted last year, CDC’s

buildings and facilities create serious problems regarding employee

safety and interfere with the ability of the agency to carry out its

mission in an efficient and effective manner. Some facilities are

more than 40 years past their original life expectancy and should

be replaced, while others are in great need of complete renovation.

The Committee directs CDC to continue full implementation of

the agency’s 10 year buildings and facilities Master Plan. As provided by the Committee last year, CDC should use the enhanced

contracting language provided in the bill to accelerate the start of

new projects. This authority has acquired greater urgency in light

of recent events impacting the security of Federal facilities. It is

also the same authority that has allowed the National Institutes of

Health to move forward quickly on the Clinical Center. The Committee is particularly interested in ensuring that the agency improves communications and distance training of local public health

professionals in State and local health departments throughout the

country. These institutions are the first line of defense in the event

of bioterrorism and naturally occurring adverse health events,

whether caused by infectious disease agents, chemical exposures, or

changes in the population. CDC should focus efforts on constructing a Communications Center as soon as possible during fiscal year 2002 to address these challenges.

Additionally, the Committee directs CDC to either start or continue the planning, design or construction of the following projects

in the Master Plan: the Emerging Infectious Disease Laboratory

and its required Central Utility Plant/infrastructure; the Environmental Toxicology Laboratory and its required Central Utility

Plant/infrastructure; the Scientific Communications Center; Phase

I infrastructure, design, and construction of the East Campus Consolidated Laboratory Project; the Worker Safety and Injury Prevention facility at the Roybal Campus; the Environmental Health facility at the Chamblee Campus; the Transshipment facility and related infrastructure at the Roybal Campus; and repairs and improvements of CDC’s nationwide inventory of facilities.
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Office of the Director

The Committee recommends $49,440,000 for the Office of the Director which is $7,919,000 above the fiscal year 2001 level and the

same as the administration request.

The Office of the Director (OD) manages and directs programs of

the CDC. OD provides leadership, advises on policy matters, and

develops and evaluates progress of goals and objectives related to

disease prevention and control. OD provides direction and coordination to the epidemiologic activities of CDC and coordinates CDC’s

response to health emergencies. In addition, OD coordinates and

manages programs on global health activities, minority health, and

women’s health relating to disease prevention and control.

The Committee is pleased to learn that CDC has embarked on

an aggressive Financial Management Excellence Initiative to improve fiscal management practices in four key areas that include:

simplifying and streamlining the current fiscal structure, identifying new systems to share fiscal information throughout the agency, appointing senior level finance and accounting staff to provide

leadership, and investing in education and training for financial

management staff. The Committee recognizes that CDC’s commitment to improving their financial management practices is consistent with the findings and recommendations of independent

auditors who collaborated closely with the GAO in conducting a

management review. The Committee recognizes that continuing improvement in CDC’s financial management practices requires replacement of the agency’s financial system with an enterprise-wide

business solution. It is expected the new financial system will increase productivity and improve performance of the CDC’s financial

management practices. The Committee also recognizes and commends CDC for simplifying its budget structure at the recommendation of both an outside financial auditor and the Appropriations Subcommittee. The simplification includes changes in the

presentation of the All Purpose Table and associated sub-budget

activities. The change also adds transparency to CDC’s very complex operating structure.

The Committee notes that the Mississippi’s Delta is a community

with residents who disproportionately experience disease risk factors and have children who are significantly behind national averages for mental and physical development. The best hope for breaking the cycle of poor health in the Mississippi Delta is through a

community health education program directed at individuals, families, and communities. The Committee believes that collaboration

between Delta State University, the University of Mississippi Medical Center, University of Mississippi School of Nursing, and the

Mississippi State Department of Health with CDC will promote coordinated consolidation of health and human services that will

positively impact the education, health, and economics of this region.

The Committee encourages the CDC to support the Environmental and Public Health Alliance to perform necessary public

health service during the 2002 Winter Olympics.
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Bioterrorism

The Committee recommends $181,919,000 for preparation, infrastructure and public health response to the threat of bioterrorism

which is $1,000,000 above the fiscal year 2001 level and the same

as the administration request.

The events of September 11, 2001 have made it clear that we

must begin to look at our public health system as part of our national defense system against biological attacks. The Committee

plans to work with the administration to craft a supplemental appropriation bill that will address the needs of our State and local

health departments as our first line of defense against bioterrorism

and to provide CDC with the needed resources to coordinate a national plan. The Committee has included the President’s request

for bioterrorism but realizes that more funds are necessary and

will address those needs in the supplemental appropriation.

As scientific and technological advances increase the ease with

which individuals are able to access and weaponize biological and

chemical agents, the potential for bioterrorism continues to threaten the health of the U.S. public. Furthermore, factors such as genetic engineering, ambiguous relationships among certain foreign

states, and decreasing biologic resistance to smallpox in the U.S.

population contribute to this national concern. A strong public

health infrastructure will result in a rapid, effective response,

thereby, minimizing morbidity and mortality associated with such

a bioterrorism event. An attack could result in a huge volume of

patients and a corresponding need for large quantities of medical

supplies and therapeutics, diagnostic tests, and hospital beds that

could overwhelm public health capacity. Emergency responders,

health care workers, and public health officials could be at special

risk, and public fear of contagion could be high. U.S. capacity to respond quickly and effectively to biological or chemical terrorist

threats depends on strong local capacity for public health surveillance, rapid laboratory diagnosis, and outbreak response.

The Committee is aware of a proposal by the University of Louisville to develop a plan for the comprehensive integration of all essential activities in preparation for an attack that could serve as

a template for medium-sized cities throughout the Nation. The

Committee is encouraged that the surveillance and control capabilities generated under this proposal and other proposals would also

produce helpful applications in the detection of other emerging

pathogens, such as West Nile Virus, or the response to an outbreak

of pandemic influenza.

The Committee is pleased with the progress of the CDC and

other public health agencies to prepare for the potential for a domestic biochemical terrorist attack, but remains concerned about

the ability of many public health entities to accurately identify biochemical agents in human victims. The Committee is aware of a

training and first responder training program utilizing human patient simulators being conducted by the National Emergency Response and Rescue Training Center.

The Committee continues to support the work of the University

of Texas, Medical Branch—Galveston National Rapid Response

Bioterrorism Defense Center, which has been at the forefront of de-
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veloping drugs to counter hazardous viruses that could be used by

terrorists.

National Pharmaceutical Stockpile.—The National Pharmaceutical Stockpile has been established to assure rapid availability

of pharmaceuticals, supplies and medical equipment in the event of

a bioterrorism or chemical incident. The Committee was pleased by

the rapid deployment of materials from the stockpile to New York

following the September 11, 2001 terrorist attacks, and strongly

supports the continued maintenance and expansion of the stockpile

so that it will continue to be available and effective when requested.

NATIONAL INSTITUTES OF HEALTH

The fruits of medical research have proved to be among this Nation’s greatest achievements. Countless saved lives, new cures and

treatments, and a thriving biomedical research industry are all the

result of a long-standing Federal investment in improving people’s

health. Americans today are living longer than ever. Life expectancy at birth was less than 50 years in 1900; it is 77 years today.

Life expectancy at age 65 was about 11 years in the first half of

the 20th century; today, it is 17. Medical research has also improved the quality of those added years of life, as reflected by the

steady decline of disabilities and other impairments among the elderly population. By another measure, basic research has stimulated immeasurable economic dividends in the form of new products, skilled jobs, and increased productivity. In sum, the Nation’s

investments in this area have directly benefited the lives of millions of Americans while reaffirming the central tenet of our democratic society: to protect the value and the sanctity of every individual.

The unparalleled scientific advances of the past, however, are not

self-sustaining—nor is the promise of future breakthroughs self-fulfilling. Despite remarkable progress, there are new and growing

challenges to confront. Infectious diseases are now the second-leading cause of death worldwide. At least 20 well-known diseases—including tuberculosis, malaria, and cholera—have reemerged as

major threats to health, while 30 previously unknown disease

agents have been identified. On another front, while society’s overall health status has improved, troubling disparities persist among

African Americans, Hispanics, Native Americans, Alaskan natives,

Asians, and Pacific Islanders. The graying of America is another

area of concern. Ten years from now, 75 million baby boomers will

begin to turn 65. By 2050, the number of Americans over 65 will

more than double, and the number of individuals over 85 will grow

five-fold. With that demographic explosion comes greater risk of

disease and disability, as well as enormous strain on Medicare,

Medicaid, and the Nation’s health care infrastructure.

But there is also good cause to hope for the future. The Human

Genome Project has revolutionized our understanding of the fundamental mechanisms of life. As scientists learn more about how to

decipher our DNA code, 95 percent of which has now been

sequenced, we can look forward to a day when genetic tests will

routinely predict a person’s susceptibility to disease; diagnoses will
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be far more precise; treatments will attack diseases at the molecular level; and drugs will be matched to a patient’s likely response.

The Committee has a long tradition of support for the NIH, the

single largest source for medical research funding. In 1998, the

Committee played a lead role in launching an effort to double funding for the NIH by fiscal year 2003. That decision was rooted in

the firm belief that sustained and sufficient funding is essential to

accelerate the pace of research advances, ensure the timely application of new discoveries into clinical practice, and maintain the Nation’s research infrastructure. At the same time, the Committee

notes that an investment of this magnitude demands accountability. The NIH must preserve a rigorous system for determining

research priorities and for selecting those most qualified to pursue

those priorities. And it must monitor research conducted with taxpayer dollars to ensure it is carried out ethically, responsibly and

consistent with the research funding award. The Committee recommends $23,695,260,000 for the NIH, an increase of $3,400,000,000 over the fiscal year 2001 appropriation

and $748,358,000 more than the budget request. This amount

maintains the goal of doubling funding for the NIH by fiscal year

2003.

NATIONAL CANCER INSTITUTE

Appropriations, 2001 ............................................................................. $3,716,064,000

Budget estimate, 2002 ........................................................................... 4,153,398,000

Committee recommendation ................................................................. 4,258,516,000

The Committee recommends an appropriation of $4,258,516,000 for the National Cancer Institute [NCI]. This is $105,118,000 more

than the budget request and $542,452,000 more than the fiscal

year 2001 appropriation. 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.

The Committee continues to regard scientific investigation into

the cause, cure, prevention, and treatment of cancer as one of the

Nation’s top priorities. Research offers the only hope for putting a

stop to a disease that wastes precious human resources and contributes to spiraling health care costs.

Behavioral science research.—The Committee commends NCI for

expanding its infrastructure to fund behavioral and population research in cancer prevention, treatment, and control. NCI is encouraged to expand its investigation of the effective provision of mental

health services to improve the course of cancer treatment and to

aid in the adjustment to cancer survivorship. NCI is also encouraged to build upon its collaborations with the National Institute on

Drug Abuse to more thoroughly investigate issues of youth tobacco

use. In particular, the Committee is interested in expanding health
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promotion research focused on children and youth, and interdisciplinary research on tobacco addiction and cessation. The Committee also encourages NCI to expand its research on adherence to

treatment regimens and to health-promoting behaviors such as

physical activity and healthy diet.

Blood cancers.—The Committee is interested in NCI’s upcoming

Progress Review Group report on leukemia, lymphoma, and multiple myeloma, and it is eager to know what research strategies

NCI is pursuing to improve treatments for these blood cancers. In

particular, the Committee urges NCI to expand its research on

myelodysplasia, a serious blood disorder affecting primarily older

adults and individuals who have previously undergone radiation or

chemotherapy treatment for cancer.

The Committee has listened to testimony about the devastating

effects that multiple myeloma has on its victims and recognizes

that, despite recent advances, median survival for patients responding to treatment is only 3 to 5 years. The Committee urges

continued research and effort to seek new and better treatment for

this disease. The Committee also requests that the NCI and

NIEHS develop a joint report by April 1, 2002, on the progress of

lymphoma and hematological cancer research. The report should

address how the PRG has determined funds will be expended to expand the current base of lymphoma and hematological cancer research.

Bone metastasis.—The Committee encourages NCI to conduct research to develop a better understanding of the unique role the

bone microenvironment plays in metastatis of cancer to bone, in

particular, breast cancer, prostate cancer and myeloma. The Committee also encourages NCI to support research on the development

of animal models of bone metastasis and the identification of novel

therapeutic targets and modalities to prevent and treat bone metastases.

Brain tumors.—The Committee is concerned that insufficient attention is being given by NCI and the National Institute for Neurological Diseases and Stroke (NINDS) to brain tumor research. The

recently issued report of the NCI/NINDS-sponsored Brain Tumor

Progress Review Group has called for substantially greater effort

into this little-understood area of tumor research and treatment.

The Committee encourages NCI to fund at least three Specialized

Program 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.—The Committee continues to be concerned over

the disparity in breast cancer mortality and morbidity among African-American women. The Committee therefore encourages the

NCI to report to Congress by April 1, 2002, about existing efforts,

as well as planned future efforts, to better understand and respond

to this disturbing phenomenon.

The Committee is aware of the importance of restoring sensitivity of tumor cells to standard chemotherapy drugs by reversing

the effects of low oxygen stress on the cells. Cancer researchers

have developed methods of achieving this important scientific tool,
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and the Committee encourages the NCI to consider this important

research.

Breast implants.—The Committee encourages the NCI to continue to collect and analyze data from the women in its three recent studies of the health risks of breast implants, to determine

whether there is a link between breast implants and breast cancer,

other cancers, or mortality from all causes.

Cancer and minorities.—The Committee remains concerned over

recent statistics citing higher incidences of cancer among the native

Hawaiian population. In comparison to other ethnic and racial

groups, native Hawaiians have the highest incidence of the most

common forms of cancer such as breast, colon, and lung cancer. The

Committee encourages continued research in the areas of prevention and detection, utilizing nurse practitioners in communitybased centers for screening and education for the underserved populations.

Cancer centers.—The Committee recognizes the high quality of

care provided by NCI-designated Cancer Centers, but notes that

many cancer patients must travel great distances to receive care

from these centers. In addition, many other smaller institutions

provide excellent patient care, perform high-caliber basic research,

address unique cancer prevention and treatment issues, and lend

great expertise to cancer treatment and control. The Committee encourages the NCI to further expand their Cancer Centers Program

and give full consideration to applicants that care for a large number of underserved patients from rural and economically distressed

areas.

Cancer gene therapy.—With the sequencing of the human genome

nearly complete, the challenge is no longer to identify genes but to

understand the functions of these genes in order to find cures and

treatments for cancer—especially prostate, breast and pancreatic

cancer. As a result, the Committee and the NCI have previously

supported cancer genomics projects that investigate the role of

oncogenes in the CaSm, Ets 2 and ESF genes. The Committee expects the NCI to continue these projects with the goal of identifying

potential cancer therapies.

Chronic lymphocytic leukemia (CLL).—The Committee, during its

fiscal year 2002 hearings, heard compelling testimony from patients regarding the devastating effects of chronic lymphocytic leukemia (CLL). This disease has evaded a satisfying cure, as only 50

percent of patients with CLL survive 6 years and only 25 percent

survive 10 years. The Committee urges the NCI to increase research on CLL, its underlying cause, and improved therapies. The

Committee is pleased to learn that the NCI awarded a program

project grant last year to establish and lead a multidisciplinary national research consortium to study CLL at both the cellular and

clinical levels. The Committee strongly encourages the NCI to give

full and fair consideration to expanding the scope of research activities funded through the CLL Research Consortium and the participating partners involved.

Complementary and alternative cancer therapies.—The Committee expects NCI to expand its work and its collaborative efforts

with the National Center for Complementary and Alternative Medicine to support research on promising complementary and alter-
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native cancer therapies as well as on their integration with traditional therapies. Thousands of Americans are turning to these

therapies, and consumers will benefit from a rigorous scientific review of them.

DES.—The Committee continues to strongly 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

its support of research in this area. In addition, the Committee

urges NCI to continue its agreement with CDC to implement a national education program for consumers and health professionals.

The Committee expects NCI and these other agencies to continue

to consult with organizations representing individuals impacted by

DES as they carry out DES research and education efforts.

Gynecologic cancer.—Ovarian cancer remains one of the deadliest

cancers for women, in part due to the lack of effective early screening methods. The Committee strongly urges NCI to expedite current research on screening methods to detect, diagnose, and identify staging of ovarian cancer. The Committee is pleased that NCI

has fully funded four ovarian cancer SPOREs, and it encourages

the Institute to consider issuing a new request for applications for

additional ovarian cancer SPOREs. The Committee also believes

that identification of a cost-effective screening strategy could result

in earlier diagnosis for women and higher cure rates. NCI is

strongly urged to accelerate research in this area.

Healthy eating.—The Committee commends the NCI’s national 5-

A-Day program. The Committee recognizes that a diet including a

minimum of five servings of fruits and vegetables is a critical factor

in reducing cancer risk. The Committee encourages NCI to fund behavioral research on how best to promote healthy eating, especially

fruit and vegetable consumption. New research projects could include, but not be limited to (a) children and adolescents, the general adult population, policymakers, and low-income and disparate

groups, especially African Americans and Latinos; (b) program

channels such as the mass media, restaurants, supermarkets,

schools, and faith organizations; and (c) transfer of already-developed technologies to other units and levels of government and to

non-profit, civic, and other organizations.

Hepatocellular carcinoma.—The Committee is aware that the incidence of hepatocellular carcinoma in the United States has increased by more than 70 percent in the last two decades. Given the

limited treatment options available, most cases are fatal. Viral hepatitis is the leading predisposing factor contributing to this affliction. With 4 million Americans infected with hepatitis C virus, it

is predicted that the incidence of hepatocellular carcinoma will continue to increase. The Committee is aware that too little is known

about the mechanisms and natural history of this disease. The

Committee, therefore, strongly encourages the NCI to work closely

with the NIDDK to develop a comprehensive liver cancer research

initiative to investigate prevention, diagnosis, and therapy.

Imaging systems technologies.—The Committee is encouraged by

progress made by NCI following its August 1999 conference on biomedical imaging, and it urges NCI to continue to take a leadership

role with the Health Care Financing Administration and the Food
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and Drug Administration to avoid duplicative reviews of new imaging technologies that 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). The Committee continues to support

NCI’s increased emphasis on examining the molecular basis of disease through imaging technologies such as PET and MicroPET.

The Committee continues to encourage the large-scale testing of

women for breast cancer and of 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.

Melanoma.—The Committee is aware of numerous epidemiologic

accounts and personal stories of melanoma. The Committee believes that public knowledge of overexposure to sunlight and its

connection with melanoma may be lacking. The Committee urges

the NCI to continue seeking new therapies for melanoma as well

as educate the public through campaigns that encourage appropriate protection from sunlight.

National cancer registries.—The Committee encourages the Registries program to establish, with the States, high-risk registries for

the digestive cancers (liver, pancreatic) and other cancers with significantly low survival rates following diagnosis.

Neurofibromatosis (NF).—Neurofibromatosis research has significant potential for cancer patients since NF genes have been implicated in the signaling process that determines cell growth and cell

differentiation. The Committee encourages NCI to strengthen its

NF research portfolio in such areas as further development of animal models, natural history studies, therapeutic experimentation

and clinical trials.

Neurological cancer.—The Committee is pleased to learn of innovative research on the uniformly fatal brain cancer glioblastoma

multiorme. Investigators have developed a transgenic mouse model

in which tumor growth can be reduced by replacing a new gene

that helps transport the brain chemical glutamate. The Committee

is also aware of the importance of this research in the study of epilepsy. The Committee encourages the NCI to take note of these exciting developments.

Pancreatic cancer.—The Committee commends NCI for its report

on the Pancreatic Cancer Progress Review Group. The Committee

urges the NCI to develop a professional judgment budget in line

with the Progress Review Group for the period from fiscal year

2003 to fiscal year 2008. This budget should be presented to the

Committee by April 1, 2002. In addition, the Committee encourages

NCI to develop an initiative to raise the awareness of pancreatic

cancer in the general public and the research community.

Population health.—The Committee congratulates the NCI for

building and nurturing an infrastructure to support rigorous community-based research. Community-based research makes it possible for interventions developed at taxpayer expense to reach the

greatest number of people. The National Research Council has

called attention to the need for additional research at multiple levels of analysis (individual, family, community) that integrates pop-
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ulation health dynamics with behavioral, psychosocial, and environmental factors. One challenge is the development of methodologies that can enable such multilevel analyses. The Committee encourages NCI to continue its leadership in this area.

Primary immunodeficiencies (PI).—The Committee notes that

NCI held a symposium in March 2000 concerning the relationship

between primary immunodeficiencies and cancer. The symposium

showed, among other things, that PI patients have a 200 times

greater risk of developing cancer (including lymphomas) than someone without PI. The Committee strongly encourages the Institute

to develop a comprehensive research portfolio on the basis of the

data generated at that conference and to supply the Committee

with a report concerning its research plans not later than April 1,

2002. In addition, NCI is urged to greatly expand its role in the

national education and awareness campaign sponsored by the Jeffrey Modell Foundation.

Prostate cancer.—The Committee believes that prostate cancer

research has not kept pace with the scientific opportunities and the

proportion of the male population who are afflicted with the disease. This has resulted in significant gaps in scientific and clinical

knowledge that contribute to the ongoing impact of prostate cancer

on patients and their families. NIH has begun to address this

shortcoming in the 5-year prostate cancer research strategy presented to Congress in June 1999. The Committee strongly urges

the NIH to renew its commitment to prostate cancer research with

special emphasis on accelerating new avenues for basic research,

drug development and clinical research. The Committee further requests that NIH submit a prostate research plan for fiscal year

2003 to fiscal year 2008 by April 1, 2002. In developing this plan,

the Committee urges the NIH to consult and work closely with the

research community, clinicians, patient advocacy groups and the

Congress.

The Committee is aware of a novel DNA-based tumor vaccine

that has proven effective in pre-clinical, phase I and phase II studies for the treatment of advanced prostate cancer. The Committee

is also aware of complementary research in prostate cancer treatment using Cox-2 inhibitors. The Committee encourages NCI to explore the use of these important research initiatives.

Transdisciplinary tobacco use research centers.—The Committee

commends the Institute for its collaboration with the National Institute on Drug Abuse and private foundations in establishing

seven new Transdisciplinary Tobacco Use Research Centers. These

Centers establish critical links across diverse scientific disciplines

in order to evaluate new models of nicotine addiction; heredity factors in vulnerability, treatment success, and deleterious consequences of tobacco use; cultural determinants of successful prevention efforts; treatment-resistant populations; and determinants

of relapse.

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2001 ............................................................................. $2,287,015,000

Budget estimate, 2002 ........................................................................... 2,554,319,000

Committee recommendation ................................................................. 2,618,966,000
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The Committee recommendation includes $2,618,966,000 for the

National Heart, Lung, and Blood Institute [NHLBI]. This is

$64,647,000 more than the budget request and $331,951,000 more

than the fiscal year 2001 appropriation. 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 innovative basic, clinical, population-based, 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

ability of the heart to survive an event is a biochemical question

that can be determined through PET, which is biological imaging.

The Committee encourages 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.

Alpha-1.—The Committee is aware that Alpha-1 Antitrypsin Deficiency is a genetic disorder that can result in devastating and

fatal lung and or liver disease that is often misdiagnosed as asthma or Chronic Obstructive Pulmonary Disease (COPD). Alpha-1 is

a major cause of lung transplantation in adults. The Committee encourages the NHLBI to expand its resources dedicated to researching and raising awareness of this devastating disorder.

Bone formation and cardiovascular disease.—The Committee is

aware that calcium is an early marker of atherosclerosis involving

the arterial wall. Evidence suggests an association between bone

formation, repair and breakdown (e.g. osteoporosis) and development of heart disease and other cardiovascular diseases. The Committee encourages the NHLBI to explore basic research in this area

that may result in strategies to prevent osteoporosis and cardiovascular diseases.

Cardiovascular diseases.—The Committee continues to regard research into the causes, cure, prevention and treatment of heart disease, stroke and other cardiovascular diseases as one of the Nation’s top priorities. The Committee is alarmed that an expert

panel, convened in 1999 at the request of this Committee, reports

that progress in reducing the death rate from cardiovascular diseases has slowed and that there are striking differences in these

death rates by race/ethnicity, socioeconomic status and geography,

suggesting that new strategies are needed to control these diseases.

The Committee continues to believe that an intensive research program on heart disease, stroke and other cardiovascular diseases

should be a priority of the NHLBI and of the NIH.

Children’s heart defects.—Congenital heart defects are the most

prevalent birth defect in the United States today. More than 32,000

babies—1 out of every 115 births—are born each year with congenital heart defects. The Committee encourages the NHLBI to research the issue of newborn screening for such defects in order to
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develop improved and cost-effective methodologies for heart screening and for the proper training of physicians.

Cholesterol.—It has been brought to the Committee’s attention

that immunizing rabbits and mice against their own LDL (‘‘bad’’)

cholesterol can significantly reduce arterial plaque build-up despite

very high cholesterol levels in the blood. Further work is needed

to bring this concept to human testing and application, and identify

which part of the LDL-cholesterol molecule provokes a protective

immune response will be necessary. The Committee urges the Institute to facilitate research in this area.

Cooley’s anemia.—The Committee continues to be pleased with

the outstanding progress being made by the Thalassemia Clinical

Research Network, which is comprised of the leading research centers in North America on thalassemia, the medical term for

Cooley’s anemia, as well as with the leadership of NHLBI. The

Committee understands that the Network is currently prioritizing

the wide variety of potential research areas that are ripe for investigation. NHLBI and NIDDK should submit a joint report to the

Committee on the work of the Network and, in general, the work

they are doing that is of direct benefit to thalassemia patients by

April 1, 2002.

Cord blood.—The Committee recognizes the advances that are

being made in the use of life-saving hematopoietic stem cells and

the growing use of umbilical cord blood and placental blood as rich

sources of these cells. The Committee is aware of the success of

cord blood stem cell transplants in treating diseases such as leukemia, lymphoma, severe aplastic anemia and sickle cell disease.

The Committee urges the NHLBI to support research on umbilical

cord blood and cord blood stem cells to determine the nature of

their capabilities, to identify their similarities and differences to

stem cells from other sources, and to understand the mechanisms

of differentiation.

Heart disease, stroke and other cardiovascular diseases in

women.—Cardiovascular diseases remain a major cause of disability and the leading cause of death of American females. The

clinical course of cardiovascular disease is different in women than

in men, and current diagnostic capabilities are less accurate in

women than in men. Despite the seriousness of these diseases in

women, they are largely unrecognized both by women and their

doctors. The Committee urges the NHLBI to expand cardiovascular

disease research in women, including studies to develop safe, efficient and cost-effective diagnostic approaches for women, and to

create more informational and educational programs for women patients and health care providers on heart disease and stroke risk

factors.

Hemophilia.—The Committee commends NHLBI for the significant support it has provided for hemophilia gene therapy research,

and it urges the Institute to continue this and other efforts to address the needs of persons with hemophilia and bleeding disorders,

including blood and blood product safety, treatment of hepatitis C

and other complications, and women’s bleeding disorders. The Committee is concerned about the increasing shortage of trained hematology specialists to translate research discoveries into the treatment of hemophilia and prevention of its complications. The Com-
128

mittee urges NHLBI to work with the National Hemophilia Foundation to pursue strategies for addressing this critical issue.

Juvenile diabetes.—Vascular complications including cardiovascular, peripheral vascular, and cerebrovascular are a major

cause of mortality and morbidity in persons with diabetes—particular in those with juvenile diabetes. NHLBI is encouraged to

launch major initiatives in diabetic-specific vascular complications,

with emphasis on the accelerate pathways seen in juvenile diabetes, in order to develop effective treatments and prevention. NHLBI

should consider newer therapeutic modalities, including gene therapy, and build upon the growing understanding of angiogenesis.

The Institute should also consider collaborating with NIDDK to assess the genetics of complications of juvenile diabetes, understand

gene function in individuals with diabetes who have serious and

life-threatening complications, and help develop more effective

therapeutic interventions.

National Asthma Education and Prevention Program (NAEPP).—

The Committee commends the National Asthma Education and

Prevention Program (NAEPP) for its leadership in helping to educate physicians, asthma patients, their families and the general

public regarding asthma and asthma management. The Children’s

Health Act of 2000 authorized NAEPP to develop, in conjunction

with other Federal agencies and voluntary and professional health

organizations, a Federal plan to respond to asthma. The Committee

urges NHLBI to move forward as expeditiously as possible.

Pediatric Asthma Network.—The Committee recognizes that little

is known about the optimal treatment for asthma in infants and

young children. For example, it is still unknown what the most effective dose and type of medicine would be for different types of

asthma and whether early therapy can prevent asthma. The Committee urges the NHLBI to consider the research amassed through

the Pediatric Asthma Clinical Research Network to provide clearer

choices for childhood asthma therapy, to encourage the development of new therapies, and to identify optimum asthma-management strategies for children.

Primary pulmonary hypertension.—Primary pulmonary hypertension (PPH) is a rare, progressive, and fatal disease that predominantly affects women. PPH 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 supports

continued, high-quality research in this area and urges the Institute to increase funding for basic research, gene therapy, and clinical trials or promising pharmaceuticals.

Sickle cell anemia.—Sickle cell anemia is an inherited condition

that is particularly prevalent among African Americans. While

there is no cure for sickle cell anemia, several promising developments have occurred to improve the quality of life of sickle cell patients, and the Committee encourages the Institute to carry out

further research.

Transfusion medicine.—The Committee supports the establishment of a clinical research network in transfusion medicine and hemostasis, which would attract and train much-needed clinicians to

hematology, while at the same time enabling patients with non-ma-
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lignant blood disorders to participate in high-quality clinical protocols.

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2001 ............................................................................. $304,606,000

Budget estimate, 2002 ........................................................................... 340,158,000

Committee recommendation ................................................................. 348,767,000

The Committee recommendation includes $348,767,000 for the

National Institute of Dental and Craniofacial Research [NIDCR].

This is $8,609,000 more than the budget request and $44,161,000

more than the fiscal year 2001 appropriation. 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 the American people. 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 includes 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 caries.—The Committee is concerned about the exceptionally high rate of severe dental caries suffered by American Indian

children. Within the funds provided, the Committee encourages the

NIDCR to support long-term research of the etiology and pathogenesis of dental caries in these populations. The Committee also

encourages NIDCR to conduct clinical research trials on effective

ways to control severe caries in American Indian children.

Fibrous dysplasia.—The Committee is aware that the NIDCR is

playing a critical role in studies of fibrous dysplasia. In particular,

the Committee is aware of NIDCR support for studies on drugs and

surgical procedures to treat fibrous dysplasia. The Committee understands that one of the key problems faced by people with fibrous

dysplasia is the lack of medical professionals who know and understand the disease. Therefore, the Committee encourages the

NIDCR to work with other institutes to highlight and expand these

activities in fibrous dysplasia and other bone research.

Head and neck cancer.—Head and neck cancer has serious and

debilitating effects on quality of life. Surgical treatment often

leaves patients with impaired speech, eating difficulties, and severe

disfigurement. The Institute is encouraged to support basic, clinical, and translational research to advance techniques for replacing

bony structures of the head and face, and restoring sensory and

motor functions of the reconstructed structures.

Osteoporosis.—Given that osteoporosis and related bone diseases

affect millions of Americans, the Committee encourages NIDCR to

enhance its research efforts to compare bone loss in the oral cavity

with bone loss elsewhere in the body. The Committee also encourages NIDCR to enhance research on dentinogenesis imperfecta and

orthodontic manipulation in individuals with osteogenesis

imperfecta.

Temporomandibular joint disorders (TMJ).—The Committee is

aware that the research portfolio on temporomandibular diseases
130

and disorders includes extensive studies on the psychological and

behavioral factors in the etiology or chronicity of TMJ diseases and

disorders. The Committee urges the Institute to broaden its scientific base for TMJ research by putting greater emphasis on basic

and clinical research on normal and abnormal structural and functional features of the joint and related structures, using the tools

of cell and molecular biology as well as advanced imaging techniques. The Committee expects NIDCR to collaborate on this research with the National Institute of Arthritis and Musculoskeletal

and Skin Diseases, the National Institute of Allergy and Infectious

Diseases, and the National Institute of Biomedical Imaging and

Bioengineering.

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

Appropriations, 2001 ............................................................................. $1,302,798,000

Budget estimate, 2002 ........................................................................... 1,456,996,000

Committee recommendation ................................................................. 1,501,476,000

The Committee recommends an appropriation of $1,501,476,000

for the National Institute of Diabetes and Digestive and Kidney

Diseases [NIDDK]. This is $44,480,000 more than the administration’s request and $198,678,000 more than the fiscal year 2001 appropriation. The comparable amounts for the budget estimate 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.

Adult stem cell research.—The Committee is aware of the rapidly

developing field of research in adult stem cell plasticity, and it encourages NIDDK to work with the American Society of Hematology

in determining the next steps for realizing the full potential of

adult stem cell biology in curing disease.

The Committee encourages the National Institutes of Health to

continue working with the Office of Naval Research to support research to develop curative therapies for patients with breast cancer, leukemia, lymphoma, and sickle cell disease, and for victims of

radiation, chemical, and biological exposure.

Benign prostatic hypertrophy.—The Committee is aware that benign prostatic hypertrophy affects more than 12 million men over

age 50. Although new treatments have become available, there is

still a poor understanding of the factors that affect prostate growth.

The Committee encourages NIDDK to stimulate additional work

and to capitalize on developments in other fields of science through

additional funding. The Committee further encourages NIDDK to

focus more attention on the bladder and urethral changes in response to the enlarged prostate.
131

Bladder disease.—More than 1 of every 10 Americans suffers

from bladder disease, 1 in 9 women will require bladder-related

surgery, and patients continue to be added as the population ages.

The Committee believes that these needs must be met with a

strong commitment to fund research concerning bladder disease.

The Committee is also pleased by NIDDK’s issuance of an RFA related to urinary incontinence. While these steps are important, the

Committee remains concerned about the funding level for research

in bladder disease. The Committee urges the Institute to finalize

a long-term research strategy based upon the recommendations of

the Bladder Research Progress Review Group convened in 2001.

The Committee supports increased bladder disease research by any

available means, and encourages the Institute to consider initiating

and maintaining a National Cell/Tissue Archive for Bladder Disease.

Crohn’s disease.—The Committee is concerned about the increasing frequency of regional enteritis (Crohn’s disease) in the United

States. The Committee is aware of the complicated etiology of this

disease, which involves immunologic, infectious, and dietary factors. The Committee supports further research into Crohn’s disease

that may lead to better treatment of this chronic illness.

Complementary and alternative medicine treatments.—Complementary and alternative medicine treatments for liver diseases

are becoming more common despite limited evidence of safety and

efficacy. The Committee is aware that the NIDDK, working with

the NCCAM, has begun funding studies of some of these treatments. The Committee urges the NIDDK to continue supporting

this research and ensure that the public is aware of the results.

Congenital urological disorders.—The Committee is aware that

urology problems that are present at birth result in significant

physical and psychological stress for both the parents and the

child. The Committee urges NIDDK to collaborate with other interested institutes in developing a strategic research plan to address

congenital urological disorders in the pediatric age group, and to

initiate new, innovative research projects in areas such as ureteral

reflux, fetal hydronephrosis, and bladder dysfunction of spina

bifida.

Cooley’s anemia.—The Committee continues to support strongly

the work being done in NIDDK to advance treatments for Cooley’s

anemia in the fields of iron measurement, fetal hemoglobin, iron

chelation, and more. The April 2001 iron measurement workshop

helped to set a direction for future research. In addition, the development of HBED, a more efficient iron chelator, under an NIDDK

contract holds great promise to improve treatment and compliance.

NIDDK and NHLBI should submit a joint report on the work they

are conducting that is of direct benefit to thalassemia patients by

April 1, 2002. In addition, the Committee would like NIDDK to encourage greater investigator-initiated research in this area.

Diabetes in native Hawaiians.—The Committee recognizes the

Institute’s interest in studying the incidence of diabetes in native

American, Hawaiian, and Alaskan populations, and encourages

NIDDK to include native Hawaiian and Alaskan populations, the

Mississippi Band of the Choctaw Indians, and the Eastern Band of

the Cherokee Indians in diabetes studies.
132

Diabetic macular edema.—The Committee urges the Director of

NIDDK to consider the National Eye Institute’s new multicenter

clinical trial initiative on diabetic macular edema, a major cause of

visual loss in patients with diabetes, when allocating the special

funds targeted for diabetes made available to the Department.

Digestive cancers.—The Committee is pleased with the NCI

Progress Review Group on Pancreatic Cancer and urges the

NIDDK to collaborate with NCI on mutual research areas and

awareness programs for the scientific and lay communities. The

Committee urges NIDDK to establish translational research activities to understand the inter-relationships of pancreatitis, diabetes,

and pancreatac cancer.

Digestive diseases.—Diseases of the digestive system, such as

colorectal cancer, inflammatory bowel disease, irritable bowel syndrome, and hepatitis, continue to affect more than one-half of all

Americans at some time in their lives. The Committee continues to

encourage NIDDK to strike an appropriate balance between conducting basic studies on digestive diseases and bringing those research findings to the bedside in the form of improved patient care.

The Committee recognizes the success of NIDDK’s 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 inflammatory bowel disease.

Drug-induced liver disease.—The Committee is aware of the findings of a recent NIDDK-sponsored workshop that discussed the

most appropriate response to the growing problem of drug-induced

liver injury. Liver injury due to over-the-counter and prescription

drugs is an increasingly frequent cause of acute and chronic liver

disease and is the single most common cause of acute liver failure

in the United States. The Committee urges the NIDDK, in cooperation with other appropriate Institutes and the pharmaceutical industry, to establish a national surveillance system to further document hepatotoxicity of medications and to fund research to prevent

and treat this serious cause of liver injury.

Glomerular injury research.—The Committee urges NIDDK to

expand its research efforts on glomerular injury, a group of diseases which affect the filtering mechanisms of the kidney. The

Committee is pleased that in addition to basic research being conducted, NIDDK is working to initiate several clinical trials related

to glomerular injury. Further, the Committee encourages NIDDK

to consider initiating a consensus development conference on glomerular injury research, and to explore support for gathering prevalence data on glomerular injury.

Hepatitis C.—The Committee is encouraged that the HALT-Hepatitis C Clinical Trial should yield important information about the

relatively low response rates to current hepatitis C treatments. The

Committee is concerned, however, with the slower than expected

progress to enroll patients in the clinical trial. The Committee has

also learned that 10 promising ancillary research projects have

been developed, which is more than anticipated. The Committee

therefore requests a report by April 1, 2002, on the timetable, new
133

findings and additional resources that may be necessary to complete the HALT-Hepatitis C clinical trial.

The Committee is also aware that the prevalence of hepatitis C

in African Americans is more than two times greater than in Caucasians and that African Americans have a poor response rate to

treatments. The Committee encourages the Institute to establish

the appropriate number of clinical trial centers and a data-coordinating center to study the impact of the hepatitis C virus infection

and the variable response to treatment in different human hosts.

The Committee also urges the Institute to collaborate with the National Center on Minority Health and Health Disparities on this

issue.

Hereditary hemochromatosis.—Hereditary hemochromatosis, the

most common genetic disease in human beings, is associated with

identified genetic mutations in 70 to 90 percent of cases. The Committee urges the Institute, working with NHLBI, to expand research funding on this common disease with particular emphasis

on screening, early diagnosis, and the still-unknown genetic

mutations that cause 10 to 30 percent of cases.

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). The Committee commends NIDDK for its leadership in this

area and encourages the Institute to give priority consideration to

the following areas of IBD research; (1) investigation into 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) coordination and integration of

basic investigations designed to clarify mechanisms of action and

disease pathogenesis into clinical trials, as described in the research agenda developed by the scientific community titled ‘‘Challenges in Inflammatory Bowel Disease.’’ The Committee believes

that NIDDK should review the current intestinal transplantation

procedures and make future recommendations on how they could

be improved. It also encourages the Institute to implement a longrange research agenda to adequately fund research into the cause

of and a cure for IBD and short bowel syndrome.

Interstitial cystitis.—The Committee is aware that there is unprecedented momentum in interstitial cystitis research, particularly in the area of urinary markers. The Committee urges the

NIDDK to aggressively support research that will enhance these

recent advances. The Committee is pleased that the NIDDK convened a Bladder Research Review Group in 2001 to create a strategic plan and set research priorities for all aspects of bladder disease, including IC. The Committee urges that the strategic plan’s

recommendations regarding IC be implemented and fully funded as

soon as possible. The Committee is pleased with the progress of the

IC Clinical Trials group and it urges the NIDDK to re-compete the

trials at the end of the current grant period. Since patients with

IC frequently get multiple disorders, the Committee also encourages the NIDDK to support collaborative research on IC that includes urologists, neurologists, geneticists, and specialists in visceral pain, vulvodynia, irritable bowel syndrome, and irritable

bowel disease
134

Irritable bowel syndrome.—The Committee remains concerned

about the increasing frequency of irritable bowel syndrome (IBS),

a chronic complex of disorders that malign the digestive system.

The Committee encourages NIDDK to provide adequate funding for

irritable bowel syndrome/functional bowel disorders research and to

give priority consideration to funding IBS education/scientific symposiums. Moreover, the Committee urges NIDDK to work with

CDC and the private sector to initiate an IBS public awareness

campaign.

Juvenile diabetes.—The Committee wishes to commend NIDDK

for its leadership in implementing the juvenile diabetes research

funding approved by Congress last year. The Committee hopes that

NIDDK’s juvenile diabetes research portfolio will include such

areas as vaccine development, the creation of genomics/

bioinformatic capability, initiatives to enhance research training for

juvenile diabetes, and the vigorous pursuit of the most promising

scientific opportunities to develop alternative sources of insulinproducing beta cells for therapeutic replacement.

Kidney disease clinical research.—It has been brought to the

Committee’s attention that the lack of a permanent infrastructure

for clinical trials to study kidney disease is hampering the translation of basic research discoveries to the bedside. In order to provide an organizational framework, the Committee urges the

NIDDK to make resources available to plan the development of a

Cooperative Clinical Trials Group Program for Kidney Disease Research.

Liver transplantation.—The Committee is aware of the significant and continuing shortage of livers available for transplantation,

and therefore urges additional research that would facilitate the

success of liver transplantation and the number of livers available

for transplantation. Many believe that the use of living liver donors

may be one of the most important surgical and scientific breakthroughs that can assist people in the need of liver transplants.

Mucopolysaccharidosis (MPS).—The Committee encourages the

NIDDK to expand research efforts in the development of effective

treatments for MPS disorders. The Committee encourages the Institute to pursue research addressing genotype-phenotype studies,

the blood brain barrier, cell biology, pathophysiology of brain damage and substrate deprivation as they relate to MPS disorders. The

Committee urges the NIDDK, NINDS, and NICHD to engage in

collaborative research efforts and enhance grant support for current studies as well as new efforts to develop effective therapies for

these deadly disorders.

Neurological disorder-associated bladder dysfunction.—The Committee encourages NIDDK to increase funding into the effective

treatment of bladder dysfunction associated with spinal cord injury

and neurological diseases. The Committee urges NIDDK to investigate the most effective methods of treatment and new and innovative approaches to treatment.

Non-alcoholic steatohepatitis.—Non-alcoholic steatohepatitis liver

disease (NASH) is the second-most common cause of liver disease

after hepatitis C. The disease is often unrecognized and

undiagnosed, and it leads to cirrhosis and liver failure. The Committee urges the Institute to initiate a long-term epidemiological
135

study including research focused on treatment options and outcomes for NASH.

Obesity.—Obesity is a major health threat in the United States,

with more than 49 million American adults considered clinically

obese. The Committee urges the NIDDK to expand research in this

area, particularly into the effects of obesity on gene expression, as

well as excessive risk of gastrointestinal cancers, including colon

cancer and liver disease. The Committee also encourages NIDDK

to support research in the role of GI hormones, motility, and

mucosal absorption in the complex balances of satiety, nutrient uptake and calorie and energy balance. Finally, the Committee urges

NIDDK to support research into the effect of diet and nutrient intake on metabolism and gene function to provide further insight

into how nutrients conversely affect gut function.

Osteoporosis and related bone disorders.—The Committee urges

NIDDK to enhance research on osteoporosis, primary

hyperparathyroidism and other disorders of calcium metabolism,

including renal osteodystrophy, a disorder affecting individuals suffering from chronic kidney disease. NIDDK is also encouraged to

enhance its efforts in the areas of nutritional and hormonal influences on calcium and skeletal status and functional genomics in

bone. The Committee urges NIDDK to work with NCI to focus on

cancer that spreads to bone.

Parity for kidney research.—The Committee is concerned that the

resources available to conduct kidney research are not keeping pace

with inflation. The Committee urges the NIDDK to review the current funding policy and provide increased funding for kidney disease research.

Pediatric kidney disease.—The Committee remains concerned

over the alarming number of children and adolescents suffering

from kidney disease, a disproportionate number of whom are minorities. In calling for greater research emphasis on this vulnerable

segment of our population, the Committee notes that chronic kidney failure among young people results in particularly severe consequences. Normal growth and development are impaired, and

many scientists believe that chronic kidney failure has a profound

effect on the developing brain, often resulting in learning disabilities and mental retardation. The Committee urges NIDDK to

sharpen its research focus on both congenital and acquired chronic

renal failure, including: the molecular mechanisms underlying

growth failure in children with kidney failure; hypertension as a

risk factor for cardiovascular and renal disease; and the development of a database of genetic renal diseases. Additionally, NIDDK

is encouraged to launch new training initiatives to help ease the

workforce shortage in this field.

Pediatric liver disease.—The Committee is aware of the ‘‘Pediatric Liver Research Agenda 2000: A Blueprint for the Future’’ developed by the Children’s Liver Council of the American Liver

Foundation, which defines research priorities for biliary atresia. Although rare, biliary atresia is the most common cause of liver

transplantation in children. Since too few patients are seen annually at individual centers, a collaborative network of centers is

needed to gather sufficient data and study specific hypotheses of

the cause and treatment of biliary atresia. The Committee encour-
136

ages the Institute to establish clinical centers and a data-coordinating center to address the scourge of biliary atresia.

Phytotherapy.—The Committee is aware of the increasing use of

patient self-administered phytotherapy (saw palmetto) to treat benign prostatic hypertrophy. However, there is little information

available to clinicians or patients regarding the relative safety and

effectiveness of this therapy. The Committee encourages NIDDK to

move forward on clinical trials aimed at aiding the public and urologists better understanding whether or not there is a role for

phytotherapy in treating benign prostatic hypertrophy.

Polycystic kidney disease (PKD).—The Committee is encouraged

that the number and significance of research discoveries leading to

a treatment and cure for PKD are growing at a rapid pace and that

notable breakthroughs are coming from the four P–50 PKD research centers established last year by NIDDK. The Committee is

also pleased that the NIDDK is planning an International Scientific Workshop focusing on clinical aspects of PKD and an RFA

for a PKD Interventional Trials Network, both in early fiscal year

2002. The Committee recommends that the NIDDK fund and execute the PKD Strategic Plan without delay.

Training programs for physicians.—The Committee is aware of

the need to encourage physicians who wish to pursue careers in the

epidemiology of urologic disease and in the development and conduct of urological clinical trials. The Committee encourages NIDDK

to initiate a training program to meet these needs.

Urinary incontinence.—The Committee urges the NIDDK to significantly enhance its support of urinary incontinence research following the recommendations from the Bladder Progress Review

Group. The Committee encourages the NIDDK to elevate its focus

on urinary incontinence research by expanding its support to the

Urinary Incontinence Treatment Network Initiative by increasing

the number of clinical sites.

Urinary tract obstruction.—The Committee is encouraged that

the NIDDK will hold a workshop on obstructive uropathy and

reflux in infancy and early childhood. Urinary tract obstruction, if

left untreated, can result in progressive, irreversible loss of kidney

function and end-stage renal disease.

Urologic disorders and diabetes.—The Committee is aware of

urological complications such as impotence and urinary retention

associated with diabetes. The Committee encourages NIDDK to examine these aspects of diabetes and asks that NIDDK provide the

Committee with its plan to address this problem.

Urological disorders affecting women.—The Committee is aware

that urological disorders affect millions of women of all ages. Urinary incontinence is a major cause of nursing home admissions for

women. The Committee encourages NIDDK to support research

targeted to these problems that may substantially prolong the ability of many elderly women to remain in their homes.

Urology research.—The Committee is concerned that the urology

research effort is not addressing the large public health impact of

urological diseases and conditions. The Committee encourages

NIDDK to increase funding for existing programs in urology research at a growth rate similar to that for the overall agency budget. The Committee is also aware of the significant progress made
137

at the George M. O’Brien Kidney and Urology Research Centers of

the NIDDK. The Committee urges continued and increased funding

for their activities. In addition, the Committee encourages the creation of two new urologic centers, both of which should have a clinical component and a research training component.

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2001 ............................................................................. $1,172,132,000

Budget estimate, 2002 ........................................................................... 1,311,179,000

Committee recommendation ................................................................. 1,352,055,000

The Committee recommends an appropriation of $1,352,055,000

for the National Institute of Neurological Disorders and Stroke

[NINDS]. This is $40,876,000 more than the budget request and

$179,923,000 more than the fiscal year 2001 appropriation. The

comparable amounts for the budget estimate 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 continues to play an integral role in

advancing science’s understanding of Alzheimer’s, a progressive

brain disorder that results in memory loss, behavior and personality changes, and a decline in thinking abilities. Working collaboratively with NIA, NINDS-supported researchers found that cortical degeneration, or brain atrophy, was 20 to 25 percent greater

in patients with Alzheimer’s, confirming this as the major basis for

cognitive decline in Alzheimer’s patients. The Committee encourages NINDS to treat Alzheimer’s research as a high priority, and

to continue to work closely with NIA and other research Institutes.

The Committee is aware that positron emission tomography

(PET) has been shown to identify Alzheimer’s disease at a significantly earlier stage than other diagnostic methods. Earlier diagnosis of Alzheimer’s allows for added treatment options which may

delay the onset of the more debilitating aspects of this disease. The

Committee urges NINDS, in collaboration with the National Institute on Aging and the National Institute of Mental Health, to expand its research into early diagnosis of Alzheimer’s using PET imaging of the brain.

Amyotropic Lateral Sclerosis (ALS).—Also known as Lou Gehrig’s

Disease, ALS is a progressive, fatal, neurological disease that attacks specialized nerve cells that control the movement of voluntary muscles. Findings with respect to ALS can lead to methods

for prevention and treatment of many other neurodegenerative disorders, including Parkinson’s, Alzheimer’s, Huntington’s, and multiple sclerosis. The Committee encourages the Institute to continue

to expand and intensify its research efforts into ALS.
138

Batten disease.—The Committee is disappointed with the pace of

research in Batten disease. The Committee believes that the Institute should actively solicit grant applications for Batten disease

and also take aggressive steps to assure that a vigorous research

program is established. In recent years, funding for this disease

has decreased. The Committee strongly urges that increased funding be provided to combat this devastating disease.

Brachial plexus injuries.—The Committee understands that injury to the nerves of the brachial plexus, which control the muscles

of the shoulder, arm, elbow, wrist, hand, and fingers, can result in

full to partial paralysis. While these injuries most often occur during the birthing process at a rate of 2–3 of every 1,000 births, traumatic injury is another cause. Although many affected individuals

recover without intervention, and others can be helped with surgery, some experience permanent nerve damage. The Committee

encourages NINDS to continue an aggressive program of nerve regeneration research, which should have benefits that can be applied to these injuries as well as to other forms of damage to the

peripheral and central nervous systems.

Brain tumors.—The Committee is concerned that not enough attention is being given by NINDS to identifying causes of and treatments for brain tumors, and it encourages NINDS to continue

working with NCI to carry out the recommendations of the recently

issued Report of the Brain Tumor Progress Review Group.

Congenital muscular dystrophy (CMD).—The Committee urges

the Institute to collaborate with the NIAMS to intensify research

into CMD. The Committee is extremely concerned that, unlike

nearly all other forms of muscular dystrophy, no specific gene defect or protein deficiency has even been identified to date for several types of CMD. The Committee requests that the NIH report

to the Committee by April 1, 2002, on steps it will take to create

a comprehensive research portfolio in CMD.

Duchenne muscular dystrophy.—The Committee is aware that

NIH has been directed to intensify and enhance muscle disease research, and it urges NINDS to aggressively support translational

research where possible. To accomplish this, the Committee strongly urges NINDS to establish no fewer than three centers of excellence for basic and applied research in the muscular dystrophies

and encourages the Institute to provide sufficient funds for this

purpose. The Committee expects NINDS to coordinate with NIAMS

and the Centers for Disease Control and Prevention on the planning and activities for the centers of excellence.

Dystonia.—The Committee is concerned that NIH has traditionally underfunded research to develop treatments for the neurological movement disorder dystonia. In light of the fact that it

ranks as the third most common movement disorder behind Parkinson’s and tremor, the Committee encourages NIH to afford substantial increased funding for additional research on both focal and

genetic dystonia as its sets its priorities for fiscal year 2002. The

Committee also continues to be interested in the expansion of

NINDS’s extramural research portfolio with respect to dystonia,

and it encourages NINDS to continue to expand the study of the

DYT1 gene. In addition, the Committee encourages the Institute to

increase its collaboration with the dystonia research community in
139

supporting epidemiological studies on dystonia and in increasing

public and professional awareness of this disorder.

Epilepsy.—The Committee believes that NIH should make finding a cure and effective treatments for epilepsy a priority. The

Committee is encouraged by the establishment of 13 epilepsy research benchmarks resulting from the NINDS March 2000 conference ‘‘Curing Epilepsy: Focus on the Future.’’ The Committee encourages NIH to develop a plan to implement the research benchmarks, as the Director deems appropriate, including the funding

projections needed to carry out the plan. The Committee directs

that the plan be submitted to Congress by April 1, 2002. Further,

the Committee encourages the establishment of an Interagency

Epilepsy Coordinating Committee comprised of agency scientists,

industry, and patient representatives.

Multiple sclerosis (MS).—Multiple sclerosis is a chronic, progressive disease of the central nervous system which is estimated to affect between 250,000 and 350,000 persons in the United States.

While there is no known cure for MS, a number of therapies have

been found helpful in slowing the disabling progression of the disease. The cause of MS remains equally elusive, although investigators are examining such factors as the role of viruses, genetics, and

the environment. The Committee is aware that several scientific

studies have not supported the role of trauma in causing MS or in

triggering MS exacerbations. Nevertheless, the Committee is concerned over increasing reports of MS incidence caused by environmental triggers, be they allergic reactions, or more commonly, traumas such as automobile accidents. The Committee urges the Institute to devote additional resources toward study of the role of such

traumas in causing multiple sclerosis.

Neurofibromatosis.—Neurofibromatosis (NF) is a genetic disorder

of the nervous system that causes tumors to grow along nerves

anywhere on or in the body. The Committee is aware that recent

advances in research have linked NF to cancer, brain tumors,

learning disabilities and heart disease. It urges NINDS to expand

its NF basic and clinical research portfolio through mechanisms

such as requests for applications and program announcements.

Prion disease.—Britain and several other countries in Europe

have documented transmissible forms of spongiform

encephalopathies (TSEs) and variant Creutzfeldt-Jakob Disease

(vCJD), a type of TSE, caused by small infectious proteins called

prions. It appears that the prions causing vCJD come from eating

infected beef cattle. To date, NIH funding of prion-mediated diseases has been mainly for Creutzfeldt-Jakob disease (CJD—a separate but related disease to vCJD) but also has included funding for

bovine (cow) spongiform encephalopathy, scrapie (sheep spongiform

encephalopathy) and chronic wasting (human). The Committee

urges NINDS to specifically fund research into prion disease and

to work with other agencies to develop a diagnostic test to detect

the presence of the disease.

Stroke.—The Committee continues to regard research into the

causes, cure, prevention, treatment and rehabilitation of stroke as

a top priority of the NINDS and of the NIH. Stroke remains the

third-leading cause of death in the United States, a leading cause

of permanent disability and a major contributor to late-life demen-
140

tia. The Committee commends the NINDS for its efforts in beginning to develop a 5-year strategic stroke research plan. Expected

to be released in fall 2001, this plan will strongly stimulate novel

ideas in stroke research. The Committee also encourages NINDS to

expand its research efforts into the utility of PET scans of the

brains of stroke victims to determine whether brain tissue damage

from stroke may be reversible.

Stroke in women.—Stroke in women is a major health problem,

with women representing 61 percent of all deaths from stroke.

Stroke kills twice as many women as breast cancer and AIDS combined. The Committee is concerned that very little research has

been directed toward understanding gender differences in stroke

and cerebrovascular disease. Since the physiology of women’s bodies is different from men’s, stroke prevention and treatments may

affect women in dissimilar ways. The Committee is pleased to learn

that NINDS is funding a trial looking at whether postmenopausal

hormone replacement therapy alters stroke risk. The Committee

urges the Institute to increase research specifically in the area of

stroke-related care, risk factors, preventive strategies, acute stroke

management, aspects of post-stroke recovery and long-term outcomes among women. The Committee further urges the Institute to

take steps to increase research into new therapies for stroke in

women as well as ways of enhancing the vascular health of all

Americans.

Stroke research.—The Committee supports continued research

and development efforts in the area of Polynitroxylated Albumin

(PNA) as a neuroprotectant for ischemic stroke, hemorrhagic stroke

and transient ischemic attack.

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2001 ............................................................................. $2,062,089,000

Budget estimate, 2002 ........................................................................... 2,329,643,000

Committee recommendation ................................................................. 2,375,836,000

The Committee recommends an appropriation of $2,375,836,000

for the National Institute of Allergy and Infectious Diseases

[NIAID]. This is $46,193,000 more than the budget request and

$313,747,000 more than the fiscal year 2001 appropriation. Included in these funds is $25,000,000 to be transferred to the Global

Fund to fight HIV/AIDS, Malaria, and Tuberculosis. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research.

Mission.—The NIAID supports and conducts basic and clinical

research and research training programs in infectious diseases, including AIDS, and diseases caused by, or associated with, disorders

of the immune system. The NIAID is the lead NIH Institute

charged with developing new and improved vaccines and supporting research on acquired immunodeficiency syndrome, tuberculosis, sexually transmitted diseases, and tropical diseases. The

NIAID’s research goal is to improve the health and quality of life

of people by improving diagnosis, treatment, and prevention of diseases.

Asthma research and management.—The Committee is pleased

with NIAID’s leadership regarding asthma research and management. The Committee recognizes the role that NIAID has played
141

with the Inner City Asthma Study and the importance of this effort

concerning morbidity and mortality among underserved populations, particularly children. The Committee urges NIAID to continue to improve its focus and efforts on asthma management, particularly as it relates to children.

Chronic fatigue syndrome (CFS).—The Committee supports the

development of a multidisciplinary, multidimensional Chronic Fatigue Syndrome Assessment and Treatment Center where people

can be assessed and treated.

Crohn’s disease.—The Committee notes with interest and concern

NIAID’s report titled ‘‘Crohn’s Disease—Is There a Microbial Etiology?’’ The report findings show that Crohn’s disease may have an

infectious etiology. The Committee shares NIAID’s concern that if

it is proven that Mycobacterium avium, subspecies paratuberculosis is the cause of Crohn’s disease, the impact upon the public health could be enormous because of the prevalence of this

mycobacteria on farms and in standing water. The Committee

urges the NIH to consider designating Crohn’s as an ‘‘emerging infectious disease’’ and encourages the NIAID to establish a formal

Crohn’s disease program specifically for research into an infectious

cause of Crohn’s disease.

Hemophilia.—The Committee encourages NIAID to continue its

efforts with the National Hemophilia Foundation leadership to ensure that persons with hemophilia have access to and opportunities

to participate in research for improving treatment of HIV and complications of hemophilia, including hepatitis C.

Gender-based research.—The Committee understands that the

NIAID has partnered with the National Multiple Sclerosis Society

and other groups to support research related to gender-based differences in immune function and immunologic disease. The Committee commends the Institute for undertaking this important initiative.

Hepatitis C vaccine development.—The Committee encourages increased priority on research that will accelerate the development of

a hepatitis C vaccine. The development of an effective vaccine

would be greatly assisted by research that studies the mechanisms

that lead to recovery from initial infection, the mechanism that

leads to the transition from asymptomatic infection to chronic infection and recovery in response to therapy. The Committee is

aware that the NIAID has conceptually approved research in this

field encompassed by a project titled Hepatitis C: Recovery Research Network. The Committee urges that adequate funding be

made available to initiate this project. As part of that effort, the

Committee urges the Institute to evaluate early treatment or treatment within the first year of infection.

Inflammatory bowel disease (IBD).—The Committee is aware of

NIAID’s research partnerships with the IBD community, and it encourages the Institute to expand its support of research focused on

the immunology of IBD as well as the interaction of genetics and

environmental factors in the development of the disease.

Pediatric kidney disease.—Studies have shown that improvements seen in transplant survival among adults with kidney disease have not been completely realized in children, who have not

fully benefited from improvements in immunosuppressive medica-
142

tions tested largely in the adult population. NIAID is encouraged

to step up its efforts to maintain transplants over a longer period,

thereby improving kidney transplant outcomes in children and adolescents.

Population mixing.—The Committee urges the NIAID, in cooperation with the Department of Defense, to develop a plan for

studying population mixing, which is an unusual mixing of people

in relatively isolated rural areas. In such situations, a variety of infectious viruses and bacteria may trigger an unusual and rare reaction that affects children in susceptible populations. The Committee hopes that this study will contribute to a greater understanding of this important possible cause of childhood cancers. This

will benefit communities around the Nation such as Fallon, Nevada, which has experienced an outbreak of childhood acute

lymphocytic leukemia (ALL).

Primary immunodeficiencies (PI).—The Committee continues to

be pleased with NIAID’s strong commitment to addressing the

medical and other problems caused by primary immunodeficiencies.

In particular, the Committee looks forward to learning the results

of the NIAID-sponsored research concerning the impact of PI

among urban minority populations and seeing the research replicated on a larger scale throughout the country. Building on past

collaborations with nonprofit groups, the Committee encourages

NIAID to move aggressively in all research areas, including cutting-edge research related to gene therapy, bone marrow transplantation, and cord blood transplantation. The Committee also continues to be pleased with NIAID’s PI clinical registries program,

and urges the NIAID to continue to support this important initiative. The Committee also encourages the Institute to work with the

PI community and the Centers for Disease Control and Prevention

on a national surveillance program. Finally, the Committee urges

NIAID to continue to remain actively and meaningfully involved in

the national education and awareness campaign for PI sponsored

by the Jeffrey Modell Foundation and to expand its role in fiscal

year 2002.

Prostatitis research.—The Committee strongly urges the formation of prostatitis research centers under the direction of infectious

disease specialists as separate and distinct entities from the

urological centers.

Rhinosinusitis.—Chronic rhinosinusitis affects approximately

33,000,000 Americans, yet its cause remains unclear. Recent studies have suggested that the trigger is fungus or fungi that circulate

in the environment. Many healthy, normal people may be exposed

to the same fungi, yet do not develop rhinosinusitis or sinus polyps.

The Institute is urged to support studies to determine the factors

that sensitize an individual to fungus or which generate a fungusspecific immune response.

Temporomandibular joint disorders (TMJ).—The Committee

urges NIAID to put a greater focus in its research portfolio on TMJ

patients and autoimmune and inflammatory processes. The collection of tissue samples from TMJ patients and people without TMJ

disease has been suggested (as part of a patient registry) to determine whether inflammatory mediators, growth factors, cytokines
143

and other cell and molecular factors affecting immunity may differ

between people with and without TMJ disease.

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2001 ............................................................................. $1,530,988,000

Budget estimate, 2002 ........................................................................... 1,710,182,000

Committee recommendation ................................................................. 1,753,465,000

The Committee recommendation includes $1,753,465,000 for the

National Institute of General Medical Sciences [NIGMS]. This is

$43,283,000 more than the budget request and $222,477,000 more

than the fiscal year 2001 appropriation. 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, and biological chemistry, study normal biological

processes to better understand what goes wrong when disease occurs. In this way, 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.

Behavioral science research and training.—The Committee is concerned that NIGMS does not support behavioral science research

training. As the only Institute mandated to support research not

targeted to specific diseases or disorders, there is a range of basic

behavioral research and training that NIGMS could be supporting.

The Committee urges NIGMS, in consultation with the Office of

Behavioral and Social Sciences, to develop a plan for pursuing the

most promising research topics in this area.

Promoting adherence to medical and behavioral therapies.—The

Committee notes that failure to follow medical recommendations

causes tens of thousands of deaths a year, increased hospitalizations and delayed recovery. The Committee encourages the Institute to expand research on innovative theories about behavioral,

cultural, social, psychological and environmental methods to increase adherence to lifestyle and medical regimen. The Committee

further encourages the Institute to take steps to inform medical

personnel of effective indicators to measure the standard of delivery of care of health systems and to change physician behavior and

practices.

Training.—The Committee continues to be pleased with the quality of NIGMS’s training programs, particularly those that have a

special focus on increasing the number of minority scientists, such

as the Minority Access to Research Careers (MARC) and Minority

Biomedical Research Support (MBRS) programs. The Committee

expects NIGMS to continue to support these important initiatives,

and is particularly pleased that NIGMS has supported biomedical

research career opportunity programs for high school and undergraduate college students in conjunction with minority institutions.

The Committee urges continued, long-term support of this program.
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NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

Appropriations, 2001 ............................................................................. $978,136,000

Budget estimate, 2002 ........................................................................... 1,095,954,000

Committee recommendation ................................................................. 1,123,692,000

The Committee recommends an appropriation of $1,123,692,000

for the National Institute of Child Health and Human Development

[NICHD]. This is $27,738,000 more than the budget request and

$145,556,000 more than the fiscal year 2001 appropriation. The

comparable amounts for the budget estimate include funds to be

transferred from the Office of AIDS Research.

Mission.—NICHD is that component of the National Institutes of

Health which is 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.

Adolescent health and disparities.—The Committee strongly encourages the collaboration of NICHD, the National Cancer Institute, the NIH Office of Behavioral and Social Science Research,

and the Centers for Disease Control and Prevention (CDC) in efforts to support CDC’s Healthy Passages Program, which studies

the developmental paths of health risk behaviors and adverse

health outcomes in white, African-American, and Hispanic youth.

The Committee commends the involvement of NIH Institutes in

supporting this CDC study on adolescent health and health disparities.

Autism.—The Committee is aware that NIH, under the auspices

of its Autism Coordinating Committee, has established a plan to

implement the autism provisions of recent legislation dealing with

children’s health. The Committee notes that current plans include

an expedited implementation of the full-scale program of Centers

for Research in Autism. Despite the expedited nature of this plan

for centers, the Committee expects that peer review will be a primary factor in funding decisions regarding these grants. The Committee also commends NIH efforts in a program under which samples of tissues and genetic materials are donated, collected, preserved, and made available for autism research.

The Committee also urges the NICHD to continue its support of

the Collaborative Programs of Excellence in Autism (CPEA), a program that has encouraged collaboration in research efforts among

leading institutions in the field of autism research.

Behavioral and social sciences research.—The Committee is

pleased to learn that NICHD is undertaking a strategic planning

process strongly emphasizing a collaborative process between the

biomedical and behavioral sciences to successfully accomplish the

goals of the Institute.

Bone disease in adolescents.—Given the high incidence of teen

pregnancies, more research is needed to understand the relation-
145

ship between pregnancy, lactation, and bone mass in adolescents.

In particular, NICHD is urged to support research on the impact

of chronic anticoagulation on bone mass in pregnancy, the effect of

oral contraceptives on acquisition of peak bone mass and bone loss

in early adolescence, and the impact on bone status of chronic

under-nutrition of young women. The Committee supports the continuing efforts of the Institute to provide a database of bone density across a decade for white and minority children and adolescents. Furthermore, the Committee encourages NICHD to expand

research on osteogenesis imperfecta, with special emphasis on further research into genetic therapies, animal models, drug treatment and rehabilitation techniques.

Child development and behavioral research.—The Committee is

pleased that NICHD is undertaking a number of initiatives to increase understanding of the behavioral and cognitive aspects of

child development. The Committee encourages these efforts.

Child development and literacy.—The Committee recognizes

NICHD’s leading role in identifying factors affecting how children

learn generally, both with and without formal instruction, and for

normal children as well as children for whom learning is a challenge. NICHD research on early child development, reading development and disorders has contributed to converging evidence about

how children must be taught in order to read and how children

who are likely to have difficulty learning may be identified early

in their education. The Committee strongly supports NICHD’s efforts to translate this research to improve literacy and academic

performance.

Chromosome 18.—The Committee is aware of efforts to encourage new scientific work into the molecular genetic, clinical and

therapeutic aspects for chromosome abnormalities. NIH has supported little research into the abnormalities of Chromosome 18, despite repeated urging by this Committee. The Committee believes

that the NIH must ensure that this research be performed. It requests that a strategic plan and report addressing initiatives to

fund Chromosome 18 research be provided to the Committee by no

later than April 1, 2002.

Demographic research.—The Committee strongly endorses demographic and behavioral research supported by NICHD, which includes studies of poor families and neighborhoods, adolescent

health, fertility patterns and their relationship to education and

labor, risky sexual behavior and HIV, infant mortality, and particularly health disparities. The Committee is pleased that NICHD

plans to expand its examination of health disparities through research on the social and behavioral factors leading to pre-term

births and low birth weight, as well as research to develop more

effective means of preventing and treating HIV among minority

youth. The Committee strongly supports planned research linking

social and cultural understandings of gender dynamics to account

for how these factors may influence HIV risk among different racial, ethnic and socioeconomic groups. The Committee also supports

research identifying the barriers to school readiness and academic

success for minority and low-income children.

Duchenne muscular dystrophy.—The Committee is aware that

NICHD has done little in the field of muscular dystrophy research,
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even though Duchenne muscular dystrophy is the single most common lethal genetic disorder of children in America. The Committee

urges NICHD to develop collaborative partnerships with NINDS

and NIAMS to advance basic, clinical, and translational research

into treatment for Duchenne muscular dystrophy.

Environmental effects on child health and development.—The

Committee applauds NICHD for its efforts to work with the Environmental Protection Agency and the Centers for Disease Control

and Prevention on developing a major national longitudinal study

quantifying the effects of environmental exposures and biological

and social factors on child health and development. The Committee

places a high priority on investigating the relationship between behavior and exposure to harmful environmental influences, such as

the extent to which behavior drives exposure to low-level contaminants during key developmental phases of a child’s life.

Fatherhood and family stability.—The Committee applauds

NICHD’s demographic, behavioral and social science-based surveys

on fatherhood, marriage and other issues affecting the stability of

families. NICHD’s leading efforts to understand the impact of fatherhood and other factors affecting the integrity of families will

provide critical information to enhance our understanding of family

formation, family structure and parent roles, and the impact of

these factors on the development and well-being of children.

Fragile X.—Fragile X, the most common inherited cause of mental retardation, results from the failure of a single gene to produce

a specific protein. Researchers at the NICHD have made great

strides in understanding the mechanism by which this genetic defect causes mental retardation, seizures, aggressive outbursts and

severe anxiety. Fragile X has the potential to be a powerful research model for other forms of X-linked mental retardation, as

well as neuropsychiatric disorders, including autism, schizophrenia,

mood disorders, and pervasive developmental disorder. The Committee is gratified that the NICHD has enhanced its research efforts on fragile X both internally and by partnering with the

FRAXA Research Foundation in the issuance and funding of a Request for Applications to research scientists.

The Committee notes that Title II of the Children’s Health Act

of 2000 calls for the establishment of at least three fragile X research centers. The Committee strongly urges the NICHD to allocate sufficient funds for that purpose, to expedite that objective,

and to ensure the discrete accountability of the Centers.

Health behaviors of youth.—The Committee is increasingly concerned about youth and health behaviors and their impact on society as a whole. The Committee is pleased that the NICHD will be

collaborating with the Centers for Disease Control and Prevention,

the Substance Abuse and Mental Health Services Administration,

and the Health Resources and Services Administration, and it requests that the agencies involved focus a portion of their efforts on

discovering approaches to intervene and prevent complex behavior

problems in children and youth which utilize molecular neuroscience, brain mapping, and behavioral analysis.

Infertility and contraceptive research.—The Committee continues

to place a high priority on research to combat infertility and speed

the development of improved contraceptives. NICHD is urged to
147

continue aggressive activities in this area, including individual research grants and those of the infertility and contraceptive research centers.

Juvenile diabetes.—The Committee is concerned about reports of

a severe shortage of pediatric endocrinologists, and it urges NICHD

to develop a strategy to ameliorate this problem. The Committee

also wishes to reiterate its interest in NICHD collaborating with

NIAID and NIDDK in leading a project that will develop a vaccine

for juvenile diabetes. The Committee understands that CDC is

funding a pediatric diabetes registry project and urges NICHD to

collaborate in this project.

Maternal-fetal medicine.—The Committee urges the NICHD to

sponsor a planning workshop for the purpose of defining research

questions regarding the causes of pre-term delivery, building on

previous research surrounding the role of infection and the immune

response, and the role of genetics. The outcome should provide the

basis for the development of appropriate funding mechanisms and

increased collaboration with academic centers not currently participating in cooperative agreements with the NICHD. The Director is

urged to report to the Committee on activities in this area by June

30, 2002.

Medical rehabilitation.—The Committee is pleased with the Center’s progress in addressing rehabilitation and disability research

issues. The Committee encourages the Center to focus on a number

of priority areas including: advanced orthotics and prosthetics; increased research into engineered biomaterials and tissue reengineering as strategies for rehabilitation with a focus on incorporating nanotechnology and robotics into orthotics and prosthetics;

and additional research in traumatic brain injury through the clinical trials network. The Committee is also pleased with the

progress on clinical trials in the areas of hip fracture and stroke,

and it requests progress reports on the results of these trials.

National longitudinal cohort study.—The Committee understands

that the NICHD is leading a consortium of representatives from

appropriate Federal agencies, including other NIH Institutes, CDC

and EPA, in planning and developing a national longitudinal cohort

study of environmental influences on children’s health. The Committee is pleased that an interagency workgroup has begun preliminary work in developing an innovative structure for the study

and initiating necessary pilot studies. The Committee urges the Institute to provide sufficient funds to support increased planning

and piloting activities over the next 2 fiscal years, so that the full

study is underway by the end of 2003.

Pediatric emergency medicine.—The Committee encourages

NICHD to develop a research initiative on pediatric emergency

medicine, including both prehospital and emergency care. To date,

only minimal attention has been paid to addressing this costly and

important aspect of children’s health care. We also encourage

NICHD to work closely with HRSA in the development of national

educational programs and conferences to encourage and support research in emergency medical services for children.

Pediatric kidney disease.—Despite scientific advances, kidney disease continues to be a major cause of illness and death among children and adolescents. NICHD is encouraged to strengthen support
148

for research on the understanding and treatment of congenital diseases and kidney malformations which lead to chronic renal failure

and end-stage renal disease in children and adolescents, as well as

the prevention and treatment of the adverse effects of chronic renal

failure on cognitive and physical development in children.

Pelvic floor dysfunction.—The Committee is encouraged by the

NICHD’s accomplishments to date on establishing a research portfolio into pelvic floor disorders. The Committee urges NICHD make

resources available to fund additional grant applications for epidemiological research and for the newly created clinical trials network. The Committee also encourages NICHD to foster research interest by sponsoring a grantsmanship’s technical assistance workshop for gynecologic and obstetrics researchers.

Policy-relevant demographic research.—The Committee urges the

NICHD to continue its strong support for objective, policy-relevant

demographic research on vital issues such as marriage, family

structure, teen childbearing, fatherhood, immigration, child and adolescent health, and the impact of changing age structures on children and adults. It endorses the expansion of interdisciplinary research which bridges biomedical, demographic, social and spatial

sciences. The Committee continues to strongly support NICHD’s

partnerships with Federal statistical agencies that help to produce

the data so critical to demographic research.

