95–685 

108TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 108–636 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2005 

SEPTEMBER 7, 2004.—Committed to the Committee of the Whole House on the State 

of the Union and ordered to be printed 

Mr. REGULA, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 5006] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for the 

Departments of Labor, Health and Human Services (except the 

Food and Drug Administration and the Indian Health Service), and 

Education, Armed Forces Retirement Home, Committee for Purchase from People Who are Blind or Severely Disabled, Corporation 

for National and Community Service, Corporation for Public Broadcasting, Federal Mediation and Conciliation Service, Federal Mine 

Safety and Health Review Commission, Institute of Museum and 

Library Services, Medicare Payment Advisory Commission, National Commission on Libraries and Information Science, National 

Council on Disability, National Labor Relations Board, National 

Mediation Board, Occupational Safety and Health Review Commission, Railroad Retirement Board, and the Social Security Administration for the fiscal year ending September 30, 2005, and for other 

purposes. 

2 

INDEX TO BILL AND REPORT 

Page number 

Bill Report 

Title I—Department of Labor: 

Employment and Training Administration ....................................... 2 8 

Employee Benefits Security Administration ..................................... 8 15 

Pension Benefit Guaranty Corporation ............................................. 8 15 

Employment Standards Administration ........................................... 9 15 

Occupational Safety and Health Administration ............................. 14 17 

Mine Safety and Health Administration ........................................... 17 18 

Bureau of Labor Statistics ................................................................. 18 18 

Office of Disability Employment Policy ............................................. 19 18 

Departmental Management ............................................................... 19 19 

Veterans Employment and Training ................................................. 21 20 

Office of the Inspector General .......................................................... 21 21 

General Provisions .............................................................................. 22 21 

Title II—Department of Health and Human Services: 

Health Resources and Services Administration ............................... 23 21 

Centers for Disease Control and Prevention .................................... 26 43 

National Institutes of Health ............................................................. 28 61 

Substance Abuse and Mental Health Services Administration ...... 35 116 

Agency for Healthcare Research and Quality ................................... 37 121 

Centers for Medicare and Medicaid Services .................................... 37 123 

Administration for Children and Families ........................................ 40 128 

Administration on Aging .................................................................... 49 141 

Office of the Secretary ........................................................................ 49 144 

General Provisions .............................................................................. 54 151 

Title III—Department of Education: 

Education for the Disadvantaged ...................................................... 65 153 

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

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

Indian Education ................................................................................. 69 162 

Innovation and Improvement ............................................................. 69 163 

Safe Schools and Citizenship Education ........................................... 70 167 

English Language Acquisition ........................................................... 70 169 

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

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

Special Institutions for Persons with Disabilities ............................ 72 175 

Vocational and Adult Education ........................................................ 72 175 

Student Financial Assistance ............................................................. 74 178 

Student Aid Administration ............................................................... 75 180 

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

Howard University .............................................................................. 76 186 

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

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

Institute of Education Sciences .......................................................... 77 187 

Departmental Management ............................................................... 78 189 

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

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

General Provisions .............................................................................. 78 190 

Title IV—Related Agencies: 

Armed Forces Retirement Home ....................................................... 80 191 

Committee for Purchase from People Who Are Blind or Severely 

Disabled ............................................................................................ 80 191 

Corporation for National and Community Service ........................... 80 191 

Corporation for Public Broadcasting ................................................. 81 193 

Federal Mediation and Conciliation Service ..................................... 82 193 

Federal Mine Safety and Health Review Commission ..................... 84 194 

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Page number 

Bill Report 

Institute of Museum and Library Services ....................................... 84 194 

Medicare Payment Advisory Commission ......................................... 84 194 

National Commission on Libraries and Information Science .......... 84 195 

National Council on Disability ........................................................... 85 195 

National Labor Relations Board ........................................................ 85 195 

National Mediation Board .................................................................. 86 195 

Occupational Safety and Health Review Commission ..................... 86 195 

Railroad Retirement Board ................................................................ 86 196 

Social Security Administration .......................................................... 88 197 

Title V—General Provisions: 

House of Representatives Report Requirements .............................. 91 198 

SUMMARY OF ESTIMATES AND APPROPRIATIONS

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

for fiscal year 2005 and the Committee recommendation for fiscal 

year 2005 in the accompanying bill. 

2005 LABOR, HHS, EDUCATION APPROPRIATIONS BILL 

[In millions of dollars] 

Fiscal year— 2005 committee compared to— 

2004 comparable 2005 budget 2005 

committee 2004 comparable 2005 budget 

Department of Labor ............................................. $15,278 $15,186 $14,906 ¥$372 ¥$280 

Advances ...................................................... 2,545 2,551 2,551 +6 0 

Department of Health and Human Services ......... 353,642 369,010 368,990 +15,348 ¥20 

Advances ...................................................... 56,099 62,784 62,784 +6,685 0 

Department of Education ...................................... 58,236 59,975 60,317 +2,081 +342 

Advances ...................................................... 15,011 15,022 15,022 +11 0 

Related Agencies ................................................... 44,428 48,915 48,708 +4,280 ¥207 

Advances ...................................................... 11,458 12,980 12,980 +1,522 0 

Grand Total, current year ...................................... 471,584 493,086 492,921 +21,337 ¥165 

Advances ...................................................... 85,113 93,337 93,337 +8,224 0 

Current year total using 302(b) scorekeeping ..... 471,288 492,125 492,327 +21,039 +202 

Mandatory ..................................................... 331,864 349,801 349,801 +17,937 0 

Discretionary ................................................. 139,424 142,324 142,526 +3,102 +202 

PROGRAM LEVEL DISCRETIONARY 

[In millions of dollars] 

Fiscal year— 2005 committee compared 

to— 

2004 

comparable 2005 budget 2005 committee 2004 

comparable 2005 budget 

Department of Labor ............................................. $11,821 $12,003 $11,723 ¥$98 ¥$280 

Department of Health and Human Services ......... 62,201 63,231 63,210 1,009 ¥21 

Department of Education ...................................... 55,662 57,339 57,681 2,019 342 

Related Agencies ................................................... 10,070 10,712 10,505 435 ¥207 

Subtotal Program Level ........................... 139,754 143,285 143,119 3,365 ¥166 

GENERAL SUMMARY OF THE BILL

Funding levels in the fiscal year 2005 appropriation bill for the 

Departments of Health and Human Services, and Education and 

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

4 

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

Bill total.—Total funding, including offsets, for fiscal year 2005 

in the Departments of Health, and Human Services and Education 

and Related Agencies Appropriations Act, 2005 is 

$492,327,096,000. 

Discretionary Programs.—For Discretionary accounts for 2005 the bill provides $142,526,000,000, including offsets. This is 

$3,101,931,000 above the fiscal year 2004 comparable level. After 

adjusting for fluctuations in advance appropriations, the comparable program increase is $3,366,085,000, or 2.41 percent, over 

fiscal year 2004. 

Mandatory programs.—The bill provides $349,801,096,000 for en- titlement programs in fiscal year 2005. This is $17,937,264,000 

above the fiscal year 2004 comparable level, or an increase of 5.4 

percent. Over two thirds of the funding in the bill is for these mandatory costs. Funding requirements for entitlement programs are 

determined by the basic authorizing statutes. Mandatory programs 

include general fund support for the Medicare and Medicaid programs, Supplemental Security Income, Trade Adjustment Assistance and Black Lung payments. The following chart indicates the 

funding levels for the major mandatory programs in fiscal years 

2004 and 2005 and the growth in these programs. 

MANDATORY 

[Dollars in thousands] 

Program Fiscal Year 2004 Fiscal Year 2004 Change 

Department of Labor: 

Federal Unemployment Benefits and Allowances ........................ 1,338,200 1,057,300 ¥280,900 

Advances to the UI and other trust funds .................................. 467,000 517,000 +50,000 

Special Benefits ........................................................................... 163,000 233,000 +70,000 

Special Benefits for Disabled Coal Miners ................................. 299,991 188,000 ¥111,991 

Energy Employees Occupational Illness Compensation Fund ..... 51,651 40,821 ¥10,830 

Black Lung Disability Trust ......................................................... 1,055,000 1,059,000 +4,000 

Department of Health and Human Services: 

Vaccine Injury Compensation Trust fund .................................... 66,000 66,000 0 

Medicaid current law benefits ..................................................... 172,706,067 167,013,865 ¥5,692,202 

Medicaid State and Local Administration ................................... 9,067,320 9,318,602 +251,282 

CMS Vaccines for Children .......................................................... 980,196 1,208,296 +228,100 

Medicare Payments to Healthcare Trust Funds .......................... 95,084,100 114,608,900 +19,524,800 

Child Support Enforcement .......................................................... 4,361,674 4,398,698 +37,024 

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

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

Payments to States for Foster Care and Adoption ..................... 5,068,300 5,037,900 ¥30,400 

Medical Benefits for Commissioned Officers .............................. 321,763 330,636 +8,873 

Department of Education: 

Vocaltional Rehabilitation ............................................................ 2,584,162 2,635,845 +51,683 

Related Agencies: 34,336,000 38,181,929 +3,845,929 

Department of Labor.—The bill appropriates $11,723,237,000 for 

the discretionary programs of the Labor Department. 

Employment and Training.—The Committee recommends 

$5,112,728,000 to carry out the provisions of the Workforce Investment Act of 1998. This is $32,736,000 below the fiscal year 2004 

comparable level and $213,564,000 below the request. The Committee recommends an increase in funding over fiscal year 2004 for 

dislocated worker re-employment assistance of $25,000,000. 

Employee Benefits Security Administration.—The Committee recommends $132,345,000 for the EBSA to carry out their responsibilVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
5 

ities to American workers and their families who are covered by 

private sector pension, health, and other employee benefit plans. 

This is $8,305,000 above the fiscal year 2004 comparable level and 

the same as the request. 

Employment Standards Administration.—The Committee recommends $402,818,000 for ESA. This level is $10,802,000 above 

the fiscal year 2004 comparable level and $6,476,000 below the 

President’s program level request for the Agency. 

Occupational Safety and Health Administration.—The Committee recommends funding for OSHA at $461,599,000, $4,058,000 

above the fiscal year 2004 comparable level and the same as the 

request. 

Department of Health and Human Services.—The bill appro- priates $63,210,324,000 for discretionary programs of the Department. 

Health Resources and Services Administration.—Funding for the 

Health Resources and Services Administration (HRSA) programs is 

$6,330,333,000, $287,970,000 below the fiscal year 2004 comparable level and $282,500,000 above the request. Within HRSA, 

the community health centers funding is at $1,835,925,000, an increase of $218,544,000 above the fiscal year 2004 comparable level 

and the same as the request. Health professions training is funded 

at $416,365,000, $19,715,000 below last year’s comparable level 

and $258,582,000 above the request. Ryan White AIDS Care Act 

programs are funded at $2,099,861,000, $35,000,000 above last 

year’s comparable level and $20,000,000 above the request. In addition, $542,649,000 is recommended for HRSA’s bioterrorism preparedness and response activities. This is the same as the fiscal 

year 2004 comparable level and $39,000,000 above the request. 

Centers for Disease Control and Prevention.—The bill provides a total program level of $4,477,878,000 directly to the Centers for 

Disease Control and Prevention (CDC). This is $101,421,000 below 

the fiscal year 2004 comparable level and $15,244,000 above the request. In addition, $1,637,760,000 is available for CDC homeland 

security activities funded through the Public Health and Social 

Services Emergency Fund. CDC programs and activities include: 

Immunization; bioterrorism preparedness and response; chronic 

disease prevention; domestic and Global HIV/AIDS; surveillance, 

prevention, and control of infectious diseases, such as hepatitis, 

SARS, and the West Nile Virus. 

National Institutes of Health.—The Committee recommends 

$28,441,371,000 for the biomedical research activities of the National Institutes of Health (NIH). This is $782,238,000 above the 

fiscal year 2004 comparable level and the same as the request. The 

Committee continues to support strongly the research and training 

activities of the NIH. The Committee has maintained its policy of 

resisting disease specific earmarks in the bill and report, believing 

that decisions as to appropriate levels of funding and appropriate 

avenues of research are best left to the scientific managers at NIH. 

It is the view of the Committee that this is the best means available for advancing our understanding of human health and disease 

and improving the quality of life for affected individuals and families. 

Substance Abuse and Mental Health Services Administration.— 

The bill provides $3,270,360,000 for the Substance Abuse and MenVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
6 

tal Health Services Administration (SAMHSA), an amount 

$36,452,000 above the fiscal year 2004 level and $158,579,000 

below the request. 

Agency for Healthcare Research and Quality.—The bill provides $303,695,000 for the Agency for Healthcare Research and Quality 

(AHRQ), an amount that is the same as the fiscal year 2004 comparable level and the request. 

Medicare and Medicaid.—The bill provides $177,540,763,000 for Medicaid and $114,608,900,000 in Federal funds for the Government’s share of payments to Medicare in fiscal year 2005. 

Low Income Home Energy Assistance.—The Committee provides $1,900,000,000 for the Low Income Home Energy Assistance Program formula grants to States in fiscal year 2005. This is 

$110,620,000 more than the fiscal year 2004 level and $99,500,000 

more than the request. The Committee includes $100,000,000 in 

contingent emergency funding for heating and cooling emergencies, 

which is $590,000 more than last year’s level and $100,000,000 less 

than the request. 

Child Care and Development Block Grant.—The Committee includes $2,099,729,000 for the Child Care and Development Block 

Grant for fiscal year 2005. This is $12,419,000 above the fiscal year 

2004 level and the same as the request. 

Social Services Block Grant.—The Committee provides $1,700,000,000 for the Social Services Block Grant, the same as 

both the fiscal year 2004 level and the request. 

Head Start.—The bill includes $6,898,580,000 for Head Start, 

$123,732,000 above last year’s level and $45,000,000 below the request. 

Human Embryo Research.—The bill includes the same language 

included for the past several years to prohibit the use of federal 

funds for research involving human embryos. This language also 

has the effect of prohibiting the use of funds in the bill to support 

human cloning. 

