```

[Senate Report 112-84]
[From the U.S. Government Publishing Office]

                                                       Calendar No. 178
112th Congress                                                   Report
                                 SENATE
 1st Session                                                     112-84

======================================================================

 
  DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND 
               RELATED AGENCIES APPROPRIATION BILL, 2012
                                _______
                                

               September 22, 2011.--Ordered to be printed

                                _______
                                

           Mr. Harkin, from the Committee on Appropriations, 
                        submitted the following

                                 REPORT

                         [To accompany S. 1599]

    The Committee on Appropriations reports the bill (S. 1599) 
making appropriations for Departments of Labor, Health and 
Human Services, and Education, and related agencies for the 
fiscal year ending September 30, 2012, and for other purposes, 
reports favorably thereon and recommends that the bill do pass.

                       Amount of budget authority
Total of bill as reported to the Senate.............    $742,432,508,000
Amount of 2011 appropriations.......................     722,738,724,000
Amount of 2012 budget estimate......................     758,715,002,000
Bill as recommended to Senate compared to--
    2011 appropriations.............................     +19,693,784,000
    2012 budget estimate............................     -16,282,494,000

                                CONTENTS

                              ----------                              
                                                                   Page

Summary of Budget Estimates and Committee Recommendations........     4
    Overview.....................................................     4
    Fiscal Accountability........................................     5
    Leveraging Reform............................................     6
    Investing in the Future......................................     8
    Other Highlights of the Bill.................................     8
    Reprogramming and Transfer Authority.........................    10
Title I: Department of Labor:
    Employment and Training Administration.......................    12
    Employee Benefits Security Administration....................    22
    Pension Benefit Guaranty Corporation.........................    23
    Wage and Hour Division.......................................    23
    Office of Labor-Management Standards.........................    24
    Office of Federal Contract Compliance Programs...............    24
    Office of Workers' Compensation Programs.....................    25
    Occupational Safety and Health Administration................    28
    Mine Safety and Health Administration........................    29
    Bureau of Labor Statistics...................................    30
    Office of Disability Employment Policy.......................    32
    Departmental Management......................................    33
    General Provisions...........................................    36
Title II: Department of Health and Human Services:
    Health Resources and Services Administration.................    36
    Centers for Disease Control and Prevention...................    59
    National Institutes of Health................................    84
    Substance Abuse and Mental Health Services Administration....   116
    Agency for Healthcare Research and Quality...................   126
    Centers for Medicare and Medicaid Services...................   129
    Administration for Children and Families.....................   134
    Administration on Aging......................................   149
    Office of the Secretary......................................   153
    General Provisions...........................................   164
Title III: Department of Education:
    Education for the Disadvantaged..............................   166
    Impact Aid...................................................   170
    School Improvement Programs..................................   171
    Indian Education.............................................   177
    Innovation and Improvement...................................   177
    Safe Schools and Citizenship Education.......................   184
    English Language Acquisition.................................   186
    Special Education............................................   187
    Rehabilitation Services and Disability Research..............   191
    Special Institutions for Persons With Disabilities:
        American Printing House for the Blind....................   196
        National Technical Institute for the Deaf................   197
        Gallaudet University.....................................   197
    Career, Technical, and Adult Education.......................   197
    Student Financial Assistance.................................   199
    Student Aid Administration...................................   202
    Higher Education.............................................   203
    Howard University............................................   210
    College Housing and Academic Facilities Loans................   211
    Historically Black College and University Capital Financing 
      Program Account............................................   211
    Institute of Education Sciences..............................   212
    Departmental Management:
        Program Administration...................................   214
        Office for Civil Rights..................................   215
        Office of the Inspector General..........................   215
    General Provisions...........................................   215
Title IV: Related Agencies:
    Committee for Purchase From People Who Are Blind or Severely 
      Disabled...................................................   217
    Corporation for National and Community Service...............   217
    Corporation for Public Broadcasting..........................   220
    Federal Mediation and Conciliation Service...................   221
    Federal Mine Safety and Health Review Commission.............   221
    Institute of Museum and Library Services.....................   222
    Medicaid and CHIP Payment and Access Commission..............   223
    Medicare Payment Advisory Commission.........................   223
    National Council on Disability...............................   224
    National Health Care Workforce Commission....................   224
    National Labor Relations Board...............................   224
    National Mediation Board.....................................   225
    Occupational Safety and Health Review Commission.............   225
    Railroad Retirement Board....................................   225
    Social Security Administration...............................   226
Title V: General Provisions......................................   231
Compliance With Paragraph 7, Rule XVI of the Standing Rules of 
  the Sen- 
  ate............................................................   232
Compliance With Paragraph 7(c), Rule XXVI of the Standing Rules 
  of the Senate..................................................   232
Compliance With Paragraph 12, Rule XXVI of the Standing Rules of 
  the Senate.....................................................   233
Budgetary Impact of Bill.........................................   236
Comparative Statement of New Budget Authority....................   237

       SUMMARY OF BUDGET ESTIMATES AND COMMITTEE RECOMMENDATIONS

    For fiscal year 2012, the Committee recommends total budget 
authority of $742,432,508,000 for the Departments of Labor, 
Health and Human Services [HHS], and Education, and Related 
Agencies. Of this amount, $158,027,000,000 is current year 
discretionary funding, including offsets and $893,000,000 in 
cap adjustments for healthcare fraud and abuse and for program 
integrity at the Social Security Administration, in accordance 
with the 302(b) allocation for this bill. Not counting cap 
adjustments, the 302(b) allocation provided by the Committee 
for this bill is $308,000,000 below the fiscal year 2011 level.
    The Committee recommendation reflects a program level of 
$165,384,183,000 for fiscal year 2012. (Program level is 
current year discretionary funding plus additional spending 
that is offset by savings in mandatory programs and other 
adjustments to discretionary funding.) Within this total, the 
Committee included an additional $409,000,000 in spending 
necessary to receive the two cap adjustments. When program 
level is adjusted for this additional program integrity 
spending, the program level is $308,000,000 below the 2011 
comparable level of $165,283,184,000. This difference mirrors 
the reduction in the Committee 302(b) allocation for this bill, 
before cap adjustments, from the fiscal year 2011 enacted level 
to fiscal year 2012.
    The bill provides discretionary program level funding of 
$12,687,502,000 for the Department of Labor, $70,183,059,000 
for the Department of HHS, $68,425,775,000 for the Department 
of Education and $14,087,847,000 for related agencies. The 
comparable fiscal year 2011 levels were $12,662,505,000 for 
Labor, $70,444,321,000 for HHS, $68,345,327,000 for Education 
and $13,831,031,000 for related agencies.

                                Overview

    It has been said that while the Defense appropriations bill 
defends America, the Labor, HHS, and Education, and Related 
Agencies appropriations bill defines America.
    This bill is made up of over 300 programs, spanning three 
Federal departments and numerous related agencies. But the bill 
is more than its component parts. Virtually every element of 
this bill reflects the traditional ideal of democracy: that 
every citizen deserves the right to a basic education and job 
skills training; protection from illness and want; and an equal 
opportunity to reach one's highest potential.
    This year, the Committee has been asked to help Americans 
achieve those ideals with less funding than was available the 
year before. That constraint has forced the Committee to make 
difficult cuts, some of which may be unpopular, or eliminate 
programs altogether. In other cases, the Committee has 
recommended targeted increases to address needs that are 
particularly pressing in today's struggling economy.
    Three themes permeate the Committee's recommendation. 
First, the Committee recognizes that every taxpayer dollar 
should be used wisely; efforts to root out waste are bolstered, 
and duplicative and inefficient programs are eliminated. 
Second, just because times are lean doesn't mean that 
innovation should cease. This bill launches or continues 
several new initiatives that will leverage reform and transform 
key Federal services. Finally, the Committee invests in the 
future of this Nation by helping ensure that our young people 
receive a strong education and are prepared to compete in a 
global economy.
    Each theme is described more fully below.

                         Fiscal Accountability

    For fiscal year 2012, the Committee increases funding for 
key activities aimed at reducing fraud, waste and abuse of 
taxpayer dollars. These program integrity initiatives have 
proven to be a wise Federal investment, resulting in billions 
of dollars of savings in Federal entitlement programs.
    Health Care Program Integrity.--Fraud committed against 
Federal healthcare programs puts Americans at increased risk 
and diverts critical resources from providing necessary health 
services to some of the Nation's most vulnerable populations. 
The Committee includes $581,000,000 for Health Care Fraud and 
Abuse Control activities at the Centers for Medicare and 
Medicaid Services. This amount is a $270,623,000 increase over 
the fiscal year 2011 level of $310,377,000. The historical 
return on investment for the life of the Medicare Integrity 
program has been about $14 for every $1 spent. For fraud and 
abuse activities throughout Medicare and Medicaid, the Federal 
Government saves or recovers $6 for every $1 spent.
    Social Security Program Integrity.--The Committee 
recommendation includes $896,000,000, an increase of 
$139,516,000 over the fiscal year 2011 level, for the Social 
Security Administration to conduct continuing disability 
reviews and redeterminations of non-medical eligibility under 
the Supplemental Security Income program. This investment will 
save approximately $8,900,000,000 over 10 years for the Social 
Security, Medicare, and Medicaid programs, almost $10 for every 
$1 spent.
    340B User Fee.--The Committee has included a provision, 
requested by the administration, to institute a 0.1 percent 
user fee on 340B discount drugs. The fee is expected to 
generate $5,000,000 in fiscal year 2012, which will be used to 
implement program integrity work recommended by the Government 
Accountability Office and mandated by the Patient Protection 
and Affordable Care Act.
    Unemployment Insurance Program Integrity.--The Committee 
recommendation includes $59,900,000 to conduct re-employment 
and eligibility assessments and unemployment insurance [UI] 
improper payment reviews. The recommendation will support the 
continuation of this initiative in approximately 40 States and 
will save State UI Trust funds by helping claimants exit the UI 
program faster and avoid exhausting UI benefits. These 
activities have a return on investment of more than $3 for 
every $1 spent.
    Program Eliminations.--Lean economic times require tough 
choices and a critical look at all programs in the bill, even 
those that have been funded for decades. The fiscal year 2011 
appropriations bill eliminated 46 programs, totaling 
$1,336,540,000, within the jurisdiction of this bill. In fiscal 
year 2012, the Committee recommendation eliminates another 15 
programs totaling $263,383,000.

                           Leveraging Reform

    Accelerating Cures.--The Committee bill includes 
$582,362,000 to create the National Center for Advancing 
Translational Sciences [NCATS] within the National Institutes 
of Health [NIH]. The new Center is part of a broader 
restructuring at NIH that also includes the termination of the 
National Center for Research Resources. The mission of NCATS is 
to transform the way NIH pursues the translation of basic 
science into treatments and cures. Too often, basic biomedical 
research will suggest a promising path for a treatment or cure, 
but funding falls short to pursue the idea to its fullest 
potential. A new program within NCATS--the Cures Acceleration 
Network [CAN]--will help speed the translation and application 
of discoveries that have shown signs of success at the 
laboratory level but have not advanced far enough to attract 
significant investments from the private sector. CAN, for which 
the Committee provides $20,000,000, will make grants to biotech 
companies, universities, and patient advocacy groups, and will 
also help facilitate FDA review for the high-need cures that 
are funded by this initiative. The other programs within NCATS 
will be transferred from other Institutes and Centers.
    Race to the Top.--The Committee includes $698,600,000, the 
same as the fiscal year 2011 level, for the administration's 
signature education reform program. Race to the Top was created 
in the American Recovery and Reinvestment Act and continued in 
the fiscal year 2011 appropriations bill. This competitive 
program has achieved enormous success in spurring States to 
change their practices for the purposes of closing the 
achievement gap and making other needed improvements. Thus far, 
11 States and the District of Columbia have been awarded funds 
and are now implementing their Race to the Top plans. This bill 
will offer additional opportunities to support reform, 
including new authority to award grants directly to local 
educational agencies interested in pursuing ambitious education 
reform in their local communities.
    The bill also continues to support the Race to the Top--
Early Learning Challenge program, which was first funded in the 
fiscal year 2011 appropriations bill. More than 30 States and 
the District of Columbia have signaled an interest in applying 
for $500,000,000 available in that bill. There is robust 
evidence that high-quality early learning programs help 
children develop the cognitive, social, and emotional skills 
needed to succeed in school and later in life. Yet quality 
varies greatly across settings, within States, and across the 
Nation. The fiscal year 2012 bill provides the Department with 
authority to further support States' plans for raising the bar 
for early childhood programs, particularly disadvantaged 
children, and ensure that more children enter kindergarten 
ready to succeed.
    Investing in Innovation.--The Committee bill includes 
$149,700,000, the same as the fiscal year 2011 level, to 
replicate education programs that have high levels of 
effectiveness as established under rigorous research and to 
develop and test promising new ideas. Like Race to the Top, 
Investing in Innovation was created in the Recovery Act and 
continued in the fiscal year 2011 bill.
    Workforce Innovation Fund.--In an increasingly competitive 
economy, America's strength depends on the education and skills 
of our workforce. To that end, the Committee includes 
$100,000,000 to continue the Workforce Innovation Fund, which 
will help reform the Nation's workforce investment system and 
improve the delivery of training programs to workers. Created 
in the fiscal year 2011 appropriations bill, WIF will support 
innovative, systemic and evidence-based reforms and help 
determine which strategies are cost-effective and have the 
greatest impact.
    Community Transformation Grants.--The Committee recommends 
dedicating $280,000,000 of the Prevention and Public Health 
Fund, an increase of $135,000,000 over the fiscal year 2011 
level, for implementing evidence-based public health 
interventions to reduce obesity and smoking and make preventive 
services more accessible. The Committee believes this program 
offers enormous potential to turn the environment in which 
Americans work, live and raise their families into one that 
offers a much greater array of healthy choices.
    Promoting School Readiness for Minors in SSI.--The 
Committee includes $4,000,000 and the authority to allocate 
unspent vocational rehabilitation State grant funds within the 
Department of Education and $10,000,000 at the Social Security 
Administration [SSA] for a new Promoting School Readiness for 
Minors in SSI [PROMISE] program. PROMISE will bring together 
these agencies with the Departments of HHS and Labor in 
unprecedented interagency effort to improve outcomes for 
children, and the families of children, receiving Supplemental 
Security Income benefits. Almost 60 percent of child SSI 
recipients who turn 18, and become ineligible for child 
benefits, immediately continue receiving benefits as an adult. 
Those who do enter the workforce have average earnings that are 
only one-third the level as their peers. This program will 
improve services for these transition-aged youth by encouraging 
State-level innovation and facilitating better coordination 
between existing programs serving disabled youth. To the extent 
that this initiative can help young people with disabilities 
eventually support themselves, it will also reduce SSI program 
costs.
    Social Innovation Fund.--The Committee recommendation 
provides $49,900,000, the same as the fiscal year 2011 level, 
for the Social Innovation Fund at the Corporation for National 
and Community Service. This Fund mobilizes public and private 
resources to expand and evaluate promising, innovative 
community-based solutions in three areas: economic opportunity, 
healthy futures and youth development.

                        Investing in the Future

    Pell Grants.--One of the Committee's highest priorities in 
the bill is maintaining the maximum Pell Grant award. Now more 
than ever, students need affordable, quality education 
opportunities to help make our economy strong and competitive. 
Pell Grants, the foundation of Federal postsecondary student 
aid, are essential to helping students enter college and gain 
the education and skills needed for jobs in the 21st century 
economy.
    The Committee bill maintains the discretionary portion of 
the maximum Pell Grant award level at $4,860 for the 2012-2013 
school year. Combined with mandatory funding, the total maximum 
award is maintained at $5,550. The Pell Grant program supports 
an estimated 9.4 million low- and middle-income students.
    Head Start.--Quality early childhood education has been 
proven to have lasting effects for low-income children and 
their families. Investments in early childhood education not 
only improve outcomes for low-income children and families, but 
save taxpayer dollars in the long-run through lower Federal and 
State welfare, special education, and criminal justice costs. 
The Committee recommendation includes a $340,000,000 increase 
for Head Start, maintaining the recent expansion of 61,000 Head 
Start slots funded with Recovery Act funding in fiscal years 
2009 and 2010. In total, Head Start will provide comprehensive 
early childhood services to 968,000 low-income children and 
families.
    Striving Readers.--The Committee includes $183,000,000 for 
this comprehensive, competitive literacy program. Funds will be 
used by States to implement their statewide literacy plans, 
which address activities from birth through 12th grade and will 
support programs that advance literacy skills through 
professional development, screening and assessment, targeted 
interventions for students reading below grade level and other 
research-based methods of improving classroom instruction and 
practice.
    Promise Neighborhoods.--The Committee recommends 
$60,000,000--a doubling of the fiscal year 2011 level--for the 
Promise Neighborhoods program. Inspired by the successful 
Harlem Children's Zone program, Promise Neighborhoods supports 
local efforts to establish cradle-to-career services designed 
to improve educational outcomes for students in distressed 
neighborhoods. Funds provided in this bill will allow a third 
group of communities to develop their Promise Neighborhood 
plans and enable communities that are farther along to 
implement their plans. Hundreds of communities from across the 
country have applied for Promise planning grants--evidence of 
the great interest in comprehensive solutions for our Nation's 
most challenged communities.

                      Other Highlights of the Bill

    Mine Safety Appeals.--The number of violations appealed 
annually to the Federal Mine Safety and Health Review 
Commission has quadrupled since 2006. Because staffing at the 
Commission has not kept pace with this increase, the number of 
pending cases has skyrocketed and it now takes over 500 days to 
issue a final decision. These delays undermine mine safety and 
ultimately put miners at risk. The Committee recommendation 
includes a combined $26,656,000 increase at the Commission and 
the Department of Labor, building off of supplemental funding 
provided in fiscal year 2010, to continue efforts to reduce the 
backlog of cases, decrease case processing time, and improve 
the safety of American miners.
    Centers for Medicare and Medicaid Services [CMS].--The 
Committee recommends $4,044,876,000 for operations of CMS. The 
fiscal year 2011 level was $3,586,855,000. Additional funding 
is needed to continue implementation of the Patient Protection 
and Affordable Care Act and to accommodate an increase in the 
Medicare population, as 2011-2012 are the first years that the 
baby boom generation will begin enrolling in this program.
    National Institutes of Health [NIH].--The bill provides 
$30,498,289,000, a decrease of $190,000,000, to fund biomedical 
research at the 27 institutes and centers that comprise the 
NIH.
    Community Health Centers [CHCs].--The Committee bill 
includes $1,580,749,000 for CHCs. Combined with mandatory 
funding provided in the health reform law, the fiscal year 2012 
program level for CHCs is $2,780,749,000--an increase of 
$200,000,000. This level will allow for base grant adjustments 
for all existing CHCs and the expansion of the national network 
of clinics.
    Low Income Home Energy Assistance.--The Committee 
recommendation includes $3,600,580,000 for the Low Income Home 
Energy Assistance Program. The fiscal year 2011 level was 
$4,700,580,000. The recommended level, while a significant cut, 
is $1,031,029,000 more than the administration's budget request 
and $1,030,252,000 more than the comparable fiscal year 2008 
funding level.
    Child Care and Development Block Grant.--The Committee 
recommendation includes $2,222,627,000 for the Child Care and 
Development Block Grant, including $283,592,000 specified for 
child care quality improvement activities. This recommendation 
maintains funding at the fiscal year 2011 level and, including 
mandatory funding, will allow States to provide child care 
subsidies to an estimated 1.6 million low-income children and 
their working families.
    Senior Nutrition.--The Committee recommendation includes 
$817,835,000 for senior nutrition programs, including 
congregate meals, home-delivered meals and the nutrition 
services incentive program. These programs provide seniors with 
the meals they need to stay healthy and remain independent in 
their community. The Committee recommendation maintains funding 
at the fiscal year 2011 level.
    Homelessness.--The Committee recommendation includes 
$14,576,000 for a new initiative targeting mental health and 
substance abuse treatment services to homeless and at-risk 
families. This initiative, in collaboration with the Department 
of Housing and Urban Development, aims to provide permanent 
supportive housing to those who experience chronic, long-term 
homelessness.
    Community Services Block Grant [CSBG].--The Committee 
recommendation includes $678,640,000, the same as the fiscal 
year 2011 funding level, for CSBG. This block grant provides 
critical funding for community action agencies across the 
country to help ensure a safety net at the local level for the 
most vulnerable Americans.
    AIDS Drug Assistance Program [ADAP].--The Committee 
recommends $900,000,000 for ADAP, an increase of $15,000,000 
over the fiscal year 2011 level.
    Polio Eradication.--The Committee bill provides 
$111,597,000, an increase of $10,000,000 over the fiscal year 
2011 level, for CDC efforts to eradicate polio.
    Education for Individuals With Disabilities.--The Committee 
bill provides $11,482,200,000, the same amount as the fiscal 
year 2011 level, under section 611 of part B grants to States 
for educating students with disabilities.
    Title I (Education for the Disadvantaged).--The Committee 
bill includes $14,463,417,000, the same amount as the fiscal 
year 2011 level, for title I grants to local education agencies 
for improving education for low-income students. These funds 
support more than 90 percent of the 15,000 school districts 
across the Nation--an important contribution given the 
reductions to education spending by State and local 
governments.
    Corporation for Public Broadcasting.--The Committee 
recommendation includes $445,000,000 in fiscal year 2014 
advanced funding for the Corporation for Public Broadcasting, 
the same as the advance provided last year for fiscal year 
2013. The Committee maintains 2-year advance funding, which has 
been in place since 1975 to ensure the independence of public 
broadcasting programming. The Committee recommendation also 
includes $5,988,000 in fiscal year 2012 funding for digital 
broadcasting equipment and programming related to the 
transition from analog to digital broadcasting.
    Social Security Administration [SSA].--The Committee 
recommendation includes $11,631,948,000, an increase of 
$208,342,000 over the fiscal year 2011 level, for the SSA's 
administrative expenses. This increase includes $139,516,000 
for program integrity activities and $68,826,000 in base 
administrative expenses. As SSA faces sustained record levels 
of core workloads, the increase for base administrative 
expenses will allow SSA to provide targeted increases to parts 
of the agency facing the highest demand for services while 
maintaining the goal of eliminating the disability hearings 
backlog by the end of 2013.
    Corporation for National and Community Service.--The 
Committee recommendation includes $1,092,578,000 for the 
Corporation for National and Community Service, an increase of 
$17,000,000. The additional funds are necessary to offer over 
82,000 Americans the opportunity to join AmeriCorps. AmeriCorps 
places members in settings where they can provide a service to 
the community while they gain valuable experience. Other 
programs of the Corporation engage seniors in part-time 
volunteerism, work with nonprofit organizations to improve 
their management, and link volunteers to programs of need.

                  Reprogramming and Transfer Authority

    The Committee includes bill language delineating 
permissible transfer authority in general provisions for each 
of the Departments of Labor, Health and Human Services, and 
Education, as well as specifying reprogramming authority in a 
general provision applying to all funds provided under this 
act, available for obligation from previous appropriations 
acts, or derived from fees collected.

                                TITLE I

                          DEPARTMENT OF LABOR

                 Employment and Training Administration

                    TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2011....................................  $3,344,497,000
Budget estimate, 2012...................................   3,626,947,000
Committee recommendation................................   3,310,247,000

    The Committee recommends $3,310,247,000 for this account, 
which provides funding primarily for activities under the 
Workforce Investment Act [WIA]. The fiscal year 2011 comparable 
amount is $3,344,497,000 and the budget request provides 
$3,626,947,000 for this purpose.
    The training and employment services account 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. Funds provided for fiscal year 2012 will support the 
program from July 1, 2012, through June 30, 2013. A portion of 
this account's funding, $1,772,000,000, is available on October 
1, 2012, for the 2012 program year.
    Pending reauthorization of WIA, the Committee is acting on 
the basis of current law.
    The Committee recommendation includes bill language 
requiring that the Department take no action to amend, through 
regulatory or other administrative action, the definition 
established in 20 CFR 677.220 for functions and activities 
under title I of WIA until such time as legislation 
reauthorizing the act is enacted.

Grants to States

    The Committee recommends $2,660,268,000 for Training and 
Employment Services Grants to States. The fiscal year 2011 
level for these grants is $2,785,018,000 and includes funding 
for the Workforce Innovation Fund [WIF]. The budget request is 
$2,959,043,000. Funding for WIF in fiscal year 2012 is provided 
under federally administered programs.
    The bill includes legislative language that allows a local 
workforce board to transfer up to 30 percent between the adult 
and dislocated worker assistance State grant programs, if such 
transfer is approved by the Governor. This language was 
proposed in the budget request. In addition, the bill includes 
language that allows a local board to award a contract to an 
institution of higher education or other eligible training 
provider if the local board determines that it would facilitate 
the training of multiple individuals in high-demand 
occupations, if such contract does not limit customer choice. 
This language was also included in the budget request.
    Adult Employment and Training.--For Adult Employment and 
Training activities, the Committee recommends $770,922,000. 
This is the same amount provided in fiscal year 2011. The 
budget request provides $860,527,000 for this purpose and 
includes an 8 percent set-aside, $68,842,000, for WIF.
    This program is funded by formula to States and further 
distributed to local workforce investment areas. Three types of 
services for adults are provided through the one-stop system: 
core services, intensive services and job training. Core 
services are available to all adults with no eligibility 
requirements. Intensive services are provided to unemployed 
individuals who are not able to find jobs through core services 
alone. Training services may be available to adults who have 
been determined unable to obtain or retain employment through 
intensive services. Most customers receiving a training service 
will use their individual training accounts to determine which 
programs and providers fit their needs.
    The Committee commends the Employment and Training 
Administration for its collaborative work with the Institute 
for Museum and Library Services [IMLS] to integrate the 
education, employment and training services provided by and/or 
supported through public libraries into the workforce 
investment system. According to a survey conducted by IMLS and 
the Gates Foundation, 30 million people used public library 
computers to help address their career and employment needs and 
an estimated 3.7 million Americans found work with the support 
of their public libraries in 2009. The Committee encourages the 
Department to continue to invest in building and strengthening 
partnerships between the one-stop system and public libraries.
    The Committee is greatly concerned about the low level of 
literacy and numeracy skills among adult workers, as 1 in 7 
adults do not have basic literacy skills to succeed in 
tomorrow's industries and jobs. The Committee encourages the 
Department to work with the Department of Education to examine 
and publish best practices from local organizations that 
integrate adult literacy and workforce development skills to 
help adults with the lowest literacy levels improve their 
overall skills and employment opportunities.
    Funds made available in this bill support program year 2012 
activities that occur from July 1, 2012, through June 30, 2013. 
The bill provides that $58,922,000 is available for obligation 
on July 1, 2012, and that $712,000,000 is available on October 
1, 2012. Both categories of funding are available for 
obligation through June 30, 2013.
    Youth Training.--For youth training programs, the Committee 
recommends $825,914,000, the same as the fiscal year 2011 
comparable amount. The budget request provides $923,913,000 for 
this purpose and includes an 8 percent set-aside, $73,913,000, 
for WIF.
    The purpose of this program is to provide eligible youth 
with assistance in achieving academic and employment success 
through improved education and skill competencies, connections 
to employers, mentoring, training and supportive services. The 
program also supports summer employment directly linked to 
academic and occupational learning, incentives for recognition 
and achievement, and activities related to leadership 
development, citizenship and community service. Funds made 
available for youth training support program year 2012 
activities, which occur from April 1, 2012, through June 30, 
2013.
    Dislocated Worker Assistance.--For Dislocated Worker 
Assistance, the Committee recommends $1,063,432,000, the same 
as the fiscal year 2011 comparable amount. The budget request 
provides $1,174,603,000 for this purpose and includes an 8 
percent set-aside, $93,968,000, for WIF.
    This program is a State-operated effort that provides core 
and intensive services, training and support to help 
permanently separated workers return to productive, 
unsubsidized employment. In addition, States must use statewide 
reserve funds for rapid response assistance to help workers 
affected by mass layoffs and plant closures. Also, States must 
use these funds to carry out additional statewide employment 
and training activities such as providing technical assistance 
to certain low-performing local areas, evaluating State 
programs and assisting with the operation of one-stop delivery 
systems. States may also use funds for implementing innovative 
incumbent and dislocated worker training programs.
    Funds made available in this bill support program year 2012 
activities, which occur from July 1, 2012, through June 30, 
2013. The bill provides that $203,432,000 is available for 
obligation on July 1, 2012, and that $860,000,000 is available 
on October 1, 2012. Both categories of funding are available 
for obligation through June 30, 2013.

Federally Administered Programs

    Dislocated Worker Assistance National Reserve.--The 
Committee recommends $224,112,000 for the Dislocated Worker 
National Reserve, which is available to the Secretary for 
activities such as responding to mass layoffs, plant and/or 
military base closings and natural disasters that cannot be 
otherwise anticipated as well as for technical assistance, 
training, and demonstration projects. This amount is the same 
as the fiscal year 2011 level. The budget request includes 
$229,160,000.
    Funds made available in this bill support activities in 
program year 2012, which occurs from July 1, 2012, through June 
30, 2013. The bill provides that $24,112,000 is available for 
obligation on July 1, 2012, and that $200,000,000 is available 
on October 1, 2012. Both categories of funding are available 
for obligation through June 30, 2013.
    The Committee bill includes language authorizing the use of 
funds under the dislocated workers program for projects that 
provide assistance to new entrants in the workforce or 
incumbent workers and assistance where there have been 
dislocations across multiple sectors or local areas of a State. 
This language was included in the budget request.
    Native American Programs.--The Committee recommends 
$52,652,000, the same amount provided in fiscal year 2011, for 
Native American programs. The budget request is $54,158,000. 
This program is designed to improve the economic well-being of 
Native Americans (Indians, Eskimos, Aleuts, and Native 
Hawaiians) through the provision of training, work experience 
and other employment-related services and opportunities that 
are intended to aid the participants in securing permanent, 
unsubsidized employment.
    Migrant and Seasonal Farmworker Programs.--The Committee 
recommends $84,451,000, the same amount as fiscal year 2011, 
for migrant and seasonal farmworkers. The budget request is 
$86,620,000 for this program. Authorized by WIA, this program 
is designed to serve members of economically disadvantaged 
families whose principal livelihood is derived from migratory 
and other forms of seasonal farmwork, 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 provides that $78,253,000 be 
used for State service area grants. The Committee 
recommendation also includes bill language directing that 
$5,689,000 be used for migrant and seasonal farmworker housing 
grants, of which not less than 70 percent shall be for 
permanent housing. The principal purpose of these funds is to 
continue the network of local farmworker housing organizations 
working on permanent housing solutions for migrant and seasonal 
farmworkers. The Committee recommendation also includes 
$509,000 to be used for section 167 training, technical 
assistance and related activities, including funds for migrant 
rest center activities.
    Women in Apprenticeship.--The Committee recommends $998,000 
for program year 2012 activities as authorized under the Women 
in Apprenticeship and Non-Traditional Occupations [WANTO] Act 
of 1992. This amount is the same as the fiscal year 2011 level. 
The budget request includes $1,000,000. These funds provide for 
technical assistance to employers and unions to assist them in 
training, placing and retraining women in nontraditional jobs 
and occupations.
    YouthBuild.--The Committee recommends $79,840,000, the same 
as the fiscal year 2011 level, for the YouthBuild program. The 
budget request includes $115,000,000 for this purpose. 
YouthBuild targets at-risk, high-school dropouts and prepares 
them with the skills and knowledge they need to succeed in a 
knowledge-based economy.
    Workforce Innovation Fund.--The Committee recommends 
$100,000,000 in fiscal year 2012 funding for WIF to make 
competitive awards for workforce innovation activities. The 
comparable fiscal year 2011 level is $124,750,000. The budget 
request includes $378,704,000 for this initiative by 
designating a portion of funds from the WIA formula programs 
and Department of Education Rehabilitation Services and Adult 
Education States Grants accounts.
    The Committee provided initial support for this initiative 
in fiscal year 2011 and requests that the Department brief the 
Committee not less than 30 days prior to the release of a 
solicitation of grant applications for this program. The 
Committee also encourages the Department to implement WIF in a 
manner consistent with the bipartisan framework that the Senate 
Health, Education, Labor and Pensions Committee developed for 
WIA reauthorization.
    The Committee continues its support for activities within 
the WIF that are intended to test innovative strategies, 
replicate proven practices or promote workforce system reform. 
Among those activities are those that will improve services for 
youth who are transitioning from school to post-school 
activities, with the goal of improving employment outcomes. 
Within activities for youth, the Committee is particularly 
interested in addressing services to youth with disabilities.
    WIF awards should be made either to States, in partnership 
with local workforce investment boards, or to local workforce 
investment boards or consortia of such boards that serve a 
regional labor market. Priority should be given to applicants 
that demonstrate significant alignment across workforce 
development and supportive services at the State, regional or 
local level and that support economic development goals and 
improved employment outcomes for participants, particularly 
those who are hardest to serve. Awards should also prioritize 
applicants that demonstrate comprehensive strategic planning 
and coordination at the State, regional or local level.
    In addition, the Committee believes that a component of the 
WIF should include the promising results of pay-for-performance 
models. These models have been particularly successful at 
reaching populations with the most significant barriers to 
employment. The Committee encourages the Secretary to use 
innovation funds to replicate pay-for-performance models with 
proven track records of helping hard-to-serve workers in 
additional sites.

National Activities

    Pilots, Demonstrations and Research.--The Committee 
recommends $10,480,000 for pilots, demonstrations and research 
authorized by section 171 of WIA. The comparable fiscal year 
2011 amount is $9,980,000. The budget request includes 
$6,616,000 for this purpose. These funds support grants or 
contracts to conduct research, pilots or demonstrations that 
foster promising practices for national policy application or 
launch pilot projects on a broader scale.
    The Committee recognizes the importance of building 
stronger linkages between title I job training programs and 
title II adult education and literacy programs in WIA in order 
to create career pathways that enhance participants' long-term 
economic success. The Committee urges the Department to expand 
funding to programs that have successfully implemented 
strategies for delivering basic literacy instruction together 
with employment training so that they may document and 
disseminate best practices related to this goal.
    The Committee recommends $500,000 for a competitive grant 
to a national intermediary to support local initiatives that 
improve mobility and promote employment by improving 
transportation assistance. Lack of mobility is an obstacle for 
people living in small towns and farming communities as well as 
low-income people living in small cities and people with 
disabilities who are looking for work or seeking employment and 
training assistance. The grant award should allow for the 
demonstration of the effectiveness of specialized methods and 
activities that address employment and training needs of 
individuals by improving coordination between local government, 
employment and training agencies, and transit providers; 
providing technical assistance on revising routes and 
schedules; and conducting demonstration programs that encourage 
partnerships between community-based transportation 
organizations and local job training and welfare departments.
    Green Jobs Innovation Fund.--The Committee does not 
recommend funding for the Green Jobs Innovation Fund, which was 
eliminated in fiscal year 2011. The budget request includes 
$60,000,000 for competitive grants to help workers access green 
training and green career pathways.
    Reintegration of Ex-offenders.--The Committee recommends 
$75,390,000 for the Reintegration of Ex-offenders program. The 
comparable fiscal year 2011 level is $85,390,000 and the budget 
request includes $90,000,000 for this program. The 
Reintegration of Ex-offenders program helps prepare and assist 
ex-offenders return to their communities through pre-release 
services, mentoring and case management. The program also 
provides support, opportunities, education and training to 
youth who are involved in court and on probation, in aftercare, 
on parole or who would benefit from alternatives to 
incarceration or diversion from formal judicial proceedings. 
Programs are carried out directly through State and local 
governmental entities and community-based organizations, as 
well as indirectly through intermediary organizations.
    The Committee recommendation includes $20,000,000 for 
competitive grants to national or regional intermediaries for 
activities that prepare young ex-offenders and school dropouts 
for employment. Priority should be given to projects that serve 
high-crime, high-poverty areas. The budget request also 
includes this set-aside.
    Evaluation.--The Committee recommends $9,581,000, the same 
as the fiscal year 2011 level, to provide for new and 
continuing rigorous evaluations of programs conducted under 
WIA, as well as of federally funded employment-related 
activities under other provisions of law. The budget requests 
$11,600,000 for this purpose.
    Workforce Data Quality Initiative.--The Committee 
recommends $12,475,000, the same as the fiscal year 2011 level, 
for the Workforce Data Quality Initiative. The budget request 
includes $13,750,000. Funds are used to assist States with 
incorporating comprehensive workforce information into 
longitudinal data systems being developed in part with the 
support of funding provided by the Department of Education. The 
initiative is also intended to help improve the quality and 
accessibility of performance data being produced by training 
providers.

                          OFFICE OF JOB CORPS

Appropriations, 2011....................................  $1,706,171,000
Budget estimate, 2012...................................   1,699,747,000
Committee recommendation................................   1,706,171,000

    For Job Corps, the Committee recommends $1,706,171,000. 
This is the same level provided in fiscal year 2011. The budget 
request includes $1,699,747,000 for Job Corps.
    The recommendation for operations of Job Corps centers is 
$1,572,049,000, comprised of $981,049,000 in fiscal year 2012 
funds and $591,000,000 in advance appropriations provided in 
fiscal year 2011. The Committee also recommends fiscal year 
2013 advance funding of $591,000,000, which will become 
available on October 1, 2012. The budget request provides 
$1,589,817,000, comprised of $998,817,000 in fiscal year 2012 
funds and $591,000,000 in advance appropriations provided in 
fiscal year 2011. The budget request also includes $591,000,000 
for fiscal year 2013 advance funding.
    The Committee recommendation for administration costs is 
$29,132,000, the same amount as the fiscal year 2011 level. The 
budget request includes $31,430,000.
    The Committee also recommends a total of $104,990,000 in 
construction, renovation and acquisition [CRA] funds. Of this 
amount, $4,990,000 is available from July 1, 2012, to June 30, 
2015. In addition, the Committee recommends $100,000,000 in 
advance appropriations, which will become available on October 
1, 2012, through June 30, 2015.
    As requested by the administration, the Committee again 
includes bill language allowing the Secretary to transfer up to 
15 percent of CRA funds, if necessary, to meet the operational 
needs of Job Corps centers or to achieve administrative 
efficiencies.
    Since fiscal year 2008, the Committee has highlighted the 
fact that a number of large metropolitan areas remain 
underserved by Job Corps and has called on the Department to 
establish a process for opening new centers. In fiscal year 
2011, as a first step in initiating a competition for a new Job 
Corps center, the Department completed a study to determine 
needs around the country. The Committee urges the Department to 
continue to prepare for a future competition to expand Job 
Corps services in large, underserved metropolitan areas.

            community service employment for older americans

Appropriations, 2011....................................    $449,100,000
Budget estimate, 2012...................................     450,000,000
Committee recommendation................................     449,100,000

    The Committee recommends $449,100,000, the same as the 
fiscal year 2011 level, for the Community Service Employment 
for Older Americans [CSEOA] program. The budget request is 
$450,000,000.
    This program, authorized by title V of the Older Americans 
Act [OAA], provides part-time employment in community service 
activities for unemployed, low-income persons aged 55 and over.
    CSEOA provides a direct, efficient and quick means to 
assist economically disadvantaged older workers. Administrative 
costs for the program are low and the vast majority of the 
money goes directly to low-income seniors as wages and fringe 
benefits.
    Senior enrollees provide necessary and valuable services at 
Head Start centers, schools, hospitals, libraries, elderly 
nutrition sites, senior centers and elsewhere in the community.
    A large proportion of senior enrollees use their work 
experience and training to obtain employment in the private 
sector. This not only increases our Nation's tax base but also 
enables more low-income seniors to participate in the program.
    The budget proposes to transfer the program to the 
Administration on Aging in the Department of Health and Human 
Services. The Committee does not recommend transferring the 
program. As authorized under OAA, CSEOA's purpose is to foster 
individual economic self-sufficiency, which the Committee views 
as an employment activity. Additionally, the Senate authorizing 
committee with jurisdiction over OAA is in the process of 
reauthorizing this law. As a result, the Committee 
recommendation follows current law.
    The Committee strongly encourages grantees to develop and 
implement research-based curriculum designed specifically for 
older adults.

              FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2011....................................    $721,312,000
Budget estimate, 2012...................................   1,100,100,000
Committee recommendation................................   1,100,100,000

    The Committee recommends $1,100,100,000, the same as the 
budget request, in mandatory funds for Federal unemployment 
benefits and allowances. The fiscal year 2011 comparable amount 
is $721,312,000.
    This program assists trade-impacted workers with services 
including: training, income support, employment, case 
management and assistance with health insurance coverage. The 
program also includes a wage insurance option for certain 
workers at least 50 years old. These benefits and services are 
designed to help trade-impacted participants find a path back 
into middle class jobs, improve earnings and increase 
credential and education rates.

     STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Appropriations, 2011....................................  $4,102,672,000
Budget estimate, 2012...................................   4,202,057,000
Committee recommendation................................   4,094,672,000

    The Committee recommends $4,094,672,000 for this account. 
The recommendation includes $4,008,441,000 authorized to be 
drawn from the Employment Security Administration account of 
the unemployment trust fund and $86,231,000 to be provided from 
the general fund of the Treasury.
    The funds in this account are used to provide 
administrative grants and assistance to State agencies that 
administer Federal and State unemployment compensation laws and 
operate the public employment service.
    The Committee bill continues language that enables States 
to use funds appropriated under this account to assist other 
States if they are impacted by a major disaster declared by the 
President; at the request of one or more States, authorizes the 
Secretary to reallot funds for States to carry out activities 
that benefit the administration of unemployment compensation 
laws of a requesting State; and permits the Secretary to use 
funds to make payments on behalf of States for the use of the 
National Directory of New Hires.
    The Committee recommends a total of $3,242,441,000 for 
unemployment insurance activities. The fiscal year 2011 level 
is $3,250,441,000 and the budget requests $3,286,920,000.
    For unemployment insurance [UI] State operations, the 
Committee recommends $3,231,154,000. The fiscal year 2011 level 
is $3,239,154,000 and the budget request is $3,275,610,000. 
These funds are available for obligation by States through 
December 31, 2012. However, funds used for automation 
acquisitions or for competitive grants to be awarded to States 
to address worker misclassification, system improvements or 
improper payments are available for obligation by States 
through September 30, 2014.
    The recommendation includes $59,900,000, the same as the 
fiscal year 2011 level, to conduct in-person re-employment and 
eligibility assessments [REAs] and unemployment insurance 
improper payment reviews. The budget requests $70,000,000 for 
this purpose. The recommendation will support continuation of 
the REA initiative. This important program integrity initiative 
has been shown to help claimants exit the UI program faster and 
avoid exhausting UI benefits. The Committee intends for a 
portion of the funds to be used for additional technology-based 
overpayment prevention, detection and collection activities.
    The administration's budget includes $24,711,000 for a new 
initiative to address the issue of employee misclassification, 
allowing States to compete for grants to increase their 
capacity in this area and provide funds to pilot high-
performance awards to incentivize States to improve their 
misclassification efforts.
    The budget request also includes $10,000,000 for a new 
program to provide incentives for States to improve their UI 
operations, supplementing the current system of nonmonetary 
awards with grants for improved performance.
    The Committee recommendation for UI State operations does 
not explicitly include funds for expansion of REAs or for 
either of the new initiatives requested above. However, the 
projected improvement in the economy and resulting declines in 
State UI workload should result in sufficient funding being 
available for these activities. The Committee recommends that 
funds not required for workload be used to increase REA funding 
and other activities to address improper payments, to fund 
State requests for technology improvement funding, and to 
initiate the misclassification and performance improvement 
grants proposed in the budget.
    The Committee recommendation provides for a contingency 
reserve amount should the unemployment workload exceed an 
average weekly insured claims volume of 4,832,000, as proposed 
in the budget request. This contingency amount would fund the 
administrative costs of the unemployment insurance workload 
over the level of 4,832,000 insured unemployed persons per week 
at a rate of $28,600,000 per 100,000 insured unemployed 
persons, with a pro rata amount granted for amounts of less 
than 100,000 insured unemployed persons.
    For UI national activities, the Committee recommends 
$11,287,000, the same level provided in fiscal year 2011. The 
budget requests $11,310,000. These funds are directed to 
activities that benefit the State/Federal unemployment 
insurance program including helping States adopt common 
technology-based solutions to improve efficiency and 
performance and supporting training and contracting for 
actuarial support for State trust fund management.
    For the Employment Service allotments to States, the 
Committee recommends $702,169,000, which includes $22,638,000 
in general funds together with an authorization to spend 
$679,531,000 from the Employment Security Administration 
account of the unemployment trust fund. This amount is the same 
as the fiscal year 2011 level. The budget requests $764,757,000 
and includes an 8 percent set-aside, $61,181,000, for WIF.
    The Committee also recommends $20,952,000, the same as the 
fiscal year 2011 level, for Employment Service national 
activities. The budget request includes $20,994,000 for this 
purpose. The administration of the work opportunity tax credit 
accounts for $18,520,000 of the recommended amount and the 
balance is for technical assistance, training and the Federal 
share of State Workforce Agencies Retirement System payments.
    For carrying out the Department's responsibilities related 
to foreign labor certification activities, the Committee 
recommends $65,517,000, the same amount provided in fiscal year 
2011. The budget requests $65,666,000. In addition, 5 percent 
of the revenue from H-1B fees is available to the Department 
for costs associated with processing H-1B alien labor 
certification applications.
    For One-Stop Career Centers and Labor Market Information, 
the Committee recommends $63,593,000, the same as the fiscal 
year 2011 level. The budget request includes $63,720,000. The 
Committee recommendation includes $11,976,000 for ETA, in 
collaboration with the Office of Disability Employment Policy 
[ODEP], to continue to implement their joint plan for improving 
effective and meaningful participation of persons with 
disabilities in the workforce. The Committee expects that these 
funds, in combination with funding available to ODEP, will 
improve the accessibility and accountability of the public 
workforce development system for individuals with disabilities. 
The Committee further expects these funds to continue promising 
practices implemented by disability program navigators. Such 
practices include the effective deployment of staff in selected 
States to improve coordination and collaboration among 
employment and training and asset development programs carried 
out at a State and local level, including the Ticket to Work 
program; and to build effective community partnerships that 
leverage public and private resources to better serve 
individuals with disabilities and improve employment outcomes.

                         STATE PAID LEAVE FUND

Appropriations, 2011....................................................
Budget estimate, 2012...................................     $23,000,000
Committee recommendation................................................

    Because of budget constraints, the Committee does not 
recommend funding to create a new State Paid Leave Fund, which 
would help States establish paid leave programs. The budget 
request includes $23,000,000 for this purpose.

        ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2011....................................    $290,000,000
Budget estimate, 2012...................................................
Committee recommendation................................................

    The Committee recommends and the budget requests such sums 
as are necessary in mandatory funds for this account. The 
budget estimates that there will be no net costs in fiscal year 
2012 because of expected repaid advances to the trust fund. 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 Committee bill includes language proposed in the budget 
request to allow the Department additional flexibility to 
access funds as needed for covered programs.

                         PROGRAM ADMINISTRATION

Appropriations, 2011....................................    $147,360,000
Budget estimate, 2012...................................     159,882,000
Committee recommendation................................     147,360,000

    The Committee recommends $97,320,000 in general funds for 
the Program Administration account, as well as authority to 
expend $50,040,000 from the Employment Security Administration 
account of the unemployment trust fund, for a total of 
$147,360,000, the same as the fiscal year 2011 level. The 
budget request provides $159,882,000 for this purpose.
    General funds in this account pay for the Federal staff 
needed to administer employment and training programs under the 
Workforce Investment Act, the Older Americans Act, the Trade 
Act of 1974, the Women in Apprenticeship and Non-Traditional 
Occupations Act of 1992, and the National Apprenticeship Act. 
Trust funds provide for the Federal administration of 
employment security functions under title III of the Social 
Security Act.

               Employee Benefits Security Administration

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $159,363,000
Budget estimate, 2012...................................     197,528,000
Committee recommendation................................     195,528,000

    The Committee recommends $195,528,000 for the Employee 
Benefits Security Administration [EBSA]. The budget request for 
fiscal year 2012 is $197,528,000, and the comparable fiscal 
year 2011 amount is $159,363,000.
    EBSA plays a critical role in improving health benefits and 
retirement security for American workers and their families. 
EBSA is responsible for the enforcement of title I of the 
Employee Retirement Income Security Act of 1974 [ERISA] in both 
civil and criminal areas. EBSA is also responsible for 
enforcement of sections 8477 and 8478 of the Federal Employees' 
Retirement Security Act of 1986. EBSA administers an integrated 
program of regulation, compliance assistance and education, 
civil and criminal enforcement, and research and analysis.
    The Committee expects this appropriation to help EBSA 
better protect pension and health benefits for workers, 
retirees, and their families. These funds will provide for 
increased enforcement capacity, continued investments in EBSA 
education and compliance assistance programs, and enhanced 
research and evaluation activities. The Committee commends EBSA 
for its cost-reduction efforts, including the new paperless 
participant complaint system. The Committee requests that EBSA 
include in its fiscal year 2013 congressional budget 
justification information on additional steps it will take to 
carry out its responsibilities more cost effectively.

                  Pension Benefit Guaranty Corporation

    The Pension Benefit Guaranty Corporation's estimated 
obligations for fiscal year 2012 include single-employer 
benefit payments of $6,688,000,000, multi-employer financial 
assistance of $123,000,000 and administrative expenses of 
$476,901,000. Administrative expenses are comprised of three 
activities: (1) pension insurance activities, $86,023,000; (2) 
pension plan termination expenses, $243,372,000; and (3) 
operational support, $147,506,000. These expenditures are 
financed by permanent authority.
    The Pension Benefit Guaranty Corporation [PBGC] is a wholly 
owned Government corporation established by ERISA. The law 
places it within the Department of Labor and makes the 
Secretary of Labor the Chair of its Board of Directors. The 
corporation receives its income primarily from insurance 
premiums collected from covered pension plans, assets of 
terminated pension plans, collection of employer liabilities 
imposed by the act, and investment earnings. The primary 
purpose of the corporation is to guarantee the payment of 
pension plan benefits to participants if covered defined 
benefit plans fail or go out of existence.
    The President's budget proposes to continue authority for a 
contingency fund for PBGC that provides additional 
administrative resources when the number of participants in 
terminated plans exceeds 100,000. When the trigger is reached, 
an additional $9,200,000 becomes available for every 20,000 
participants in terminated plans. A trigger also is included 
for additional investment management fees for plan terminations 
or asset growth. These additional funds would be available for 
obligation through September 30, 2013. The Committee bill 
continues these provisions to ensure that PBGC can take 
immediate, uninterrupted action to protect participants' 
pension benefits. The Committee expects to be notified 
immediately of the availability of any funds provided by these 
provisions.
    The President's budget also proposes language slightly 
modified from current PBGC authority that allows PBGC 
additional obligation authority for unforeseen and 
extraordinary pre-termination expenses, after approval by the 
Office of Management and Budget and notification of the 
Committees on Appropriations of the House of Representatives 
and the Senate. The modification would allow PBGC to obligate 
funds for extraordinary multi-employer program related 
expenses. The Committee bill includes the requested language.
    The single-employer program protects about 33.8 million 
participants in approximately 28,000 defined benefit pension 
plans. The multi-employer insurance program protects about 10 
million participants in more than 1,500 plans.

                         Wage and Hour Division

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $227,491,000
Budget estimate, 2012...................................     240,937,000
Committee recommendation................................     227,491,000

    The Committee recommends $227,491,000, the same amount as 
the fiscal year 2011 level, for the Wage and Hour Division 
[WHD]. The budget request for fiscal year 2012 is $240,937,000.
    WHD is responsible for administering and enforcing laws 
that provide minimum standards for wages and working conditions 
in the United States. The Fair Labor Standards Act, employment 
rights under the Family and Medical Leave Act, and the Migrant 
and Seasonal Agricultural Worker Protection Act are several of 
the important laws WHD is charged with administering and/or 
enforcing.
    The Committee strongly urges WHD to increase its oversight 
of organizations participating in the special minimum wage 
program for individuals with disabilities authorized under 
section 14(c) of the Fair Labor Standards Act, in order to 
protect the rights of workers with disabilities.
    The Committee notes that WHD is taking steps to provide 
better and timelier services to the public at a lower cost. The 
Committee requests that WHD include in its fiscal year 2013 
congressional budget justification information on additional 
steps it will take to carry out its responsibilities more cost 
effectively.

                  Office of Labor-Management Standards

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $41,367,000
Budget estimate, 2012...................................      41,367,000
Committee recommendation................................      41,367,000

    The Committee recommends $41,367,000 for the Office of 
Labor-Management Standards [OLMS]. This is the same amount as 
the fiscal year 2012 budget request and comparable fiscal year 
2011 level.
    OLMS administers the Labor-Management Reporting and 
Disclosure Act of 1959 and related laws. These laws establish 
safeguards for union democracy and financial integrity. They 
also require public disclosure by unions, union officers, 
employers, and others. In addition, the office administers 
employee protections under federally sponsored transportation 
programs.
    The Committee notes that OLMS is taking steps to reduce 
costs and focus activities on its core mission. The Committee 
requests that OLMS include in its fiscal year 2013 
congressional budget justification information on additional 
steps it will take to carry out its responsibilities more cost 
effectively.

             Office of Federal Contract Compliance Programs

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $105,386,000
Budget estimate, 2012...................................     109,010,000
Committee recommendation................................     105,386,000

    The Committee recommends $105,386,000, the same amount as 
the fiscal year 2011 level, for the Office of Federal Contract 
Compliance Programs [OFCCP]. The budget request for fiscal year 
2012 is $109,010,000.
    OFCCP protects workers and potential employees of Federal 
contractors from employment discrimination prohibited under 
Executive Order 11246, section 503 of the Rehabilitation Act of 
1973 and the Vietnam Era Veterans' Readjustment Assistance Act 
of 1974.
    The Committee notes that last year the Department issued an 
advance notice of proposed rulemaking regarding regulations 
implementing section 503 of the Rehabilitation Act. The 
Committee expects the Department to issue a final rule in 
fiscal year 2012, and encourages the Department to make 
technical assistance available to Federal contractors regarding 
the rule, and to increase Federal contractor employment 
opportunities for workers with disabilities.
    The Committee notes that OFCCP is taking steps to reduce 
costs and focus activities on its core mission. The Committee 
requests that OFCCP include in its fiscal year 2013 
congressional budget justification information on additional 
steps it will take to carry out its responsibilities more cost 
effectively.

                Office of Workers' Compensation Programs

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $118,063,000
Budget estimate, 2012...................................     123,538,000
Committee recommendation................................     118,063,000

    The Committee recommends $118,063,000, the same amount as 
the fiscal year 2011 level, for the Office of Workers' 
Compensation Programs [OWCP]. The budget request for fiscal 
year 2012 is $123,538,000. The bill provides authority to 
expend $2,124,000 from the special fund established by the 
Longshore and Harbor Workers' Compensation Act.
    OWCP administers four distinct compensation programs: the 
Federal Employees' Compensation Act, the Longshore and Harbor 
Workers' Compensation Act, the Black Lung Benefits programs and 
the Energy Employees Occupational Illness Compensation Program. 
In addition, the Office houses the Division of Information 
Technology Management and Services.
    The Committee notes that OWCP is taking steps to reduce 
costs, through automation efforts and increased use of 
teleconferencing among other efforts. The Committee requests 
that OWCP include in its fiscal year 2013 congressional budget 
justification information on additional steps it will take to 
carry out its responsibilities more cost effectively.

     DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $53,778,000
Budget estimate, 2012...................................      52,147,000
Committee recommendation................................      52,147,000

    The Committee recommends $52,147,000 for the Division of 
Energy Employees Occupational Illness Compensation. The budget 
request for fiscal year 2012 is $52,147,000, and the comparable 
fiscal year 2011 amount is $53,778,000. This is a mandatory 
appropriation.
    The Division administers the Energy Employees Occupational 
Illness Compensation Program Act [EEIOCPA], which provides 
benefits to eligible employees and former employees of the 
Department of Energy [DOE], its contractors and subcontractors 
or to certain survivors of such individuals. The mission also 
includes delivering benefits to certain beneficiaries of the 
Radiation Exposure Compensation Act. The Division is part of 
the Office of Workers' Compensation Programs.
    In 2012, the volume of incoming claims under part B of the 
EEOICPA is estimated at about 8,000 claims from DOE employees 
or survivors, and private companies under contract with DOE, 
who suffer from a radiation-related cancer, beryllium-related 
disease, or chronic silicosis as a result of their work in 
producing or testing nuclear weapons.
    Under part E, approximately 6,600 new claims will be 
received during fiscal year 2012. Under this authority, the 
Department provides benefits to eligible DOE contractor 
employees who were found to have work-related occupational 
illnesses due to exposure to a toxic substance at a DOE 
facility or their survivors.

                            SPECIAL BENEFITS

Appropriations, 2011....................................    $183,000,000
Budget estimate, 2012...................................     350,000,000
Committee recommendation................................     350,000,000

    The Committee recommends $350,000,000, the same as the 
budget request for fiscal year 2012, for this account. The 
comparable fiscal year 2011 amount is $183,000,000. This 
mandatory appropriation primarily provides benefits under the 
Federal Employees' Compensation Act [FECA]. This benefit 
program is administered by the Office of Workers' Compensation 
Programs.
    The Committee recommends continuation of appropriation 
language to provide authority to require disclosure of Social 
Security account numbers by individuals filing claims under the 
Federal Employees' Compensation Act or the Longshore and Harbor 
Workers' Compensation Act and its extensions.
    The Committee recommends continuation of appropriation 
language that provides authority to use FECA funds to reimburse 
a new employer for a portion of the salary of a newly re-
employed injured Federal worker. FECA funds will be used to 
reimburse new employers during the first 3 years of employment, 
not to exceed 75 percent of salary in the worker's first year 
and declining thereafter.
    The Committee recommendation also continues language 
allowing carryover of unobligated balances to be used in the 
following year.
    The Committee again includes appropriation language that 
retains the drawdown date of August 15. The drawdown authority 
enables the agency to meet any immediate shortage of funds 
without requesting supplemental appropriations. The August 15 
drawdown date allows flexibility for continuation of benefit 
payments without interruption.
    The Committee recommends continuation of appropriation 
language to provide authority to deposit into the special 
benefits account of the employees' compensation fund those 
funds that the Postal Service, the Tennessee Valley Authority, 
and other entities are required to pay to cover their fair 
share of the costs of administering the claims filed by their 
employees under FECA. Finally, the Committee continues to allow 
use of fair share collections to fund capital investment 
projects and specific initiatives to strengthen compensation 
fund control and oversight.

               SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2011....................................    $203,220,000
Budget estimate, 2012...................................     182,227,000
Committee recommendation................................     182,227,000

    The Committee recommends a mandatory appropriation of 
$141,227,000 in fiscal year 2012 for special benefits for 
disabled coal miners. This is in addition to the $41,000,000 
appropriated last year as an advance for the first quarter of 
fiscal year 2012. These mandatory funds are used to provide 
monthly benefits to coal miners disabled by black lung disease 
and their widows and certain other dependents, as well as to 
pay related administrative costs.
    This account pays for the benefits and administrative costs 
of part B of the Black Lung Benefits Act. The program is 
administered by the Division of Coal Mine Workers' 
Compensation, which is part of the Office of Workers' 
Compensation Programs.
    Part B benefits are based on black lung claims filed on or 
before December 31, 1973. In fiscal year 2012, an estimated 
21,150 beneficiaries will receive benefits. 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 
$40,000,000 for the first quarter of fiscal year 2013. This 
amount is the same as the budget request. These funds will 
ensure uninterrupted benefit payments to coal miners, their 
widows, and dependents.

                    BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2011....................................    $296,960,000
Budget estimate, 2012...................................     300,495,000
Committee recommendation................................     300,495,000

    The Committee recommends $300,495,000 for this mandatory 
appropriations account. This amount is the same as the budget 
request. The comparable fiscal year 2011 amount is 
$296,960,000.
    This benefit program is administered by the Division of 
Coal Mine Workers' Compensation, which is part of the Office of 
Workers' Compensation Programs.
    The appropriation language continues to provide indefinite 
authority for the Black Lung Disability Trust Fund to provide 
for benefit payments. The recommendation assumes that 
$204,490,000 for benefit payments will be paid in fiscal year 
2012. In addition, the appropriation bill provides for 
transfers from the trust fund for administrative expenses for 
the following Department of Labor agencies: up to $32,906,000 
for the part C costs of the Division of Coal Mine Workers' 
Compensation Programs, up to $25,217,000 for Departmental 
Management, Salaries and Expenses, and up to $327,000 for 
Departmental Management, Inspector General. The bill also 
allows a transfer of up to $356,000 for the Department of the 
Treasury.
    The trust fund pays all black lung compensation/medical and 
survivor benefit expenses when no responsible mine operation 
can be assigned liability for such benefits or when coal mine 
employment ceased prior to 1970, as well as all administrative 
costs that are incurred in administering the benefits program 
and operating the trust fund.
    It is estimated that 22,850 individuals will receive black 
lung benefits financed through the end of the fiscal year 2012.
    The basic financing for the trust fund comes from a coal 
excise tax for underground and surface-mined coal. Additional 
funds come from reimbursement from the Advances to the 
Unemployment Trust Fund and Other Funds as well as payments 
from mine operators for benefit payments made by the trust fund 
before the mine operator is found liable. The advances to the 
fund assure availability of necessary funds when liabilities 
may exceed other income. The Emergency Economic Stabilization 
Act of 2008 authorized the restructuring of the Black Lung 
Disability debt and extended the current tax structure until 
the end of 2018.

             Occupational Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $558,619,000
Budget estimate, 2012...................................     583,386,000
Committee recommendation................................     561,119,000

    The Committee recommends $561,119,000 for this account. The 
budget request for fiscal year 2012 is $583,386,000 and the 
fiscal year 2011 level is $558,619,000. This agency is 
responsible for enforcing the Occupational Safety and Health 
Act of 1970 in the Nation's workplaces.
    The Committee continues bill language to allow the 
Occupational Safety and Health Administration [OSHA] to retain 
up to $200,000 per fiscal year of training institute course 
tuition fees to be used for occupational safety and health 
training and education grants in the private sector.
    The Committee retains language that continues to 
effectively exempt farms employing 10 or fewer people from the 
provisions of the act with the exception of those farms having 
a temporary labor camp. The 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 recommendation supports the important mission 
carried out by OSHA. The Committee notes that an average of 12 
workers suffered a fatal occupational injury each day during 
calendar year 2010. While an improvement from recent years, 
this rate is still too high. This appropriation will help OSHA 
meet its goal of securing safe and healthy workplaces, 
particularly for the most dangerous workplaces. The Committee 
intends these funds to help rebuild OSHA's enforcement 
capacity, accelerate safety and health standards development, 
and maintain robust compliance assistance programs.
    The Committee recommends $104,393,000 for grants to States 
under section 203(g) of the Occupational Safety and Health Act. 
These funds are provided to States that have taken 
responsibility for administering their own occupational safety 
and health programs for the private sector and/or the public 
sector. State plans must be at least as effective as the 
Federal program and are monitored by OSHA. The Committee 
continues language that allows OSHA to provide grants of up to 
50 percent for the costs of State plans approved by the agency. 
The Committee believes that, given the continuing fiscal 
pressures facing State budgets, OSHA should continue its 
practice of allowing States an extra year to match the 
appropriation provided by this bill for support of their State 
plans, and also should extend the period of expenditure for 
these funds for an additional quarter.
    The Committee also 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 
recommendation includes $10,729,000 for the OSHA Susan Harwood 
Training Grant Program.
    The Committee notes that OSHA has reduced travel costs by 
using videoconferencing technology for training and other 
purposes, and taken other steps to realize cost savings. The 
Committee requests that OSHA include in its fiscal year 2013 
congressional budget justification information on additional 
steps OSHA will take to carry out its responsibilities more 
cost effectively.

                 Mine Safety and Health Administration

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $361,844,000
Budget estimate, 2012...................................     384,277,000
Committee recommendation................................     371,500,000

    The Committee recommendation includes $371,500,000 for the 
Mine Safety and Health Administration [MSHA]. The budget 
request for fiscal year 2012 is $384,277,000, and the 
comparable fiscal year 2011 amount is $361,844,000.
    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 bill continues language authorizing MSHA to 
use up to $2,000,000 for mine rescue and recovery activities. 
It also retains the provision allowing the Secretary of Labor 
to use any funds available to the Department to provide for the 
costs of mine rescue and survival operations in the event of a 
major disaster. In order to prepare properly for an actual 
emergency, the Committee also directs MSHA to continue to 
devote additional resources toward effective emergency response 
and recovery training in various types of mine conditions. 
Funding for Brookwood Sago grants was increased from $500,000 
in fiscal year 2010 to $1,000,000 in fiscal year 2011, and a 
further increase is warranted in fiscal year 2012 given the 
need to provide miners and rescue teams with opportunities for 
realistic mine emergency training.
    In addition, bill language is included to allow the 
National Mine Health and Safety Academy to collect not more 
than $750,000 for room, board, tuition, and the sale of 
training materials to be available for mine safety and health 
education and training activities. Bill language also allows 
MSHA to retain up to $1,475,000 from fees collected for the 
approval and certification of equipment, materials, and 
explosives for use in mines, and may utilize such sums for such 
activities.
    In recent years, some mine operators have challenged an 
increasing share of their mine safety violations. The budget 
request proposes $15,000,000 to expand the Department's effort 
to reduce the backlog of contested violations, and this bill 
includes sufficient funds to continue this backlog reduction 
plan. This effort was initiated with funding provided in the 
fiscal year 2010 supplemental appropriations bill and continued 
with funding in the fiscal year 2011 full-year continuing 
appropriations act. The budget proposes and the Committee bill 
includes legislative language to transfer a portion of these 
funds to support related activities in the Office of the 
Solicitor.
    The Committee recommendation also includes funding to 
address other important issues at MSHA, including $3,100,000 to 
purchase continuous personal dust monitors and continue the 
spot inspection initiative related to respirable coal dust. 
These funds should help MSHA make progress on this important 
issue. Funds also are provided for the expansion and renovation 
of the Mount Hope laboratory, maintenance of mine emergency 
operations equipment, the operation of a new coal office 
district, the continued support of the Office of Accountability 
and other important priorities.
    The Committee notes that MSHA's budget includes a proposal 
to reduce printing and mailing costs by adopting a suggestion 
made by one of MSHA's employees. This suggestion was a finalist 
in the administration's 2010 SAVE (Securing Americans Value and 
Efficiency) award process. The Committee appreciates this 
suggestion and requests that MSHA include in its fiscal year 
2013 congressional budget justification information on 
additional steps the MSHA proposes to carry out its 
responsibilities more cost effectively.

                       Bureau of Labor Statistics

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $610,224,000
Budget estimate, 2012...................................     647,030,000
Committee recommendation................................     611,224,000

    The Committee recommends $611,224,000 for this account. The 
budget request for fiscal year 2012 is $647,030,000 and the 
fiscal year 2011 level is $610,224,000. The recommendation 
includes $67,303,000 from the Employment Security 
Administration account of the unemployment trust fund, and 
$542,921,000 in Federal funds. Language pertaining to the 
Current Employment Survey is retained from prior-year bills.
    The Bureau of Labor Statistics [BLS] is the principal fact-
finding agency in the Federal Government in the broad field of 
labor economics.
    The Committee recommendation also includes $1,500,000 to 
continue to support the Mass Layoff Statistics Program.
    As requested by the administration, the Committee does not 
include bill language from prior years that requires BLS to 
continue the women worker series within the current employment 
statistics program. The Committee understands BLS will continue 
this data collection as it currently exists; therefore, this 
bill language is unnecessary.
    The Committee recognizes that the Nation requires current, 
accurate, detailed labor statistics for Federal and non-Federal 
data users. The Nation also requires Government programs to be 
administered as cost effectively as possible. However, the 
current ability of the cooperative statistics system to meet 
those needs is in question. This gap could reduce the ability 
of State and local regions to effectively plan for recovery, 
anticipate industry demand for workforce needs and meet other 
labor market information challenges.
    Therefore, the Committee directs the Secretary of Labor to 
commission a study of and report on a comprehensive assessment 
of the proper purpose, structure, methods, and operations of 
the Federal-State cooperative statistics system (including the 
CES, QCEW, LAUS, OES, and MLS programs), particularly regarding 
the appropriate roles and responsibilities of BLS, ETA, the 
State labor market information agencies, and the system's 
relationship with the Census Bureau, the National Center for 
Education Statistics, State workforce agencies, State education 
agencies, and private vendors.
    The Committee believes the National Academies of Science 
(Committee on National Statistics) and the National Academy of 
Public Administration are very well qualified to produce such a 
report.
    The Committee requests the release of an interim report 
within 12 months of the enactment of this act and a final 
report within 24 months of the enactment of this act. The 
interim report shall contain, at minimum, a rigorous assessment 
of the Current Employment Statistics Program, including an 
evaluation of the accuracies of past and present methods for 
producing initial State and metro area CES estimates, 
identification of the methods most likely to produce accurate 
initial estimates, and recommendations for appropriate BLS and 
State roles and responsibilities in preparing such accurate 
estimates. The report also should consider recommendations for 
how to improve the collection of this large volume of 
information, including through the use of technology; 
coordinate the Federal and State data systems to provide 
timely, accurate, and geographically detailed information on 
employment, education and training, occupations and worker 
skills, as well as ease of access and technical assistance; and 
improve responsiveness to the data needs of labor market 
participants and policymakers at the Federal, State, and local 
levels.
    The Committee directs the Secretary of Labor to use such 
sums as may be necessary for this study which shall be 
allocated equally from funds available to the Secretary, BLS, 
ETA, and the States. The State contribution should be made 
through a set-aside from BLS cooperative system grants to 
States.
    The Committee notes that BLS has reduced travel costs by 
using videoconferencing technology and Web-based services for 
training and other purposes, and taken other steps to realize 
cost savings. The Committee requests that the BLS include in 
its fiscal year 2013 congressional budget justification 
information on additional steps it will take to carry out its 
responsibilities more cost effectively.

                 Office of Disability Employment Policy

Appropriations, 2011....................................     $38,953,000
Budget estimate, 2012...................................      39,031,000
Committee recommendation................................      38,953,000

    The Committee recommends $38,953,000, the same amount as 
the fiscal year 2011 level, for this account. The budget 
request for fiscal year 2012 is $39,031,000. The Committee 
intends that at least 80 percent of these funds shall be used 
to design and implement research and technical assistance 
grants and contracts to develop policy that reduces barriers to 
competitive, integrated employment for youth and adults with 
disabilities.
    Congress created the Office of Disability Employment Policy 
[ODEP] in the Department of Labor's fiscal year 2001 
appropriation. The mission of ODEP is to provide leadership, 
develop policy and initiatives, and award grants furthering the 
objective of eliminating physical and programmatic barriers to 
the training and employment of people with disabilities. The 
Committee strongly supports each of the components of ODEP's 
mission and, in particular, urges the Secretary to ensure that 
ODEP is properly supported in carrying out its leadership role 
with respect to Government-wide policies related to the 
training and employment of individuals with disabilities. The 
Committee is particularly interested in ODEP providing support 
and technical assistance to Federal agencies for the 
implementation of Executive Order 13548 (2010) regarding 
Federal hiring of persons with disabilities.
    The Committee recommendation includes $11,976,000 for ODEP, 
in collaboration with the Employment and Training 
Administration [ETA], to continue to implement their joint plan 
for improving effective and meaningful participation of persons 
with disabilities in the workforce. The Committee expects that 
these funds, in combination with funding available to ETA, will 
improve the accessibility and accountability of the public 
workforce development system for individuals with disabilities. 
The Committee further expects these funds to continue promising 
practices implemented by disability program navigators. Such 
practices include the effective deployment of staff in selected 
States to improve coordination and collaboration among 
employment and training and asset development programs carried 
out at a State and local level, including the Ticket to Work 
program; and to build effective community partnerships that 
leverage public and private resources to better serve 
individuals with disabilities and improve employment outcomes.
    The Committee notes that ODEP has prioritized its spending, 
including shifting some financing of its activities to other 
Federal agencies. The Committee requests that ODEP include in 
its fiscal year 2013 congressional budget justification 
information on additional steps it will take to carry out its 
responsibilities more cost effectively.

                        Departmental Management

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $356,861,000
Budget estimate, 2012...................................     371,554,000
Committee recommendation................................     366,861,000

    The Committee recommendation includes $366,861,000 for the 
Departmental Management account. The budget request for fiscal 
year 2012 is $371,554,000, and the comparable fiscal year 2011 
amount is $356,861,000. An amount of $326,000 is available by 
transfer from the Black Lung Disability Trust Fund.
    The primary goal of the Department of Labor is to protect 
and promote the interests of American workers. The departmental 
management appropriation pays the salaries of staff responsible 
for formulating and overseeing the implementation of 
departmental policy and management activities in support of 
that goal. In addition, this appropriation includes a variety 
of operating programs and activities that are not involved in 
departmental management functions, but for which other 
appropriations for salaries and expenses are not suitable.
    The Committee recommendation includes $10,000,000 within 
the legal services activity to continue support of the 
Department's efforts to reduce the backlog of cases before the 
Federal Mine Safety and Health Review Commission [FMSHRC]. This 
effort was initiated with funding provided in the fiscal year 
2010 supplemental appropriations bill and continued with 
funding in the fiscal year 2011 full-year continuing 
appropriations act. The Committee remains concerned that the 
backlog of cases at the FMSHRC is currently higher than 
historical levels. The Committee understands that this increase 
has resulted largely from the fact that the rate of contested 
citations has grown from 7 percent before the enactment of the 
MINER Act of 2006 to more than 25 percent last year. The 
Committee is continuing its efforts to address this issue by 
increasing funding for the FMSHRC, as described later in the 
report, to reduce the backlog by engaging additional judges and 
support staff, and to continue the transition to an electronic 
case management system.
    The Committee intends these funds, as well as funds 
provided to MSHA, to support necessary expenses of the 
Department of Labor related to an increased capacity of the 
Commission to process caseloads pending before it. The 
Committee expects the Department to make every effort to 
support the timely processing of contested citations, 
particularly for operators that have the highest proportion of 
significant and substantial citations or other evidence of 
unacceptable health and safety records.
    The Committee recommendation includes $92,484,000, the same 
as the fiscal year 2011 level, for the Bureau of International 
Labor Affairs [ILAB]. The budget request for fiscal year 2012 
is $101,504,000. These funds are available to help improve 
working conditions and labor standards for workers around the 
world and carry out ILAB's statutory mandates and international 
responsibilities. These funds may be used to support 
microfinance programs and other livelihood activities that 
contribute to a more comprehensive approach to addressing the 
root causes of labor exploitation, including child and forced 
labor, as provided in prior appropriations bills and proposed 
in the fiscal year 2012 budget.
    The budget request proposes making the appropriation for 
ILAB available for obligation through December 31, 2012. The 
Committee bill allows $66,500,000 to be available for 
obligation for an extra quarter. The Committee will continue to 
monitor ILAB's use of the extended obligation authority 
provided for the current fiscal year in making a final decision 
about this budget proposal.
    The budget request proposes $18,400,000 for program 
evaluation and requests that the funds be available for 
obligation through September 30, 2013. The Committee recommends 
$8,500,000, the same amount as the fiscal year 2011 level, and 
allows funds to be available for obligation through September 
30, 2013. The budget also proposes to continue the authority of 
the Secretary to transfer these funds to any other account in 
the Department for evaluation purposes. The Committee bill 
continues to provide this transfer authority and supports the 
mission of the Office of the Chief Evaluation Officer. The 
Committee bill also includes requested authority to use up to 
0.5 percent of certain Department appropriations for evaluation 
activities identified by the Chief Evaluation Officer. The 
Committee expects to be notified of the planned uses of funds 
derived from this authority.
    The budget request also proposes $11,620,000 for the 
Women's Bureau and requests bill language allowing the bureau 
to award grants to promote the interests of women in the 
workforce. The Committee bill includes $11,581,000 for the 
bureau and the requested language. The Committee believes the 
bureau should sharpen its mission and demonstrate effectively 
the impact of its efforts on important issues such as the wage 
gap, pay discrimination and family and medical leave.
    The Committee notes that agencies and offices funded within 
this account have taken steps to create efficiencies and 
realize cost savings by better using technology and 
prioritizing agency activities. The Committee requests that the 
Secretary include in the fiscal year 2013 congressional budget 
justification information on additional actions related to this 
account that will enable funded agencies to carry out their 
responsibilities more cost effectively.

                    VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2011....................................    $255,614,000
Budget estimate, 2012...................................     261,036,000
Committee recommendation................................     258,614,000

    The Committee recommends $258,614,000 for this account, 
including $47,879,000 in general revenue funding and 
$210,735,000 to be expended from the Employment Security 
Administration account of the unemployment trust fund. The 
budget request for fiscal year 2012 is $261,036,000, and the 
comparable fiscal year 2011 amount is $255,614,000.
    This account includes resources for the Veterans' 
Employment and Training Services [VETS] that enable it to 
maximize employment opportunities for veterans and 
transitioning service members, including protecting their 
employment rights. VETS carries out its mission through a 
combination of grants to States, competitive grants, and 
Federal enforcement and oversight.
    The Committee expects this appropriation to help VETS 
better meet the employment and training needs and employment 
rights of veterans and service members. The Committee requests 
that VETS include in its fiscal year 2013 congressional budget 
justification information on steps it will take to carry out 
its responsibilities more cost effectively.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2011....................................     $83,846,000
Budget estimate, 2012...................................      84,445,000
Committee recommendation................................      83,846,000

    The Committee recommends $83,846,000 for the Office of the 
Inspector General [OIG]. The bill includes $77,937,000 in 
general funds and authority to transfer $5,909,000 from the 
Employment Security Administration account of the unemployment 
trust fund. In addition, an amount of $327,000 is available by 
transfer from the black lung disability trust fund. The budget 
request for the OIG for fiscal year 2012 is $84,445,000 and the 
comparable fiscal year 2011 amount is $83,846,000.
    The OIG was created by law to protect the integrity of 
departmental programs as well as the welfare of beneficiaries 
served by those programs. Through a comprehensive program of 
audits, investigations, inspections, and program evaluations, 
the OIG attempts to reduce the incidence of fraud, waste abuse, 
and mismanagement, and to promote economy, efficiency and 
effectiveness.
    The Committee requests that the OIG include in its fiscal 
year 2013 congressional budget justification information on 
steps it will take to carry out its responsibilities more cost 
effectively.

               INFORMATION TECHNOLOGY [IT] MODERNIZATION

Appropriations, 2011....................................................
Budget estimate, 2012...................................     $25,000,000
Committee recommendation................................................

    The Committee recommends no funds for the IT Modernization 
account. The budget request for fiscal year 2012 is $25,000,000 
for this new account. The Departmental Management account 
includes $19,852,000 in fiscal year 2011 and 2012 resources for 
similar purposes.
    Funds requested in the budget request would be used for two 
primary activities. The first is a consolidated IT 
infrastructure modernization activity. Of the requested amount, 
$8,000,000 would assist in using information technology 
strategically to modernize the Department's infrastructure and 
supporting project-oriented investments that will demonstrably 
improve program performance and contribute to achieving the 
Secretary's outcome goals. The remaining $17,000,000 requested 
would be allocated to the Departmental Support Systems budget 
activity.

                           General Provisions

    General provision bill language is included to:
    Limit the use of Job Corps funding for compensation of an 
individual that is not a Federal employee at a rate not to 
exceed Executive Level I (sec. 101).
    Provide for general transfer authority (sec. 102).
    Prohibit funding for the procurement of goods and services 
utilizing forced or indentured child labor in industries and 
host countries already identified by the Labor Department in 
accordance with Executive Order 13126 (sec. 103).
    Require that funds available under section 414(c) of the 
American Competitiveness and Workforce Improvement Act of 1998 
may only be used for training in occupations and industries for 
which employers are using H-1B visas to hire foreign workers 
(sec. 104).
    Require the Secretary to award competitively funds 
available for section 414(c) of the American Competitiveness 
and Workforce Improvement Act of 1998 (sec. 105).
    Prohibit the Secretary from taking any action to alter the 
procedure for redesignating local areas under subtitle B of 
title I of the Workforce Investment Act (sec. 106).
    Provide the Employment and Training Administration with 
authority to transfer funds provided for technical assistance 
services to grantees to program administration when it is 
determined that those services will be more efficiently 
performed by Federal employees (sec. 107).
    Allow up to 0.5 percent of discretionary appropriations 
provided in this act for all DOL agencies, except the 
Employment and Training Administration, to be used by the 
Office of the Chief Evaluation Officer for evaluation purposes 
consistent with the terms and conditions in this act applicable 
to such Office (sec. 108).
    Prohibit funding for the enforcement of the rule entitled 
``Wage Methodology for the Temporary Non-Agricultural 
Employment H-2B Program'' (76 Fed. Reg. 3452 (January 19, 
2011)) (sec. 109).

                                TITLE II

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

              Health Resources and Services Administration

    Activities of the Health Resources and Services 
Administration [HRSA] support programs to provide healthcare 
services for mothers and infants; the underserved, elderly and 
homeless; migrant farm workers; and disadvantaged minorities. 
This agency supports cooperative programs in community health, 
AIDS care, healthcare provider training, and healthcare 
delivery systems and facilities.

                     HEALTH RESOURCES AND SERVICES

Appropriations, 2011....................................  $6,287,241,000
Budget estimate, 2012...................................   7,081,685,000
Committee recommendation................................   6,229,517,000

    The Committee provides a program level of $6,229,517,000 
for Health Resources and Services. The Committee recommendation 
includes $6,204,517,000 in budget authority and an additional 
$25,000,000 via transfers available under section 241 of the 
Public Health Service [PHS] Act. The fiscal year 2011 
comparable program level was $6,287,241,000. The budget request 
for fiscal year 2012 was $7,081,685,000.