Primary immunodeficiencies (PI).—The Committee continues to

be impressed by the comprehensive commitment that NICHD has

shown in addressing PI, particularly with regard to the national

education and awareness campaign sponsored by the Jeffrey

Modell Foundation in partnership with the Institute, as well as

NIAID, NCI, CDC, and other private entities. The Committee encourages NICHD to expand its commitment in fiscal year 2002

through such steps as additional Clinical Center Grand Rounds,

distribution of appropriate materials to pediatricians and others,

trans-institute cooperation on research issues, and replication of

successful programs to determine the nature of under-diagnosis in

minority communities.

Reproductive health.—The Committee commends NICHD on its

strategic plan to translate research on reproductive health to reduce the incidence of unwanted pregnancy and to identify usable

strategies to increase knowledge about healthy adult sexuality and

improved reproductive health. The Committee is pleased that such

translation will draw from the research advances of the last 10

years including improved identification of behavioral factors affecting both fertility and infertility. The Committee supports NICHD’s

perspective that research relating to reproductive health should integrate economic, political, sociocultural and psychological factors

while considering other factors that affect reproductive function.

The Committee additionally encourages efforts to understand and

better address the barriers to appropriate contraceptive services in

minority communities.

Small grants.—The Committee is pleased to learn that NICHD

recently began promoting small grants as a way to attract new investigators to child development research. The Committee encourages the Institute to examine whether B/START small grant
149

awards as used by other Institutes would encourage interest among

your investigators.

Sudden Infant Death Syndrome (SIDS).—The Committee is

pleased with NICHD’s continued efforts to extend the reach of its

extremely successful ‘‘Back to Sleep’’ campaign to underserved populations and daycare providers. The Committee also commends

NICHD’s attempts to further its progress in SIDS research by initiating a third SIDS 5-year research plan. This third 5-year plan will

continue the efforts of the past two 5-year plans, which have been

responsible for many of the research breakthroughs in the effort to

reduce SIDS cases in the Nation. The Committee is particularly

pleased that NICHD is collaborating with HRSA’s Maternal and

Child Health Bureau and the NIH Director’s Office to improve public awareness about SIDS to the African-American community.

Uterine fibroids.—Uterine fibroids (leiomyomata) are one of the

most prevalent diseases impacting women today, with over 70 percent of all women having fibroids present in/on their uterus. African-American women have the highest prevalence rates and are

two to three times more likely to acquire symptoms related to uterine fibroids. The majority of all women with symptomatic uterine

fibroids undergo a hysterectomy. The Committee urges NICHD to

aggressively increase efforts that will lead to an understanding of

the physiological endocrine mechanisms that allow uterine fibroids

to grow and become symptomatic. The Conferees also encourage research leading to new treatments, new preventives, and new interventions (beyond the hysterectomy) in the care and treatment of

women with uterine fibroids.

Vulvodynia.—Preliminary new research indicates that millions of

American women suffer from vulvodynia, a painful and often debilitating disorder of the female reproductive system. Despite its prevalence, very little attention has been paid to the disorder by health

professionals or researchers. Since fiscal year 1998, the Committee

has called on the NICHD to support research on the prevalence,

causes and treatment of vulvodynia. While some initial steps have

been taken, the Committee continues to be very concerned about

the lack of research progress made in this important area and the

low priority placed on it by NICHD. The Committee urges NICHD

to significantly expand research on vulvodynia.

NATIONAL EYE INSTITUTE

Appropriations, 2001 ............................................................................. $507,842,000

Budget estimate, 2002 ........................................................................... 568,103,000

Committee recommendation ................................................................. 614,000,000

The Committee recommends an appropriation of $614,000,000 for

the National Eye Institute [NEI]. This is $45,897,000 more than

the budget request and $106,158,000 more than the fiscal year

2001 appropriation. 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
150

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.

The Committee is pleased that vision impairment is a priority

area in the national Healthy People 2010 initiative. The Institute

is urged to develop the data on the extent of the problem of eye

disease, especially among the aging population, and the economic

consequences of eye disease so progress in these areas can be measured.

Diabetic retinopathy.—Diabetic retinopathy is the leading cause

of new cases of blindness in working-age adults. The Committee

recognizes the collaborative efforts of the NEI with other Institutes

and Centers to study ways to control the proliferation of abnormal

vessels that give rise to diabetic complications within the eye and

in other organs and systems of the body. The Committee encourages the NEI to continue this important research that may lead to

the development of methods to inhibit this proliferation before

sight-threatening damage has occurred.

Genomic research.—The Committee recognizes the outstanding

success of the NEI’s Functional Genomics Workshop and the implementation of its recommendations to create a national eye genome

resource. Not only has the NEI significantly increased its support

of research to identify and sequence genes that are expressed in

the visual system, work is now underway to make this information

publicly available through a NEI-supported Web site. This will assist researchers in gaining a better understanding of genetic diseases that affect the eye and visual system and will speed development and testing of new gene-based therapies. The Committee encourages the Institute to emphasize the development of these genebased therapies especially for retinal degenerative diseases.

Glaucoma.—Glaucoma is a significant cause of blindness in older

Americans and is the number one cause of blindness in African

Americans, who are disproportionally at greater risk for developing

the disease and being blinded by it. NEI-supported clinical trials

have demonstrated the effectiveness of a variety of treatments, as

well as the importance of early detection and appropriate treatment in preventing or delaying vision loss. The Committee looks

forward to the results of the Ocular Hypertension Treatment

Study, which will determine the benefit of treating people with ocular hypertension with pressure-lowering drugs to prevent or delay

sight-threatening eye damage. The Committee also encourages the

NEI to continue its research on the genetics of the development of

glaucoma and on the discovery of ways to protect against nerve

damage from glaucoma.

Health education.—The Committee is pleased with the NEI’s efforts to communicate the results of its research efforts into meaningful health education messages to the public and to professionals

through its National Eye Health Education Program. The Committee is particularly pleased with the NEI’s efforts to increase

awareness of low vision and its impact on quality of life. Through

a mobile exhibit that travels to shopping malls and centers around

the country, information on low-vision services and resources are

made directly available to those with low vision and their families.
151

The Institute should continue its emphasis on this important outreach program.

Macular degeneration.—The Committee commends the NEI for

the prioritization of its research on macular degenerative diseases,

which account for nearly 30 percent of the bilateral blindness in

this country and are particularly devastating to the independence

and quality of life of our older citizens. NEI-supported research has

demonstrated that two potentially modifiable risk factors, smoking

and hypertension, are associated with the most severe form of the

disease. The Committee eagerly awaits the results of a clinical trial

that will determine whether low-intensity laser treatment can prevent the development of advanced complications in the age-related

form of the disease.

Retinitis pigmentosa.—Retinitis pigmentosa is a chronic, progressive, degenerative disease that causes the deterioration of the

photoreceptor cells in adolescence and leads to substantial visual

loss in adulthood. Retinitis pigmentosa, Usher’s Syndrome, and

other related degenerative disorders can have a dramatic effect on

the quality of life of those affected and their families. The Committee recognizes the technical difficulties associated with rescue

and regeneration of deteriorating neurons but is encouraged by the

Institute’s exploration of the use of growth factors, transplantation,

and gene-based techniques to combat this destructive disease.

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2001 ............................................................................. $502,987,000

Budget estimate, 2002 ........................................................................... 561,729,000

Committee recommendation ................................................................. 585,946,000

The Committee recommends an appropriation of $585,946,000 for

the National Institute of Environmental Health Sciences [NIEHS].

This is $24,217,000 more than the budget request and $82,959,000

more than the fiscal year 2001 appropriation. 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.

Agent Orange.—The Committee urges the NIEHS to continue its

work with scientists in the United States and Southeast Asia on

the health and environmental effects of the use of Agent Orange

and dioxin. Scientists representing the United States and Vietnamese Governments have recently negotiated a landmark commitment to proceed with this program, and this Committee recognizes

the importance of demonstrating sustained, timely interest and engagement on the part of the U.S. Government. NIEHS is encouraged to continue these efforts and expand them when feasible into

a broader-based effort, including a grants program that funds both

independent and collaborative research. NIEHS should provide a

report on these activities to the Congress by April 1, 2002.

Animal manure management.—The Committee urges NIEHS to

study the issue of animal manure management and storage by ag-
152

ricultural producers, and to explore the public health implications

of this issue.

Breast cancer.—The Committee recognizes the serious lack of research on the relationship between the environment and breast

cancer, and believes that it is essential for the Institute to support

such research. The Committee understands that the Institute will

establish a Breast Cancer and Environmental Research Advisory

Board to make recommendations to the Director with regard to the

development of Breast Cancer and Environmental Research Centers. The Committee is aware of the tremendous success of the

DOD Breast Cancer Research Program and its grant process. The

Committee expects the Advisory Board to integrate a peer review

and planning process along the lines of the DOD integration panel.

The Committee is pleased that the Advisory Board will include representatives from the breast cancer community who have had

breast cancer. The Committee further strongly urges the NIEHS to

establish centers to conduct multi-disciplinary and multi-institution

research on environmental factors that may be related to breast

cancer.

Environmental factors and liver disease.—The impact of environmental factors on liver disease is an important area that needs additional attention. The Committee urges the Institute to collaborate

with NIDDK in an effort to better understand environmental factors that may contribute to the development of liver disease.

Environmental health sciences centers.—The Committee continues to strongly support the Environmental Health Sciences Centers program and believes that a fully funded Centers program is

critical to carrying out the mission of NIEHS. The Committee expects these Centers to be funded at peer-reviewed levels.

Lymphoma.—The Committee encourages NIEHS to expand its

research on investigating the potential of environmental, bacterial,

and viral factors that are associated with the development of

lymphoma and other hematological cancers. The Committee also

encourages NIEHS to collaborate with NCI and CDC to conduct research that will lead to a better understanding on how environmental factors contribute to the development of lymphoid malignancies. The Committee requests that NIEHS and NCI submit a

joint report to the Committee by April 1, 2002, on their current research portfolios on lymphoma and the direction of future research.

Test methods.—The Committee supports the assessment of scientific validation of new, revised and alternative toxicological test

methods by ICCVAM. The Committee encourages NIEHS to use

the expertise and credibility of ICCVAM for these assessments to

streamline their individual consideration of new, revised and alternative toxicological test methods.

Waste treatment management.—The Committee urges NIEHS to

study the issue of waste treatment management by indigenous native Hawaiians, and to explore the public health implications of

this issue and the ‘‘living machines’’ approach to waste management.
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NATIONAL INSTITUTE ON AGING

Appropriations, 2001 ............................................................................. $786,056,000

Budget estimate, 2002 ........................................................................... 879,651,000

Committee recommendation ................................................................. 909,174,000

The Committee recommendation includes $909,174,000 for the

National Institute on Aging [NIA]. This is $29,523,000 more than

the budget request and $123,118,000 more than the fiscal year

2001 appropriation. 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.

Advanced imaging technology for Alzheimer’s.—The Committee

continues to urge NIA to focus on early detection of Alzheimer’s

disease so clinical interventions to slow or stop the progression of

the disease may be undertaken. The Committee notes that positron

emission tomography (PET) has now been shown to identify Alzheimer’s disease definitively and at a much earlier stage than other

diagnostic methods, and it encourages NIA, in collaboration with

NINDS and NIMH, to expand its research efforts into early diagnosis of Alzheimer’s using PET imaging of the brain.

Alzheimer’s disease.—Few diseases affect more Americans, require more prolonged treatment, cause more suffering for the families of the afflicted, and waste more precious human and financial

resources than Alzheimer’s disease. An estimated 4 million persons

suffer from Alzheimer’s, or about one in 10 Americans over age 65

and nearly half of those over age 85. As the baby boom generation

shoulders its way into old age, few diseases represent a greater

threat to the health and financial well being of society as a whole.

Within the next few decades, 14 million individuals will be stricken

with Alzheimer’s, raising the annual cost of caring for its victims

to $375,000,000. Because of its critical size and tragic impact, Alzheimer’s disease represents one of the nation’s most critical health

problems. After two decades of intensive research, scientists have

begun to understand the basic mechanisms of Alzheimer’s as well

as the complex interplay of genetic and environmental risk factors.

Past investments have opened the doors to exciting new opportunities, including clinical trials of a vaccine that may prevent amyloid

deposits in the brain, a hallmark of Alzheimer’s; evidence that cholesterol-lowering drugs may delay or prevent the onset of the disease; and FDA approval of a fourth drug for the treatment of the

disease’s cognitive symptoms. But if society hopes to avert widespread suffering and enormous strain on its health care system,

science must act now because researchers believe that Azheimer’s

actually begins 10 to 20 years before its first symptoms appear.

While investigator-initiated research continues, concurrent largescale clinical trials offer the best hope for finding ways to treat,

delay or prevent Alzheimer’s disease. The Committee urges NIA to

expand its investment in Alzheimer’s disease research, particularly
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for clinical trials, and has provided additional funds for that purpose. It is the Committee’s goal to increase the NIH commitment

to Alzheimer’s research to $1,000,000,000 as soon as possible, a

goal made even more compelling by the growing number of Americans who will soon be at greatest risk.

Alzheimer’s research.—NIA is commended for its innovative research on effective management of Alzheimer’s disease patients

(special care units) and the needs of Alzheimer’s caregivers. The

Committee commends NIA for its efforts to plan and map promising topics in cognitive research. The Committee also commends

NIA for its excellent public information materials on encouraging

older adults to exercise and stay physically active. NIA is encouraged to expand its research on health promotion interventions in

aging populations.

Behavioral and Social Research.—The Committee commends

NIA’s Behavioral and Social Research (BSR) program for its demographic and economic research portfolio on health dynamics in

older populations and the early life determinants of the late life

health disparities. The Health and Retirement Study and the National Long Term Care Survey, the Office of Demography and the

11 demographic research centers are important national resources

for advancing research on the Medicare and Social Security systems. The Committee is very pleased with the BSR’s efforts to link

demography and biology, and to develop a more integrated social

and behavioral science.

Bone disease and aging.—The Committee encourages NIA to coordinate its research on osteoporosis and Paget’s disease with

NIAMS. NIA is also encouraged to study the effects of aging on individuals with osteogenesis imperfecta. The Committee urges the

Institute to renew its commitment to funding studies related to the

aging skeleton.

Cardiovascular aging research.—Heart attack, congestive heart

failure, stroke, and other cardiovascular diseases remain America’s

leading cause of death of older men and women and a main cause

of disability. The Committee encourages the Institute to make cardiovascular research a priority, and urges it to expand into innovative extramural and intramural cardiovascular research programs.

Claude D. Pepper Older Americans 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. The centers also play

a critical role in developing top-level experts in geriatrics. The

Committee again urges NIA to expand these centers to include a

school of nursing.

Cognitive changes during aging.—The Committee understands

that research on cognitive changes during aging is an important

focus of the Institute, and that maintaining mental acuity is an important concern of aging adults. It is generally recognized that research on higher-order mental processing is underdeveloped in the

field of aging. NIA is working to expand is portfolio in this area,

and the Committee encourages those efforts. The Committee is

pleased to learn that a study now underway at the Institute of

Medicine is examining the current knowledge base in the area of

cognition and aging. The Committee urges NIA to use the IOM rec-
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ommendations as a guide for expanding its portfolio in this critical

area of research.

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

Appropriations, 2001 ............................................................................. $394,968,000

Budget estimate, 2002 ........................................................................... 441,803,000

Committee recommendation ................................................................. 460,202,000

The Committee recommends an appropriation of $460,202,000 for

the National Institute of Arthritis and Musculoskeletal and Skin

Diseases [NIAMS]. This is $18,399,000 more than the budget request and $65,234,000 more than the fiscal year 2001 appropriation. The comparable amounts for the budget estimate include

funds to be transferred from the Office of AIDS Research.

Mission.—The NIAMS conducts and supports basic and clinical

research and research training, and the dissemination of health information on the more than 100 forms of arthritis; osteoporosis and

other bone diseases; muscle biology and muscle diseases; orthopedic

disorders, such as back pain and sports injuries; and numerous

skin diseases. The research agenda of the 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 and

lost productivity. The research activities of this Institute serve the

concerns of many different special populations, including women,

minorities, children, and the elderly.

Behavioral and social science research.—The Committee notes

that the portion of the NIAMS research portfolio devoted to behavioral and social sciences research is significantly lower than the

NIH average. Therefore, the Committee urges the NIAMS to fund

promising behavioral social sciences research. Additionally, the

Committee urges favorable consideration of research in the area of

behavioral and social science factors relating to the adherence to

medical recovery regimes, exercise and weight-reduction programs.

Drug research.—The Committee supports research in the area of

TOPS-ester therapeutics, a type of drug being developed that is

compartmentalized inside skin cells and expresses antioxidant actions that limit oxidant mediated pathologies including psoriasis,

sunburn, skin aging and cancer.

Duchenne muscular dystrophy.—The Committee is aware of past

collaboration between NIAMS and NINDS to intensify and enhance

muscle disease research. The Committee urges NIAMS to continue

working closely with NINDS to identify collaborative opportunities

to advance basic, clinical, and translational research into treatment

for Duchenne muscular dystrophy. The Committee has urged

NINDS to establish centers of excellence for basic and applied research in the muscular dystrophies. The Committee urges NIAMS

to coordinate with NINDS and the Centers for Disease Control and

Prevention on the planning and activities for these centers.

Economic burden of skin diseases.—The Committee is aware of

the lack of information regarding the overall economic burden of

skin diseases for the nation, as well as the lack of reliable data on
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how many individuals in the United States are affected by these

diseases. The Committee, therefore, encourages the NIAMS, in conjunction with other PHS components, including NCHA, CDC,

AHRQ, and HRSA, to sponsor a workshop to identify existing information sources on the costs and scope of skin diseases, and to recommend strategies for developing new information sources. The Institute is encouraged to work with skin diseases researchers and

voluntary health organizations to plan the workshop.

Ehlers-Danlos syndrome.—Ehlers-Danlos syndrome (EDS) is a

family of genetic disorders whose manifestations include, but are

not limited to, the skin, joints and other components of the connective tissue. EDS is potentially a model for a number of more common medical and biological problems stemming from genetic acquired connective tissue defect. The Institute is encouraged to provide greater funding for continued research of this disease.

Fibrous dysplasia.—Fibrous dysplasia is a chronic disorder of the

skeleton that predominantly afflicts young children and adolescents, resulting in uneven growth, severe pain, and deformed extremities. Given the long-term implications of this disorder on both

children and adults, the Committee sees the need for a targeted research effort to evaluate promising drug therapies. NIAMS is encouraged to support such research at an institution with a large

population of both pediatric and adolescent fibrous dysplasia patients, as well as a staff of orthopedic and endocrinology specialists

qualified to conduct this research.

Osteogenesis imperfecta.—Osteogenesis imperfecta (OI) is a genetic disorder characterized by frequent fractures from little or no

trauma. The Committee commends the effort NIAMS has made to

encourage and fund osteogenesis imperfecta research and recommends that osteogenesis imperfecta continue to be an area of

special emphasis in the Institute. NIAMS and NHLBI are urged to

investigate respiratory and cardiovascular problems associated

with OI. The Committee also encourages NIAMS to continue its

strong support of research into gene therapies and drug treatment

for OI, and to continue its active follow-up of new research opportunities arising out of the 2001 NIH workshop on OI.

Osteoporosis and related bone diseases.—The Committee recognizes that osteoporosis and related bone diseases are a major public

health problem that exacts an enormous human and economic toll.

The Committee commends the National Resource Center for its

role in providing patients, health professionals and the public with

access to resources, and encourages the Center to increase prevention and treatment efforts. The Committee encourages NIAMS to

devote additional resources to studying osteoporosis in non-white

women, as well as understanding the genetic predisposition of

osteoporosis in certain populations. Moreover, given the large number of individuals affected by this disease, NIAMS is urged to focus

on therapies to improve quality of life and to reduce the subsequent

risk of fractures. The Committee encourages NIAMS to continue to

work with NHLBI to investigate the basic and clinical relationship

between cardiovascular diseases and osteoporosis.

Paget’s disease.—The Committee is aware of the importance of

research on the viral and genetic factors that may cause Paget’s
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disease, and it encourages NIAMS to enhance efforts in this area

as well as research to develop animal models for Paget’s disease.

Pediatric rheumatoid arthritis.—The Committee commends the

NIAMS for its growing support of research and training activities

to better understand childhood rheumatic diseases, including pediatric rheumatoid arthritis. The Committee is especially pleased

with the continued operation of the Pediatric Rheumatology Clinic,

which opened on the NIH campus in the fall of 2000. The Committee is also pleased to learn that, through research at an

NIAMS-supported Multipurpose Arthritis and Musculoskeletal Diseases Center, the drug Etanercept has recently been shown to be

a safe and effective drug in the treatment of children and teenagers

with pediatric rheumatoid arthritis. The Committee appreciates the

Institute’s emphasis on pediatric rheumatic diseases in recent research solicitations. The Committee understands that the Institute’s pediatric rheumatoid arthritis registry has been expanded to

include a major emphasis on a genome-wide search for susceptibility genes and strongly urges the Institute to continue its research into the genetic factors as well as infectious triggers of the

disease.

Psoriasis.—Psoriasis is a genetically acquired immune-mediated

disease of the skin and joints that affects over 7 million Americans.

The Committee encourages NIAMS to conduct a scientific workshop

to assess basic and clinical research in psoriasis, especially prospects for innovative therapeutic approaches for moderate to severe

forms of the disease. The Committee urges the Institute to collaborate with patient organizations, medical specialty societies, and

other interested parties in the development of this workshop.

NIAMS is further urged to work with these partners through all

available mechanisms to support a public awareness and education

program on the best available treatments for moderate and severe

psoriasis.

Sjogren’s syndrome.—The Committee is pleased that the NIAMS

has published a booklet on Sjogren’s syndrome, providing an important means of educating people about this common autoimmune

disease. The Committee encourages the Institute to do more for

this disease, including holding scientific workshops, providing

grant monies, and including Sjogren’s in autoimmune databases.

Temporomandibular joint disorders (TMJ).—The Institute is

urged to increase research on unique features of the

temporomandibular joint as well as exploring to what extent TM

disorders share common pathogenic mechanisms with fibromyalgia

and osteoarthritis.

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

Appropriations, 2001 ............................................................................. $301,069,000

Budget estimate, 2002 ........................................................................... 336,744,000

Committee recommendation ................................................................. 349,983,000

The Committee recommends an appropriation of $349,983,000 for

the National Institute on Deafness and Other Communication Disorders [NIDCD]. This is $13,239,000 more than the budget request

and $48,914,000 more than the fiscal year 2001 appropriation. The
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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.

Dysphonia.—The Committee continues to be pleased with

NIDCD’s expanding intramural research program with respect to

dysphonia. The Committee encourages NIDCD to explore possibilities for a more active extramural research effort on dysphonia, and

for collaboration with other NIH Institutes on this important disorder.

Health survey.—The Committee encourages the Institute to create and administer a national deaf and hard of hearing health survey, conducted annually, to assess the health status of this population and monitor changes as a result of intervention efforts.

Noise-induced hearing loss.—The Committee continues to be concerned by the number of Americans who suffer from noise-induced

hearing loss. Thirty million Americans are exposed to dangerous

levels of noise that can permanently impair their hearing. Ten million Americans have suffered irreversible noise-induced hearing

loss. The Committee has been pleased by the Institute’s efforts to

tackle this preventable health problem. The Wise Ears campaign

has the potential to make significant inroads towards educating

Americans of all ages. The Committee urges the Institute to provide sufficient funds to expand this promising new initiative.

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2001 ............................................................................. $105,158,000

Budget estimate, 2002 ........................................................................... 117,681,000

Committee recommendation ................................................................. 125,659,000

The Committee recommends an appropriation of $125,659,000 for

the National Institute of Nursing Research [NINR]. This is

$7,978,000 more than the budget request and $20,501,000 more

than the fiscal year 2001 appropriation. 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.
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Cancer screenings.—The Committee continues to be concerned

about disparities in the incidence and prevalence of cancer among

minorities. The Committee believes that the NINR is positioned

well to address prevention strategies, particularly screening for minority populations. Therefore, the Committee urges increased promotion of regular cancer screenings and positive behavioral modifications that will help prevent cancers.

Caregivers.—Informal caregivers in the home need help as they

administer to the needs of patients with chronic illnesses. One in

four U.S. families is involved in caregiving. The Committee is troubled that caregivers themselves are at risk for poor physical and

emotional health as they devote themselves to tending to others.

The NINR is urged to devote greater attention to caregiver needs

regarding improved strategies, skills, and support.

Chronic conditions.—The NINR is to be commended for its increased focus on chronic illnesses, which affect growing numbers of

people in this country as patients live longer with severe but enduring diseases. The Committee urges the Institute to continue its

emphasis on pain management and other conditions such as

cachexia, which involves muscle wasting and weight loss.

End-of-life care.—The Committee is pleased with the NINR’s efforts to stimulate research on palliative care. Research supported

by the NINR and collaborative organizations is critical to addressing key issues such as how to manage pain and help patients and

their families make difficult choices about treatment and care.

Mentorship program.—The Committee is greatly encouraged by

the progress made by the NINR and the NIMH in implementing

a technical assistance workshop on grant writing and navigating a

research career trajectory in the area of behavioral change related

to psychiatric populations—a program that will build the research

capacity of our Nation’s psychiatric mental health nurse researchers. The Committee urges the NINR and NIMH to implement a a

mentorship program that will enable participants to develop formal

grant proposals for ultimate submission to the Institutes.

New research opportunities.—The Committee encourages the Institute to take advantage of increased funding by supporting new

research opportunities in several areas, including: research on

health disparities in diseases such as diabetes and cardiovascular

disease, self-management of chronic pain, end-of-life research to address weight loss, muscle wasting, fatigue, and caregiver issues.

Most critical to enhancing research within the nursing profession

is infrastructure development that increases the pool of nurse investigators, expands programs to develop partnerships between research-intensive environments and small colleges and universities,

and promotes career development for minority researchers.

Nurse researchers.—The Committee is concerned about the effects of the nursing shortage on evidence-based practice. The NINR

has the Committee’s strong support for its emphasis on protecting

and expanding the infrastructure of nursing research. Recruiting

minority researchers and enhancing career development for all

nurses interested in research is essential to addressing the Nation’s

pressing health issues. Expanding technological skills for the nursing discipline, through efforts such as the NINR’s training program

in genetics, is another laudable goal for the Institute.
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Nursing interventions for psychiatric populations.—The Committee is concerned over the lack of resources for outcomes research focused on nursing interventions for psychiatric populations.

The Committee urges the NINR and the NIMH to jointly sponsor

a workshop with the psychiatric nursing community to identify

areas of research and specific questions directed at interventions in

psychiatric populations that directly correlate to enhanced patient

care. This workshop would lead to a joint request for applications

by the NINR and the NIMH.

Volcanic emissions.—The Committee continues to be very concerned about the public health aspects of volcanic emissions in Hawaii, and it urges the Institute to collaborate with the National Institute of Environmental Health Sciences to develop a multidisciplinary approach to this problem.

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2001 ............................................................................. $340,537,000

Budget estimate, 2002 ........................................................................... 381,951,000

Committee recommendation ................................................................. 390,761,000

The Committee recommends an appropriation of $390,761,000 for

the National Institute on Alcohol Abuse and Alcoholism [NIAAA].

This is $8,810,000 more than the budget request and $50,224,000

more than the fiscal year 2001 appropriation. 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

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, and moderate

drinking.

Alaska native substance abuse.—The Committee is aware of serious problems with alcohol and substance abuse in Alaska, 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 and the State of Alaska 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 consumption and hepatitis C.—It is well established that

alcohol consumption in patients with hepatitis C increases the

damage caused by the disease. Less well known is the mechanism

by which this happens, as well as why alcohol inhibits the success

of standard treatments for the disease. Both of these areas are im-
161

portant for dealing with this disease, and the Committee strongly

encourages the Institute to pursue them both individually and collectively with other interested Institutes.

Alcoholic liver disease.—The Committee recognizes that alcoholic

liver disease (ALD) is a major cause of morbidity and mortality in

the United States today. Developing effective interventions for this

disease is of paramount importance. The Committee is pleased that

the Institute has begun to focus greater attention on this problem,

and it encourages NIAAA to consider sponsoring additional research on treatment.

Alcohol treatment services.—Given the rapid growth of managed

behavioral health care, the Committee is concerned that more

needs to be known about how alcohol treatment services are delivered under managed care arrangements and the specific characteristics of behavioral health components of health insurance plans

and managed care organizations. The Committee is supportive of

the NIAAA Advisory Council’s comprehensive plan for health services, particularly its recommendation to prioritize research to understand the effects of managed care on treatment services. The

Committee acknowledges NIAAA’s progress in implementing this

recommendation and encourages the Institute to consider supporting additional research in this area.

Behavioral research to identify high-risk youth.—Studies show

that people who begin drinking early in life have a dramatically

higher risk of later becoming alcoholic than do those who begin

later. Other studies show that personality characteristics that are

evident as early as age 3 predict alcoholism in adulthood. Given

these data, developing effective methods for identifying high-risk

youth, as well as appropriate prevention strategies, is particularly

important. The Committee urges NIAAA to expand efforts on this

promising line of research.

College drinking.—The Committee continues its strong support of

the NIAAA Advisory Council’s Subcommittee on College Drinking

and its efforts to create a unique dialogue among college presidents, administrators and alcohol researchers. The Committee appreciates the progress made by NIAAA in building community

partnerships to help expand the research on college drinking and

in developing research-based interventions for preventing the harm

caused by misuse of alcohol. Further, the Committee understands

that NIAAA will soon begin the first national, longitudinal survey

to assess alcohol consumption and contributing characteristics of

adolescents and college-age youth. The Committee encourages

NIAAA to continue and expand these activities.

Health disparities.—The Committee encourages the NIAAA to

place a priority on studying the disparities in risk of alcoholism

and treatment availability and accessibility among various ethnic

and racial groups. Additionally, the Committee urges the Institute

to consider establishing a mentoring program with the specific objective of providing quality research training for all racial groups.

Multidisciplinary approaches.—The examination of alcohol misuse and alcohol use disorders must include the effective integration

of multiple disciplines and strong interdisciplinary coordination.

Thus, the Committee urges that sufficient funding be directed toward those endeavors which seek to apply multidisciplinary ap-
162

proaches to relevant questions of etiology, consequences and recovery. Specifically, the Committee urges support for efforts directed

toward integrating animal and human data as well as the multiple

sources of human data.

Prevention and treatment of violence.—The Committee is supportive of NIAAA’s efforts to understand the relationships between

alcohol use and violence. The Committee encourages NIAAA to consider supporting more research in this area, particularly to understand individual characteristics and environmental conditions, situations, and circumstances under which alcohol use and violent behavior are connected. The Committee also encourages the NIAAA

to consider supporting additional research on the prevention and

treatment of violence by persons with alcohol problems.

Risk and resiliency.—The Committee sees a critical need to identify adequate resources regarding risk and resiliency, including

both genetic and psychosocial factors, and age-appropriate education and prevention materials which can be empirically evaluated.

Technology advances.—Advances in a range of technologies, such

as genetic applications and brain imaging, may benefit the study

of alcoholism. The Committee encourages the NIAAA to allocate

adequate funding not only for the application of these technologies,

but also for providing training to current and new investigators in

these technologies.

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2001 ............................................................................. $779,510,000

Budget estimate, 2002 ........................................................................... 905,810,000

Committee recommendation ................................................................. 902,000,000

The Committee recommends an appropriation of $902,000,000 for

the National Institute on Drug Abuse [NIDA]. This is $3,810,000

less than the budget request and $122,490,000 more than the fiscal

year 2001 appropriation. 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.

Behavioral sciences.—The Committee understands that behavioral intervention is a critical, and sometimes only, component of

drug addiction. The Committee continues to support NIDA’s expansion of its behavioral science portfolio and views NIDA as a model
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of how to approach its behavioral science and public health responsibilities.

Children and adolescents.—Recognizing the devastating impact

of drug addiction on children and youth, the Committee commends

NIDA’s children and adolescent research initiative. The Committee

urges NIDA to continue to support its research portfolio in areas

of co-occurring mental disorders, developmental consequences, prenatal exposure, genetic vulnerability, and environmental risk factors. The Committee is especially pleased that NIDA is planning to

launch a drug abuse prevention model to more systematically test

prevention programs in a wide variety of diverse settings and populations.

Clinical trials network.—The Committee applauds NIDA’s success in launching and expanding the new National Drug Abuse

Treatment Clinical Trials Network, a much-needed infrastructure

to test science-based drug addiction treatments in real-life community-based treatment settings. The Committee believes this is an

extraordinary step forward in improving the quality of drug addiction treatment in this country, especially for minority populations

and disadvantaged groups in both rural and urban settings. The

Committee commends NIDA’s leadership in forging strong partnerships with treatment researchers and community-based treatment

providers to ensure that new treatments are tested and incorporated into ongoing drug treatment programs. The Committee encourages NIDA to continue to make this network, and research of

new behavioral and pharmacological treatments, a top priority.

Emerging drug problems.—The Committee is pleased that NIDA

has launched a new Club Drug Research and Dissemination Initiative. Given the emergence of club drugs, such as ecstasy, methamphetamine, GHB, and ketamine, the Committee is encouraged

by NIDA’s proactive efforts to curtail these emerging drug problems, and it urges NIDA to continue its efforts to develop an even

broader array of effective new prevention and treatment approaches to focus on these emerging drug challenges.

Genes and drug abuse.—The Committee recognizes that treating

drug abuse effectively requires understanding what makes individuals more or less vulnerable to addiction. The Committee urges further research in the Human Genome Project, which will provide

the information and technology to identify genes that may play a

role in addiction.

International efforts.—The Committee commends NIDA for expanding its international efforts to more globally address drug addiction and the health consequences such as HIV/AIDS that it

brings in its wake. These international efforts will better equip the

United States to effectively prevent and treat addiction and infectious diseases.

Medications development.—The Committee encourages NIDA to

study the development of anti-addiction medications, clarify the

neurological and behavioral benefits of the use of pharmacological

agents, and develop an understanding of how best to use these

medications.

Methamphetamine.—The Committee continues to be concerned

about methamphetamine abuse across the nation. The problem is

essentially acute in Iowa and other Midwestern states. The Com-
164

mittee again urges NIDA to expand its research on improved methods of prevention and treatment of methamphetamine abuse.

National Drug Abuse Clinical Trials Network.—The Committee

commends NIDA’s leadership in continuing to recognize the importance of behavioral and social science research, and it is especially

pleased that this is reflected in the recent NIDA reorganization,

which elevates behavioral research in both the Division of Neuroscience and Behavioral Research and the Division of Treatment Research and Development. The Committee believes NIDA could consider evaluating these promising behavioral treatments in clinical

trials through its new National Drug Abuse Clinical Trials Network.

Neuroscience.—The Committee recognizes that basic neuroscience

and behavioral research provides a foundation for NIDA’s research

portfolio. The Committee urges NIDA to continue its efforts to develop new areas of neuroscience research, including the role that

genetics plays in vulnerability to addiction.

Nicotine research.—The Committee recognizes that the consequences of nicotine addiction are substantial to adults, children,

and adolescents, and it commends NIDA’s support of research

yielding effective replacement therapies and behavioral interventions. The Committee encourages NIDA to continue to support research on the prevention and behavioral and pharmacological treatment of nicotine addiction. The Committee supports NIDA’s ongoing research in the basic sciences, behavioral and medical treatments, genetic vulnerability, and epidemiology of nicotine use and

abuse.

Prescription drug abuse.—Certain segments of the population, including adolescents, women, and the elderly, appear to be particularly vulnerable to the problem of prescription drug abuse. The

Committee is particularly pleased that NIDA has taken a proactive

leadership role in informing the public, health care professionals

and others about the misuse and abuse of certain medications, particularly opiates. The Committee recognizes the importance of both

behavioral and pharmacological interventions in treating prescription drug abuse and the critical role that primary care providers

and mental health specialists play in identifying abuse and addiction.

Prevention.—As our Nation continues to look for effective and

cost-effective ways to reduce drug abuse, the Committee is pleased

to hear that NIDA will launch a new initiative to develop a National Drug Abuse Prevention Trials System. The system will test

proven research-based efforts in a wide variety of populations and

settings. The Committee recognizes that different racial and ethnic

groups have different patterns of drug use and abuse. NIDA is encouraged to expand research aimed at developing effective, culturally specific drug abuse prevention strategies for minority populations who are at increased risk for drug abuse.

The Committee also applauds NIDA’s efforts to launch a major

new National Prevention Research Initiative. This initiative will

establish the Prevention Research System, which is intended to ensure that communities across the country have effective ways to

prevent drug abuse, particularly among adolescents.
165

Stress.—NIDA is to be commended for its work on determining

the role that stress plays in drug abuse and relapse to addiction

and for developing science-based approaches to help individuals

cope with stress and drug craving. The recent terrorist attacks and

the fact that Post-Traumatic Stress Disorder is a known risk factor

for substance abuse and addiction warrants that NIDA expand its

research in this important area.

Transdisciplinary tobacco research centers.—The use of tobacco

products remains one of the Nation’s deadliest addictions. The

Committee strongly supports NIDA’s continuing efforts to address

this major public health problem through its comprehensive research portfolio. The Committee is pleased that NIDA has teamed

with the National Cancer Institute and an outside foundation to establish the Transdisciplinary Tobacco Use Research Center

(TTURC). This multifaceted approach should lead to an increased

understanding of how nicotine acts in the brain and body, and to

new strategies for treating nicotine addiction and preventing tobacco use, particularly by teens and younger children.

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2001 ............................................................................. $1,103,062,000

Budget estimate, 2002 ........................................................................... 1,234,389,000

Committee recommendation ................................................................. 1,279,383,000

The Committee recommends an appropriation of $1,279,383,000

for the National Institute of Mental Health [NIMH]. This is

$44,994,000 more than the budget request and $176,321,000 more

than the fiscal year 2001 appropriation. The comparable amounts

for the budget estimate include funds to be transferred from the

Office of AIDS Research.

Mission.—The research programs of the Institute lead the Federal effort to identify the causes of—and the most effective treatments for—mental illnesses, which, according to a report recently

issued by the Surgeon General of the United States, afflict more

than one in five American adults. One result of the Federal research investment has been a growing awareness that undiagnosed

and untreated mental illness, in all its forms and with all of its

consequences, is as damaging as physical illness to the Nation’s

well-being.

Aging.—Studies show that elderly people are at greater risk of

mental disorders and their complications than younger people;

major life changes, such as the loss of friends and loved ones, and

physical illnesses, which often co-occur with depression, are often

contributing factors. The Committee is pleased that NIMH has renewed and strengthened its emphasis on mental disorders among

the elderly, and it commends the increased resources being directed

to this critical area. The Committee also notes the launch of an

intra-NIMH consortium of scientists concerned with mental disorders in the aging population, with a goal of increasing coordinated research efforts, expanding recognition of disorders in the elderly, developing new treatments, and reducing stigma.

Alzheimer’s disease.—NIMH continues to play an important role

in research on the causes of Alzheimer’s disease, its clinical course,

and treatment and services for patients. For example, the Institute

is providing extensive support to scientists to investigate aspects of
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depression, an important problem that affects both Alzheimer’s patients and family caregivers. A clinical study already underway has

documented a strong link between depression and physical aggression in Alzheimer’s patients, suggesting that depression treatment

may reduce aggression in patients. The Committee encourages

NIMH to assign a high priority to Alzheimer’s research and to continue to collaborate with NIA and other institutes.

Children’s mental health.—The Committee is aware that NIMH’s

National Advisory Mental Health Council established a Workgroup

on Child and Adolescent Mental Health that is charged with charting a new, more rational course for the future of child and adolescent mental health research. The Committee supports this effort in

light of the continuing evidence of high prevalence of mental illnesses in children and adolescents, and the difficulty many children encounter in accessing effective treatments, preventive strategies, and services. The Committee endorses the further direction of

targeted research programs specifically for children and adolescents.

Clinical trials.—The Committee commends NIMH on its launch

of four large clinical trials to investigate real-world effectiveness of

mental health research. The Committee recognizes the efforts of

NIMH to study treatments in everyday settings by enrolling a representative sample of typical clinic patients who may have co-occurring diseases and come from diverse backgrounds. The Committee

urges a balanced approach in this endeavor, integrating clinical approaches to disease and intervention efforts that address social and

behavioral determinants of disease.

Emergency medical services.—The Committee commends the

work supported by NIMH on mental health issues related to emergency medical services for children through the University of Tennessee, and also the collaboration of NIMH with HRSA in funding

the National Congress on EMSC in 1998. The Committee encourages NIMH to enhance its support of EMSC–related projects and

to continue to work with HRSA in educational programs on EMSC

such as national conferences.

Extramural aging research.—The Committee is concerned that,

despite substantial funding increases for NIMH in recent years, the

Institute’s sponsorship of extramural research on the mental health

of the elderly has not kept pace with its funding of research for

other populations. The Committee strongly encourages NIMH to

devote additional resources to extramural aging research and urges

the Director of NIMH to designate an individual within the Office

of the Director to oversee the Institute’s aging research agenda and

initiatives. The Committee also encourages the Director to ensure

that reviewers of research proposals include members with specialized expertise in geriatrics.

Families and School Together Track program.—The Committee

commends NIMH for building science-based programs, such as the

Families and School Together (FAST) Track program, designed to

improve school-based mental health delivery systems. The Committee encourages NIMH to continue to support research on multiyear, multi-component interventions at the family, school, and community levels. The Committee also urges NIMH to further develop

research on early interventions in children, with a particular em-
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phasis on problems of mood, anxiety and conduct, taking into account informational deficits, attitudinal factors, and cultural barriers that inhibit use of these services.

Fragile X.—Fragile X is the most common single-gene

neuropsychiatric disease known, affecting 1 in 2,000 males and 1

in 4,000 females with cognitive impairment and mental disorders

such as obsessive-compulsive disorder and extreme anxiety. The

Committee urges NIMH to conduct research on the neurobiological

basis of fragile X, including studies on specific neural circuits and

molecules. The Committee encourage NIMH to use its unique expertise to characterize the mental health symptoms of fragile X and

to investigate effective treatments and promising new

psychopharmacologic interventions that target those symptoms.

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.

Frontier mental health needs.—The Committee is pleased that

NIMH continued its series of conferences on the mental health

needs of remote rural and frontier communities with a ‘‘Mental

Health at the Frontier’’ conference in Alaska in August 1999 and

commends NIMH on its outreach efforts to determine the differences in mental health needs which may exist in remote frontier

communities. 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.—The Committee commends NIMH’s efforts to

investigate the causes for the disproportionate impact of mental

disorders on racial and ethnic minority groups, as well as methods

of addressing and alleviating these health disparities. The Committee is concerned that within and among minority populations of

Hawaii, access to health services and treatment is uneven and at

times nonexistent, and that prevention of illness, recovery and

treatment have often been poorer in minority populations. The

Committee strongly supports NIMH’s strategic plan to address

problems and develop solutions in the area of health disparities,

and particularly supports the following strategic goals: to achieve

a more ethnic and racially diverse pool of mental health investigators; to ensure inclusion of minority groups in clinical trials funded

by NIMH; to obtain an accurate measurement of the extent of mental health disparities; and to use basic behavioral science to determine cultural differences in stress, coping and resilience. The Committee also notes that NIMH has established a Workgroup on Initiatives on Racial/Ethnic Diversity in Training and Health Disparities Research. The Committee endorses such efforts to increase racial/ethnic diversity among research scientists as a means to reduce

the severe disparities that exist in the burden that mental illnesses

place on minority groups.

HIV/AIDS prevention for individuals at high risk.—The Committee commends NIMH for developing research knowledge essential for understanding and preventing HIV transmission, particularly among people at high risk for infection (such as the mentally
168

ill, women of color, youth, and rural populations) where the epidemic is spreading most rapidly. NIMH should continue to support

studies seeking to develop more effective ways to prevent infections

and strategies to deliver cost-effective services.

Joint workshop between NINR and NIMH.—The Committee is

concerned regarding the lack of resources for outcomes research focused on nursing interventions for psychiatric populations. The

Committee urges the NINR and the NIMH to jointly sponsor a

workshop with the psychiatric nursing community to identify areas

of research and specific questions directed at interventions in psychiatric populations that directly correlate to enhanced patient

care.

Learning disabilities in infants and children.—The Committee

commends NIMH for the work conducted to explore the neurological and behavioral aspects of learning disabilities. The Committee encourages the Institute to continue to coordinate with

other Institutes to work on related activities.

Native Hawaiian center of excellence.—The Committee remains

very supportive of NIMH’s efforts to develop a cadre of native Hawaiian mental health researchers. Native Hawaiians have historically experienced a disproportionate incidence of various mental

health problems, including depression. In order to effectively address these issues in the long run, NIMH should consider establishing a native Hawaiian center of excellence in mental health.

New neuroscience center.—The NIMH, the NINDS, and other Institutes have begun to design the John Edward Porter National

Neuroscience Research Center (NNRC), which will house outstanding trans-NIH research programs. Intramural neuroscience

researchers from nine Institutes will perform cutting-edge projects

and form better collaborations due to proximity in the same facility. This is critically important to increasing the effectiveness, efficiency and pace of progress in overall neuroscience being conducted

at the NIH. The Committee hopes that by fostering interaction

among scientists in different organizational settings, and among diverse disciplines, the NNRC will serve to break down artificial barriers that can keep scientists who are studying complementary

areas of science from communicating and collaborating. Additionally, this will hasten the translation of new knowledge into clinical

applications.

Review of mood disorders research.—NIMH recently conducted a

major review of its research portfolio on mood disorders, such as

major depression and bipolar disorder. To do this, NIMH brought

together almost 100 of the country’s leading researchers in this

area to evaluate the state of the field of research and to make recommendations for future directions for research. Participants were

also asked to offer their views and ideas for shaping the Institute’s

research agenda, as well as informing educational and communication efforts for improving health care. The Committee looks forward to hearing more from NIMH about how this process is succeeding, and how it has influenced the conduct of research in this

area.

Social work research.—The Committee commends NIMH for its

continued recognition of the importance of social work research in

the delivery of disease prevention and treatment services. The
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Committee urges NIH to explore ways to further involve social

workers in research efforts and to report back to Congress on the

involvement of social work in promoting effective prevention and

treatment outcomes throughout all NIH Institutes and programs.

The Committee continues to support the NIMH’s efforts to expand

the number of social work research development centers in light of

the important work the centers do to inform the delivery of mental

health services by social workers and other providers.

Suicide risk and protective factors.—The Committee urges that

NIMH and the CDC continue their collaboration to develop and implement a consensus agenda of key questions on suicide risk and

protective factors. The NIMH should consider supporting additional

research on protective factors to better understand phenomena

such as why African-American women have among the lowest suicide rates but have mental disorders at rates comparable to those

experienced by white women. The Committee requests that the

NIMH and the CDC submit an updated consensus agenda on key

research questions on suicide to the Committee along with the administration’s fiscal year 2003 budget proposal.

Tourette syndrome.—The Committee recognizes that public misunderstanding of the neurobiological disorder Tourette syndrome

frequently results in ridicule, denied learning accommodations and

lost employment opportunities for children and adults who have

this disorder. The Committee is concerned that lack of knowledge

about and treatment for this disorder may be particularly onerous

in traditionally under-served communities. The Committee is

pleased that NIH has initiated research into the genetic basis of

this little-known disorder. Consistent with the Children’s health

Act of 2000, the NIMH is urged to develop a public education program that would reach parents, educators, pediatricians, family

physicians, and other health care workers.

Translational behavioral research.—The Committee strongly supports NIMH’s efforts to investigate methods of building on the Institute’s portfolio of basic behavioral science in order to address

major public health issues including mental health disorders. The

Committee strongly supports translational research in the behavioral and social sciences in order to inform the diagnosis, treatment

and delivery of services for mental illness, particularly for young

people. The Committee commends NIMH for convening conferences

bringing together experts in basic behavioral research, clinical research and services research, and others, to share information and

identify specific areas of promise for translational research in addressing public health problems. The Committee also promotes the

establishment of translational behavioral research as a priority

funding area for NIMH.

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2001 ............................................................................. $381,101,000

Budget estimate, 2002 ........................................................................... 425,674,000

Committee recommendation ................................................................. 440,448,000

The Committee recommendation includes $440,448,000 for the

National Human Genome Research Institute [NHGRI]. This is

$14,774,000 more than the budget request and $59,347,000 more

than the fiscal year 2001 appropriation. The comparable amounts
170

for the budget estimate include funds to be transferred from the

Office of AIDS Research.

Mission.—The NHGRI has the responsibility at the National Institutes of Health for providing leadership and support for the

Human Genome Project and for conducting a vigorous research

program aimed at understanding and treating both simple and

complex genetic disorders.

The Human Genome Project (HGP) is an international collaboration to characterize the complete set of genetic instructions encoded

in the estimated 3.1 billion base pairs of DNA. Begun in October

1990, the HGP is funded in the United States by the NHGRI and

the Department of Energy (DOE). International partners include

the United Kingdom, France, Germany, Japan, and China. A major

goal of the Human Genome Project is to read each of the 3.1 billion

bases, or letters, in the human genetic instruction book. The rapid

availability of sequence, deposited every 24 hours into a publicly

available database, is providing valuable information to the research community.

Human DNA sequencing is not the only goal of the Project. The

new 5-year Human Genome Project Research Plan, published in

Science magazine in October 1998, includes another seven ambitious goals. These goals are guiding the development of a new and

more diverse set of genomic research tools for researchers in both

the public and private sectors in order to advance our understanding and treatment of human disease. These tools include: (1)

optimization of current sequencing technologies and development of

novel strategies; (2) a catalog of common variations, or single-nucleotide polymorphisms (SNPs), in the human DNA sequence; (3)

new technologies and strategies for studying the function of genes

and genomes; (4) completion of the DNA mapping and sequence of

additional model organisms, including the fruit fly and mouse; (5)

new approaches to addressing the ethical, legal, and social implications (ELSI) of research; (6) development of improved databases

and analytical tools in bioinformatics and computational biology;

and (7) training programs in scientific and ELSI aspects of genomic

and genetic sciences.

Using the information and tools produced by the Human Genome

Project, scientists in the Institute’s intramural research program

are developing techniques to study the fundamental mechanisms of

genetic disorders and genetic factors involved in disease risks.

These cutting-edge approaches are yielding new knowledge about

human genetic diseases and their diagnosis, prevention and treatment.

Clearinghouse for rare and genetic disorders.—Approximately

6,000 of the 7,000 genetic disorders are rare disorders. Unfortunately, there is no centralized clearinghouse that can provide information to health professionals and the public about such disorders.

In previous years, the Committee has encouraged the NHGRI, in

collaboration with the Office of Rare Diseases (ORD), to create an

information center to disseminate information, knowledge, and understanding of rare and genetic disorders. The Committee is

pleased to learn that the NHGRI and the ORD plan to establish

such a center this fiscal year.
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Epilepsy.—The Committee encourages the Institute to intensify

its efforts to identify epilepsy genes for the more than 40 different

types of epilepsy, and to assist the NINDS in the search for a genetic fingerprint diagnostic test aimed at improving drug therapy

for epilepsy. The Committee suggests that the Institute coordinate

efforts with the NINDS to create a national consortium to identify

new epilepsy susceptibility genes through a large-scale genotype:phenotype screen. The Committee urges the Institute to make

research in epilepsy a priority and to coordinate research efforts

with other Institutes through the Interagency Epilepsy Coordinating Committee comprised of agency scientists and industry and

patient representatives.

Human Genome Project.—The Committee commends the international Human Genome Project, led by the NHGRI, for sequencing 95 percent of the 3.1 billion bases of the human genome years

ahead of schedule. This was a remarkable achievement that could

not have occurred without Federal support. At the same time, the

Committee recognizes that substantial effort will be required to

produce the final, highly accurate sequence by 2003. The Committee encourages NHGRI to pursue the development of the next

generation of genomic tools and technologies needed to study the

human genome and understand its role in human health and disease.

The Committee is pleased that the NHGRI has made it a policy

to provide the sequence information immediately and freely to the

world via the World Wide Web, with no restrictions on its use or

redistribution. The information is scanned daily by scientists in

academia and industry, as well as by commercial database companies, providing key information services to biotechnologists. Already, tens of thousands of genes have been identified from the genome sequence, including more than 30 in just the last 2 years that

play a direct role in human disease. The Committee encourages the

NIH to continue this policy of free and unfettered access to genomic

data.

The Committee also commends the NHGRI for its leadership in

research and policy development related to the ethical, legal and

social implications of the Human Genome Project. The early commitment to devote 5 percent of the Institute’s research budget to

study the ethical, legal, and social implications of genome research

has generated important information and recommendations regarding research and public policy. The Committee is particularly

pleased with the Institute’s attention to protecting the genetic information of individuals from misuse in health insurance and employment and its development of policy recommendations in both

areas. The Committee supports and encourages the NHGRI’s ongoing efforts to examine the privacy and fair use of genetic information in these settings and the many other important issues related

to human genetics research and its consequences, including: the

appropriate use of genetic tests; the protection of human subjects

who participate in genetic research; the development of policies to

guide research into genetic variation; and the attention to complex

social issues, such as how genetics informs concepts of race and

ethnicity.
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NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2001 ............................................................................. $68,823,000

Budget estimate, 2002 ........................................................................... 115,425,000

Committee recommendation ................................................................. 140,000,000

The Committee recommends an appropriation of $140,000,000 for

the National Institute of Biomedical Imaging and Bioengineering

[NIBIB]. This is $24,575,000 more than the budget request and

$71,177,000 more than the fiscal year 2001 appropriation. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research.

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.

The Committee recognizes the contribution bioengineering brings

to medicine. Bioengineering improves the quality of life through its

contribution to advances in science and technology related to

health. The Committee understands that this newly created Institute must have adequate resources to begin its important task of

high-quality research.

Imaging technologies.—The Committee encourages this new 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.

Joint replacement wear.—Average life expectancy has at least

doubled over the past century, presenting new challenges in our efforts to reduce disability. For example, an estimated 500,000 joint

replacements are performed in the United States each year, many

of which fail and require additional surgery. Because the patients

are typically elderly and frail, the failed implant is often difficult

to remove. The required surgery is much more complex, dangerous,

and expensive than the original procedure, and the failure rate is

several times greater. It is widely recognized that the majority of

failures of artificial joints are caused by wear of the weight-bearing

surfaces. In light of demographic projections of a rapid increase in

the elderly population, the Committee expects the Institute to assign a high priority to research identifying the causes of wear in
173

prosthetic joints as well as to finding solutions to the problem, such

as new materials.

Non-destructive evaluation.—The Committee is encouraged by

the possible use of non-destructive evaluation research for the improvement of diagnostic capabilities in medicine. It also recognizes

that the initial parts of many clinical studies will proceed more

quickly on living animals. Research on developing quantitative

measurement techniques in the areas of radiography, CT,

ultrasound and magnetic resonance, and others should be investigated, with experiments on animals being a vehicle for early clinical studies.

Temporomandibular joint disorders (TMJ).—The Committee is

aware that the research portfolio on temporomandibular diseases

and disorders has extensively studied psychological and behavioral

factors in the etiology or chronicity of TMJ diseases and disorders.

The Committee urges the Institute to broaden its scientific base for

TMJ research by putting greater emphasis on basic and clinical research on normal and abnormal structural and functional features

of the joint and related structures, using the tools of cell and molecular biology as well as advanced imaging techniques.

NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 2001 ............................................................................. $811,237,000

Budget estimate, 2002 ........................................................................... 967,025,000

Committee recommendation ................................................................. 1,014,044,000

The Committee recommends an appropriation of $1,014,044,000

for the National Center for Research Resources [NCRR]. This is

$47,019,000 more than the budget request and $202,807,000 more

than the fiscal year 2001 appropriation. 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 precollege students

and the general public.

Crystallography.—The Committee is aware of the important role

that X-ray diffractometers and crystallography laboratories play in

allowing researchers to study the interaction between possible

drugs and receptor proteins. The Committee encourages NCRR to

consider supporting these systems, which could benefit the development of new cancer treatments.

Extramural construction.—The Committee has included bill language identifying $125,000,000 for extramural biomedical facility

renovation and construction. This is an increase of $50,000,000

over the fiscal year 2001 appropriation. 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. The

Committee commends NCRR for taking a more proactive role in

fulfilling this requirement.
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General Clinical Research Centers.—Over three decades ago, NIH

established the General Clinical Research Centers (GCRCs) program to support regional patient-oriented research centers. Today,

the NCRR supports about 80 GCRCs, which provide citizens across

the country with local access to clinical research programs focused

on a wide range of diseases and disorders. In recent years, the

Committee has expressed concern regarding the inadequate funding provided to the GCRCs. Last year, the Congress recognized the

need to expand the GCRCs by authorizing them in law as part of

the Clinical Research Enhancement Act. To achieve this goal and

ensure that the GCRCs are equipped to support clinical research

aimed at preventing and curing disease, the Committee has provided $275,000,000 for the GCRC program as authorized by Section

481C of the Public Health Act. This increase should be used to address the funding shortfall of recent years; upgrade GCRC facilities

with the sophisticated technologies needed to apply information

from the mapping of the human genome to the pursuit of cures for

diseases with a genetic component; expand staffing as recently

mandated by NCRR to ensure patient safety and maximum compliance with new regulatory requirements; and support local GCRC

pilot projects as approved by the NCRR Advisory Council in May

of last year.

Human tissue supply.—The Committee continues to be very interested in matching the increased needs of researchers, particularly NIH grantees, as well as intramural and university-based researchers, who rely upon human tissues and organs to study

human diseases and to search for cures. The Committee is aware

that the leader in this competitive field, the National Disease Research Interchange [NDRI], is uniquely positioned to serve NIH

grantees, as well as the intramural and university-based researchers who are finding it increasingly difficult to obtain this valuable

and effective alternative research resource. More than 400 peer-reviewed research advances made by NDRI–dependent researchers

have been published during the past 3 years contributing to the research community’s fund of knowledge. The Committee is greatly

encouraged by NDRI’s role in these research advances and applauds the Director’s initial efforts to expand support for NDRI by

bringing NEI, NIDDK, NIAID, and the Office of Rare Diseases into

the multi-institute initiative. While this is promising, more needs

to be done to match the expanding and unmet demand for the use

of human tissue in research. The Committee, therefore, expects the

Director to advise the Director of NCRR to substantially increase

its core support for NDRI, and to continue to encourage the Institute Directors NIH-wide to identify and implement program-specific initiatives to expand support for NDRI. The NIH should submit a written progress report to the Committee no later than April

1, 2002, outlining its plan and action steps to accomplish these

goals in fiscal year 2002.

IDeA grants.—The Committee has provided $200,000,000 for the

Institutional Development Award [IDeA] Program authorized by

section 402(g) of the Public Health Service Act. This is a

$100,000,000 increase over fiscal year 2001.

The Committee urges the NCRR to continue the successful Centers of Biomedical Research Excellence program, as well as the Bio-
175

medical Research Infrastructure Network program. 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.

Imaging technology.—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.

Science Education Partnership Awards.—The Committee applauds NCRR’s demonstrated commitment to the Science Education Partnership Awards (SEPA) program and the full participation of the Nation’s science centers and museums in enhancing

public awareness of health related research. The Committee expects that a portion of NCRR’s overall increase will be used for a

new competition of SEPA grants.

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE [CCAM]

Appropriations, 2001 ............................................................................. $89,121,000

Budget estimate, 2002 ........................................................................... 100,059,000

Committee recommendation ................................................................. 110,000,000

The Committee has included $110,000,000 for the National Center for Complementary and Alternative Medicine, an increase of

$9,941,000 above the budget request and $20,879,000 over the fiscal year 2001 appropriation. 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 ensuring that complementary and alternative therapies be rigorously reviewed to provide consumers with reliable information.

The Committee expects that funding for existing and new Centers supported by NCCAM will be maintained and directs the Center to undertake field investigations and a program for the collection and evaluation of outcome data on promising alternative

therapies. The Committee expects NCCAM to expand its support of

CDC’s field investigations program and of AHRQ literature reviews

and data-analysis efforts. The Committee also expects the Center

to allocate sufficient funds 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.

The Committee also expects the Center to transfer sufficient

funds to the White House for the operations of the White House

Commission on Complementary and Alternative Medicine Policy if

funds provided in previous years prove insufficient.

Plant-based medicinal products.—The Committee supports the

need to accelerate the development and commercialization of plantbased medicinal products, and encourages the NCCAM to consider

collaborating with plant scientists and companies in Hawaii to responsibly use that State’s unprecedented biodiversity in developing

new, health-enhancing products.
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Traditional and indigenous medicine.—The Committee is aware

that knowledge of traditional and folk medicine is rapidly disappearing from areas such as the Appalachian region of the eastern United States, and it encourages NCCAM to fund studies that

preserve indigenous knowledge of the uses of medicinal plants and

investigate possible scientific bases for their efficacy. The Committee further recognizes that the moderated harvest of wild medicinal plants is important to their availability for future use and

recommends that funding preference be afforded to those studies

that incorporate a holistic approach of scientific investigation and

resource management.

NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2001 ............................................................................. $132,044,000

Budget estimate, 2002 ........................................................................... 158,421,000

Committee recommendation ................................................................. 158,421,000

The Committee has included $158,421,000 for the National Center on Minority Health and Health Disparities, the same as the

budget request and $26,377,000 over the fiscal year 2001 appropriation. 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

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.

Glomerular injury.—The Committee understands that glomerular injury, a group of diseases that affect the filtering mechanisms

of the kidney, are more prevalent among African Americans than

the general population. The Committee urges NCMHD to explore

collaborations with NIDDK to conduct and support research activities related to glomerular injury.

Osteoporosis.—The Committee urges the Center to support research that furthers the understanding of the risk factors, causes

and consequences of osteoporosis among African-American, Hispanic, Asian-American and Native American women and men. Furthermore, the Center is encouraged to undertake epidemiological

studies to establish the prevalence of osteoporosis among these populations and to determine whether FDA-approved drug therapies

are as efficacious among these populations as in white postmenopausal women and men.
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JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN

THE HEALTH SCIENCES

Appropriations, 2001 ............................................................................. $50,472,000

Budget estimate, 2002 ........................................................................... 56,446,000

Committee recommendation ................................................................. 57,874,000

The Committee recommends an appropriation of $57,874,000 for

the Fogarty International Center [FIC]. This is $1,428,000 more

than the budget request and $7,402,000 more than the fiscal year

2001 appropriation. 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

understand disease pathogenesis, anticipate disease trends, or develop interventions of relevance and priority for both the U.S. and

the collaborating country.

Global tuberculosis threat.—The Committee recognizes the growing importance of international research and surveillance programs

with respect to infectious diseases such as tuberculosis (TB). The

Committee is pleased by the Center’s research collaboration with

international organizations and governments on multi-drug-resistant TB, and it encourages the Center to continue these important

studies. The Committee is aware that FIC offers TB supplemental

training grants to recipients of the AIDS International Training

and Research Program (AITRP) or the International Training and

Research Program in Emerging Infectious Diseases (ERID). The

Committee encourages FIC to develop a specific free-standing TB

training program.

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2001 ............................................................................. $245,338,000

Budget estimate, 2002 ........................................................................... 274,633,000

Committee recommendation ................................................................. 281,584,000

The Committee recommends an appropriation of $281,584,000 for

the National Library of Medicine [NLM]. This is $6,951,000 more
178

than the budget request and $36,246,000 more than the fiscal year

2001 appropriation. 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.

Bioethical issues.—Since 1985, the NLM has undertaken important work in support of information retrieval in bioethics and has

established an effective and cooperative relationship with the National Reference Center for Bioethics Literature at the Georgetown

University-based Kennedy Institute of Ethics. As public policy debates today increasingly include in-depth discussion of the bioethical aspects of topics such as the oversight of human experimentation, stem cell research, cloning and privacy issues surrounding

health and genetic records, the Committee is particulary aware of

the importance of the work begun through this partnership. The

Committee encourages the NLM and the Kennedy Institute of Ethics to maintain and build upon this important work.

Facility expansion.—The Committee is pleased to actively support the allocation of the needed funds to complete the full design

of the NLM facilities expansion. It hopes the design will be completed expeditiously so that the burgeoning programs of the National Center for Biotechnology Information and the growing limits

of available space for the world’s greatest medical collection can be

satisfied through new facility construction.

Home medical consultations.—The Committee expects NLM to

provide sufficient funds for a demonstration to test the use of stateof-the-art telemedicine technology for home medical consultations.

This innovative approach holds great promise for improving the

care and lowering health care costs for home-bound individuals

who require frequent monitoring.

Outreach.—The Committee continues to note the success of

NLM’s MEDLINE and MEDLINEplus databases. 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. The Committee

continues to be concerned about challenges related to access to

health information in the rural and other medically underserved

areas, and it particularly supports NLM’s efforts to address this

through its Internet Connection Grant program.

PubMed Central.—The Committee commends NLM for its leadership in developing PubMed Central, an electronic online repository

for life sciences articles. PubMed Central holds great promise for

increasing access to health care literature by health professionals,
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students, educators, researchers and the general public. The Committee encourages NLM to work with the medical library community regarding issues related to copyright, fair use, peer-review and

classification of information on PubMed Central.

Senior citizen outreach.—The Committee again notes that senior

citizens would benefit greatly from expanded access to NLM’s databases, and it therefore expects NIH to provide sufficient funds for

a demonstration of a different means to that end, such as including

Internet access at senior centers and congregate meal sites. The

Committee expects to be briefed on NLM’s progress in this area.

OFFICE OF THE DIRECTOR

Appropriations, 2001 ............................................................................. $188,346,000

Budget estimate, 2002 ........................................................................... 232,929,000

Committee recommendation ................................................................. 236,408,000

The Committee recommends an appropriation of $236,408,000 for the Office of the Director [OD]. This is $3,479,000 more than the

budget request and $48,062,000 more than the fiscal year 2001 appropriation. The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research.

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.

The Committee directs the Director of NIH to make a written request to the chairman of the Committee prior to any reprogramming of $1,000,000 or more, between programs, projects, activities,

institutes, divisions and centers. The Committee desires to have

the requests for reprogramming actions which involve less than the

above-mentioned amounts if such actions would have the effect of

changing funding requirements in future years, if programs or

projects specifically cited in the Committee’s reports are affected,

or if the action can be considered to be the initiation of a new program.

Aphasia.—It has come to the Committee’s attention that the scientific knowledge of this common and devastating acquired speech

and language disorder has gone virtually unchanged for decades.

The Committee, therefore, urges the appropriate Institutes and

Centers to expand and better coordinate their support of research

into the cause, incidence, treatment and prevention of aphasia.

Furthermore, the Committee urges the Director to initiate a transNIH aphasia research planning and coordinating function, charged

initially with developing an aggressive Aphasia Research Agenda

that involves a comprehensive state-of-the-science review and a delineation of those areas with the most potential for yielding significant advances in near-term treatments and rehabilitation methodology.

Asian Indians.—The Committee recognizes that Asian Indians

worldwide have one of the highest rates of coronary artery disease

(CAD) and diabetes mellitus (DM) of any community around the
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world, ranging from 2 to 10 times higher in any given age range.

The Committee understands that while there are data in other

countries regarding the prevalence of and risk factors for CAD and

DM of Asian Indians, there is a lack of such data in the U.S. The

Committee recommends that the Director gather and analyze data

from Indian-American communities to study the prevalence of DM

and CAD within this population, and to create a registry for a longitudinal study to gain insight into effective intervention strategies.

Asthma and allergic diseases.—Given the widespread incidence

of asthma and allergies and their high economic toll on society, the

Committee urges the NIH to consider a cooperative effort by the

appropriate Institutes and Centers, including the NHLBI and

NIAID, to encourage and promote increased research in these

areas.

Autism.—The Committee urges the Director, in coordination with

NIAID, NIDCD, NIEHS, NIMH, and NINDS, to continue to fund

and aggressively encourage researchers to engage in research related to the potential causes, treatments, prevention, and cure of

autism spectrum disorders. In particular, the Committee wishes to

see the meaningful implementation of the new Centers of Excellence in Autism Research, mandated in the Children’s Health Act

of 2000. To that end, the Committee urges the Director to allocate

sufficient resources to advance the scientific and research agenda

related to autism spectrum disorders.

Autoimmune diseases.—Autoimmunity is at the root of a family

of over 80 genetically and clinically interrelated major diseases affecting some 50 million Americans. The Committee encourages

NIH and its Autoimmune Disease Coordinating Committee to expand research aimed at improving awareness, diagnosis and treatment for the entire family of autoimmune diseases. Interrelated

disease research will accelerate the application of important findings among the many medical specialties dealing with autoimmune

diseases. The Committee encourages NIH to study the overlapping

genetics of autoimmune diseases in order to improve diagnostic

procedures and effective treatments.

Behavioral science.—There is growing public awareness of the behavioral underpinnings of disease. Heart disease, lung cancer, liver

disease, AIDS, suicide, developmental disabilities, and many neurological and cognitive disorders in some cases can be attributed directly or indirectly to unhealthy behavior. The Committee urges

NIH to incorporate behavioral research as part of its core public

health mission. The Committee also urges the NIH to provide a detailed description of its ongoing work in the behavioral sciences, including a breakdown by Institute, and funds within each Institute

of research and training activities included in NIH’s behavioral and

social science portfolio.

Biotechnology.—Over the last decade, there has been an enormous growth in development of products from biotechnology. With

the nearing completion of the Human Genome Project and the development of many new biological techniques, there are still a large

number of untapped areas of research that may produce cures for

many debilitating diseases. The Committee encourages the Director

to explore new projects that link government, academia and indus-
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try, and involve public-private partnerships across traditionally

separated disciplines including genetics, nano-technology, material

sciences, physics, biology and chemistry.

Child abuse and neglect.—The Committee recognizes the significance of child abuse and neglect as a serious public health problem

claiming an estimated 826,000 victims in 1999, according to the

most recent data reported by the Department of Health and

Human Services. In 1996, the Committee called upon NIH to develop a research agenda designed to address the problems and gaps

that currently exist in the State of research in child abuse and neglect. The Committee encourages NIH to proceed at a high level of

attention with addressing the research agenda with which it began

in examining the National Research Council report entitled Understanding Child Abuse and Neglect, and requests that the working

group be prepared to report on current NIH research efforts in this

area, the accomplishments of that research, and on plans for future

coordination efforts at NIH at the fiscal year 2003 hearings.

Childhood birth defects and developmental disorders.—The Committee recognizes the importance of helping children suffering from

birth defects and developmental disorders. Thousands of children

each year suffer from birth defects and developmental disorders including cleft lip, cleft palate, missing limbs and other facial deformities from hemangiomas, hemifacial microsomia, microtia, aural

atresia, and craniosynostosis. The Committee, therefore, urges the

appropriate Institutes and Centers to expand and better coordinate

their support of research into the causes, incidence, treatment and

prevention of these and other children’s congenital or developmental conditions and to develop a comprehensive action plan targeting these conditions.

Chronic fatigue syndrome (CFS).—Despite the Committee’s supportive report language for CFS research and generous funding increases to NIH overall, CFS funding has not increased. The Committee is pleased by NIH’s efforts toward elevating the prominence

of CFS, such as moving the CFS program to the Office of the Director, revitalizing the internal NIH CFS Working Group, and holding

two ‘‘State of the Science’’ conferences on CFS. In fiscal year 2001,

the NIH developed a program announcement to solicit applications

in the priority areas identified by the 2000 CFS State of the

Science meetings, and its next priority task will be to work on

building a multifaceted intramural research project.

Clinical research loan repayment.—The Committee is concerned

about the declining numbers of physician-scientists pursuing careers in clinical research. In 1994, the Institute of Medicine recommended the creation of an NIH extramural loan repayment program. Last year, the Congress authorized the program in the Clinical Research Enhancement Act. The Committee believes that this

program is critically important and that tuition loan repayment

should be made available to the largest possible number of health

professionals who are pursuing structured training experience in

clinical research; actively engaged in clinical research career development activities with the guidance of a mentor; or conducting clinical research with independent support from NIH.

Collaboration with the CDC.—The Committee urges the Office of

Behavioral and Social Sciences Research (OBSSR) to develop a
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working group or groups in collaboration with the Centers for Disease Control in order to speed translation of behavioral research to

practice. The Committee recognizes that without dedicated resources it is difficult for staff in different agencies to collaborate as

closely as may be needed. NIH is urged to use its increased funding

to intensify collaboration, as well as facilitate communication and

the transfer of information.

Epilepsy.—The Committee recognizes that while the NINDS is

the primary Institute for addressing epilepsy, several other Institutes are also involved in related research. As 75 percent of epilepsy cases begin in childhood, the NICHD has an important role

to play in studying this disease. So, too, does the NHGRI, which

is urged to assist the NINDS in the search for a genetic fingerprint

diagnostic test aimed at improving drug therapy for epilepsy, and

the NIMH, which is urged to explore the link between epilepsy and

mood disorders, both of which are often treated with anticonvulsant medications. Finally, the NIA is encouraged to examine

epilepsy in patients over age 65. The Committee urges the Director

to coordinate research efforts among all these Institutes through an

Interagency Epilepsy Coordinating Committee that includes agency

scientists and industry and patient representatives.

Graduate Training in Clinical Investigation Awards.—The Committee is pleased that the NIH has initiated the Clinical Research

Curriculum Awards to improve the quality of training in clinical research. However, it is clear that a shortcoming of this program is

the absence of support for tuition and stipends for the individual

students. Last year, the Congress addressed this by authorizing the

Graduate Training in Clinical Investigation Awards in the Clinical

Research Enhancement Act. The Committee believes that these

grants are necessary if the Curriculum Awards are to fulfill their

enormous potential to replenish the supply of well-trained clinical

investigators.

Information technology.—Advances in information technology

make it possible to build powerful software-based simulations that

integrate the information emanating from medical and biological

science in ways that greatly enhance research, education and training and medical practice. The Committee urges the Director to facilitate the development and use of these new tools by leading a national effort to ensure that software components for simulations developed by NIH contractors and by other Federal agencies can

interoperate and easily be improved and reused. The Director

should also encourage researchers to form an open-source community that would facilitate sharing of software components and ensure thorough peer review and testing of simulations against empirical data. The Committee also urges the Director to coordinate

NIH’s activities with other Federal agencies including the National

Science Foundation, the Department of Defense and DARPA, and

NASA.

Juvenile arthritis.—The Committee urges the Director, in collaboration with the NIAMS, NICHD, and NIAID, to strengthen its

investment in and commit additional resources to basic, clinical,

and translational research efforts and related activities specific to

juvenile arthritis as authorized by the Children’s Health Act.
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Lyme disease.—The Committee recommends that the NIH improve its communication across Institutes in order to better coordinate Lyme disease research and outreach to public and private scientists with the goal of stimulating research interest in this field.

The Committee encourages the Office of the Director to involve

NIAID, NHLBI, NINDS, NEI, NIMH, and NCCAM in promising

areas of research. The Committee urges NIH officials to identify

appropriate NIH advisory committees for Lyme disease representation and ensure the appointment of qualified persons. The NIH is

encouraged to include a broad range of scientific viewpoints in the

process of planning and executing these efforts, including community-based clinicians with extensive experience in treating these

patients, voluntary agencies who have advocacy in their mission,

and patient advocates.

Microbicides research.—The Committee is supportive of increased

funding for microbicide research and product development through

the OAR, NIAID, NICHD, NIMH, NIDA, and ORWH. The Committee urges NIH to begin implementation of the 5-year strategic

plan for microbicide research, development and evaluation in coordination with other Federal agencies. To accelerate that implementation, the Committee encourages NIH to increase the number

of full-time employees dedicated to work encompassed by the plan.