Needle Exchange.—The bill includes a prohibition on the use of 

Federal funds for needle exchange programs, which is the same as 

last year. 

Title X Family Participation in Decisions of Minors to Seek Family Planning.—The bill includes language requiring recipients of 

title X funding, family planning funding, to certify that it encourages family participation in the decision of minors to seek family 

planning services and that it provides counseling to minors on how 

to resist attempts to coerce minors into engaging in sexual activities. This language has been included in the bill for several years. 

Title X Compliance With State Laws.—The bill includes a provision, continued from last year, requiring Title X clinics to comply 

with State laws relating to notification or reporting of child abuse, 

child molestation, sexual abuse, rape or incest. 

Department of Education.—The bill funds programmatic and support activities in the Department of Education at $57,681,171,000, 

an increase of $342,119,000 above the request and $2,018,710,000 

above last year’s comparable level (adjusted for advance appropriations in fiscal year 2004). 

Education for the Disadvantaged.—The bill provides 

$13,342,309,000, for grants to local education agencies under title 

I of the Elementary and Secondary Education Act. This level is 

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$1,000,000,000 above the fiscal year 2004 amount and the same as 

the request level. 

Impact Aid.—The bill provides $1,250,893,000 for school districts 

that are impacted by Federal activities, such as military bases or 

Indian lands. This is an increase of $21,367,000 above the fiscal 

year 2004 level, and the President’s request. 

School Improvement Programs.—The bill provides $5,641,401,000 

for the school improvement programs. The bill includes 

$2,950,000,000 for state grants for improving teacher quality, 

$19,874,000 above last year’s level and the request. The bill also 

includes $269,115,000 for math and science partnerships, an increase of $120,000,000 above last year’s level and the same as the 

request. 

Innovation and Improvement.—The bill provides $669,936,000 for 

innovation and improvement programs. Included within this account is $268,702,000 for charter schools, an increase of 

$12,721,000 above last year’s levels. 

Special Education.—The Committee recommends an overall program funding level for special education programs of 

$12,176,101,000, $1,015,393,000 above last year’s level and the 

same as the President’s request. The bill provides a $1,000,000,000 

increase for grants to states under part B of the Individuals with 

Disabilities Education Act. 

Vocational and Adult Education.—Vocational education state 

grants are funded at $1,215,008,000 and adult education state 

grants are funded at $574,372,000. 

Student Financial Assistance and Higher Education.— For Student Financial Aid, the Committee provides $14,755,794,000, 

$748,498,000 above last year and $57,172,000 above the President. 

For Higher Education, the Committee provides $1,976,056,000. 

This level is $116,586,000 below last year and $972,000 below the 

request. The bill allows the maximum Pell grant to be maintained 

at $4,050—the highest in history. 

Institute of Education Sciences.—The Committee proposes 

$526,804,000 for education research and statistics. For on-going activities, this level is $30,069,000 above last year and $77,183,000 

above the request level. 

TITLE IV—RELATED AGENCIES 

Institute of Museum and Library Services.—Funding for the Institute of Museum and Library Services is $261,743,000 including 

$23,000,000 for a librarian recruitment initiative. 

Social Security Administrative Costs.—Funding provided for the 

cost of administering the Social Security programs is 

$8,798,100,000, $484,926,000 above the fiscal year 2004 level and 

$82,900,000 below the request. 

GOVERNMENT PERFORMANCE AND RESULTS ACT

The Committee commends the Departments and Agencies under 

its jurisdiction for the progress they have made toward the establishment of goals and other benchmarks as required by the Government Performance and Results Act. However, these Departments 

and Agencies remain a long way from meeting its overall intent. 

The Committee continues to feel that quantifiable and measurable 

8 

individual performance indicators need to be developed for each 

program. Individual indicators need to be specific and measurable 

wherever possible, need to be consistent with other measures used 

in similar programs and need to be supported by systems that can 

provide annual information on the progress being made toward 

achieving the stated goals. There are still far too many programs 

with indicators using the terms ‘‘increase,’’ or ‘‘decrease,’’ or ‘‘improve’’ rather than specific numerical goals. 

In addition, these indicators must increasingly focus on the improvements in employment and income, worker safety, health status, biomedical discoveries, the quality of life of various populations, educational achievement, and the many other goals that 

are the primary purpose of the programs funded by this bill. Again, 

the indicators are far too often related to the issuance of program 

guidance or focus on the number of individuals served. 

Finally, the Committee continues to urge the Departments and 

Agencies under its jurisdiction to manage themselves based on performance and outcomes. They should use outcome and performance 

measures as the primary management tool for resource allocation 

and the evaluation of programs and individuals. The Committee expects that each Department and office funded in the bill will be 

prepared to testify during the fiscal year 2005 cycle on how performance and outcome measures are being used to manage their 

programs, including: 

How outcome and performance goals are being established for individual offices within departments and how they are held accountable for the achievement of these goals; 

How such data is used to establish individual performance goals; 

and 

How actual performance is measured against these goals and the 

kinds of incentives, both positive and negative, that are in place to 

assure the achievement of overall goals. 

EFFECT STATEMENTS

The Committee directs the Departments and agencies identified 

in the report accompanying the fiscal year 1998 bill to continue to 

provide it with effects statements within 45 days of enactment of 

this Act. 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

(INCLUDING RESCISSION)

The Committee recommends $5,112,728,000 for this account, 

which provides funding authorized primarily by the Workforce Investment Act of 1998 (WIA). This is $32,736,000 below the fiscal 

year 2004 level and $213,564,000 below the budget request. 

The Training and Employment Services account is comprised of 

programs that enhance the employment and earnings of those in 

need of such services, operated through a decentralized system of 

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

9 

2005 supporting the effort from July 1, 2005 through June 30, 

2006. 

The Committee directs that Department take no action in fiscal 

year 2005 to amend, through regulatory or other administrative action, the definition established in 20 CFR 667.220 for functions and 

activities under title I of the Workforce Investment Act until such 

time as legislation reauthorizing the Act is enacted. 

Adult employment and training activities 

For adult employment and training activities, the Committee rec- ommends $900,000,000. This is $1,109,000 above the fiscal year 

2004 level and the same as the budget request. Of the amount recommended $712,000,000 will become available on October 1, 2005. 

This program is authorized by the Workforce Investment Act of 

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

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

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

are not able to find jobs through core services alone. 

Dislocated worker employment and training activities 

For dislocated worker employment and training activities, the Committee recommends $1,479,149,000. This is $25,000,000 above 

the fiscal year 2004 level and $96,379,000 above the budget request. Of the amount recommended, $1,060,000,000 will become 

available on October 1, 2005. Of the total, $1,178,192,000 is designated for State formula grants that support core services, intensive services, training, and supportive services. In addition, States 

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

$301,227,000 for the National Reserve, which supports National 

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

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

training and demonstration projects. 

Within funds available under the dislocated worker national reserve, the Secretary may use up to $50,000,000 to carry out the 

Community College/Community-Based Job Training Initiative. The 

Committee encourages the Secretary to ensure that funds used for 

Initiative strengthen partnerships between community colleges, 

employers, and local workforce investment boards. Within the total 

for the National Reserve, the Committee also intends that up to 

$30,000,000 shall be available to the Secretary of Labor to support 

health insurance coverage assistance authorized in the Trade Act 

of 2002. 

Youth activities 

For youth activities, the Committee recommends $1,000,965,000. 

This is $5,906,000 above the fiscal year 2004 level and the same 

as the budget request. 

The Workforce Investment Act of 1998 consolidated the Summer 

Youth Employment and Training Program and Youth Training 

10 

Grants under the Job Training Partnership Act into a single youth 

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

further distributed to local workforce investment boards. 

Job Corps 

For Job Corps, the Committee recommends $1,542,321,000. This is $1,169,000 above the fiscal year 2004 level and $14,966,000 

below the budget request. Of the amount recommended, 

$691,000,000 will become available on October 1, 2004. 

The Job Corps, authorized by the Workforce Investment Act of 

1998, is a nationwide network of residential facilities chartered by 

Federal law to provide a comprehensive and intensive array of 

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

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

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

Participation in the program is open to economically disadvantaged 

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

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

to residential facilities where they can benefit from the highly 

structured and carefully integrated services provided by the Job 

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

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

The Committee recognizes the significant impact of the home 

building industry on the economic recovery, and its efforts to house 

our nation’s working families, notwithstanding an ongoing shortage 

of labor in the construction trades. The Committee recognizes the 

essential role of the National Training Contractors (NTCs) such as 

the Home Builders Institute (HBI), the workforce development arm 

of the National Association of Home Builders, in training Job Corps 

youth for careers in this high growth industry. The Committee 

commends HBI on its 30 years of proven results in building our nation’s workforce by providing at-risk youth with the skills training 

and employment opportunities they need to succeed. The Committee encourages the Department to identify existing and future 

sites for potential expansion of construction trades training by the 

NTCs to help alleviate the industry’s worker shortages and to 

impel its continued prosperity. 

The Committee applauds Job Corps’ proactive approach to protecting America’s homeland security, including offering the security 

trade at many of the 118 Job Corps centers. The Committee believes that the Job Corps program is in an excellent position to provide a substantial human resource pool of certified entry-level 

screeners for the Transportation Security Administration (TSA). 

The Committee recognizes that Job Corps is training a quality 

workforce of entry-level employees with the skills in high demand 

by TSA for our nation’s municipal, national, and international airports. The Committee directs the U.S. Department of Labor and 

the U.S. Department of Homeland Security to enter into a memorandum of understanding that establishes the parameters for Job 

Corps and TSA to: cost-effectively leverage resources, create customized training curriculum, and enhance the labor pool. These 

11 

steps will enable TSA to locate and hire qualified entry-level airport screeners from Job Corps for local, national and international 

airports. 

The Committee commends the Job Corps program for establishing cost-effective national and local partnerships with the U.S. 

Army, Navy and Coast Guard to recruit high quality military personnel. Job Corps students’ average scores on military entrance 

exams exceed the national average. Twenty-eight centers are 

former military installations, and many of the program’s basic 

training and residential practices are based on a military model. 

The residential component of Job Corps instills discipline, responsibility, and group cohesion, preparing students in a way that is conducive to military life. The Committee encourages the Department 

to establish Junior Reserve Officers Training Corps (JROTC) programs that would be located near existing military installations. 

Together, Job Corps and the JROTC program would offer training 

in leadership skills, organizational management, and physical fitness for students pursuing advanced military careers. Job Corps 

centers that have expressed interest in a JROTC program include 

Shriver (MA), Cassadaga (NY), New Haven (CT) and Atterbury 

(IN). 

The Committee commends the Job Corps for developing programs to help address the nation’s shortfall of staff in health professions, including nursing, pharmacy, and lab technician trades. 

Private sector companies including HCR Manor Care, HCA, CVS, 

and Walgreens and others have formed partnerships with Job 

Corps to help fill nursing and other allied heath care vacancies 

(such as facilities maintenance and dietary management). The 

Committee supports training Job Corps students in the health 

sciences, including CNAs, LPNs, health records technicians, dieticians, pharmacy technicians, healthcare facilities maintenance, and 

medical billing. The Committee understands several Job Corps 

Centers have expressed interest in being designated health care 

magnet centers, including the Columbia Basin (WA), Keystone 

(PA), and the Miami (FL) Job Corps Centers. 

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

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

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

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

supportive services as they transition from Job Corps back to their 

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

the continued availability to youth to transition services that are 

national in scope, yet local in focus. 

Native Americans 

For Native Americans, the Committee recommends $54,675,000. 

This is the same as the fiscal year 2004 level and $325,000 below 

the budget request. This program, authorized by the Workforce Investment Act of 1998, is designed to improve the economic well 

being of Native Americans (Indians, Eskimos, Aleuts, and Native 

Hawaiians) through the provision of training, work experience, and 

12 

other employment-related services and opportunities that are intended to aid the participants to secure permanent, unsubsidized 

jobs. The Department of Labor allocates formula grants to Indian 

tribes and other Native American groups whose eligibility for such 

grants is established in accordance with Department regulations. 

Migrant and seasonal farmworkers 

For Migrant and Seasonal Farmworkers, the Committee rec- ommends $76,874,000. This is the same as the fiscal year 2004 

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

The Committee recommendation includes bill language directing 

that $4,583,000 for migrant and seasonal farmworker housing 

grants. The bill language further directs that not less than 70 percent of this amount be used for permanent housing grants. The recommendation also provides that the remaining amount be used for 

State service area grants, including funding grantees in those 

States impacted by formula reductions at no less than eighty-five 

percent of the comparable 1998 levels for such States. Within the 

National Activities/Other line item, the Committee includes 

$504,000 to be used for Section 167 training, technical assistance 

and related activities, including continuing funding for migrant 

rest center activities at the current level. 

This program, authorized by the Workforce Investment Act of 

1998, is designed to serve members of economically disadvantaged 

families whose principal livelihood is derived from migratory and 

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

Enrollees and their families are provided with employment training 

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

National programs 

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

and research. 

Pilots, Demonstrations and Research: The Committee recommends $48,474,000 for grants or contracts to conduct research, 

pilots or demonstrates that improve techniques or demonstrate the 

effectiveness of programs. This is $9,277,000 below the fiscal year 

2004 level and $18,474,000 above the budget request. 

Evaluation: The Committee recommends $8,000,000 to provide 

for the continuing evaluation of program conducted under the 

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

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

$986,000 below the fiscal year 2004 level and the same as the 

budget request. 

Responsible Reintegration of Youthful Offenders: The Committee 

does not include funding for the Responsible Reintegration of 

Youthful Offenders program. The fiscal year 2004 level was 

$49,705,000 and the budget request is $50,000,000. 

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

The funds recommended support the development of performance 

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

the fiscal year 2004 level and the same as the budget request. 

13 

The Committee has not included separate funding for new programs requested by the Administration. The Administration requested $50,000,000 for Personal Reemployment Accounts and 

$40,000,000 for the Prisoner Re-entry Initiative. The Committee 

has deferred action on these two new programs until after the passage of authorizing legislation. In addition, the Administration requested $250,000,000 for the Community College Initiative. The 

Committee has provided up to $50,000,000 of National Reserve 

funds for this purpose. 