    In addition, the Committee recommendation includes 
$25,000,000 in transfers from the Prevention and Public Health 
[PPH] Fund. The fiscal year 2011 comparable transfer was 
$20,000,000, as was the budget request for transfers in fiscal 
year 2012.

                     BUREAU OF PRIMARY HEALTH CARE

Community Health Centers

    The Committee provides $1,580,749,000 in this bill for the 
community health centers program. Combined with the 
$1,200,000,000 in mandatory funding appropriated for fiscal 
year 2012 in Public Law 111-152, the recommended fiscal year 
2012 program level totals $2,780,749,000.
    The fiscal year 2011 comparable program level was 
$2,580,749,000. The budget request for fiscal year 2012 is 
$3,317,814,000.
    This group of programs includes community health centers, 
migrant health centers, healthcare for the homeless, and public 
housing health service grants. The Committee continues to 
support the ongoing effort to increase the number of people who 
have access to medical services at health centers.
    Within the amount provided, the Committee has provided up 
to $100,000,000 under the Federal Tort Claims Act [FTCA] for 
the Health Centers program. The Committee has included bill 
language making this funding available until expended. The 
Committee intends that the fund be used to pay judgments and 
settlements, occasional witness fees and expenses, and the 
administrative costs of the program, which include the cost of 
evaluating claims, defending claims and conducting settlement 
activities. The Committee intends FTCA coverage funded through 
this bill to be inclusive of all providers, activities and 
services included within the health centers' federally approved 
scope.
    Base Grants.--The Committee recognizes the importance of 
maintaining a solid foundation of stable, viable existing 
health centers and urges HRSA to increase base funding to 
existing health centers due to increasing demands. The 
Committee also urges HRSA to use additional programmatic 
funding to expand access to health centers in those areas of 
the country with high need and inadequate access to services to 
meet such need. The Committee expects HRSA to implement any new 
expansion initiative using the existing, and statutorily 
required, proportionality for urban and rural communities, as 
well as migrant, homeless and public housing health centers.
    Health Care for the Homeless [HCH].--HCH projects funded 
under section 330(h) of the PHS Act provide essential services 
to people experiencing homelessness, providing the access to 
comprehensive services and the continuity of care that are 
critical to establishing and maintaining housing and health 
stability. Permanent supportive housing is an important step in 
the process to permanent housing; however, the Committee 
believes that permanent supportive housing has important 
differences from truly permanent housing. Therefore the 
Committee believes that it is consistent with Sec. 330(h)(4) 
for HCH grantees to treat residents of permanent supportive 
housing or other housing programs that are targeted to homeless 
populations but do not limit tenant length of stay as persons 
who are homeless.
    Nurse-Managed Health Clinics.--Nurse-managed health clinics 
[NMHCs] strengthen nursing workforce development efforts by 
acting as clinical education sites for nursing students. The 
Committee strongly encourages HRSA to prioritize funding for 
NMHCs within any competition for new access points in fiscal 
year 2012. Expanding services this way will help expand 
coverage to underserved populations, including native and rural 
communities. The Committee also believes that supporting the 
nurse-managed model will facilitate the implementation the 
recommendations in the Institute of Medicine's report on the 
future of nursing.
    Technical Assistance.--The Committee believes that adequate 
funding for technical assistance and networking functions for 
health centers is critical to the successful operation and 
expansion of the Health Centers program. Funds are available 
within the amount provided to invest in the technical 
assistance necessary to support existing centers and assist 
communities that currently lack, but seek, a health center 
presence.
    Workforce.--The Committee recognizes that the National 
Health Service Corps [NHSC] is an essential tool for the 
recruitment and retention of primary care health professionals 
in Health Professional Shortage Areas nationwide. The Committee 
applauds efforts by HRSA to enhance access to the NHSC by 
streamlining the application process for health professionals 
and prospective sites, implementing part-time service 
arrangements, enhancing customer service and accepting 
applicants with consolidated or refinanced educational loans. 
The Committee encourages HRSA to continue with these 
improvements, as well as collaborate with the Health Centers 
program in order to maximize the investment in both programs.

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 healthcare 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 last year's level be 
provided for these activities in fiscal year 2012.
    The Committee is concerned by a recent letter of 
clarification of Medicare payment policy that blocks 
implementation of a Hawaii State law allowing advanced practice 
registered nurses to practice without the physical supervision 
of a physician. Given the remote locations of many of the 
grantees of the Native Hawaiian Health Care program and the 
barrier imposed by island geography, enforcing the physical 
requirement may have the unintended consequence of reducing 
access to care. The Committee urges HRSA to work with the 
Centers for Medicare and Medicaid Services to find a suitable 
resolution that maximizes access to care in remote locations.

Free Clinics Medical Malpractice Coverage

    The Committee provides $40,000 in funding for payments of 
claims under the Federal Tort Claims Act to be made available 
for free clinic health professionals as authorized by section 
224(o) of the PHS Act. The fiscal year 2011 comparable level 
and the budget request for fiscal year 2012 both included 
$40,000 for this program. This appropriation continues to 
extend Federal Tort Claims Act coverage to medical volunteers 
in free clinics in order to expand access to healthcare 
services to low-income individuals in medically underserved 
areas.

National Hansen's Disease Program

    The Committee includes $16,077,000 for the National 
Hansen's Disease Program, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$16,075,000. The program consists of inpatient, outpatient and 
long-term care and training and research in Baton Rouge, 
Louisiana; a residential facility at Carville, Louisiana; and 
11 outpatient clinic sites in the continental United States and 
Puerto Rico.

National Hansen's Disease Program Buildings and Facilities

    The Committee provides $129,000 for the repair and 
maintenance of buildings at the Gillis W. Long Hansen's Disease 
Center, the same as the fiscal year 2011 comparable level and 
the budget request for fiscal year 2012.

Payment to Hawaii for Hansen's Disease Treatment

    The Committee provides $1,964,000 for Hansen's Disease 
services, the same as the fiscal year 2011 comparable level. 
The budget request for fiscal year 2012 was $1,976,000. 
Payments are made to the State of Hawaii for the medical care 
and treatment of persons with Hansen's Disease in hospital and 
clinic facilities at Kalaupapa, Molokai and Honolulu. Expenses 
above the level of appropriated funds are borne by the State of 
Hawaii.

                      BUREAU OF HEALTH PROFESSIONS

National Health Service Corps

    The Committee provides $24,848,000 in this bill for 
National Health Service Corps [NHSC] activities. This is the 
same level as was provided in the fiscal year 2011 bill. 
Together with $295,000,000 appropriated for fiscal year 2012 in 
the Patient Protection and Affordable Care Act, the 
recommendation for the fiscal year 2012 program level is 
$319,848,000. The fiscal year 2011 comparable level was 
$314,848,000. The comparable budget request for fiscal year 
2012 is $431,925,000.
    This program provides full-cost scholarships or sizable 
loan repayments to students in exchange for an agreement to 
serve as a primary care provider in a federally designated 
health professional shortage area. These funds should support 
multi-year, rather than single-year, commitments. Salary costs 
of most new assignees are paid by the employing entity. The 
Committee has modified bill language to clarify that all NHSC 
funding may be used to adjust prior-year awards.
    Demonstrations.--An essential component of patient-
centered, team-based care is the appropriate management of 
medications. This management also improves healthcare quality 
and lowers costs. The Committee has included funding in the 
past to conduct demonstration programs on the benefits of 
including pharmacists and chiropractic care into primary care 
teams through NHSC. The Committee is impressed by the results 
of those demonstrations and urges the Secretary to offer 
pharmacists and chiropractors loan repayment through NHSC so 
that eligible entities may be able to improve the quality of 
care for underserved patients and populations.

                           HEALTH PROFESSIONS

    The Committee recommendation includes $497,924,000 for HRSA 
health professions programs. The fiscal year 2011 comparable 
level was $514,922,000. The budget request for fiscal year 2012 
was $823,529,000.

Training for Diversity

            Centers of Excellence
    The Committee provides $24,452,000, the same as the fiscal 
year 2011 comparable level, for the Centers of Excellence 
Program. The budget request for fiscal year 2012 was 
$24,602,000.
    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.
    The Committee recognizes the longstanding commitment of 
minority health professions schools to diversity in the health 
professional workforce and the vital role the Minority Centers 
of Excellence Program continues to play in assisting those 
institutions fulfill their mission. The Committee encourages 
HRSA to continue to support minority health professions 
schools' work to diversify and improve the healthcare 
workforce, focusing the Centers of Excellence Program on 
institutions with a historic mission of promoting health 
professions diversity.
    Mid-Career Support.--The Committee is aware that 
unemployment is particularly high among minority populations at 
a time of acute shortages in health professionals. The 
Committee urges HRSA to encourage health professions schools to 
develop innovative programs for recruiting and supporting 
individuals, particularly underrepresented minorities, who 
decide to switch to a career in primary care or allied health 
professions.
            Health Careers Opportunity Program
    The Committee has not included funding for the Health 
Careers Opportunity Program. The fiscal year 2011 comparable 
level was $21,998,000. The budget request for fiscal year 2012 
was $22,133,000.
    This program provides funds to medical and other health 
professions schools for engagement of disadvantaged K-12 
students in health professions education.
    The Committee strongly supports the goal of this program, 
but because of budget constraints and the prevalence of waiting 
lists for health training programs nationwide, the Committee 
has prioritized healthcare job training programs over 
recruitment and youth engagement programs.
            Faculty Loan Repayment
    The Committee provides $1,258,000, the same as the fiscal 
year 2011 comparable level, for the Faculty Loan Repayment 
Program. The budget request for fiscal year 2012 was 
$1,266,000.
    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 at least 2 years as a faculty member of a health 
professions school.
            Scholarships for Disadvantaged Students
    The Committee provides $49,042,000, the same as the fiscal 
year 2011 comparable level, for the Scholarships for 
Disadvantaged Students Program. The budget request for fiscal 
year 2012 proposed $52,921,000 in budget authority and another 
$7,079,000 in transfers available under section 241 of the PHS 
Act.
    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.

Primary Care Training and Enhancement

    The Committee provides $39,036,000, the same as the fiscal 
year 2011 comparable level, for Primary Care Training and 
Enhancement programs. The budget request for fiscal year 2012 
proposed $53,018,000 in budget authority and another 
$86,914,000 in transfers available under section 241 of the PHS 
Act for this program.
    This program supports the expansion of training in internal 
medicine, family medicine, pediatrics and physician assistance. 
Funds may be used for developing training programs or providing 
direct financial assistance to students and residents. The 
Committee urges HRSA to prioritize the training of physician 
assistants and has included bill language allowing HRSA to 
determine the funding amount for this activity.
    Quality Improvements.--The Committee continues to support 
efforts to develop and implement national quality measures for 
clinical practice. The Committee urges HRSA to require that 
primary care physicians and dentists be educated and trained in 
relevant quality measures in use for clinical practice.
    Understanding Basic Science.--The Committee encourages HRSA 
to give preference to applicants that seek to develop or expand 
a research infrastructure, critical appraisal and evidence-
based curricula, and longitudinal research opportunities for 
students.

Training in Oral Health Care

    The Committee recommends $32,781,000, the same as the 
fiscal year 2011 comparable level, for Training in Oral Health 
Care programs. The budget request for fiscal year 2012 proposed 
$35,419,000 in budget authority and another $14,509,000 in 
transfers available under section 241 of the PHS Act.
    These programs support a variety of training opportunities 
in the field of oral health, authorized under sections 748 and 
340G of the PHS Act. Funds may be used to expand training in 
general dentistry, pediatric dentistry, public health 
dentistry, dental hygiene and other oral health programs. Funds 
may be used to plan and operate training programs, as well as 
to provide financial assistance to students and residents.
    The Committee supports opportunities for advanced training 
for dentists and faculty loan repayment programs because it 
recognizes that there is a shortage of pediatric and public 
health dentists. Dentists who complete a general residency 
receive additional training that allows them to take on complex 
cases of patients with autoimmune or systemic diseases. The 
Committee remains concerned about the growing aging population 
and encourages HRSA to initiate training programs that target 
vulnerable populations in risk-based clinical disease 
management of all populations.
    The Committee further encourages HRSA to create a grant 
program to provide access to unpaid, volunteer dental services 
for medically necessary but otherwise uncovered and 
unaffordable dental treatment. Grant costs may include the 
salaries and other employment costs of professionals who verify 
the medical and financial needs, including the absence of other 
insurance coverage, of individual patients potentially eligible 
for such services.

Interdisciplinary, Community-based Linkages

            Area Health Education Centers
    The Committee provides $33,142,000, the same as the fiscal 
year 2011 comparable level, for the Area Health Education 
Centers [AHEC] program. The budget request for fiscal year 2012 
was $33,345,000, including $1,488,000 in transfers available 
under section 241 of the PHS Act.
    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 AHEC grants; and model programs to 
extend AHEC programs with 50 percent Federal funding.
            Allied Health and Other Disciplines
    The Committee provides $1,933,000, the same as the fiscal 
year 2011 comparable level, for the Allied Health and Other 
Disciplines programs. The budget for fiscal year 2012 did not 
request funds for this program.
    Career Pathways and Articulation Agreements.--The Committee 
is concerned that many graduates of certificate and 2-year 
degree programs are often unable to pursue more advanced 
degrees in one of the health professions. The Committee urges 
HRSA to support programs that encourage graduates of 
certificate and 2-year community college programs to enroll in 
baccalaureate degree-granting programs and health professions 
schools and to encourage articulation agreements between 
community colleges and baccalaureate-degree granting programs 
and health professions schools that allow for transfer of 
credits earned in the certificate and associate degree 
programs.
    Vacancy Rates.--The Committee remains concerned that many 
allied health professions continue to experience high vacancy 
rates and encourages HRSA to give priority consideration to 
schools that are educating and training people in these 
professions.
            Mental and Behavioral Health
    The Committee provides $2,927,000, the same as the fiscal 
year 2011 comparable level, for Mental and Behavioral Health 
programs. The budget request for fiscal year 2012 was 
$17,945,000.
    These programs provide grants to higher education 
institutions and accredited training programs to recruit and 
train professionals and faculty in the fields of social work, 
psychology, psychiatry, marriage and family therapy, substance 
abuse prevention and treatment, and other areas of mental and 
behavioral health.
    Graduate Psychology Education Program.--The Committee is 
concerned that the Nation's mental health infrastructure will 
experience increased strain for years to come as individuals 
and their families increasingly turn to behavioral healthcare 
professionals in local communities. The Nation's population is 
rapidly aging and significant numbers of veterans are returning 
from war. Ramifications of current economic conditions also are 
significantly increasing the numbers of people seeking mental 
health services as they struggle with unemployment, job and 
income loss, and the many associated problems that result. The 
Committee supports efforts by HRSA that would expand training 
sites, reinstate the geropsychology component, initiate a new 
focus on veterans and help integrate health service psychology 
trainees at federally Qualified Health Centers to provide 
behavioral and mental health services to underserved 
populations.
            Geriatric Education
    The Committee provides $33,542,000 for Geriatric Education 
programs, the same as the fiscal year 2011 comparable level. 
The budget request for fiscal year 2012 was $36,907,000 in 
budget authority and $6,840,000 in transfers available under 
section 241 of the PHS Act.
    Geriatric programs include: Geriatric Education Centers, 
the Geriatric Academic Career awards program, and the Geriatric 
Training program for Physicians, Dentists, and Behavioral and 
Mental Health Professionals.
    Innovation.--The Committee remains concerned that 7 out 10 
deaths among older Americans each year are from chronic 
diseases. The Committee urges HRSA to support projects that 
propose innovative educational and practice techniques with 
regard to treating at least one of the 10 most prevalent 
chronic diseases (such as, heart disease, stroke, diabetes and 
cancer) in order to improve the quality of care for that 
condition and have an effect on primary care and the health of 
the general public.
    Reducing Hospital Readmission Rates.--Approximately 20 
percent of hospitalized Medicare patients are readmitted within 
30 days. The Committee urges HRSA to support curriculum 
projects that examine innovative educational and practice 
techniques with regard to preventing hospital readmissions 
among older Americans.

State Health Care Workforce Development Grants

    The Committee has not included funding for the State Health 
Care Workforce Development Grant program, authorized in the 
Patient Protection and Affordable Care Act. The fiscal year 
2012 budget requests $51,000,000 for this new program.
    The State Health Care Workforce Development Program is 
designed to support State partnerships (generally the State 
Workforce Investment Board) to conduct planning and 
coordination among the variety of programs related to 
healthcare workforce training.

Health Professions Workforce Information and Analysis

    The Committee is recommending $2,815,000 for health 
professions workforce information and analysis, the same as the 
fiscal year 2011 comparable level. The budget request for 
fiscal year 2012 did not request new budget authority but did 
propose $20,000,000 in transfers available under section 241 of 
the PHS Act. The program provides grants and contracts to 
eligible entities to provide for the collection and analysis of 
targeted information, research on high-priority workforce 
questions, the development of analytic and research 
infrastructure, and program evaluation and assessment.
    The Committee commends HRSA for the information that the 
National Center for Health Workforce Analysis has collected and 
disseminated. The Committee encourages HRSA to make their Web 
site ``one-stop shopping'' for any researcher or policy-maker 
on health workforce issues. For that reason, the Committee 
encourages HRSA to integrate data from the Bureau of Labor 
Statistics and other Federal agencies to the greatest extent 
possible.

Public Health and Preventive Medicine Training Programs

    The Committee provides $34,609,000 for these programs, 
including $9,609,000 in budget authority and $25,000,000 in 
transfers from the PPH Fund. The fiscal year 2011 comparable 
level was $9,609,000 in budget authority and $20,000,000 in 
funding from the PPH Fund. The budget request for fiscal year 
2012 did not include new budget authority, but proposed 
$10,068,000 in transfers available under section 241 of the PHS 
Act and $15,000,000 from the PPH Fund for these programs. The 
Committee directs HRSA to fund preventive medicine residencies 
at no less than last year's level.
    This funding supports awards to schools of medicine, 
osteopathic medicine, and public health to provide for 
residency training programs in preventive medicine and public 
health; and for financial assistance to trainees enrolled in 
such programs.
    The Committee recommendation includes $5,000,000 from the 
PPH Fund for an initiative on integrative medicine residency 
[IMR] training. Of this amount, $2,500,000 is to be used for 
grants of $100,000 to $150,000 to accredited residency programs 
to incorporate competency-based integrative medicine curricula 
in graduate medical education. The remaining funds are intended 
to establish a national coordinating center responsible for 
conducting data collection, providing technical assistance to 
residency programs, and conducting an evaluation of the IMR 
training program.

Nursing Workforce Development Programs

    The Committee provides $242,387,000 for the Nursing 
Workforce Development programs, the same as the fiscal year 
2011 comparable level. The budget request for fiscal year 2012 
was $224,550,000 in budget authority and $108,525,000 in 
transfers available under section 241 of the PHS Act.
    The Committee directs HRSA to maintain all Nursing 
Workforce Development programs at no less than last year's 
level.
    Advanced Nursing Education Grants.--The Committee is 
concerned that masters and doctoral programs lack the resources 
necessary to keep pace with the demand for new nurse faculty. 
Doctoral prepared nurse educators are in especially high 
demand, as the majority of vacant faculty positions require 
this level of education. The Committee notes that lack of 
faculty is often cited as the reason why community colleges 
turn away potential nursing students, despite severe shortages 
at all levels of nursing. Therefore, the Committee encourages 
the Division of Nursing to establish a priority for funding 
full-time doctoral nursing students including Ph.D. or the 
doctor of nursing practice [DNP]. The Committee further 
encourages HRSA to give priority to nursing students who 
indicate an interest in teaching.
    Baccalaureate Nursing Degrees.--In recognition of the 
Institute of Medicine [IOM] and the Robert Wood Johnson 
Foundation report, ``The Future of Nursing: Leading Change, 
Advancing Health,'' the Committee urges the Division of Nursing 
to enhance programs that increase the number of nurses with 
baccalaureate degrees. Research has shown that nurses who hold 
a bachelor of nursing have better patient outcomes such as 
lower mortality and failure to rescue rates. The Committee 
further concurs with the IOM report recommendation that the 
Division's programs need to encourage nurses with associate 
degrees and diplomas to enter baccalaureate programs. For that 
reason, the Committee encourages HRSA to focus grants in 
nursing education to create and support career ladder programs.
    Innovative Entry Points.--The Committee is encouraged by 
various innovative models in K-12 education that allow students 
to take college courses while in high school, some of which are 
partnerships with nursing programs. The Committee urges HRSA to 
partner with the Department of Education to promote innovative 
programs that support K-12 students as they transition into 
nursing education.
    Nurse Practitioners.--In the presence of an acute shortage 
of primary care providers, the need to prepare quality, cost 
effective clinicians such as nurse practitioners continues to 
be severe. Nurse practitioners are primary care providers who 
can assist in meeting the needs of our communities and help to 
increase access to primary care. The Committee urges HRSA to 
support educational programs and traineeships for nurse 
practitioners to help meet the growing health needs of the 
Nation particularly in rural America.

Children's Hospitals Graduate Medical Education Program

    The Committee provides $268,356,000 for the Children's 
Hospitals Graduate Medical Education [GME] program, the same as 
the fiscal year 2011 comparable level. The administration did 
not request funds for this program for fiscal year 2012.
    The program provides support for graduate medical education 
training programs in freestanding children's teaching hospitals 
and is intended to provide with them a similar level of Federal 
GME support that other teaching hospitals receive through 
Medicare. Prior to the enactment, the freestanding children's 
hospitals, whose inpatients are predominantly under the age of 
18, received only 0.05 percent of Federal GME funding. 
Children's Hospitals GME [CHGME] 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 recognizes the program's contributions to the 
future pediatric workforce and children's healthcare. The 56 
freestanding children's hospitals receiving CHGME funding train 
40 percent of all general pediatric residents and 43 percent of 
all pediatric specialty residents, in addition to serving large 
disproportionate underserved populations, such as those in 
Medicaid and the State Children's Health Insurance Program 
[SCHIP]. CHGME funding has enabled the hospitals to increase 
their training by 35 percent, in response to State, local and 
national needs, including the reversal of a prior decline in 
pediatric specialty residencies. The program improves access to 
healthcare by not only ensuring an adequate supply of pediatric 
providers, but also by expanding the capacity of the healthcare 
safety net as freestanding children's hospitals care for 
underserved children in both inpatient and outpatient settings. 
The program has also enabled the hospitals to increase the 
diversity of their training experiences in underserved urban 
and rural areas.

Patient Navigator

    The Committee recommendation does not include funding for 
the Patient Navigator Outreach and Chronic Disease Outreach 
Program. The comparable funding level for fiscal year 2011 was 
$4,990,000. The budget did not request funding for this program 
in fiscal year 2012.
    The program provides demonstration grants to public or 
nonprofit health centers to help patients overcome barriers in 
the healthcare system to prompt screening, referral, diagnosis, 
and treatment services.
    The Committee strongly supports efforts to reduce the 
complexity of the current healthcare system and notes that the 
expansion of decision support features in electronic health 
records and current CMS demonstrations on accountable care 
organizations and medical home models aim to reduce or even 
eliminate the need for patient navigation models.

Teaching Health Centers Development Grants

    The Committee has not provided funding for the Teaching 
Health Centers [THC] Development Grant program in fiscal year 
2012. The administration requested $10,000,000 for this new 
program.
    The Teaching Health Centers [THC] Development Grant Program 
is designed to provide funding to cover the costs of curriculum 
development, accreditation, faculty salaries, and the 
recruitment, training and retention of residents and faculty. 
Eligible entities include community-based clinics that intend 
to operate a primary care residency program.
    The Committee is aware of $230,000,000 available in 
mandatory funds for graduate medical education payments to THCs 
for the period of fiscal years 2011 through 2015. These funds 
will cover the costs of new resident training in community-
based ambulatory primary care settings, such as health centers.

National Practitioner Data Bank

    The Committee provides $28,016,000 for the National 
Practitioner Data Bank, the same as the budget request. The 
comparable level for fiscal year 2011 was $23,508,000. The 
Committee and the budget request assume that full funding will 
be provided entirely through the collection of user fees and 
will cover the full cost of operating the data bank. Bill 
language is included to ensure that user fees are collected to 
cover all costs of processing requests and providing such 
information to data bank users.
    The National Practitioner Data Bank collects certain 
adverse information, medical malpractice payment history, and 
information related to healthcare fraud and abuse. The data 
bank is open to healthcare agencies and organizations that make 
licensing and employment decisions.

                    MATERNAL AND CHILD HEALTH BUREAU

Maternal and Child Health Block Grant

    The Committee provides $606,319,000 for the maternal and 
child health [MCH] block grant. The fiscal year 2011 comparable 
level was $656,319,000 and the budget request for fiscal year 
2012 was $654,489,000.
    The MCH block grant program provides a flexible source of 
funding that allows States to target their most urgent maternal 
and child health needs through the 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 
providing prenatal care, well child services and immunizations; 
reducing infant mortality; preventing injury and violence; 
expanding access to oral healthcare; addressing racial and 
ethnic disparities; and providing comprehensive care for 
children, adolescents and families through clinics, home visits 
and school-based health programs.
    The Committee has included bill language requiring that the 
State grant portion of the block grant be funded at no less 
than $535,748,000, compared to $556,333,000 in fiscal year 2011 
and the budget request. This reduction will be more than offset 
by an increase in mandatory appropriations for the Maternal, 
Infant, and Early Childhood Home Visiting [MIECHV] program.
    State agencies funded by the MCH block grant receive 
additional mandatory funding from the MIECHV program. In fiscal 
year 2012, mandatory appropriations for this program will rise 
from $250,000,000 to $350,000,000, a majority of which will be 
distributed to State agencies. The MIECHV program and the MCH 
block grant serve the same population with overlapping goals. 
Both programs include a formula-based distribution to States 
and a demonstration authority to allow grants for special 
projects of regional and national significance.
    The Committee has included bill language identifying 
$60,171,000 for the Title V Special Projects of Regional and 
National Significance [SPRANS] set-aside. Within that total, 
the Committee recommendation includes sufficient funding to 
continue the set-asides for oral health, epilepsy and fetal 
alcohol syndrome at no less than last year's level.
    Global Health Strategies.--The Committee recognizes that 
some global models of healthcare have been proven to be cost 
effective and provide a high level of quality care. The 
Committee urges the Department to consider projects that 
demonstrate and pilot global health strategies in underserved 
domestic healthcare markets. These projects should include 
programs that improve overall community health and wellness; 
increase access to primary health services; support innovative 
payment models that offer affordable healthcare payment options 
for low-income families; and improve access to immunizations.
    Healthy Homes.--The Committee supports efforts by HRSA to 
fund evidence-based maternal, infant and early childhood home 
visiting programs that are consistent with the Patient 
Protection and Affordable Care Act. The Committee is aware of 
nurse home visiting programs in New York State, Rhode Island 
and Oklahoma that have adopted healthy homes activities as part 
of their programming. This integrative approach of identifying 
and preventing environmental health and safety hazards in the 
homes of high-risk pregnant mothers and their babies is a cost-
effective and efficient strategy for preventing disease and 
injury among the Nation's most vulnerable families. The 
Committee recommends that HRSA expand and incentivize the 
implementation of these integrative programs in consultation 
with the Centers for Disease Control and Prevention.
    Hemophilia.--The Committee supports continued funding for 
the network of hemophilia treatment centers supported by the 
SPRANS program.
    Mobile Health Messaging.--The Committee is concerned that 
the United States now ranks 33rd among industrialized and 
developed Nations in its infant mortality rate. The Committee 
notes the successful use of mobile health outreach programs 
that send cell phone text messages to low-income women to 
provide advice to help keep the mothers and their babies 
healthy. The Committee encourages HRSA to engage and support 
mobile health messaging programs that target the goals of the 
title V program in areas with the worst overall outcomes.
    Oral Health.--The Committee has included sufficient funding 
to continue early childhood oral health interventions and 
prevention programs encompassing the medical/dental interface, 
topical fluorides, school and community-based sealant programs, 
and systems building with Head Start and the Women, Infants and 
Children program.

Sickle Cell Anemia Program

    The Committee provides $4,721,000 for the sickle cell 
anemia demonstration program, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$4,740,000.
    This program provides grants and contracts to help 
coordinate service delivery for individuals with sickle cell 
disease, including genetic counseling and testing; training of 
health professionals; and other efforts related to the 
expansion and coordination of education, treatment, and 
continuity of care programs for individuals with sickle cell 
disease.

Traumatic Brain Injury Program

    The Committee provides $9,878,000 for the Traumatic Brain 
Injury program, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $9,918,000.
    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 no less than last 
year's funding level for protection and advocacy services, as 
authorized under section 1305 of Public Law 106-310.
    The Committee supports the efforts of HRSA to develop a 
long-range plan for the Traumatic Brain Injury program. The 
Committee encourages HRSA to collaborate with other Federal 
agencies during this process and to solicit broad input from 
consumers, States, professionals and care providers in order to 
ensure that the program maximizes resources related to the 
treatment and prevention of traumatic brain injury.

Autism and Other Developmental Disorders

    The Committee provides $47,708,000 for the Autism and Other 
Developmental Disorders initiative, the same as the fiscal year 
2011 comparable level. The budget request for fiscal year 2012 
was $55,000,000.
    The program supports surveillance, early detection, 
education, and intervention activities on autism and other 
developmental disorders, as authorized in the Combating Autism 
Act of 2006.
    Bill language is included to ensure that fiscal year 2012 
grants may be awarded.

Newborn Screening for Heritable Disorders

    The Committee provides $9,952,000, the same as the fiscal 
year 2011 comparable level, for the newborn heritable disorders 
screening program, as described in section 1109 of the Newborn 
Screening Saves Lives Act of 2008. The fiscal year 2012 budget 
request was $9,992,000.
    This program provides funding to improve States' ability to 
provide newborn and child screening for heritable disorders. 
Newborn screening provides early identification and follow-up 
for treatment of infants affected by certain genetic, 
metabolic, hormonal, and/or functional conditions.

Congenital Disabilities Program

    The Committee has not provided funding for the congenital 
disabilities program. The budget request for fiscal year 2012 
included $499,000 for these activities. The program was 
discontinued in fiscal year 2011.
    The purpose of the program is to provide information and 
support services to families receiving a positive test 
diagnosis for down syndrome, spina bifida, dwarfism, or other 
prenatally and postnatally diagnosed conditions.
    The Committee is pleased with the materials created in this 
program and encourages HRSA to distribute them through the 
Maternal Child Health Bureau's programs.

Healthy Start

    The Committee provides $104,361,000 for the Healthy Start 
infant mortality initiative, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$104,776,000.
    The primary purpose of Healthy Start is to reduce infant 
mortality by 50 percent and generally improve maternal and 
infant health in at-risk communities. Grants are awarded 
largely to State and local health departments and nonprofit 
organizations to conduct an infant mortality review, develop a 
package of innovative health and social services for pregnant 
women and infants, and evaluate these efforts.
    The Committee is aware that racial disparities in 
stillbirth and sudden unexpected infant deaths [SUIDs] persist 
and significantly contribute to the more than 25,000 
stillbirths and over 4,000 SUIDs each year. The Committee 
encourages HRSA to support training and assistance that will 
enhance cooperative partnerships among local community health 
professionals, public health officers, community advocates and 
consumers to address racial disparities in SUIDs and 
stillbirth. In addition, the Committee encourages Healthy Start 
grantees to promote local efforts to review stillbirth and 
SUIDs, especially in addressing racial disparities.

Universal Newborn Hearing Screening and Early Intervention

    The Committee provides $18,884,000 for universal newborn 
hearing screening and early intervention activities, the same 
as the fiscal year 2011 comparable level. The budget request 
for fiscal year 2012 was $18,960,000.
    The Committee expects HRSA to coordinate its early hearing 
detection and intervention activities with the National Center 
on Birth Defects and Developmental Disabilities, the National 
Institute on Deafness and Other Communication Disorders, the 
National Institute on Disability and Rehabilitation Research 
and the Office of Special Education and Rehabilitative 
Services.
    This program awards grants to 53 States and territories 
that support statewide systems of newborn hearing screening, 
audiologic diagnostic testing before 3 months of age and 
enrollment in early intervention programs before the age of 6 
months.

Emergency Medical Services for Children

    The Committee provides $21,369,000 for the Emergency 
Medical Services for Children [EMSC] program, the same as the 
fiscal year 2011 comparable level. The budget request for 
fiscal year 2012 was $21,454,000. The program supports 
demonstration grants for the delivery of emergency care to 
acutely ill and seriously injured children.
    The EMSC program makes funding available to every State EMS 
office to improve emergency care for children and to pay for 
critical research and dissemination of best practices. The 
Committee commends the program's efforts to improve the 
evidence base for pediatric emergency care in the pre-hospital 
and emergency department settings and to drive the rapid 
translation of new science into professional practice.
    The Committee commends the program's efforts to improve the 
evidence base for pediatric emergency care and urges HRSA to 
continue creating innovative initiatives to improve evidence-
based pediatric emergency care and be cognizant of the 
educational and training needs of those serving in rural 
America.

                            HIV/AIDS BUREAU

                  ACQUIRED IMMUNE DEFICIENCY SYNDROME

                        RYAN WHITE AIDS PROGRAMS

    The Committee provides $2,351,665,000 for Ryan White AIDS 
programs. The recommendation includes $25,000,000 in transfers 
available under section 241 of the Public Health Service Act. 
The fiscal year 2011 comparable level was $2,336,665,000, and 
the budget request for fiscal year 2012 was $2,400,587,000.
    These programs provide a wide range of community-based 
services, including primary and home healthcare, case 
management, substance abuse treatment, mental health services, 
and nutritional services.

Emergency Assistance

    The Committee provides $672,529,000 for emergency 
assistance grants to eligible metropolitan areas 
disproportionately affected by the HIV/AIDS epidemic, the same 
as the fiscal year 2011 comparable level. The budget request 
for fiscal year 2012 was $679,074,000.
    Grants are provided to metropolitan areas meeting certain 
criteria. Two-thirds of the funds are awarded by formula, and 
the remainder is awarded through supplemental competitive 
grants.
    The Committee has continued a statutory provision that 
reduces the rate of cuts to metropolitan areas enacted in the 
reauthorization of the Ryan White Care Act formula in 2006.

Comprehensive Care Programs

    The Committee provides $1,323,141,000 for HIV healthcare 
and support services. The fiscal year 2011 comparable level was 
$1,308,141,000, and the budget request for fiscal year 2012 was 
$1,358,791,000.
    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.
    The Committee includes bill language providing $900,000,000 
for AIDS medications in the AIDS Drug Assistance Program 
[ADAP]. The fiscal year 2011 comparable level was $885,000,000, 
and the budget request for fiscal year 2012 was $940,000,000.
    The Committee is very concerned by the vulnerability of 
State funding for ADAP, the continuing increases in drug 
prices, and ongoing high unemployment, which has caused spikes 
in enrollment. Sufficient funding is included to continue the 
emergency allocations from the past 2 fiscal years and extend 
additional life-saving support in fiscal year 2012.

Early Intervention Services

    The Committee provides $205,564,000 for early intervention 
grants, the same as the fiscal year 2011 comparable level. The 
budget request for fiscal year 2012 was $211,522,000.
    Funds are awarded competitively to primary healthcare 
providers to enhance healthcare services available to people at 
risk of HIV and AIDS. Funds are used for comprehensive primary 
care, including counseling, testing, diagnostic, and 
therapeutic services.

Children, Youth, Women, and Families

    The Committee provides $77,313,000 for grants for 
coordinated services and access to research for women, infants, 
children and youth, the same as the fiscal year 2011 comparable 
level. The budget request for 2012 was $77,787,000.
    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 healthcare 
services to populations with or at risk for HIV disease.

AIDS Dental Services

    The Committee provides $13,511,000 for AIDS Dental 
Services, the same as the fiscal year 2011 comparable level. 
The budget request for fiscal year 2012 was $13,594,000.
    This program provides grants to dental schools, dental 
hygiene schools and postdoctoral dental education programs to 
assist with the cost of providing unreimbursed oral healthcare 
to patients with HIV disease.

AIDS Education and Training Centers

    The Committee provides $34,607,000 for the AIDS Education 
and Training Centers [AETCs], the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 
included $34,819,000.
    AETCs train healthcare practitioners, faculty, and students 
who care for AIDS patients outside of the traditional health 
professions education venues and support curriculum development 
on diagnosis and treatment of HIV infection for health 
professions schools and training organizations.

                       HEALTH CARE SYSTEMS BUREAU

Organ Donation and Transplantation

    The Committee provides $24,896,000 for organ donation and 
transplantation activities, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$25,991,000.
    Funds support a scientific registry of organ transplant 
recipients and the National Organ Procurement and 
Transplantation Network to match donors and potential 
recipients of organs. A portion of the appropriated funds may 
be used to educate the public and health professionals about 
organ donations and transplants, and to support agency staff 
providing clearinghouse and technical assistance functions.
    The Committee is aware of the large and growing national 
organ transplantation waiting list, in part due to the 
unavailability of organs. Healthcare professionals, 
particularly physicians, nurse, and physician assistants, if 
given enhanced knowledge and training, can positively impact 
organ donation. Therefore, the Committee encourages HRSA to 
develop curriculum and continuing education programs for 
targeted health professionals.
    Vascularized Composite Allografts Rulemaking Process.--The 
Committee notes that more than 3 years ago, on March 3, 2008, 
the Department published a Request for Information in the 
Federal Register to assist the Department in determining 
whether it should engage in a rulemaking with respect to the 
growing field of transplantation referred to as vascularized 
composite allografts [VCAs]. The Committee believes that this 
rulemaking process is necessary to bring this growing category 
of transplantation, which includes the transplantation of 
hands, arms and faces, under the policy umbrella of the 
National Organ Transplantation Act. The Committee therefore 
urges the Department to proceed with rulemaking to place VCA 
transplants under the policy oversight of the Organ Procurement 
Transplant Network.

National Cord Blood Inventory

    The Committee has provided $11,910,000 for the National 
Cord Blood Inventory, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$13,883,000. The purpose of this program is to provide funds to 
cord blood banks to build an inventory of the highest-quality 
cord blood units for transplantation.

C.W. Bill Young Cell Transplantation Program

    The Committee provides $23,374,000 for the C.W. Bill Young 
Cell Transplantation Program, the same as the fiscal year 2011 
comparable level. The budget request for fiscal year 2012 was 
$26,544,000.

Office of Pharmacy Affairs

    The Committee provides $4,480,000 for the Office of 
Pharmacy Affairs, the same as the fiscal year 2011 comparable 
level for this program. The budget request for fiscal year 2012 
was $5,220,000.
    The Office of Pharmacy Affairs promotes access to clinical 
and cost-effective pharmacy services among safety-net clinics 
and hospitals that participate in the 340B Drug Pricing 
program. Section 340B of the Public Health Service Act requires 
drug manufacturers to provide discounts or rebates to a 
specified set of HHS-assisted programs and hospitals that meet 
the criteria in the Social Security Act for serving a 
disproportionate share of low-income patients. These funds are 
used to help resolve deficiencies that could not be addressed 
within resources available for the normal operations of the 
office. Specifically, these deficiencies include noncompliance 
with the 340B pricing requirements and errors and omissions in 
the office's covered entity database.
    The Committee strongly supports the efforts of the Office 
of Pharmacy Affairs to ensure the integrity of the 340B 
program. The Committee is particularly supportive of HRSA's 
plan to develop a transparent system to verify the accuracy of 
the 340B ceiling price. Therefore, the Committee has included 
bill language, requested by the administration, to allow a 
nominal cost recovery fee to fund the implementation of program 
integrity provisions recommended by the inspector general and 
included in the Patient Protection and Affordable Care Act. The 
fee will be set at 0.1 percent for covered entities and is 
expected to generate $5,000,000. The Committee expects HRSA to 
report the expected and actual amounts generated by the fee in 
HRSA's annual budget justification.
    New Access Points.--The Committee is strongly supportive of 
efforts to expand access to care, particularly for those who 
are currently uninsured. Therefore, HRSA is encouraged to 
review its application policy and guidance to find 
opportunities to move more expeditiously in making 340B 
available to new clinics and access points. For example, the 
Committee is aware that HRSA requires a filed Medicare cost 
report for all hospital-affiliated clinic applications, which 
can take up to a year after the clinic opens. The Committee 
encourages HRSA to explore other forms of documentation that 
might be available more quickly upon the opening of a new 
access point.
    Outpatient Coverage.--The Committee is aware that treatment 
guidelines over the last few decades have been moving to 
provision of care from inpatient to outpatient. The Committee 
encourages HRSA to review the definition of patient to ensure 
that the 340B program continues to serve the population it was 
intended to serve, even as that population accesses care in 
different ways. In any guidance that HRSA might issue, the 
Committee recommends that HRSA keep an eye trained on 
preventing society's most vulnerable patients from losing 
access to affordable drugs.
    Supplanting.--The Committee remains strongly supportive of 
the 340B program and its emphasis on helping hospitals, health 
centers and other safety net providers extend care to those who 
need it most. For that reason, the Committee is troubled by 
reports of health care insurers and other third party payers 
setting reimbursement rates that discriminate against 340B 
covered entities and supplant the benefit of the 340B 
discounts. The Committee urges HRSA to clarify to healthcare 
insurers and other third party payers that discriminatory 
reimbursement rates for 340B covered entities is inconsistent 
with congressional intent.

Poison Control Centers

    The Committee provides $21,866,000 for poison control 
center activities, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $29,250,000. 
The Poison Control Centers program currently supports a mix of 
grantees. Most grantees serve entire States; a few grantees 
serve multistate regions; and, in a handful of cases, more than 
one grantee serves a single State.
    HRSA estimates that $7 is saved in medical spending for 
every dollar spent on Poison Control Centers because treatment 
guidance for the majority of poison exposures (over 70 percent) 
can be provided over the phone, thereby reducing emergency 
department visits, ambulance use, and hospital admissions. For 
that reason, the Committee is strongly supportive of ensuring 
that all citizens have access to poison control hotlines.

                         RURAL HEALTH PROGRAMS

Rural Healthcare Services Outreach Grants

    The Committee provides $55,658,000 for rural health 
outreach grants, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $57,266,000. 
This program supports projects that demonstrate new and 
innovative models of outreach in rural areas, such as 
integration and coordination of health services.
    The Delta States Network Grant Program provides network and 
rural health infrastructure development grants to the eight 
States in the Mississippi River Delta region. The Committee 
recognizes that residents in this region disproportionately 
experience disease risk factors and show positive behavioral 
change when community-based programs and infrastructure are in 
place. The Committee believes that collaborative programs 
offering health, education, coordination of health services 
offer the best hope for breaking the cycle of poor health in 
this region. Therefore, the Committee has included sufficient 
funding to continue these activities at no less than last 
year's level.
    Mental Health Outreach.--The Committee urges HRSA to 
support programs that demonstrate new and innovative models of 
regional outreach to meet the behavioral and mental health 
needs of rural America. In particular, HRSA is encouraged to 
give priority to clinical training sites that encompass a 
multicounty area; train students to use secure telemedicine 
applications that result in timely triage, disposition and 
treatment; and provide outreach to veterans, older Americans 
and underserved populations with limited or no access to 
behavioral health services.
    Oral Health.--The Committee recognizes that access to oral 
health providers can be particularly challenging in rural 
areas. The Committee encourages HRSA to consider supporting 
oral healthcare outreach to underserved communities by 
accredited dental schools.

Rural Health Research

    The Committee provides $9,885,000 for the Rural Health 
Research program, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $9,929,000.
    The funds provide support for the Office of Rural Health 
Policy to be the focal point for the Department's efforts to 
improve the delivery of health services to rural communities 
and populations. Funds are used for rural health research 
centers, the National Advisory Committee on Rural Health, and a 
reference and information service.

Rural Hospital Flexibility Grants

    The Committee provides $41,118,000 for rural hospital 
flexibility grants, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $26,200,000.
    Under this program, HRSA works with States to provide 
support and technical assistance to critical access hospitals 
to focus on quality and performance improvement and to 
integrate emergency medical services.
    The Committee remains supportive of the collaboration 
between the Department of Veterans Affairs and rural hospitals 
to provide locally based care, and understands that one of the 
largest barriers to this effort is the lack of electronic 
medical records that are interoperable with the VISTA system. 
For that reason, the Committee has again included bill language 
identifying $1,000,000 for grants authorized under section 
1820(g)(6) of the Social Security Act to provide telehealth 
equipment and to develop electronic health records that are 
compatible with the VISTA system. The Committee encourages HRSA 
to coordinate with the Department of Veterans Affairs to ensure 
that this equipment furthers the goal of treating the illnesses 
and disabilities of our Nation's veterans. The Committee is 
particularly concerned with ensuring that veterans receive 
appropriate mental healthcare.

Rural Access to Emergency Devices

    The Committee provides $2,500,000 for rural access to 
emergency devices. The fiscal year 2011 comparable level was 
$236,000. The budget for fiscal year 2012 did not request funds 
for this program.
    This appropriation funds the Rural Access to Emergency 
Devices Act, authorized under section 413 of the Cardiac Arrest 
Survival Act of 2000. Funding will be used to purchase 
automated external defibrillators [AED], place them in public 
areas where cardiac arrests are likely to occur and train lay 
rescuers and first responders in their use.
    Only an estimated 8 percent of victims who suffer a sudden 
cardiac arrest outside of a hospital survive. Immediate 
cardiopulmonary resuscitation and early intervention, using an 
AED, can more than double a patient's chance of survival. 
Communities with comprehensive AED programs, including training 
of anticipated rescuers, have achieved survival rates of nearly 
40 percent.
    The Committee directs HRSA to prepare and submit within 90 
days after the enactment of this act a report on the impact of 
this program since its inception, similar to the one released 
in 2005. The report should include the locations where AEDs 
were placed, the grant dollars requested and awarded, and the 
number of applications received and awards granted, lay 
rescuers and first responders trained in their use, and an 
estimate of the number of individuals saved under this program. 
This information, comparable to that requested in its January 
2011 Funding Opportunity Announcement, should be shown by State 
and grantee as in the 2005 report.

State Offices of Rural Health

    The Committee provides $10,055,000 for State Offices of 
Rural Health, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was $10,075,000.
    The State Offices of Rural Health program helps States 
strengthen rural healthcare delivery systems by allowing them 
to better coordinate care and improve support and outreach in 
rural areas.

Black Lung Clinics

    The Committee provides $7,153,000 for black lung clinics, 
the same as the fiscal year 2011 comparable level. The budget 
request for fiscal year 2012 was $7,185,000.
    This program funds clinics that treat respiratory and 
pulmonary diseases of active and retired coal miners, steel 
mill workers, agricultural workers, and others with 
occupationally related respiratory and pulmonary impairments. 
These clinics reduce the incidence of high-cost inpatient 
treatment for these conditions.

Radiation and Exposure Screening and Education Program

    The Committee provides $1,939,000 for activities authorized 
by the Radiation Exposure Compensation Act, the same as the 
fiscal year 2011 comparable level. The budget request for 
fiscal year 2012 was $1,948,000.
    This program provides grants for the education, prevention, 
and early detection of radiogenic cancers and diseases 
resulting from exposure to uranium during mining and milling at 
nuclear test sites.

Telehealth

    The Committee provides $13,524,000 for telehealth 
activities. The fiscal year 2011 comparable level was 
$11,524,000. The budget request for fiscal year 2012 was 
$11,575,000. The telehealth program promotes the effective use 
of technologies to improve access to health services for people 
who are isolated from healthcare and to provide distance 
education for health professionals.
    The Committee is aware of various telemonitoring 
demonstration programs, including programs for non-homebound 
patients with chronic heart failure. The Committee believes 
that telemonitoring has the potential to reduce healthcare 
costs and improve patient outcomes in rural and frontier areas. 
The Committee encourages the Office for the Advancement of 
Telehealth to develop best practices that can reduce healthcare 
costs throughout the Federal Government. In particular, the 
Committee encourages HRSA to examine how these programs can 
scale across a large population, including patient 
identification and enrollment, communications with treating 
physicians, technology inventory management, customer support, 
and program evaluation.

Family Planning

    The Committee provides $299,400,000 for the title X family 
planning program, the same as the fiscal year 2011 comparable 
level. The budget request for fiscal year 2012 was 
$327,356,000.
    Title X grants support preventive and primary healthcare 
services at clinics nationwide. Approximately 70 percent of 
family planning clients are at or below 100 percent of the 
poverty level. In 2009, title X health centers saw more 
patients than at any time in the last decade. Title X of the 
PHS Act, which established the national family planning 
program, authorizes the provision of a broad range of effective 
family planning methods and preventive health services to 
individuals, regardless of age or marital status. This includes 
all FDA-approved methods of contraception.
    The Committee encourages HRSA to allocate resources from 
the Patient Protection and Affordable Care Act to the Office of 
Population Affairs to be used to provide technical assistance 
to grantees to help them prepare for the implementation of the 
Affordable Care Act, including the expansion of Medicaid, 
technology upgrades and participating essential community 
providers.
    The Committee is aware of a 2009 Institute of Medicine 
report which found that the title X family planning program 
provides critically needed health services to individuals with 
the most difficulty accessing family planning care. The 
Committee supports the Office of Family Planning's efforts to 
review and update the title X program guidance and 
administrative directives.

Program Management

    The Committee provides $161,815,000 for program management 
activities for fiscal year 2012, the same as the fiscal year 
2011 comparable level. The budget request for fiscal year 2012 
was $170,808,000.

               HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

Appropriations, 2011....................................      $2,841,000
Budget estimate, 2012...................................................
Committee recommendation................................       2,841,000

    The Committee has provided $2,841,000 to administer the 
Health Education Assistance Loans program, the same as the 
fiscal year 2011 comparable level. The Committee has rejected 
the administration's proposal to transfer the this workload to 
the Department of Education.

             VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2011....................................    $226,489,000
Budget estimate, 2012...................................     241,502,000
Committee recommendation................................     241,489,000

    The Committee provides that $241,489,000 be released from 
the vaccine injury compensation trust fund in fiscal year 2012. 
The budget request for fiscal year 2012 was $241,502,000. The 
comparable level in fiscal year 2011 was $226,489,000. Of that 
amount, $6,489,000 is for administrative costs.
    The National Vaccine Injury Compensation program provides 
compensation for individuals with vaccine-associated injuries 
or deaths. Funds are awarded to reimburse medical expenses, 
lost earnings, pain and suffering, legal expenses, and a death 
benefit. The vaccine injury compensation trust fund is funded 
by excise taxes on certain childhood vaccines.

               Centers for Disease Control and Prevention

Appropriations, 2011....................................  $6,281,544,000
Budget estimate, 2012...................................   6,393,242,000
Committee recommendation................................   6,218,450,000

    The Committee recommendation for the Centers for Disease 
Control and Prevention [CDC] is $6,218,450,000, including 
$5,765,735,000 in discretionary budget authority and an 
additional $367,357,000 via transfers available under section 
241 of the Public Health Service [PHS] Act. The recommendation 
also assumes $30,000,000 in balances from Public Law 111-32 in 
accordance with the budget request, and $55,358,000 in 
mandatory funds under the terms of the Energy Employees 
Occupational Illness Compensation Program Act [EEOICPA].
    The comparable level in fiscal year 2011 was 
$6,281,544,000, including $352,357,000 in transfers available 
under section 241 of the PHS Act, $224,859,000 in balances from 
Public Law 111-32 and $55,358,000 in EEOICPA mandatory funds.
    The budget recommendation for fiscal year 2012 was 
$6,393,242,000, including $490,472,000 in transfers available 
under section 241 of the PHS Act, and $30,000,000 in balances 
from Public Law 111-32 and $55,358,000 in EEOICPA mandatory 
funds.
    In addition, the Committee has included statutory language 
transferring $848,000,000 in mandatory funds to CDC from the 
Prevention and Public Health [PPH] Fund. The fiscal year 2011 
comparable level was $610,900,000 and the budget request for 
fiscal year 2012 was $752,500,000.
    All told, the Committee provides a program level of 
$7,066,450,000 for CDC.
    The activities of CDC focus on several major priorities: 
providing core public health functions; responding to urgent 
health threats; monitoring the Nation's health using sound 
scientific methods; building the Nation's health infrastructure 
to insure our national security against bioterrorist threats; 
assuring the Nation's preparedness for emerging infectious 
diseases and potential pandemics; promoting women's health; and 
providing leadership in the implementation of nationwide 
prevention strategies to encourage responsible behavior and 
adoption of lifestyles that are conducive to good health.

       NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES

    The Committee has included a program level of $798,257,000 
for the activities of this Center in fiscal year 2012, 
including $150,000,000 in transfers from the PPH Fund and 
$12,864,000 in transfers available under section 241 of the PHS 
Act.
    The comparable level for fiscal year 2011 was $748,257,000, 
including $156,344,000 in transfers from Public Law 111-32, 
$100,000,000 in PPH Fund transfers and $12,864,000 in section 
241 transfers.
    The budget request for fiscal year 2012 included 
$721,663,000 for this Center, including $61,599,000 in PPH Fund 
transfers and $12,864,000 in section 241 transfers.
    The Committee recommendation includes funding for the 
following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Section 317 Immunization Program................................         425,571         433,503         425,571
Section 317 Immunization Program (PPH Fund).....................         100,000          61,599         150,000
Influenza Planning and Response.................................         159,681         159,672         159,681
Program Implementation and Accountability.......................          63,005          66,889          63,005
    National Immunization Survey (non-add)......................          12,864          12,864          12,864
----------------------------------------------------------------------------------------------------------------

    Section 317 Immunization Program.--The Committee recognizes 
that high rates of childhood immunization coverage are 
important for reducing child mortality and saving costs over a 
lifetime. For every $1 spent on the childhood series of 
vaccines, $16.50 is saved. Therefore, the Committee has 
included $150,000,000 from the PPH Fund to expand the section 
317 immunization program. The additional funding will allow 
more recommended immunizations to be available through the 
existing network of private and public immunization providers, 
and support and expand the network as needed.
    Immunization Infrastructure.--The Committee recognizes that 
the Nation's immunization infrastructure is essential for 
ensuring the continued high rates of childhood immunization 
coverage and supports efforts to modernize this infrastructure 
in making recommended immunizations more widely available. The 
Committee supports CDC's decision to support these efforts out 
of the PPH Fund rather than at the expense of funding used for 
vaccine purchase. The Committee urges the Secretary to continue 
this policy.
    As investments are made to modernize the immunization 
infrastructure, and as the Nation's health care delivery system 
continues to evolve though enhanced health insurance coverage, 
the Committee recommends that CDC develop strategies to (1) 
modernize immunization information systems; (2) prepare public 
health departments for changes in the health care delivery 
system, including new billing procedures related to privately 
insured patients; and (3) strengthen the evidence base to 
inform immunization policy and program monitoring, including 
vaccine-preventable disease surveillance, vaccine coverage 
assessment, and laboratory training. The strategy should also 
address how CDC will maintain and expand partnerships with the 
healthcare sector to provide routine and emergency immunization 
services.
    The Committee recognizes that past cost savings from the 
section 317 program that supported an at-risk adult hepatitis B 
vaccine initiative have been expended. The Committee commends 
CDC for its efforts to provide hepatitis vaccinations through 
the section 317 program.
    Immunization Report.--The Committee finds the annual report 
on the estimated funding needs of the section 317 immunization 
program to be vital information and requests that it be 
submitted not later than February 1 of each year to reflect the 
following fiscal year cost estimates. The report should include 
an estimate of optimum State and local operations funding, as 
well as CDC operations funding needed relative to current 
levels to conduct and support childhood, adolescent, and adult 
programs. In addition, the report should include a discussion 
of specific strategies to improve the overall immunization 
infrastructure and to reduce barriers and increase adult 
immunization rates in the United States and how section 317 
immunization program funds are currently used to reach 
immunization goals. The report should further include a 
discussion of the evolving role of the 317 program as expanded 
coverage for vaccination becomes available from private and 
public sources over the next several years.

    NATIONAL CENTER FOR HIV, VIRAL HEPATITIS, STD, AND TB PREVENTION

    The Committee recommends $1,115,995,000 for the activities 
at this Center in fiscal year 2012 and an additional 
$10,000,000 in transfers from the PPH Fund. The fiscal year 
2011 level was $1,115,995,000. The fiscal year 2012 budget 
request was $1,157,133,000 in discretionary appropriations and 
an additional $30,400,000 in transfers from the PPH Fund. The 
Committee has included funding for the following activities at 
the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research.......................         800,445         827,208         800,445
    HIV Prevention by Health Department.........................         336,912         343,318         336,912
    HIV Surveillance............................................         117,667         115,803         117,667
    Enhanced HIV Testing Initiative.............................          65,401          66,043          65,401
    Improving HIV Program Effectiveness.........................         102,406         120,602         102,406
    Non-Governmental Organizations..............................         138,059         141,442         138,059
    School Health--HIV..........................................          40,000          40,000          40,000
Viral Hepatitis.................................................          19,784          25,000          19,784
Viral Hepatitis Screening (PPH Fund)............................  ..............  ..............          10,000
Sexually Transmitted Infections.................................         154,666         161,353         154,666
Tuberculosis....................................................         141,100         143,572         141,100
----------------------------------------------------------------------------------------------------------------

    Hepatitis Testing.--The Committee recognizes that early 
diagnosis of hepatitis is a cost-effective way to reduce 
morbidity and mortality rates and encourages CDC to implement 
plans for risk-based hepatitis testing, including baby-boomers, 
injection drug users, and ethnic minorities such as Native 
Hawaiians, Native Alaskans, African Americans, and Asian and 
Pacific Islanders.
    HIV Prevention.--The Committee commends CDC for conducting 
evaluations into a number of new locally developed and 
investigator-developed interventions for men who have sex with 
men [MSM], particularly African-American MSM, and conducting 
research to adapt existing effective behavioral interventions 
for additional populations such as women and other racial and 
ethnic minorities. The Committee looks forward to the results 
of this research and encourages CDC to develop a plan for 
disseminating any new proven interventions, including technical 
assistance and training opportunities for community-based 
organizations.
    HIV Testing.--The Committee commends CDC for recently 
expanding the Heightened Awareness HIV Testing program to 
include additional jurisdictions and risk groups. The Committee 
requests an update on the implementation of this expansion in 
the fiscal year 2013 congressional budget justification.
    Tuberculosis [TB].--The Committee notes that TB, including 
drug-resistant TB, remains a public health concern and that 
there are significant barriers to optimal diagnosis and 
treatment and national shortages of second-line TB drugs. The 
committee urges the Federal Tuberculosis Task Force to work 
with the Food and Drug Administration and other partners to 
accelerate the introduction of new rapid diagnostic tests and 
to alleviate national shortages of TB drugs.
    TB in High-Risk Areas.--The Committee is aware that the TB 
program distributes supplemental funding based on outbreaks. 
The Committee is concerned that areas with persistently high 
rates of TB and drug-resistant TB experience outbreak 
conditions routinely. The Committee directs CDC to review the 
epidemiology of TB in States and territories with more than 
double the average rate of TB cases to determine if a visit 
from CDC's TB outbreak response team or an outbreak 
supplemental grant could jumpstart significant improvement in 
TB prevention and control in these high-risk areas.
    Viral Hepatitis.--The Division of Viral Hepatitis is the 
centerpiece of the Federal response to controlling, reducing 
and preventing the suffering and deaths resulting from viral 
hepatitis. CDC is responsible for surveillance, research, 
education, training and program development focusing on 
activities related to hepatitis A virus, hepatitis B virus 
[HBV], and hepatitis C virus [HCV].
    CDC estimates that up to 5.3 million Americans have chronic 
HBV and HCV infections and that each year up to 15,000 
Americans die of HBV- and HCV-related disease. Because of the 
asymptomatic nature of hepatitis B and hepatitis C, 
approximately 65 percent and 75 percent, respectively, of the 
infected population are unaware that they are infected with HBV 
and HCV. The prevention of chronic hepatitis B and hepatitis C 
serves to prevent liver cancer, because HBV and HCV are the 
leading causes of this type of cancer throughout the world.
    The Committee directs that $10,000,000 transferred from the 
PPH Fund be prioritized to support Division efforts to expand 
identification of those chronically infected persons who do not 
know their status and their referral to medical care, 
particularly focusing on groups disproportionately affected by 
chronic hepatitis B and hepatitis C. In particular, the 
Committee notes that hepatitis B and hepatitis C testing 
guidelines are not aligned across HHS operating divisions, and 
expects CDC to work expeditiously with the Assistant Secretary 
for Health, AHRQ and the U.S. Preventive Services Task Force to 
develop a consistent national testing guideline by early 2012 
to improve testing rates. As noted in the HHS action plan, the 
effectiveness of risk-based approaches to testing is hindered 
by the reluctance of providers and patients to discuss 
behaviors not connected with the patient's chief complaint. The 
Committee urges CDC to update and implement HHS recommendations 
for viral hepatitis testing as a standard of care in CDC-
sponsored HIV/STD prevention programs, correctional health, and 
other programs serving populations with high disease 
prevalence. The Committee further encourages CDC to conduct 
prevention research to identify and disseminate best practices 
for screening and the prompt linkage to needed medical 
management and treatment.
    In addition, the Committee recognizes that the Adult Viral 
Hepatitis Prevention Coordinator program is the only Federal 
hepatitis prevention program operating in all States and 
understands that the program does not include any dedicated 
funding for direct services. The Committee encourages the 
Division of Viral Hepatitis to maintain this program in all 
previously funded jurisdictions to build the Federal response 
for both low- and high-impacted areas.
    The Committee further encourages CDC to continue to 
validate interventions focused on mother-child transmission. As 
the hepatitis B virus is the single greatest health disparity 
impacting the Asian and Pacific Islander [API] populations in 
the United States, the Committee urges a targeted and increased 
effort to address this issue, including the funding of 
replicable demonstration projects to help reach the API 
populations.
    Finally, the Committee encourages CDC to develop and 
implement a standard curriculum to train the multiple 
disciplines of the public health and clinical care workforce to 
deliver viral hepatitis prevention, screening and referral for 
care. CDC is also urged to help reduce health disparities by 
implementing a national education campaign targeting at risk 
communities, strengthening the capacity of community-based 
organizations to provide viral hepatitis prevention services 
and observing May 19 of each year as Viral Hepatitis Testing 
Day to raise awareness of the importance of viral hepatitis 
screening.

     NATIONAL CENTER FOR EMERGING AND ZOONOTIC INFECTIOUS DISEASES

    The Committee includes $252,443,000 for fiscal year 2012 
for this Center, the same as the comparable fiscal year 2011 
level. In addition, the Committee has included $51,750,000 in 
transfers from the PPH Fund, the same level as was transferred 
in fiscal year 2011.
    The fiscal year 2012 budget request was $289,118,000 in 
discretionary appropriations and an additional $60,000,000 in 
PPH Fund transfers. This Center provides outbreak 
investigation, infection control and scientific evaluations of 
emerging zoonotic, vector-borne and infectious diseases, and 
conducts food-borne illness surveillance and investigation.
    PPH Fund transfers ensure that CDC can invest no less than 
last year's funding for Epidemiology-Laboratory Capacity 
grants. The Committee recommendation also includes funding for 
the following activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Lyme Disease....................................................           8,773  ..............           8,773
Prion Disease...................................................           5,373  ..............           5,373
Chronic Fatigue Syndrome........................................           4,737  ..............           4,737
----------------------------------------------------------------------------------------------------------------

    Blood Safety Surveillance.--The Committee supports the 
National Healthcare Safety Network [NHSN], a surveillance tool 
used by hospitals and other health care facilities to better 
understand and prevent healthcare-associated infections. With 
the addition of a hemovigilance module in fiscal year 2010, 
NHSN also became a tool to collect and analyze national data on 
adverse events and medical errors occurring during blood 
transfusions. The Committee encourages CDC to broaden its 
outreach to increase hospital participation, undertake measures 
to assure the quality of the data collected and disseminate the 
data in ways that support the development of effective 
interventions.
    Food Safety.--The Committee directs that CDC spend no less 
than last year's level on food safety activities. The Committee 
strongly supports the CDC program to ensure food safety through 
surveillance outbreak response. The Committee supports an 
expansion of OutbreakNet to all 50 States in order to increase 
capacity and speed of food-borne outbreak detection and 
response. In addition, CDC is encouraged to support efforts to 
build a faster and more comprehensive public health laboratory 
and epidemiological surveillance and investigations.
    Infection Control.--The Committee is concerned by ongoing 
exposures and outbreaks caused by the reuse of syringes and 
misuse of vials in healthcare facilities. These outbreaks are 
entirely preventable when well-known infection control 
practices are practiced. The Committee urges CDC to continue 
its injection safety activities in three areas: provider 
education and awareness, detection and tracking, and response.
    Prion Disease.--The Committee has included sufficient 
funding to continue prion disease research and surveillance. 
The Committee recognizes the importance of surveillance and 
safeguarding the Nation against prion diseases.
    Vector-Borne Diseases.--As international travel becomes 
more commonplace, new pathogens can be introduced into new 
environments more quickly than ever before, as the Nation has 
seen with SARS, avian influenza and dengue fever. Arboviruses 
like chikungunya and others are a constant threat to travelers 
and to Americans overall. The Committee urges CDC to continue 
surveillance and monitoring of vector-borne diseases within the 
agency's new structure.

  NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

    The Committee recommends $777,987,000 for chronic disease 
prevention and health promotion. The comparable level for 
fiscal year 2011 was $773,987,000 and the budget request for 
fiscal year 2012 was $725,207,000. In addition, the Committee 
recommends $487,050,000 in mandatory funding to be transferred 
from the Prevention and Public Health [PPH] Fund, which 
compares to $300,950,000 in fiscal year 2011 and $460,301,000 
in the fiscal year 2012 budget request.
    America's poor health is plaguing our country and taking a 
severe toll on our economy. One-half of all American adults 
have at least one chronic illness; such diseases account for 
nearly 70 percent of all U.S. deaths and cost the Nation 
approximately $1,800,000,000 per year.
    Many chronic diseases are preventable, so there is an 
urgent need to reduce their prevalence, both for the sake of 
the people affected by them and for the Nation's economy. CDC 
administers numerous programs intended to prevent chronic 
diseases, but the funding structure for these programs evolved 
over the years in ways that were not well coordinated. In many 
States, the missions for several of these programs overlap.
    This Committee, CDC and States have all struggled with how 
to better coordinate chronic disease programs. Pilot programs 
have included giving States transfer authority and adding 
program coordination staff at the State and regional levels. 
The President's budget for fiscal year 2012 proposed 
consolidating 27 programs in the National Center for Chronic 
Disease Prevention and Health Promotion. The Committee, 
meanwhile, has been particularly interested in streamlining 
CDC's obesity-related programs. In fiscal year 2011, the 
Committee proposed consolidating the Diabetes; Heart Disease 
and Stroke; Arthritis; School Health; and Nutrition, Physical 
Activity and Obesity programs, all of which include a goal of 
reducing obesity.
    The Committee does not recommend a consolidation in fiscal 
year 2012, not because the need has gone away but because 
budget constraints make it impossible to achieve without 
cutting funding to numerous States.
    States currently receive anywhere from 1 to 5 of the 5 
obesity-related grants listed above. Without significant 
additional resources, as the Committee had recommended 
providing in fiscal year 2011, creating a national, 
consolidated program might lead to increased funding for some 
States but would certainly cause cuts in many others, some of 
which might be national leaders in reducing obesity. The 
Committee cannot support a consolidation without enough funding 
to ensure that the new program would be effective, efficient 
and fair.
    In the meantime, there are numerous opportunities to reduce 
inefficiencies through administrative means. All of the 
obesity-related grants described above include reducing obesity 
as a key priority. Yet the obesity-related performance measures 
and goals in each of these programs vary. The Committee 
strongly urges CDC to reevaluate the obesity-related grant 
programs and take administrative steps to improve their 
alignment.
    Within the total provided for the National Center for 
Chronic Disease Prevention and Health Promotion, the following 
amounts are available for the following categories of funding:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Tobacco.........................................................         108,685         107,226         108,685
Tobacco (PPH Fund)..............................................          50,000          79,000         100,000
Nutrition, Physical Activity and Obesity........................          34,189           (\1\)          34,189
School Health on Chronic Disease................................          13,600           (\1\)          13,600
    Food Allergies (non-add)....................................             488           (\1\)             488
Glaucoma........................................................           3,337           (\1\)           3,337
Alzheimer's Disease.............................................           1,812           (\1\)           1,812
Inflammatory Bowel Disease......................................  ..............           (\1\)             680
Interstitial Cystitis...........................................  ..............           (\1\)             654
Excessive Alcohol Use...........................................           2,454           (\1\)           2,454
Chronic Kidney Disease..........................................           2,093           (\1\)           2,093
Prevention Research Centers.....................................          18,001           (\1\)          18,001
Prevention Research Centers (PPH Fund)..........................          10,000  ..............          10,000
Heart Disease and Stroke........................................          55,284           (\1\)          55,284
Diabetes........................................................          64,796           (\1\)          64,796
Cancer Prevention and Control...................................         345,332           (\1\)         345,332
    Breast and Cervical Cancer..................................         206,001           (\1\)         206,001
        WISEWOMAN (non-add).....................................          20,745           (\1\)          20,745
    Breast Cancer Awareness for Young Women.....................           4,908           (\1\)           4,908
    Cancer Registries...........................................          50,295           (\1\)          50,295
    Colorectal Cancer...........................................          43,070           (\1\)          43,070
    Comprehensive Cancer........................................          20,313           (\1\)          20,313
    Ovarian Cancer..............................................           4,909           (\1\)           4,909
    Prostate Cancer.............................................          13,188           (\1\)          13,188
    Skin Cancer.................................................           2,150           (\1\)           2,150
    Cancer Survivorship Resource Center.........................             498           (\1\)             498
Oral Health.....................................................          14,726          14,609          14,726
Safe Motherhood/Infant Health...................................          44,049          55,734          44,049
Breast-Feeding Promotion and Support grants (PPH Fund)..........  ..............           2,500           7,050
Arthritis.......................................................          13,075           (\1\)          13,075
Epilepsy........................................................           7,801           (\1\)           7,801
National Lupus Patient Registry.................................           1,886           (\1\)           4,462
Healthy Communities.............................................          22,197           (\1\)          22,197
Racial and Ethnic Approach to Community Health..................          14,018           (\1\)          14,018
Racial and Ethnic Approach to Community Health (PPH Fund).......          25,000  ..............          50,000
Community Transformation Grants (PPH Fund)......................         145,000         221,061         280,000
Community Health Worker pilot (PPH Fund)........................  ..............  ..............          20,000
Chronic Disease Innovation grants (PPH Fund)....................  ..............  ..............          10,000
Small Business Workplace Wellness (PPH Fund)....................          10,000  ..............         10,000
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.

    Breastfeeding.--The Committee is aware of research showing 
that suboptimal breastfeeding rates are a significant 
contributor to our Nation's epidemic of obesity, increasing 
risks of several acute and chronic diseases and conditions, 
including diabetes and cardiovascular disease. The Committee 
supports the Surgeon General's Call to Action to Support Breast 
Feeding. The Committee has included funding through the PPH 
Fund to support hospitals that promote breastfeeding and non-
governmental organizations that assist breastfeeding mothers. 
The Committee urges CDC to collaborate with the Maternal and 
Child Health Bureau's doula best practices initiative.
    Cancer Registries.--The Committee is pleased that CDC has 
provided 35 cancer registries with funding to transform 
information technology that will improve electronic reporting 
of pediatric cancer patient data and that six additional 
registries will be supported in an effort to improve rapid 
patient data ascertainment and case completeness of pediatric 
cancer patients. These improvements will help create a national 
pediatric cancer database for researchers to use in finding 
pediatric cancer indicators, developing and applying 
appropriate treatments, and tracking long-term health outcomes 
of pediatric cancer patients.
    Chronic Disease Innovation Grants.--Of the amounts provided 
in the PPH Fund for Innovation grants, the Committee has 
included $10,000,000 to expand the National Diabetes Prevention 
program authorized in section 399V-3 of the PHS Act. The 
Committee recognizes that approximately one-third of people 
with diabetes do not know that they have it, while another 57 
million have pre-diabetes and are at high risk for developing 
this deadly disease. The Committee strongly supports efforts to 
curb the growing cost of healthcare by targeting populations 
known to be at risk of developing disease.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee recognizes that COPD is now the third-leading cause 
of death in the United States. The Committee encourages CDC to 
work with the National Heart, Lung, and Blood Institute to 
prepare a national action plan to address COPD, including 
public awareness and surveillance activities.
    Chronic Kidney Disease [CKD].--The Committee notes that 
nearly 26 million Americans suffer from CKD and that CKD has a 
disproportionately high impact on minority communities such as 
Native Hawaiians and Pacific Islanders. The Committee continues 
to assign high priority to the CKD program, with particular 
emphasis on early detection to improve health outcomes and 
reduce the economic burden caused by dialysis and kidney 
transplantation.
    Community Health Worker Demonstration.--The Committee 
recommendation includes $20,000,000 in mandatory funding to be 
transferred from the PPH Fund for grants to hire community 
health workers, a program newly authorized in section 399V of 
the PHS Act. The Committee encourages CDC to prioritize 
applications from areas that have high health disparities and 
that propose increasing awareness of the new preventive 
benefits covered in the Patient Protection and Affordable Care 
Act.
    Community Transformation Grants.--The Committee recommends 
transferring $280,000,000 from the PPH Fund for Community 
Transformation Grants, authorized in section 4201 of the 
Patient Protection and Affordable Care Act. The Committee 
believes this program offers enormous potential to turn the 
environment in which Americans work, live and raise their 
families into one that offers a much greater array of healthy 
choices.
    Within this total, the Committee assumes the continuation 
of $145,000,000 in 5-year grants that will be awarded in 
September 2011 in the fiscal year 2011 competition. This 
competition emphasized State health department coordination and 
required a wide range of activities related to chronic 
diseases. Funds will be used for the implementation, evaluation 
and dissemination of evidence-based community preventative 
health activities in order to develop strategies and practices 
that will enable States to control chronic disease and co-
morbidity health disparities. Grantees are charged with 
reducing obesity and smoking rates by 5 percent within 5 years, 
two goals that are strongly supported by the Committee.
    In addition, the Committee has included statutory language 
requiring that the $135,000,000 increase over the fiscal year 
2011 level must be awarded through a new competition that will 
differ from the first one in several ways. In particular, this 
competition will allow applicants to propose catchment areas 
that are smaller than the minimum of 500,000 people required in 
the original competition. Grantees will have greater 
flexibility regarding the scope of the evidence-based 
interventions they wish to pursue; however, they must all 
relate to the prevention of chronic diseases. The Committee 
encourages the CDC to maintain the 5 percent reduction goal for 
the chronic disease or diseases targeted by a grantee.
    The Committee is eager to see public health interventions 
being adopted by towns, counties, neighborhoods and 
organizations for which public health is not their primary 
mission. Therefore, the pool of eligible applicants for the new 
competition will be focused on non-governmental organizations, 
school districts, local housing authorities, Indian tribes and 
local transportation authorities. As the authorization 
requires, not less than 20 percent of grant funds will be 
directed to rural and frontier areas, and eligible applicants 
will be required to show strong collaboration with multi-sector 
partners, such as business, government and non-profit 
organizations in order to ensure a broad base of support for 
changes to the community.
    Crohn's and Colitis Area Registry.--A substantial Federal 
investment has already been made in connecting patients and 
providers to the Crohn's and Colitis Area Registry, which has 
consistently improved insight into the etiology of inflammatory 
bowel disease, the course of illness, and methods to improve 
patient outcomes. The Committee restores funding for this 
program, which was eliminated by the Department in its fiscal 
year 2011 operating plan.
    Diabetes in Native Americans/Native Hawaiians.--The high 
incidence of diabetes and kidney disease among Native American, 
Native Alaskan, Native Hawaiian and Filipino populations 
persists. The Committee urges CDC to continue its efforts to 
target this population within Community Transformation grants 
and the REACH program.
    Farm-to-School Programs.--The Committee is strongly 
supportive of farm-to-school programs, which work to improve 
school nutrition through partnerships with local farms. The 
Committee urges CDC to give priority to applicants that propose 
to establish this type of partnership through the Healthy 
Communities and Community Transformation Grant programs. 
Further, the Committee is aware that the U.S. Department of 
Agriculture [USDA] will establish a mandatory funding stream 
for these programs in fiscal year 2013. The Committee further 
urges CDC to collaborate with USDA as the guidelines for this 
new program are established.
    Food Allergy.--The Committee encourages CDC to develop a 
comprehensive plan to provide healthcare providers with better 
information about food allergies. In addition, the Committee 
encourages CDC to collaborate with other relevant agencies to 
assure the broadest possible dissemination of the NIAID 
Guidelines for the Diagnosis and Management of Food Allergy.
    Healthy Communities.--The Committee strongly supports 
Healthy Communities as an important entry point into community 
chronic disease prevention. This program provides rural and 
urban communities with the foundational knowledge to make 
changes in environments that enhance healthy options, leading 
to improved health outcomes. With these small, one-time grants, 
communities have leveraged $3 for each Federal $1 and have 
sustained their work with technical assistance and resources 
they have secured.
    Heart Disease and Stroke.--The Committee notes that heart 
disease, stroke and other forms of cardiovascular disease 
continue to be the leading cause of death in the United States. 
The Committee remains supportive of CDC's Division for Heart 
Disease and Stroke Prevention, which provides public health 
leadership to improve cardiovascular health for all, as well as 
reduce the burden and eliminate disparities associated with 
heart disease and stroke. The Committee has included sufficient 
resources for the Division to continue its national heart 
disease and stroke evidence-based prevention and control 
programs and activities. They include the Paul Coverdell 
National Acute Stroke Registry and the ``ABCs'' initiative, 
which promotes appropriate low-dose aspirin therapy, improved 
high blood pressure and cholesterol control and prevention, and 
smoking avoidance and cessation. Also, the Division conducts 
prevention research and evaluation and works with communities, 
other Federal agencies, and food manufacturers to reduce sodium 
in food to help control heart disease and stroke. Further, the 
Division continues to develop a comprehensive national 
cardiovascular disease surveillance system to monitor and track 
heart disease, stroke, and their risk factors.
    Inflammatory Bowel Disease.--The Committee notes CDC's 
history of supporting epidemiology research on inflammatory 
bowel disease and encourages CDC to facilitate opportunities 
for renewed support of current research in this area within the 
Comprehensive Chronic Disease and Prevention Program. The 
Committee requests a report on progress made on this issue in 
the fiscal year 2013 congressional budget justification.
    Interstitial Cystitis.--The Committee has included funding 
to continue its interstitial cystitis education and awareness 
activities and requests an update in the fiscal year 2013 
congressional budget justification.
    Lupus.--The Committee remains committed to the objective of 
developing reliable epidemiological data on the incidence and 
prevalence of all forms of lupus among various ethnic and 
racial groups. The Committee has included sufficient funding to 
continue to expand the CDC National Lupus Patient Registry and 
address the epidemiological gaps among Hispanics/Latinos, Asian 
Americans and Native Americans. In addition, a cohort of 
registry patients will be established to further study long-
term outcomes, socioeconomic burdens and mortality associated 
with the disease.
    Office on Smoking and Health [OSH].--The Committee includes 
$208,685,000 for OSH, including $100,000,000 in transfers from 
the PPH Fund. The Committee is pleased that HHS has developed a 
strategic action plan for ending the tobacco epidemic and that 
CDC included tobacco as one of its priority ``winnable 
battles.'' The Committee has long recognized that efforts to 
reduce tobacco use are among the most effective and cost-
effective investments in prevention. Funding from OSH is 
particularly important in fiscal year 2012 because States have 
cut funding for tobacco prevention programs by 28 percent in 
the last 3 years and declines in high school smoking rates have 
slowed significantly in recent years, with 19.5 percent of high 
school students still smoking.
    Within the increase provided, the Committee intends that no 
less than $15,000,000 be used to support a media campaign to 
prevent and reduce tobacco use. In addition, the Committee has 
long supported cessation counseling through quitlines. This 
funding will grow in importance when the quitline number, 1-
800-QUIT-NOW, is included on the planned new, graphic warning 
labels on cigarette packages, which are scheduled to be 
implemented in September 2012.
    The Committee is pleased with the work of the Environmental 
Health Laboratory's effort to analyze tobacco products and 
cigarette smoke, and believes this work will become more 
important as the FDA continues to implement the Family Smoking 
Prevention and Tobacco Control Act. The Committee expects OSH 
to transfer no less than the amount it did in fiscal year 2011 
to the Environmental Health Laboratory. The Committee notes 
that this transfer is to be provided to the lab in a manner 
that supplements and in no way replaces existing funding for 
tobacco-related activities.
    Finally, the Committee is deeply concerned by the 
development and sale of new nicotine delivery products with 
flavors or shapes that simulate candy in an effort to target 
youth. Research by HHS has revealed that nearly 90 percent of 
tobacco users began smoking at or before age 18. As of 2009, 
there are 400,000 new underage daily smokers in this country 
each year--and roughly one-third of them will eventually die 
prematurely from smoking-caused disease. In addition to funds 
for media campaigns that aim to prevent youth smoking, the 
Committee has included bill language making $10,000,000 
available over a 2-year period for incentive grants to 
communities that succeed in reducing their youth nicotine 
consumption rate or that implement an evidence-based policy 
proven to reduce such rate.