The Committee requests a report by March 31, 2002, on the status

of its new microbicides program, including research efforts, funding

and staffing levels, and implementation of the strategic plan.

Mississippi Delta.—The Committee urges the NIH to pursue a

comprehensive medical research agenda with academic institutions

in the Mississippi Delta that have partnered together to develop

initiatives and research projects focusing on the disproportionate

disease-risk factors and high rates of morbidity in this health-challenged region. Though this area leads the Nation in several chronic

disease categories, the NIH has not conducted any systematic

study of the region. The Committee requests that the Director report to the Committee by March 1, 2002, on what comprehensive

study should be undertaken, when the research will begin, and

with what institutions the NIH will partner.

Neurofibromatosis.—The Committee recognizes that

neurofibromatosis (NF) research involves many Institutes and Centers, including NCI, NINDS, NHLBI, NEI, NIDCD, and NIAMS.

The Committee urges the Director to develop a plan to identify new

research opportunities regarding NF that cuts across Institutes and

Centers. The Committee encourages the Director to intensify and

expand its NF research portfolio, and to work with NF advocacy

groups when identifying and pursuing new scientific opportunities

that will ultimately allow for the development of effective treatments of NF.

NIH/DOE Medical Technology Partnership.—The Committee

urges the NIH to continue to collaborate with the Department of

Energy (DOE) to evaluate the technologies developed within the

nuclear weapons program and other DOE programs in terms of

their potential to enhance health sciences, with the goal of achieving clinical applications and improved national health care.

Office of Dietary Supplements.—The use of dietary supplements

has increased significantly among Americans who want to improve
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their health and prevent disease, and there is a great need for additional research to better inform consumers of the benefits of

these supplements. The Committee expects the Office to allocate

sufficient funds to expand the number of botanical research centers, and it urges that hypericum and echinacea be studied at one

of these new centers.

The Committee has included sufficient funds to speed up ongoing

collaborative efforts to develop, validate, and disseminate analytical

methods, and reference materials for the most commonly used

botanicals and other dietary supplements.

The Committee is pleased that the ODS has followed through on

its recommendation to begin a major research initiative on the

safety and efficacy of products containing ephedra, and it urges the

Office to continue and expand this important effort. The results of

this expanded research should be evaluated by the FDA to ensure

that any final action on the proposed rule on products containing

ephedrine alkaloids is based on sound science. The Committee believes the Department should immediately take necessary interim

action that addresses scientifically supportable safety activities

(such as adopting appropriate warning labels that include contraindications and warn against sales to minors) while this research

is being completed.

Office of Research on Women’s Health.—The Office of Research

on Women’s Health (ORWH) works in collaboration with the Institutes and Centers (ICs) of the 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 the initiation of new investigative studies. The ORWH is responsible for ensuring the inclusion of women in clinical research funded by the

NIH, including the development and implementation of a computerized tracking system and the implementation of guidelines on

such inclusion. The Office is also involved in promoting programs

to increase the number of women in biomedical science careers, and

in developing women’s health and sex and gender factors in biology

as a focus of medical/scientific research. The Committee urges the

Director to use the increased funds provided to ORWH for new research activities in a variety of health issues and new and expanded career development programs for women scientists, such as

Building Indisciplinary Research Careers in Women’s Health. In

addition, the Committee strongly supports the creation of new

interdisciplinary research centers to focus on multi-systemic diseases in women, and urges ORWH, in conjunction with the NIH

ICs, to move forward with this proposal without delay. The Director is asked to present a progress report to the Committee by April

1, 2002.

Omega-3 fatty acids.—The Committee is aware of promising research showing significant positive heart health effects related to

the consumption of omega-3 fatty acids through foods or supplements. Given the significant human and financial costs associated

with coronary heart disease, the Committee urges the Office to

begin preliminary work on a major assessment of the health benefits of omega-3 fatty acid consumption.

Parkinson’s disease.—In consultation with the extramural research community, the NIH has developed a Parkinson’s Disease
185

Research Agenda that would require an estimated $1,000,000,000

increase in funding over 5 years to carry out. It is the clear intent

of the Committee that the NIH seek to implement this research

agenda, and that the Office of the Director assume an aggressive

leadership role in this effort.

Last year, the Congress strongly urged the NIH to work toward

implementing Year 1 of the research agenda, which cited the need

for a $71,400,000 increase in Parkinson’s research funding. The

Committee is concerned that the NIH did not meet that goal. As

a consequence, much of the agenda remains to be undertaken, and

this highly promising field of research is not moving ahead as

speedily as the Congress intended. An estimated $143,500,000 increase over the baseline year would

be needed to implement Year 2 of the research agenda, and the

Committee has provided additional funds for that purpose. In order

to ensure full implementation and funding, the Committee directs

the NIH to host a series of consortia in collaboration with the Parkinson’s research-related Institutes and the extramural research

community by February 15, 2002. The consortia shall identify, to

the full extent of available scientific opportunity, the research

needed to implement the Research Agenda and the funding mechanism and dollars necessary for each area. The Committee requests

the Director to report by March 15, 2002, that the consortia have

been held, and on the specific steps the NIH will take to implement

the Research Agenda.

The Committee commends the NIH for encouraging and supporting workshops and other collaboration between sectors of the

Parkinson’s research community, including the NIEHS-supported

consortia and the NINDS-supported workshop on gene therapy,

and encourages similar collaborative models. The Committee also

urges the NIH to continue support of the Udall Centers program

and to continue expansion thereof.

Pediatric research initiative.—The Committee is aware that the

Children’s Health Act of 2000 authorized the establishment of the

Pediatric Research Initiative within the Office of the NIH Director,

for the purpose of encouraging an increased emphasis on research

addressing children’s illnesses and conditions across the various Institutes and Centers. The Committee urges the Office of the NIH

Director to carry out the Initiative, including supporting training

for pediatric researchers, as authorized by Title X of the Children’s

Health Act. The Committee requests NIH to provide a report to the

Committee by April 1, 2002, on the pediatric research activities

supported with these Initiative funds.

Pediatric Research Loan Repayment.—The Children’s Health Act

of 2000 established the Pediatric Research Loan Repayment Program to ensure the future supply of researchers dedicated to the

care and research needs of children. The Committee urges NIH to

use this program to encourage promising investigators to enter various areas of pediatric research, particularly in the areas of

Duchenne muscular dystrophy and fragile X. The Committee requests that the Director prepare a report, by April 1, 2002, detailing the progress of this program.

Population-based prevention research.—The Committee urges

NIH to significantly expand its support for studies that examine
186

the biological, behavioral and environmental risks for disease. The

Committee is especially interested in the assessment of preventionfocused interventions designed to enhance health status, the exploration of heath disparities across population subgroups, the examination of strategies designed to move the findings of laboratorybased research from individuals to population-wide applications,

and the exploration of the potential uses of communication technologies to enhance human health. The Committee urges NIH to

submit a report to the Committee by April 1, 2002, that indicates

total dollars spent on population-based prevention research by Institute and relevant disease areas where possible.

Resuscitation research.—Some 600 Americans die each day from

cardiac arrest. The Committee understands that cardiopulmonary

and trauma resuscitation techniques have only about a 10 to 15

percent success rate, and the average survival rate has not improved significantly over the last four decades. The Committee is

pleased that the NHLBI, the NINDS, the NICHD, the NIGMS, the

Department of Defense, and the Food and Drug Administration

supported a forum to set a broad research agenda on novel life-saving therapies and to identify promising new directions in CPR and

trauma resuscitation research. The Committee encourages these

agencies to pursue these new areas of investigation.

Sjogren’s syndrome.—Sjogren’s syndrome is an autoimmune disease with significant impact, and the Committee recommends that

the NIH Autoimmune Diseases Coordinating Committee include

Sjogren’s syndrome as a priority in its strategic plan. Sjogren’s

crosses many specialties and falls under the auspices of many NIH

institutes, including the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Allergy

and Infectious Diseases, the National Institute of Dental and

Craniofacial Research, and the National Eye Institute. The Committee recognizes the need for NIH to develop an integrated plan

to cover Sjogren’s syndrome that cuts across the Institutes and

meets the diverse needs of Sjogren’s patients.

Summer Student Research Program.—The Committee is aware of

the highly successful ‘‘Summer Student Research Program,’’ administered through Children’s Research Institute at Children’s Hospital in Columbus, Ohio, that addresses the critical shortage of

physician-scientists in pediatrics—a shortage that is far more acute

in pediatrics than in adult medicine. This program should be made

permanent due to its success in placing highly-qualified medical

students in summer research experiences in pediatrics and due to

its outstanding track record of including under-represented minorities and women. Since 1991 there have been 1,183 applications to

the program, and 370 students from more than 80 different medical

schools have been successfully placed in nearly 140 laboratories

throughout the United States and Canada. One-fourth of awardees

have been from under-represented minorities, and women awardees have outnumbered men by more than 1.5 to 1.

Systems and integrated biology.—The Committee recommends increased support for research and training in whole-systems pharmacology, physiology, toxicology, and other integrative biological

disciplines that help to define the effects of therapy on disease and

the overall function of the human body. Over the past two decades,
187

there has been an emphasis on supporting research and training

at the cellular and molecular levels, but diminished support for

training and research in systems and integrated biology. The erosion of support in the area of integrated systems threatens to slow

the rate at which fundamental discoveries made at the cellular and

subcellular levels are translated into useful therapies. The Committee understands that the Center for Scientific Review (CSR) is

currently reorganizing its peer review panels. It hopes that the

CSR will ensure that scientists with whole-systems expertise will

be represented on those panels.

Tobacco products.—The Committee urges that the NIH, including NCI, NIDA, NHLBI, and NIMH, increase its commitment to tobacco-related research, especially regarding cigarette design, including ingredients and constituents. There is a growing concensus

in the scientific community that cigarettes could be made less toxic

and that changes in tobacco products could reduce the risk of the

disease and death in people who continue to use them. However,

there are major gaps in the science base necessary for guiding such

efforts. For example, research is needed to understand the impact

of tobacco product variations on the development of cancer, heart

disease, brain diseases, fetal growth and nicotine addition itself. A

specific request for research applications, along with support for intramural researchers to conduct such research, would accelerate

the process of discovery and cultivation of expertise on this critical

subject.

Temporomandibular joint disorders (TMJ).—The Committee recognizes that the problems associated with temporomandibular diseases and disorders involve many Institutes and Centers, including

the National Institute of Dental and Craniofacial Research, the National Institute of Arthritis and Muscoloskeletal and Skin Diseases,

the National Institute of Allergy and Infectious Diseases, and the

National Institute of Biomedical Imaging and Bioengineering. The

Committee calls on the Office of the Director to coordinate crosscutting research by the various Institutes and Centers and provide

a report directly to the Committee by April 1, 2002, on TMJ initiatives begun in fiscal year 2001 or scheduled to begin in fiscal year

2002. In addition, a Special Emphasis Panel should be established

to review applications in the multiple disciplines applied to studies

of the causes, manifestations and treatments of temporomandibular

diseases and disorders.

Veterans affairs cooperation.—The VA system of 173 hospitals

and 771 clinics provides medical care for the full array of diseases

and medical conditions to 4.1 million veterans. The Committee,

therefore, believes that the VA system is an ideal setting for large

multi-center studies and clinical trials and that NIH should more

aggressively utilize this resource to facilitate and accelerate research. The Committee requests that NIH explore with the VA

ways to increase cooperative research efforts and develop an interagency Memorandum of Understanding to accomplish this purpose

and report to the Committee by April 1, 2002, on the projects initiated under this move.
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BUILDINGS AND FACILITIES

Appropriations, 2001 ............................................................................. $153,761,000

Budget estimate, 2002 ........................................................................... 236,600,000

Committee recommendation ................................................................. 306,600,000

The Committee recommends an appropriation of $306,600,000 for

buildings and facilities [B&F]. The amount recommended is

$70,000,000 more than the budget request and $152,839,000 more

than the fiscal year 2001 appropriation. Included in these funds is

$70,000,000 to be transferred to the Global Fund to fight HIV/

AIDS, Malaria, and Tuberculosis.

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.

OFFICE OF AIDS RESEARCH

Appropriations, 2001 ............................................................................. ...........................

Budget estimate, 2002 ........................................................................... ...........................

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

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. These modifications to the budget recommendation are consistent with the manner in which funding for AIDS research was

provided in fiscal year 2001. The Committee requests that the Director report on the fiscal year 2001 allocation plans for AIDS research within 60 days of enactment and 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.

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Appropriations, 2001 ............................................................................. $2,963,856,000

Budget estimate, 2002 ........................................................................... 3,029,456,000

Committee recommendation ................................................................. 3,073,456,000
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The Committee recommends $3,073,456,000 for the Substance

Abuse and Mental Health Services Administration [SAMHSA] for

fiscal year 2002, an increase of $109,600,000 over the fiscal year

2001 level and $44,000,000 more than the administration request.

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 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 within CSAP and CSAT

to continue supporting projects that increase knowledge about effective ways to deliver services to rural and native communities.

The Committee believes that Community Health Centers should be

utilized in this effort.

The Children’s Health Act of 2000 reauthorized programs administered by the SAMHSA and created new program authorities designed to address emerging mental health, alcohol and other drug

abuse issues. 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.

CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2001 ............................................................................. $782,048,000

Budget estimate, 2002 ........................................................................... 766,148,000

Committee recommendation ................................................................. 787,148,000

The Committee recommends $787,148,000 for mental health

services, $5,100,000 more than last year’s level and $21,000,000

more than the budget request. Included in this amount 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. The Committee continues to support

funding for mental health counselors for school-age children, as

part of an effort to reduce the incidence of youth violence. The

Committee intends that $90,000,000 be used for counseling services

for school-age youth.

Programs of regional and national significance

The Committee recommends $203,599,000 for programs of regional and national significance, $5,100,000 more than the fiscal

year 2001 amount and $21,000,000 more than the administration’s
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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 has again included resources to continue and expand mental health services for schoolchildren that are at risk of

exhibiting violent behavior. Among other things, the Committee believes that mental health counseling for troubled youth can help

prevent violent acts, and therefore is providing additional resources

to help 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 is concerned that the Agency’s funding of health

services knowledge development for the mental health of the elderly has not kept pace with its funding for other populations. For example, CMHS does not have any projects planned to assess how

health care systems impact access to quality mental health for the

elderly population. The Committee strongly encourages CMHS to

devote additional resources in fiscal year 2002 and subsequent fiscal years to this issue, and urges the Director of CMHS to designate an individual within the Office of the Director to oversee the

Center’s aging knowledge development agenda and initiatives. Special priority should be given to funding dissemination and implementation of evidence based practices in real world health care settings.

The Committee is aware of the need for additional suicide prevention activities and is impressed with the Surgeon General’s report, ‘‘A National Strategy for Suicide Prevention: Goals and Objectives for Action’’, which was released in May 2001. The passage of

S. Res. 84 and H. Res. 212 in the 105th Congress recognized suicide as a national problem and declared suicide prevention to be a

national priority. Since then, the Committee is encouraged by the

progress being made through the collaborative efforts of both the

public and private sectors to raise national awareness on suicide

prevention, to develop a national suicide prevention strategy, and

to involve States in the development of State plans for grassroots

implementation to continue reducing the rate of suicide in America.

Preliminary data from the National Center for Health Statistics for

1999 suggest that these collective efforts have had a positive impact. The number of suicides in the United States decreased more

than 5 percent from 30,575 in 1998 to 29,041 in 1999. Nevertheless, suicide remains a serious public health challenge and more

needs to be done.

The Committee commends the joint efforts of the SAMHSA/

CMHS, NIH/NIMH, CDC, and HRSA to launch a website resource

which provides a wide array of suicide prevention related information and resources for mental and public health professionals,

health care providers, community coalitions, policymakers, survivors, and advocates. Significant activity is now ongoing at the

State, community, and non-profit levels in developing and implementing plans, programs and services. This follows the guidance

outlined in the National Strategy for Suicide Prevention: Goals and

Objectives for Action (NSSP). Further, the NSSP recommends the
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development of one or more training and technical resource centers

to build capacity for States and communities to implement and

evaluate suicide prevention programs. The Committee has included

$3,000,000 to build upon the work of the Agencies identified above

by establishing a National Suicide Prevention Resource Center to

provide technical assistance in developing, implementing and evaluating effective suicide prevention programs. The Resource Center

will provide training and field support and serve as a clearinghouse

for all pertinent best practices information regarding suicide prevention. The Center should promote evaluation of suicide prevention programs to ensure that effective techniques, strategies, and

recommended best practices are made available to users.

Hawaii has a large refugee immigrant population that has been

found to be suffering from a disproportionately high amount of

post-traumatic stress disorder. Because of the multiple diverse cultures that these future citizens come from and the fact many speak

no English, it is very difficult to meet their mental health needs.

The Committee urges attention be given to effectively resolving the

mental health problems of these future citizens.

The Committee recommendation includes funding for the Safe

Schools/Healthy Students Program, which supports the Departments of Health and Human Services, Justice, and Education,

working together to develop empirically supported programs to prevent youth violence and to intervene with families, schools, and

communities where violence has already occurred. The Committee

urges the use of community health centers as part of this effort.

The Committee commends CMHS for its efforts to reduce stigma

and other barriers that discourage Americans from seeking mental

health services. The Committee is aware that fewer than one-third

of Americans with a diagnosable mental disorder seek out services

and notes the recent Surgeon General finding that stigma is a barrier that both discourages people from obtaining treatment and

promotes discrimination against the mentally ill. The Committee

understands that the National Mental Health Awareness Campaign has launched a very successful youth initiative designed to

reduce the fear and shame associated with childhood mental disorders. The Committee believes that a nationwide public service

advertising campaign combating stigma among adults and senior

citizens could have a positive effect on public attitudes and behaviors.

The Committee is aware of the significant steps CMHS has taken

to improve services to those living with and suffering from HIV/

AIDS and has included sufficient funding to continue these efforts.

The Committee recognizes the need for more trained health providers, including allied health professionals and social workers, to

work with people suffering from HIV/AIDS and commends the collaborative effort of CMHS, HRSA, NIMH, NIAAA and NIDA to address this issue. The Committee also notes the support CMHS has

provided to community-based initiatives to deliver direct mental

health services for people living with HIV/AIDS. These HIV/AIDS

activities should continue to develop and apply new knowledge that

improves the quality of services available.

The Committee recommendation includes resources for Targeted

Capacity Expansion (TCE) activities to develop and implement em-
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pirically based models for prevention and early intervention for

children’s mental health problems. The Committee recognizes that

the increased number of young children diagnosed with mental disorders, the rising teen suicide rate, and the recent incidents of

school violence are all indicators that our Nation’s children and

youth have serious unmet mental health needs.

The Committee appreciates CMHS’s commitment to improving

the quality, effectiveness and availability of therapeutic services

delivered to traumatized children and adolescents; furthering the

understanding of the individual, familial, and community impact of

child and adolescent traumatic stress and the methods used to prevent its consequences; and reducing the frequency and consequences of traumatic events on children and adolescents. The

Committee recommendation includes sufficient funding to expand

activities of the Child Traumatic Stress Program.

The Committee notes that the Minority Fellowship Program

(MFP) plays a crucial role in reducing the racial and ethnic disparities in mental health status in Native Hawaiian and Samoan communities. The MFP plays a significant role in training minority

mental health professionals to provide services, through community

health centers and other clinics, to individuals who would otherwise go untreated.

The Committee is pleased that the Center for Mental Health

Services funds state-of-the-art, peer-run programs that help people

with mental illnesses live successfully in the community. These

low-cost services have an impressive record of assisting people with

mental disorders to decrease their dependence on expensive social

services and avoid hospitalization. The Committee is supportive of

CMHS’s funding of five national technical assistance centers that

provide training and information to help these programs serve

their clients.

The Committee is aware of the following projects and programs,

and encourages SAMHSA to give each full and fair consideration

for awards available in new grant competitions.

Expansion of Phase II of the HIV/AIDS High Risk Behavior Prevention Program will help reduce the behavioral transmission of

the virus and support mental health services to those persons already infected with the disease.

The Comprehensive Community Mental Health Services for Children and their Families program will continue the development

and evaluation of mental health services for children and youth in

States and localities using community health centers.

Life Quest Community Mental Health Center, which serves the

second largest population center in Alaska, is seeking to fill the

previously unmet need for treatment of co-occurring disorders for

severely and persistently mentally ill, severely emotionally disturbed adults and children in the Mat-Su Valley region of Alaska.

Ventura County, California has developed its capacity to effectively transition mentally ill prisoners out of detention facilities

and into a community treatment environment.

The Pennington County Detention Center in Rapid City, South

Dakota has experienced significant growth in the number of detainees in need of mental health and substance abuse treatment services.
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The Weingart Center in Los Angeles, California will develop and

expand mental health support and long-term case management

within transitional housing and clinical programs to help end poverty and break the cycle of homelessness.

Washoe County, Nevada will develop a suicide prevention program designed to investigate the effect of an Intensive Depression

Recognition and Treatment Training Program for primary care

physicians and their nurses, psychiatrists, and corporate and student health personnel on the recognition of mood disorder, suicide

mortality and morbidity.

The Texas Medication Algorithm Project (T–MAP) has developed

a disease management program that synthesizes scientific and

practitioner consensus into a practical guideline for physicians, and

also has demonstrated improvements in the quality of care for individuals receiving psychotropic medications.

The Mental Health Connection of Tarrant County, Texas, is planning a collaborative initiative to provide families and individuals

with a seamless, accessible ‘‘wraparound’’ system of community

mental health services.

The Fairbanks Native Association, Tanana Chiefs Conference,

and the University of Alaska Fairbanks’ ‘‘Ch’eghutsen’’ comprehensive mental health services program for children in interior Alaska

is addressing the critical shortage of culturally relevant mental

health services for children, especially those who are seriously emotionally disturbed, in the vast area which comprises interior Alaska. Ch’eghutsen is guided by Alaska Native principles which view

the child as inseparable from family and community, and is addressing suicide attempts, substance abuse, fetal alcohol syndrome

and fetal alcohol effect, sexual abuse, violence, and individual and

collective trauma for the more than 600 Alaska Native children

who are estimated to suffer from serious emotional disturbances in

this region.

The Alaska Psychiatric Institute and the State of Alaska will

continue designing programs to treat co-occurring disorders and

focus efforts on developing treatments for victims and witnesses of

domestic violence and child abuse, a considerable problem in Alaska, which has the highest rates of child abuse and domestic violence in the Nation.

The Alaska Federation of Natives, in consultation with the State

of Alaska, continues to develop integrated systems of community

care for Alaska Native children who commit suicide at the highest

rate in the Nation and suffer disproportionately from behavioral

and mental disorders, some caused by fetal alcohol syndrome.

The Alaska Federation of Natives, in consultation with the State

of Alaska, will develop a plan for outreach, screening and diagnostic treatment services, rehabilitation, mental health services, alcohol and drug treatment, training, and case management to help

reduce the large numbers of individuals, particularly Alaska Natives, suffering from severe mental illness and substance abuse disorders who are also homeless. This problem is especially acute in

Anchorage, Alaska.

Family Communications and its pilot project, ‘‘What Do You Do

with the Mad that You Feel?’’ has provided encouraging evidence

of success in preventing youth violence. Family Communications
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proposes to expand this initiative beyond the original pilot States

and plans to introduce a follow-up program, ‘‘The Challenging

Child.’’

The 2nd Trauma project, an initiative designed to help over 7

million families each year who receive the news of the sudden, unexpected violent death or critical injury of their child, spouse, parent or other loved one, has developed a program to train trauma

center and emergency room personnel to develop the skills needed

to tell a family member that a loved one has suffered a traumatic

injury or death, prepare personnel to provide immediate and sensitive counseling on critical decisions, and engage long-term community support networks when appropriate.

Safe Havens, an award-winning training program for care givers

and teachers, aims to help adults counsel children who have witnessed violence and plans to expand its training beyond the pilot

States of Pennsylvania, Iowa, Massachusetts, Maryland, and New

York.

The Alaska Federation of Natives, in consultation with the State

of Alaska, will identify the most effective service delivery practices

and develop model programs for implementation in the Alaska Native community that help reduce the rates of suicide, child abuse,

and alcohol dependency, especially in Native communities. Alaska

has the highest rates of alcohol dependency in the Nation, the

highest rate of suicide, and the highest rate of child abuse, especially in Native communities in Alaska.

Mental health performance partnership block grant

The Committee recommends $420,000,000 for the mental health

performance partnership block grant, the same amount as the fiscal year 2001 appropriation and the budget request. 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 States and territories by

formula.

Children’s mental health services

The Committee recommends $91,694,000 for the children’s mental health services program, the same amount as the fiscal year

2001 level and the administration’s 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.

The Committee has provided sufficient resources to expand the

child mental health services program over the past several years.

However, staff resources dedicated to administering this program

have not grown. The Committee recognizes the benefit of providing

sufficient staff support to ensure that local grantees have the technical capacity to operate this program effectively.
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Projects for assistance in transition from homelessness [PATH]

The Committee recommends $39,855,000 for the PATH Program,

an increase of $3,000,000 over the fiscal year 2001 amount and the

administration’s request.

PATH is a critical program which provides outreach, mental

health, and case management services and other assistance to persons who are homeless and have serious mental illnesses. 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 $32,000,000 for the protection and

advocacy program, an increase of $2,000,000 over the fiscal year

2001 amount and the administration’s 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 States according to a formula based on population and relative per capita income.

The Committee notes the Children’s Health Act of 2000 provided

additional authorities to State P&A systems in their efforts to protect the rights of individuals with mental illness and severe emotional impairment. This includes the specific authority to monitor

all public and private residential care and treatment facilities and

non-medical community-based facilities for children and youth to

ensure that they are not at risk for inappropriate use of seclusion

and restraint and to investigate all incidents involving serious injuries and deaths related to incidents of seclusion and restraint used

by staff at these facilities. State P&A systems also have a significant role in addressing the community integration needs of individuals identified in the Olmstead decision. The Committee recommendation includes $2,000,000 more than last year’s appropriation to support State P&A systems in their effort to address these

critical issues.

CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2001 ............................................................................. $1,921,122,000

Budget estimate, 2002 ........................................................................... 2,021,122,000

Committee recommendation ................................................................. 2,001,122,000

The Committee recommends $2,001,122,000 for substance abuse

treatment programs, an increase of $80,000,000 over last year’s

funding and $20,000,000 less than the budget request. This amount

funds substance abuse treatment programs of regional and national

significance and the substance abuse prevention and treatment

block grant to the States.
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The Committee is concerned about the treatment gap that continues to exist for those Americans in need of substance abuse

treatment services, for whom treatment is not available. The latest

estimates indicate that millions of Americans with serious substance abuse treatment go untreated each year, adding billions in

monetary costs to our society each year and immeasurable emotional pain and suffering for millions of families. Studies have

shown that substance abuse treatment is effective at reducing primary drug use by nearly 50 percent, criminal activity by 80 percent

and alcohol- and drug-related medical visits by 50 percent while increasing individual financial self-sufficiency. The Committee commends CSAT for initiating its National Treatment Plan Initiative

(NTP), and believes that additional resources need to be devoted to

the NTP and to reducing, and eventually eliminating, the treatment gap.

Programs of regional and national significance

The Committee recommends $276,122,000 for programs of regional and national significance [PRNS]. This amount is

$20,000,000 above the fiscal year 2001 amount and $20,000,000

less than the budget request.

Programs of regional and national significance, as reauthorized

by the Children’s Health Act of 2000, include three primary activities: knowledge development and application projects 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 $10,000,000 to expand

CSAT’s support of clinically based treatment and related services

for adult, juvenile and family drug courts and individuals returning

from the community who are on probation, parole, or unsupervised

release. The Committee is aware of the rapid increases in the use

of drug courts throughout the country as an alternative to the traditional court system. These courts make substance abuse treatment available, when appropriate, as an alternative to incarceration, and are considered a cost-effective approach to helping drug

users regain control of their lives. While the fiscal year 2002 appropriation for CSAT includes additional resources for treatment, the

Committee notes that support for treatment services has not kept

pace with the increase in the use of drug courts, thereby limiting

the cost-effectiveness of this approach. The Committee also believes

SAMHSA should work with the Department of Justice (DOJ) to ensure that administrative and drug testing costs associated with

sanctions-based treatment for individuals under DOJ supervision

are distributed fairly.

Programs of regional and national significance include critical

support for substance abuse treatment services for the Nation’s

homeless population. The homeless have unique needs and life circumstances that have received inadequate attention in terms of

substance abuse treatment. Therefore, the Committee continues to

advocate coordinated and seamless service delivery for the homeless that includes mental health, primary care, and other social
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services that will support positive treatment outcomes. The Committee recommendation includes additional resources to continue to

make progress in this area.

The Committee understands that methamphetamine abuse continues to be a major problem in many areas of the country, in particular, the South and the Midwest. The State of Iowa is experiencing a particularly high incidence of methamphetamine abuse, as

well as other emerging drug issues. The Committee recommendation includes sufficient funding to support prevention and treatment demonstration projects in Iowa and other parts of the Midwest and South. School-based prevention demonstration projects

would teach the dangers of methamphetamine abuse and addiction

as well as other emerging drug issues, using methods that are effective and evidence-based and include initiatives that give students the responsibility to create their own anti-drug abuse education programs for their schools. Treatment demonstrations would

carry out planning, establishing, or administering evidence-based

treatment programs that are designed to assist individuals to quit

their use of methamphetamine or other emerging drugs and remain drug-free.

The Committee recognizes the importance of the residential

treatment program for pregnant and postpartum women, which

was authorized as part of the Children’s Health Act of 2000 (Public

Law 106–310). This program has helped significantly increase the

percentage of children born free of illicit substances. Continued

funding of this program will contribute to the health and well being

of pregnant women with addictions and their children.

The Committee is aware of the following projects and programs,

and encourages SAMHSA to give each full and fair consideration

for awards available in new grant competitions.

The Cook Inlet Council on Alcohol and Drug Abuse is providing

coordinated treatment services to meet the needs of an underserved

group of women and their children who are in the custody of the

State of Alaska and women affected by domestic violence in the

Kenai Peninsula area of Alaska.

Center Point, Inc. will demonstrate and evaluate the effectiveness of its Adolescent Residential and Aftercare Treatment Program, which is widely recognized throughout Northern California

as an effective option for troubled youth because it provides a continuum of care, involves the family and provides critical aftercare

support.

The City of New Orleans Seamless Accountability System for

Substance Involved Offenders is a pre-sentencing program that focuses on anti-violence behaviors and treatment therapies. The program targets offenders 17 to 24 years of age.

The City of San Francisco’s Treatment on Demand program provides services that advance individuals’ recovery through abstinence and harm reduction, including the reduction of delays in

gaining access to substance abuse.

Haymarket West in Schaumburg, Illinois will expand its comprehensive substance abuse treatment and related services in the

northwest suburbs.
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The city of Baltimore is employing innovative techniques to enhance drug treatment services for area residents, particularly for

those in need of intermediate residential treatment.

Spectrum Youth and Family Services proposes to expand services

provided through its Youth Health Clinic located in Burlington,

Vermont.

Recovery House, Inc., in Wallingford, Vermont is developing a

day treatment program for women with dependent children and

pregnant women.

The Vermont Division of Alcohol and Drug Abuse Program and

the Vermont Department of Social and Rehabilitative Services will

improve access to residential treatment for adolescents in custody

in Rutland County.

The Navajo-Farmington Alcohol Crisis Response Program is addressing the substance abuse problems in the City of Farmington,

San Juan County, and also working with affiliated partners by establishing and operating an alcohol crisis response network of services to address serious alcohol problems.

The United Community Center/Centro de la Comunidad Unida’s

demonstration project to address domestic violence in Milwaukee’s

Hispanic community represents an innovative integration of domestic violence intervention with the Center’s Latinas Unidas treatment program for substance-abusing women and their families.

Lutheran Social Services of Wisconsin and Upper Michigan, Inc.

is developing a unique alcohol and other drug abuse treatment program to address the specific needs of the older adult population by

locating certified alcohol treatment in the community-based settings of three senior centers in northeast Wisconsin.

The Corporation for Supportive Housing will help combat chronic

homelessness in communities by supporting the provision of healthrelated assistance to this vulnerable population.

The National Center on Addiction and Substance Abuse at Columbia University is partnering with the New Jersey Department

of HHS and the Department of Health and Senior Services to

evaluate strategies to assist women who have substance abuse

problems and are approaching Federal welfare time limits.

The Southcentral Foundation in Anchorage has developed an innovative program designed to provide substance abuse treatment

for Alaska Native adolescents.

The inpatient treatment program for adult Alaska Native substance abusers at the Ernie Turner Center operated by the Cook

Inlet Tribal Council continues to provide inpatient and outpatient

services.

The Allegheny County Department of Human Services continues

to provide for both inpatient and outpatient drug and alcohol services for its citizens as it faces increasing costs for inpatient services

that severely strain its ability to meet the demand for treatment.

Substance abuse prevention and treatment block grant

The Committee recommends $1,725,000,000 for the substance

abuse prevention and treatment block grant, $60,000,000 more

than the fiscal year 2001 level and the same as the administration’s request.
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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 Children’s Health Act of 2000 made several changes to the

authority for the substance abuse prevention and treatment block

grant, including the development of a performance partnership

framework in which States are granted program flexibility for

achieving a common set of performance measures; extending the

period of time States have to obligate block grant funds; and prohibiting discrimination against religious organizations in receiving

Federal assistance for providing substance abuse services. The

Committee expects SAMHSA to be prepared to provide detailed information about implementation of these and other modified and

new program authorities during the fiscal year 2003 budget process.

The Committee supports efforts currently underway in SAMHSA

to create a strategic plan around homelessness. The Committee

commends SAMSHA on this initiative, and encourages the Agency

to tie this plan in with planning requirements in the recent

SAMSHA reauthorization bill. Specifically, the Committee encourages SAMSHA to build housing status into the common set of performance measures required from States reporting on block grant

programs. The Committee is concerned about the lack of data from

the mental health and substance abuse block grant programs on

the housing status of persons entering and exiting programs. A set

of consistent performance measures is needed across programs

serving homeless and precariously housed people in SAMHSA and

other Operating Divisions, including HRSA, ACF and CMS, to understand the impact HHS programs are having. Further, the Committee requests reports on the status of plans for performance partnerships, including the outcomes to be measured, from the Substance Abuse Prevention and Treatment Block Grants and Mental

Health Block Grants within 6 months of the enactment of this Act.

CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2001 ............................................................................. $175,013,000

Budget estimate, 2002 ........................................................................... 175,013,000

Committee recommendation ................................................................. 189,013,000

The Committee recommends $189,013,000 for programs to prevent substance abuse, an increase of $14,000,000 above last year’s

level and $14,000,000 more than the budget request. This amount

funds substance abuse prevention programs of regional and national significance.

Programs of regional and national significance

The Committee has provided $189,013,000 for programs of regional and national significance [PRNS], $14,000,000 more than

the fiscal year 2001 amount and $14,000,000 more than the administration’s request. The Center for Substance Abuse Prevention is

the sole Federal organization with responsibility for improving

accessability and quality of substance abuse prevention services.

Through the programs of regional and national significance activity, CSAP supports: development of new practice knowledge on sub-
200

stance 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 notes the alarming increase in use and availability of ecstasy and other club drugs among our Nation’s youth.

For 2 consecutive years, ecstasy use reported by 10th and 12th

grade students has increased. According to SAMHSA’s Drug Abuse

Warning Network, ecstasy-related emergency room admissions in

the United States increased significantly from 253 in 1994 to 4,511

in 2000. The Committee urges SAMHSA to pay close attention to

this and other emerging drug use issues.

The Committee is aware of the need to strengthen fetal alcohol

syndrome (FAS) prevention efforts and improve service delivery by

ensuring that professionals in key fields are knowledgeable about

FAS and related birth defects, particularly in high-prevalence regions. The Committee has therefore included sufficient funding to

allow the Four-State FAS Consortium in Minnesota, Montana,

North Dakota, and South Dakota to develop programs to provide

training on FAS and related birth defects for professionals and students in health care, education, social work, foster care, criminal

justice, and other relevant fields.

The Committee notes the insufficient number of effective fetal alcohol syndrome and fetal alcohol effects (FAS/FAE) programs in

communities affected by this problem. The Committee has provided

an additional $1,300,000 to expand efforts to identify, disseminate

and implement effective FAS/FAE prevention and treatment programs.

The Committee is aware of the following projects and programs,

and encourages SAMHSA to give each full and fair consideration

for awards available in new grant competitions.

The Fairbanks Native Association’s LifeGivers residential treatment program continues to achieve successes in helping pregnant

women with substance abuse problems and their children.

The Vermont Department of Health, Division of Alcohol and

Drug Abuse Programs proposes a pilot project of support for community-based programs in Rutland, Burlington, and Barre to explore best practices for combating the growing drug abuse problem.

The Ai Ki Ruti Center is developing outreach initiatives to underserved Native American populations in Northeast Nebraska to

increase their access to needed prevention and treatment services.

The Start SMART Foundation in Bethlehem, Pennsylvania is developing a pilot project to reduce underage drinking utilizing QED,

a new saliva alcohol test which returns an accurate measurement

of blood alcohol levels in 2 to 5 minutes.

The National Center on Addiction and Substance Abuse at Columbia University has developed CASEWORKS for Families, an innovative program to help women at risk of substance abuse.

The Institute for Research, Education, and Training in Addictions in Pittsburgh will facilitate the coordination of approaches to

research, treatment and health policy development.

The Municipality of Anchorage, home to almost 50 percent of

Alaska’s population, plans to initiate a prevention program based
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on research into best practices and culturally relevant programs to

reduce the incidence of drug and alcohol abuse among Anchorage

residents.

The City of Providence’s Southeast Asian Youth and Family Development (SEAYFD) project has helped address the increase in

drug and alcohol abuse, and the alarming gang activity among the

Southeast Asian community.

The Bridgebuilders program in Ohio will create and evaluate the

effectiveness of a multi-tiered blueprint for reducing youth alcohol

and drug use that uses a systematic, statewide approach to bridge

the divide between youth, parents, community systems, and related

State systems.

The Alaska Department of Health and Social Services will assess

and screen Alaska youth for alcohol abuse and dependency and develop a statewide plan to address youth alcohol abuse and dependency in Alaska. The plan is a response to concerns that 50.8 percent of Alaska high school youth report current alcohol use and

33.4 percent report binge drinking at least once a month.

PROGRAM MANAGEMENT

The Committee recommends $96,173,000 for program management activities of the agency, $10,500,000 more than the fiscal year

2001 level and $29,000,000 more than the President’s request.

The additional $29,000,000 provided by the Committee support

national data collection activities, including the Household Survey

on Drug Abuse. The increase will be used to add to the survey two

new components: The Longitudial Survey of Youth and Survey of

the Elderly, as well as augment the Drug Abuse Warning System.

The budget requested the $29,000,000 for these activities under the

Department’s evaluation authority.

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.

The Committee commends SAMHSA for its prompt, effective response to the terrorist attacks that occurred on September 11,

2001. The Committee is aware that the agency promptly mobilized

personnel, resources and other supportive services to help address

the needs of individuals in affected areas. Mental health experts

were provided promptly to help address immediate needs as well

as to assist with longer-term planning for future mental health and

substance abuse services in affected States and communities. The

Committee is supportive of additional resources being made available to SAMHSA to ensure that individuals affected by the events

of that day have access to appropriate mental health and substance

abuse prevention and treatment services.

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Appropriations, 2001 ............................................................................. $269,796,000

Budget estimate, 2002 ........................................................................... 306,245,000

Committee recommendation ................................................................. 291,245,000
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The Committee recommends $291,245,000 for the Agency for

Healthcare Research and Quality [AHRQ]. This is $15,000,000 less

than the administration request and $21,449,000 more than the fiscal year 2001 level. The administration proposed to fund AHRQ

through transfers available under section 241 of the Public Health

Service Act. The Committee did not approve this request.

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 $240,145,000 for research on health

costs, quality and outcomes [HCQO], which is $15,000,000 less

than the administration request and $13,699,000 above the fiscal

year 2001 level. 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.

MEDICAL ERRORS

The Committee continues to be very concerned about the enormous personal and economic cost of medical errors. According to

the Institute of Medicine (IOM), an estimated 44,000 to 98,000 people each year die from medical errors. Even using the lower estimate, this would make medical errors the eighth leading cause of

death in this country—higher than car accidents, breast cancer or

AIDS. The IOM also suggests that medical errors may cost up to

$29,000,000,000 in excess health care expenditures and lost productivity each year.

Last year the Committee provided $50,000,000 for initiating research into the causes of medical errors in the hope of dramatically

improving the safety of health care services in this country. The

Committee commends the Agency for planning and instituting an

impressive patient safety initiative, which includes demonstrations

to test best practices for reducing errors, development and testing

the use of appropriate technologies to reduce medical errors, such

as hand-held electronic medication systems, and research in geographically diverse locations to determine the causes of medical errors.

Of the total amount provided for HCQO, the Committee directs

AHRQ to devote $60,000,000 to determining ways to reduce medical errors, an increase of $10,000,000 over the amount provided in

fiscal year 2001. The Committee expects that AHRQ will use these

funds to share lessons learned and best practices among hospitals

and healthcare providers. The Committee directs AHRQ to work

with the Center for Medicare and Medicaid Services (CMS) to pro-
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vide this information to participating hospitals and healthcare facilities so that they can begin implementing successful strategies.

The Committee further directs AHRQ to provide a report detailing the results of its efforts to reduce medical errors. The report

should include how hospitals and other healthcare facilities are reducing medical errors; how these strategies are being shared

among healthcare professionals; how many hospitals and other

healthcare facilities record and track medical errors; how medical

error information is used to improve patient safety; what types of

incentives and/or disincentives have helped healthcare professionals reduce medical errors and; a list of the most common root

causes of medical errors. The report should provide data showing

the effectiveness of State requirements in reducing medical errors.

The report should also describe how AHRQ is responding to some

of the findings in the IOM’s report ‘‘To Err is Human: Building a

Safer Health System.’’

The Committee reiterates its position that there should be zero

tolerance for preventable medical mistakes and that the Congress,

the Administration, State licensing boards, and private healthcare

institutions and providers should work together to prevent further

unnecessary deaths and injuries.

The Committee encourages the Agency to fund research on

health costs, quality, and outcomes, especially in the chronic illness

and disability population.

The Committee notes that the University of Louisville, in conjunction with experts in computers, medical informatics, nosology,

and related fields, is developing and implementing a new system

of electronic medical record transfer that would facilitate the selected transfer of medical information. The University is also working with health care facilities to capture data from all available

electronic sources and provide access to the data from multiple perspectives and groupings, which will enable uses from the research,

community health and consumer health communities. The University would be eligible to receive funding under AHRQ’s patient

safety initiative for both these efforts.

The Committee supports the Vermont Oxford Network in Burlington, Vermont and its efforts to improve the quality of health

care available to children born prematurely through the reduction

of medical errors.

The Committee is aware of the Medical Error Reduction project

at Valley Hospital in Ridgewood, New Jersey. Valley Hospital has

found that the complete standardization of processes and use of

hand-held technology help guarantee the correct dispensation of

medications and collection of specimens.

The Committee is aware that Cedars-Sinai Hospital will design

and implement a computer-based integrated health information

system to track patient care resulting in a reduction of preventable

medical errors.

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL).—The Committee encourages AHRQ to consider an evidence-based review for the care

of CADASIL carriers, including Native Hawaiians. AHRQ is encouraged to work closely with the Native Hawaiian Health Care
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System to translate the evidence on the care of CADISIL into clinical practice strategies.

Chronic fatigue syndrome.—The Committee understands that

AHRQ is nearing completion of its evidence report on chronic fatigue syndrome and encourages the Agency to make databases used

in the writing of this report readily available to researchers and

the public on the Internet.

End of life care.—In order to address the lack of adequate information to tailor programs and match needs in end of life care, the

Committee encourages the Agency to develop methods of measurement, translation of findings into usual practice and guidelines to

improve the reliability of care of the seriously, chronically ill individual.

Geographical distribution.—In order to broaden the geographic

distribution of health services research funding by enhancing the

competitiveness for research funding among institutions, the Committee encourages the Agency for Healthcare Research and Quality

to continue the peer reviewed and merit-based program, ‘‘Building

Research Infrastructure and Capacity (BRIC).’’ Pharmaceutical pricing.—The Committee recognizes the high

prevalence of chronic disease in rural areas. The management and

control of these chronic diseases through medication and lifestyle

alteration is essential to controlling overall health expenditures.

However, the lack of documented outcome measures of health improvement and cost savings has hindered the progression of Disease State Management programs in both treatment and reimbursement. The Mississippi Medicaid model produces significant

outcome improvements and cost savings in theory, and in the limited practice settings allowed in small demonstration projects. The

Committee also recognizes the expertise in Marketing and Management of the University of Mississippi. The Committee believes that

AHRQ could undertake a research project to examine the cost savings and improved clinical outcomes associated with the Mississippi Medicaid Disease State Management Program that would

result from the application of this disease management program to

a demonstration project in the Medicare population of the Mississippi Delta region.

Practice guidelines.—The Committee is concerned that a study

published in the Journal of the American Medical Association

found that three-quarters of the practice guidelines developed by

AHRQ for treating illnesses were outdated. While AHRQ has removed these out-of-date guidelines from its web site and no longer

produces guidelines, the Committee encourages AHRQ to devote

more resources to ensuring that the National Guideline Clearinghouse contains updated and timely information.

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $48,500,000 for health insurance and

medical expenditures panel surveys [MEPS], which is the same as

the administration request and $7,650,000 above the fiscal year

2001 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-
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mates of proposed changes in policy and identifies impact of policy

changes on payers, providers, and patients.

Program support

The Committee recommends $2,600,000 for program support.

This amount is the same as the administration request and is

$100,000 more than the fiscal year 2001 level. This activity supports the overall management of the Agency.

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Appropriations, 2001 ............................................................................. $99,613,130,000

Budget estimate, 2002 ........................................................................... 106,821,882,000

Committee recommendation ................................................................. 106,821,882,000

The Committee recommends $106,821,882,000 for Grants to

States for Medicaid. This amount is $7,208,752,000 more than the

fiscal year 2001 appropriation and the same as the administration’s

request. This amount excludes $36,207,551,000 in fiscal year 2001

advance appropriations for fiscal year 2002. In addition,

$46,601,937,000 is provided for the first quarter of fiscal year 2003,

as requested by the administration.

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,

which may range from 50 to 90 percent, is based upon the State’s

average per capita income relative to the national average.

The Committee understands that a General Accounting Office report estimated that two-thirds of children on Medicaid have never

been screened for lead, despite Federal laws requiring such screening. The Committee urges CMS to more closely monitor screening

rates and take every appropriate step to ensure that screening

rates among children enrolled in Medicaid are substantially increased, reporting the national results to Congress within 18

months, including lead screening rates for children age 2 and

under.

PAYMENTS TO HEALTH CARE TRUST FUNDS

Appropriations, 2001 ............................................................................. $70,381,600,000

Budget estimate, 2002 ........................................................................... 81,924,200,000

Committee recommendation ................................................................. 81,994,200,000

The Committee recommends $81,994,200,000 for Federal payments to health care trust funds. This amount is $70,000,000 more

than the administration’s request and is an increase of

$11,612,600,000 from the fiscal year 2001 appropriation. The committee recommendation includes $70,000,000 to reimburse the Hospital Insurance Trust Fund for funds advanced on behalf of the

general fund for Real Choice Systems Change Grants to States and

Medicaid community-based attendant care demonstrations in the

research and demonstration activity of program management.
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This entitlement account includes the general fund subsidy to

the Supplementary Medical Insurance Trust Fund (Medicare Part

B), plus other reimbursements to the Hospital Insurance Trust

Fund (Medicare Part A), for benefits and related administrative

costs which have not been financed by payroll taxes or premium

contributions.

A shortfall of $832,000,000 is anticipated in fiscal year 2001 for

the Federal contribution of the Supplementary Medical Insurance

Trust Fund. This shortfall is a result of the current estimate being

slightly higher than when Congress enacted the appropriation. The

fiscal year 2002 request includes an estimated payback of

$844,000,000 including the fiscal year 2001 shortfall plus interest.

The Committee has provided $81,332,000,000 for Federal payment

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 $11,555,000,000 more than the fiscal year 2001

amount.

The recommendation also includes $292,000,000 for hospital insurance for the uninsured. This amount is the same as the administration’s request and is $29,000,000 less than the 2001 amount.

The Committee also recommends $150,000,000 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 is $18,000,000 more than the fiscal year 2001 appropriation. The Committee recommendation includes $220,200,000 to be transferred to the Hospital Insurance

Trust Fund as the general fund share of CMS’s program management administrative expenses. This amount is $70,000,000 more

than the administration’s request and is $68,600,000 more than the

fiscal year 2001 level.

PROGRAM MANAGEMENT

Appropriations, 2001 ............................................................................. $2,242,162,000

Budget estimate, 2002 ........................................................................... 2,351,158,000

Committee recommendation ................................................................. 2,464,658,000

The Committee recommends $2,464,658,000 for CMS program

management. This is $113,500,000 more than the administration

request and $222,496,000 more than the fiscal year 2001 enacted

level.

Research, demonstrations, and evaluations

The Committee recommends $125,311,000 for research, demonstration, and evaluation activities. This amount is $70,000,000

more than the budget request and $13,000,000 less than the

amount provided in fiscal year 2001.

CMS research and demonstration activities facilitate informed,

rational Medicare and Medicaid policy choices and decisionmaking.

These studies and evaluations include projects to measure the impact of Medicare and Medicaid policy analysis and decisionmaking,

to measure the impact of Medicare and Medicaid on health care

costs, to measure patient outcomes in a variety of treatment set-
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tings, and to develop alternative strategies for reimbursement, coverage, and program management.

The recommended funding level for the research and demonstration program will provide for continuation of current activities. Priority areas for CMS research include access to high-quality health

care, health service delivery systems, and provider payment systems.

The Committee has included funds to continue at $20,000,000

the Nursing Home Transition Initiative, to help States carry out

demonstration projects of developing community-based attendant

care services that ensure maximum control by consumers to select

and control their attendant care services, including the provision of

support and technical assistance from CMS to assure effective implementation of these demonstrations.

The Committee has included $50,000,000 for Real Choice Systems Change Grants to States to fund initiatives that establish

specific actions steps and timetables to achieve enduring system

improvements and to provide long term services and supports, including community-based attendant care, to eligible individuals in

the most integrated setting appropriate. Grant applications should

be developed jointly by the State and Consumer Task Force. The

Task Force should be composed of individuals with disabilities, consumers of long-term care services and supports, and those who advocate on behalf of such individuals. Grant funded activities should

focus on areas of need as determined by the States and the Task

Force such as needs assessment and data gathering, strategies to

modify policies that unnecessarily bias the provision of long-term

care to institutional settings or health care professionals, strategies

to ensure the availability of a sufficient number of qualified personal attendants and training and technical assistance.

The Committee encourages CMS to consider creating a statewide

network of community-based early learning and professional development hubs located in high needs neighborhoods to improve access to early childhood physical and mental health services and

professional development opportunities for childcare professionals.

The Committee is supportive of the continuation of CMS’s demonstration program to develop a comprehensive and reliable paramedic services program.

The Committee reiterates its continued support for a lifestyle

modification demonstration, begun in fiscal year 2000, at the MindBody Institute of Boston, Massachusetts. The Committee encourages CMS to expand the eligibility criteria by increasing the number of enrollees and including in the demonstration ischemia-free

patients with recent acute myocardial infarctions, coronary artery

bypass graft surgery, angioplasty and stents.

The Committee is pleased with the progress of the Western Governors’ Association Health Passport project and commends HHS in

the awarding of discretionary funding in 2001 allowing continuation of this pilot project that demonstrates an important new public-private, multi-agency, integrated model of health care and benefit delivery using smart cards, magnetic stripe, and public key infrastructure secure certificate technologies. The Committee reiterates its support for this demonstration project which serves as a
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model for complying with the Health Insurance Portability and Accountability Act.

The Committee recognizes that persons with uncontrolled diabetes account for about 50 percent of all leg amputations, 25 percent

of all kidney failure, and are the leading source of preventable

blindness and a major cost to the Medicare program. Diabetes

mullitus is clearly a major health problem in the country and is

particularly acute among Hispanics and Native Americans. Funds

for this project would be used to establish six rural regional programs to improve the access to care for some of our elderly citizens.

The programs would provide monitoring and diet assistance for

rural elderly with diabetes, as well as assessment and referral related to depression of rural elderly. This demonstration will provide

much needed nutrition and social services to our most vulnerable

elderly populations and potentially decrease the effects of diabetes

and depression. Funding would be targeted to low-income elderly

in geographic regions with high incidence of diabetes mullitus.

The Committee is aware of the need for a mobile asthma care

program at Valley Children’s Hospital in California. The poor air

quality in California makes those children who suffer from asthma

particularly vulnerable to asthma attacks. These mobile asthma

care teams would work with patients and families throughout the

Central Valley to reduce the cost of asthma care.

The Committee is aware of the California State University Hayward’s Health and Wellness Program. This program produces graduates that are well prepared to be health care professionals in the

region. With additional funding, the Institute would create a model

program for students to enter a mental health career.

The Committee is aware of the University of Kentucky’s Cooperative Extension Service and School of Public Health’s partnership to

identify and target the most frequent and expensive medication use

issues in the State. This center would improve medication use in

Kentucky’s highest need counties with additional Federal funds.

The Committee is concerned about the confidentiality of patient

medical records. The University of Louisville is currently constructing an electronic medical record that could serve as a prototype for proper transmission of medical records. Additional Federal

funding would further this effort significantly.

Providing health care professionals access to patient data both in

the community and the university setting is a complex task but

necessary to provide uniform quality. A demonstration project between the University of Louisville and the surrounding community

hospitals would be important to further this goal.

With additional Federal funding, the Center for Healthcare Systems Standards in South Carolina would conduct a demonstration

project to examine reducing medical errors through standardsbased Quality Management Systems.

The Committee encourages CMS to consider a 2-year demonstration project conducted by the Regional Nursing Center Consortium

to determine the potential of nurse-managed health clinics as a

safety net model in underserved communities.

As a follow-up to the Committee’s recommendation in fiscal year

2001, and in order to determine the effectiveness of the nurse-managed clinic model, the Committee encourages CMS to conduct a 5-
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year demonstration project that provides financial support for existing nurse-managed clinics and their utilization of advance practice registered nurses as primary care providers, minimally in Hawaii, Pennsylvania, Delaware, and New Jersey. These clinics operate with limited and short term funding, limited Medicaid and

Medicare reimbursement, and yet provide up to 60 percent uncompensated care. Despite limited funding, preliminary data from the

Regional Nursing Center Consortium indicates that nurse-managed

health clinics have better patient outcomes than conventional primary health care models. To determine the potential of nurse managed health clinics as a safety net model in underserved communities, the Committee encourages CMS to consider both operating

support and funding for clinical and information management systems to existing nurse-managed clinics to determine client outcomes and the effectiveness of the model.

The Committee encourages CMS to consider the concept of nurserun clinics and the utilization of advanced practice nurses as primary care providers in its research and demonstration activities.

As Medicare and Medicaid move into the managed care arena, it

is important that the most effective health care delivery systems be

identified and utilized. Health promotion and prevention initiatives

which are integral functions of nursing will play a significant role

in the future of health care of our aging population.

The Committee is aware of the proposed modification by CMS in

determining the eligibility status for Medicaid of individuals who

migrate to Hawaii under the provisions of the Compact of Free Association. The State of Hawaii has no control over its borders.

Thus, there remains a clear Federal responsibility for the health of

these individuals. Accordingly, CMS should continue its negotiations with the appropriate State authorities and inform the Committee of its deliberations, prior to making any modifications.

The Committee remains concerned about the extraordinary adverse health status of Native Hawaiians and encourages CMS to

continue its demonstration project at the Waimanalo health center

exploring the use of preventive and indigenous health care expertise. The Committee further recommends that Papa Ola Lokahi,

the Native Hawaiian health care organization recognized in the

Native Hawaiian Health Care Act, participate in this demonstration project.

The Committee encourages the Department to consider a demonstration project on the island of Molokai that would integrate

health education and prevention with the delivery of primary

health care services. The Committee recommends that the Native

Hawaiian Health Care Systems, recognized in the Native Hawaiian

Health Care Act, be considered to participate in this demonstration

project, along with community health centers whose clientele is primarily Native Hawaiian.

The Committee is aware that Daniel Freeman Hospital is seeking a Federal partnership to pursue necessary program expansion

directed to improving the health status of multi-cultural and medically disenfranchised populations, and insuring their access to insurance enrollment, primary care, and education.

The Committee is supportive of efforts by the University of Pittsburgh Medical Center Health System (UPMC–HS) to implement a
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state-of-the-art Health System-wide project to electronically store

and provide all clinical and administrative information in a secure

and automated manner. The UPMC–HS automation project will

serve as a national model for reducing medical errors; improving

medical efficiency; reducing health care costs; and improving access

to high quality, cost-effective care for the elderly and the medically

underserved.

The Committee understands that the State University System of

Florida is creating a statewide network of community-based professional development hubs in high needs neighborhoods to improve

access to healthcare services for children.

The Committee is aware that the Kettering Medical Center has

a Healthy Hearts 2000 demonstration project that, with additional

Federal funding, will focus on the effectiveness of three levels of

prevention: primary (education), secondary (screening, detection

and education) and tertiary (treatment, health maintenance and

education).

The Committee is aware of an innovative program begun by the

non-profit organization We Are Family/The Family Van in Boston,

MA, to maintain a periodic presence in low-income urban neighborhoods and provide education on how uninsured low-income families

may access medical insurance and medical care.

The Committee is aware that Children’s Hospital of Boston seeks

to construct a state-of-the-art research facility that will enable it to

continue its exemplary record of advancing scientific knowledge

through biomedical research and improving outcomes for children

stricken with serious illness or injury. Existing research space is

used to maximum density and productivity. Additional facilities are

needed to translate new biomedical insights learned daily through

basic research into new treatments for cancer, neurological diseases, spinal cord injuries, and organ failure in the youngest patients, as well as for adults.

The Committee is supportive of a study to estimate the total unreimbursed costs that hospitals, localities, and States incur to treat

undocumented aliens for medical emergencies. Hospitals, States,

and localities are increasingly financially burdened by the costs associated with providing undocumented aliens emergency medical

care.

The Committee also understands that Carondolet Health Network plans to initiate a project which targets the need for health

access and continuity of care for the uninsured in urban and rural

communities.

The Committee is aware of research being conducted by the Appalachian Center for Low Vision Rehabilitation which is aimed at

testing interventions and improving the quality of life for individuals with low vision, with a particular focus on the elderly and

children.

The Committee is aware that the Kansas University Human Imaging Institute is planning to utilize innovative technology to detect abnormal electrical activity in deep brain regions invisible to

electroencephalography.

The Committee remains strongly supportive of CMS’s telemedicine demonstration projects. The Committee has provided funds for

the administrative and evaluation costs at these sites in order to
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ensure that they would be able to continue operating through the

full period associated with the pilot waiver program.

With additional Federal funding, the Children’s Hospital Los Angeles would purchase and develop programming for a Magnetic

Resonance Microscope.

The Committee is supportive of the continuation of CMS’s demonstration program to develop a comprehensive and reliable paramedic services program.

The Committee is pleased with the progress of the Mississippi

Medicaid Disease State Management plan approved in 1998 that

allows reimbursement of pharmacists working under protocol of

physicians to manage patients with certain chronic diseases. The

Committee urges CMS to consider extension of a demonstration

project for the Mississippi Medicare population. The Committee expects CMS to continue to provide demonstration grants to States

for the extension of Disease State Management Programs to Medicare demonstration projects, giving priority to States with established Medicaid models.

The Committee is aware of efforts by the Center for Pharmaceutical Marketing and Management to conduct analysis and provide research on the effective and efficient pricing and marketing

of pharmaceutical products through a Medicare drug benefit, and

encourages CMS to utilize the expertise of the center in policy

making.

The Committee understands that terminally ill patients desire to

receive outpatient end-of-life care in their homes. Hospice care is

an effort to meet these needs. Currently, no reimbursement is allowed for inpatient hospice, but there are individuals in rural areas

in every State who are denied hospice care because they lack

homes or have no able care giver. The Committee recognizes the

need for freestanding inpatient hospice residence homes in rural

areas. The Committee is aware that the Sanctuary Hospice House,

located in Tupelo, Mississippi, has developed a demonstration

model to care for the short-term needs of terminally ill patients requiring pain management and palliative care.

The Committee is supportive of Health Link of Idaho, to establish private-public partnerships with employers, State governments, and health insurance providers, to provide health coverage

for very small businesses (employing fewer than 10 people) with

low-wage employees. The project will test the efficacy of the model

in both urban and rural areas for its ability to increase access, foster appropriate use of health care services and reduce public expenditures.

The Committee is aware of a proposal that would enable a multilingual, mulitmedia screening tool for citizens to better determine

their potential eligibility for Medicare Medicaid, and QMB, and

urges CMS to fully assess the concept.

The Committee encourages CMS to consider a proposal to provide a pilot project for Arizona to provide reimbursement to Arizona hospitals and localities for cost associated with providing federally-defined emergency medical care to undocumented immigrants.

The Committee encourages CMS to consider expansion of the

California State University expansion of the Health and Wellness
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program. The program is designed to meet increasing demand for

well prepared health care professionals in the region.

The Committee encourages CMS to consider a 2-year demonstration model for establishing private-public partnerships with employers, State governments, and health insurance providers, to provide health coverage for very small businesses (employing fewer

than 10 people) with low-wage employees (average of less than $10

per hour). The project would test the efficacy of the model in both

urban and rural areas for its ability to increase access, foster appropriate use of health care services and reduce public expenditures. Results would be evaluated and disseminated nationally.

The Committee is pleased with CMS’s proposal to provide demonstration grants to States to test innovative asthma disease management techniques for children enrolled in Medicaid. The Committee encourages CMS to provide this program with the necessary

funding to carry out this initiative.

The Committee encourages CMS to consider a demonstration

project in Cook County, Illinois to reduce morbidity and mortality

from asthma in the community areas in Cook County with the

highest prevalence and inadequate service.

The Committee encourages CMS to consider a project for the Illinois Primary Health Care Association to implement the Shared Integrated Management Information System and provide centralized

case management, reimbursement, and administrative support

services to a number of Consolidated Health Centers in Illinois.

The Committee encourages CMS to continue an outreach program designed to provide Chicago public school students with vision care.

The Committee encourages CMS to consider a proposal from the

Madonna Rehabilitation Center Institute for Rehabilitation Science

and Engineering in Lincoln, Nebraska.

The Committee encourages CMS to conduct a Medicare Medical

Nutrition Therapy Education Campaign, to inform both Medicare

beneficiaries and physicians about the new Medicare benefit of

Medicare Nutrition Therapy for patients with diabetes and renal

disease, available January 2002.

The Balanced Budget Refinement Act of 1999 required the Medicare Payment Advisory Commission (MEDPAC) study to determine

whether skilled nursing facilities in Alaska and Hawaii should receive additional payment to accommodate their unique circumstances. The Committee recommends CMS conduct a detailed

study to determine if there are enough differences in these States

non-labor costs to justify a payment adjustment for the skilled

nursing facilities in Alaska and Hawaii, the Committee further

suggests consideration of a temporary adjustment to the non-labor

share of the per diem payment for skilled nursing facilities in Alaska and Hawaii at this time.

The Committee understands that the Montana Comprehensive

Health Care Association in Helena, Montana has expressed a need

for a demonstration project to subsidize coverage to individuals

under 150 percent of the Federal poverty level who have significant

health conditions and are therefore uninsurable.
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Medicare contractors

The Committee recommends $1,547,000,000 for Medicare contractors, which is $25,000,000 more than the budget request and

$190,000,000 more than the comparable fiscal year 2001 appropriation. In addition, $700,000,000 is available for the Medicare Integrity Program within the mandatory budget as part of the health insurance reform legislation.

Medicare contractors, which are usually insurance companies,

are responsible for reimbursing Medicare beneficiaries and providers in a timely fashion and a fiscally responsible manner. These

contractors also provide information, guidance, and technical support to both providers and beneficiaries. The Committee recommendation includes $15,000,000 to support

grants for State Health Insurance Counseling and Assistance programs (SHIPs), an increase of $5,000,000 over last year and

$15,000,000 more than the budget request. SHIPs provide information, counseling and decision support to people with Medicare. The

53 State and territorial programs are administered either by the

State unit on aging or the State department of insurance. The

Committee is aware that these programs provide a valuable service

to people with Medicare and require a stable source of funding. The

Centers for Medicare and Medicaid Services (CMS) shall use these

resources to provide grants to States for SHIPs to enable them to

increase their capacity, to operate a resource center and to administer special projects that will help SHIPs continuously improve the

quality of service they provide. The Committee expects CMS to include, within its fiscal year 2003 congressional justification, a specific dollar request for SHIPs, or to indicate that no resources are

being requested for this activity.

State survey and certification

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. The Committee recommends $260,647,000 for Medicare State

survey and certification activities, which is an increase of

$18,500,000 over the fiscal year 2001 level.

Federal administration

The Committee recommends $531,700,000 for Federal administration costs. This recommendation is $26,996,000 more than the

fiscal year 2001 level, and the same as the budget request. This

will support 4,632 full-time equivalent positions, an increase of 22

over fiscal year 2001. Most of the increase is for fixed expenses of

personnel compensation and benefits.

The Committee understands that HIV drug resistance testing is

a critical component of the Nation’s fight against AIDS. HIV drug

resistance testing lengthens life expectancy, enhances life functions

and retards emergence of a more resistant virus. Because of the

life-saving aspect of these tests and because their reliability has

historically been so variable, the FDA has determined that HIV

drug resistance tests should be subject to FDA approval to insure
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a high degree of reliability. One such test has already been approved and others are in progress. The Committee understands

that the differential in cost between FDA approved and non-approved tests may be significant, therefore urges CMS to review its

reimbursement policies to assure that Medicare beneficiaries have

access to the highest quality most medically beneficial HIV drug resistance tests.

Medicaid and the SCHIP program are the sole source of most

dental care provided to the Nation’s poor children. However, according to the U.S. Surgeon General’s report, ‘‘Oral Health in

America’’, fewer than one in five Medicaid-covered children received a single preventive dental visit in a year. Left untreated,

dental disease is inevitable and will not abate. Therefore, the Committee believes that it is important that CMS maintain a distinct

focus on oral health by retaining a position of Chief Dental Officer.

The Committee remains extremely concerned over CMS’s continuing failure to articulate clear guidelines and to set expeditious

timetables for consideration of new technologies, procedures and

products for Medicare coverage. A particularly troubling example is

CMS’s lengthy delays and failure to articulate clear standards regarding Medicare coverage of positron emission tomography (PET).

The effect of these delays in instituting Medicare coverage is to

continue to deny the benefits to these technologies and procedures

to Medicare patients. The Committee also remains concerned that

CMS appears to be requiring some new technologies to repeat clinical trials and testing already successfully completed by the new

technologies in the process of gaining FDA approval or in NIH clinical trials and which serve as signals to private insurers to cover

new technologies. The Committee is also concerned that CMS appears to be requiring substantially different levels of evidence to

approve various new products for Medicare coverage, requiring, for

example, very little documentation for approval of MRA (magnetic

resonance angiography), while at the same time continuing to demand voluminous amounts of data to make a coverage decision on

PET. The Committee remains concerned that the recently created

120-person technical advisory committee to review new technologies may be further delaying coverage decisions and creating

unnecessary costs for the Medicare program. Because of the possible duplication of efforts among HHS agencies and related unnecessary costs to the Medicare program and the Department, the

Committee again asks that the Secretary take a leadership role in

resolving this matter expeditiously. The Committee also urges the

Secretary to investigate the recent proposal by CMS to reduce hospital outpatient payment for PET scans from $2,200 to $841 in

light of the fact that each PET scan uses a unit of the radioisotope

FDG which generally costs from $500 to $600 per dose.

In the Balanced Budget Act of 1997, Congress urged the Secretary to provide GME reimbursement for clinical psychological

programs. To date CMMS has not issued the necessary rule. The

Committee expects the agency to release the rule immediately.

A provision was included in the Health Insurance Portability and

Accountability Act (HIPAA) to redesign the specialty provider code

system to an alphanumeric system; however, implementation of

this new system seems to be in doubt. In the interim, to ensure
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that pregnant women receive risk-appropriate care, the Committee

urges CMS to create an interim two-digit specialty code under the

current system, recognizing maternal-fetal medicine.

The Committee is concerned that many severely disabled Medicare recipients are being denied access to specialized equipment

that can improve their health and quality of life. Through administrative ruling 96–1 Medicare changed its coverage policy and classified certain highly specialized sets of braces individually fit for the

patient as non-covered wheelchairs. Congress has since mandated

that the GAO review this change in policy. While the Congress

awaits GAO’s report, the Committee calls on CMS to withhold enforcement of 96–1 and to develop a proper ‘‘L’’ code and carrier instructions that would provide permanent and clear parameters for

this type of reimbursement while safeguarding program integrity.

The Omnibus Consolidated & Emergency Supplemental Appropriations Act for Fiscal Year 2001, which included ‘‘the Medicare,

Medicaid & S–CHIP Benefits Improvement & Protection Act of

2000,’’ incorporated provisions relating to States’ Medicaid upper

payment limit programs. These provisions, which included reasonable transition periods for States to adopt a revised standard for

treatment of their programs, were adopted after intense bipartisan

negotiations among the House, Senate, and administration.

The Committee is pleased that the administration, in January

and September 2001, supported this Medicaid upper payment limit

agreement in the promulgation of Medicaid upper payment limit

regulations. Further, the Committee reiterates its commitment to

both the letter and spirit of this agreement, and directs the administration to maintain its course in complying with congressional intent. Any subsequent modifications should be done only after the

administration has had an opportunity to assess the implementation of the new regulations and only in consultation with the States

and their Medicaid programs, as well as the other stakeholders.

The Committee is extremely concerned that eliminating the higher

payment limit category compromise struck last year would be disastrous for all safety net hospitals, both public and private, that

participate in the Medicaid program.

The Committee is aware of the progress made in translating selected CMS material into Chinese and disseminating to selected

communities, and encourages the agency expand these efforts by

broadening dissemination to a national basis and including additional Asian and Pacific languages. The Committee further encourages the agency to continue its collaboration with national aging

organizations with proven experience in serving minority elders.

The Committee is aware of efforts by the Center for Healthcare

Systems Standards to help hospitals implement the ‘‘Guidelines for

Process Improvements in Healthcare Organizations,’’ developed as

international standards under ISO 9001:2000 and ISO 9004:2000.

These new standards focus attention on reducing medical errors

through process improvement including identifying systemic root

causes of medical errors, improving the documentation process, and

changing organizations towards a culture of systemic review, continuous error reduction, and overall quality improvement. The

Committee encourages CMS to pursue efforts like this to help hospitals reduce errors.
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The Committee is pleased with improvements in the rate of

mispayments by the Medicare program. Additional resources and

efforts have begun to make a difference. However, the Committee

remains very concerned with the amount of money that continues

to be lost to fraud, waste and abuse in the Medicare program. The

Committee has held many hearings and taken other corrective actions over a 10-year period to expose and reduce these losses. The

Balanced Budget Act contains a number of important reforms derived from Committee hearings.

The Committee continues to urge CMS to utilize new authorities

for competitive bidding and improved beneficiary information so

that savings to Medicare will accrue as quickly as possible.

There is strong evidence, through reports by the General Accounting Office, the Department and others that Medicare is significantly overpaying for many medical supplies. Therefore, the

Committee continues to strongly urge use of the Secretary’s enhanced inherent reasonableness authority on a national basis.

The Committee is aware that CMS completed tests of commercial

off-the-shelf computer software designed to reduce Medicare

mispayments and found that significant savings could be achieved

by employing edits from the tested software. The Committee urges

CMS to undertake testing of other similar commercial software and

to incorporate edits found to achieve savings within current Medicare regulations and without harming quality of care.

The Committee is pleased that CMS has moved ahead to establish program integrity contracts. These contractors have significant

potential to reduce losses to the Medicare program. The Committee

encourages CMS to fully utilize these contractors and to explore

the use of companies to recover mispayments that have significant

experience providing this service to major commercial insurers and

major employers.

The Committee believes that compliance with Medicare reimbursement policies would be enhanced by an expansion of provider

education. Such an expansion would also aid health professionals

who often feel overwhelmed by the volume and complexity of Medicare requirements. Therefore, the Committee urges that a portion

of the increase in MIP funds be used to expand provider education

and assistance.

The Committee is pleased with the progress that the CMS has

made in meeting the Congressional mandates for a Medicare prospective payment system for long-term care hospitals. It remains

important that this payment system be based on data from longterm care hospital patients and be designed expressly for patients

treated in long-term care hospitals. It is also important that this

improved payment system be based on patient medical diagnoses,

reflect the level of acuity for long-term care hospital patients, recognize that these patients often have multiple medical problems,

and include appropriate adjustments for outlier patients and other

typical payment factors. CMS should maintain these efforts and

continue to coordinate with Congress and all affected parties.

The Committee has held hearings documenting the need to reform Medicare’s payments for ambulance services. It is this Committee’s understanding that CMS will implement this year a comprehensive regulation establishing a new fee schedule for ambu-
217

lance payments as required by the Balanced Budget Act of 1997.

The Committee is concerned that CMS is considering implementing

the new fee schedule without fully implementing the required condition codes and believes such a decision would be adverse to beneficiaries, quality health care and program integrity. Therefore, the

Committee directs CMS to implement the full set of condition codes

simultaneously with the implementation of the fee schedule.

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Appropriations, 2001 ............................................................................. $2,441,800,000

Budget estimate, 2002 ........................................................................... 2,447,800,000

Committee recommendation ................................................................. 2,447,800,000

The Committee recommends that $2,447,800,000 be made available in fiscal year 2002 for payments to States for child support enforcement and family support programs, the same as the administration request. These payments support the States’ efforts to promote the self-sufficiency and economic security of low-income families. The appropriation, when combined with the $1,000,000,000 in

advance funding provided in last year’s bill and an estimated

$460,000,000 from offsetting collections, makes $3,907,800,000

available for this program.

The Committee also has provided $1,100,000,000 in advance

funding for the first quarter of fiscal year 2003 for the child support enforcement program, the same as the budget request. These

funds support efforts to locate noncustodial parents, determine paternity when necessary, and establish and enforce orders of support.

LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2001 ............................................................................. $2,000,000,000

Budget estimate, 2002 ........................................................................... 1,700,000,000

Committee recommendation ................................................................. 2,000,000,000

The Committee recommendation for LIHEAP is $2,000,000,000.

This amount, when combined with the $300,000,000 available from

the Supplemental Appropriations Act, 2001, provides a total of

$2,300,000,000 for the LIHEAP program. This level of funding is

$300,000,000 more than last year and $600,000,000 more than the

budget request.

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.

The Committee recommendation includes $1,700,000,000 for the

State grant program, $300,000,000 more than last year’s funding

level and the amount requested by the administration. These resources are distributed by formula to States, territories, Indian

tribes and tribal organizations defined by statute, based in part on

each State’s share of home energy expenditures by low-income

households nationwide.
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The Committee recommendation includes $300,000,000 for the

contingency fund, the same as the amount requested by the Administration and $300,000,000 less than the fiscal year 2001 appropriation. These resources are available until expended and can be released only upon submission of a formal request designating the

need for the funds as an emergency, as defined by the Balanced

Budget and Emergency Deficit Control Act. The Administration did

not request resources for the contingency fund subject to this emergency requirement. The contingency fund may be used to provide

assistance to one or more States adversely affected by extreme heat

or cold, significant price increases or other causes of energy-related

emergencies. The Committee intends that up to $27,500,000 of the amounts

appropriated for LIHEAP for fiscal year 2002 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, 2001 ............................................................................. $433,103,000

Budget estimate, 2002 ........................................................................... 445,224,000

Committee recommendation ................................................................. 445,224,000

The Committee recommends $445,224,000 for refugee and en- trant assistance, $12,121,000 more than the fiscal year 2001 level

and the same amount as the budget request.