Rescission: The Committee has included language rescinding 

$100,000,000 of the unobligated funds contained in the H1–B Nonimmigrant Petitioner Account. The Committee understands that 

the authorization for this program has expired and that the Administration does not intend to seek reauthorization of this program. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

The Committee recommends $440,200,000 for community service 

employment for older Americans. This is $1,550,000 above the fiscal year 2004 level and the same as the budget request. 

The community service employment for older Americans program 

provides grants to public and private nonprofit organizations that 

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

does not exceed 125 percent of the poverty level. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

The Committee recommends $1,057,300,000. This is 

$280,900,000 below the fiscal year 2004 level and the same as the 

budget request. 

The Trade Adjustment Assistance Program provides assistance to 

certified workers adversely affected by imports and trade with 

countries covered by the North America Free Trade Agreement. 

Funding will continue the implementation of the TAA program 

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

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

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

The Committee recommends $3,582,848,000 for this account. 

This is $5,056,000 below the fiscal year 2004 level and $10,586,000 

less than the budget request. Included in the total availability is 

$3,440,914,000 authorized to be drawn from the Employment Security Administration Account of the Unemployment Trust Fund and 

$141,934,000 to be provided from the general fund of the Treasury. 

The funds in this account are used to provide administrative grants 

and assistance to State agencies that administer Federal and State 

unemployment compensation laws and operate the public employment service. 

For Unemployment Insurance Services, the Committee recommends $2,701,214,000. This is $82,685,000 above the fiscal year 

2004 level and $10,000,000 below the budget request. The total includes $2,690,714,000 for State Operations and $10,500,000 for national activities. Included in the amount provided for State OperVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00013 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
14 

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

conduct Unemployment Insurance eligibility interviews. 

For the Employment Service, the Committee recommends 

$763,000,000, which includes $23,300,000 in general funds together 

with an authorization to spend $739,700,000 from the Employment 

Security Administration Account of the Unemployment Trust Fund. 

This is $87,995,000 below the fiscal year 2004 level and the same 

as the budget request. Included in the bill for the Employment 

Service grants to States is $696,000,000, available for the program 

year of July 1, 2005 through June 30, 2006. This is $90,887,000 

below the fiscal year 2004 level and the same as the budget request. 

The Committee recommends $67,000,000 for ES national activities. This is $3,029,000 above the fiscal year 2004 level and the 

same as the budget request. 

The Committee recommends $98,764,000 for America’s Labor 

Market Information System. This is the same as the fiscal year 

2004 level and $586,000 below the budget request. This funding 

supports core employment statistics, universal access for customers, improving efficiency in labor market transactions, and 

measuring and displaying WIA performance information. 

The Committee recommendation includes $19,870,000 for the 

Work Incentives Grants program, $117,000 above the fiscal year 

2004 level and the same as the budget request, to help persons 

with disabilities find and retain jobs through the One-Stop Career 

Center system mandated by the Workforce Investment Act. Funding will support systems building grants intended to ensure that 

One-Stop systems integrate and coordinate mainstream employment and training programs with essential employment-related 

services for persons with disabilities. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee recommends $517,000,000. This is $50,000,000 

above the fiscal year 2004 level and the same as the budget request. The appropriation is available to provide advances to several 

accounts for purposes authorized under various Federal and State 

unemployment compensation laws and the Black Lung Disability 

Trust Fund, whenever balances in such accounts prove insufficient. 

PROGRAM ADMINISTRATION

The Committee recommends $170,354,000. This is $1,995,000 

below the fiscal year 2004 level and $10,664,000 below the budget 

request. This includes $111,375,000 in general funds and authority 

to expend $57,479,000 from the Employment Security Administration Account of the Unemployment Trust Fund. Within the 

amounts provided, the Committee has included $6,900,000 for Executive Direction. This is $1,500,000 below the fiscal year 2004 

comparable level and $1,818,000 below the request. General funds 

in this account provide the Federal staff to administer employment 

and training programs under the Workforce Investment Act of 

1998, the Older Americans Act, the Trade Act, and the National 

Apprenticeship Act. Trust funds provide for the Federal administration of employment security functions under title III of the Social Security Act and the Immigration and Nationality Act. 

15 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

The bill provides $132,345,000 for the Employee Benefits Security Administration, an increase of $8,305,000 over the fiscal year 

2004 level and the same amount as the budget request. 

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

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

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

8477 and 8478 of the Federal Employees’ Retirement Security Act 

of 1986. The agency was also given responsibilities under the 

Health Insurance Portability and Accountability Act of 1996. 

The Committee is interested in policy initiatives that enhance 

personal retirement readiness and security of the Nation’s workforce. The Committee is aware of an innovative proposal of the 

International Foundation for Retirement Education to identify the 

real rate of retirement readiness of the workforce and the Committee encourages EBSA to consider supporting such a project. 

PENSION BENEFIT GUARANTY CORPORATION

The Corporation’s budget for fiscal year 2004 is $266,330,000, 

which is $33,558,000 above the fiscal year 2004 level and the same 

as the budget request. 

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

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

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

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

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

or go out of existence. 

The bill includes language permitting obligations in excess of the 

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

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

may change the total amount available to any agency. 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $402,818,000 for this account. This is 

$10,802,000 above the budget request and $6,476,000 below the fiscal year 2004 comparable level. The bill includes $400,797,000 in 

general funds for this account and contains authority to expend 

$2,021,000 from the Special Fund established by the Longshore 

and Harbor Workers’ Compensation Act. 

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

Act, the Immigration and Nationality Act, the Migrant and SeaVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00015 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
16 

sonal Agricultural Workers’ Protection Act, the Davis-Bacon Act, 

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

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

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

The Committee requests the Department submit a report that 

details: (1) the specific changes that have been made to the wage 

determination process, the costs associated with those changes, and 

the effectiveness of those changes; (2) what additional changes are 

planned for the future and the proposed schedule for implementation; and (3) any recommendations for further changing the wage 

determination process. 

SPECIAL BENEFITS

The bill includes $233,000,000. This is the same $70,000,000 

above the fiscal year 2004 appropriation and the same as the budget request. This appropriation primarily provides benefits under 

the Federal Employees’ Compensation Act (FECA). The payments 

are required by law. In fiscal year 2004, an estimated 155,000 injured Federal workers or their survivors will file claims; 55,500 will 

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

The total amount to be available in fiscal year 2004 for FECA 

payments is expected to be $3,561,963,000, an increase of 

$113,202,000 over the fiscal year 2004 comparable level. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

The Committee recommends an appropriation of $276,000,000 for 

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

$88,000,000 appropriated last year as an advance for the first quarter of fiscal year 2004, the same as the budget request. These funds 

are used to provide monthly benefits to coal miners disabled by 

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

The Committee recommends an advance appropriation of 

$81,000,000 for the first quarter of fiscal year 2005, the same as 

the budget request. These funds will ensure uninterrupted benefit 

payments to coal miners, their widows, and dependents. 

The Black Lung Consolidation of Administrative Responsibility 

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

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

ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL

ILLNESS COMPENSATION FUND

The bill includes $40,821,000 for the Energy Employees Occupational Illness Compensation Program authorized by Title XXXVI of 

the National Defense Authorization Act of 2001. This is 

$10,830,000 below the fiscal year 2004 level and the same as the 

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

provides compensation to employees or survivors of employees of 

the Department of Energy (DOE), its contractors and subcontracVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00016 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
17 

tors, companies that provided beryllium to DOE, and atomic weapons employees who suffer from a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of their work 

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

BLACK LUNG DISABILITY TRUST FUND

The bill includes $1,058,644,000 for this account, of which 

$57,049,000 is definite budget authority and $1,001,951,000 is indefinite budget authority. The bill language provides such sums as 

may be necessary to pay for benefits. 

The Trust Fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operator can 

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

are incurred in administering the benefits program and operating 

the Trust Fund. 

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

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

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

liable. The advances to the Fund assure availability of necessary 

funds when liabilities may exceed other income. The Omnibus 

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

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $461,599,000 for the Occupational Safety and Health Administration. This is $4,058,000 above the fiscal year 

2004 level and the same as the budget request. This agency is responsible for enforcing the Occupational Safety and Health Act of 

1970 in the Nation’s workplaces. 

The Committee has included language prohibiting OSHA from 

obligating or expending any of these funds to enforce the annual 

fit test requirement of the General Industry Respiratory Protection 

Standard with respect to exposure to tuberculosis. 

The Committee commends OSHA, EPA and the private-sector 

participants who are supporting the Alliance on Identification and 

Management of Chemical Reactivity Hazards as an outstanding example of joint cooperative public/private efforts to improve health 

and safety in the workplace and community. The Committee directs the Director of the Occupational Safety and Health Administration to assure that sufficient resources will be made available to 

support this Alliance’s objectives to develop and disseminate materials to assist in the identification and management of reactive 

chemical hazards, including electronic assistance resources (e.g., 

interactive software e-Tools, technology-based training), training 

and materials for OSHA staff, and the customization of these tools 

and resources for specific workplace sectors, such as small and medium enterprises. 

The Committee is disappointed by OSHA’s decision to proceed 

with enforcement of the General Industry Respiratory Protection 

Standard as it applies to occupational exposure to tuberculosis 

18 

(TB). The Committee strongly urges the agency to delay enforcement of the Respiratory Standard as it applies to TB. Personal respiratory protections have been in place in healthcare facilities for 

over 10 years, as recommended by the Centers for Disease Control 

and Prevention (CDC), and as enforced through OSHA’s General 

Duty Clause. Additionally, the Committee strongly advises OSHA 

to take no further action with regard to occupational exposure to 

TB until such time as the CDC has completed the ongoing revisions 

of its TB guidelines. Subsequent actions should only be taken in accordance with the CDC’s recommendations. 

The Committee continues to be concerned with the lack of 

progress on the agency’s regulation concerning Employer Payment 

for Personal Protective Equipment, the public comment period for 

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

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

whom work in the nation’s most dangerous professions, including 

the construction industry. The Committee urges the agency to 

move expeditiously toward the completion of this regulation. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The bill includes $275,567,000 for this agency. This is $6,710,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. This agency enforces the Federal Mine Safety and 

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

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

The total funding recommended by the Committee for the Bureau of Labor Statistics (BLS) is $533,518,000. This is $15,022,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. The bill includes $455,045,000 in general funds for 

this account and authority to spend $78,473,000 from the Employment Security Administration Account of the Unemployment Trust 

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

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

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES

The bill includes $47,555,000 for the Office of Disability Employment Policy, which is $531,000 above the fiscal year 2004 comparable level and the same as the budget request. The Office provides leadership to eliminate employment barriers to people with 

disabilities. 

19 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

The bill includes $259,967,000 for Departmental Management activities. This is $90,352,000 below the fiscal year 2004 level and 

$27,201,000 below the budget request. The bill includes 

$259,653,000 in general funds for this account along with authority 

to transfer $314,000 from the Employment Security Administration 

Account of the Unemployment Trust Fund. 

The Departmental Management appropriation finances staff is 

responsible for formulating and overseeing the implementation of 

Departmental policy and management activities. In addition, this 

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

but for which other salaries and expenses appropriations are not 

suitable. 

The Committee recommendation includes $27,084,000 for Executive Direction, the same as the fiscal year 2004 level and 

$6,122,000 below the budget request. 

The bill provides $30,000,000 for the Department-wide information technology crosscut, which is $18,219,000 below the fiscal year 

2004 comparable level and $3,565,000 below the budget request. 

The Committee commends the Department in streamlining its information technology infrastructure into a single, uniform system 

and encourages the Department in this effort. 

The bill provides $5,000,000 for the Departmental Management 

Crosscut. This is $35,000 above the fiscal year 2004 level and 

$5,100,000 below the budget request. 

The bill includes $32,675,000 for the Administration and Management program that provides leadership and policy guidance for 

a number of Department-wide activities. This is $478,000 above the 

fiscal year 2004 level and the same as the budget request. 

The bill includes $35,545,000 for the Bureau of International 

Labor Affairs (ILAB), which is $5,000,000 above the budget request 

and $74,317,000 below the fiscal year 2004 comparable level. At 

the level in this bill, ILAB will continue to coordinate the Department’s global responsibilities in 2004 and to provide expert support 

for many of the Administration’s international initiatives, including 

the promotion of core labor standards and the elimination of exploitative child labor. 

The Committee recognizes the importance of fostering economic 

growth in developing regions of the world and recommends that the 

International Labor Affairs Bureau ensure that the United States 

Government recognizes and promotes international standards of 

excellence, and encourages public-private partnerships that focus 

on capacity building in priority areas such as labor standards and 

human rights, rule of law, trade facilitation, and workforce training 

and education. The Committee is aware of the work being performed by the Global Training Partnership (GTP) to promote capacity building for jobs and economic growth in developing regions 

globally. The Committee recommends that the agency expand the 

work of the Global Training Partnership to build regional capacity 

in Sub-Saharan Africa, Central America, the Caribbean and Andean regions, in order to maximize benefits from improvement of 

20 

sound policies and practices conducive to economic growth, poverty 

reduction, and the rule of law. 

The Committee intends that the Women’s Bureau increase funding for Women Work! training and technical assistance services for 

programs that assist women in transition to reenter the workforce. 

Women Work! has valuable experience, is uniquely qualified to deliver these services through its national network, and has demonstrated results through outcome assessments. An increase in 

funding is needed to meet the needs of more than 1,000 programs 

in the Women Work! Network. 

The Committee is aware of ongoing discussions concerning the 

mandatory expensing of stock options and believes that further information is needed about the possible consequences of such expensing for the high technology workforce. The Committee has provided $50,000 to initiate this study to examine the role of broadbased stock option plans in the recruitment and retention of skilled 

workers. The study shall be provided to the Committee on Appropriations by December 31, 2004. 

ASSISTANT SECRETARY FOR VETERANS EMPLOYMENT AND TRAINING

The Committee recommends $220,648,000 for veteran employ- ment and training activities. This is $2,002,000 above the fiscal 

year 2004 level and the same as the budget request. Within this 

amount, the bill includes $194,098,000 to be expended from the 

Employment Security Administration account of the Unemployment Trust Fund for the traditional State and Federal administration of veterans’ employment and training activities. For State grants the Committee recommends $162,415,000. This is $1,007,000 above the fiscal year 2004 level and the same as the 

budget request. 