    Oral Health.--The Committee is deeply concerned by CDC's 
plan to convert the Division of Oral Health to a branch. This 
action appears to counter the recent IOM report ``Advancing 
Oral Health in America,'' which recommended that oral health be 
given a high priority within HHS. The Committee is concerned 
that this reorganization has instead lowered the visibility and 
priority of the Division of Oral Health. The Committee urges 
CDC to reestablish the Division. Absent such a move, the 
Committee directs CDC to report to the Committee by January 1, 
2012, on how the oral health branch will be more effective in 
improving oral health in America, what steps CDC is taking to 
recruit and retain the high caliber staff that the Division 
employed, and how CDC intends to ensure that oral health is 
appropriately represented in leadership meetings at CDC.
    The Committee recognizes that reducing disparities in oral 
disease will require investments in proven prevention 
strategies at the State and local levels. The Committee 
strongly supports broad-based community programs that can 
result in significant cost savings. The Committee 
recommendation assumes that CDC will support grants to States 
at no less than last year's level to strengthen oral health 
infrastructure and community prevention programs. The Committee 
remains concerned about the high incidence of tooth decay among 
American Indian/Alaska Native [AI/AN] children and is pleased 
by the work CDC has done to support effective oral health 
messages in these communities. CDC is encouraged to continue 
pursuing collaborative efforts with the Indian Health Service 
and through the National Oral Health Surveillance System to 
assess early childhood caries [ECC] epidemiology in AI/AN 
children. The Committee encourages CDC to work with key 
external stakeholders to identify and fill strategic 
information gaps about age of onset, prevalence, severity and 
microbiology to improve and accelerate existing and novel 
approaches to prevent ECC.
    Pre-school Programs.--The Committee strongly supports 
efforts to build good nutrition and exercise habits early in 
life, to more effectively combat rising rates of childhood 
obesity. The Committee directs CDC to give priority within the 
Community Transformation Grants to interventions aimed at pre-
school populations.
    Prevention Research Centers.--The Committee recognizes the 
importance of a focus on prevention in improving health, 
especially in rural America where access to care may be 
limited, and the significant contributions to research on 
evidence-based approaches in health promotion by the Prevention 
Research Centers network of community, academic and public 
health partners. The Committee has included the resources 
necessary to support the Prevention Research Centers program at 
no less than last year's level so that this network of academic 
institutions and organizations can continue to contribute 
widely and effectively to prevention science.
    Psoriasis.--Approximately 7.5 million Americans are 
affected by psoriasis and/or psoriatic arthritis--chronic, 
inflammatory, painful, and disfiguring autoimmune diseases for 
which there are limited treatment options and no cure. The 
Committee is aware of evidence showing significant and costly 
co-morbidities associated with psoriasis, including heart 
attack, diabetes, Crohn's disease, cancer, obesity and 
cardiovascular disease. The Committee is pleased that CDC used 
funding provided in fiscal year 2010 to establish a blueprint 
for how to better understand psoriasis, examine the 
relationship of psoriasis to other serious diseases, develop 
public health strategies to reduce the burden of these diseases 
and prevent the onset of co-morbid conditions, and gain insight 
into the long-term impact of psoriasis and psoriatic arthritis.
    Safe Motherhood and Infant Health.--The Committee commends 
CDC for its research and evaluation efforts regarding 
stillbirths, pre-term births and sudden unexpected infant 
deaths [SUIDs]. CDC is urged to improve and expand national and 
State data systems to track these conditions and to expand 
epidemiological research that focuses especially on their 
causes and prevention.
    In addition to focusing on infant health, the Committee 
commends CDC for collecting information on maternal mortality 
through the Pregnancy Mortality Surveillance System.
    The Committee encourages the Safe Motherhood and Infant 
Health program to collaborate with the National Center for 
Health Statistics to explore how the implementation of the 
electronic death certificate might be used to expand the effort 
to collect information on pregnancy-related deaths, information 
about women's health and behaviors around pregnancy, and the 
translation of findings and guidelines on preconception care 
into everyday practice and healthcare policy.
    Sleep Disorders.--The Committee is pleased with the 
activities of the National Sleep Awareness Roundtable and 
encourages CDC to continue to promote awareness of the 
importance of sleep and sleep disorders.
    Small Business Wellness Grants.--The Committee 
recommendation transfers $10,000,000 from the PPH Fund to 
continue the small business wellness grant program at no less 
than last year's level. The Committee is aware of the struggle 
that small businesses face meeting the rising cost of health 
insurance premiums. For that reason, the Committee directs CDC 
to focus this program on small businesses, as authorized in 
section 10408 of the Patient Protection and Affordable Care 
Act.
    WISEWOMAN [Well-Integrated Screening and Evaluation for 
Women Across the Nation].--The Committee includes bill language 
stating that funding shall be available for making 
competitively awarded grants under section 1509 of the PHS Act 
to not less than 21 States, tribes or tribal organizations. 
WISEWOMAN serves uninsured and under-insured low-income women 
ages 40 to 64. This program helps these women avoid heart 
disease and stroke by providing preventive health services, 
referrals to local healthcare providers, as needed, and 
lifestyle counseling and interventions tailored to their 
identified risk factors to promote lasting, healthy behavior 
modifications. From July 2008 to June 2010, WISEWOMAN reached 
more than 70,000 low-income women. At their initial screening, 
89 percent of these women had at least one risk factor and 28 
percent had three or more risk factors for heart disease and 
stroke.

     NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, 
                         DISABILITY AND HEALTH

    The Committee includes $138,072,000 for birth defects, 
developmental disabilities, disability and health in fiscal 
year 2012. The comparable level for fiscal year 2011 was 
$136,072,000 and the fiscal year 2012 budget request was 
$143,899,000.
    The Committee has rejected the consolidation proposed in 
the fiscal year 2012 budget for disability initiatives in the 
National Center on Birth Defects and Developmental Disabilities 
[NCBDDD] out of concern that the progress that has been made on 
behalf of people with disabilities would be lost in the 
proposed structure. Should the administration decide to put 
forward a similar request in fiscal year 2013, the Committee 
encourages CDC to ensure that it is accompanied by a needs 
assessment that includes the categories of disabilities 
currently served, validates the value of such a consolidation, 
considers the input of stakeholders and establishes the basis 
for any proposed efficiencies and commonalities.
    Within the total provided, the following amounts are 
provided for the following categories of funding:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Craniofacial Malformation.......................................           1,809           (\1\)           1,809
Fetal Death.....................................................             808           (\1\)             808
Fetal Alcohol Syndrome..........................................           9,891           (\1\)           9,891
Folic Acid......................................................           2,795           (\1\)           2,795
Infant Health...................................................           7,925           (\1\)           7,925
Autism..........................................................          21,380          23,778          21,380
Limb Loss.......................................................           2,836           (\1\)           2,836
Tourette Syndrome...............................................           1,701           (\1\)           1,701
Early Hearing Detection and Intervention........................          10,672           (\1\)          10,672
Muscular Dystrophy..............................................           5,865           (\1\)           5,865
Paralysis Resource Center.......................................           6,739           (\1\)           6,739
Attention Deficit Hyperactivity Disorder........................           1,718           (\1\)           1,718
Fragile X.......................................................           1,684           (\1\)           1,684
Spina Bifida....................................................           5,812           (\1\)           5,812
Congenital Heart Failure........................................  ..............  ..............           2,000
Hemophilia......................................................          16,670           (\1\)          16,670
Thallasemia.....................................................           1,861           (\1\)          1,861
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.

    Congenital Heart Disease.--Approximately 800,000 children 
and 1,000,000 adults in the United States are now living with 
congenital heart disease [CHD], which requires life-long 
cardiac care. The Committee is concerned that there is a lack 
of rigorous epidemiological and longitudinal data on 
individuals of all ages with CHD and has included funding to 
begin to compile this information. The Committee is 
particularly interested in information on prevalence, barriers 
to effective care, survival outcomes and neuro-cognitive 
outcomes.
    Craniofacial Malformation.--The Committee commends the work 
that CDC has done on craniofacial malformation. In particular, 
the Committee is pleased with the goals and scope of work 
included in fiscal year 2011 grant competition and has included 
funding to continue that work. In addition, the Committee is 
impressed by the results of the March 2010 conference in 
Atlanta and would support a follow up conference, if funds are 
available.
    Duchenne Muscular Dystrophy [DMD].--The Committee commends 
CDC for developing the DMD Care Considerations. The Care 
Considerations serve as a milestone for the DMD community, as 
they provide a framework for recognizing the multisystem 
primary manifestations and secondary complications of DMD and 
for providing coordinated multidisciplinary care to improve the 
lives of those individuals living with DMD. The Committee 
encourages CDC to continue its work to enhance the Care 
Considerations by convening a meeting of scientific experts to 
identify what gaps still exist in the current guidelines and 
additional areas where further research is critical. Following 
the completion of the expert meeting, CDC is encouraged to 
publish the areas of consensus from the meeting.
    Fragile X-Associated Disorders [FXD].--The Committee 
encourages CDC to focus its efforts on identifying ongoing 
needs, effective treatments and positive outcomes for families 
through epidemiological research, surveillance, screening and 
the promotion of early interventions and supports for 
individuals living with FXD. The Committee commends CDC for its 
efforts to establish the Fragile X Clinical & Research 
Consortium. The Committee encourages CDC to work with the 
National Institute of Child Health and Human Development to 
consolidate and coordinate Federal investments in data 
collection efforts related to Fragile X. Additionally, the 
Committee encourages CDC to focus on improving access to 
clinical services for underserved populations and to 
effectively disseminate information on promising practices 
related to diagnosis and early intervention to healthcare 
entities working with underserved populations.
    Hemophilia.--The Committee has included sufficient funding 
to maintain the Center's hemophilia programs, particularly the 
surveillance, prevention and wellness activities of the 
hemophilia treatment centers. The comprehensive care provided 
by the network of hemophilia treatment centers has resulted in 
reduced morbidity and mortality rates for individuals with 
hemophilia and is a model system for caring for other high-
cost, chronic conditions.
    Hereditary Angioedema [HAE].--The Committee is concerned by 
the high rate of fatalities caused by undiagnosed or 
misdiagnosed HAE. The Committee encourages CDC to support 
efforts to increase awareness and education of HAE among 
healthcare providers and the general public.
    Hereditary Hemorrhagic Telangiectasia [HHT].--The Committee 
encourages CDC to develop a sentinel network of surveillance 
utilizing HHT Centers that are currently co-located with 
Hemophilia Treatment Centers [HTCs]. The Committee hopes that 
the existing infrastructure at the HTCs can be used to collect 
data and conduct surveillance on HHT. The committee also 
encourages CDC to increase outreach and education to the public 
and health care professionals accessed by HHT patients.
    Infant Health.--The Committee is concerned by the lack of 
information available to pregnant women and their health care 
providers about the safety of various prenatal exposures that 
may be associated with birth defects or other health risks. 
These exposures range from prescription medicines to daily 
household products. The Committee requests a report no later 
than 180 days after enactment of this act on the current state 
of information and how CDC can work with States and 
stakeholders to improve access to this vital information.
    Intellectual Disabilities.--The Committee is aware of a 
growing body of evidence concluding that children and adults 
with mobility limitations and intellectual or learning 
disabilities face a high risk of obesity and other harmful 
health conditions. CDC is commended for its leadership in 
screening, referrals, research, epidemiological, preventative 
services, training, and other essential health services to the 
disability community. The Committee is particularly concerned 
about the lack of access to screening and preventative services 
within the growing population of people with intellectual 
disabilities. The Committee has included sufficient funding for 
CDC to extend screening and other preventative health services 
to address health disparities in this at-risk population.
    Maternal Infections.--The Committee encourages CDC to 
continue its activities to prevent Cytomegalovirus [CMV] 
infection among women. These activities should include research 
to address gaps in knowledge, and the development of tools to 
prevent and reduce disease burden and disability from CMV in 
infants born to mothers with CMV infection. Research directed 
at congenital CMV prevention strategies will allow CDC to 
better understand how to prevent CMV transmission during 
pregnancy, support prenatal and newborn CMV testing and 
intervention for infants born to women with CMV infection, and 
work with providers on recommendations for CMV and infection 
during pregnancy. The Committee encourages CDC to develop 
evidence-based guidance to prevent congenital CMV and to 
continue research for more effective interventions, including 
longer-range options such as vaccines, aimed at preventing 
congenital CMV and reducing disease burden among children born 
to women with CMV infection during pregnancy.
    Marfan Syndrome.--Many people affected by Marfan syndrome, 
a genetic connective tissue disorder that can result in sudden 
loss of life from aortic dissection, remain undiagnosed or 
misdiagnosed until they experience a cardiac complication. The 
Committee encourages CDC to increase awareness of this disease 
among the general public and healthcare providers.
    Spina Bifida.--The Committee encourages CDC to work with 
the FDA to establish folic acid fortification levels of corn 
products grown and consumed both domestically and 
internationally to ensure that women of child-bearing age 
benefit from the advantages of folic acid contained in enriched 
foods. The Committee also recommends continued support of a 
data collection initiative to improve the efficacy and quality 
of care.

                   PUBLIC HEALTH SCIENTIFIC SERVICES

    The Committee recommendation includes a program level of 
$465,564,000 for Public Health and Scientific Services. The 
budget request for fiscal year 2012 was $493,616,000. The 
fiscal year 2011 comparable funding level was $467,564,000. The 
Committee recommendation includes $70,000,000 in transfers from 
the PPH Fund and $247,769,000 in transfers available under 
section 241 of the PHS Act.
    The Center for Public Health and Scientific Services 
includes funding for the National Center for Health Statistics 
[NCHS]; the Offices of Surveillance, Epidemiology and Public 
Health Informatics; and Public Health Workforce Development.
    The Committee recommendation includes funding for each of 
these programs to continue at no less than last year's level.
    The Committee requests a report to Congress no later than 
120 days after enactment of this act that details CDC's various 
internal laboratory activities and associated funding levels.
    Preserving Integrity of Seminal Surveys.--The Committee 
encourages NCHS to fully support its ongoing seminal health 
surveys, in particular the National Health Interview Survey and 
National Health and Nutrition Examination Survey. The Committee 
urges NCHS to protect these core surveys without comprising 
data quality or accessibility, particularly with regard to 
minority populations.
    Sexual and Gender Identity Inclusion in Health Data 
Collection.--The Committee encourages CDC to consider expanding 
the National Health Interview Survey to include questions 
relating to sexual orientation and gender identity to better 
enable government agencies to understand and meet the unique 
health needs of lesbian, gay, bisexual, and transgender 
individuals.
    Standardized Obesity Measurements.--The Committee is 
strongly supportive of the 2010 Institute of Medicine 
recommendation in ``For the Public's Health: The Role of 
Measurement in Action and Accountability'' that calls on CDC to 
develop a standardized set of measurements for obesity 
reduction and other public health programs. A standardized set 
of measurements would provide the Federal Government and other 
grant-making institutions with a consistent way to evaluate and 
compare the effectiveness and outcomes of obesity-reduction 
programs and other public health initiatives. The Committee 
urges NCHS to undertake this effort, in consultation with State 
and local health departments, medical and public health 
professional associations, charitable foundations, the academic 
and research communities, and other nonprofit and community-
based organizations.
    Task Force on Community Preventive Services.--The Committee 
recommendation includes $11,800,000 for the task force, 
including $10,000,000 in transfers from the PPH Fund.
    Vital Statistics.--Vital statistics provide complete and 
continuous data on births, deaths and fetal deaths that are 
essential for understanding our Nation's health. The Committee 
encourages CDC to obtain data items currently collected by 
States and territories and collect 12 months of these data 
within the calendar year.
    Vital Statistics Infrastructure.--The Committee understands 
that not all States and territories have adopted the more 
comprehensive 2003 standard certificates of births and deaths, 
which have the potential to expand the scope and quality of 
vital statistics collected on a national basis. The Committee 
urges NCHS to sustain the National Vital Statistics System to 
support States and territories in implementing these 
certificates and modernizing their infrastructure to collect 
these data electronically.

                NATIONAL CENTER FOR ENVIRONMENTAL HEALTH

    The Committee recommends $105,855,000 for Environmental 
Health in fiscal year 2012. The fiscal year 2011 comparable 
funding level was $134,855,000 and the budget request for 
fiscal year 2012 was $128,715,000.
    In addition, $35,000,000 is provided in transfers from the 
PPH Fund for the Environmental Health Tracking Network, the 
same level as was transferred in fiscal year 2011.
    Many modern public health successes can be traced to 
innovations in environmental health practices. However, 
emerging pathogens and environmental toxins continue to pose 
risks to our health and significant challenges to public 
health. The task of protecting people's health from hazards in 
their environment requires a broad set of tools. First among 
these tools are surveillance and data collection to determine 
which substances in the environment are getting into people and 
to what degree. It also must be determined whether these 
substances are harmful to humans and at what level of exposure.
    The Committee recommendation includes funding for the 
following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Volcanic Emissions Research.....................................             197           (\1\)             197
Amyotrophic Lateral Sclerosis Registry..........................           5,903           (\1\)           5,903
Built Environment and Health Initiative.........................           2,634           (\1\)           2,634
Asthma..........................................................          27,444  ..............          27,444
Healthy Homes/Childhood Lead Poisoning..........................          29,257  ..............  ..............
Healthy Home and Community Environments.........................  ..............          32,674  ..............
----------------------------------------------------------------------------------------------------------------
\1\Not applicable.

    Amyotrophic Lateral Sclerosis [ALS].--The Committee 
strongly supports the efforts of CDC and the Agency for Toxic 
Substances and Disease Registry [ATSDR] to maintain and enhance 
the National ALS Registry. The Committee intends the data 
collected in the registry to be used by researchers to advance 
the research into the cause, treatment and cure for ALS. CDC/
ATSDR is encouraged to continue to collaborate with the ALS 
community in exploring additional ways in which the registry 
can support the ALS scientific and patient communities. The 
Committee is particularly supportive of the addition of a 
biorepository component and the development of strategies that 
can enhance clinical trials and clinical trial enrollment.
    Asthma.--The Committee is concerned that CDC's proposal to 
consolidate the asthma program with the Healthy Homes/Childhood 
Lead Poisoning Program would jeopardize the Federal response to 
asthma at a time when asthma rates are rising. Asthma is a 
large public health problem in the country, affecting 25 
million Americans, of whom 7 million are children. The 
Committee supports science-based, effective asthma 
interventions and management implemented by the National Asthma 
Control Program. The Committee directs CDC to continue its 
support of the program, its approach to asthma control, its 
community partners and its successful interventions.
    Biomonitoring.--The Committee strongly supports quality 
assurance in current biomonitoring program efforts aimed at 
ensuring that results are accurate and comparable across the 
many different State programs. CDC is encouraged to explore the 
feasibility of developing reference methods and materials for 
several cardiovascular disease biomarkers, including 
apolipoprotein B, high-sensitivity C-reactive protein, small 
LDL and troponion. The Committee recognizes both the need for 
reference methods for these biomarkers and the potential return 
on investment in the form of cost savings for Federal health 
care programs, like Medicare and Medicaid, and other programs.
    Blood Lead Proficiency Testing.--The Committee encourages 
CDC to collaborate with the Health Resources and Services 
Administration to ensure continued support for the National 
Blood Lead Proficiency Testing Program. Since 1988, this 
program has played an important role in combating childhood 
lead poisoning by assuring and improving the accuracy of lead 
poisoning screenings.
    Environmental Health Tracking Network.--The National 
Tracking Network was launched in July 2009, and CDC continues 
to expand the quality and quantity of health and environmental 
information and data available through the network. The network 
includes data for cancer, reproductive health outcomes, birth 
defects, demographics, socioeconomic status, outdoor air 
quality, drinking water quality, hospitalizations for asthma, 
cardiovascular disease, carbon monoxide poisoning and childhood 
lead poisoning.
    The Committee is aware of research suggesting that many 
diseases and conditions with rising rates may have 
environmental triggers. The Committee directs CDC to work with 
NIH and the ALS Registry to explore how the Environmental 
Health Tracking Network could map and help researchers evaluate 
potential environmental risk factors to autoimmune diseases, 
neurodegenerative diseases and autism.
    In addition, the Committee encourages CDC to develop a wide 
variety of baseline community health data that will be tracked 
over time. As drilling for natural gas increases across the 
Nation, this information will allow communities to monitor the 
impact of current and future drilling sites on the health of 
individuals living nearby.
    Healthy Homes and Lead Poisoning Prevention Program.--The 
Committee commends CDC for preventing approximately 100,000 
children from being poisoned by lead each year through the 
Healthy Homes and Lead Poisoning Prevention Program. The 
Committee has not included funding for this program in fiscal 
year 2012. The Committee is aware of nurse home visiting 
programs in New York State, Rhode Island, and Oklahoma that 
have adopted healthy homes activities as part of their 
programming. This integrative approach of identifying and 
preventing environmental health and safety hazards in the homes 
of high-risk pregnant mothers and their babies is a cost-
effective and efficient strategy for preventing disease and 
injury among the Nation's most vulnerable families. The 
Committee notes that $350,000,000 will be spent by DHS to 
conduct home visiting programs in fiscal year 2012 through the 
Maternal, Infant, and Early Childhood Home Visiting Program; 
this funding appropriated by the Patient Protection and 
Affordable Care Act, is $100,000,000 more than the fiscal year 
2011 level. The Committee intends the Health Resources and 
Services Administration and CDC to work together to ensure that 
activities previously funded through Healthy Homes will be 
fully incorporated into the Home Visiting Program.
    Newborn Screening Quality Assurance Program.--The Committee 
continues to support quality assurance efforts in the Nation's 
newborn screening program. CDC is commended for providing 
training, consultation, guidelines, proficiency testing and 
reference materials to nearly 500 laboratories responsible for 
newborn screening and conducts research on new tests.

           NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL

    The Committee recommends $129,714,000 for injury prevention 
and control activities at CDC and an additional $3,000,000 in 
transfers from the PPH Fund. The comparable fiscal year 2011 
funding level was $143,714,000. The budget request for 2012 was 
$147,501,000. The administration also requested $20,000,000 in 
transfers from the PPH Fund.
    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 non-occupational 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 recommendation includes $6,039,000 for 
Traumatic Brain Injury programs, $10,522,000 for the Injury 
Control Centers, $5,423,000 for Domestic Violence Community 
Projects and $3,479,000 for the National Violent Death 
Reporting System, the same as the comparable fiscal year 2011 
levels. The Committee has included $44,474,000 for rape 
prevention activities, compared to $39,474,000 in fiscal year 
2011. The Committee has not included funding for youth violence 
prevention programs, funded at $19,708,000 in fiscal year 2011.
    Falls Prevention Interventions.--The Committee has included 
$3,000,000 from the PPH Fund to expand older adult falls 
prevention activities at CDC, in coordination with the 
Administration of Aging [AOA]. The Committee intends that CDC 
use the funding to conduct research to evaluate and disseminate 
the most effective fall prevention interventions and that AOA 
use the funding provided that agency to conduct outreach and 
demonstration programs to expand the implementation of 
effective interventions.
    In addition, the Committee is aware that osteoporosis is a 
chronic condition that puts individuals at risk for more 
serious injuries in a fall. The Committee encourages CDC to 
develop an education and outreach plan in consultation with the 
patient and medical community to focus public health strategies 
on osteoporosis.
    Violence Against Women.--The Committee applauds CDC's 
development of the National Institute Partner and Sexual 
Violence Surveillance System to monitor State and national 
trends and to inform public policies and prevention strategies. 
The Committee urges more research on the psychological impact 
of violence against women in order to increase and improve 
evidence-based interventions to support the recovery of women 
from the trauma of violence.
    Youth Violence Prevention.--The Committee remains 
supportive of efforts to reduce youth violence through 
evidence-based prevention strategies. The Committee notes that 
the Office of Juvenile Justice and Delinquency Prevention 
Programs [OJJDP] at the Department of Justice conducts a 
comprehensive suite of prevention programs aimed at youth in 
high-risk categories and exhibiting high-risk behaviors. The 
Committee urges CDC to continue providing technical assistance 
to OJJDP with the data gained from the National Violent Death 
Reporting System and other surveillance activities.

                     OCCUPATIONAL SAFETY AND HEALTH

    The Committee recommends a program level of $295,079,000 
for occupational safety and health programs, including 
$106,724,000 in transfers available under section 241 of the 
PHS Act. The comparable fiscal year 2011 program level was 
$316,079,000, and the budget request for fiscal year 2012 was 
$259,934,000, entirely funded through transfers available under 
section 241 of the PHS Act.
    The CDC's National Institute for Occupational Safety and 
Health [NIOSH] is the only Federal agency responsible for 
conducting research and making recommendations for the 
prevention of work-related illness and injury. The NIOSH 
mission spans the spectrum of activities necessary for the 
prevention of work-related illness, injury, disability and 
death by gathering information, conducting scientific 
biomedical research (both applied and basic) and translating 
the knowledge gained into products and services that impact 
workers in settings from corporate offices to construction 
sites to coal mines. The Committee recommendation includes 
funding for the following activities at the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Education and Research Centers..................................          24,321  ..............          24,321
Healthier Workforce Center......................................           5,026  ..............           5,026
National Occupational Research Agenda [NORA]....................         111,367         101,528         111,367
    Budget Authority............................................          19,643  ..............           4,643
    PHS Evaluation Transfers....................................          91,724         101,528         106,724
Mining Research.................................................          52,687  ..............          52,687
Miners Choice...................................................             647  ..............             647
----------------------------------------------------------------------------------------------------------------

    Cost Efficiency.--The Committee strongly encourages NIOSH 
to continue to use existing Federal research facilities and 
Federal property to conduct its existing research programs. The 
Committee recognizes the advantages of using existing federally 
owned property to fulfill NIOSH's mandate and believes this 
approach will help NIOSH realize the most efficient use of 
Federal funds possible.
    Education and Research Centers [ERCs].--The Committee 
directs CDC to spend no less than last year for ERCs.
    National Occupational Research Agenda [NORA].--The 
Committee directs CDC to spend no less than last year for the 
Agriculture, Forestry and Fishing Program within the National 
Occupational Research Agenda.
    World Trade Center Health Program.--In the 10 years since 
September 11, this Committee was responsible for appropriating 
$408,000,000 in discretionary funding for the World Trade 
Center Health Program. This funding made it possible to screen 
56,000 workers who risked their lives after the World Trade 
Center attack and treat 18,000 who required medical care. 
Discretionary funds are no longer needed because of mandatory 
funding appropriated in the James Zadroga 9/11 Health and 
Compensation Act of 2010. From this point forward, all of the 
treatment costs previously borne by the discretionary 
appropriation will be funded through Zadroga Act funding.

                             GLOBAL HEALTH

    The Committee recommends $350,265,000 for global health-
related activities at CDC in fiscal year 2012. The fiscal year 
2011 comparable level was $340,265,000 and the budget request 
for fiscal year 2012 was $381,245,000.
    The Center for Global Health leads international programs 
and coordinates CDC's global efforts funded out of other 
centers with the goal of promoting health and preventing 
disease in the United States and abroad, including ensuring 
rapid detection and response to emerging health threats. The 
Committee recommendation includes funding for the following 
activities in the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Global AIDS Program.............................................         118,741         118,023         118,741
Global Immunization Program.....................................         150,854         163,602         160,854
    Polio Eradication...........................................         101,597         112,441         111,597
    Measles and Other Vaccine Preventable Diseases..............          49,257          51,161          49,257
Global Disease Detection and Emergency Response.................          41,902          44,191          41,902
Parasitic Diseases and Malaria..................................          19,467          19,643          19,467
Global Public Health Capacity Development.......................           9,301          35,786           9,301
----------------------------------------------------------------------------------------------------------------

    Global Immunization Activities.--The bill provides not less 
than $111,597,000 for CDC's global polio eradication 
activities. The Committee strongly supports the dramatic 
progress being made in the international partnership to 
eradicate polio. Although resources are limited, the Committee 
is well aware of the aligning of technical skill, vaccine 
availability and strong country engagement taking place in the 
four countries still plagued by this disease. The Committee 
encourages CDC and its partners to take advantage of this 
historic opportunity.
    Hepatitis B.--The Committee continues to encourage CDC to 
consider expanding global programs to increase the rate of 
vaccination, reduce mother-child transmission and promote 
educational programs to prevent hepatitis B and to reduce 
discrimination targeted against individuals with the disease.
    Parasitic Diseases and Malaria.--The Committee is pleased 
with the CDC's ongoing efforts to fight global malaria and 
neglected tropical diseases through the Center for Global 
Health. Despite progress, much still needs to be done to 
address malaria and neglected topical diseases [NTDs] on a 
global scale. In 2009 more than 700,000 people died from 
malaria. NTDs, including enteric diseases, continue to affect 
more than 1 billion people worldwide. CDC research plays an 
essential role in the continued progress towards control and 
elimination efforts of global malaria and NTDs. The Committee 
encourages CDC to continue its research, monitoring and 
evaluation efforts for malaria and NTDs and its collaboration 
with other agencies as part of the Global Health Initiative.
    Product Development Partnerships [PDPs].--PDPs enable 
critical research and development in the global health arena 
while creating jobs in the United States. The Committee 
encourages CDC to cultivate public-private partnerships like 
PDPs and to work in collaboration with the National Institutes 
of Health and U.S. Aid for Institutional Development to 
identify and pursue other innovative research and development 
opportunities.

                PUBLIC HEALTH PREPAREDNESS AND RESPONSE

    The Committee recommends $1,405,416,000 for public health 
preparedness and response activities. The fiscal year 2011 
level was $1,415,416,000. The amount requested by the 
administration in fiscal year 2012 was $1,452,618,000. The 
recommendation includes $30,000,000 in transfers from Public 
Law 111-32, as requested by the administration. The comparable 
fiscal year 2011 transfer level is $68,515,000. The Committee 
recommendation includes funding for the following activities in 
the following amounts:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
State and Local Preparedness and Response Capability............         664,294         651,048         654,294
    Public Health Emergency Preparedness Cooperative Agreement           632,861         643,264         632,861
     Program (non-add)..........................................
CDC Preparedness and Response Capability........................         160,121         146,570         160,121
Strategic National Stockpile....................................         591,001         655,000         591,001
----------------------------------------------------------------------------------------------------------------

    Centers of Excellence.--The Committee supports the work of 
the Preparedness and Emergency Response Learning Centers and 
the Advanced Practice Centers. These centers provide training 
and support for the public health system to prepare for, 
respond to, and recover from public health emergencies. The 
Committee encourages CDC to support these centers to the extent 
of CDC's ability.
    Public Health Emergency Preparedness.--The cooperative 
agreement provides funding to enable public health departments 
to have the capacity and capability to effectively respond to 
the public health emergencies consisting of terrorist threats, 
infectious disease outbreaks, natural disasters, and 
biological, chemical, nuclear, and radiological emergencies.
    Strategic National Stockpile.--The Committee is concerned 
that prior to the 2009 H1N1 influenza pandemic, the Strategic 
National Stockpile [SNS] contained only enough needles and 
syringes to immunize between 5 and 10 percent of the 
population. Stockpiling is an efficient means of preparedness 
for drug delivery devices and other medical supplies because 
these are generally low-cost products with long shelf-lives. 
The Committee requests a professional judgment recommendation 
as to the level of funding needed to acquire an adequate supply 
of these drug delivery devices.
    In addition, the Committee encourages CDC to continue 
efforts to ensure that vaccines, medications, and equipment in 
the SNS are replenished and upgraded as needed. In particular, 
the Committee encourages CDC to review the supply of antiviral 
medications remaining since the H1N1 outbreak, including a 
review of the supply in light of the needs of special 
populations, such as children.

                  PUBLIC HEALTH LEADERSHIP AND SUPPORT

    The Committee provides $121,419,000 for public health 
leadership and support activities at CDC, the same as the 
fiscal year 2011 comparable level. The budget request for 
fiscal year 2012 was $121,368,000.
    In addition, the Committee includes $41,200,000 in 
transfers from the PPH Fund, the same as was transferred in 
fiscal year 2011.
    Throughout CDC's accounts, the Committee has granted 
additional flexibility for CDC to respond to challenging budget 
times. The Committee does not expect that this flexibility will 
be used to reduce transparency on CDC's expenditure of funds 
appropriated in this bill. The Committee directs that CDC 
include summaries of programmatic activities consistent with 
the fiscal year 2011 operating plan level, along with the 
associated funding levels in the annual congressional 
justification, beginning in fiscal year 2014. These summaries 
should include a short description of the nature of CDC's work 
on a particular subject, the number of grants made, the average 
grant size, and a State-by-State table for any formula-based 
funding. The Committee understands that the fiscal year 2013 
justification is already in draft form; therefore, the 
Committee expects an operating plan 90 days after enactment of 
this act that details spending levels for all CDC budget lines 
included in the Senate Committee report accompanying the fiscal 
year 2011 Appropriations Act for Labor, Health and Human 
Services, and Education and Related Agencies (S. Rpt. 111-243).
    Extramural Research.--The Committee requests a report from 
CDC by March 1 of each year that details the breakdown of 
intramural and extramural funding for each program of the 
various offices and centers at CDC. The Committee believes that 
the balance between intramural and extramural funding is an 
important measure for assessing and understanding how the 
agency is meeting its national and State responsibilities.
    Institutional Research Training Grant Program.--The 
Committee encourages CDC to continue the Institutional Research 
Training Grant Program.
    Leadership and Management Savings.--The Committee strongly 
believes that as much of CDC's of funding as possible should go 
to programs and initiatives that improve the health and safety 
of Americans. To facilitate this goal, any savings in 
leadership and management may be reallocated to the Director's 
Discretionary Fund upon notification of the Committee.
    Public Health Infrastructure.--The Committee recommendation 
transfers $40,200,000 from the PPH fund, the same level as in 
fiscal year 2011, to continue the Strengthening Public Health 
Infrastructure for Improved Health Outcomes program. These 
resources are intended to support State, local, tribal, and 
territorial health departments to ensure that the systems 
supporting public health services are robust and efficient, 
including workforce capacity and competency; laboratory 
systems; health information and systems, as well as health 
information analysis for decisionmaking; communications; legal 
authorities; financing; organizations capacity; and other 
related activities.

           PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT

    The Committee does not provide funding for the Preventive 
Health and Health Services block grant [PHHSBG], in accordance 
with the administration proposal for fiscal year 2012. The 
fiscal year 2011 comparable level was $80,094,000.
    For over 30 years, this block grant has supported States in 
improving their response to critical public health needs. The 
Committee has regretfully accepted the administration's 
recommendation to eliminate this program in light of the 
overlap between this grant and other funds being awarded to 
States throughout this bill.
    The Committee is aware that over 10 percent of PHHSBG 
funding has been used to support national rape prevention 
activities. The Committee has included additional funding for 
this purpose in the National Center for Injury Prevention and 
Control.
    An additional 40 percent of PHHSBG funds have been used for 
activities related to chronic diseases. The Committee has 
provided a total of $329,582,000 in this bill to States for 
these purposes through various grant programs, including 
Community Transformation State grants in the PPH Fund and CDC's 
grant programs for diabetes; heart disease and stroke; 
comprehensive cancer grants; and nutrition, physical activity 
and obesity.
    PHHSBG has also provided States with flexible funding to 
shore up critical infrastructure needs of their public health 
departments. The Committee has included $40,200,000 from the 
PPH Fund for the Strengthening Public Health Infrastructure for 
Improved Health Outcomes program, which allows States to 
provide many of the same activities covered by PHHSBG. State 
health departments can use this flexible funding source to 
improve their systems that support public health services, 
including workforce capacity and competency; laboratory 
systems; health information and systems, as well as health 
information analysis for decision making; communications; legal 
authorities; financing; organizations capacity; and other 
related activities.

                     BUSINESS SERVICES AND SUPPORT

    The Committee provides $427,026,000 for business services 
support functions including costs relating to buildings and 
facilities. The administration request for fiscal year 2012 was 
$447,466,000. The fiscal year 2011 comparable level was 
$362,026,000. These funds will be used to support agency-wide 
support functions.
    Due to budgetary constraints, the Committee is unable to 
provide the full President's budget request for these costs. 
For that reason, the Committee has included bill language to 
allow CDC to begin creating a Working Capital Fund [WCF] to 
achieve greater cost efficiencies across the administrative 
operations of the agency. The Committee directs CDC to create a 
strong auditing system for the WCF and brief the Committee on 
controls CDC will put in place to ensure that WCF funds are 
used solely for administrative costs and that CDC Centers and 
Offices are not over-charged for services.

                     National Institutes of Health

    The Committee recommends an overall funding level for the 
National Institutes of Health [NIH] of $30,498,288,000. The 
budget request for NIH activities within the jurisdiction of 
this bill is $31,747,915,000 and the fiscal year 2011 level is 
$30,688,288,000.
    The Committee regrets that fiscal constraints prevent a 
higher recommended funding level for NIH. With tight budgets 
likely to continue for the foreseeable future, the Committee 
strongly urges NIH to explore creative ways to rethink the way 
it allocates its funding. The alternative--continuing to nick 
away, little by little, at the success rate or the size of 
awards--will inevitably have a negative impact on young 
investigators, who represent the Nation's future, and on high-
risk, high-reward research opportunities.
    The Committee credits NIH with making significant efforts 
in both of these priority areas despite relatively flat budgets 
in recent years. With the help of the New Innovator Award and 
Pathway to Independence Award programs, NIH funded more new 
investigators in 2010 than in any year before. The 
Transformative Research Projects Program, meanwhile, rewards 
exceptionally innovative ideas. The Committee encourages NIH to 
continue and expand on these initiatives.
    The creation of the National Center for Advancing 
Translational Sciences [NCATS], proposed by the administration 
and endorsed in the Committee recommendation, is an even more 
far-reaching example of how NIH can refocus its mission in a 
difficult fiscal environment. This bill creates NCATS, 
abolishes the National Center for Research Resources [NCRR] and 
redistributes existing NCRR programs throughout other 
Institutes and Centers [ICs]. With the exception of $20,000,000 
for the new Cures Acceleration Network, all of the changes 
involved in this restructuring are budget neutral.
    The mission of NCATS is nothing less than fundamentally 
changing the way NIH pursues the translation of basic science 
into treatments and cures. The average length of time from 
target discovery to FDA approval of a new drug is 14 years, a 
delay that is costing lives and prolonging human suffering.
    NCATS will study steps in the therapeutics development and 
implementation process, consult with experts in academia and 
the biotechnology and pharmaceutical industries to identify 
bottlenecks in the processes that are amenable to re-
engineering, and develop new technologies and innovative 
methods for streamlining the processes. In order to evaluate 
these innovations and new approaches, NCATS will undertake 
targeted therapeutics development and implementation projects. 
In all of these efforts, the Committee expects that NCATS will 
complement, not compete with, the efforts of the private 
sector.
    While the Committee welcomes the creation of NCATS, it was 
disappointed by the way the administration requested it. The 
President's proposed budget for fiscal year 2012 included a 
vague description of NCATS but did not formally request funding 
for the restructuring or provide any details about which 
components of NIH would be consolidated into the new Center. 
The failure to do so caused unnecessary uncertainty about the 
proposal and contributed to the impression that it was being 
rushed.
    Lessons learned with NCATS should guide NIH as it considers 
another proposed restructuring, one that would involve 
consolidating NIDA, NIAAA and components of other ICs into a 
new Institute devoted to research on substance use, abuse and 
addiction. The Committee understands that NIH plans to adopt a 
more deliberate approach in evaluating the need for this 
Institute. The Committee strongly recommends that if the 
administration ultimately decides to seek such a restructuring, 
it should provide sufficient details in a formal budget request 
to Congress.

                       NATIONAL CANCER INSTITUTE

Appropriations, 2011....................................  $5,058,577,000
Budget estimate, 2012...................................   5,196,136,000
Committee recommendation................................   5,001,623,000

    The Committee recommends an appropriation of $5,001,623,000 
for the National Cancer Institute [NCI]. Of this amount, 
$8,000,000 is available for repairs and improvements to the NCI 
facility in Frederick, Maryland. The budget request for fiscal 
year 2012 is $5,196,136,000 and the comparable level for fiscal 
year 2011 is $5,058,577,000.
    Breast Cancer.--The Committee notes that triple-negative 
breast cancer is poorly understood and has a disproportionate 
prevalence among African-American women. The Committee 
encourages NCI to increase research and awareness of this 
disease, and to advance prevention, detection, diagnosis, care, 
and treatment. The Institute is urged to collaborate with ORWH, 
NIMHD, the Office of Minority Health, and the Office of Women's 
Health in these efforts.
    Health Decisionmaking.--The Committee commends NCI for its 
efforts to understand how the ability to comprehend and use 
numerical information affects health decisionmaking, as low 
numerical skills may not only distort perception of risks and 
impair risk communication, but may also impede treatment.
    Health Services Research.--The Committee commends NCI for 
its efforts to determine how well state-of-the-art cancer care 
is actually delivered. Ongoing health services data collection 
and surveillance programs represent an important contribution 
to cancer surveillance and the efforts to understand and 
improve clinical and community practices. NCI is strongly urged 
to maintain support for ongoing activities that advance cancer 
prevention and early detection research, including data 
collection infrastructure that can contribute to measuring the 
delivery and outcome of services, and comparative effectiveness 
research.
    Liver Cancer.--The Committee urges NCI to increase its 
efforts in the area of liver cancer, particularly by creating a 
Specialized Program of Research Excellence [SPORE] for this 
disease and by funding projects focusing on pathogenesis, 
detection and/or therapeutics.
    Lung Cancer.--The Committee remains concerned by the high 
morbidity and mortality rates of lung cancer, particularly the 
increased lung cancer rates among women and the high incidence 
among African-American men. NCI is urged to enhance support for 
research in these areas.
    Melanoma.--The Committee urges more research on melanoma 
that will identify and develop molecular markers to aid 
accurate diagnosis of the primary tumor; prognostication that 
will determine extent and type of treatment; and prediction of 
treatment response. The Committee commends NCI for the 
inclusion of melanoma in The Cancer Genome Atlas; however, in 
view of the relative scarcity of melanoma biospecimens 
available for this effort, additional resources are needed to 
facilitate specimen collection. Given the rising incidence 
rates of melanoma, the Committee encourages NCI to support 
research directed at the biology of tumor initiation including 
UV radiation as a carcinogen, host risk factors and risk 
reduction strategies. The Committee continues to urge NCI to 
promote mechanisms of collaboration between industry, the 
extramural program and foundations that will accelerate 
translational and clinical research as outlined in the 
strategic action plan, including annotated specimen collection 
from key trials independent of sponsorship and novel trial 
designs to accommodate testing agents contributed by more than 
one company. The Committee requests an update on these requests 
in the fiscal year 2013 congressional budget justification.
    Metastasis to Bone.--The Committee urges additional 
research on how to repair bone defects caused by cancer cells. 
Translational research is also needed to understand the impact 
of metastasis on the biomechanical properties of bone and the 
mechanisms by which bone marrow and tumor-derived cells can 
influence metastatic growth, survival and therapeutic 
resistance.
    Pancreatic Cancer.--The Committee commends NCI on its 
fiscal year 2011 Action Plan for Pancreatic Cancer, which marks 
an important first step to making a targeted research 
investment in this deadly disease. As the plan recommends, the 
Committee urges NCI to put in place a long-term, comprehensive 
strategic plan; move forward with requests for applications or 
program announcements specific to pancreatic cancer; and 
include more experts in pancreatic cancer on scientific review 
panels in fiscal year 2012. In addition, earlier this year NCI 
reported to the Committee that extramural research staff has 
been empowered to propose exceptions for promising pancreatic 
cancer research proposals that may not otherwise be funded, and 
that the Institute has made it a priority to identify novel 
research ideas. The Committee requests an update in the fiscal 
year 2013 congressional budget justification on the use of 
exceptions as well as a description of novel research ideas 
being pursued in relation to pancreatic cancer.
    Pediatric Cancer.--The Committee notes that childhood 
cancer research accounts for less than 5 percent of the 
Institute's annual budget and encourages NCI to increase that 
amount, as cancer remains the leading cause of disease-related 
death in children. More effective and less toxic treatments are 
needed.
    Slow-Growing Children's Brain Tumors.--Two primary 
roadblocks to basic research on pediatric low-grade astrocytoma 
[PLGA] brain tumors have been identified: a shortage of viable 
tissue samples and the lack of a mouse model. The Committee 
urges NCI to establish research priorities that address the 
shortage of tissue samples by incentivizing hospitals and 
medical institutions to centralize and share tissue samples. 
The Committee also urges NIH to examine possible solutions to 
address the lack of a mouse model for PLGA brain tumors. The 
Committee requests an update on these issues in the fiscal year 
2013 congressional budget justification.

               NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2011....................................  $3,069,723,000
Budget estimate, 2012...................................   3,147,992,000
Committee recommendation................................   3,036,189,000

    The Committee recommendation includes $3,036,189,000 for 
the National Heart, Lung, and Blood Institute [NHLBI]. The 
budget request for fiscal year 2012 is $3,147,992,000 and the 
comparable level for fiscal year 2011 is $3,069,723,000.
    The Committee recommendation for NHLBI includes sufficient 
funding to accommodate the transfer of gene vector grants 
currently administered by NCRR.
    Asthma.--NHLBI is urged to advance more effective life-
saving and life-enhancing treatments for asthma and to 
collaborate with the FDA, NIAID, NICHD, NIMHD, and the Office 
of Minority Health in this regard. The Committee notes that the 
prevalence and burden of asthma are high among African-
Americans, Latinos and other communities of color, as well as 
children. The Committee urges NHLBI to examine the impact of 
long-acting medications and prescribed steroids on overall 
health, growth and development of children.
    Cardiovascular Disease.--The Committee continues to place a 
high priority on research related to heart disease, stroke and 
other forms of cardiovascular disease and remains concerned 
that NIH still spends less than 8 percent of its budget on our 
Nation's No. 1 and most costly killer. The Committee strongly 
urges NHLBI to significantly enhance its investment and further 
stimulate interest in multidisciplinary and interdisciplinary 
basic, clinical, translational, and prevention cardiovascular 
disease research, including its risk factors, using all 
appropriate mechanisms. In addition, the Committee urges the 
prompt implementation of priority initiatives outlined in its 
Division of Cardiovascular Diseases Strategic Plan. NHLBI is 
also encouraged to increase its attention to the impact of 
cardiovascular disease on ethnic minorities such as Native 
Hawaiians and Asians.
    Chronic Obstructive Pulmonary Disease [COPD].--The 
Committee applauds NHLBI's efforts to raise public awareness of 
COPD and encourages the Institute to work with community 
stakeholders and other Federal agencies, including CDC, to 
develop a national action plan to respond to the growing burden 
of this disease.
    Jackson Heart Study.--The Committee recognizes that the 
Jackson Heart Study in Jackson, Mississippi, is the largest 
investigation of cardiovascular disease in the African-American 
population. The Committee acknowledges the continued need for 
comprehensive research to address this health disparity and the 
important implications for such research to all persons 
threatened by cardiovascular disease. The Committee urges 
continued focus in addressing cardiovascular disease in 
African-Americans at NHLBI and NIMHD.
    Marfan Syndrome and Thoracic Aortic Aneurysms.--The 
Committee commends NHLBI for its ongoing support of clinical 
research on Marfan syndrome in the pediatric population, and it 
encourages support for basic and translational research on this 
complex connective tissue disorder. The Committee also notes 
recent advancements in genetic research related to thoracic 
aortic aneurysms and encourages the Institute to promote 
additional research on this condition.
    Pulmonary Hypertension [PH].--The Committee encourages 
NHLBI to support the establishment of a Pulmonary Hypertension 
Clinical Research Network to expand clinical trials and 
facilitate collaboration and data sharing among PH 
investigators. The Committee also continues to encourage the 
Institute to collaborate with the PH community to raise 
awareness of the disease.
    RuSH Project.--The Committee supports the Registry and 
Surveillance System in Hemoglobinopathies [RuSH] project, which 
will determine the number of Americans with sickle cell 
disease, thalassemia and hemoglobin E disease. The Committee 
believes that NHLBI should retain control of the data system to 
fully characterize these patient populations and use the data 
to conduct research for new therapies, as well as to monitor 
the implementation of Healthy People 2020 using leading health 
indicators. NHLBI should also consult with HRSA concerning an 
expansion of sites for treatment centers.
    Sleep Disorders.--The Committee awaits the imminent release 
of the National Sleep Disorders Research Plan by the National 
Center on Sleep Disorders Research, which will articulate 
priorities and opportunities NIH-wide for addressing the 
challenge of sleep disorders and circadian disturbances. The 
Committee is concerned by the growing body of knowledge 
demonstrating linkages between sleep disorders and a number of 
health conditions, including obesity, diabetes and 
cardiovascular disease, and the impact of sleep disturbances on 
safety at the workplace and in transportation. The Committee 
recommends more collaboration among ICs regarding sleep 
research and accelerated efforts in sleep research training.
    Social Support.--NHLBI is encouraged to continue its 
research on how psychosocial factors, such as social support, 
may affect the course of prevention and treatment of, and 
recovery from, cardiovascular illness or events.

         NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2011....................................    $409,608,000
Budget estimate, 2012...................................     420,369,000
Committee recommendation................................     404,997,000

    The Committee recommendation includes $404,997,000 for the 
National Institute of Dental and Craniofacial Research [NIDCR]. 
The budget request for fiscal year 2012 is $420,369,000 and the 
comparable level for fiscal year 2011 is $409,608,000.
    Systemic Bone Active Therapeutics.--The Committee urges 
continued research on the effects of systemic bone active 
therapeutics on the craniofacial skeleton, including factors 
predisposing individuals to osteonecrosis of the jaw, as well 
as new approaches to facilitate bone regeneration.
    Temporomandibular Joint [TMJ] Disorders.--The Committee 
encourages NIDCR to collaborate with other ICs regarding the 
etiology and pathogenesis of TMJ disorders as well as the co-
morbid chronic pain conditions and disorders that solely or 
predominantly affect women. In particular, NIDCR should work 
with NIAMS and NIBIB to develop research opportunities in the 
area of joint pain. Examples of topics that need more 
exploration include: a basic understanding of the kinematics 
and biomechanics of TMJ disorders as they relate to normal jaw 
function and in disease; the development of biomarkers in bone, 
muscle and cartilage that are predictive of temporomandibular 
disease progression; the interactions of the TMJ 
musculoskeletal system with the nervous system; and the 
development of non-invasive measures of TMJ bone structure, 
growth, degradation and repair. The recent scientific meeting 
of the TMJ Association, co-sponsored by NIDCR and other ICs, 
concluded that there needs to be a shift in research toward a 
systematic exploration of common underlying root causes. The 
Committee strongly urges NIH to heed the recommendations from 
this meeting, which have the potential to accelerate scientific 
progress not just in TMJ disorders but in the other coexisting 
conditions.

    NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES

Appropriations, 2011....................................  $1,792,224,000
Budget estimate, 2012...................................   1,837,957,000
Committee recommendation................................   1,772,045,000

    The Committee recommendation includes $1,772,045,000 for 
the National Institute of Diabetes and Digestive and Kidney 
Diseases [NIDDK]. The budget request for fiscal year 2012 is 
$1,837,957,000 and the comparable level for fiscal year 2011 is 
$1,792,224,000.
    Chronic Pelvic Pain.--The Committee is pleased by the 
progress made in the Multidisciplinary Approach to the Study of 
Chronic Pelvic Pain [MAPP] Research Network, particularly the 
inclusion of male subjects, as the research plan continues to 
focus on the natural history of interstitial cystitis. The 
Committee encourages the MAPP Research Network to collaborate 
closely with patient health organizations.
    Depression and Diabetes.--NIDDK is encouraged to strengthen 
collaborations with other institutes regarding research on the 
links between diabetes and depression.
    Diabetes Prevention Program.--The Committee recognizes the 
success of the NIDDK-funded Diabetes Prevention Program, a 
clinical research trial which found that modest weight loss 
through dietary changes and increased physical activity could 
prevent or delay the onset of type 2 diabetes significantly. 
The Committee urges NIDDK to support further diabetes research 
that will build upon past successes, improve prevention and 
treatment, and close in on a cure.
    Functional Gastrointestinal Disorders and Gulf War 
Syndrome.--The Committee recognizes the direct link between 
functional gastrointestinal disorders, such as irritable bowel 
syndrome and functional dyspepsia, and gulf war syndrome, as 
detailed in the Institute of Medicine report ``Gulf War and 
Health: Volume 8. Health Effects of Serving in the Gulf War.'' 
The Committee urges NIDDK to collaborate with the Department of 
Defense and the Department of Veterans Affairs to advance 
research on the etiology, natural history and quality of 
functional gastrointestinal disorders in patients with gulf war 
syndrome.
    Gestational Diabetes.--The Committee urges NIDDK to explore 
additional opportunities for research on gestational diabetes, 
particularly regarding possible long-term health consequences 
such as a susceptibility to type 2 diabetes.
    Glomerular Diseases.--The Committee recognizes the recent 
progress made in understanding glomerular diseases, such as 
focal segmental glomerulosclerosis [FSGS], including the 
discovery of specific genetic factors which make African-
Americans five times more likely to develop FSGS than 
Caucasians. The Committee urges NIDDK to continue to support 
research on glomerular diseases and collaborate with NIMHD to 
expand research on the impact these diseases have on minority 
populations.
    Inflammatory Bowel Disease [IBD].--The Committee commends 
NIDDK for recent advancements in IBD research and encourages 
continued support for the study of genetic, cellular and 
environmental factors that contribute to the development of 
these complex diseases. The Committee also notes the increasing 
incidence of IBD in children and urges the Institute to expand 
support for genetic and clinical studies of pediatric patients.
    Pediatric Functional Gastrointestinal Disorders [FGIDs].--
The Committee urges NIDDK to work with NICHD to support 
research on the quality of life for children suffering from 
FGIDs, which often interfere with emotional, social and 
professional development and can impair physical, economic and 
educational well being.
    Pediatric Kidney Disease.--The Committee supports NIDDK's 
research emphasis on pediatric kidney disease and continues to 
encourage the development of multicenter, pediatric prospective 
clinical/translational trials.
    Polycystic Kidney Disease [PKD].--The Committee urges NIDDK 
to collaborate with other institutes and leverage discoveries 
from its portfolio of PKD grants for the purpose of developing 
a comprehensive strategic plan for PKD and other related neo-
plastic genetic diseases. For example, the Committee 
understands that cysts in PKD emulate the uncontrolled cell 
growth observed in cancer. The Committee believes this analysis 
will allow NIH to more effectively use Federal funds, create 
and identify additional public-private partnerships to maximize 
investments, and more quickly move PKD research findings to 
clinical trials.
    Vitamin D Deficiency and Chronic Kidney Disease.--The 
Committee is pleased to note the full range of bone and mineral 
research under way in both the intramural and extramural 
programs at NIDDK, including the additional research emphasis 
the Institute is placing on the relationship between vitamin D 
deficiency and chronic kidney disease. These research findings 
are expected to be particularly relevant to national efforts 
aimed at reducing health disparities in diverse populations.

        NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2011....................................  $1,622,003,000
Budget estimate, 2012...................................   1,664,253,000
Committee recommendation................................   1,603,741,000

    The Committee recommendation includes $1,603,741,000 for 
the National Institute of Neurological Disorders and Stroke 
[NINDS]. The budget request for fiscal year 2012 is 
$1,664,253,000 and the comparable level for fiscal year 2011 is 
$1,622,003,000.
    Dystonia.--The Committee commends the participation of 
NINDS in the Dystonia Coalition and encourages continued 
investments in dystonia research.
    Epilepsy.--The Committee applauds the establishment of the 
Interagency Collaborative to Advance Research in Epilepsy 
[ICARE], led by NINDS, which includes all Federal institutes 
and centers that fund epilepsy research along with voluntary 
organizations in the field. The Committee encourages ICARE's 
continuation as a venue for sharing efforts and perspectives on 
finding cures for epilepsy. The Committee also commends NINDS 
for its plans to create the Epilepsy Centers Without Walls 
program, which will promote multidisciplinary research efforts 
targeted toward specific topic areas in epilepsy, including 
epileptogenesis, comorbidities and mortality in epilepsy.
    Muscular Dystrophy.--The Committee commends NIH for 
collaborating with the Parent Project Muscular Dystrophy [PPMD] 
End Duchenne Grant Award Program by referring applicants who 
propose translational research on Duchenne muscular dystrophy 
but miss NIH paylines to PPMD for the opportunity to seek 
bridge funding. The Committee encourages additional efforts at 
NIH to translate research findings on Duchenne into novel 
discoveries.
    Network of Excellence in Neuroscience Clinical Trials.--The 
Committee commends NINDS for its leadership in creating the 
Network of Excellence in Neuroscience Clinical Trials [NEXT] 
program, which will create a robust, standardized and 
accessible infrastructure to facilitate rapid development and 
implementation of protocols in neurological disorders affecting 
adult and/or pediatric populations. NINDS has indicated that 
the first project to utilize the new NEXT infrastructure will 
be a biomarker validation study of spinal muscular atrophy 
[SMA]. Identifying one or more biomarkers for SMA would 
represent a significant step towards accelerating efforts to 
create effective treatments for this disease. The Committee 
also urges NINDS to continue to demonstrate strong support for 
translational research on SMA that will accelerate the 
development of therapies for testing in the clinic and 
facilitate the submittal of investigational new drug 
applications to the Food and Drug Administration. The Committee 
requests an update in the fiscal year 2013 congressional budget 
justification on the specific goals for the NEXT SMA initiative 
and its efforts relative to translational research on SMA.
    Stroke.--The Committee continues to prioritize research 
into the causes, diagnosis, treatment, recovery, rehabilitation 
and prevention of stroke. The Committee urges NINDS to foster 
innovative basic, clinical, translational and prevention stroke 
research for all age groups affected by stroke, including 
children and newborns, through all available mechanisms as 
appropriate. Further, the Committee notes that NINDS will 
manage a novel stroke planning effort beginning in 2011, 
building on the work of the Stroke Progress Review Group, to 
assess the current state of stroke research and develop 
priorities to advance the most promising areas in prevention, 
treatment, recovery, and rehabilitation research. The Committee 
requests an update on this initiative in the fiscal year 2013 
congressional budget justification.

         NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2011....................................  $4,775,968,000
Budget estimate, 2012...................................   4,915,970,000
Committee recommendation................................   4,725,288,000

    The Committee recommendation includes $4,725,288,000 for 
the National Institute of Allergy and Infectious Diseases 
[NIAID]. The budget request for fiscal year 2012 is 
$4,915,970,000 and the comparable level for fiscal year 2011 is 
$4,775,968,000. Included in these funds is $299,000,000 to be 
transferred to the Global Fund to Fight HIV/AIDS, Malaria, and 
Tuberculosis. The budget request was $300,000,000 for this 
purpose and the fiscal year 2011 level was $297,300,000.
    Anti-Malarial Medicines.--The Committee encourages the 
Institute to continue supporting the work of institutions of 
higher learning in combating the health, economic and security 
impacts of malaria. The Committee encourages NIAID to increase 
its investment in public-private partnerships that are involved 
in research and development of anti-malarial medicines; the 
development of safe and effective drugs for malaria prophylaxis 
and treatment, including 8-aminoquinolines; new, effective 
pediatric formulations; and alternatives to artemisinin 
combination therapies in response to the rapidly emerging 
threat of artemisinin resistance.
    Food Allergies.--The Committee is pleased that NIAID has 
convened periodic expert panels on food allergy research since 
1996 to make key recommendations to investigate the natural 
history of food allergy in young children who have risk factors 
predisposing them to develop food allergy; resolve impediments 
to clinical trials design and conduct; and perform clinical 
trials using food allergens, given orally or sublingually, to 
treat existing food allergy. The Committee is aware that public 
and private research to develop immunotherapies is progressing 
to an advanced clinical trials stage with the consensus support 
of the Nation's leading food allergy research institutions. 
NIAID is strongly encouraged to support this stage of the 
research, which has the potential to cure food allergies.
    Hepatitis B Virus [HBV].--The Committee applauds NIAID's 
efforts to pursue the development of new classes of drugs that 
are safe and effective in treating HBV. The Committee urges 
continued HBV research on different courses of treatment as 
well as ways to support efforts to identify new cellular and 
antiviral targets and develop new strategies for intervention. 
The Committee also urges an increased focus on pregnant women 
and pediatric cases of hepatitis B.
    Immunotherapy.--The Committee is aware of research showing 
that broader use of immunotherapy for the treatment of allergic 
rhinitis could improve clinical outcomes and significantly 
reduce healthcare costs. Additional research is needed to 
examine the clinical and economic impact of immunotherapy in 
both children and adults. The Committee encourages NIAID to 
collaborate with AHRQ and the Centers for Medicare and Medicaid 
Services on the development and support of a research 
initiative on this topic.
    Kidney Transplantation.--As the demand for suitable kidneys 
for transplantation continues to far exceed the supply, the 
Committee is pleased to learn that research funded by NIAID has 
resulted in the establishment of desensitization protocols that 
have successfully demonstrated an increase to the suitability 
of a larger number of cadaver kidneys for transplantation for 
highly sensitized candidates, who are the sickest and most 
difficult to match on the kidney transplant waiting list. The 
Committee therefore urges NIAID to support a multi-center 
initiative with a companion data collection and analysis center 
to facilitate the use of this protocol at an increasing number 
of transplant centers across the country.
    Microbicides.--With NIH and USAID leadership, proof of 
concept has been established for an antiretroviral [ARV]-based 
microbicide to prevent HIV infection in women. The Committee 
encourages NIAID to coordinate with USAID, the State 
Department, other Federal agencies and global donors to 
prioritize and expedite microbicide development efforts with 
the goals of enabling regulatory approval of the first 
effective microbicide and providing support for efficacy trials 
of new and complementary ARV-based microbicides.
    Tuberculosis [TB].--The Committee notes the recent 
development of GeneXpert, the new TB diagnostic test that holds 
the potential to dramatically improve TB diagnosis, treatment 
and control. The Committee applauds NIAID for its continued 
attention to the development of new TB diagnostics, drugs and 
vaccines.

             NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2011....................................  $2,033,782,000
Budget estimate, 2012...................................   2,102,300,000
Committee recommendation................................   2,347,309,000

    The Committee recommendation includes $2,347,309,000 for 
the National Institute of General Medical Sciences [NIGMS]. The 
budget request for fiscal year 2012 is $2,102,300,000 and the 
comparable level for fiscal year 2011 is $2,033,782,000.
    The recommended increase for NIGMS over the fiscal year 
2011 level results mostly from the planned transfer of the 
Institutional Development Awards [IDeA] program and the 
Division of Biomedical Technology, Bioinformatics and 
Computational Biology from NCRR.
    Behavioral Research.--The Committee applauds the leadership 
of NIGMS in the development of the OppNet collaboration on 
basic behavioral and social science research, and it encourages 
NIGMS to maintain its commitment to that trans-NIH initiative. 
The Committee also commends NIGMS's program of research on the 
efficacy of interventions to promote research careers, such as 
its studies on effective mentoring and career transitions.
    Institutional Development Awards [IDeA].--The Committee 
recognizes the importance of the Centers of Biomedical Research 
Excellence and the IDeA Networks of Biomedical Research 
Excellence programs, which are essential components to the 
overall success of the IDeA 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.

  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN 
                              DEVELOPMENT

Appropriations, 2011....................................  $1,317,854,000
Budget estimate, 2012...................................   1,352,189,000
Committee recommendation................................   1,303,016,000

    The Committee recommendation includes $1,303,016,000 for 
the Eunice Kennedy Shriver National Institute of Child Health 
and Human Development [NICHD]. The budget request for fiscal 
year 2012 is $1,352,189,000 and the comparable level for fiscal 
year 2011 is $1,317,854,000.
    Adverse Pregnancy Outcomes.--The Committee is pleased with 
the progress NICHD has made to identify women at risk for long-
term morbidity, as women with severe, early adverse pregnancy 
outcomes are at increased risk for chronic health problems. The 
Committee encourages NICHD to continue developing strategies to 
prevent long-term adverse outcomes in these women.
    Chromosome Abnormalities.--The Committee appreciates recent 
accomplishments by NIH in addressing the science of dosage-
sensitive and -insensitive genes. The Committee now urges NIH 
to leverage these efforts to achieve the translational science 
goal of producing detailed clinical data that can both move the 
science forward by being useful to researchers and assist 
clinicians in working with affected individuals and their 
families. The Committee also acknowledges and appreciates the 
ongoing NIH activities related to genetic disorders but urges 
new funding to support independent investigators whose work can 
provide pilot data or insight into future directions for the 
study of chromosome abnormalities, particularly those involving 
chromosome 18.
    Demographic and Economic Research.--The Institute's 
investment in population-representative longitudinal studies, 
such as the National Longitudinal Study of Adolescent Health, 
the National Longitudinal Study of Youth Child Supplement and 
Panel Study of Income Dynamics has yielded groundbreaking 
scientific research and served as a model for making publicly 
funded research data widely available, spurring cost-effective 
research in numerous disciplines and across multiple 
institutions. The Committee urges NICHD to continue investing 
in these large-scale population data sets and to sustain 
support for critical research infrastructure for demographic 
and behavioral population science.
    Learning and School Readiness.--The Committee recognizes 
the important contribution of NICHD in establishing the 
scientific foundation of the development of reading, math and 
science skills that are critical to maintaining the Nation's 
competitiveness in math and science achievement.
    Maternal Morbidity.--Though maternal morbidity rates are 
rising, the Committee understands that there are no uniform 
definitions of severe maternal morbidity. The Committee 
encourages NICHD to hold a consensus workshop to identify such 
definitions, which would help Federal, State and local agencies 
and research institutions establish standardized and 
interoperable processes for surveillance, data collection and 
research.
    Metabolic Bone Disease.--The Committee is encouraged by 
results thus far from the Bone Mineral Density in Childhood 
Study, which will serve as a valuable resource for clinicians 
and investigators to assess bone deficits in children and risk 
factors for impaired bone health. The Committee urges the 
Institute to extend the study and explore additional research 
that will lead to a better understanding and prevention of 
osteopenia and osteoporosis.
    Preterm Birth.--The Committee notes that the preterm birth 
rate has begun to decline from its peak of 12.8 percent in 2006 
to 12.3 percent in 2008. The Committee urges increased Federal 
investment to continue the downward trend. Specifically, the 
Committee urges NICHD to expand its support of prematurity 
research by creating integrated transdisciplinary research 
centers on preterm birth as recommended by the Institute of 
Medicine and the Surgeon General's Conference on the Prevention 
of Preterm Birth. To initiate this process, the Committee 
encourages NICHD to establish transdisciplinary research 
centers for prematurity. The Committee also encourages NICHD to 
expand its support for preterm birth-related research through 
the Maternal-Fetal Medicine Units Network, the Neonatal 
Research Network and the Genomic Proteomic Network for Preterm 
Birth Research.
    Prosthetics Research.--The Committee is aware that 
increasing numbers of Americans are undergoing amputation as a 
result of the growing prevalence of diabetes, cardiovascular 
disease and other reasons. The Committee also understands that, 
to date, little research has been done to examine prosthetic 
outcomes and to link prosthetic and orthotic treatments, 
devices and supports to patient outcomes. In order to support 
evidence-based healthcare practice in prosthetics and 
orthotics, and establish which approaches work best for which 
patients, the Committee encourages NICHD to work with the 
National Institute on Disability and Rehabilitation Research 
and experts in the field of prosthetic research to develop a 
prosthetics outcomes research agenda and implement needed 
research.
    Psychotropic Drugs and Children.--The Committee is aware 
that NICHD has formed a special workgroup, which includes 
representatives from NIMH and the FDA, to better understand the 
impact of medications on developing children. The Committee 
requests an update in the fiscal year 2013 congressional budget 
justification on the workgroup's activities regarding 
psychotropic drugs and a description of the basic and clinical 
research the workgroup believes should be undertaken.
    Rehabilitation Research.--The Committee commends NIH for 
appointing a blue-ribbon panel to evaluate rehabilitation 
research at the National Center for Medical Rehabilitation 
Research [NCMRR] and across all of NIH. The Committee requests 
a copy of the panel's report when it is available. The panel is 
urged to identify gaps in the field of rehabilitation research 
and recommend which ICs or other Federal agencies should be 
responsible for addressing them. In addition, the Committee 
recognizes the improvements that have been made in delineating 
rehabilitation research as part of NIH reporting mechanisms 
established since the passage of the NIH Reform Act. However, 
the Committee encourages NIH, through the leadership of NCMRR, 
to further clarify a consistent definition of rehabilitation 
across all institutes and centers and to seek ways to delineate 
between physical, cognitive, mental and substance abuse 
rehabilitation when characterizing NIH-supported research. 
Finally, the Committee encourages NCMRR to explore the broader 
social, emotional and behavioral context of rehabilitation, 
including effective interventions to increase social 
participation and reintegrate individuals with disabilities 
into their communities.
    SMA Newborn Screening.--The Committee applauds NICHD for 
funding a pilot study of newborn screening for spinal muscular 
atrophy [SMA] that will confirm the efficacy and accuracy of 
the SMA screening technology. The Committee understands that 
newborn screening holds promise for assisting with early 
interventions of SMA and developing improved and more 
standardized care protocols for patients living with SMA, and 
it may also assist in the development of potential drug 
therapies. Natural history, preclinical and preliminary 
clinical data all suggest that potential therapies will 
demonstrate the greatest effectiveness when delivered 
presymptomatically. The Committee encourages NICHD to support 
the development of crucial follow-up care protocols for 
children identified with SMA through the pilot study, and to 
report on progress made in this area in the fiscal year 2013 
budget justification.
    Vulvodynia.--The Committee is encouraged by positive signs 
that NICHD is devoting greater attention to this long-neglected 
condition, especially with regard to stimulating interest in 
both the intramural and extramural research community and 
ensuring adequate representation of vulvodynia experts on peer-
review panels. The Committee expects to be updated on progress 
in these areas in the fiscal year 2013 congressional budget 
justification. The Committee also notes that vulvodynia often 
coexists with other persistent pain conditions, including 
interstitial cystitis, fibromyalgia, temporomandibular joint 
and muscles disorders, irritable bowel syndrome, endometriosis, 
headache, and chronic fatigue syndrome. The Committee strongly 
urges the creation of a trans-NIH research initiative that will 
support studies aimed at identifying common etiological 
pathways among these disorders, with the goal of developing 
potential therapeutic targets.

                         NATIONAL EYE INSTITUTE

Appropriations, 2011....................................    $700,828,000
Budget estimate, 2012...................................     719,059,000
Committee recommendation................................     692,938,000

    The Committee recommendation includes $692,938,000 for the 
National Eye Institute [NEI]. The budget request for fiscal 
year 2012 is $719,059,000 and the comparable level for fiscal 
year 2011 is $700,828,000.
    Age-Related Macular Degeneration [AMD].--The Committee 
commends NEI for conducting the Comparison of AMD Treatments 
Trial, a comparative effectiveness trial of the two leading 
anti-angiogenic drug therapies currently used to treat the 
``wet'' form of AMD.
    Diabetic Eye Disease.--The Committee acknowledges the NEI 
Diabetic Retinopathy Clinical Research Network's results that 
laser treatment for diabetic macular edema, when combined with 
anti-angiogenic drug treatment, is more effective than laser 
treatment alone, and notes that this finding will revolutionize 
the standard of care that has been in place for the past 25 
years. With NIDDK leading a new NIH strategic plan to combat 
diabetes, NEI's research through its various diabetic eye 
disease networks will be more important than ever.
    Genetic Basis of Eye Disease.--The Committee commends NEI 
for elucidating the genetic basis of devastating eye diseases, 
such as AMD, retinitis pigmentosa and glaucoma. The Committee 
is pleased that, building upon the first successful use of 
genome-wide association studies [GWAS] to determine the 
increased risk of developing AMD from gene variants, NEI has 
created a new International AMD Genetics Consortium to bring 
together researchers to share and analyze GWAS results to 
further determine the genetic basis of the disease.
    Translational Research.--The Committee commends NEI's 
translational research initiatives through partnerships with 
other ICs, other agencies within HHS, and private funding 
organizations. The Committee acknowledges NEI's leadership of 
the human gene therapy clinical trial for neurodegenerative eye 
disease Leber Congenital Amaurosis, which has indicated that 
the treatment is safe and produces lasting visual improvement, 
and it is pleased that NEI is expanding the trial to younger 
patients with less severe disease.

          NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2011....................................    $683,724,000
Budget estimate, 2012...................................     700,537,000
Committee recommendation................................     676,033,000

    The Committee recommendation includes $676,033,000 for the 
National Institute of Environmental Health Sciences [NIEHS]. 
The budget request for fiscal year 2012 is $700,537,000 and the 
comparable level for fiscal year 2011 is $683,724,000.
    Multidisciplinary Research.--The Committee notes that 
research conducted through NIEHS is steadily revealing 
previously unrecognized influences of environmental exposures 
on a wide range of diseases and conditions, including breast 
cancer, autism, obesity, asthma and chemical sensitivities, and 
has the potential to lead to novel methods of preventing, 
detecting and treating disease. The Committee commends NIEHS 
for its research across many disease areas, including the 
Institute's translational and community-based studies, and 
involving those living in rural communities.
    Public Health Hazards.--The Committee recommends that NIEHS 
address the public health hazards associated with exposure to 
volcanoes, such as on the Big Island of Hawaii, and continue 
efforts to evaluate the health impact of natural environmental 
hazards.

                      NATIONAL INSTITUTE ON AGING

Appropriations, 2011....................................  $1,100,481,000
Budget estimate, 2012...................................   1,129,987,000
Committee recommendation................................   1,088,091,000

    The Committee recommendation includes $1,088,091,000 for 
the National Institute on Aging [NIA]. The budget request for 
fiscal year 2012 is $1,129,987,000 and the comparable level for 
fiscal year 2011 is $1,100,481,000.
    Age-Related Bone Loss.--The Committee supports the 
Institute's continuing Biology of Aging Program and appreciates 
the focus on developing a further understanding of aging 
processes, health and longevity. Given the demographics of our 
rapidly aging population, a continuing need exists for new 
therapeutic approaches to prevent and treat age-related bone 
loss, fractures and other metabolic bone diseases, including 
osteogenesis imperfecta, glucocorticoid-induced osteoporosis 
and bone loss due to kidney disease.
    Basic Behavioral Research.--The Committee applauds the 
Institute's leadership role in the OppNet initiative, which 
will build a collective body of knowledge about the nature of 
behavioral systems, deepen the understanding of basic 
mechanisms of behavioral processes and emphasize the relevance 
of basic behavioral science research throughout NIH's mission.
    Demographic and Economic Research.--The Committee commends 
NIA for prioritizing support of the Health and Retirement Study 
[HRS], which includes data from a representative sample of 
20,000 Americans aged 50 and over regarding their health and 
healthcare needs, income and savings, and work and retirement 
plans. NIA is especially encouraged to continue its successful 
collaboration and co-funding agreements for the HRS with the 
Social Security Administration. The Committee commends NIA's 
initiative in developing comparable international surveys, 
particularly in countries that have aged faster than the United 
States. The Committee anticipates important research advances 
regarding gene-environment interactions once the genome-wide 
array study of the HRS sample is fully implemented.
    Life Course Perspectives.--The Committee encourages NIA to 
maintain its important emphasis on life course studies, which 
focus on how transitions among family and other relationships 
may affect health, healthcare and aging.

 NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES

Appropriations, 2011....................................    $534,349,000
Budget estimate, 2012...................................     547,891,000
Committee recommendation................................     528,332,000

    The Committee recommendation includes $528,332,000 for the 
National Institute of Arthritis and Musculoskeletal and Skin 
Diseases [NIAMS]. The budget request for fiscal year 2012 is 
$547,891,000 and the comparable level for fiscal year 2011 is 
$534,349,000.
    Marfan Syndrome.--The Committee encourages NIAMS to expand 
support for research on the multi-body system disorder Marfan 
syndrome, including musculoskeletal and extracellular matrix 
biology studies.
    Scleroderma.--The Committee continues to prioritize 
research on scleroderma and commends the Institute for its 
ongoing efforts in this area. The Committee notes the high 
mortality associated with pulmonary complications from 
scleroderma, and it encourages NIAMS to collaborate with NHLBI 
on this important issue.
    Temporomandibular Joint [TMJ] Disorders.--Many people who 
have TMJ disorders suffer from conditions that routinely affect 
other joints in the body, such as trauma and arthritis. 
Therefore, the Committee calls on NIAMS to collaborate with 
NIDCR to study the jaw anatomy and physiology and the complex 
neural, endocrine and immune system interactions that 
orchestrate jaw function and trigger jaw joint pathology. NIAMS 
should integrate findings from studies of the structure, 
mechanical function, metabolism and blood flow of bone, joints 
and muscles with studies of central and peripheral neural 
pathways, as well as the endocrine, paracrine and cytokine 
factors that impact upon craniofacial structures as a means to 
understanding the underlying causes of pain and dysfunction. 
The Committee also urges NIAMS to support comparative studies 
of the TMJ with other joints that could document similarities 
and differences at the clinical and molecular levels.

    NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

Appropriations, 2011....................................    $415,155,000
Budget estimate, 2012...................................     426,043,000
Committee recommendation................................     410,482,000

    The Committee recommendation includes $410,482,000 for the 
National Institute on Deafness and Other Communication 
Disorders [NIDCD]. The budget request for fiscal year 2012 is 
$426,043,000 and the comparable level for fiscal year 2011 is 
$415,155,000.
    Early Detection, Diagnosis and Intervention.--The Committee 
urges NIDCD to continue to study the speech, language, voice, 
auditory and psychosocial outcomes of children identified with 
hearing loss through newborn screening, including evaluation of 
different sound amplification strategies (including multiple 
hearing aid fittings) on perception and understanding; the 
impact of complex listening environments, such as noisy 
classrooms, on hearing aid performance; and the effects of 
parental engagement and delivery of services on emotional well-
being. The Committee also recommends continuing study of the 
neurological basis of variability in outcomes in children with 
cochlear implants.
    Hair Cell Regeneration.--The Committee continues to place a 
high priority on research involving inner ear hair cell 
regeneration and stem cells. It applauds NIDCD's development of 
a system for making what appear to be functional hair cells 
from stem cells and recommends further studies in this area. 
The Committee encourages continuing development of in vitro 
assays to identify molecules involved in the differentiation of 
adult and embryonic stem cells into specific cell types used in 
communication, as well as research on how to regenerate 
connections between nerve cells that project to the brain and 
replacement hair cells. Also advocated are the continuation of 
gene transfer studies that have shown transcription factors are 
able to induce some non-sensory cells within the cochlea to 
develop as neurons.
    Hearing Aids and Cochlear Implants.--The Committee is 
pleased that NIDCD has launched a series of research 
initiatives between clinicians and researchers based on 
recommendations from a 2009 NIDCD Working Group on Accessible 
and Affordable Health Care for Adults with Mild to Moderate 
Hearing Loss. The Committee urges continuing collaborations 
between industry, scientists, clinicians and consumers in the 
area of low-cost hearing aids so that more of the population 
who need hearing aids can obtain them at affordable costs. The 
Committee is aware that some individuals need alternative 
hearing prostheses and therefore recommends additional studies 
evaluating the ``bimodal'' option of an implant in one ear and 
a hearing aid in the other as well as the option of implanting 
a short electrode, which combines electric and acoustical 
stimulation in the same ear.
    Synapse Function.--The use of hearing aids and cochlear 
implants may be limited by dramatic changes in synapse 
connections following developmental hearing loss. Recognizing 
this, the Committee supports research on genetic and cellular 
mechanisms of normal synapse function and on approaches to 
prevent or reverse deafness-caused disruptions that affect 
one's ability to benefit from aids or implants.
    Hearing Impairment Among Children and Young Adults.--The 
Committee urges additional research on children and young 
adults with unilateral hearing loss [UHL] from all modes of 
injury. In particular, it recommends further studies on 
educational and behavioral problems among children with UHL and 
development of strategies to minimize this risk. The Committee 
also supports additional research to understand the 
susceptibility of adolescents and young adults to develop 
noise-induced hearing loss. The Committee commends NIDCD for 
its public education efforts about the dangers of hearing loss 
from noise exposure, especially the ``It's a Noisy Planet. 
Protect Their Hearing'' campaign, which was expanded to include 
Spanish language publications.
    Hereditary Hearing Loss.--The Committee encourages 
additional efforts by NIDCD to identify and understand the 
structure, function and regulation of genes whose mutation 
results in deafness and other communication disorders.
    Noise-Induced Hearing Loss.--The Committee continues to put 
a high priority on better understanding and preventing noise-
induced hearing loss. In particular, the Committee encourages 
NIDCD to support environmental and genetics studies assessing 
predisposition to noise-induced hearing loss and additional 
research on the use of antioxidants and other micronutrients to 
prevent cell death in the inner ear. Genetic and proteomic 
studies in zebrafish concerning the effect of ototoxic drugs on 
hair cells are also encouraged.
    Otitis Media.--The Committee recognizes the threat to 
infants' and children's health and development from ear 
infection, or otitis media. The Committee therefore urges NIDCD 
to accelerate its research on the pathogenesis of ear infection 
and its consequences. In particular, it urges additional 
studies of genetic risk factors, new treatments for chronic and 
recurrent otitis media, and new methods for the delivery of 
drugs to the middle ear.
    Plasticity.--The Committee continues to support research on 
functional changes of neurons and synapses of the central 
auditory nervous system during development and following 
hearing loss. Specifically, the Committee encourages the 
continuation of brain-imaging research in children with severe 
to profound unilateral hearing loss to understand the 
reorganization that occurs to process sound, speech and 
language, as well as experiments in animals to understand 
perceptual and neural coding changes in the auditory cortex 
during conductive hearing loss and after restoration of normal 
hearing.
    Presbycusis.--The Committee urges NIDCD to continue 
multidisciplinary physiological and neurological studies of the 
peripheral and central mechanisms of presbycusis, or age-
related hearing loss. It commends NIDCD's support of a P50 
Specialized Center on Experimental and Clinical Studies of 
Presbycusis. The Committee also recommends support for temporal 
bone banks so that inner ear bones from individuals diagnosed 
with presbycusis can be studied.