Based on an estimated refugee admission ceiling of 121,000, this

appropriation, together with prior-year funds available for fiscal

year 2002 expenses, will enable States to continue 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.

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.

In order to carry out the refugee and entrant assistance program,

the Committee recommends $227,291,000 for transitional and medical assistance, including State administration and the voluntary

agency program; $10,000,000 for victims of trafficking;

$143,621,000 for social services; $4,835,000 for preventive health;

and $49,477,000 for targeted assistance.

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.

The Committee recommends $10,000,000 to treat and assist victims of torture. These funds may also be used to provide training

to healthcare providers to enable them to treat the physical and

psychological effects of torture. The Committee acknowledges that
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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.

CHILD CARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2001 ............................................................................. $1,999,987,000

Budget estimate, 2002 ........................................................................... 2,199,987,000

Committee recommendation ................................................................. 2,000,000,000

The Committee recommendation provides $2,000,000,000 for the child care and development block grant, $199,987,000 less than the

budget request and $13,000 more than fiscal year 2001.

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 allow States to continue funding the activities previously provided under the consolidated programs.

The Committee rejects the administration proposal to set aside $400,000,000 within the block grant for States to provide certificates for low-income parents to help defray the costs of after-school

programs with an education focus. The Committee notes that the

21st century community learning centers program administered by

the Department of Education currently operates an educationbased extended learning program for school-aged students. Fiscal

year funding for this program was sufficient to fund just one in five

high quality applications and approximately $800,000,000 was

needed to provide grants to all applicants considered worthy of

funding. Any fundamental change in the way the program operates

is an issue that should be considered during the reauthorization of

the child care and development block grant program. The Committee recommendation provides $19,120,000 for the

purposes of supporting resource and referral programs and before

and afterschool services. This represents the Federal commitment

to the activities previously funded under the dependent care block

grant. The Committee further 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 address

the matters of before and afterschool care and the establishment of

resource and referral programs with the funds provided in this program. The Committee recommendation includes $272,672,000 for child

care quality activities, and sets aside $100,000,000 specifically for

an infant care quality initiative. The Committee recommendation

also provides $10,000,000 for child care research, demonstration

and evaluation activities.

The Committee understands that the National Association of

Child Care Resource and Referral Agencies is currently operating
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Child Care Aware, the national toll-free information hotline, which

links families to local child care services and programs. The Committee recognizes that funding from the resource and referral programs would allow the Association to continue to provide this critical assistance to parents returning to the workforce.

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2001 ............................................................................. $1,725,000,000

Budget estimate, 2002 ........................................................................... 1,700,000,000

Committee recommendation ................................................................. 1,700,000,000

The Committee recommends an appropriation of $1,700,000,000

for the social services block grant. The recommendation is the same

amount as the budget request and $25,000,000 below the 2001 enacted level.

The Committee has included bill language that will allow States

to transfer up to 5.9 percent from their fiscal year 2002 allocations

under the Temporary Assistance for Needy Families program to the

Social Services Block Grant program. Under the budget request,

States would be limited to transfers of up to 4.25 percent for fiscal

year 2002. The Committee recognizes that the block grant is a vital

source of support for many vulnerable children and families, the elderly and single adults.

CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2001 ............................................................................. $7,965,739,000

Budget estimate, 2002 ........................................................................... 8,191,398,000

Committee recommendation ................................................................. 8,592,496,000

The Committee recommends an appropriation of $8,592,496,000 for children and families services programs. This is $626,757,000

more than the fiscal year 2001 appropriation and $401,098,000

more than the budget request.

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

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 recommends $6,600,000,000 for the Head Start

Program, an increase of $400,188,000 above the 2001 level and

$275,188,000 more than the budget request. The Committee recommendations includes $1,400,000,000 in advance funding that

will become available on October 1, 2002.

The Committee is aware of the unique circumstances rural areas

face in designing Early Head Start programs to meet the needs of

families. Rural areas experience higher costs per child, either due

to the higher cost of transporting infants and children to Early

Head Start Centers, or because of higher rents due to the lack of

adequate and licensable facilities in rural areas. In selecting new
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grantees under this program, the Committee believes the Department should give consideration to applicants serving rural areas

that meet or exceed all performance criteria but propose a higher

cost per child due to these factors.

The Committee is aware that, in fiscal year 2001, approximately

$180,000,000 was included in Head Start funding to improve staff

salaries and professional development. This has increased both

teacher compensation and retention rates among Head Start staff.

The Committee expects the Department to continue to focus quality

improvement efforts on improving Head Start teacher compensation such that teacher salaries more equitably reflect educational

level and experience.

The Committee is aware of the need to strengthen the qualifications of Head Start teachers. At least 50 percent of teachers in center-based Head Start programs must have an associate, baccalaureate, or advanced degree in early childhood education or a degree in a related field, with experience in teaching preschool children, by September 30, 2003. 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 Head Start Act contemplates services to low-income children

and their families. The law does not, however, prescribe age requirements for Head Start participation, short of limiting enrollment to children ‘‘who have not yet reached the age of compulsory

school attendance.’’ Despite this fact, Head Start has traditionally

served children in their years immediately prior to their entering

into kindergarten. With States and localities increasing their investments in preschool services, local Head Start programs have

been presented with not only an opportunity, but a need to serve

infants and toddlers—in their years proven to be the most formative in recently publicized brain research developmental studies.

Accordingly, the Committee encourages the Department of

Health and Human Services to support efforts by local Head Start

programs to use grant funds to deliver quality services to the infant and toddler population where a community assessment evidences a need for such services and the local program has the capacity to meet that need. The Committee supports this expansion

in response to changing local community needs, separate and apart

from the new grant process under the Early Head Start program

created as part of the 1994 Head Start reauthorization. When combined with the new grant authority for Early Head Start which

flows from increased appropriations annually, expansion of existing

preschool programs to serve infants and toddlers is particularly responsive to research emphasizing the developmental needs of our

youngest children—needs which can be ably addressed through the

Head Start model of comprehensive services.

During the 107th Congress, the House and Senate will consider

reauthorization of the Personal Responsibility and Work Opportunities Act, in order to assist individuals to secure gainful employment and help families to gain self-sufficiency in the new economy.

As a result of the 1996 enactment of welfare reform, families previously eligible for Head Start services based on their low-income

status have found themselves marginally exceeding those income
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limitations and, therefore, losing access to Head Start services for

their children.

The Committee recognizes that Head Start does not serve all income-eligible children and their families in the country. Nonetheless, while eligibility for other programs is sensitive to regional disparities in income, Head Start eligibility is not. It is clear that an

inner-city family’s expenses with respect to food, housing and medical needs are different from those of a rural family, while a rural

family’s transportation needs, for one, may well outpace similar

needs for their urban neighbors. Eligibility requirements should reflect this difference. Current law gives the Secretary of Health and

Human Services authority to permit the enrollment of a ‘‘reasonable number’’ of over-income families in Head Start. In a welfarereformed era, families may find their income marginally exceeding

national poverty guidelines, while their need for quality early childhood programming is even more pronounced. The Committee encourages the Secretary to permit local programs to best address

local community needs in these changing times, but encourages

flexibility which does not deny services to the neediest of the

needy.

Accordingly, the Committee encourages the Secretary to exercise

his authority to permit the enrollment of over-income children and

their families in up to 25 percent of program placements, so long

as services are not denied to income-eligible children and families

as a result of this flexibility.

The Committee is aware that the goal of the Head Start program

is to ensure the school readiness of children upon completion of the

program. The Committee expects the Department of Health and

Human Services to continue to promote learning and brain development to accelerate and improve the cognitive development of Head

Start children. The Committee expects the Department to monitor

Head Start programs to ensure that a majority of children participating in Head Start programs meet the minimum educational performance measures and standards upon completion of the program

as outlined in the Head Start Act, as amended in 1998.

The Committee believes that Head Start funds should be spent

to maximize the number of children served. Therefore, Head Start

should limit its own operation of vehicles for the transportation of

Head Start children, working to increase coordination with publicly-funded transit agencies or other public entities when such

agencies can provide for the safe transportation of Head Start children at a reasonable cost. The Committee is aware of cases where

Head Start has purchased buses when local transit authorities

have been able to provide that service at a lower cost. In some

cases, buses have been sold after being significantly underutilized.

The Committee directs Head Start programs to purchase their own

vehicles to transport children only when it can be demonstrated

that such an approach is safer, more cost effective and more responsive to family needs than alternative approaches, including vehicle leasing and contracting with local transportation providers.

The Committee expects the Department to provide adequate direction and decisional support to regional offices responsible for assessing the need for bus purchases and requests that the Department provide the Committee with a report of steps taken to ensure
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that vehicles are purchased only when the local program demonstrates that this approach is safest and most cost effective. The

Committee believes that the level of bus purchases in fiscal year

2002 should not exceed the fiscal year 2001 level. Further, the

Committee directs the Head Start Bureau to provide the Committee with a list of all bus purchases made by local programs, the

number of vehicle lease agreements entered into and the number

of contracts for services with local transportation providers for fiscal year 2002.

The Committee understands that there are serious concerns that

the bus safety rule promulgated at the beginning of 2001 contains

elements that make it difficult to use the same buses for children

and adults throughout the day in ways that have little or no effective safety benefits to Head Start participants, significantly increasing the program’s transportation costs. The Department is

urged to carefully examine that issue.

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 for facilities in the Alaskan communities served

by the Tanana Chiefs Conference and the Central Council of

Tlingit-Haida of Alaska.

The Committee encourages the agency to continue and expand

its support of the Alaska SEED initiative to expand early childhood

services for at risk children in Alaska ages 0–6 and to train Early

Head Start teachers with AAS degrees through distance delivery

for positions in rural Alaskan communities.

Consolidated runaway and homeless youth program

The Committee recommends $105,133,000 for this program, an increase of $36,000,000 above the fiscal year 2001 level and

$3,000,000 more than the Administration request.

This program addresses the crisis needs of runaway and homeless youth and their families through support to local and State

governments and private agencies. The Runaway and Homeless

Youth Act requires that not less than 90 percent of the funds be

allocated to States for the purpose of establishing and operating

community-based runaway and homeless youth centers, as authorized under Parts A and B of the Act. Funds are distributed on the

basis of the State youth population under 18 years of age in proportion to the national total. The remaining 10 percent funds networking and research and demonstration activities including the

National Toll-Free Communications Center.

Grants are used to develop or strengthen community-based programs which assist homeless youth in making a smooth transition

to productive adulthood and social self-sufficiency; and to provide

technical assistance to transitional living programs for the acquisition and maintenance of resources and services.

The basic centers program, authorized under Part A of the Act,

supports grants to community-based public and private agencies for

the provision of outreach, crisis intervention, temporary shelter,

counseling, family unification and aftercare services to runaway

and homeless youth and their families.
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The transitional living grant program provides grants to local

public and private organizations to address shelter and service

needs of homeless youth, ages 16–21. The program’s goals are to

have youth safe at home or in appropriate alternative settings and

to help them develop into independent, contributing members of society.

A homeless youth accepted into the program is eligible to receive

shelter and services continuously for up to 540 days. The services

include counseling; life skills training, such as money management

and housekeeping; interpersonal skill building, such as decisionmaking and priority setting; educational advancement; job preparation attainment; and mental and physical health care.

Maternity group homes.—Within the Committee recommendation

for the consolidated runaway and homeless youth program,

$33,000,000 is available for the maternity group home program,

the same as the budget request. This is a new program proposed

by the administration as part of its Faith Based Initiative. Under

this program, the ACF will provide targeted funding for community-based, adult-supervised group homes for young mothers and

their children. These homes will 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.

Child abuse prevention programs

The Committee has included $54,743,000 for child abuse and neglect prevention and treatment activities, including $21,026,000 for

State grants and $33,717,000 for discretionary activities. This is

the same as the fiscal year 2001 level and $15,739,000 more than

the administration request. 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. The Committee believes that the agency should fund activities aimed at developing and disseminating research-based models

for child abuse prevention.

The Committee is aware of the following projects and programs,

and encourages ACF to give each full and fair consideration for

awards available in new grant competitions.

Parents Anonymous, Inc. will establish and maintain a national

network of mutual support and parent leadership programs as a

means of strengthening families in partnership with their communities.

A significant number of abused or neglected children in foster

care programs have serious emotional, psychological and developmental problems which cannot be adequately addressed in regular

foster care. Ohel Family Services in Brooklyn, New York plans to

provide specialized services to aid these children, including intensive psychiatric and psychological treatment and crisis intervention, in-home support for foster parents, and rehabilitation activities for biological families.
225

Babyland Family Services, Inc. will integrate its family violence

and child abuse prevention and crisis intervention services in order

to develop a comprehensive program for children and families.

The University of Notre Dame has proposed a collaborative intervention and research project to prevent child neglect and delinquency among teenage mothers and their children.

Casa Myrna Vazquez is the largest provider of comprehensive

services to battered women and children in New England.

Klamath Tribes Children’s Protective Services and Family Preservation program will provide child abuse and prevention services.

The Alaska Native Health Board and Alaska Department of

Health and Social Services will support the development and implementation of a statewide child abuse prevention and treatment

plan to identify, prevent, and treat child abuse and neglect through

technical assistance, research, demonstration and service improvement.

The innovative Connecticut Healthy Families Initiative will expand to additional sites and help prevent child abuse and neglect

in families at risk for such behavior. ‘‘STOP IT NOW!’’, a national non-profit organization dedicated to

preventing the sexual abuse of children, will continue to increase

public awareness about child sexual abuse, educate adults about

the ways to stop it, and call on abusers and potential abusers to

stop and seek help.

Healthy Families Home Visiting program in Alaska continues to

achieve success especially in the area of preventing child abuse, in

part due to the one-on-one interaction represented by this program.

The State of Alaska will work with Alaska Native regional nonprofit corporations to continue and expand the Healthy Families

Home Visiting Program in Alaska.

The Alaska Department of Health and Social Services proposes

to develop a training program for social service and health providers in Alaska designed to help these providers identify cases of

child abuse and document them appropriately.

Abandoned infants assistance

The Committee concurs with the budget request in recommending an appropriation of $12,205,000 for abandoned infants assistance, the same as the 2001 level and the administration request. This program provides financial support to public and private entities to develop, implement, and operate demonstration

projects that will prevent the abandonment of infants and young

children. Grants provide additional services such as identifying and

addressing the needs of abandoned infants, especially those who

are drug exposed or HIV positive; providing respite care for families and care givers; and assisting abandoned infants and children

to reside with their natural families or in foster care.

Child welfare services

The Committee recommends an appropriation of $291,986,000 for

child welfare services, the same as the fiscal year 2001 level and

the administration request. This program helps State public welfare agencies improve their child welfare services with the goal of

keeping families together. State services include: preventive inter-
226

vention, 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.

Child welfare training

The Committee recommends $7,998,000, an increase of

$1,000,000 over the fiscal year 2001 level and the administration

request. Under section 426, title IV–B 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.

Adoption opportunities

The Committee recommends $27,405,000 for adoption opportunities, the same as the fiscal year 2001 level and the administration

request. This program eliminates barriers to adoption and helps

find permanent homes for children who would benefit by adoption,

particularly children with special needs. Since the Committee recommendation exceeds $5,000,000, grants for placement of minority

children and postlegal adoption services, as well as grants for improving State efforts to increase placement of foster children legally

free for adoption, should be made, as required by law.

Adoption incentives

The Committee recommends $43,000,000 for adoption incentives,

the same amount as the fiscal year 2001 appropriation and the

budget request. 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 in fiscal years 2000 and 2001.

Adoption awareness

The Committee recommendation includes $12,906,000 for the

adoption awareness program, an increase of $3,006,000 over the

fiscal year 2001 level and $3,000,000 more than the administration

request. This program was authorized in the Children’s Health Act

of 2000. The program consists of two activities: the Infant Adoption

Awareness Training Program and the Special Needs Awareness

Campaign. The Committee has provided resources above the request to implement the Special Needs Awareness Campaign in fiscal year 2002.

Compassion capital fund

The Committee recommendation includes $89,000,000 for the

compassion capital fund, the same as the budget request. This new

program is part of the Administration’s Faith Based Initiative.

Funds available for this program will be used for grants to public/

private partnerships that help small faith-and community-based organizations replicate or expand model social services programs.

Partnerships will provide technical assistance to these entities to
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increase their capacity to deliver high quality social services and

provide financial assistance to support start up and operational

costs of their social service programs.

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.

Responsible fatherhood initiative

The Committee recommendation does not include resources for

this proposed program. As part of its Faith Based Initiative, the

administration proposed creating a new program to make responsible fatherhood a national priority and requested $64,000,000 for

this new effort. The Committee has deferred action on this program

pending the enactment of authorizing language. The proposed program would support competitive grants to faith- and communitybased organizations to support initiatives that promote responsible

fatherhood.

Social services research

The Committee recommends $27,426,000 for social services and

income maintenance research, $10,175,000 less than the fiscal year

2001 level and $21,000,000 above the administration request.

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 is concerned about the current status and future

prospects for hard-to-employ welfare recipients who are close to

meeting the 60-month time limit on benefits established by the

Personal Responsibility and Work Opportunity Reconciliation Act

(PRWORA). A March, 2001 report by the General Accounting Office

entitled ‘‘Moving Hard-to-Employ Recipients Into the Workforce’’, found that many current welfare recipients have two or more characteristics that make it difficult for them to find and hold a job.

The report also observed that some States are unclear about the

kinds of activities they are allowed to provide to welfare recipients,

and as a result, are hesitant to allow recipients to participate in

the full range of activities that might help them find and keep jobs.

The Committee strongly urges the Department to undertake research to identify the types of barriers hard-to-employ welfare recipients face, the pervasiveness of these barriers among the current

population of recipients and to estimate the number of such recipients who will reach their 60-month limit on benefits. The Committee also encourages the Department to expand its efforts to help

States better understand how to use the flexibility they have under

the PRWORA to provide appropriate services to hard-to-employ

welfare recipients.

At the Committee’s request, ACF 3 years ago launched a concerted effort to assist States in meeting the complex information

and systems reporting requirements of TANF. ACF turned to the

State information technology consortium, out of which emerged a

knowledge base that is enabling each State to tailor the best practices developed by others to meet their own unique needs. In order
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to further streamline service delivery and reduce overall costs, an

effort is now underway to apply web-based technology to help each

State integrate their loosely connected stand-alone systems under

a single information technology network. The Committee supports

this common-sense approach to systems coordination and encourages ACF to continue this effort at the current level of support.

The Committee continues to be supportive of the National Center

for Appropriate Technology’s information technology clearinghouse

in Butte, Montana.

The Committee is aware of the following projects and programs,

and encourages the Department to give each full and fair consideration when making awards in new grant competitions.

The Toni Jennings Exceptional Education Institute located within the University of Central Florida’s Academy for Teaching,

Learning and Leadership has developed programs to enhance parenting skills; develop new approaches for interaction between fathers and their special needs children; and facilitate the development of knowledge and skills necessary to provide educational and

clinical services for children and adults.

The Montana Child Care Financing Demonstration Project proposes to establish an ongoing child care financing fund to create

meaningful support for the many low income working families who

earn just above the eligibility guidelines for child care financial assistance.

The City of Newark will develop and evaluate a coordinated approach for the delivery of a full spectrum of social services to

underinsured and uninsured women and youth ages 0–5 to improve

the health status of this target population.

CONTACT project provides health and human services information and referrals, as well as Elder Reassurance and volunteer referrals in support of the needs of community residents.

The family resiliency initiative of the University of Hawaii Center on the Family will include the development of a comprehensive

data system for a wide range of end users.

Community-based resource centers

The Committee recommends $32,834,000 for community-based

resource centers, the same level as provided in fiscal year 2001.

This amount, the same as the administration request, funds a consolidation of the community-based family resource program and the

temporary child care and crisis nurseries program. This program is

intended to assist States in implementing and enhancing a statewide system of community-based, family-centered, family resource

programs, and child abuse and neglect prevention through innovative funding mechanisms and broad collaboration with educational,

vocational, rehabilitation, health, mental health, employment and

training, child welfare, and other social services within the State.

The temporary child care and crisis nurseries serve thousands of

families with children who have a disability or serious illness, and

families that are under stress, including families affected by HIV/

AIDS, homelessness, violence, family crisis, and drugs and alcohol.
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Developmental disabilities

The Committee recommends $140,534,000 for developmental disabilities programs, an increase of $7,000,000 over last year and

$7,200,000 more than the request. 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.

State councils

For State councils, the Committee recommends $69,800,000. In

1987, the Developmental Disabilities Act changed the focus of State

councils from services provision and demonstration to planning and

services coordination directed to effecting systems change. Since

that time, the States have been shifting away from their original

role of services provision to their current mission to effect system

change on behalf of persons with developmental disabilities.

Protection and advocacy grants

For protection and advocacy grants, the Committee recommends

$35,000,000. 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 supports the continuation of an interagency approach to providing training and technical assistance to the Protection and Advocacy System. This collaboration has worked well in

coordinating the provision of critical information to the system. The

Committee intends that training and technical assistance should be

delivered through a multiyear cooperative agreement with an agency that has demonstrated the capacity to provide this service and

is supported by the P&A agencies in the States. The Committee

recommends that ADD involve other agencies which administer

P&A programs such as Social Security Administration and HRSA

in determining the entity to receive the interagency grant.

Projects of national significance

The Committee recommends $11,734,000 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 work of the Family Friends program in training senior volunteers to provide respite to families

whose members have disabilities. The Committee believes that additional funds from the Department will assist in the development

of a Family Friends pilot project to provide technical assistance and

training in the application of the successful Family Friends volun-
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teer respite care model to the needs of aging parents of adult individuals with developmental disabilities.

University-affiliated programs

For university-affiliated programs, the Committee recommends $24,000,000. This program provides operational and administrative

support for a national network of university-affiliated programs

and satellite centers. Grants are made annually to university-affiliated programs and satellite centers for interdisciplinary training,

exemplary services, technical assistance, and information dissemination activities.

Native American programs

The Committee recommends $45,996,000 for Native American

programs, the same amount as the 2001 level and $1,600,000 more

than the budget request. 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.

The Committee continues to be concerned that Native American

children may be placed in homes without foster care maintenance

payments to support the cost of food, shelter, clothing, daily supervision, school supplies, or liability insurance for the child. For children adopted through tribal placements, there may be no administrative payments for expenses associated with adoption and training of professional staff or parents involved in the adoption. In the

past, the Committee has supported a demonstration project to provide funding to two Alaska Native regional non-profit organizations, Cook Inlet Tribal Council, Inc. in Anchorage, and Kawerak,

Inc. in Nome. Also, the Tanana Chiefs Conference in Interior Alaska is developing a State/Alaska Native information system so that

Alaska Native children have the same support as other American

children.

The Committee is aware that in Alaska Native villages, disparate programs exist to deal with problems of infants, children,

the disabled, the elderly and others, as well as for alcohol and drug

use, physical and sexual abuse, and mental health, and that the

Alaska Federation of Natives has initiated a program to bring together the resources of all such programs to help Native communities in Alaska heal themselves and their members on a holistic

basis, without social stigma attached to any individual or family.

The Committee is aware that the Tate Ota (Many Winds) Corporation on the Rosebud Indian Reservation in Mission, South Dakota, will research historical efforts to educate Native American

youth and apply what is learned to improve the educational process

in tribal schools.

The Committee is concerned about the allocation of resources for

Native Hawaiian groups, and urges equal consideration for future

government-funded programs that affect Native Hawaiians. The

Committee recommends equitable funding from the Administration

for Native Americans for the provision of assistance to support educational activities associated with the exercise of self-determination
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by Native Hawaiian people and the identification of self-government.

Community services

The Committee recommends an appropriation of $765,304,000 for the community services programs. This is $82,654,000 more than

the fiscal year 2001 level and $110,289,000 higher than the administration request.

Within the funds provided, the Committee recommends $675,000,000 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 recommendation

recognizes the increased demand by the low-income population for

services provided by CSBG-funded community action agencies.

The Committee continues to recognize the importance of the

Community Services Block Grant and the Community Action Agencies it funds. An appropriation of $675,000,000 has been provided

for CSBG for fiscal year 2002, a sizable increase of $75,009,000

over the fiscal year 2001 level.

It is the intent of the Committee that all eligible entities in good

standing receive a proportionate share of the increase provided for

fiscal year 2002. Congress has provided significant investment in

the Community Services Block Grant in recent years, and expects

all eligible entities, particularly Community Action Agencies, to

benefit. The Committee is aware that report language in the statement of the managers accompanying the fiscal year 2001 conference report to this effect (H. Rept. 106–1033) was not universally implemented in all States; therefore the Committee has

adopted legislative language to make its intentions unambiguously

clear. The Committee expects that the Office of Community Services will enforce this bill language.

The Committee expects the Office of Community Services to release funding to the States in the most timely manner. The Committee also expects the States to makes funds available promptly.

The Committee is aware that the Office of Community Services and

some States have been extraordinarily delinquent in providing

funds to local eligible entities.

The Committee is aware that Community Action Agencies have

well-established partnerships with the private sector, the public

sector, other community-based organizations, and faith-based organizations. The Committee expects fiscal year 2002 funding to help

provide stronger partnerships of eligible entities of the Community

Services Block Grant, which are predominantly Community Action

Agencies.

The Committee is also aware that Community Action Agencies

are developing model programs in the areas of fatherhood initiatives, mentoring, literacy, and family development. For example,

CAP of Lancaster County, of Lancaster, Pennsylvania, and Metropolitan Development Council of Tacoma, Washington, have excellent fatherhood programs. CHANGE, Inc. of Weirton, West Virginia

and the Rural Alaska Community Action Program, Inc., which

serves the entire State of Alaska, have developed exemplary men-
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toring programs. CAP Services, Inc. of Stevens Point, Wisconsin

and the Community Action Council of Lexington, Kentucky, have

implemented nationally recognized literacy programs. Community

Action Agencies across Iowa and Wisconsin have developed exemplary family development programs. The Committee expects that

the money going to Community Action Agencies through the Community Services Block Grant will continue to provide services that

innovate and create model programs such as these.

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 discretionary programs are funded from this account.

Funding for these programs is recommended at the following levels

for fiscal year 2002: community economic development,

$35,000,000; individual development accounts, $24,990,000; rural

community facilities, $7,000,000; national youth sports,

$16,000,000; and community food and nutrition, $7,314,000.

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 $5,000,000 for the Job Creation Demonstration authorized under the Family Support Act to target community development activities to create jobs for people on public

assistance. As in the past, the Committee expects that a priority

for grants under this program go to experienced community development corporations. The Committee reiterates its expectation that

national youth sports funds be awarded competitively.

The Committee has provided funding for Rural Community Facilities Technical Assistance. Most of the drinking water and waste

water systems in the country that are not in compliance with Federal standards are in communities of 3,000 or fewer. Rural Community Assistance Programs [RCAPs] use these funds to assist a number of communities in gaining access to adequate community facilities, gaining financing for new or improved water and waste water

systems and in complying with Federal standards.

The Committee continues to support the Job Creation Demonstration program, authorized by the Family Support Act. Approximately 46 nonprofit organizations have been funded under

this program since 1990, providing welfare recipients and low income individuals an estimated 4,000 new jobs and allowing them

to start 2,000 new micro-businesses. The Committee recognizes

that continued and additional funding of the Job Creation Demonstration program would provide opportunities for more low-income individuals.

The Committee is aware that Yellowstone County, Montana is

home to a growing number of low income, high-risk, preschool children and families with escalating needs. The County is developing
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innovative solutions that coordinate employment training, health

services and school readiness programs for these disadvantaged

families. The Committee encourages ACF to give consideration to

such a proposal.

Family violence prevention and services

The Committee recommends $139,156,000 for family violence

prevention and services programs, an increase of $5,082,000 over

the fiscal year 2001 appropriation and the budget request.

For the runaway youth prevention program, the Committee recommends $14,999,000, which is the same as the fiscal year 2001

appropriation and the administration request. 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.

For the national domestic violence hotline, the Committee recommends $2,157,000, which is the same amount as the fiscal year

2001 appropriation and the administration request. 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.

The Committee recommends $122,000,000 for the grants for battered women’s shelters program, $5,082,000 above the fiscal year

2001 program level and the administration request. This is a formula grant program to support community-based projects which

operate shelters for victims of domestic violence. Emphasis is given

to projects which provide counseling, advocacy, and self-help services to victims and their children.

Early learning opportunities program

The Committee recommendation includes $25,000,000 for the

early learning opportunities program, $5,002,000 more than the fiscal year 2001 funding level. The administration proposed eliminating this program. 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 recommendation does not include $3,000,000 requested for staff to support operation of a Center for Faith-Based

and Community Initiatives. The staff resources required for the

Center can be absorbed within the general departmental management account.
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Program administration

The Committee recommends $171,870,000 for program administration, $8,000,000 above the fiscal year 2001 appropriation and

the same as the administration request.

The Committee appreciates the contributions made by ACF in responding to the tragedy that occurred on September 11, 2001. The

Committee notes that ACF promptly released resources to support

the social service needs of individuals in affected communities and

provide for child care and related services required to sustain the

heroic efforts of relief workers. These resources, as well as the additional support provided to ACF’s programs that serve children in

affected communities, will help individuals and families access the

services and information they need to cope with and heal from the

tragic events of that day.

The Committee is aware of the Department’s new rule regarding

outcome-based 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 resources

to ensure full implementation of the new collaborative monitoring

system.

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2001 ............................................................................. $305,000,000

Budget estimate, 2002 ........................................................................... 572,000,000

Committee recommendation ................................................................. 305,000,000

The Committee recommends $305,000,000 for fiscal year 2002,

$267,000,000 less than the amount requested by the administration

and the same amount as the fiscal year 2001 level. These funds

will support: (1) community-based family support services to assist

families before a crisis arises; and (2) innovative child welfare services such as family preservation, family reunification, and other

services for families in crisis. These funds include resources to help

with the operation of shelters for abused and neglected children,

giving them a safe haven, and providing a centralized location for

counseling.

The promoting safe and stable families program is under consideration for reauthorization this year. The administration proposed

increasing the authorization level of this appropriated entitlement

program by $200,000,000 and also requested $67,000,000 for a new

mentoring children of prisoners program. The Committee defers action on these requests pending enactment of authorizing legislation.

MENTORING CHILDREN OF PRISONERS

The Committee defers action on this request pending enactment

of authorizing legislation. As part of its Faith Based Initiative, the

administration proposed a new program designed to mentor children of prisoners and requested $67,000,000 for this purpose.

Funds would be used to award competitive grants to local governments for the establishment or operation of programs providing

mentoring for children of prisoners and probationers through net-
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works of community organizations, including faith based organizations.

PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION ASSISTANCE

Appropriations, 2001 ............................................................................. $4,863,100,000

Budget estimate, 2002 ........................................................................... 4,945,200,000

Committee recommendation ................................................................. 4,885,200,000

The Committee recommends $4,885,200,000 for this account,

which is $22,100,000 more than the 2001 comparable level and

$60,000,000 less than the budget request. In addition, the Committee recommendation concurs with the administration’s request

of $1,754,000,000 for an advance appropriation for the first quarter

of fiscal year 2003. 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

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.

The administration proposed amending the Independent Living

program by increasing the cap on entitlement spending to

$200,000,000. The additional $60,000,000 made available through

this proposal would support vouchers for children who age out of

the foster care system so they can pursue vocational training or college and be better prepared to live independently and contribute

productively to society. The Committee defers action on this proposal pending enactment of authorizing legislation.

ADMINISTRATION ON AGING

Appropriations, 2001 ............................................................................. $1,103,093,000

Budget estimate, 2002 ........................................................................... 1,097,718,000

Committee recommendation ................................................................. 1,209,756,000

The Committee recommends an appropriation of $1,209,756,000

for aging programs, $106,663,000 above the 2001 appropriation and

$112,038,000 more than the budget request.

Supportive services and senior centers

The Committee recommends an appropriation of $366,000,000 for

supportive services and senior centers, $41,425,000 more than the
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amount appropriated in fiscal year 2001 and $39,425,000 more

than the administration request. The increased funding will provide additional transportation, in-house services, chore services,

case management and other support for frail older individuals. 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 $22,000,000 for preventive health services, an increase of $877,000 more than the amount appropriated in fiscal year 2001 and the budget 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. Within the appropriation for this program, $5,000,000 is provided to continue medication management,

screening and education activities to prevent incorrect medication

and adverse drug reactions. These activities will help older adults

learn more about managing medications safely and help reduce unnecessary hospitalizations and illnesses.

Protection of vulnerable older Americans

The Committee recommends $18,181,000 for grants to States for

protection of vulnerable older Americans. Within the Committee

recommendation, $12,949,000 is for the ombudsman services program and $5,232,000 is for the prevention of elder abuse program.

The amount recommended for the ombudsman services program is

$3,500,000 more than the fiscal year 2001 level and the administration request. The amount recommended for the elder abuse prevention program is $500,000 more than the fiscal year 2001 level

and budget request. Both programs provide formula grants to

States to prevent the abuse, neglect, and exploitation of older individuals. The ombudsman program focuses on the needs of residents

of nursing homes and board and care facilities, while elder abuse

prevention targets its message to the elderly community at large.

The Committee recognizes the importance of the Long-Term Care

Ombudsman Program in assisting residents of nursing homes and

board and care facilities resolve abuse and neglect complaints. The

Committee is aware of the Institute of Medicine’s 1995 study which

recommended a ratio of 1 Ombudsman for every 2,000 nursing

home beds to meet the needs of long-term care residents, as well

as DHHS Office of Inspector General’s 1999 report recommending

additional funding for the program. Therefore, the Committee has
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provided an increase of $3,500,000 for the Long-Term Ombudsman

Program, which will allow the program to hire additional Ombudsman staff, expand public information and education campaigns,

and upgrade technology.

The Committee supports continued and additional funding for

the long-term care ombudsman resource center and its training and

clearinghouse functions, which provide information, technical assistance, programmatic, and other support for State and regional

long-term care ombudsmen.

National family caregiver support program

The Committee recommends $140,000,000 for the national family caregiver support program, an increase of $20,000,000 over the

amount appropriated in fiscal year 2001 and $18,000,000 more

than the budget 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 $6,000,000 to carry out

the Native American Caregiver Support Program, an increase of

$1,000,000 over last year. 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. In fiscal year 2001, funds were used to provide both discretionary and formula grants to support the purpose of this program.

Congregate and home-delivered nutrition services

For congregate nutrition services, the Committee recommends an

appropriation of $384,000,000, an increase of $5,588,000 over the

amount appropriated in fiscal year 2001 and the budget request.

For home-delivered meals, the Committee recommends

$177,000,000, an increase of $25,000,000 over the amount appropriated in fiscal year 2001 and $19,000,000 more than 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.

Aging grants to Indian tribes and native Hawaiian organizations

The Committee recommends $26,000,000 for grants to native

Americans, $2,543,000 more than the amount appropriated in fiscal
238

year 2001 and $543,000 more than 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.

Training, research and discretionary projects

The Committee recommends $36,574,000 for training, research, and discretionary projects, $722,000 more than the fiscal year 2001

enacted level and $19,000,000 more than the budget 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 who administer the Older

Americans Act.

The Committee has provided support at last year’s level to continue the pilot project to test the best ways of using the skills of

retired nurses, doctors, accountants and other professionals to train

other seniors and to serve as expert resources to detect and stop

Medicare fraud, waste and abuse. The Committee expects that

these funds will be used to make grants and that administrative

costs will be minimized. In addition, the Committee expects that an

improved system will be developed and implemented in coordination with CMS and the OIG to track cases referred by this initiative.

The following programs and projects have been brought to the

Committee’s attention. The Committee expects the Administration

on Aging to give each full and fair consideration for awards available under new grant competitions.

The National Indian Council on Aging continues to initiate programs designed to improve access to social services at the Federal,

State, and tribal levels for elders in Indian Country through the

nation’s 235 Title VI programs.

Recent studies have forecasted significant changes in the size

and economic well being of the elderly population in Missoula,

Montana. The Missoula Aging Services will continue to develop

new and innovative programs such as a resource center and other

support systems to serve the needs of community residents.

The SPRY Foundation will continue its efforts to improve the

quality of life for seniors throughout the United States by developing web-based resources and related training programs to help

seniors and their families access high-quality information and caregiver support services.

The West Virginia University National Rural Aging Project proposes to support State efforts to implement and evaluate best practices in improving service delivery to the elderly in rural areas.

The National Council on the Aging proposes to establish the National Center on Senior Benefit Outreach to provide seniors and

caregivers with timely information and assistance about State and

Federal programs that address important health, financial and social needs.
239

The Motion Picture and Television Fund, in partnership with the

University of Southern California’s Andrus School of Gerontology

has developed the Eden Alternative demonstration project, which

seeks to improve quality of care and life for seniors residing in

nursing homes and assisted living facilities.

Sonoma State University has developed the Lifelong Learning Institute which encompasses a university-community partnership designed to promote a wide range of intellectually stimulating learning opportunities in support of the creative growth of retired individuals.

Naturally Occurring Retirement Communities (NORCs) provide

seniors with the supportive services that they need to continue living independently and avoid early and unnecessary institutionalization. A multi-state demonstration project targeting NORC communities in Baltimore, Cleveland, Detroit, St. Louis, and Pittsburgh could promote the testing and development of improved integrated systems providing supportive services to large concentration

of seniors, the results of which could be used to formulate national

models.

Access Community Health Network in Chicago has developed a

Senior Outreach Program to provide direct links to primary health

care for the isolated elderly.

The Florida State University System has developed a major research initiative consisting of an integrated set of research, policy

analysis and development projects designed to address long-term

care in Florida and the nation, in particular focusing on community-based long-term care services with the integration of housing,

assistive technology, transportation, caregiver, mental health and

acute-care services.

The Gerontological Studies Center at Northern Michigan University will combine research and educational programming with community services to benefit the elderly population of Michigan’s

upper peninsula.

Oregon Health Sciences University will expand its Healthy Aging

project by helping the elderly and their family maintain self-determination, dignity and optimal quality of life as they deal with inevitable declines in physical independence.

Texas Tech University’s Center for Healthy Aging, a state-of-the

art geriatric care, training, and research center, will serve as a national model for the treatment and understanding of long-term

health care for older Americans.

The Coalition of Wisconsin Aging Groups proposes to expand the

Elder Law Center to provide legal backup to benefit specialists and

to educate members of the legal community and the public on

growing concerns about financial elder abuse and possible remedies

to that problem.

The La Crosse Hmong Mutual Assistance Association is developing programs to provide employment, social, economic and educational assistance to elderly Hmong refugees.

Champlain Senior Center in Burlington, Vermont proposes to

utilize technology in its efforts to help more low income senior remain independent and active for as long as possible.

The University of Indianapolis, through its new Center for Aging

and Community Health, is developing an integrated complement of
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clinical, educational, and research programs in order to improve

services to the community.

The Center to Enhance Quality of Life in Chronic Illness at Indiana University proposes to undertake research on preventing falls

among the elderly, home support of patients with congestive heart

failure and interventions to family care givers of Alzheimer patients.

The National Asian Pacific Center for Aging’s efforts have helped

increase access for American Asian and Pacific Islander seniors to

social services and other support programs.

The Franciscan Health System’s program ‘‘Improving Care

through the End of Life’’ has demonstrated cost savings achieved

by programs that integrate palliative care into a comprehensive,

interdisciplinary service geared toward patients with terminal illnesses.

The Hana Community Health Center provides traditional nutrition services to the area’s elderly population, and also provides additional wellness programs, home health care and transportation

assistance, enabling the elderly to remain in the Hana Community.

The Allegheny County Homestead Apartments LIFE Center will

provide quality primary health care, physical and occupational

therapy, and limited social services to the senior citizens at the

Homestead Apartments and in the surrounding area, allowing seniors to remain at home.

The International Longevity Center proposes to establish a Visiting Scholars Program, expand research focused on the daily life

experiences of older persons and disseminate research findings

widely.

The Family Friends Project continues to pursue new replication

approaches and support technical assistance and training for local

sites through the Family Friends national office.

Aging network support activities

The Committee recommends $2,379,000 for aging network support activities, $567,000 more than the fiscal year 2001 level and

the budget request. The Committee recommendation includes

$1,198,607 for Eldercare Locator, $337,557 more than the fiscal

year 2001 appropriation. The Committee recommendation provides

$1,180,393 for the pension information and counseling projects,

$229,000 more than last year. These program were funded as demonstration activities through the fiscal year 2001 appropriation.

Last year’s reauthorization of the Older Americans Act authorized

both of these activities under section 201 of the Act.

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 nearly 500,000 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 pursuing

claims when pension problems arise.
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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 twenty years. The Committee recommends a funding level of

$13,000,000, an increase of $4,038,000 over the fiscal year 2001

level and the Administration’s 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, care giving comes at enormous

physical, emotional and financial sacrifice. The Alzheimer’s disease

demonstration grant program currently provides matching grants

to 24 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. Given the programs proven

record of success, the Committee recommends an increase of

$4,038,000 over the comparable 2001 appropriation to expand the

program to additional States.

Program administration

The Committee recommends $18,122,000 to support Federal staff

that administer the programs in the Administration on Aging,

$903,000 above the 2001 level and the same amount as the budget

request. These funds provide administrative and management support for programs administered by the agency.

The Committee applauds the efforts of the AoA and the national

aging network in helping address the needs of the elderly and their

caregivers arising from the tragedy that occurred on September 11,

2001. The Committee recognizes that AoA and many State and

local organizations serving the elderly and caregivers focused resources and increased attention on helping support the local aging

network in responding to the needs of elderly individuals residing

in communities affected by that day’s tragedy. These events underscore both the vulnerability of the elderly, and especially homebound elderly, in times of both natural and man-made disasters.

However, these events also underscore the fact that the national

aging network, comprising 56 State units on aging, 655 area agencies on aging, 235 Tribes and Tribal organizations, and 29,000 local

services providers, represents a tremendous resource for assisting

the community at large during emergency situations. The Committee commends and supports the continued efforts of AOA and

the aging network in providing for the needs of the elderly and

their caregivers, including mental health needs, in affected communities. The Committee also urges the Secretary to continue efforts

to plan for emergencies, to ensure that the elderly and their caregivers receive the help they need and to facilitate making the resources of the national aging network available to the community

at large in emergency situations.
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OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2001 ............................................................................. $378,019,000

Budget estimate, 2002 ........................................................................... 442,751,000

Committee recommendation ................................................................. 422,212,000

The Committee recommends $422,212,000 for general depart- mental management [GDM]. This is $20,539,000 less than the administration request and $44,193,000 above the fiscal year 2001

level. Within this amount, the Committee includes the transfer of

$5,851,000 from Medicare trust funds, which is the same as the administration request and the fiscal year 2001 level. Included in

these funds is $5,000,000 to be transferred to the Global Fund to

Fight HIV/AIDS, Malaria, and Tuberculosis.

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 is aware that, in response to the September 11th

terrorist attacks, the Department activated the National Disaster

Medical System (NDMS) to provide emergency medical assistance

to local officials in New York City and at the Pentagon. The Office

of Emergency Preparedness deployed 328 medical personnel as part

of Disaster Medical Assistance Teams (DMATS), which consisted of

physicians, nurses and emergency medical technicians trained to

deal with traumatic injuries. In addition, four Disaster Mortuary

Operation Response Teams (DMORTS) were dispatched to New

York City, and three to the Washington area. The Committee commends the Department for its quick response and for providing

needed resources to local emergency personnel.

The Committee has provided $4,000,000 to support the activities

of the United States-Mexico Border Health Commission as authorized by Public Law 103–400. The Commission is authorized to assess and resolve current and potential health problems that affect

the general population of the United States-Mexico border area.

The Committee directs that specific information requests from

the Chairman and Ranking Members 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
243

researchers and scientists be transmitted to the Committee on Appropriations, uncensored and without delay.

The Committee is aware that the Department is undertaking an

overhaul of its internal computer systems, specifically a Unified Financial Management System. The Committee is further aware that

there are concerns about the process by which the Department has

solicited bids for fulfilling its software needs. Therefore, the Committee urges the Department to ensure that the procurement process for any and all service and software purchases is conducted in

the most open, fair, and appropriate manner in compliance with

current Federal guidelines.

The Committee has included funding for the Human Services

Transportation Technical Assistance Program. These funds shall be

used to provide assistance to human service transportation providers on management, coordination and meeting the requirements

of the Americans with Disabilities Act. Funding is also included for

a Medicare Transportation Demonstration Program in Iowa. Under

this demonstration, residents of an urban and rural community

shall receive non-emergency transportation assistance for visits to

hospitals, clinics, and physicians and for related services. The purpose of this demonstration is to ascertain the obstacles, including

costs, that senior citizens encounter in securing non-emergency

transportation to health care providers. The Committee notes that

the technical assistance provided by the Community Transportation Association of America is vital to the success of these demonstrations.

The Committee understands that Mercy Housing, Inc., a national

non-profit faith-based organization focused on improving the health

care and housing opportunities available to low-income families, elderly households and individuals, would benefit from technical assistance to develop linkages between health care services and affordable housing developments.

Children’s eye exams.—As 80 percent of what children learn is

acquired through vision processing information, the Committee recognizes that ensuring that all children start school ready to learn

is essential to their academic achievement and our Nation’s economic success and urges that all children have access to comprehensive eye examinations prior to school matriculation. The

Committee believes that comprehensive eye exams in children prior

to entering school are an important step to assure they start their

academic careers ready to learn and that the full range of visual

impairments are identified and diagnosed. The Committee therefore urges the Secretary to explore and develop ways in which to

assure that more children receive comprehensive eye examinations.

Chronic fatigue.—The Committee is pleased that the Department

has announced that it will establish a chronic fatigue syndrome advisory committee to build upon progress made by the DHHS CFS

Coordinating Committee within the limits of its charter. It is this

Committee’s expectation that this transition to an advisory committee will not diminish the full partnership of involved agencies

or the collaborative relationships among Federal agencies, scientists, and CFS advocates that have developed over recent years

through the CFS Coordinating Committee. The Committee is disappointed that, despite 2 years of report language, the Department
244

has not yet undertaken a prominent educational campaign to inform health care professionals and the general public about CFS.

The Committee urges the Secretary and the Surgeon General to

take a leadership role in this effort and to report back to the Committee within 90 days on plans to inform the public that CFS is

a serious, prevalent, and disabling illness.

Coordination of child support enforcement activities.—The flow of

information between Federal and State agencies and the court system continues to be a critical factor in the success of the Child Support Enforcement program. While some States have succeeded in

implementing seamless, cost-effective processes for informationsharing among their human service agencies and the courts, others

have not. The Committee has been impressed with the results of

ACF’s efforts using the State information technology consortium to

improve the information and systems reporting requirements of

TANF. That success underscores the notion that States are in the

best position to solve their own problems. The Committee therefore

encourages the Secretary to utilize this consortium of States to

identify and widely disseminate methods for improving the flow of

information between agencies and the court system.

Dietary supplements.—The Committee recognizes the substantial

role that dietary supplements can play in improving the health status of Americans. Indeed, improved nutrition and healthful diets

may mitigate the need for expensive medical procedures and reduce

health care expenditures. In 1994, the Congress passed the Dietary

Supplement Health and Education Act (DSHEA), which provides

the regulatory framework necessary to ensure that consumers have

access to safe, accurately labeled dietary supplements and information about those products. However, while the Food and Drug Administration (FDA) has spent resources to take action against a

number of important healthful products, the Committee believes it

has failed to take action against a number of clearly violative

claims and inaccurate ingredient labels. The Committee is aware

that funding for the Food and Drug Administration is in the Department of Agriculture appropriations bill. However, the Committee directs the Secretary to work with the FDA to undertake appropriate enforcement of DSHEA in areas relating to the accuracy

of claims about dietary supplement ingredients, and prohibiting

any dietary supplement claim that is false or misleading.

Embryo adoption awareness.—During hearings devoted to Stem

Cell research, the Committee became aware of approximately

100,000 spare frozen embryos stored in in vitro fertilization (IVF)

clinics throughout the United States. The Committee is also aware

of many infertile couples who, if educated about the possibility,

may choose to implant such embryos into the woman and, potentially, bear children. The Committee therefore directs the Department to launch a public awareness campaign to educate Americans

about the existence of these spare embryos and adoption options.

The Committee has provided $1,000,000 for this purpose.

Homelessness.—The Committee supports the ongoing efforts of

the Department in its initiative to end chronic homelessness. The

Committee encourages the collaboration between HHS and the Department of Housing and Urban Development (HUD) and supports

the goal of ending homelessness for the estimated 150,000 chron-
245

ically homeless. The Department should continue to identify funds

for supportive services to supplement permanent supportive housing projects being funded by HUD.

Long-term care.—The Committee notes that long-term care settings (nursing homes, assisted living, home health care, etc.) nationwide are facing a shortage of frontline caregivers including registered and licensed practical nurses, certified nurse aids (CNAs)

and other direct care workers. The Committee notes that the General Accounting Office estimates that the U.S. health care system

will need an additional 800,000 nurse aides by the year 2008. The

Committee expects the Secretary to coordinate a study with the

Administrators of HRSA and CMS to identify the causes of the

shortage of frontline caregivers in long-term care settings and

make comprehensive recommendations to the Committee to address the increasing demand of an aging baby-boomer generation,

and report findings and recommendations to the Committee by

June 1, 2002.

Medical devices.—The Secretary is urged to submit a report to

the Committee on medical devices developed or improved by the

Federal Government or in conjunction with Federal funds. The report should specifically address medical devices used in the treatment of chronic illness, including diabetes. To the extent possible,

the report should address how medical devices developed or used

by the Federal Government are introduced into the mainstream

health care delivery system; how the use of a medical device by a

chronically ill person is evaluated for efficacy; how the Federal

Government can improve efforts to introduce medical device technology developed by its agencies and programs into the mainstream

health care delivery system; and how the Department can improve

its consideration of the needs of chronically ill patients when evaluating the efficacy of medical devices. The Secretary is urged to report to the Committee no later than May 30, 2002.

Nurse anesthetists.—The Committee understands that concerns

have been raised about the administration’s proposed rules to address the issue of physician supervision of certified registered nurse

anesthetists. The Committee urges the Secretary to take the differing views of the interested parties, including the nurse anesthetists and anesthesiologists, into consideration before issuing a

final rule.

Report on osteoporosis and related bone diseases.—More than 30

million Americans suffer from some form of bone disease, including

osteoporosis, Paget’s disease and osteogenesis imperfecta. The

Committee therefore recommends that the Department commission

a Surgeon General’s report on osteoporosis and related bone diseases, detailing the burden bone diseases places on society, and

highlighting preventive measures to improve and maintain bone

health throughout life. The report should also identify best practices for collecting data about the prevalence, morbidity and disability associated with bone diseases among minority populations.

Runaway youth.—The Committee is concerned with reports that

runaway, throwaway, homeless, and street experiences among

youth are increasing. The Committee is also troubled that the exact

nature of these problems is not well defined because national statistics on the number, characteristics, and circumstances of this
246

population are not tabulated. The Committee instructs the Secretary, acting through the Assistant Secretary of Planning and

Evaluation, to prepare and submit by September 30, 2002 a plan

for developing estimates of the incidences of runaway, throwaway,

homeless, and street experiences among youth, as well as a plan

for regularly monitoring incidence trends.

Underage drinking prevention.—The Committee recommendation

includes $1,000,000 for the National Academy of Sciences Institute

of Medicine to conduct a comprehensive review of all existing Federal, State and non-governmental programs designed specifically to

reduce the illegal purchase and consumption of alcohol, as well as

media-based programs with the purpose of changing the attitudes

and behaviors of youth. The Committee directs the NAS to review,

evaluate and report on the effectiveness of all such programs, the

results of which shall identify those programs which have been the

most successful at accomplishing the goals of reducing underage

drinking or successfully altering the attitudes and behaviors of

youth. The NAS shall, based on its review, make recommendations

on a comprehensive strategy for reducing and preventing underage

drinking in the United States. The review and recommendations of

the NAS shall be reported to the United States Senate Committee

on Appropriations, the United States Secretary of Health and

Human Services, the United States Secretary of Education and the

United States Attorney General no later than 12 months after the

date of enactment of this Act.

Adolescent family life

The Committee has provided $30,000,000 for the Adolescent

Family Life Program [AFL]. This is $5,673,000 more than the fiscal

year 2001 appropriation and $2,138,000 over the administration request.

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.

Within the total provided, the Committee continues the prevention projects begun in fiscal year 1998, as well as new prevention

projects. The Committee again expects the Department to fund new

prevention projects which enable smaller communities to begin the

organization and implementation of coalitions to implement abstinence-based education programs. The Committee again expects the

Department, when announcing grant competitions, to provide a

reasonable length of time for applicants to complete application

packages, provide extensive technical assistance to applicants, with

special assistance given to new applicants, and revise the terminology and instructions in grant applications to assure that the information being requested is as clear as possible.

Physical fitness and sports

The Committee recommends $1,139,000 for the Federal staff

which supports the President’s Council on Physical Fitness and
247

Sports. This is the same as the budget request and $48,000 more

than the fiscal year 2001 appropriation.

The President’s Council on Physical Fitness and Sports serves as

a catalyst for promoting increased physical activity/fitness and

sports participation for Americans of all ages and abilities, in accordance with Executive Order 12345, as amended. The programs

sponsored by PCPFS are supported largely through private sector

partnerships.

Minority health

The Committee recommends $43,084,000 for the Office of Minority Health. This is the same as the budget request and $5,935,000

less than the fiscal year 2001 appropriation.

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 has provided $1,000,000, the same as the budget

request, to support a national program to assess and reduce health

disparities affecting minority males. The Committee urges the Department, when launching the new National Minority Male Health

Project, to do so through a consortium of historically black colleges

and universities with a demonstrated relationship that will contribute to educating minority males about their health. The Committee further urges the Department to directly involve historically

black colleges and universities in the community-based health

strategies affecting minority males.

The Committee encourages the Office of Minority Health to provide support to historically black serving institutions and other minority-serving institutions to enhance their efforts in HIV/AIDS

and other disease prevention.

The Committee recommends continuation of the following fiscal

year 2001 projects and activities referenced in the fiscal year 2001

conference agreement:

—Trinity Health in Detroit, Michigan for its primary care clinic

that serves underserved, low-income and minority individuals

—the Community Lead Education and Reduction Corps

(CLEARCorps) at the University of Maryland Baltimore County to prevent lead poisoning among low-income and minority

children.

The Committee is aware of the following projects and urges the

Department to give them full and fair consideration:

—the American Association of Physicians of Indian Origin

(AAPI) efforts to study bone mineral density (BMD) in the Indian American community

—the AIDS Foundation of Chicago’s efforts to expand current

prevention programs
248

—the Center for Hispanic Community and Family Health at the

University of North Carolina at Greensboro —Padres Contra El Cancer, a non-profit organization that serves

Latino children with cancer in Los Angeles, CA —the Institute for the Elimination of Health Disparities at the

University of Medicine and Dentistry of New Jersey (UMDNJ)

for focusing on minority health issues —the California Teratogen Information Service in San Diego, CA

for its outreach and education program directed at Hispanic

women of reproductive age —the Chronic Disease Prevention for Hispanic Children Project

being sponsored through the Texas Agricultural Extension

Service, Baylor Children’s Hospital and the Texas A&M Health

Sciences Center —the Baltimore City Health Department for HIV/AIDS testing

for high-risk individuals. —the Thomas Jefferson University Hospital for providing linguistically competent and culturally sensitive health care services

to the Chinese community.

Office on Women’s Health

The Committee recommends $27,396,000 for the Office on Women’s Health. This is the same as the administration request and $10,126,000 more than the fiscal year 2001 appropriation.

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.

The Committee remains strongly supportive of the various women’s health-related offices in NIH, CDC, HRSA, FDA, SAMHSA,

AHRQ, and HCFA. These offices are essential to the mission of the

Department and must be adequately supported to accomplish their

goals in line with the expanded role planned for OWH. The Secretary should notify the Committee in advance of any significant

changes in the status of any of these offices.

The Committee is supportive of the efforts of Wishard Health

Services in Indianapolis, Indiana to establish a National Center of

Excellence in Women’s Health. The Center of Excellence would

offer a comprehensive array of programs designed to help women

take important steps toward leading positive, productive lives.

National Bone Health Campaign.—The Committee commends

the Office on Women’s Health for their commitment to the National

Bone Health Campaign aimed at girls aged 9 to 18. The Committee

encourages the Office on Women’s Health to increase their support

of the Campaign.

Office of Emergency Preparedness

The Committee has provided $14,200,000, which is the same as

the budget request and $2,532,000 more than last year, for activities to counter the adverse health and medical consequences from

major terrorist events. Within this amount, sufficient funds are
249

provided for the Office of Emergency Preparedness to staff and administer this program, as well as the other OEP activities specified

in the administration’s request. The amount provided by the Committee is intended to continue the formation of new metropolitan

medical strike teams in key uncovered urban areas of the country.

The Department has lead responsibility for health, medical, and

health-related support under the Federal response plan to catastrophic disasters. On behalf of the Department, the Office of

Emergency Preparedness assesses the potential health and medical

consequences of a terrorist incident and to formulate necessary responses. The funds provided would support activities to build local,

State, and Federal capacity to respond to terrorist acts with public

health implications. Such activities would include assisting local

emergency managers through the MMST system to build an enhanced capability to detect and identify biologic and chemical

agents.

Bioterrorism

The Committee recommendation includes $68,700,000 for bioterrorism activities, which is the same as the administration request

and $8,670,000 above the fiscal year 2001 level. In fiscal year 2001

funds for bioterrorism were appropriated in the Public Health and

Social Services Emergency Fund. The fiscal year 2002 budget request funds bioterrorism programs in the OEP and the Office of the

Secretary. Additional funds for bioterrorism have been provided by

the Committee within the CDC and NIH.

The Committee expects that, within the amount provided to the

Secretary for biosecurity, the rebuilding of the nation’s public

health infrastructure be given the highest priority. Communications, information technology, laboratories and associated technologies, hospital capacity, and trained professionals are essential

elements of a national public health infrastructure which protects

the civilian population against both bioterrorist threats and the

rapid onset of naturally occurring diseases.

The Committee is aware that the administration is submitting a

supplemental budget request for additional fiscal year 2002 bioterrorism funding. The Committee looks forward to working with the

administration on this request to insure that substantially increased investments are made in our public health infrastructure,

and that our first-responders at the State and local level are sufficiently prepared in the event of a bioterrorist attack.

The Committee recommends continuation of the following fiscal

year 2001 projects and activities in the fiscal year 2001 conference

agreement:

—the West Virginia University Virtual Medical Campus to address medical community needs for weapons of mass destruction readiness and preparedness.

—University of Findlay’s National Center for Terrorism Preparedness for an ALERT (Actual Learning Environment Response Training) Center.

—the Center for the Study of Bioterrorism and Emerging Infections at the St. Louis University School of Public Health.

The Committee is aware of the following projects that it encourages the Department to consider supporting:
250

—The Center for BioDefense at the University of Medicine and

Dentistry in New Brunswick, New Jersey

—The Detroit Medical Center for an urban disaster and emergency medical response initiative

—The Center for Civilian Biodefense Studies at Johns Hopkins

University

—St. Michael’s Medical Center in Newark, New Jersey, for its

work on bioterrorism as part of the practice and study of high

risk infectious disease

—The Centers for Biopreparedness and Infectious Disease at the

University of North Carolina.

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 $50,000,000. 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.

OFFICE OF INSPECTOR GENERAL

Appropriations, 2001 ............................................................................. $33,786,000

Budget estimate, 2002 ........................................................................... 35,786,000

Committee recommendation ................................................................. 35,786,000

The Committee recommends an appropriation of $35,786,000 for

the Office of Inspector General. This is the same as the administration request and $2,000,000 higher than the fiscal year 2001 level.

In addition to discretionary funds, the Health Insurance Portability

and Accountability Act of 1996 provides $150,000,000 in mandatory

funds for the Office of the Inspector General in fiscal year 2002; the

total funds provided to the Office by this bill and the authorizing

bill would be $185,786,000 in fiscal year 2002.

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.

The Committee commends the Office of Inspector General for

their continued good work to reduce waste, fraud and abuse in Department programs. The Committee expects efforts to reduce Medicare mispayments will be continued and expanded. The Committee

also wants to assure that seniors calling into the toll-free telephone

line to report Medicare mispayments get a prompt and complete response.

OFFICE FOR CIVIL RIGHTS

Appropriations, 2001 ............................................................................. $28,005,000

Budget estimate, 2002 ........................................................................... 32,005,000

Committee recommendation ................................................................. 32,005,000

The Committee recommends $32,005,000 for the Office for Civil

Rights. This is the same as the administration request and

$4,000,000 more than the fiscal year 2001 level.
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This recommendation includes the transfer of $3,314,000 from

the Medicare trust funds, which is the same as the administration

request and the fiscal year 2001 level.

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.

The Committee supports the efforts of OCR to properly enforce

the final medical privacy regulation that went into effect earlier

this year. The Committee urges OCR to ensure that the necessary

resources are not taken away from the Office’s other enforcement

areas of responsibilities.

POLICY RESEARCH

Appropriations, 2001 ............................................................................. $16,715,000

Budget estimate, 2002 ........................................................................... 20,500,000

Committee recommendation ................................................................. 20,500,000

The Committee recommends $20,500,000 for policy research,

which is the same as the administration request and $3,785,000

more than the fiscal year 2001 amount.

Funds appropriated under this title provide resources for research programs that examine broad issues which cut across agency and subject lines, as well as new policy approaches outside the

context of existing programs. This research can be categorized into

three major areas: health policy, human services policy, and disability, aging and long-term care policy.

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

Appropriations, 2001 ............................................................................. $219,772,000

Budget estimate, 2002 ........................................................................... 242,577,000

Committee recommendation ................................................................. 242,577,000

The Committee provides an estimated $242,577,000 for retirement pay and medical benefits for commissioned officers of the U.S.

Public Health Service. This is the same as the administration request and is $22,805,000 over the estimated payments for fiscal

year 2001.

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.

GENERAL PROVISIONS, DEPARTMENT OF HEALTH AND HUMAN

SERVICES

The Committee recommendation includes language placing a

$37,000 ceiling on official representation expenses (sec. 201), the

same as existing law.
252

The Committee recommendation includes language included in

fiscal year 2001 which limits assignment of certain public health

personnel (sec. 202).

The Committee recommendation retains language carried in fiscal year 2001 regarding set-asides in the authorizing statute of the

National Institutes of Health (sec. 203).

The Committee recommendation retains a provision carried in

fiscal year 2001 to limit use of grant funds to pay individuals more

than an annual rate of Executive level I (sec. 204).

The Committee recommendation retains language from fiscal

year 2001 restricting the use of taps (sec. 205) for program evaluation activities by the Secretary prior to submitting a report on the

proposed use of the funds to the Appropriations Committee.

The Committee recommendation (sec. 206) authorized transfer of

up to 2 percent of Public Health Service funds for evaluation activities.

The Committee recommendation retains language included in fiscal year 2001 restricting transfers of appropriated funds among accounts and requiring a 15-day notification of both Appropriations

Committees prior to any transfer (sec. 207).

The Committee recommendation includes language included in

fiscal year 2001 permitting the transfer of up to 3 percent of AIDS

funds among Institutes and Centers (sec. 208) by the Director of

NIH and the Director of the Office of AIDS Research of NIH.

The recommendation also includes language included in fiscal

year 2001 which directs that the funding for AIDS research as determined by the Directors of the National Institutes of Health and

the Office of AIDS Research be allocated directly to the OAR for

distribution to the Institutes and Centers consistent with the AIDS

research plan (sec. 209).

The Committee recommendation includes a provision (sec. 210)

regarding family planning applicants to certify to the Secretary to

encourage family participation in the decision of a minor who seeks

family planning services.

The Committee recommendation includes a provision included in

fiscal year 2001 which restricts the use of funds to carry out the

MedicareChoice Program if the Secretary denies participation to an

otherwise eligible entity (sec. 211).

The Committee includes a provision (sec. 212) which states that

no provider of services under Title X of the PHS Act except from

State laws regarding child abuse.

The Committee includes a provision (sec. 213) extending the refugee status for persecuted religious groups.

The Committee continues to include a provision prohibiting the

Secretary from withholding substance abuse treatment funds (sec.

214).

The Committee recommendation includes a provision (sec. 215)

that facilities expenditure of funds for international AIDS activities.

The Committee recommendation includes a provision allowing

the Acting Director of NIH to remain in that position until a new

Director is confirmed (sec. 216).
253

The Committee has included a provision (sec. 217) transferring $100,000,000 to International Assistance Programs for the Global

Fund to Fight HIV/AIDS, Malaria and Tuberculosis.
(254)

TITLE III—DEPARTMENT OF EDUCATION

The Committee understands that programs authorized by the Elementary and Secondary Education Act (ESEA) of 1965, as amended, currently are under consideration for reauthorization. Therefore, the Committee has allocated funds for these programs in accordance with H.R. 1, the ESEA reauthorization bill, as passed by

the Senate on June 14, 2001.

EDUCATION FOR THE DISADVANTAGED

Appropriations, 2001 ............................................................................. $10,014,621,000

Budget estimate, 2002 ........................................................................... 11,045,621,000

Committee recommendation ................................................................. 11,879,900,000

The Committee recommends an appropriation of $11,879,900,000 for education for the disadvantaged. This is $1,865,279,000 more

than the fiscal year 2001 appropriation and $834,279,000 more

than the budget request. In fiscal year 2001, $6,953,300,000 was

made available for this account in fiscal year 2002 funds. The Committee recommends the same amount in fiscal year 2003 funds for

fiscal year 2002.

Programs financed under this account are authorized under Title

I of the ESEA as amended by H.R. 1 as passed by the Senate and

section 418A of the Higher Education Act. ESEA Title I programs

provide financial assistance to State and local educational agencies

(LEAs) to meet the special educational needs of educationally disadvantaged children, migrant children, neglected and delinquent

children in State institutions, homeless children, and juveniles in

adult correctional institutions. In addition, the Even Start Program

supports projects that integrate early childhood education with parenting and adult literacy training. Funds for most of these programs are allocated through formulas that include the number of

eligible children and each State’s average per-pupil expenditure.

Even Start funds are allocated according to each State’s proportion

of Title I grants to LEAs.

Grants to local educational agencies

Title I grants to local educational agencies provide supplemental

education funding to LEAs and schools, especially in high-poverty

areas, to help low-income, low-achieving students learn to the same

high standards as other children. The formula for basic grants is

based on the number of children from low-income families in each

LEA, weighted by per-pupil expenditures for education in the

State. The Department makes Federal allocations to the LEA level.

States have the option to reallocate funds to LEAs serving areas

with fewer than 20,000 residents using the best data available on

the number of poor children. States are also required to reserve

funds generated by counts of children in correctional institutions to

make awards to LEAs for dropout-prevention and high-quality edu-
255

cational programs involving youth from correctional facilities and

other at-risk children. By law, 1 percent of the total LEA grant appropriation is set aside for the Bureau of Indian Affairs and the

outlying areas.

The Committee is aware that the distribution formula for Title

I grants to LEAs is the subject of ongoing negotiations by House

and Senate conferees on the ESEA reauthorization bill. Given the

uncertain outcome of that process, the Committee recommends distributing the funds under the formula used in fiscal year 2001 and

will revisit this issue at conference for this bill.

For Title I basic grants, including the amount transferred to the

Census Bureau for poverty updates, the Committee recommends an

appropriation of $8,568,000,000, which is $1,169,279,000 more than

appropriated in fiscal year 2001 and $1,330,279,000 more than the

budget request. The Committee recommends $1,632,000,000 for concentration

grants. This amount is $268,000,000 more than the amount appropriated in fiscal year 2001 and the budget request. 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 equals at least 6,500, or 15 percent, of the total school-aged

population.

The Committee recommends that each State and LEA should receive the greater of either the amount it would receive at specified

levels under a 100 percent hold-harmless provision or what it

would receive using the statutory formulas. This applies for both

basic and concentration grants. Also, the Department should make

100 percent hold-harmless awards to LEAs that were eligible for

concentration grants in fiscal year 2001, but are not eligible to receive grants in fiscal year 2002.

William F. Goodling Even Start Family Literacy Program

For the Even Start program, the Committee recommends $200,000,000, which is $50,000,000 less than the budget request

and the fiscal year 2001 appropriation.

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.

States receive funds on the basis of their proportion of Title I

LEA grant allocations and make competitive 4-year grants to partnerships of local educational agencies and community-based organizations. Grant funds must be equitably distributed among urban

and rural areas. The local share of program costs must increase

from 10 percent in the first year to 40 percent in the 4th year, 50

percent in years 5 through 8, and 65 percent after 8 years.

The Committee is aware that the National Even Start Association, in conjunction with the National Center for Family Literacy,

the National Institute for Child Health and Human Development,

the National Institute for Literacy and the William F. Goodling Institute for Research in Family Literacy, will provide training and

technical assistance to local Even Start programs in need of such

support (as identified by the States). Activities shall include, but
256

are not limited to, assistance to personnel to help them meet the

qualifications for instructional personnel set forth in the Even

Start law, and training and materials to ensure instructional programs are based on scientifically based reading research.

Reading First State Grants

The Committee recommends $900,000,000, the same as the budget request, for the Reading First State Grants program. This program will build on and replace the Reading and Literacy Grants

program, which was authorized under the Reading Excellence Act

program and funded at $286,000,000 in fiscal year 2001.

Reading First is a comprehensive effort, authorized by the Senate-passed version of H.R. 1, 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 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.

Early Reading First

The Committee recommends $75,000,000, the same as the budget

request, for Early Reading First, a new program authorized by the

Senate-passed version of H.R. 1. Early Reading First will complement 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 will be targeted to communities with high numbers of

low-income families.

Migrant

For the State agency migrant program, the Committee recommends $380,000,000, the same as the budget request and the

fiscal year 2001 appropriation.

The Title I migrant 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 counts of migratory children ages 3 through 21 residing within

the States. 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.
257

Neglected and delinquent

The Committee recommends $50,000,000 for the Title I neglected and delinquent program. This amount is $4,000,000 more than the

budget request and the fiscal year 2001 appropriation.

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 perpupil education expenditures for the State.

States are authorized to set aside up to 10 percent of their neglected and delinquent funds to help students in State-operated institutions make the transition into locally operated programs.

Transition activities are designed to address the high failure and

dropout rate of institutionalized students and may include alternative classes, counseling and supervisory services, or educational

activities in State-supported group homes.

Evaluation

The Committee bill includes $8,900,000, the same as the budget

request and the fiscal year 2001 appropriation, for Title I evaluation activities. Evaluation funds are used to support large-scale national surveys that examine how the Title I program is contributing to student performance.

High school equivalency program

The Committee bill includes $20,000,000 for the high school

equivalency program (HEP). This amount is the same as the budget request and the fiscal year 2001 appropriation.

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. HEP serves about 6,000 migrants.

College Assistance Migrant Program

For the College Assistance Migrant Program (CAMP), the Com- mittee recommends $10,000,000, the same as the budget request

and the fiscal year 2001 appropriation.

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

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.

Education for homeless children and youth

For carrying out education activities authorized by part B, subtitle B of the Stewart B. McKinney Homeless Assistance Act, the
258

Committee recommends $36,000,000, which is $1,000,000 more

than the budget request and the fiscal year 2001 appropriation.

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 carry out other activities to ensure that all

homeless children and youth in the State have access to the same

free, appropriate public education, including a public preschool education, as provided to other children and youth. Grants are made

to States based on the total that each State receives under the

Title I program.

IMPACT AID

Appropriations, 2001 ............................................................................. $993,302,000

Budget estimate, 2002 ........................................................................... 1,130,500,000

Committee recommendation ................................................................. 1,130,500,000

The Committee recommends an appropriation of $1,130,500,000

for impact aid for the Department of Education. This amount is the

same as the budget request and $137,198,000 more than the fiscal

year 2001 appropriation.

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.

Basic support payments.—The Committee recommends

$954,000,000 for basic support payments, $72,000,000 more than

the budget request and the fiscal year 2001 appropriation. Under

statutory formula, payments are made on behalf of all categories

of federally connected children.

The Committee is aware that the Frazer School District in Montana must repay over $350,000 in impact aid funding because of errors made by former school district administrators, and that the

district does not qualify for the forgiveness criteria as currently encoded. The Committee urges the Department to work with the district to identify possible solutions to this problem.

Payments for children with disabilities.—Under this program additional payments are made for certain federally connected children

eligible for services under the Individuals with Disabilities Education Act. The Committee bill includes $50,000,000 for this purpose, the same as the fiscal year 2001 level and the budget request.

Facilities maintenance.—This activity provides funding for maintaining certain school facilities owned by the Department of Education. The Committee recommends $8,000,000 for this purpose,

the same as the budget request and the fiscal year 2001 level.

Construction.—Payments are made to eligible LEAs to be used

for construction and renovation of school facilities, or for debt service related to the construction of school facilities. The Committee
259

recommends $68,000,000 for this program. This amount is

$82,000,000 less than the budget request and $55,198,000 more

than the fiscal year 2001 appropriation.

The Committee is aware that Blair Elementary School, which operates on Fairfield Air Force Base in Washington State, has inadequate electrical, heating, ventilation, and air conditioning systems.

The Committee urges the Department to work with the Medical

Lake School District to identify possible solutions to this situation.

The Committee is aware that the Ronan School District in Montana was forced to close its middle school because of sewer contamination and poor indoor air quality, and that the students are now

attending the already crowded elementary and high schools. The

Committee encourages the Department to work with the school district to remedy this situation.

The Committee understands that Harlem Elementary School, at

the edge of the Fort Belknap Indian Reservation in Montana, requires major reconstruction because of damage caused by an underground stream. The Committee urges the Department to work with

the Harlem School District to rectify this situation.

The Committee understands that San Juan School District in

Utah serves children in extremely rural areas, including many residing on Indian reservations. The Committee is aware of the need

for a new elementary school in Monument Valley, and it urges the

Department to work with the District to rectify this situation.

The Committee is aware of the critical construction needs for a

new regional vocational school in the Yukon-Kuskokwim delta area

of Alaska, the poorest region in the State. The Committee requests

that the Department work with the Lower Kuskokwim School District in Alaska and its partners to address this issue and ensure

that all possible solutions are explored.

The Committee is aware that Brockton School in Montana is experiencing significant problems with the K–8 facility, including a

leaky roof, faulty boilers, deteriorating pipes and plumbing, and asbestos removal. The Committee urges the Department to provide

assistance to the Brockton School in identifying appropriate measures to improve the learning environment.

The Committee recognizes the need for further construction monies for Hays/Lodgepole Elementary School in Montana and encourages the Department of Education to give every consideration to its

construction needs.

Payments for Federal property.—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. The Committee recommends $50,500,000 for

this activity, $10,000,000 more than the budget request and the fiscal year 2001 appropriation.

SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2001 ............................................................................. $7,053,575,000

Budget estimate, 2002 ........................................................................... 6,353,794,000

Committee recommendation ................................................................. 8,717,014,000
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The Committee recommends an appropriation of $8,717,014,000 for school improvement programs. This is $2,363,220,000 more

than the budget request and $1,663,439,000 more than comparable

programs in the fiscal year 2001 appropriation. Unless otherwise

noted, programs under this account are authorized by the Senatepassed version of H.R. 1.

State grants for improving teacher quality

The Committee recommends an appropriation of $3,039,834,000

for State grants for improving teacher quality, a new program. This

amount is $439,834,000 more than the budget request and

$931,834,000 more than comparable programs in the fiscal year

2001 appropriation.