For Federal administration, the Committee recommends 

$29,683,000. This is $826,000 above the fiscal year 2004 level and 

the same as the budget request. The Committee recommends 

$2,000,000 for the National Veterans Training Institute, the same 

as the budget request. The Committee recommends $19,000,000 for 

the homeless veterans reintegration program assisting homeless 

veterans to find jobs, the same as the budget request. The Committee recommends $7,550,000 for veterans workforce investment 

programs, the same as the budget request. 

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

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

guide for veterans in accessing workforce investment services; a 

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

workforce investment planning processes; and a guide to inform 

workforce systems on the employment services needs of veterans 

and the responsibility of such systems to prioritize veterans for 

services and to collaborate with veterans organizations and providers. 

The Committee urges the Secretary to instruct state workforce 

agencies to increase their outstationing of disabled veterans outreach program specialists and local veterans employment representatives in locations where homeless veterans congregate, inVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00020 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
21 

cluding grantees under the homeless provider grant and per diem 

program and the homeless veterans reintegration program. 

Individuals leaving the military are at high risk of homelessness 

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

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

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

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

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

OFFICE OF THE INSPECTOR GENERAL

The bill includes $69,590,000 for the Office of the Inspector General (OIG). This is $4,251,000 above the fiscal year 2004 comparable level and the same as the budget request. This includes 

$64,029,000 in general funds for this account along with the authority to transfer $5,561,000 from the Employment Security Administration Account of the Unemployment Trust Fund. 

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

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

program evaluations, the OIG attempts to reduce the incidence of 

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

efficiency, and effectiveness throughout the Department. 

WORKING CAPITAL FUND

The Committee includes $10,000,000 for a new core accounting 

system for the Department of Labor, including hardware and software infrastructure. 

GENERAL PROVISIONS

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

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

rate in excess of Executive Level II. 

Sec. 102. The Committee includes a provision to permit transfers 

of up to one percent between appropriations, the same as the budget request. 

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

to receive. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

The bill includes $6,266,982,000 for health resources and services 

programs, which is $326,321,000 below the fiscal year 2004 comparable level for these activities and $244,149,000 above the budget 

22 

request. In addition, the Committee provides $542,649,000 in the 

Public Health and Social Services Emergency Fund for two programs administered by the Health Resources and Services Administration (HRSA)—$514,944,000 for hospital preparedness and 

$27,705,000 for education incentives for medical school curriculum. 

HRSA supports programs which provide health services to disadvantaged, medically undeserved, and special populations; improve infant mortality rates; direct the education, supply, and distribution of a wide range of health professionals; and provide technical assistance regarding the utilization of health resources and 

facilities. 

Community health centers 

The Committee provides $1,835,925,000 for community health centers, which is $218,544,000 above the fiscal year 2004 comparable level and the same as the budget request. These funds support programs which include community health centers, migrant 

health centers, health care for the homeless and public housing 

health service grants. 

The Committee includes bill language similar to previous years 

limiting the amount of funds available for the payment of claims 

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

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

2004 bill. The Committee recognizes the value of this program for 

health centers and as additional health centers participate in the 

program, the number of claims submitted and paid also increases. 

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

Act. The Committee notes that $121 million remains, of the $160 

million appropriated in fiscal years 1997 and 1998, for loan guarantee authority for guarantees of both loan principal and interest. 

Although the Committee continues to support the expansion of 

the health center program to double the number of patients served, 

the Committee is concerned that current funding methodologies 

may not recognize the increased cost of providing services for current patients at existing health centers. The Committee urges 

HRSA to use a portion of the increased funding provided to increase support for existing health centers based on performance-related criteria in addition to site and service expansion applications. 

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

wasting scarce resources to reapply for funding. However, HRSA 

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

expected Presidential requests. 

The Committee is pleased with the success of the school-based 

health center initiative, but is concerned that in the last fiscal year 

only 3 of 43 applications were funded. The Committee expects 

HRSA to continue to target funds for school-based health centers 

operated by fully qualified organizations and expresses concern 

that school-based health centers often experience difficulty completing the complex application process for community health center funding. The Committee requests that HRSA establish a separate application process for school-based health centers that recogVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00022 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
23 

nizes the distinct patient volume, productivity, scope of service, and 

staffing requirements that are more appropriate to school-based delivery systems. 

Community health centers are encouraged to make ultrasound 

services available to their patients. 

Free clinics medical malpractice 

The Committee does not provide fiscal year 2005 funding for payments of claims under the Federal Tort Claims Act to be made 

available for volunteer free clinic health care professionals. 

$4,821,000 was provided for this purpose in fiscal year 2004 and 

claims are not expected against the fund until at least fiscal year 

2006. The program extends Federal Tort Claims Act coverage to 

health care professional volunteers in free clinics in order to expand access to health care services to low-income individuals in 

medically underserved areas. According to Title 42, Section 233(o), 

a free clinic must apply, consistent with the provisions applicable 

to community health centers, to have each health care professional 

‘deemed’ an employee of the Public Health Service Act, and therefore eligible for coverage under the Federal Tort Claims Act. The 

Committee will be interested to learn how many health care professionals apply to be deemed for coverage under the program as it 

begins operation this year. 

National Health Service Corps: Field placements 

The Committee provides $45,506,000 for field placements, which is the same as the fiscal year 2004 comparable level and $229,000 

below the budget request. These funds are used to support the activities of National Health Service Corps (NHSC) obligors and volunteers in the field, including travel and transportation costs of assignees, training and education, recruitment of students, residents 

and clinicians and retention activities. Salary costs of most new assignees are paid by the employing entity. 

National Health Service Corps: Recruitment 

The Committee provides $124,397,000 for recruitment activities, 

which is the same as the fiscal year 2004 comparable level and 

$34,735,000 below the budget request. The program awards scholarships to health professions students and assists graduates in repaying their student loans. In return for every year of support, 

these individuals are obligated to provide a year of service in 

health professional shortage areas of greatest need. The minimum 

obligation is two years. The Committee does not include the bill 

language requested by the Administration to establish a flexible 

Commissioned Corps reserve within the NHSC and does not expect 

funds to be used for this purpose. 

The Committee is pleased by the increasing proportion of NHSC 

assignees being placed at community, migrant, homeless, and public housing health centers. The Committee encourages HRSA to 

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

through the NHSC. 

The Committee is concerned that the current HPSA scoring process used by HRSA may disadvantage some health centers located 

in medically underserved areas of the country. The Committee enVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00023 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
24 

courages HRSA to consider using alternative data to score Federally qualified health centers under the automatic designation process. 

Health professions 

The Committee provides $416,365,000 for all health professions training programs, which is $19,715,000 below the fiscal year 2004 

comparable level and $258,582,000 above the budget request. The 

Committee was unable to restore completely the $278,297,000 reduction in health professions funding proposed by the Administration, but intends to continue all the programs at manageable operating levels with the funds provided. The Committee felt it was especially important to support diversity and nurse training programs. The Bureau of Health Professions provides both policy leadership and support for health professions workforce enhancement 

and educational infrastructure development. 

The Committee commends HRSA for its continuing efforts to address the growing gap between the size of the Nation’s aging baby 

boom population and the number of pulmonary/critical care physicians. The Committee continues to encourage HRSA to address the 

critical care workforce shortage issue and use the pulmonary/critical care specialty as a model for developing and testing policy approaches to address workforce shortage issues. 

The Committee is concerned that too few clinics and physicians 

are prepared to treat patients with rare diseases. Therefore, the 

Committee encourages HRSA to include ‘‘treatment of patients 

with rare diseases’’ and ‘‘training of health professionals to recognize and treat patients with rare diseases’’ as priority areas in its 

selection of health professions training grants. 

Centers of excellence 

The Committee provides $33,882,000 for centers of excellence, 

which is the same as the fiscal year 2004 comparable level. The Administration did not request funding for this program. The program 

is designed to strengthen the national capacity to educate underrepresented minority (URM) students in the health professions by 

offering special support to those institutions which train a significant number of URM individuals, including African-Americans, 

Hispanics and Native Americans. Funds are used for the recruitment and retention of students and faculty, information resources 

and curricula, faculty and student research, and the development 

of plans to achieve institutional improvements. 

The Committee is pleased that HRSA has re-focused the minority 

centers of excellence program on providing support to historically 

minority health professions institutions. The Committee recognizes 

the important role of this program in supporting faculty and other 

academic programs at minority institutions. The Committee encourages the program to consider applications that are responsive 

to allied health professions that are experiencing shortages and 

high vacancy rates, such as laboratory personnel. 

Health careers opportunity program 

The Committee provides $35,935,000 for the health careers opportunity program, which is the same as the fiscal year 2004 comparable level. The Administration did not request funding for this 

25 

program. This program provides grants and contracts to eligible 

health professions schools for identifying, recruiting, and selecting 

individuals from the various racial and ethnic populations who are 

from disadvantaged backgrounds for education and training in a 

health profession and facilitating their entry into, retention and 

completion of their education at a health professions school. 

The Committee encourages HRSA to give priority consideration 

to awarding grants to those institutions with a historic mission of 

training minorities in the health professions. The Committee encourages the program to consider applications that are responsive 

to allied health professions that are experiencing shortages and 

high vacancy rates, such as laboratory personnel. 

Faculty loan repayments 

The Committee provides $1,313,000 for loan repayments and fellowships regarding faculty positions, which is the same as the fiscal year 2004 comparable level. The Administration did not request 

funding for this program. The program provides for the repayment 

of educational loans of individuals from disadvantaged backgrounds 

who are health professions students or graduates, and who have 

agreed to serve for not less than two years as a faculty member of 

an eligible health professions school. The school matches the Federal contribution toward loan repayment. The program also supports fellowships for URM faculty members. 

Scholarships for disadvantaged students 

The Committee provides $47,510,000 for scholarships for disadvantaged students, which is the same as the fiscal year 2004 

comparable level and $37,613,000 above the budget request. The 

program provides grants to eligible health professions and nursing 

schools to provide scholarships to eligible individuals from disadvantaged backgrounds, including students who are members of 

racial and ethnic minority groups. By statute, not less than 16 percent of the funds must go to schools of nursing. 

Training in primary care medicine and dentistry 

The Committee provides $63,857,000 for training in primary care 

medicine and dentistry, which is $17,885,000 below the fiscal year 

2004 comparable level. The Administration did not request funding 

for this program. The program is comprised of four elements: (1) 

family medicine programs; (2) general internal medicine and general pediatrics (GIM/GP) training; (3) physician assistants (PA) 

training; and (4) general or pediatric dentistry training. Family 

medicine grants and contracts promote the predoctoral training of 

medical students, support family medicine residency programs and 

their trainees, train physicians who plan to teach in family medicine programs, and assist in establishing or improving family medicine academic administrative units. GIM/GP grants and contracts 

are to plan and operate residency programs and to provide financial assistance for residents, meet the costs of training programs 

for physicians who plan to teach in GIM/GP, as well as to support 

the faculty trainees, and develop programs to support predoctoral 

activities. PA training grants and contracts are to plan, develop, 

and operate programs for the training of PAs and for the training 

of individuals who will teach in programs to provide such training. 

26 

General or pediatric dentistry training grants and contracts are to 

meet the costs of planning, developing, or operating programs and 

to provide financial assistance to residents in such programs. 

The Committee recognizes the important role that HRSA centers 

for leadership in pediatric dentistry education provide in preparing 

dentists with dual training in pediatric dentistry and dental public 

health. Dentists in the three currently funded programs concentrate on working with federal, state and local programs that 

provide services for vulnerable populations including low-income 

children and women and children with special health care needs. 

Dentists trained through these centers provide State and community leadership in maternal and child oral health programs, and become future faculty specializing in pediatric dentistry and maternal 

and child health. 

The Committee recognizes there will be a major increase in the 

pediatric population through 2020 and an increased percentage of 

the children will be under-privileged. The roughly one of every six 

children living in poverty today has about five times the level of 

untreated dental disease compared to their more affluent peers. Pediatric dentistry residency programs provide both treatments for 

underprivileged children and training opportunities for pediatric 

dentists. In fact, two-thirds of the patients treated in these programs are Medicaid recipients. Recruitment and retention of pediatric dental educators is vital to pediatric dental residency programs. While pediatric dentists treat about 30 percent of the children in this country, they train 100 percent of the dentists who 

treat children. The Committee encourages HRSA to develop innovative programs, such as faculty development initiatives and a faculty loan repayment pilot program. 

Area health education centers 

The Committee provides $29,206,000 for area health education 

centers (AHEC), which is the same as the fiscal year 2004 comparable level. The Administration did not request funding for this 

program. The program links university health science centers with 

community health service delivery systems to provide communitybased training sites for students, faculty, and practitioners. The 

program supports two types of projects: (1) basic/core AHEC cooperative agreement projects to plan and implement new and developing programs; and (2) model programs to extend AHEC cooperative agreement projects, with not less than 50 percent of the project 

costs supported by non-Federal monetary contributions. The Committee encourages AHEC programs to coordinate with the rural 

health outreach program for the greater effectiveness of both programs. 

Health education and training centers 

The Committee has provided $3,851,000 for health education and 

training centers, the same as fiscal year 2004. The Administration 

did not request funds for this program. The program funds schools 

of medicine and osteopathy to conduct training and education programs for health professions students to improve the access, diversity, and quality of health personnel along the border between the 

United States and Mexico, in the State of Florida, and in other 

urban and rural areas with populations with serious unmet health 

27 

care needs. The program also provides educational support to 

health professionals, including nursing, practicing in the area. 