    Tinnitus.--The Committee urges NIDCD to address the lack of 
knowledge about the specific neural dysfunction responsible for 
tinnitus. It also encourages research on the prevention, 
treatment and cure of this prevalent disorder, including 
identifying chemicals to prevent development of chronic 
tinnitus; developing preventative delivery methods for ototoxic 
drugs; and discovering treatments to suppress hearing-system 
hyperactivity.
    Translational Research.--The Committee recommends 
additional research activities and clinical trials on the 
prevention and treatment of hearing loss from noise, drugs, 
aging, and genetic causes, and translation of these studies to 
therapies. Clinical trials relevant to Meniere's disease, 
sudden deafness and autoimmune inner ear disease are 
encouraged.
    Usher Syndrome.--The Committee encourages NIDCD to continue 
to support genetic research into Usher syndrome, the most 
common condition that affects both hearing and vision.
    Vestibular Research.--The Committee continues to urge the 
NIDCD to conduct vestibular research in animal models and 
humans.

                 NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2011....................................    $144,381,000
Budget estimate, 2012...................................     148,114,000
Committee recommendation................................     142,755,000

    The Committee recommendation includes $142,755,000 for the 
National Institute of Nursing Research [NINR]. The budget 
request for fiscal year 2012 is $148,114,000 and the comparable 
level for fiscal year 2011 is $144,381,000.
    Science-Driven Practice.--The Committee supports NINR's 
efforts to prepare faculty researchers, who are desperately 
needed to educate new nurses. NINR's continued commitment to 
the science-driven practice of the nursing profession remains 
vital to preventing disease, improving quality patient care, 
and ensuring the proper training and development of nurse 
researchers.

           NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2011....................................    $458,286,000
Budget estimate, 2012...................................     469,197,000
Committee recommendation................................     453,127,000

    The Committee recommendation includes $453,127,000 for the 
National Institute on Alcohol Abuse and Alcoholism [NIAAA]. The 
budget request for fiscal year 2012 is $469,197,000 and the 
comparable level for fiscal year 2011 is $458,286,000.
    Underage Drinking Initiatives.--The Committee applauds 
NIAAA's continued focus on underage alcohol use and college 
binge drinking research. The Committee urges NIAAA to continue 
research to evaluate campus-based programs that seek to reduce 
drinking and related problems among college students using both 
individual and environmental approaches, including mandated 
intervention and/or treatment and community partnerships that 
involve heavy publicity and highly visible enforcement. The 
Committee recognizes the critical role of psychological 
research in understanding drinking behavior and in developing 
behaviorally based interventions as well as the demonstrated 
effectiveness of those interventions alone or in combination 
with pharmacotherapy.

                    NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2011....................................  $1,050,542,000
Budget estimate, 2012...................................   1,080,018,000
Committee recommendation................................   1,038,714,000

    The Committee recommendation includes $1,038,714,000 for 
the National Institute on Drug Abuse [NIDA]. The budget request 
for fiscal year 2012 is $1,080,018,000 and the comparable level 
for fiscal year 2011 is $1,050,542,000.
    Blending Initiative.--The Committee is concerned that NIDA 
has reduced funding for activities that help State substance 
abuse agencies infuse into the Nation's publicly funded 
substance abuse system the knowledge gained by NIDA's research. 
In particular, the Committee is concerned that NIDA reduced 
funds for its Blending Initiative, which supported a dialogue 
between NIDA, SAMHSA and State substance abuse agencies on 
``research to practice'' and ``practice to research'' 
activities. The Committee urges NIDA to allocate funding to re-
engage State substance abuse agencies on this important issue.
    Education.--The Committee encourages NIDA to continue its 
work in the area of education to inform people of all ages of 
the detriment to society that drug abuse causes in terms of 
pronounced effects on health and the extensive expense to the 
economy of the Nation.
    Medications Development.--The Committee encourages NIDA to 
use all available mechanisms, including the Small Business 
Innovation in Research program, to expand support for 
medications development to treat diseases of drug abuse and 
addiction.
    Military Personnel, Veterans, and Their Families.--The 
Committee commends NIDA for its successful efforts to 
coordinate and support research with the Department of Veterans 
Affairs and other NIH institutes on substance abuse and 
associated problems among U.S. military personnel, veterans and 
their families. Many military personnel need help confronting 
war-related problems including traumatic brain injury, post-
traumatic stress disorder, depression, anxiety, sleep 
disturbances, and substance abuse, including tobacco, alcohol 
and other drugs. Many of these problems are interconnected and 
contribute to individual health and family relationship crises, 
yet there has been little research on how to prevent and treat 
the unique characteristics of wartime-related substance abuse 
issues. The Committee commends NIDA for this crucial work.
    Prescription Drug Abuse.--The Committee applauds the 
Committee for its continued effort to halt prescription drug 
abuse. This effort requires the cooperation of many components 
of the Federal Government, but NIDA should maintain its 
comprehensive leadership role in this important area.
    Substance Abuse by Teenagers.--The Committee urges NIDA to 
concentrate its effort to reverse the recent increase in 
experimentation in substance abuse by teenagers. This effort 
will require innovative approaches in the education, prevention 
and treatment arenas.
    Translational Research.--The Committee recognizes the value 
of the translational research funded by NIDA, which includes 
preventive and treatment modalities directed toward a decrease 
in drug experimentation and most importantly the development of 
treatments for the diseases of drug dependence.

                  NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2011....................................  $1,477,292,000
Budget estimate, 2012...................................   1,517,006,000
Committee recommendation................................   1,460,671,000

    The Committee recommendation includes $1,460,671,000 for 
the National Institute of Mental Health [NIMH]. The budget 
request for fiscal year 2012 is $1,517,006,000 and the 
comparable level for fiscal year 2011 is $1,477,292,000.
    HIV/AIDS Behavioral Research.--The Committee supports 
NIMH's critical work in developing behavioral interventions to 
prevent the spread of HIV/AIDS across multiple populations as 
well as addressing co-morbid mental and substance abuse 
disorders. The Committee recognizes that new research is needed 
to ensure the long-term maintenance of behavior changes as HIV/
AIDS has become a chronic disease. Behavioral research aimed at 
reducing the likelihood of HIV infection should include 
structural, environmental and socioeconomic variables to ensure 
that research-based interventions can be evaluated as 
appropriate for racial and ethnic minority populations.
    Premature Mortality.--The Committee continues to be 
concerned about premature mortality and lower life expectancy 
experienced by adults living with serious mental illness as 
result of treatable medical conditions such as cardiovascular, 
pulmonary, endocrine, and infectious diseases. The Committee 
urges NIMH to collaborate with other institutes including NIDDK 
and NHLBI on a focused research program into the causes and 
interventions needed to address this crisis. The Committee 
requests an update on this topic in the fiscal year 2013 budget 
justification.

                NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2011....................................    $511,497,000
Budget estimate, 2012...................................     524,807,000
Committee recommendation................................     505,738,000

    The Committee recommendation includes $505,738,000 for the 
National Human Genome Research Institute [NHGRI]. The budget 
request for fiscal year 2012 is $524,807,000 and the comparable 
level for fiscal year 2011 is $511,497,000.

      NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2011....................................    $313,802,000
Budget estimate, 2012...................................     322,106,000
Committee recommendation................................     333,671,000

    The Committee recommendation includes $333,671,000 for the 
National Institute of Biomedical Imaging and Bioengineering 
[NIBIB]. The budget request for fiscal year 2012 is 
$322,106,000 and the comparable level for fiscal year 2011 is 
$313,802,000.
    The recommended increase for NIBIB over the fiscal year 
2011 level results from the planned transfer of several grants 
focused on point-of-care diagnostics and biomedical imaging 
from NCRR.

                 NATIONAL CENTER FOR RESEARCH RESOURCES

Appropriations, 2011....................................  $1,257,754,000
Budget estimate, 2012...................................   1,297,900,000
Committee recommendation................................................

    The Committee recommends eliminating the National Center 
for Research Resources [NCRR] as part of its plan to create 
NCATS. The budget request for fiscal year 2012 is 
$1,297,900,000 and the comparable level for fiscal year 2011 is 
$1,257,754,000.
    The Committee recommendation includes sufficient funding to 
accommodate the transfer of programs currently administered by 
NCRR to NIGMS, NIBIB, NIMHD, NHLBI and OD.

       NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE

Appropriations, 2011....................................    $127,713,000
Budget estimate, 2012...................................     131,002,000
Committee recommendation................................     126,275,000

    The Committee recommendation includes $126,275,000 for the 
National Center for Complementary and Alternative Medicine 
[NCCAM]. The budget request for fiscal year 2012 is 
$131,002,000 and the comparable level for fiscal year 2011 is 
$127,713,000.
    Access to Natural Product Collections.--The Committee 
supports the efforts of NCCAM to increase its access to 
comprehensive and professionally organized natural product 
libraries, as such collections represent valuable research 
resources to facilitate the efficiency and cost-effectiveness 
of the Center's research program.
    Behavioral Interventions.--The Committee commends NCCAM's 
support of research on the cognitive and emotional effects of 
mindfulness meditation, and it encourages the Center to 
collaborate with other institutes and centers to explore 
additional behavioral interventions.

      NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2011....................................    $209,713,000
Budget estimate, 2012...................................     214,608,000
Committee recommendation................................     272,650,000

    The Committee recommendation includes $272,650,000 for the 
National Institute on Minority Health and Health Disparities 
[NIMHD]. The budget request for fiscal year 2012 is 
$214,608,000 and the comparable level for fiscal year 2011 is 
$209,713,000.
    The bill includes new language allowing the planned 
transfer of the Research Centers in Minority Institutions 
program from NCRR. This transfer accounts for most of the 
recommended increase for NIMHD over the fiscal year 2011 level.
    Diabetes.--The Committee urges NIMHD to expand, intensify 
and support ongoing research and other activities with respect 
to pre-diabetes and diabetes, particularly type 2 diabetes, in 
minority populations, including research to identify clinical, 
socioeconomic, geographical, cultural and organizational 
factors that contribute to diabetes in such populations. 
Specifically, the Committee encourages the Institute to support 
research on behavior and obesity; environmental factors that 
may contribute to the increase in type 2 diabetes in 
minorities; environmental triggers and genetic interactions 
that lead to the development of type 2 diabetes in minority 
newborns; genes that may predispose individuals to the onset of 
type 1 and type 2 diabetes and its complications; methods and 
alternative therapies to control blood glucose; and diabetic 
and gestational diabetic pregnancies in minority mothers. The 
Committee also asks that NIH, through NIMHD and the National 
Diabetes Education Program, mentor health professionals to be 
more involved in weight counseling, obesity research and 
nutrition; provide for the participation of minority health 
professionals in diabetes focused research programs; and 
encourage increased minority representation in diabetes-focused 
health fields.
    Glomerular Diseases.--The Committee notes that African-
Americans are five times more likely to develop glomerular 
diseases, such as focal segmental glomerulosclerosis [FSGS], 
than Caucasians. The Committee urges NIMHD to collaborate with 
NIDDK on this important issue.
    Obesity.--The Committee strongly urges NIH to continue to 
support research to identify and reduce health disparities, 
including studies focusing on populations at disproportionate 
risk for obesity and its accompanying health consequences such 
as, but not limited to, cancer, diabetes and cardiovascular 
disease. To effectively address the problem of obesity and its 
health consequences, the Committee requests that NIMHD 
intensify its investment in obesity research and review the 
benefits of establishing a Comprehensive Center of Excellence 
for Obesity Research and Prevention. Further, the Committee 
urges NIH to develop a trans-NIH strategy for obesity research 
that is coordinated and has a significant health disparity 
obesity research focus coordinated through NIMHD. This 
comprehensive approach will critically and systematically 
explore the causes and potential solutions for health 
disparities in obesity. Studies should focus on regions with 
populations at disproportionate risk for obesity and its health 
consequences, in particular populations most affected--racial 
and ethnic minorities, low-income populations and rural 
populations--and include regional analysis. The Committee 
requests NIH to participate in a trans-HHS working group that 
sets measurable objectives based on scientific data and 
information that leverages the appropriate HHS agencies like 
AHRQ and CDC in order to improve dissemination and 
implementation of scientific information to clinicians and 
community organizations to aggressively improve obesity rates 
in health disparate populations.
    Scleroderma.--The Committee commends the Institute for 
establishing the Exploratory Centers of Excellence Program and 
is pleased that health disparities research related to 
scleroderma will be prioritized.

 JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH 
                                SCIENCES

Appropriations, 2011....................................     $69,436,000
Budget estimate, 2012...................................      71,328,000
Committee recommendation................................      68,653,000

    The Committee recommendation includes $68,653,000 for the 
Fogarty International Center [FIC]. The budget request for 
fiscal year 2012 is $71,328,000 and the comparable level for 
fiscal year 2011 is $69,436,000.
    The Committee continues to support FIC's efforts to foster 
long-term research and training partnerships between U.S. 
research institutions and those in developing countries.

          NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2011....................................................
Budget estimate, 2012...................................................
Committee recommendation................................    $582,326,000

    The Committee recommendation includes $582,326,000 to 
create the National Center for Advancing Translational Sciences 
[NCATS].
    NCATS will house several programs that are currently 
administered by and/or funded through NCRR, NHGRI or OD. They 
include Clinical and Translational Science Awards [CTSAs], 
Therapeutics for Rare and Neglected Diseases [TRND], Rapid 
Access to Interventional Development, the Office of Rare 
Diseases Research [ORDR] and the NIH-FDA Regulatory Science 
Initiative.
    The recommended appropriation for NCATS is sufficient to 
fund the above programs at the same level at which they were 
funded in fiscal year 2011. The Committee especially urges no 
reduction in funding for CTSAs.
    In addition, the Committee includes $20,000,000 to create 
the Cures Acceleration Network [CAN], which was authorized in 
the Patient Protection and Affordable Care Act. The Committee 
believes this program offers exciting potential to help speed 
the translation and application of promising new treatments for 
diseases. CAN is authorized to make grants to biotech 
companies, universities and patient advocacy groups to target 
new discoveries that have shown potential at the laboratory 
level but have not advanced far enough to attract significant 
investments from the private sector. Specifically, CAN will 
focus on funding the development of ``high need cures,'' which 
are defined as drugs, biological products or medical devices 
that the NIH Director determines to be a priority ``to 
diagnose, mitigate, prevent, or treat harm from any disease or 
condition, and for which the incentives of the commercial 
market are unlikely to result in its adequate or timely 
development.'' CAN is also intended to reduce the barriers 
between laboratory discoveries and clinical trials for new 
therapies and facilitate FDA review for the high need cures 
funded by this initiative.
    Two types of awards are authorized--grant awards and 
partnership awards, the latter of which require a $1 to $3 
match. Up to 20 percent of the appropriated funds may be used 
to obligate funds through ``other transactions,'' which are 
funding agreements or mechanisms that are not grants, 
contracts, or cooperative agreements, and are intended to 
provide additional flexibility akin to that of the Department 
of Defense's Defense Advanced Research Projects Agency [DARPA].
    Behavioral Research.--The Committee encourages NCATS to 
include staff expertise and resources to manage research on the 
translation of behavioral interventions into communities.
    Clinical and Translational Science Awards [CTSAs].--The 
Committee is encouraged by the success of the CTSA consortium 
and strongly recommends that the program be fully funded, 
consistent with professional judgment, as it nears full 
implementation. As the CTSA program transitions to NCATS, the 
Committee urges the NIH Director to ensure that the current 
focus on the full spectrum of translational research is 
maintained. The inclusion of patient-centered outcomes 
research, community engagement, training, dissemination 
science, and behavioral research is extremely important to the 
translation and application of basic science discoveries and 
success of the CTSAs.
    Drug Repurposing.--There are over 11,000 commercial 
compounds that are in a pool of late-stage, pre-clinical 
through phase III clinical trials that have been tested in 
humans, but whose development has been discontinued by 
pharmaceutical companies. By leveraging existing compounds, 
researchers and industry can develop new treatments for 
patients. The Committee encourages NIH to work with 
pharmaceutical companies to support drug repurposing and the 
sharing of compounds; in particular, NIH is encouraged to 
develop guidelines for drug repurposing technology transfer 
agreements.
    Dystonia Coalition.--The Committee commends ORDR for the 
work conducted in the Rare Diseases Clinical Research Network 
and requests an update on the patient registry of the Dystonia 
Coalition.
    Hereditary Angioedema [HAE].--The Committee encourages ORDR 
and relevant Institutes and Centers to expand research on HAE, 
a rare and potentially life-threatening genetic condition. In 
particular, the Committee urges ORDR to support a scientific 
conference on HAE, with the goal of identifying research 
opportunities and priorities for this disease.

                      NATIONAL LIBRARY OF MEDICINE

Appropriations, 2011....................................    $336,733,000
Budget estimate, 2012...................................     387,153,000
Committee recommendation................................     358,979,000

    The Committee recommendation includes $358,979,000 for the 
National Library of Medicine [NLM]. The budget request for 
fiscal year 2012 is $387,153,000 and the comparable level for 
fiscal year 2011 is $336,733,000. An additional $8,200,000 is 
made available from program evaluation funds. Of the funds 
provided, $4,000,000 is for the improvement of information 
systems, to remain available until expended.
    The Committee recommendation allows that additional funding 
for the National Center for Biotechnology Information and 
support for the Public Access program may be provided directly 
to NLM. Under current practice, some of this funding is 
provided to NLM through a small tap on ICs.

                         OFFICE OF THE DIRECTOR

Appropriations, 2011....................................  $1,166,963,000
Budget estimate, 2012...................................   1,298,412,000
Committee recommendation................................   1,439,064,000

    The Committee recommendation includes $1,439,064,000 for 
the Office of the Director [OD]. The budget request for fiscal 
year 2012 is $1,298,412,000 and the comparable level for fiscal 
year 2011 is $1,166,963,000.
    The recommended increase for OD over the fiscal year 2011 
level results from several changes connected to the planned 
elimination of NCRR. OD will now house the Comparative Medicine 
Program, including National Primate Research Centers; shared 
and high-end instrumentation; Science Education Partnership 
Awards; and selected other programs that are currently 
administered by NCRR.
    The Committee recommendation is sufficient to allow up to 
$189,215,000 to be used for continuation of the National 
Children's Study.
    The Committee recommends $537,811,000 for the Common Fund. 
The budget request is $556,890,000 and the fiscal year 2011 
level is $543,021,000.
    Angiogenesis.--The Committee encourages NIH to support 
research that will determine the role angiogenesis may have in 
disease prevention and intervention. The Trans-Institute 
Angiogenesis Research Program should implement a vigorous 
agenda that examines current angiogenesis therapies in order to 
improve outcomes. In particular, the Committee urges NCI to 
take a leading role in examining angiogenic levels in the body 
prior, during and after treatments. The Committee urges NIH to 
use current population studies to determine the angiogenic 
effect of medication, diet and lifestyle. In addition, all 
relevant institutes are urged to coordinate efforts to study 
the correlation of platelet proteomes to angiogenesis with the 
goal of developing a health marker.
    Autism.--The Committee encourages NIMH, NINDS and NICHD to 
expand their support for the development of clinically based 
therapeutics for autistic children through the use of a variety 
of mechanisms, including grants, contracts and the Small 
Business Innovation in Research program.
    Black Scientists.--The Committee is deeply disturbed by the 
recent study which found that between 2000 and 2006, black 
scientists were much less likely to win approval of R01 grants 
than white scientists, even after controlling for the education 
level of the applicants and the academic institution where they 
work. Also of concern is the disproportionately low number of 
black researchers who applied for a grant--just 1.5 percent of 
all applicants. In addition, the study raises questions about 
the effectiveness of NIH's graduate and postgraduate training, 
as black researchers do not seem to benefit from this training 
as much as white researchers do. The Committee notes that NIH 
itself funded this study and that the agency appears to be 
responding with significant actions designed to redress the 
disparities. Ultimately, however, NIH will be judged on whether 
the disparities are reduced. The Committee requests an update 
on this issue in the fiscal year 2013 congressional budget 
justification.
    Bone Research.--The Committee urges the Director to work 
with all relevant institutes to enhance interdisciplinary 
research leading to targeted therapies for improving bone 
density, quality and strength for all Americans. More 
scientific knowledge is needed in a number of key areas 
involving bone and muscle, fat and the central nervous system. 
Research is also urgently needed to improve the identification 
of populations who might require earlier treatment because they 
are at risk of rapid bone loss due to a wide range of 
conditions or diseases, including obesity, diabetes, chronic 
renal failure, cancer, HIV, conditions that affect absorption 
of nutrients or medications, or addiction to tobacco, alcohol 
or other opiates. The Committee also encourages NIH to develop 
a plan to expand genetics and other research on rare bone 
diseases, including: osteogenesis imperfecta, Paget's disease 
of bone, fibrous dysplasia, osteopetrosis, fibrous ossificans 
progressiva, melorheostosis, X-linked hypophosphatemic rickets, 
multiple hereditary exostoses and multiple osteochondroma.
    Chemical Risk Assessment.--The Committee understands that 
NIH supports a new approach on chemical risk assessment based 
on the incorporation of advanced molecular biological and 
computational methods in lieu of animal toxicity tests as 
outlined in a recent National Research Council report. As part 
of that effort, the Committee encourages NIH to continue to 
support extramural and ``proof of concept'' studies on the use 
of toxicity pathway analyses for assessing human risks to 
chemical exposures. The Committee requests an update on these 
efforts in the fiscal year 2013 congressional budget 
justification.
    Chimpanzees.--The Committee is eagerly anticipating the 
release later this year of the Institute of Medicine's analysis 
of whether chimpanzees should continue to be used in medical 
research.
    Chronic Fatigue Syndrome [CFS].--The Committee commends NIH 
for holding a state of the knowledge workshop on CFS in 2011. 
Within 1 year following that workshop, the Committee urges NIH 
to develop a CFS research plan outlining a coordinated strategy 
for intramural and extramural research on CFS and related 
funding opportunity announcements. Further, the Committee 
supports the development of a CFS research database to 
catalogue the intramural and extramural NIH research funding 
that has been awarded for CFS research to date and the 
resulting advances.
    Class B Animal Dealers.--The Committee is encouraged by the 
steps NIH is taking to increase the capacity of Class A vendors 
to supply the types of dogs that currently come from Class B 
random source dealers; to notify its grant recipients that as 
of 2015, the use of NIH grant funds to acquire dogs from Class 
B dealers will be prohibited; and to advise its grantees to 
identify new sources for such animals. The Committee urges NIH 
to set 2015 as the outside target date for completing this 
process. Meanwhile, NIH has informed the Committee that no 
phase-out of cats from Class B vendors is needed, because 
sufficient numbers of cats currently are available through 
Class A vendors to support the needs of NIH-supported research. 
If there is already no need for Class B cats in NIH-funded 
research, the Committee sees no reason why NIH should wait 
until Class B dogs are prohibited--a process that will take at 
least 3 years--to prohibit the use of Class B cats as well. The 
Committee therefore expects NIH to begin informing researchers 
of this policy as soon as possible and requests an update in 
the fiscal year 2013 congressional budget justification.
    Cystic Fibrosis [CF].--While the life expectancy of CF 
patients has slowly improved, the Committee remains concerned 
regarding the severe morbidity and early mortality associated 
with the condition and acknowledges that improvements to date 
have largely focused on enhanced supportive care. The Committee 
cites the strong need for further research regarding treatments 
that target the underlying cause of CF and recognizes that 
protein structural studies may advance the understanding of the 
mechanisms of action of CF drugs in clinical development. The 
Committee encourages support for such protein structural 
studies and encourages the use of new technologies to discover, 
develop and characterize the effect of new treatments, 
including the use of airway imaging to characterize the 
function of the airways. The Committee also notes the potential 
for research in CF to have applications on a wide array of 
human diseases, and urges continued work to identify the 
applications of CF treatments to other disease states.
    Eosinophil-Associated Disorders.--The Committee urges NIH 
to prioritize research on eosinophilic disorders and develop a 
trans-institute strategy involving NIAID, NIDDK, NICHD and 
NIMH. Multidisciplinary research efforts are needed to develop 
improved methods of diagnosis and treatment in adults and 
children and to assess strategies for managing depression and 
emotional stress in patients with severe eosinophilic 
disorders. NIH should seek opportunities to collaborate with 
private sector organizations on this initiative. The Committee 
requests an update on this effort in the fiscal year 2013 
congressional budget justification.
    Fragile X.--The Committee urges NIH, working with NICHD, 
the Fragile X Clinical Research Consortium and the private 
research sector, to fully implement the NIH Research Plan on 
Fragile X Syndrome and Associated Disorders. NIH is encouraged 
to support translational research that shows significant 
promise of safer and more effective treatments for the various 
Fragile X-associated disorders. The Committee requests an 
update in the fiscal year 2013 congressional budget 
justification regarding the status of federally funded registry 
initiatives and how they might be coordinated.
    Global Rare Diseases Patient Registry and Data 
Repository.--The Committee commends NIH for its plans to 
develop the Global Rare Diseases Patient Registry and Data 
Repository [GRDR]. The Committee understands that a pilot 
program of the GRDR will include the creation of an 
infrastructure for an Internet-based platform to aggregate de-
identified patient data from existing and newly established 
rare diseases registries and the development of a web-based 
template to allow any patient group to establish its own 
patient registry. The purpose of this pilot program is to 
develop a resource for patient support organizations and the 
scientific community, academic centers and industry in the 
United States and globally to mine the de-identified, aggregate 
data for various medical research studies, including clinical 
trials. The Committee encourages NIH to consider Duchenne 
muscular dystrophy and glomerular disease for inclusion in the 
pilot program.
    Hereditary Hemorrhagic Telangiectasia [HHT].--The Committee 
urges the Director to bring together representatives from 
NHLBI, NINDS, NIDDK, NIAMS, NICHD, NCI and ORDR to develop a 
coordinated strategy for advancing research on HHT, 
particularly regarding translational research and early 
detection and intervention.
    Human Tissue Supply.--The Committee remains committed to 
matching the increased needs of NIH-funded researchers, both 
intramural and extramural, who rely upon human tissues and 
organs to study human diseases, both normal and rare, and 
strive to translate research advances and discoveries into 
treatments and cures. Furthermore, the Committee recognizes 
that meeting the national demand of production of high-quality 
biospecimens in a timely manner is crucial to advancing 
translational research across all institutes and centers. 
Therefore, the Committee urges the Director to maintain core 
and trans-NIH support for its nationwide human tissue and organ 
procurement network.
    Inflammatory Bowel Disease [IBD].--The Committee commends 
NIH for its support of the Human Microbiome Project and notes 
the significance of this groundbreaking research in advancing 
the understanding of inflammatory bowel disease. The Committee 
encourages NIH to expand research in this area in collaboration 
with the IBD scientific community. In particular, the Committee 
supports expanded genetic and clinical studies of pediatric 
patients.
    Interdisciplinary Research Consortia and the 
NeuroTherapeutics Research Institute.--The Committee encourages 
NIH to continue its initial investments in the development of 
the Interdisciplinary Research Consortia, in particular the 
NeuroTherapeutics Research Institute.
    Lymphatic Research and Lymphatic Disease.--The Committee 
commends the trans-NIH Coordinating Committee for Lymphatic 
Research [CCLR] for its efforts. Nevertheless, stronger 
oversight and engagement is needed from the leadership of the 
Office of the Director and the ICs to help make more meaningful 
advances into the lymphatic system and lymphatic diseases, as 
the Committee has requested for many years. In particular, the 
Committee requests explicit, prospective, actionable plans and 
implementation strategies for each of the 2007 CCLR Working 
Group Recommendations that detail the prospective roles that 
each pertinent Institute and Center would undertake. A 
particular emphasis is needed on the plans for the patient 
registry/tissue bank; clinical and experimental imaging 
initiatives; the incorporation of additional expertise in 
lymphatic biology/disease in the pertinent CSR study sections; 
and the creation of programs to train new investigators in 
lymphatic research. Furthermore, the Committee urges NIAID and 
NIAMS to demonstrate greater emphasis on lymphatics.
    Mitochondrial Disease.--The Committee appreciates the 
efforts of NIH to study mitochondrial function and primary 
mitochondrial disease. Research on primary mitochondrial 
disease is highly relevant to progress on a host of common 
diseases and conditions where mitochondrial dysfunction is 
clearly implicated. The Committee encourages NIH to expand its 
mitochondrial research portfolio to support the training of 
young investigators in the field and incorporate researchers 
with expertise in mitochondrial structure and function into the 
grants review and priority-setting process. Finally, the 
Committee urges NIH to take tangible actions to implement the 
recommendation from NHLBI's 2007 symposium on ``Modeling 
Mitochondrial Dysfunction'' that NIH should better coordinate 
and share the advances that have been made by various ICs 
regarding mitochondrial disease.
    Mobile Technology.--The Committee supports the new 
initiative by the Office of Behavioral and Social Sciences 
Research [OBSSR] in the area of mobile technology research to 
enhance health. The Committee urges that research focus on 
developing pilot programs to support smoking cessation, the 
prevention and detection of diabetes, and maternal and child 
health. The Committee also encourages OBSSR to engage in 
discussions with the Department of State and USAID to evaluate 
and consider global initiatives in these areas.
    Mucopolysaccharidoses [MPS].--The Committee encourages 
NINDS, NIDDK, NIAMS and ORDR to expand research efforts in the 
development of effective treatments for MPS, a group of 
genetic, progressive disorders that are caused by the absence 
or malfunctioning of certain enzymes. The Committee also urges 
all relevant ICs and the ORDR to fund research consortia and 
support conferences on MPS and lysosomal diseases. The 
Committee commends NINDS and the ORDR for sponsoring the recent 
Gordon Research Conference focusing on the basic science of 
lysosomal biology and function but with strong emphasis on 
pathogenic mechanisms of lysosomal disease. The Committee also 
encourages NIAMS to continue to support investigator-initiated 
research focused on the skeletal complications associated with 
MPS.
    Neurofibromatosis [NF].--NF is an important research area 
for multiple NIH institutes. As NF is connected to many forms 
of cancer in children and adults, the Committee encourages NCI 
to substantially increase its NF research portfolio in pre-
clinical and clinical trials by applying newly developed and 
existing drugs. The Committee also encourages NCI to support NF 
centers, clinical trials consortia, patient databases, and 
biospecimen repositories. The Committee urges additional focus 
from NHLBI, given NF's involvement with hypertension and 
congenital heart disease. Because NF causes tumors to grow on 
the nerves throughout the body, the Committee urges NINDS to 
continue aggressive research on nerve damage and repair. In 
addition, the Committee continues to encourage NICHD and NIMH 
to expand funding of clinical trials for NF patients in the 
area of learning disabilities. Children with NF1 are prone to 
the development of severe bone deformities, including 
scoliosis; the Committee therefore encourages NIAMS to expand 
its NF1 research portfolio. The NIDCD is urged to expand its 
research on NF2, which accounts for approximately 5 percent of 
genetic forms of deafness. The Committee encourages the NEI to 
support research on the treatment of optic gliomas, vision loss 
and cataracts, major clinical problems associated with NF. 
Finally, the Committee encourages NHGRI to expand its NF 
portfolio, as NF represents an ideal model to study the 
genomics of cancer predisposition, learning and behavior, and 
bone disease.
    OppNet.--The Committee encourages NIH to continue its 
support of the NIH Basic Behavioral and Social Science 
Opportunity Network [OppNet] and requests an update on the 
network's progress in the fiscal year 2013 congressional budget 
justification.
    Overlapping Chronic Pain Conditions.--The Committee 
recognizes that NIH has taken seriously its repeated calls for 
an improved and expanded research effort to better understand 
overlapping chronic pain conditions including chronic fatigue 
syndrome, endometriosis, fibromyalgia, headache, interstitial 
cystitis, irritable bowel syndrome, temporomandibular joint and 
muscle disorders, and vulvodynia. As noted by the IOM report on 
pain released in June, these poorly understood and neglected 
conditions impact 50 million American women and cost the Nation 
$80,000,000,000 annually, an amount that could be substantially 
reduced with improved research, education and care. The 
Committee is aware that initial progress is being made toward 
the development and implementation of a trans-NIH research 
initiative to support studies aimed at identifying etiological 
pathways of these overlapping conditions, with the goal of 
identifying potential therapeutic targets, and expects further 
substantial progress to be made this fiscal year. This will 
require continued and expanded efforts by all the relevant ICs. 
The Committee urges NINDS to take the lead on this effort.
    Pain.--The Committee has for many years encouraged a 
stronger emphasis on pain research at NIH, and so it notes with 
great interest the recent Institute of Medicine report 
``Relieving Pain in America: A Blueprint for Transforming 
Prevention, Care, Education, and Research.'' The report, which 
was mandated by the Patient Protection and Affordable Care Act 
and funded by NIH, estimates that chronic pain afflicts at 
least 116 million adults in the United States and costs the 
Nation between $560,000,000,000 and $635,000,000,000 a year, of 
which $99,000,000,000 is borne by the Federal Government and 
States. The report documents the growing recognition that 
chronic pain can be a disease in itself, causing changes 
throughout the nervous that often worsen over time. 
Nevertheless, the biological and psychological aspects of pain, 
as well as its diagnosis, treatment and prevention, remain 
poorly understood. NIH took a first step toward addressing 
these questions in a systematic way by creating the NIH Pain 
Consortium in 2003. Eight years later, it is clear that NIH 
must do more. Although every Institute and Center deals in some 
way with pain, none of them ``owns'' this critical area of 
research. If that is to be responsibility of the Pain 
Consortium rather than an individual IC, then the consortium 
needs more resources, more staffing and a more elevated status 
within NIH. The IOM report concludes that ``there needs to be a 
transformation in how pain research is conducted and that the 
Pain Consortium should take an even more proactive role in 
effecting that transformation.'' In addition, the report 
recommends that the consortium should hold ``more frequent, 
regular, structured and productive meetings'' and improve the 
process for reviewing grant proposals related to pain, and that 
NIH should consider the possibility of identifying a lead IC on 
pain. The Committee requests a response to the IOM 
recommendations in the fiscal year 2013 congressional budget 
justification.
    Pediatric Low-Grade Astrocytoma [PLGA].--The Committee 
understands that current treatments for PLGA, a slow-growing 
children's brain cancer, are invasive, toxic and largely 
ineffective, and have not advanced in almost 25 years. 
Therefore, the Committee urges NCI, NINDS, NIBIB, and ORDR to 
accelerate the pace of expansion of the pediatric cancer 
research portfolio by creating research priorities with a 
sequential agenda and timeline, and facilitating the 
collaboration of organizations (both public and private) 
already funding related research initiatives. The Committee 
further encourages the institutes to prioritize targeted 
translational research projects that will help identify 
chemical compounds or combination therapies for use as more 
effective, less toxic treatments. The Committee requests an 
update on these efforts in the fiscal year 2013 congressional 
budget justification.
    Primate Research.--The Committee continues to support the 
National Primate Research Centers, which allow NIH-supported 
scientists to conduct nonhuman primate research in the pursuit 
of improving human health.
    Product Development Partnerships.--Public-private 
partnerships, including product development partnerships 
[PDPs], can both enable critical research and development in 
the global health arena and create jobs in the United States. 
The Committee encourages NIH to cultivate PDPs and to work with 
CDC and other agencies that have a role in advancing global 
health to identify and pursue other innovative research and 
development opportunities.
    Rehabilitation Research.--The Committee recognizes the need 
to continue to build a sustainable infrastructure and capacity 
of emerging scientists in rehabilitation research. The 
Committee encourages the use of career development awards for 
emerging scientists, such as physical therapists, to meet this 
need.
    Spina Bifida.--The Committee encourages NIDDK, NICHD and 
NINDS to study the causes and care of the neurogenic bladder to 
improve the quality of life of children and adults with spina 
bifida; to support research to address issues related to 
treatment, management and associated secondary conditions, such 
as hydrocephalus; and to invest in understanding the myriad co-
morbid conditions experienced by children with spina bifida, 
including those associated with both paralysis and 
developmental delay.
    Tuberous Sclerosis Complex [TSC].--The Committee continues 
to encourage additional research on TSC and related 
neurological disorders. Because TSC serves as a gateway for 
understanding more prevalent neurological disorders such as 
autism and epilepsy, the Committee encourages NIH to focus 
resources on clinical trials for new drug targets for TSC.
    Vulvodynia.--The Committee notes that educational materials 
developed as part of the vulvodynia educational campaign have 
not been made available to key audiences and urges ORWH to 
widely disseminate them to federally funded health centers and 
college health clinics, as well as to the public and patient 
and medical communities.

                        OFFICE OF AIDS RESEARCH

    The Office of AIDS Research [OAR] coordinates the 
scientific, budgetary, legislative and policy elements of the 
NIH AIDS research program. The Committee recommendation does 
not include a direct appropriation for OAR. Instead, funding 
for AIDS research is included within the appropriation for each 
Institute, Center and Division of NIH. The recommendation also 
includes a general provision which directs that the funding for 
AIDS research, as determined by the Director of NIH and OAR, be 
allocated directly to OAR for distribution to the Institutes 
consistent with the AIDS research plan. The recommendation also 
includes a general provision permitting the NIH Director and 
OAR to shift up to 3 percent of AIDS research funding among 
Institutes and Centers throughout the year if needs change or 
unanticipated opportunities arise.
    The Committee includes bill language permitting OAR to use 
up to $8,000,000 for construction or renovation of National 
Primate Research Centers. This is the same as the fiscal year 
2011 level and the budget request.

                        BUILDINGS AND FACILITIES

Appropriations, 2011....................................     $49,900,000
Budget estimate, 2012...................................     125,581,000
Committee recommendation................................     125,581,000

    The Committee recommendation includes $125,581,000, the 
same as the budget request, for NIH buildings and facilities. 
The comparable level for fiscal year 2011 is $49,900,000.
    The Committee understands that the average age of NIH's 280 
buildings is 41 years and that the backlog of maintenance of 
repair exceeds $1,400,000,000. The Committee recommendation 
will not be sufficient to drive down the backlog, but it is 
expected to prevent further degradation of NIH facilities.

       Substance Abuse and Mental Health Services Administration

Appropriations, 2011....................................  $3,511,081,000
Budget estimate, 2012...................................   3,556,648,000
Committee recommendation................................   3,484,262,000

    The Committee recommends $3,484,262,000 for the Substance 
Abuse and Mental Health Services Administration [SAMHSA] for 
fiscal year 2012. The comparable fiscal year 2011 level is 
$3,511,081,000 and the administration request is 
$3,556,648,000. The recommendation includes $129,625,000 in 
transfers available under section 241 of the PHS Act. SAMHSA is 
responsible for supporting mental health programs and alcohol 
and other drug abuse prevention and treatment services 
throughout the country, primarily through categorical grants 
and block grants to States. In addition, the Committee 
recommends that $88,000,000 in mandatory funds be transferred 
to SAMHSA from the Prevention and Public Health [PPH] Fund.
    SAMHSA's work to improve the provision of mental health and 
substance abuse services is carried out by three statutorily-
created Centers: the Center for Mental Health Services, Center 
for Substance Abuse Treatment and the Center for Substance 
Abuse Prevention. The Committee does not concur with the 
administration proposal to reorganize the Programs of Regional 
and National Significance [PRNS] function of each center into a 
single agency-wide account for Innovation and Emerging Issues. 
The Committee believes the proposed consolidated structure 
would be detrimental to the specific programmatic and policy 
expertise of each center, especially as it relates to substance 
abuse prevention and substance abuse treatment. Therefore, the 
Committee has provided funding for PRNS under each of the three 
SAMHSA centers as it has done in previous years.
    The Committee has included new bill language that creates 
separate appropriations for each Center, along with a separate 
appropriation for cross-cutting Health Surveillance and Program 
Support activities. In previous years the Committee provided 
funding to SAMHSA through one agency-wide appropriation. The 
Committee believes this more detailed appropriation structure 
better reflects the organization of SAMHSA's programmatic 
activities and provides for greater transparency and 
accountability of SAMHSA funding.
    The Committee recommendation includes $154,279,000 for 
grants throughout SAMHSA that fund mental health and substance 
use treatment services targeted to homeless and at-risk 
families. Within this total, $14,576,000 is included for a new 
Homeless Initiative Program with the Department of Housing and 
Urban Development to provide permanent supportive housing to 
those who experience chronic, long-term homelessness.

                   CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2011....................................    $977,236,000
Budget estimate, 2012...................................   1,020,769,000
Committee recommendation................................     970,640,000

    The Committee recommends $970,640,000 for mental health 
services. The comparable level for fiscal year 2011 is 
$977,236,000 and the administration request is $1,020,769,000. 
The recommendation includes $20,997,000 in transfers available 
under section 241 of the PHS Act. In addition, the Committee 
recommends that $45,000,000 in mandatory funds be transferred 
to the Center for Mental Health Services [CMHS] from the PPH 
Fund. Included in the recommendation is funding for programs of 
regional and national significance, the community mental health 
services block grant to the States, children's mental health 
services, projects for assistance in transition from 
homelessness, and protection and advocacy services for 
individuals with mental illnesses.

Programs of Regional and National Significance

    The Committee recommends $331,680,000 for programs of 
regional and national significance [PRNS]. The comparable level 
for fiscal year 2011 is $338,276,000 and the administration 
request is $273,342,000. In addition, the Committee recommends 
that $45,000,000 in mandatory funds be transferred to this 
activity from the PPH Fund. These programs address priority 
mental health needs through developing and applying evidence-
based practices, offering training and technical assistance, 
providing targeted capacity expansion grants, and changing the 
delivery system through family, client-oriented and consumer-
run activities.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Co-Occurring State Incentive Grant..........................          $2,168          $2,168          $2,168
    Seclusion & Restraint.......................................           2,449           2,449           2,449
    Youth Violence Prevention...................................          77,568          94,333          77,568
    National Traumatic Stress Network...........................          40,718          11,300          40,800
    Children and Family Programs................................           9,194           6,486           6,486
    Consumer and Family Network Grants..........................           6,236           4,966           6,236
    MH System Transformation and Health Reform..................          26,606          10,623          10,623
    Project LAUNCH..............................................          24,706  ..............          34,706
    Primary and Behavioral Health Care Integration..............          27,807          14,000          27,807
        Primary & Behavioral Health Integration [PPHF]..........          35,000          20,000          35,000
    Community Resilience and Recovery Initiative................           5,000           5,000  ..............
    Suicide Lifeline............................................           5,522           5,522           5,522
    GLS--Youth Suicide Prevention--States.......................          29,374          29,738          29,738
    GLS--Youth Suicide Prevention--Campus.......................           4,858           4,975           4,975
        Suicide Prevention [PPHF]...............................          10,000  ..............          10,000
    AI/AN Suicide Prevention Initiative.........................           2,944           2,944           2,944
    Homelessness Prevention Programs............................          30,830          39,696          39,696
    Older Adult Programs........................................           2,814  ..............  ..............
    Minority AIDS...............................................           9,283           9,283           9,283
    Criminal and Juvenile Justice Programs......................           6,684           6,684           6,684

SCIENCE AND SERVICE:
    GLS--Suicide Prevention Resource Center.....................           4,957           4,957           4,957
    Information Dissemination and Training......................           8,168           7,878           7,878
    Consumer & Consumer Support T.A. Centers....................           1,927           1,927           1,927
    Minority Fellowship Program.................................           4,279           4,279           5,099
    Disaster Response...........................................             904           1,054           1,054
    Homelessness................................................           2,306           2,306           2,306
    HIV/AIDS Education..........................................             974             774             774
----------------------------------------------------------------------------------------------------------------

    Child Trauma.--The Committee reiterates its strong support 
for the National Child Traumatic Stress Network [NCTSN]. The 
Committee has provided $40,800,000 under section 582 of the PHS 
Act to support the continuance of the current model and mission 
of the NCTSN. This activity provides grants to the National 
Center for Child Traumatic Stress [NCCTS] and academic, 
clinical, and community-based centers for the purposes of 
developing knowledge of best practices, offering trauma 
training to child-serving providers, and providing mental 
health services to children and families suffering from PTSD 
and other trauma-related disorders.
    The Committee also recognizes the extraordinary value of 
the core data set developed by the NCCTS, which identifies the 
impact of multiple traumas on the lives of children and the 
effectiveness of evidence-based treatment and services. Within 
the funding provided, the Committee again provides $1,000,000 
for continued data analysis and reports related to the NCCTS 
core data set. Additional data collection by the NCCTS 
regarding clinical processes and outcomes could enhance 
evidence-based practices being utilized through the NCTSN.
    Clinical Training.--The Committee is aware that a new 
clinical accreditation program is being developed by the 
Psychological Clinical Science Accreditation System to ground 
training of practitioners in empirically supported treatments. 
SAMHSA is encouraged to continue its collaboration with 
relevant professional organizations regarding this program so 
that those seeking services are assured of receiving 
scientifically sound treatment.
    Disabilities.--The Committee recognizes the important role 
that SAMHSA plays relative to many Americans with disabilities. 
Emerging research indicates that persons with severe mental 
illness experience additional conditions that impact their 
ability to function within the community. These co-occurring or 
other functional disorders can include substance use disorder, 
hidden traumatic brain injury, chronic medical conditions, or 
other conditions. The Committee urges SAMHSA to continue making 
a substantial commitment to the development of new 
interventions and services for individuals with mental health 
conditions who have co-occurring or multiple disabilities.
    Minority Fellowship Program.--The Committee is concerned 
that while minorities represent 30 percent of the population 
and are projected to increase to 40 percent by 2025, only 23 
percent of recent doctorates in psychology, social work and 
nursing were awarded to minorities. The Committee also 
recognizes that professional counselors are highly trained and 
well-qualified mental health professionals who deliver 
culturally appropriate behavioral health services to diverse 
populations. The Committee has provided an increase in funding 
to allow SAMHSA to increase the pool of culturally competent 
mental health professionals by granting professional counselors 
eligibility to participate in the Minority Fellowship Program.
    Primary and Behavioral Healthcare Integration.--The 
Committee notes that adults with serious mental illness have 
chronic health conditions, such as heart disease, hypertension, 
diabetes and chronic respiratory conditions, at higher rates 
than adults in the general population. The Committee continues 
to believe aggressive action is necessary to eliminate this 
disparity and has continued funding for Primary and Behavioral 
Health Care Integration grants at SAMHSA. The Committee 
provides $62,807,000 for this program, which includes 
$27,807,000 provided in discretionary appropriations and 
$35,000,000 in transfers from the PPH Fund. This is the same as 
the comparable level for fiscal year 2011. The Committee 
directs SAMHSA to ensure that new grants awarded for fiscal 
year 2012 are funded under the authorities in section 520(k) of 
the PHS Act.
    Project LAUNCH.--The Committee recommendation includes 
$34,706,000 for the Project LAUNCH program, which funds mental 
health prevention and promotion strategies for young children 
aged zero to eight. The Committee notes that many prevention 
interventions that reduce risk factors and increase resilience 
are funded in other agencies such as HRSA and the 
Administration for Children and Families. The Committee intends 
that funds provided to Project LAUNCH not duplicate activities 
eligible for funding elsewhere in the Department. The Committee 
requests a list of all grant awards made under this program, 
along with a description of the activities undertaken by 
grantees.
    Suicide Prevention in Indian Populations.--The Committee 
continues to be concerned about the high incidence of drug and 
alcohol abuse and suicide in American Indian populations. 
SAMHSA is encouraged to develop culturally competent suicide 
prevention training courses to be used with selected 
gatekeepers in Indian country. The Committee further urges 
SAMHSA to collaborate with the Indian Health Service to 
identify priority communities to pilot this gatekeeper 
initiative and to develop a plan to help insure the 
sustainability within American Indian and Alaska Native 
communities.

Community Mental Health Services Block Grant

    The Committee recommends $419,933,000 for the community 
mental health services block grant. This amount is the same as 
the comparable fiscal year 2011 level. The administration 
request is $434,684,000. The recommendation includes 
$20,997,000 in transfers available under section 241 of the PHS 
Act.
    The community mental health services block grant 
distributes funds to 59 eligible States and territories through 
a formula based on specified economic and demographic factors. 
Grant applications must include an annual plan for providing 
comprehensive community mental health services to adults with a 
serious mental illness and children with a serious emotional 
disturbance.

Children's Mental Health Services

    The Committee recommends $117,803,000 for the children's 
mental health services program. This amount is the same as the 
comparable fiscal year 2011 level for this program. The 
administration request is $121,316,000. This program provides 
grants and technical assistance to support a network of 
community-based services for children and adolescents with 
serious emotional, behavioral or mental disorders. Grantees 
must provide matching funds and services must be coordinated 
with the educational, juvenile justice, child welfare and 
primary healthcare systems.

Projects for Assistance in Transition From Homelessness [PATH]

    The Committee recommends $64,917,000 for the PATH Program. 
This amount is the same as the comparable fiscal year 2011 
level. The administration request is $65,047,000. The PATH 
program addresses the needs of individuals with serious mental 
illness who are experiencing homelessness or are at risk of 
homelessness. Funds are used to provide an array of services, 
such as screening and diagnostic services, emergency 
assistance, case management, and referrals to the most 
appropriate housing environment.

Protection and Advocacy

    The Committee recommends $36,307,000 for the protection and 
advocacy for individuals with mental illness [PAIMI] program. 
This amount is the same as the comparable fiscal year 2011 
funding level. The administration request is $36,380,000. This 
program helps ensure that the rights of mentally ill 
individuals are protected while they are patients in all public 
and private facilities, or while they are living in the 
community, including in their own homes. Funds are allocated to 
States according to a formula based on population and relative 
per capita incomes.

Mental Health State Prevention Grants

    The Committee recommendation does not include funding for 
the proposed Mental Health State Prevention Grant program. This 
is a new activity that was not funded in fiscal year 2011. The 
administration request is $90,000,000 for this program, which 
would promote the wellness of children, youth and young adults 
up to age 25. While the Committee applauds the administration 
for emphasizing mental health prevention, it was not able to 
provide significant resources to a new State formula program in 
the current fiscal environment. The Committee also notes that 
several key features of the program--such as the allocation 
formula, required activities of grantees and outcome measures--
have not yet been determined.

                  CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2011....................................  $2,189,132,000
Budget estimate, 2012...................................   2,293,136,000
Committee recommendation................................   2,194,227,000

    The Committee recommends $2,194,227,000 for substance abuse 
treatment programs, including programs of regional and national 
significance and the substance abuse prevention and treatment 
block grant to the States. The comparable fiscal year 2011 
level is $2,189,132,000 and the administration request is 
$2,293,136,000. The recommendation includes $81,200,000 in 
transfers available under section 241 of the PHS Act. In 
addition, the Committee recommends that $25,000,000 in 
mandatory funds be transferred to the Center for Substance 
Abuse Treatment [CSAT] from the PPH Fund.

Programs of Regional and National Significance

    The Committee recommends $411,575,000 for programs of 
regional and national significance [PRNS] within CSAT. The 
comparable fiscal year 2011 level is $406,480,000 and the 
administration request is $403,822,000. The recommendation 
includes $2,000,000 in transfers available under section 241 of 
the PHS Act. In addition, the Committee recommends that 
$25,000,000 in mandatory funds be transferred to PRNS from the 
PPH Fund.
    Programs of regional and national significance include 
activities to increase capacity by implementing service 
improvements using proven evidence-based approaches as well as 
science-to-services activities that promote the identification 
of practices thought to have potential for broad service 
improvement.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Co-occurring State Incentive Grants [SIGs]..................           4,263           4,263           4,263
    Opioid Treatment Programs/Regulatory Activities.............           8,903           8,903           8,903
    Screening, Brief Intervention, Referral, & Treatment [SBIRT]          28,237          29,106          28,237
        SBIRT [PPHF]............................................          25,000  ..............          25,000
    TCE--General................................................          28,033          17,411          28,033
    Pregnant & Postpartum Women.................................          16,000          16,000          16,000
    Strengthening Treatment Access and Retention................           1,775           1,675           1,675
    Recovery Community Services Program.........................           5,236           2,450           2,450
    Access to Recovery..........................................          98,954          98,454          98,454
    Children and Families.......................................          30,678          30,678          30,678
    Treatment Systems for Homeless..............................          41,650          47,360          47,360
    Minority AIDS...............................................          65,988          65,988          65,988
    Criminal Justice Activities.................................          65,135          67,635          67,635
    NASPER......................................................  ..............           2,000  ..............
SCIENCE AND SERVICE:
    Addiction Technology Transfer Centers.......................           9,081           9,081           9,081
    Minority Fellowship Program.................................             547             547             547
    Special Initiatives/Outreach................................           2,000           2,271           2,271
----------------------------------------------------------------------------------------------------------------

    Addiction Services Workforce.--The Committee notes the 
growing workforce crisis in the addictions field due to high 
turnover rates, worker shortages, an aging workforce, stigma 
and inadequate compensation. The Mental Health Parity and 
Addiction Equity Act and the Patient Protection and Affordable 
Care Act are anticipated to increase the number of individuals 
who will seek substance use disorder services and may 
exacerbate current workforce challenges. As the provision of 
quality substance use disorder services is dependent on an 
adequate qualified workforce and SAMHSA is the lead Federal 
agency charged with improving these services, the Committee 
expects SAMHSA to focus on developing the addiction workforce 
and identify ways to address the current and future workforce 
needs of the addiction field. The Committee directs SAMHSA to 
submit a report by March 31, 2012, on current workforce issues 
in the addiction field, as well as the status and funding of 
its substance use disorder services workforce initiatives. This 
report should also detail how SAMHSA is working with HRSA to 
address addiction service workforce needs and should identify 
the two agencies' specific roles, responsibilities, funding 
streams and action steps aimed at strengthening the addiction 
services workforce.
    Addiction Technology Transfer Centers [ATTCs].--The 
Committee directs SAMHSA to ensure that ATTCs continue to 
maintain a primary focus on addiction treatment and recovery 
services in order to strengthen the addiction workforce. As 
more individuals become eligible for substance abuse services 
through Medicaid and private insurance, the ATTC network is 
critical to ensure there is a skilled workforce able to meet 
the demand in substance use disorder services.
    Drug Courts.--The Committee directs SAMHSA to ensure that 
all funding appropriated to CSAT for drug treatment courts is 
allocated to serve people diagnosed with a substance use 
disorder as their primary condition. In addition, the Committee 
urges SAMHSA to ensure that State substance abuse agencies are 
eligible to apply for all drug treatment court grant programs 
in its portfolio. The Committee expects SAMHSA to ensure that 
non-State substance abuse agency applicants for these grants 
continue to demonstrate evidence of working directly and 
extensively with the corresponding State substance abuse agency 
in the planning, implementation and evaluation of the grant.
    Hepatitis Testing.--The Committee continues to recognize 
the high incidence of hepatitis among substance abusers. The 
Committee encourages SAMHSA to develop a demonstration project 
on hepatitis education and testing for patients and providers.
    Screening, Brief Intervention, and Referral to Treatment 
[SBIRT].--The Committee recommendation includes $53,237,999 for 
the SBIRT program, which includes $28,237,000 in discretionary 
and evaluation tap funding, along with $25,000,000 in transfers 
from the PPH Fund. The Committee directs SAMHSA to ensure that 
funds provided for SBIRT are used for existing evidence-based 
models of providing early intervention and treatment services 
to those at risk of developing substance abuse disorders.
    Substance Abuse Testing.--The Committee notes the 
scientific progress that has been made on alternative means of 
substance abuse testing, including oral fluid testing, and 
encourages SAMHSA to continue to update its drug testing 
guidelines in order to take advantage of these new 
opportunities.

Substance Abuse Prevention and Treatment Block Grant

    The Committee recommends $1,782,652,000 for the substance 
abuse prevention and treatment [SAPT] block grant. The amount 
is the same as the comparable level for fiscal year 2011. The 
administration request is $1,494,314,000. The recommendation 
includes $79,200,000 in transfers available under section 241 
of the PHS Act. The block grant provides funds to States to 
support alcohol and drug abuse prevention, treatment and 
rehabilitation services. Funds are allocated to the States 
according to a formula. State plans must be submitted and 
approved annually.
    The Committee recommendation does not include a waiver, 
requested by the administration, of the statutory requirement 
that 20 percent of the SAPT block grant be set aside for 
substance abuse prevention. The administration proposes to 
reallocate these setaside funds to a new Substance Abuse State 
Prevention Grant program. The Committee is concerned that 
creating another State grant program with new requirements 
would represent an unnecessary and burdensome approach and 
would not support services being delivered on a continuum of 
prevention, treatment and recovery support services. 
Furthermore, a 1-year waiver of the setaside is not a stable 
basis for States to make long-term plans for substance abuse 
prevention programming.

                 CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2011....................................    $186,061,000
Budget estimate, 2012...................................      74,582,000
Committee recommendation................................     186,361,000

    The Committee recommends $186,361,000 for programs to 
prevent substance abuse. The comparable fiscal year 2011 level 
is $186,061,000 and the administration request is $74,582,000. 
The Center for Substance Abuse Prevention [CSAP] is the sole 
Federal organization with responsibility for improving 
accessibility and quality of substance abuse prevention 
services.

Programs of Regional and National Significance

    The Committee has provided $186,361,000 for programs of 
regional and national significance [PRNS] within CSAP. Through 
the PRNS, CSAP supports: development of new practice knowledge 
on substance abuse prevention; identification of proven 
effective models; dissemination of science-based intervention 
information; State and community capacity building for 
implementation of proven, effective substance abuse prevention 
programs; and programs addressing new needs in the prevention 
system.
    Within the total provided for PRNS, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
CAPACITY:
    Strategic Prevention Framework/Partnerships for Success.....         110,015  ..............         110,015
    Mandatory Drug Testing......................................           4,906           5,206           5,206
    Minority AIDS...............................................          41,385          41,385          41,385
    Sober Truth on Preventing Underage Drinking (STOP Act)......           7,000           7,000           7,000
        National Adult-Oriented Media Public Service Campaign...           1,000           1,000           1,000
        Community-based Coalition Enhancement Grants............           5,000           5,000           5,000
        Intergovernmental Coordinating Committee on the                    1,000           1,000           1,000
         Prevention of Underage Drinking........................
SCIENCE AND SERVICE:
    Fetal Alcohol Spectrum Disorder.............................           9,821           8,000           9,821
    Center for the Application of Prevention Technologies.......           8,074           8,511           8,074
    Science and Service Program Coordination....................           4,789           4,409           4,789
    Minority Fellowship Program.................................              71              71              71
----------------------------------------------------------------------------------------------------------------

    The Committee notes that the Strategic Prevention Framework 
State Incentive Grant [SPF SIG] program promotes an evidence-
based, public health approach to substance abuse prevention. 
This program utilizes a five-step, data-driven planning model 
to ensure that services target areas of greatest need. Grantees 
use the findings from public health research along with 
evidence-based prevention programs to build State and local 
capacity, which will in turn promote resilience and decrease 
risk factors in individuals, families and communities. The 
Partnerships for Success program builds on this model by 
providing additional funding to eligible SPF SIG grantees that 
achieve a quantifiable decline in statewide substance abuse 
rates. Both programs are promising approaches to preventing the 
onset and reducing the progression of substance abuse, 
including childhood and underage drinking.
    The administration proposes to eliminate funding for both 
the SPF SIG and Partnerships for Success programs, terminating 
many grants mid-cycle and before an assessment of program 
performance is completed. While the administration proposed to 
redirect funding to a new Substance Abuse State Prevention 
Grant program, the Committee notes that the President's budget 
would cut substance abuse prevention grants across SAMHSA by 
$71,545,000 below the comparable fiscal year 2011 level. The 
Committee further notes that youth drug use rates are 
increasing and perceptions of harm decreasing. According to 
SAMHSA's National Survey on Drug Use and Health, use of 
marijuana rose among Americans aged 12 and older from 5.8 
percent in 2007 to 6.9 percent in 2010. This is not the time to 
cut funding for substance abuse prevention or to disrupt a 
promising approach to this problem. For this reason the 
Committee recommendation does not approve the administration 
request and provides funding to the SPF SIG and Partnership for 
Success programs at last year's levels. SAMHSA is directed to 
allocate funding to the remaining cohort of SPF SIG grantees at 
amounts not less than what they received in fiscal year 2011.
    The Committee recognizes substance abuse prevention as a 
unique and distinct field and urges SAMHSA to promote 
programming consistent with this finding. The Committee intends 
that funds specifically appropriated for bona fide substance 
abuse and underage drinking prevention purposes shall not be 
consolidated with, reallocated to or used for any other 
programs or initiatives in SAMHSA which do not have youth drug 
and underage alcohol abuse as a primary purpose, even if it may 
have secondary effects on these goals.
    Underage Drinking.--The Committee has provided $1,000,000 
for the Interagency Coordinating Committee on the Prevention of 
Underage Drinking [ICCPUD] and expects this interagency group 
to explicitly address the issue of underage, high-risk drinking 
on college campuses through an identification of best 
practices, strategies and policies currently being implemented 
on college campuses to deal with this persistent and pervasive 
public health issue. The Committee expects to see this specific 
information included in the next ICCPUD report.

                HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2011....................................    $158,652,000
Budget estimate, 2012...................................     168,161,000
Committee recommendation................................     133,034,000

    The Committee recommends $133,034,000 for health 
surveillance and program support activities. The comparable 
level for fiscal year 2011 is $158,652,000 and the 
administration request is $168,161,000. The recommendation 
includes $27,428,000 in transfers available under section 241 
of the PHS Act. In addition, the Committee recommends that 
$18,000,000 in mandatory funds be transferred to this account 
from the PPH Fund for surveillance activities.
    This activity supports Federal staff and the administrative 
functions of the agency. It also provides funding to SAMHSA's 
surveillance and data collection activities, including national 
surveys such as the National Survey on Drug Use and Health.
    The Committee has also provided funding in this account for 
agency activities that cut across SAMHSA's three centers. The 
Committee recommendation reflects the administration proposal 
to consolidate funding for public awareness, performance 
management and information dissemination, including SAMHSA's 
Health Information Network and the National Registry of 
Evidence-based Programs. These support activities were 
previously funded in each Center. Combining these functions in 
a single budget line will allow SAMHSA to achieve efficiencies 
from the consolidation of multiple contracts. The fiscal year 
2011 amounts have been adjusted for comparability.
    The Committee recommendation does not include funding 
requested by the administration for cross-cutting initiatives 
relating to military families or behavioral health information 
technology. The Committee was not able to fund either activity 
due to fiscal constraints.
    The Committee recommendation does not provide discretionary 
funding or transfers from the PPH Fund for the administration's 
proposed Prevention Prepared Communities initiative. According 
to the proposed budget, this new program would implement 
evidence-based programs to prevent substance abuse and mental 
health issues in individuals aged 9 to 25. The Committee 
believes the proposal would be duplicative of other programs, 
such as the SPF SIG and Partnerships for Success. The 
administration requested $22,600,000 for this new program.
    Due to budget constraints, the Committee has not provided 
funding or transfers from the PPH Fund for the administration's 
proposed Tribal Behavioral Health Grant program. The 
administration requested $50,000,000 for this new program.
    The Committee is concerned by the reliance of SAMHSA on 
contractors for the provision of technical assistance. The 
Committee believes that dependence on contractors is 
detrimental to building and maintaining specific knowledge and 
expertise within SAMHSA's workforce. In addition, the Committee 
notes a recent report by the Project on Government Oversight 
showing that the Federal government pays billions more annually 
in taxpayer dollars to hire contractors than it would to hire 
Federal employees to perform comparable services. In this time 
of fiscal constraint, the Committee is concerned that overuse 
of contractors may not maximize the amount of agency funding 
going to service provision. The Committee requests a report no 
later than 3 months after enactment, detailing all agency 
technical assistance contracts issued with fiscal year 2011 
funding. The report should include descriptions of each 
contract, the entities receiving contracts and the amount 
provided.

               Agency for Healthcare Research and Quality

Appropriations, 2011....................................    $372,053,000
Budget estimate, 2012...................................     366,397,000
Committee recommendation................................     372,053,000

    The Committee recommends $372,053,000 for the Agency for 
Healthcare Research and Quality [AHRQ]. This amount is the same 
as the comparable funding level for fiscal year 2011. The 
administration request is $366,397,000 for AHRQ. The Committee 
recommendation is funded entirely from transfers available 
under section 241 of the PHS Act. In addition, the Committee 
recommends that $12,000,000 in mandatory funds be transferred 
to AHRQ from the PPH Fund.
    AHRQ was established in 1990 to enhance the quality, 
appropriateness and effectiveness of health services, as well 
as access to such services. In order to fulfill this mission, 
AHRQ conducts, supports and disseminates scientific and policy-
relevant research on topics such as reducing medical errors, 
eliminating healthcare disparities, using information 
technology, and comparing the effectiveness of drugs and 
medical procedures. AHRQ-supported research provides valuable 
information to researchers, policymakers, healthcare providers 
and patients on ways to improve our Nation's health system and 
make healthcare more affordable.

                  HEALTH COSTS, QUALITY, AND OUTCOMES

    The Committee provides $238,768,000 for research on health 
costs, quality and outcomes [HCQO]. The comparable funding 
level for fiscal year 2011 is $245,653,000 and the 
administration request is $232,612,000 for this activity. In 
addition, the Committee recommends that $12,000,000 in 
mandatory funds be transferred to HCQO from the PPH Fund. The 
HCQO research activity is focused upon improving clinical 
practice, improving the healthcare system's capacity to deliver 
quality care, and tracking progress toward health goals through 
monitoring and evaluation.
    Within the total provided for HCQO, the Committee 
recommendation includes funding for the following activities:

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year
                         Budget activity                               2011         Fiscal year      Committee
                                                                    comparable     2012 request   recommendation
----------------------------------------------------------------------------------------------------------------
Patient-Centered Outcomes Research..............................          21,000          21,600          19,600
Prevention/Care Management......................................          15,904          23,304          15,904
    Prevention and Public Health Fund Transfer (non-add)........          12,000  ..............          12,000
Value...........................................................           3,730           3,730           3,730
Health Information Technology...................................          27,645          27,572          25,572
Patient Safety..................................................          65,585          64,622          65,585
Crosscutting Activities Related to Quality, Effectiveness &              111,789          91,784         108,377
 Efficiency.....................................................
----------------------------------------------------------------------------------------------------------------

    Within the total for HCQO, the Committee provides 
$19,600,000 for patient-centered outcomes research, also known 
as comparative effectiveness research [CER]. The recommendation 
provides sufficient resources to maintain existing grants and 
contracts at AHRQ but does not include funding for new 
research. The Committee has not funded new CER research 
activity in recognition that the Patient Centered Outcomes 
Research Institute, created by the Affordable Care Act, will be 
responsible for managing and prioritizing CER.
    Building the Next Generation of Researchers.--The Committee 
is deeply concerned about declines in the number of, and 
funding for, training grants for the next generation of 
researchers. The Committee urges AHRQ to provide greater 
support to pre- and post-doctoral training grants and 
fellowships to ensure America stays competitive in the global 
research market.
    Clinical Preventive Services Research.--The Committee has 
included $5,000,000 in transfers from the PPH Fund to continue 
to build the evidence base regarding clinical preventive 
services. This research will address evidence gaps in 
implementation of preventive services in primary care, as well 
as advance the national research agenda regarding how to 
improve access, delivery and outcomes of clinical preventive 
services in priority populations.
    Investigator-Initiated Research.--The Committee continues 
to support investigator-initiated research, which forms the 
backbone of AHRQ's ability to improve healthcare with creative 
and innovative approaches to ongoing and emerging healthcare 
issues. Within the Crosscutting Activities Related to Quality, 
Effectiveness and Efficiency Research portfolio, the Committee 
provides $43,364,000, the same as the comparable funding level 
for fiscal year 2011, for investigator-initiated research. This 
funding level will allow ARHQ to support new investigator-
initiated research grants to advance discovery and the free 
marketplace of ideas.
    Moving Research Into Practice.--The Committee continues to 
support AHRQ's research translation activities, including 
practice-based research centers and learning networks that are 
designed to better understand healthcare delivery and move the 
best available research and decisionmaking tools into 
healthcare practice. The Committee recommendation includes 
funding for AHRQ to continue these programs.
    Nurse Staffing Ratios.--The Committee notes that minimum 
nurse staffing standards have been found to increase patients' 
satisfaction with the care they receive and increase the number 
of nurses who serve at the bedside. The Committee encourages 
AHRQ to study the impact that nurse-to-patient ratios, in 
conjunction with the organizational setting, have on the 
quality of care and patient outcomes. AHRQ is also encouraged 
to recommend further integration of these ratios into quality 
measurement and quality improvement activities.
    Rehabilitation Research.--The Committee is aware that 
rehabilitation interventions offer potential solutions to many 
health policy issues regarding cost-effective interventions 
that improve the health of citizens and contribute to a higher 
quality healthcare delivery system. The Committee encourages 
AHRQ to seek opportunities to collaborate with CMS and the 
National Center for Medical Rehabilitation Research [NCMRR] 
within the Eunice Kennedy Shriver National Institute for Child 
Health and Human Development [NICHD]. The Committee believes 
such a partnership should advance potential opportunities to 
conduct comparative investigations of rehabilitation 
interventions with other healthcare treatment approaches.
    Scientific Freedom in Contracted Research.--The Committee 
understands that AHRQ continues to increase its use of 
contracts for conducting research and that in a number of 
circumstances the principal investigator is not allowed to 
publish scientific findings in peer-reviewed journals in a 
reasonable time due to contract clause limitations. The 
Committee is concerned that such contractual prior restraint 
clauses on the publication of research may inadvertently stifle 
scientific freedom and hinder the dissemination of findings 
that can inform health policymaking. The Committee directs AHRQ 
to review its policies to ensure researchers have the 
opportunity to publish research findings in scientific peer-
reviewed journals without unreasonable restrictions to allow 
greater review and input from the scientific community.
    U.S. Preventive Services Task Force [USPSTF].--The 
Committee provides a program level of $11,300,000 for the 
USPSTF, the same as the comparable funding level for fiscal 
year 2011. The recommendation includes $4,300,000 in transfers 
available from section 241 of the PHS Act and $7,000,000 in 
transfers from the PPH Fund.

                   MEDICAL EXPENDITURES PANEL SURVEYS

    The Committee provides $59,300,000, the same as the 
administration request, for medical expenditures panel surveys 
[MEPS]. The comparable funding level for fiscal year 2011 is 
$58,800,000. MEPS collects detailed information annually from 
households, healthcare providers and employers regarding how 
Americans use and pay for healthcare. The data from MEPS are 
used to develop estimates of healthcare utilization, 
expenditures, sources of payment and the degree of health 
insurance coverage of the U.S. population. The increase 
provided will support the precision of survey estimates and 
analytic capacity by maintaining MEPS' sample size.

                            PROGRAM SUPPORT

    The Committee recommends $73,985,000 for program support. 
The comparable funding level for fiscal year 2011 is 
$67,600,000 and the administration request is $74,485,000. The 
Committee recommendation includes funding requested by the 
administration for tenant improvement costs associated with a 
possible relocation of staff. Funding has also been provided to 
support dissemination of USPSTF recommendations and increase 
transparency of USPSTF methods and processes.

               Centers for Medicare and Medicaid Services

                     GRANTS TO STATES FOR MEDICAID

Appropriations, 2011....................................$173,143,799,000
Budget estimate, 2012................................... 184,279,110,000
Committee recommendation................................ 184,279,110,000

    The Committee recommends $184,279,110,000 in mandatory 
funding for Grants to States for Medicaid. This is the same 
amount as the administration's request for fiscal year 2012. 
The fiscal year 2011 comparable level was $173,143,799,000.
    The fiscal year 2012 recommendation excludes 
$86,445,289,000 in fiscal year 2011 advance appropriations for 
fiscal year 2012. As requested by the administration, 
$90,614,082,000 is provided for the first quarter of fiscal 
year 2013.
    The Medicaid program provides medical care for eligible 
low-income individuals and families. It is administered by each 
of the 50 States, the District of Columbia, Puerto Rico and the 
territories. Federal funds for medical assistance are made 
available to the States according to a formula that determines 
the appropriate Federal matching rate for State program costs. 
This matching rate is based on the State's average per capita 
income relative to the national average and cannot be less than 
50 percent.

                   PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2011....................................$229,464,000,000
Budget estimate, 2012................................... 231,011,580,000
Committee recommendation................................ 231,012,000,000

    The Committee recommends $231,012,000,000 in mandatory 
funding for Payments to Healthcare Trust Funds. The 
administration's request for fiscal year 2012 is 
$231,011,580,000. The fiscal year 2011 comparable level was 
$229,464,000,000.
    This entitlement account includes the general fund subsidy 
to the Federal Supplementary Medical Insurance Trust Fund for 
Medicare part B benefits and for Medicare part D drug benefits 
and administration, plus other reimbursements to the Federal 
Hospital Insurance Trust Fund for part A benefits and related 
administrative costs that have not been financed by payroll 
taxes or premium contributions.
    The Committee provides $178,041,000,000 for the Federal 
payment to the Supplementary Medical Insurance Trust Fund. This 
payment provides matching funds for premiums paid by Medicare 
part B enrollees. The Committee further provides 
$51,451,000,000 for the general fund share of benefits paid 
under Public Law 108-173, the Medicare Prescription Drug, 
Improvement and Modernization Act of 2003. The Committee 
includes bill language requested by the administration 
providing indefinite authority for paying the general revenue 
portion of the part B premium match and provides resources for 
the part D drug benefit program in the event that the annual 
appropriation is insufficient.
    The Committee recommendation also includes $475,000,000 to 
be transferred to the Supplementary Insurance Trust Fund as the 
general fund share of part D administrative expenses. The 
Committee recommendation includes $581,000,000 in 
reimbursements to the Health Care Fraud and Abuse Control 
[HCFAC] fund.

                           PROGRAM MANAGEMENT

Appropriations, 2011....................................  $3,586,855,000
Budget estimate, 2012...................................   4,396,973,000
Committee recommendation................................   4,044,876,000

    The Committee recommends $4,044,876,000 for CMS program 
management. The administration requested $4,396,973,000. The 
fiscal year 2011 comparable level was $3,586,855,000.

Research, Demonstrations and Evaluations

    The Committee recommends $31,200,000 for research, 
demonstrations and evaluation activities. The Committee 
includes sufficient funding to fulfill the President's request 
for the Medicare Current Beneficiaries Survey, Real Choice 
Systems Change grants, other activities and continuations of 
the demonstrations previously authorized under this account.
    CMS research and demonstration activities expand efforts 
that improve the efficiency of payment, delivery, access and 
quality of the Medicare and Medicaid programs.
    The Committee encourages the Center for Medicare and 
Medicaid Innovation to collaborate with AHRQ to expand and 
implement research that has resulted in successful strategies 
to reduce waste and duplication in hospitals while improving 
the quality of healthcare. The Committee believes that AHRQ's 
research translation activities, such as its ACTION network, 
could be used to promote these strategies to hospitals and help 
with their implementation.
    Atrial Fibrillation [AFib].--The Committee is aware that 
AFib is the most common chronic cardiac arrhythmia, affecting 
an estimated 2.3 million Americans. The number of patients with 
AFib is likely to increase significantly, underscoring a 
substantial public health risk. Already, the disease accounts 
for approximately one-third of hospitalizations for cardiac 
rhythm disturbances, costing $4,700 per patient annually. AFib 
also has significant morbidity and mortality consequences, 
increasing the risk of stroke approximately five-fold and 
causing an estimated 15 percent of all strokes in the United 
States. The Committee encourages CMS to consider targeting AFib 
patients in current and planned Medicare payment and quality 
improvement programs for the purpose of improving patient 
outcomes and reducing avoidable healthcare costs, including 
those associated with hospital admissions and readmissions for 
these patients. Such programs could include those pertaining to 
quality reporting, performance measurement, medication therapy 
management, wellness assessments, transitions of care, support 
services, and post-acute care.
    Chronic Kidney Disease.--The Committee is aware that 
approximately 23 million Americans have evidence of kidney 
disease and another 20 million are at risk of developing it. 
Therefore the Committee strongly supports efforts to prevent 
kidney disease and detect symptoms early to improve treatment 
outcomes. The Kidney Disease Education and Awareness program 
authorized in section 152 of the Medicare Improvements for 
Patients and Providers Act of 2008 is one such program. The 
intent of this program is to increase awareness and screening 
of chronic kidney disease and enhance surveillance systems to 
better assess the incidence and prevalence of this disease. The 
program would be carried out through a 5-year pilot project in 
three States, with a GAO evaluation. The Committee encourages 
CMS to consider implementing this demonstration to determine if 
greater outreach can improve health outcomes and generate cost 
savings for the Federal Government.

Program Operations

    The Committee recommends $2,813,935,000 for program 
operations. The comparable funding level for fiscal year 2011 
was $2,397,655,000 and the fiscal year 2012 budget request was 
$3,062,025,000.
    The program operations account covers a broad range of 
activities including claims processing and program safeguard 
activities performed by Medicare contractors. These contractors 
also provide information, guidance and technical support to 
both providers and beneficiaries.
    The Committee recommendation includes $167,863,000 for 
contract costs for the Healthcare Integrated General Ledger 
Accounting System and includes bill language that extends the 
availability of those funds until September 30, 2013.
    The Committee has included additional funding within 
Program Operations to help support the work required of CMS to 
implement the Patient Protection and Affordable Care Act, 
signed into law on March 23, 2010.
    This funding will be used to support the development of 
quality standards for the Medicare Shared Savings plan, 
performance measures to reduce hospital acquired infections, 
quality incentives on end-stage renal disease and value-based 
purchasing standards.
    In addition, the Patient Protection and Affordable Care Act 
requires CMS in fiscal year 2012 to improve parts C and D of 
Medicare by closing the ``doughnut hole,'' simplifying election 
periods, reducing wasteful dispensing, and extending special 
needs plans.
    CMS will expand consumer assistance and education efforts, 
with healthcare.gov being the primary example. CMS plans to 
expand provider assistance as well, including the introduction 
of additional transparency in the Medicare appeals process.
    Finally, the Patient Protection and Affordable Care Act 
requires CMS in fiscal year 2012 to support States as they 
attempt to meet the January 1, 2013, deadline for a viable 
State-based health insurance exchange.
    The Committee recommendation also includes increased 
funding for the National Medicare Education program. This 
funding supports beneficiary materials, Internet sites, contact 
centers and support services. The Committee notes that the baby 
boom generation is beginning to age into Medicare, with average 
monthly enrollment jumping from 45.9 million in 2009 to 47.2 
million in 2010. That trend will only accelerate in the coming 
years, causing a dramatic increase in the need for support as 
these Americans set up their Medicare benefit plans. Baby 
boomers access information in different ways than previous 
generations already on Medicare did and the Committee commends 
CMS for modifying beneficiary materials and support systems 
accordingly.
    Collaboration With the Food and Drug Administration 
[FDA].--The Committee encourages CMS to review information from 
FDA that describes if a newly approved drug indication was 
approved by FDA through either a noninferiority or a 
superiority trial. A manufacturer can choose to submit a new 
drug application using either a non-inferiority or a 
superiority clinical trial or both.
    Medicare Secondary Payer Reimbursement.--The Committee is 
concerned by the delays experienced in the Medicare Secondary 
Payer reimbursement system, in part caused by a lack of clear 
information about the amount owed to Medicare. The Committee 
expects CMS to submit a plan to the Committee within 180 days 
of enactment of this act that allows Medicare beneficiaries to 
obtain a final and reliable demand letter regarding how much 
they must reimburse Medicare under the Medicare Secondary Payer 
Act prior to reaching a settlement in the associated civil 
litigation. That plan must identify any statutory of other 
barriers to implementing such a process, make recommendations 
related to any barriers identified and propose a timeline for 
implementation.
    Mobile Oxygen Therapy.--The Committee is aware of ongoing 
research into mobile applications of oxygen therapy in wound 
care, which might allow for less onerous and less expensive 
forms of delivery. Some of these devices provide episodic 
oxygen delivery, while others provide continuous streams of 
oxygen. The Committee encourages CMS to review clinical data on 
all forms of mobile oxygen delivery, with an eye toward 
improved wound healing.
    Remote Access to Care.--The Committee is concerned by a 
recent letter from CMS to a grantee of the Federal Native 
Hawaiian Health Care program that effectively blocks the 
implementation of a Hawaii State law allowing advanced practice 
registered nurses to practice without the physical supervision 
of a physician. Given the barrier imposed by island geography, 
blocking the State law may have the unintended consequence of 
reducing access to care. The Committee urges CMS to work with 
the Health Resources Services Administration to find a suitable 
resolution that maximizes access to care in remote locations.
    Uniformed Services Plans.--The Committee understands that 
CMS may assume responsibility for future enrollees of the 
Uniformed Services Family Health Plans [USFHP] past age 65 
pending the final disposition of a Department of Defense [DOD] 
proposal included in the fiscal year 2012 National Defense 
Authorization Act. The Committee is aware of the high patient 
satisfaction rates that this plan enjoys. The Committee directs 
CMS to work with DOD to ensure that beneficiaries experience 
the smoothest possible transition. In addition, the Committee 
urges CMS to explore the quality of care, cost-effectiveness 
and medical outcomes of this model to determine if a 
demonstration is warranted on capitation-based payment systems. 
If this proposal is enacted, the Committee requests a report in 
the fiscal year 2013 justification on the steps CMS has taken 
to ensure the continuity of care for beneficiaries and to 
review the USFHP model for any strategies CMS might adopt 
around delivering high-quality integrated care.
    Vaccination.--It is estimated that the cost of the health 
burden to society from vaccine preventable diseases, including 
influenza, is approximately $10,000,000,000 annually. In 
particular, the Committee is concerned that the majority of 
healthcare workers do not get regularly recommended 
vaccinations and that adult vaccination rates are particularly 
low for minority groups. The Committee commends CMS for 
including healthcare workers in seasonal influenza vaccination 
reporting rates and performance metric. The Committee looks 
forward to reviewing the data that will be collected beginning 
in 2012.