This program replaces the Eisenhower professional development

State grants program, Eisenhower professional development Federal activities, Eisenhower regional math and science education

consortia, and the class size reduction program. Reducing class

sizes will remain an allowable use of teacher quality State grants.

States and LEAs that receive grants for improving teacher quality will be required to ensure that program funds are used for professional development that is based on the best available research

on training and learning, tied to State or local standards, of sufficient intensity and duration to affect teaching performance, and designed to improve teachers’ knowledge concerning the subjects they

teach. In addition, States will be held accountable for ensuring that

all children are taught by highly qualified teachers and for improving student achievement.

States and LEAs may use funds for a range of activities related

to the certification, recruitment, professional development and support of teachers. 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.

The Committee recognizes that smaller classes in the early

grades can have a positive impact on students for years to come by

improving classroom discipline, providing students with more individualized attention, and allowing parents and teachers to work

more closely together. Some research has shown that reducing

class sizes in kindergarten through third grade to no more than 18

students improves student achievement, especially among our most

disadvantaged students. Congress has appropriated funds specifically for reducing class sizes for the past 3 years, with the goal of

enabling schools to hire an additional 100,000 fully qualified teachers. Although the fiscal year 2002 bill does not include a guaranteed funding stream for class-size reduction, 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.

The first year of Federal class-size-reduction funds enabled

schools to hire 29,000 teachers who are already teaching in smaller

classes across the country. As a result, approximately 1.7 million

students are learning in smaller classrooms. Another 8,000 teach-
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ers will be hired with the funds provided by the fiscal year 2001

appropriations bill, creating smaller learning environments for

hundreds of thousands of additional students. The Committee encourages districts to continue that progress.

The Committee directs the Department to submit a report as

soon as possible at the end of the program year on how much

money was spent to reduce class sizes and how many new teachers

were hired through the program.

Mathematics and science partnerships

In January 2001, the U.S. Commission on National Security/21st

Century issued a report titled ‘‘Road Map for National Security:

Imperative for Change.’’ This Commission, co-chaired by former

Senators Warren Rudman and Gary Hart, concluded that ‘‘America

faces distinctly new dangers, particularly to the homeland and to

our scientific and educational base.’’ One of the many recommendations outlined in the report was the need to produce more science

and engineering professionals as well as qualified teachers in

science and math.

In responding to this need, the Committee recommends $25,000,000 for mathematics and science partnerships, a new program authorized by the Senate-passed version of the ESEA reauthorization bill. The administration requested no funds 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. The

Secretary is authorized to award grants, on a competitive basis, to

eligible partnerships to enable the entities to pay the Federal share

of the costs of developing or redesigning more rigorous mathematics and 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.

National activities/Transition to Teaching

The Committee recommends $95,000,000 for professional development national activities. This amount is $54,000,000 more than

the fiscal year 2001 appropriation and $65,000,000 more than the

budget request. Within those funds, $15,000,000 is included for

professional development activities for early childhood educators

and caregivers in high-poverty communities. This amount is

$5,000,000 more than the fiscal year 2001 appropriation and

$15,000,000 more than the budget request. In addition, $5,000,000

is included for the Eisenhower National Clearinghouse for Mathematics and Science Education, and $10,000,000 for the National

Board for Professional Teaching Standards.

Funds are also included for the Transition to Teaching program

requested by the administration. The purpose of Transition to

Teaching is to support the Defense Department’s Troops to Teach-
262

ers program, which helps prepare retiring military personnel to

teach in high-poverty school districts, as well as other recruitment

efforts involving non-military teacher candidates. The budget request for Transition to Teaching is $30,000,000. The remaining

funds may be used for other efforts to recruit teachers and principals, subject to ongoing conference negotiations over the Elementary and Secondary Education Act.

Innovative education program strategies State grants

The Committee recommends $410,000,000 for innovative education program strategies State grants. This amount is $25,000,000

more than the fiscal year 2001 appropriation and $61,500,000 less

than the amount requested by the administration for the proposed

Choice and Innovation State Grants program, which has a similar

purpose.

The innovative education program provides support to States and

LEAs in developing education reform initiatives that will improve

the performance of students, schools and teachers.

School renovation

The Committee recommends $925,000,000 for grants to local educational agencies for emergency school renovation and repair activities, as authorized in section 321 of this Act. This amount is

$250,000,000 less than the fiscal year 2001 appropriation. The administration requested no funds for this program.

The funds should be distributed to State educational agencies

based on the Title I, part A allocations under the Elementary and

Secondary Education Act. The State educational agency or other

entity with jurisdiction over school facilities financing, as the case

may be, would distribute the State funds to local educational agencies through competitive grants for emergency school repair and

renovation activities.

These funds may be used by local educational agencies to meet

the requirements of Federal mandates such as the Americans with

Disabilities Act, Section 504 of the Rehabilitation Act, asbestosabatement requirements and security upgrades. Funds may also be

used for emergency health and safety of students and staff (repairing, replacing, or installing roofs, electrical wiring, plumbing systems, or sewage systems; repairing, replacing, or installing heating,

ventilation, or air conditioning systems, including insulation; and

bringing schools into compliance with fire and safety codes.)

If a State holds a grant competition among LEAs that attracts

school renovation applications that are of insufficient quality and

quantity, it must use 100 percent of its excess allocation to provide

all LEAs in the State an award under section 5312 of H.R. 1 as

passed by the Senate on June 14, 2001. This reallocation can take

place only after the State has held a period of public notice and

comment about the availability of funds for emergency repairs and

the insufficient response, consistent with State and local laws governing how the comments may be received and reviewed by the

public. Funds received by LEAs under this reallocation may be

used for any purpose under section 5331 of H.R. 1, including professional development, acquisition of instructional materials, and

school improvement activities.
263

Educational technology state grants

The Committee recommends $712,146,000 for educational technology State grants, as authorized under the Senate-passed version

of H.R. 1. This is $40,000,000 less than the budget request.

This program consolidates four current educational technology

programs, five fewer than the budget request. Funds will flow by

formula to States and may be used for the purchase of hardware

and software, and teacher training on integrating technology into

the curriculum.

Community technology centers

The Committee recommends $64,950,000, the same amount as

the fiscal year 2001 appropriation, for community technology centers. The administration proposed eliminating this program by consolidating it into the educational technology State grants program.

This community technology centers program supports grants, contracts, or cooperative agreements to local and State educational

agencies, institutions of higher education, libraries, museums, foundations, or other public, private, non-profit and for-profit entities or

consortia of such organizations to create or expand community

technology centers. Although the number of Americans connected

to the Internet is soaring, there remains a digital divide between

those who have access to technology and use it effectively, and

those who don’t. In many cases, the divide is actually widening. Minorities, low-income persons, the less-educated, and children of single-parent households, particularly when they reside in rural areas

or central cities, are among the groups that lack access to information resources. 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.

Preparing Tomorrow’s Teachers to Use Technology

The Committee recommends $125,000,000, the same amount as

the fiscal year 2001 appropriation, for the Preparing Tomorrow’s

Teachers to Use Technology program. The administration proposed

consolidating this program into the educational technology States

grants program. Funds will be used to assist consortia of private

and public entities to prepare prospective teachers to use advanced

technology in the classroom.

Ready to Learn Television

The Committee recommends an appropriation of $24,000,000 for the Ready to Learn Television program. This is $8,000,000 more

than the fiscal year 2001 level. The administration proposed consolidating this program into the educational technology State

grants program.

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, consistent with the first national education goal

that all children should start school ready to learn. The program
264

supports the development, production, and dissemination of educational materials designed to help parents, children, and caregivers obtain the maximum advantage from educational programming. Funding will support the growth in demand for related local

educational activities, improve training for professional caregivers,

provide new foreign language translations of children’s programs,

enhance the online components of the program, reach additional

underserved populations, and demonstrate the use of digital broadcasting to provide programming and training to underserved populations.

Ready to Teach/Teacherline

The Committee recommends $15,000,000 for the continuation of

the Public Broadcasting Service initiative called Teacherline, formerly known as Mathline. This amount is $6,500,000 more than

the fiscal year 2001 appropriation. The administration proposed

consolidating this program into the educational technology State

grants program. Within this amount, the Committee provides $6,000,000 for digital educational content (DEC) development grants, a demonstration project authorized by the Senate-passed version of the ESEA

reauthorization bill. DEC grants will allow community partnerships among local public television stations, State and local educational agencies, institutions of higher education, and businesses

to develop, produce, and distribute innovative educational instructional video programming that is designed for use by K–12 schools

based on State and local standards and capable of distribution

through digital broadcasting and school digital networks. The Committee strongly encourages the Secretary to award DEC grants

that assure the delivery of integrated data to schools serving high

concentrations of disadvantaged children.

The remaining funds should be used to provide high-quality, accessible and continuous professional development to school teachers. The increase from the fiscal year 2001 level will allow the

Teacherline Program to link the digitized public broadcasting infrastructure beyond its current partnership with 29 local public television stations and LEAs to provide training services to institutions

of higher education for pre-service teacher training as well as inservice professional development for K–12 teachers.

Safe and drug-free schools and communities

The Committee remains extremely concerned about the frequent

and horrific occurrence of violence in our Nation’s schools. The

Committee recommends a total of $644,250,000 for activities to promote safe and drug-free schools and communities. This amount is

the same as the budget request and the fiscal year 2001 appropriation.

State grant program.—The Committee bill provides $444,250,000

for the safe and drug-free schools and communities State grant program. This amount is $5,000,000 more than the fiscal year 2001

appropriation and $103,362,000 less than the budget request.

National programs.—The Committee has included $150,000,000

for the national programs portion of the safe and drug-free schools

program. This amount is $5,000,000 less than the fiscal year 2001
265

appropriation and $53,362,000 more than the budget request. The

Committee intends that $117,000,000 of these funds, the same

amount as last year, be used for the Safe Schools/Healthy Students

program, which the Department funds in conjunction with the Departments of Justice and Health and Human Services. Safe

Schools/Healthy Students supports LEAs and communities in developing and implementing comprehensive programs that create

safe, disciplined, and drug-free learning environments and promote

healthy childhood development. Funds for national programs are

also used for a variety of other activities designed to improve the

field of drug and violence prevention.

The Committee is aware of the increasing problem of alcohol and

drug abuse on college campuses. Therefore, it has included

$850,000 to continue the National Recognition Awards program

under the same guidelines outlined by Section 120(f) of Public Law

105–244. This amount is the same as the fiscal year 2001 level.

This program identifies and provides models of alcohol and drug

abuse prevention and education programs in higher education. The

Committee encourages the Secretary to make fiscal year 2002

awards to institutions of higher education that did not receive an

award in the fiscal year 2001 competition.

Coordinator initiative

The Committee has included $50,000,000 for the coordinator initiative, the same amount as the fiscal year 2001 appropriation. The

administration requested no funds for this program. The Committee has provided resources for this program as part of its youth

violence prevention initiative. The Committee recommendation will

enable the Department to provide assistance to LEAs to recruit,

hire, and train drug prevention and school safety program coordinators in middle schools with significant drug and school safety

problems. These coordinators will be responsible for developing,

conducting and analyzing assessments of their school’s drug and

crime problems, and identifying promising research-based drug and

violence prevention strategies and programs to address these problems.

21st Century Community Learning Centers

The Committee recommends an appropriation of $1,000,000,000

for the 21st Century Community Learning Centers program. This

amount is $154,386,000 more than the budget request and the fiscal year 2001 appropriation.

The purpose of the program is to support public elementary and

secondary schools, especially low-performing schools, or consortia of

such schools, to implement or expand projects that benefit the educational, health, social service, cultural, and recreational needs of

the community.

The Committee has been alerted to the increasing demands made

by parents and school administrators for after-school programming

and encourages local innovation to remedy the multitude of social

problems that arise after school hours. The Committee encourages

the States to target funds to areas of high need that have lowachieving students and lack resources to establish after-school centers. The Committee notes that successful after-school programs
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often combine academic enrichment, through the use of supplementary educational materials and instruction, with other extracurricular activities.

The Committee has listed relevant projects of interest under the

Local Innovations for Education program in this year’s Committee

report.

State assessments

A key accountability measure in the Senate-passed version of the

ESEA reauthorization calls for annual State assessments in reading and mathematics for all students in grades 3–8. States will be

permitted to select and design their own new assessments, as long

as they are aligned with State standards and student achievement

results are comparable from year to year. Funds under this new

program would pay the Federal share of developing and implementing these new assessments. The Committee recommends

$320,000,000 for this purpose, the same amount as the budget request.

Inexpensive book distribution

For the inexpensive book distribution program, the Committee provides $25,000,000, which is $2,000,000 more than the fiscal year

2001 appropriation. The administration proposed consolidating this

program into the Choice and Innovation State Grants program.

The inexpensive book distribution program is operated by Reading Is Fundamental (RIF), a private nonprofit organization associated with the Smithsonian Institution. This program has been successful in motivating children to read, increasing the use of libraries, increasing parental involvement in schools, and contributing to

improved reading achievement.

Enhanced assessment instruments

The Committee recommends $32,000,000 for enhanced assessment instruments, a new program authorized by the Senate-passed

version of the ESEA reauthorization bill. The administration did

not request funds for this program.

Grants under this program will be awarded to States and LEAs

to help them collaborate with institutions of higher education,

other research institutions, and other organizations on ways to improve the quality and fairness of State assessment systems required under Title I of the ESEA. Grant recipients should strive to

design enhanced assessments that better measure higher-order

thinking skills, analytical abilities, and learning over time.

Magnet schools assistance

For the magnet schools assistance program, the Committee bill

provides $110,000,000, the same as the budget request and the fiscal year 2001 appropriation.

This program supports grants to local educational agencies to establish and operate magnet schools that are part of an approved

desegregation plan and are designed to attract substantial numbers

of students of different social, economic, ethnic, and racial backgrounds. Grantees may use funds for teacher salaries, purchase of

computers, and other educational materials and equipment.
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Within the amount provided, the Committee has included $5,000,000 for innovative programs, the same as the fiscal year

2001 appropriation.

Training and advisory services

For training and advisory services authorized by Title IV of the Civil Rights Act, the Committee recommends $7,334,000, the same

as the budget request and the fiscal year 2001 appropriation.

The funds provided will continue the 10 regional equity assistance centers (EACs) formerly known as regional desegregation assistance centers. 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. No funds are included for civil rights units in State education agencies.

Ellender fellowships

For Ellender fellowships, the Committee bill includes $1,500,000,

the same as the fiscal year 2001 appropriation. The administration

proposed consolidating this program into the Choice and Innovation State Grants program. The Ellender fellowship program makes

an award to the Close Up Foundation of Washington, D.C., to provide fellowships to students from low-income families and their

teachers to enable them to participate with other students and

teachers for 1 week of seminars on Government and meetings with

representatives of the three branches of the Federal Government.

Education for Native Hawaiians

For programs for the education of Native Hawaiians, the Com- mittee bill includes $33,000,000, which is $5,000,000 more than the

budget request and the fiscal year 2001 appropriation. When allocating these funds, the Committee urges the Department to provide

$7,500,000 for curricula development, teacher training, and recruitment programs, including native language revitalization. Priority

should be given to the University of Hawaii at Hilo Native Language College, aquaculture, prisoner education initiatives, waste

management, computer literacy, big island astronomy, and indigenous health programs. The Committee also recommends $2,600,000

for the community-based learning centers; $3,700,000 for the Hawaii higher education program; $1,500,000 for the gifted and talented programs; $2,200,000 for construction of schools with high

enrollments of Native Hawaiian children, pursuant to ESEA reauthorization language; $3,100,000 for the special education programs; $500,000 for the Native Hawaiian education councils; and

$11,900,000 for family-based education centers, including early

childhood education for Native Hawaiian children.

Child literacy initiative.—The Committee is concerned that Hawaiian students are significantly behind in quantitative literacy,

and it encourages teachers to promote teacher training in this area.

The Committee is aware that the Hawaii State Department of Education, the American Statistical Association, and the Kamehameha

school district have collaborated to design and implement workshops for teachers in quantitative literacy.
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Education for Native Hawaiians in agriculture and business.— The Committee supports the expansion of the partnerships between community-based agricultural businesses and cooperating

Hawaii high schools where agricultural and business practices are

integrated into the curriculum, resulting in hands-on agribusiness

training, exposure to entrepreneurship, and marketable products.

The Committee recommends full funding be made available by

grant or otherwise to the Hawaii Farm Bureau to carry out this

program.

Education for Native Hawaiians in community education.—The

Committee is aware of the Malama Hawaii initiative and the effort

to provide for community education programs that address issues

of education, health, justice, environment, culture, and the economy through experiential and outdoor education programs that involve children, youth, and families. These community-led outreach

projects foster community stewardship of geographic areas and natural resources employing cultural practices and protocols in programs that train formal and informal teachers to educate others

about critical issues facing the Hawaii community, and through interpretive programs that educate the public and increase appreciation and support for significant cultural and natural heritage sites.

The Committee recommends that full funding be made available in

fiscal year 2002 under the authority of the Native Hawaiian Education Act for the Malama Hawaii Community Education Initiative.

Native Hawaiian Agriculture Partnership.—The Committee is

aware of the dismal economic and social conditions in the rural

areas of Hawaii resulting from the closure of several sugar cane

plantations that formerly provided infrastructure for these communities. The Committee favors and continues to support the expansion of the partnerships between community-based agricultural

businesses and cooperating high schools, where agricultural and

business practices are integrated into the curriculum and products

that are ultimately purchased by the cooperating businesses.

Computer literacy and access for Hawaiian and part-Hawaiian

children.—The importance of literacy for success in school has been

clearly demonstrated. Disadvantaged Native Hawaiian and partHawaiian children struggle for opportunities. The Committee urges

that students interested in becoming elementary and high school

teachers be strongly encouraged to pursue these fields of study.

Indigenous health and traditional medicine education.—The Native Hawaiian Health Care Improvement Act provides authority for

inclusion of Native Hawaiian traditional healers in the comprehensive health care delivery system. There is similar recognition of traditional healing within the Indian Health Service health care delivery system. Because of a lack of available instruction in traditional

medicine, this knowledge is being lost for younger generations of

Native Americans and Native Hawaiians. The Committee is aware

of the benefits of educating health care practitioners in traditional

medicines and techniques in Native Indian and Native Hawaiian

communities.

Hawaii marine resource management.—The Committee notes

that the Hui Malama o Mo’omomi has been working to document

the traditional fishery management techniques used in the Hawaiian culture. These techniques have both scientific and cultural rel-
269

evance to the efficient management of Hawaii’s marine resources.

The Committee understands the value of a community-based outreach program to teach Hawaiian children these traditional marine

management practices and recognizes the expertise that Hui

Malama o Mo’omomi and their consortium partners have in this

area.

Hawaiian development of culturally appropriate curricula.—Because Hawaiian and part-Hawaiian children have fallen behind in

this area during the past decade, the Committee strongly recommends that the Department fund an initiative to develop culturally appropriate curricula and programs that would meet the

National Council of Teachers of Mathematics’ 2000 standards. Such

a curricula must successfully equip students with tools to present,

organize and interpret numerical information while reflecting the

traditional culture’s reliance on observation and practical use of

statistical processes. The Committee urges the Department to develop these materials with nonprofit, community organizations

such as the Pacific American Foundation and/or the foundation

Partners in Development.

Curricula workshops for teachers in Hawaii.—Hawaiian and

part-Hawaiian families suffer from elevated levels of health problems, alcoholism, drug use, and domestic violence. These form significant barriers to the successful education of Hawaiian and partHawaiian children. Public and private schools and their staffs are

not sufficiently prepared to identify, treat, or refer students and

their families to appropriate public or private agencies providing

help in these areas of need. The Committee urges the Department

to fund the development and implementation of curricula and

workshops for teachers and staff in culturally appropriate ways to

identify and refer students and their families in need of counseling

and assistance and to provide teachers and staff with information

and resources on the most current and effective referral agencies

available. The Committee urges the Department to use nonprofit,

community development agencies and organizations such as the

Pacific American Foundation and/or Partners in Development to

develop and implement such needed programs.

Curricula teaching environmental stewardship.—A strong understanding of environmental stewardship and the responsible use of

the environment are anchor values in the traditional Hawaiian culture. Environmental stewardship needs to be taught to all students, particularly Hawaiian and part-Hawaiian students. The

Committee urges the Department to fund the development and implementation of curricula teaching environmental stewardship

based on the traditional ecological knowledge (TEK) of the Hawaiian culture. Given the oral tradition of the Hawaiian culture, this

development program should include the identification, translation,

and analysis of appropriate traditional chants and stories related

to the management and responsible use of Hawaii’s resources and

the integration of these perspectives into an effective curriculum

that addresses Hawaii State Educational Standards in social and

natural sciences. The Committee recommends that nonprofit organizations with experience in these areas, such as the Pacific American Foundation and/or Partners in Development, be used to develop these curricula units.
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Native Hawaiian Mid-level Practitioners Training Program.—The

Committee urges the Department of Education to develop a focused

program to recruit, train, and place nurse practitioners, physician

assistants, clinical psychologists, and clinical pharmacists to work

in Hawaiian communities. The Committee also recommends that

nongovernmental agencies, such as health care providers, insurers,

and nonprofit foundations like Partners in Development, be integrated into the effort.

Adjudicated and High-Risk Native Hawaiian Youth Education

Program.—The Committee is concerned about the high proportion

of Native Hawaiian Youth on legal status with Family Court statewide and in Hawaii youth correctional facilities. Therefore, the

Committee recommends that the Adjudicated and High-Risk Native

Hawaiian Youth Education Program, which is intended to prevent

recidivism and strengthen Hawaiian families, should be considered

a priority to receive funding.

Postsecondary computer and technology training for Native Hawaiians.—The Committee recognizes the lack of computer and

technology skills possessed by the Native Hawaiian community and

its resultant impact on their employability. The Committee requests culturally sensitive educational centers be established to

provide training in career skills, technology readiness, technology

management, and advanced technology certification. The Committee recommends this program should be considered a priority to

receive funding.

Native Hawaiian Financial Literacy Program.—The Committee

is concerned of the inability of many Native Hawaiians to understand money management and financial planning. The Committee

recommends the development of culturally sensitive training on

money management, financial literacy, family budgeting, and debt

avoidance. The Committee recommends this program should be

considered a priority to receive funding.

Alaska Native educational equity

The Committee recommends $33,000,000 for the Alaska Native

educational equity assistance program. This amount is $18,000,000

more than the budget request and the fiscal year 2001 appropriation. The Committee recommends expanding this program to include cultural education programs operated by the Alaska Native

Heritage Center and continuing operation of the Rose program operated by the Alaska Humanities Forum to expose urban students

to Native culture in rural Alaska.

Funds from this program address the severe educational handicaps of Alaska Native schoolchildren. It has been brought to the

Committee’s attention that in urban areas, 60 percent of Alaska

Natives entering high school do not graduate, and that Alaska Natives’ test scores are on average 40 percent lower than those of

other students. In some districts, none of the Alaska Native elementary students and 40 percent of Native high school students

are performing at their grade level. The funds provided under the

Alaska Native education equity assistance program will help to address some of the barriers faced by Native Alaskan schoolchildren

and develop programs tailored to the unique needs of these children to improve performance levels.
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Charter Schools Homestead Fund

The Committee recommends $50,000,000 for the Charter Schools

Homestead Fund, a new program authorized in the Senate-passed

version of H.R. 1. This amount is $125,000,000 less than the budget request.

A major obstacle to the creation of charter schools in many communities is the limited availability of suitable academic facilities.

The Charter Schools Homestead Fund would build on and replace

the Charter School Facility Demonstration Grants program by providing grants to public and nonpublic entities to leverage funds to

help charter schools purchase, construct, renovate, or lease academic buildings or obtain donated buildings. The demonstration

grants program, currently funded through the school renovation

program, received $25,000,000 in fiscal year 2001.

Charter schools

The Committee recommends $200,000,000 for the support of

charter schools. This amount is the same as the budget request and

$10,000,000 more than the fiscal year 2001 appropriation.

This program provides funds to the Secretary to make awards to

State educational agencies, which, in turn, make subgrants to partnerships of developers and local education agencies or other public

entities that can authorize or approve a charter school. Grants are

limited to 3 years in duration, of which not more than 18 months

may be used for planning and program design, not more than 2

years for the initial implementation of a charter school, and not

more than 2 years to carry out dissemination activities.

Comprehensive regional assistance centers

The Committee has included bill language to provide $28,000,000

to continue the operation of the current comprehensive regional

technical assistance centers. This recommendation is the same as

the budget request and the fiscal year 2001 level. This program

supports 15 regional centers that provide support, training, and

technical assistance to Department of Education grantees.

Advanced Placement test fees

The Committee recommends $22,000,000 for the Advanced Placement test fees program. This amount is the same as the budget request and the fiscal year 2001 appropriation. This program awards

grants to States to enable them to cover part or all of the cost of

Advanced Placement test fees of low-income individuals who are

enrolled in an Advanced Placement class and plan to take an Advanced Placement test. The Committee is aware of the benefits of

Internet-based AP pilot programs in rural parts of the country or

other underserved districts where students would otherwise not

have access to AP instruction, and it encourages the Department

to consider proposals that meet the needs of students in these

areas of the country.

Parental assistance

The Committee recommends $45,000,000 for parental assistance

services. This amount is $7,000,000 more than the fiscal year 2001

appropriation. The administration proposed eliminating this pro-
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gram by consolidating it into the teacher quality State grants program. This title authorizes a variety of activities designed to improve parenting skills and strengthen the partnership between parents and professionals in meeting the education needs of their children ages 5 and under.

Sociological and scientific studies show that the first 3 years of

a child’s cognitive development set the foundation for life-long

learning and can determine an individual’s emotional capabilities.

Parents, having the primary and strongest influence on their child,

play a pivotal role at this stage of development. Scientists have

found that parental relationships affect their child’s brain in many

ways. Research further indicates that a secure connection with the

parent will better equip a child to handle stressful events throughout life.

The Committee strongly urges the Department of Education to

stipulate that at least 50 percent of each grant award shall be used

for Parents as Teachers Programs.

Small, Safe and Successful High Schools

The Committee recommends an appropriation of $100,000,000 for

the Small, Safe and Successful High Schools program. This amount

is $25,000,000 less than the fiscal year 2001 appropriation. The administration recommended eliminating this program by consolidating it into its proposed Choice and Innovation State Grants program.

These funds shall be used for activities related to the redesign

of large high schools enrolling 1,000 or more students.

Local Innovations for Education

The Committee recommends an appropriation of $300,000,000 for

the Local Innovations for Education (LIFE) program, a new program authorized by the Senate-passed version of H.R. 1 that consolidates eight existing activities or programs, including five in the

Fund for the Improvement of Education. This amount is

$124,099,000 less than comparable activities and programs in the

fiscal year 2001 appropriation. The administration proposed eliminating most of these programs through consolidations.

LIFE provides the Secretary with broad authority to support nationally significant programs and projects to improve the quality of

education, help all students meet high academic standards, and

contribute to the achievement of the national education goals.

Within the amount recommended, the Committee includes

$35,000,000 for the Elementary School Counseling Demonstration

Program to establish or expand counseling programs in elementary

schools, and $10,000,000 to make awards under part H of Title I

of the Senate-passed version of H.R. 1 for a dropout prevention

demonstration project. These levels are each $5,000,000 higher

than the fiscal year 2001 appropriations.

The Committee also includes $100,000,000 for a demonstration

program focusing on the instruction of American history in elementary and secondary education. This amount is $50,000,000 more

than the fiscal year 2001 level. Under this program, the Secretary

of Education will award grants to local educational agencies, and,

in turn, the LEAs will make awards to schools that are teaching
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American history as a separate subject within a school curriculum,

not as a part of a social studies course. 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 LIFE appropriation also includes $59,318,000 for the Star

Schools program. This amount is the same as the fiscal year 2001

appropriation. The Star Schools program is designed to improve instruction in math, science, foreign languages, and other subjects

such as vocational education, to underserved populations by means

of telecommunications technologies. The program supports eligible

telecommunications partnerships to develop and acquire telecommunications facilities and equipment, instructional programming, teacher training programs and technical assistance. The

Committee recognizes the efforts of the Star Schools program to

provide educational resources for traditionally underserved populations, including disadvantaged, illiterate, and limited-Englishproficient persons, and individuals with disabilities through the use

of distance learning technologies. The Committee recommends $10,000,000 for a new program to

provide educational, cultural, apprenticeship, and exchange programs for Alaska Natives, Native Hawaiians and their historical

whaling and trading partners in Massachusetts. This is a new program authorized by the Senate-passed version of the ESEA reauthorization bill; it was not requested by the administration.

Funds will be used to develop and implement 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, and to develop

internship and apprenticeship programs to assist these groups prepare for professional careers in cultural institutions and related

fields. The Committee expects that funds will be equally divided by

the Department among the Alaska Native Heritage Center, the

Inupiat Heritage Center in Barrow, AK, the Bishop Museum in Hawaii, the Peabody-Essex Museum in Salem, MA, and the New Bedford Whaling Museum/New Bedford Historical Site in MA.

The Committee also includes $30,000,000 for the arts in education program. This amount is the same as the fiscal year 2001

appropriation. It includes $6,650,000 for a grant to VSA arts, which

supports the development of programs to integrate the arts into the

lives of children and adults with disabilities, and $5,600,000 for a

grant to the John F. Kennedy Center for the Performing Arts,

which supports a variety of activities throughout the Nation. Funds

provided in this account also support youth violence prevention activities and model professional development activities to support

the increasing demand for arts and music teachers.

The Committee is supportive of the upcoming Very Special Arts

International Festival. Held every 5 years in locations throughout

the world, the June 2004 festival will take place in Washington,

D.C. Approximately 2,000 children and adults with disabilities will

participate in this 5-day exploration and celebration of the role of

the arts in learning at home, in the workplace and in the community. The Committee recommends $1,650,000 for this purpose.
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The Committee is aware that recent data and empirical evidence

indicate that specific instruction in music, art, and dance improves

the success of K–12 students. The Committee supports grants, authorized under this program, to eligible recipients for: the development and implementation of curriculum frameworks for arts education; the development of model pre-service and in-service professional development programs for arts educators and other instructional staff; specific instruction in music, art, theater, and dance;

the development of model arts education assessments based on

high standards; and supporting model projects and programs to integrate arts education into the regular elementary and secondary

school curriculum.

The LIFE appropriation also includes $3,000,000 for the women’s

educational equity program. This amount is the same as the fiscal

year 2001 appropriation. The program supports projects that assist

in the local implementation of gender equity policies and practices.

The Committee also recommends $25,000,000 for character education grants to States and LEAs. The administration requested

the same amount as part of its proposed Reform and Innovation

Fund. The money may be used for developing character education

curricula, implementing model character education programs that

involve parents and community members, and training teachers to

incorporate character-building lessons and activities into the classroom.

The LIFE appropriation includes sufficient funds for the Reach

Out and Read program, which promotes literacy by providing children’s books to pediatricians and arranging for trained volunteers

to read to children while they wait for their appointments in doctors’ waiting rooms.

The appropriation also includes sufficient funds for Project

GRAD, a school-community program designed to improve the instructional quality and school environment of at-risk children. The

core program focuses on improving student achievement in math,

reading and language arts. Another component of the program addresses student behavior and discipline problems. Students participating in Project GRAD have a 24 percent increase in graduation

rates, an 18 percent increase in their reading skills, a 34 percent

increase in their math scores and a 25 percent increase in college

enrollment. Project GRAD is currently operating in Houston; Los

Angeles; Atlanta; Columbus, Ohio; Nashville; Newark, N.J.; Cincinnati; Knoxville, Tenn.; and Laredo and Brownsville, Texas.

Projects will soon be operating in Philadelphia and three other

Ohio communities.

The Committee notes that there is considerable evidence that

lack of appropriate nutrition, and in particular deficiencies in basic

vitamins and minerals, can reduce students’ academic performance.

The Committee is aware of a pilot project by the Healthy Foundation to distribute a daily multi-vitamin to impoverished school children. The Committee commends this program and urges the Department to fund an expansion of this promising initiative and to

rigorously evaluate its impact on school performance.

The Committee is aware of the following projects and encourages

the Department to give them full and fair consideration:
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The University of Montana, working with law enforcement, education, and community organizations, will develop a statewide community-based curriculum that promotes responsible behavior and

prevents violence in schools and communities.

Montana State University-Bozeman will coordinate an Educational Technology Leadership Institute that will train school administrators in rural areas how to encourage their teachers and

students to use technology effectively.

The Montana TREK Center at Flathead Valley Community College will provide rural educators with professional and educational

growth opportunities through access to technology and training.

The Indiana Academy for Science, Mathematics and Humanities

develops distance education programs to bring enhanced science

education into classrooms across the Nation.

The ProEquity Advancement Placement teacher training project

will increase the availability of AP coursework, expand the number

of schools participating in the AP program, and train teachers at

urban and rural schools serving disadvantaged students in five

States.

The Riverside School for the Arts in California trains students

for performing and technical careers in the entertainment industry

while providing a strong liberal arts and sciences education.

Columbia Teachers College plans to expand its successful teacher

training pilot program to Mississippi, Pennsylvania, New York, and

Dallas, Texas. This program has been proven effective at increasing

teacher retention.

The Wheeling Jesuit University NASA Center for Educational

Technologies will provide technology training to all elementary and

secondary West Virginia mathematics and science teachers.

Steps to Success, an ongoing initiative which plans on attracting

significant non-Federal funding, plans to expand its efforts to provide parents of children from birth to 3 years of age with the information and support necessary for their development.

The Missoula Family YMCA in Missoula, Montana is developing

the ‘‘Give Me Five’’ after school program.

The After School Recreation Program works in cooperation with

Pasadena Unified School District in California to provide a recreation program for elementary-school-age children.

The San Francisco Unified School District Child Development/

Pre-School Program provides early childcare and educational services for young children. It promotes cognitive development and ensures that children are ready and eager to learn.

The Fresno Unified School District in California will expand the

Keep Kids in School program, which the district runs in collaboration with the Fresno County District Attorney’s Office, the Fresno

County Superior Court and the Fresno County Interagency.

California State University, San Bernardino will create a Math/

Science Demonstration Center that will house a wide variety of

university and collaborative school district programs revolving

around an advanced math/science lab school.

The County of San Bernardino, Calif., will expand a program

that provides family-centered case management and special schoolbased, grade-appropriate education for the children of homeless

families.
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Fresno Pacific University in California will expand its math and

science program to more effectively deliver quality math and

science education to teachers, and to encourage more underrepresented students to teach those subjects.

California State University San Marcos runs the Barahona Center for the Study of Books in Spanish for Children and Adolescents,

which collects, catalogues and reviews the world’s only complete

collection of Spanish-language books published since 1989 for children and adolescents.

The Los Angeles Center Theatre Group will develop a national

model K–12 curriculum for the integration of the dramatic arts into

general reading and language arts skills.

The American Film Institute will establish a Screen Education

Center within the Los Angeles Unified School District that will develop curricular modules for teachers and students.

THINK Together provides after-school tutoring and homework

assistance for low-income and low-achieving students in Orange

County, Calif.

The city of Twentynine Palms in California will expand its education and after-school care program, which serves many low-income families and helps ensure that students are academically

ready to enter kindergarten.

The California Department of Education’s Technology Information Center for Administrative Leadership (TICAL) Project, administered through the Santa Cruz County Office of Education, is a

Web site where school administrators can access resources on using

technology to improve teaching, learning, and school management.

Audubon After School plans to expand its two existing afterschool programs, and add a third program, for at-risk students in

kindergarten through 8th grade in New Orleans.

The University of New Orleans’ Millennium School Project will

establish a charter school district and redesign teacher education

to support school restructuring.

Nicholls State University’s Center for the Study of Dyslexia will

train faculty, reading specialists and families to identify the reading disabilities of children and adults in the Southern Gulf Coast

region of Louisiana.

Southeastern Louisiana University’s Alternate Teacher Certification Program offers all its professional education courses via the

Internet.

Prevent Child Abuse Louisiana and the Task Force on Child Sexual Abuse plan to train 10,500 teachers in the greater New Orleans

area on how to recognize and report child abuse cases among their

students.

Southern University plans to study the use and effectiveness of

an interactive Web-based learning program.

Prime Time Family Reading Time, a family literacy program,

plans to expand into 20 States.

The city of Shreveport’s Sci-Port Discovery Center plans to develop space science educational programs.

Louisiana Tech University’s CATALYST program will be a regional center for math and science education serving rural populations in Louisiana, Arkansas, Texas, and Mississippi.
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Southern University will conduct research on the influence of nutrition and access to health care on elementary school student performance.

Virtual school classroom demonstration programs have been proposed for the Washington State Office of Public Instruction, New

Mexico, the Iowa Department of Education, and the U.S. Secretary

of Education.

The Olympic National Institute Hands-on Environmental Education Access Project in Washington State seeks to improve student

competencies in science and math through hands-on educational

training.

The Pacific Science Center in Seattle is developing a hands-on

genetic exhibit to explain basic concepts of genetics and the Human

Genome Project to children.

The Washington Department of Public Instruction is designing a

project to use the Web to link together schools, districts, and the

Office of Public Instruction to provide an accessible central database for student information.

The Pacific Northwest Aquarium in Seattle will develop exhibits

designed to educate students about marine ecosystems.

The NASA Educator Resource Center at Southeast Missouri

State University will make available to K–12 schools, teachers, and

students throughout Missouri a wide array of educational materials

related to science and math.

Finance CIRCLE is a new demonstration initiative that will set

up financial-aid systems to help families send their children to

early learning and after-school programs in five sites: greater Kansas City, Mo.; Seattle/King County; greater Minneapolis; the lakes

region of New Hampshire; and Fairfax County, Va.

The Georgia Project, a nonprofit consortium of business and community leaders in Dalton, continues to support the academic and

social needs of Hispanic children and their families in northern

Georgia.

The Great Cities’ Universities coalition plans to expand its

Urban Educator Corps Partnership Initiative, which seeks to meet

the urgent demand for classroom teachers in the Nation’s urban

schools.

The Ellijay Wildlife Rehabilitation Sanctuary seeks to expand its

ecological science education programs to make them available to

more students in Georgia.

The city of Macon, Ga., plans to develop and implement a character-building education program.

Spelman College’s Teacher as Leader Educational Initiative

seeks to provide early intervention and academic support for atrisk, disadvantaged children and their families.

The Challenger Learning Center at SciTrek in Atlanta will use

a simulated mission control station and space laboratory to create

a dynamic learning environment for students in the areas of

science and technology.

The Institute for Student Achievement in New York plans to expand its programs, which are designed to support school districts’

strategies for helping students overcome academic and social challenges adversely affecting performance.
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The Long Island Works Coalition is consolidating and building

upon school-to-career partnerships educating students in Long Island.

Life and Industry for Education (LIFE) provides vocational and

computer training, family workshops, after-school and weekend initiatives for at-risk youth, and English language instruction in New

York. LIFE’s proposed Recreational, Educational, and Counseling

Center would centralize the group’s efforts in Hewlett, N.Y.

The ExplorNet Technology Learning Project provides technology

education and workforce development programs to K–12 students

and helps schools and communities implement their technology

plans.

The Center for Math, Science, and Teaching Excellence at New

Jersey Institute of Technology will develop and deploy technology

to provide interactive learning experiences for teachers who want

to improve their math, science, and technology skills.

RUNet 2000 at Rutgers University will continue to expand its innovative voice-video-data communications system to bring the resources of the university to more K–12 teachers and students

throughout the State.

Babyland Family Services, Inc. will launch the Newark Project,

a technology initiative that will provide minority inner-city children and families with access to educational institutions and other

community resources.

The New York University Child Study Center will expand the

ParentCorps project into urban New Jersey areas and evaluate its

impact. ParentCorps trains parents to improve parenting skills and

promote the academic, social, and emotional readiness of their children.

Project REACH will provide before-school, after-school, and summer programming for K–12 students at six schools in Mitchell, S.D.

Marty Indian School in South Dakota will provide students with

after-school and summer educational opportunities.

The East Dakota Educational Cooperative in Sioux Falls, S.D.,

will provide before-and after-school programs, as well as summer

activities, in eleven communities.

The HOPE Consortium, which consists of seven schools in South

Dakota, will address educational, health, social services, cultural,

and recreational needs of students and their communities through

school-based learning centers.

Crazy Horse School in Wanblee, S.D., plans to provide afterschool and summer programs on the Pine Ridge Indian Reservation.

The Brookings School District in South Dakota will provide students with after-school and summer educational opportunities in a

wide variety of subjects and interest areas.

The Huron School District in South Dakota, in conjunction with

the local YWCA and Career Learning Center, will expand its afterschool programming.

The Howard and Carthage School Districts in Miner County,

S.D., will expand an after-school program to make it available to

more students and begin a summer program.
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The Consortium Community Education Project will provide outof-school activities to students in the Redfield, Lower Brule, and

Beresford School Districts in South Dakota.

The Foundation for School Safety runs a Safe and Disaster-Resistant Schools Initiative to help school facilities address disaster

risks through the help of disaster-mitigation professionals.

The Digital Dakota Network wires South Dakota classrooms to

the Internet, trains teachers and administrators on how to use

technology in schools, and facilitates distance education.

The Dial Corporation will develop, implement, and evaluate

three K–12 courses in biology, health sciences, and earth sciences,

to be delivered over South Dakota’s distance learning network.

Kids Voting USA is a nonprofit, nonpartisan, grassroots organization that works with schools and communities to enhance civics

education and encourage voter participation.

The Bushnell Center for the Performing Arts in Hartford, Conn.,

will expand its Partners in Arts and Education Revitalizing Schools

Program, which strengthens language arts instruction and multicultural understanding for students.

Amistad America, Inc., a foundation that built and operates a

full-size, working replica of the slave ship Amistad, will coordinate

with local schools to provide students free admission, tours, and

history lessons on the schooner when it visits various ports in the

United States.

Minot State University in North Dakota is developing an Institute for Rural Human Services to study and develop systems designed to meet the unique needs of persons with disabilities living

in rural communities, with a special emphasis on working with

hearing-impaired children.

Millikin University in Decatur, Ill., runs an initiative to assist

inner-city and rural high school students in preparing for college.

The Chicago Public Schools plan to expand tutoring and mentoring programs.

Columbia College—Chicago will establish a mentoring program

designed to improve minority student educational success and retention.

The Virginia Frank Child Development Center in Chicago will

provide youth scholarships to support inner-city children.

Southern Illinois University will undertake a teacher preparation

and placement initiative.

The Northwest Community Center in Rockford, Ill., will develop

technology-based educational outreach programs.

The Illinois Institute of Technology’s Digital Media Center will

use digital technology to help elementary and high school students

and their teachers improve learning in math and science.

Chicago State University’s Urban Campus/Community Technology Initiative is designed to support teacher training and expand teachers’ technology skills.

College Summit is a national program that assists low-income

students prepare for and enroll in college. College Summit Chicago

is the hub of the program.

The Teen Reach Community Youth Program in Illinois is a comprehensive initiative to teach Temporary Assistance for Needy
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Families populations and at-risk youth practical skills while encouraging tutoring and mentoring.

The North Carolina Electronics and Information Technologies Association will help bridge the digital divide in the State’s rural and

under-served school districts through a school technology demonstration program.

Fresno At-Risk Youth Services in California will attack the problem of at-risk youths by coordinating the city’s efforts through an

education program coordinator, working with targeted groups, and

making peer counselors available to students.

The Foundation for the Improvement of Mathematics and Education seeks to improve math and science testing scores through

the advancement of curriculum and improvement in teacher/administrator education.

Yosemite National Institutes will develop more outreach programs targeted on Native American and minority communities,

support training programs for educators from disadvantaged areas,

and purchase advanced technology.

The Los Angeles Unified School District will provide a pilot prekindergarten program to 1,000 students.

The California Institute for the Arts teaches college-level arts

programs for high school-age students with the goal of providing

young people with job skills needed for the arts and entertainment

industry.

The Florida Department of Education is continuing its Comprehensive Plan for Teacher Recruitment and Retention (formerly

known as ‘‘SchoolNet’’).

The YMCAs of Sarasota, St. Petersburg, and Clearwater, Fla.,

will launch additional YMCA Character Development Schools, also

known as ‘‘Second Chance Schools.’’ The schools, conducted in cooperation with local school districts, are designed to address behavior problems.

The Technology Research and Development Authority of Florida

will continue implementation of a program for math, science and

technology teacher education for grades 9 through 12.

One-to-one ‘‘e-learning’’ pilot programs are planned at one school

in each of these four States: South Carolina, Montana, Massachusetts, and Washington. The programs will provide students with

their own wireless laptop computer, teacher and administrator

training, and progress reports on student achievement.

The South Carolina Association of School Administrators continues to develop a clearinghouse to facilitate the distribution and

implementation of the methodology and pedagogy used by Blue

Ribbon Schools.

Clemson University has developed the Call Me Mister collaborative effort with Morris College, Benedict College, and Claflin College to recruit, train, certify, and secure employment for 200 minority male teachers in public schools.

The University of South Carolina continues to develop the Partners for Literacy model to promote the literacy growth of children

from birth through age 8.

Everybody Wins! is a mentoring program that promotes children’s literacy and love of learning through shared reading experiences with caring adults.
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YMCA centers in Texas will continue and expand their youth assistance and teen intervention programs, in conjunction with the

YMCA of the USA.

The Houston Independent School District will expand and improve the computer and telecommunications technology of its

schools through its Technology Infrastructure Plan.

The Early Childhood Development Center at Texas A&M, Corpus

Christi, serves as a childhood development center for at-risk children, a professional development center for area public school

teachers, and a clinical research facility in the study of childhood

development.

The Novice and Student Teacher Support Project of West Texas

A&M University and Texas A&M University, College Station, will

continue its efforts to recruit and retain more qualified teachers to

America’s public schools.

The National Association of Partners in Education establishes

mentoring programs for students across the country and encourages business-education partnerships.

Building Trust in Representative Democracy, a joint effort of the

National Conference of State Legislatures, the Center for Civic

Education, and the Center on Congress at Indiana University, will

work to improve public understanding and trust in our Nation’s

democratic institutions through multimedia classroom materials.

The Reading Evaluation and Assessment Demonstration (READ)

project, supported by the Today Foundation of Dallas, Texas, uses

educational software to help students learn to read.

Help One Student to Succeed (HOSTS) programs encourage volunteers to provide effective one-on-one academic mentoring to students in districts across the Nation, including Texas.

The Institute for Engineering at Southern Methodist University

brings together engineering and science professors with high school

educators, in conjunction with private industry, to increase the interest and quality of math and science programs in Dallas-area

high schools.

The National Center for School Improvement, formed by a consortium of universities and led by Southwest Texas State University, sends teams of educators into struggling schools to help turn

them around.

Sam Houston State University will continue its efforts to establish a technical assistance learning center to facilitate the development of after-school programs for at-risk youth.

The California School of Professional Psychology, in cooperation

with school districts in the San Diego, Los Angeles, San Francisco

and Fresno metropolitan areas, plans to develop and implement

model teacher training programs regarding using technology in the

classroom, violence prevention, and brain functioning.

The Pacific Islands Center for Educational Development develops

and implements training and educational programs aimed at assisting Samoan and other Pacific Islander students who aspire college education.

The Vermont Higher Education Consortium will support universal, early learning programs through the development, coordination and delivery of academic and experiential training programs

for early childhood educators.
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Watertown Public Schools in South Dakota will integrate technology in the classroom by expanding Macintosh iBook Wireless

Labs and computers to five elementary schools.

Jobs for Youth uses technology to provide basic literacy and jobskill training to youths and adults.

WGBH, the Nation’s largest producer of public television programming, will develop the earth sciences portion of a Web site

called TeachersDomain.org, an Internet portal that will benefit

teachers and children nationwide.

The Milwaukee Teacher Education Center will expand programs

to recruit, prepare and retain a diverse, effective, innovative teaching force for the Milwaukee Public Schools.

The University of Wisconsin—Extension’s School Readiness

Project will provide training and technical assistance to its partners in preparing children for learning in school.

St. Norbert College in DePere, Wis., runs a field-based teacher

training program that partners with K–12 area schools to better

prepare teachers to address obstacles in the classroom.

The Green Bay Area Public Schools will establish a project-oriented model for technology integration by introducing teachers and

students to effective and appropriate use of untethered (wireless,

battery-powered) network-connected computers.

The YMCA of Metropolitan Milwaukee is expanding its Teen

Agenda to serve at-risk teenage youth.

The Grand Valley State University Teacher Academy in Michigan will train a cadre of master teachers who will develop a curriculum and mentor pre-service and novice science and math teachers.

The University of Arkansas Little Rock will offer high school students a Web-based math course with the goal of reducing the number of entering freshmen who need math remediation.

The Early Childhood Compact between Arkansas, Louisiana,

Mississippi, and Alabama is a plan to develop and implement a

high-quality, early childhood educational pilot program for at-risk

4-year-olds that will form the basis of a comprehensive, cohesive,

universally accessible preschool education program.

The Yell County schools in Arkansas will expand their bilingual

programs to address the needs of a growing Hispanic population.

The Maryland Institute for Minority Achievement and Urban

Education, which is run by the University of Maryland’s College of

Education in partnership with the Maryland Department of Education, will serve State school districts by enhancing urban education and closing the minority achievement gap.

The Boys & Girls Clubs of Greater Washington is one of the region’s largest service organizations helping at-risk youths develop

the skills necessary for their growth into adulthood.

The Northeast and Islands Regional Educational Laboratory at

Brown University has created a Web site called Knowledge Loom

that provides enrichment resources for educators.

The Professional Partnership Laboratory School at Roger Williams University in Bristol, R.I., will provide an innovative learning environment for approximately 500 K–12 students in the Bristol Warren Regional School District.
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The Institute for International Sport, a nonprofit group located

on the campus of the University of Rhode Island, plans to expand

the reach of its Center for Sports Parenting. The center addresses

the difficult questions related to sportsmanship between young athletes and their parents, coaches, and teachers.

The Charter School Development Foundation will operate a charter school that is intended to improve the dropout rate in Las

Vegas schools by offering academic programs designed to enhance

students’ character, self-esteem, and career possibilities.

The Humboldt County School District in Winnemuca, Nev., will

operate an English as a Second Language program for each of its

schools.

Project STARS will provide literacy interventions for Nevada students in grades 3 to 5.

Pahranagat Valley Elementary School, Hawthorne Elementary

and Junior High School, and Schurz Elementary School in Nevada

will provide each of their students with a laptop computer.

The Baltimore City Public School system is continuing its efforts

to provide each of its classrooms with the technology needed to

bridge the digital divide.

The Kennedy Krieger Institute’s Career and Technology High

School in Baltimore provides a school-to-work transition for youths

with serious learning, emotional, neurological, and development

disabilities and adolescents who have suffered traumatic brain injury.

The University of Maryland College Park and Morgan State University will create a Center for Minority Achievement and Urban

Education Research.

The Baltimore Symphony Orchestra’s Distance Learning at

Home and Abroad initiative will extend the reach of BSO’s programming to students in Maryland public schools and to students

across the Nation via the Internet.

New York City’s Museum of Modern Art will use a distance

learning program to maintain education-outreach opportunities

while the museum embarks on a major expansion and renovation

project.

The 24 Challenge/Jumping Levels Math Program supplements

basic math curriculum in grades 1–8.

Bloomsburg University in Pennsylvania is providing computers,

computer wiring, and training for teachers in 25 surrounding

school districts.

The Boys and Girls Clubs of Philadelphia are developing a

school-based mentoring program.

Cabrini College in Pennsylvania is developing a new Center for

Science, Education, and Technology that will provide a model elementary education classroom to facilitate and enhance the educational experience of Cabrini undergraduate students majoring in

education.

CAPE/PETE Net is continuing to develop its national demonstration program for distance learning with 105 Pennsylvania universities and colleges.

Cheyney University in Pennsylvania is creating a pilot Collaborative Center for Teacher Preparation program by partnering with

area school districts.
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The city of Philadelphia is continuing to modernize its community recreational centers with new computer terminals and other

technological improvements. The City is also developing an antitruancy initiative and establishing after-school programs for its

students.

The College of Physicians of Philadelphia is expanding its educational outreach to all students in the Philadelphia School District

through a medical science museum-based experimental learning

program.

Communities in Schools of Lehigh Valley is developing in-school

and after-school programs for at-risk middle school and high school

students.

Drug-Free Pennsylvania is implementing a demonstration project

in which it would partner with local school districts and media outlets in an effort to provide at-risk students with an opportunity to

develop and produce public service announcements targeting drug

use prevention.

The Eisenhower Foundation is replicating a full community

school program that emphasizes the school as the central point of

the community.

Freedom Theatre, the Nation’s largest African-American theater

and performing arts training program, trains over 900 youth annually by promoting artistic and personal development. It plans to

provide greater access to its training programs for talented youth.

HUBS is providing tools for teacher training tools and classroom

management, including school-to-home communication.

Indiana University of Pennsylvania is establishing a K–12 computer services center for area school districts.

Jazz in the Schools is continuing to expand its program to engage

inner city high school students in a hands-on program that uses

jazz as a means to maintain student interest in academic subjects

in the core curriculum.

MICROSOCIETY has developed and will continue to disseminate

a comprehensive school reform model.

The National Foundation for Teaching Entrepreneurship plans to

expand to Philadelphia. The program partners with high schools

and community-based organizations to teach topics such as sales,

marketing, venture capital, and business ethics classes.

The Opera Company of Philadelphia is developing the Sounds of

Learning, which uses opera as the base for integrating all aspects

of a child’s formal education. The program targets low-income

households living in urban school districts.

The Pennsylvania Ballet is developing the Accent on Dance program for elementary and secondary school students for in-school

and after-school programs.

The Philadelphia Orchestra is expanding its five educational programs to reach a broader and more diverse audience.

The Philadelphia Zoo is seeking to develop and create programs

and interpretive media for the Avian Conservation Center.

Pittsburgh Technology Council is providing computer training to

teachers in school districts in a 13-county area.

Project 2000 is planning to expand its existing academic support

and mentoring programs for inner-city African-American youth to

an adjoining housing project.
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SEPCHE is developing a ‘‘global curriculum’’ to challenge students to develop their knowledge of foreign languages and cultures,

and recognize relationships between history and current issues.

Tesoro High School in California is developing a Knowledge Center which will be a customized facility consisting of a technology

lab, seminar lab, communications center, and library.

Washington and Jefferson College is conducting quality education initiatives and professional development in the southwest region of Pennsylvania. A key focus of the program is to integrate

technology into teacher preparation and performance.

Walnut Street Theatre’s Educational Outreach Program for K–12

schools in the Philadelphia area includes an apprenticeship program, an adopt-a-school program, and a summer camp.

Widener University in Pennsylvania is seeking to provide computer networking management services to 12 area school districts

and other educational entities.

The Pittsburgh YWCA is continuing to expand its after-school activities.

Big Brothers/Big Sisters is hoping to double the number of children served in school-based mentoring.

The Detroit Science Center will develop and implement an educational series of new Urban Intervention Science Programs that

will correlate with Michigan Educational Assessment Program

measures. Students will be introduced to careers in science, technology, and engineering.

The Detroit Public Schools will provide professional development

for its site-based management teams.

The Principals Academy in Detroit will serve as the primary entity for ensuring that the school system’s principals are trained to

run high-quality schools.

The Detroit Public Schools will create an alternative teacher certification program to attract working professionals who want to

teach but are not currently certified.

The Michigan Association of School Administrators (Region I)

will expand its telecommunications infrastructure in the upper peninsula to allow schools to communicate with individuals more effectively.

The Eastern Upper Peninsula Intermediate School District in

Michigan will offer services and activities for youths and adults

during after-school hours and, during the summer, all day.

The Eastern Upper Peninsula Intermediate School District in

Michigan will provide cost-effective curriculum and student enrichment programs to 12 communities through distance learning.

The Flint Area Chamber of Commerce in Michigan will establish

an ‘‘e-mentoring’’ program designed to create a partnership between employers and students, with the goal of improving academic performance and workforce readiness.

The YWCA of Anchorage offers after-school and enrichment programs to at-risk schoolchildren and their mothers that stress building self-esteem and strong value systems.

The United Way of Anchorage supports a number of high-quality

after-school programs designed to help students stay out of trouble

and do well in school.
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Alaska’s Right Start program provides extended-day programs

for kindergarten-age schoolchildren who are behind expected developmental levels and makes use of academic program coordinators.

The Alaska Initiative for Community Engagement (Alaska ICE)

program uses community resources to help schoolchildren increase

academic performance and involve them in their own communities.

Alyeska Central School in Alaska plans to use online distance

education to help students in small, rural schools prepare for the

State’s high school graduation qualifying examination.

The Qualified Teachers for Alaska program recruits and prepares

teachers to work in the State.

The Alaska Department of Education runs an intense remedial

summer reading program for high school students that is designed

to help them graduate on time and with their classmates.

Big Brothers Big Sisters agencies in Alaska plan to extend their

after-school mentoring programs across the State to include rural

and remote villages and communities.

The Anchorage School District will develop a Summer Reading

Lab to increase reading comprehension skills for Anchorage area

high school students.

The Sheldon Jackson College Center for Life Long Learning

trains teachers, especially Alaska Natives, to teach in remote Alaskan villages.

Alaska Geographic Alliance plans to work with Library of Congress to incorporate its Meeting of the Frontiers project into the

Alaska school history and geography curriculum.

The Galena School District and several partners are assisting

Alaska Native students who attend boarding schools and colleges

make the transition from rural village life to educational residence

facilities.

The University of Alaska Anchorage’s LitSite project will help

bridge the rural/urban literacy gap in Alaska, especially for schoolchildren in grades K–12.

The Anchorage Community Theater School is initiating an afterschool performing arts program for Anchorage-area schoolchildren

in grades K–12.

The Rowan Center for the Advancement of Learning at Rowan

University in New Jersey has developed a process called Let Me

Learn that enables students to understand what types of learners

they are so they can learn more effectively. The center plans to implement its programs in eight sites throughout the State.

Schools Plus is a safe, neighborhood-based, after-school program

designed to provide academic assistance and one-on-one mentoring

for students.

The Northwest Regional Education Laboratory in Portland, Ore.,

is training senior citizens to serve as reading tutors in K–12 school

settings in Oregon, Alaska and Washington.

Oregon State University’s Lifelong Learning Alliance will use

distance learning to create a new statewide system for providing a

variety of education-related services, including professional development for teachers and school counselors.

The Schools Uniting Neighborhoods (SUN) program in Portland,

Ore., is creating and supporting school/neighborhood partnerships
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in an effort to increase student achievement and family involvement with children.

Portland State University in Oregon is establishing the Portland

Metropolitan Partnership for School Leadership, a program that

will recruit, prepare, and offer professional development for school

leaders in the region’s secondary schools.

Self-Enhancement, Inc. in Portland, Ore., provides after-school

services for at-risk students.

The Native American Performing Arts Project will add a 3-day

performing arts workshop to the Konaway Nika Tillicum, Southern

Oregon University’s summer youth academic camp for middle

school students. It will also create a Native American Theater production that would travel the State.

The Multnomah Outdoor School project in Oregon is a residential

program that allows students to experience hands-on science learning over an extended weekend.

Friends of the Children, a national nonprofit group based in

Portland, Ore., provides adult mentors to children who are most in

danger of school failure, abuse, gang and drug involvement, and

other serious problems.

The Integrated Performance Benchmarking System, tested by

Oregon and Nebraska the past 2 years, is a proposed initiative to

eliminate cumbersome paperwork currently required by the Department by allowing States to electronically store, share, and even

compare State education data.

Several school districts in Utah plan to conduct a demonstration

project in which they would administer their annual assessments

using computers.

Under the Utah Reading Excellence Act, school districts in the

State are working to improve literacy among their students, especially those in grades K–3.

The University of Montana’s Safe Schools Project is facilitating

a statewide community-based curriculum development initiative

that promotes responsible youth behavior.

Fisher’s Peak YMCA in Trinidad, Colo., has established a teen

center and is sustaining a conflict resolution center.

The YMCA of Metropolitan Denver is developing a teen initiative

program targeting at-risk African-American and Hispanic teens at

the East Denver Family YMCA.

The Pikes Peak YMCA is expanding the Youth Connection Program in Colorado Springs, which connects at-risk teens with business leaders to learn job skills and model other healthy behavior.

The Pueblo YMCA in Colorado is developing teen programs and

a new teen center that will focus on leadership development, outdoor adventure skills and intramural sports programs.

Longmont YMCA is trying to double the number of teens served

in Longmont and the St. Vrain Valley in Colorado. Additional

funds will allow the programs to mentor youths, provide employment and training skills, and offer community service activities,

reading skills, fitness activities, and summer camping.

The Boulder Valley YMCA in LaFayette, Colo., is expanding its

After School and Active Peer (ASAP) program, which works in conjunction with local universities to provide mentoring and tutoring

to high school students.
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The Pathway Partners rural education program, developed in the

mountains of Maine, plans to expand to more rural communities.

The Lewiston-Auburn College/University of Southern Maine

TEAMS Program is preparing future and current teachers to meet

the demands of Maine’s 21st century elementary and middle

schools.

The University of Maine Foreign Language Education Initiative

aims to increase the competitiveness of the U.S. workforce in the

global economy by enhancing foreign language education.

I–SAFE America, an Internet-safety education foundation, plans

to expand a current pilot project in Utah to encompass school districts and police departments nationwide.

The University of Nebraska at Omaha’s P–12 Urban Education

Program plans to implement an innovative program to improve

mathematics and science education in urban public schools. This

project will be a collaborative effort between the College of Education at UNO, Omaha Public Schools, and other partners.

The University of Nebraska at Kearney is working with pre-service and in-service teachers to assist them in dealing with an increasingly diverse student population.

Stillman College, in conjunction with Zelpha Wells Cultural Education Center, is providing music education and music instruction

to minority and disadvantaged youth.

The Pendleton, Pilot Rock, and Athena-Weston school districts in

Oregon have partnered with the Confederated Tribes of the

Umatilla Indian Reservation (CTUIR) to establish a formal cooperative dropout-prevention program.

Fayette County High School in Tennessee is continuing its efforts

to support technology enhancements and improve after-school programs.

Classika Theatre of Arlington, Va., plans to expand its successful

ARTsmarts and SS VETA (Social Studies: Virginia Education

Through Arts) programs, which are intended to improve students’

overall academic performance, enhance reading and comprehension

skills, and strengthen concentration and memorization ability.

Junior Achievement of Delaware Valley educates students about

free enterprise, business, and economics through its Exchange City

program.

The Regional Performing Arts Center in Philadelphia will include a state-of-the-art concert hall, a recital theater, and an arts

education center that will offer distance learning programs, with

instant access for schools in the region.

The Tupelo Public School District plans to expand its

C*R*E*A*T*E* for Mississippi project, which joins teachers in several districts into a network to model successful, replicable technology application and use in classrooms.

The Electronic Learning Marketplace uses technology in support

of educators’ efforts to improve the learning of all Maine students

toward the rigorous standards defined by the Maine Learning Results.

The Maine Center for Educational Services’ Discover ME Web

site will create an on-line resource center that will allow students

and teachers to access curriculum materials, participate in panel
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discussions with experts, share resources, and build an online community.

The Schools and Technology for Assessment and Reflection

(STAR) project in Maine uses telecommunications technology with

the goal of significantly increasing the number of students who

demonstrate proficiency on State mathematics, science, reading

and writing educational standards.

The University of Alabama plans to upgrade its science lecture

halls to incorporate state-of-the-art, multimedia rooms, instant response devices, and distance learning technology to provide instruction to K–12 classes.

Spring Hill College in Mobile, Ala., is developing technology enhancements and technology training of their teachers for distance

learning.

Three Rivers Connect of Allegheny County, Pennsylvania, plans

to acquire and upgrade nearly 3,000 Federal surplus computers to

be used by Pittsburgh Public Schools to provide an Internet-based

learning curriculum.

Educational Service District 117 in Wenatchee, Wash., will equip

a community technology center to expand technology-based training.

KCTS, a PBS affiliate in Seattle, will develop a database of primary-source research materials.

The Washington Association of Career and Technical Education

will update its training technology to ensure that it meets industry

standards.

The Community Education and Lifelong Learning Center at

Satsop Development Park in Washington State will equip its classrooms and conference facilities.

The Temple University Center for Research in Human Development and Education is developing innovative models to address

teacher recruitment, training, and mentoring that will enhance student achievement and raise the capabilities of low-performing

schools.

Lock Haven University and the Keystone Central School District

in Pennsylvania will collaborate to form a model alternative school

that will provide educational opportunities for students who are not

able to succeed in the conventional classroom.

The First Freedom Center in Richmond, Va., will prepare and design educational exhibits to show the history of religious freedom

and its role in U.S. democracy.

Great Films Project Co., Inc. of New York produces documentary

films to provide objective assessments of the impact of Federal education programs on the education of our Nation’s youth.

The Pennsylvania Department of Education’s Division of Migrant

Education, in a consortium with the Migrant Education Division of

Arkansas, Colorado, Texas, Florida, Illinois, Montana and Kansas,

will create an educational technology system geared toward improving K–8 migrant student achievement in reading, language

proficiency and mathematics.

The New Mexico Department of Education will continue to expand use of the Individual Services Model to help reduce the dropout rate for high school students in the State.
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The New Mexico Department of Education is developing a ‘‘virtual school’’ technology plan that would ensure that all students,

regardless of circumstance or geographic location, have equal opportunity to develop a strong academic foundation, by creating dynamic, student-centered learning environment delivered via the

World Wide Web, two-way interactive video conferencing, and satellite downlink technologies in collaboration with the State’s major

education partners.

The Children and Family Development Education Center in Albuquerque, N.M., will expand access to comprehensive, communitybased continuum of services to preschoolers and their families, including comprehensive child and family development services.

The Mid-Rio Grande Collaborative for Educational in Albuquerque is developing innovative strategies for working with atrisk students, aligning curriculum and standards, and improving

literacy, math and science studies.

Albuquerque Public Schools will continue to develop an innovative schoolwide program at one of its high schools. The program

will focus on the teaching and learning of mathematics, science and

technologies, and serve as a resource for all of New Mexico’s school

districts through research, teacher training, and distance learning.

The Integrated TechCenter program in Roswell, N.M., is an innovative program designed to provide secondary students with technology skills that will prepare them for employment.

St. Joseph’s Indian School in South Dakota plans to expand and

improve education outcomes of at-risk Native American youth by

providing services that help reduce the high school drop-out rate,

improve academic standing, and provide rehabilitative counseling.

The Alameda County Social Services Agency in California will

support an education and training program for high school students.

The California School of Professional Psychology runs an initiative to help ensure that elementary and secondary school students

have adequate access to counseling and mental health services in

their schools.

The Enterprise Center, in West Philadelphia, will expand its revitalization program in distressed urban neighborhoods to educate

its residents with entrepreneurial skills, resources, and opportunities.

The Louisiana State University Health Science Center will establish the National Center for Special Education Accountability and

Monitoring, which will be devoted to improving education for children with disabilities.

School boards in Orleans Parish and Jefferson Parish, La., will

implement a universal literacy system at competitively selected

schools.

The District Attorney’s Office in Orleans Parish, La., will run a

school-based, drug-awareness education and prevention program.

The North Carolina Electronics and Information Technologies Association will improve workforce development in underserved areas

to increase technology tools, including teacher training, hardware,

software, connectivity.

The Holy Redeemer Health System in Philadelphia will expand

and enhance afterschool programs for at-risk youth.
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The Department of Education of the Commonwealth of Pennsylvania will provide assistance to low-performing school districts that

are deemed distressed and slated for potential takeover by the

Commonwealth as prescribed by Pennsylvania law. The initiative

is intended to improve the management and operations of the

school districts; assist with curriculum development; provide afterschool, summer and weekend programs; offer teacher and principal

professional development; and promote the acquisition and effective

use of instructional technology and equipment.

Do Something America instills self-confidence and leadership

skills in K–12 students by encouraging them to participate in community projects.

American Theater Arts for Youth, Inc. is developing an Arts in

Education Program.

The Children’s Literacy Initiative is planning to supplement

Head Start’s distance learning programs and provide a teacher

education program.

Friends of the Children is providing full-time, paid adult mentors

to at-risk children in Chester, Pennsylvania.

Music Education and Technology Advancement (MENC) is planning to establish a standard music education and creativity instructional technology and professional development program for

approximately 4,000 K–12 public schools.

Lincoln University plans to purchase laboratory and computer

equipment to provide a 6-week summer workshop for Philadelphia

teachers, and also to conduct a 1-day annual workshop for approximately 200 high school students to expose them to scientific disciplines.

Champions of Caring programs encourage young people to take

an active role in their communities.

A consortium of nine school districts in Washington State will establish interconnectivity in rural schools to expand learning opportunities.

The YMCA of Greater Seattle will expand teen activities offering

academic support and leadership development.

First Book will expand to serve an additional 80 communities nationwide.

The Odyssey Maritime Discovery Center in Seattle will develop

educational programs.

The I Can Learn program assists teachers in algebra instruction.

The Correction Education Association, in partnership with the

Pennsylvania Department of Education, Juvenile Corrections Education, and Lock Haven University, will design and develop curricula and student assessments.

Delta State University will run an initiative to address to address teacher recruitment and retention, technology development,

and administrator training in the Mississippi Delta.

The Madison County, Mississippi, school district will conduct an

impact study of the sudden influx of new students in the district.

Protecting You, Protecting Me is an educational curriculum for

grades 1–5 developed by Mother’s Against Drunk Driving.

Futures for Children of Albuquerque will expands its educational

services to American Indian children to prepare them for high

school.
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New Mexico public broadcasters are implementing a digital

translator project to deliver educational programming to two demonstration sites in rural New Mexico.

The Spring Arbor University-based consortium of higher education institutions is using high voluntary standards in technology

integration to improve teacher preparation and classroom practice.

Reading Together USA is a demonstration program working to

improve reading comprehension and fluency among second grade

children.

The Clark County (Nevada) School-to-Work Program provides

students who do not plan to attend college with instruction in nursing and home health aid.

The Lynn Meadows Discovery Center for Arts Education in Gulfport, Mississippi will continue and enhance its Shooting Stars program for students ages 12–17.

The University of Southern Mississippi Frances Karnes Gifted

Center will continue its summer programs and make participation

available to an increased number of students.

The Mississippi Humanities Council will provide programs in

local libraries to support Prime Time Family Reading Time.

The Fort Lewis College Child Development Center is designed to

serve young children, their families, students, faculty and community members in Southwest Colorado and the Four Corners Region.

A Rural Distance Learning Coalition comprising three States—

Montana, Alaska, and Hawaii—will address the issues and challenges surrounding distance learning opportunities for rural and

remote populations.

The Committee is aware of the need for an up-to-date comprehensive management information system for the Alaska Department of Education and Early Development’s early childhood activities, including all of the programs it administers and central eligibility and payment components to reduce duplication and provide

better access to needed services.

The Committee is concerned that Alaska Native students in high

schools and middle schools in Anchorage have achievement scores

well below those of their non-Native counterparts and that the

dropout rate for Alaska Native students is more than twice that of

non-Native students. The Committee encourages the Department

to consider the ‘‘Partners for Success’’ program of the Cook Inlet

Tribal Council, Inc. and the Anchorage School District to provide

additional resources to increase graduation rates and achievement

scores of Alaska Native schoolchildren in the Anchorage area.

The Committee encourages the Department to continue its support of the Galena School District’s innovative distance education

program, which benefits thousands of children across Alaska, especially in remote areas, by allowing students access to more courses

and subject-qualified teachers.

The Committee encourages the Department to continue its support of the Partnerships 2000 project of the National Association of

Partners in Education, and to consider a study by the organization

of the effectiveness of business/community/school partnerships on

student performance and to explore additional strategies to expand

these partnerships at the State and local levels.
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The Committee encourages the Department to consider a proposal from Alaska Digital Video to document important segments

of Alaska’s history from 18,000 B.C. to the present to help Alaskan

schoolchildren learn the history of an important part of their State.

The Committee is concerned that students and teachers in rural,

remote communities of Alaska do not have access to coursework,

teaching materials and teacher training in science and mathematics, and it encourages the Department to consider a proposal

from the Imaginarium in Anchorage to develop new courses in

math and science for students and teachers in rural communities

in Alaska using distance delivery.

The Committee is concerned that in the first round of Alaska’s

High School Qualifying Exam, more than two-thirds of students

failed the math portion and over half of students failed the writing

portion. The Committee urges the Department to work with the

University of Alaska and the Alaska Department of Education and

Early Development to establish the Alaska Center for Excellence in

Schools at the University of Alaska to assist Alaska’s low-performing schools meet requirements of new State educational standards.

The Committee is aware of the Tanana School District’s need for

technology to help its students bridge the digital divide in this remote rural Alaskan community.

Mentoring

The Committee recommends $5,000,000 for mentoring programs.

This is a new program authorized by the Senate-passed version of

the ESEA reauthorization bill; it was not requested by the administration.

Funds will be used to promote mentoring programs for children

who lack strong, positive adult role models or who are at risk of

educational failure or involvement in criminal or delinquent activities. Such programs must seek to help these children receive support and guidance from a caring adult, improve their academic performance, and avoid involvement with gangs. The Department may

award grants through this program to LEAs; nonprofit, communitybased groups; or partnerships between the two.

Community service for expelled or suspended students

The Committee recommends $50,000,000 for a new program to

encourage community service by students who have been expelled

or suspended from school. This program was authorized by the

Senate-passed version of H.R. 1; it was not requested by the administration.

The program will provide grants to States to help make it possible for students who have been expelled or suspended from school

to participate in a community service activity during the period of

expulsion or suspension. While the Committee recognizes that most

LEAs require expelled or suspended students to attend an alternative school during the period of expulsion or suspension, the

hours for such schools often differ from those of regular schools.

The Committee also recognizes that primary caretakers in many

households work outside of their homes, giving students the opportunity to engage in inappropriate behavior during non-school hours.
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This program is intended to demonstrate to students who are apathetic about their expulsion or suspension that there are repercussions to their bad behavior, as well as give them the opportunity

to give back to their community in a positive way.

Public school choice

The Committee recommends $50,000,000 for public school choice,

a new program authorized by the Senate-passed version of the

ESEA reauthorization bill. This program was not requested by the

administration.

Funds will be used to assist school districts implement public

school choice programs that permit disadvantaged students to

transfer from a failing public school to a high-performing public

school. School districts may use funds for a variety of purposes associated with implementing a public school choice program including: informing parents and students about the choice program, covering the costs of transportation, and capacity-enhancing activities

that enable high-demand schools to accommodate transfer requests.

Grants will be made on a competitive basis to local educational

agencies to plan and implement programs of intradistrict-wide or

interdistrict-wide public school choice. In awarding the grants, the

Secretary is directed to give the highest priority to school districts

with low-performing schools.

Youth Alcohol Abuse Prevention Initiative

The Committee recommends $25,000,000 for the Youth Alcohol

Abuse Prevention Initiative, a new program authorized by the Senate-passed version of H.R. 1; it was not requested by the administration.

This program authorizes competitive grants to LEAs to implement proven strategies for reducing underage drinking in secondary schools. The Committee directs the Department and the

Substance Abuse and Mental Health Services Administration

(SAMHSA) to work together on this effort. According to SAMHSA,

by the time students are high school seniors, more than 80 percent

have used alcohol and 64 percent have gotten drunk. When adolescents move on to college, they bring their drinking habits with

them. Members of the Committee are deeply concerned about the

prevalence of underage drinking, and this program addresses the

need for this issue to be an educational priority.

The Committee directs that $20,000,000 should be used to provide the grants and $5,000,000 should be used by SAMHSA to provide alcohol abuse resources to assist in implementing the anti-alcohol programs.