Allied health and other disciplines 

The Committee provides $11,849,000 for allied health and other 

disciplines, which is the same as the fiscal year 2004 comparable 

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

The program is comprised of three elements: (1) allied health special projects; (2) podiatric primary care residency training; and (3) 

chiropractic demonstration projects. Allied health special projects 

assist entities in meeting the costs associated with expanding or establishing programs that will increase the number of individuals 

trained in allied health professions. Activities included are those 

that: (1) expand enrollments; (2) provide rapid transition and career advancement training programs; (3) establish communitybased training programs; (4) expand or establish interdisciplinary 

training programs, demonstration centers, and clinical training 

sites in medically underserved or rural communities; (5) provide 

traineeships to students; and (6) plan, develop, and operate or 

maintain graduate programs in behavioral and mental health practice. Podiatric primary care residency training grants and contracts 

are for planning and implementing projects in residency programs 

and providing traineeships to residents who plan to specialize in 

primary care. Chiropractic demonstration grants and contracts are 

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

spinal and lower-back conditions. 

The Committee intends that the same amounts as in fiscal year 

2004 be provided for the graduate psychology education program to 

train health service psychologists as well as the geropsychology 

training program. The Committee understands that this is the only 

federally funded psychology training program, and for this reason, 

considers its continuation a high priority. This competitive program 

will continue to provide grant awards for work with underserved 

populations, particularly in rural communities, including elderly, 

children, the chronically ill, and victims of abuse or terror. 

The Committee continues to encourage HRSA to give priority 

consideration to projects for schools training allied health professionals experiencing shortages, such as medical technologists and 

cytotechnologists. The Committee is concerned about high vacancy 

rates for these laboratory personnel and urges HRSA to redouble 

efforts to address these shortages. 

Geriatric programs 

The Committee provides $31,805,000 for geriatric programs, 

which is the same as the fiscal year 2004 comparable level. The Administration did not request funding for this program. The program 

provides grants and contracts to eligible entities to: (1) establish 

geriatric education centers to provide training for health care professionals who provide treatment and for training and retraining of 

faculty who teach geriatrics; (2) provide support for geriatric training projects to train physicians, dentists, and behavioral and mental health professionals who plan to teach geriatrics; and (3) establish a program to provide Geriatric Academic Career Awards to eliVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00027 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
28 

gible individuals to promote the career development of such individuals as academic geriatricians. 

The Committee intends that the same amounts as in fiscal year 

2004 be provided to geriatric education centers, geriatric training 

programs, and geriatric academic career awards. The Committee is 

concerned that there is an insufficient number of health care providers trained to address the health care needs of the growing older 

population. With only a small number of new physicians going into 

the field and those already in the field approaching retirement age, 

incentives are needed to increase the number of academic geriatricians to competently train health professionals from a variety of 

disciplines, including geriatric medicine. The Committee believes 

that to meet the needs of an aging population, HRSA needs to improve the training of all health professionals in geriatrics. 

Quentin N. Burdick program for rural interdisciplinary training 

The Committee provides $2,255,000 for the Quentin N. Burdick program for rural interdisciplinary training, which is $3,871,000 

below the fiscal year 2004 comparable level. The Administration 

did not request funding for this program. The program provides 

grants and contracts to entities for the purpose of funding interdisciplinary training projects that are designed to train, recruit, 

and retain teams of interdisciplinary professionals to work in underserved areas. 

Health professions workforce information and analysis 

The Committee has not provided funding for health professions 

workforce information and analysis. The Administration requested 

$999,000 for this program, and the fiscal year 2004 comparable 

level is $722,000. The Department is encouraged to use policy evaluation funds to support this program. 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 a non-Federal analytic and research infrastructure, and the conduct of program evaluation and 

assessment. 

Public health, preventive medicine and dental public health programs 

The Committee provides $6,970,000 for public health, preventive 

medicine and dental public health programs, which is $2,200,000 

below the fiscal year 2004 comparable level. The Administration 

did not request funding for this program. The program is comprised 

of three elements: (1) public health training centers; (2) public 

health traineeships; and (3) preventive medicine and dental public 

health residencies. Grants or contracts for the operation of public 

health training centers are awarded to an accredited school of public health, or another public or nonprofit private institution accredited for the provision of graduate or specialized training in public 

health, that plans, develops, operates, and evaluates projects in the 

areas of preventive medicine, health promotion and disease prevention, or improving access to and quality of health services in medically underserved communities. Public health traineeship grants 

provide graduate or specialized public health training to individuals in the fields of epidemiology, environmental health, biostatisVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00028 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
29 

tics, toxicology, nutrition, and maternal and child health. Preventive medicine and dental public health residency grants and contracts assist schools in developing new residency training programs 

or improving existing programs and in providing financial assistance to residency trainees. 

Health administration programs 

The Committee provides $1,045,000 for health administration programs, which is $34,000 below the fiscal year 2004 comparable 

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

These programs provide grants to eligible entities with an accredited program in health administration, hospital administration, or 

health policy analysis and planning to provide traineeships to students and to assist accredited health administration programs in 

the development or improvement of programs to prepare students 

for employment with public or nonprofit private agencies. 

Advanced education nursing 

The Committee provides $53,634,000 for advanced education nursing, which is $5,002,000 below the fiscal year 2004 comparable 

level and $9,997,000 above the budget request. The program provides grants and contracts to eligible entities to meet the costs of: 

(1) projects that support the enhancement of advanced nursing 

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

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

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

Nurse education, practice and retention 

The Committee provides $36,765,000 for nurse education, practice and retention, which is $4,997,000 above the fiscal year 2004 

comparable level and $5,000,000 below the budget request. As 

amended by the Nurse Reinvestment Act of 2002, the nurse education, practice and retention program is a broad authority with 

targeted purposes under three priority areas—education, practice 

and retention—in response to the growing nursing shortage. Under 

this authority, purposes identified under the Education Priority 

Area include: (1) expanding enrollment in baccalaureate nursing 

programs to increase the number of registered nurses; (2) developing and implementing internship and residency programs with 

mentoring components designed to retain new nurses, bring nurses 

back into the workforce and support the development of specialties 

for experienced nurses; and (3) providing education in new technologies, including distance learning methodologies. Purposes identified under the Practice Priority Area include: (1) establishing or 

expanding nursing practice arrangements, commonly referred to as 

nurse managed centers, in noninstitutional settings to demonstrate 

methods to improve access to primary health care in medically underserved communities; (2) providing care for underserved populations and other high risk groups such as the elderly, individuals 

with HIV/AIDS, substance abusers, the homeless, and victims of 

30 

domestic violence; (3) providing managed care, quality improvement, and other skills needed to practice in existing and emerging 

organized health care systems; and (4) developing cultural competencies among nurses. Purposes identified under the Retention 

Priority Area include: (1) career ladder programs to promote advancement in a variety of training settings and assisting individuals in obtaining education and training required to enter the 

nursing profession; and (2) projects to improve the retention of 

nurses and enhance patient care that is directly related to nursing 

activities. 

Nursing workforce diversity 

The Committee provides $16,402,000 for nursing workforce diversity, which is the same as the fiscal year 2004 comparable level 

and $4,997,000 below the budget request. The program provides 

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

backgrounds, including racial and ethnic minorities, by providing 

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

within the nursing and health care community. 

Loan repayment and scholarship program 

The Committee provides $31,738,000 for nurse loan repayment for shortage area service, which is $5,002,000 above the fiscal year 

2004 comparable level and the same as the budget request. This 

program offers student loan repayment to nurses in exchange for 

an agreement to serve not less than two years in an Indian Health 

Service health center, Native Hawaiian health center, public hospital, community or migrant health center, or rural health clinic. 

Comprehensive geriatric education 

The committee provides $3,478,000 for comprehensive education, 

which is the same as the fiscal year 2004 comparable level and the 

Administration request. The comprehensive geriatric education program supports grants to develop and implement, in coordination 

with Title VII geriatric education programs, to train and educate 

individuals providing care for the elderly. Funds are to be used for 

(1) providing training to individuals who will provide geriatric care 

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

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

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

Nurse faculty loan program 

The Committee provides $4,870,000 for the nurse faculty loan 

program, which is the same as the fiscal year 2004 comparable 

level and the Administration request. The nurse faculty loan program addresses the problem of a growing shortage of nursing faculty. Both the National League for Nursing and the American Association of Colleges of Nursing have published data on the severity 

of the shortage and the implications. Potential nursing students 

are being turned away from nursing schools because faculty are not 

31 

available. The nurse faculty loan program supports the development of a student loan fund in schools of nursing to increase the 

number of qualified nursing faculty. Students may receive loans up 

to $30,000 per year for a maximum of 5 years. The program has 

a cancellation provision for up to 85 percent of the loan for recipients working full-time as nursing faculty for a period of 4 years. 

Twenty percent of the principal and interest may be canceled for 

each of the first, second and third year, and 25 percent may be canceled for the fourth year of full-time employment as nursing faculty. 

Hansen’s disease services 

The Committee provides $17,413,000 for the Hansen’s disease 

program, which is the same as the fiscal year 2004 comparable 

level and the budget request. This program offers Hansen’s disease 

treatment to about 35 long term residents who continue to receive 

care from the National Hansen’s Disease Center and to others who 

receive care from grant-supported outpatient regional clinics. Other 

former long term residents have been offered and elected to receive 

a living allowance from the program and now live independently. 

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

Maternal and child health block grant 

The Committee provides $729,817,000 for the maternal and child 

health (MCH) block grant, which is the same as the fiscal year 

2004 comparable level and the budget request. The MCH block 

grant provides funds to States to meet a broad range of basic and 

enabling health services, including personal health services; general, population-wide health services, such as screening; family 

support services; and integrated systems of care. The authorizing 

statute provides that, up to a funding level of $600,000,000, 85 percent of the funds are distributed to the States, with 15 percent of 

the funds set aside for special projects of regional and national significance (SPRANS). When the appropriation exceeds $600,000,000, 

12.75 percent of the amount over $600,000,000 is directed to the 

Community Integrated Service Systems set-aside program. The remaining 87.25 percent is distributed by the same 85/15 percent allocation as in the basic block grant formula. 

The Committee has included bill language identifying 

$119,158,000 for the SPRANS set-aside. Within that total, 

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

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

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

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

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

targeting the reduction of early childhood caries and strengthening 

school-linked dental sealant programs. The Committee has also 

provided $4,000,000 within the SPRANS set-aside to support the 

continuation of the locally based newborn screening follow-up and 

community based sickle cell disease outreach and supportive service initiative. The Committee also provides $3,000,000 for the continuation of model demonstration programs and public awareness 

campaigns on epilepsy. The Committee recognizes epilepsy, a 

32 

chronic neurological condition, as a significant public health concern affecting over 2.5 million persons in the United States. As 

125,000 new cases of epilepsy are diagnosed annually, delayed diagnosis, along with inadequate seizure treatment, greatly increases 

the risk of subsequent seizures, brain damage, disability, and 

death. Therefore, timely, effective treatment is essential. The Committee is supportive of services that would improve access to health 

and other services to encourage early detection and treatment for 

children and others residing in rural, urban and otherwise medically underserved areas. The Committee is pleased that HRSA has 

partnered with a national voluntary epilepsy agency to carry out 

these activities. In addition, the Committee provides $2,000,000 to 

continue the newborn screening for heritable disorders demonstrations begun last year. Newborn screening is used for early identification of infants affected by certain genetic, metabolic, hormonal 

and or functional conditions for which there is effective treatment 

or intervention. Screening detects disorders in newborns that, left 

untreated, can cause death, disability, mental retardation and 

other serious illnesses. The Committee is aware of the wide disparity that exists between state newborn screening programs that 

can result in children suffering irreversible injury or death versus 

children receiving successful diagnosis and treatment, depending 

upon whether their state tests for certain disorders. The Committee encourages HRSA to work with States to facilitate the development of educational materials that inform parents and health 

care providers of the benefits of newborn screening, about which 

conditions are screened for in their state, and about options to have 

babies screened for additional conditions that are not covered by 

their state programs. The Committee commends the department on 

the establishment of the Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children and the appointment by the Secretary of fifteen members. The Committee 

urges the advisory committee to work promptly in order to provide 

States with valuable guidance and recommendations regarding 

newborn screening. 

Biliary atresia is a pediatric liver disease which affects one in 

10,000 infants. If identified and treated before the infant reaches 

the age of 60 days, biliary atresia has a high cure rate. If left untreated, it will result in liver failure, a liver transplant or death. 

The Committee is aware that other nations, such as Japan, have 

instituted infant screening for biliary atresia. The Committee requests a report by March 15, 2005 on the steps taken to validate 

a screening tool. 

It has come to the Committee’s attention that NIH has developed 

a technology to screen newborns for severe combined immune deficiency disease (SCID). The Committee commends the work that the 

Advisory Committee on Heritable Disorders and Newborn Screening under HRSA is doing in developing a list of recommended diseases to be screened for at birth. Since SCID is a pediatric emergency that can now be detected at birth and successfully treated, 

and is fatal without immediate diagnosis and treatment, the Committee recommends that the Advisory Committee include SCID 

newborn screening in its list of recommended newborn screening 

tests. 

33 

The Committee continues to recognize the critical role of the national network of hemophilia treatment centers in providing needed 

comprehensive care for bleeding disorders and urges HRSA to 

strengthen resources for the centers to ensure continued access to 

this model disease management network. 

The Committee commends HRSA for its support of the Sudden 

Infant Death Syndrome (SIDS) program support center and encourages the Maternal and Child Health Bureau to continue its efforts 

in this area of service. The Committee is pleased that the SIDS and 

Other Infant Death Support Center is collaborating with the National Institutes of Health to address the disproportionately high 

incidence of SIDS among African Americans. 

The Committee restates its long-standing interest in the support 

that MCHB has provided to comprehensive treatment centers for 

thalassemia patients under the SPRANS program and notes that 

the current funding is due to expire in FY05. The Committee encourages MCHB to continue this program and to coordinate its activities with relevant voluntary health organizations. 

The Committee recognizes the contributions of the long-standing 

Provider’s Partnership program. The Partnership includes a series 

of state-level projects initiated to address female psychosocial 

issues. The morbidity and mortality attributed to these issues such 

as a woman’s depression, tobacco use, substance abuse and domestic violence are becoming increasingly apparent. Obstetrician-gynecologists can play a critical role in addressing these problems within their current practice, however because of their complexity, and 

the importance of promptly linking at-risk women with appropriate 

services, responsibility for full psychosocial assessment and treatment cannot fall solely to obstetrician-gynecologists. Partnerships 

between these women’s health care providers and community programs are needed that allow for integration of medical care with 

psychosocial services. The Committee encourages continued funding of the Provider’s Partnership program. 