State Survey and Certification

    The Committee recommends $361,276,000, the same as the 
fiscal year 2011 level, for Medicare State survey and 
certification activities. The administration's request for 
fiscal year 2012 was $400,283,000.
    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.

High Risk Insurance Pools

    The Committee has included $44,000,000, the same as the 
budget request, for High Risk Insurance Pools. The fiscal year 
2011 level was $54,890,000.

Federal Administration

    The Committee recommends $794,465,000 for Federal 
administration costs. The fiscal year 2011 funding level was 
$737,505,000 and the budget request was $859,465,000.
    Dental Disease.--The Committee notes that, although 
virtually all dental disease is fully preventable, tooth decay 
remains the most common chronic illness among children. With 
more children expected to receive coverage for dental services, 
there will be even greater pressure on an already challenged 
dental delivery system. Increasing entry points into the oral 
healthcare delivery system is increasingly being recognized as 
essential to improving access to oral healthcare. Currently, 34 
States allow dental hygienists to provide dental care outside 
of a dental office without a prior exam or pre-authorization by 
a dentist. The Committee urges CMS and HRSA to take steps to 
facilitate expanded access to dental services in community 
health centers and other public health settings. Further, 
dental Medicaid regulations should be updated to reflect how 
practice has evolved and dental services are currently 
delivered.
    Tuberculosis [TB].--The Committee is concerned about the 
growth in cases of drug-resistant forms of TB, including 114 
cases of multi-drug-resistant TB in the United States in 2009. 
The Committee notes that timely and effective treatment 
regimens are necessary to reduce transmission of drug-resistant 
TB. Therefore, the Committee strongly supports the ongoing 
collaboration between CMS and CDC that has thus far resulted in 
multi-level communication to States about options in Medicaid. 
The Committee encourages CMS to continue this collaboration.

                  HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2011....................................    $310,377,000
Budget estimate, 2012...................................     580,580,000
Committee recommendation................................     581,000,000

    The Committee recommends $581,000,000, to be transferred 
from the Medicare trust funds, for health care fraud and abuse 
control activities. The comparable amount in fiscal year 2011 
was $310,377,000 and the fiscal year 2012 budget request 
included $580,580,000.
    The Committee recommendation includes a base amount of 
$311,000,000 and an additional $270,000,000 through a budget 
cap adjustment authorized by section 251(b) of the Balanced 
Budget and Emergency Deficit Control Act of 1985.
    This amount, in addition to the $1,271,930,000 in mandatory 
monies for these activities, will provide a total of 
$1,852,930,000 for health care fraud and abuse control 
activities in fiscal year 2012.
    The Committee has included $345,715,000 in discretionary 
funds for the Medicare Integrity Program and intends the 
remaining funds to be allocated as they were requested in the 
administration's budget for fiscal year 2012.

                Administration for Children and Families

  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT 
                                PROGRAMS

Appropriations, 2011....................................  $2,964,323,000
Budget estimate, 2012...................................   2,305,035,000
Committee recommendation................................   2,305,035,000

    The Committee recommends $2,305,035,000, the same as the 
budget request under current law, in fiscal year 2012 mandatory 
funds for payments to States for child support enforcement and 
family support programs. The comparable fiscal year 2011 
appropriation is $2,964,323,000. In addition, the Committee 
recommends $1,100,000,000, the same as the budget request, in 
advance funding for the first quarter of fiscal year 2013. The 
comparable advance appropriation provided in fiscal year 2011 
as an advance appropriation for fiscal year 2012 is 
$1,200,000,000.
    These funds support States' efforts to promote the self-
sufficiency and economic security of low-income families, 
including administrative expenses matching funds and incentive 
payments to States for child support enforcement; grants to 
States to help establish and administer access and visitation 
programs between non-custodial parents and their children; 
payments to territories for benefits to certain aged, blind, or 
disabled individuals; and temporary benefits for certain 
repatriated citizens.
    The Committee notes that the budget request includes a 
legislative proposal that would require that child support 
payments made on behalf of youth in foster care are used in the 
best interest of the child, rather than as an offset to State 
and Federal child welfare costs. The Committee supports this 
initiative and will work with the Committees of jurisdiction on 
this proposal as necessary.

               LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2011....................................  $4,700,580,000
Budget estimate, 2012...................................   2,569,551,000
Committee recommendation................................   3,600,580,000

    The Committee recommends $3,600,580,000 for the low income 
home energy assistance program [LIHEAP]. The comparable fiscal 
year 2011 funding level is $4,700,580,000 and the fiscal year 
2012 budget request is $2,569,551,000. LIHEAP provides home 
heating and cooling assistance to low-income households, 
generally in the form of payments to energy vendors on behalf 
of the recipient.
    The Committee is aware of the significant continuing demand 
for LIHEAP assistance and regrets that budget constraints 
require a cut in funding. The Committee notes that the 
recommended level for fiscal year 2012 is $1,030,252,000 higher 
than the fiscal year 2008 funding level and $1,031,029,000 
higher than the administration's budget request.
    Within the total, the Committee recommendation includes 
$3,400,653,000 for the State formula block grant. Bill language 
stipulates that all of the funds should be allocated to States 
based on the original LIHEAP formula. The comparable fiscal 
year 2011 funding level is $4,500,653,000 and the budget 
request is $1,980,000,000. LIHEAP block grants are awarded to 
States, territories, Indian tribes, and tribal organizations 
according to a statutory formula, based in part on each State's 
share of home energy expenditures by low-income households. 
Within this amount, the Committee includes up to $3,000,000 for 
program integrity and oversight efforts and $27,000,000 for 
leveraging incentive funds, as requested by the administration.
    The Committee recommendation also includes $199,927,000, 
the same as the comparable fiscal year 2011 level, for the 
contingency fund. The budget request is $589,551,000. The 
Committee does not include bill language making the contingency 
fund available until expended, as proposed by the 
administration. The contingency fund is used to provide 
additional assistance to States adversely affected by extreme 
heat or cold, significant price increases, or other causes of 
energy-related emergencies.

                     REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2011....................................    $729,466,000
Budget estimate, 2012...................................     824,694,000
Committee recommendation................................     787,639,000

    The Committee recommends $787,639,000 for refugee and 
entrant assistance. The comparable fiscal year 2011 funding 
level is $729,466,000 and the fiscal year 2012 budget request 
is $824,694,000. The refugee and entrant assistance program is 
designed to assist refugees, asylees, Cuban and Haitian 
entrants, trafficking victims, and torture victims (summarized 
below as ``refugees'') to become employed and self-sufficient 
as quickly as possible. It also funds temporary shelter and 
services for unaccompanied alien children apprehended by law 
enforcement who are in Federal custody awaiting adjudication of 
their immigration status.

Transitional and Medical Services

    The Committee recommendation includes $386,625,000 for 
transitional and medical assistance. The comparable fiscal year 
2011 funding level is $352,625,000 and the budget request is 
$394,224,000.
    Transitional and medical services provide grants to States 
and nonprofit organizations to provide up to 8 months of cash 
and medical assistance to incoming refugees as well as foster 
care services to unaccompanied minors. Within the total, the 
Committee recommendation includes not less than $65,000,000 for 
the voluntary agency matching grant program, which provides 
grants to resettlement agencies to provide comprehensive 
services, including case management, job development, job 
placement, and interim housing and cash assistance, with the 
goal of refugees becoming self-sufficient within their first 4 
months. Refugees enrolled in this program are not eligible for 
regular transitional and medical assistance. The Committee 
continues to support the voluntary agency matching grant 
program and encourages the Office of Refugee Resettlement [ORR] 
to explore the continued expansion of this program.
    While many of the costs of the transitional and medical 
services program are outside of HHS' control, the Committee 
remains concerned with the projected increases in these costs. 
The Committee directs ACF to include actual and projected 
information in their fiscal year 2013 budget justification, 
broken out by refugees in State-administered, voluntary agency 
matching grant, and Wilson-Fish programs where applicable, on 
the number of refugees arriving in the United States, 
potentially eligible for assistance and actually receiving 
assistance; the average amount of time refugees receive 
assistance; the average cash and medical assistance benefit; 
and the total obligations of the program. The Committee also 
directs ACF to separately include information on the actual and 
projected costs of reimbursing States for providing foster care 
for unaccompanied refugee minors [URM], including the number of 
URMs in foster care.

Victims of Trafficking

    The Committee recommendation includes $9,794,000, the same 
amount as the comparable fiscal year 2011 funding level, for 
victims of trafficking. The fiscal year 2012 budget request is 
$9,814,000. This program supports a national network for 
identifying, certifying and providing comprehensive services to 
international victims of trafficking.

Social Services

    The Committee recommendation includes $153,697,000, the 
same amount as the comparable fiscal year 2011 funding level, 
for social services. The fiscal year 2012 budget request is 
$179,005,000. These funds include formula and discretionary 
grants to States and nonprofit organizations to provide a 
variety of employment and support services to recently arrived 
refugees.

Preventive Health

    The Committee recommendation includes $4,739,000, the same 
amount as the comparable fiscal year 2011 funding level, for 
preventive services. The budget request is $4,748,000. This 
program funds grants to coordinate and promote refugees' access 
to health screening, treatment and follow-up services.

Targeted Assistance

    The Committee recommendation includes $48,493,000 for 
targeted assistance, the same amount as the comparable fiscal 
year 2011 funding level, for the targeted assistance program, 
which provides additional funds to States with an influx of 
refugee arrivals and a high concentration of refugees facing 
difficulties achieving self-sufficiency. The budget request is 
$48,590,000.

Unaccompanied Alien Children

    The Committee recommendation includes $173,225,000 for 
unaccompanied alien children [UAC]. The comparable fiscal year 
2011 funding level is $149,052,000 and the budget request is 
$177,225,000. The unaccompanied alien children program provides 
shelter and support services to unaccompanied alien minors 
apprehended in the United States by the Department of Homeland 
Security or other law enforcement agencies. Children are taken 
into ORR's care pending resolution of their claims for relief 
under U.S. immigration law or release to an adult family member 
or guardian.
    Within the total, the Committee provides $6,100,000 to 
continue the pro bono legal services initiative to ensure legal 
representation for both released and detained children. These 
funds should be used to train legal counsel to detect abuse, 
mistreatment, labor exploitation and trafficking of these 
children. In addition, a portion of these funds should be used 
to train legal counsel in methods that will ensure the 
appearance of children at all immigration court hearings.

Victims of Torture

    The Committee recommendation includes $11,066,000, the same 
amount as the comparable fiscal year 2011 funding level, for 
victims of torture. The budget request is $11,088,000. This 
program provides treatment, social and legal services to 
victims of torture and training to healthcare providers on 
treating the physical and psychological effects of torture.

    PAYMENTS TO STATES FOR THE CHILDCARE AND DEVELOPMENT BLOCK GRANT

Appropriations, 2011....................................  $2,222,627,000
Budget estimate, 2012...................................   2,926,757,000
Committee recommendation................................   2,222,627,000

    The Committee recommends $2,222,627,000, the same amount as 
the comparable fiscal year 2011 funding level, for the 
childcare and development block grant [CCDBG]. The budget 
request is $2,926,757,000. The CCDBG is a formula grant to 
States to provide financial assistance to low-income families 
to help pay for childcare and improve the quality of childcare 
programs.
    Within the total, the Committee recommendation includes 
$18,922,000 for resource and referral programs and school-aged 
childcare activities, of which $1,000,000 is specified in bill 
language for a national toll-free hotline and Web site that 
provides consumer education materials and assists families in 
accessing local information on childcare options. The Committee 
recommendation also includes $283,592,000 for childcare quality 
improvement activities, of which $104,005,000 is specified for 
improving infant and toddler childcare. These quality 
improvement funds are in addition to the 4 percent quality 
improvement set-aside established in the authorizing 
legislation. Finally, the Committee recommendation includes 
$9,890,000 for childcare research and evaluation activities.
    The Committee notes the administration has proposed revised 
reporting requirements for tribes that integrate Federal 
funding, including CCDBG funding, for employment, job training 
and related services into a single coordinated program, as 
authorized by Public Law 102-477. While the Committee supports 
an improved reporting system, any changes should be made 
consistent with Public Law 102-477, which is intended to 
improve efficiencies and lessen the administrative burden on 
tribes. The Committee does not support the proposed requirement 
that tribes under this program report separately on CCDBG, 
Temporary Assistance for Needy Families, and Native Employment 
Works funding. The Committee expects notification prior to ACF 
implementing any changes to reporting requirements under these 
programs.

                      SOCIAL SERVICES BLOCK GRANT

Appropriations, 2011....................................  $1,700,000,000
Budget estimate, 2012...................................   1,700,000,000
Committee recommendation................................   1,700,000,000

    The Committee recommends $1,700,000,000 in mandatory funds 
for fiscal year 2012 for the social services block grant 
[SSBG]. This amount is the same as the comparable fiscal year 
2011 funding level and the budget request. The SSBG is a 
flexible source of funding that allows States to provide a 
diverse array of services to low-income children and families, 
the disabled and the elderly.
    The Committee continues to regard the SSBG as a critical 
source of funding for services that protect children from 
neglect and abuse, including providing foster and respite care, 
as well as related services for children and families, persons 
with disabilities and older adults. The Committee recognizes 
the importance of this program, especially in providing mental 
health and counseling services to underserved populations, and 
recommends continued usage and flexibility of these funds for 
such purposes.

                 CHILDREN AND FAMILY SERVICES PROGRAMS

Appropriations, 2011....................................  $9,519,357,000
Budget estimate, 2012...................................   9,794,598,000
Committee recommendation................................   9,845,685,000

    The Committee recommends $9,845,685,000 for fiscal year 
2012 for children and families services programs. The 
comparable funding level for fiscal year 2011 is $9,519,357,000 
and the budget request is $9,794,598,000. The recommendation 
includes an additional $5,762,000 in transfers available under 
section 241 of the Public Health Service Act.
    This appropriation supports a variety of programs for 
children, youth and families; the developmentally disabled; 
Native Americans; victims of child abuse, neglect and domestic 
violence; and other vulnerable populations.

Head Start

    The Committee recommends $7,899,633,000 for Head Start. The 
comparable funding level for fiscal year 2011 is $7,559,633,000 
and the budget request is $8,099,783,000.
    Head Start provides comprehensive early childhood 
development services for low-income children and families that 
emphasize cognitive and language development, socio-emotional 
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 recommendation maintains the expansion of the 
Head Start program started with Recovery Act funding in fiscal 
years 2009 and 2010. It fully supports the increase of over 
61,000 Head Start slots funded through the Recovery Act and in 
total will allow Head Start to provide comprehensive early 
childhood services to 968,000 low-income children and their 
families.
    There is considerable and increasing evidence that high-
quality early childhood education has long lasting effects for 
low-income children and families. Children receiving high-
quality care are more likely to graduate high school on time 
and go on to college, more likely to earn higher incomes later 
in life and less likely to commit a crime. The Committee's 
investments in Head Start and elsewhere in HHS and the 
Department of Education, as well as changes in the Improving 
Head Start for School Readiness Act of 2007, will ensure that 
more low-income children and families have access to high-
quality early childhood education.

Consolidated Runaway and Homeless Youth Program

    The Committee recommends $97,539,000, the same as the 
fiscal year 2011 level, for the consolidated runaway and 
homeless youth program. The budget request includes 
$102,734,000 for this purpose. This program supports basic 
centers which provide temporary shelter, counseling and after-
care services to runaway and homeless youth under age 18 and 
their families; the transitional living program, which provides 
longer-term shelter and services for older youth; and a 
national toll-free runaway and homeless youth crisis hotline. 
Because of budget constraints, the Committee recommendation 
regretfully does not include increased funding for the 
administration's proposal targeted at enhancing services for 
youth victims of sex trafficking.
    Basic centers and transitional living programs provide 
services to help address the needs of some of the estimated 
1,600,000 runaway and homeless youth, many of whom are running 
away from unsafe or unhealthy living environments. These 
programs have been proven effective at lessening rates of 
family conflict and parental abuse, as well as increasing 
school participation and the employment rates of youth.

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth

    The Committee recommends $17,935,000, the same as the 
fiscal year 2011 level, for education and prevention grants to 
reduce sexual abuse of runaway and homeless youth. The budget 
request is $17,971,000. This program provides competitive 
grants for street-based outreach and education services for 
runaway and homeless youth who are subjected to or are at risk 
of being subjected to sexual abuse or exploitation.

Child Abuse Prevention and Treatment Programs

    The Committee recommends $93,881,000, the same as the 
fiscal year 2011 level, for child abuse prevention and 
treatment programs. The budget request is $97,244,000. These 
programs seek to improve and increase activities that identify, 
prevent and treat child abuse and neglect through grants to 
States; research and demonstrations; technical assistance; and 
grants to community-based organizations.
            State Formula Grants
    Within the total for child abuse prevention and treatment, 
the Committee recommendation includes $26,482,000 for State 
formula grants, the same as the comparable fiscal year 2011 
funding level. The budget request is $26,535,000. This program 
provides formula grants to States to improve their child 
protective service systems.
            Discretionary Activities
    Within the total for child abuse prevention and treatment, 
the Committee recommendation includes $25,793,000 for 
discretionary activities, the same as the comparable fiscal 
year 2011 funding level. The budget request is $29,020,000. 
This program supports discretionary grants for research, 
demonstration and technical assistance to increase the 
knowledge base of evidence-based practices and disseminate 
information to State and local child welfare programs.
            Community-Based Grants
    Within the total for child abuse prevention and treatment, 
the Committee recommendation includes $41,606,000 for 
community-based grants, the same as the comparable fiscal year 
2011 funding level. The budget request is $41,689,000. This 
program provides formula grants to States that then disburse 
funds to local, community-based organizations to improve local 
child abuse prevention and treatment efforts, including 
providing direct services and improving the coordination 
between State and community-based organizations.

Abandoned Infants Assistance

    The Committee recommends $11,575,000, the same as the 
budget request, for the abandoned infants assistance program. 
The comparable fiscal year 2011 funding level is $11,605,000. 
This program provides discretionary grants to public and 
private community and faith-based organizations to develop, 
implement and operate demonstration projects that prevent the 
abandonment of infants and young children impacted by substance 
abuse and HIV. Funds may be used to provide respite care for 
families and caregivers, allow abandoned infants and children 
to reside with their natural families or in foster care, and 
carry out residential care programs for abandoned infants and 
children who are unable to reside with their families or be 
placed in foster care.

Child Welfare Services

    The Committee recommends $281,181,000, the same as the 
comparable fiscal year 2011 funding level, for child welfare 
services. The budget request is $281,744,000. This formula 
grant program helps State and tribal public welfare agencies 
improve their child welfare services with the goal of keeping 
families together. States and tribes provide a continuum of 
services that prevent child neglect, abuse or exploitation; 
allow children to remain with their families, when appropriate; 
promote the safety and permanence of children in foster care 
and adoptive families; and provide training and professional 
development to the child welfare workforce.

Child Welfare Research, Training and Demonstration

    The Committee recommends $27,153,000, the same as the 
fiscal year 2011 level, for child welfare research, training 
and demonstration. The budget request is $27,207,000. This 
program provides grants to public and nonprofit organizations 
for demonstration projects that encourage experimental and 
promising types of child welfare services, as well as projects 
that improve education and training programs for child welfare 
service providers.
    Within this amount, the Committee recommendation includes 
$20,000,000, as requested by the administration, for innovative 
approaches to foster care program. This continues funding for 
5-year demonstration projects started in fiscal year 2010 to 
improve the outcomes of children and families in foster care, 
particularly those with long-term involvement in the foster 
care system.

Adoption Opportunities

    The Committee recommends $39,253,000, the same as the 
comparable fiscal year 2011 funding level, for adoption 
opportunities. The budget request is $39,332,000. In fiscal 
year 2011 the more narrowly focused adoption awareness program 
was eliminated and its funding redirected to the adoption 
opportunities program. The Committee supports and maintains 
this consolidation.
    The adoption opportunities program funds discretionary 
grants to help facilitate the elimination of barriers to 
adoption and provide technical assistance to help States 
increase the number of children adopted, particularly children 
with special needs. The adoption awareness program provided 
grants to train health center staff to inform pregnant women 
about adoption and to make referrals on request to adoption 
agencies. It also funded the planning, development and 
operation of a national campaign to inform the public about the 
adoption of children with special needs. The adoption 
opportunities program has broad authority to fund these types 
of awareness activities and will continue to fund them in the 
consolidated program.
    Consistent with the authorization of this program, the 
Committee expects that these funds will focus on facilitating 
the adoption of older children, minority children, and children 
with special needs, particularly infants and toddlers with 
disabilities who have life-threatening conditions.

Adoption Incentives

    The Committee recommends $39,421,000, the same as the 
comparable fiscal year 2011 funding level, for the adoption 
incentives program. The budget request is $49,875,000. This 
program provides incentive payments to States based on a 
formula in law to encourage States to increase the number of 
adoptions of children from the foster care system, with an 
emphasis on children who are the hardest to place. If the 
payments due to States are higher than the amount of funds 
available, the payments are reduced on a pro rata basis based 
on the amount available.

Strengthening Communities Fund

    The Committee recommendation does not include funding for 
the strengthening communities fund. This program was first 
funded in the American Recovery and Reinvestment Act but did 
not receive funding in fiscal year 2011. The budget request for 
fiscal year 2012 is $20,000,000. The strengthening communities 
fund is designed to improve the capacity of community and 
faith-based organizations to contribute to economic development 
and revitalization. ACF is currently conducting an outcome-
based evaluation of this program and the Committee will 
consider funding in future fiscal years pending the results of 
that evaluation.

Social Services and Income Maintenance Research

    The Committee recommends $5,762,000, the same as the fiscal 
year 2011 level, for social services and income maintenance 
research. This entire amount is funded through transfers 
available under section 241 of the PHS Act, the same as in 
fiscal year 2011. The budget request is $8,762,000, of which 
$5,762,000 is from transfers available under the PHS Act. These 
funds support research and evaluation of cost-effective 
programs that increase the stability and economic independence 
of American families, and contribute to the healthy development 
of children and youth.
    The Committee recommendation does not provide increased 
funding specified for an early childhood care and education 
research and evaluation study. The Committee supports this 
research and the administration's initiative to strengthen 
program evaluation, but notes that research and evaluation 
funding for early childhood programs is set aside within Head 
Start and the Child Care and Development Block Grant.
    The Committee encourages ACF to continue to work with the 
Administration on Aging and other HHS agencies to evaluate 
intergenerational approaches aimed at improving the outcomes 
for vulnerable populations. The Committee is aware of effective 
neighborhood based programs that utilize older volunteers to 
foster permanency and improved outcomes for at risk youth.

Developmental Disabilities

    The Committee recommends $163,056,000 for developmental 
disabilities programs. The comparable fiscal year 2011 funding 
level is $168,857,000 and the budget request is $163,366,000. 
These programs support community-based delivery of services 
that 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
    Within the total for developmental disabilities, the 
Committee recommendation includes $74,916,000 for State 
councils, the same as the comparable fiscal year 2011 funding 
level. The budget request is $75,066,000. State developmental 
disability councils work to develop, improve and expand the 
system of services and supports for people with developmental 
disabilities. By engaging in activities such as training, 
educating the public, building capacity and advocating for 
change in State policies, these councils support the inclusion 
and integration of individuals with developmental disabilities 
in all aspects of community life.
            Protection and Advocacy
    Within the total for developmental disabilities, the 
Committee recommendation includes $40,942,000 for protection 
and advocacy programs, the same as the comparable fiscal year 
2011 funding level. The budget request is $41,024,000. This 
formula grant program provides funds to States to establish and 
maintain protection and advocacy systems to protect the legal 
and human rights of persons with developmental disabilities who 
are receiving treatment, services or rehabilitation.
            Projects of National Significance
    Within the total for developmental disabilities, the 
Committee recommendation includes $8,333,000, the same as the 
budget request, for projects of national significance to assist 
persons with developmental disabilities. The comparable fiscal 
year 2011 funding level is $14,134,000. This program funds 
grants and contracts that develop new technologies and 
demonstrate innovative methods to support the independence, 
productivity and integration into the community of persons with 
developmental disabilities.
    The Committee recommendation supports the continuation of 
current grants, including initiatives on youth transition to 
employment, family support, technical assistance and data 
collection, as well as continued support of the Autism Research 
Center.
            University Centers for Excellence
    Within the total for developmental disabilities, the 
Committee recommendation includes $38,865,000 for the 
University Centers for Excellence in Developmental Disabilities 
[UCEDDs], the same as the comparable fiscal year 2011 funding 
level. The budget request is $38,943,000. The UCCEDD program 
supports a network of 67 university-based centers that provide 
interdisciplinary education, conduct research and develop model 
services for children and adults with disabilities. The centers 
serve as the major vehicle to translate disability-related 
research into community practice and to train the next cohort 
of future professionals who will provide services and supports 
to an increasingly diverse population of people with 
disabilities.

Voting Access for Individuals With Disabilities

    The Committee recommendation includes $5,245,000 for voting 
access for individuals with disabilities. The budget request 
did not include funding for this program. The comparable fiscal 
year 2011 funding level is $17,375,000. This program supports 
formula grants to States for the Secretary of State or chief 
election official to make polling places more accessible and 
increase individuals with disabilities' participation in the 
voting process, as well as a separate formula grant to States 
for protection and advocacy organizations to do the same.
    The Committee recommendation does not provide formula 
funding for Secretaries of State but maintains funding for 
protection and advocacy programs. States have over $33,000,000 
in fiscal year 2007 to fiscal year 2010 unexpended funds 
available to their Secretaries of State under this program, and 
States may still use those funds for these activities. In 
addition, the Committee encourages ACF to work with States and 
protection and advocacy organizations to ensure that these 
funds are used in a timely manner. The Committee also 
encourages ACF, in consultation with the National Council on 
Disability, to monitor the implementation of the Help America 
Vote Act for voters with disabilities during the 2012 election 
cycle.

Native American Programs

    The Committee recommends $48,675,000, the same as the 
fiscal year 2011 level, for Native American programs. The 
budget request is $48,773,000. The Administration for Native 
Americans [ANA] assists tribal and village governments and 
Native Indian institutions and organizations to support and 
develop stable, diversified local economies. In promoting 
social and economic self-sufficiency, ANA provides financial 
assistance through direct grants for individual projects, 
training and technical assistance, and research and 
demonstration programs.
    Within the total, the Committee recommendation includes 
$12,000,000 for Native American language preservation 
activities, including no less than $4,000,000 for language 
immersion programs authorized by 803C(b)(7)(A)-(C) of the 
Native American Programs Act, as amended by the Esther Martinez 
Native American Language Preservation Act of 2006. The 
Committee strongly encourages ANA to give priority to grantees 
with rigorous immersion programs.

Community Services Programs

    The Committee recommends $731,501,000 for community 
services programs. The comparable fiscal year 2011 funding 
level is $727,212,000 and the budget request is $393,907,000.
            Community Services Block Grant
    Within the total for community services programs, the 
Committee recommendation includes $678,640,000 for the 
community services block grant [CSBG], the same as the 
comparable fiscal year 2011 funding level. The budget request 
is $350,000,000. The CSBG is a formula grant 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. 
States are required to pass on at least 90 percent of these 
funds to local community-based organizations, that vast 
majority of which are community action agencies.
    The Committee strongly supports the CSBG, which provides 
critical flexible funding for local organizations that serve as 
a central source of assistance for low-income populations. 
These local organizations typically administer larger Federal 
programs such as Head Start, LIHEAP and the Weatherization 
Assistance Program. The CSBG provides critical funding to 
support the administration of these programs at the local 
level, as well as flexible funding to fill in service gaps and 
meet the particular needs of local communities. The Committee 
supports efforts to improve accountability and transparency, 
but within the current framework of the program.
            Community Economic Development
    Within the total for community services programs, the 
Committee recommendation includes $21,964,000 for the community 
economic development program. The comparable fiscal year 2011 
funding level was $17,964,000. The budget request is 
$20,000,000. This program provides grants to community 
development corporations to support employment and business 
development opportunities for low-income individuals.
    Within this total for community economic development, the 
Committee recommendation includes up to $10,000,000, including 
any related program support and evaluation costs, for the 
Healthy Foods Financing Initiative [HFFI]. A recent study by 
the Department of Agriculture found that over 23 million 
Americans, including 6.5 million children, live in low-income 
areas without ready access to grocery stores. HFFI is a joint 
initiative with the Department of Agriculture and Department of 
the Treasury to provide financial and technical assistance to 
community development financial institutions, nonprofit 
organizations and businesses to expand access to healthy foods 
in these low-income and underserved areas.
            Rural Community Facilities
    Within the total for community services programs, the 
Committee recommendation includes $6,990,000 for the rural 
community facilities program. The comparable fiscal year 2011 
funding level was $4,990,000. The budget request did not 
include funding for this program. The rural community 
facilities program provides grants to regional nonprofit 
organizations to provide training and technical assistance to 
low-income rural communities in developing and managing safe 
and affordable water and wastewater treatment facilities.
            Job Opportunities for Low-Income Individuals
    Within the total for community services programs the 
Committee recommendation does not include funding for the job 
opportunities for low-income individuals [JOLI] program. The 
comparable fiscal year 2011 funding level is $1,641,000. The 
budget request did not include funding for this program. JOLI 
provides grants to nonprofit organizations to support 
employment and business opportunities for Temporary Assistance 
for Needy Families [TANF] recipients and other low-income 
individuals, focusing on micro-enterprise and self-employment. 
This small discretionary grant program has never been evaluated 
and duplicates activities funded in the TANF program.
            Individual Development Accounts
    Within the total for community services programs, the 
Committee recommendation includes $23,907,000, the same as the 
budget request, for individual development accounts. The 
comparable fiscal year 2011 funding level is $23,977,000. This 
program funds activities to encourage and help low-income 
individuals and families accumulate savings for dedicated 
purposes, including buying a home, paying for college or 
starting a business.

Domestic Violence Hotline

    The Committee recommends $3,203,000, the same as the 
comparable fiscal year 2011 funding level, for the national 
domestic violence hotline. The budget request is $4,500,000. 
This national, toll-free hotline provides information and 
assistance to victims of domestic violence 24 hours a day.

Family Violence Prevention and Services

    The Committee recommends $129,792,000, the same as the 
comparable fiscal year 2011 funding level, for the family 
violence prevention and services program. The budget request is 
$135,052,000. These funds support programs to prevent family 
violence and provide immediate shelter and related assistance 
for victims of domestic violence and their dependents.
    The Committee encourages ACF to provide funding for State 
resource centers to reduce disparities in domestic violence in 
States with high proportions of Indian (including Alaskan 
Native) or Native Hawaiian populations, as authorized by 
section (a)(2)(B)(i) of the Family Violence Prevention and 
Services Act.

Mentoring Children of Prisoners

    The Committee does not include funding for the mentoring 
children of prisoners program, which was eliminated in fiscal 
year 2011. The budget request is $25,000,000. This program 
provided grants to community organizations to create and 
sustain mentoring relationships between children of prisoners 
and adults in their community. Program data showed that the 
majority of the mentoring relationships established through the 
program lasted fewer than 12 months.

Independent Living Training Vouchers

    The Committee recommends $45,260,000, the same as the 
comparable fiscal year 2011 funding level, for independent 
living training vouchers. The budget request is $45,351,000. 
This program supports vouchers of up to $5,000 per year for 
postsecondary education and training for foster care youth up 
to 21 years of age. This program increases the likelihood that 
individuals who age out of the foster care system will be 
better prepared to live independently and contribute 
productively to society.

Disaster Human Services Case Management

    The Committee recommends $1,996,000, the same as the 
comparable fiscal year 2011 funding level, for the disaster 
human services case management program. The budget request is 
$2,000,000. This program assists States in establishing the 
capacity to provide case management services in a timely manner 
in the event of a disaster. It ensures that States are able to 
meet social service needs during disasters by helping disaster 
victims prepare recovery plans, referring them to service 
providers and FEMA contacts in order to identify needed 
assistance, and providing ongoing support and tracking through 
the recovery process.

Program Administration

    The Committee recommends $209,386,000, the same as the 
comparable fiscal year 2011 funding level, for program 
administration. The budget request is $226,184,000. Within this 
amount, the Committee includes $1,376,000 for the Center for 
Faith-based and Community Initiatives.

         SUPPORTING HEALTHY FAMILIES AND ADOLESCENT DEVELOPMENT

Appropriations, 2011....................................    $428,184,000
Budget estimate, 2012...................................     428,311,000
Committee recommendation................................     428,184,000

    The Committee recommends $428,184,000, the same as the 
comparable fiscal year 2011 funding level, for supporting 
healthy families and adolescent development. The budget request 
is $428,311,000. The recommendation consists of $365,000,000 in 
mandatory funds authorized by the Social Security Act and 
$63,184,000 in discretionary appropriations. This account was 
previously named Promoting Safe and Stable Families and has 
been revised to better describe the activities funded within 
it.
    This program supports activities that can prevent the 
emergence of family crises which might require the temporary or 
permanent removal of a child from his or her own home. Grants 
allow States to operate coordinated programs of family 
preservation services, time-limited family reunification 
services, community-based family support services, and adoption 
promotion and support services.

                PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2011....................................  $4,769,000,000
Budget estimate, 2012...................................   5,153,000,000
Committee recommendation................................   5,153,000,000

    The Committee recommends $5,153,000,000 in mandatory funds 
for payments for foster care and permanency, an appropriated 
entitlement that includes funding for the foster care, adoption 
assistance, guardianship assistance and independent living 
programs. This is in addition to the $1,850,000,000 
appropriated last year as an advance appropriation for the 
first quarter of fiscal year 2012. The comparable funding level 
for fiscal year 2011 is $4,769,000,000, in addition to the 
$1,850,000,000 provided as an advance appropriation the 
previous year. The Committee recommends $2,100,000,000, the 
same as the budget request, for an advance appropriation for 
the first quarter of fiscal year 2013. The Committee 
recommendation provides the full amount requested under current 
law.
    The foster care program, authorized under title IV-E of the 
Social Security Act, provides Federal reimbursement to States 
and tribes for maintenance payments to families and 
institutions caring for eligible foster children. Funds are 
matched at the Federal medical assistance percentage [FMAP] 
rate for each State. Funding is also provided for 
administrative costs for the management of the foster care 
program, as well as training costs for foster care workers and 
parents.
    The adoption assistance program provides funds to States 
for maintenance payments and the nonrecurring costs of adoption 
for children with special needs. The goal of this program is to 
facilitate the adoption of hard-to-place children in permanent 
homes and thus prevent long, inappropriate stays in foster 
care. As in the foster care program, State administrative and 
training costs are eligible under this program for Federal 
reimbursement subject to a matching rate.
    The Fostering Connections to Success and Increasing 
Adoptions Act of 2008 created a new IV-E guardianship 
assistance program. This program gives States and tribes an 
option under their IV-E foster care programs to provide 
assistance payments to relatives taking legal guardianship of 
eligible children who have been in foster care.
    The independent living program provides services to foster 
children under 18 and foster youth ages 18 to 21 to help them 
make the transition to independent living by engaging in a 
variety of services including educational assistance, life 
skills training and health services. States are awarded grants 
based on their share of the number of children in foster care, 
subject to a matching requirement.

                        Administration on Aging

                        AGING SERVICES PROGRAMS

Appropriations, 2011....................................  $1,549,322,000
Budget estimate, 2012...................................   1,787,944,000
Committee recommendation................................   1,534,701,000

    The Committee recommends an appropriation of $1,534,701,000 
for the Administration on Aging [AoA], which includes 
$52,000,000 in Medicare trust funds. The comparable fiscal year 
2011 level is $1,549,322,000. The administration request is 
$1,787,944,000 for AoA. In addition, the Committee recommends 
that $17,000,000 in mandatory funds be transferred to AoA from 
the PPH Fund. The AoA is charged with administering programs 
through the national aging network that promote the development 
of comprehensive, coordinated home- and community-based care 
for seniors.

Supportive Services and Senior Centers

    The Committee recommends an appropriation of $367,611,000 
for supportive services and senior centers. This amount is the 
same as the comparable funding level for fiscal year 2011. The 
administration request is $416,476,000. The supportive services 
program provides formula grants to States and territories to 
fund a wide range of social services such as multipurpose 
senior centers, adult day care, transportation and in-home 
assistance such as personal care and homemaker assistance. 
State agencies on aging award funds to designated area agencies 
on aging that, in turn, make awards to local services 
providers.

Preventive Health Services

    The Committee recommends $20,984,000 for preventive health 
services. This amount is the same as the comparable funding 
level for fiscal year 2011. The administration request is 
$21,026,000 for this activity. The preventive health services 
program funds activities that help seniors stay healthy and 
avoid chronic disease, thus reducing the need for more costly 
medical interventions. The Committee has included bill language 
requiring States to use these funds for evidence-based 
interventions, such as enhanced fitness and wellness programs, 
depression screening and medication management programs. These 
evidence-based prevention programs have been shown through 
randomized-controlled trials to be effective at helping older 
adults improve their health status and lower their use of 
healthcare services.

Protection of Vulnerable Older Americans

    The Committee recommends $21,839,000 for grants to States 
for protection of vulnerable older Americans. This is the same 
as the comparable fiscal year 2011 funding level. The 
administration request is $26,880,000. This activity funds the 
long-term care ombudsman program and the prevention of elder 
abuse program. Both programs provide formula grants to States 
to prevent the abuse, neglect and exploitation of older 
individuals. The ombudsman program focuses on the needs of 
residents of nursing homes and other long-term care facilities, 
while elder abuse prevention targets its message to the elderly 
community at large.

National Family Caregiver Support Program

    The Committee recommends $153,912,000 for the national 
family caregiver support program. This amount is the same as 
the comparable funding level for fiscal year 2011. The 
administration request for this program is $192,220,000. Funds 
appropriated for this activity establish a multifaceted support 
system in each State for family caregivers, allowing them to 
care for their loved ones at home for as long as possible. 
States may use funding to include the following five components 
into their program: information to caregivers about available 
services; assistance to caregivers in gaining access to 
services; caregiver counseling and training; respite care to 
enable caregivers to be temporarily relieved from their 
caregiving responsibilities; and limited supplemental services 
that fill remaining service gaps.

Native American Caregiver Support Program

    The Committee recommendation includes $6,376,000, the same 
as the fiscal year 2011 level, to carry out the Native American 
caregiver support program. The administration request is 
$8,388,000 for this activity. This program assists tribes in 
providing multifaceted systems of support services for family 
caregivers and for grandparents or older individuals who are 
relative caregivers.

Congregate and Home-Delivered Nutrition Services

    For congregate nutrition services, the Committee recommends 
an appropriation of $439,901,000, which is the same as the 
comparable fiscal year 2011 level. The administration request 
is $440,718,000 for this activity. For home-delivered meals, 
the Committee recommends a funding level of $217,241,000. This 
is the same as the comparable fiscal year 2011 level. The 
administration request is $217,644,000 for this activity.
    These programs address the nutritional needs 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 a minimum of one-third of daily dietary 
requirements. While States receive separate allotments of funds 
for congregate meals, home-delivered meals and supportive 
services, they have flexibility to transfer funds between these 
programs.

Nutrition Services Incentives Program

    The Committee recommendation includes $160,693,000 for the 
nutrition services incentives program [NSIP]. This amount is 
the same as the comparable funding level for fiscal year 2011. 
The administration request is $160,991,000. This program 
augments funding for congregate and home-delivered meals 
provided to older adults. Funds provided under this program are 
dedicated exclusively to the provision of meals. NSIP rewards 
effective performance by States and tribal organizations in the 
efficient delivery of nutritious meals to older individuals 
through the use of cash or commodities.

Aging Grants to Indian Tribes and Native Hawaiian Organizations

    The Committee recommends $27,653,000 for grants to Native 
Americans. This amount is the same as the comparable fiscal 
year 2011 level. The administration request is $27,704,000. 
Under this program, awards are made to eligible organizations 
based on their share of Native Americans, Native Alaskans and 
Native Hawaiians aged 60 and over.

Program Innovations

    The Committee recommends $12,728,000 for program 
innovations. The comparable fiscal year 2011 level is 
$13,023,000. The administration request is $18,705,000 for this 
activity. These funds support activities that expand public 
understanding of aging and the aging process, apply social 
research and analysis to improve access to and delivery of 
services for older individuals, test innovative ideas and 
programs to serve older individuals, and provide technical 
assistance to agencies that administer the Older Americans Act.
    Older Adults and Mental Health.--The Committee urges AoA to 
expand its efforts to address the mental and behavioral health 
needs of older adults, including an emphasis on mental health 
screening, treatment services for older individuals and 
programs to increase public awareness and reduce the stigma 
associated with mental disorders in older individuals. The 
Committee is pleased with AoA efforts to implement the mental 
and behavioral health aspects of the Older American Act 
Amendments of 2006 and continues to urge AoA to designate an 
officer to focus on the mental health needs of older Americans.
    Within funding for Program Innovations, the Committee has 
provided $1,000,000 to continue the 24-hour call center that 
provides Alzheimer family caregivers with professional care 
consultation and crisis intervention.

Aging Network Support Activities

    The Committee recommends $24,143,000 for aging network 
support activities. The comparable fiscal year 2011 funding 
level is $34,214,000. The administration request is 
$17,727,000. These funds provide support for the national aging 
services network and also allow seniors and their families to 
obtain information about their care options and benefits. 
Programs funded include the Eldercare Locator, the Pension 
Information and Counseling program and Senior Medicare Patrols.

Alzheimer's Disease Demonstration Grants to States

    The Committee recommendation includes $4,018,000 for the 
Alzheimer's disease demonstration grants to States program. The 
comparable fiscal year 2011 funding level for this program is 
$11,441,000 and the administration request is $11,462,000. Due 
to budget constraints, the Committee recommendation includes 
funding only for the continuation costs of existing grants. 
This program was started in 1992 with the goal of testing and 
implementing new models of care for individuals with 
Alzheimer's disease. The Committee notes that all States have 
received funding for one or more demonstrations. States should 
incorporate the successful models created as a result of these 
demonstrations into other funding streams, such as the Family 
Caregiver Support Services program.

Lifespan Respite Care

    The Committee recommends $2,495,000 for the Lifespan 
Respite Care program. This amount is the same as the comparable 
fiscal year 2011 level. The administration request is 
$10,000,000 for this program. The Lifespan Respite Care program 
provides grants to States to expand respite care services to 
family caregivers, improve the local coordination of respite 
care resources, and improve access and quality of respite care 
services thereby reducing family caregiver strain. The 
Committee recognizes that respite care can provide family 
caregivers with relief necessary to maintain their own health, 
bolster family stability and avoid or delay more costly nursing 
home or foster care placements. The Committee commends AoA 
efforts to ensure that grantees use the funds to serve all age 
groups, chronic conditions and disability categories equitably 
and without preference.

Chronic Disease Self-Management Program

    The Committee recommends $10,000,000 in mandatory funding, 
provided through a transfer from the PPH Fund, for the Chronic 
Disease Self-Management Program [CDSMP]. The administration 
requested $10,000,000 in discretionary funds for this activity. 
This program was not funded in fiscal year 2011 but did receive 
funding through the American Recovery and Reinvestment Act of 
2009. CDSMP assists those with chronic disease with managing 
their conditions and improving their health status. Topics 
covered by the program include nutrition, appropriate use of 
medications, fitness and effective communications with 
healthcare providers. The Committee notes that CDSMP has been 
shown through multiple studies to result in significant and 
measurable improvements in health and quality of life, as well 
as reductions in hospitalizations and emergency rooms visits.

Elder Falls Prevention

    The Committee recommends that $7,000,000 in mandatory 
funding be transferred from the PPH Fund for elder falls 
prevention activities at AoA, in coordination with CDC. This is 
a new activity that was not funded in fiscal year 2011. The 
administration did not request funding. The Committee notes 
that falls are the leading cause of fatal and nonfatal injuries 
for those 65 and older. Among older adults who sustain hip 
fractures in falls, 25 percent remain institutionalized for at 
least 1 year and 50 percent cannot return home or live 
independently. The Committee intends that funds provided to AoA 
should be used for public education about the risk of these 
falls, as well as implementation and dissemination of 
community-based strategies that have been proven to reduce the 
incidence of falls among seniors.

Adult Protective Services Demonstrations

    Due to budget constraints, the Committee recommendation 
does not include funding for Adult Protective Services 
demonstrations. The administration requested $16,500,000 for 
this new program, which would test and evaluate innovative 
approaches to preventing and responding to elder abuse.

State Health Insurance Assistance Program

    The Committee recommendation includes $52,000,000 for State 
Health Insurance Assistance Programs [SHIPs]. This amount is 
the same as the comparable funding level for fiscal year 2011. 
The administration request is $46,960,000 for this program. 
SHIPs provide accurate and understandable health insurance 
information to Medicare beneficiaries and their families. The 
Committee concurs with the administration's proposal to 
transfer this grant program to AoA from the Centers for 
Medicare and Medicaid Services. The Committee notes that many 
SHIPs are already housed in, or are partnered with, area 
agencies on aging. Activities of the SHIPs are also aligned 
with AoA's mission to develop a comprehensive system of home 
and community-based services to help seniors maintain their 
health and independence.

Community Living Assistance Services and Supports

    The Committee recommendation does not include funding for 
the Community Living Assistance Services and Supports [CLASS] 
program, a new long-term care insurance program created by the 
Affordable Care Act. The administration requested $120,000,000 
to fund an education campaign, information technology and other 
administrative costs. The Committee has not provided funding 
for this activity in recognition that its implementation has 
been delayed and the Congressional Budget Office estimates that 
AoA will not begin collecting premiums for CLASS until fiscal 
year 2013.

Program Administration

    The Committee recommends $23,107,000 for program 
administration. The comparable fiscal year 2011 funding level 
is $19,939,000 and the administration request is $24,543,000. 
These funds support salaries and related expenses for program 
management and oversight activities. The Committee 
recommendation includes funding for tenant improvement and 
other costs related to the expiration of AoA's lease and a 
possible office relocation.

                        Office of the Secretary

                    GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2011....................................    $544,981,000
Budget estimate, 2012...................................     490,346,000
Committee recommendation................................     549,032,000

    The Committee recommends $549,032,000 for general 
departmental management [GDM]. The comparable fiscal year 2011 
funding level is $544,981,000. The administration request is 
$490,346,000 for this activity. The recommendation includes 
$72,811,000 in transfers available under section 241 of the PHS 
Act. In addition, the Committee recommends that $10,000,000 in 
mandatory funds be transferred to this account from the PPH 
Fund.
    This appropriation supports activities that are associated 
with the Secretary's role as policy officer and general manager 
of the Department. It supports health activities performed by 
the Office of Public Health and Science [OPHS], 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 Committee recommendation includes $250,000 for the 
Advisory Council on Alzheimer's Research, Care, and Services. 
This Advisory Council, as created by the National Alzheimer's 
Project Act (Public Law 111-375), will coordinate the activity 
of Federal agencies conducting Alzheimer's-related care, 
services and research.
    Antideficiency Act.--The Committee is aware that the 
Department recently reported 47 violations of the 
Antideficiency Act which involved several agencies and occurred 
over multiple fiscal years dating back at least to 2002. 
Contributing causes of the problems were inconsistent 
acquisition guidance regarding multi-year contracts and the 
lack of a legal review process for large contracts. While the 
Department has taken corrective action, including revising its 
guidance and providing appropriations law training, the 
Committee remains deeply concerned that these violations 
indicate a widespread lack of understanding of appropriations 
law by departmental staff. Accordingly, the Committee directs 
the Secretary to institute a process by which all large 
contracts above a certain dollar threshold are sent to the 
Office of the General Counsel for legal review to ensure 
sufficiency of available funds and compliance with 
appropriations law. The thresholds may vary from agency to 
agency. The Committee directs the Department to perform follow-
up sampling of contracts to ensure that improper funding 
practices have been corrected.
    Blood Donor Policy.--The Committee commends the Department 
for releasing a research agenda that will yield the data 
necessary to re-evaluate FDA's existing donor deferral policy 
and develop alternative policies that maintain the safety of 
blood and blood products. The Committee encourages the 
Secretary, working in collaboration with NIH, CDC and FDA, to 
move forward with this research agenda and to devote resources 
toward an evaluation of a screening strategy that assures blood 
safety and allows for the development of alternative deferral 
criteria. The Committee requests an update on the Department's 
progress toward meeting the research agenda by April 1, 2012.
    Hearing Loss.--The Committee is aware that loud and 
prolonged noise can permanently damage hearing. The Committee 
continues to encourage the Department to educate the public 
about the importance of protecting their hearing, through 
public service announcements or other means, as there is no 
cure for deafness caused by exposure to loud noise.
    Human Services Transportation.--The Committee recognizes 
the importance of community providers that ensure safe, 
efficient and cost-effective transportation for older 
Americans, children, people with disabilities, and those with 
lower incomes. The Committee recommendation includes $1,000,000 
for a competitive grant to provide assistance to local 
government and nonprofit transportation providers on the most 
cost-effective ways to provide transportation assistance and 
information and technical assistance to persons with 
disabilities.
    Nursing.--The Committee is aware that the Institute of 
Medicine [IOM] report ``The Future of Nursing: Leading Change, 
Advancing Health'' made a series of important recommendations 
to advance nursing practice, education, leadership and 
workforce data as well as promote inter-professional education 
and collaboration. The Committee encourages the Secretary to 
develop an implementation plan regarding these recommendations, 
in collaboration with CMS and HRSA, and provide the Committee 
with an update on its progress in the fiscal year 2013 
congressional budget justification.
    Oral Health Research.--The Committee notes that the recent 
IOM report ``Advancing Oral Health in America'' highlights the 
important role that the Department can play in improving oral 
health and oral healthcare in the United States. The Committee 
encourages the Secretary to place a high priority on efforts to 
advance oral health research, as recommended by IOM.
    Urban-Based Network.--The Committee encourages the 
Secretary and other agencies within the Department, such as 
HRSA and the Office of Minority Health, to partner with the 
NIH's NIMHD in supporting a network of urban-based institutions 
focused on, and with demonstrated commitment and capacity to, 
addressing recruitment and training needs of minority and urban 
underserved populations and reducing health disparities in 
these urban communities.
    Viral Hepatitis.--The Committee commends the Secretary for 
developing the HHS Action Plan for the Prevention, Care and 
Treatment of Viral Hepatitis and urges her to increase the 
staff capacity at the Office of the Assistant Secretary for 
Health [OASH] to implement the plan. The Committee notes that 
hepatitis B and hepatitis C testing guidelines are not aligned 
across HHS operating divisions, and expects OASH to work 
expeditiously with CDC, AHRQ and the U.S. Preventive Services 
Task Force to develop a consistent national testing guideline 
by early 2012 to improve testing rates.

Teen Pregnancy Prevention

    The Committee recommendation includes $113,245,000 for the 
Teenage Pregnancy Prevention [TPP] program. The recommendation 
includes $8,455,000 in transfers available under section 241 of 
the PHS Act. The administration requested $118,445,000 for the 
TPP program, with $110,000,000 funded through transfers from 
the PPH Fund. The comparable funding level for fiscal year 2011 
is $109,245,000. The Committee recommendation includes 
$4,000,000 for a Federal evaluation of the projects funded by 
this program. This program supports competitive grants to 
public and private entities to replicate evidence-based teen 
pregnancy prevention approaches.

Adolescent Family Life

    The Committee recommendation does not include funding for 
the Adolescent Family Life [AFL] program. The comparable fiscal 
year 2011 level is $12,474,000 and the administration did not 
request funding for this program. AFL is duplicative of the 
Pregnancy Assistance Fund, a mandatory program created by the 
Patient Protection and Affordable Care Act, which provides 
similar support services to pregnancy and parenting teens.

Minority Health

    The Committee recommends $55,888,000 for the Office of 
Minority Health. This amount is the same as the comparable 
fiscal year 2011 funding level. The administration requested 
$57,980,000. The Office of Minority Health [OMH] focuses on 
strategies designed to decrease health disparities and to 
improve the health status of racial and ethnic minority 
populations in the United States. OMH establishes goals and 
coordinates all departmental activity related to improving 
health outcomes for disadvantaged and minority individuals.
    The Committee recommendation includes $1,000,000 to 
continue the national health education program on lupus for 
healthcare providers. The Committee notes that this 
debilitating autoimmune disease is up to three times more 
common among African Americans, Hispanics and Native Americans 
and affects over 1.5 million persons, 90 percent of whom are 
women. The Committee continues to support this important 
national education effort to engage healthcare providers, 
educators and schools of health professions in working together 
to improve lupus diagnosis and treatment through education.
    Cancer in Asian/Pacific Islanders.--Asian and Pacific 
Islanders have a high incidence of stomach cancer and liver 
cancers compared to Caucasians. The Committee continues to urge 
the Department to focus on the unique and pressing needs 
regarding cancer in this population.
    Chronic Kidney Disease [CKD].--The Committee recognizes 
that African-Americans represent nearly 29 percent of all those 
treated for kidney failure and have an end-stage renal disease 
rate nearly three times that of their non-minority 
counterparts. Asian and Pacific Islanders experience a higher 
than average rate of CKD, with Filipinos having one of the 
highest rates of incidence per capita. The Committee encourages 
OMH to prioritize the early detection of CKD in minority 
communities in order to improve health outcomes and eliminate 
these disparities.
    Health Disparities in Women.--Women of racial and ethnic 
minorities face higher rates of obesity, cancer, diabetes, 
heart disease, HIV/AIDS and other diseases when compared with 
White women. A disproportionately higher rate of preterm birth 
exists among African American women that cannot be accounted 
for by known risk factors. The Committee encourages HHS to 
conduct research into the causes of these health disparities 
and develop and evaluate interventions to address these causes. 
The Committee also understands that continued and expanded 
collection of data capturing racial and ethnic information is 
essential in understanding and reducing disparities.
    Hepatitis B.--The Committee notes that Asian Americans, 
Native Hawaiians and other Pacific Islanders comprise more than 
1.5 million of the 2 million estimated hepatitis B carriers in 
the United States and consequently have the highest rate of 
liver cancer among all ethnic groups. The Committee urges OMH 
to expand outreach and preventive hepatitis B programs specific 
to Asian and Pacific Islanders and other groups 
disproportionately affected by hepatitis B. The Committee 
believes that the recently completed HHS Action Plan for the 
Prevention and Treatment of Viral Hepatitis will inform and 
guide this expanded effort.
    Offices of Minority Health.--The Committee is encouraged by 
the implementation of the HHS Action Plan to Reduce Racial and 
Ethnic Health Disparities, as well as the National Stakeholder 
Strategy for Achieving Health Equity. The Committee strongly 
supports the Offices of Minority Health in the Office of the 
Secretary, AHRQ, CDC, CMS, FDA, HRSA and SAMHSA, which are 
charged with leading the strategy. The Secretary is encouraged 
to work closely with communities, as well as the public and 
private sectors, to end longstanding and costly disparities.

Office of Women's Health

    The Committee recommends $33,746,000 for the Office of 
Women's Health [OWH]. This amount is the same as the comparable 
fiscal year 2011 level and the administration request. OWH 
develops, stimulates and coordinates women's health research, 
healthcare services, and public and healthcare professional 
education across the Department. It advances important 
crosscutting initiatives and develops public-private 
partnerships, providing leadership and policy direction, and 
initiating and synthesizing program activities to redress the 
disparities in women's health.
    The Committee recommendation includes $3,010,000 to 
continue the violence against women's initiative. This 
initiative provides funding to public health programs that 
integrate domestic and sexual violence assessment and 
intervention into basic care, as well as encourages 
collaborations between healthcare providers, public health 
programs, and domestic and sexual violence programs.

HIV/AIDS in Minority Communities

    The Committee recommends $53,783,000 for this activity, 
which addresses high-priority HIV prevention and treatment 
needs of minority communities heavily impacted by HIV/AIDS. 
This amount is the same as the comparable fiscal year 2011 
level. The administration request is $53,891,000. The Committee 
has provided funding for this activity through budget 
authority, rather than through transfers available under 
section 241 of the PHS Act as requested by the administration. 
These funds are available to key operating divisions of the 
Department with expertise in HIV/AIDS services to assist 
minority communities with education, community linkages and 
technical assistance.

Transformation of the Commissioned Corps

    The Committee request does not include funding for this 
activity. The comparable fiscal year 2011 level is $8,071,000 
and the administration request is $7,013,000. The Committee has 
provided funding since fiscal year 2007 for an initiative to 
train and provide career development programs for Corps 
officers so that the Corps can respond more quickly and 
effectively to public health emergencies. The Committee has 
eliminated funding for this activity in recognition that this 
transformation initiative has been completed.

Embryo Donation and Adoption

    The Committee has not provided funding for embryo donation 
and adoption awareness activities. The comparable fiscal year 
2011 funding level is $2,004,000 and the administration 
requested $2,000,000 for this activity. This program has had a 
limited number of applicants since its inception and has been 
unable to demonstrate its effectiveness.

Acquisition Reform

    The Committee recommendation does not include funding 
requested by the administration for an acquisition reform 
initiative. The administration request is $7,000,000 for this 
activity. While the Committee supports the Secretary's efforts 
to improve the capability of the Department's acquisition 
workforce and contracting systems, funding was not provided due 
to budget constraints.

                OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2011....................................     $71,147,000
Budget estimate, 2012...................................      81,019,000
Committee recommendation................................      71,147,000

    The Committee provides $71,147,000 for the Office of 
Medicare Hearings and Appeals [OMHA]. This amount is the same 
as the comparable level for fiscal year 2011. The 
administration request for OMHA is $81,019,000.
    OMHA is responsible for hearing Medicare appeals at the 
administrative law judge level, which is the third level of 
Medicare claims appeals. The Office ensures that Medicare 
beneficiaries who are dissatisfied with the initial decisions 
about their benefits or eligibility can appeal and exercise 
their right to a hearing in front of an administrative law 
judge.

  OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY

Appropriations, 2011....................................     $61,257,000
Budget estimate, 2012...................................      78,413,000
Committee recommendation................................      61,257,000

    The Committee makes available $61,257,000 to the Office of 
the National Coordinator for Health Information Technology 
[ONC]. This amount is the same as the comparable fiscal year 
2011 funding level. The administration request for ONC is 
$78,413,000. The Committee recommendation includes $19,011,000 
in transfers available under section 241 of the PHS Act.
    ONC is responsible for promoting the use of electronic 
health records in clinical practice, coordinating Federal 
health information systems and collaborating with the private 
sector to develop standards for a nationwide interoperable 
health information technology infrastructure. ONC was 
permanently established under the Health Information Technology 
for Economic and Clinical Health [HITECH] Act, which was 
intended to promote not only the adoption of health information 
technology, but its meaningful use.
    The Committee recognizes the importance of widespread 
adoption of health information technology and encourages ONC to 
more aggressively assist providers not eligible for meaningful 
use incentives under Medicare and Medicaid. The Committee notes 
that ONC could assist these providers, many of which are in 
small towns and rural areas, in affording meaningful health IT 
options by building upon existing open source platforms such as 
the Veterans Health Administration's VistA software and the 
Indian Health Services' Resource and Patient Management System.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2011....................................     $50,178,000
Budget estimate, 2012...................................      63,329,000
Committee recommendation................................      50,178,000

    The Committee recommends an appropriation of $50,178,000 
for the Office of Inspector General [OIG]. This amount is the 
same as the comparable level for fiscal year 2011. The 
administration request is $63,329,000 for this activity, 
including $10,000,000 in funds transferred under section 241 of 
the PHS Act. In addition to discretionary funds provided in 
this act, the Health Insurance Portability and Accountability 
Act of 1996 provides a permanent appropriation of $193,387,000 
for the Office of Inspector General.
    OIG conducts audits, investigations, and evaluations of the 
programs administered by the Department's operating and staff 
divisions, including the recipients of the Department's grant 
and contract funds. In doing so, the OIG addresses issues of 
waste, fraud and abuse and makes recommendations to improve the 
efficiency and effectiveness of the Department's programs and 
operations.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2011....................................     $41,016,000
Budget estimate, 2012...................................      46,717,000
Committee recommendation................................      41,016,000

    The Committee recommends $41,016,000 for the Office for 
Civil Rights [OCR]. This amount is the same as the comparable 
funding level for fiscal year 2011. The administration request 
is $46,717,000. OCR is responsible for enforcing civil rights-
related statutes in healthcare and human services programs. To 
enforce these statutes, OCR investigates complaints of 
discrimination, conducts program reviews to correct 
discriminatory practices and implements programs to generate 
voluntary compliance among providers and constituency groups of 
health and human services. This office also has responsibility 
for implementing and enforcing privacy protections under the 
HITECH Act.

     RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Appropriations, 2011....................................    $517,537,000
Budget estimate, 2012...................................     564,505,000
Committee recommendation................................     564,505,000

    The Committee provides an estimated $564,505,000 in 
mandatory funds for retirement pay and medical benefits for 
commissioned officers of the U.S. Public Health Service [PHS]. 
This amount is the same as the administration request. This 
account provides for retirement payments to PHS officers who 
are retired due to age, disability or length of service; 
payments to survivors of deceased officers; and medical care to 
active duty and retired officers, as well as their dependents.

            PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2011....................................  $1,089,829,000
Budget estimate, 2012...................................   1,360,023,000
Committee recommendation................................     989,452,000

    The Committee recommends $989,452,000 for the Public Health 
and Social Services Emergency Fund. The administration 
requested $1,360,023,000 and the comparable fiscal year 2011 
level is $1,089,829,000. This appropriation supports the 
activities of the Office of the Assistant Secretary for 
Preparedness and Response and other activities within the 
Office of the Secretary to prepare for the health consequences 
of bioterrorism and other public health emergencies, including 
pandemic influenza, and to support the Department's 
cybersecurity efforts.

Office of the Assistant Secretary for Preparedness and Response [ASPR]

    The Office of the Assistant Secretary for Preparedness and 
Response [ASPR] was created by the Pandemic and All-Hazards 
Preparedness Act to lead the Federal Government's activities 
regarding preventing, preparing for and responding to public 
health emergencies and disasters. The Committee recommendation 
includes $931,724,000 for activities administered by ASPR. The 
administration requested $1,302,295,000 and the comparable 
funding level for fiscal year 2011 is $913,419,000. These funds 
will support the Department's efforts to prepare for and 
respond to public health emergencies, including acts of 
terrorism.
    Virtual Training.--The Committee notes the need to provide 
major medical emergency preparedness and response training for 
doctors, nurses and paramedics using today's enabling training 
technologies. There is also a need to develop a standardized 
competency-based simulation curriculum. Virtual training tools 
have the potential to revolutionize medical emergency response 
training with a corresponding reduction in costs. The 
Department is encouraged to explore developing and 
standardizing medical emergency training using state-of-the-art 
medical response simulation.
            Hospital Preparedness
    The Committee's recommendation includes $375,466,000, the 
same as the budget request, for the hospital preparedness 
program. The comparable funding level for fiscal year 2011 is 
$377,997,000. This program provides grants to States and 
localities to enhance hospital preparedness and improve overall 
surge capacity in public health emergencies. These preparedness 
activities strengthen the capabilities of hospitals throughout 
the country to respond to floods, hurricanes, wildfires or 
infrastructure collapse, and also include training for a 
potential influenza pandemic or terrorist attack. Given the 
significant tornado devastation and flooding seen this year 
across the United States, the Committee believes this funding 
is vital to providing our Nation's hospitals and emergency 
responders the necessary tools to respond quickly and 
collaboratively to these and other public health emergencies.
            Emergency System for Advance Registration of Volunteer 
                    Health Professionals
    The Committee recommendation includes $5,000,000, the same 
as the administration request, for the Emergency System for 
Advance Registration of Volunteer Health Professionals. This 
program is a national network of State-based registries that 
allows health professionals to volunteer in public health 
emergencies and disasters. The comparable funding level for 
fiscal year 2011 is $5,861,000.
            Biomedical Advanced Research and Development
    The Committee has included bill language, proposed by the 
administration, to transfer $415,000,000 from the Project 
BioShield Special Reserve Fund [SRF] advance appropriation to 
fund advanced research and development of medical 
countermeasures. This amount is the same as the comparable 
level from fiscal year 2011. The administration requested 
$665,000,000 for this activity. The Committee is concerned that 
the administration has proposed to greatly increase the amount 
of transfers from the Project BioShield SRF to fund advanced 
research and development. While the Committee strongly supports 
the efforts of the Biomedical Advanced Research and Development 
Authority [BARDA] to develop the countermeasures necessary to 
protect against public health threats, the Committee has not 
provided funding at the level requested by the administration. 
The Committee notes that after the award of a smallpox anti-
viral contract in May, approximately $1,500,000,000 in SRF 
balances remain available. The SRF was intended to serve as a 
signal to the private sector that the Federal Government will 
purchase countermeasures for the Strategic National Stockpile. 
The Committee is concerned that increased transfers will 
further deplete the SRF and significantly weaken the private 
sector's confidence that the SRF will remain a stable funding 
source.
    Advanced Research and Development.--The Committee is aware 
that in order to adequately prepare for and respond to public 
health emergencies, including those caused by acts of 
terrorism, there is a need by first responders to identify 
quickly and accurately potentially dangerous pathogens in 
complex samples. The Committee encourages ASPR to work with 
NIAID to ensure that sufficient research is being conducted to 
develop a bioagent detection and bioterrorism warning system 
based on bioinformatics technology that would allow for the 
direct identification and sample characterization of pathogens 
in rapid fashion.
    Manufacturing Surge Capacity.--The Committee remains 
concerned that during its response to the 2009 H1N1 influenza 
pandemic, the Department relied disproportionately on 
manufacturing surge capacity to produce the needles and 
syringes required to administer the vaccine. The Committee 
believes that the manufacturing surge capacity for these 
products may not be sufficient to respond to the next global 
public health emergency as well as support routine care. ASPR 
should conduct a review of the existing manufacturing surge 
capacity for drug-delivery devices as well as assess the 
adequacy of the Strategic National Stockpile's current 
inventory of drug-delivery devices.
    Medical Countermeasures.--The Committee commends the 
Department for the release of the Public Health Emergency 
Medical Countermeasures Enterprise Review Report in August 
2010. The Committee urges increased coordination between FDA, 
NIH, BARDA and CDC in the development of medical 
countermeasures for public health emergencies. The Committee 
requests that the Department provide additional detail about 
implementation strategy for medical countermeasures, including 
a multiyear professional judgment budget. The implementation 
strategy should not simply focus on initial investments, but 
also on advanced development, procurement, distribution, 
dispensing and surveillance.
    Next Generation Anthrax Vaccine.--The Committee remains 
concerned about the country's level of preparedness against 
biological threats. Anthrax remains the number one biological 
terrorist threat facing this country. However, nearly 10 years 
after 9/11, and 6 years after the requirement for a recombinant 
anthrax vaccine was issued, the Nation still lacks a 
recombinant anthrax vaccine. The Committee directs BARDA, no 
later than 60 days after enactment of this act, to brief the 
Committee on its plans to deliver recombinant anthrax vaccine 
to the Strategic National Stockpile by 2015.
            Strategic Investor
    The Committee recommendation does not include funding or 
bill language requested by the administration for a Strategic 
Investor initiative. The purpose of this initiative is to 
provide financial support and business expertise to emerging 
biodefense companies that will develop Government-required 
countermeasures. The administration proposed to fund this 
activity through a transfer of $100,000,000 from the Project 
BioShield SRF. The Committee does not support additional SRF 
transfers for this purpose.
            Facilities Project
    The Committee recommendation does not include funding for 
the ASPR Facilities project. The administration requested 
$10,000,000 to co-locate ASPR staff in a new facility. Funds 
were not provided for this activity in fiscal year 2011.
            Other Activities
    The Committee recommendation includes the following amounts 
for the following activities within the Office of the Assistant 
Secretary for Preparedness and Response:
  --Operations--$33,053,000;
  --Preparedness and Emergency Operations--$34,647,000;
  --National Disaster Medical System--$52,850,000; and
  --Policy, Strategic Planning and Communications--$15,708,000.

Office of the Assistant Secretary for Administration

    The Committee recommendation for the Office of the 
Assistant Secretary for Administration includes $40,000,000 for 
information technology cybersecurity, the same as the 
administration request. The comparable funding level for fiscal 
year 2011 is $56,680,000. These funds provide for continuous 
monitoring and security incident response coordination for the 
Department's computer systems and networks.

Office of Public Health and Science

    The Committee recommendation includes $11,268,000 for the 
medical reserve corps program, a national network of local 
volunteers that work to strengthen the public health 
infrastructure and preparedness capabilities of their 
communities. This amount is the same as the administration 
request. The comparable level for fiscal year 2011 is 
$11,925,000.

Office of the Secretary

    The Committee recommendation includes $6,460,000 for 
activities within the Office of the Secretary. This amount is 
the same as the administration request. The comparable fiscal 
year 2011 level is $107,805,000.
            Pandemic Influenza Preparedness
    The Committee has not provided funding for pandemic 
influenza preparedness activities, consistent with the 
administration request. The Committee notes that the 
administration plans to use $47,000,000 in balances from Public 
Law 111-32, the fiscal year 2009 emergency supplemental, for 
additional pandemic preparedness investments in fiscal year 
2012. The comparable fiscal year 2011 level is $65,447,000.
            Office of Security and Strategic Information
    The Committee has included $6,460,000 for the Office of 
Security and Strategic Information to secure and strengthen the 
Department's critical assets. This amount is the same as the 
administration request. The comparable level for fiscal year 
2011 is $7,428,000.

                   PREVENTION AND PUBLIC HEALTH FUND

    The Prevention and Public Health Fund was created in 
section 4002 of the Patient Protection and Affordable Care Act 
[PPACA]. The fund provides $17,750,000,000 in mandatory funds 
over the next 10 years to supplement investments in public 
health and prevention.
    The Committee strongly believes that additional resources 
for prevention will improve people's health and reduce 
healthcare costs over the long term. Discretionary funding is 
needed for these purposes because many of the health promotion 
activities that reach the populations most in need take place 
outside the reimbursement system, through community- and State-
based initiatives.
    In recognition of the Committee's responsibility to 
determine funding levels for community-based prevention and 
public health programs, the PPACA specifically gives the 
Committee authority to transfer funds into Federal programs 
that support the goal of making America healthier.
    The PPACA provided $750,000,000 for the fund in fiscal year 
2011. In fiscal year 2012, the level appropriated for the fund 
is $1,000,000,000. The Committee includes bill language in 
section 219 of this act that requires that funds be transferred 
within 45 days of enactment of this act to the following 
accounts, for the following activities, and in the following 
amounts:

------------------------------------------------------------------------
              Account                     Activity            Amount
------------------------------------------------------------------------
Aging Services Programs...........  Chronic Disease Self     $10,000,000
                                     Management program
                                     authorized under
                                     section 411 of the
                                     Older Americans Act.
Aging Services Programs...........  Elder falls               $7,000,000
                                     prevention
                                     activities
                                     authorized under
                                     section 393D of the
                                     PHS Act.
Disease Control, Research, and      Activities of the       $100,000,000
 Training.                           Office of Smoking
                                     and Health.
Disease Control, Research, and      Breastfeeding             $7,050,000
 Training.                           promotion and
                                     support grants.
Disease Control, Research, and      Chronic Disease          $10,000,000
 Training.                           Innovation Grants.
Disease Control, Research, and      Community Health         $20,000,000
 Training.                           Worker program
                                     authorized under
                                     section 399V of the
                                     PHS Act.
Disease Control, Research, and      Community               $280,000,000
 Training.                           Transformation
                                     Grants authorized
                                     under section 4201
                                     of the Patient
                                     Protection and
                                     Affordable Care Act.
Disease Control, Research, and      Elder falls               $3,000,000
 Training.                           prevention research
                                     authorized under
                                     section 393D of the
                                     PHS Act.
Disease Control, Research, and      Environmental and        $35,000,000
 Training.                           Health Outcome
                                     Tracking Network.
Disease Control, Research, and      Epidemiology and         $40,000,000
 Training.                           Laboratory Capacity
                                     Grants authorized
                                     under section 2821
                                     of the PHS Act.
Disease Control, Research, and      National Center for      $35,000,000
 Training.                           Health Statistics.
Disease Control, Research, and      National Prevention,      $1,000,000
 Training.                           Health Promotion &
                                     Public Health
                                     Council authorized
                                     under section 4001
                                     of the Patient
                                     Protection and
                                     Affordable Care Act.
Disease Control, Research, and      Prevention of            $11,750,000
 Training.                           healthcare
                                     associated
                                     infections.
Disease Control, Research, and      Prevention Research      $10,000,000
 Training.                           Centers.
Disease Control, Research, and      Public Health            $40,200,000
 Training.                           Infrastructure
                                     grants.
Disease Control, Research, and      Public Health            $25,000,000
 Training.                           Workforce.
Disease Control, Research, and      Racial and Ethnic        $50,000,000
 Training.                           Approaches to
                                     Community  Health.
Disease Control, Research, and      Immunization program    $150,000,000
 Training.                           authorized under
                                     Section 317 of the
                                     PHS Act.
Disease Control, Research, and      Task Force on            $10,000,000
 Training.                           Community
                                     Preventive Services.
Disease Control, Research, and      Infectious disease       $10,000,000
 Training.                           screening
                                     activities.
Disease Control, Research, and      Small Business           $10,000,000
 Training.                           Workplace Wellness
                                     grants authorized
                                     under section 10408
                                     of the Patient
                                     Protection and
                                     Affordable Care Act.
General Departmental Management...  Tobacco prevention       $10,000,000
                                     and cessation
                                     activities.
Health Resources and Services.....  Public Health and        $25,000,000
                                     Preventive Medicine
                                     training programs.
Healthcare Costs, Quality and       Clinical preventive       $5,000,000
 Outcomes.                           services research.
Healthcare Costs, Quality and       U.S. Preventive           $7,000,000
 Outcomes.                           Services Task Force.
Substance Abuse and Mental Health   Primary and              $35,000,000
 Services.                           Behavioral Health
                                     Integration grants.
Substance Abuse and Mental Health   Screening, Brief         $25,000,000
 Services.                           Intervention and
                                     Referral to
                                     Treatment.
Substance Abuse and Mental Health   Suicide Prevention..     $10,000,000
 Services.
Substance Abuse and Mental Health   Surveillance             $18,000,000
 Services.                           activities.
------------------------------------------------------------------------

    Not later than 90 days after enactment of this act, the 
Secretary shall submit to the Chairman and Ranking Members of 
the Committees on Appropriations, and Health, Education, Labor 
and Pensions a report identifying all recipients of funds 
provided pursuant to sections 4002 and 4201 of Public Law 111-
148. The report should identify each individual recipient of 
funds, how much they received, the specific prevention, 
wellness and public health activities they will perform and how 
these activities will restrain the rate of growth in private 
and public sector health care costs.

                           General Provisions

    The Committee recommendation continues a provision placing 
a $50,000 ceiling on official representation expenses (sec. 
201).
    The Committee recommendation continues a provision which 
limits the assignment of certain public health personnel (sec. 
202).
    The Committee recommendation continues a provision limiting 
the use of certain grant funds to pay individuals more than an 
annual rate of executive level I (sec. 203).
    The Committee recommendation continues a provision 
restricting the Secretary's use of taps for program evaluation 
activities unless a report is submitted to the Appropriations 
Committees of the House and Senate on the proposed use of funds 
(sec. 204).
    The Committee recommendation continues a provision 
authorizing the transfer of up to 2.5 percent of Public Health 
Service funds for evaluation activities (sec. 205).
    The Committee recommendation continues a provision 
restricting transfers of appropriated funds and requires a 15-
day notification to both the House and Senate Appropriations 
Committees (sec. 206).
    The Committee recommendation continues a provision 
permitting the transfer of up to 3 percent of AIDS funds among 
Institutes and Centers by the Director of NIH and the Director 
of the Office of AIDS Research at NIH (sec. 207).
    The Committee recommendation retains language which 
requires that the use of AIDS research funds be determined 
jointly by the Director of the National Institutes of Health 
and the Director of the Office of AIDS Research and that those 
funds be allocated directly to the Office of AIDS Research for 
distribution to the Institutes and Centers consistent with the 
AIDS research plan (sec. 208).
    The Committee recommendation continues a provision 
regarding requirements for family planning applicants (sec. 
209).
    The Committee recommendation retains language which states 
that no provider services under title X of the PHS Act may be 
exempt from State laws regarding child abuse (sec. 210).
    The Committee recommendation retains language which 
restricts the use of funds to carry out the Medicare Advantage 
Program if the Secretary denies participation to an otherwise 
eligible entity (sec. 211).
    The Committee recommendation modifies a provision which 
facilitates the expenditure of funds for international health 
activities (sec. 212).
    The Committee recommendation continues a provision 
authorizing the Director of the National Institutes of Health 
to enter into certain transactions to carry out research in 
support of the NIH Common Fund (sec. 213).
    The Committee continues a provision that permits the 
Centers for Disease Control and Prevention and the Agency for 
Toxic Substances and Disease Registry to transfer funds that 
are available for Individual Learning Accounts to ``Disease 
Control, Research, and Training'' (sec. 214).
    The Committee recommendation includes bill language 
allowing use of funds to continue operating the Council on 
Graduate Medical Education (sec. 215).
    The Committee recommendation continues a provision 
permitting the National Institutes of Health to use up to 
$2,500,000 per project for improvements and repairs of 
facilities (sec. 216).
    The Committee recommendation includes a provision that 
transfers funds from NIH to HRSA and AHRQ, to be used for 
National Research Service Awards (sec. 217).
    The Committee recommendation includes a provision 
transferring mandatory funds section 4002 of the Patient 
Protection and Affordable Care Act to accounts within the 
Department for activities outlined under the heading 
``Prevention and Public Health Fund'' in this report (sec. 
218).

                               TITLE III

                        DEPARTMENT OF EDUCATION

                    Education for the Disadvantaged

Appropriations, 2011.................................... $15,535,934,000
Budget estimate, 2012...................................  16,224,267,000
Committee recommendation................................  15,714,934,000

    The Committee recommends an appropriation of 
$15,714,934,000 for education for the disadvantaged. The budget 
request for fiscal year 2012 is $16,224,267,000 and the 
comparable fiscal year 2011 amount is $15,535,934,000.
    The President's budget for fiscal year 2012 was based on 
the administration's proposal to reauthorize the Elementary and 
Secondary Education Act [ESEA], but no such bill has passed the 
Senate. As a result, the Committee bill is based on current law 
for programs authorized under the ESEA.
    The programs in the Education for the Disadvantaged account 
help ensure that poor and low-achieving children are not left 
behind in the Nation's effort to raise the academic performance 
of all children and youth. Funds appropriated in this account 
primarily support activities in the 2012-2013 school year.

Grants to Local Educational Agencies

    Title I grants to local educational agencies [LEAs] provide 
supplemental education funding, especially in high-poverty 
areas, for local programs that provide extra academic support 
to help raise the achievement of eligible students or, in the 
case of schoolwide programs, help all students in high-poverty 
schools meet challenging State academic standards.
    The Committee recommends $14,463,417,000, the same amount 
as the fiscal year 2011 level, for the title I grants to LEAs 
program. The budget request for fiscal year 2012 is 
$14,792,401,000.
    Title I grants are distributed through four formulas: 
basic, concentration, targeted and education finance incentive 
grant [EFIG]. The budget request also proposes a new 
distribution mechanism and authority called Title I Rewards.
    For title I basic grants, including up to $3,992,000 
transferred to the Census Bureau for poverty updates, the 
Committee recommends an appropriation of $6,584,750,000, the 
same amount as the fiscal year 2011 level. The budget request 
for fiscal year 2012 is $6,597,946,000.
    For concentration grants, the Committee recommends 
$1,362,301,000, the same amount as the fiscal year 2011 level. 
The budget request for fiscal year 2012 is $1,365,031,000.
    For grants through the targeted formula, the Committee 
recommends $3,258,183,000, the same amount as the fiscal year 
2011 level. The budget request for fiscal year 2012 is 
$3,264,712,000.
    For grants through the EFIG formula, the Committee 
recommends $3,258,183,000, the same amount as the fiscal year 
2011 level. The budget request for fiscal year 2012 is 
$3,264,712,000.
    For grants for Title I Rewards, the Committee recommends no 
funds. The budget request for fiscal year 2012 is $300,000,000 
for this proposed activity. This new authority would provide 
formula grants to States that would in turn allocate financial 
and other awards to high-poverty LEAs and schools that are 
highest-achieving and making the most progress in raising 
student achievement.
    Of the funds available for title I grants to LEAs, up to 
$3,992,000 shall be available on October 1, 2011, not less than 
$3,618,248,000 will become available on July 1, 2012 and 
$10,841,177,000 will become available on October 1, 2012. The 
funds that become available on July 1, 2012 and October 1, 
2012, will remain available for obligation through September 
30, 2013.
    The Committee notes that the biggest barrier for homeless 
children and youth attempting to enroll in and attend school 
regularly is the lack of transportation. The Committee bill 
includes language clarifying that title I funds may be used to 
address this transportation issue, as well as support homeless 
liaisons.

Early Learning Challenge Fund

    The Committee does not recommend resources for a separate 
Early Learning Challenge Fund. The budget request includes 
$350,000,000 for this activity. The fiscal year 2011 bill 
includes $500,000,000 for a new Race to the Top-Early Learning 
Challenge [RTT-ELC] program.
    The Committee will continue the effort to improve early 
learning and development programs for young children through 
the RTT-ELC program. The Early Learning Challenge Fund proposes 
to achieve the same goal.