Rural education

The Committee recommends $125,000,000 for rural education

programs. The funding should be equally divided between the

Small Rural Schools Achievement Program and the Low-Income

and Rural Schools Program. The administration did not request

funding for these new programs, which were authorized by the

Senate-passed version of H.R. 1.

The Small Rural School Achievement Program permits rural

school districts to combine certain Federal education funds and
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apply them toward local initiatives, such as professional development to improve student achievement. The Low-Income and Rural

Schools Program is designed to meet the needs of school districts

serving large numbers of economically disadvantaged students.

Participating local education agencies are eligible to receive supplemental grant funds that will enable the rural schools to offer activities of sufficient size, scope, and quality to have a significant impact on student achievement.

Physical Education for Progress

The Committee recommends $50,000,000 for the Physical Education for Progress program, which received $5,000,000 in fiscal

year 2001 as part of the Fund for the Improvement of Education.

The administration did not request any funding for this program.

Under this program, the Secretary is authorized to award grants

to, and enter into contracts with, LEAs to pay the Federal share

of the costs of initiating, expanding and improving physical education programs in grades K–12 by: (1) providing equipment and

support to enable students to actively participate in physical education activities; and (2) providing funds for staff and teacher training and education. Each LEA desiring a grant or contract shall

submit to the Secretary an application outlining its plan to initiate,

expand or improve its physical education program. The Secretary

shall ensure that grants and contracts that are awarded shall be

equitably distributed between LEAs serving urban and rural areas,

and areas with both large and small student enrollments. Not more

than 5 percent of any grant or contract may be used for administrative costs.

Improving Literacy Through School Libraries

Recognizing the strong, research-based connection between wellequipped and well-staffed school libraries and the literacy skills of

students, the Committee recommends $25,000,000 for the Improving Literacy Through School Libraries program, which was authorized in the Senate-passed version of H.R. 1. This is a new program

that was not requested by the administration.

Improving Literacy Through School Libraries will provide 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 new Reading First

initiative. States and local educational agencies will receive funds

on the basis of their proportion of Title I allocations. Funds should

be targeted by LEAs to high-poverty schools and schools with the

greatest need for school library improvement. Funds may be used

to acquire up-to-date 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 non-school hours.

INDIAN EDUCATION

Appropriations, 2001 ............................................................................. $115,500,000

Budget estimate, 2002 ........................................................................... 116,000,000

Committee recommendation ................................................................. 117,000,000
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The Committee recommends $117,000,000 for Indian education

programs. This amount is $1,500,000 more than the fiscal year

2001 appropriation and $1,000,000 more than the budget request.

Grants to local education agencies

For grants to local education agencies, the Committee rec- ommends $94,265,000, which is $1,500,000 more than the budget

request and the fiscal year 2001 appropriation. These funds provide

financial support to reform elementary and secondary school programs that serve Indian students, including preschool children.

Funds are awarded on a formula basis to local educational agencies

and schools supported and operated by the Bureau of Indian Affairs.

Special programs for Indian children

The Committee recommends $20,000,000 for special programs for

Indian children, the same as the budget request and the fiscal year

2001 appropriation. Funds will be used for demonstration grants to

improve Indian student achievement through early childhood and

preschool education programs, and professional development grants

for training Indians who are preparing to begin careers in teaching

and school administration.

National activities

The Committee recommends $2,735,000 for national activities,

the same as the fiscal year 2001 appropriation and $500,000 less

than the budget request. Funds are used for research, evaluation,

and data collection to provide information on the educational status

for the Indian population and on the effectiveness of Indian education programs.

BILINGUAL AND IMMIGRANT EDUCATION

Appropriations, 2001 ............................................................................. $460,000,000

Budget estimate, 2002 ........................................................................... 460,000,000

Committee recommendation ................................................................. 516,000,000

The Committee recommends an appropriation of $516,000,000 for

bilingual and immigrant education, $56,000,000 more than the

budget request and the fiscal year 2001 appropriation. The bilingual programs authorized by the Senate-passed version of H.R. 1

are designed to increase the capacity of States and school districts

to provide special instruction to limited-English-proficient students.

Bilingual and immigrant education State grants

The Committee recommends $500,000,000 for bilingual and immigrant education State grants, a new program that consolidates

the three bilingual activities with the immigrant education program. This amount is $40,000,000 more than the budget request.

The program is intended to help States address the needs of limited-English-proficient and immigrant students statewide, instead

of dealing with these problems on a piecemeal basis.

Foreign language assistance

The Committee recommends $16,000,000, which is $2,000,000

more than the fiscal year 2001 appropriation, for competitive for-
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eign language assistance grants. The administration proposed consolidating this program into the State block grant program.

The Committee notes the lack of Federal incentives to provide

adequate instruction in second language acquisition to elementary

and secondary students. Recent research shows that the optimum

human learning time for all languages is between birth and age 10.

The Committee is especially concerned that the nation’s educational system is not meeting a critical need for speakers of foreign languages to fill sensitive Federal agency jobs, and is not preparing enough students to face an internationally competitive business environment. Further, the Committee is distressed that the

only Federal program designed to help schools meet this need is

unavailable to the poorest schools. The Committee encourages the

Secretary to use his ability to waive the matching requirement for

qualifying schools and to increase awareness of this accommodation

among the affected school population.

SPECIAL EDUCATION

Appropriations, 2001 ............................................................................. $7,439,948,000

Budget estimate, 2002 ........................................................................... 8,425,595,000

Committee recommendation ................................................................. 8,439,643,000

The Committee is aware that the Senate-passed version of the

ESEA reauthorization bill would fully fund the Federal Government’s share of special education costs within 7 years. If Senate

and House conferees agree to that measure, special education

grants to States will become a mandatory spending program.

In the meantime, the Committee recommends a program level of $8,439,643,000 for special education. This amount is $999,695,000

more than the fiscal year 2001 appropriation and $14,048,000 more

than the budget request. It includes $5,072,000,000 in fiscal year

2003 advanced funding.

These programs, which are authorized by the Individuals with

Disabilities Education Act (IDEA), provide assistance to ensure

that all children with disabilities have access to a free, appropriate

public education, and that all infants and toddlers with disabilities

have access to early intervention services. This assistance is provided through State grants that offset a portion of the costs incurred by States and local educational agencies in educating children with disabilities and in developing and implementing statewide systems of early intervention services, and through six programs that provide a streamlined structure to help States improve

educational and early intervention results for children with disabilities.

The Committee is aware of the greater difficulties faced by special needs students and their parents in remote rural communities

in Alaska, and it urges the Department to continue and expand its

work with Alaska’s PARENTS, Inc., which trains teachers, specialists and parents in the use of technology to assist students with

disabilities. PARENTS, Inc. also plans to create a matching, mentoring and home-visit system to support rural Alaskan parents of

children with disabilities, and to partner with community faithbased organizations to develop a mentoring program for youth with

disabilities at risk for entering the juvenile justice system in Alaska.
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The Committee recognizes the unique and progressive work of

the University of Southern Mississippi’s Center for Literacy and

Assessment. For over 30 years, this center has served as the

South’s only comprehensive resource for reading disabled students.

Reading difficulty is the most prevalent disability and recent research by the National Institute of Health suggests that it is treatable, and most important, preventable in a large portion of the population. The Committee is impressed with the Center’s progress

and responsiveness in meeting the expectations set out in fiscal

year 2000 and fiscal year 2001. It is especially encouraged that the

Center is using the recommendations of the National Reading

Panel in its research dissemination, teacher and parent training,

development of replicable models for reading assessment and intervention.

The Committee also urges the Department to provide funds required to support operations for the 2002 Paralympic Games in

Salt Lake City.

Grants to States

The Committee bill provides $7,339,685,000, including $5,072,000,000 in fiscal year 2003 advanced funding, for special

education grants to States. The amount recommended is

$1,000,000,000 more than the fiscal year 2001 appropriation and

the same as the budget request. This program supports formula

grants to States to finance a portion of the cost of providing special

education and related services for children with disabilities.

The Committee’s recommended funding level represents approximately 17 percent of the estimated average per-pupil expenditure

and 14 percent of excess costs, and would provide an estimated

Federal share of $1,133 per child for the 6.5 million children expected to receive special education services.

Preschool grants

The Committee recommends $390,000,000 for preschool grants,

the same as the fiscal year 2001 appropriation and the budget request. The preschool grants program provides formula grants to

States based on the amount of funding received in fiscal year 1997,

the number of preschool children aged 3 through 5, and the number of preschool children aged 3 through 5 living in poverty.

The amount provided by the Committee is approximately $637

per child for the 612,700 preschoolers expected to receive special

education and related services in the next school year.

States may retain an amount equal to 25 percent of their 1997

allocation, cumulatively adjusted upward by the lesser of inflation

or the percentage increase in the State’s allocation, of which 20

percent may be used for administration. These funds may be used

for direct and support services for 3- through 5-year-olds; at a

State’s discretion, to serve 2-year-olds with disabilities who will

turn age 3 during the school year; and for other purposes. The remaining funds must be distributed to local educational agencies.

Grants for infants and families

The Committee bill provides $383,567,000 for grants for the infants and families program under part C of the IDEA. This is the
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same amount as the fiscal year 2001 appropriation and the budget

request. This program provides formula grants to States 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.

State improvement

For State improvement grants, the bill provides $49,200,000, the

same as the fiscal year 2001 appropriation and the budget request.

This program provides competitive grants to State educational

agencies to assist them, in partnership with parents, teachers, institutions of higher education, interest groups, and others, to improve results for children with disabilities by reforming and improving their educational systems.

Research and innovation

The Committee has included $70,000,000, the same as the budg- et request, for research and innovation. This amount is $7,353,000

less than the fiscal year 2001 appropriation. This program supports

competitive awards to produce and advance the use of knowledge

to improve services and results for children with disabilities.

The Committee urges the Secretary to emphasize research that

contributes to the development and evaluation of empirically based

practices designed to address the needs of children in special education, and enhance our knowledge of best practices, as well as research on programs that provide early intervention for children and

youth with behavioral disorders at risk of requiring more intensive

special education services.

The Committee is aware of the following project and encourages

the Department to give it full and fair consideration:

Oregon State University will research and pilot a program to expand the scope of special education training to include cultural influences on special needs, and to address the shortage of special

education teachers with a bilingual background.

Technical assistance and dissemination

The Committee bill provides $53,481,000, the same as the fiscal

year 2001 level and the budget request. These funds provide technical assistance and information through competitive awards that

support institutes, regional resource centers, clearinghouses, and

efforts to build State and local capacity to make systemic changes

and improve results for children with disabilities.

Personnel preparation

The Committee recommends $90,000,000 for the personnel preparation program. This amount is $8,048,000 more than the fiscal

year 2001 appropriation and the budget request. Funds support

competitive awards to help address State-identified needs for qualified personnel to work with children with disabilities, and to ensure that these personnel have the skills and knowledge they need

to serve these children.

The appropriation includes funds to provide preparation for personnel to serve children with high-incidence disabilities, including
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grants for graduate support, to ensure a proper balance among all

authorized grant categories.

The Committee has increased funds for personnel preparation in

response to the alarming shortage of special education personnel,

including special education teachers and faculty. The increase

should help institutions of higher learning address this shortage so

that students with disabilities will be appropriately served.

Parent information centers

The Committee bill provides $26,000,000 for parent information

centers, the same as the fiscal year 2001 appropriation and the

budget request. This program makes awards to parent organizations to support parent training and information centers, including

community parent resource centers. These centers provide training

and information to meet the needs of parents of children with disabilities living in the areas served by the centers, particularly underserved parents, and parents of children who may be inappropriately identified.

Technology and media services

The Committee recommends $36,210,000 for technology and media services, $1,000,000 less than the fiscal year 2001 appropriation and $4,500,000 more than the budget request. 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 $9,500,000 for Recording for the Blind and Dyslexic, Inc. This is the same amount as the

fiscal year 2001 level and $3,500,000 more than the budget request.

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 Committee notes that video description is important for the

full inclusion of blind and visually impaired children in the education process, and it directs the Department to fund this service

at a level of $2,500,000, an increase of $1,000,000 over the budget

request and the fiscal year 2001 appropriation.

Readline

The Committee recommends $1,500,000 for the Readline Program. The amount recommended is the same as the fiscal year

2001 appropriation for this activity. The administration proposed

eliminating 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 Readline 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
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media resources to reach the parents and teachers of children with

reading disabilities.

REHABILITATION SERVICES AND DISABILITY RESEARCH

Appropriations, 2001 ............................................................................. $2,805,339,000

Budget estimate, 2002 ........................................................................... 2,930,117,000

Committee recommendation ................................................................. 2,932,617,000

The Committee recommends $2,932,617,000 for rehabilitation

services and disability research, $127,278,000 more than the 2001

appropriation and $2,500,000 more than the administration request.

Vocational rehabilitation State grants

The Committee provides $2,481,383,000 for vocational rehabilita- tion grants to States, which is $81,593,000 more than the fiscal

year 2001 appropriation and the same as the budget request.

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 legislation requires States to give priority to persons with 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 2002

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.

The Committee strongly supports individual States’ efforts to

provide vocational services to the disabled and recognizes that the

Vocational Rehabilitation program has helped put millions of people back to work. The Committee is aware that the cost of critical

care and counseling services is rising, while per capita income and

population in most States is increasing at a slower rate. The Committee notes that the authorizing statute determines the annual increase in this mandatory appropriation, and also specifies the allotment for each State. The Committee recognizes that if formula allocations for each State increased by the annual cost of living, States

would be better prepared to ensure that services continue to be

successfully rendered.

Client assistance

The Committee bill recommends $12,147,000 for the client assistance program, $500,000 more than the fiscal year 2001 appropriation and the administration request.

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 minimum grants of
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$100,000 are guaranteed to each of the 50 States, the District of

Columbia, and Puerto Rico, and $45,000 is guaranteed to each of

the outlying areas, if the appropriation exceeds $7,500,000. States

must operate client assistance programs in order to receive vocational rehabilitation State grant funds.

Training

The Committee provides $39,629,000 for training rehabilitation

personnel, the same as the 2001 appropriation and the administration request.

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 $16,492,000 for demonstration and

training programs for persons with disabilities, $4,600,000 less

than the fiscal year 2001 appropriation and the same as the administration request. 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. Demonstration programs

support projects for individuals with a wide array of disabilities.

The Committee is aware of the following projects and encourages

the Department to give them full and fair consideration:

The University of New Orleans will provide support services to

meet the needs of entrepreneurs with disabilities through its Training Research and Assistive Technology Center.

Minot State University has initiated a program designed to meet

the unique needs of persons with disabilities living in remote rural

communities through the use of telecommunications technology and

ongoing training for families and professionals.

The Virtual Reality-Based Education and Training for Deaf and

Hearing Impaired Children and Adults Project at Orange County

(FL) Public Schools allows hearing-impaired children and adults to

gain life experience skills through the use of virtual reality and

military simulation technology. The project will also provide a medium for adults to acquire job skills and support teacher training

and professional development.

The member institutions of the Consortium for Orthotic and

Prosthetic Education and Research will develop programs designed

to improve the quality of applied orthotic and prosthetic research

and help meet the increasing demand for provider services.

The National Literacy Center for the Visually Impaired in Atlanta, Georgia is well suited to address the growing need to up-
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grade and keep current the skills of the cadre of teachers across

the country that teach blind or visually impaired children and

adults.

The Hot Springs Rehabilitation Center continues to help individuals with disabilities gain the vocational skills they need to lead

productive and independent lives.

The Seattle Lighthouse for the Blind will offer support-service

providers to deaf-blind citizens, improve outreach and enhance support programs for eligible individuals.

Migrant and seasonal farmworkers

The Committee recommends $2,350,000 for migrant and seasonal

farmworkers, the same as the fiscal year 2001 appropriation and

the budget request.

This program provide 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 $2,596,000 for recreational programs,

the same amount as the fiscal year 2001 appropriation and the administration request.

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 $14,000,000 for protection and advocacy of individual rights, the same as the 2001 appropriation and

the budget request.

This program provides grants to agencies to protect and advocate

for the legal and human rights of persons with disabilities.

The Committee understands that the issue of program income is

treated differently among protection and advocacy systems established under various Federal laws. The Committee recommends

that RSA review its policies on program income and develop a policy that is consistent with the other Federal agencies that administer P&A programs.

Projects with industry

The Committee bill includes $22,071,000 for projects with industry, the same as the 2001 appropriation and the administration request.
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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 makes 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 $38,152,000 for the supported employment State grant program, the same as the 2001 appropriation

and the budget request.

This program assists persons who may have been considered too

severely disabled to benefit from vocational rehabilitation services

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 $22,296,000 for independent living

State grants, which is the same as the amount appropriated in

2001 and the budget request.

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

For independent living centers, the Committee bill includes $60,000,000, an increase of $2,000,000 over the 2001 appropriation

and the budget request.

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 $20,000,000 for independent living services to older blind individuals, the same as the 2001 appropriation

and the administration request.

States participating in the program must match every $9 of Federal funds with not less than $1 in non-Federal resources. 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 low-vision devices community
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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. The Committee

is informed that the yearly savings to society for just 10 percent

of the clients now receiving independent living services is

$56,000,000. The Committee believes this program is deserving of

future increases.

Program improvement activities

For program improvement activities, the Committee provides

$900,000, a decrease of $1,000,000 from the 2001 appropriation and

the same as the budget request. In fiscal year 2002, 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 ongoing program improvement activities and to support ongoing dissemination and performance

measurement activities.

Evaluation

The Committee recommends $1,000,000 for evaluation activities,

$587,000 less than the 2001 appropriation and the same amount

as the administration request.

These funds support evaluations of the impact and effectiveness

of programs authorized by the Rehabilitation Act. 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 bill includes $8,717,000 for the Helen Keller National Center for Deaf-Blind Youth and Adults, the same as the

2001 appropriation and the budget request.

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 47 agencies. At the recommended level, the

center would serve approximately 102 persons with deaf-blindness

at its headquarters facility and provide field services to approximately 1,950 individuals and families.

National Institute on Disability and Rehabilitation Research

The Committee recommends $110,000,000 for the National Institute on Disability and Rehabilitation Research [NIDRR],

$9,600,000 more than the amount appropriated in 2001 and the

same as the budget request.
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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 urges the NIDRR to focus on activities to enhance access to assistive technology for people with disabilities, including technology-based activities, such as technology transfer.

The Committee strongly encourages NIDDR to give priority in

awarding grants for the establishment of new rehabilitation and research engineering centers which will aid in the implementation of

the Executive Order to implement the Supreme Court Decision in

L.C. vs. Olmstead. The Committee recommendation supports increased funding for

the Interagency Committee on Disability Research (ICDR) and

notes that the primary purpose of the ICDR is to promote cooperation across various government agencies in the development and

execution of disability and rehabilitation and research activities.

The Committee strongly encourages the ICDR to enter into cooperative agreements with other ICDR members to identify federally

funded technological and scientific research that could be applied

to promote the independence of people with disabilities and the elderly. The same Federal agencies shall work in partnership with

the private sector to develop a plan to bring the applied technologies to the private marketplace. The Committee also encourages ICDR to expand its website/database for the coordination of

research by various agencies.

The Committee strongly urges NIDRR to use resource appropriated for the Assistive Technology Development Fund to develop

new assistive technology, bring technology that has already been

developed to market and expand the availability of existing assistive technology to people with disabilities. The Committee believes

that priority for grants should be given to the development of technology that has a limited number of users, or orphan technology.

In addition, a portion of these funds should be used to further the

development of assistive technology for children and students and

reach the goals of projects that were previously funded through the

small business innovation research activity of OSER’s technology

and media services program.

Assistive technology

The Committee bill provides $60,884,000 for assistive technology,

an increase of $19,772,000 over the fiscal year 2001 appropriation

and the same as the budget request.

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. It provides grants to States to de-
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velop comprehensive, consumer-responsive statewide programs that

increase access to, and the availability of, assistive technology devices and services. The National Institute on Disability and Rehabilitation Research administers the program. The Committee recommendation includes $34,000,000 for activities authorized under title I of the Assistive Technology Act (AT

Act). The Committee has included bill language which allows all

State projects funded currently under title I of the AT Act to receive minimum grants of $500,000. The bill language also provides

outlying areas minimum grants of $150,000 and State protection

and advocacy systems minimum grants of $100,000. In fiscal year

2002, the AT Act would require 9 States to lose Federal financial

support provided by title I, at a time when States are operating in

a new policy landscape that includes the Olmstead decision, final

section 508 guidelines and the Ticket to Work and Work Incentives

Improvement Act. The Committee notes that all of the grants

awarded in fiscal year 2000 for the alternative financing program

were provided to State entities receiving Federal support under

title I of the AT Act.

The Committee recommendation includes $26,884,000 to support

grants to States and technical assistance activities, authorized

under title III of the AT Act, to establish or maintain alternative

loan financing programs, an increase of $11,884,000 over the fiscal

year 2001 level. Currently, major service programs such as Medicaid, Medicare, special education, and vocational rehabilitation

cannot meet the growing demand for assistive technology. Loan

programs offer individuals with disabilities attractive options that

significantly enhance their ability to purchase assistive technology

devices and services.

The Committee recommendation concurs with the administration

request to make technical changes to the alternative financing program authorized under title III of the AT Act. The changes will

eliminate the minimum grant amount and formula allocation requirements, allow States to receive more than 1 year of funding

and enable States to be awarded more than one grant. These

changes will ensure that States are able to take full advantage of

the opportunities presented by this program and are the same as

enacted in the Department of Education Appropriations Act, 2001.

The Committee believes that States should be allowed to utilize

non-Federal resources from any source in order to meet the match

required to receive an award to operate alternative loan programs.

Access to telework fund

The Committee bill provides $20,000,000 for the access to

telework fund, the same as the budget request. This fund is a new

program requested by the administration.

The access to telework fund is designed to increase employment

opportunities for individuals with disabilities by providing greater

access to computers and other equipment individuals need if they

decide to work from home. The fund would provide matching funds

to States to enable them to provide loans for individuals with disabilities to purchase computers and other equipment so that they

can telework from home. Funds appropriated are available until

September 30, 2003.
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The Committee encourages the Department of Education to design the access to telework loan program in a manner which creates the maximum incentives for people with disabilities to participate. The Committee recognizes that the decision to attempt to

work involves a high level of risk for a person with a disability, including the potential loss of health care coverage and income subsidies, and that the design of the program should take this fact into

account (including the possibility of loan forgiveness should the

person’s attempt to work fail). Finally, the Committee encourages

the Department to allow States flexibility in implementation of the

program to encourage participation, including the use of any nonFederal resources to meet the match requirement.

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2001 ............................................................................. $12,000,000

Budget estimate, 2002 ........................................................................... 12,000,000

Committee recommendation ................................................................. 14,000,000

The Committee recommends $14,000,000 for the American Printing House for the Blind [APH], $2,000,000 above the 2001 appropriation and the budget request.

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 about 49 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. The Committee recommendation includes sufficient funds to continue the Accessible Textbook Initiative and Collaborative Project.

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2001 ............................................................................. $53,376,000

Budget estimate, 2002 ........................................................................... 52,570,000

Committee recommendation ................................................................. 54,976,000

The Committee recommends an appropriation of $54,976,000 for

the National Technical Institute for the Deaf [NTID], an increase

of $1,600,000 over the 2001 appropriation and $2,406,000 above the

budget request.

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,

$5,376,000 is for construction.

It has come to the Committee’s attention that the administration

request for the third installment towards NTID’s $14,900,000 dormitory renovations project has been reduced by a total of $806,000

to $4,570,000. This reduction reflects the Department’s expectation

that NTID raise 15 percent of the funds required to complete the
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project from private sources. It is NTID’s professional judgment,

based on extensive discussions with potential donors, that they are

far better served using their very limited fundraising resources on

raising funds for scholarships, classroom technology and new academic programs. The Committee notes that NTID has been very

successful in raising funds for these purposes over the past 5 years.

Given NTID’s efforts in reducing its appropriation needs in these

other areas through fundraising, the fact that it has already contributed $1,000,000 from its operating funds to supplement the dormitory project and the hardship placed upon the institution to raise

private funds for this purpose, the Committee directs the Department of Education not to impose a matching requirement on this

construction project.

GALLAUDET UNIVERSITY

Appropriations, 2001 ............................................................................. $89,400,000

Budget estimate, 2002 ........................................................................... 89,400,000

Committee recommendation ................................................................. 97,000,000

The Committee recommends $97,000,000 for Gallaudet University, an increase of $7,600,000 above the amount appropriated in

2001 and the budget request.

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. 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 maintain and enhance its technological base,

continue investments in faculty and staff, and support improvements in physical facilities, including campus security.

VOCATIONAL AND ADULT EDUCATION

Appropriations, 2001 ............................................................................. $1,825,600,000

Budget estimate, 2002 ........................................................................... 1,801,660,000

Committee recommendation ................................................................. 1,818,060,000

The Committee recommendation includes a total of

$1,818,060,000 for vocational and adult education, consisting of

$1,240,000,000 for vocational education and $556,060,000 for adult

education, and $22,000,000 for State grants for incarcerated youth

offenders. Of the total, $791,000,000 is advanced funded for fiscal

year 2003.
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VOCATIONAL EDUCATION

The Committee recommendation of $1,240,000,000 for vocational

education is $3,100,000 less than the fiscal year 2001 amount and

$16,400,000 more than the administration’s request.

Basic grants.—The Committee has included $1,100,000,000 for

basic grants, the same as the fiscal year 2001 appropriation and

the administration request. Of the recommended amount,

$791,000,000 will become available on October 1, 2002.

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.

The Committee has included bill language allowing the Secretary

to establish the set aside available for incentive grants. Incentive

grants are provided to States that exceed their adjusted level of

performance required in title I of WIA, the Adult Education and

Family Literacy Act and the Perkins Act. The Committee requests

that the Department provide a report detailing how the incentive

grant set aside is determined for fiscal year 2002 incentive grant

awards.

Tech-prep education.—The Committee recommends $106,000,000

for tech-prep programs. This is the same as the 2001 appropriation

and the administration request. 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.

Tribally controlled postsecondary vocational institutions.—The

Committee has provided $7,000,000 on a current-funded basis for

tribally controlled postsecondary vocational institutions, an increase of $1,400,000 over the fiscal year 2001 level and the budget

request. This program provides grants for the operation and improvement of two tribally controlled postsecondary vocational institutions to ensure continued and expanded opportunities for Indian

students: United Tribes Technical College in Bismarck, North Dakota, and Crownpoint Institute of Technology in Crownpoint, New

Mexico. Grantee institutions may use the funds for costs connected
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with training teachers, providing instructional services, purchasing

equipment, administering programs, and operating and maintaining the institution.

National programs, research.—The Committee recommends

$12,000,000 for national research programs and other national activities, $5,500,000 less than the 2001 appropriation and the same

amount as the administration request. The National Research Center for Career and Technical Education and the National Dissemination Center for Career and Technical Education are the only federally funded centers charged with the responsibility to conduct research and provide technical assistance to vocational educators.

The results of the applied research done by the Center 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 includes $5,000,000 for this program, the same

amount as provided in fiscal year 2001. The administration did not

request funding for this program. Under this demonstration authority, the Secretary awards 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 may be used for

curriculum, professional development, equipment, and other startup and operational costs.

Occupational and employment information program.—The

amount of $10,000,000 has been provided to continue activities authorized by Section 118 of the Carl Perkins Act, $1,000,000 more

than last year. The administration proposed to eliminate this program. The Act requires that at least 85 percent of the amount be

provided directly to State entities to develop and deliver occupational and career information to students, job seekers, employers,

education, employment and training programs; make available and

improve access to career information and planning resources; equip

teachers, administrators and counselors with the skills and knowledge to assist students and parents; and improve coordination and

communication among workforce development administrators and

planners. The remaining funds may be used for national activities

to support the efforts of the State entities, including technical assistance, dissemination of information promoting replication of

high-quality practices, and the development and distribution of

products and related services.

ADULT EDUCATION

The Committee has included $556,060,000 for adult education,

$4,440,000 less than the 2001 appropriation and the same as the

administration request.

Adult education State programs.—For adult education State programs, the Committee recommends $540,000,000, the same amount
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as the fiscal year 2001 appropriation and the administration request. 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, $70,000,000 is

available to help States or localities affected significantly by immigration 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 amount recommended is the same as the fiscal

year 2001 level and the budget request.

The Committee has included bill language allowing the Secretary

to establish the set aside available for incentive grants. Incentive

grants are provided to States that exceed their adjusted level of

performance required in title I of WIA, the Adult Education and

Family Literacy Act and the Perkins Act. The Committee requests

that the Department provide a report detailing how the incentive

grant set aside is determined for fiscal year 2002 incentive grant

awards.

National activities.—The Committee has included $9,500,000, a

decrease of $4,500,000 from the 2001 appropriation and the same

as the administration request.

National Institute for Literacy.—The Committee recommends

$6,560,000 for the National Institute for Literacy, authorized under

section 242 of the Adult Education and Family Literacy Act,

$60,000 more than the amount appropriated in 2001 and the same

as the budget request. The Institute provides leadership and coordination for national literacy efforts by conducting research and

demonstrations on literacy, providing technical assistance through

a State capacity building grant program, 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.

STATE GRANTS FOR INCARCERATED YOUTH OFFENDERS

The Committee has included $22,000,000 for a program authorized by part D of title VIII of the Higher Education Act, the same

as the amount appropriated in fiscal year 2001 and the administration request. 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. 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 develop-
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ment, 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.

Within the appropriation for State grants for incarcerated youth offenders, the Committee includes $5,000,000 to continue the prisoner literacy initiative. The Committee notes that the extremely

high rates of illiteracy or marginal reading skills among inmates

is a national problem and therefore encourages the development of

a uniform model to evaluate literacy programs across the country.

STUDENT FINANCIAL ASSISTANCE

Appropriations, 2001 ............................................................................. $10,674,000,000

Budget estimate, 2002 ........................................................................... 11,674,000,000

Committee recommendation ................................................................. 12,284,100,000

The Committee recommends an appropriation of $12,284,100,000 for student financial assistance, an increase of $1,610,100,000 over

the fiscal year 2001 appropriation and $610,100,000 over the administration request.

Federal Pell Grant Program

For Pell grant awards in the 2002–2003 academic year, the Com- mittee recommends $10,314,000,000.

Pell grants provide need-based financial assistance that helps

low- and middle-income undergraduate students and their families

pay 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 amount recommended is sufficient to raise the maximum

Pell grant to $4,000, the highest level in the program’s history and

an increase of $250 over the maximum grant for the 2001–2002

academic year.

Federal supplemental educational opportunity grants

The Committee recommends $713,100,000 for Federal supplemental educational opportunity grants [SEOG], an increase of

$22,100,000 above the 2001 appropriation level and the budget request.

This program provides funds to postsecondary institutions for

need-based grants to undergraduate students. Institutions must

contribute 25 percent of 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 $1,011,000,000 for the Federal

Work-Study Program, the same as the 2001 level and the administration request. This program provides grants to more than 3,300
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institutions to help an estimated 1 million 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.

Federal Perkins loans

The Committee bill includes $100,000,000 for Federal Perkins

loans capital contributions, which is the same as the 2001 appropriation and the budget request. The amount recommended, when

combined with institutional revolving funds, would maintain the

2002 loan volume at the current estimated level of $1,112,692,000.

At this funding level nearly 700,000 loans would be made.

The Federal Perkins Loan Program supports student loan revolving funds built up with capital contributions to about 2,000 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

has included the amount necessary to maintain the current loan

volume level.

The Committee bill also includes $70,000,000 for loan cancellations, an increase of $15,000,000 over the 2001 level and amount

requested by the administration. 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.

Leveraging educational assistance partnership program

For the Leveraging educational assistance partnership [LEAP]

program, the Committee includes $70,000,000, an increase of

$15,000,000 over the 2001 appropriation and the administration request. This program provides a Federal match to States as an incentive for providing need-based grant and work-study assistance

to eligible postsecondary students. Federally supported grants and

job earnings are limited to $5,000 per award year for full-time students.

Loan forgiveness for child care providers

The Committee recommends $1,000,000 for this demonstration

program, the same as the fiscal year 2001 appropriation and the

budget request. Under this demonstration program, Stafford and

Unsubsidized Stafford Loan borrowers under the Federal Family
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Education Loan Program and the William D. Ford Direct Loan program who have earned a degree in early childhood education and

work for 2 full years as a child care provider in a low-income community may have a portion of their loan obligation forgiven.

FEDERAL FAMILY EDUCATION LOAN PROGRAM

Appropriations, 2001 ............................................................................. $48,000,000

Budget estimate, 2002 ........................................................................... 49,636,000

Committee recommendation ................................................................. 49,636,000

The Committee recommends $49,636,000 for discretionary Federal administrative expenses related to the Federal Family Education Loan [FFEL] Program, formerly known as the Guaranteed

Student Loan Program. The amount recommended is $1,636,000

more than the amount appropriated in fiscal year 2001 and the

same as the budget request.

Funds appropriated for Federal administrative expenses will partially cover the fiscal year 2002 salaries and benefits, travel, printing, contracts, and other expenses associated with the program, including payment and claims processing, reducing loan default costs,

and program monitoring. This discretionary administrative funding

is included in the ‘‘Federal family education loans’’ appropriation

account rather than under the Department’s ‘‘Salaries and expenses’’ account pursuant to a requirement of the Federal Credit

Reform Act of 1990.

The FFEL Program is administered through State and private

nonprofit guaranty agencies that insure loans directly, collect defaulted loans, and provide various services to lenders. The Federal

Government supports the guaranty agencies by providing loan advances and reinsurance payments for borrower default, death, disability, and bankruptcy. The Federal Government also pays guaranty agencies loan processing and issuance fees out of the FFEL

subsidy and account maintenance fees in the administrative funds

under section 458 of the Higher Education Act.

The Federal Government also pays an interest subsidy to lenders, based on the borrower’s interest rate, on behalf of Stafford loan

student borrowers while they are in school and during certain

grace and deferment periods. To be eligible for this subsidy, students must demonstrate financial need, be enrolled at least half

time, and not be incarcerated. Federal Stafford loans may be borrowed by eligible students, regardless of their school year or dependency status. Borrowing limits are tied to the extent of need,

for the cost of attendance minus an expected family contribution,

and other aid as determined by a statutory need analysis system.

An unsubsidized Stafford Loan Program for middle-income borrowers provides federally reinsured loans to borrowers who do not

qualify for Federal interest subsidy payments under the need-based

Stafford Loan Program. Except for the interest benefit and certain

loan limits, all other terms and conditions of the Federal Stafford

Loan Program apply to the unsubsidized Stafford loans.

Federal PLUS loans are made to parents of dependent undergraduate students. Interest rates for PLUS loans are usually higher than those for Federal Stafford loans, and the Federal Government does not pay the interest during in-school, grace, and
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deferment periods. No need analysis is required, but borrowing

cannot exceed cost of attendance minus other aid.

HIGHER EDUCATION

Appropriations, 2001 ............................................................................. $1,911,710,000

Budget estimate, 2002 ........................................................................... 1,723,223,000

Committee recommendation ................................................................. 1,764,223,000

The Committee recommends an appropriation of $1,764,223,000 for higher education programs, $147,487,000 less than the fiscal

year 2001 amount and $41,000,000 more than the budget request.

Aid for institutional development

The Committee recommends $418,000,000 for aid for institutional development authorized by titles III and V of the Higher

Education Act, $25,500,000 above the 2001 appropriation and

$6,500,000 more than the budget request.

The Committee encourages the Department to provide technical

assistance and conduct research on issues germane to predominately and Historically Black Colleges and Universities (HBCUs)

and other institutions of higher education that have large minority

student populations, including disseminating best practices information on the most efficient and cost-effective uses of title III funding, reducing student loan default rates, increasing graduation

rates, and grant writing training.

Strengthening institutions.—The Committee bill includes

$74,250,000 for the part A strengthening institutions program, an

increase of $1,250,000 over the fiscal year 2001 level and the budget request. 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 $73,750,000 for institutions at which Hispanic students

make up at least 25 percent of enrollment, $5,250,000 more than

the fiscal year 2001 level and $1,250,000 more than the administration request. 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 provides $197,000,000 for part B grants, $12,000,000

more than the fiscal year 2001 level and the same as the administration request. The part B strengthening historically black colleges and universities [HBCU] program makes formula grants to
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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.

The Committee encourages Historically Black Colleges and Universities to use funds, as suggested by the Hart-Rudman Report of

2001, to train students in the fields of math, science, and engineering as well as to be teachers in those fields.

Strengthening historically black graduate institutions.—The Committee bill includes $48,000,000 for the part B, section 326 program, $3,000,000 more than the fiscal year 2001 level and the

same amount as the administration request. 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 $7,000,000 for this program, an increase of $1,000,000 over the fiscal year 2001 appropriation and the

budget request. 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 instructional facilities, student services, and the

purchase of library books and other educational materials.

Strengthening tribally controlled colleges and universities

The Committee recommends $18,000,000 to support the Title III

program for strengthening the Nation’s tribal colleges and universities (TCUs), an increase of $3,000,000 over the fiscal year 2001

level and the budget request. While sufficient funds are not available to adequately address all of the needs of these important institutions, the Committee believes that the funds provided represent

an important step in that direction. The recommendation includes

$6,000,000 for grants for renovation and construction of facilities.

The additional funds provided for facilities grants, a program

launched by the Committee last year, will enable TCUs to begin

remedying serious structural and safety issues at these institutions. Over the past three decades, tribally controlled colleges and

universities (TCCUs) have emerged to play a pivotal role in meeting the educational needs of American Indian students. Driven by

the premise that education is the key to social renewal, TCCUs

have demonstrated their ability to educate students who might not

otherwise be served by mainstream postsecondary institutions.

However, TCCUs are among the most poorly funded institutions in
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America. Unlike non-Indian institutions, TCCUs cannot rely on endowments, State appropriations or wealthy alumni to defray costs.

Fund for the improvement of postsecondary education

The Committee recommends $51,200,000 for the fund for the improvement of postsecondary education [FIPSE], which is

$95,487,000 less than the 2001 appropriation and the same amount

as the administration request. 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 an independent board that 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 non-profit institutions and organizations concerned with

education beyond high school.

The Committee recommendation includes sufficient funding for

the Shriver Peace Worker Program, Inc. to support the establishment of the Sargent Shriver Peace Center and graduate research

fellowships, professorships, and grants and scholarships for students related to peace studies and social change.

The Committee recommendation for FIPSE is consistent with the

Administration request to consolidate the Learning Anytime Anywhere program (LAAP) within the FIPSE program. The Committee

recommendation includes $22,680,000 to continue support for 63

current LAAP grantees. The Committee notes that the administration’s rationale for this action is that new projects focused on the

development and improvement of distance learning technologies

can be funded under FIPSE.

The Committee is aware of the following projects and encourages

the Department to give them full and fair consideration:

The National Center for Health Care Informatics at Montana

Tech University will link the disciplines of information technology

and health care administration through internships and specialized

degree programs to support the job skill needs of workers in the

health care industry.

The University of Great Falls will utilize state-of-the-art computer, video and audio equipment to provide distance students the

opportunity to access and fully participate in university courses.

The University of New Mexico, through its nonprofit Science and

Technology Corporation, is developing an innovative core cluster of

courses at their Anderson Business School for a High Technology

Executive Training Program.

A 3-year service learning program at Eastern New Mexico University will be designed to integrate volunteer community service

and pre-professional experiential learning with active guided reflection into the curriculum to enhance and enrich student learning of

course material.

The California School of Professional Psychology has developed

an initiative to train doctorate level counseling personnel and masters level school psychologists to help participating school districts

in California meet the recommended 250 to 1 student to counselor

ratio.
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The Ruby Gerontology Center at California State University,

Fullerton proposes to utilize technology in delivering high-quality

training and education programs.

CADERA connects rural Americans to the new distance education and on-line career training mainstream by incorporating

best educational methods and technologies in a model program.

Occidental College will improve access to higher education for

non-native English speakers through the Northeast Los Angeles

College Resource Center.

California State University-Northridge will develop specialized

applications for a new entertainment engineering curriculum.

California State University-Chico continues to develop its polymer engineering program.

The Lifelong Learning and Technology Complex at Grambling

State University will improve academic programs offered at the

University.

Dillard University’s Center for Technology, Learning and Culture

will improve preparation of minority students entering graduate

business programs.

Louisiana State University and Southern University will establish the Center for Analytical Chemistry to focus on developing solutions to environmental and medical research problems.

City University plans to expand its distance learning program in

Slovakia by enhancing its technology infrastructure and course offerings, which will enable the University to increase student exchange programs in Eastern Europe.

The University of Washington-Tacoma is developing the Washington Institute for Technology to address the gap between the

number of technology jobs being created within the region and the

number of college graduates with sufficient education and training

to meet this increasing employment.

Westminster College will support programs to improve leadership among high school and college students and faculty through

innovative services provided by its Center for Leadership Service

and Churchill Summer Leadership Academy.

Logan College of Chiropractic will alter significantly the college’s

instructional framework, through the use of technology, to make

college education more accessible.

Southeast Missouri State University will utilize advanced communication and computer technology to improve curricula and programs offered by its integrated School of Visual and Performing

Arts.

The Advanced Distributed Learning project at Middle Georgia

College has been developed to provide technology-based training

and access to educational programs to America’s servicemen and

women throughout the world.

Albany Technical College in Georgia has developed an Interactive Distance Learning Project to provide high-quality educational opportunities in rural communities.

The Coles College of Business at Kennesaw State University in

Georgia will utilize technology to link universities across the country to facilitate the sharing of programs, information and materials

to enhance the ongoing educational training and development opportunities for family businesses.
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The C.W. Post Campus of Long Island University has proposed

to augment its efforts in education in the arts and sciences programs, and improve outreach to students.

The North Dakota State University will continue to address the

need for technically trained personnel through its Tech Based Industry Traineeship program by expanding and enhancing a program which provides post-secondary students with carefully constructed and monitored traineeship operations in companies in

North Dakota, South Dakota and Minnesota.

Minnesota State Colleges and Universities’ Emerging Curriculum

project supports the development and design of emerging curriculum, professional development, development of an e-monitoring

environment to support e-learning needs and formulating and implementing pilot policies for the new era of e-learning.

Fairfield University will develop instructional technology to improve access to and enhance the quality of its graduate and undergraduate programs.

Darton College will establish and operate an information and

technology network that will provide underserved and disadvantaged populations access to education opportunities and career

services in the health care and information technology fields.

The Federation of Independent Illinois Colleges and Universities

will utilize a high bandwidth network, distance learning technologies and innovative training programs to link Illinois institutions and improve access to and quality of postsecondary education.

California State University at Dominquez Hill plans to improve

academic support services for students by utilizing digital media

and advanced technologies.

The University of San Francisco has launched programs to train

adult learners for positions in the new economy and will incorporate advanced technologies and related training in expanded programs throughout northern California.

St. Mary’s College of Maryland has developed an initiative to enhance the technology skills of K–16 students and adult learners

through its proposed Center for Teaching and Learning Systems.

The University of Maryland Baltimore County and Georgetown

University have proposed the shared development of advanced degree programs to accelerated the training period of students entering the field of biotechnology.

The Grand Valley State University Teacher Academy will provide training and support for math and science teachers.

Lake Superior State University will develop and implement a

new degree program and utilize distance learning to increase the

number of skilled trade workers trained in new technologies.

The Gerald R. Ford School of Public Policy at the University of

Michigan will continue to increase understanding of public policy

problems and contribute to the development of solutions.

Finlandia University plans to improve educational programs for

nursing and teaching and other specialties that meet the needs of

rural areas.

Michigan Technological University will increase student exposure

to high-tech instructional practices and advanced learning technologies through its Center for Microsystems Technology.
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The Lifelong Learning Center at Northwestern Michigan College

will support innovative educational partnerships between the public and private sectors.

The Center for Teacher Preparation and Learning Technologies

at Montclair State University will provide teachers with the most

recent skills, techniques and training for use of technology in the

classroom.

Brookdale Community College has developed an innovative approach for establishing higher education and business training solutions in Central New Jersey.

The Plangere Center for Communication and Instructional Technology at Monmouth University will utilize state-of-the-art instructional technology to improve the technical skills of communication

students.

The Oregon Graduate Institute at Oregon Health Sciences University seeks to increase student participation and retention, particularly for those from diverse and disadvantage backgrounds, in

certificate and degree programs in Environmental Information

Technology.

New Mexico State University Cooperative Extension Service in

Las Cruces is developing a training program utilizing a national E– commerce model to assist experienced business and community

leaders with making strategic electronic business and community

planning decisions, and establishing a network of youth with advanced computer training to provide rural community and rural

business leaders with fundamental computer and Internet access

skills.

Salve Regina University will expand and update its distance education efforts to serve a larger potential student market via web

links and interactive communication to courses, services, and information.

The African Technology for Education and Workforce Development Initiative will employ new information technologies to deliver

education and training from American universities to Africa.

The University of Alaska and the State of Alaska propose to establish the Alaska Digital Archives and Digital Library to help students and others in rural and remote parts of Alaska access historical materials and research tools relating to Alaska’s history.

The partnership of the Galena School District and the University

of Alaska-Southeast continues to develop and implement occupation-based curriculum for students in Alaska.

The Alaska Distance Education Corsortium will serve students

throughout the entire State, regardless of how remote the area.

The collaborative technology transfer program of the College of

Rural Alaska-Interior Aleutians and the Galena School District

continues to improve access and quality of education.

The Barahona Center for the Study of Books in Spanish at California State University, San Marcos’ will continue its effort to improve access to Spanish-language literature.

California State University, Northridge will implement a new entertainment engineering curriculum.

The Oregon Institute of Technology has established a Technology

Training Program designed to integrate technology into the lives of

disadvantaged students and improve student success.
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The Early Childhood Leadership initiative of Oregon State University will pioneer new strategies to develop collaboration, administration and evaluation skills among early childhood personnel.

Oregon State University will design and implement a model program for placement of graduate students and interns within positions of government and nonprofit agencies.

The Center for Distance Learning and Accessibility Research at

Oregon State University will develop programs that support an integrated strategy of linking accessibility research and distance

learning technologies.

The Tides Foundation plans to support an existing charitable

program of the McKelvey Foundation which provide entrepreneurial college scholarships to rural, low-income Pennsylvania high

school graduates who demonstrate spirit and excellence.

Western Governors University, an online university created by

the governors of 19 western States, continues the development of

innovative distance learning programs.

The University of Idaho continues to test, evaluate, and develop

Internet-based interactive learning environments for physically

handicapped, at-risk, isolated, rural, and other populations.

The Burns Telecommunications Center (BTC) at Montana State

University-Bozeman plans to launch a Coalition for Establishing a

National Teacher Enhancement Network, which will improve professional development opportunities for science teachers.

The University of Idaho will continue to develop its Advanced

Computing and Modelling Laboratory in Boise, to educate students

in using new tools for research and practical applications.

The Maine Technical College System ‘‘Careers for ME’’ project

will develop a multimedia, Internet-based career information site

for careers in Maine related to programs of the Technical Colleges.

Southern New Hampshire University in Manchester plans to expand its high tech infrastructure and professional development, as

part of its distance learning program.

Colorado State University proposes to use an existing network of

universities to assess the software and the technical health of solutions to common technical problems and a research laboratory

based on collaborative projects in response to business needs disseminate the concept throughout Colorado.

The University of Nebraska Medical Center is developing distance education programs in Medical Technology, Radiation Science

Technology, Physical Therapy and Nursing.

Utah State University (USU) will advance science education for

all USU students through innovative applications of distance learning.

The University of Colorado, Boulder Alliance for Technology,

Learning, and Society (ATLAS) program is developing new curricula and teaching methods that employ leading technologies in

classrooms and through distance learning.

Montana State University in Billings is developing a pilot project

to initiate a 2-year computer science program within the College of

Technology.

University of Southern Colorado, the only comprehensive regional university in Southern Colorado, has developed a plan to
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make significant improvements to its information technology infrastructure.

Oklahoma State University (OSU), through its School of International Studies, is organizing OSU’s intellectual capital around

international regional bureaus, a world-region focused structure

similar to that utilized by the U.S. State Department. ‘‘Peirce Online’’, an Internet Mediated Delivered Learning

(IMDL) degree program at Peirce College in Philadelphia, helps

students reach their educational goals and earn a degree via the

flexibility of online learning.

The University of Maine offers associate and baccalaureate programs at its three campus locations in Augusta, Bangor, and

Lewiston, Maine. UMA has developed plans for a technological extension of existing academic courses and programs from one or

more UMA campus locations to its other locations, focusing specifically on UMA, Lewiston-Auburn.

Lehigh University, through its Integrated Product, Project and

Process (IP3) Program involve students in all phases of the industrial design discipline.

The Coalition for Ultrasound Education and Training is developing a comprehensive multi-institution model distance training

network for the training of ultrasound technologists and medical

sonographers.

The Mark Hatfield School of Government at Portland State University will enhance academic programs that support professional

development of elected officials and other individuals associated

with public and nonprofit management.

The Native American Tribal Government Center at Portland

State University will improve recruitment and retention of Native

American students and provide professional development opportunities for Tribal governments.

The collaborative efforts of the University of Charleston and the

Clay Center for Arts and Sciences will promote access to and effective use of technology for arts and science education and outreach.

The Concord College Technology Center will better equip new

teachers with the technical skills essential for the utilization of informational technologies in the classroom.

Maryland Community College Information Technology Initiative

will support collaborative efforts designed to improve the quality

and quantity of programs that train information technology workers.

The Consortium on the Advancement of Women, Minorities and

Persons with Disabilities in Science, Engineering and Technology

will develop programs to encourage and support women, minorities

and persons with disabilities to enter and complete programs in

science, engineering and technology.

The Single Parents Support System Program at Texas College in

Tyler, Texas will provide assistance that addresses the support

needs of single parent students.

College Summit will expand programs designed to help promising, low-income students access, persist in and complete postsecondary education.

The University of Hawaii’s efforts continue to support development of a Globalization Research Consortium.
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The Flandrau Santee Sioux Tribe will improve postsecondary

education opportunities through expansion of the higher education

assistance program.

The Standing Rock Sioux Tribe will help improve access to opportunities in higher education for tribal members.

Lake Area Technical College proposes to integrate interactive

learning in its technical education programs.

South Dakota State University, Brookings will enhance the programs offered by the Polytechnic Center of Excellence in the College of Engineering.

Waukesha County Technical College and Marquette University

are developing joint curricula to train minority students in the

fields of engineering and nursing.

The Community-Based Services Training Partnership for Adults

proposes to develop curriculum to support professional development

opportunities for those social workers whose client populations are

primarily rural, impoverished, and vulnerable adults.

Norwalk Community College will develop new information technology courses and service learning opportunities through its new

center for excellence in information technology.

California State University at Stanislaus has developed a proposal to address the acute regional and statewide nursing shortage.

The University of South Dakota and Good Samaritan Society

Nursing Education/Service Partnership will support remote learning for those interested in entering the nursing profession.

The Connecticut State University System continues to develop

innovative initiatives for its nursing program.

The University of San Diego Institute for Advancement of Health

Policy is expanding its programs to develop more professionally

trained nurses.

Wayne State University and the University of Detroit-Mercy

Nurse will expand programs designed to prepare nurse anesthetists.

The Nursing Center of Excellence at the University of Vermont

proposes programs designed to address rural nursing workforce

issues.

The Washington Health Foundation initiative will improve nurse

retention in the State of Washington.

The Creighton University Accelerated Nursing Program will increase the number of well-qualified nurses in Nebraska and Iowa.

The Ryan-Matura Library and Jandrisevits Learning Center at

Sacred Heart University will utilize new technology to improve access to University resources for students and faculty.

Project Access, an initiative of the University of Indianapolis,

will employ advanced technologies to enable Indiana’s first generation higher education students to pursue a degree.

The Indiana Higher Education Commission, in collaboration with

Intelenet, Indiana’s telecommunication commission, will support

small Indiana colleges and universities as they develop applications

for higher-performance computer networks.

Ivy Tech State College of Indiana, through its campuses in East

Chicago and South Bend, is developing an education and training

program in machine tool technology.
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The East Chicago campus of Ivy Tech State College is developing

a mortuary science degree program.

Indiana University proposes to expand the successful Project

TEAM initiative to additional campuses in the Indiana University

system.

Indiana State University, in collaboration with Bowling Green

State University, East Carolina University, University of Wisconsin-Stout, North Carolina A&T State University and Central

Missouri State University, will create a shared doctoral program

for technology management.

The Columbia River Estuary Research Program will establish

certificate and degree programs.

The Native American Law Center at the University of Washington School of Law provides a tremendous opportunity for students interested in Native American issues to gain academic and

practical experience in the field.

Green River Community College is developing a program in Communications Access Realtime Translation Services Training.

The Center for Families at Edmonds Community College is developing curriculum for training and certificate programs in early

childhood education.

The Technology Training Center at Seminole State College will

provide a high-quality environment for dynamic and interactive

training.

Emmanuel College will continue to improve access to higher education programs for all students.

The University of Massachusetts School of Marine Science and

Technology proposes to enhance research programs in fisheries

management, aquaculture and ocean communications and control.

Emerson College will develop educational programs through its

Performance and Production Center.

The Assumption College Lt. Joseph P. Kennedy Jr. Science and

Technology Center will improve research and instructional opportunities for students and faculty.

The University of Arkansas Little Rock will utilize advanced and

simulation technology to improve teaching and learning in medical,

engineering and other sciences.

The University of Arkansas Mountain Home will utilize distance

learning technology to develop and offer a new degree program for

hearing healthcare practitioners.

The Environmental Biotechnology Initiative at the University of

Rhode Island will enhance teaching, research and outreach through

programs in genomics, transgenics, imaging and bioinformatics.

Cabrini College is developing a new Center for Science, Education, and Technology which will provide a model elementary education classroom to facilitate and enhance the educational experience of Cabrini undergraduate students majoring in education.

The Army War College is developing a major educational center

to provide research and educational programs in military and social

history.

East Stroudsburg University is planning to purchase laboratory

equipment for its degree programs in biotechnology and chemical

biotechnology at its Science and Technology Center.
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Eastern College plans to hire additional faculty and purchase

computers, printers, telecommunications equipment, and laboratory

equipment for the Center for Information, Science and Learning

Resources.

Keystone Virtual University is establishing an ‘‘online’’ Pennsylvania University.

Lehigh University is developing a Center for Promoting Healthy

Development for Individuals with Disabilities.

Temple University’s Center for Research in Human Development

and Education is developing innovative models to address teacher

recruitment, training, and mentoring which will enhance student

achievement.

The George Mitchell Scholarships program is providing scholarships to allow Americans to pursue a year of post-graduate study

at universities in Ireland.

The Benjamin L. Hooks Institute for Social Change at the University of Memphis will pursue a broad agenda that emphasizes

the continued importance of the civil rights movement and encourage academic research and community outreach.

The Clinical Skills Training and Assessment Center at Thomas

Jefferson University will supplement the clinical learning and evaluation skills of healthcare professionals. ‘‘Project Promotion’’ for Paraprofessional Educators, a cooperative

project of the Southern Penobscot Regional Program for Children

with Exceptionalities and Eastern Maine Technical College, aims to

improve the education and support for currently employed educational technicians.

The University of Hartford-Hartt Performing Arts Education

Center will enhance educational opportunities for its students, and

improve theater and music instruction and educational programs

for area teachers and students.

The Center for Science and Technology at Dominican University

of California will improve access to and delivery of nurse and

teacher development programs, as well as other educational opportunities at the university.

The United Negro College Fund will conduct a project for curriculum development at historically black colleges and universities

and other institutions to develop the capacity of these entities to

prepare minority students for careers in international affairs and

business and the global employment market.

Urban College will continue its efforts to provide affordable continuing education for nontraditional students through tutoring and

other supportive services.

The University of Detroit Mercy will improve its information

technology infrastructure to provide students and faculty with an

enhanced learning environment.

The Center for International Education and Entrepreneurship at

Ramapo College would expand the offerings of international, intercultural and global courses and related services.

The Technology Center at Mountain State University will improve its information technology infrastructure and establish interactive classrooms for students to improve training and education

programs for students to create their own electronic business opportunities.
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Pittsburgh Digital Greenhouse is continuing to develop a stateof-the-art, high-tech curriculum in a collaborative effort with three

member universities—Penn State, University of Pittsburgh and

Carnegie Mellon Contact—to train university students. This initiative will further enhance the high tech talent pool (which is in

short supply) in the Allegheny County area.

Shippensburg University is wiring its computers for the Performing Arts Center.

Wilson College is expanding and developing the ‘‘Women with

Children Program,’’ which assists single women with children in

earning a degree, becoming financially independent, and raising

the children’s aspirations for educational accomplishment.

Westchester University plans to develop curriculum for the University’s Business and Information Technology Center.

The partnership of Jackson State University, located in Jackson,

Mississippi, with three other Historically Black Universities, Alabama A&M, Prairie View A&M University in Texas and Southern

University and A&M College in Louisiana, will establish four Minority Centers of Excellence for Math & Science Teacher Preparation. This concerted effort to prepare minority teachers of math and

science will help reduce the disproportionate representation of minorities in the math and science teaching field, where less than 6

percent of teachers are minorities.

Jackson State University will establish electronics-based program to advance the Central Mississippi Communications and Information Technology Cluster at the Mississippi e-Center.

East Central Community College, Ellisville, Mississippi will establish a Wireless Computer Lab to enhance learning on that campus and in that community.

The La Roche College plans to develop its Integrated

Transcultural Technology Center with information technology features critical to 21st Century educational institutions, including

state-of-the-art ‘‘smart’’ classrooms.

Minority science and engineering improvement

The Committee recommends $8,500,000 for the minority science

and engineering improvement program [MSEIP], the same as the

fiscal year 2001 level and the administration request. This program

provides 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.

International education and foreign language studies

The bill includes a total of $78,022,000 for international education programs, the same as the fiscal year 2001 level and the

budget request.

Domestic programs.—The Committee recommends $67,000,000

for domestic program activities related to international education

and foreign language studies, including international business education, under title VI of the HEA, the same as the fiscal year 2001

appropriation and the administration request. Domestic programs
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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 $10,000,000 for overseas

programs authorized under the Mutual Educational and Cultural

Exchange Act of 1961, popularly known as the Fulbright-Hays Act.

The recommendation is the same amount as the fiscal year 2001

level and the budget request. 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 $1,022,000 for the Institute for International Public Policy. This is the same amount as the fiscal year 2001 level and the

budget request. 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.

Interest subsidy grants

The Committee recommends $5,000,000 for interest subsidy grants, $5,000,000 less than the fiscal year 2001 level and the

same as the administration request. This appropriation is required

to meet the Federal commitment to pay interest subsidies on 124

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.

Federal TRIO programs

The Committee bill includes $805,000,000 for Federal TRIO programs, an increase of $75,000,000 above the fiscal year 2001 appropriation and $25,000,000 more than the administration request.

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 opportunities for completing high school and enrolling in postsecondary education; Educational Opportunity Centers provide information and counseling on available financial and academic assist-
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ance 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.

The Committee notes that, at the budget request level, $3,070,000 has not been allocated to any particular TRIO program.

To the extent that the Department receives highly rated applications for funding under the Talent Search and Educational Opportunity Centers grant competitions, the Committee encourages the

Secretary to allocate these undistributed funds, as well as the increase provided by the Committee, to additional or increased grants

for these programs.

Gaining early awareness and readiness for undergraduate programs [GEAR UP]

The Committee recommends $227,000,000, a decrease of

$68,000,000 from the amount provided in fiscal year 2001 and the

same as the budget request. 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 low-income students. Services provided help

students prepare for and pursue a postsecondary education. The

Committee notes that at the funding level requested by the administration, all continuing GEAR UP cohorts of low-income middle

and high school students would be fully funded.

The Committee is very concerned that the Department decided

to alter significantly its plans for awarding new grants under the

GEAR UP program. The Committee notes that the number of new

partnership grants the Department planned to award according to

the fiscal year 2001 congressional justification was 127, for total

new award funding of $58,457. The actual number of new partnership awards made with the fiscal year 2001 appropriation for this

program was six, for total new award funding of $42,502. The Committee’s ability to respond to and act on the budget request for a

given fiscal year depends on credible and reliable information about

the rationale supporting the request, as well as the plan for implementing the program. The Committee strongly urges the Department to notify the Committee not less than 3 business days prior

to any grant opportunities or notices inviting applications that include funding priorities, competitive preferences or stated funding

availability different from what is contained in the congressional

justification.

Byrd honors scholarships

The Committee recommends $41,001,000 for the Byrd Honors

Scholarship program, the same amount as the fiscal year 2001 appropriation and the budget request.

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,
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teachers, counselors, and parents. The funds provided will support

a new cohort of first-year students in 2002, and continue support

for the 1999, 2000, and 2001 cohorts of students in their fourth,

third and second years of study, respectively. The amount recommended will provide scholarships of $1,500 to 27,334 students.

Javits fellowships

The Committee recommends $10,000,000 for the Javits Fellowships program, the same as the fiscal year 2001 amount and the

budget request.

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

2002 appropriation support fellowships for the 2003–2004 academic

year.

Graduate assistance in areas of national need [GAANN]

The Committee recommends $31,000,000 for graduate assistance

in areas of national need, the same as the fiscal year 2001 level

and the budget request. 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 2001, 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.

Learning anytime anywhere partnerships

The Committee does not recommend an appropriation for the

learning anytime anywhere partnerships program (LAAP) in fiscal

year 2002. Consistent with the administration’s request, the Committee has included sufficient resources under the fund for the improvement of postsecondary education to continue all grants funded

under this program. In fiscal year 2001, $30,000,000 was made

available for the LAAP program. Funds support projects using

technology and other innovations to enhance the delivery of postsecondary education and lifelong learning opportunities, especially

for underserved populations in underserved geographic areas.

The Committee notes that the administration’s rationale for not

requesting funds for the LAAP program is that all of the activities

carried out under its authority can be supported under FIPSE. The

Committee expects the Department to provide the Committee with

a report documenting FIPSE grant support in fiscal years 2001 and

2002 of projects that support the use of technology and other innovations to enhance the delivery of postsecondary education and lifelong learning, especially for underserved populations in underserved geographic areas.
331

Teacher quality enhancement grants

The Committee recommends $54,000,000 for the teacher quality enhancement grants program, $44,000,000 less than the fiscal year

2001 level and the same as the budget request. The program was

established to support statewide initiatives that best meet their

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 administration has requested resources sufficient to fund

only current State and partnership grantees and has not included

funding for recruitment grants nor for new awards under this program. Further, the administration has proposed to set aside 1.4

percent of the appropriation for two national evaluations of the program.

The Committee recommendation is made consistent with the

budget request to fund only current State and partnership grantees, and has therefore, included bill language overriding the distribution requirements of section 210 of the HEA.

The Committee recommendation does not include the bill language requested to establish a set-aside for the two national evaluations. Instead, the Committee will provide sufficient resources

within the GPRA/HEA evaluation program for this purpose.

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.

Child care means parents in schools

The Committee recommends an appropriation of $25,000,000 for

the Child Care Access Means Parents in School (CAMPUS) program, the same amount as the 2001 appropriation and the budget

request. This program was established in the Higher Education
332

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.

Demonstration projects to ensure quality higher education for students with disabilities

The Committee recommends $7,000,000 for this program, an in- crease of $1,000,000 over the fiscal year 2001 appropriation and

$7,000,000 over the budget request. This program’s purpose is to

ensure that students with disabilities receive a high-quality 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.

Underground railroad program

The Committee recommendation includes $2,000,000 for the Underground Railroad program, an increase of $250,000 over the fiscal year 2001 amount. The administration did not request any resources for this program. The program was newly 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.

Web-based Education Commission

The Committee recommendation does not include funding for this

program, the same as the budget request. The fiscal year 2001 appropriation for the Commission was $250,000. The Web-based Education Commission was established by Congress to conduct a thorough study to assess the educational software available in retail

markets for secondary and postsecondary education students who

choose to use such software. In December 2000, the Commission

completed its work when it released its report, ‘‘The Power of the

Internet for Learning: Moving from Promise to Practice.’’

GPRA/Higher Education Act Program Evaluation

The Committee recommends $1,500,000 for the Government Performance and Results Act data collection and for the Higher Education Act Program Evaluation program, $1,500,000 less than the

fiscal year 2001 appropriation and $500,000 more than the budget

request. The administration requested these funds to comply with

the Government Performance and Results Act, which requires the

collection of data and evaluation of Higher Education programs and
333

the performance of recipients of Higher Education funds. Additional resources have been provided to continue support for evaluations of the teacher quality enhancements grants program.

Thurgood Marshall legal educational opportunity program

The Committee recommendation does not include funding for this

program, the same as the budget request. The $4,000,000 appropriated for fiscal year 2001 will be used to provide minority, lowincome or disadvantaged college students with the information,

preparation, and financial assistance needed to gain access to and

complete law school study.

B.J. Stupak Olympic scholarships

The Committee recommendation does not include funding for this

program, the same as the budget request. The $1,000,000 appropriated for fiscal year 2001 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.

HOWARD UNIVERSITY

Appropriations, 2001 ............................................................................. $232,474,000

Budget estimate, 2002 ........................................................................... 232,474,000

Committee recommendation ................................................................. 232,474,000

The Committee recommends an appropriation of $232,474,000 for

Howard University, which is the same as the fiscal year 2001 appropriation and the budget request. 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

about 53 percent of the university’s projected educational and general expenditures, excluding the hospital. The Committee agrees

with the administration and recommends, within the funds provided, $3,600,000 for the endowment program.

Howard University Hospital.—Within the funds provided, the

Committee recommends $30,374,000 for the Howard University

Hospital, the same as the fiscal year 2001 level and the budget request. The hospital serves as a major acute and ambulatory care

center for the District of Columbia and functions as a major teaching facility attached to the university that trains physicians in 25

specialty areas. The Federal appropriation provides partial funding

for the hospital’s operations.

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS

Appropriations, 2001 ............................................................................. $762,000

Budget estimate, 2002 ........................................................................... 762,000

Committee recommendation ................................................................. 762,000

Federal administration.—The Committee bill includes $762,000

for Federal administration of the CHAFL program, the same as the

2001 level and the same as the administration request.
334

These funds will be used to reimburse the Department for expenses incurred in managing the existing CHAFL loan portfolio

during fiscal year 2002. 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, 2001 ............................................................................. $208,000

Budget estimate, 2002 ........................................................................... 208,000

Committee recommendation ................................................................. 208,000

Federal administration.—The Committee recommends $208,000

for Federal administration of the Historically Black College and

University [HBCU] Capital Financing Program, the same as the

fiscal year 2001 level and the administration request.

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.

EDUCATION RESEARCH, STATISTICS, AND ASSESSMENT

Appropriations, 2001 ............................................................................. $383,367,000

Budget estimate, 2002 ........................................................................... 382,120,000

Committee recommendation ................................................................. 431,567,000

The bill includes $431,567,000 for educational research, statistics, assessment, and improvement programs. This amount is

$48,200,000 more than the fiscal year 2001 appropriation and

$49,447,000 more than the budget request. This account supports

education research, statistics, and assessment activities, as well as

a variety of other discretionary programs for educational improvement.

Research, development, and dissemination

The Committee recommends $120,567,000 for educational research and national dissemination activities. This amount is the

same as the fiscal year 2001 appropriation and $2,500,000 less

than the budget request. The Committee has also included

$65,000,000 for regional educational laboratories, the same as the

fiscal year 2001 appropriation and the budget request. These activities are administered by the Office of Educational Research and

Improvement (OERI).

These funds support research, development, dissemination, and

technical assistance activities that are aimed at expanding fundamental knowledge of education and promoting the use of research

and development findings in the design of efforts to improve education.

Statistics

The Committee recommends $80,000,000 for data-gathering and

statistical-analysis activities of the National Center for Education

Statistics (NCES), the same as the fiscal year 2001 appropriation

and $5,000,000 less than the budget request.
335

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. Technical assistance to State and

local education agencies and postsecondary institutions is also provided by the Center.

Assessment

The Committee recommends $109,000,000 for assessment. This

amount is $53,000 less than the budget request and $69,000,000

more than the fiscal year 2001 appropriation.

The National Center for Education Statistics uses these funds to

administer 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.

NAEP has been expanded in recent years to include State representative assessments as well.

The Committee encourages the Department to consider conducting a feasibility study for a trial urban assessment of the National Assessment of Educational Progress. This study would involve up to five voluntarily participating large urban school districts.

Within these funds, the Committee recommends $4,000,000 for

the National Assessment Governing Board (NAGB), the same as

the fiscal year 2001 appropriation and $53,000 less than the budget

request. The NAGB is responsible for formulating policy for NAEP.

International education exchange

The Committee provides $12,000,000 to the Center for Civic Education and the National Council on Economic Education for the

International Education Exchange program, which was authorized

by the Senate-passed version of H.R. 1. This amount is $2,000,000

more than the fiscal year 2001 appropriation. The administration

requested no funds for this program. These funds are intended, in

part, to sustain current activities in Bosnia-Herzegovina and the

civic education program in Ireland and Northern Ireland. The Committee further intends that $2,000,000 of the funds be reserved to

expand and strengthen the civic education and the economics education programs currently underway in Russia.

Civic education

The Committee recommends $15,000,000 for the Center for Civic

Education. This amount is $3,000,000 more than the fiscal year

2001 appropriation. The administration recommended eliminating

this program by consolidating it into its proposed Choice and Innovation State Grants program. The civic education program provides

a course of instruction at the elementary and secondary level on

the basic principles of our constitutional democracy and the history

of the Constitution and the Bill of Rights. Funds also may be used

to provide advanced training for teachers concerning the Constitution and the Bill of Rights.
336

The Committee intends that $1,500,000 of the amount provided

be used to continue the violence prevention demonstration program

and $500,000 be used to conduct a Native American civic education

initiative.

Javits gifted and talented students education

The Committee has included $15,000,000 for the Javits Gifted

and Talented Students Education Program. This amount is

$7,500,000 more than the fiscal year 2001 appropriation. The administration recommended eliminating this program by consolidating it into its proposed Choice and Innovation State Grants program.

The Javits program authorizes awards to State and local education agencies, institutions of higher education, and 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. Priority is given to projects that identify and

serve gifted and talented students who may not be identified and

served through traditional assessment methods, including those

who are economically disadvantaged or limited-English-proficient,

or have disabilities. Some funds are set aside for a national center

for research and development in the education of gifted and talented children and youth, which conducts research on methods and

techniques for identifying and teaching gifted and talented students. The Committee intends that the additional funding provided

be used to award grants to State educational agencies, regional

educational service centers and local educational agencies to expand programs for gifted and talented students.

National Writing Project

The Committee bill provides $15,000,000 for the National Writ- ing Project. This amount is $5,000,000 more than the fiscal year

2001 appropriation. The administration recommended eliminating

this program by consolidating it into its proposed Choice and Innovation State Grants program.

These funds are awarded to the National Writing Project in

Berkeley, Calif., which in turn funds projects in 47 States, Washington, D.C., and Puerto Rico, to train teachers of all subjects how

to teach effective writing.

The writing project is the only federally funded program for the

teaching of writing skills at all grade levels.

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION

Appropriations, 2001 ............................................................................. $412,196,000

Budget estimate, 2002 ........................................................................... 424,212,000

Committee recommendation ................................................................. 424,212,000

The Committee recommends $424,212,000 for program adminis- tration, $12,016,000 more than the fiscal year 2001 appropriation

and the same as the budget request.

Funds support personnel compensation and benefits, travel, rent,

communications, utilities, printing, equipment and supplies, auto-
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mated data processing, and other services required to award, administer, and monitor approximately 170 Federal education programs. Support for program evaluation and studies and advisory

councils is also provided under this activity.

OFFICE FOR CIVIL RIGHTS

Appropriations, 2001 ............................................................................. $75,822,000

Budget estimate, 2002 ........................................................................... 79,934,000

Committee recommendation ................................................................. 79,934,000

The Committee bill includes $79,934,000 for the Office for Civil

Rights [OCR], $4,112,000 more than the fiscal year 2001 appropriation and the same as the budget request.

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

Federal education funds, and provides technical assistance to recipients of funds to help them meet civil rights requirements.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2001 ............................................................................. $36,411,000

Budget estimate, 2002 ........................................................................... 38,720,000

Committee recommendation ................................................................. 38,720,000

The Committee recommends $38,720,000 for the Office of the Inspector General, $2,309,000 more than the fiscal year 2001 appropriation and the same as the budget request.

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 regulations, 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).
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TITLE IV—RELATED AGENCIES

ARMED FORCES RETIREMENT HOME BOARD

Appropriations, 2001 ............................................................................. $69,832,000

Budget estimate, 2002 ........................................................................... 71,440,000

Committee recommendation ................................................................. 71,440,000

The Committee recommends authority to expend $71,440,000

from the Armed Forces Home Trust Fund to operate and maintain

the United States Soldiers’ and Airmen’s Home and the United

States Naval Home. This amount is equal to the budget request.

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

DOMESTIC VOLUNTEER SERVICE PROGRAMS

Appropriations, 2001 ............................................................................. $303,850,000

Budget estimate, 2002 ........................................................................... 316,850,000

Committee recommendation ................................................................. 321,276,000

The Committee recommends an appropriation of $321,276,000 for

the domestic volunteer service programs of the Corporation for National and Community Service. The Committee recommendation is

$17,426,000 above the fiscal year 2001 comparable level, and

$4,426,000 more than the budget request.

The Committee applauds the Corporation and its programs—

AmeriCorps, VISTA, and the National Senior Volunteer Corps—for

their exemplary work in support of the relief efforts following the

terrorist attacks on New York City and the Pentagon. AmeriCorps

members, VISTA volunteers and National Senior Service Corps volunteers helped coordinate blood drives, collected food and clothing

for victims’ families, and provided valuable support to the American Red Cross in this time of need.

The Committee recognizes that coordination of National Senior

Volunteer Corps activities with other senior initiatives is critical to

avoid duplication and maximize the potential of scarce Federal,

State, local, and private resources to serve our Nation’s elderly population. The Committee directs the Assistant Secretary of the Administration on Aging and the Chief Executive Officer of the Corporation for National Service to coordinate activities under the National Family Caregiver Support program of the Older Americans

Act in a way that maximizes the ability of local communities to

meet the burgeoning need for home and community-based care for

seniors and respite care for caregivers. The Senior Companion Program authorized under the Domestic Volunteer Service Act, specifically, has been providing in-home services to homebound seniors,

respite services to their families, and more for three decades. And

volunteers under the Retired and Senior Volunteer Program provide hundreds of thousands of hours annually to homebound seniors and their families. The Committee notes that coordination be-
339

tween area agencies on aging and these grantees, particularly

those sponsored by groups other than senior organizations, can

serve to strengthen the infrastructure of support available in communities throughout the country and in doing so, provide seniors

and their families greater access to much-needed services.

The Corporation for National Service has a network of State offices that provide accountability, oversight, and technical assistance for National Senior Volunteer Corps and the VISTA programs.

The Committee commends the work of the State offices for providing the support structure for thousands of volunteers nationwide. The Corporation also supports governor-appointed State commissions on national and community service that administer the

AmeriCorps program. These state commissions provide direction

that allows AmeriCorps to respond efficiently to local needs and

priorities. The Committee requests a report by March 31, 2002 on

the division of responsibilities between the CNS State offices and

the State commissions and how these two entities are functioning

in the States. The report should include an examination of the

unique ways both the State offices and State commissions can best

serve communities in the future.

VISTA

The Committee bill provides $86,500,000 for the Volunteers in Service to America (VISTA) Program, $3,426,000 above the fiscal

year 2001 level and $4,426,000 above the budget request.

VISTA is a 36-year-old program which 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.

National Senior Volunteer Corps

The Committee bill provides $202,547,000 for the National Sen- ior Volunteer Corps programs, $14,000,000 above the fiscal year

2001 level and equal to the budget request.