Since 1990, the Maternal and Child Health Bureau has worked 

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

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

family friendly services. Such efforts are crucial to understanding 

and addressing infant health disparities in communities at highest 

risk. The Committee encourages HRSA to continue to use Healthy 

Start funds to support the NFIMR project. 

The Committee encourages ACF’s Head Start Bureau and the 

Maternal and Child Health Bureau to continue and expand their 

successful interagency agreement to jointly address dental disease, 

the number one unmet health need of Head Start children. This 

partnership has brought together Head Start and the dental community at the national, state and local levels to seek solutions to 

improve access to oral health care for these children through the 

public and private sectors. 

34 

Abstinence education 

The Committee does not provide funding for abstinence education within the Health Resources and Services Administration. 

As requested by the Administration, this account is now funded 

within the Administration for Children and Families. 

Healthy Start 

The Committee provides $97,751,000 for Healthy Start, which is 

the same as the fiscal year 2004 comparable level and the budget 

request. Healthy Start provides grants to select communities with 

high rates of infant mortality to help them identify, plan, and implement a diverse range of community-driven strategies that can 

successfully and significantly reduce disparities in perinatal health 

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

Universal newborn hearing 

The Committee provides $9,872,000 for the universal newborn 

hearing screening program, which is the same as the fiscal year 

2004 comparable level. The Administration did not request funding 

for this program. The program provides competitive grants to 

States for the purpose of implementing a national program of universal newborn hearing screening by means of physiologic testing 

prior to hospital discharge, audiologic evaluation by three months 

of age, and entry into a program of early intervention by six 

months of age. 

Organ transplantation 

The Committee provides $24,632,000 for organ transplantation 

activities, which is the same as the fiscal year 2004 comparable 

level and the budget request. The program supports a scientific 

registry of organ transplant recipients; the National Organ Procurement and Transplantation Network, which matches organ donors with potential recipients; and grants and contracts with public 

and private non-profit organizations to promote and improve organ 

donation. 

The Committee is encouraged by the initial success of the organ 

donation collaborative project. This project is focused on the nation’s largest hospitals and has adopted the goal of assisting these 

hospitals achieve organ donation rates of 75% or higher, which will 

result in at least 6,000 additional organs available for transplantation. The Committee also encourages HRSA to consider adopting 

a national system of simultaneous referrals of available organs as 

opposed to the current system of sequential or serial referrals, as 

this will further guarantee that all available organs are utilized. 

The Committee also encourages HRSA to continue to support 

studies and demonstration projects to increase and maximize organ 

donation and recovery rates, including living donation. 

The Committee encourages the Division of Transplantation to enhance its partnership with the pulmonary hypertension (PH) community aimed at increasing awareness about the need for increased 

heart and lung donations. The Committee is aware that the Organ 

Procurement and Transplantation Network/United Network for 

Organ Sharing has issued a proposed rule governing the allocation 

of lungs for transplantation. The Committee encourages OPTN/ 

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35 

garding the methodology used to determine transplantation eligibility for PH patients. 

Cord blood bank 

The Committee does not provide additional funding for the cord 

blood program pending the completion of the Institute of Medicine 

report on the structure and administration of such a program. 

$9,941,000 was provided for this purpose in fiscal year 2004 to remain available until expended and requested by the President’s 

budget. 

Bone marrow program 

The Committee provides $25,662,000 for the bone marrow pro- gram, which is $3,000,000 above the fiscal year 2004 comparable 

level and the budget request. In addition to funding from HRSA in 

fiscal year 2004, the National Marrow Donor Program (NMDP) is 

expected to receive $17,350,000 from the U.S. Navy. Funds are 

used for donor medical costs, donor centers, tissue typing, research, 

minority recruitment, and program administration. The Committee 

recognizes the important life-saving role of the Registry in the lives 

of thousands of Americans. The National Marrow Donor Program 

(NMDP), which operates the Registry through a contract with 

HRSA, anticipates facilitating its 20,000th transplant by November 

2004. The Committee understands that the Registry lists three 

sources of blood forming non-embryonic stem cells used in transplantation: marrow and peripheral blood from adult donors, and 

umbilical cord blood units. The NMDP now lists 5,000,000 potential 

volunteer, adult donors of marrow and peripheral blood stem cells 

on the Registry. In addition, 16 of the 19 public cord banks are or 

have applied to become NMDP network members. The Committee 

urges the NMDP to continue innovative, technological, and scientific advances in non-embryonic cell therapies that have the potential to help some of the hundreds of thousands of Americans 

with leukemia or other life threatening blood diseases. The Committee also strongly encourages the NMDP to continue the enhancement of the Registry through its umbilical cord blood program. In addition, the Committee supports the NMDP’s important 

role in conducting and supporting research to improve the availability, efficiency, safety, and cost of transplants and the effectiveness of Registry operations; maintaining and expanding its medical 

emergency contingency response capabilities for our nation’s national security; and increasing donor and patient outreach programs, especially for minorities and medically underserved population groups. 

Rural outreach grants 

The Committee provides $30,124,000 for rural outreach grants, 

which is $9,477,000 below the fiscal year 2004 comparable level 

and $19,026,000 above the budget request. The program supports 

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

Rural health research 

The Committee provides $8,902,000 for rural health research, 

which is the same as the fiscal year 2004 comparable level and the 

36 

budget request. The activity supports several rural health research 

centers and the Secretary’s rural health advisory committee as well 

as staffing for the Secretary’s rural initiative. 

Telehealth 

The Committee provides $3,949,000 for telehealth, which is the 

same as the fiscal year 2004 comparable level and the budget request. The telehealth program works with and supports communities in their efforts to develop cost-effective uses of telehealth 

technologies. These technologies bring health services to residents 

of the Nation who are isolated from health care, and health-related 

education to the practitioners who serve them. 

The Committee strongly supports HRSA’s numerous rural telehealth initiatives and continues to encourage the agency to work in 

partnership with medical librarians, the National Library of Medicine, and other health information specialists in the development 

and implementation of its telehealth projects. 

Rural hospital flexibility grants 

The Committee provides $32,500,000 for rural hospital flexibility grants, which is $6,999,000 below the fiscal year 2004 comparable 

level and $32,500,000 above the budget request. The program is 

comprised of two parts: (1) flexibility grants to States to assist 

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

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

small hospital improvement grants that provide very modest 

amounts to hospitals to assist them in automation and compliance 

with confidentiality requirements. $25,000,000 is provided for the 

flexibility grants and $7,500,000 is provided for the small hospital 

improvement grants. 

Rural and community access to emergency devices 

The Committee provides $5,000,000 for the public access defibrillation demonstration grant program, which is $5,933,000 

below the fiscal year 2004 comparable level and $2,985,000 above 

the budget request. The program assists both urban and rural communities in increasing survivability from sudden cardiac arrest by 

providing funding for the purchase, placement, and training in the 

use of automated external defibrillators (AEDs). The Committee intends that $1,000,000 of this total should be allocated to the community program and $4,000,000 should be directed to the rural 

program. 

Rural EMS 

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

$497,000 lower than the fiscal year 2004 comparable level and the 

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

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

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

State offices of rural health 

The Committee provides $8,390,000 for State offices of rural 

health, which is the same as the fiscal year 2004 comparable level 

37 

and the budget request. The State office of rural health program 

creates a focal point for rural health within each of the fifty States. 

In each State, the office collects and disseminates information on 

rural health, coordinates rural health resources and activities, provides technical assistance to rural providers and communities, and 

helps communities recruit and retain health professionals. 

Denali Commission 

The Committee has not included funding for the Denali Commis- sion, which is $34,793,000 below the fiscal year 2004 comparable 

level and $22,000,000 below the budget request. 

Emergency medical services for children 

The Committee provides $19,860,000 for emergency medical services for children, which is the same as the fiscal year 2004 comparable level and the Administration request. The program supports grants for the delivery of emergency medical services to 

acutely ill and seriously injured children. 

Poison control centers 

The Committee provides $23,696,000 for poison control centers, 

which is the same as the fiscal year 2004 comparable level and the 

Administration request. These funds support a grant program for 

poison control centers. In addition, funds are used to maintain a 

national toll-free number and implement a media campaign to advertise that number, as well as to support the development of uniform patient management guidelines and the improvement of data 

collection. 

Traumatic brain injury 

The Committee provides $9,375,000 for the traumatic brain injury (TBI) program, which is the same as the fiscal year 2004 comparable level and the budget request. The TBI program funds the 

development and implementation of statewide systems to ensure 

access to care including prehospital care, emergency department 

care, hospital care, rehabilitation, transitional services, and longterm community support. Grants also go to State protection and 

advocacy systems. 

Black lung clinics 

The Committee provides $5,963,000 for black lung clinics, which 

is the same as the fiscal year 2004 comparable level and the budget 

request. The program supports fifteen grantees that treat a declining population of coal miners with respiratory and pulmonary impairments. The clinics presently receive more than one-third of 

their funding from other sources, such as Medicaid and Medicare. 

Of the fifteen grantees, seven actually receive health center funding as well as black lung grants. 

Trauma care 

The Committee provides $3,449,000 for the trauma care program, which is the same as the fiscal year 2004 comparable level. 

The Administration did not request funds for this program. The 

program provides small grants to States to establish State offices 

to coordinate trauma systems within the States. 

38 

Payment to Hawaii for treatment of Hansen’s disease 

The Committee provides $2,033,000 for the treatment of persons 

with Hansen’s disease in the State of Hawaii, which is the same 

as the fiscal year 2004 comparable level and the Administration request. The program, which provides a partial matching payment to 

the State of Hawaii, dates to the period of Father Damien’s facility 

for sufferers of Hansen’s disease (leprosy). That facility now has 

only 43 residents who live there by choice, and the grounds have 

been converted to a historical site. Most patients diagnosed with 

Hansen’s disease in Hawaii are now treated in the same manner 

as new patients on the mainland; their care is handled on an outpatient basis, with the program paying for about 300 active ambulatory Hansen’s Disease cases. 

Ryan White AIDS programs 

The Committee provides $2,074,861,000 for Ryan White AIDS 

programs, which is $35,000,000 above the fiscal year 2004 comparable level and $20,000,000 above the budget request. The bill 

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

under section 241 of the Public Health Service for special projects 

of national significance. The Committee’s allocation among the various titles of the Ryan White program reflect the high priority the 

Committee places on providing resources for the AIDS drug assistance program. Within the total provided, the Committee expects 

that Ryan White AIDS activities that are targeted to address the 

growing HIV/AIDS epidemic and its disproportionate impact upon 

communities of color, including African Americans, Latinos, Native 

Americans, Asian Americans, Native Hawaiians, and Pacific Islanders will be supported at no less than the fiscal year 2004 level. 

The Committee is aware that, for a number of eligible metropolitan areas, the amount of their supplemental grant under title I of 

the Ryan White CARE Act has fluctuated markedly from year to 

year, thereby disrupting ongoing programs and services. Accordingly, the Committee directs HRSA to review the processes it uses 

to evaluate applications and award supplemental grants and to 

take appropriate steps to reduce such fluctuations and disruptions. 

Emergency assistance 

The Committee provides $615,023,000 for the Part A, emergency 

assistance program, which is the same as the fiscal year 2004 comparable level and the budget request. These funds provide grants 

to metropolitan areas with very high numbers of AIDS cases for 

outpatient and ambulatory health and social support services. Half 

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

competitive grant process. 

Comprehensive care programs 

The Committee provides $1,140,900,000 for Part B, comprehensive care programs, which is $35,000,000 above the fiscal year 2004 

comparable level and $20,000,000 above the budget request. The 

funds provided support formula grants to States for the operation 

of HIV service delivery consortia in the localities most heavily affected, for the provision of home and community-based care, for 

39 

continuation of health insurance coverage for infected persons, and 

for purchase of therapeutic drugs. 

The Committee has included bill language identifying $803,872,000 specifically to support State AIDS Drug Assistance 

Programs. In fiscal year 2004, $768,872,000 was designated for this 

purpose. 

Early intervention program 

The Committee provides $197,170,000 for Part C, the early intervention program, which is the same as the fiscal year 2004 comparable level and the budget request. Funds are used for discretionary grants to migrant and community health centers, health 

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

comprehensive primary care services to populations with or at risk 

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

Pediatric HIV/AIDS 

The Committee provides $73,108,000 for Part D, pediatric AIDS 

demonstrations, which is the same as the fiscal year 2004 comparable level and the budget request. The program supports demonstration grants to foster collaboration between clinical research 

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

pregnant women and their families. The projects are intended to 

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

AIDS dental services 

The Committee provides $13,325,000 for AIDS dental services, 

which is the same as the fiscal year 2004 comparable level and the 

budget request. The program provides reimbursements to dental 

schools and postdoctoral dental education programs to assist with 

the cost of providing unreimbursed oral health care to patients 

with human immunodeficiency virus disease. Dental students and 

residents participating in this program receive extensive training 

in the understanding and management of the oral health care 

needs of people living with HIV/AIDS. 

Education and training centers 

The Committee provides $35,335,000 for AIDS education and 

training centers (AETCs), which is the same as the fiscal year 2004 

comparable level and the budget request. The centers train health 

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

Family planning 

The Committee provides $278,283,000 for the family planning 

program, which is the same as the fiscal year 2004 comparable 

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

planning and reproductive services, as well as related preventive 

health services such as patient education and counseling, breast 

40 

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

provided in family planning centers. 

The bill repeats language from the 2004 appropriations bill making clear that these funds shall not be expended for abortions, that 

all pregnancy counseling shall be nondirective, and that these 

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

of any legislative proposal or candidate for public office. 