School Improvement Grants

    The Committee recommendation includes $534,562,000, the 
same amount as the fiscal year 2011 level, for the School 
Improvement Grants [SIG] program. The budget request for fiscal 
year 2012 is $600,000,000.
    The Committee continues authority provided by prior 
appropriations acts that addresses several issues. First, it 
continues the expansion of the number of schools that may 
receive funds through the program. This language allows schools 
to be eligible for SIG if they are eligible for title I and 
have not made adequate yearly progress for at least 2 years or 
are in the State's lowest quintile of performance based on 
proficiency rates. Second, language also allows States to make 
subgrants of not more than $2,000,000 to each participating 
school. Funds made available in the fiscal year 2012 bill will 
pay for the continuation costs of awards made previously.
    The Committee continues to have concerns about 
implementation challenges related to the SIG program. A recent 
Government Accountability Office interim report on the program 
noted that some States have implemented SIG more rigorously 
than others and that limited capacity, challenges in rural 
areas and short timeframes affected school reform efforts. 
Also, the Department's monitoring reports have found 
significant implementation issues related to SIG that require 
corrective action. The Committee strongly urges the Department 
to help build the capacity of States to carry out their 
responsibilities under the SIG program; make more timely 
awards, so States can run competitions that effectively 
identify the schools with the highest-quality plans for turning 
around; help engage communities and families in school 
turnaround planning and implementation; support the effective 
use of time in schools, including through the adoption of 
effective, extended learning time activities, and support the 
effective utilization of the knowledge available for turning 
around low-performing schools. To aid in this effort, the 
Committee bill includes language providing the Department with 
a set-aside of up to 5 percent of the SIG appropriation for 
national activities designed to address implementation issues 
identified through Department monitoring and other sources. 
Prior to obligating any of these national activities funds, the 
Committee requests a multi-year strategic vision and operating 
plan for how it will utilize this new authority and coordinate 
these new efforts with existing technical assistance and 
related efforts that the Department supports.

Striving Readers

    The Committee recommends $183,000,000 to continue the 
Striving Readers initiative. The budget proposes to consolidate 
this funding within a new Effective Teaching and Learning 
program under its reauthorization proposal. The fiscal year 
2011 bill did not include funds for Striving Readers, but 
fiscal year 2010 funding of $200,000,000 allowed the Department 
to make $180,500,000 in 3- and 5-year awards to States in 
September 2011 and support other activities.
    The Committee bill includes language that continues the 
competitive portion of the program as it was established in the 
fiscal year 2010 appropriations act. This comprehensive 
literacy program will advance literacy skills, including 
language development, reading and writing for all students, 
including English language learners and students with 
disabilities, from birth through grade 12.
    Funds provided by the 2012 appropriations bill will be used 
for the second-year costs of awards made in September 2011. 
States will be required to distribute not less than 95 percent 
of their funds as subgrants to LEAs or, in the case of early 
literacy, to LEAs or other entities providing early childhood 
care and education. State subgrants must first be prioritized 
to such agencies or other entities serving greater percentages 
or numbers of disadvantaged students and ensure that: at least 
15 percent go to serve children from birth through age 5, 40 
percent to serve students in kindergarten through grade 5, and 
40 percent to serve students in middle and high school, through 
grade 12. States also must equitably distribute funds between 
middle and high schools.

Migrant Education Program

    The Committee recommends $393,981,000, the same as the 
fiscal year 2011 level, for the migrant education program. The 
budget request for fiscal year 2012 is $394,771,000.
    The title I migrant education program authorizes grants to 
State educational agencies for programs to meet the special 
educational needs of the children of migrant agricultural 
workers and fishermen. This appropriation also supports 
activities to improve interstate and intrastate coordination of 
migrant education programs, as well as identify and improve 
services to the migrant student population.

Neglected and Delinquent

    The Committee recommends $50,326,000, the same amount as 
the fiscal year 2011 level, for the title I neglected and 
delinquent program. The budget request for fiscal year 2012 is 
$50,427,000.
    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. States are 
authorized to set aside at least 15 percent, but not more than 
30 percent, of their neglected and delinquent funds to help 
students in State-operated institutions make the transition 
into locally operated programs and to support the successful 
re-entry of youth offenders who are age 20 or younger and have 
received a secondary school diploma or its recognized 
equivalent.

Evaluation

    The Committee recommends $4,151,000 for evaluation of title 
I programs. The budget request proposes to fund evaluation 
efforts through a comprehensive evaluation authority contained 
in the administration's reauthorization proposal. The 
comparable fiscal year 2011 amount is $8,151,000.
    Evaluation funds are used to support large-scale national 
surveys that examine how the title I program is contributing to 
student academic achievement. Funds also are used to evaluate 
State assessment and accountability systems and analyze the 
effectiveness of educational programs supported with title I 
funds.
    Funds provided will support costs associated with studies 
of the implementation of title I and title II program 
initiatives, Early Childhood Language Development activities 
and School Turnaround.

High School Graduation Initiative

    The Committee recommends $48,902,000, the same amount as 
the fiscal year 2011 level, for the High School Graduation 
Initiative under title I, part H of the ESEA. The budget 
request funds related activities through a broader College 
Pathways and Accelerated Learning program.
    The High School Graduation Initiative provides competitive 
grants to LEAs or State educational agencies to implement 
effective high school graduation and re-entry strategies in 
schools and districts that serve students in grades 6 through 
12 and have annual school dropout rates that are above their 
State's average. Funds also are used for certain national 
activities, including evaluation, technical assistance and 
dissemination of information on effective programs and best 
practices.

Special Programs for Migrant Students

    The Committee recommends $36,595,000, the same as the 
fiscal year 2011 level, for Special Programs for Migrant 
Students. The budget request for fiscal year 2012 is 
$36,668,000.
    The Higher Education Opportunity Act of 2008 reauthorized 
the High School Equivalency Program [HEP] and College 
Assistance Migrant Program [CAMP] within the Special Programs 
for Migrant Students, and added a new provision allowing the 
Department to reserve up to 0.5 percent of the funds 
appropriated between the two programs for outreach, technical 
assistance and professional development activities. In 
addition, under current law, if the total amount appropriated 
is below $40,000,000, the remaining funds are to be distributed 
between the two programs in the same proportion as the amounts 
available for each program the previous year.
    HEP projects are 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 post-secondary institution or a job-training program, or join 
the military. Projects provide counseling, health services, 
stipends, and placement assistance.
    CAMP projects are 5-year grants to institutions of higher 
education and nonprofit organizations to provide tutoring, 
counseling, and financial assistance to migrant students during 
their first year of postsecondary education.

                               Impact Aid

Appropriations, 2011....................................  $1,273,631,000
Budget estimate, 2012...................................   1,276,183,000
Committee recommendation................................   1,273,631,000

    The Committee recommends $1,273,631,000, the same amount as 
the fiscal year 2011 level, for impact aid. The budget request 
for fiscal year 2012 is $1,276,183,000.
    Impact aid provides financial assistance to school 
districts for the costs of educating children when enrollments 
and the availability of revenues from local sources have been 
adversely affected by the presence of Federal activities. 
Children who reside on Federal or Indian lands generally 
constitute a financial burden on local school systems because 
these lands do not generate property taxes--a major revenue 
source for elementary and secondary education in most 
communities. In addition, realignments of U.S. military forces 
at bases across the country often lead to influxes of children 
into school districts without producing the new revenues 
required to maintain an appropriate level of education.
    The Committee bill retains language that provides for 
continued eligibility for students affected by the deployment 
or death of their military parent, as long as these children 
still attend schools in the same school district.
    Basic Support Payments.--The Committee recommends 
$1,135,724,000, the same amount as the fiscal year 2011 level, 
for basic support payments. The budget request for fiscal year 
2012 is $1,138,000,000. Under this statutory formula, payments 
are made on behalf of all categories of federally connected 
children, with a priority placed on making payments first to 
heavily impacted school districts and providing any remaining 
funds for regular basic support payments.
    The Department shall continue to make heavily impacted 
payments to qualifying school districts that are affected by 
ongoing military housing privatization projects, as required 
under section 8003(b)(2)(H) of title VIII of the ESEA, 
including if the completion of these projects has been 
postponed due to economic conditions.
    Payments for Children With Disabilities.--The Committee 
bill includes $48,505,000, the same amount as the fiscal year 
2011 level, for payments for children with disabilities. The 
budget request for fiscal year 2012 is $48,602,000. Under this 
program, additional payments are made for certain federally 
connected children eligible for services under the Individuals 
with Disabilities Education Act.
    Facilities Maintenance.--The Committee recommends 
$4,854,000, the same amount as the fiscal year 2011 level, for 
facilities maintenance. The budget request for fiscal year 2012 
is $4,864,000. This activity provides funding for emergency 
repairs and comprehensive capital improvements to certain 
school facilities owned by the Department of Education and used 
by local educational agencies to serve federally connected 
military dependent students. Funds appropriated for this 
purpose are available until expended.
    Construction.--The Committee recommends $17,474,000, the 
same amount as the fiscal year 2011 level, for the construction 
program. The budget request for fiscal year 2012 is 
$17,509,000. Formula and competitive grants are authorized to 
be awarded to eligible LEAs for emergency repairs and 
modernization of school facilities.
    The Committee recommendation includes bill language 
allowing these funds to be awarded entirely through a 
competitive process, as proposed in the budget request. Funds 
also are available for obligation through September 30, 2013. 
Last year's bill provided these funds entirely through formula 
allocations.
    Payments for Federal Property.--The Committee recommends 
$67,074,000, the same amount as the fiscal year 2011 level, for 
payments for Federal property. The budget request for fiscal 
year 2012 is $67,208,000. These payments compensate LEAs in 
part for revenue lost due to the removal of Federal property 
from local tax rolls.

                      School Improvement Programs

Appropriations, 2011....................................  $4,597,019,000
Budget estimate, 2012...................................   2,996,572,000
Committee recommendation................................   4,570,145,000

    The Committee recommendation includes $4,570,145,000 for 
school improvement programs. The budget request for fiscal year 
2012 is $2,996,572,000 and the comparable fiscal year 2011 
amount is $4,597,019,000.
    The President's budget for fiscal year 2012 was based on 
the administration's proposal to reauthorize the Elementary and 
Secondary Education Act [ESEA], but no such bill has passed the 
Senate. As a result, programs in this account are based 
generally on current law, as authorized under the ESEA.

Effective Teaching and Learning: Literacy

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning: Literacy program. The budget 
request for fiscal year 2012 is $383,348,000. Activities 
supported under this proposed program are instead funded under 
current law.
    The Effective Teaching and Learning: Literacy program would 
provide competitive grants to State educational agencies 
[SEAs], or SEAs in partnership with appropriate outside 
entities, to support development and implementation of 
comprehensive, evidence-based State and local efforts to 
provide high-quality literacy programs aligned with college- 
and career-ready English language standards.

Effective Teaching and Learning: Science, Technology, Engineering, and 
        Mathematics [STEM]

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning: STEM program. The budget 
request for fiscal year 2012 is $206,046,000. Activities 
supported under this proposed program are instead funded under 
current law.
    The Effective Teaching and Learning: STEM would provide 
competitive grants to SEAs, or SEAs in partnership with 
appropriate outside entities, to support State and local 
efforts to implement a comprehensive strategy for the provision 
of high-quality STEM instruction and support to students from 
preschool through grade 12.

Effective Teaching and Learning for a Well-Rounded Education

    The Committee recommends no funds for the proposed 
Effective Teaching and Learning for a Well-Rounded Education. 
The budget request for fiscal year 2012 is $246,084,000. 
Activities supported under this proposed program are instead 
funded under current law.
    The Effective Teaching and Learning for a Well-Rounded 
Education would provide competitive grants to high-need local 
educational agencies [LEAs], SEAs and institutions of higher 
education or nonprofit organizations in partnership with one or 
more high-need LEAs to support the development and expansion of 
innovative practices to improve teaching and learning across a 
well-rounded curriculum that includes the arts, health 
education, physical education, foreign languages, civics and 
government, history, geography, environmental education, 
economics and financial literacy and other subjects.

College Pathways and Accelerated Learning

    The Committee recommends no funds for the proposed College 
Pathways and Accelerated Learning program. The budget request 
for fiscal year 2012 is $86,000,000. Activities supported under 
this proposed program are instead funded under current law.
    The College Pathways and Accelerated Learning program would 
support efforts to increase high school graduation rates and 
preparation for college matriculation and success by providing 
college-level and other accelerated courses and instruction in 
middle and high schools with concentrations of students from 
low-income families and in high-schools with low graduation 
rates.

State Grants for Improving Teacher Quality

    The Committee recommends $2,468,054,000, the same amount as 
the fiscal year 2011 level, for State grants for improving 
teacher quality. The budget request proposes $2,500,000,000 for 
a new effective teacher and leaders State grants program within 
the Innovation and Improvement account.
    The appropriation for this program primarily supports 
activities associated with the 2012-2013 academic year. Of the 
funds provided, $786,613,000 will become available on July 1, 
2012, and $1,681,441,000 will become available on October 1, 
2012. These funds will remain available for obligation through 
September 30, 2013.
    States and LEAs may use funds for a range of activities 
related to the certification, recruitment, professional 
development and support of teachers and administrators. 
Activities may include reforming teacher certification and 
licensure requirements, addressing alternative routes to State 
certification of teachers, recruiting teachers and principals, 
and implementing teacher mentoring systems, teacher testing, 
merit pay and merit-based performance systems. These funds may 
also be used by districts to hire teachers to reduce class 
sizes.
    The Committee bill continues a set-aside established in the 
fiscal year 2011 bill for competitive awards to national not-
for-profit organizations for teacher training or professional 
enhancement activities. Up to 5 percent of funds available for 
the State grants for improving teacher quality program shall be 
used for this purpose. In fiscal year 2011, the set-aside was 1 
percent.

Mathematics and Science Partnerships

    The Committee recommends $175,127,000, the same amount as 
the fiscal year 2011 level, for the mathematics and science 
partnerships program. The budget proposes $206,046,000 for a 
new Effective Teaching and Learning: Science, Technology, 
Engineering, and Mathematics program.
    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 Department awards grants to States by a formula 
based on the number of children aged 5 to 17 who are from 
families with incomes below the poverty line. States then are 
required to make grants competitively to eligible partnerships, 
which must include an engineering, math or science department 
of an institution of higher learning and a high-need LEA.

Supplemental Education Grants

    The Committee recommendation includes $17,652,000, the same 
amount as the fiscal year 2011 level, for supplemental 
education grants to the Republic of Marshall Islands [RMI] and 
the Federated States of Micronesia [FSM]. The budget request 
for fiscal year 2012 is $17,687,000.
    This grant program was authorized by the Compact of Free 
Association Amendments Act of 2003. These funds will be 
transferred from the Department of Education to the Secretary 
of the Interior for grants to these entities. The Committee 
bill includes language that allows up to 5 percent to be used 
by the FSM and RMI to purchase oversight and technical 
assistance, which may include reimbursement to the Departments 
of Labor, Health and Human Services, and Education for such 
services.

21st Century Community Learning Centers

    The Committee recommends an appropriation of 
$1,153,854,000, the same amount as the fiscal year 2011 level, 
for the 21st Century Community Learning Centers program. The 
budget request for fiscal year 2012 is $1,266,166,000.
    Funds are allocated to States by formula, which in turn, 
award at least 95 percent of their allocations to LEAs, 
community-based organizations and other public and private 
entities. Grantees use these resources to establish or expand 
community learning centers that provide activities offering 
significant extended learning opportunities, such as before- 
and after-school programs, recreational activities, drug and 
violence prevention and family literacy programs for students 
and related services to their families. Centers must target 
their services on students who attend schools that are eligible 
to operate a schoolwide program under title I of the ESEA or 
serve high percentages of students from low-income families.
    A growing body of evidence demonstrates that students 
benefit academically from a longer school day, week and year. 
The Committee notes that some school districts have adopted 
strategies to extend the school day without significant new 
investments, such as through staggered school schedules and 
innovative partnerships with community partners.
    The Committee believes State educational agencies should 
award grants to high-quality programs that address individual 
student learning needs and student well-being. Funded programs 
should (1) deliver services through a variety of high-quality 
and effective strategies for boosting learning and enrichment 
including after school, before school, summer school, and 
extended school day, week or year opportunities; and (2) align 
with and complement, rather than replicate, the regular school 
day by offering a range of activities that capture student 
interest and support student engagement to promote higher class 
attendance, reduce risk for retention or dropping out, and 
include activities that promote good health. The Committee 
directs the Department to provide guidance and support 
technical assistance on how to form and maintain strong 
community-school partnerships, promote continuous quality 
improvement and ensure that funded programs meet the needs of 
individual students.

State Assessments and Enhanced Assessment Instruments

    The Committee recommends $389,951,000, the same amount as 
the fiscal year 2011 level, for State assessments and enhanced 
assessment instruments. The budget request for fiscal year 2012 
is $420,000,000.
    This program has two components. The first provides formula 
grants to States to pay the cost of developing and implementing 
standards and assessments required by the Elementary and 
Secondary Education Act. The Committee provides $380,000,000 
for this purpose.
    Under the second component--grants for enhanced assessment 
instruments--appropriations in excess of the State assessment 
program are used for a competitive grant program designed to 
support efforts by States to improve the quality and fairness 
of their assessment systems. The Committee recommendation for 
the second component is $9,951,000.
    The Committee urges the Department to continue to place a 
high priority on grant applications that aim to improve the 
quality of State assessments for students with disabilities and 
students with limited English proficiency, and to ensure the 
most accurate means of measuring their performance on these 
assessments.

Foreign Language Assistance

    The Committee recommends no funds for the foreign language 
assistance program. The comparable fiscal year 2011 amount is 
$26,874,000.
    The budget request proposes to fund similar activities 
under Effective Teaching and Learning for a Well-Rounded 
Education. Funds from this program have supported competitive 
grants to increase the quality and quantity of foreign language 
instruction.

Education for Homeless Children and Youth

    For carrying out education activities authorized by title 
VII, subtitle B of the Stewart B. McKinney Homeless Assistance 
Act, the Committee recommends $65,296,000. The budget request 
for fiscal year 2012 is $65,427,000 and the comparable fiscal 
year 2011 amount is $65,296,000.
    This program provides assistance to each State to support 
an office of the coordinator of education for homeless children 
and youth, to develop and implement State plans for educating 
homeless children, and to make subgrants to LEAs to support the 
education of those children. Grants are made to States based on 
the total that each State receives in title I grants to LEAs.
    Under the McKinney-Vento Homeless Children and Youths 
Program, State educational agencies must ensure that homeless 
children and youth have equal access to the same free public 
education, including a public preschool education, as is 
provided to other children and youth.

Training and Advisory Services

    For training and advisory services authorized by title IV 
of the Civil Rights Act, the Committee recommends $6,975,000. 
The budget request for fiscal year 2012 is $6,989,000 and the 
comparable fiscal year 2011 amount is $6,975,000.
    The funds provided will support awards to operate the 10 
regional equity assistance centers [EACs]. Each EAC provides 
services to school districts upon request. Activities include 
disseminating information on successful practices and legal 
requirements related to nondiscrimination on the basis of race, 
color, sex, or national origin in education programs.

Education for Native Hawaiians

    For programs for the education of Native Hawaiians, the 
Committee recommends $34,246,000. The budget request for fiscal 
year 2012 is $34,315,000 and the comparable fiscal year 2011 
amount is $34,246,000.
    The Committee bill includes language that allows funding 
provided by this program to be used for construction.

Alaska Native Educational Equity

    The Committee recommends $33,248,000, the same amount as 
the fiscal year 2011 level, for the Alaska Native educational 
equity assistance program. The budget request for fiscal year 
2012 is $33,315,000.
    These funds address the severe educational handicaps of 
Alaska Native schoolchildren. Funds are used for the 
development of supplemental educational programs to benefit 
Alaska Natives. The Committee bill includes language that 
allows funding provided by this program to be used for 
construction. The Committee expects the Department to use some 
of these funds to address the construction needs of rural 
schools.
    The Committee bill also includes language overriding the 
authorizing statute's requirement to make non-competitive 
awards to certain organizations.

Rural Education

    The Committee recommends $174,532,000, the same amount as 
the fiscal year 2011 level, for rural education programs. The 
budget request for fiscal year 2012 is $174,882,000.
    The Committee expects that rural education funding will be 
equally divided between the Small, Rural Schools Achievement 
Program, which provides funds to LEAs that serve a small number 
of students, and the Rural and Low-Income Schools Program, 
which provides funds to LEAs that serve concentrations of poor 
students, regardless of the number of students served.

Comprehensive Centers

    The Committee recommends $51,210,000, the same amount as 
the fiscal year 2011 level, for the comprehensive centers 
program. The budget request for fiscal year 2012 is 
$56,313,000.
    These funds provide support to a network of 21 
comprehensive centers that are operated by research 
organizations, agencies, institutions of higher education or 
partnerships thereof, and provide training and technical 
assistance on various issues to States, LEAs and schools as 
identified through needs assessments undertaken in each region. 
The system also currently includes 16 regional centers, which 
are charged with providing intensive technical assistance to 
State educational agencies to increase their capacity to assist 
LEAs and schools with meeting the goals of the Elementary and 
Secondary Education Act, and five content centers, which are 
organized by topic area.

                            Indian Education

Appropriations, 2011....................................    $127,027,000
Budget estimate, 2012...................................     127,282,000
Committee recommendation................................     128,027,000

    The Committee recommends $128,027,000 for Indian education 
programs. The budget request for fiscal year 2012 is 
$127,282,000 and the comparable fiscal year 2011 amount is 
$127,027,000.

Grants to Local Educational Agencies

    For grants to local educational agencies, the Committee 
recommends $104,122,000, the same amount as the fiscal year 
2011 level. The budget request for fiscal year 2012 is 
$104,331,000.
    These funds provide financial support to elementary and 
secondary school programs that serve Indian students, including 
preschool children. Funds are awarded on a formula basis to 
local educational agencies, schools supported and operated by 
the Department of the Interior/Bureau of Indian Education, and 
in some cases directly to Indian tribes.

Special Programs for Indian Children

    The Committee recommends $19,022,000, the same amount as 
the fiscal year 2011 level, for special programs for Indian 
children. The budget request for fiscal year 2012 is 
$19,060,000.
    Funds are used for demonstration grants to improve Indian 
student achievement through early childhood education and 
college preparation programs, and for professional development 
grants for training Indians who are preparing to begin careers 
in teaching and school administration.

National Activities

    The Committee recommends $4,883,000 for national 
activities. The budget request for fiscal year 2012 is 
$3,891,000 and the comparable fiscal year 2011 amount is 
$3,883,000.
    Funds will be used to expand efforts to improve research, 
evaluation, and data collection on the status and effectiveness 
of Indian education programs. The $1,000,000 increase over the 
fiscal year 2011 level shall be used for grants to tribes for 
education administration and planning.

                       Innovation and Improvement

Appropriations, 2011....................................  $1,856,179,000
Budget estimate, 2012...................................   4,995,000,000
Committee recommendation................................   1,740,212,000

    The Committee recommendation includes $1,740,212,000 for 
programs within the innovation and improvement account. The 
budget request for fiscal year 2012 is $4,995,000,000 for 
related activities and the fiscal year 2011 appropriation is 
$1,856,179,000 for programs in this account.
    The President's budget for fiscal year 2012 was based on 
the administration's proposal to reauthorize the Elementary and 
Secondary Education Act [ESEA], but no such bill has passed the 
Senate. As a result, programs in this account are based 
generally on current law, as authorized under the ESEA.

Race to the Top

    The Committee recommends $698,600,000, the same amount as 
the fiscal year 2011 level, for the Race to the Top [RTT] 
program. The budget request for fiscal year 2012 includes 
$900,000,000 for this program. These funds are available for 
obligation on July 1, 2012, and will remain available through 
September 30, 2013.
    RTT was established in the American Recovery and 
Reinvestment Act and continued in the fiscal year 2011 
appropriations bill. It has supported and incentivized reforms 
that are designed to reduce achievement gaps, significantly 
improve student achievement, graduation rates and college 
enrollments, and encourage the broad replication of effective 
practices. The Committee bill includes new language allowing 
local school districts to be eligible for RTT grants. With 
funds provided in this appropriations bill, the Department may 
make awards to SEAs and/or LEAs based on their commitment to 
and plan for innovation and reform that will improve student 
achievement. States receiving awards must use not less than 50 
percent of their funds to local educational agencies 
participating in the State's RTT plan.
    Funds also may be used for Race to the Top-Early Learning 
Challenge [RTT-ELC], a component that was added in the fiscal 
year 2011 appropriations bill. The goal of RTT-ELC is to 
improve the quality of early learning and development and close 
the achievement gap for children with high needs. The RTT-ELC 
grant competition focuses on improving early learning and 
development for young children by supporting States' efforts to 
increase the number and percentage of low-income and 
disadvantaged children in each age group of infants, toddlers 
and preschoolers enrolled in high-quality early learning and 
development programs; and designing and implementing an 
integrated system of high-quality early learning and 
development programs and services. Grants are made to States, 
which may make subgrants to appropriate entities so they can 
help achieve the goals of States' plans.
    The Committee bill includes new language providing up to 5 
percent of the appropriation for this program to be used for 
evaluation and technical assistance. These funds may be used to 
continue to collect implementation data, possibly to expand the 
implementation study to include more districts or to conduct 
impact evaluations of interventions supported by RTT including 
impact studies of the RTT-ELC. The Committee expects to be 
notified in advance of the proposed uses of these funds.

Investing in Innovation

    The Committee recommends $149,700,000, the same amount as 
the fiscal year 2011 level, for the Investing in Innovation 
program. The budget request for fiscal year 2012 is 
$300,000,000 for this purpose.
    Investing in Innovation was established in the American 
Recovery and Reinvestment Act and continued in the fiscal year 
2011 appropriations bill. The program has provided a source for 
replicating education programs that meet the highest level of 
evidence; expanding those with significant levels of evidence; 
and supporting promising practices for which there is some 
level of appropriate research. The Committee supports this 
three-tier evidentiary model and believes that this feature of 
the program should continue to guide future funding 
opportunities and decisions. The Committee also appreciates the 
priority given to rural applicants in the fiscal year 2011 
competition and believes that this priority should continue to 
be used in the fiscal year 2012 competition. The Committee 
expects the Department to equally distribute grants among the 
absolute priority categories unless there are an insufficient 
number of qualified grants for a priority category.
    The Committee bill includes new language providing up to 5 
percent of the appropriation for this program to be used for 
evaluation and technical assistance. These funds may be used to 
provide technical assistance and to summarize the evaluations 
from 2011 grantees. The Committee expects to be notified in 
advance of the proposed uses of these funds.

Effective Teachers and Leaders

    The Committee recommends no funding for the Effective 
Teachers and Leaders State grant program. The budget request 
for fiscal year 2012 includes $2,500,000,000 for this new 
program based on the administration's reauthorization proposal.
    The Committee has provided $2,468,054,000 for State Grants 
for Improving Teacher Quality within the school improvement 
programs account. These funds may be used for similar purposes 
as those proposed under this new program.

Effective Teachers and Leaders Innovation Fund

    The Committee recommends no funding for the Effective 
Teachers and Leaders Innovation Fund. The budget request for 
fiscal year 2012 includes $500,000,000 for this new program 
based on the administration's reauthorization proposal.
    The Committee has provided $300,000,000 for the Teacher 
Incentive Fund and additional funds for other current law 
programs that may be used for similar purposes as those 
proposed under this new program.

Teacher and Leader Pathways

    The Committee recommends no funding for the Teacher and 
Leader Pathways program. The budget request for fiscal year 
2012 includes $250,000,000 for this new program based on the 
administration's reauthorization proposal.
    The Committee has provided resources under current law 
programs that may be used for similar purposes as those 
proposed under this new program.

Expanding Educational Options

    The Committee recommends no funding for the Expanding 
Educational Options program. The budget request for fiscal year 
2012 includes $372,000,000 for this new program based on the 
administration's reauthorization proposal.
    The Committee has provided resources under current law 
programs that may be used for similar purposes as those 
proposed under this new program.

Transition to Teaching

    The Committee recommends $20,125,000 for the Transition to 
Teaching program. The budget request for fiscal year 2012 
proposes an Excellent Instructional Teams initiative that could 
support activities carried out under this program. The fiscal 
year 2011 level is $41,125,000 for this program.
    This program provides grants to help support efforts to 
recruit, train and place nontraditional teaching candidates 
into teaching positions and to support them during their first 
years in the classroom. In particular, this program is intended 
to attract mid-career professionals and recent college 
graduates. Program participants are placed in high-need schools 
in high-need LEAs.
    The level recommended by the Committee is sufficient to pay 
the continuation costs for existing grants.

Teaching of Traditional American History

    The Committee recommends $45,908,000, the same amount as 
the fiscal year 2011 level, for the Teaching of Traditional 
American History program. The budget request for fiscal year 
2012 proposes an Effective Teaching and Learning for a Well-
Rounded Education program that could support activities carried 
out under this program.
    The Teaching of Traditional American History program 
supports competitive grants to LEAs. Funds may be used only to 
undertake activities that are related to American history and 
cannot be used for social studies coursework. Grant awards are 
designed to augment the quality of American history instruction 
and to provide professional development activities and teacher 
education in the area of American history. Grants are awarded 
for 3 years, with 2 additional years allowed for grantees that 
are performing effectively.
    The Committee bill retains language that allows the 
Department to reserve up to 3 percent of funds appropriated for 
this program for national activities. The Committee continues 
to believe that the Department should use these funds to help 
grantees reach those teachers most in need of services 
supported by these grant funds.

School Leadership

    The Committee recommends $29,162,000, the same amount as 
the fiscal year 2011 level, for the school leadership program. 
The budget request for fiscal year 2012 proposes a Teacher and 
Leader Pathways program that could support activities funded 
through this program.
    The program provides competitive grants to assist high-need 
LEAs to recruit and train principals and assistant principals 
through activities such as professional development and 
training programs. The Committee continues to recognize the 
critical role that principals and assistant principals play in 
creating an environment that fosters effective teaching and 
high academic achievement for students.

Charter Schools

    The Committee recommends a total of $255,519,000, the same 
amount as the fiscal year 2011 level, for the support of 
charter schools. The budget request for fiscal year 2012 
proposes no dedicated funding for the charter schools program, 
instead providing support for such activities through a broader 
Expanding Educational Options program.
    The Committee allocates the recommended funding as follows: 
up to $221,519,000 for charter school grants, not less than 
$23,000,000 for the State facilities, and credit enhancement 
for charter schools facilities programs, and up to $11,000,000 
for national activities designed to support local, State and 
national efforts to increase the number of high-quality charter 
schools.
    The Charter Schools grants program supports the planning, 
development and initial implementation of charter schools. 
State educational agencies [SEAs] that have the authority under 
State law to approve charter schools are eligible to compete 
for grants. If an eligible SEA does not participate, charter 
schools from the State may apply directly to the Secretary.
    Under the State facilities program, the Department awards 
5-year competitive grants to States that operate per-pupil 
facilities aid programs for charters schools. Federal funds are 
used to match State-funded programs in order to provide charter 
schools with additional resources for charter school facilities 
financing.
    The credit enhancement program provides assistance to help 
charter schools meet their facility needs. Funds are provided 
on a competitive basis to public and nonprofit entities, to 
leverage non-Federal funds that help charter schools obtain 
school facilities through purchase, lease, renovation and 
construction.
    The Committee continues language initiated with the fiscal 
year 2010 bill that allows the Secretary to reserve up to 
$55,000,000 of the charter school grant funds to make multiple 
awards to charter management organizations and other entities 
for the replication and expansion of successful charter school 
models that have a track record of success.
    The Committee is particularly interested in the Department 
using a portion of the $11,000,000 available for national 
activities to help address issues related to services to 
students with disabilities enrolled in or interested in 
enrolling in charter schools, as well as efforts to strengthen 
charter authorizing practices.

Voluntary Public School Choice

    The Committee recommends no funds for the voluntary public 
school choice program. The comparable fiscal year 2011 level is 
$25,767,000. The budget request for fiscal year 2012 includes 
no funds for this program, but instead consolidates them within 
the proposed Expanding Educational Options program.
    This program has supported efforts by States and school 
districts to establish or expand State- or district-wide public 
school choice programs, especially for parents whose children 
attend low-performing public schools.

Magnet Schools Assistance

    The Committee recommends $99,800,000, the same amount as 
the fiscal year 2011 appropriation, for the magnet schools 
assistance program. The budget request for fiscal year 2012 
includes $110,000,000 for this purpose.
    This program supports grants to local educational agencies 
to establish and operate magnet schools that are part of a 
court-ordered or federally approved voluntary desegregation 
plan. Magnet schools are designed to attract substantial 
numbers of students from different social, economic, ethnic, 
and racial backgrounds. Grantees may use funds for planning and 
promotional materials, teacher salaries and the purchase of 
computers and other educational materials and equipment.

Fund for the Improvement of Education

    The Committee recommends an appropriation of $70,900,000 
for the Fund for the Improvement of Education [FIE]. The fiscal 
year 2011 appropriation is $40,900,000 and the budget request 
for fiscal year 2012 is $63,000,000 for this purpose.
    Within programs of national significance, the Committee 
includes $30,000,000 for competitive awards to national not-
for-profit organizations or school libraries for providing 
books and childhood literacy activities to children and 
families living in high need communities. The competition 
should be designed so that funds are awarded to entities that 
have evidence of effectiveness or high-quality plans for 
addressing childhood literacy activities for the target 
population. The Committee expects no less than 50 percent of 
these funds to be made available to applications from school 
libraries proposing high-quality projects for increasing access 
to a wide range of print and electronic resources that provide 
learning opportunities to all students, but particularly those 
less likely to have access to such materials at home.
    Funds for programs of national significance also support 
$1,000,000 to continue the educational facilities 
clearinghouse, which provides information on planning, 
designing, financing, building, maintaining and operating safe, 
healthy, high-performance educational facilities, including 
early learning centers, and $9,750,000 to continue awards for 
full service community schools. The Committee also provides 
$2,600,000 for data quality and evaluation initiatives and peer 
review.
    Within the amount for FIE, the Committee also includes 
$27,550,000 for arts in education. The budget request includes 
funds for similar activities under its proposed Effective 
Teaching and Learning for a Well-Rounded Education program. The 
fiscal year 2011 appropriation is $27,447,000 for competitive 
awards for national nonprofit organizations engaged in arts 
education, professional development activities and model arts 
education programs. Funds also are used for evaluation and 
dissemination activities, as well as a partnership with the 
National Endowment for the Arts.
    The Committee recommends no funds for activities authorized 
by the Excellence in Economic Education Act. The Department 
used $1,444,000 from the fiscal year 2011 appropriation for 
this purpose. The budget proposes to support similar activities 
under its proposed Effective Teaching and Learning for a Well-
Rounded Education program. Funds support a grant to a nonprofit 
educational organization to promote economic and financial 
literacy among kindergarten through 12th grade students.

Teacher Incentive Fund

    The Committee recommendation includes $300,000,000 for the 
Teacher Incentive Fund [TIF] program. The comparable fiscal 
year 2011 level is $399,200,000. The budget proposal supports 
the program through a broader Teacher and Leader Innovation 
Fund based on the administration's reauthorization proposal.
    The goals of TIF are to improve student achievement by 
increasing teacher and principal effectiveness; reform 
compensation systems to reward gains in student achievement; 
increase the number of effective teachers teaching low-income, 
minority, and disadvantaged students, and students in hard-to-
staff subjects; and other activities designed to increase the 
effectiveness of teachers, principals and other personnel in 
high-need schools.
    The Committee-recommended funding level provides robust 
support for activities designed to support reforms in 
evaluation, compensation, hiring and advancement in order to 
increase the effectiveness of teachers, principals and other 
personnel in high-need schools. Grants funded under this 
program may continue to address reform of compensation, but the 
Committee bill now will allow applicants to propose additional 
activities designed to increase teacher and principal 
effectiveness. The Committee bill includes language broadening 
the TIF program because of the rigorous research released over 
the past year showing that performance-based compensation 
systems had no effect in increasing student achievement.
    At the Committee-recommended level, the Department will 
have more than $290,000,000 to make new awards.

Ready-to-Learn Television

    The Committee recommendation includes $27,245,000, the same 
amount as the fiscal year 2011 level, for the Ready-to-Learn 
Television program. The budget request proposes to fund similar 
activities through its proposed Effective Teaching and 
Learning: Literacy program.
    The Ready-to-Learn program was created by Congress in 1992 
to use the power and reach of public television to help prepare 
children, especially disadvantaged children, enter and succeed 
in school. The Elementary and Secondary Education Act requires 
that all programming and digital content created under Ready-
to-Learn be specifically designed for nationwide distribution 
over public television stations' digital broadcasting channels 
and the Internet. The act also requires funds to be made 
available to public telecommunications entities to ensure that 
these programs, and related educational materials, are 
disseminated and distributed to the widest possible audience 
and are made accessible to all Americans.

Advanced Placement [AP]

    The Committee recommends $43,253,000, the same amount as 
the fiscal year 2011 appropriation, for AP programs. The budget 
request proposes to fund similar activities through its College 
Pathways and Accelerated Learning program.
    These funds support two programs, the Advanced Placement 
Test Fee program and the Advanced Placement Incentive [API] 
program. The purpose of both is to aid State and local efforts 
to increase access to AP and International Baccalaureate [IB] 
classes and tests for low-income students. Under the test fee 
program, the Department makes awards to State educational 
agencies to enable them to cover part or all of the cost of 
test fees of low-income students who are enrolled in an AP or 
IB class and plan to take an AP or IB test. Under the API 
program, the Department makes 3-year competitive awards to 
State educational agencies, LEAs, or national nonprofit 
educational entities to expand access for low-income 
individuals to AP programs through activities including teacher 
training, development of pre-advanced placement courses, 
coordination and articulation between grade levels to prepare 
students for academic achievement in AP or IB courses, books 
and supplies, and participation in online AP or IB courses. 
Under the authorizing statute, the Department must give 
priority to funding the test fee program.

                 Safe Schools and Citizenship Education

Appropriations, 2011....................................    $288,465,000
Budget estimate, 2012...................................     514,966,000
Committee recommendation................................     270,463,000

    The Committee recommends a total of $270,463,000 for 
activities to promote safe schools, healthy students and 
citizenship education. The budget request for fiscal year 2012 
is $514,966,000 and the comparable fiscal year 2011 amount is 
$288,465,000.
    The President's budget for fiscal year 2012 was based on 
the administration's proposal to reauthorize the Elementary and 
Secondary Education Act [ESEA], but no such bill has passed the 
Senate. As a result, the Committee bill is based on current law 
for programs authorized under the ESEA.

Promise Neighborhoods

    The Committee recommends $60,000,000 for the Promise 
Neighborhoods program. The budget request for fiscal year 2012 
is $150,000,000 and the comparable fiscal year 2011 amount is 
$29,940,000.
    Funds are available for obligation through December 31, 
2012. By providing an extra quarter to obligate these funds, 
the Committee gives fiscal year 2011 planning grantees 
sufficient time to develop implementation plans that could be 
funded by this bill and provides the Department ample time to 
evaluate whether fiscal year 2011 implementation grantees are 
making significant progress required to justify the receipt of 
continuation awards in fiscal year 2012.
    Competitive grants will be awarded to nonprofit, community-
based organizations for the development of comprehensive 
neighborhood programs designed to combat the effects of poverty 
and improve educational and life outcomes for children and 
youth, from birth through college. Each Promise Neighborhood 
grantee will serve a high-poverty urban neighborhood or rural 
community.
    Two types of awards will be made under this program, 1-year 
planning grants and implementation grants. Funds for planning 
grants are used by communities to develop a plan for providing 
a continuum of services and supports for the children and youth 
in a particular neighborhood. Implementation grants are awarded 
to organizations with feasible plans for achieving the goals of 
the program.
    At the funding level recommended by the Committee, the 
Department could use more than $45,000,000 to support 
implementation grants for prior planning grant recipients or 
communities with high-quality plans for achieving the goals of 
the program. Approximately $10,000,000 would be available for 
another round of planning grants and for technical assistance 
activities.

Successful, Safe, and Healthy Students

    The Committee recommends no funds for this proposed new 
program, which is based on the administration's reauthorization 
plan. The Committee has allocated funds for related current law 
programs, as described under the individual headings in this 
account.
    Under this program, the Department would award grants to 
State educational agencies, title I eligible LEAs and their 
partners for programs designed to improve the school culture 
and climate; improve students' physical health and well-being; 
and improve students' mental health and well-being.

Safe and Drug-Free National Activities

    The Committee recommendation includes $79,226,000 for the 
national activities portion of the Safe and Drug-Free Schools 
and Communities program. The fiscal year 2011 appropriation is 
$119,226,000 for this purpose. The budget request proposes to 
fund related activities within the proposed Successful, Safe 
and Healthy Students program.
    The Committee recognizes the need to address the problems 
of bullying, harassment, threats of violence and other types of 
behavior that detract from the learning environment in our 
Nation's schools, and urges the Department to increase support 
for research-based programs, such as bullying prevention, 
threat assessment protocols, social and emotional learning, and 
positive behavioral supports and interventions.
    The Committee recommends no funds for Project SERV (School 
Emergency Response to Violence), which provides education-
related services to LEAs and institutions of higher education 
in which the learning environment has been disrupted due to a 
violent or traumatic crisis. Project SERV funds are available 
until expended. The budget request includes $5,000,000 for this 
purpose. No funds were appropriated for Project SERV in fiscal 
year 2011. The Committee believes that no additional funds are 
required in fiscal year 2012, given the amount of unobligated 
funds that have been carried over from previous years.
    The Committee recommendation includes funds for 
continuation costs related to safe and supportive schools, Safe 
Schools/Healthy Students, and other activities.

Alcohol Abuse Reduction

    The Committee recommends no funds for grants to LEAs to 
develop and implement programs to reduce underage drinking in 
secondary schools. The comparable fiscal year 2011 amount is 
$6,907,000. The budget recommended consolidating this program 
into its proposed Successful, Safe and Healthy Students 
program.

Elementary and Secondary School Counseling

    The Committee recommends $52,395,000, the same as the 
fiscal year 2011 level, to establish or expand counseling 
programs in elementary and secondary schools. The budget 
request recommended consolidating this program into its 
proposed Successful, Safe and Healthy Students program. As 
currently authorized, at least $40,000,000 must be used to 
support elementary school counseling programs.

Carol M. White Physical Education for Progress Program

    The Committee recommendation includes $78,842,000, the same 
as the fiscal year 2011 level, to help LEAs and community-based 
organizations initiate, expand and improve physical education 
programs for students in grades K-12. The budget request 
proposed to consolidate this program into its proposed 
Successful, Safe and Healthy Students program. This funding 
will help schools and communities improve their structured 
physical education programs for students and help children 
develop healthy lifestyles to combat the national epidemic of 
obesity.

Civic Education

    The Committee recommends no funds for the civic education 
program, which is intended to improve the quality of civics and 
government education, foster civic competence and 
responsibility, and improve the quality of civic and economic 
education through exchange programs with emerging democracies. 
The fiscal year 2011 appropriation is $1,155,000 for this 
purpose. The budget request proposes to fund similar activities 
through the Effective Teaching and Learning for a Well-Rounded 
Education program.

                      English Language Acquisition

Appropriations, 2011....................................    $733,530,000
Budget estimate, 2012...................................     750,000,000
Committee recommendation................................     733,530,000

    The Committee recommends an appropriation of $733,530,000, 
the same amount as the fiscal year 2011 level, for English 
language acquisition. The budget request for fiscal year 2012 
is $750,000,000.
    The President's budget for fiscal year 2012 was based on 
the administration's proposal to reauthorize the Elementary and 
Secondary Education Act [ESEA], but no such bill has passed the 
Senate. As a result, the Committee bill is based on current law 
for programs authorized under the ESEA.
    The Department makes formula grants to States based on each 
State's share of the Nation's limited-English-proficient and 
recent immigrant student population. The program is designed to 
increase the capacity of States and school districts to address 
the needs of these students. The Committee includes bill 
language requiring that 6.5 percent of the appropriation be 
used to support national activities, which include professional 
development activities designed to increase the number of 
highly qualified teachers serving limited-English-proficient 
students; a National Clearinghouse for English Language 
Acquisition and Language Instructional Programs; and evaluation 
activities. National activities funds shall be available for 2 
years.
    The Committee bill continues language that requires the 
Secretary to use a 3-year average of the most recent data 
available from the American Community Survey for calculating 
allocations to all States under the English Language 
Acquisition State Grants program. Under the authorizing 
statute, the Department would use 1-year estimates, which are 
not as reliable and produce more volatility in the allocations 
from year to year.

                           Special Education

Appropriations, 2011.................................... $12,542,912,000
Budget estimate, 2012...................................  12,861,351,000
Committee recommendation................................  12,553,066,000

    The Committee recommends an appropriation of 
$12,553,066,000 for special education programs. The fiscal year 
2011 funding level is $12,542,912,000 and the budget request 
includes $12,861,351,000 for special education.

Grants to States

    The Committee recommends $11,482,200,000, the same amount 
as the fiscal year 2011 level, for special education grants to 
States, as authorized under section 611 of part B of the IDEA. 
The budget request proposes $11,705,211,000 under this 
authority.
    This program provides formula grants to assist States, 
outlying areas and other entities in meeting the costs of 
providing special education and related services for children 
with disabilities. States pass along most of these funds to 
local educational agencies, but may reserve some for program 
monitoring, enforcement, technical assistance, and other 
activities.
    The appropriation for this program primarily supports 
activities associated with the 2012-2013 academic year. Of the 
funds available for this program, $2,889,817,000 will become 
available on July 1, 2012, and $8,592,383,000 will become 
available on October 1, 2012. These funds will remain available 
for obligation until September 30, 2013.
    As requested by the administration, the Committee continues 
bill language capping the Department of the Interior set-aside 
at the prior year level, adjusted by the lower of the increase 
in inflation or the change in the appropriation for grants to 
States. This provision also would prevent a decrease in the 
amount to be transferred in case the funding for this program 
decreases or does not change.

Preschool Grants

    The Committee recommends $373,351,000, the same amount as 
the fiscal year 2011 level, for preschool grants. The budget 
request for fiscal year 2012 is $374,099,000. The preschool 
grants program provides formula grants to States to assist them 
in making available special education and related services for 
children with disabilities aged 3 through 5. States distribute 
the bulk of the funds to local educational agencies. States 
must serve all eligible children with disabilities aged 3 
through 5 and have an approved application under the IDEA.

Grants for Infants and Families

    The Committee recommends $443,548,000 for the grants for 
infants and families program under part C of the IDEA. The 
budget request for fiscal year 2012 is $489,427,000 and the 
comparable fiscal year 2011 level is $438,548,000. Part C of 
the IDEA authorizes formula grants to States, outlying areas 
and other entities to implement statewide systems of 
coordinated, comprehensive, multidisciplinary interagency 
programs to make available early intervention services to all 
children with disabilities, ages 2 and under, and their 
families.

State Personnel Development

    The Committee recommends $44,000,000 for the State 
personnel development program. The budget request for fiscal 
year 2012 is $48,000,000 and the comparable fiscal year 2011 
amount is $46,846,000. This program focuses on the professional 
development needs in States by requiring that 90 percent of 
funds be used for professional development activities. The 
program supports grants to State educational agencies to help 
them reform and improve their personnel preparation and 
professional development related to early intervention, 
educational and transition services that improve outcomes for 
students with disabilities.
    The Committee encourages funds available for new awards to 
be used to support activities devoted to increasing the skills 
of general educators in working collaboratively with special 
educators, and ultimately, students with disabilities.

Technical Assistance and Dissemination

    The Committee recommends $49,306,000 for technical 
assistance and dissemination. The budget request for fiscal 
year 2012 is $49,549,000 and the comparable fiscal year 2011 
amount is $48,806,000. This program supports awards for 
technical assistance, model demonstration projects, the 
dissemination of useful information and other activities. 
Funding supports activities that are designed to improve the 
services provided under IDEA.
    The Committee continues to support activities that address 
the need for high-quality, evidence-based technical assistance 
activities that improve the services to and outcomes for 
students with disabilities. The Committee encourages the 
Department to strengthen its efforts to align the investments 
of the Office of Special Education Programs [OSEP] with a 
strategic plan designed to improve outcomes for students with 
disabilities and to ensure that OSEP's technical assistance 
activities are coordinated with other Department technical 
assistance activities.

Personnel Preparation

    The Committee recommends $88,966,000 for the personnel 
preparation program. The budget request for fiscal year 2012 is 
$90,653,000 and the comparable fiscal year 2011 amount is 
$88,466,000.
    Funds support competitive awards to help address State-
identified needs for personnel who are qualified to work with 
children with disabilities, including special education 
teachers and related services personnel. The program has 
requirements to fund several other broad areas, including 
training for leadership personnel and personnel who work with 
children with low incidence disabilities, and providing 
enhanced support for beginning special educators.

Parent Information Centers

    The Committee recommends $28,972,000 for parent information 
centers. The budget request for fiscal year 2012 is $28,028,000 
and the comparable fiscal year 2011 amount is $27,972,000. 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 $30,644,000 for technology and 
media services. The budget request for fiscal year 2012 is 
$33,289,000 and the comparable fiscal year 2011 amount is 
$28,644,000. 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 is particularly interested in the fiscal year 
2012 competition on Educational Materials in Accessible Formats 
for Students with Visual Impairments and Other Print 
Disabilities and the recommendation includes no less than the 
fiscal year 2012 budget request for this activity. The 
Committee notes that the last competition helped improve SEA 
and LEA compliance with requirements to provide accessible 
instructional materials to students with visual impairments and 
other print disabilities by providing 130,000 students with 
disabilities with free access to instructional materials and 
making over 100,000 books digitally available in multiple 
accessible formats. The Committee expects the fiscal year 2012 
competition to continue to improve the speed and ease of access 
to materials as well as the volume of materials available to 
such students.

Mentoring for Individuals With Intellectual Disabilities

    The Committee recommends no funds for this proposed 
program. The budget proposes $5,000,000 to support grants or 
contracts to expand the Best Buddies organization, as well as 
support activities to increase the participation of people with 
intellectual disabilities in social relationships and other 
aspects of community life, including education and employment. 
Legislation is pending in Congress that would authorize similar 
activities.

PROMISE: Promoting Reading of Minors in SSI

    The Committee recommendation includes $4,000,000 for the 
PROMISE program and makes these funds available for obligation 
through September 30, 2013. The budget request includes 
$30,000,000 for this new activity. The Committee provides 
additional support for PROMISE through $10,000,000 for the 
Social Security Administration and the authority to use 
unobligated Vocational Rehabilitation State grant funds for the 
PROMISE program. The Committee intends to provide additional 
funds for this program in fiscal year 2013 as the planning and 
grant competition process described below moves forward and 
helps identify any additional funding needed to accomplish the 
goal of this program.
    The goal of the PROMISE program is to improve outcomes of 
children who receive Supplemental Security Income [SSI], as 
well as their families. The Committee is aware of the research 
showing that less than half of 17- and 18-year-olds receiving 
SSI had worked during ages 16-17, almost 60 percent of child 
SSI recipients who turn 18, and become ineligible for child 
benefits, immediately continue receiving benefits as an adult, 
and fewer than a quarter of SSI youth ages 14-17 or their 
parents know about various work incentives available to them. 
The PROMISE program will primarily address the barriers 
preventing more positive outcomes for youths receiving SSI by 
encouraging innovation through better coordination between 
existing programs and services. The program will provide such 
youth with more intense and coordinated services, particularly 
around the transition to competitive, integrated employment, 
completion of postsecondary education, and other activities 
that are likely to reduce the likelihood of future dependency 
on SSI. The program also intends to help families of child SSI 
recipients through improved services and supports such as 
education and training.
    The Department, in cooperation with the Social Security 
Administration and Departments of Labor and Health and Human 
Services, may use funds provided in this bill to undertake a 
thorough planning process that includes consultation with 
experts on the relevant research base and possible program 
outcome measures as well as engagement with stakeholders on the 
research base and promising models, barriers to better uses of 
funds and improved outcomes, and possible approaches to 
evaluation of the PROMISE program. The goal of the process is 
to help the administration design and implement a program that 
will award grants to States that have proposed projects that 
have the greatest potential for transformational impact, 
including through the better use of existing resources and 
services, and to develop information that can improve program 
delivery and outcomes in all States and localities, including 
those that do not receive PROMISE pilot funding.
    The Committee expects the administration to update the 
Committees on Appropriations, Health, Education, Labor and 
Pensions, and Finance of its activities related to the PROMISE 
program. Such notification and consultation shall occur no 
later than 30 days after conclusion of the review of relevant 
research and engagement with stakeholders. If the 
administration determines, based on stakeholder input, that 
legislation is required to allow waivers of statutory barriers, 
the administration will request legislative authority to grant 
such waivers at least 60 days prior to their proposed issuance 
or announcement in notices of priorities or funding 
availability. Such requests should also explain the full range 
of administrative, regulatory and legislative flexibilities 
that would be granted by Federal agencies and the safeguards 
that would be instituted to protect program beneficiaries and 
taxpayers.

Special Olympics

    The Committee recommendation includes $8,079,000, the same 
amount as the fiscal year 2011 level, for Special Olympics 
education activities. The budget request for fiscal year 2012 
is $8,095,000. Under the Special Olympics Sport and Empowerment 
Act of 2004, the Secretary is authorized to provide financial 
assistance to Special Olympics for activities that promote the 
expansion of Special Olympics and for the design and 
implementation of education activities that can be integrated 
into classroom instruction and are consistent with academic 
content standards.
    The Committee bill continues to allow funds to be used to 
support Special Olympics National and World Games, as 
authorized in the fiscal year 2011 bill and proposed in the 
budget request.

            Rehabilitation Services and Disability Research

Appropriations, 2011....................................  $3,474,719,000
Budget estimate, 2012...................................   3,521,845,000
Committee recommendation................................   3,511,735,000

    The Committee recommends $3,511,735,000 for rehabilitation 
services and disability research. The comparable fiscal year 
2011 funding level is $3,474,719,000. The budget request 
includes $3,521,845,000 for programs in this account.

Vocational Rehabilitation State Grants

    The Committee recommends $3,121,712,000 for vocational 
rehabilitation grants to States. The Committee recommends the 
full amount authorized by the Rehabilitation Act of 1973 for 
this mandatory funding stream. The comparable fiscal year 2011 
level is $3,084,696,000. The fiscal year 2012 budget request is 
$3,140,978,000 and assumes several program consolidations and 
eliminations as part of a proposal to reauthorize the Workforce 
Investment Act [WIA]. While the Senate authorizing committee 
has made significant progress on a WIA reauthorization, 
legislation has not yet passed the Senate. As a result, the 
Committee recommendation follows current law.
    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 the most significant disabilities. Funds are 
allotted to States based on a formula that takes into account 
population and per capita income. States must provide a 21.3 
percent match of Federal funds with the exception of 
construction costs for the development of a facility for 
community rehabilitation programs, for which States must 
provide a 50 percent match.
    The Rehabilitation Act requires that not less than 1 
percent and not more than 1.5 percent of the appropriation in 
fiscal year 2012 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 bill includes new language allowing unmatched 
funds in excess of any funds requested during the reallotment 
process to be available for the PROMISE program described under 
the Special Education account and Social Security 
Administration. Such funds used for the PROMISE program will 
remain available for obligation through September 30, 2013.

Workforce Innovation Fund

    The Committee does not recommend any funds for the 
Workforce Innovation Fund [WIF] from this account. The budget 
request provides $30,000,000. The Committee is supportive of 
this initiative and instead recommends funding through the 
Department of Labor's Employment and Training Administration. 
This program is intended to test innovative strategies or 
replicate proven practices that support systemic reform of the 
workforce investment system and substantially improve 
employment and education outcomes for people with disabilities.

Client Assistance State Grants

    The Committee recommends $12,263,000 in discretionary 
funds, the same amount provided in fiscal year 2011, for the 
client assistance State grants program. The budget request 
provides $12,288,000.
    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. States must operate 
client assistance programs in order to receive vocational 
rehabilitation State grant funds. Funds are distributed to 
States according to a population-based formula, except that 
increases in minimum grants are guaranteed to each of the 50 
States, the District of Columbia, Puerto Rico, and each of the 
outlying areas, by a percentage not to exceed the percentage 
increase in the appropriation.

Training

    The Committee recommends $35,582,000, the same as the 
comparable fiscal year 2011 level, for training rehabilitation 
personnel. The budget request provides $33,251,000.
    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, 
short-term, 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 recommends $6,459,000 for this program, which 
is the same as the comparable fiscal year 2011 funding level. 
The budget request eliminates funding for this program as part 
of the administration's proposed program consolidations.
    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 recommends continued support for parent 
training and information centers. The Committee expects the 
Rehabilitation Services Administration to coordinate with the 
Office of Special Education Programs in carrying out this 
activity.

Migrant and Seasonal Farmworkers

    The Committee recommends $1,856,000, the same as the 
comparable fiscal year 2011 amount, for migrant and seasonal 
farmworkers. The budget request proposes consolidation of this 
program into the State Grants Program.
    This program provides grants for comprehensive 
rehabilitation services to migrant and seasonal farmworkers 
with disabilities and their families. The size of the grants is 
limited to 90 percent of the costs of the projects. 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.

Protection and Advocacy of Individual Rights

    The Committee recommends $18,065,000 for protection and 
advocacy of individual rights. This amount is the same as the 
comparable fiscal year 2011 funding level. The budget request 
provides $18,101,000 for this purpose.
    This program provides grants to agencies to protect and 
advocate for the legal and human rights of persons with 
disabilities who are ineligible for protection and advocacy 
services available through the Developmental Disabilities 
Assistance and Bill of Rights Act or the Protection and 
Advocacy for Individuals with Mental Illness Act.

Supported Employment State Grants

    The Committee recommends $29,123,000, the same as the 
comparable fiscal year 2011 amount, for the supported 
employment State grant program. The budget request eliminates 
funding for this program as part of the administration's 
proposed program consolidations.
    This program assists the most severely disabled individuals 
by providing the ongoing support needed to obtain competitive 
employment. Short-term vocational rehabilitation services are 
augmented with extended services provided by State and local 
organizations. Federal funds are distributed on the basis of 
population.

Grants for Independent Living

    The budget request includes $103,716,000 to create the 
Grants for Independent Living program as part of the 
administration's proposed WIA reauthorization. The Committee 
does not include any funds for this program because it 
recommends retaining the current account structure.

Independent Living State Grants

    The Committee recommends $23,403,000, the same as the 
comparable fiscal year 2011 amount, for independent living 
State grants. The budget request does not include funding for 
this program as part of its consolidation proposal.
    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.

Centers for Independent Living

    The Committee recommends $80,105,000 for independent living 
centers, which is the same as the comparable fiscal year 2011. 
The budget request eliminates funding for this program as part 
of the administration's proposed program consolidations.
    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.
    The Committee commends the work by these centers and 
encourages them to continue their efforts to facilitate the 
transition of individuals with significant disabilities from 
institutional settings to home and community based residences, 
and from school to postsecondary life, including employment.

Independent Living Services for Older Blind Individuals

    The Committee provides $34,083,000 for independent living 
services to older blind individuals. This is the same level as 
the comparable fiscal year 2011 amount. The budget requests 
$34,151,000 for this program.
    Through this program, assistance is provided to persons 
aged 55 or older to adjust to their blindness, continue living 
independently and avoid societal costs associated with 
dependent care. Services most commonly provided by this program 
are daily living skills training, counseling, community 
integration, information and referral, the provision of low-
vision devices and communication devices and low-vision 
screening. These services help older individuals age with 
dignity, continue to live independently and avoid significant 
societal costs associated with dependent care.

Helen Keller National Center

    The Committee recommends $9,163,000 for the Helen Keller 
National Center for Deaf-Blind Youth and Adults. This is the 
same amount as the comparable fiscal year 2011 funding level. 
The budget request includes $9,181,000 for this purpose.
    The Helen Keller National Center consists of a national 
headquarters in Sands Point, New York, with a residential 
training and rehabilitation facility where deaf-blind persons 
receive intensive specialized services; a network of 10 
regional field offices that provide referral and counseling 
assistance to deaf-blind persons; and an affiliate network of 
agencies. The center serves approximately 75 persons with deaf-
blindness at its headquarters facility and provides field 
services to approximately 2,000 individuals and families and 
1,000 organizations.

National Institute on Disability and Rehabilitation Research

    The Committee recommends $109,023,000, the same as the 
comparable fiscal year 2011 level, for the National Institute 
on Disability and Rehabilitation Research [NIDRR]. The budget 
request includes $110,485,000 for this purpose.
    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 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 strongly supports the mission of NIDRR, which 
includes research in the interrelated domains of health and 
function, employment, and participation and community living. 
NIDRR's resources should focus on each of these statutory 
research priorities to ensure the advancement of economic and 
social self-sufficiency and full community inclusion and 
participation. Future Rehabilitation Research Training Centers' 
priorities should advance knowledge of effective strategies to 
reduce the impact of poverty, promote affordable housing and 
independent living with improved access to long-term supports, 
how new technologies can promote independence and self-
sufficiency and facilitate greater individual choice and 
control of individualized plans under the Rehabilitation and 
Social Security laws.
    The Committee is aware that along with the growing 
prevalence of diabetes and cardiovascular disease, increasing 
numbers of Americans are undergoing amputation. The costs of 
limb loss to Medicare, Medicaid, the Department of Veterans 
Affairs, Department of Defense and private healthcare systems 
are projected to increase dramatically over the coming decades. 
The Committee recognizes that, to date, little research has 
been done to examine prosthetic outcomes and to link prosthetic 
and orthotic treatments, devices and supports to patient 
outcomes. In order to support evidence-based healthcare 
practice in prosthetics and orthotics, and establish which 
approaches work best for which patients, the Committee 
encourages NIDRR to work with experts in the field of 
prosthetic research to develop a prosthetics outcomes research 
agenda and implement needed research.
    The Committee strongly supports the Traumatic Brain Injury 
Model Systems [TBIMS] Centers program funded by NIDRR. Almost 
500 peer-reviewed publications have resulted from TBIMS 
research since 1987, bringing dramatic improvements to the 
treatment of traumatic brain injury for both civilian and 
military populations. The Committee is aware that the TBIMS 
Centers will compete for new 5-year awards in fiscal year 2012. 
The Committee bill includes sufficient funds to support the 
current size of the TBIMS Centers program and to provide 
adequate resources to meet the research objectives of the TBIMS 
program. The Committee intends that funds provided will enhance 
the capability of the TBIMS Centers to conduct critical multi-
center investigations, expand the TBIMS Centers' scope of 
intervention studies, maintain the ongoing high quality TBIMS 
Centers' longitudinal research while keeping pace with the 
increased number of participants followed, and promote 
continued collaboration to improve outcomes for civilians and 
military populations with traumatic brain injury. The Committee 
also commends NIDRR for establishing collaboration between the 
TBIMS Centers program and the Department of Veterans Affairs 
and encourages continuation of these efforts.

Access Through Cloud Computing

    The Committee does not recommend funding for this program. 
The program did not receive funding in fiscal year 2011. The 
budget requests $10,000,000 for a new initiative that would 
improve access to technology for people with disabilities.

Assistive Technology

    The Committee recommends $30,898,000 for assistive 
technology. This amount is the same as the comparable fiscal 
year 2011 funding level. The budget request includes 
$30,960,000 for this purpose.
    The Assistive Technology program is designed to improve 
occupational and educational opportunities and the quality of 
life for people of all ages with disabilities through increased 
access to assistive technology services and devices. The 
program supports various activities that help States develop 
comprehensive, consumer-responsive statewide programs that 
increase access to, and the availability of, assistive 
technology devices and services.
    The Committee recommendation includes $25,645,340 for State 
grant activities authorized under section 4 of the 
Rehabilitation Act of 1973, $4,325,720 for protection and 
advocacy systems authorized by section 5 and $926,940 for 
technical assistance activities authorized under section 6.

           Special Institutions for Persons With Disabilities

                 AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2011....................................     $24,551,000
Budget estimate, 2012...................................      24,600,000
Committee recommendation................................      24,551,000

    The Committee recommends $24,551,000 to help support the 
American Printing House for the Blind [APH]. This amount is the 
same as the comparable fiscal year 2011 funding level. The 
budget request includes $24,600,000 for this purpose.
    The APH provides educational materials to students who are 
legally blind and enrolled in programs below the college level. 
The Federal subsidy provides approximately 70 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 computer applications. Appropriated 
funds may be used for staff salaries and expenses, as well as 
equipment purchases and other acquisitions consistent with the 
purpose of the Act to Promote the Education of the Blind.
    The Committee continues to support the APH's National 
Instructional Materials Center, which was established by the 
Individuals with Disabilities Education Act of 2004.

               NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2011....................................     $65,546,000
Budget estimate, 2012...................................      65,037,000
Committee recommendation................................      65,546,000

    The Committee recommends $65,546,000, the same as the 
fiscal year 2011 level, for the National Technical Institute 
for the Deaf [NTID]. This funding supports operational costs at 
NTID. The budget request includes $65,037,000 for this purpose, 
of which $2,000,000 is provided for construction.
    The Institute, located on the campus of the Rochester 
Institute of Technology in Rochester, New York, was created by 
Congress in 1965 to provide a residential facility for 
postsecondary technical training and education for persons who 
are deaf. The NTID also provides support services for students 
who are deaf, trains professionals in the field of deafness and 
conducts applied research.

                          GALLAUDET UNIVERSITY

Appropriations, 2011....................................    $122,754,000
Budget estimate, 2012...................................     118,000,000
Committee recommendation................................     125,754,000

    The Committee recommends $125,754,000 for Gallaudet 
University. The comparable fiscal year 2011 funding level is 
$122,754,000 and the budget request includes $118,000,000 for 
the university.
    Gallaudet University is a private, nonprofit institution 
offering undergraduate and continuing education programs for 
students who are deaf, as well as graduate programs in fields 
related to deafness for students who are hearing and deaf. The 
university conducts basic and applied research related to 
hearing impairments and provides public service programs for 
the deaf community.
    Federal funding also supports the Model Secondary School 
for the Deaf, which serves as a laboratory for educational 
experimentation and development, disseminates curricula, 
materials and models of instruction for students who are deaf, 
and prepares adolescents who are deaf for postsecondary 
academic or vocational education or the workplace. The Kendall 
Demonstration Elementary School develops and provides 
instruction for children from infancy through age 15.
    The Committee bill includes $7,990,000 for construction-
related activities at Gallaudet University. The administration 
did not request funds for this purpose.

                 Career, Technical, and Adult Education

Appropriations, 2011....................................  $1,738,946,000
Budget estimate, 2012...................................   1,683,392,000
Committee recommendation................................   1,738,946,000

    The Committee recommends a total of $1,738,946,000 for 
career, technical and adult education. This amount is the same 
as the comparable funding level in fiscal year 2011. The budget 
request provides $1,683,392,000. The recommendation consists of 
$1,131,503,000 for career and technical education and 
$607,443,000 for adult education.

Career and Technical Education

    The Committee recommends $1,131,503,000, the same as the 
comparable fiscal year 2011 level, for career and technical 
education. The fiscal year 2012 request provides 
$1,007,860,000.
    State Grants.--The Committee recommends $1,123,659,000, the 
same as the comparable fiscal year 2011 level, for Career and 
Technical Education [CTE] State grants. The fiscal year 2012 
request level is $1,000,000,000.
    Funds provided under the State grant program assist States, 
localities and outlying areas expand and improve their programs 
of career and technical education and provide equal access to 
career and technical 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, with special provisions 
for small States and a fiscal year 1998 base guarantee.
    Under the Indian and Hawaiian Natives programs, competitive 
grants are awarded to federally recognized Indian tribes or 
tribal organizations and to organizations primarily serving and 
representing Hawaiian Natives for services that are additional 
to services received by these groups under other provisions of 
the Perkins Act.
    Of the funds available for this program, $332,659,000 will 
become available July 1, 2012 and $791,000,000 will become 
available on October 1, 2012. These funds will remain available 
for obligation until September 30, 2013.
    National Programs.--The Committee recommends $7,844,000 for 
national research programs and other national activities. This 
is the same amount as the comparable fiscal year 2011 funding 
level. The budget request includes $7,860,000.
    Funds will be used to support the national research center 
on career and technical education, as well as activities 
designed to improve the quality of performance data States 
collect and report to the Department.

Adult Education

    The Committee recommends $607,443,000, the same as the 
fiscal year 2011 level, for adult education. The budget request 
includes $658,346,000.
    Adult Education State Programs.--For the adult basic and 
literacy education State grants program, the Committee 
recommends $596,120,000, the same as the fiscal year 2011 
level. The budget request is $635,000,000 and includes an 8 
percent set-aside to fund WIF. Funds are used by States for 
programs to enable 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 grants appropriation. Within the total, 
$74,850,000 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. This 
set-aside is the same as the fiscal year 2011 level. The budget 
request includes $75,000,000.
    The Committee does not recommend any funds for WIF from 
this account as requested by the administration. The Committee 
is supportive of this initiative, which is intended to test 
innovative strategies or replicate proven practices that 
support systemic reform of the workforce investment system and 
substantially improve employment and education outcomes for 
people with disabilities. However, the Committee recommends 
funding through the Department of Labor's Employment and 
Training Administration.
    National Leadership Activities.--The Committee recommends 
$11,323,000, the same amount as the fiscal year 2011 level, for 
national leadership activities. The budget request includes 
$23,346,000.

Grants to States for Workplace and Community Transition Training for 
        Incarcerated Individuals

    The Committee does not recommend funding for this program. 
The program did not receive funding in fiscal year 2011. The 
administration requested $17,186,000 for education and training 
for incarcerated individuals.

                      Student Financial Assistance

Appropriations, 2011.................................... $24,670,517,000
Budget estimate, 2012...................................  33,513,957,000
Committee recommendation................................  24,670,517,000

    The Committee recommends an appropriation of 
$24,670,517,000 for programs under the student financial 
assistance account. This is the same as the fiscal year 2011 
level. The budget request includes $33,513,957,000 for this 
account and proposes several legislative changes intended to 
provide a more sustainable financial foundation for the Pell 
Grant program.

Federal Pell Grant Program

    The Committee has no higher priority in fiscal year 2012 
than maintaining the maximum Pell Grant award. Now more than 
ever, students need affordable, quality education opportunities 
to help make our economy strong and competitive again. The Pell 
Grant program, the foundation of Federal postsecondary student 
aid, is essential to helping students enter college and gain 
the education and skills needed for jobs in the 21st century 
economy. The Bureau of Labor Statistics projects that 21 of the 
30 fastest growing occupations will require a postsecondary 
degree or credential by the year 2018.
    Pell Grants are especially important to our country's 
neediest students as the cost of postsecondary education 
continues to rise. Since 2000, the cost of tuition and fees has 
more than doubled, outpacing the growth rates of healthcare, 
energy and housing costs. Of the 8 million students who relied 
on Pell Grants in the 2009-2010 award year, 76 percent had 
incomes or came from families with incomes less than or equal 
to $30,000.
    Pell Grants provide need-based financial assistance that 
helps low- and middle-income undergraduate students and their 
families defray a portion of the costs of postsecondary 
education and vocational training. Awards are determined 
according to a statutory need-analysis formula that takes into 
account a student's family income and assets, household size 
and the number of family members, excluding parents, attending 
postsecondary institutions.
    The HEA allows any eligible student to receive a Pell Grant 
award, regardless of whether there are sufficient funds for the 
program. Because of higher than projected costs in recent 
years, the Pell Grant program has faced a shortfall between the 
amount needed to meet actual program costs and the amount 
provided in appropriations based on projected program costs. 
Mandatory funds have been provided over the past several years 
to fill the gap, but the problem of insufficient appropriations 
and program costs persists.
    The Pell Grant program grows the most in years when the 
number of students attending postsecondary education increases. 
As usually occurs during difficult economic times, college 
enrollment is growing and students are demonstrating greater 
financial need. The number of recipients is expected to grow 
from 6.2 million in the 2008-2009 award year to a projected 9.4 
million in the 2011-2012 award year, a 52 percent increase. 
Costs have also risen because of recent changes to the need-
analysis formula that provided additional assistance and 
enabled more students to be eligible for the maximum award.
    The Budget Control Act of 2011 took an important step 
toward closing the Pell shortfall in fiscal year 2012 by 
providing $10,000,000,000 in mandatory funding for that fiscal 
year. The elimination of the ``year-round Pell'' provision 
included in the Department of Defense and Full-Year Continuing 
Appropriations Act of 2011 provided another $3,183,000,000 in 
mandatory funding for the program in fiscal year 2012.
    The Committee recommends $22,955,996,000 in discretionary 
funding for Pell in fiscal year 2012. This is the same amount 
as the fiscal year 2011 level. Combined with the measures 
described above, that leaves a fiscal year 2012 shortfall of 
$1,296,000,000.
    The Committee recommends closing the fiscal year 2012 
shortfall by eliminating the grace period for interest on 
subsidized Stafford loans. Making this change also provides 
additional funding to address the expected shortfall in fiscal 
year 2013. Currently, the Federal Government pays interest on 
subsidized Stafford loans during the 6-month grace period that 
begins when a borrower leaves school. The Committee 
recommendation would still allow a 6-month grace period during 
which students would not be required to make monthly payments, 
but the interest would accrue to the outstanding loan balance 
and would need to be repaid after the grace period.
    The Committee makes this change reluctantly, but believes 
it is preferable to reducing the maximum Pell Grant award. In 
addition, interest subsidies are poorly targeted because they 
are based on a student's family's income upon entering school 
and not on the student's ability to repay loans after leaving 
school. Some students, for example, might obtain a well-paying 
job immediately after school and would not need a grace period. 
The subsidies also do not necessarily go to the neediest 
students. In 2008, 40 percent of subsidized loan recipients 
were dependent students from families with annual incomes above 
$60,000, and 31 percent of subsidized loan recipients were 
independent students with annual incomes over $30,000.
    For students whose Federal student loan debt is high in 
relation to their income, the Income-based Repayment [IBR] 
program provides relief by capping monthly loan payments at an 
affordable amount based on income and family size. The Student 
Aid and Fiscal Responsibility Act [SAFRA] of 2010 made the IBR 
program more generous, and the Committee urges the Department 
to educate more borrowers about these improvements and the 
program's ability to provide assistance to borrowers struggling 
to repay their loans.

Federal Supplemental Educational Opportunity Grants

    The Committee recommends $735,990,000 for Federal 
supplemental educational opportunity grants [SEOG]. This is the 
same amount as the fiscal year 2011 level. The budget request 
includes $757,465,000. This program provides funds to 
postsecondary institutions for need-based grants to 
undergraduate students. Institutions must contribute 25 percent 
toward SEOG awards. Students qualify for grants of up to $4,000 
by demonstrating financial need. School financial aid officers 
have flexibility to determine student awards, though they must 
give priority to Pell Grant recipients with exceptional need.

Federal Work-Study Programs

    The Committee bill provides $978,531,000 for the Federal 
work-study program. This is the same amount as the comparable 
fiscal year 2011 level. The budget request includes 
$980,492,000
    This program provides grants to about 3,400 institutions to 
help an estimated 700,000 undergraduate, graduate and 
professional students meet the costs of postsecondary education 
through part-time employment. Work-study jobs must pay at least 
the Federal minimum wage and institutions must provide at least 
25 percent of student earnings. Institutions also must use at 
least 7 percent of their grants for community service jobs.
    The Committee expects the Department to provide the same 
funding from the Federal Work-Study Program appropriation in 
fiscal year 2012 as in the prior year for the Work Colleges 
program authorized under section 448 of the HEA.

Federal Perkins Loans

    The Federal Perkins loan program supports student loan 
revolving funds built up with capital contributions to nearly 
1,700 participating institutions. Institutions use these 
revolving funds, which also include Federal capital 
contributions [FCC], institutional contributions equal to one-
third of the FCC, and student repayments, to provide low-
interest (5 percent) loans that help financially needy students 
pay the costs of postsecondary education.
    The Committee recommends no new funds for the Perkins Loans 
program, as was the case in fiscal year 2011. The budget 
proposes to restructure the Perkins Loan program as a mandatory 
credit program, with nearly $8,500,000,000 a year in new loan 
volume--eight and a half times the current Perkins volume. 
Congress has not acted on this proposal.

Leveraging Educational Assistance Partnership Program [LEAP]

    Neither the Committee nor the budget request recommends 
funding for the LEAP program, which was eliminated in fiscal 
year 2011. The Committee requests that the Department report on 
the impact that the elimination of the LEAP program has had on 
the total amount of need-based grant aid available to low- and 
moderate-income students in the 2011-2012 academic year. The 
report should be submitted to the Committee by August 1, 2012.

                       Student Aid Administration

Appropriations, 2011....................................    $992,012,000
Budget estimate, 2012...................................   1,095,418,000
Committee recommendation................................   1,045,363,000

    The Committee recommends $1,045,363,000 for the Student Aid 
Administration account. The comparable fiscal year 2011 level 
is $992,012,000. The budget request includes $1,095,418,000. 
These funds are available until September 30, 2013.
    Funds appropriated for the Student Aid Administration 
account will support the Department's student aid management 
expenses. The Office of Federal Student Aid and Office of 
Postsecondary Education have primary responsibility for 
administering Federal student financial assistance programs.
    SAFRA terminated the authority under the Higher Education 
Act of 1965 to make loans under the Federal Family Education 
Loan Program as of June 2010. Beginning July 1, 2010, 100 
percent of student loans are now made through the William D. 
Ford Direct Loan [DL] Program. DL program loans are serviced by 
private for-profit and not-for-profit servicers under contract 
with the Department.
    The Committee recommendation includes $675,363,000 for 
administrative costs and $370,000,000 for loan servicing 
activities. The Committee recommendation for these two 
activities represents a $53,351,000 increase over the fiscal 
year 2011 level. The Committee recommendation reflects the 
increased application, origination and servicing costs 
associated with the legislative changes. These increases are 
necessary to manage the higher loan volume, ensure the 
operational integrity of Federal student aid systems and 
provide high-quality service to student and parent borrowers. 
The budget request includes $725,104,000 for administrative 
costs and $370,314,000 for servicing.

                            Higher Education

Appropriations, 2011....................................  $1,903,946,000
Budget estimate, 2012...................................   2,240,401,000
Committee recommendation................................   1,903,946,000

    The Committee recommends an appropriation of $1,903,946,000 
for higher education programs, the same as the fiscal year 2011 
level. The fiscal year 2012 requested level is $2,240,401,000 
for programs in this account.
    The Committee is concerned about the lack of useful, 
accurate and comparable information available to students 
regarding postsecondary education opportunities. Despite Higher 
Education Act [HEA] requirements on institutions of higher 
learning to disclose certain student outcome data and the 
efforts of the Department to make the National Center for 
Education Statistic's College Navigator site more robust, 
students still have difficulty obtaining the information they 
need to make well-informed decisions on where to invest their 
time and financial resources. This is especially true for low-
income students who may be the first in their family to attend 
college. These students often have difficulty finding the 
College Navigator site and other free resources to aid in the 
college search process. Better information on student outcomes 
is also important for policymakers who are facing difficult 
decisions on where to invest scarce taxpayer resources.
    Transfer rates, completion rates for part-time and transfer 
students, and rates of students who successfully complete 
developmental courses are among the factors that would assist 
students and policymakers in determining which institutions are 
serving students best. Information such as graduation rates for 
Pell Grant recipients, regardless of their first-time, full-
time status, would help students and policymakers determine 
which postsecondary education choices provide the best outcomes 
for low-income students.
    The Committee is aware that some institutions of higher 
education are not disclosing information to students as 
required by the HEA. While there are institutions not meeting 
these obligations, others may be technically in compliance with 
the law but provide information in formats that are very 
difficult for students to find and understand. Even more of a 
challenge to students is comparing information across the 
institutions they are considering, since the information is not 
disclosed consistently. Additionally, because there is no 
systematic effort to evaluate whether all institutions are in 
compliance, the Committee is concerned that many schools may be 
violating HEA disclosure requirements.
    The Committee strongly believes better tools can and should 
be developed through the use of technology to assist students 
who are making the important decision of where to enroll in 
postsecondary education. The Committee also believes more can 
be done to evaluate which institutions are following not only 
the letter but the spirit of the law. The Committee requests 
that the Department submit a report describing how disclosure 
requirements can be improved by June 30, 2012. The report 
should also address how technology can be used to more 
thoroughly evaluate compliance with the HEA.

Aid for Institutional Development

    The Committee recommends $552,088,000, the same as the 
fiscal year 2011 level, for Aid for Institutional Development. 
The fiscal year 2012 requested level is $603,194,000.
    Strengthening Institutions.--The Committee bill recommends 
$83,832,000 to provide competitive, 1-year planning and 5-year 
development grants for institutions with a significant 
percentage of financially needy students and low educational 
and general expenditures per student in comparison with similar 
institutions. This is the same level provided in fiscal year 
2011. The budget request is $84,000,000. Applicants may use 
these funds to develop faculty, strengthen academic programs, 
improve institutional management, and expand student services.
    Hispanic-Serving Institutions.--The Committee recommends 
$104,395,000, the same as the fiscal year 2011 level, for 
competitive grants to institutions at which Hispanic students 
make up at least 25 percent of enrollment. The budget request 
is $117,429,000. 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.