The Committee has included $400,000 for senior demonstration

programs. The Committee has provided these resources solely for

the purpose of continuing grants for existing demonstration activities and its recommendation does not include resources for any new

grants or activities.

The Committee recognizes the valuable contributions of seniors

participating in the Foster Grandparent (FGP), Retired and Senior

Volunteer (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 2001 level shall be used to fund Program

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. Within the appropriation, sufficient funding has been included to provide adequate resources for administrative cost increases realized by all current grantees in each DVSA program. Remaining funds should be used to begin new FGP, RSVP and SCP

programs in geographic areas currently underserved. The Com-
340

mittee expects these projects to be awarded via a nationwide competition among potential community-based sponsors.

Foster Grandparent Program

The Committee recommends $102,868,000 for the Foster Grandparent Program, $4,000,000 above the fiscal year 2001 appropriations level and equal to the budget request.

This program provides volunteer opportunities to seniors age 60

and over who serve at-risk youth. This program involves seniors in

their communities and provides a host of services to children.

Senior Companion Program

For the Senior Companion Program, the Committee bill includes

$44,395,000, an increase of $4,000,000 over the fiscal year 2001 appropriations level and equal to the budget request.

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.

The Committee recognizes the work of the Civic Venture’s Experience Corps in developing a model program that mobilizes the

time, talent, and experience of older adults in service to the younger generation. The Committee encourages the Corporation to give

full and fair consideration to this project, in particular its activities

in Indianapolis, Indiana.

Retired and Senior Volunteer Program

The Committee bill provides $54,884,000 for the Retired and

Senior Volunteer Program (RSVP), $6,000,000 above the fiscal year

2001 level and equal to the budget request.

This program involves persons age 55 and over in volunteer opportunities in their communities.

The Committee recognizes the work of the Nevada Rural Counties RSVP Home Companion Program in assisting seniors in rural

areas remain in their homes.

Program support

The Committee bill includes $32,229,000 for program support,

equal to the fiscal year 2001 appropriation and the budget request.

CORPORATION FOR PUBLIC BROADCASTING

Appropriations, 2000 ............................................................................. $350,000,000

Appropriations, 2001 ............................................................................. 365,000,000

Budget estimate, 2002 ........................................................................... ...........................

Committee recommendation ................................................................. 395,000,000

The Committee recommends an appropriation of $395,000,000 for

the Corporation for Public Broadcasting (CPB), an advance appropriation for fiscal year 2004. This amount is $30,000,000 more than

the fiscal year 2003 appropriation and $395,000,000 more than the

budget request.
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In addition, the Committee recommends $25,000,000 for the conversion to digital broadcasting. The recommendation is $5,000,000

above the administration request for fiscal year 2002 and 2001.

The Committee encourages CPB to explore new methodologies for

distribution of Federal matching dollars which take into account

measures such as per capita support and other factors that would

serve to level the playing field between urban and rural stations

in the distribution of matching funds.

FEDERAL MEDIATION AND CONCILIATION SERVICE

Appropriations, 2001 ............................................................................. $38,200,000

Budget estimate, 2002 ........................................................................... 39,482,000

Committee recommendation ................................................................. 40,482,000

The Committee recommends an appropriation of $40,482,000 for

the Federal Mediation and Conciliation Service (FMCS), $2,282,000

above the fiscal year 2001 appropriation and $1,000,000 more than

the budget request.

The Committee commends FMCS for their work to prevent youth

violence by teaching students mediation and conflict resolution

techniques. Additional funds have been included to continue and

expand this important work.

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.

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

Appropriations, 2001 ............................................................................. $6,320,000

Budget estimate, 2002 ........................................................................... 6,939,000

Committee recommendation ................................................................. 6,939,000

The Committee recommends an appropriation of $6,939,000 for

the Federal Mine Safety and Health Review Commission, an increase of $619,000 over the fiscal year 2001 appropriation and the

same as the budget request.

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 administrative appellate review of

the Commission’s administrative law judge decisions.

NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES

INSTITUTE OF MUSEUM AND LIBRARY SERVICE

OFFICE OF LIBRARY SERVICES: GRANTS AND ADMINISTRATION

Appropriations, 2001 ............................................................................. $207,469,000

Budget estimate, 2002 ........................................................................... 168,078,000

Committee recommendation ................................................................. 168,078,000

The Committee recommends an appropriation of $168,078,000 for

the Office of Library Services: Grants and Administration. This is

$39,391,000 less than the 2001 level and equal to the administration request.
342

Office of Library Services State Grants

The Committee recommends $151,955,000 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. Within the total recommended,

$2,941,000 has been provided for library services to Native Americans and Native Hawaiians.

National leadership projects

The Committee recommends $11,081,000 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.

The following programs under this account have been brought to

the Committee’s attention. The Committee believes that each will

support improvements to the quality of services provided to communities, consistent with the priorities of the Institute. The Committee encourages the Department to give each of the following

projects full and fair consideration:

—A.E. Seaman Mineral Museum in Houghton, Michigan;

—Academy of Natural Sciences in Philadelphia to preserve natural science specimens and provide natural science educational

programs;

—Alaska Humanities Forum for the ‘‘Alaska 20/20’’ project to develop a long range vision and goals for Alaska’s future;

—Alaska Moving Image Preservation Association to inventory,

assess, and preserve historic Alaska audio visual collections;

—Adler Center for Space Science Education and CyberSpace

Learning Center in Chicago for the development of educational

programs;

—American Helicopter Museum Education Center located in

Westchester, Pennsylvania;

—Audubon Aquarium of the Americas traveling wetlands exhibit;

—Bishop Museum and the Alaska Native Heritage Center for the

‘‘New Trade Winds’’ project to establish an educational and cul-
343

tural demonstration project to help youth strengthen their appreciation and knowledge of regional heritage;

—Boston Museum of Science for the new National Center for Informational Technology Education;

—Children’s Museum in Brownsville, Texas, for renovations of

exhibits and facilities;

—City of Los Angeles Gene Autry Museum’s Multicultural Heritage Camp Immersion Program and Feria de California to offer

courses to high school seniors;

—City of Twentynine Palms in California to complete murals and

provide public outreach;

—Dallas Children’s Theater to provide additional services to atrisk children in the Dallas area;

—Delaware Valley Historic Aircraft Association to develop educational programs related to the historic military aircraft presently on display at the Naval Air Station at Willow Grove;

—Discovery Square in Pennsylvania to develop science and technology exhibits in its new cultural complex;

—Exploris in Raleigh, North Carolina to develop and evaluate

on-site learning environments, on-line programming, curriculum and instruction materials, and faculty training and development programs;

—Fine Arts Museums of San Francisco for educational programming and technology improvements at the de Young Memorial

Museum;

—Franklin Pierce College in Rindge, New Hampshire for the Life

Center library project;

—Herreshoff Marine Museum/America’s Cup Museum in Bristol,

Rhode Island to enhance educational staff, facilities and resources;

—Heritage Harbor Museum in Providence, Rhode Island for operations support to facilitate exhibit space preparation;

—Houston Public Library for the ‘‘Cybraries’’ program to improve

public access to online information and computer training;

—Independence Seaport Museum to develop educational materials for K–12 students to learn about the OLYMPIA ship,

which is being preserved for Penn’s Landing in Philadelphia;

—Koahnic Broadcasting Corporation and the Alaska Humanities

Forum to record histories of Native elders and pioneers in communities throughout Alaska, so that these resources are not

lost to future generations of Alaskans and scholars;

—Lake Champlain Science Center in Burlington, Vermont for

the establishment of displays and collections;

—Long Island Children’s Museum for the development of exhibits to be placed in their newly renovated airplane hangar;

—Mandan-on-a-Slant Museum in North Dakota to replace exhibits and interpretive research;

—Monmouth University’s Guggenheim Library in New Jersey to

provide computer equipment, updated wiring for computer labs

throughout the buildings and library-specific software;

—Montshire Museum in Norwich, Vermont to help meet its

added responsibilities as the education center for the Silvio

Conte National Wildlife Refuge;
344

—Mystic Seaport Museum Onboard and Online program to provide distance learners with improved orientation and content

pathways; —National Accounting Library of the University of Mississippi at

Oxford to digitize the library of the American Institute of Certified Public Accountants; —National Aviary in Pittsburgh to develop the ‘‘Conservation

Education Technology Integration Project,’’ which will provide

increased internet access to environmental education programs; —National Liberty Museum of Philadelphia to expand its pilot

program of after-school workshops to reinforce themes of responsible citizenship, reducing violence in schools, and promoting racial and religious harmony; —National Museum of Women in the Arts in Washington, D.C.

for exhibit, education and project expansions; —North Carolina Museum of Art for cultural and educational

programming; —North Dakota State Historical Society and the Confluence Visitor Center in Williston, North Dakota for Lewis and Clark exhibits; —Oregon Museum of Science and Industry to upgrade and expand its network and video conferencing to develop interactive

demonstrations; —Paso del Norte Immigration Museum at the University of

Texas, El Paso to highlight the history and importance of immigration, particularly in the American Southwest; —Pittsburgh Children’s Museum to develop educational exhibits

and programs for area K–12 schools; —Please Touch Museum in Philadelphia to develop hands-on

learning exhibits to engage children in problem solving activities that promote the development of cognitive, communication

and social skills; —Princeton Public Library for technology enhancements;

—Rosa and Raymond Parks Institute for Self Development to

continue and expand its Pathways to Freedom program;

—Salem Daycare Center to enhance their Literacy & Bookmobile

project;

—ScienceSouth to develop a math, science and technology center

for South Carolina’s Pee Dee region;

—Shakespeare Theatre in Massachusetts;

—Shasta County Library for technology enhancements;

—Towamencin Township’s Kooker Mill Reserve Discover and

Learn Center to restore a reserve which provided shelter to

George Washington after the battle of Germantown;

—University of Oregon Museum of Natural History Conservation

Project to survey environmental conditions in exhibition and

storage spaces as well as determine conservation problems specific to particular artifacts;

—University of Idaho to continue to develop an archival library

and research program in the fine arts including cataloguing,

displaying, and digitally accessing materials;

—Vermont Historical Society in Montpelier, Vermont to expand

displays, exhibits and programming;
345

—Wayne Arts Center to develop programs in partnership with

three area K–12 public schools to provide a community resource for teachers and specialized workshops for students;

—Webster University in St. Louis, Missouri to create a centralized and technologically advanced Global Access Library;

—Weis Earth Science Museum on the campus of the University

of Wisconsin-Fox Valley in Menasha, Wisconsin.

Administration

The Committee recommends $5,042,000 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.

MEDICARE PAYMENT ADVISORY COMMISSION

Appropriations, 2001 ............................................................................. $8,000,000

Budget estimate, 2002 ........................................................................... 8,000,000

Committee recommendation ................................................................. 8,500,000

The Committee recommends an appropriation of $8,500,000 for

the Medicare Payment Advisory Commission, $500,000 more than

the fiscal year 2001 appropriation and the budget request.

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.

The Committee is concerned by the great disparity in Medicare

per beneficiary reimbursement rates among States. States receiving lower per beneficiary rates suffer a myriad of problems, including rural providers that are unable to meet operating margins, increased workforce shortages, and seniors receiving less services and

benefits.

For these reasons, the Committee has included additional funding for MedPAC to prepare a report identifying programatic

changes that would, when taken together, ensure that on an annual basis no State receives over 105 percent of the national average of per beneficiary reimbursement, no State receives under 95

percent of the national average of per beneficiary reimbursement

and the range for Geographical Payment Classification Indices

(GPCI) is restricted so that no GPCI is greater than 1.05 or less

than .95 of the standard index of 1.00. The report should include

specific details on both the necessary reimbursement rate and policy changes and the minimum timeline for such changes to be implemented. The changes should assure that beneficiaries are held

harmless and that overall reimbursement changes would be budget

neutral. The Committee expects to receive this report no later than

June 30, 2002.

NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE

Appropriations, 2001 ............................................................................. $1,495,000

Budget estimate, 2002 ........................................................................... ...........................

Committee recommendation ................................................................. 1,495,000
346

The Committee recommends an appropriation of $1,495,000 for

the National Commission on Libraries and Information Science, the

same as the fiscal year 2001 appropriation and $1,495,000 more

than the budget request.

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. The Committee

is considerably disturbed over the administration request to terminate this Commission at a time when information science and management continue to spur the economic growth of the Nation. The

Committee, therefore, has recommended an appropriation that will

allow the Commission to continue to play its important role in the

library and information science field.

NATIONAL COUNCIL ON DISABILITY

Appropriations, 2001 ............................................................................. $2,615,000

Budget estimate, 2002 ........................................................................... 2,830,000

Committee recommendation ................................................................. 2,830,000

The Committee recommends an appropriation of $2,830,000 for the National Council on Disability, $215,000 above the fiscal year

2001 appropriation and the same as the budget request.

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 EDUCATION GOALS PANEL

Appropriations, 2001 ............................................................................. $1,500,000

Budget estimate, 2002 ........................................................................... 2,000,000

Committee recommendation ................................................................. 2,000,000

The Committee recommends $2,000,000 for the national education goals panel, $500,000 above the 2001 appropriation and the

same as the budget request.

Following the 1989 education summit in Charlottesville, the Governors and President Bush agreed on education goals for the Nation and created the National Education Goals Panel as an accountability mechanism to monitor and report on the Nation’s

progress toward reaching the goals.

NATIONAL LABOR RELATIONS BOARD

Appropriations, 2001 ............................................................................. $216,438,000

Budget estimate, 2002 ........................................................................... 221,438,000

Committee recommendation ................................................................. 226,438,000

The Committee recommends an appropriation of $226,438,000 for

the National Labor Relations Board (NLRB), $10,000,000 more

than the fiscal year 2001 comparable level and $5,000,000 more

than the budget request.
347

The Committee is pleased to note that the NLRB has made significant progress, reducing the unfair labor practice case backlog by

approximately 800 cases in fiscal year 2000. While the bulk of the

increased appropriation is intended to cover built in costs, such as

the mandatory cost of living adjustments, the Committee has included funds to continue the effort to reduce backlogged cases.

The NLRB is a law enforcement agency which adjudicates disputes under the National Labor Relations Act.

NATIONAL MEDIATION BOARD

Appropriations, 2001 ............................................................................. $10,400,000

Budget estimate, 2002 ........................................................................... 10,635,000

Committee recommendation ................................................................. 10,635,000

The Committee recommends an appropriation of $10,635,000 for

the National Mediation Board, $235,000 more than the fiscal year

2001 appropriation and the same as the budget request.

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.

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

Appropriations, 2001 ............................................................................. $8,720,000

Budget estimate, 2002 ........................................................................... 8,964,000

Committee recommendation ................................................................. 8,964,000

The Committee recommends an appropriation of $8,964,000 for

the Occupational Safety and Health Review Commission, $244,000

above the fiscal year 2001 appropriation and the same as the budget request.

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, 2001 ............................................................................. $150,000,000

Budget estimate, 2002 ........................................................................... 146,000,000

Committee recommendation ................................................................. 146,000,000

The Committee has provided a total of $146,000,000 for dual ben- efits, including $9,000,000 in income tax receipts on dual benefits

as authorized by law. The Committee recommendation is

$4,000,000 less than the fiscal year 2001 level and the same as the

budget request.

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.
348

FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2001 ............................................................................. $150,000

Budget estimate, 2002 ........................................................................... 150,000

Committee recommendation ................................................................. 150,000

The Committee recommends $150,000 for interest earned on unnegotiated checks. This is the same as the fiscal year 2001 appropriation and budget request.

LIMITATION ON ADMINISTRATION

Appropriations, 2001 ............................................................................. $95,000,000

Budget estimate, 2002 ........................................................................... 97,700,000

Committee recommendation ................................................................. 97,700,000

The Committee recommends an appropriation of $97,700,000 for

the administration of railroad retirement/survivor benefit programs. This amount is $2,700,000 more than the fiscal year 2001

comparable level, and the same as the budget request.

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.

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2001 ............................................................................. $5,700,000

Budget estimate, 2002 ........................................................................... 6,480,000

Committee recommendation ................................................................. 6,480,000

The Committee recommends $6,480,000 for the Office of the Inspector General, $780,000 above the 2001 appropriation and the

same as the budget request.

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 RRB’s separate Medicare contract.

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2001 ............................................................................. $20,400,000

Budget estimate, 2002 ........................................................................... 434,400,000

Committee recommendation ................................................................. 434,400,000

The Committee recommends an appropriation of $434,400,000 for

payments to Social Security trust funds, the same as the administration request. 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.
349

The increase includes $414,000,000 for the quinquennial adjustment to reimburse the OASI trust funds for the costs of granting

noncontributory wage credits for military service.

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2001 ............................................................................. $365,748,000

Budget estimate, 2002 ........................................................................... 332,840,000

Committee recommendation ................................................................. 332,840,000

The Committee recommends an appropriation of $332,840,000 for

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

$114,000,000 appropriated last year as an advance for the first

quarter of fiscal year 2002. The recommendation is the same as the

administration request. These funds are used to provide monthly

benefits to coal miners disabled by black lung disease and to their

widows and certain other dependents, as well as to pay related administrative costs.

The Social Security Administration holds primary responsibility

for claims filed before July 1973, with the Department of Labor responsible for claims filed after that. 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

$108,000,000 for the first quarter of fiscal year 2003, the same as

the administration request. These funds will ensure uninterrupted

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

SUPPLEMENTAL SECURITY INCOME

Appropriations, 2001 ............................................................................. $23,344,000,000

Budget estimate, 2002 ........................................................................... 21,576,412,000

Committee recommendation ................................................................. 21,577,412,000

The Committee recommends an appropriation of $21,577,412,000

for supplemental security income. This is in addition to the

$10,470,000,000 appropriated last year as an advance for the first

quarter of fiscal year 2002 and includes funds for continuing disability reviews. The recommendation is $1,000,000 more than the

administration’s request and $1,766,588,000 less than the fiscal

year 2001 level. The Committee also recommends an advance appropriation of $10,790,000,000 for the first quarter of fiscal year

2003 to ensure uninterrupted benefits payments.

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 6.4 million

persons will receive SSI benefits each month during fiscal year

2002. 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.
350

Beneficiary services

The Committee recommendation includes $37,412,000 for beneficiary services, which is the same as the administration request

and $33,588,000 less than the fiscal year 2001 level. This appropriation added to carryover funding of approximately $38,000,000

will bring the fiscal year 2002 program funding level to approximately $75,000,000. This amount is available for reimbursement of

State vocational rehabilitation agencies and alternate public or private providers. In 1994 SSA published a regulation permitting direct reimbursement of alternate public and private providers to

provide vocational rehabilitation services. Vocational rehabilitation

services are now more readily available to a larger number of people with disabilities, since the regulation allows SSA to use an alternate public or private sector provider, if a State vocational rehabilitation agency has not accepted an SSA-referred person for services or extended evaluation.

Research and demonstration projects

The Committee recommendation includes $37,000,000 for research and demonstration projects conducted under sections 1110

and 1115 of the Social Security Act. This is $7,000,000 more than

the fiscal year 2001 level and the administration request.

This amount will support SSA’s efforts to strengthen its policy

evaluation capability and focus on research of: program solvency

issues, the impact of demographic changes on future workloads and

effective return-to-work strategies for disabled beneficiaries. The Committee has added $7,000,000 to the Administration’s request in order to enable SSA to implement Section 1144 of the Social Security Act. This section requires the Commissioner of Social

Security to conduct outreach efforts to identify individuals who

may be eligible for payment of the cost of medicare cost-sharing

under the medicaid program. This outreach, including notices to individuals and States of an individual’s potential eligibility, will be

evaluated by the General Accounting Office. The Committee looks

forward to the GAO report regarding SSA’s efforts in this area as

well as the report’s recommendations for further action.

The Committee understands that some patients with Lyme disease and other tick-borne disorders have encountered some difficulty when applying for assistance through SSA offices, due to

SSA employees’ unfamiliarity with these illnesses. SSA is encouraged to work on developing educational materials for SSA employees to facilitate a better understanding of the potential debilitating

effects of these disorders. The Committee suggests that SSA collaborate with clinicians who have expertise on the multi-system

chronic effects of Lyme, as well as patient and voluntary communities, to accomplish this goal.

The Committee is pleased that SSA officials have continued to

educate adjudicators at all levels of the SSA process about the

April 1999 CFS ruling (99–2p). The Committee encourages SSA to

continue these educational efforts, to ensure SSA employees are

properly informed about CFS and the functional limitations it imposes. Finally, the Committee encourages SSA to continue its investigation of obstacles to benefits for persons with CFIDS, to assess the impact of the new ruling on CFS patients’ access to bene-
351

fits, and to keep medical information updated throughout all levels

of the application and review process.

Administration

The Committee recommendation includes $2,627,000,000 for payment to the Social Security trust funds for the SSI Program’s share

of SSA’s base administrative expenses. This is $278,000,000 above

the fiscal year 2001 level and equal to the administration request.

Continuing Disability Reviews

The recommendation includes $200,000,000 for payments to the

Social Security trust fund to process continuing reviews and redeterminations of the disability and nondisability eligibility factors of

entitlement for individuals receiving supplemental security income

on the basis of their disability.

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2001 ............................................................................. $7,124,000,000

Budget estimate, 2002 ........................................................................... 7,574,000,000

Committee recommendation ................................................................. 7,568,000,000

The Committee recommends a program funding level of $7,568,000,000 for the limitation on administrative expenses, which

is equal to the administration request and $444,000,000 higher

than the fiscal year 2001 level.

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 limitation includes $7,035,000,000 for routine operating expenses of the agency, which is equal to the amount requested by

the President and $452,000,000 over the 2001 comparable amount.

These funds, as well as those derived from an increase in the user

fees which are discussed below, cover the mandatory costs of maintaining equipment and facilities, as well as staffing.

The Committee has provided $433,000,000 to process continuing

reviews and redeterminations of the disability and nondisability

eligibility factors of entitlement for individuals receiving benefits

on the basis of their disability.

The Committee commends the efforts of the Social Security Administration in establishing and publicizing special emergency handling procedures for claims resulting from the terrorist attacks at

the World Trade Center, the Pentagon, and Pennsylvania, particu-
352

larly in light of the obstacles faced in the New York region. The

Committee thanks the employees of the Social Security Administration for their extraordinary efforts in response to this crisis.

Given the limited resources, the Committee encourages the Agency to consider the service delivery preferences of its customers

when making resource allocation decisions regarding customer

points of contact (field offices, teleservice centers, internet-based

services). The agency, as part of the congressional justification for

its fiscal year 2003 budget request, should include information

about the service delivery preferences of current and future customers and a plan for allocating resources to best meet their needs.

The Committee is concerned that barriers exist preventing eligible homeless persons from applying for and receiving SSDI and SSI

benefits. The Agency is to be commended for their past participation in the Interagency Council on the Homeless (ICH). The mission of the Council is vital to ending homelessness by coordinating

Federal resources, reducing duplications of service and recommending improvements in Federal programs. The Committee

strongly encourages the Agency to continue and expand its participation in the Council, preparing an Agency-wide plan for providing

services to the homeless. This plan should include an overview of

ways for the Agency to work with non-profit and community based

organizations to assist homeless persons in applying for and receiving much needed benefits. The Agency should comment in its fiscal

year 2003 budget request on the status of this plan and on any efforts undertaken to assist homeless people.

The Committee is monitoring the implementation of the Return

to Work Program created by the TWWIIA Act. The Committee encourages the Social Security Administration to fund the components of the program at the authorized level in fiscal year 2002.

These components include the Protection and Advocacy System for

Beneficiaries of Social Security (PABSS) and the Benefits Planning,

Assistance and Outreach Program (BPAO).

Social Security Advisory Board

The Committee has included $1,800,000 within the limitation on

administrative expenses account for the Social Security Advisory

Board for fiscal year 2002, the same level as the administration request and the same as the fiscal year 2001 level.

User fees

In addition to other amounts provided, the Committee rec- ommends $100,000,000 for administrative activities funded from

user fees that were authorized in fiscal year 1998. This is

$6,000,000 less than the administration’s request and an increase

of $9,000,000 over the fiscal year 2001 level.

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2001 ............................................................................. $69,444,000

Budget estimate, 2002 ........................................................................... 75,000,000

Committee recommendation ................................................................. 75,000,000

The Committee recommends $75,000,000 for activities for the Office of the Inspector General, $5,556,000 more than fiscal year 2001

and equal to the administration request. This includes a general
353

fund appropriation of $19,000,000 together with an obligation limitation of $56,000,000 from the Federal old-age and survivors insurance trust fund and the Federal disability insurance trust fund.

The Committee continues to be very concerned with the many

challenges to protecting the privacy of individuals’ Social Security

Numbers (SSNs). The number of complaints of identity theft and

other abuses due to the inappropriate sale or misuse use of SSNs

has risen dramatically. The Committee commends the Office of Inspector General for their work on the inappropriate sale and misuse of SSNs and has included additional funds above the fiscal year

2001 appropriation to allow an expansion of these important consumer protection efforts and to appropriately respond to the rapidly

rising number of complaints.

U.S. INSTITUTE OF PEACE

Appropriations, 2001 ............................................................................. $15,000,000

Budget estimate, 2002 ........................................................................... 15,207,000

Committee recommendation ................................................................. 15,207,000

The Committee recommends an appropriation of $15,207,000 for

the U.S. Institute of Peace, $207,000 more than the fiscal year

2001 appropriation and equal to the budget request.

The Institute was established by the U.S. Institute of Peace Act

(Public Law 98–525) in 1984. The Institute is an independent, nonprofit, national organization whose primary mission is to promote,

through scholarship and education, international peace, and the

resolution of conflicts without recourse to violence.

The setting of Federal budget priorities is an issue of critical relevance to the international community, U.S. foreign policy and the

field of international conflict resolution. Inadequate Federal funds

have historically undermined efforts to strengthen the Nation’s capacity to promote the peaceful resolution of international conflict.

The Committee directs the Institute to support research, through

the Jennings Randolph Program for International Peace on setting

and implementing Federal budget priorities.
(354)

TITLE V—GENERAL PROVISIONS

The Committee recommendation retains 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 unless the Secretary of HHS determines such programs

are effective in preventing the spread of HIV and do not encourage

the use of illegal drugs (sec. 505); state the sense of Congress about

purchase of American-made equipment and products (sec. 506);

clarify Federal funding as a component of State and local grant

funds (sec. 507); and limit use of funds for abortion (sec. 508 and

sec. 509).

The Committee recommendation includes language on human

embryo research (sec. 510).

The Committee recommendation retains the limitation on use of

funds for promotion of legalization of controlled substances included last year (sec. 511).

The Committee recommendation retains the bill language limitation on 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. 512).

The Committee bill includes language regarding the individual

health identifier (sec. 513).

The Committee recommendation includes a provision relating to

grant notification procedures (sec. 514).
(355)

TITLE VI—MARK-TO-MARKET EXTENSION ACT OF 2001

This title includes the text to H.R. 2589, the ‘‘Mark-to-Market

Extension Act of 2001’’ which has been passed by the House and

reflects the agreement of the Senate Committee on Banking, Housing, and Urban Affairs. This legislation, among other things, would

extend HUD’s authority to restructure the oversubsidized mortgages of multifamily housing with expiring section 8 contracts to

ensure that the assisted rents are consistent with the rents of comparable private units in a marketplace.
(356)

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 First Concurrent Resolution

for 2002: Subcommittee on Labor, Health and

Human Services, Education, and Related

Agencies:

General purpose, non-defense ..................... 123,071 123,071 NA NA

General purpose ........................................... NA NA 107,716 1 107,716

Mandatory .................................................... 272,937 272,937 272,968 272,968

Projections of outlays associated with the recommendation:

2002 ............................................................. .................... .................... .................... 2 258,082

2003 ............................................................. .................... .................... .................... 86,032

2004 ............................................................. .................... .................... .................... 18,269

2005 ............................................................. .................... .................... .................... 5,057

2006 and future years ................................ .................... .................... .................... 1,017

Financial assistance to State and local governments for 2002 ................................................ NA 164,180 NA 132,426

1 Includes outlays from prior-year budget authority.

2 Excludes outlays from prior-year budget authority.

NA: Not applicable.

Note.—Consistent with the funding recommended in the bill for continuing disability reviews and adoption assistance,

and in accordance with section 314 of the Congressional Budget Act of 1974, the Committee anticipates that the Budget

Committee will file a revised section 302(a) allocation for the Committee on Appropriations reflecting an upward adjustment of $453,000,000 in budget authority and $384,000,000 in outlays.

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:

Trade adjustment assistance, $349,500,000;

National Skills Standards Board, $3,500,000;

Work Opportunity Tax Credits, $22,000,000;

Family Planning, $260,000,000;
357

Preventive Health and Health Services Block Grant,

$139,030,000;

Sexually transmitted diseases, $166,200,000;

Community health centers, $1,343,723,000;

National Health Service Corps, $154,427,000;

Denali Commission, $20,000,000;

Health care facilities, $10,000,000;

Rural health and telehealth programs, $103,527,000;

School renovation grants, $925,000,000;

Adolescent Family Life, $30,000,000;

Nursing Loan Payment, $15,000,000;

Organ Transplantation, $19,992,000;

Abandoned infants assistance, $12,205,000;

Adoptions opportunities, $27,405,000;

Child Abuse Prevention and Treatment Act programs, $88,577,000;

Promoting safe and stable families, $305,000,000;

National Education Goals Panel, $2,000,000;

National Commission on Libraries and Information Science,

$1,495,000.

COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE

STANDING RULES OF THE SENATE

Pursuant to paragraph 7(c) of rule XXVI, the Committee ordered

reported, S. 1536, an original Departments of Labor, Health and

Human Services, and Education, and related agencies appropriations bill, 2002, subject to amendment and subject to its budget allocations, by a recorded vote of 29–0, a quorum being present. The

vote was as follows:

Yeas Nays

Chairman Byrd

Mr. Inouye

Mr. Hollings

Mr. Leahy

Mr. Harkin

Ms. Mikulski

Mr. Reid

Mr. Kohl

Mrs. Murray

Mr. Dorgan

Mrs. Feinstein

Mr. Durbin

Mr. Johnson

Ms. Landrieu

Mr. Reed

Mr. Stevens

Mr. Cochran

Mr. Specter

Mr. Domenici

Mr. Bond

Mr. McConnell

Mr. Burns

Mr. Shelby
358

Mr. Gregg

Mr. Bennett

Mr. Campbell

Mr. Craig

Mrs. Hutchison

Mr. DeWine

COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE

STANDING RULES OF THE SENATE

Paragraph 12 of rule XXVI requires that Committee reports on

a bill or a joint resolution repealing or amending any statute include ‘‘(a) the text of the statute or part thereof which is proposed

to be repealed; and (b) a comparative print of that part of the bill

or joint resolution making the amendment and of the statute or

part thereof proposed to be amended, showing by stricken through

type and italics, parallel columns, or other appropriate typographical devices the omissions and insertions which would be

made by the bill or joint resolution if enacted in the form recommended by the committee.’’ In compliance with this rule, the following changes in existing

law proposed to be made by the bill are shown as follows: existing

law to be omitted is enclosed in black brackets; new matter is

printed in italic; and existing law in which no change is proposed

is shown in roman.

TITLE 8—ALIENS AND NATIONALITY

* * * * * * *

CHAPTER 12—IMMIGRATION AND NATIONALITY

* * * * * * *

SUBCHAPTER II—IMMIGRATION

PART I—SELECTION SYSTEM

* * * * * * *

§ 1157. Annual admission of refugees and admission of emergency situation refugees

* * * * * * *

ESTABLISHING CATEGORIES OF ALIENS FOR PURPOSES OF REFUGEE

DETERMINATIONS

* * * * * * *

‘‘(a) * * *

* * * * * * *

‘‘(b) ESTABLISHMENT OF CATEGORIES.—

‘‘(1) * * *

‘‘(3) Within the number of admissions of refugees allocated

for for [sic] each of fiscal years ø1997, 1998, 1999, 2000, and

2001¿ 1997, 1998, 1999, 2000, 2001, and 2002 for refugees who

are nationals of the Soviet Union under section 207(a)(3) of the

Immigration and Nationality Act [8 U.S.C. 1157(a)(3)] and
359

within the number of such admissions allocated for each of fiscal years 1993, 1994, 1995, and 1996 for refugees who are nationals of the independent states of the former Soviet Union,

Estonia, Latvia, and Lithuania under such section, notwithstanding any other provision of law, the President shall allocate one thousand of such admissions for such fiscal year to

refugees who are within the category of aliens described in

paragraph (2)(B).

* * * * * * * ‘‘(e) PERIOD OF APPLICATION.— ‘‘(1) Subsections (a) and (b) shall take effect on the date of

the enactment of this Act [Nov. 21, 1989] and shall only apply

to applications for refugee status submitted before øOctober 1,

2001¿ October 1, 2002. ‘‘(2) Subsection (c) shall apply to decisions made after the

date of the enactment of this Act and before øOctober 1, 2001¿

October 1, 2002. ‘‘(3) Subsection (d) shall take effect on the date of the enactment of this Act and shall only apply to reapplications for

refugee status submitted before øOctober 1, 2001¿ October 1,

2002.’’

* * * * * * *

PART V—ADJUSTMENT AND CHANGE OF STATUS

* * * * * * *

§ 1255. Adjustment of status of nonimmigrant to that of person admitted for permanent residence

* * * * * * *

ADJUSTMENT OF STATUS FOR CERTAIN SOVIET AND INDOCHINESE

PAROLEES

Pub. L. 101–167, title V, Sec. 599E, Nov. 21, 1989, 103 Stat.

1263, as amended by Pub. L. 101–513, title V, Sec. 598(b), Nov. 5,

1990, 104 Stat. 2063; Pub. L. 101–649, title VI, Sec. 603(a)(22),

Nov. 29, 1990, 104 Stat. 5084; Pub. L. 102–232, title III, Sec.

307(l)(9), Dec. 12, 1991, 105 Stat. 1757; Pub. L. 102–391, title V,

Sec. 582(a)(2), (b)(2), Oct. 6, 1992, 106 Stat. 1686; Pub. L. 102–511,

title IX, Sec. 905(b)(2), Oct. 24, 1992, 106 Stat. 3356; Pub. L. 103– 236, title V, Sec. 512(2), Apr. 30, 1994, 108 Stat. 466; Pub. L. 103– 416, title II, Sec. 219(bb), Oct. 25, 1994, 108 Stat. 4319; Pub. L.

104–208, div. A, title I, § 101(c) [title V, Sec. 575(2)], Sept. 30, 1996,

110 Stat. 3009–121, 3009–168; Pub. L. 104–319, title I, Sec. 101(2),

Oct. 19, 1996, 110 Stat. 3865; Pub. L. 105–118, title V, Sec. 574(2),

Nov. 26, 1997, 111 Stat. 2432; Pub. L. 105–277, div. A, Sec. 101(f)

[title VII, § 705(2)], Oct. 21, 1998, 112 Stat. 2681–337, 2681–389;

Pub. L. 106–113, div. B, Sec. 1000(a)(4) [title II, Sec. 214(2)], Nov.

29, 1999, 113 Stat. 1535, 1501A–240, provided that:

‘‘(a) IN GENERAL.—The Attorney General shall adjust the status of an alien described in subsection (b) to that of an alien lawfully admitted for permanent residence if the alien—

* * * * * * *
360

‘‘(b) Aliens Eligible for Adjustment of Status.—The benefits provided in subsection (a) shall only apply to an alien who— ‘‘(1) was a national of an independent state of the former

Soviet Union, Estonia, Latvia, Lithuania, Vietnam, Laos, or

Cambodia, and ‘‘(2) was inspected and granted parole into the United

States during the period beginning on August 15, 1988, and

ending on øSeptember 30, 2001¿ September 30, 2002, after

being denied refugee status.

* * * * * * *

TITLE 42—THE PUBLIC HEALTH AND WELFARE

* * * * * * *

CHAPTER 69—COMMUNITY DEVELOPMENT

* * * * * * *

§ 5305. Activities eligible for assistance

(a) Enumeration of eligible activities

Activities assisted under this chapter may include only—

(1) * * *

* * * * * * *

(8) provision of public services, including but not limited to

those concerned with employment, crime prevention, child

care, health, drug abuse, education, energy conservation, welfare or recreation needs, if such services have not been provided by the unit of general local government (through funds

raised by such unit, or received by such unit from the State in

which it is located) during any part of the twelve-month period

immediately preceding the date of submission of the statement

with respect to which funds are to be made available under

this chapter, and which are to be used for such services, unless

the Secretary finds that the discontinuation of such services

was the result of events not within the control of the unit of

general local government, except that not more than 15 per

centum of the amount of any assistance to a unit of general

local government (or in the case of nonentitled communities

not more than 15 per centum statewide) under this chapter including program income may be used for activities under this

paragraph unless such unit of general local government used

more than 15 percent of the assistance received under this

chapter for fiscal year 1982 or fiscal year 1983 for such activities (excluding any assistance received pursuant to Public Law

98–8), in which case such unit of general local government may

use not more than the percentage or amount of such assistance

used for such activities for such fiscal year, whichever method

of calculation yields the higher amount, except that of any

amount of assistance under this chapter (including program income) in each of fiscal years 1993 øthrough 2001¿ through

2003 to the City of Los Angeles and County of Los Angeles,

each such unit of general government may use not more than

25 percent in each such fiscal year for activities under this
361

paragraph, and except that of any amount of assistance under

this chapter (including program income) in each of fiscal years

1999, 2000, and 2001, to the City of Miami, such city may use

not more than 25 percent in each fiscal year for activities

under this paragraph;

* * * * * * *

UNITED STATES HOUSING ACT OF 1937

* * * * * * *

TITLE I—GENERAL PROGRAM OF ASSISTED

HOUSING

* * * * * * *

LOWER INCOME HOUSING ASSISTANCE

SEC. 8. (a) * * *

* * * * * * *

(t) ENHANCED VOUCHERS.—

(1) * * *

* * * * * * *

(2) ELIGIBILITY EVENT.—For purposes of this subsection,

the term ‘‘eligibility event’’ means, with respect to a multifamily housing project, the prepayment of the mortgage on

such housing project, the voluntary termination of the insurance contract for the mortgage for such housing project (including any such mortgage prepayment during fiscal year 1996 or

a fiscal year thereafter or any insurance contract voluntary termination during fiscal year 1996 or a fiscal year thereafter), the

termination or expiration of the contract for rental assistance

under section 8 of the United States Housing Act of 1937 for

such housing project, or the transaction under which the

project is preserved as affordable housing, that, under paragraphs (3) and (4) of section 515(c), section 524(d) of the Multifamily Assisted Housing Reform and Affordability Act of 1997

(42 U.S.C. 1437f note), section 223(f ) of the Low-Income Housing Preservation and Resident Homeownership Act of 1990 (12

U.S.C. 4113(f )), or section 201(p) of the Housing and Community Development Amendments of 1978 (12 U.S.C. 1715z–

1a(p)), results in tenants in such housing project being eligible

for enhanced voucher assistance under this subsection.

* * * * * * *

NATIONAL HOUSING ACT

* * * * * * *

MISCELLANEOUS HOUSING INSURANCE

SEC. 223. (a) * * *
362

(1) * * *

* * * * * * *

(7) given to refinance an existing mortgage insured øunder

this Act: Provided, That the principal¿ under this Act, or an existing mortgage held by the Secretary that is subject to a mortgage restructuring and rental assistance sufficiency plan pursuant to the Multifamily Assisted Housing Reform and Affordability Act of 1997 (42 U.S.C. 1437f note), provided that—

(A) the principal amount of any such refinancing mortgage shall not exceed the original principal amount or the

unexpired term of such existing mortgage and shall bear

interest at such rate as may be agreed upon by the mortgagor and the mortgagee, øexcept that (A)¿ except that (i)

the principal amount of any such refinancing mortgage

may equal the outstanding balance of an existing mortgage

insured pursuant to section 245, if the amount of the

monthly payment due under the refinancing mortgage is

less than that due under the existing mortgage for the

month in which the refinancing mortgage is executed;

ø(B)¿ (ii) a mortgagee may not require a minimum principal amount to be outstanding on the loan secured by the

existing mortgage; ø(C)¿ (iii) in any case involving the refinancing of a loan in which the Secretary determines that

the insurance of a mortgage for an additional term will

inure to the benefits of the applicable insurance fund, taking into consideration the outstanding insurance liability

under the existing insured mortgage, such refinancing

mortgage may have a term not more than twelve years in

excess of the unexpired term of such existing insured mortgage; and ø(D)¿ (iv) any multifamily mortgage that is refinanced under this paragraph shall be documented through

amendments to the existing insurance contract and shall

not be structured through the provisions of a new insurance contractø: Provided further, That a mortgage¿; and

(B) a mortgage of the character described in paragraphs (1) through (6) of this subsection shall have a maturity and a principal obligation not in excess of the maximums prescribed under the applicable section or title of

this Act, except that in no case may the principal obligation of a mortgage referred to in paragraph (5) of this subsection exceed 90 per centum of the appraised value of the

mortgage property, and shall bear interest at such rate as

may be agreed upon by the mortgagor and the mortgagee;

øor¿

(C) a mortgage that is subject to a mortgage restructuring and rental assistance sufficiency plan pursuant to

the Multifamily Assisted Housing Reform and Affordability

Act of 1997 (42 U.S.C. 1437f note) and is refinanced under

this paragraph may have a term of not more than 30 years;

or

* * * * * * *
363

HOUSING AND COMMUNITY DEVELOPMENT ACT OF 1974

* * * * * * *

TITLE I—COMMUNITY DEVELOPMENT

FINDINGS AND PURPOSE

* * * * * * *

(8) provision of public services, including but not limited to

those concerned with employment, crime prevention, child

care, health, drug abuse, education, energy conservation, welfare or recreation needs, if such services have not been provided by the unit of general local government (through funds

raised by such unit, or received by such unit from the State in

which it is located) during any part of the twelve-month period

immediately preceding the date of submission of the statement

with respect to which funds are to be made available under

this title, and which are to be used for such services, unless

the Secretary finds that the discontinuation of such services

was the result of events not within the control of the unit of

general local government, except that not more that 15 per

centum of the amount of any assistance to a unit of general

local government (or in the case of nonentitled communities

not more than 15 per centum statewide) under this title including program income may be used for activities under this paragraph unless such unit of general local government used more

than 15 percent of the assistance received under this title for

fiscal year 1982 or fiscal year 1983 for such activities (excluding any assistance received pursuant to Public Law 98–8), in

which case such unit of general local government may use not

more than the percentage or amount of such assistance used

for such activities for such fiscal year, whichever method of calculation yields the higher amount, except that of any amount

of assistance under this title (including program income) in

each of fiscal years 1993 through 1999 to the City of Los Angeles and County of Los Angeles, each such unit of general government may use not more than 25 percent in each such fiscal

year for activities under this paragraph, and except that of any

amount of assistance under this title (including program income) in each of fiscal years 1999, 2000, and 2001, to the City

of Miami, such city may use not more than 25 percent in each

fiscal year for activities under this paragraph;

* * * * * * *

MULTIFAMILY ASSISTED HOUSING REFORM AND

ACCOUNTABILITY ACT OF 1997

* * * * * * *

TITLE V—HUD MULTIFAMILY HOUSING REFORM

* * * * * * *
364

SUBTITLE A—FHA-INSURED MULTIFAMILY HOUSING MORTGAGE AND

HOUSING ASSISTANCE RESTRUCTURING

* * * * * * *

SEC. 511. FINDINGS AND PURPOSES.

(a) * * *

(1) * * *

* * * * * * *

(12) the authority and duties of the Secretary, not including the control by the Secretary of applicable accounts in the

Treasury of the United States, may be delegated to State, local

or other entities at the discretion of the Secretary, to the extent the Secretary determines, and for the purpose of carrying

out øthis Act¿ this title, so that the Secretary has the discretion to be relieved of processing and approving any document

or action required by these reforms.

* * * * * * *

SEC. 512. DEFINITIONS.

In this subtitle:

(1) * * *

* * * * * * *

(2) * * *

(A) * * *

* * * * * * *

(C) financed by a mortgage insured or held by the Secretary under the National Housing Act.

Such term does not include any project with an expiring contract described in paragraph (1) or (2) of section 524(e), but

does include a project described in section 524(e)(3). Notwithstanding any other provision of this title, the Secretary may

treat a project as an eligible multifamily housing project for

purposes of this title if (I) the project is assisted pursuant to a

contract for project-based assistance under section 8 of the

United States Housing Act of 1937 renewed under section 524

of this Act, (II) the owner consents to such treatment, and (III)

the project met the requirements of the first sentence of this

paragraph for eligibility as an eligible multifamily housing

project before the initial renewal of the contract under section

524.

* * * * * * *

(18) * * *

(A) * * *

* * * * * * *

(C) is not in default under any Government National

Mortgage Association obligation.

‘‘(19) OFFICE.—The term ‘Office’ means the Office of Multifamily Housing Assistance Restructuring established under section 571.’’

* * * * * * *
365

SEC. 513. AUTHORITY OF PARTICIPATING ADMINISTRATIVE ENTITIES.

(a) * * *

(1) * * *

* * * * * * *

(2) PORTFOLIO RESTRUCTURING AGREEMENTS.—Each portfolio restructuring agreement entered into under this subsection shall—

(A) * * *

* * * * * * *

(I) include, where appropriate, incentive agreements

with the participating administrative entity to reward superior performance in meeting the purposes of øthis Act¿

this title.

(b) * * *

(1) * * *

* * * * * * *

(3) PARTNERSHIPS.—For the purposes of any participating

administrative entity applying under this subsection, participating administrative entities are encouraged to develop partnerships with each other and with nonprofit organizations, if

such partnerships will further the participating administrative

entity’s ability to meet the purposes of øthis Act¿ this title.

* * * * * * *

SEC. 514. MORTGAGE RESTRUCTURING AND RENTAL ASSISTANCE

SUFFICIENCY PLAN.

(a) * * *

* * * * * * *

(f) * * *

* * * * * * *

(3) FUNDING.—

(A) IN GENERAL.—The øSecretary may provide not more than $10,000,000 annually in funding¿ Secretary shall make available not more than $10,000,000 annually

in funding, which amount shall be in addition to any

amounts made available under this subparagraph and carried over from previous years, from which the Secretary

may make obligations to tenant groups, nonprofit organizations, and public entities for building the capacity of tenant organizations, for technical assistance in furthering

any of the purposes of this subtitle (including transfer of

developments to new owners), for technical assistance for

preservation of low-income housing for which project-based

rental assistance is provided at below market rent levels

and may not be renewed (including transfer of developments to tenant groups, nonprofit organizations, and public øentities), and for tenant services,¿ entities), for tenant

services, and for tenant groups, nonprofit organizations,

and public entities described in section 517(a)(5), from

those amounts made available under appropriations Acts

for implementing this subtitle or previously made avail-
366

able for technical assistance in connection with the preservation of affordable rental housing for low-income persons.

(B) MANNER OF PROVIDING.—Notwithstanding any

other provision of law restricting the use of preservation

technical assistance funds, the Secretary may provide any

funds made available under subparagraph (A) through existing technical assistance programs pursuant to any other

Federal law, including the Low-Income Housing Preservation and Resident Homeownership Act of 1990 and the

Multifamily Housing Property Disposition Reform Act of

1994, or through any other means that the Secretary considers consistent with the purposes of this subtitle, without regard to any set-aside requirement otherwise applicable to those funds.

* * * * * * *

(g) RENT LEVELS.—

(1) * * *

* * * * * * *

(2) EXCEPTIONS.—

(A) IN GENERAL.—A contract under this section may

include rent levels that exceed the rent level described in

paragraph (1) at rent levels that do not exceed 120 percent

of the fair market rent for the market area (except that

the Secretary may waive this limit for not more than five

percent of all units subject to ørestructured mortgages in

any fiscal year¿ portfolio restructuring agreements, based

on a finding of special need), if the participating administrative entity—

* * * * * * *

(h) * * *

(1) * * *

(2) the project is a project financed under section 202 of

the Housing Act of 1959 or section 515 of the Housing Act of

1949, or refinanced pursuant to section 811 of the American

Homeownership and Economic Opportunity Act of 2000 (12

U.S.C. 1701q note); or

* * * * * * *

SEC. 515. SECTION 8 RENEWALS AND LONG-TERM AFFORDABILITY

COMMITMENT BY OWNER OF PROJECT.

(a) * * *

* * * * * * *

(c) DETERMINATION OF WHETHER TO RENEW WITH PROJECTBASED OR TENANT-BASED ASSISTANCE.—

(1) MANDATORY RENEWAL OF PROJECT-BASED ASSISTANCE.—

Section 8 assistance shall be renewed with project-based assistance, if—

(A) the project is located in an area in which the participating administrative entity determines, based on housing market indicators, such as low vacancy rates or high

absorption rates, that there is not adequate available and

affordable housing or that the tenants of the project would
367

not be able to locate suitable units or use the tenant-based

assistance successfully;

(B) a predominant number of the units in the project

are occupied by elderly families, disabled families, or elderly and disabled families; or

* * * * * * *

SEC. 516. PROHIBITION ON RESTRUCTURING.

(a) * * *

* * * * * * *

(d) DISPLACED TENANTS.—øSubject to¿

(1) NOTICE TO CERTAIN RESIDENTS.—The Office shall notify

any tenant that is residing in a project or receiving assistance

under section 8 of the United States Housing Act of 1937 (42

U.S.C. 1437f) at the time of rejection under this section, of such

rejection, except that the Office may delegate the responsibility

to provide notice under this paragraph to the participating administrative entity.

(2) ASSISTANCE AND MOVING EXPENSES.—Subject to the

availability of amounts provided in advance in appropriations

Acts, for any low-income tenant that is residing in a project or

receiving assistance under section 8 of the United States Housing Act of 1937 at the time of rejection under this section, that

tenant shall be provided with tenant-based assistance and reasonable moving expenses, as determined by the Secretary.

* * * * * * *

SEC. 517. RESTRUCTURING TOOLS.

(a) MORTGAGE RESTRUCTURING.—

(1) * * *

(A) * * *

(B) a second mortgage that is in an amount equal to

øno more than the¿ not more than the greater of—

‘‘(i) the full or partial payment of claim made

under this subtitle; or

‘‘(ii) the difference between the restructured or

new first mortgage and the indebtedness under the existing insured mortgage immediately before it is restructured or refinanced, provided that the amount of

the second mortgage shall be in an amount that the

Secretary or participating administrative entity determines can reasonably be expected to be repaid.

* * * * * * *

(5) The Secretary may modify the terms of the second

mortgage, assign the second mortgage to the acquiring organization or agency, or forgive all or part of the second mortgage

if the Secretary holds the second mortgage and if the project

is acquired by a tenant organization or tenant-endorsed community-based nonprofit or public agency, pursuant to guidelines established by the Secretary.

(b) RESTRUCTURING TOOLS.—In addition to the requirements of

subsection (a) and to the extent these actions are consistent with

this section and with the control of the Secretary of applicable ac-
368

counts in the Treasury of the United States, an approved mortgage

restructuring and rental assistance sufficiency plan under this subtitle may include one or more of the following actions:

(1) FULL OR PARTIAL PAYMENT OF CLAIM.—øm¿Making a

full payment of claim or partial payment of claim under section

541(b) of the National Housing Act, as amended by section

523(b) of this Act. Any payment under this paragraph shall not

require the approval of a mortgageeø;¿. (2) REFINANCING OF DEBT.—ør¿Refinancing of all or part of

the debt on a project. If the refinancing involves a mortgage

that will continue to be insured under the National Housing

Act, the refinancing shall be documented through amendment

of the existing insurance contract and not through a new insurance contractø;¿. (3) MORTGAGE INSURANCE.—øp¿Providing FHA multifamily mortgage insurance, reinsurance or other credit enhancement alternatives, including multifamily risk-sharing

mortgage programs, as provided under section 542 of the Housing and Community Development Act of 1992. The Secretary

shall use risk-shared financing under section 542(c) of the

Housing and Community Development Act of 1992 for any

mortgage restructuring, rehabilitation financing, or debt refinancing included as part of a mortgage restructuring and rental assistance sufficiency plan if the terms and conditions are

considered to be the best available financing in terms of financial savings to the FHA insurance funds and will result in reduced risk of loss to the Federal Government. Any limitations

on the number of units available for mortgage insurance under

section 542 shall not apply to eligible multifamily housing

projects. Any credit subsidy costs of providing mortgage insurance shall be paid from the Liquidating Accounts of the General Insurance Fund or the Special Risk Insurance Fund and

shall not be subject to any limitation on appropriationsø;¿. (4) CREDIT ENHANCEMENT.—øp¿Providing any additional

State or local mortgage credit enhancements and risk-sharing

arrangements that may be established with State or local

housing finance agencies, the Federal Housing Finance Board,

the Federal National Mortgage Association, and the Federal

Home Loan Mortgage Corporation, to a modified or refinanced

first mortgageø;¿.

(5) COMPENSATION OF THIRD PARTIES.—øc¿Consistent with

the portfolio restructuring agreement, entering into agreements, incurring costs, or making payments, including incentive agreements designed to reward superior performance in

meeting the purposes of this Act, as may be reasonably necessary, to compensate the participation of participating administrative entities and other parties in undertaking actions authorized by this subtitle. Upon request to the Secretary, participating administrative entities that are qualified under the

United States Housing Act of 1937 to serve as contract administrators shall be the contract administrators under section 8

of the United States Housing Act of 1937 for purposes of any

contracts entered into as part of an approved mortgage restructuring and rental assistance sufficiency plan. Subject to the
369

availability of amounts provided in advance in appropriations

Acts for administrative fees under section 8 of the United

States Housing Act of 1937, such amounts may be used to compensate participating administrative entities for compliance

monitoring costs incurred under section 519ø;¿.

(6) USE OF PROJECT ACCOUNTS.—øa¿Applying any residual

receipts, replacement reserves, and any other project accounts

not required for project operations, to maintain the long-term

affordability and physical condition of the property or of other

eligible multifamily housing projects. The participating administrative entity may expedite the acquisition of residual receipts, replacement reserves, or other such accounts, by entering into agreements with owners of housing covered by an expiring contract to provide an owner with a share of the receipts, not to exceed 10 percent, in accordance with guidelines

established by the Secretaryø; and¿.

* * * * * * *

(c) REHABILITATION NEEDS AND ADDITION OF SIGNIFICANT FEATURES.—

* * * * * * *

ø(7)¿ (1) REHABILITATION NEEDS.—

* * * * * * *

(B) * * *

‘‘(2) ADDITION OF SIGNIFICANT FEATURES.—

‘‘(A) AUTHORITY.—An approved mortgage restructuring

and rental assistance sufficiency plan may require the improvement of the project by the addition of significant features that are not necessary for rehabilitation to the standard provided under paragraph (1), such as air conditioning, an elevator, and additional community space. The

Secretary shall establish guidelines regarding the inclusion

of requirements regarding such additional significant features under such plans.

‘‘(B) FUNDING.—Significant features added pursuant to

an approved mortgage restructuring and rental assistance

sufficiency plan may be paid from the funding sources specified in the first sentence of paragraph (1)(A).

‘‘(C) LIMITATION ON OWNER CONTRIBUTION.—An owner

of a project may not be required to contribute from nonproject resources, toward the cost of any additional significant features required pursuant to this paragraph, more

than 25 percent of the amount of any assistance received for

the inclusion of such features.

‘‘(D) APPLICABILITY.—This paragraph shall apply to all

eligible multifamily housing projects, except projects for

which the Secretary and the project owner executed a mortgage restructuring and rental assistance sufficiency plan on

or before the date of the enactment of the Mark-to-Market

Extension Act of 2001.’’

* * * * * * *
370

ø(c) ROLE OF FNMA AND FHLMC.—Section 1335 of the Federal Housing Enterprises Financial Safety and Soundness Act of

1992 (12 U.S.C. 4565) is amended— ø(1) in paragraph (3), by striking ‘‘and’’ at the end;

ø(2) paragraph (4), by striking the period at the end and

inserting ‘‘; and’’;

ø(3) by striking ‘‘To meet’’ and inserting the following:

ø‘‘(a) IN GENERAL.—To meet’’; and

ø(4) by adding at the end the following:

ø‘‘(5) assist in maintaining the affordability of assisted

units in eligible multifamily housing projects with expiring

contracts, as defined under the Multifamily Assisted Housing

Reform and Affordability Act of 1997.

ø‘‘(b) AFFORDABLE HOUSING GOALS.—Actions taken under subsection (a)(5) shall constitute part of the contribution of each entity

in meeting its affordable housing goals under sections 1332, 1333,

and 1334 for any fiscal year, as determined by the Secretary.’’.¿

* * * * * * *

SEC. 520. REPORTS TO CONGRESS.

(a) ANNUAL REVIEW.—In order to ensure compliance with this

subtitle, the Secretary shall conduct an annual review and report

to the Congress on actions taken under this subtitle and the status

of eligible multifamily housing projects.

(b) SEMIANNUAL REVIEW.—Not less than semiannually during

the 2-year period beginning on the date of the enactment of this

Act and not less than annually thereafter, the Secretary shall submit reports to the Committee on øBanking and¿ Financial Services

of the House of Representatives and the Committee on Banking,

Housing, and Urban Affairs of the Senate stating, for such periods,

the total number of projects identified by participating administrative entities under each of clauses (i) and (ii) of section 515(c)(2)(C).

* * * * * * *

SEC. 524. RENEWAL OF EXPIRING PROJECT-BASED SECTION 8 CONTRACTS.

(a) * * *

(1) * * *

* * * * * * *

(4) * * *

(A) * * *

* * * * * * *

(B) * * *

(C) RENTS NOT EXCEEDING MARKET RENTS.—In the

case of a project that is not subject to subparagraph (A) or

(B), at rent levels that—

(i) are not less than the existing rents under the

terminated or expiring contract, as adjusted by an operating cost adjustment factor established by the Secretary (which shall not result in a negative adjustment), if such adjusted rents do not exceed comparable

market rents for the market area; and
371

(ii) do not exceed comparable market rents for the

market area.

In determining the rent level for a contract under this subparagraph, the Secretary shall approve rents sufficient to

cover budget-based cost increases and shall give greater

consideration to providing rent at a level up to comparable

market rents for the market area based on the number of

the criteria under clauses (i) through (iii) of subparagraph

(D) that the project meets. Notwithstanding any other provision of law, the Secretary shall include in such budgetbased cost increases costs relating to the project as a whole

(including costs incurred with respect to units not covered

by the contract for assistance), but only (I) if inclusion of

such costs is requested by the owner or purchaser of the

project, (II) if inclusion of such costs will permit capital repairs to the project or acquisition of the project by a nonprofit organization, and (III) to the extent that inclusion of

such costs (or a portion thereof) complies with the requirement under clause (ii).

* * * * * * *

(e) CONTRACTUAL COMMITMENTS UNDER PRESERVATION

LAWS.—Except as provided in subsection (a)(2) and notwithstanding any other provision of this subtitle, the following shall

apply:

(1) * * *

* * * * * * *

(2) DEMONSTRATION PROJECTS.—

(A) * * *

* * * * * * *

(i) * * *

* * * * * * *

(iii) * * *

(3) MORTGAGE RESTRUCTURING AND RENTAL ASSISTANCE

SUFFICIENCY PLANS.—Notwithstanding paragraph (1), the

owner of the project may request, and the Secretary may consider, mortgage restructuring and rental assistance sufficiency

plans to facilitate sales or transfers of properties under this

subtitle, subject to an approved plan of action under the Emergency Low Income Housing Preservation Act of 1987 (12 U.S.C.

1715l note) or the Low-Income Housing Preservation and Resident Homeownership Act of 1990 (12 U.S.C. 4101 et seq.),

which plans shall result in a sale or transfer of those properties.

* * * * * * *

SEC. 525. CONSISTENCY OF RENT LEVELS UNDER ENHANCED VOUCHER ASSISTANCE AND RENT RESTRUCTURINGS.

(a) IN GENERAL.—The Secretary shall examine the standards

and procedures for determining and establishing the rent standards

described under subsection (b). Pursuant to such examination, the

Secretary shall establish procedures and guidelines that are designed to ensure that the amounts determined by the various rent

standards for the same dwelling units are reasonably consistent and
372

reflect rents for comparable unassisted units in the same area as

such dwelling units.

(b) RENT STANDARDS.—The rent standards described in this

subsection are as follows:

(1) ENHANCED VOUCHERS.—The payment standard for enhanced voucher assistance under section 8(t) of the United

States Housing Act of 1937 (42 U.S.C. 1437f(t)).

(2) MARK-TO-MARKET.—The rents derived from comparable

properties, for purposes of section 514(g) of the Multifamily Assisted Housing Reform and Affordability Act of 1997 (42 U.S.C.

1437f note).

(3) CONTRACT RENEWAL.—The comparable market rents for

the market area, for purposes of section 524(a)(4) of the Multifamily Assisted Housing Reform and Affordability Act of 1997

(42 U.S.C. 1437f note).

* * * * * * *

SEC. 572. DIRECTOR.

ø(a) APPOINTMENT.—The Office shall be under the management of a Director, who shall be appointed by the President by and

with the advice and consent of the Senate, from among individuals

who are citizens of the United States and have a demonstrated understanding of financing and mortgage restructuring for affordable

multifamily housing. Not later than 60 days after the date of the

enactment of this Act, the President shall submit to the Senate a

nomination for initial appointment to the position of Director.¿

(a) APPOINTMENT.—The Office shall be under the management

of a Director, who shall be appointed by the President from among

individuals who are citizens of the United States and have a demonstrated understanding of financing and mortgage restructuring

for affordable multifamily housing.

ø(b) VACANCY.—A vacancy in the position of Director shall be

filled in the manner in which the original appointment was made

under subsection (a).¿

(b) VACANCY.—A vacancy in the position of Director shall be

filled by appointment in the manner provided under subsection (a).

The President shall make such an appointment not later than 60

days after such position first becomes vacant.

* * * * * * *

SEC. 573. DUTY AND AUTHORITY OF DIRECTOR.

(a) * * *

(b) AUTHORITY.—The Director is authorized to make such determinations, take such actions, issue such regulations, and perform such functions assigned to the Director under law as the Director determines necessary to carry out such functions, subject to

the review and approval of the Secretary. The Director shall semiannually submit a report to the øSecretary¿ Assistant Secretary of

the Department of Housing and Urban Development who is the Federal Housing Commissioner regarding the activities, determinations, and actions of the Director.

* * * * * * *

(d) INDEPENDENCE IN PROVIDING INFORMATION TO CONGRESS.—

(1) * * *
373

(2) REQUIREMENT.—If the Director determines at any time

that the Secretary is taking or has taken any action that interferes with the ability of the Director to carry out the duties of

the Director under this Act or that affects the administration

of the program under subtitle A of this Act in a manner that

is inconsistent with the purposes of this Act, including any proposed action by the Director, in the discretion of the Director,

that is overruled by the Secretary, the Director shall immediately report directly to the Committee on øBanking and¿ Financial Services of the House of Representatives and the Committee on Banking, Housing, and Urban Affairs of the Senate

regarding such action. Notwithstanding subsection (a) or (b),

any determination or report under this paragraph by the Director shall not be subject to prior review or approval of the

Secretary.

* * * * * * *

SEC. 576. LIMITATION ON SUBSEQUENT EMPLOYMENT.

Neither the Director nor any former officer or employee of the

Office who, while employed by the Office, was compensated at a

rate in excess of the lowest rate for a position classified higher

than GS–15 of the General Schedule under section 5107 of title 5,

United States Code, may, during the ø2-year period¿ 1-year period

beginning on the date of separation from employment by the Office,

accept compensation from any party (other than a Federal agency)

having any financial interest in any mortgage restructuring and

rental assistance sufficiency plan under subtitle A or comparable

matter in which the Director or such officer or employee had direct

participation or supervision.

* * * * * * *

øSEC. 578. SUSPENSION OF PROGRAM BECAUSE OF FAILURE TO APPOINT DIRECTOR.

ø(a) IN GENERAL.—If, upon the expiration of the 12-month period beginning on the date of the enactment of this Act, the initial

appointment to the office of Director has not been made, the

operation of the program under subtitle A shall immediately be

suspended and such provisions shall not have any force or effect

during the period that ends upon the making of such appointment.

ø(b) INTERIM APPLICABILITY OF DEMONSTRATION PROGRAM.—

Notwithstanding any other provision of law, during the period referred to in subsection (a), the Secretary shall carry out sections

211 and 212 of the Departments of Veterans Affairs and Housing

and Urban Development, and Independent Agencies Appropriations

Act, 1997. For purposes of applying such sections pursuant to the

authority under this section, the term ‘‘expiring contract’’ shall

have the meaning given in such sections, except that such term

shall also include any contract for project-based assistance under

section 8 of the United States Housing Act of 1937 that expires

during the period that the program is suspended under subsection

(a).¿

SEC. 578. OVERSIGHT BY FEDERAL HOUSING COMMISSIONER.

All authority and responsibilities assigned under this subtitle to

the Secretary shall be carried out through the Assistant Secretary
374

of the Department of Housing and Urban Development who is the

Federal Housing Commissioner.

* * * * * * *

SEC. 579. TERMINATION.

ø(a) REPEAL.—Subtitle A (except for section 524) and subtitle

D (except for this section) are repealed effective October 1, 2001.¿

(a) REPEALS.—

(1) MARK-TO-MARKET PROGRAM.—Subtitle A (except for section 524) is repealed effective October 1, 2006.

(2) OMHAR.—Subtitle D (except for this section) is repealed

effective October 1, 2004.

(b) EXCEPTION.—Notwithstanding the repeal under subsection

(a), the provisions of subtitle A (as in effect immediately before

such repeal) shall apply with respect to projects and programs for

which binding commitments have been entered into under this Act

before øOctober 1, 2001¿ October 1, 2006.

(c) TERMINATION OF DIRECTOR AND OFFICE.—The Office of Multifamily Housing Assistance Restructuring and the position of Director of such Office shall terminate øupon September 30, 2001¿ at

the end of September 30, 2004.

ø(d) TRANSFER OF AUTHORITY.—Effective upon the termination

under subsection (c), any authority and responsibilities assigned to

the Director that remain applicable after such date pursuant to

subsection (b) are transferred to the Secretary.¿

(d) TRANSFER OF AUTHORITY.—Effective upon the repeal of subtitle D under subsection (a)(2) of this section, all authority and responsibilities to administer the program under subtitle A are transferred to the Secretary.

McKINNEY-VENTO HOMELESS ASSISTANCE ACT, H.R.

5417

AN ACT

To rename the Stewart B. McKinney Homeless Assistance Act as the ‘McKinneyVento Homeless Assistance Act’.

* * * * * * *

SECTION 1. DESIGNATION.

øSection 1¿ Section 101 of the Stewart B. McKinney Homeless

Assistance Act (42 U.S.C. 11301 note; Public Law 100-77) is

amended by striking subsection (a) and inserting the following new

subsection:

* * * * * * *

DEPARTMENTS OF VETERANS AFFAIRS AND HOUSING

AND URBAN DEVELOPMENT, AND INDEPENDENT

AGENCIES APPROPRIATIONS ACT, 2000, PUBLIC LAW

106–74

* * * * * * *

TITLE V—PRESERVATION OF AFFORDABLE HOUSING

* * * * * * *
375

Subtitle C—Renewal of Expiring Rental

Assistance Contracts and Protection of

Residents

SEC. 531. RENEWAL OF EXPIRING CONTRACTS AND ENHANCED

VOUCHERS FOR PROJECT RESIDENTS.

(a) * * *

* * * * * * *

(c) PROJECTS EXEMPTED FROM RESTRUCTURING AGREEMENTS.—

øSection 514(h)¿ Section 514(h)(1) of the Multifamily Assisted

Housing Reform and Affordability Act of 1997 (42 U.S.C. 1437f

note) is amended by inserting before the semicolon at the end the

following: ‘‘and the financing involves mortgage insurance under

the National Housing Act, such that the implementation of a mortgage restructuring and rental assistance sufficiency plan under this

subtitle is in conflict with applicable law or agreements governing

such financing’’.

* * * * * * *

AMERICAN HOMEOWNERSHIP AND ECONOMIC

OPPORTUNITY ACT OF 2000

SEC. 811. PROGRAM REQUIREMENTS.

(a) * * *

* * * * * * *

ø(e) MANAGEMENT AND MAINTENANCE.—As a condition to receiving grant amounts under this title, the Director shall develop

policies governing the management and maintenance of housing assisted with grant amounts under this title.¿

* * * * * * *
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

TITLE I

—DEPARTMENT OF LABOR

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Grants to States:

Adult Training, current year ................................................................................... 238,000 900,000 238,000 ............................

¥

Advance from prior year ................................................................................ (712,000) (712,000) (712,000) ............................ ............Fiscal year 2003 ............................................................................................ 712,000 ............................ 712,000 ............................

∂

Adult Training, program level ................................................................... 950,000 900,000 950,000 ............................

Youth Training ........................................................................................................ 1,127,965 1,000,965 1,127,965 ............................

∂

Dislocated Worker Assistance, current year ........................................................... 352,540 1,383,040 489,000

∂136,460

¥

Advance from prior year ................................................................................ (1,060,000) (1,060,000) (1,060,000) ............................ ............Fiscal year 2003 ............................................................................................ 1,060,000 ............................ 1,060,000 ............................

∂1

Dislocated Worker Assistance, program level .......................................... 1,412,540 1,383,040 1,549,000

∂136,460

∂

Federally administered programs:

Native Americans ................................................................................................... 55,000 55,000 57,800

∂2,800

Migrant and Seasonal Farmworkers ...................................................................... 76,770 76,770 80,770

∂4,000

Job Corps:

Operations ..................................................................................................... 687,773 1,278,773 687,773 ............................

¥

Advance from prior year ....................................................................... (591,000) (591,000) (591,000) ............................ ............Fiscal year 2003 ................................................................................... 591,000 ............................ 591,000 ............................

∂

Construction and Renovation ........................................................................ 20,375 120,375 20,375 ............................

¥

Advance from prior year ....................................................................... (100,000) (100,000) (100,000) ............................ ............
Fiscal year 2003 ................................................................................... 100,000 ............................ 100,000 ............................

∂

Subtotal, Job Corps, program level ................................................. 1,399,148 1,399,148 1,399,148 ............................ ............

National activities:

Pilots, Demonstrations and Research ........................................................... 97,432 35,000 35,000

¥62,432 ............

Responsible Reintegration of Youthful Off ................................................... 55,000 ............................ 55,000 ............................Evaluation ...................................................................................................... 9,098 9,098 9,098 ............................ ............Youth Opportunity Grants .............................................................................. 250,000 250,000 250,000 ............................ ............

Technical Assistance/Incentive grants ................................................................... 15,000 15,000 15,000 ............................ ............

Subtotal, National activities .............................................................................. 426,530 309,098 364,098 ¥62,432Subtotal, Federal activities ................................................................................ 1,957,448 1,840,016 1,901,816

¥55,632

Total, Workforce Investment Act ........................................................................ 5,447,953 5,124,021 5,528,781

∂80,828

∂

Women in Apprenticeship ....................................................................................... 1,000 1,000 1,000 ............................ ............Skill Standards ....................................................................................................... 3,500 3,500 3,500 ............................ ............

Subtotal, National activities, TES ...................................................................... 431,030 313,598 368,598

¥62,432

Total, Training and Employment Services ......................................................... 5,452,453 5,128,521 5,533,281

∂80,828

∂

Current Year .............................................................................................. (2,989,453) (5,128,521) (3,070,281) (

∂80,828) (

¥2

Advance year ............................................................................................. (2,463,000) ............................ (2,463,000) ............................ (

∂2

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS ....................................... 440,200 440,200 450,000

∂9,800

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Trade Adjustment ............................................................................................................ 342,400 ............................ 349,500

∂7,100

∂

NAFTA Activities ............................................................................................................... 64,150 11,000 66,150

∂2,000

Legislative Proposal (NAFTA/TAA) .................................................................................... ............................ 404,650 ............................ ............................

¥

Total ................................................................................................................... 406,550 415,650 415,650

∂9,100 ............

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Unemployment Compensation:

State Operations ..................................................................................................... 2,353,795 2,403,923 2,403,923

∂50,128 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

National Activities .................................................................................................. 10,000 10,000 10,000 ............................ ............

Subtotal, Unemployment Comp (trust funds) ................................................... 2,363,795 2,413,923 2,413,923

∂50,128 ............

Employment Service:

Allotments to States:

Federal Funds ................................................................................................ 23,452 23,452 23,452 ............................ ............Trust Funds ................................................................................................... 773,283 773,283 773,283 ............................ ............

Subtotal ..................................................................................................... 796,735 796,735 796,735 ............................ ............

ES National Activities ............................................................................................. 49,680 49,680 51,680

∂2,000

Subtotal, Employment Service ........................................................................... 846,415 846,415 848,415

∂2,000

Federal Funds ........................................................................................... 23,452 23,452 23,452 ............................ ............Trust Funds ............................................................................................... 822,963 822,963 824,963

∂2,000

One Stop Career Centers/Labor Market Information ....................................................... 150,000 134,000 148,000

¥2,000

Work Incentives Grants ................................................................................................... 20,000 20,000 20,000 ............................ ............

Total, State Unemployment ................................................................................ 3,380,210 3,414,338 3,430,338

∂50,128

Federal Funds ........................................................................................... 193,452 177,452 191,452

¥2,000

Trust Funds ............................................................................................... 3,186,758 3,236,886 3,238,886

∂52,128

ADVANCES TO THE UI AND OTHER TRUST FUNDS 1 ........................................................ 435,000 464,000 464,000

∂29,000 ............

PROGRAM ADMINISTRATION

Adult Employment and Training ..................................................................................... 32,911 34,010 34,010

∂1,099 ............

Trust Funds ............................................................................................................ 2,797 2,887 2,887

∂90 ............

Youth Employment and Training ..................................................................................... 37,011 37,557 37,557

∂546 ............
Employment Security ....................................................................................................... 4,974 5,789 5,789

∂815 ............

Trust Funds ............................................................................................................ 44,351 44,216 44,216

¥135 ............

Apprenticeship Services .................................................................................................. 21,069 21,367 21,367

∂298 ............

Executive Direction .......................................................................................................... 7,960 7,945 7,945

¥15 ............

Trust Funds ............................................................................................................ 1,359 1,404 1,404

∂45 ............

Welfare to Work ............................................................................................................... 6,431 5,903 5,903

¥528 ............

Total, Program Administration ........................................................................... 158,863 161,078 161,078

∂2,215 ............

Federal Funds ................................................................................................ 110,356 112,571 112,571

∂2,215 ............

Trust Funds ................................................................................................... 48,507 48,507 48,507 ............................ ............

Total, Employment and Training Administration ............................................... 10,273,276 10,023,787 10,454,347

∂181,071

∂

Federal Funds ........................................................................................... 7,038,011 6,738,394 7,166,954

∂128,943

∂

Current Year ..................................................................................... (4,575,011) (6,738,394) (4,703,954) (

∂128,943) (

¥2

Advance year .................................................................................... (2,463,000) ............................ (2,463,000) ............................ (

∂2

Trust Funds ............................................................................................... 3,235,265 3,285,393 3,287,393

∂52,128

PENSION AND WELFARE BENEFITS ADMINISTRATION

SALARIES AND EXPENSES

Enforcement and Compliance ......................................................................................... 83,453 84,640 87,542

∂4,089

Policy, Regulation and Public Service ............................................................................ 20,205 19,234 20,762

∂557

Program Oversight ........................................................................................................... 3,975 4,114 4,114

∂139 ............

Total, PWBA ........................................................................................................ 107,633 107,988 112,418

∂4,785

PENSION BENEFIT GUARANTY CORPORATION

Program Administration subject to limitation (TF) ......................................................... 11,652 11,652 11,690

∂38

Termination services not subject to limitation (NA) ...................................................... (178,924) (178,924) (178,924) ............................ ............