Children’s hospitals graduate medical education program 

The Committee provides $303,258,000 for the children’s hospitals 

graduate medical education program, which is $88,000 above the 

fiscal year 2004 comparable bill and the same as the budget request. The program provides a more adequate level of support for 

health professions training in children’s teaching hospitals that 

have a separate Medicare provider number (‘‘free-standing’’ children’s hospitals). Children’s hospitals are statutorily defined under 

Medicare as those whose inpatients are predominantly under the 

age of 18. The funding in this program is intended to make the 

level of Federal Graduate Medical Education support more consistent with other teaching hospitals, including children’s hospitals 

which share provider numbers with other teaching hospitals. Payments are determined by formula, based on a national per-resident 

amount. Payments support training of resident physicians as defined by Medicare in both ambulatory and inpatient settings. 

Health care facilities and other programs 

The Committee has not included funding for health care facilities. A total of $371,536,000 was provided for this purpose in fiscal 

year 2004; no funding was included in the budget request. This 

program provides funds to public and private nonprofit entities for 

construction or modernization of outpatient medical facilities. 

Buildings and facilities 

The Committee provides $249,000 for buildings and facilities, 

which is the same as the fiscal year 2004 comparable level and the 

budget request. These funds are used to finance the repair and upkeep of buildings at the Gillis W. Long Hansen’s Disease Center at 

Carville, Louisiana. 

Radiation exposure compensation act 

The Committee provides $1,974,000 for the radiation exposure 

compensation act, which is the same as the fiscal year 2004 comparable level and the budget request. This program provides grants 

for the education, prevention and early detection of radiogenic cancers and diseases resulting from exposure to uranium during its 

mining and milling at nuclear test sites. 

41 

National practitioner data bank 

The Committee does not provide funding for the national practitioner data bank for fiscal year 2005, which is the same as both 

the fiscal year 2004 action on appropriations and the budget request. The Committee recommendation and the budget request assume that the data bank will be self-supporting, with collections of 

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

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

professional review actions taken by health care entities. Insurance 

companies, State licensure boards and authorities, and other 

health care entities and professional societies are required to report 

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

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

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

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

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

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

the full costs of the data bank operations. 

Health care integrity and protection data bank 

The Committee does not provide funding for the health care integrity and protection data bank (HIPDB) for fiscal year 2005. The 

Committee recommendation and the budget request assume that 

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

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

on final adverse actions taken against health care providers, suppliers, and practitioners. This information is collected from and 

made available to Government agencies and health plans. In addition, disclosure of the information is made available, upon request, 

to health care providers, suppliers, and practitioners who wish to 

self-query. 

Community access program 

The Committee does not provide funding for the community access program, which is $83,674,000 below the fiscal year 2004 comparable level and $9,998,000 below the Administration request. 

The program is designed to increase the capacity and effectiveness 

of the variety of community health care institutions and providers 

who serve patients regardless of their ability to pay through development of community consortia. 

State planning grants for health care 

The Committee provides $14,810,000 for state planning grants, 

which is the same as the fiscal year 2004 comparable level. The Administration did not request funding for this program. The program 

makes grants to states to gather and analyze information on problems of access to health insurance within the state and develop 

plans for providing access to affordable health insurance coverage 

to all their residents. 

42 

The Committee intends that, as in fiscal year 2004, these funds 

will be used for contination grants to assist states in completing or 

expanding their research and planning activities, and for grants to 

support the design and planning for pilot projects to expand health 

insurance coverage to a significant uninsured population within the 

state, as well as for initial grants to any states that have not yet 

received funding and wish to participate. 

Program management 

The Committee provides $151,317,000 for the cost of Federal 

staff and related activities to coordinate, direct and manage the 

programs of the Health Resources and Services Administration, 

which is $2,784,000 above the comparable 2004 action and the 

same as the budget request. The Committee includes funding for 

new HRSA activities proposed by the Administration. 

The Committee requested a report last year from HRSA detailing 

HRSA’s response to a January 2002 report submitted by HRSA regional dental consultants. That report identified the decline in oral 

health leadership and personnel. The report requested by the Committee was due by February 1, 2004. The Committee is very disappointed that it has not received this report. The Committee has 

received testimony from various organizations concerned about the 

lack of access to dental care, the increase in oral disease among 

vulnerable populations and the decrease in state dental programs. 

The Committee expects HRSA to submit this report without further delay. 

MEDICAL FACILITIES GUARANTEE AND LOAN FUND

FEDERAL INTEREST SUBSIDIES FOR MEDICAL FACILITIES

The Committee does not provide funding for the Medical Facilities Guarantee and Loan Fund, which is the same as the budget 

request. Appropriations are used to pay interest subsidies on loans 

made or guaranteed prior to fiscal year 1977 for hospital construction. There are sufficient carryover funds from prior years’ appropriations to pay defaults and interest subsidy payments; therefore, 

no appropriation is required to cover these payments. 

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

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

professions schools. Under the accounting rules established in the 

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

the obligations arising from loans guaranteed prior to fiscal year 

1992. A second account pays obligations and collects income from 

premiums on loans guaranteed in fiscal year 1992 and beyond. 

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

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

to previous borrowers under the HEAL authority. 

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

loans guaranteed prior to 1992, which is $21,000,000 below the fiscal year 2004 level and the same as the budget request. 

43 

The Committee provides $3,270,000 for HEAL program manage- ment, which is $83,000 below the fiscal year 2004 comparable level 

and the same as the budget request. 

NATIONAL VACCINE INJURY COMPENSATION PROGRAM

The Committee makes available the release of $66,000,000 from 

the Vaccine Injury Compensation Trust Fund in fiscal year 2004, 

which is the same as the fiscal year 2004 level and the budget request. 

The National Vaccine Injury Compensation Program provides a 

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

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

the sale of selected prescribed vaccines. Revenues raised by this tax 

are maintained in a Vaccine Injury Compensation Trust Fund. 

Trust funds made available in the bill will support the liability 

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

also support the $3,176,000 in costs incurred by the agency in the 

operation of the program, which is $14,000 below fiscal year 2004 

level and the same as the budget request. 

CENTERS FOR DISEASE CONTROL

DISEASE CONTROL, RESEARCH AND TRAINING

The Committee provides a program level of $4,477,878 for the 

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

$101,421,000 below the fiscal year 2004 comparable level and 

$15,224,000 above the request. Of the funds provided, $249,100,000 

shall be derived from evaluation set-aside funds available under 

Section 241 of the Public Health Service Act, as proposed in the request. 

The CDC assists State and local health authorities and other 

health-related organizations to control and reduce disease and 

other health problems. The activities of CDC focus on several major 

priorities, including providing core public health functions, responding to urgent health threats, monitoring the Nation’s health 

using scientific methods, building the Nation’s health infrastructure to insure our national security against bioterrorist threats, 

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. 

The Committee considers the table accompanying this report to 

be determinative of the CDC budget. Funds should be apportioned 

and allocated consistent with the table, and any changes in funding 

are subject to the normal reprogramming and notification procedures. 

Birth defects, developmental disabilities, disability and health 

The Committee provides $119,214,000 for birth defects, developmental disabilities, disability and health, which is $6,471,000 above 

the fiscal year 2004 comparable level and $6,242,000 above the request. This program collects, analyzes, and makes available data 

on the incidence and causes of birth defects and developmental disabilities. 

44 

Within the total provided, $2,054,000 above the fiscal year 2004 

comparable level is to expand autism and developmental disabilities activities. 

Within the total provided, $1,500,000 above the fiscal year 2004 

comparable level is to expand surveillance, epidemiological and 

education efforts of Duchenne and Becker muscular dystrophy in 

the United States. 

Within the total provided, $907,000 above the fiscal year 2004 

comparable level is to support activities related to the National 

Spina Bifida Program. Within the total provided, not less than $1,000,000 is for studies 

involving Down Syndrome. Within the total provided, $2,000,000 is to continue and expand 

the public health education initiative related to Tourette Syndrome. 

Within the total provided, $500,000 above the fiscal year 2004 

comparable level is to enhance the national campaign to increase 

the number of women taking folic acid daily. 

Attention Deficit/Hyperactivity Disorder (AD/HD).—The Committee continues to support the National Resource Center on AD/ 

HD and has provided sufficient funds to continue the activities at 

the Center to respond to the overwhelming demand for information 

and support services; to better reach special populations in need; 

to develop on-line educational tools for professionals; and, to enable 

CDC to expand its population-based research and surveillance. 

Autism.—The Committee is aware of the progress that has been 

made with the autism programs at the CDC. The Committee acknowledges the importance of this work in the area of autism surveillance and research and urges it to continue in a timely manner. 

Within the funds provided, $15,300,000 is for the autism epidemiology program, including the CADDRE and ADDM Network, and 

$2,700,000 is to build upon last year’s launch of the Autism Awareness and Education Campaign. 

Diamond Blackfan Anemia.—The Committee encourages the 

CDC to establish a public health outreach and surveillance program for Diamond Blackfan Anemia as authorized under Title III 

of the Public Health Services Act. 

Down Syndrome.—The Committee understands that in FY2004 

the CDC initiated planning for two epidemiological studies on 

Down syndrome. The first study will obtain an accurate estimate 

of the number of people in the United States living with the disorder and identify them by age and ethnic group. The second study 

will document the onset and course of secondary and related developmental and mental disorders in individuals with Down syndrome. The Committee has included $1,000,000 above the request 

to initiate these studies in FY2005. 

Duchenne and Becker Muscular Dystrophy.—The Committee is 

concerned with the pace of the development of the CDC Birth Defects Surveillance program covering the muscular dystrophies and 

is aware that the agency has made the commitment to enhance the 

internal staff commitment to the program. The Committee is encouraged by that new commitment and expects that CDC dedicate 

its efforts to organize, coordinate and implement the agency’s 

Duchenne MD surveillance program. In addition, within the 

$1,500,000 increase provided for fiscal year 2005, the Committee 

45 

has provided $500,000 to initiate a coordinated education and outreach initiative through the Parent Project Muscular Dystrophy. 

Folic Acid.—The Committee is pleased to learn that severe brain 

and spinal defects have dropped 27 percent in the U.S. since certain food producers have been required to fortify their foods with 

folic acid. The Committee encourages CDC to work with producers 

of suitable ethnic foods, such as tortillas, so ethnic populations may 

also benefit from folic acid fortification. 

Fragile X.—The Committee supports the CDC’s focus on maximizing prevention potential, minimizing impact on families and 

promoting early intervention through developmental screening and 

encourages CDC to incorporate individuals affected by fragile X. In 

addition, the Committee encourages the CDC to consider developing a fragile X public health program to expand surveillance and 

epidemiological study of fragile X, as well as provide patient and 

provider outreach on fragile X syndrome and other developmental 

disabilities. 

Hemophilia.—The Committee urges CDC to continue working 

closely with voluntary health organizations, such as the National 

Hemophilia Foundation, concerned about carrying out disease management, prevention, outreach, and blood safety surveillance programs for persons with bleeding and clotting disorders. The Committee encourages the CDC to maintain its support for surveillance 

of the bleeding disorders community to address concerns about inhibitor development and prevention within this population. 

Early Hearing Detection and Intervention.—The Committee continues to support the work of the CDC related to the early detection of hearing loss in infants. The recommendation provides 

$7,361,000 to maintain support for the program and its activities 

in FY2005. 

Limb Loss Information Center.—The Committee recognizes that 

one of the greatest challenges facing individuals with limb loss is 

access to necessary health and rehabilitative services. The Committee urges CDC to work with the Amputee Coalition of America 

(ACA) to identify strategies to remove these barriers. The Committee applauds the partnerships developed between the ACA and 

the CDC, Walter Reed, and Johns Hopkins University to advance 

the quality of life through research and support programs for people living with limb loss. The Committee continues to support the 

CDC’s resource and information center which assists individuals 

living with disabilities, and their families, in need of information 

on medical, physical, and emotional needs, and resources and support to reintegrate socially and economically into society. 

Spina Bifida.—Spina Bifida and related neural tube defects are 

highly preventable through proper nutrition, including appropriate 

folic acid consumption, and its secondary effects can be mitigated 

through appropriate and proactive medical care and management. 

In an effort to improve the quality-of-life for individuals affected by 

Spina Bifida and reduce and prevent the occurrence of, and suffering from, this birth defect, $907,000 is provided above FY2004 

for the CDC’s National Spina Bifida Program. The Committee continues to support the partnership between CDC and the Spina 

Bifida Association of America (SBAA) and urges the CDC to establish a National Spina Bifida Clearinghouse and Resource Center at 

the SBAA to meet the current and growing demand for information 

46 

and support services for individuals and families affected by Spina 

Bifida. 

Tourette Syndrome.—The Committee commends CDC for its partnership with the national Tourette Syndrome Association in developing a public health education and research program and has provided $2,000,000 in FY2005 to continue to educate parents, physicians, educators and other health care workers about the disorder 

and to expand on the scientific knowledge base on prevalence, risk 

factors and co-morbidities of Tourette Syndrome. The Committee 

intends that these resources be used to support the partnership between the TSA and CDC 

Vision Loss.—The Committee encourages the Director to consider 

the creation of a National Information Center on Vision Loss to address the need for appropriate public health information to prevent 

further impairment and disability among individuals who are blind 

or who have low vision. The Committee further encourages CDC to 

partner with a national non-profit organization that is recognized 

for leadership in providing information to persons who are blind or 

visually impaired, including published resource guides, directories 

of services for consumers in the field, scholarly journals on blindness and vision loss, assistive technology magazines, and talking 

books. Particular attention should be paid to entities that have successfully implemented interactive and accessible information resources or comprehensive libraries for persons who are blind or visually impaired. 

Chronic disease prevention and health promotion 

The Committee provides $915,711,000 for chronic disease preven- tion and health promotion, which is $62,333,000 above the fiscal 

year 2004 comparable level and $286,000 and above the request. 

Chronic diseases have had a profound human and economic toll 

on our nation. Nearly 125 million Americans today are living with 

some form of chronic condition, including cancer, cardiovascular 

disease, diabetes, arthritis, obesity and various neurological conditions such as epilepsy. Complications from these conditions include 

vision loss, kidney disease, limb loss, oral disease and paralysis. 