    Promoting Postbaccalaureate Opportunities for Hispanic 
Americans.--The Committee recommends $9,336,000, the same as 
the fiscal year 2011 level, for competitive 5-year grants to 
Hispanic-serving institutions to help Hispanic Americans gain 
entry into and succeed in graduate study. The budget request is 
$10,500,000. Institutions may use funding to support low-income 
students through outreach programs, academic support services, 
mentoring and financial assistance, acquisition, rental or 
lease of scientific or laboratory equipment, construction and 
other facilities improvements, and purchase of educational 
materials.
    Strengthening Historically Black Colleges and Universities 
[HBCUs].--The Committee recommends $236,991,000, the same as 
the comparable fiscal year 2011 level, for the strengthening 
HBCUs program. The budget request is $266,586,000. The program 
makes formula grants to HBCUs that may be used to purchase 
equipment, construct and renovate facilities, develop faculty, 
support academic programs, strengthen institutional management, 
enhance fundraising activities, provide tutoring and counseling 
services to students, and conduct outreach to elementary and 
secondary school students. In addition to the Committee-
recommended level, this program will receive $85,000,000 of 
mandatory funding through SAFRA in each fiscal year through 
2019.
    Strengthening Historically Black Graduate Institutions 
[HBGIs].--The Committee recommends $61,302,000, the same as the 
fiscal year 2011 level, for the Strengthening HBGIs program. 
The budget request is $61,425,000. This program provides 5-year 
grants to provide scholarships for low-income students and 
academic and counseling services to improve student success. 
Funds may also be used for construction, maintenance and 
renovation activities, the purchase or lease of scientific and 
laboratory equipment and the establishment of an endowment.
    Strengthening Predominately Black Institutions [PBIs].--The 
Committee recommends $9,602,000, the same as the comparable 
fiscal year 2011 level, for the Strengthening PBIs program. The 
fiscal year 2012 budget request is $10,801,000. This program 
provides 5-year grants to PBIs to plan and implement programs 
to enhance the institutions' capacity to serve more low- and 
middle-income Black American students. Funding is allocated 
among PBIs based on the number of Pell Grant recipients 
enrolled, the number of graduates and the percentage of 
graduates who are attending a baccalaureate degree-granting 
institution or a graduate or professional school in degree 
programs in which Black American students are underrepresented. 
In addition to the Committee-recommended level, this program 
will receive $15,000,000 of mandatory funding through SAFRA in 
each fiscal year through 2019.
    Strengthening Asian American and Native American Pacific 
Islander-Serving Institutions [AANAPISIs].--The Committee 
recommends $3,199,000, the same as the comparable fiscal year 
2011 level, for this program. The budget request level is 
$3,600,000. This program provides competitive grants to 
AANAPISIs that have an enrollment of undergraduate students 
that is at least 10 percent Asian American or Native American 
Pacific Islander students. Grants may be used to improve their 
capacity to serve Asian American and Native American Pacific 
Islander students and low-income individuals. In addition to 
the Committee-recommended level, this program will receive 
$5,000,000 of mandatory funding through SAFRA in each fiscal 
year through 2019.
    Strengthening Alaska Native and Native Hawaiian-Serving 
Institutions.--The Committee recommends $13,412,000, the same 
as the comparable fiscal year 2011 level, for this program. The 
budget request level is $15,084,000. In addition to the 
Committee-recommended level, this program will receive 
$15,000,000 of mandatory funding through SAFRA in each fiscal 
through 2019.
    The purpose of this program is to improve and expand the 
capacity of institutions serving Alaska Native and Native 
Hawaiian students and low-income individuals. Funds may be used 
to plan, develop and implement activities that encourage: 
faculty and curriculum development; better fund administrative 
management; renovation and improvement of educational 
facilities; enhanced student services; and the purchase of 
library and other educational materials.
    Strengthening Native American-Serving Nontribal 
Institutions.--The Committee recommends $3,199,000, the same as 
the comparable fiscal year 2011 level, for this program. The 
fiscal year 2012 budget request is $3,600,000. These 
institutions enroll at least 10 percent Native American 
students and at least 50 percent low-income students. In 
addition to the Committee-recommended level, this program will 
receive $5,000,000 of mandatory funding through SAFRA in each 
fiscal year through 2019.
    Strengthening Tribally Controlled Colleges and 
Universities.--The Committee recommends $26,820,000, the same 
as the comparable fiscal year 2011 level, for this program. The 
fiscal year 2012 budget request is $30,169,000. Tribal colleges 
and universities rely on a portion of the funds provided to 
address developmental needs, including faculty development, 
curriculum and student services. In addition to the Committee-
recommended level, this program will receive $30,000,000 of 
mandatory funding through SAFRA in each fiscal year through 
2019.

International Education and Foreign Language Studies

    The bill includes a total of $75,729,000, the same as the 
fiscal year 2011 level, for international education and foreign 
language programs. The budget request is $125,881,000 for this 
program.
    The Committee bill includes language allowing funds to be 
used to support visits and study in foreign countries by 
individuals who plan to utilize their language skills in world 
areas vital to U.S. national security in the fields of 
government, international development, and the professions. 
Bill language also allows up to 1 percent of the funds provided 
to be used for program evaluation, national outreach and 
information dissemination activities. This language was 
proposed in the budget request.
    Domestic Programs.--The Committee recommends $66,712,000 
for domestic program activities related to international 
education and foreign language studies, including international 
business education, under title VI of the HEA. This amount is 
the same as the fiscal year 2011 level. The budget request is 
$108,360,000. Domestic programs include national resource 
centers, undergraduate international studies and foreign 
language programs, international research and studies projects, 
international business education projects and centers, American 
overseas research centers, language resource centers, foreign 
language and area studies fellowships, and technological 
innovation and cooperation for foreign information access.
    The Committee funding level includes $2,000,000 to be made 
available under section 604 of the HEA to create new and 
improve existing undergraduate international student abroad 
programs.
    Overseas Programs.--The bill includes $7,465,000 for 
overseas programs authorized under the Mutual Educational and 
Cultural Exchange Act of 1961, popularly known as the 
Fulbright-Hays Act. This is the same amount as the comparable 
fiscal year 2011 funding level. The budget request is 
$15,576,000. Under these overseas programs, grants are provided 
for group, faculty or doctoral dissertation research abroad as 
well as 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 
provides $1,552,000 for the Institute for International Public 
Policy. This amount is the same as the comparable fiscal year 
2011 funding level. The budget request is $1,945,000. This 
program is designed to increase the number of minority 
individuals in international policy and foreign service 
positions by providing a grant to a consortium of institutions 
for undergraduate and graduate level foreign language and 
international studies. A consortium of institutions of higher 
education consisting of one or more of the following entities 
is eligible to apply for the grant: Historically Black Colleges 
and Universities, Hispanic-Serving Institutions, Tribally 
Controlled Colleges and Universities, Alaska Native and Native 
Hawaiian-Serving Institutions and institutions with programs to 
train foreign service professionals. An institutional match of 
50 percent is required.

Fund for the Improvement of Postsecondary Education

    The Committee recommends $19,607,000 for the Fund for the 
Improvement of Postsecondary Education [FIPSE]. This is the 
same as the comparable fiscal year 2011 funding level. The 
budget request is $150,000,000.
    The budget request includes $122,800,000 to support the 
proposed First in the World initiative, which would be modeled 
after the Investing in Innovation program for K-12. The 
initiative would help ensure institutions of higher education 
have access to innovative strategies and practices that have 
been shown to be effective in improving educational outcomes. 
The Committee recommendation does not include funding for this 
initiative because of budget constraints.
    Low-Income Single Parents.--The Committee recognizes the 
importance of providing targeted, supportive services to low-
income, single-parent students, such as on-campus housing, 
childcare, counseling, advising, internship opportunities, 
financial aid and financial aid counseling and assistance. The 
Committee encourages the Department to promote replication of 
best practices that have proven to successfully provide 
postsecondary degree completion opportunities for low-income 
single parents, the overwhelming majority of whom are women, as 
they struggle to balance commitments to family with their need 
to pursue a college education and build a career.
    Training for Realtime Writers.--Within the total for FIPSE, 
the Committee recommendation includes $998,000 for the Training 
for Realtime Writers program authorized by section 872 of the 
HEA, which is the same as the fiscal year 2011 level. The 
budget request does not include funding for this program. This 
program provides grants to institutions of higher education to 
establish programs to train realtime writers. Eligible 
activities include curriculum development, student recruitment, 
distance learning, mentoring and scholarships. The program 
places a priority on encouraging individuals with disabilities 
to pursue careers in realtime writing. More than 30 million 
Americans are considered deaf or hard of hearing, and many 
require captioning services to participate in mainstream 
activities and gain access to emergency broadcasts. Federal law 
requires that all television broadcasts be closed captioned, 
yet a shortage of trained captioners is creating a barrier to 
full-quality captioning of realtime television programming such 
as news, weather and emergency messaging.

Model Comprehensive Transition and Postsecondary Programs for Students 
        With Intellectual Disabilities

    The Committee recommendation includes $10,978,000 for this 
program as authorized by section 769 of HEA. This is the same 
level that was provided in fiscal year 2011. The budget does 
not request funds for this program.
    These funds are used to award competitive grants to 
postsecondary institutions to establish model programs to help 
students with intellectual disabilities transition to and 
complete college. Funds may be used for student support 
services; academic enrichment, socialization or independent 
living; integrated work experiences; and partnerships with 
local educational agencies to support students with 
intellectual disabilities participating in the model program 
who are still eligible for special education and related 
services under IDEA. Institutions of higher education receiving 
funds under this program are required to match Federal funds in 
an amount that is no less than 25 percent of the award amount.

Minority Science and Engineering Improvement

    The Committee recommends $9,484,000 for the Minority 
Science and Engineering Improvement program. This amount is the 
same as the comparable fiscal year 2011 funding level. The 
budget request includes $9,503,000 for this program. Funds are 
used to provide discretionary grants to institutions with 
minority enrollments greater than 50 percent to purchase 
equipment, develop curricula and support advanced faculty 
training. Grants are intended to improve science and 
engineering education programs and increase the number of 
minority students in the fields of science, mathematics and 
engineering.

Tribally Controlled Postsecondary Career and Technical Institutions

    The Committee recommends $8,146,000 for tribally controlled 
postsecondary vocational institutions. This amount is the same 
as the comparable fiscal year 2011 funding level. The budget 
request includes $8,162,000. This program provides grants for 
the operation and improvement of tribally controlled 
postsecondary vocational institutions to ensure continued and 
expanding opportunities for Indian students.

Federal TRIO Programs

    The Committee recommends $826,522,000, the same amount as 
the fiscal year 2011 level, for Federal TRIO programs. The 
budget request is $920,089,000.
    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 pursue and complete 
a postsecondary education; Student Support Services provides 
developmental instruction, counseling, summer programs and 
grant aid to disadvantaged college students to help them 
complete their postsecondary education; Talent Search 
identifies and counsels individuals between ages 11 and 27 
regarding opportunities for completing high school and 
enrolling in postsecondary education; Educational Opportunity 
Centers provide information and counseling on available 
financial and academic assistance to low-income adults who are 
first-generation college students; and the Ronald E. McNair 
Postbaccalaureate Achievement Program supports research 
internships, seminars, tutoring, and other activities to 
encourage disadvantaged college students to enroll in doctoral 
programs.

Gaining Early Awareness and Readiness for Undergraduate Programs [GEAR 
        UP]

    The Committee recommends $302,816,000 for GEAR UP. This 
amount is the same as the comparable fiscal year 2011 funding 
level. The budget request includes $323,212,000. GEAR UP funds 
are used by States and partnerships of colleges, middle and 
high schools, and community organizations to assist cohorts or 
students in middle and high schools serving a high percentage 
of low-income students. Services provided help students prepare 
for and pursue a postsecondary education.
    The Committee is concerned that the Department has not 
awarded TRIO and GEAR UP grants in a timely manner. For TRIO 
programs, the HEA sets specific timelines for the Department to 
notify new, continuing and non-continuing grantees. 
Specifically, the law requires that grantees be notified of 
their funding status 8 months prior to the start date of their 
grant. The Department routinely misses this deadline. For 
awards made with fiscal year 2010 funds, Student Support 
Services applicants were not notified until August 2010 of 
their awards. For fiscal year 2011 awards, the announcement of 
the Educational Opportunity Centers grant awards was not made 
until September 2011. Similarly, GEAR UP awards are not 
expected to be announced before the end of September 2011. 
These programs operate on an academic program year. Delays in 
making awards compromise the grantees' abilities to serve 
students and successfully achieve the goals of the programs.
    The Committee expects that the Department provide within 30 
days of enactment of this act a report on the causes of the 
tardiness in making grant awards for these programs and an 
action plan to remedy them.

Javits Fellowships

    The Committee recommends $8,084,000, the same amount as the 
fiscal year 2011 level, for the Javits Fellowships program. The 
administration proposed eliminating this program and 
consolidating the funds with the Graduate Assistance in Areas 
of National Need program. The Javits Fellowships program 
provides fellowships of up to 4 years to students of superior 
ability who are pursuing doctoral degrees in the arts, 
humanities, and social sciences at any institution of their 
choice. Each fellowship consists of a student stipend to cover 
living costs and an institutional payment to cover each 
fellow's tuition and other expenses.

Graduate Assistance in Areas of National Need [GAANN]

    The Committee recommends $30,968,000, the same amount as 
the fiscal year 2011 level, for the GAANN program. The budget 
request includes $40,717,000 for GAANN, which would have 
absorbed the Javits Fellowship program under the 
administration's proposal. GAANN 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 2010, the Secretary designated the 
following areas of national need: biology, chemistry, computer 
and information sciences, engineering, mathematics, physics, 
nursing, and educational assessment, evaluation and research.

Teacher Quality Partnership Program

    The Committee recommends $42,914,000, the same as the 
fiscal year 2011 level, for the teacher quality partnership 
program. The budget request would eliminate this program and 
consolidate it into a proposed new Teacher and Leader Pathways 
authority as part of the administration's plan for 
reauthorizing ESEA. The Teacher Quality Partnership Program 
helps improve the quality of teachers working in high-need 
schools and early childhood education programs by creating 
model teacher preparation and residency programs.

Child Care Access Means Parents in Schools

    The Committee recommends an appropriation of $16,002,000 
for the Child Care Access Means Parents in School [CCAMPIS] 
program. This amount is the same as the comparable fiscal year 
2011 funding level. The budget request includes $16,034,000 for 
this program. CCAMPIS supports the efforts of a growing number 
of nontraditional 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.

GPRA/Higher Education Act Program Evaluation

    The Committee recommends $608,000 to collect data 
associated with the Government Performance and Results Act 
[GPRA] and to evaluate programs authorized by the HEA. This 
amount is the same as the comparable fiscal year 2011 funding 
level. The budget request includes $609,000.

Thurgood Marshall Legal Educational Opportunity Program

    The Committee does not recommend funding for the Thurgood 
Marshall Legal Educational Opportunity Program, which was 
eliminated in fiscal year 2011. The budget request includes 
$3,000,000. This program helped provide low-income, minority or 
disadvantaged college students with the information, 
preparation and financial assistance needed to enter and 
complete law school study.

Hawkins Centers of Excellence

    The Committee does not recommend funding for the proposed 
new Hawkins Centers of Excellence. The budget request included 
$40,000,000 for this program as a way to increase the talent 
pool of effective minority educators by expanding and reforming 
teacher education programs at minority-serving institutions.

                           Howard University

Appropriations, 2011....................................    $234,507,000
Budget estimate, 2012...................................     234,977,000
Committee recommendation................................     234,507,000

    The Committee recommends an appropriation of $234,507,000 
for Howard University. This is the same amount as the 
comparable fiscal year 2011 funding level. The budget request 
is $234,977,000. 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. 
Federal funds from this account support approximately 46 
percent of the university's projected educational and general 
expenditures, excluding the hospital. The Committee recommends, 
within the funds provided, not less than $3,600,000 for the 
endowment program.
    Howard University Hospital.--Within the funds provided, the 
Committee recommends $28,888,000 for the Howard University 
Hospital. This is the same amount as the fiscal year 2011 
funding level. The budget request is $28,946,000. The hospital 
provides inpatient and outpatient care, as well as training in 
the health professions. It also serves as a major acute and 
ambulatory care center for the District of Columbia and 
functions as a major teaching facility attached to the 
university. The Federal appropriation provides partial funding 
for the hospital's operations.

             College Housing and Academic Facilities Loans

Appropriations, 2011....................................        $460,000
Budget estimate, 2012...................................         478,000
Committee recommendation................................         460,000

    Federal Administration.--The Committee bill includes 
$460,000 for Federal administration of the College Housing and 
Academic Facilities Loans [CHAFL] program. This is the same 
amount as the comparable fiscal year 2011 level. The budget 
request is $478,000. These funds will be used to reimburse the 
Department for expenses incurred in managing the existing CHAFL 
loan portfolio during fiscal year 2012. 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 
                                Account

Appropriations, 2011....................................     $20,541,000
Budget estimate, 2012...................................      20,582,000
Committee recommendation................................      20,541,000

    The Committee recommends $20,541,000 for the Historically 
Black College and University [HBCU] Capital Financing Program. 
This is the same amount as the comparable fiscal year 2011 
level. The budget request is $20,582,000 for this activity.
    The Committee recommendation includes $20,188,000 to pay 
the loan subsidy costs in guaranteed loan authority under this 
program. This will support $367,255,000 in new loan volume in 
fiscal year 2012. The budget proposes $20,228,000 to pay for 
the subsidy costs. 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. As 
requested by the administration, the Committee includes new 
bill language allowing the program to make loans to public and 
private HBCUs without regard to the limitations within section 
344(a) of the HEA.
    The Committee recognizes the impact Hurricanes Katrina and 
Rita continue to have on institutions of higher education in 
the Gulf region, particularly HBCUs. Enrollments at these 
institutions declined after the hurricanes and have not 
returned to pre-hurricane levels. Given this challenging 
circumstance, the Committee includes new bill language that 
authorizes the Secretary of Education to modify the terms and 
conditions of loans issued through the HBCU Hurricane 
Supplemental Loan Program in such a way that does not result in 
any net cost to the Federal Government.

                    Institute of Education Sciences

Appropriations, 2011....................................    $608,788,000
Budget estimate, 2012...................................     760,473,000
Committee recommendation................................     609,788,000

    The Committee recommends $609,788,000 for the Institute of 
Education Sciences [IES]. The budget request for fiscal year 
2012 is $760,473,000 and the comparable fiscal year 2011 level 
is $608,788,000. This account supports education research, data 
collection and analysis activities, and the assessment of 
student progress.
    The Committee commends IES's attempts to improve the 
utilization of education research and to enhance classroom 
practices and collaborations between researchers and 
practitioners. The Committee believes more needs to be done, 
particularly with regard to research intended to improve 
academic achievement for students with mental, emotional and 
behavioral disorders as well as physical, intellectual and 
developmental disabilities. The Committee requests that IES 
describe its current and planned activities in these areas in 
the fiscal year 2013 congressional budget justification.

                RESEARCH, DEVELOPMENT, AND DISSEMINATION

    The Committee recommends $199,796,000, the same as the 
fiscal year 2011 level, for education research, development and 
national dissemination activities. The budget request for 
fiscal year 2012 is $260,413,000. Funds are available for 
obligation for 2 fiscal years. These funds support research, 
development and dissemination activities that are aimed at 
expanding fundamental knowledge of education and promoting the 
use of research and development findings in the design of 
efforts to improve education.
    The Committee strongly urges IES to continue support for 
research and development activities related to gifted and 
talented education, particularly for underrepresented 
populations, to support a National Research Center on the 
Gifted and Talented, and to ensure that the condition of gifted 
and talented students is reported in key national reports 
produced by the IES.
    The Committee notes that some research has shown that 
captioned educational television programs have shown potential 
to improve literacy, particularly for low-income children. The 
Committee encourages IES to examine how closed captions could 
be best used to increase literacy and to evaluate whether 
changes to closed captions might enhance their effect.

                               STATISTICS

    The Committee recommends $109,304,000 for data gathering 
and statistical analysis activities of the National Center for 
Education Statistics [NCES]. The budget request for fiscal year 
2012 is $117,021,000 and the comparable fiscal year 2011 amount 
is $108,304,000.
    The NCES collects, analyzes and reports statistics on 
education in the United States. Activities are carried out 
directly and through grants and contracts. The Center collects 
data on educational institutions at all levels, longitudinal 
data on student progress and data relevant to public policy. 
The NCES also provides technical assistance to State and local 
educational agencies and postsecondary institutions.
    The Committee recommendation includes sufficient resources 
for NCES to update the report, Condition of America's Public 
School Facilities: 1999. The Committee expects a First Look 
report on this topic to be published in calendar year 2013.

                   REGIONAL EDUCATIONAL LABORATORIES

    The Committee recommends $57,535,000, the same amount as 
the fiscal year 2011 level, to continue support for the 
regional educational laboratories. The budget request for 
fiscal year 2012 is $69,650,000. Funds available in this bill 
will support competitive grants to support a network of 10 
laboratories. The laboratories are responsible for promoting 
the use and development of knowledge and evidence in broad-
based systemic strategies to increase student learning and 
further school improvement efforts. The Committee appreciates 
the efforts of IES to strengthen the connections between 
practitioners and the research community, so that federally 
supported research is practical and meets the needs of the 
field. The Committee requests that IES describe in the fiscal 
year 2013 congressional budget justification its efforts in 
this area, as well as how IES measures the extent of progress 
being achieved.

              RESEARCH AND INNOVATION IN SPECIAL EDUCATION

    The Committee recommends $50,983,000, the same amount as 
the fiscal year 2011 funding level, for research and innovation 
in special education conducted by the National Center for 
Special Education Research. The budget request for fiscal year 
2012 is $58,085,000. The center addresses gaps in scientific 
knowledge in order to improve special education and early 
intervention services and outcomes for infants, toddlers and 
children with disabilities. Funds provided to the center are 
available for obligation for 2 fiscal years.

               SPECIAL EDUCATION STUDIES AND EVALUATIONS

    The Committee recommends $11,437,000, the same amount as 
the fiscal year 2011 funding level, for special education 
studies and evaluations. The budget request for fiscal year 
2012 is $11,460,000.
    This program supports competitive grants, contracts and 
cooperative agreements to assess the implementation of the 
Individuals with Disabilities Education Act. Funds are also 
used to evaluate the effectiveness of State and local efforts 
to deliver special education services and early intervention 
programs. Funds are available for obligation for 2 fiscal 
years.

                         STATEWIDE DATA SYSTEMS

    The Committee recommendation includes $42,166,000, the same 
amount as the fiscal year 2011 funding level, for statewide 
data systems. The budget request for fiscal year 2012 is 
$100,000,000.
    This program supports competitive grants to State 
educational agencies to enable such agencies to design, develop 
and implement statewide, longitudinal data systems to manage, 
analyze, disaggregate and use individual data for students of 
all ages. Early childhood, postsecondary and workforce 
information and systems may be linked to, included in, or 
developed with program funds. Funds are available for 
obligation for 2 fiscal years.
    The Committee bill allows up to $12,500,000 to be used for 
awards to public or private agencies or organizations to 
support activities to improve data coordination, quality and 
use at the local, State and national levels. The Committee 
requests that, prior to obligating any funds for this purpose, 
the Department provide to the Committee an operating plan 
describing the proposed purpose and use of such funds.

                               ASSESSMENT

    The Committee recommends $138,567,000 to provide support 
for the National Assessment of Educational Progress [NAEP], a 
congressionally mandated assessment created to measure the 
educational achievement of American students. The budget 
request for fiscal year 2012 is $143,844,000 and the comparable 
fiscal year 2011 amount is $138,567,000.
    The primary goal of NAEP is to determine and report the 
status and trends over time in educational achievement, subject 
by subject.
    Within the funds appropriated, the Committee recommends 
$8,706,000, the same amount as the fiscal year 2011 funding 
level, for the National Assessment Governing Board [NAGB]. The 
budget request for fiscal year 2012 is $8,723,000. NAGB is 
responsible for formulating policy for NAEP.

                        Departmental Management

                         PROGRAM ADMINISTRATION

Appropriations, 2011....................................    $455,288,000
Budget estimate, 2012...................................     479,038,000
Committee recommendation................................     449,074,000

    The Committee recommends $449,074,000 for program 
administration. The budget request for fiscal year 2012 is 
$479,038,000 and the comparable fiscal year 2011 level is 
$455,288,000.
    Funds support personnel compensation and benefits, travel, 
rent, communications, utilities, printing, equipment and 
supplies, automated data processing and other services required 
to award, administer and monitor Federal education programs. 
Support for program evaluation and studies and advisory 
councils also is provided under this account.
    The Committee recommendation does not include additional 
funds for building modernization activities for the Department 
of Education. The budget request for these activities for 
fiscal year 2012 is $2,711,000 and the comparable fiscal year 
2011 amount is $8,184,000.

                        OFFICE FOR CIVIL RIGHTS

Appropriations, 2011....................................    $102,818,000
Budget estimate, 2012...................................     107,772,000
Committee recommendation................................     102,818,000

    The Committee recommends $102,818,000, the same as the 
fiscal year 2011 level, for the Office for Civil Rights [OCR]. 
The budget request for fiscal year 2012 is $107,772,000.
    OCR is responsible for the enforcement of laws that 
prohibit discrimination on the basis of race, color, national 
origin, sex, disability, and age in all programs and 
institutions 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. The Committee encourages 
OCR to focus resources on documenting and investigating the use 
of restraint and seclusion procedures by school personnel.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2011....................................     $59,933,000
Budget estimate, 2012...................................      67,187,000
Committee recommendation................................      59,933,000

    The Committee recommends $59,933,000, the same as the 
fiscal year 2011 level, for the Office of the Inspector 
General. The budget request for fiscal year 2012 is 
$67,187,000.
    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 involuntary transportation of 
students other than to the school nearest to the student's home 
(sec. 302).
    The Committee bill contains language which has been 
included in the bill since 1980, prohibiting the use of funds 
to prevent the implementation of programs of voluntary prayer 
and meditation in public schools (sec. 303).
    The Committee bill includes a provision giving the 
Secretary of Education authority to transfer up to 1 percent of 
any discretionary funds between appropriations (sec. 304).
    The Committee continues a provision that allows the 
outlying areas to consolidate funds under title V of the 
Elementary and Secondary Education Act (sec. 305).
    The Committee bill continues a provision that allows the 
Republic of Palau to receive certain Federal funds (sec. 306).
    The Committee bill includes new language related to the 
Pell Grant program (sec. 307).
    The Committee bill includes a new provision concerning the 
HBCU Hurricane Supplemental Loan Program (sec. 308).
    The Committee bill includes language clarifying the 
authority available under the Race to the Top--Early Learning 
Challenge (sec. 309).

                                TITLE IV

                            RELATED AGENCIES

 Committee for Purchase From People Who Are Blind or Severely Disabled

                         SALARIES AND EXPENSES

Appropriations, 2011....................................      $5,385,000
Budget estimate, 2012...................................       5,841,000
Committee recommendation................................       5,385,000

    The Committee recommends $5,385,000 for fiscal year 2012 
for the Committee for Purchase from People Who Are Blind or 
Severely Disabled. The fiscal year 2011 comparable level is 
$5,385,000. The fiscal year 2012 budget request was $5,841,000.
    The primary purpose of the Committee for Purchase from 
People Who Are Blind or Severely Disabled is to increase the 
employment opportunities for people who are blind or have other 
severe disabilities and, whenever possible, to prepare them to 
engage in competitive employment.

             Corporation for National and Community Service

                           OPERATING EXPENSES

Appropriations, 2011....................................    $778,869,000
Budget estimate, 2012...................................     916,390,000
Committee recommendation................................     781,869,000

    The Committee recommends $781,869,000 for the operating 
expenses of the Corporation for National and Community Service 
[CNCS] in fiscal year 2012. The administration request for 
fiscal year 2012 was $916,390,000. The fiscal year 2011 
comparable level was $778,869,000.
    The Committee recommendation is sufficient to maintain the 
number of AmeriCorps members at over 82,000.
    CNCS, a corporation owned by the Federal Government, was 
established by the National and Community Service Trust Act of 
1993 to enhance opportunities for national and community 
service and provide national service education awards. The 
Corporation makes grants to States, institutions of higher 
education, public and private nonprofit organizations, and 
others to create service opportunities for students, out-of-
school youth and adults.
    CNCS administers programs authorized under the Domestic 
Volunteer Service Act, the National and Community Service Trust 
Act and the SERVE America Act.

                                 VISTA

    The Committee recommends $98,876,000, the same as the 
fiscal year 2011 level, for the Volunteers in Service to 
America [VISTA] Program. The budget request for fiscal year 
2012 was $100,000,000.
    VISTA, created in 1964 under the Economic Opportunity Act, 
provides capacity building for small, community-based 
organizations. VISTA volunteers raise resources for local 
projects, recruit and organize volunteers, and establish and 
expand local community-based programs in housing, employment, 
health and economic development activities.

                    NATIONAL SENIOR VOLUNTEER CORPS

    The Committee recommends $207,883,000, the same as the 
fiscal year 2011 level, for the National Senior Volunteer Corps 
Programs. The fiscal year 2012 budget request was $226,100,000.
    The Committee has included sufficient funding to continue 
all activities at no less than last year's level.

                  AMERICORPS STATE AND NATIONAL GRANTS

    The Committee recommends $347,360,000, the same as the 
fiscal year 2011 level, for AmeriCorps State and National 
grants in fiscal year 2012. The budget request for fiscal year 
2012 was $399,790,000.

                       DISABILITY PLACEMENT FUNDS

    The Committee recommendation includes $4,990,000 for 
Disability Placement funds, the same as the comparable fiscal 
year 2011 level. The budget request for fiscal year 2012 was 
$5,000,000.
    Grant funds are for the placement of, reasonable 
accommodation of, and auxiliary services for members and 
potential members with disabilities serving in AmeriCorps 
programs.

          INNOVATION, DEMONSTRATION AND ASSISTANCE ACTIVITIES

    The Committee has included $60,379,000 for Innovation, 
Demonstration and Assistance Activities. The comparable fiscal 
year 2011 level was $60,379,000 and the budget request for 
fiscal year 2012 was $80,500,000.
    Within the funds provided for the Innovation account, the 
Committee has included $49,900,000 for the Social Innovation 
fund authorized under section 1807 of the SERVE America Act.
    In addition, $3,992,000 is included for the Volunteer 
Generation Fund authorized under section 198P of the SERVE 
America Act. The Committee has included bill language similar 
to that requested by the administration to allow all funds to 
be awarded competitively.

                               EVALUATION

    The Committee recommendation includes $5,988,000, the same 
as the fiscal year 2011 level, for evaluation activities. The 
budget request for fiscal year 2012 was $6,000,000.

                   NATIONAL CIVILIAN COMMUNITY CORPS

    The Committee recommendation includes $31,942,000 for the 
National Civilian Community Corps. The comparable fiscal year 
2011 level was $28,942,000 and the budget request for fiscal 
year 2012 was $35,000,000.
    The National Civilian Community Corps is a full-time, team-
based residential program for men and women ages 18 to 24. 
Members are assigned to one of five campuses for a 10-month 
service commitment.
    The Committee is concerned by the pending loss of the 
Atlantic campus of the National Civilian Community Corps and 
the gap in disaster response services that even a temporary 
displacement could create. Therefore, the Committee has 
included an additional $3,000,000 for contracting, planning and 
services required for the relocation of this campus. The 
Committee requests that the Corporation provide the chairs and 
ranking members of the appropriations and authorizing 
committees of relevant jurisdiction with a proposed plan for 
the relocation of the Atlantic campus within 60 days of the 
enactment of this act.

                        LEARN AND SERVE AMERICA

    The Committee has not included funding for Learn and Serve 
America. The program was eliminated in fiscal year 2011. The 
budget request for fiscal year 2012 was $39,500,000.
    Learn and Serve America provided direct and indirect 
support to K-12 schools, community groups and higher education 
institutions to facilitate service-learning projects.

                 STATE COMMISSION ADMINISTRATION GRANTS

    The Committee has included $16,966,000, the same as the 
fiscal year 2011 level, for State Commission Administration 
grants. The budget request for fiscal year 2012 was 
$17,000,000.

                   TRAINING AND TECHNICAL ASSISTANCE

    The Committee recommendation includes $7,485,000, the same 
as the fiscal year 2011 level, for Training and Technical 
Assistance. The budget request for fiscal year 2011 was 
$7,500,000.

                         NATIONAL SERVICE TRUST

Appropriations, 2011....................................    $201,200,000
Budget estimate, 2012...................................     235,326,000
Committee recommendation................................     215,200,000

    The Committee recommends an appropriation of $215,200,000 
for the National Service Trust. The comparable level for fiscal 
year 2011 was $201,200,000. The administration request for 
fiscal year 2012 was $235,326,000.
    The National Service Trust is an account in the Treasury of 
the United States from which the Corporation makes payments of 
Segal education awards, pays interest that accrues on qualified 
student loans for AmeriCorps participants during terms of 
service in approved national service positions, and makes other 
payments entitled to members who serve in the programs of CNCS.
    The Committee notes that the funding level recommended is 
sufficient to support no less than the same number of service 
members as were enrolled in fiscal year 2011.

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $87,824,000
Budget estimate, 2012...................................      97,694,000
Committee recommendation................................      87,824,000

    The Committee recommends an appropriation of $87,824,000, 
the same as the fiscal year 2011 level, for the Corporation's 
salaries and expenses. The budget request for fiscal year 2012 
was $97,694,000.
    The salaries and expenses appropriation provides funds for 
staff salaries, benefits, travel, training, rent, advisory and 
assistance services, communications and utilities expenses, 
supplies, equipment and other operating expenses necessary for 
management of the Corporation's activities under the National 
and Community Service Act of 1990 and the Domestic Volunteer 
Service Act of 1973.

                      OFFICE OF INSPECTOR GENERAL

Appropriations, 2011....................................      $7,685,000
Budget estimate, 2012...................................       8,450,000
Committee recommendation................................       7,685,000

    The Committee recommends an appropriation of $7,685,000, 
the same as the fiscal year 2011 level, for the Office of 
Inspector General [OIG]. The administration request for fiscal 
year 2012 was $8,450,000.
    The goals of the OIG are to increase organizational 
efficiency and effectiveness and to prevent fraud, waste and 
abuse.

                       ADMINISTRATIVE PROVISIONS

    The Committee has retained language in previous bills 
concerning three administrative provisions: language requiring 
the Corporation to make any significant changes to program 
requirements or policy through rule-making (sec. 401), language 
stipulating minimum share requirements (sec. 402), and language 
requiring that donations supplement and not supplant operations 
(sec. 403). In addition, the Committee has included one new 
statutory provision requested in the President's budget, 
aligning requirements regarding the use of Education Awards at 
GI Bill-eligible institutions (sec. 404).

                  Corporation for Public Broadcasting

Appropriations, 2011....................................    $435,138,000
Budget estimate, 2012...................................     451,000,000
Committee recommendation, 2012..........................     450,998,000
Appropriations, 2013....................................     445,000,000
Budget estimate, 2014...................................     451,000,000
Committee recommendation, 2014..........................     445,000,000

    The Committee recommends $445,000,000 for the Corporation 
for Public Broadcasting [CPB] as an advance appropriation for 
fiscal year 2014, the same as the advance appropriation 
provided last year for fiscal year 2013. The budget request for 
fiscal year 2014 is $451,000,000. Two-year advance funding has 
been in place since 1975 to ensure the independence of public 
broadcasting programming.
    In addition to the advance appropriation, the Committee 
recommends $5,998,000 in fiscal year 2012 for digital 
broadcasting equipment and programming activities related to 
the transition from analog to digital broadcasting. This is the 
same as the comparable fiscal year 2011 funding level for these 
activities. The budget request is $6,000,000. In total, 
including $445,000,000 in advanced funding available in fiscal 
year 2012, the Committee recommends a fiscal year 2012 program 
level of $450,998,000. The comparable fiscal year 2011 program 
level is $435,138,000 and the budget request for fiscal year 
2012 is $451,000,000.
    The majority of funds appropriated to CPB go directly to 
local public television and radio stations to support their 
programming. CPB funds also support the creation of content for 
radio, television and other platforms; system support 
activities that benefit the entire public broadcasting 
community; and the administration of the CPB.

               Federal Mediation and Conciliation Service

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $46,559,000
Budget estimate, 2012...................................      48,025,000
Committee recommendation................................      46,559,000

    The Committee recommends $46,559,000, the same as the 
comparable fiscal year 2011 funding level, for the Federal 
Mediation and Conciliation Service [FMCS]. The budget request 
is $48,025,000.
    FMCS provides mediation, conciliation and arbitration 
services to labor and management organizations to prevent and 
minimize work stoppages and promote stable labor-management 
relationships. FMCS is also authorized to provide dispute 
resolution consultation and training to all Federal agencies.
    Within the total, the Committee recommendation includes 
$349,000 for labor-management partnership grants. The 
comparable fiscal year 2011 funding level is $348,302 and the 
budget request is $750,000. These grants support innovative 
approaches to collaborative labor-management relationships to 
resolve potential problems, explore ways to improve 
productivity and avert serious work stoppages.

            Federal Mine Safety and Health Review Commission

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $10,337,000
Budget estimate, 2012...................................      22,417,000
Committee recommendation................................      17,337,000

    The Committee recommends $17,337,000 for fiscal year 2012 
for the Federal Mine Safety and Health Review Commission 
[FMSHRC]. The comparable funding level for fiscal year 2011 is 
$10,337,000 and the budget request is $22,417,000. The 
Supplemental Appropriations Act, 2010 included an additional 
$3,800,000 for FMSHRC, available over the 12-month period from 
July 2010 through June 2011.
    FMSHRC provides administrative trial and appellate review 
of legal disputes under the Federal Mine Safety and Health Act 
of 1977. Most cases involve civil penalties proposed by the 
Department of Labor's Mine Safety and Health Administration 
[MSHA]. FMSHRC's administrative law judges [ALJs] decide cases 
at the trial level and the five-member Commission provides 
review of the ALJ decisions.
    This increase in funding, and corresponding increases at 
DOL, supports continued Federal efforts to reduce the backlog 
of appealed cases up for review at FMSHRC. The rate of 
contested MSHA citations has more than quadrupled since the 
passage of the MINER Act of 2006, resulting in a more than 
fourfold increase in the number of cases appealed to FMSHRC 
annually. As a result, the backlog of cases has increased from 
1,300 at the beginning of fiscal year 2005 to over 18,000 at 
the beginning of fiscal year 2011.
    The disaster at the Upper Big Branch coal mine in April 
2010 was a tragic reminder of the importance of mine safety. 
The backlog of cases up for review at FMSHRC delays processing 
times and creates a dangerous incentive for mine operators, 
particularly those with a pattern of serious and substantial 
safety violations, to contest violations simply to delay 
enforcement. This delay undermines mine safety efforts and puts 
miners at risk. The Committee recommendation builds off of 
investments in the Supplemental Appropriations Act, 2010 and 
will enable FMSHRC to continue to work down the backlog of 
cases and reduce case processing times. The Committee 
recommendation also includes up to $1,000,000 to continue the 
transition to an electronic case management system that will 
further improve productivity.
    The Committee directs FMSRHC and the Department of Labor to 
brief the Committees on Appropriations of the House of 
Representatives and the Senate within 30 days of enactment of 
this act with an update on its backlog reduction plan based on 
the enacted fiscal year 2012 appropriation.

                Institute of Museum and Library Services

       OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2011....................................    $237,393,000
Budget estimate, 2012...................................     242,605,000
Committee recommendation................................     237,393,000

    The Committee recommends $237,393,393, the same as the 
comparable fiscal year 2011 funding level, for the Institute of 
Museum and Library Services. The budget request is 
$242,605,000.
    Within the total for IMLS, the Committee recommendation 
includes the amounts below. The Museum Assessment Program and 
Conservation Assessment Program were consolidated with the 
National Leadership: Museums program in fiscal year 2011. The 
Committee supports and maintains this consolidation.

                                            [In thousands of dollars]
----------------------------------------------------------------------------------------------------------------
                                                                    Fiscal year     Fiscal year     Fiscal year
                         Budget activity                               2011         2012 budget   2012 Committee
                                                                    comparable        request     recommendation
----------------------------------------------------------------------------------------------------------------
Library Services Technology Act:
    Grants to States............................................         160,032         161,345         160,032
    Native American Library Services............................           3,960           4,000           3,960
    National Leadership: Libraries..............................          12,225          12,250          12,225
    Laura Bush 21st Century Librarian...........................          12,818          15,628          12,818
                                                                 -----------------------------------------------
      Subtotal, LSTA............................................         189,035         193,223         189,035
                                                                 -----------------------------------------------
Museum Services Act:
    Museums for America.........................................          18,453          18,976          18,453
    Museum Assessment Program...................................  ..............  ..............  ..............
    21st Century Museum Professionals...........................           2,015           2,073           2,015
    Conservation Project Support................................           2,675           2,747           2,675
    Conservation Assessment Program.............................  ..............  ..............  ..............
    Native American/Hawaiian Museum Services....................             947             975             947
    National Leadership: Museums................................           6,050           6,062           6,050
                                                                 -----------------------------------------------
      Subtotal, MSA.............................................          30,140          30,833          30,140
                                                                 -----------------------------------------------
African American History & Culture Act:
    Museum Grants for African American History & Culture........           1,443           1,485           1,443
Administration..................................................          14,845          15,130          14,845
Research, Analysis & Data Collection............................           1,930           1,934           1,930
----------------------------------------------------------------------------------------------------------------

            Medicaid and CHIP Payment and Access Commission

                         SALARIES AND EXPENSES

Appropriations, 2011....................................................
Budget estimate, 2012...................................     $11,000,000
Committee recommendation................................      10,500,000

    The Committee recommends $10,500,000 for the Medicaid and 
CHIP Payment and Access Commission [MACPAC]. The fiscal year 
2012 budget request is $11,000,000. MACPAC was established in 
the Children's Health Insurance Program Reauthorization Act of 
2009 and is tasked with reviewing State and Federal Medicaid 
and CHIP access and payment policies and making recommendations 
to Congress, the Secretary of Health and Human Services, and 
the States on a wide range of issues affecting those programs.

                  Medicare Payment Advisory Commission

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $12,425,000
Budget estimate, 2012...................................      13,100,000
Committee recommendation................................      12,425,000

    The Committee recommends $12,425,000, the same as the 
comparable fiscal year 2011 funding level, for the Medicare 
Payment Advisory Commission (MedPAC). The budget request is 
$13,100,000. MedPAC was established by Congress as part of the 
Balanced Budget Act of 1997 and provides independent policy and 
technical advice on issues affecting the Medicare program.

                     National Council on Disability

                         SALARIES AND EXPENSES

Appropriations, 2011....................................      $3,264,000
Budget estimate, 2012...................................       3,400,000
Committee recommendation................................       3,264,000

    The Committee recommends $3,264,000, the same as the 
comparable fiscal year 2011 funding level, for the National 
Council on Disability. The fiscal year 2012 budget request is 
$3,400,000.
    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 re-enter the Nation's workforce and to live 
independently.

               National Health Care Workforce Commission

                         SALARIES AND EXPENSES

Appropriations, 2011....................................................
Budget estimate, 2012...................................      $3,000,000
Committee recommendation................................       3,000,000

    The Committee recommendation includes $3,000,000 for the 
National Health Care Workforce Commission. The budget request 
is $3,000,000. The National Health Care Workforce Commission 
was authorized in the Patient Protection and Affordable Care 
Act but has not yet been funded.
    This commission will serve as a resource to Congress, the 
President, and State and local entities in evaluating 
healthcare workforce needs, including assessing education and 
training activities to determine to what extent the demand for 
health workers is being met, identifying barriers to improved 
coordination at the Federal, State and local levels and 
recommending changes to address those barriers.

                     National Labor Relations Board

                         SALARIES AND EXPENSES

Appropriations, 2011....................................    $282,833,000
Budget estimate, 2012...................................     287,699,000
Committee recommendation................................     282,833,000

    The Committee recommends $282,833,000, the same as the 
comparable fiscal year 2011 funding level, for the National 
Labor Relations Board [NLRB]. The fiscal year 2012 budget 
request is $287,699,000.
    NLRB is a law enforcement agency that adjudicates disputes 
under the National Labor Relations Act. The mission of NLRB is 
to carry out the statutory responsibilities of the National 
Labor Relations Act as efficiently as possible and in a manner 
that gives full effect to the rights afforded to employees, 
unions and employers under the act.

                        National Mediation Board

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $13,436,000
Budget estimate, 2012...................................      13,961,000
Committee recommendation................................      13,436,000

    The Committee recommends $13,436,000, the same as the 
comparable fiscal year 2011 funding level, for the National 
Mediation Board [NMB]. The fiscal year 2012 budget request is 
$13,961,000.
    The NMB protects interstate commerce as it mediates labor-
management relations in the railroad and airline industries 
under the Railway Labor Act. It mediates collective bargaining 
disputes, conducts elections to determine the choice of 
employee bargaining representatives and administers arbitration 
of employee grievances.

            Occupational Safety and Health Review Commission

                         SALARIES AND EXPENSES

Appropriations, 2011....................................     $11,689,000
Budget estimate, 2012...................................      12,773,000
Committee recommendation................................      11,689,000

    The Committee recommends $11,689,000, the same as the 
comparable fiscal year 2011 funding level, for the Occupational 
Safety and Health Review Commission [OSHRC]. The budget request 
is $12,773,000.
    OSHRC 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, 2011....................................     $56,886,000
Budget estimate, 2012...................................      51,000,000
Committee recommendation................................      51,000,000

    The Committee recommends $51,000,000, the same as the 
fiscal year 2012 budget request, for the Dual Benefits Payments 
Account. Of these funds, an estimated $2,000,000 is from income 
taxes on vested dual benefits. The comparable fiscal year 2011 
funding level is $56,886,000, of which an estimated $3,000,000 
is from income taxes.
    This appropriation provides for vested dual benefit 
payments to beneficiaries covered under both the railroad 
retirement and Social Security systems.

          FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNT

Appropriations, 2011....................................        $150,000
Budget estimate, 2012...................................         150,000
Committee recommendation................................         150,000

    The Committee recommends $150,000 for fiscal year 2011 for 
interest earned on non-negotiated checks. This is the same as 
the comparable fiscal year 2011 funding level and the fiscal 
year 2012 budget request.

                      LIMITATION ON ADMINISTRATION

Appropriations, 2011....................................    $108,855,000
Budget estimate, 2012...................................     112,239,000
Committee recommendation................................     108,855,000

    The Committee recommends $108,855,000, the same as the 
comparable fiscal year 2011 funding level, for the 
administration of railroad retirement/survivor and 
unemployment/sickness benefit programs. The fiscal year 2012 
budget request is $112,239,000.
    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 that may be used by 
the Board for administrative expenses.

           LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2011....................................      $8,170,000
Budget estimate, 2012...................................       9,259,000
Committee recommendation................................       8,170,000

    The Committee recommends $8,170,000, the same as the 
comparable fiscal year 2011 funding level, for the Office of 
the Inspector General. The fiscal year 2011 budget request is 
$9,259,000.

                     Social Security Administration

                PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2011....................................     $21,404,000
Budget estimate, 2012...................................      20,404,000
Committee recommendation................................      20,404,000

    The Committee recommends $20,404,000, the same as the 
budget request, in mandatory funds for payments to Social 
Security trust funds. The comparable fiscal year 2011 funding 
level is $21,404,000. This account 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 
and they were properly charged to general revenues.

                  SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2011.................................... $39,976,214,000
Budget estimate, 2012...................................  38,083,000,000
Committee recommendation................................  37,922,543,000

    The Committee recommends $37,922,543,000 for the 
supplemental security income [SSI] program. This is in addition 
to $13,400,000,000 provided in fiscal year 2011 as an advance 
appropriation for fiscal year 2012, for a total program level 
of $51,216,714,000. The budget request for fiscal year 2012 is 
$38,083,000,000, for a total program level of $51,483,000,000. 
The comparable fiscal year 2011 appropriation is 
$39,976,214,000, plus an additional $13,400,000,000 provided as 
an advance appropriation the previous fiscal year for a total 
fiscal year 2011 program level of $55,976,214,000. The 
significant decrease in the fiscal year 2012 program level is 
due to the timing of monthly benefit payments that results in 
13 monthly benefit payments in fiscal year 2011 but only 11 in 
fiscal year 2012.
    In addition to these fiscal year 2012 funds, the Committee 
recommends an advance appropriation of $18,200,000,000, the 
same as the budget request, for the first quarter of fiscal 
year 2013 to ensure benefit payments continue uninterrupted.
    The SSI program guarantees a minimum level of income to 
financially needy individuals who are aged, blind or disabled. 
In fiscal year 2012 the SSI program will provide an average 
monthly benefit of $521 to over 8 million recipients. In 
addition to benefit payments, these funds support beneficiary 
services including vocational rehabilitation and return-to-work 
activities; research and demonstration projects; and costs to 
administer the program. Except for administrative costs, this 
appropriation represents mandatory funding.

Beneficiary Services

    The Committee recommendation includes $47,000,000, the same 
as the budget request, in mandatory funds for beneficiary 
services. The comparable fiscal year 2011 funding level is 
$60,000,000. These funds reimburse Vocational Rehabilitation 
[VR] agencies for successfully rehabilitating disabled SSI 
recipients by helping them achieve and sustain productive, 
self-supporting work activity. Funds also support the Ticket to 
Work program that provides SSI recipients with a ticket to 
offer employment networks [EN], including VR agencies, in 
exchange for employment and support services. Instead of 
reimbursing ENs for specific services, the Ticket to Work 
program pays ENs based on recipients achieving certain 
milestones and outcomes.

Research and Demonstration

    The Committee recommendation includes $38,000,000, the same 
as the budget request, in mandatory funds for research and 
demonstration projects conducted under sections 1110, 1115 and 
1144 of the Social Security Act. The comparable fiscal year 
2011 funding level is $42,928,000. Because of the availability 
of unobligated balances, these funds will support a fiscal year 
2012 program level of $70,254,000, compared to $51,176,000 in 
fiscal year 2011.
    These funds support a variety of research and demonstration 
projects designed to improve the disability process; promote 
self-sufficiency and assist individuals in returning to work; 
encourage savings and retirement planning through financial 
literacy; and generally provide analytical and data resources 
for use in preparing and reviewing policy proposals.
    Within the total for research and demonstration the 
Committee recommends up to $10,000,000 for a new Promoting 
Readiness of Minors in SSI [PROMISE] program. This program will 
be jointly administered by SSA and the Department of Education 
and include interagency collaboration with the Department of 
Health and Human Services and the Department of Labor. The goal 
of the PROMISE program is to improve outcomes for children, and 
the families of children, receiving SSI benefits by encouraging 
innovation and improving coordination between existing programs 
and services. The committee recommendation for SSA includes 
funds for program design and evaluation activities, as well as 
for incentive payments to States based on successful 
interventions. The Committee has also included funding for this 
program within the Department of Education.
    Within the total for research and demonstration, the 
Committee recommends $5,000,000 for the establishment of a new 
Disability Research Consortium [DRC]. The DRC will work to 
improve disability policy research by facilitating 
collaboration between researchers and focusing on cross-cutting 
issues affecting multiple Federal agencies and the disability 
population in general. The Committee encourages SSA to consult 
with the National Council on Disability in establishing the 
DRC.

Administration

    The Committee recommendation includes $3,683,543,000 for 
SSI program administrative expenses. The comparable fiscal year 
2011 funding level is $3,486,286,000 and the budget request is 
$3,844,000,000. This appropriation funds the SSI program's 
share of administrative expenses incurred through the 
limitation on administrative expenses account.

                 LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2011.................................... $11,423,606,000
Budget estimate, 2012...................................  12,513,200,000
Committee recommendation................................  11,631,948,000

    The Committee recommends $11,631,948,000 for the Social 
Security Administration's limitation on administrative expenses 
[LAE] account. The comparable fiscal year 2011 funding level is 
$11,423,606,000 and the budget request is $12,513,200,000.
    This account provides resources for SSA to administer the 
old age and survivors insurance [OASI], the disability 
insurance [DI], and the supplemental security income [SSI] 
programs, and to support the Center for Medicare and Medicaid 
Services in administering its programs. The LAE account is 
funded by the Social Security and Medicare trust funds for 
their share of administrative expenses, the general fund for 
the SSI program's share of administrative expenses, and 
applicable user fees.
    The Committee recommendation includes a $139,516,000 
increase for program integrity activities, provided through a 
cap adjustment mechanism described below, and a $68,826,000 
increase for non-program integrity base administrative 
expenses.
    In fiscal year 2012 the number of disability claims and 
hearings requests SSA receives is expected to remain at near 
record levels. The Committee recommendation will allow SSA to 
continue towards the goal of eliminating the disability hearing 
backlog by the end of 2013 while providing targeted increases 
to those parts of the agency facing the greatest demand for 
services or abnormal staff attrition. Because of budget 
constraints, the Committee was not able to provide the full 
amount requested by the administration, so it recognizes that 
processing times and pending levels for other key workloads, 
including initial disability claims, will rise. The Committee 
directs SSA to provide a report to the Committees on 
Appropriations of the House of Representative and the Senate 
within 30 days of enactment of this act on the impact of 
enacted funding levels on key workloads and services.

Program Integrity

    Within the total for LAE, the Committee recommendation 
includes $896,000,000 for program integrity activities, 
including conducting continuing disability reviews [CDRs] and 
redeterminations of non-medical eligibility factors under the 
SSI program. This amount includes $273,000,000 in base funding 
and $623,000,000 in cap adjustment funding provided under 
section 251(b)(2)(C)(ii) of the Balanced Budget and Emergency 
Deficit Control Act of 1985. The comparable fiscal year 2011 
funding level is $746,484,000 and the budget request is 
$938,000,000.
    This increase in funding in fiscal year 2012 will allow SSA 
to conduct 263,000 additional full-medical CDRs and 200,000 
additional SSI redeterminations than in fiscal year 2011. In 
total, SSA will conduct 569,000 full-medical CDRs and 2,622,000 
SSI redeterminations, saving approximately $8,900,000,000 over 
10 years to the Social Security, Medicare and Medicaid 
programs.

No-Year Information Technology Funding

    The Committee maintains bill language allowing SSA to carry 
over unobligated LAE balances for use in future fiscal years, 
without fiscal year limitation, for investments in information 
technology and telecommunications infrastructure. In fiscal 
year 2011 SSA made available $461,413,000 in prior-year 
unobligated balances for these activities and the Committee 
recommendation assumes SSA will make an additional $60,000,000 
available in fiscal year 2012. This is in addition to funding 
within SSA's annual appropriation used for these activities in 
those years. This significant decrease is due to a rescission 
of $275,000,000 in fiscal year 2011 that otherwise would have 
been available in fiscal year 2012. The Committee also includes 
new bill language directing SSA to include information in their 
congressional budget justification each year regarding the 
estimated amount of prior year unobligated balances that will 
be available and used for these purposes, and to notify the 
Committees on Appropriations of the House of Representatives 
and the Senate before those funds are made available. 
Information included in the congressional budget justification 
should include a consolidated information technology plan and 
include the actual and estimated amounts funded with annually 
appropriated and no-year funds.

Social Security Advisory Board

    Within the total for LAE, the Committee recommendation 
includes not less than $2,150,000, the same as the budget 
request, for the Social Security Advisory Board. The comparable 
fiscal year 2011 funding level is $2,295,000. The Social 
Security Advisory Board advises the Commissioner of Social 
Security and makes recommendations to Congress and the 
President on policies relating to the OASI, DI and SSI 
programs.

User Fees

    Within the total for LAE, the Committee recommendation 
includes $155,500,000 for administrative activities funded from 
user fees. This amount includes $155,000,000 in fees paid to 
SSA by States that request SSA to administer State SSI 
supplementary payments and $500,000 from a fee payment process 
for non-attorney representatives of claimants.

Acquisition Workforce

    The Committee recommendation does not include funding 
specified for strengthening the capacity and capability of 
SSA's acquisition workforce. The budget request includes 
$1,863,000 for this activity.

                    OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2011....................................    $102,477,000
Budget estimate, 2012...................................     107,113,000
Committee recommendation................................     102,477,000

    The Committee recommends $102,477,000, the same as the 
comparable fiscal year 2011 funding level, for the Office of 
the Inspector General. The budget request is $107,113,000. The 
recommendation includes $73,535,000 funded from the OASI and DI 
trust funds for those programs' share of inspector general 
expenses and $28,942,000 funded from general revenues for the 
SSI program's share of expenses.

                      TITLE V--GENERAL PROVISIONS

    The Committee recommendation includes provisions which: 
authorize transfers of unexpended balances (sec. 501); limit 
funding to 1 year availability unless otherwise specified (sec. 
502); limit lobbying and related activities (sec. 503); limit 
official representation expenses (sec. 504); prohibit funding 
of any program to carry out distribution of sterile needles for 
the hypodermic injection of any illegal drug without the 
approval of appropriate local officials (sec. 505); clarify 
Federal funding as a component of State and local grant funds 
(sec. 506); limit use of funds for abortion (sec. 507 and sec. 
508); restrict human embryo research (sec. 509); limit the use 
of funds for promotion of legalization of controlled substances 
(sec. 510); prohibit the use of funds to promulgate regulations 
regarding the individual health identifier (sec. 511); limit 
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); prohibit transfer of funds made 
available in this act to any department, agency, or 
instrumentality of the U.S. Government, except as otherwise 
provided by this or any other act (sec. 513); prohibit Federal 
funding in this act for libraries unless they are in compliance 
with the Children's Internet Protection Act (sec. 514); 
maintain a procedure for reprogramming of funds (sec. 515); 
prohibit candidates for scientific advisory committees from 
having to disclose their political activities (sec. 516); 
require each department and related agency to submit an 
operating plan (sec. 517); require the Secretaries of Labor, 
Health and Human Services, and Education to submit a report on 
the number and amounts of contracts, grants, and cooperative 
agreements awarded by the Departments on a noncompetitive basis 
(sec. 518); prohibit the use of funds for first-class travel 
(sec. 519); prohibit the use of funds for a grant or contract 
exceeding $5,000,000 unless the prospective contractor or 
grantee makes certain certifications regarding Federal tax 
liability (sec. 520); and a provision rescinding funds from the 
State Children's Health Insurance Program performance bonus 
fund (sec. 521).

  COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE 
                                 SENATE

    Paragraph 7 of rule XVI requires that Committee reports on 
general appropriations bills identify each Committee amendment 
to the House bill ``which proposes an item of appropriation 
which is not made to carry out the provisions of an existing 
law, a treaty stipulation, or an act or resolution previously 
passed by the Senate during that session.''
    The Committee recommends funding for the following programs 
and activities which currently lack authorization: Elementary 
and Secondary Education Act; National Center for Special 
Education Research; parts C and D of the Individuals with 
Disabilities Education Act; Education Sciences Reform Act; 
Special Olympics Sport and Empowerment Act of 2004; Workforce 
Investment Act; Homeless Veterans Reintegration Program; 
Universal Newborn Hearing Screening; Organ Transplantation; 
Family Planning; Rural Health programs; Traumatic Brain Injury 
programs; Combating Autism Act; Public Health Improvement Act; 
Healthy Start; Telehealth; Health Professions Education 
Partnership Act; Children's Health Act; Women's Health Research 
and Prevention Amendments of 1998; Birth Defects Prevention, 
Preventive Health Amendments of 1993; Substance Abuse and 
Mental Health Services programs, except for Depression Centers 
of Excellence and grants for Primary and Behavioral Healthcare 
Integration; Low Income Home Energy Assistance Program; Refugee 
and Entrant Assistance programs; Adoption Opportunities; Child 
Welfare Services and Research; Child Care and Development Block 
Grant; Developmental Disabilities programs; Voting Access for 
Individuals with Disabilities; Native American Programs; 
Community Services Block Grant; Rural Facilities; Individual 
Development Accounts; Community Economic Development; 
Alzheimer's Disease Demonstration Grants; Adolescent Family 
Life; Office of Disease Prevention and Health Promotion; 
Rehabilitation Services and Disability Research, except 
sections 4, 5, and 6 of the Assistive Technology Program; 
Institute of Education Sciences; Corporation for Public 
Broadcasting; Museum and Library Services Act programs; 
National Council on Disability; and Older Americans Act.

COMPLIANCE WITH PARAGRAPH 7(c), RULE XXVI OF THE STANDING RULES OF THE 
                                 SENATE

    Pursuant to paragraph 7(c) of rule XXVI, on September 21, 
2011, the Committee ordered favorably reported an original bill 
(S. 1599) making appropriations the Departments of Labor, 
Health and Human Services, and Education, and related agencies 
for the fiscal year ending September 30, 2012, and for other 
purposes, provided that the bill be subject to amendment and 
that the bill be consistent with its spending allocations, by a 
recorded vote of 16-14, a quorum being present. The vote was as 
follows:
        Yeas                          Nays
Chairman Inouye                     Mr. Cochran
Mr. Leahy                           Mr. McConnell
Mr. Harkin                          Mr. Shelby
Ms. Mikulski                        Mrs. Hutchison
Mr. Kohl                            Mr. Alexander
Mrs. Murray                         Ms. Collins
Mrs. Feinstein                      Ms. Murkowski
Mr. Durbin                          Mr. Graham
Mr. Johnson (SD)                    Mr. Kirk
Ms. Landrieu                        Mr. Coats
Mr. Reed                            Mr. Blunt
Mr. Lautenberg                      Mr. Moran
Mr. Nelson                          Mr. Hoeven
Mr. Pryor                           Mr. Johnson (WI)
Mr. Tester
Mr. Brown

 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.''

                          TITLE 20--EDUCATION

     Chapter 28--Higher Education Resources and Student Assistance

                   Subchapter IV--Student Assistance

  PART A--GRANTS TO STUDENTS IN ATTENDANCE AT INSTITUTIONS OF HIGHER 
                               EDUCATION

                     SUBPART 1--FEDERAL PELL GRANTS

Sec. 1070a. Federal Pell Grants: amount and determinations; 
                    applications.

(a) Program authority and method of distribution

           *       *       *       *       *       *       *

(b) Purpose and amount of grants

            (1) * * *

           *       *       *       *       *       *       *

            (8) Additional funds.--
                    (A) In general.-- * * *
                            (i) * * *

           *       *       *       *       *       *       *

                            [(iv) $3,090,000,000 for fiscal 
                        year 2011;]
                            (iv) to carry out this section--
                                    (I) $13,500,000,000 for 
                                fiscal year 2011;
                                    (II) $13,583,000,000 for 
                                fiscal year 2012;
                                    (III) $8,940,000,000 for 
                                fiscal year 2013, of which 
                                $896,000,000 shall be available 
                                for the 2012-2013 award year;
                                    (IV) $0 for fiscal year 
                                2014;
                                    (V) $0 for fiscal year 
                                2015;
                                    (VI) $0 for fiscal year 
                                2016;
                                    (VII) $1,640,000,000 for 
                                fiscal year 2017;
                                    (VIII) $1,705,000,000 for 
                                fiscal year 2018;
                                    (IX) $1,775,000,000 for 
                                fiscal year 2019;
                                    (X) $1,870,000,000 for 
                                fiscal year 2020; and
                                    (XI) $2,055,000,000 for 
                                fiscal year 2021 and each 
                                succeeding fiscal year.

           *       *       *       *       *       *       *

             PART B--FEDERAL FAMILY EDUCATION LOAN PROGRAM

Sec. 1078. Federal payments to reduce student interest costs

(a) Federal interest subsidies

    (1) Types of loans that qualify

           *       *       *       *       *       *       *

    (3) Amount of interest subsidy

            (A)(i) * * *
                    [(I) which accrues prior to the beginning 
                of the repayment period of the loan, or]
                                    (I) which accrues prior to 
                                the date the student ceases to 
                                carry at least one-half the 
                                normal full-time academic 
                                workload (as determined by the 
                                institution), or
                                ------                                

             TITLE 48--TERRITORIES AND INSULAR POSSESSIONS

          Chapter 18--Micronesia, Marshall Islands, and Palau

             Subchapter I--Micronesia and Marshall Islands

         PART A--APPROVAL AND IMPLEMENTATION OF RIGINALCOMPACT

Sec. 1921d. Supplemental provisions

(a) Domestic program requirements

           *       *       *       *       *       *       *

(f) Continuing programs and laws

        (1) Federated States of Micronesia and Republic of the 
        Marshall Islands

           *       *       *       *       *       *       *

                (A) Emergency and disaster assistance

           *       *       *       *       *       *       *

                (B) Treatment of additional programs

                        (i) Consultation

           *       *       *       *       *       *       *

                        (ix) Applicability

                            The government, institutions, and 
                        people of Palau shall remain eligible 
                        for appropriations and to receive 
                        grants under the provisions of law 
                        specified in clauses (ii) and (iii) 
                        until the end of fiscal year [2009] 
                        2012, to the extent the government, 
                        institutions, and people of Palau were 
                        so eligible under such provisions in 
                        fiscal year 2003.
                                ------                                

     AMERICAN RECOVERY AND REINVESTMENT ACT, 2009, PUBLIC LAW 111-5

               TITLE XIV--STATE FISCAL STABILIZATION FUND

                     GENERAL PROVISIONS--THIS TITLE

SEC. 14006. STATE INCENTIVE GRANTS.

    (a) In General.--

           *       *       *       *       *       *       *

    (c) Subgrants to Local Educational Agencies.--(1) In 
General.--* * *
    (2) Exception.--Paragraph (1) does not apply to grants made 
by the Secretary to consortia of States to develop academic 
assessments that are aligned with academic standards, or to a 
State or States for improving early childhood care and 
education except that such a State may use its grant funds to 
make subgrants to public or private agencies and organizations 
for activities consistent with the purposes of the grant.

                        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    Amount  in   Committee    Amount  in
                                                               allocation      bill      allocation      bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
 to its subcommittees of amounts in the Budget Resolution
 for 2012: Subcommittee on Labor, HHS, Education:
    Mandatory...............................................      540,370      540,370      540,108   \1\540,108
    Discretionary...........................................      157,134      158,027      180,041   \1\180,803
        Security............................................          299          299           NA           NA
        Nonsecurity.........................................      156,835      157,728           NA           NA
Projections of outlays associated with the recommendation:
    2012....................................................  ...........  ...........  ...........   \2\612,960
    2013....................................................  ...........  ...........  ...........       68,409
    2014....................................................  ...........  ...........  ...........       14,255
    2015....................................................  ...........  ...........  ...........        2,458
    2016 and future years...................................  ...........  ...........  ...........           98
Financial assistance to State and local governments for                NA      323,580           NA      289,735
 2012.......................................................

----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority.
\2\Excludes outlays from prior-year budget authority.

NA: Not applicable.

Consistent with the funding recommended in the bill for continuing disability reviews and redeterminations and
  for healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C) of section 251(b)(2)
  of the BBEDCA of 1985 and section 106 of the Deficit Control Act of 2011, 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 $893,000 in budget authority plus associated outlays.

  COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2011 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
                                                                        YEAR 2012
                                                                [In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                        Senate Committee recommendation
                                                                                                                            compared with (+ or -)
                             Item                                     2011         Budget estimate      Committee    -----------------------------------
                                                                  appropriation                      recommendation         2011
                                                                                                                        appropriation    Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------

                TITLE I -- DEPARTMENT OF LABOR

            EMPLOYMENT AND TRAINING ADMINISTRATION

               TRAINING AND EMPLOYMENT SERVICES

Grants to States:
    Adult Training, current year..............................           58,922           148,527            58,922   ................          -89,605
        Advance from prior year...............................         (710,576)         (712,000)         (712,000)          (+1,424)  ................
        FY 2013...............................................          712,000           712,000           712,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          770,922           860,527           770,922   ................          -89,605

    Youth Training............................................          825,914           923,913           825,914   ................          -97,999

    Dislocated Worker Assistance, current year................          203,432           314,603           203,432   ................         -111,171
        Advance from prior year...............................         (858,280)         (860,000)         (860,000)          (+1,720)  ................
        FY 2013...............................................          860,000           860,000           860,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        1,063,432         1,174,603         1,063,432   ................         -111,171
                                                               =========================================================================================
      Subtotal, Grants to States..............................        2,660,268         2,959,043         2,660,268   ................         -298,775
          Current Year........................................       (1,088,268)       (1,387,043)       (1,088,268)  ................        (-298,775)
          FY 2013.............................................       (1,572,000)       (1,572,000)       (1,572,000)  ................  ................

Federally Administered Programs:
    Dislocated Worker Assistance National Reserve:
        Current year..........................................           24,112            29,160            24,112   ................           -5,048
        Advance from prior year...............................         (199,600)         (200,000)         (200,000)            (+400)  ................
        FY 2013...............................................          200,000           200,000           200,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          224,112           229,160           224,112   ................           -5,048
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Dislocated Worker Assistance..................        1,287,544         1,403,763         1,287,544   ................         -116,219

    Native Americans..........................................           52,652            54,158            52,652   ................           -1,506
    Migrant and Seasonal Farmworkers..........................           84,451            86,620            84,451   ................           -2,169
    Women in Apprenticeship...................................              998             1,000               998   ................               -2
    YouthBuild................................................           79,840           115,000            79,840   ................          -35,160
    Workforce Innovation Fund.................................          124,750   ................          100,000           -24,750          +100,000
                                                               =========================================================================================
      Subtotal, Federally Administered Programs (FAP).........          566,803           485,938           542,053           -24,750           +56,115
          Current Year........................................         (366,803)         (285,938)         (342,053)         (-24,750)         (+56,115)
          FY 2013.............................................         (200,000)         (200,000)         (200,000)  ................  ................

    National Activities:
        Pilots, Demonstrations and Research...................            9,980             6,616            10,480              +500            +3,864
        Green Jobs Innovation Fund............................  ................           60,000   ................  ................          -60,000
        Reintegration of Ex-Offenders.........................           85,390            90,000            75,390           -10,000           -14,610
        Evaluation............................................            9,581            11,600             9,581   ................           -2,019
        Workforce Data Quality Initiative.....................           12,475            13,750            12,475   ................           -1,275
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          117,426           181,966           107,926            -9,500           -74,040
                                                               =========================================================================================
      Total, Training and Employment Services (TES)...........        3,344,497         3,626,947         3,310,247           -34,250          -316,700
          Current Year........................................       (1,572,497)       (1,854,947)       (1,538,247)         (-34,250)        (-316,700)
          FY 2013.............................................       (1,772,000)       (1,772,000)       (1,772,000)  ................  ................

                      OFFICE OF JOB CORPS

Administration................................................           29,132            31,430            29,132   ................           -2,298
Operations....................................................          981,049           998,817           981,049   ................          -17,768
    Advance from prior year...................................         (589,818)         (591,000)         (591,000)          (+1,182)  ................
    FY 2013...................................................          591,000           591,000           591,000   ................  ................

Construction and Renovation...................................            4,990             3,500             4,990   ................           +1,490
    Advance from prior year...................................          (99,800)         (100,000)         (100,000)            (+200)  ................
    FY 2013...................................................          100,000            75,000           100,000   ................          +25,000
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Job Corps..............................        1,706,171         1,699,747         1,706,171   ................           +6,424
          Current Year........................................       (1,015,171)       (1,033,747)       (1,015,171)  ................         (-18,576)
          FY 2013.............................................         (691,000)         (666,000)         (691,000)  ................         (+25,000)

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS\1\...........          449,100           450,000           449,100   ................             -900
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES..................          721,312         1,100,100         1,100,100          +378,788   ................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS

Unemployment Compensation (UI):
    State Operations..........................................        3,239,154         3,275,610         3,231,154            -8,000           -44,456
    National Activities.......................................           11,287            11,310            11,287   ................              -23
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Unemployment Compensation.....................        3,250,441         3,286,920         3,242,441            -8,000           -44,479

Employment Service (ES):
    Allotments to States:
        Federal Funds.........................................           22,638            83,864            22,638   ................          -61,226
        Trust Funds...........................................          679,531           680,893           679,531   ................           -1,362
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          702,169           764,757           702,169   ................          -62,588

    ES National Activities....................................           20,952            20,994            20,952   ................              -42
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Employment Service............................          723,121           785,751           723,121   ................          -62,630
          Federal Funds.......................................          (22,638)          (83,864)          (22,638)  ................         (-61,226)
          Trust Funds.........................................         (700,483)         (701,887)         (700,483)  ................          (-1,404)

Foreign Labor Certification:
    Federal Administration....................................           50,418            50,537            50,418   ................             -119
    Grants to States..........................................           15,099            15,129            15,099   ................              -30
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Foreign Labor Certification...................           65,517            65,666            65,517   ................             -149

One-Stop Career Centers/Labor Market Information..............           63,593            63,720            63,593   ................             -127
                                                               =========================================================================================
      Total, State UI and ES..................................        4,102,672         4,202,057         4,094,672            -8,000          -107,385
          Federal Funds.......................................          (86,231)         (147,584)          (86,231)  ................         (-61,353)
          Trust Funds.........................................       (4,016,441)       (4,054,473)       (4,008,441)          (-8,000)         (-46,032)

STATE PAID LEAVE FUND.........................................  ................           23,000   ................  ................          -23,000

ADVANCES TO THE UI AND OTHER TRUST FUNDS\2\...................          290,000   ................  ................         -290,000   ................

                    PROGRAM ADMINISTRATION
Adult Employment and Training.................................           46,765            51,577            46,765   ................           -4,812
    Trust Funds...............................................            8,536             9,960             8,536   ................           -1,424
Youth Employment and Training.................................           12,283            14,442            12,283   ................           -2,159
Employment Security...........................................            3,483             4,713             3,483   ................           -1,230
    Trust Funds...............................................           39,417            41,298            39,417   ................           -1,881
Apprenticeship Services.......................................           27,728            28,718            27,728   ................             -990
Executive Direction...........................................            7,061             7,083             7,061   ................              -22
    Trust Funds...............................................            2,087             2,091             2,087   ................               -4
                                                               -----------------------------------------------------------------------------------------
      Total, Program Administration...........................          147,360           159,882           147,360   ................          -12,522
          Federal Funds.......................................          (97,320)         (106,533)          (97,320)  ................          (-9,213)
          Trust Funds.........................................          (50,040)          (53,349)          (50,040)  ................          (-3,309)
                                                               =========================================================================================
      Total, Employment and Training Administration (ETA).....       10,761,112        11,261,733        10,807,650           +46,538          -454,083
          Federal Funds.......................................        6,694,631         7,153,911         6,749,169           +54,538          -404,742
              Current Year....................................       (4,231,631)       (4,715,911)       (4,286,169)         (+54,538)        (-429,742)
              FY 2013.........................................       (2,463,000)       (2,438,000)       (2,463,000)  ................         (+25,000)
          Trust Funds.........................................        4,066,481         4,107,822         4,058,481            -8,000           -49,341

           EMPLOYEE BENEFITS SECURITY ADMINISTRATION

                     SALARIES AND EXPENSES

Enforcement and Participant Assistance........................          131,137           149,884           149,884           +18,747   ................
Policy and Compliance Assistance..............................           21,571            40,926            38,926           +17,355            -2,000
Executive Leadership, Program Oversight and Admin.............            6,655             6,718             6,718               +63   ................
                                                               -----------------------------------------------------------------------------------------
      Total, EBSA.............................................          159,363           197,528           195,528           +36,165            -2,000

          PENSION BENEFIT GUARANTY CORPORATION (PBGC)

Pension Insurance Activities..................................          (74,506)          (86,023)          (86,023)         (+11,517)  ................
Pension Plan Termination......................................         (242,300)         (243,372)         (243,372)          (+1,072)  ................
Operational Support...........................................         (147,261)         (147,506)         (147,506)            (+245)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, PBGC (program level).............................         (464,067)         (476,901)         (476,901)         (+12,834)  ................

ENFORCEMENT OF WAGE AND HOUR STANDARDS........................          227,491           240,937           227,491   ................          -13,446
OFFICE OF LABOR-MANAGEMENT STANDARDS..........................           41,367            41,367            41,367   ................  ................
FEDERAL CONTRACTOR EEO STANDARDS ENFORCEMENT..................          105,386           109,010           105,386   ................           -3,624

          FEDERAL PROGRAMS FOR WORKERS' COMPENSATION

Salaries and Expenses.........................................          115,939           121,354           115,939   ................           -5,415
    Trust Funds...............................................            2,124             2,184             2,124   ................              -60
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and Expenses............................          118,063           123,538           118,063   ................           -5,475
          Federal Funds.......................................         (115,939)         (121,354)         (115,939)  ................          (-5,415)
          Trust Funds.........................................           (2,124)           (2,184)           (2,124)  ................             (-60)

                       SPECIAL BENEFITS

Federal Employees' Compensation Benefits......................          180,000           347,000           347,000          +167,000   ................
Longshore and Harbor Workers' Benefits........................            3,000             3,000             3,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits.................................          183,000           350,000           350,000          +167,000   ................

           SPECIAL BENEFITS FOR DISABLED COAL MINERS

Benefit Payments..............................................          198,000           177,000           177,000           -21,000   ................
Administration................................................            5,220             5,227             5,227                +7   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, program level.................................          203,220           182,227           182,227           -20,993   ................

        Less funds advanced in prior year.....................          -45,000           -41,000           -41,000            +4,000   ................
                                                               -----------------------------------------------------------------------------------------
          Total, Current Year.................................          158,220           141,227           141,227           -16,993   ................

          New advances, 1st quarter FY 2013...................           41,000            40,000            40,000            -1,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Special Benefits for Disabled Coal Miners........          199,220           181,227           181,227           -17,993   ................

    ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND

Part B Administrative Expenses................................           53,778            52,147            52,147            -1,631   ................

               BLACK LUNG DISABILITY TRUST FUND

Benefit Payments and Interest on Advances.....................          237,808           241,689           241,689            +3,881   ................
Employment Standards Administration, Salaries and Expenses....           33,075            32,906            32,906              -169   ................
Departmental Management, Salaries and Expenses................           25,394            25,217            25,217              -177   ................
Departmental Management, Inspector General....................              327               327               327   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Black Lung Disability.........................          296,604           300,139           300,139            +3,535   ................

Treasury Department Administrative Costs......................              356               356               356   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Black Lung Disability Trust Fund.................          296,960           300,495           300,495            +3,535   ................
                                                               =========================================================================================
      Total, Federal Programs for Workers' Compensation.......          851,021         1,007,407         1,001,932          +150,911            -5,475
          Federal Funds.......................................          848,897         1,005,223           999,808          +150,911            -5,415
              Current year....................................         (807,897)         (965,223)         (959,808)        (+151,911)          (-5,415)
              FY 2013.........................................          (41,000)          (40,000)          (40,000)          (-1,000)  ................
          Trust Funds.........................................            2,124             2,184             2,124   ................              -60

     OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA)

                     SALARIES AND EXPENSES

Safety and Health Standards...................................           20,288            25,982            21,288            +1,000            -4,694
Federal Enforcement...........................................          208,146           216,365           208,146   ................           -8,219
Whistleblower enforcement.....................................           14,806            20,948            16,306            +1,500            -4,642
State Programs................................................          104,393           105,893           104,393   ................           -1,500
Technical Support.............................................           25,868            25,950            25,868   ................              -82
Compliance Assistance:
    Federal Assistance........................................           73,383            74,039            73,383   ................             -656
    State Consultation Grants.................................           54,688            55,798            54,688   ................           -1,110
    Training Grants...........................................           10,729            12,000            10,729   ................           -1,271
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Compliance Assistance.........................          138,800           141,837           138,800   ................           -3,037

Safety and Health Statistics..................................           34,805            34,875            34,805   ................              -70
Executive Direction and Administration........................           11,513            11,536            11,513   ................              -23
                                                               =========================================================================================
      Total, OSHA.............................................          558,619           583,386           561,119            +2,500           -22,267

             MINE SAFETY AND HEALTH ADMINISTRATION

                     SALARIES AND EXPENSES

Coal Enforcement..............................................          160,369           161,303           164,969            +4,600            +3,666
Metal/Non-Metal Enforcement...................................           87,644            89,990            88,394              +750            -1,596
Standards Development.........................................            4,352             5,550             4,352   ................           -1,198
Assessments...................................................            6,221             6,574             6,221   ................             -353
Educational Policy and Development............................           38,148            36,338            36,838            -1,310              +500
Technical Support.............................................           31,031            33,403            31,431              +400            -1,972
Program Evaluation and Information Resources (PEIR)...........           18,173            20,654            18,423              +250            -2,231
Program Administration........................................           15,906            30,465            20,872            +4,966            -9,593
                                                               =========================================================================================
      Total, Mine Safety & Health Administration MSHA.........          361,844           384,277           371,500            +9,656           -12,777

                  BUREAU OF LABOR STATISTICS

                     SALARIES AND EXPENSES

Employment and Unemployment Statistics........................          210,673           219,043           210,673   ................           -8,370
Labor Market Information......................................           67,303            69,136            68,303            +1,000              -833
Prices and Cost of Living.....................................          205,410           232,839           205,410   ................          -27,429
Compensation and Working Conditions...........................           80,418            81,197            80,418   ................             -779
Productivity and Technology...................................           12,078            10,201            12,078   ................           +1,877
Executive Direction and Staff Services........................           34,342            34,614            34,342   ................             -272
                                                               =========================================================================================
      Total, Bureau of Labor Statistics.......................          610,224           647,030           611,224            +1,000           -35,806
          Federal Funds.......................................          542,921           577,894           542,921   ................          -34,973
          Trust Funds.........................................           67,303            69,136            68,303            +1,000              -833

            OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES.........................................           38,953            39,031            38,953   ................              -78

                    DEPARTMENTAL MANAGEMENT

                     SALARIES AND EXPENSES

Executive Direction...........................................           33,283            33,213            33,283   ................              +70
Departmental IT Crosscut......................................           19,852   ................           19,852   ................          +19,852
Departmental Program Evaluation...............................            8,500            18,400             8,500   ................           -9,900
Legal Services................................................          119,121           132,578           129,121           +10,000            -3,457
    Trust Funds...............................................              326               331               326   ................               -5
International Labor Affairs...................................           92,484           101,504            92,484   ................           -9,020
Administration and Management.................................           30,339            30,745            30,339   ................             -406
Adjudication..................................................           29,227            30,576            29,227   ................           -1,349
Women's Bureau................................................           11,581            11,620            11,581   ................              -39
Civil Rights Activities.......................................            6,798             7,223             6,798   ................             -425
Chief Financial Officer.......................................            5,350             5,364             5,350   ................              -14
                                                               -----------------------------------------------------------------------------------------
      Total, Salaries and expenses............................          356,861           371,554           366,861           +10,000            -4,693
          Federal Funds.......................................         (356,535)         (371,223)         (366,535)         (+10,000)          (-4,688)
          Trust Funds.........................................             (326)             (331)             (326)  ................              (-5)

               VETERANS EMPLOYMENT AND TRAINING

State Administration, Grants..................................          165,063           165,394           165,063   ................             -331
Transition Assistance Program.................................            6,986             9,000             8,006            +1,020              -994
Federal Administration........................................           35,242            35,222            35,222               -20   ................