Total, PBGC (Program level) .............................................................................. (190,576) (190,576) (190,614) (

∂38) 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

Enforcement of Wage and Hour Standards .................................................................... 152,369 152,569 158,322

∂5,953

Office of Labor-Management Standards ......................................................................... 30,492 30,632 32,869

∂2,377
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Federal Contractor EEO Standards Enforcement ............................................................ 76,148 76,308 78,849

∂2,701

Federal Programs for Workers’ Compensation ................................................................ 88,687 90,098 91,866

∂3,179

FECA Fees ............................................................................................................... ............................

¥80,281 ............................ ............................

Trust Funds ............................................................................................................ 1,981 1,981 1,981 ............................ ............

Program Direction and Support ...................................................................................... 13,039 13,127 13,258

∂219

Total, ESA salaries and expenses ..................................................................... 362,716 284,434 377,145

∂14,429

Federal Funds ........................................................................................... 360,735 282,453 375,164

∂14,429

Trust Funds ............................................................................................... 1,981 1,981 1,981 ............................ ............

SPECIAL BENEFITS

Federal employees compensation benefits ..................................................................... 53,000 118,000 118,000 ∂65,000 ............Longshore and harbor workers’ benefits ........................................................................ 3,000 3,000 3,000 ............................ ............

Total, Special Benefits ....................................................................................... 56,000 121,000 121,000

∂65,000 ............

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND

Program Benefits (NA) .................................................................................................... (358,000) (597,000) (597,000) (

∂239,000) ............

Administrative Expenses 2 ............................................................................................... 60,328 136,000 136,000

∂75,672 ............

Total, Energy Emp Occupational Illness Comp Fund ........................................ 60,328 136,000 136,000

∂75,672 ............

BLACK LUNG DISABILITY TRUST FUND

Benefit payments and interest on advances .................................................................. 975,343 981,283 981,283 ∂5,940 ............Employment Standards Adm. S&E .................................................................................. 30,293 31,443 31,558

∂1,265

Departmental Management S&E ..................................................................................... 21,590 22,590 22,590

∂1,000 ............
Departmental Management, Inspector General .............................................................. 318 328 328

∂10 ............

Subtotal, Black Lung Disability ......................................................................... 1,027,544 1,035,644 1,035,759

∂8,215

Treasury Administrative Costs ........................................................................................ 356 356 356 ............................ ............

Total, Black Lung Disability Trust Fund ............................................................ 1,027,900 1,036,000 1,036,115

∂8,215

Total, Employment Standards Administration ................................................... 1,506,944 1,577,434 1,670,260

∂163,316

Federal Funds ........................................................................................... 1,504,963 1,575,453 1,668,279

∂163,316

Trust Funds ............................................................................................... 1,981 1,981 1,981 ............................ ............

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Safety and Health Standards .......................................................................................... 15,069 13,875 16,321

∂1,252

Federal Enforcement ........................................................................................................ 151,836 154,816 162,768

∂10,932

State Programs ................................................................................................................ 88,369 88,119 92,119

∂3,750

Technical Support ............................................................................................................ 20,189 19,562 20,251

∂62

Compliance Assistance:

Federal Assistance ................................................................................................. 56,255 57,180 60,173

∂3,918

State Consultation Grants ...................................................................................... 48,834 48,834 51,843

∂3,009

Training Grants ...................................................................................................... 11,175 8,175 11,175 ............................

Subtotal .............................................................................................................. 116,264 114,189 123,191

∂6,927

Safety and Health Statistics ........................................................................................... 25,597 26,257 26,595

∂998

Executive Direction and Administration .......................................................................... 8,562 9,017 9,017

∂455 ............

Total, OSHA ........................................................................................................ 425,886 425,835 450,262

∂24,376

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Coal Enforcement ............................................................................................................ 114,505 110,915 119,885

∂5,380

Metal/Non-Metal Enforcement ......................................................................................... 55,117 60,424 60,424

∂5,307 ............

Standards Development .................................................................................................. 1,760 2,304 2,357

∂597

Assessments .................................................................................................................... 4,265 4,701 4,807

∂542

Educational Policy and Development .............................................................................. 31,455 27,984 27,984

¥3,471 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Technical Support ............................................................................................................ 27,053 27,427 28,085

∂1,032

Program Administration .................................................................................................. 12,151 12,551 12,551

∂400 ............

Total, Mine Safety and Health Administration .................................................. 246,306 246,306 256,093

∂9,787

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Employment and Unemployment Statistics .................................................................... 142,313 146,796 146,796

∂4,483 ............

Labor Market Information (Trust Funds) ......................................................................... 67,257 69,132 69,132

∂1,875 ............

Prices and Cost of Living ............................................................................................... 135,136 149,264 149,264

∂14,128 ............

Compensation and Working Conditions .......................................................................... 71,076 74,126 74,126

∂3,050 ............

Productivity and Technology ............................................................................................ 9,164 9,599 9,599

∂435 ............

Executive Direction and Staff Services ........................................................................... 25,941 27,083 27,083

∂1,142 ............

Total, Bureau of Labor Statistics ...................................................................... 450,887 476,000 476,000

∂25,113 ............

Federal Funds ........................................................................................... 383,630 406,868 406,868

∂23,238 ............

Trust Funds ............................................................................................... 67,257 69,132 69,132

∂1,875 ............

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Executive Direction .......................................................................................................... 26,303 26,502 25,177

¥1,126

Departmental IT Crosscut ............................................................................................... 37,000 80,000 37,000 ............................Legal Services ................................................................................................................. 74,384 74,657 74,657

∂273 ............

Trust Funds ............................................................................................................ 310 310 310 ............................ ............

International Labor Affairs .............................................................................................. 147,982 71,588 147,982 ............................
Administration and Management .................................................................................... 24,732 29,732 29,732

∂5,000 ............

Adjudication ..................................................................................................................... 24,688 24,688 24,688 ............................ ............Women’s Bureau .............................................................................................................. 10,186 10,186 10,186 ............................ ............Civil Rights Activities ...................................................................................................... 5,839 5,839 5,839 ............................ ............Chief Financial Officer .................................................................................................... 5,963 6,263 6,263

∂300 ............

Total, Salaries and expenses ............................................................................. 357,387 329,765 361,834

∂4,447

Federal Funds ........................................................................................... 357,077 329,455 361,524

∂4,447

Trust Funds ............................................................................................... 310 310 310 ............................ ............

OFFICE OF DISABILITY EMPLOYMENT POLICY

Office of Disability Employment Policy ........................................................................... 20,413 40,623 40,623

∂20,210 ............

Task Force on Employment of Adults with Disabilities .................................................. 2,556 2,640 2,640

∂84 ............

Total, Office of Disability Employment Policy ................................................... 22,969 43,263 43,263

∂20,294 ............

VETERANS EMPLOYMENT AND TRAINING

State Administration:

Disabled Veterans Outreach Program .................................................................... 81,615 81,615 81,615 ............................ ............Local Veterans Employment Program .................................................................... 77,253 77,253 77,253 ............................ ............

Subtotal, State Administration .......................................................................... 158,868 158,868 158,868 ............................ ............

Federal Administration .................................................................................................... 27,988 28,035 28,035

∂47 ............

Homeless Veterans Program ........................................................................................... 17,500 17,500 19,000

∂1,500

Veterans Workforce Investment Programs ...................................................................... 7,300 7,300 7,800

∂500

Total, Veterans Employment and Training ........................................................ 211,656 211,703 213,703

∂2,047

Federal Funds ........................................................................................... 24,800 24,800 26,800

∂2,000

Trust Funds ............................................................................................... 186,856 186,903 186,903

∂47 ............

OFFICE OF THE INSPECTOR GENERAL

Program Activities ........................................................................................................... 43,111 45,114 45,114

∂2,003 ............

Trust Funds ............................................................................................................ 4,770 4,951 4,951

∂181 ............

Executive Direction and Management ............................................................................. 6,802 7,068 7,068

∂266 ............

Total, Office of the Inspector General ............................................................... 54,683 57,133 57,133

∂2,450 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Federal funds ............................................................................................ 49,913 52,182 52,182

∂2,269 ............

Trust funds ............................................................................................... 4,770 4,951 4,951

∂181 ............

Total, Departmental Management ..................................................................... 646,695 641,864 675,933

∂29,238

Federal Funds ........................................................................................... 454,759 449,700 483,769

∂29,010

Trust Funds ............................................................................................... 191,936 192,164 192,164

∂228 ............

Total, Labor Department .................................................................................... 13,669,279 13,510,866 14,107,003

∂437,724

∂

Federal Funds ........................................................................................... 10,161,188 9,950,544 10,544,643

∂383,455

∂

Current Year ..................................................................................... (7,698,188) (9,950,544) (8,081,643) (

∂383,455) (

¥1

Advance year ............................................................................... (2,463,000) ............................ (2,463,000) ............................ (

∂2

Trust Funds ............................................................................................... 3,508,091 3,560,322 3,562,360

∂54,269

TITLE II

—DEPARTMENT OF HEALTH AND HUMAN SERVICES

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

Community health centers .............................................................................................. 1,168,612 1,292,723 1,343,723

∂175,111

National Health Service Corps:

Field placements .................................................................................................... 41,464 42,511 49,511

∂8,047

Recruitment ............................................................................................................ 87,916 87,916 104,916

∂17,000

Subtotal .............................................................................................................. 129,380 130,427 154,427

∂25,047
Health Professions

Training for Diversity:

Centers of excellence ............................................................................................. 30,639 12,847 ............................ ¥30,639 Health careers opportunity program ...................................................................... 32,797 13,752 ............................ ¥32,797 Faculty loan repayment .......................................................................................... 1,330 557 ............................ ¥1,330 Scholarships for disadvantaged students ............................................................. 44,475 18,651 ............................ ¥44,475 

Subtotal .............................................................................................................. 109,241 45,807 ............................ ¥109,241 

Training in Primary Care Medicine and Dentistry .......................................................... 91,053 ............................ ............................ ¥91,053 ............Interdisciplinary Community-Based Linkages:

Area health education centers ............................................................................... 33,364 7,556 ............................ ¥33,364 Health education and training centers .................................................................. 4,403 ............................ ............................ ¥4,403 ............Allied health and other disciplines ........................................................................ 8,422 1,907 ............................ ¥8,422 Geriatric programs ................................................................................................. 12,411 ............................ ............................ ¥12,411 ............Quentin N. Burdick pgm for rural training ............................................................ 5,988 ............................ ............................ ¥5,988 ............

Subtotal .............................................................................................................. 64,588 9,463 ............................ ¥64,588 

Health Professions Workforce Info and Analysis ............................................................ 824 824 ............................ ¥824 Public Health Workforce Development:

Public health, preventive med. and dental pgms ................................................. 9,478 2,147 ............................ ¥9,478 Health administration programs ............................................................................ 1,231 ............................ ............................ ¥1,231 ............

Subtotal .............................................................................................................. 10,709 2,147 ............................ ¥10,709 

Children’s Hospitals Graduate Medical Educ ................................................................. 234,992 200,094 243,442 ∂8,450 Advanced Education Nursing .......................................................................................... 59,048 59,048 ............................ ¥59,048 Basic nurse education and practice ............................................................................... 12,791 16,291 ............................ ¥12,791 Nursing workforce diversity ............................................................................................. 4,673 6,173 ............................ ¥4,673 Consolidated Health professions ..................................................................................... ............................ ............................ 352,927 ∂352,927 ∂

Subtotal, Health professions ............................................................................. 587,919 339,847 596,369 ∂8,450 ∂

Other HRSA Programs:

Hansen’s Disease Services ..................................................................................... 17,890 18,391 18,391 ∂501 ............Maternal and Child Health Block Grant ................................................................ 709,187 704,087 719,087 ∂9,900 Abstinence Education:

Advance from prior year ................................................................................ (20,000) (30,000) (30,000) (∂10,000) ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Fiscal year 2002 ............................................................................................ 30,000 ............................ ............................

¥30,000 ............

Fiscal year 2003 ............................................................................................ ............................ ............................ 30,000

∂30,000

Current Year .................................................................................................. ............................ 15 15

∂15 ............

Healthy Start .......................................................................................................... 89,996 89,996 89,996 ............................ ............Universal Newborn Hearing .................................................................................... 7,999 6,581 10,000

∂2,001

Organ Transplantation ........................................................................................... 14,992 19,992 19,992

∂5,000 ............

Bone Marrow Program ............................................................................................ 21,958 22,000 22,000

∂42 ............

Rural outreach grants ............................................................................................ 58,214 37,863 57,921

¥293

Rural Health Research ........................................................................................... 13,437 6,099 15,000

∂1,563

Telehealth ............................................................................................................... 35,978 5,609 5,609

¥30,369 ............

Denali Commission ................................................................................................. 10,000 ............................ 20,000

∂10,000

Critical care programs:

Emergency medical services for children ..................................................... 18,986 15,574 18,986 ............................Poison control ................................................................................................ 19,996 16,421 24,000 ∂4,004Traumatic Brain injury .................................................................................. 5,000 5,000 10,000

∂5,000

Subtotal, Critical care programs .............................................................. 43,982 36,995 52,986

∂9,004

Black lung clinics .................................................................................................. 6,000 6,000 7,000

∂1,000

Trauma Care ........................................................................................................... 3,000 2,467 4,000

∂1,000

Nursing loan repayment for shortage area service ............................................... 2,279 2,279 15,000

∂12,721

Payment to Hawaii, treatment of Hansen’s ........................................................... 2,045 2,045 2,045 ............................ ............

Subtotal, Other HRSA programs:.

Current year .............................................................................................. 1,036,957 960,419 1,059,042

∂22,085

Other HRSA programs

—Advance Years ............................................................ 30,000 ............................ 30,000 ............................
Ryan White AIDS Programs:

Emergency Assistance ............................................................................................ 604,169 604,169 620,000 ∂15,831 Comprehensive Care Programs .............................................................................. 910,969 910,969 950,000 ∂39,031 

AIDS Drug Assistance Program (ADAP) (NA) ................................................ (589,000) (589,000) (610,000) (∂21,000) (

Early Intervention Program ..................................................................................... 185,879 186,034 195,000 ∂9,121 Pediatric HIV/AIDS .................................................................................................. 64,995 64,995 72,000 ∂7,005 AIDS Dental Services .............................................................................................. 9,999 9,999 12,000 ∂2,001 Education and Training Centers ............................................................................ 31,598 31,598 34,000 ∂2,402 

Subtotal, Ryan White AIDS programs ................................................................ 1,807,609 1,807,764 1,883,000 ∂75,391 

Family Planning ............................................................................................................... 253,910 254,170 266,000 ∂12,090 Health Care and Other Facilities .................................................................................... 251,561 ............................ 10,000 ¥241,561 Buildings and Facilities .................................................................................................. 250 250 250 ............................ ............Rural Hospital Flexibility Grants ..................................................................................... 24,997 24,997 25,000 ∂3 National Practitioner Data Bank ..................................................................................... 17,200 17,200 17,200 ............................ ............

User Fees ................................................................................................................ ¥17,200 ¥17,200 ¥17,200 ............................ ............

Health Care Integrity and Protection Data Bank ............................................................ 4,317 8,000 8,000 ∂3,683 ............

User Fees ................................................................................................................ ¥4,317 ¥8,000 ¥8,000 ¥3,683 ............

Community Access Program ............................................................................................ 139,991 15,041 15,041 ¥124,950 ............Program Management ..................................................................................................... 138,991 147,049 135,991 ¥3,000 

Total, Health resources and services ................................................................ 5,570,177 4,972,687 5,518,843 ¥51,334 ∂

Current year .............................................................................................. (5,540,177) (4,972,687) (5,488,843) (¥51,334) (∂

Advance year .................................................................................... (30,000) ............................ (30,000) ............................ (

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM:

Liquidating account ............................................................................................... (10,000) (10,000) (10,000) ............................ ............Program account .................................................................................................... (9,000) ............................ ............................ (¥9,000) ............Program management ............................................................................................ 3,672 3,792 3,792 ∂120 ............

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:

Post-fiscal year 1988 claims ................................................................................. 114,355 114,855 114,855 ∂500 ............HRSA administration .............................................................................................. 2,992 2,992 2,992 ............................ ............

Total, Vaccine injury .......................................................................................... 117,347 117,847 117,847 ∂500 ............Total, Health Resources and Services Admin ................................................... 5,691,196 5,094,326 5,640,482 ¥50,714 ∂

Current year .............................................................................................. (5,661,196) (5,094,326) (5,610,482) (¥50,714) (∂
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Fiscal year 2003 ....................................................................................... (30,000) ............................ (30,000) ............................ (

CENTERS FOR DISEASE CONTROL

DISEASE CONTROL, RESEARCH AND TRAINING

Birth Defects/Developmental Disabilities/Disability and Health .................................... 70,733 76,280 88,748

∂18,015

Chronic Disease Prevention and Health Promotion ........................................................ 749,773 574,560 701,654

¥48,119

∂

Environmental Health ...................................................................................................... 137,279 136,683 171,863

∂34,584

Epidemic Services and Response ................................................................................... 77,797 80,303 85,303

∂7,506

Health Statistics .............................................................................................................. 50,276 ............................ 126,978

∂76,702

∂

Evaluation Tap funding (NA) ................................................................................. (71,690) (126,978) ............................ (

¥71,690) (

¥

HIV/AIDS, STD and TB Prevention ................................................................................... 1,044,149 1,068,452 1,121,612

∂77,463

Immunization ................................................................................................................... 552,605 574,645 637,145

∂84,540

Infectious Disease Control .............................................................................................. 317,674 331,518 331,518

∂13,844 ............

Injury Prevention and Control ......................................................................................... 142,850 143,655 146,655

∂3,805

Occupational Safety and Health 3 ................................................................................... 260,134 266,135 276,135

∂16,001

Preventive Health and Health Services Block Grant ...................................................... 135,030 135,030 135,030 ............................ ............Public Health Improvement ............................................................................................. 110,889 109,910 114,910

∂4,021

Buildings and Facilities .................................................................................................. 175,000 150,000 250,000

∂75,000

∂

Office of the Director ...................................................................................................... 41,521 49,440 49,440

∂7,919 ............

Bioterrorism ..................................................................................................................... 180,919 181,919 181,919

∂1,000 ............

ATSDR 4 ............................................................................................................................ (74,835) (78,235) (78,235) (

∂3,400) ............

Total, Disease Control ........................................................................................ 4,046,629 3,878,530 4,418,910

∂372,281

∂

Evaluation Tap funding (NA) .................................................................... (71,690) (126,978) ............................ (

¥71,690) (

¥

Total, Disease Control program level ................................................................ (4,118,319) (4,005,508) (4,418,910) (

∂300,591) (

∂
NATIONAL INSTITUTES OF HEALTH

National Cancer Institute ................................................................................................ 3,716,064 4,153,398 4,258,516 ∂542,452 ∂National Heart, Lung, and Blood Institute ..................................................................... 2,287,015 2,554,319 2,618,966 ∂331,951 National Institute of Dental and Craniofacial Research ................................................ 304,606 340,158 348,767 ∂44,161 National Institute of Diabetes and Digestive and Kidney Diseases .............................. 1,302,798 1,456,996 1,501,476 ∂198,678 National Institute of Neurological Disorders and Stroke ................................................ 1,172,132 1,311,179 1,352,055 ∂179,923 National Institute of Allergy and Infectious Diseases .................................................... 2,062,089 2,329,643 2,375,836 ∂313,747 National Institute of General Medical Sciences ............................................................. 1,530,988 1,710,182 1,753,465 ∂222,477 National Institute of Child Health and Human Development ........................................ 978,136 1,095,954 1,123,692 ∂145,556 National Eye Institute ...................................................................................................... 507,842 568,103 614,000 ∂106,158 National Institute of Environmental Health Sciences ..................................................... 502,987 561,729 585,946 ∂82,959 

NIEHS/Superfund (NA) 5 .......................................................................................... (62,861) (70,228) (70,228) (∂7,367) ............

National Institute on Aging ............................................................................................. 786,056 879,651 909,174 ∂123,118 National Institute of Arthritis and Musculoskeletal and Skin Diseases ........................ 394,968 441,803 460,202 ∂65,234 National Institute on Deafness and Other Communication Disorders ........................... 301,069 336,744 349,983 ∂48,914 National Institute of Nursing Research .......................................................................... 105,158 117,681 125,659 ∂20,501 National Institute on Alcohol Abuse and Alcoholism ..................................................... 340,537 381,951 390,761 ∂50,224 National Institute on Drug Abuse ................................................................................... 779,510 905,810 902,000 ∂122,490 National Institute of Mental Health ................................................................................ 1,103,062 1,234,389 1,279,383 ∂176,321 National Human Genome Research Institute .................................................................. 381,101 425,674 440,448 ∂59,347 National Institute of Biomedical Imaging and Bioengineering ...................................... 68,823 115,425 140,000 ∂71,177 National Center for Research Resources ........................................................................ 811,237 967,025 1,014,044 ∂202,807 National Center for Complementary and Alternative Medicine ...................................... 89,121 100,059 110,000 ∂20,879 National Center on Minority Health and Health Disparities ........................................... 132,044 158,421 158,421 ∂26,377 ............John E. Fogarty International Center .............................................................................. 50,472 56,446 57,874 ∂7,402 National Library of Medicine ........................................................................................... 245,338 274,633 281,584 ∂36,246 Office of the Director ...................................................................................................... 188,346 232,929 236,408 ∂48,062 Buildings and Facilities .................................................................................................. 153,761 236,600 306,600 ∂152,839 

Total, N.I.H ......................................................................................................... 20,295,260 22,946,902 23,695,260 ∂3,400,000 ∂

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Mental Health:

Programs of Regional and National Significance ................................................. 203,499 187,599 203,599 ∂100 Mental Health Performance Partnership ................................................................ 420,000 420,000 420,000 ............................ ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Children’s Mental Health Services ......................................................................... 91,694 91,694 91,694 ............................ ............Grants to States for the Homeless (PATH) ............................................................ 36,855 36,855 39,855

∂3,000

Protection and Advocacy ........................................................................................ 30,000 30,000 32,000

∂2,000

Subtotal, Mental Health ..................................................................................... 782,048 766,148 787,148

∂5,100

Substance Abuse Treatment:

Programs of Regional and National Significance ................................................. 256,122 296,122 276,122

∂20,000

Substance Abuse Performance Partnership ........................................................... 1,665,000 1,725,000 1,725,000

∂60,000 ............

Subtotal, Substance Abuse Treatment .............................................................. 1,921,122 2,021,122 2,001,122

∂80,000

Substance Abuse Prevention: Programs of Regional and National Significance .......... 175,013 175,013 189,013

∂14,000

Program Management and Buildings and Facilities ...................................................... 85,673 67,173 96,173

∂10,500

Evaluation funds (NA) ............................................................................................ ............................ (29,000) ............................ ............................ (

Total, Substance Abuse and Mental Health ...................................................... 2,963,856 3,029,456 3,073,456

∂109,600

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Research on Health Costs, Quality, and Outcomes:

Federal Funds ......................................................................................................... 102,316 ............................ 240,145

∂137,829

∂

Evaluation funds (NA) ............................................................................................ (124,130) (255,145) ............................ (

¥124,130) (

¥

Portion for reducing medical errors (non-add) ................................................. (50,000) (50,000) (60,000) (

∂10,000) (

Subtotal ......................................................................................................... (226,446) (255,145) (240,145) (

∂13,699) (

Health insurance and expenditure surveys:

Federal Funds ......................................................................................................... ............................ ............................ 48,500

∂48,500
Evaluation funds (NA) ............................................................................................ (40,850) (48,500) ............................ (

¥40,850) (

Program Support ............................................................................................................. 2,500 ............................ 2,600

∂100

Evaluation funds (NA) ............................................................................................ ............................ (2,600) ............................ ............................ 

Total, AHRQ ........................................................................................................ (269,796) (306,245) (291,245) (

∂21,449) (

Federal Funds .................................................................................. 104,816 ............................ 291,245

∂186,429

∂

Evaluation funds (NA) .............................................................................. (164,980) (306,245) ............................ (

¥164,980) (

¥

Total, Public Health Service .............................................................................. 33,101,757 34,949,214 37,119,353

∂4,017,596

∂2

CENTER FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Medicaid current law benefits ........................................................................................ 122,488,800 134,308,100 134,308,100

∂11,819,300 ............

State and local administration ....................................................................................... 6,998,100 7,995,800 7,995,800

∂997,700 ............

Vaccines for Children ...................................................................................................... 775,233 795,533 795,533

∂20,300 ............

Subtotal, Medicaid program level, current year ................................................ 130,262,133 143,099,433 143,099,433

∂12,837,300 ............

Less Medicare Transfer (Public Law 105–33) .........................................

¥60,000

¥70,000

¥70,000

¥10,000 ............

Less funds advanced in prior year ..........................................................

¥30,589,003

¥36,207,551

¥36,207,551

¥5,618,548 ............

Total, request, current year .................................................................. 99,613,130 106,821,882 106,821,882

∂7,208,752 ............

New advance 1st quarter ..................................................................... 36,207,551 46,601,937 46,601,937

∂10,394,386 ............

PAYMENTS TO HEALTH CARE TRUST FUNDS

Supplemental medical insurance .................................................................................... 69,777,000 81,332,000 81,332,000

∂11,555,000 ............

Hospital insurance for the uninsured ............................................................................. 321,000 292,000 292,000

¥29,000 ............

Federal uninsured payment ............................................................................................. 132,000 150,000 150,000

∂18,000 ............

Program management ..................................................................................................... 151,600 150,200 220,200

∂68,600

Total, Payments to Trust Funds, current law .................................................... 70,381,600 81,924,200 81,994,200

∂11,612,600

PROGRAM MANAGEMENT

Research, demonstration, and evaluation:

Regular Program .................................................................................................... 138,311 55,311 125,311

¥13,000

Medicare Contractors ...................................................................................................... 1,305,000 1,470,000 1,495,000

∂190,000
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

User fee legislative proposal ................................................................................. ............................ (115,000) ............................ ............................ (

¥

H.R. 3103 funding (NA) ......................................................................................... (682,552) (700,000) (700,000) (

∂17,448) ............

Medicare Plus Choice ............................................................................................. 52,000 52,000 52,000 ............................ ............

Subtotal, Contractors program level ................................................................. (2,039,552) (2,222,000) (2,247,000) (

∂207,448) (

State Survey and Certification ........................................................................................ 242,147 242,147 260,647

∂18,500

Federal Administration:

Federal Administration ........................................................................................... 506,778 533,818 533,818

∂27,040 ............

User Fees ................................................................................................................

¥2,074

¥2,118

¥2,118

¥44 ............

Subtotal, Federal Administration ....................................................................... 504,704 531,700 531,700

∂26,996 ............

Total, Program management ............................................................................. 2,242,162 2,351,158 2,464,658

∂222,496

∂

Total, Program management, program level ..................................................... (2,924,714) (3,051,158) (3,164,658) (

∂239,944) (

∂

Total, Center for Medicare and Medicaid Services ........................................... 208,444,443 237,699,177 237,882,677

∂29,438,234

∂

Federal funds ............................................................................................ 206,202,281 235,348,019 235,418,019

∂29,215,738

Current year ..................................................................................... (169,994,730) (188,746,082) (188,816,082) (

∂18,821,352) (

New advance, 1st quarter, fiscal year 2003 .................................. (36,207,551) (46,601,937) (46,601,937) (

∂10,394,386) ............

Trust Funds ............................................................................................... 2,242,162 2,351,158 2,464,658

∂222,496

∂

ADMINISTRATION FOR CHILDREN AND FAMILIES

FAMILY SUPPORT PAYMENTS TO STATES

AFDC/JOBS Child Care (State Claims) ............................................................................ 2,000 ............................ ............................

¥2,000 ............
Payments to territories .................................................................................................... 23,000 23,000 23,000 ............................ ............Emergency assistance ..................................................................................................... 37,000 ............................ ............................

¥37,000 ............

State and Local Administrative Training ........................................................................ 1,000 ............................ ............................

¥1,000 ............

Repatriation ..................................................................................................................... 1,000 1,000 1,000 ............................ ............

Subtotal, Welfare payments ............................................................................... 64,000 24,000 24,000

¥40,000 ............

Child Support Enforcement:

State and local administration .............................................................................. 3,247,800 3,413,800 3,413,800

∂166,000 ............

Federal incentive payments ................................................................................... 416,000 450,000 450,000

∂34,000 ............

Hold Harmless payments ....................................................................................... 10,000 10,000 10,000 ............................ ............Access and visitation ............................................................................................. 10,000 10,000 10,000 ............................ ............

Subtotal, Child Support Enforcement ................................................................ 3,683,800 3,883,800 3,883,800

∂200,000 ............

Total, Payments, current year program level .................................................... 3,747,800 3,907,800 3,907,800

∂160,000 ............

Less funds advanced in previous years ...................................................

¥650,000

¥1,000,000

¥1,000,000

¥350,000 ............

Total, payments, current request ......................................................... 3,097,800 2,907,800 2,907,800

¥190,000 ............

New advance, 1st quarter, fiscal year 2003 ....................................... 1,000,000 1,100,000 1,100,000

∂100,000 ............

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Advance from prior year (NA) ......................................................................................... (1,100,000) ............................ ............................ (

¥1,100,000) ............

Current Year .................................................................................................................... 300,000 1,400,000 1,700,000

∂1,400,000

∂

Current year program level ................................................................................ 1,400,000 1,400,000 1,700,000

∂300,000

∂

Emergency Allocation:

Non-emergency funding ......................................................................................... 300,000 300,000 ............................

¥300,000

¥

Contingent emergency funding .............................................................................. 300,000 ............................ 300,000 ............................

∂

Subtotal .............................................................................................................. 600,000 300,000 300,000

¥300,000 ............

REFUGEE AND ENTRANT ASSISTANCE

Transitional and Medical Services .................................................................................. 220,170 227,291 227,291

∂7,121 ............

Victims of Trafficking ...................................................................................................... 5,000 10,000 10,000

∂5,000 ............

Social Services ................................................................................................................ 143,621 143,621 143,621 ............................ ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Preventive Health ............................................................................................................ 4,835 4,835 4,835 ............................ ............Targeted Assistance ........................................................................................................ 49,477 49,477 49,477 ............................ ............Victims of Torture ............................................................................................................ 10,000 10,000 10,000 ............................ ............

Total, Refugee and entrant assistance ............................................................. 433,103 445,224 445,224

∂12,121 ............

CHILD CARE AND DEVELOPMENT GRANT

Advance funding from prior year (NA) ............................................................................ (1,182,672) ............................ ............................ (

¥1,182,672) ............

Current year request ....................................................................................................... 817,315 1,799,987 2,000,000

∂1,182,685

∂

After school voucher program ................................................................................ ............................ 400,000 ............................ ............................

¥

Current year program level ................................................................................ 1,999,987 2,199,987 2,000,000

∂13

¥

SOCIAL SERVICES BLOCK GRANT (TITLE XX) .................................................................. 1,725,000 1,700,000 1,700,000

¥25,000 ............

CHILDREN AND FAMILIES SERVICES PROGRAMS

Programs for Children, Youth, and Families:

Head Start, current funded .................................................................................... 4,799,812 6,324,812 5,200,000

∂400,188

¥1

Advance from prior year ................................................................................ (1,400,000) (1,400,000) (1,400,000) ............................ ............Fiscal year 2003 ............................................................................................ 1,400,000 ............................ 1,400,000 ............................

∂1

Subtotal, Head Start program level ......................................................... 6,199,812 6,324,812 6,600,000

∂400,188

∂

Consolidated Runaway, Homeless Youth Prog ....................................................... 69,133 102,133 105,133

∂36,000

Maternity Group Homes (NA) .................................................................................. ............................ (33,000) (33,000) (

∂33,000) ............

Child Abuse State Grants ...................................................................................... 21,026 21,026 21,026 ............................ ............Child Abuse Discretionary Activities ...................................................................... 33,717 17,978 33,717 ............................Abandoned Infants Assistance ............................................................................... 12,205 12,205 12,205 ............................ ............
Child Welfare Services ........................................................................................... 291,986 291,986 291,986 ............................ ............Child Welfare Training ........................................................................................... 6,998 6,998 7,998 ∂1,000Adoption Opportunities ........................................................................................... 27,405 27,405 27,405 ............................ ............Adoption Incentive .................................................................................................. 20,000 20,000 20,000 ............................ ............Adoption Incentive (no cap adjustment) ............................................................... 23,000 23,000 23,000 ............................ ............Adoption Awareness ............................................................................................... 9,900 9,906 12,906

∂3,006

Compassion Capital Fund ...................................................................................... ............................ 89,000 89,000

∂89,000 ............

Responsible Fatherhood Initiative .......................................................................... ............................ 64,000 ............................ ............................

Social Services and Income Maintenance Research ...................................................... 37,601 6,426 27,426

¥10,175

Community Based Resource Centers .............................................................................. 32,834 32,834 32,834 ............................ ............Developmental disabilities program:

State Councils ........................................................................................................ 67,800 67,800 69,800

∂2,000

Protection and Advocacy ........................................................................................ 33,000 33,000 35,000

∂2,000

Developmental Disabilities Special Projects .......................................................... 10,934 10,734 11,734

∂800

Developmental Disabilities University Affiliated .................................................... 21,800 21,800 24,000

∂2,200

Subtotal, Developmental disabilities ................................................................. 133,534 133,334 140,534

∂7,000

Native American Programs .............................................................................................. 45,996 44,396 45,996 ............................Community services:

Grants to States for Community Services ............................................................. 599,991 599,991 675,000

∂75,009

Community initiative program:

Economic Development .................................................................................. 30,034 30,034 35,000

∂4,966

Individual Development Account Initiative ................................................... 24,990 24,990 24,990 ............................ ............Rural Community Facilities ........................................................................... 5,321 ............................ 7,000

∂1,679

Subtotal, discretionary funds ................................................................... 60,345 55,024 66,990

∂6,645

National Youth Sports ............................................................................................ 16,000 ............................ 16,000 ............................Community Food and Nutrition .............................................................................. 6,314 ............................ 7,314

∂1,000

Subtotal, Community services ........................................................................... 682,650 655,015 765,304

∂82,654

∂

Runaway Youth Prevention .............................................................................................. 14,999 14,999 14,999 ............................ ............Domestic Violence Hotline ............................................................................................... 2,157 2,157 2,157 ............................ ............Battered Women’s Shelters ............................................................................................. 116,918 116,918 122,000

∂5,082

Early Learning Fund ........................................................................................................ 19,998 ............................ 25,000

∂5,002

Faith-Based Center ......................................................................................................... ............................ 3,000 ............................ ............................
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Program Direction ............................................................................................................ 163,870 171,870 171,870

∂8,000 ............

Total, Children and Families Services Programs .............................................. 7,965,739 8,191,398 8,592,496

∂626,757

∂

Current Year .............................................................................................. (6,565,739) (8,191,398) (7,192,496) (

∂626,757) (

¥

Fiscal year 2003 ....................................................................................... (1,400,000) ............................ (1,400,000) ............................ (

∂1

Rescission of permanent appropriations ........................................................................

¥21,000 ............................

¥21,000 ............................

PROMOTING SAFE AND STABLE FAMILIES ....................................................................... 305,000 305,000 305,000 ............................ ............

Legislative Proposal ............................................................................................... ............................ 200,000 ............................ ............................

¥

MENTORING CHILDREN OF PRISONERS ........................................................................... ............................ 67,000 ............................ ............................

PAYMENTS TO STATES FOR FOSTER CARE AND ADOPTION

Foster Care ...................................................................................................................... 5,063,500 5,055,100 5,055,100

¥8,400 ............

Adoption Assistance ........................................................................................................ 1,197,600 1,426,000 1,426,000

∂228,400 ............

Independent living ........................................................................................................... 140,000 140,000 140,000 ............................ ............Independent living (legislative proposal) ....................................................................... ............................ 60,000 ............................ ............................

Total, Payments, current year program level .................................................... 6,401,100 6,681,100 6,621,100

∂220,000

Less Advances from Prior Year ................................................................

¥1,538,000

¥1,735,900

¥1,735,900

¥197,900 ............

Total, payments, current request ......................................................... 4,863,100 4,945,200 4,885,200

∂22,100

New Advance, 1st quarter .................................................................... 1,735,900 1,754,000 1,754,000

∂18,100 ............

Total, Administration for Children and Families ............................................... 22,821,957 25,515,609 25,668,720

∂2,846,763

∂

Current year .............................................................................................. (18,686,057) (22,661,609) (21,414,720) (

∂2,728,663) (

¥1

Fiscal year 2003 ....................................................................................... (4,135,900) (2,854,000) (4,254,000) (

∂118,100) (

∂1
ADMINISTRATION ON AGING

Grants to States:

Supportive Services and Centers ........................................................................... 325,075 327,075 366,500 ∂41,425 Preventive Health ................................................................................................... 21,123 21,123 22,000 ∂877 Protection of vulnerable older Americans .............................................................. 14,181 14,181 18,181 ∂4,000 Family Caregivers Support ..................................................................................... 120,000 122,000 140,000 ∂20,000 Native American Caregivers support ..................................................................... 5,000 5,000 6,000 ∂1,000 Nutrition:

Congregate Meals .......................................................................................... 378,412 378,412 384,000 ∂5,588 Home Delivered Meals ................................................................................... 152,000 158,000 177,000 ∂25,000 

Grants to Native Americans ............................................................................................ 23,457 25,457 26,000 ∂2,543 Aging Research, Training and Special Projects ............................................................. 35,852 17,574 36,574 ∂722 Aging Network Support Activities .................................................................................... 1,812 1,812 2,379 ∂567 Alzheimer’s Initiative ....................................................................................................... 8,962 8,962 13,000 ∂4,038 Program Administration .................................................................................................. 17,219 18,122 18,122 ∂903 ............

Total, Administration on Aging .......................................................................... 1,103,093 1,097,718 1,209,756 ∂106,663 ∂

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT:

Federal Funds ......................................................................................................... 130,511 145,532 157,807 ∂27,296 

NAS study ...................................................................................................... 500 ............................ 1,000 ∂500 

Trust Funds ............................................................................................................ 5,851 5,851 5,851 ............................ ............

Evaluation funds (ASPE) (NA) ....................................................................... (21,552) (21,552) ............................ (¥21,552) (

Subtotal ..................................................................................................... (158,414) (172,935) (164,658) (∂6,244) 

Adolescent Family Life (Title XX) ........................................................................... 24,327 27,862 30,000 ∂5,673 Physical Fitness and Sports ................................................................................... 1,091 1,139 1,139 ∂48 ............Minority health ....................................................................................................... 49,019 43,084 43,084 ¥5,935 ............Office of Women’s Health ...................................................................................... 17,270 27,396 27,396 ∂10,126 ............U.S. Surgeon General ............................................................................................. 400 400 1,000 ∂600 Office of Emergency Preparedness ........................................................................ 11,668 14,200 14,200 ∂2,532 ............Office of Human Research Protection .................................................................... 5,800 7,035 7,035 ∂1,235 ............Bioterrorism (PHSSEF) ............................................................................................ 60,030 68,700 68,700 ∂8,670 ............Minority HIV/AIDS .................................................................................................... 50,000 50,000 50,000 ............................ ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

IT Security and Innovation Fund ............................................................................ ............................ 30,000 15,000

∂15,000

Total, General Departmental Management ........................................................ 356,467 421,199 422,212

∂65,745

Federal Funds ........................................................................................... 350,616 415,348 416,361

∂65,745

Trust Funds ............................................................................................... 5,851 5,851 5,851 ............................ ............

Total, program level ........................................................................................... (378,019) (442,751) (422,212) (

∂44,193) (

OFFICE OF THE INSPECTOR GENERAL:

Federal Funds ......................................................................................................... 33,786 35,786 35,786

∂2,000 ............

HIPAA funding (NA) ................................................................................................ (130,000) (150,000) (150,000) (

∂20,000) ............

Total, Inspector General program level ............................................................. (163,786) (185,786) (185,786) (

∂22,000) ............

OFFICE FOR CIVIL RIGHTS:

Federal Funds ......................................................................................................... 24,691 28,691 28,691

∂4,000 ............

Trust Funds ............................................................................................................ 3,314 3,314 3,314 ............................ ............

Total, Office for Civil Rights ............................................................................. 28,005 32,005 32,005

∂4,000 ............

POLICY RESEARCH ........................................................................................................... 16,715 2,500 20,500

∂3,785

Evaluation Funds (NA) ........................................................................................... ............................ (18,000) ............................ ............................ (

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS:

Retirement payments ............................................................................................. 175,405 196,261 196,261

∂20,856 ............

Survivors benefits ................................................................................................... 12,204 12,856 12,856

∂652 ............

Dependents’ medical care ...................................................................................... 30,811 32,167 32,167

∂1,356 ............

Military services credits ......................................................................................... 1,352 1,293 1,293

¥59 ............

Total, Retirement pay and medical benefits ..................................................... 219,772 242,577 242,577

∂22,805 ............
Total, Office of the Secretary ............................................................................ 654,745 734,067 753,080

∂98,335

Federal Funds ........................................................................................... 645,580 724,902 743,915

∂98,335

Trust Funds ............................................................................................... 9,165 9,165 9,165 ............................ ............

Total, Department of Health and Human Services ........................................... 266,125,995 299,995,785 302,633,586

∂36,507,591

∂2

Federal Funds ........................................................................................... 263,874,668 297,635,462 300,159,763

∂36,285,095

∂2

Current year ..................................................................................... (223,501,217 (248,179,525) (249,273,826) (

∂25,772,609) (

∂1

Fiscal year 2003 .............................................................................. (40,373,451) (49,455,937) (50,885,937) (

∂10,512,486) (

∂1

Trust Funds ............................................................................................... 2,251,327 2,360,323 2,473,823

∂222,496

∂

TITLE III

—DEPARTMENT OF EDUCATION

EDUCATION FOR THE DISADVANTAGED

Grants to Local Education Agencies (LEAs):

Basic Grants:

Advance from prior year ................................................................................ (5,046,366) (5,394,300) (5,394,300) (

∂347,934) ............

Forward funded ............................................................................................. 2,000,921 7,237,721 3,438,200

∂1,437,279

¥3

Current funded .............................................................................................. 3,500 ............................ 3,500 ............................

Subtotal, Basic grants current year funding ........................................... 2,004,421 7,237,721 3,441,700

∂1,437,279

¥3

Basic Grants Fiscal Year 2003 Advance ...................................................... 5,394,300 ............................ 5,126,300

¥268,000

∂5

Subtotal, Basic grants, program level ..................................................... 7,398,721 7,237,721 8,568,000

∂1,169,279

∂1

Concentration Grants:

Advance from prior year ................................................................................ (1,158,397) (1,364,000) (1,364,000) (

∂205,603) ............

Forward funded ............................................................................................. ............................ 1,364,000 ............................ ............................

¥1

Fiscal year 2003 ............................................................................................ 1,364,000 ............................ 1,632,000

∂268,000

∂1

Targeted Grants ...................................................................................................... ............................ 459,000 ............................ ............................

¥

Subtotal, Grants to LEAs ................................................................................... 8,762,721 9,060,721 10,200,000

∂1,437,279

∂1

Capital Expenses for Private School Children ................................................................ 6,000 ............................ ............................

¥6,000 ............

Even Start ........................................................................................................................ 250,000 250,000 200,000

¥50,000

Reading First:

State Grants ........................................................................................................... 91,000 900,000 705,000

∂614,000

¥

Early Reading First ................................................................................................. ............................ 75,000 75,000

∂75,000 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Fiscal year 2003 ..................................................................................................... 195,000 ............................ 195,000 ............................

∂

Subtotal, Reading First ...................................................................................... 286,000 975,000 975,000

∂689,000 ............

State agency programs:

Migrant ................................................................................................................... 380,000 380,000 380,000 ............................ ............Neglected and Delinquent/High Risk Youth ........................................................... 46,000 46,000 50,000

∂4,000

Evaluation ........................................................................................................................ 8,900 8,900 8,900 ............................ ............Comprehensive School Reform Demonstration ............................................................... 210,000 260,000 ............................

¥210,000

¥

Migrant education:

High School Equivalency Program ......................................................................... 20,000 20,000 20,000 ............................ ............College Assistance Migrant Program ..................................................................... 10,000 10,000 10,000 ............................ ............

Subtotal, migrant education .............................................................................. 30,000 30,000 30,000 ............................ ............

Education for Homeless Children and Youth ......................................................... 35,000 35,000 36,000

∂1,000

Total, Education for the disadvantaged ............................................................ 10,014,621 11,045,621 11,879,900 ∂1,865,279

∂

Current Year .............................................................................................. (3,061,321) (11,045,621) (4,926,600) (

∂1,865,279) (

¥6

Advance year ............................................................................................. (6,953,300) ............................ (6,953,300) ............................ (

∂6

Subtotal, forward funded ................................................................................... (2,927,921) (10,031,721) (4,104,200) (

∂1,176,279) (

¥5

IMPACT AID

Basic Support Payments ................................................................................................. 882,000 882,000 954,000

∂72,000

Payments for Children with Disabilities ......................................................................... 50,000 50,000 50,000 ............................ ............

Subtotal .............................................................................................................. 932,000 932,000 1,004,000

∂72,000
Facilities Maintenance (Sec. 8008) ................................................................................ 8,000 8,000 8,000 ............................ ............Construction (Sec. 8007) ................................................................................................ 12,802 150,000 68,000

∂55,198

Payments for Federal Property (Sec. 8002) .................................................................... 40,500 40,500 50,500

∂10,000

Total, Impact aid ............................................................................................... 993,302 1,130,500 1,130,500

∂137,198 ............

SCHOOL IMPROVEMENT PROGRAMS

State Grants for Improving Teacher Quality 6 ................................................................. 958,000 2,600,000 1,889,834

∂931,834

¥

Fiscal year 2003 ..................................................................................................... 1,150,000 ............................ 1,150,000 ............................

∂1

Advance from prior year ......................................................................................... (900,000) (1,150,000) (1,150,000) (

∂250,000) ............

Subtotal, States Grants ..................................................................................... 2,108,000 2,600,000 3,039,834

∂931,834

∂

Mathematics and Science Partnerships ......................................................................... ............................ ............................ 25,000

∂25,000

Eisenhower National Programs/Transition to Teachers .................................................. 41,000 30,000 95,000

∂54,000

Innovative Education/Choice and Innovation .................................................................. 100,000 471,500 125,000

∂25,000

¥

Advance from prior year ......................................................................................... (285,000) (285,000) (285,000) ............................ ............Fiscal year 2003 ..................................................................................................... 285,000 ............................ 285,000 ............................

∂

Program level ..................................................................................................... 385,000 471,500 410,000

∂25,000

School Renovation Grants ............................................................................................... 1,175,000 ............................ 925,000

¥250,000

∂

Educational Technology:

Educational Technology State Grants .................................................................... ............................ 817,096 712,146

∂712,146

¥

Technology Literacy Challenge Fund ...................................................................... 450,000 ............................ ............................

¥450,000 ............

Technology Innovation Challenge Fund .................................................................. 136,328 ............................ ............................

¥136,328 ............

Regional Technology in Education Consortia ......................................................... 10,000 ............................ ............................

¥10,000 ............

Subtotal .............................................................................................................. 596,328 817,096 712,146

∂115,818

¥

National Activities:

Technology Leadership Activities ....................................................................... 2,000 ............................ ............................

¥2,000 ............

Teacher Training in Technology .................................................................... 125,000 ............................ 125,000 ............................

∂

Community-Based Technology Centers ......................................................... 64,950 ............................ 64,950 ............................

Subtotal ..................................................................................................... 191,950 ............................ 189,950

¥2,000

∂

Ready to Learn Television ............................................................................. 16,000 ............................ 24,000

∂8,000

Ready to Teach .............................................................................................. 8,500 ............................ 15,000

∂6,500
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Subtotal, Educational technology ............................................................. 812,778 817,096 941,096

∂128,318

∂

Safe and Drug Free Schools:

State Grants, current funded ................................................................................. 109,250 547,612 114,250

∂5,000

¥

Advance from prior year ................................................................................ (330,000) (330,000) (330,000) ............................ ............Fiscal year 2003 ............................................................................................ 330,000 ............................ 330,000 ............................

∂

State Grants, program level ..................................................................... 439,250 547,612 444,250

∂5,000

¥

National Programs .................................................................................................. 155,000 96,638 150,000

¥5,000

Coordinator Initiative .............................................................................................. 50,000 ............................ 50,000 ............................

Subtotal, Safe and drug free schools ............................................................... 644,250 644,250 644,250 ............................ ............

21st Century Community Learning Centers .................................................................... 845,614 845,614 1,000,000

∂154,386

∂

Improvement of Education Achievement:

State Assessments ................................................................................................. ............................ 320,000 320,000

∂320,000 ............

Reform and Innovation Fund ................................................................................. ............................ 40,000 ............................ ............................

Subtotal, Improvement of Education Achievement ........................................... ............................ 360,000 320,000

∂320,000

Inexpensive Book Distribution (RIF) ................................................................................ 23,000 ............................ 25,000

∂2,000

Enhanced Assessment Instruments ................................................................................ ............................ ............................ 32,000

∂32,000

Magnet Schools Assistance ............................................................................................. 110,000 110,000 110,000 ............................ ............Training and Advisory Services (Civil Rights) ................................................................ 7,334 7,334 7,334 ............................ ............Ellender Fellowships/Close Up ........................................................................................ 1,500 ............................ 1,500 ............................Education for Native Hawaiians ..................................................................................... 28,000 28,000 33,000

∂5,000

Alaska Native Education Equity ...................................................................................... 15,000 15,000 33,000

∂18,000

Charter Schools Homestead Fund ................................................................................... 25,000 175,000 50,000

∂25,000

¥

Charter Schools ............................................................................................................... 190,000 200,000 200,000

∂10,000 ............
Comprehensive Regional Assistance Centers ................................................................. 28,000 28,000 28,000 ............................ ............Advanced Placement Fees ............................................................................................... 22,000 22,000 22,000 ............................ ............Local Innovations for Education (LIFE) ........................................................................... 424,099 ............................ 300,000

¥124,099

∂

Parental Assistance ......................................................................................................... 38,000 ............................ 45,000

∂7,000

Small, Safe, and Successful High Schools ..................................................................... 125,000 ............................ 100,000

¥25,000

∂

Mentoring ......................................................................................................................... ............................ ............................ 5,000

∂5,000

Community Service for Expelled or Suspended Students ............................................... ............................ ............................ 50,000

∂50,000

Public School Choice ....................................................................................................... ............................ ............................ 50,000

∂50,000

Alcohol Abuse Reduction ................................................................................................. ............................ ............................ 25,000

∂25,000

Small Rural Schools Achievement .................................................................................. ............................ ............................ 62,500

∂62,500

Low-Income and Rural Schools ....................................................................................... ............................ ............................ 62,500

∂62,500

Physical Education for Progress ..................................................................................... 5,000 ............................ 50,000

∂45,000

Literacy through School Libraries ................................................................................... ............................ ............................ 25,000

∂25,000

Total, School improvement programs ................................................................ 7,053,575 6,353,794 8,717,014

∂1,663,439

∂2

Current Year .............................................................................................. (5,288,575) (6,353,794) (6,952,014) (

∂1,663,439) (

∂

Advance year ............................................................................................. (1,765,000) ............................ (1,765,000) ............................ (

∂1

Subtotal, forward funded ................................................................................... (1,385,750) (1,019,112) (1,165,750) (

¥220,000) (

∂

INDIAN EDUCATION

Grants to Local Educational Agencies ............................................................................ 92,765 92,765 94,265

∂1,500

Federal Programs:

Special Programs for Indian Children ................................................................... 20,000 20,000 20,000 ............................ ............National Activities .................................................................................................. 2,735 3,235 2,735 ............................

Subtotal .............................................................................................................. 22,735 23,235 22,735 ............................Total, Indian Education ..................................................................................... 115,500 116,000 117,000

∂1,500

BILINGUAL AND IMMIGRANT EDUCATION

Bilingual and Immigrant Education State Grants .......................................................... ............................ 460,000 500,000

∂500,000

Bilingual education:

Instructional Services ............................................................................................. 180,000 ............................ ............................

¥180,000 ............

Support Services ..................................................................................................... 16,000 ............................ ............................

¥16,000 ............

Professional Development ...................................................................................... 100,000 ............................ ............................

¥100,000 ............

Immigrant Education ....................................................................................................... 150,000 ............................ ............................

¥150,000 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Foreign Language Assistance ......................................................................................... 14,000 ............................ 16,000

∂2,000

Total, Bilingual and Immigrant Education ........................................................ 460,000 460,000 516,000

∂56,000

SPECIAL EDUCATION

State grants:

Grants to States Part B advance funded .............................................................. 5,072,000 ............................ 5,072,000 ............................

∂5

Part B advance from prior year .................................................................... (3,742,000) (5,072,000) (5,072,000) (

∂1,330,000) ............

Grants to States Part B current year .................................................................... 1,267,685 7,339,685 2,267,685

∂1,000,000

¥5

Grants to States, program level ........................................................................ 6,339,685 7,339,685 7,339,685

∂1,000,000 ............

Preschool Grants .................................................................................................... 390,000 390,000 390,000 ............................ ............Grants for Infants and Families ............................................................................ 383,567 383,567 383,567 ............................ ............

Subtotal, State grants program level ................................................................ 7,113,252 8,113,252 8,113,252

∂1,000,000 ............

IDEA National Activities (current funded):

State Program Improvement Grants ...................................................................... 49,200 49,200 49,200 ............................ ............Research and Innovation ....................................................................................... 77,353 70,000 70,000 ¥7,353 ............Technical Assistance and Dissemination .............................................................. 53,481 53,481 53,481 ............................ ............Personnel Preparation ............................................................................................ 81,952 81,952 90,000

∂8,048

Parent Information Centers .................................................................................... 26,000 26,000 26,000 ............................ ............Technology and Media Services ............................................................................. 37,210 31,710 36,210

¥1,000

Public Telecom Info/Training Dissemination .......................................................... 1,500 ............................ 1,500 ............................

Subtotal, IDEA special programs ....................................................................... 326,696 312,343 326,391

¥305
Total, Special education .................................................................................... 7,439,948 8,425,595 8,439,643

∂999,695

Current Year .............................................................................................. (2,367,948) (8,425,595) (3,367,643) (

∂999,695) (

¥5

Advance year ............................................................................................. (5,072,000) ............................ (5,072,000) ............................ (

∂5

Subtotal, Forward funded .................................................................................. (2,090,452) (8,162,452) (3,090,452) (

∂1,000,000) (

¥5

REHABILITATION SERVICES AND DISABILITY RESEARCH

Vocational Rehabilitation State Grants .......................................................................... 2,399,790 2,481,383 2,481,383

∂81,593 ............

Client Assistance State grants ....................................................................................... 11,647 11,647 12,147

∂500

Training ........................................................................................................................... 39,629 39,629 39,629 ............................ ............Demonstration and training programs ........................................................................... 21,092 16,492 16,492 ¥4,600 ............Migrant and seasonal farmworkers ................................................................................ 2,350 2,350 2,350 ............................ ............Recreational programs .................................................................................................... 2,596 2,596 2,596 ............................ ............Protection and advocacy of individual rights (PAIR) ..................................................... 14,000 14,000 14,000 ............................ ............Projects with industry ..................................................................................................... 22,071 22,071 22,071 ............................ ............Supported employment State grants .............................................................................. 38,152 38,152 38,152 ............................ ............Independent living:

State grants ........................................................................................................... 22,296 22,296 22,296 ............................ ............Centers ................................................................................................................... 58,000 58,000 60,000

∂2,000

Services for older blind individuals ....................................................................... 20,000 20,000 20,000 ............................ ............

Subtotal, Independent living ............................................................................. 100,296 100,296 102,296

∂2,000

Program Improvement ..................................................................................................... 1,900 900 900

¥1,000 ............

Evaluation ........................................................................................................................ 1,587 1,000 1,000

¥587 ............

Helen Keller National Center for Deaf/Blind ................................................................... 8,717 8,717 8,717 ............................ ............National Institute for Disability and Rehabilitation Research (NIDRR) ......................... 100,400 110,000 110,000

∂9,600 ............

Assistive Technology ........................................................................................................ 41,112 60,884 60,884

∂19,772 ............

Access to Telework Fund ................................................................................................. ............................ 20,000 20,000

∂20,000 ............

Subtotal, discretionary programs ...................................................................... 405,549 448,734 451,234

∂45,685

Total, Rehabilitation services ............................................................................ 2,805,339 2,930,117 2,932,617

∂127,278

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND ................................................................. 12,000 12,000 14,000

∂2,000

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF:

Operations ............................................................................................................. 48,000 48,000 49,600

∂1,600
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Construction ........................................................................................................... 5,376 4,570 5,376 ............................

Total ................................................................................................................... 53,376 52,570 54,976

∂1,600

GALLAUDET UNIVERSITY: Operations ............................................................................... 89,400 89,400 97,000

∂7,600

Total, Special institutions .................................................................................. 154,776 153,970 165,976

∂11,200

VOCATIONAL AND ADULT EDUCATION

Vocational education:

Basic State Grants, current funded ....................................................................... 309,000 1,100,000 309,000 ............................

¥

Advance from prior year ................................................................................ (791,000) (791,000) (791,000) ............................ ............Fiscal year 2003 ............................................................................................ 791,000 ............................ 791,000 ............................

∂

Basic State Grants, program level ........................................................... 1,100,000 1,100,000 1,100,000 ............................ ............

Tech-Prep Education .............................................................................................. 106,000 106,000 106,000 ............................ ............Tribally Controlled Postsecondary Vocational Institutions ..................................... 5,600 5,600 7,000

∂1,400

National Programs .................................................................................................. 17,500 12,000 12,000

¥5,500 ............

Tech-Prep Education Demonstration ...................................................................... 5,000 ............................ 5,000 ............................Occupational and Employment Information Program ............................................ 9,000 ............................ 10,000

∂1,000

Subtotal, Vocational education .......................................................................... 1,243,100 1,223,600 1,240,000

¥3,100

Adult education:

State Grants, current funded ................................................................................. 540,000 540,000 540,000 ............................ ............National programs:

National Leadership Activities ...................................................................... 14,000 9,500 9,500

¥4,500 ............
National Institute for Literacy ....................................................................... 6,500 6,560 6,560

∂60 ............

Subtotal, National programs .................................................................... 20,500 16,060 16,060

¥4,440 ............

Subtotal, Adult education ......................................................................... 560,500 556,060 556,060

¥4,440 ............

State Grants for Incarcerated Youth Offenders .............................................................. 22,000 22,000 22,000 ............................ ............

Total, Vocational and adult education .............................................................. 1,825,600 1,801,660 1,818,060

¥7,540

Current Year .............................................................................................. (1,034,600) (1,801,660) (1,027,060) (

¥7,540) (

¥

Fiscal year 2003 ....................................................................................... (791,000) ............................ (791,000) ............................ (

∂

Subtotal, forward funded ................................................................................... (1,029,000) (1,796,060) (1,020,060) (

¥8,940) (

¥

STUDENT FINANCIAL ASSISTANCE

Pell Grants

—maximum grant (NA) ................................................................................ (3,750) (3,850) (4,000) (

∂250) 

Pell Grants

—Regular Program ....................................................................................... 8,756,000 9,756,000 10,314,000

∂1,558,000

∂

Federal Supplemental Educational Opportunity Grants .................................................. 691,000 691,000 713,100

∂22,100

Federal Work Study .......................................................................................................... 1,011,000 1,011,000 1,011,000 ............................ ............Federal Perkins loans:

Capital Contributions ............................................................................................. 100,000 100,000 100,000 ............................ ............Loan Cancellations ................................................................................................. 60,000 60,000 75,000

∂15,000

Subtotal, Federal Perkins loans ......................................................................... 160,000 160,000 175,000

∂15,000

LEAP program .................................................................................................................. 55,000 55,000 70,000

∂15,000

Loan Forgiveness for Child Care ..................................................................................... 1,000 1,000 1,000 ............................ ............

Total, Student financial assistance .................................................................. 10,674,000 11,674,000 12,284,100

∂1,610,100

∂

FEDERAL FAMILY EDUCATION LOAN PROGRAM

Federal Administration .................................................................................................... 48,000 49,636 49,636

∂1,636 ............

HIGHER EDUCATION

Aid for institutional development:

Strengthening Institutions ...................................................................................... 73,000 73,000 74,250

∂1,250

Hispanic Serving Institutions ................................................................................. 68,500 72,500 73,750 ∂5,250Strengthening Historically Black Colleges (HBCUs) .............................................. 185,000 197,000 197,000

∂12,000 ............

Strengthening historically black graduate insts ................................................... 45,000 48,000 48,000

∂3,000 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

Strengthening Alaska/Native Hawaiian Instit ........................................................ 6,000 6,000 7,000

∂1,000

Strengthening Tribal Colleges ................................................................................ 15,000 15,000 18,000

∂3,000

Subtotal, Institutional development .................................................................. 392,500 411,500 418,000

∂25,500

Program development:

Fund for the Improvement of Postsec. Ed. (FIPSE) ............................................... 146,687 51,200 51,200

¥95,487 ............

Minority Science and Engineering Improvement .................................................... 8,500 8,500 8,500 ............................ ............International education and foreign language:

Domestic Programs ....................................................................................... 67,000 67,000 67,000 ............................ ............Overseas Programs ........................................................................................ 10,000 10,000 10,000 ............................ ............Institute for International Public Policy ........................................................ 1,022 1,022 1,022 ............................ ............

Subtotal, International education ............................................................. 78,022 78,022 78,022 ............................ ............

Interest Subsidy Grants ................................................................................................... 10,000 5,000 5,000

¥5,000 ............

Federal TRIO Programs .................................................................................................... 730,000 780,000 805,000

∂75,000

GEAR UP .......................................................................................................................... 295,000 227,000 227,000

¥68,000 ............

Byrd Honors Scholarships ............................................................................................... 41,001 41,001 41,001 ............................ ............Javits Fellowships ............................................................................................................ 10,000 10,000 10,000 ............................ ............Graduate Assistance in Areas of National Need ............................................................ 31,000 31,000 31,000 ............................ ............Learning Anytime Anywhere Partnerships ....................................................................... 30,000 ............................ ............................

¥30,000 ............

Teacher Quality Enhancement Grants ............................................................................. 98,000 54,000 54,000

¥44,000 ............

Child Care Access Means Parents in School .................................................................. 25,000 25,000 25,000 ............................ ............Demonstration in Disabilities/Higher Education ............................................................. 6,000 ............................ 7,000

∂1,000

Underground Railroad Program ....................................................................................... 1,750 ............................ 2,000

∂250

WEB Based Education Commission ................................................................................ 250 ............................ ............................

¥250 ............

GPRA data/HEA program evaluation ............................................................................... 3,000 1,000 1,500

¥1,500
Thurgood Marshall Scholarships ..................................................................................... 4,000 ............................ ............................

¥4,000 ............

Olympic Scholarships ...................................................................................................... 1,000 ............................ ............................

¥1,000 ............

Total, Higher education ..................................................................................... 1,911,710 1,723,223 1,764,223

¥147,487

HOWARD UNIVERSITY

Academic Program .......................................................................................................... 198,500 198,500 198,500 ............................ ............Endowment Program ....................................................................................................... 3,600 3,600 3,600 ............................ ............Howard University Hospital ............................................................................................. 30,374 30,374 30,374 ............................ ............

Total, Howard University .................................................................................... 232,474 232,474 232,474 ............................ ............

COLLEGE HOUSING and ACADEMIC FACILITIES LOANS PROGRAM: Federal Administration .............................................................................................................................. 762 762 762 ............................ ............

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING, PROGRAM

ACCOUNT

Federal Administration .................................................................................................... 208 208 208 ............................ ............

EDUCATION RESEARCH, STATISTICS, AND ASSESSMENT

Research and statistics:

Research ................................................................................................................. 120,567 123,067 120,567 ............................Regional Educational Laboratories ........................................................................ 65,000 65,000 65,000 ............................ ............Statistics ................................................................................................................ 80,000 85,000 80,000 ............................Assessment:

National Assessment ..................................................................................... 36,000 105,000 105,000

∂69,000 ............

National Assessment Governing Board ......................................................... 4,000 4,053 4,000 ............................

Subtotal, Assessment ............................................................................... 40,000 109,053 109,000

∂69,000

Subtotal, Research and statistics ............................................................ 305,567 382,120 374,567

∂69,000

International Education Exchange .................................................................................. 10,000 ............................ 12,000

∂2,000

Civic Education ............................................................................................................... 12,000 ............................ 15,000

∂3,000

Eisenhower Professional Dvp. Federal Activities ............................................................ 23,300 ............................ ............................

¥23,300 ............

Eisenhower Regional Math and Science Ed. Consortia .................................................. 15,000 ............................ ............................

¥15,000 ............

Javits Gifted and Talented Education ............................................................................. 7,500 ............................ 15,000

∂7,500
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

National Writing Project .................................................................................................. 10,000 ............................ 15,000

∂5,000

Total, ERSI ......................................................................................................... 383,367 382,120 431,567

∂48,200

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION ............................................................................................. 412,196 424,212 424,212

∂12,016 ............

OFFICE FOR CIVIL RIGHTS ............................................................................................... 75,822 79,934 79,934

∂4,112 ............

OFFICE OF THE INSPECTOR GENERAL ............................................................................. 36,411 38,720 38,720

∂2,309 ............

Total, Departmental management ..................................................................... 524,429 542,866 542,866

∂18,437 ............

Total, Department of Education ........................................................................ 44,637,611 47,022,546 51,022,546

∂6,384,935

∂4

Current Year .............................................................................................. (30,056,311) (47,022,546) (36,441,246) (

∂6,384,935) (

¥10

Advance year ............................................................................................. (14,581,300) ............................ (14,581,300) ............................ (

∂14

TITLE IV

—RELATED AGENCIES

ARMED FORCES RETIREMENT HOME

Operations and Maintenance .......................................................................................... 60,000 61,628 61,628

∂1,628 ............

Capital Program .............................................................................................................. 9,832 9,812 9,812

¥20 ............

Total, AFRH ........................................................................................................ 69,832 71,440 71,440

∂1,608 ............

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 7

Domestic Volunteer Service Programs:

Volunteers in Service to America (VISTA) .............................................................. 83,074 82,074 86,500

∂3,426
National Senior Volunteer Corps:

Foster Grandparents Program ....................................................................... 98,868 102,868 102,868 ∂4,000 ............Senior Companion Program ........................................................................... 40,395 44,395 44,395 ∂4,000 ............Retired Senior Volunteer Program ................................................................. 48,884 54,884 54,884 ∂6,000 ............Senior Demonstration Program ..................................................................... 400 400 400 ............................ ............

Subtotal, Senior Volunteers ...................................................................... 188,547 202,547 202,547 ∂14,000 ............

Program Administration ......................................................................................... 32,229 32,229 32,229 ............................ ............

Total, Domestic Volunteer Service Programs ..................................................... 303,850 316,850 321,276 ∂17,426 

CORPORATION FOR PUBLIC BROADCASTING:

Fiscal year 2004 (current request) with fiscal year 2003 comparable ................ 365,000 ............................ 395,000 ∂30,000 ∂Fiscal year 2003 advance with fiscal year 2002 comparable (NA) ...................... (350,000) (365,000) (365,000) (∂15,000) ............Fiscal year 2002 advance with fiscal year 2001 comparable (NA) ...................... (340,000) (350,000) (350,000) (∂10,000) ............Digitalization program8 ......................................................................................... 20,000 20,000 25,000 ∂5,000 

Subtotal, fiscal year 2002 appropriation .......................................................... (360,000) (370,000) (375,000) (∂15,000) 

FEDERAL MEDIATION AND CONCILIATION SERVICE ......................................................... 38,200 39,482 40,482 ∂2,282 FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION ........................................... 6,320 6,939 6,939 ∂619 ............INSTITUTE OF MUSEUM AND LIBRARY SERVICES ............................................................ 207,469 168,078 168,078 ¥39,391 ............MEDICARE PAYMENT ADVISORY COMMISSION ................................................................ 8,000 8,000 8,500 ∂500 NATIONAL COMMISSION ON LIBRARIES AND INFO SCIENCE ........................................... 1,495 ............................ 1,495 ............................ NATIONAL COUNCIL ON DISABILITY ................................................................................. 2,615 2,830 2,830 ∂215 ............NATIONAL EDUCATION GOALS PANEL .............................................................................. 1,500 2,000 2,000 ∂500 ............NATIONAL LABOR RELATIONS BOARD .............................................................................. 216,438 221,438 226,438 ∂10,000 NATIONAL MEDIATION BOARD .......................................................................................... 10,400 10,635 10,635 ∂235 ............OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION .......................................... 8,720 8,964 8,964 ∂244 ............

RAILROAD RETIREMENT BOARD

Dual Benefits Payments Account .................................................................................... 160,000 146,000 146,000 ¥14,000 ............Less Income Tax Receipts on Dual Benefits .................................................................. ¥10,000 ¥9,000 ¥9,000 ∂1,000 ............

Subtotal, Dual Benefits ..................................................................................... 150,000 137,000 137,000 ¥13,000 ............

Federal Payment to the RR Retirement Account ............................................................ 150 150 150 ............................ ............Limitation on administration .......................................................................................... 95,000 97,700 97,700 ∂2,700 ............

Inspector General ................................................................................................... 5,700 6,480 6,480 ∂780 ............
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

SOCIAL SECURITY ADMINISTRATION

Payments to Social Security Trust Funds ....................................................................... 20,400 434,400 434,400

∂414,000 ............

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Benefit payments ............................................................................................................ 484,078 440,931 440,931

¥43,147 ............

Administration ................................................................................................................. 5,670 5,909 5,909

∂239 ............

Subtotal, Black Lung, current year program level ............................................ 489,748 446,840 446,840

¥42,908 ............

Less funds advanced in prior year ..........................................................

¥124,000

¥114,000

¥114,000

∂10,000 ............

Total, Black Lung, current request ...................................................... 365,748 332,840 332,840

¥32,908 ............

New advances, 1st quarter fiscal year 2003 ...................................... 114,000 108,000 108,000

¥6,000 ............

SUPPLEMENTAL SECURITY INCOME

Federal benefit payments ................................................................................................ 30,483,000 29,046,000 29,046,000

¥1,437,000 ............

Beneficiary services ......................................................................................................... 71,000 37,412 37,412

¥33,588 ............

Research and demonstration .......................................................................................... 30,000 30,000 37,000

∂7,000

Administration ................................................................................................................. 2,349,000 2,627,000 2,627,000

∂278,000 ............

Subtotal, SSI current year program level .......................................................... 32,933,000 31,740,412 31,747,412 ¥1,185,588

Less funds advanced in prior year ..........................................................

¥9,890,000

¥10,470,000

¥10,470,000

¥580,000 ............

Subtotal, regular SSI current year (2001/2002) ............................................... 23,043,000 21,270,412 21,277,412

¥1,765,588

Additional CDR funding 1 .......................................................................... 210,000 200,000 200,000

¥10,000 ............
User Fee Activities .................................................................................... 91,000 106,000 100,000

∂9,000

Total, SSI, current request ................................................................... 23,344,000 21,576,412 21,577,412

¥1,766,588

New advance, 1st quarter, fiscal year 2003 ....................................... 10,470,000 10,790,000 10,790,000

∂320,000 ............

LIMITATION ON ADMINISTRATIVE EXPENSES

OASDI Trust Funds .......................................................................................................... 3,138,200 3,212,200 3,212,200

∂74,000 ............

HI/SMI Trust Funds .......................................................................................................... 1,094,000 1,194,000 1,194,000

∂100,000 ............

Social Security Advisory Board ........................................................................................ 1,800 1,800 1,800 ............................ ............SSI ................................................................................................................................... 2,349,000 2,627,000 2,627,000

∂278,000 ............

Subtotal, regular LAE ......................................................................................... 6,583,000 7,035,000 7,035,000

∂452,000 ............

User Fee Activities (SSI) .................................................................................................. 91,000 106,000 100,000

∂9,000

TOTAL, REGULAR LAE ......................................................................................... 6,674,000 7,141,000 7,135,000

∂461,000

Additional CDR funding: 1

OASDI ............................................................................................... 240,000 233,000 233,000

¥7,000 ............

SSI .................................................................................................... 210,000 200,000 200,000

¥10,000 ............

Subtotal, CDR funding ................................................................ 450,000 433,000 433,000

¥17,000 ............

TOTAL, LAE ......................................................................................................... 7,124,000 7,574,000 7,568,000

∂444,000

OFFICE OF INSPECTOR GENERAL

Federal Funds .................................................................................................................. 16,944 19,000 19,000

∂2,056 ............

Trust Funds ..................................................................................................................... 52,500 56,000 56,000

∂3,500 ............

Total, Office of the Inspector General ............................................................... 69,444 75,000 75,000

∂5,556 ............

Adjustment: Trust fund transfers from general revenues ..............................................

¥2,650,000

¥2,927,000

¥2,927,000

¥277,000 ............

Total, Social Security Administration ................................................................ 38,857,592 37,963,652 37,958,652

¥898,940

Federal funds ............................................................................................ 34,331,092 33,260,652 33,261,652

¥1,069,440

Current year ..................................................................................... (23,747,092) (22,362,652) (22,363,652) (

¥1,383,440) 

New advances, 1st quarter ............................................................. (10,584,000) (10,898,000) (10,898,000) (

∂314,000) ............

Trust funds ............................................................................................... 4,526,500 4,703,000 4,697,000

∂170,500
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN T

FOR FISCAL YEAR 2002

—Continued

[In thousands of dollars]

Item 2001 appropriation Budget estimate Committee recommendation

Senate Committee recommenda

pared with (∂ or ¥)

2001

appropriation Budget 

UNITED STATES INSTITUTE OF PEACE ............................................................................. 15,000 15,207 15,207

∂207 ............

Total, Title IV, Related Agencies ....................................................................... 40,383,281 39,096,845 39,504,266

¥879,015

∂

Federal Funds ........................................................................................... 35,748,081 34,281,665 34,694,586

¥1,053,495

∂

Current Year ..................................................................................... (24,799,081) (23,383,665) (23,401,586) (

¥1,397,495) (

Advance Year, Fiscal Year 2003 ..................................................... (10,584,000) (10,898,000) (10,898,000) (

∂314,000) ............

Advance Year, Fiscal Year 2004 ..................................................... (365,000) ............................ (395,000) (

∂30,000) (

∂

Trust Funds ............................................................................................... 4,635,200 4,815,180 4,809,680

∂174,480

SUMMARY

Grand bill total ................................................................................................................ 364,816,166 399,626,042 407,267,401

∂42,451,235

∂7

Federal Funds ......................................................................................................... 354,421,548 388,890,217 396,421,538

∂41,999,990

∂7

Current year .............................................................................................. (286,354,797) (328,536,280) (317,498,301) (

∂31,143,504) (

¥11

Advance Year, Fiscal Year 2003 .............................................................. (68,001,751) (60,353,937) (78,828,237) (

∂10,826,486) (

∂18

Advance Year, Fiscal Year 2004 .............................................................. (365,000) ............................ (395,000) (

∂30,000) (

∂

Trust Funds ............................................................................................................ 10,394,618 10,735,825 10,845,863

∂451,245

∂

1 Two year availability. 2 $10,000,000 transferred from ESA to CDC, OSHA. 3 Includes Mine Safety and Health. 4 Funded in VA/HUD appropriations bill. 5 Superfund $ are appropria

VA/HUD Bill. 6 Fiscal year 2001 comparable includes funding for Eisenhower professional development and class size reduction. 7 Appropriations for Americorps are provided in the VA

8 Current funded.

Æ