National Veterans Training Institute..........................            2,444             2,449             2,444   ................               -5
Homeless Veterans Program.....................................           36,257            39,330            38,257            +2,000            -1,073
Veterans Workforce Investment Programs........................            9,622             9,641             9,622   ................              -19
                                                               -----------------------------------------------------------------------------------------
      Total, Veterans Employment and Training.................          255,614           261,036           258,614            +3,000            -2,422
          Federal Funds.......................................           45,879            48,971            47,879            +2,000            -1,092
          Trust Funds.........................................          209,735           212,065           210,735            +1,000            -1,330

                  OFFICE OF INSPECTOR GENERAL

Program Activities............................................           77,937            78,453            77,937   ................             -516
    Trust Funds...............................................            5,909             5,992             5,909   ................              -83
                                                               -----------------------------------------------------------------------------------------
      Total, Office of Inspector General......................           83,846            84,445            83,846   ................             -599

                       IT MODERNIZATION
Departmental support systems..................................  ................           17,000   ................  ................          -17,000
IT infrastructure modernization...............................  ................            8,000   ................  ................           -8,000
                                                               -----------------------------------------------------------------------------------------
      Total, IT Modernization.................................  ................           25,000   ................  ................          -25,000
                                                               =========================================================================================
      Total, Departmental Management..........................          696,321           742,035           709,321           +13,000           -32,714
          Federal Funds.......................................          480,351           523,647           492,351           +12,000           -31,296
              Current Year....................................         (480,351)         (523,647)         (492,351)         (+12,000)         (-31,296)
          Trust Funds.........................................          215,970           218,388           216,970            +1,000            -1,418

Working Capital Fund..........................................  ................            4,620   ................  ................           -4,620
                                                               =========================================================================================
      Total, Workforce Investment Act Programs................        5,060,290         5,336,335         5,026,040           -34,250          -310,295
          Current Year........................................       (2,597,290)       (2,898,335)       (2,563,040)         (-34,250)        (-335,295)
          FY 2013.............................................       (2,463,000)       (2,438,000)       (2,463,000)  ................         (+25,000)
                                                               =========================================================================================
      Total, Title I, Department of Labor.....................       14,411,701        15,258,361        14,671,471          +259,770          -586,890
          Federal Funds.......................................       10,059,823        10,860,831        10,325,593          +265,770          -535,238
              Appropriations, fiscal year 2012................      (11,952,701)      (12,821,361)      (12,209,471)        (+256,770)        (-611,890)
              Appropriations..................................       (4,644,722)       (5,043,206)       (4,916,992)        (+272,270)        (-126,214)
                  Current Year................................       (7,555,823)       (8,382,831)       (7,822,593)        (+266,770)        (-560,238)
                  FY 2013.....................................       (2,504,000)       (2,478,000)       (2,503,000)          (-1,000)         (+25,000)
          Trust Funds.........................................        4,351,878         4,397,530         4,345,878            -6,000           -51,652
                                                               =========================================================================================

       TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES

      HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA)

                 HEALTH RESOURCES AND SERVICES

                 Bureau of Primary Health Care
Community Health Centers......................................        1,580,749         2,117,814         1,580,749   ................         -537,065
Free Clinics Medical Malpractice..............................               40                40                40   ................  ................
National Hansen's Disease Program.............................           16,077            16,075            16,077   ................               +2
Hansen's Disease Program Buildings and Facilities.............              129               129               129   ................  ................
Payment to Hawaii, Treatment of Hansen's......................            1,964             1,976             1,964   ................              -12
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,598,959         2,136,034         1,598,959   ................         -537,075

                 Bureau of Health Professions

National Health service Corps:................................           24,848           123,477            24,848   ................          -98,629

                      Health Professions

Health Professions, Training for Diversity:
    Centers of Excellence.....................................           24,452            24,602            24,452   ................             -150
    Health Careers Opportunity Program........................           21,998            22,133   ................          -21,998           -22,133
    Faculty Loan Repayment....................................            1,258             1,266             1,258   ................               -8
    Scholarships for Disadvantaged Students...................           49,042            52,921            49,042   ................           -3,879
        Evaluation Tap Funding................................  ................           (7,079)  ................  ................          (-7,079)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Training for Diversity........................           96,750           108,001            74,752           -21,998           -33,249

Training in Primary Care Medicine.............................           39,036            53,018            39,036   ................          -13,982
    Evaluation Tap Funding....................................  ................          (86,914)  ................  ................         (-86,914)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Training in Primary Care Medicine.............           39,036           139,932            39,036   ................         -100,896

Oral Health Training..........................................           32,781            35,419            32,781   ................           -2,638
    Evaluation Tap Funding....................................  ................          (14,509)  ................  ................         (-14,509)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Oral Health programs..........................           32,781            49,928            32,781   ................          -17,147

Interdisciplinary Community-Based Linkages:
    Area Health Education Centers.............................           33,142            33,345            33,142   ................             -203
        Evaluation Tap Funding................................  ................           (1,488)  ................  ................          (-1,488)
    Allied Health and Other Disciplines.......................            1,933   ................            1,933   ................           +1,933
    Geriatric Programs........................................           33,542            36,907            33,542   ................           -3,365
        Evaluation Tap Funding................................  ................           (6,840)  ................  ................          (-6,840)
    Mental and Behavorial Health..............................            2,927            17,945             2,927   ................          -15,018
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Interdisciplinary Community Linkages..........           71,544            96,525            71,544   ................          -24,981

Workforce Information and Analysis............................            2,815   ................            2,815   ................           +2,815
    Evaluation Tap Funding....................................  ................          (20,000)  ................  ................         (-20,000)
State Grants for Health Workforce Development.................  ................           51,000   ................  ................          -51,000
Public Health and Preventive Medicine programs................            9,609   ................            9,609   ................           +9,609
    Evaluation Tap Funding....................................  ................          (10,068)  ................  ................         (-10,068)
    Prevention and Public Health Fund\3\......................          (20,000)          (15,000)          (25,000)          (+5,000)         (+10,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................           29,609            25,068            34,609            +5,000            +9,541

Nursing Programs:
    Advanced Education Nursing................................           64,046            64,438            64,046   ................             -392
        Evaluation Tap Funding................................  ................          (40,000)  ................  ................         (-40,000)
    Nurse Education, Practice, and Retention..................           39,653            40,141            39,653   ................             -488
        Evaluation Tap Funding................................  ................          (19,632)  ................  ................         (-19,632)
    Nursing Workforce Diversity...............................           16,009            16,107            16,009   ................              -98
        Evaluation Tap Funding................................  ................           (3,893)  ................  ................          (-3,893)
    Loan Repayment and Scholarship Program....................           93,292            93,864            93,292   ................             -572
    Comprehensive Geriatric Education.........................            4,539   ................            4,539   ................           +4,539
        Evaluation Tap Funding................................  ................           (5,000)  ................  ................          (-5,000)
    Nurse Managed Health Centers..............................  ................           10,000   ................  ................          -10,000
        Evaluation Tap Funding................................  ................          (10,000)  ................  ................         (-10,000)
    Nursing Faculty Loan Program..............................           24,848   ................           24,848   ................          +24,848
        Evaluation Tap Funding................................  ................          (30,000)  ................  ................         (-30,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Nursing programs..............................          242,387           224,550           242,387   ................          +17,837
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Evaluation Tap Funding....................  ................          108,525   ................  ................         -108,525
                                                               =========================================================================================
      Subtotal, Health Professions............................          494,922           553,106           472,924           -21,998           -80,182
                                                               =========================================================================================
      Subtotal, Evaluation tap funding........................  ................          255,423   ................  ................         -255,423
      Subtotal, Prevention and Public Health Fund\3\..........          (20,000)          (15,000)          (25,000)          (+5,000)         (+10,000)
                                                               -----------------------------------------------------------------------------------------
      Total, Health Professions...............................          514,922           823,529           497,924           -16,998          -325,605

Children's Hospitals Graduate Medical Education...............          268,356   ................          268,356   ................         +268,356
Patient Navigator.............................................            4,990   ................  ................           -4,990   ................
Teaching Health Centers Planning Grants.......................  ................           10,000   ................  ................          -10,000
National Practitioner Data Bank...............................           23,508            28,016            28,016            +4,508   ................
    User Fees.................................................          -23,508           -28,016           -28,016            -4,508   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Bureau of Health Professions (BHP)............          793,116           686,583           766,128           -26,988           +79,545
      Subtotal, Evaluation tap funding........................  ................         (255,423)  ................  ................        (-255,423)
      Subtotal, Prevention and Public Health Fund\3\..........          (20,000)          (15,000)          (25,000)          (+5,000)         (+10,000)
                                                               -----------------------------------------------------------------------------------------
      Total, BHP program level................................          813,116           957,006           791,128           -21,988          -165,878

               Maternal and Child Health Bureau

Maternal and Child Health Block Grant.........................          656,319           654,489           606,319           -50,000           -48,170
Sickle Cell Anemia Demonstration Program......................            4,721             4,740             4,721   ................              -19
Traumatic Brain Injury........................................            9,878             9,918             9,878   ................              -40
Autism and Other Developmental Disorders......................           47,708            55,000            47,708   ................           -7,292
Heritable Disorders...........................................            9,952             9,992             9,952   ................              -40
Congenital Disabilities.......................................  ................              499   ................  ................             -499
Healthy Start.................................................          104,361           104,776           104,361   ................             -415
Universal Newborn Hearing.....................................           18,884            18,960            18,884   ................              -76
Emergency Medical Services for Children.......................           21,369            21,454            21,369   ................              -85
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Maternal and Child Health Bureau..............          873,192           879,828           823,192           -50,000           -56,636

                        HIV/AIDS Bureau

Ryan White AIDS Programs:
    Emergency Assistance......................................          672,529           679,074           672,529   ................           -6,545
    Comprehensive Care Programs...............................        1,308,141         1,358,791         1,323,141           +15,000           -35,650
        AIDS Drug Assistance Program (ADAP) (NA)..............         (885,000)         (940,000)         (900,000)         (+15,000)         (-40,000)
    Early Intervention Program................................          205,564           211,522           205,564   ................           -5,958
    Children, Youth, Women, and Families......................           77,313            77,787            77,313   ................             -474
    AIDS Dental Services......................................           13,511            13,594            13,511   ................              -83
    Education and Training Centers............................           34,607            34,819            34,607   ................             -212
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDS programs......................        2,311,665         2,375,587         2,326,665           +15,000           -48,922
    Evaluation Tap Funding (NA)...............................          (25,000)          (25,000)          (25,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Ryan White AIDs program level.................       (2,336,665)       (2,400,587)       (2,351,665)         (+15,000)         (-48,922)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, HIV/AIDS Bureau...............................        2,311,665         2,375,587         2,326,665           +15,000           -48,922

                   Healthcare Systems Bureau

Organ Transplantation.........................................           24,896            25,991            24,896   ................           -1,095
National Cord Blood Inventory.................................           11,910            13,883            11,910   ................           -1,973
Bone Marrow Program...........................................           23,374            26,544            23,374   ................           -3,170
Office of Pharmacy Affairs....................................            4,480             5,220             4,480   ................             -740
340B Drug Pricing User Fees...................................  ................            5,000             5,000            +5,000   ................
    User Fees.................................................  ................           -5,000            -5,000            -5,000   ................
Poison Control................................................           21,866            29,250            21,866   ................           -7,384
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Healthcare systems bureau.....................           86,526           100,888            86,526   ................          -14,362

                     Rural Health Programs

Rural Outreach Grants.........................................           55,658            57,266            55,658   ................           -1,608
Rural Health Research/Policy Development......................            9,885             9,929             9,885   ................              -44
Rural Hospital Flexibility Grants.............................           41,118            26,200            41,118   ................          +14,918
Rural Access to Emergency Devices.............................              236   ................            2,500            +2,264            +2,500
State Offices of Rural Health.................................           10,055            10,075            10,055   ................              -20
Black Lung Clinics............................................            7,153             7,185             7,153   ................              -32
Radiation Exposure Screening and Education Program............            1,939             1,948             1,939   ................               -9
Telehealth....................................................           11,524            11,575            13,524            +2,000            +1,949
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Rural health programs.........................          137,568           124,178           141,832            +4,264           +17,654

Healthy Weight Collaborative Prevention and Public Health       ................           (5,000)  ................  ................          (-5,000)
 Fund\3\......................................................
Family Planning...............................................          299,400           327,356           299,400   ................          -27,956
Program Management............................................          161,815           170,808           161,815   ................           -8,993
      Total, Health resources & services program level........       (6,307,241)       (7,101,685)       (6,254,517)         (-52,724)        (-847,168)

       HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT

HEAL Liquidating Account......................................           (1,000)  ................           (1,000)  ................          (+1,000)
HEAL Program Management.......................................            2,841   ................            2,841   ................           +2,841
                                                               -----------------------------------------------------------------------------------------
      Total, HEAL.............................................            2,841   ................            2,841   ................           +2,841

        VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Post-FY 1988 Claims...........................................          220,000           235,000           235,000           +15,000   ................
HRSA Administration...........................................            6,489             6,502             6,489   ................              -13
                                                               -----------------------------------------------------------------------------------------
      Total, Vaccine Injury Compensation Trust Fund...........          226,489           241,502           241,489           +15,000               -13
                                                               =========================================================================================
      Total, Health Resources & Services Administration.......        6,491,571         7,042,764         6,448,847           -42,724          -593,917
          Total, Evaluation tap funding.......................          (25,000)         (280,423)          (25,000)  ................        (-255,423)
          Total, Prevention and Public Health Fund\3\.........          (20,000)          (20,000)          (25,000)          (+5,000)          (+5,000)
      Total, HRSA program level...............................       (6,537,571)       (7,343,187)       (6,499,847)         (-37,724)        (-843,340)

          CENTERS FOR DISEASE CONTROL AND PREVENTION

            DISEASE CONTROL, RESEARCH, AND TRAINING

Immunization and Respiratory Diseases.........................          479,049           647,200           635,393          +156,344           -11,807
    Evaluation Tap Funding....................................          (12,864)          (12,864)          (12,864)  ................  ................
    Pandemic Flu balances (Public Law 111-32).................         (156,344)  ................  ................        (-156,344)  ................
    Prevention and Public Health Fund\3\......................         (100,000)          (61,599)         (150,000)         (+50,000)         (+88,401)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................         (748,257)         (721,663)         (798,257)         (+50,000)         (+76,594)

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.............        1,115,995         1,157,133         1,115,995   ................          -41,138
    Prevention and Public Health Fund\3\......................  ................          (30,400)          (10,000)         (+10,000)         (-20,400)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,115,995         1,187,533         1,125,995           +10,000           -61,538

Emerging and Zoonotic Infectious Diseases.....................          252,443           289,118           252,443   ................          -36,675
    Prevention and Public Health Fund\3\......................          (51,750)          (60,000)          (51,750)  ................          (-8,250)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Emerging and Zoonotic Infectious..............          304,193           349,118           304,193   ................          -44,925

Chronic Disease Prevention and Health Promotion...............          773,987           725,207           777,987            +4,000           +52,780
    Prevention and Public Health Fund\3\......................         (300,950)         (460,301)         (487,050)        (+186,100)         (+26,749)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,074,937         1,185,508         1,265,037          +190,100           +79,529

Birth Defects and Developmental Disabilities..................          136,072           143,899           138,072            +2,000            -5,827
Public Health Scientific Services.............................          147,795           205,942           147,795   ................          -58,147
    Evaluation Tap Funding....................................         (247,769)         (217,674)         (247,769)  ................         (+30,095)
    Prevention and Public Health Fund\3\......................          (72,000)          (70,000)          (70,000)          (-2,000)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Health Statistics/Public Health Scientific             (467,564)         (493,616)         (465,564)          (-2,000)         (-28,052)
       Services, Program Level................................

Environmental Health..........................................          134,855           128,715           105,855           -29,000           -22,860
    Prevention and Public Health Fund\3\......................          (35,000)           (9,000)          (35,000)  ................         (+26,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          169,855           137,715           140,855           -29,000            +3,140

Injury Prevention and Control.................................          143,714           147,501           129,714           -14,000           -17,787
    Prevention and Public Health Fund\3\......................  ................          (20,000)           (3,000)          (+3,000)         (-17,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          143,714           167,501           132,714           -11,000           -34,787

National Institute for Occupational Safety & Health\4\........          224,355   ................          188,355           -36,000          +188,355
    Evaluation Tap Funding....................................          (91,724)         (259,934)         (106,724)         (+15,000)        (-153,210)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Occupational Safety & Health Program\4\.......         (316,079)         (259,934)         (295,079)         (-21,000)         (+35,145)

Energy Employees Occupational Illness Compensation Program....           55,358            55,358            55,358   ................  ................
Global Health.................................................          340,265           381,245           350,265           +10,000           -30,980
Public Health Preparedness and Response.......................        1,336,901         1,422,618         1,375,416           +38,515           -47,202
Prevention and Public Health fund\3\..........................          (10,000)  ................  ................         (-10,000)  ................
    Pandemic Flu balances (Public Law 111-32).................          (68,515)          (30,000)          (30,000)         (-38,515)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................        1,415,416         1,452,618         1,405,416           -10,000           -47,202

Public Health Leadership and Support..........................          121,419           121,368           121,419   ................              +51
    Prevention and Public Health Fund\3\......................          (41,200)          (41,200)          (41,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          162,619           162,568           162,619   ................              +51

Preventive Health and Health Services Block Grant.............           80,094   ................  ................          -80,094   ................
Business Services.............................................          362,026           447,466           427,026           +65,000           -20,440
      Total, Centers for Disease Control......................        5,704,328         5,872,770         5,821,093          +116,765           -51,677
          Discretionary.......................................        5,648,970         5,817,412         5,765,735          +116,765           -51,677
          Evaluation Tap Funding (NA).........................         (352,357)         (490,472)         (367,357)         (+15,000)        (-123,115)
          Pandemic Flu balances (Public Law 111-32)...........         (224,859)          (30,000)          (30,000)        (-194,859)  ................
          Prevention and Public Health Fund\3\................         (610,900)         (752,500)         (848,000)        (+237,100)         (+95,500)
                                                               =========================================================================================
      Total, Centers for Disease Control Program Level........       (6,892,444)       (7,145,742)       (7,066,450)        (+174,006)         (-79,292)

                 NATIONAL INSTITUTES OF HEALTH

National Cancer Institute.....................................        5,058,577         5,196,136         5,001,623           -56,954          -194,513
National Heart, Lung, and Blood Institute.....................        3,069,723         3,147,992         3,036,189           -33,534          -111,803
National Institute of Dental & Craniofacial Research..........          409,608           420,369           404,997            -4,611           -15,372
National Institute of Diabetes and Digestive and Kidney               1,792,224         1,837,957         1,772,045           -20,179           -65,912
 Diseases (NIDDK).............................................
    Juvenile Diabetes (mandatory).............................         (150,000)         (150,000)         (150,000)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NIDDK program level...........................        1,942,224         1,987,957         1,922,045           -20,179           -65,912

National Institute of Neurological Disorders & Stroke.........        1,622,003         1,664,253         1,603,741           -18,262           -60,512
National Institute of Allergy and Infectious Diseases.........        4,478,668         4,615,970         4,426,288           -52,380          -189,682
    Global HIV/AIDS Fund Transfer.............................          297,300           300,000           299,000            +1,700            -1,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, NIAID program level...........................        4,775,968         4,915,970         4,725,288           -50,680          -190,682

National Institute of General Medical Sciences................        2,033,782         2,102,300         2,347,309          +313,527          +245,009
National Institute of Child Health & Human Development........        1,317,854         1,352,189         1,303,016           -14,838           -49,173
National Eye Institute........................................          700,828           719,059           692,938            -7,890           -26,121
National Institute of Environmental Health Sciences...........          683,724           700,537           676,033            -7,691           -24,504
National Institute on Aging...................................        1,100,481         1,129,987         1,088,091           -12,390           -41,896
National Institute of Arthritis and Musculoskeletal and Skin            534,349           547,891           528,332            -6,017           -19,559
 Diseases.....................................................
National Institute on Deafness and Other Communication                  415,155           426,043           410,482            -4,673           -15,561
 Disorders....................................................
National Institute of Nursing Research........................          144,381           148,114           142,755            -1,626            -5,359
National Institute on Alcohol Abuse and Alcoholism............          458,286           469,197           453,127            -5,159           -16,070
National Institute on Drug Abuse..............................        1,050,542         1,080,018         1,038,714           -11,828           -41,304
National Institute of Mental Health...........................        1,477,292         1,517,006         1,460,671           -16,621           -56,335
National Human Genome Research Institute......................          511,497           524,807           505,738            -5,759           -19,069
National Institute of Biomedical Imaging and Bioengineering...          313,802           322,106           333,671           +19,869           +11,565
National Center for Research Resources........................        1,257,754         1,297,900   ................       -1,257,754        -1,297,900
National Center for Complementary and Alternative Medicine....          127,713           131,002           126,275            -1,438            -4,727
National Institute on Minority Health and Health Disparities..          209,713           214,608           272,650           +62,937           +58,042
John E. Fogarty International Center..........................           69,436            71,328            68,653              -783            -2,675
National Center for Advancing Translation Sciences............  ................  ................          582,326          +582,326          +582,326
National Library of Medicine (NLM)............................          336,733           387,153           358,979           +22,246           -28,174
    Evaluation Tap Funding....................................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          344,933           395,353           367,179           +22,246           -28,174
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          344,933           395,353           367,179           +22,246           -28,174

Office of the Director........................................        1,166,963         1,298,412         1,439,064          +272,101          +140,652
    Common fund...............................................         (543,021)         (556,890)         (537,811)          (-5,210)         (-19,079)
Buildings and Facilities......................................           49,900           125,581           125,581           +75,681   ................
                                                               =========================================================================================
      Total, National Institutes of Health (NIH)..............       30,688,288        31,747,915        30,498,288          -190,000        -1,249,627
          Global HIV/AIDS Fund Transfer out...................         -297,300          -300,000          -299,000            -1,700            +1,000
          Evaluation Tap Funding..............................           (8,200)           (8,200)           (8,200)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, NIH Program Level................................      (30,399,188)      (31,456,115)      (30,207,488)        (-191,700)      (-1,248,627)

   SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
                           (SAMHSA)

          SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Mental Health:
    Programs of Regional and National Significance............          338,276           273,342           331,680            -6,596           +58,338
    Prevention and Public Health Fund\3\......................          (45,000)          (20,000)          (45,000)  ................         (+25,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          383,276           293,342           376,680            -6,596           +83,338

    Mental Health block grant.................................          398,936           413,645           398,936   ................          -14,709
        Evaluation Tap Funding................................          (20,997)          (21,039)          (20,997)  ................             (-42)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................         (419,933)         (434,684)         (419,933)  ................         (-14,751)

    Children's Mental Health..................................          117,803           121,316           117,803   ................           -3,513
    Grants to States for the Homeless (PATH)..................           64,917            65,047            64,917   ................             -130
    Protection and Advocacy...................................           36,307            36,380            36,307   ................              -73
    State prevention grants...................................  ................           90,000   ................  ................          -90,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental Health.................................          956,239           999,730           949,643            -6,596           -50,087
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Mental health program level...................       (1,022,236)       (1,040,769)       (1,015,640)          (-6,596)         (-25,129)

Substance Abuse Treatment:
    Programs of Regional and National Significance............          404,480           401,822           409,575            +5,095            +7,753
        Evaluation Tap Funding................................           (2,000)           (2,000)           (2,000)  ................  ................
    Prevention and Public Health Fund\3\......................          (25,000)  ................          (25,000)  ................         (+25,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program level.................................         (431,480)         (403,822)         (436,575)          (+5,095)         (+32,753)

    Substance Abuse block grant...............................        1,703,452         1,419,603         1,703,452   ................         +283,849
        Evaluation Tap Funding................................          (79,200)          (74,711)          (79,200)  ................          (+4,489)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................       (1,782,652)       (1,494,314)       (1,782,652)  ................        (+288,338)
                                                               -----------------------------------------------------------------------------------------
    Substance abuse prevention grants.........................  ................          395,000   ................  ................         -395,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Substance Abuse Treatment.....................        2,107,932         2,216,425         2,113,027            +5,095          -103,398
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................       (2,214,132)       (2,293,136)       (2,219,227)          (+5,095)         (-73,909)

Substance Abuse Prevention:
    Programs of Regional and National Significance............          186,061            74,582           186,361              +300          +111,779
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          186,061            74,582           186,361              +300          +111,779

Health Surveillance and Program Support:
    Health Surveillance.......................................            2,000             2,000             2,000   ................  ................
        Evaluation Tap Funding (NA)...........................          (22,750)          (45,428)          (27,428)          (+4,678)         (-18,000)
        Prevention and Public Health Fund\3\..................          (18,000)  ................          (18,000)  ................         (+18,000)
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Program level.............................           42,750            47,428            47,428            +4,678   ................

Program Management............................................           77,039            80,166            77,039   ................           -3,127
Health IT.....................................................            5,250             4,000   ................           -5,250            -4,000
Military Families.............................................  ................           10,000   ................  ................          -10,000
Performance and Quality Information Systems...................           30,987   ................           12,996           -17,991           +12,996
    Evaluation Tap Funding (NA)...............................           (6,596)          (12,996)  ................          (-6,596)         (-12,996)
Public Awareness and Support..................................           14,030   ................           13,571              -459           +13,571
    Evaluation Tap Funding (NA)...............................  ................          (13,571)  ................  ................         (-13,571)
Prevention Prepared Communities--PPHF\3\......................  ................          (22,600)  ................  ................         (-22,600)
Tribal Prevention Grants--PPHF\3\.............................  ................          (50,000)  ................  ................         (-50,000)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program level.................................           56,863           113,167            26,567           -30,296           -86,600
                                                               =========================================================================================
      Total, SAMHSA...........................................        3,379,538         3,386,903         3,354,637           -24,901           -32,266
          Evaluation Tap Funding..............................         (131,543)         (169,745)         (129,625)          (-1,918)         (-40,120)
          (Prevention and Public Health Fund)\3\..............           88,000            92,600            88,000   ................           -4,600
                                                               -----------------------------------------------------------------------------------------
      Total, SAMHSA Program Level.............................       (3,599,081)       (3,649,248)       (3,572,262)         (-26,819)         (-76,986)

       AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)

                HEALTHCARE RESEARCH AND QUALITY

Research on Health Costs, Quality, and Outcomes:
    Evaluation Tap Funding (NA)...............................         (245,653)         (232,612)         (238,768)          (-6,885)          (+6,156)
    Prevention and Public Health Fund\3\......................          (12,000)  ................          (12,000)  ................         (+12,000)
Medical Expenditures Panel Surveys:
    Evaluation Tap Funding (NA)...............................          (58,800)          (59,300)          (59,300)            (+500)  ................
Program Support:
    Evaluation Tap Funding (NA)...............................          (67,600)          (74,485)          (73,985)          (+6,385)            (-500)
                                                               -----------------------------------------------------------------------------------------
      Total, AHRQ Program Level...............................         (372,053)         (366,397)         (372,053)  ................          (+5,656)
                                                               =========================================================================================
      Total, Public Health Service (PHS) appropriation........       46,982,625        48,915,452        47,083,865          +101,240        -1,831,587
      Total, Public Health Service Program Level..............      (48,097,637)      (50,260,689)      (48,017,100)         (-80,537)      (-2,243,589)

          CENTERS FOR MEDICARE AND MEDICAID SERVICES

                 GRANTS TO STATES FOR MEDICAID

Medicaid Current Law Benefits.................................      242,714,348       253,884,907       253,884,907       +11,170,559   ................
State and Local Administration................................       13,567,479        12,808,496        12,808,496          -758,983   ................
Vaccines for Children.........................................        3,651,354         4,030,996         4,030,996          +379,642   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Medicaid Program Level........................      259,933,181       270,724,399       270,724,399       +10,791,218   ................
          Less funds advanced in prior year...................      -86,789,382       -86,445,289       -86,445,289          +344,093   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Grants to States for Medicaid....................      173,143,799       184,279,110       184,279,110       +11,135,311   ................
          New advance, 1st quarter............................       86,445,289        90,614,082        90,614,082        +4,168,793   ................

              PAYMENTS TO HEALTH CARE TRUST FUNDS

Supplemental Medical Insurance................................      172,697,622       178,041,000       178,041,000        +5,343,378   ................
Federal Uninsured Payment.....................................          275,000           262,000           262,000           -13,000   ................
Program Management............................................          229,000           222,000           222,000            -7,000   ................
General Revenue for Part D Benefit............................       55,548,000        51,431,000        51,431,000        -4,117,000   ................
General Revenue for Part D Administration.....................          404,000           475,000           475,000           +71,000   ................
HCFAC Reimbursement...........................................          310,378           580,580           581,000          +270,622              +420
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to Trust Funds, Program Level...........      229,464,000       231,011,580       231,012,000        +1,548,000              +420

                      PROGRAM MANAGEMENT

Research, Demonstration, Evaluation...........................           35,529            31,200            31,200            -4,329   ................
Program operations............................................        2,397,655         3,062,025         2,813,935          +416,280          -248,090
State Survey and Certification................................          361,276           400,283           361,276   ................          -39,007
High Risk Insurance Pools.....................................           54,890            44,000            44,000           -10,890   ................
Federal Administration........................................          737,505           859,465           794,465           +56,960           -65,000
                                                               =========================================================================================
      Total, Program management, Limitation on new BA.........        3,586,855         4,396,973         4,044,876          +458,021          -352,097

              HEALTH CARE FRAUD AND ABUSE CONTROL

Part D Drug Benefit/Medicare Advantage (MIP)..................          219,879           345,295           345,715          +125,836              +420
HHS Office of Inspector General...............................           29,730            97,556            97,556           +67,826   ................
Department of Justice.........................................           29,730            93,085            93,085           +63,355   ................
Medicaid/SCHIP................................................           31,038            44,644            44,644           +13,606   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Health Care Fraud and Abuse Control..............          310,377           580,580           581,000          +270,623              +420
                                                               =========================================================================================
      Total, Centers for Medicare and Medicaid Services.......      492,950,320       510,882,325       510,531,068       +17,580,748          -351,257
          Federal funds.......................................      489,053,088       505,904,772       505,905,192       +16,852,104              +420
              Current year....................................     (402,607,799)     (415,290,690)     (415,291,110)     (+12,683,311)            (+420)
              New advance, FY 2013............................      (86,445,289)      (90,614,082)      (90,614,082)      (+4,168,793)  ................
          Trust Funds.........................................        3,897,232         4,977,553         4,625,876          +728,644          -351,677

           ADMINISTRATION FOR CHILDREN AND FAMILIES

  PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY
                       SUPPORT PROGRAMS

Payments to Territories.......................................           33,000            33,000            33,000   ................  ................
Repatriation..................................................            1,000             1,000             1,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Welfare payments..............................           34,000            34,000            34,000   ................  ................

Child Support Enforcement:
    State and Local Administration............................        3,507,323         2,942,035         2,942,035          -565,288   ................
    Federal Incentive Payments................................          513,000           519,000           519,000            +6,000   ................
    Access and Visitation.....................................           10,000            10,000            10,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Child Support Enforcement.....................        4,030,323         3,471,035         3,471,035          -559,288   ................
                                                               =========================================================================================
      Total, Family Support Payments Program Level............        4,064,323         3,505,035         3,505,035          -559,288   ................

          Less funds advanced in previous years...............       -1,100,000        -1,200,000        -1,200,000          -100,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Family Support Payments, current year............        2,964,323         2,305,035         2,305,035          -659,288   ................
          New advance, 1st quarter, FY 2013...................        1,200,000         1,100,000         1,100,000          -100,000   ................

          LOW-INCOME HOME ENERGY ASSISTANCE (LIHEAP)

Formula Grants................................................        4,500,653         1,980,000         3,400,653        -1,100,000        +1,420,653
Contingency Fund..............................................          199,927           589,551           199,927   ................         -389,624
                                                               -----------------------------------------------------------------------------------------
      Total, LIHEAP, Program Level............................        4,700,580         2,569,551         3,600,580        -1,100,000        +1,031,029

                REFUGEE AND ENTRANT ASSISTANCE

Transitional and Medical Services.............................          352,625           394,224           386,625           +34,000            -7,599
Victims of Trafficking........................................            9,794             9,814             9,794   ................              -20
Social Services...............................................          153,697           179,005           153,697   ................          -25,308
Preventive Health.............................................            4,739             4,748             4,739   ................               -9
Targeted Assistance...........................................           48,493            48,590            48,493   ................              -97
Unaccompanied Minors..........................................          149,052           177,225           173,225           +24,173            -4,000
Victims of Torture............................................           11,066            11,088            11,066   ................              -22
                                                               -----------------------------------------------------------------------------------------
      Total, Refugee and Entrant Assistance...................          729,466           824,694           787,639           +58,173           -37,055

  PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK
                             GRANT

Child Care and Development Block Grant........................        2,222,627         2,926,757         2,222,627   ................         -704,130

SOCIAL SERVICES BLOCK GRANT (TITLE XX)........................        1,700,000         1,700,000         1,700,000   ................  ................

            CHILDREN AND FAMILIES SERVICES PROGRAMS

Programs for Children, Youth and Families:
    Head Start, current funded................................        7,559,633         8,099,783         7,899,633          +340,000          -200,150
    Consolidated Runaway, Homeless Youth Program..............           97,539           102,734            97,539   ................           -5,195
    Prevention Grants to Reduce Abuse of Runaway Youth........           17,935            17,971            17,935   ................              -36
    Child Abuse State Grants..................................           26,482            26,535            26,482   ................              -53
    Child Abuse Discretionary Activities......................           25,793            29,020            25,793   ................           -3,227
    Community Based Child Abuse Prevention....................           41,606            41,689            41,606   ................              -83
    Abandoned Infants Assistance..............................           11,605            11,575            11,575               -30   ................
    Child Welfare Services....................................          281,181           281,744           281,181   ................             -563
    Child Welfare Training/Innovative Approaches to Foster               27,153            27,207            27,153   ................              -54
     Care.....................................................
    Adoption Opportunities....................................           39,253            39,332            39,253   ................              -79
    Adoption Incentive........................................           39,421            49,875            39,421   ................          -10,454
Strengthening Communities Fund................................  ................           20,000   ................  ................          -20,000
Social Services and Income Maintenance Research...............  ................            3,000   ................  ................           -3,000
    Evaluation Tap Funding....................................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program Level.................................           (5,762)           (8,762)           (5,762)  ................          (-3,000)

Developmental Disabilities Programs:
    State Councils............................................           74,916            75,066            74,916   ................             -150
    Protection and Advocacy...................................           40,942            41,024            40,942   ................              -82
    Voting Access for Individuals with Disabilities...........           17,375   ................            5,245           -12,130            +5,245
    Developmental Disabilities Projects of National                      14,134             8,333             8,333            -5,801   ................
     Significance.............................................
    University Centers for Excellence in Developmental                   38,865            38,943            38,865   ................              -78
     Disabilities.............................................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Developmental Disabilities Programs...........          186,232           163,366           168,301           -17,931            +4,935

Native American Programs......................................           48,675            48,773            48,675   ................              -98
Community Services:
    Community Services Block Grant Act programs:
        Grants to States for Community Services...............          678,640           350,000           678,640   ................         +328,640
        Economic Development..................................           17,964            20,000            21,964            +4,000            +1,964
        Rural Community Facilities............................            4,990   ................            6,990            +2,000            +6,990
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          701,594           370,000           707,594            +6,000          +337,594

        Job Opportunities for Low-Income Individuals..........            1,641   ................  ................           -1,641   ................
        Individual Development Account Initiative.............           23,977            23,907            23,907               -70   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Community Services............................          727,212           393,907           731,501            +4,289          +337,594

Domestic Violence Hotline.....................................            3,203             4,500             3,203   ................           -1,297
Family Violence/Battered Women's Shelters.....................          129,792           135,052           129,792   ................           -5,260
Mentoring Children of Prisoners...............................  ................           25,000   ................  ................          -25,000
Independent Living Training Vouchers..........................           45,260            45,351            45,260   ................              -91
Faith-Based Center............................................            1,373             1,376             1,373   ................               -3
Disaster Human Services Case Management.......................            1,996             2,000             1,996   ................               -4
Program Direction.............................................          208,013           224,808           208,013   ................          -16,795
                                                               =========================================================================================
      Total, Children and Families Services Programs..........        9,519,357         9,794,598         9,845,685          +326,328           +51,087
          Current Year........................................       (9,519,357)       (9,794,598)       (9,845,685)        (+326,328)         (+51,087)
          Evaluation Tap Funding..............................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Program Level....................................       (9,525,119)       (9,800,360)       (9,851,447)        (+326,328)         (+51,087)

PROMOTING SAFE AND STABLE FAMILIES............................          365,000           365,000           365,000   ................  ................
    Discretionary Funds.......................................           63,184            63,311            63,184   ................             -127

            PAYMENTS FOR FOSTER CARE AND PERMANENCY
Foster Care...................................................        3,967,000         4,288,000         4,288,000          +321,000   ................
Adoption Assistance...........................................        2,480,000         2,495,000         2,495,000           +15,000   ................
Kinship Guardianship..........................................           32,000            80,000            80,000           +48,000   ................
Independent Living............................................          140,000           140,000           140,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Payments to States...............................        6,619,000         7,003,000         7,003,000          +384,000   ................
          Less Advances from Prior Year.......................       -1,850,000        -1,850,000        -1,850,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
              Total, payments, current year...................        4,769,000         5,153,000         5,153,000          +384,000   ................
              New Advance, 1st quarter........................        1,850,000         2,100,000         2,100,000          +250,000   ................
                                                               =========================================================================================
          Total, Administration for Children & Families.......       30,083,537        28,901,946        29,242,750          -840,787          +340,804
              Current year....................................      (27,033,537)      (25,701,946)      (26,042,750)        (-990,787)        (+340,804)
              FY 2013.........................................       (3,050,000)       (3,200,000)       (3,200,000)        (+150,000)  ................
              Evaluation Tap Funding..........................           (5,762)           (5,762)           (5,762)  ................  ................
                                                               -----------------------------------------------------------------------------------------
          Total, ACF Program Level............................       30,089,299        28,907,708        29,248,512          -840,787          +340,804

                    ADMINISTRATION ON AGING

                    AGING SERVICES PROGRAMS

Grants to States:.............................................
    Home and Community-based Supportive Services..............          367,611           416,476           367,611   ................          -48,865
    Preventive Health.........................................           20,984            21,026            20,984   ................              -42
    Protection of Vulnerable Older Americans-Title VII........           21,839            26,880            21,839   ................           -5,041
    Family Caregivers.........................................          153,912           192,220           153,912   ................          -38,308
    Native American Caregivers Support........................            6,376             8,388             6,376   ................           -2,012
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Caregivers....................................          160,288           200,608           160,288   ................          -40,320

    Nutrition:
        Congregate Meals......................................          439,901           440,718           439,901   ................             -817
        Home Delivered Meals..................................          217,241           217,644           217,241   ................             -403
        Nutrition Services Incentive Program..................          160,693           160,991           160,693   ................             -298
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................          817,835           819,353           817,835   ................           -1,518

Grants for Native Americans...................................           27,653            27,704            27,653   ................              -51
Program Innovations...........................................           13,023            18,705            12,728              -295            -5,977
Aging Network Support Activities..............................           34,214            17,727            24,143           -10,071            +6,416
Alzheimer's Disease Demonstrations............................           11,441            11,462             4,018            -7,423            -7,444
Lifespan Respite Care.........................................            2,495            10,000             2,495   ................           -7,505
Chronic Disease Self-Management Program.......................  ................           10,000   ................  ................          -10,000
    Prevention and Public Health Fund\3\......................  ................  ................          (10,000)         (+10,000)         (+10,000)
Elder Falls Prevention--PHHF\3\...............................  ................  ................           (7,000)          (+7,000)          (+7,000)
Adult Protective Services Demonstration.......................  ................           16,500   ................  ................          -16,500
State Health Insurance Program................................           52,000            46,960            52,000   ................           +5,040
Community Living Assistance Services and Supports.............  ................          120,000   ................  ................         -120,000
Program Administration--Aging services........................           19,939            24,543            23,107            +3,168            -1,436
                                                               -----------------------------------------------------------------------------------------
      Total, Administration on Aging..........................        1,549,322         1,787,944         1,534,701           -14,621          -253,243
          Federal Funds.......................................       (1,497,322)       (1,740,984)       (1,482,701)         (-14,621)        (-258,283)
          Trust Funds.........................................           52,000            46,960            52,000   ................           +5,040

                    OFFICE OF THE SECRETARY

                GENERAL DEPARTMENTAL MANAGEMENT

General Departmental Management:
    Federal Funds.............................................          203,163           255,905           228,014           +24,851           -27,891
    Prevention and Public Health Fund\3\......................          (19,100)          (24,900)          (10,000)          (-9,100)         (-14,900)
    Trust Funds...............................................            5,851   ................  ................           -5,851   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          228,114           280,805           238,014            +9,900           -42,791

Teen Pregnancy Prevention Community Grants....................          104,790   ................          104,790   ................         +104,790
    Prevention and Public Health Fund\3\......................  ................         (110,000)  ................  ................        (-110,000)
Teen Pregnancy Prevention approaches Evaluation Tap Funding...           (4,455)           (8,455)           (8,455)          (+4,000)  ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Pregnancy Grants..............................         (109,245)         (118,455)         (113,245)          (+4,000)          (-5,210)

Adolescent Family Life (Title XX).............................           12,474   ................  ................          -12,474   ................
Minority Health...............................................           55,888            57,980            55,888   ................           -2,092
Office of Women's Health......................................           33,746            33,746            33,746   ................  ................
Minority HIV/AIDS.............................................           53,783   ................           53,783   ................          +53,783
    Evaluation Tap Funding....................................  ................          (53,891)  ................  ................         (-53,891)
Transformation of the Commissioned Corps......................            8,071             7,013   ................           -8,071            -7,013
Embryo Adoption Awareness Campaign............................            2,004             2,000   ................           -2,004            -2,000
Acquisition reform............................................  ................            7,000   ................  ................           -7,000
Planning and Evaluation, Evaluation Tap Funding...............          (60,756)          (64,356)          (64,356)          (+3,600)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, General Departmental Management..................          479,770           363,644           476,221            -3,549          +112,577
          Federal Funds.......................................         (473,919)         (363,644)         (476,221)          (+2,302)        (+112,577)
          Trust Funds.........................................            5,851   ................  ................           -5,851   ................
          Prevention and Public Health Fund\3\................          (19,100)         (134,900)          (10,000)          (-9,100)        (-124,900)
          Evaluation Tap Funding (NA).........................          (65,211)         (126,702)          (72,811)          (+7,600)         (-53,891)

      Total, General Departmental Management Program..........          564,081           625,246           559,032            -5,049           -66,214

OFFICE OF MEDICARE HEARINGS AND APPEALS.......................           71,147            81,019            71,147   ................           -9,872

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION                42,246            57,013            42,246   ................          -14,767
 TECHNOLOGY...................................................
    Evaluation Tap Funding....................................          (19,011)          (21,400)          (19,011)  ................          (-2,389)
                                                               -----------------------------------------------------------------------------------------
        Total, Program Level..................................          (61,257)          (78,413)          (61,257)  ................         (-17,156)

                  OFFICE OF INSPECTOR GENERAL
Inspector General Federal Funds...............................           50,178            53,329            50,178   ................           -3,151
    Evaluation tap funding....................................  ................          (10,000)  ................  ................         (-10,000)
    HIPAA/HCFAC funding (NA)..................................         (197,998)         (193,387)         (193,387)          (-4,611)  ................
                                                               -----------------------------------------------------------------------------------------
      Total, Inspector General Program Level..................         (248,176)         (256,716)         (243,565)          (-4,611)         (-13,151)

OFFICE FOR CIVIL RIGHTS:
    Federal Funds.............................................           37,709            46,717            41,016            +3,307            -5,701
    Trust Funds...............................................            3,307   ................  ................           -3,307   ................
                                                               -----------------------------------------------------------------------------------------
      Total, Office for Civil Rights..........................           41,016            46,717            41,016   ................           -5,701

 RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

Retirement Payments...........................................          386,041           418,082           418,082           +32,041   ................
Survivors Benefits............................................           27,888            31,625            31,625            +3,737   ................
Dependents' Medical Care......................................          103,608           114,798           114,798           +11,190   ................
                                                               -----------------------------------------------------------------------------------------
      Total,Medical Benefits for Commissioned Officers........          517,537           564,505           564,505           +46,968   ................

       PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

       Assistant Secretary for Preparedness and Response

Operations....................................................           12,548            38,624            33,053           +20,505            -5,571
Preparedness and Emergency Operations.........................           32,999            34,647            34,647            +1,648   ................
National Disaster Medical System..............................           55,925            52,850            52,850            -3,075   ................
Hospital Preparedness Cooperative Agreement Grants............          377,997           375,466           375,466            -2,531   ................
Emergency Systems for Advanced Registration of Volunteer                  5,861             5,000             5,000              -861   ................
 Health Professionals (ESAR-VHP)..............................
Bioterrorism Advanced Research and Development Authority......          415,000           665,000           415,000   ................         -250,000
Medical Countermeasure Strategic Investor.....................  ................          100,000   ................  ................         -100,000
Medical Countermeasure Dispensing.............................  ................            5,000   ................  ................           -5,000
Global Medicine, Science, and Public Health...................            8,731   ................  ................           -8,731   ................
Policy, Strategic Planning, and Communications................            4,358            15,708            15,708           +11,350   ................
ASPR Co-located Office Facility...............................  ................           10,000   ................  ................          -10,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, AS for Preparedness and Response..............          913,419         1,302,295           931,724           +18,305          -370,571

            Assistant Secretary for Administration

Assistant Secretary for Administration, Cybersecurity.........           56,680            40,000            40,000           -16,680   ................

                   Public Health and Science

Medical Reserve Corps.........................................           11,925            11,268            11,268              -657   ................

                    Office of the Secretary

Parklawn Lease Expiration.....................................           34,930   ................  ................          -34,930   ................
Office of Security and Strategic Information..................            7,428             6,460             6,460              -968   ................
Pandemic Influenza Preparedness:
    Pandemic Flu balances (Public Law 111-32).................  ................          (47,000)  ................  ................         (-47,000)
    Fiscal year 2011..........................................           65,447   ................  ................          -65,447   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Office of the Secretary.......................          107,805             6,460             6,460          -101,345   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Non-pandemic flu/BARDA/BioShield/Parklawn.....          574,452           595,023           574,452   ................          -20,571
                                                               =========================================================================================
      Total, PHSSEF...........................................        1,089,829         1,360,023           989,452          -100,377          -370,571
                                                               =========================================================================================
      Total, Office of the Secretary..........................        2,291,723         2,526,250         2,234,765           -56,958          -291,485
          Federal Funds.......................................        2,211,418         2,445,231         2,163,618           -47,800          -281,613
          Trust Funds.........................................           80,305            81,019            71,147            -9,158            -9,872
          Evaluation Tap Funding (NA).........................          (84,222)         (158,102)          (91,822)          (+7,600)         (-66,280)

      Total, Office of the Secretary Program Level............        2,395,045         2,819,252         2,336,587           -58,458          -482,665
                                                               =========================================================================================
      Total, Title II, Dept of Health & Human Services........      573,138,627       592,148,817       589,666,149       +16,527,522        -2,482,668
          Federal Funds.......................................      569,109,090       587,043,285       584,917,126       +15,808,036        -2,126,159
              Current year....................................     (479,613,801)     (493,229,203)     (491,103,044)     (+11,489,243)      (-2,126,159)
              FY 2013.........................................      (89,495,289)      (93,814,082)      (93,814,082)      (+4,318,793)  ................
          Trust Funds.........................................        4,029,537         5,105,532         4,749,023          +719,486          -356,509
          1Pandemic Flu balances (Public Law 111-32)..........         (224,859)          (30,000)          (30,000)        (-194,859)  ................
          Prevention and Public Health Fund\3\................         (738,000)       (1,000,000)         (988,000)        (+250,000)         (-12,000)
                                                               =========================================================================================

              TITLE III--DEPARTMENT OF EDUCATION

                EDUCATION FOR THE DISADVANTAGED

Grants to Local Educational Agencies (LEAs)
    Basic Grants:
        Advance from prior year...............................       (3,448,145)       (2,962,510)       (2,962,510)        (-485,635)  ................
        Forward funded........................................        3,618,248         2,806,504         3,618,248   ................         +811,744
        Current funded........................................            3,992             4,000             3,992   ................               -8
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Basic grants current year approp..........        3,622,240         2,810,504         3,622,240   ................         +811,736
          Subtotal, Basic grants total funds available........       (7,070,385)       (5,773,014)       (6,584,750)        (-485,635)        (+811,736)

    Basic Grants FY 2013 Advance..............................        2,962,510         3,787,442         2,962,510   ................         -824,932
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Basic grants, program level...................        6,584,750         6,597,946         6,584,750   ................          -13,196

    Concentration Grants:
        Advance from prior year...............................       (1,365,031)       (1,362,301)       (1,362,301)          (-2,730)  ................
        FY 2013 Advance.......................................        1,362,301         1,365,031         1,362,301   ................           -2,730

    Targeted Grants:
        Advance from prior year...............................       (3,014,000)       (3,258,183)       (3,258,183)        (+244,183)  ................
        FY 2013 Advance.......................................        3,258,183         3,264,712         3,258,183   ................           -6,529
                                                               -----------------------------------------------------------------------------------------
          Subtotal (excluding emergencies)....................        3,258,183         3,264,712         3,258,183   ................           -6,529

    Education Finance Incentive Grants:
        Advance from prior year...............................       (3,014,000)       (3,258,183)       (3,258,183)        (+244,183)  ................
        FY 2013 Advance.......................................        3,258,183         3,264,712         3,258,183   ................           -6,529
                                                               =========================================================================================
          Subtotal, Grants to LEAs, program level.............       14,463,417        14,792,401        14,463,417   ................         -328,984
                                                               -----------------------------------------------------------------------------------------
          Subtotal............................................        3,258,183         3,264,712         3,258,183   ................           -6,529

    Title I Rewards...........................................  ................          300,000   ................  ................         -300,000
                                                               =========================================================================================
          Subtotal, Grants to LEAs, program level.............       14,463,417        14,792,401        14,463,417   ................         -328,984

School Improvement Grants.....................................          534,562           600,000           534,562   ................          -65,438
Early Learning Challenge Fund.................................  ................          350,000   ................  ................         -350,000
Striving Readers..............................................  ................  ................          183,000          +183,000          +183,000

State Agency Programs:
    Migrant...................................................          393,981           394,771           393,981   ................             -790
    Neglected and Delinquent/High Risk Youth..................           50,326            50,427            50,326   ................             -101
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State Agency programs.........................          444,307           445,198           444,307   ................             -891

Evaluation....................................................            8,151   ................            4,151            -4,000            +4,151
High School Graduation Initiative.............................           48,902   ................           48,902   ................          +48,902
Migrant Education:
    High School Equivalency Program...........................           36,595            36,668            36,595   ................              -73
                                                               =========================================================================================
      Total, Education for the disadvantaged..................       15,535,934        16,224,267        15,714,934          +179,000          -509,333
          Current Year........................................       (4,694,757)       (4,542,370)       (4,873,757)        (+179,000)        (+331,387)
          FY 2013.............................................      (10,841,177)      (11,681,897)      (10,841,177)  ................        (-840,720)
      Subtotal, Forward Funded................................       (4,597,117)       (4,501,702)       (4,780,117)        (+183,000)        (+278,415)

                          IMPACT AID

Basic Support Payments........................................        1,135,724         1,138,000         1,135,724   ................           -2,276
Payments for Children with Disabilities.......................           48,505            48,602            48,505   ................              -97
Facilities Maintenance (Sec. 8008)............................            4,854             4,864             4,854   ................              -10
Construction (Sec. 8007)......................................           17,474            17,509            17,474   ................              -35
Payments for Federal Property (Sec. 8002).....................           67,074            67,208            67,074   ................             -134
                                                               -----------------------------------------------------------------------------------------
      Total, Impact aid.......................................        1,273,631         1,276,183         1,273,631   ................           -2,552

                  SCHOOL IMPROVEMENT PROGRAMS

Effective Teaching and Learning: Literacy.....................  ................          383,348   ................  ................         -383,348
Effective Teaching and Learning: STEM.........................  ................          206,046   ................  ................         -206,046
Effective Teaching and Learning for Well-Rounded Education....  ................          246,084   ................  ................         -246,084
College Pathways..............................................  ................           86,000   ................  ................          -86,000
State Grants for Improving Teacher Quality....................          786,613   ................          786,613   ................         +786,613
    Advance from prior year...................................       (1,681,441)       (1,681,441)       (1,681,441)  ................  ................
    FY 2013...................................................        1,681,441   ................        1,681,441   ................       +1,681,441
                                                               -----------------------------------------------------------------------------------------
      Subtotal, State Grants for Improving Teacher Quality,           2,468,054   ................        2,468,054   ................       +2,468,054
       program level..........................................

Mathematics and Science Partnerships..........................          175,127   ................          175,127   ................         +175,127
Supplemental Education Grants.................................           17,652            17,687            17,652   ................              -35
21st Century Community Learning Centers.......................        1,153,854         1,266,166         1,153,854   ................         -112,312
State Assessments/Enhanced Assessment Instruments.............          389,951           420,000           389,951   ................          -30,049
Foreign Language Assistance...................................           26,874   ................  ................          -26,874   ................
Consolidated Runaway and Homeless Youth programs..............           65,296            65,427            65,296   ................             -131
Training and Advisory Services (Civil Rights).................            6,975             6,989             6,975   ................              -14
Education for Native Hawaiians................................           34,246            34,315            34,246   ................              -69
Alaska Native Education Equity................................           33,248            33,315            33,248   ................              -67
Rural Education...............................................          174,532           174,882           174,532   ................             -350
Comprehensive Centers.........................................           51,210            56,313            51,210   ................           -5,103
                                                               =========================================================================================
      Total, School improvement programs......................        4,597,019         2,996,572         4,570,145           -26,874        +1,573,573
          Current Year........................................       (2,915,578)       (2,996,572)       (2,888,704)         (-26,874)        (-107,868)
          FY 2013.............................................       (1,681,441)  ................       (1,681,441)  ................      (+1,681,441)
      Subtotal, Forward Funded................................       (2,745,373)       (1,926,475)       (2,745,373)  ................        (+818,898)

                       INDIAN EDUCATION

Grants to Local Educational Agencies..........................          104,122           104,331           104,122   ................             -209
Federal Programs:
    Special Programs for Indian Children......................           19,022            19,060            19,022   ................              -38
    National Activities.......................................            3,883             3,891             4,883            +1,000              +992
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Federal Programs..............................           22,905            22,951            23,905            +1,000              +954
                                                               =========================================================================================
      Total, Indian Education.................................          127,027           127,282           128,027            +1,000              +745

                  INNOVATION AND IMPROVEMENT

Race to the Top...............................................          698,600           900,000           698,600   ................         -201,400
Investing in Innovation Fund..................................          149,700           300,000           149,700   ................         -150,300
Effective Teachers and Leaders State Grants...................  ................        2,500,000   ................  ................       -2,500,000
Teacher and Leader Innovation Fund............................  ................          500,000   ................  ................         -500,000
Teacher and Leader Pathways...................................  ................          250,000   ................  ................         -250,000
Expanding Educational Options.................................  ................          372,000   ................  ................         -372,000
Transition to Teaching........................................           41,125   ................           20,125           -21,000           +20,125
Teaching of Traditional American History......................           45,908   ................           45,908   ................          +45,908
School Leadership.............................................           29,162   ................           29,162   ................          +29,162
Charter Schools Grants........................................          255,519   ................          255,519   ................         +255,519
Voluntary Public School Choice................................           25,767   ................  ................          -25,767   ................
Magnet Schools Assistance.....................................           99,800           110,000            99,800   ................          -10,200
Fund for the Improvement of Education (FIE)...................           40,900            63,000            70,900           +30,000            +7,900
Teacher Incentive Fund........................................          399,200   ................          300,000           -99,200          +300,000
Ready-to-Learn television.....................................           27,245   ................           27,245   ................          +27,245
Advanced Placement............................................           43,253   ................           43,253   ................          +43,253
                                                               =========================================================================================
      Total, Innovation and Improvement.......................        1,856,179         4,995,000         1,740,212          -115,967        -3,254,788

            SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Safe and Healthy Students.....................................  ................          364,966   ................  ................         -364,966
Promise Neighborhoods.........................................           29,940           150,000            60,000           +30,060           -90,000
National Programs.............................................          119,226   ................           79,226           -40,000           +79,226
Alcohol Abuse Reduction.......................................            6,907   ................  ................           -6,907   ................
Elementary and Secondary School Counseling....................           52,395   ................           52,395   ................          +52,395
Carol M. White Physical Education Program.....................           78,842   ................           78,842   ................          +78,842
Civic Education...............................................            1,155   ................  ................           -1,155   ................
                                                               =========================================================================================
      Total, Safe Schools and Citizenship Education...........          288,465           514,966           270,463           -18,002          -244,503

                 ENGLISH LANGUAGE ACQUISITION

Current funded................................................           47,679            48,750            47,679   ................           -1,071
Forward funded................................................          685,851           701,250           685,851   ................          -15,399
                                                               =========================================================================================
      Total, English Language Acquisition.....................          733,530           750,000           733,530   ................          -16,470

                       SPECIAL EDUCATION

State Grants:
    Grants to States Part B current year......................        2,889,817         2,272,108         2,889,817   ................         +617,709
        Part B advance from prior year........................       (8,592,383)       (8,592,383)       (8,592,383)  ................  ................
    Grants to States Part B (FY 2013).........................        8,592,383         9,433,103         8,592,383   ................         -840,720
                                                               -----------------------------------------------------------------------------------------
      Subtotal, program level (excluding emergencies).........       11,482,200        11,705,211        11,482,200   ................         -223,011

    Preschool Grants..........................................          373,351           374,099           373,351   ................             -748
    Grants for Infants and Families...........................          438,548           489,427           443,548            +5,000           -45,879
                                                               -----------------------------------------------------------------------------------------
      Subtotal, program level.................................       12,294,099        12,568,737        12,299,099            +5,000          -269,638

IDEA National Activities (current funded):
    State Personnel Development...............................           46,846            48,000            44,000            -2,846            -4,000
    Technical Assistance and Dissemination....................           48,806            49,549            49,306              +500              -243
    Personnel Preparation.....................................           88,466            90,653            88,966              +500            -1,687
    Parent Information Centers................................           27,972            28,028            28,972            +1,000              +944
    Technology and Media Services.............................           28,644            33,289            30,644            +2,000            -2,645
                                                               -----------------------------------------------------------------------------------------
      Subtotal, IDEA special programs.........................          240,734           249,519           241,888            +1,154            -7,631

Mentoring for Individuals with Disabilities...................  ................            5,000   ................  ................           -5,000
Special Olympics Education programs...........................            8,079             8,095             8,079   ................              -16
PROMISE.......................................................  ................           30,000             4,000            +4,000           -26,000
                                                               =========================================================================================
      Total, Special education................................       12,542,912        12,861,351        12,553,066           +10,154          -308,285
          Current Year........................................       (3,950,529)       (3,428,248)       (3,960,683)         (+10,154)        (+532,435)
          FY 2013.............................................       (8,592,383)       (9,433,103)       (8,592,383)  ................        (-840,720)
      Subtotal, Forward Funded................................       (3,701,716)       (3,135,634)       (3,706,716)          (+5,000)        (+571,082)

        REHABILITATION SERVICES AND DISABILITY RESEARCH

Vocational Rehabilitation State Grants........................        3,084,696         3,121,712         3,121,712           +37,016   ................
    Discretionary supplement..................................  ................          (19,266)  ................  ................         (-19,266)
                                                               -----------------------------------------------------------------------------------------
      Subtotal, VR State grants program level.................        3,084,696         3,121,712         3,121,712           +37,016   ................

Client Assistance State grants................................           12,263            12,288            12,263   ................              -25
Training......................................................           35,582            33,251            35,582   ................           +2,331
Demonstration and Training programs...........................            6,459   ................            6,459   ................           +6,459
Migrant and Seasonal Farmworkers..............................            1,856   ................            1,856   ................           +1,856
Protection and Advocacy of Individual Rights (PAIR)...........           18,065            18,101            18,065   ................              -36
Supported Employment State grants.............................           29,123   ................           29,123   ................          +29,123

Independent Living:
    Independent Living grants.................................  ................          103,716   ................  ................         -103,716
    State Grants..............................................           23,403   ................           23,403   ................          +23,403
    Centers...................................................           80,105   ................           80,105   ................          +80,105
    Services for Older Blind Individuals......................           34,083            34,151            34,083   ................              -68
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          137,591           137,867           137,591   ................             -276

National activities to improve rehabilitation.................  ................            8,000   ................  ................           -8,000
Access through cloud computing................................  ................           10,000   ................  ................          -10,000
Workforce innovation fund.....................................  ................           30,000   ................  ................          -30,000
Helen Keller National Center for Deaf/Blind Youth and Adults..            9,163             9,181             9,163   ................              -18
National Institute on Disability and Rehabilitation Research            109,023           110,485           109,023   ................           -1,462
 (NIDRR)......................................................
Assistive Technology..........................................           30,898            30,960            30,898   ................              -62
                                                               -----------------------------------------------------------------------------------------
      Subtotal................................................          390,023           400,133           390,023   ................          -10,110
                                                               =========================================================================================
      Total, Rehabilitation services..........................        3,474,719         3,521,845         3,511,735           +37,016           -10,110

      SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND.........................           24,551            24,600            24,551   ................              -49
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF (NTID):
    Operations................................................           65,306            63,037            65,546              +240            +2,509
    Construction..............................................              240             2,000   ................             -240            -2,000
                                                               -----------------------------------------------------------------------------------------
      Total, NTID.............................................           65,546            65,037            65,546   ................             +509

GALLAUDET UNIVERSITY:
    Operations................................................          117,764           118,000           117,764   ................             -236
    Construction..............................................            4,990   ................            7,990            +3,000            +7,990
                                                               -----------------------------------------------------------------------------------------
      Total, Gallaudet University.............................          122,754           118,000           125,754            +3,000            +7,754
                                                               =========================================================================================
      Total, Special Institutions for Persons with                      212,851           207,637           215,851            +3,000            +8,214
       Disabilities...........................................

             CAREER, TECHNICAL AND ADULT EDUCATION

Career Education:
    Basic State Grants/Secondary & Technical Education State            332,659           209,000           332,659   ................         +123,659
     Grants, current funded...................................
        Advance from prior year...............................         (791,000)         (791,000)         (791,000)  ................  ................
        FY 2013...............................................          791,000           791,000           791,000   ................  ................
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Basic State Grants, program level.........        1,123,659         1,000,000         1,123,659   ................         +123,659

    National Programs.........................................            7,844             7,860             7,844   ................              -16
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Career Education..............................        1,131,503         1,007,860         1,131,503   ................         +123,643

Adult Education:
    State Grants/Adult Basic and Literacy Education:
        State Grants, current funded..........................          596,120           635,000           596,120   ................          -38,880
National Leadership Activities................................           11,323            23,346            11,323   ................          -12,023
                                                               =========================================================================================
      Subtotal, Adult education...............................          607,443           658,346           607,443   ................          -50,903

State Grants for Incarcerated Youth Offenders.................  ................           17,186   ................  ................          -17,186
                                                               =========================================================================================
      Total, Career and adult education.......................        1,738,946         1,683,392         1,738,946   ................          +55,554
          Current Year........................................         (947,946)         (892,392)         (947,946)  ................         (+55,554)
                  6FY 2013                                             (791,000)         (791,000)         (791,000)  ................  ................
      Subtotal, Forward Funded................................         (947,946)         (892,392)         (947,946)  ................         (+55,554)

                 STUDENT FINANCIAL ASSISTANCE

Pell Grants--maximum grant (NA)...............................           (4,860)           (4,860)           (4,860)  ................  ................
Pell Grants...................................................       22,955,996        31,776,000        22,955,996   ................       -8,820,004
Federal Supplemental Educational Opportunity Grants...........          735,990           757,465           735,990   ................          -21,475
Federal Work Study............................................          978,531           980,492           978,531   ................           -1,961
                                                               =========================================================================================
      Total, Student Financial Assistance (SFA)...............       24,670,517        33,513,957        24,670,517   ................       -8,843,440

                  STUDENT AID ADMINISTRATION

Salaries and Expenses.........................................          675,363           725,104           675,363   ................          -49,741
Servicing Activities..........................................          316,649           370,314           370,000           +53,351              -314
                                                               =========================================================================================
      Total, Student Aid Administration.......................          992,012         1,095,418         1,045,363           +53,351           -50,055

                       HIGHER EDUCATION
Aid for Institutional Development:
    Strengthening Institutions................................           83,832            84,000            83,832   ................             -168
    Hispanic Serving Institutions.............................          104,395           117,429           104,395   ................          -13,034
    Promoting Post-Baccalaureate Opportunities for Hispanic               9,336            10,500             9,336   ................           -1,164
     Americans................................................
    Strengthening Historically Black Colleges (HBCUs).........          236,991           266,586           236,991   ................          -29,595
    Strengthening Historically Black Graduate Institutions....           61,302            61,425            61,302   ................             -123
    Strengthening Predominantly Black Institutions............            9,602            10,801             9,602   ................           -1,199
    Asian American Pacific Islander...........................            3,199             3,600             3,199   ................             -401
    Strengthening Alaska Native and Native Hawaiian-Serving              13,412            15,084            13,412   ................           -1,672
     Institutions.............................................
    Strengthening Native American-Serving Nontribal                       3,199             3,600             3,199   ................             -401
     Institutions.............................................
    Strengthening Tribal Colleges.............................           26,820            30,169            26,820   ................           -3,349
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Aid for Institutional development.............          552,088           603,194           552,088   ................          -51,106

International Education and Foreign Language:
    Domestic Programs.........................................           66,712           108,360            66,712   ................          -41,648
    Overseas Programs.........................................            7,465            15,576             7,465   ................           -8,111
    Institute for International Public Policy.................            1,552             1,945             1,552   ................             -393
                                                               -----------------------------------------------------------------------------------------
      Subtotal, International Education & Foreign Lang........           75,729           125,881            75,729   ................          -50,152

Fund for the Improvement of Postsecondary Education (FIPSE)...           19,607           150,000            19,607   ................         -130,393
Postsecondary Program for Students with Intellectual                     10,978   ................           10,978   ................          +10,978
 Disabilities.................................................
Minority Science and Engineering Improvement..................            9,484             9,503             9,484   ................              -19
Tribally Controlled Postsec Voc/Tech Institutions.............            8,146             8,162             8,146   ................              -16
Federal TRIO Programs.........................................          826,522           920,089           826,522   ................          -93,567
GEAR UP.......................................................          302,816           323,212           302,816   ................          -20,396
Javits Fellowships............................................            8,084   ................            8,084   ................           +8,084
Graduate Assistance in Areas of National Need.................           30,968            40,717            30,968   ................           -9,749
Teacher Quality Partnerships..................................           42,914   ................           42,914   ................          +42,914
Child Care Access Means Parents in School.....................           16,002            16,034            16,002   ................              -32
GPRA Data/HEA Program Evaluation..............................              608               609               608   ................               -1
Thurgood Marshall Legal Education Opportunities...............  ................            3,000   ................  ................           -3,000
Hawkins Centers of Excellence.................................  ................           40,000   ................  ................          -40,000
                                                               =========================================================================================
      Total, Higher Education.................................        1,903,946         2,240,401         1,903,946   ................         -336,455

                       HOWARD UNIVERSITY

Academic Program..............................................          205,619           202,431           202,019            -3,600              -412
Endowment Program.............................................  ................            3,600             3,600            +3,600   ................
Howard University Hospital....................................           28,888            28,946            28,888   ................              -58
                                                               -----------------------------------------------------------------------------------------
      Total, Howard University................................          234,507           234,977           234,507   ................             -470

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS(CHAFL)..........              460               478               460   ................              -18

                HBCU CAPITAL FINANCING PROGRAM

HBCU Federal Administration...................................              353               354               353   ................               -1
HBCU Loan Subsidies...........................................           20,188            20,228            20,188   ................              -40
                                                               -----------------------------------------------------------------------------------------
      Total, HBCU Capital Financing Program...................           20,541            20,582            20,541   ................              -41

             INSTITUTE OF EDUCATION SCIENCES (IES)
Research, Development and Dissemination.......................          199,796           260,413           199,796   ................          -60,617
Statistics....................................................          108,304           117,021           109,304            +1,000            -7,717
Regional Educational Laboratories.............................           57,535            69,650            57,535   ................          -12,115
Research in Special Education.................................           50,983            58,085            50,983   ................           -7,102
Special Education Studies and Evaluations.....................           11,437            11,460            11,437   ................              -23
Statewide Data Systems........................................           42,166           100,000            42,166   ................          -57,834
Assessment:
    National Assessment.......................................          129,861           135,121           129,861   ................           -5,260
    National Assessment Governing Board.......................            8,706             8,723             8,706   ................              -17
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Assessment....................................          138,567           143,844           138,567   ................           -5,277
                                                               =========================================================================================
      Total, IES..............................................          608,788           760,473           609,788            +1,000          -150,685

                    DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION:
    Salaries and Expenses.....................................          447,104           476,327           449,074            +1,970           -27,253
    Building Modernization....................................            8,184             2,711   ................           -8,184            -2,711
                                                               -----------------------------------------------------------------------------------------
      Total, Program administration...........................          455,288           479,038           449,074            -6,214           -29,964

OFFICE FOR CIVIL RIGHTS.......................................          102,818           107,772           102,818   ................           -4,954
OFFICE OF THE INSPECTOR GENERAL...............................           59,933            67,187            59,933   ................           -7,254
                                                               -----------------------------------------------------------------------------------------
      Total, Departmental management..........................          618,039           653,997           611,825            -6,214           -42,172
                                                               =========================================================================================
      Total, Title III, Department of Education...............       71,430,023        83,678,778        71,547,487          +117,464       -12,131,291
          Current Year........................................      (49,524,022)      (61,772,778)      (49,641,486)        (+117,464)     (-12,131,292)
          FY 2013.............................................      (21,906,001)      (21,906,000)      (21,906,001)  ................              (+1)
                                                               =========================================================================================

                  TITLE IV--RELATED AGENCIES

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY              5,385             5,841             5,385   ................             -456
 DISABLED.....................................................

        CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

                      OPERATING EXPENSES

Domestic Volunteer Service Programs:
    Volunteers in Service to America (VISTA)..................           98,876           100,000            98,876   ................           -1,124
    National Senior Volunteer Corps:
        Foster Grandparents Program...........................          110,774           111,100           110,774   ................             -326
        Senior Companion Program..............................           46,810            47,000            46,810   ................             -190
        1Senior Corps Demonstration...........................  ................            5,000   ................  ................           -5,000
        Retired Senior Volunteer Program......................           50,299            63,000            50,299   ................          -12,701
                                                               -----------------------------------------------------------------------------------------
          Subtotal, Senior Volunteers.........................          207,883           226,100           207,883   ................          -18,217
                                                               =========================================================================================
      Subtotal, Domestic Volunteer Service Programs...........          306,759           326,100           306,759   ................          -19,341

National and Community Service Programs:
    AmeriCorps State and National Grants......................          347,360           399,790           347,360   ................          -52,430
    Disability Placement Funds................................            4,990             5,000             4,990   ................              -10
    Innovation, Assistance, and Other Activities..............           60,379            80,500            60,379   ................          -20,121
    Evaluation................................................            5,988             6,000             5,988   ................              -12
    National Civilian Community Corps.........................           28,942            35,000            31,942            +3,000            -3,058
    Learn and Serve America...................................  ................           39,500   ................  ................          -39,500
    State Commission Administrative Grants....................           16,966            17,000            16,966   ................              -34
    Training and Technical Assistance.........................            7,485             7,500             7,485   ................              -15
                                                               -----------------------------------------------------------------------------------------
      Subtotal, National & Community Service Programs.........          472,110           590,290           475,110            +3,000          -115,180
                                                               -----------------------------------------------------------------------------------------
      Total, Operating expenses...............................          778,869           916,390           781,869            +3,000          -134,521

National Service Trust........................................          201,200           235,326           215,200           +14,000           -20,126
Salaries and Expenses.........................................           87,824            97,694            87,824   ................           -9,870
Office of the Inspector General...............................            7,685             8,450             7,685   ................             -765
                                                               =========================================================================================
      Total, Corporation for National and Community Service...        1,075,578         1,257,860         1,092,578           +17,000          -165,282

CORPORATION FOR PUBLIC BROADCASTING:
    FY 2014 (current) with FY 2013 comparable.................          445,000           451,000           445,000   ................           -6,000
    FY 2013 advance with FY 2012 comparable (NA)..............         (445,000)         (445,000)         (445,000)  ................  ................
    FY 2012 advance with FY 2011 comparable (NA)..............         (429,140)         (445,000)         (445,000)         (+15,860)  ................
    Digitalization program, current funded....................            5,998             6,000             5,998   ................               -2
                                                               -----------------------------------------------------------------------------------------
      Subtotal, FY 2012 appropriation.........................            5,998             6,000             5,998   ................               -2

FEDERAL MEDIATION AND CONCILIATION SERVICE....................           46,559            48,025            46,559   ................           -1,466
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION..............           10,337            22,417            17,337            +7,000            -5,080
INSTITUTE OF MUSEUM AND LIBRARY SERVICES......................          237,393           242,605           237,393   ................           -5,212
MEDICARE PAYMENT ADVISORY COMMISSION..........................           12,425            13,100            12,425   ................             -675
MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION...............  ................           11,000            10,500           +10,500              -500
NATIONAL COUNCIL ON DISABILITY................................            3,264             3,400             3,264   ................             -136
NATIONAL HEALTH CARE WORKFORCE COMMISSION.....................  ................            3,000             3,000            +3,000   ................
NATIONAL LABOR RELATIONS BOARD................................          282,833           287,699           282,833   ................           -4,866
NATIONAL MEDIATION BOARD......................................           13,436            13,961            13,436   ................             -525
OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION..............           11,689            12,773            11,689   ................           -1,084

                   RAILROAD RETIREMENT BOARD

Dual Benefits Payments Account................................           56,886            51,000            51,000            -5,886   ................
Less Income Tax Receipts on Dual Benefits.....................           -3,000            -2,000            -2,000            +1,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Dual Benefits.................................           53,886            49,000            49,000            -4,886   ................

Federal Payment to the RR Retirement Account..................              150               150               150   ................  ................
Limitation on Administration..................................          108,855           112,239           108,855   ................           -3,384
    Inspector General.........................................            8,170             9,259             8,170   ................           -1,089

                SOCIAL SECURITY ADMINISTRATION

Payments to Social Security Trust Funds.......................           21,404            20,404            20,404            -1,000   ................

                 SUPPLEMENTAL SECURITY INCOME

Federal Benefit Payments......................................       52,387,000        47,554,000        47,554,000        -4,833,000   ................
Beneficiary Services..........................................           60,000            47,000            47,000           -13,000   ................
Research and Demonstration....................................           42,928            38,000            38,000            -4,928   ................
Administration................................................        3,486,286         3,844,000         3,683,543          +197,257          -160,457
                                                               -----------------------------------------------------------------------------------------
      Subtotal, SSI program level.............................       55,976,214        51,483,000        51,322,543        -4,653,671          -160,457

          Less funds advanced in prior year...................      -16,000,000       -13,400,000       -13,400,000        +2,600,000   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, regular SSI current year......................       39,976,214        38,083,000        37,922,543        -2,053,671          -160,457
          New advance, 1st quarter, FY 2013...................       13,400,000        18,200,000        18,200,000        +4,800,000   ................
                                                               -----------------------------------------------------------------------------------------
      Total, SSI program......................................       53,376,214        56,283,000        56,122,543        +2,746,329          -160,457

             LIMITATION ON ADMINISTRATIVE EXPENSES

OASDI Trust Funds.............................................        5,556,741         5,931,407         5,385,504          -171,237          -545,903
HI/SMI Trust Funds............................................        2,049,942         2,253,780         2,093,751           +43,809          -160,029
Social Security Advisory Board................................            2,295             2,150             2,150              -145   ................
Acquisition Workforce Capacity and Capabilities...............  ................            1,863   ................  ................           -1,863
SSI...........................................................        3,144,970         3,546,000         3,372,543          +227,573          -173,457
                                                               -----------------------------------------------------------------------------------------
      Subtotal, regular LAE...................................       10,753,948        11,735,200        10,853,948          +100,000          -881,252
User Fees:
    SSI User Fee activities...................................          185,628           155,000           155,000           -30,628   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, User fees.....................................          185,628           155,000           155,000           -30,628   ................
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Limitation on administrative expenses.........       10,939,576        11,890,200        11,008,948           +69,372          -881,252
Program Integrity Funding:
    OASDI Trust Funds.........................................          142,714           325,000           312,000          +169,286           -13,000
    SSI.......................................................          341,316           298,000           311,000           -30,316           +13,000
                                                               -----------------------------------------------------------------------------------------
      Subtotal, Program integrity funding.....................          484,030           623,000           623,000          +138,970   ................
                                                               =========================================================================================
      Total, Limitation on Administrative Expenses............       11,423,606        12,513,200        11,631,948          +208,342          -881,252

                OFFICE OF THE INSPECTOR GENERAL

Federal Funds.................................................           28,942            30,000            28,942   ................           -1,058
Trust Funds...................................................           73,535            77,113            73,535   ................           -3,578
                                                               -----------------------------------------------------------------------------------------
      Total, Office of the Inspector General..................          102,477           107,113           102,477   ................           -4,636

Adjustment: Trust fund transfers from general revenues........       -3,486,286        -3,844,000        -3,683,543          -197,257          +160,457
                                                               =========================================================================================
      Total, Social Security Administration...................       61,437,415        65,079,717        64,193,829        +2,756,414          -885,888
          Federal funds.......................................       53,612,188        56,490,267        56,326,889        +2,714,701          -163,378
              Current year....................................      (40,212,188)      (38,290,267)      (38,126,889)      (-2,085,299)        (-163,378)
              New advances, 1st quarter.......................      (13,400,000)      (18,200,000)      (18,200,000)      (+4,800,000)  ................
          Trust funds.........................................        7,825,227         8,589,450         7,866,940           +41,713          -722,510
                                                               =========================================================================================
      Total, Title IV, Related Agencies.......................       63,758,373        67,629,046        66,547,401        +2,789,028        -1,081,645
          Federal Funds.......................................       55,803,696        58,904,998        58,551,011        +2,747,315          -353,987
              Current Year....................................      (41,958,696)      (40,253,998)      (39,906,011)      (-2,052,685)        (-347,987)
              FY 2013 Advance.................................      (13,400,000)      (18,200,000)      (18,200,000)      (+4,800,000)  ................
              FY 2014 Advance.................................         (445,000)         (451,000)         (445,000)  ................          (-6,000)
          Trust Funds.........................................        7,954,677         8,724,048         7,996,390           +41,713          -727,658
                                                               =========================================================================================

      Grand total.............................................      722,738,724       758,715,002       742,432,508       +19,693,784       -16,282,494
          Trust funds.........................................      (16,336,092)      (18,227,110)      (17,091,291)        (+755,199)      (-1,135,819)
          Advance appropriations, FY 2013.....................     (127,305,290)     (136,398,082)     (136,423,083)      (+9,117,793)         (+25,001)
          Advance appropriations, FY 2014.....................         (445,000)         (451,000)         (445,000)  ................          (-6,000)
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\The President's Budget proposed to transfer this program to the Administration on Aging at HHS.
\2\Two year availability.
\3\Sec. 4002 of Public Law 111-148.
\4\Includes Mine Safety and Health.


```