The National Center for Chronic Disease Prevention and Health 

Promotion at CDC implements research and programs to prevent 

the leading causes of death and disability (e.g., heart disease and 

stroke, cancer, diabetes, and arthritis) which are among the most 

prevalent, costly, and preventable of all health problems. CDC 

plays a leadership role in coordinating and catalyzing the efforts of 

numerous public and private partners, which allows CDC to substantially extend its effectiveness in reaching people at highest risk 

for chronic disease. The Committee recognizes the essential infrastructure that CDC has built in state health departments and encourages CDC to expand its state-based leadership in surveillance, 

public health education, communications and model programs and 

research. 

Within the total provided, the Committee has included the following amounts above the fiscal year 2004 comparable level: 

Heart Disease and Stroke ..................................................................... $3,000,000 

Diabetes .................................................................................................. 4,000,000 

Cancer Prevention and Control ............................................................ 13,000,000 

Arthritis and Other Chronic Diseases ................................................. 1,300,000 

Glaucoma/Visual Screening Education ................................................ 170,000 

47 

Childhood Obesity Prevention—Verb Campaign ................................ 29,238,000 

Steps to a Healthier U.S. ...................................................................... 12,000,000 

Oral Health ............................................................................................ 1,000,000 

Safe Motherhood/Infant Health ............................................................ 413,000 

Alzheimer’s disease.—The Committee encourages the CDC to 

work with the NIH to further research and investigate links between a healthy lifestyle and the prevention of Alzheimer’s disease 

in an effort to develop an Alzheimer’s specific segment of the 

Healthy Aging Program. The ultimate goal of the Alzheimer’s Program would be to aggressively educate the public and health professionals as to research-based ways to reduce the risks of developing Alzheimer’s by maintaining a healthy lifestyle. 

Arthritis.—The National Arthritis Action Plan (NAAP) supports 

programs to improve the quality of life of persons affected by arthritis and to improve the availability of information and self-management programs nationwide for Americans affected by the disease. The Committee recommendation includes $15,564,000 to support and expand CDC arthritis program activities, an increase of 

$800,000 over FY2004. 

Breast and Cervical Cancer Screening.—Given the high vacancy 

rates of qualified laboratory personnel who prepare and interpret 

tissue and cell samples, the Committee encourages CDC to consider 

expanding its education component and develop a partnership with 

HRSA’s Allied Health and Special Projects program. The Committee provides an increase of $10,000,000 for the National Breast 

and Cervical Cancer Early Detection Program. 

Childhood and Adolescent Obesity.—The Committee recognizes 

that childhood and adolescent obesity is a serious and growing 

health concern. It is linked to the recent rise in Type 2 diabetes 

and exposes them to greater risk for 42 diseases as an adult, including coronary heart disease and some cancers. The Committee 

urges the CDC to undertake an epidemiological study of the longterm impact of childhood and adolescent obesity. The Committee 

also encourages the CDC to fund school and community pilot programs that will increase nutritional awareness and that emphasize 

the importance of limiting non-nutritive carbohydrates. 

Colorectal Cancer.—The Committee is very pleased with the 

leadership of CDC’s National Colorectal Cancer Roundtable in promoting the availability and advisability of screening to both health 

care providers and the general public. The Committee encourages 

the CDC to continue to expand its partnerships with state health 

departments, professional and patient organizations, and private 

industry to combat this devastating disease. 

Diabetes.—The Committee applauds CDC for its new cooperative 

agreement with the American Association of Diabetes Educators 

(AADE), which is intended to ensure early diagnoses of people with 

diabetes and the best treatment and care of those trying to manage 

the disease. The Committee encourages CDC to work in partnership with AADE to identify strategies for evaluating the effectiveness of diabetes education in improving the self-care of people with 

diabetes and in reducing risk factors for diabetes. 

The Committee commends the CDC for its efforts to develop a 

standardization program to improve the measurement of portable 

blood glucose monitoring systems. The accuracy of these devices is 

crucial for assisting diabetic individuals to avoid acute episodes of 

48 

dangerously low blood glucose levels and to reduce the risk of debilitating, long-term complications. 

Epilepsy.—The Committee acknowledges and applauds CDC’s 

partnership with the Epilepsy Foundation in developing a strategic 

vision for epilepsy programs in Living Well With Epilepsy II. Funding has been provided to enhance CDC’s epilepsy efforts in partnership with a leading non-profit and to begin to implement the recommendations from Living Well With Epilepsy II. The Committee 

recommendation includes $8,674,000 for epilepsy activities, an increase of $500,000 over FY2004. 

Heart Disease and Stroke.—The Committee commends the CDC 

for convening national leaders across federal and state governments and voluntary and professional organizations to develop and 

release A Public Health Action Plan to Prevent Heart Disease and 

Stroke. The Committee recommendation includes funds above 

FY2004 for the CDC to expand, intensify and coordinate heart disease and stroke prevention activities, such as enhancing both the 

State Heart Disease and Stroke Prevention Program and the Paul 

Coverdell National Acute Stroke Registry. 

Inflammatory Bowel Disease.—For the past five years, the Committee has encouraged CDC to work in partnership with the IBD 

community to establish a national IBD epidemiology program to 

further our understanding of these diseases. The Committee understands that the Crohn’s and Colitis Foundation of America has provided financial support through the CDC Foundation to initiate 

this important program. Now that the project is established, the 

Committee encourages CDC to contribute to the project in order to 

expand the work in FY2005. 

Interstitial Cystitis.—The Committee is pleased that the CDC 

has been working closely with the interstitial cystitis (IC) patient 

community to develop a program to expand both the public’s and 

professional community’s understanding of IC. The Committee encourages the CDC to formalize its partnership with a national nonprofit voluntary health association dedicated to assisting persons 

with IC. This would allow the CDC to develop a long term, sustainable awareness campaign that has a measurable impact on patients, physicians, researchers and the general public. 

Lung Cancer.—The Committee encourages the CDC through its 

Cancer Registries program and in coordination with the Comprehensive Cancer Control program to conduct a study, or studies, 

that would examine: the current trends of lung cancer screening 

and evaluate the number of people currently getting screened for 

lung cancer; how lung cancer screening is being promoted; which 

screening methods are being promoted; how the benefits and risks 

of screening are communicated by health professionals to at risk 

populations; trends in the number of biopsies being performed following screening exams; and trends in the stage of lung cancer diagnosis. 

Lupus.—The Committee recommendation includes $993,000 

within Arthritis and Other Chronic Diseases to continue support 

for the National Lupus Patient Registry. 

Oral Health.—The Committee recognizes that to effectively reduce disparities in oral disease will require improvements at the 

State and local levels. The Committee has provided $13,428,000 to 

allow the States to target their capacities to assess the prevalence 

49 

of oral diseases, to target interventions, like additional water fluoridation and school-linked sealant programs, and resources to the 

underserved, and to evaluate changes in policies, programs and disease burden. The Committee also expects the Division to advance 

efforts to reduce the disparities and the health burden from oral 

cancers and oral diseases that are closely linked to chronic diseases 

like diabetes and heart disease. 

Pulmonary Hypertension.—The Committee continues to be interested in pulmonary hypertension (PH), a rare, progressive and fatal 

disease that predominantly affects women, regardless of age or 

race. Because early detection of PH is critical to a patient’s survival 

and quality of life, the Committee continues to encourage CDC to 

give priority consideration to supporting a cooperative agreement 

with the pulmonary hypertension community designed to foster 

greater awareness of the disease. 

Prevention of Preterm Birth.—The Committee encourages the 

CDC to expand research on the causes of preterm birth, the prevention of preterm delivery for women at risk and the social and 

environmental factors exacerbating higher rates of preterm delivery in African-American women. 

School Health.—The Committee urges the Centers for Disease 

Control and Prevention to prioritize abstinence education among 

adolescents served through the Divisions of Adolescent School 

Health. Abstinence Education is consistent with the strategic direction of CDC in providing greater holistic health protection for 

young people and should be prioritized in activities funded through 

grants, cooperative agreements and other partnerships with DASH. 

The Committee encourages the continued support of center activities aimed at improving the health and well being of adolescents. The Committee has learned of concerns that CDC decided 

not to continue funding the State Adolescent Health Coordinators 

Network (SAHCN) Annual Meeting. This meeting provides a focus 

on the unique needs and assets of the adolescent population, bringing together specific expertise on the health issues that face adolescents and on the special programmatic considerations for this population. The Committee urges CDC to consider renewing its support 

of this activity to promote adolescent health, providing that the 

meeting organizers provide the necessary assurances to be eligible 

for federal funding. 

Sleep Disorders.—The Committee is concerned about the prevalence of sleep disorders and recognizes the need for enhanced public and professional awareness on sleep and sleep disorders. The 

Committee encourages CDC to work with other agencies, such as 

the National Center on Sleep Disorders Research (NIH), and voluntary health organizations, such as the National Sleep Foundation, to support the development of a sleep education and public 

awareness initiative. 

Steps for a Healthier U.S.—The Committee commends CDC for 

its work on the Steps program, including its partnerships with national organizations, such as the YMCA, aimed at coordinating and 

delivering program models to additional communities across America, including rural and disadvantaged communities. In order to expand the reach and impact of the STEPS program, the Committee 

urges the CDC to continue and increase funding for these national 

50 

partnerships. The Committee provides an increase of $12,000,000 

to expand the Steps program in FY2005. 

Sudden Infant Death Syndrome.—The Committee notes the work 

of CDC, the National Institute of Child Health and Human Development and the Health Resources and Services Administration in 

developing model guidelines for death scene protocol for Sudden Infant Death Syndrome. The Committee continues to encourage CDC 

to implement projects to demonstrate the effectiveness of the death 

scene protocol in a variety of locales (urban, suburban, and rural) 

throughout the nation. 

VERB.—The Committee recommendation includes $65,000,000 

for the Childhood Obesity Prevention Program, known as VERB. 

The Committee understands that evaluation results from the first 

year of funding for VERB demonstrate that the campaign has directly resulted in improved physical activity among the targeted 

age group, 9-to-13 year-olds. Funds will be used to support the 

fourth year of this national campaign, including updating the campaign’s creative positioning and messages as well as marketing 

strategies and tactics in order to keep up with the rapidly changing 

target audience. Funds also will be used to continue a rigorous 

evaluation of the campaign’s effectiveness. 

Vision Screening and Education.—The Committee recommendation includes $3,000,000 to enhance the national vision screening 

and education program, and commends CDC for its partnership 

with Prevent Blindness America, a national voluntary health agency, in building a public health action plan for vision health. The 

Committee intends that CDC dedicate at least half of the funds 

provided to further expand this partnership through the existing 

cooperative agreement to jointly further develop public, patient and 

professional education, community programs, research and the necessary infrastructure to deliver vision screening and education. 

Environmental health 

The Committee provides $186,113,000 for environmental health, 

which is $2,901,000 above the fiscal year 2004 comparable level 

and $2,318,000 above the request. 

Within the total provided, the Committee provides the following 

amounts above the FY2004 comparable level: 

Environmental Health Laboratory .................................................... $2,000,000 

Asthma ................................................................................................ 901,000 

Alpha–1 Antitrypsin Deficiency.—The Committee is aware that 

Alpha–1 Antitrypsin Deficiency is a genetic disorder that can result 

in devastating and fatal lung and/or liver disease. Early detection 

allows individuals to engage in preventative health measures and 

receive appropriate therapies that significantly improve their 

health status. The Committee encourages CDC to consider supporting an Alpha–1 screening and detection program that utilizes 

public and professional education regarding lung disease, both genetic and tobacco related. 

Asthma.—The Committee is pleased with the work that the CDC 

has done to address the increasing prevalence of asthma. However, 

the increase in asthma among children remains alarming. The 

Committee urges CDC to expand its outreach aimed at increasing 

public awareness of asthma control and prevention strategies, parVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00050 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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ticularly among at-risk populations in underserved communities. 

To further facilitate this effort, CDC is urged to partner with voluntary health organizations, such as the American Lung Association to support program activity consistent with the CDC’s efforts 

to fund community-based interventions that apply effective approaches demonstrated in research projects within the scientific 

and public health community. 

Further, the Committee commends CDC’s efforts to collect national and local data on the incidence and prevalence of asthma 

and to implement asthma prevention programs. The Committee encourages CDC to continue with these activities and expand its prevention programs into areas of high pediatric asthma incidence. 

Biomonitoring.—Limited information exists about chemical exposures in humans and how these chemicals affect people’s health. 

Without this information, public health officials cannot effectively 

identify and prevent diseases that result from chemical exposures. 

With prior CDC funding, 36 state public health labs developed 

plans for increasing biomonitoring capacity—the testing of body 

fluids, hair and skin for chemical exposure. In 2004, CDC reports 

providing support for the implementation of those plans for three 

grantees. The Committee has provided $770,000 above the FY2004 

level to enhance public health laboratory biomonitoring capacity 

and to provide adequate technical assistance and training to states 

in assessing exposure to chemicals. 

Childhood Lead Poisoning Prevention.—The Committee commends the CDC for its commitment to support the enhanced development of a portable, hand-held lead screening device that holds 

great promise for increasing childhood screening rates in underserved communities. Further development of this device will help 

ensure its application in community health settings. 

Lead poisoning among Hispanic children in the nation is a significant problem. Oklahoma and Texas have a unique outreach program to the Hispanic community to help identify at-risk children 

and educate their parents about the source of the lead poisoning. 

The CDC is encouraged to work with the State Public Health Departments in Oklahoma and Texas to further develop this pilot program. 

Environmental Health Laboratory.—The Committee recognizes 

the extraordinary services of CDC’s Environmental Health Laboratory, and has provided an additional $2,000,000 above FY2004 to 

expand its work in preventing disease from toxic exposures, assessment of exposure to priority toxic chemicals, including mercury and 

arsenic, and to provide expanded and more effective laboratory response to toxic emergencies. 

Human Exposure to Environmental Chemicals.—The CDC’s National Report on Human Exposure to Environmental Chemicals is 

a significant new exposure tool that provides invaluable information for setting research priorities and for tracking trends in 

human exposures over time. The Committee continues to support 

the CDC environmental health laboratories efforts to provide exposure information about environmental chemicals. However, as CDC 

has recognized, this information does not by itself provide information on causes for effects in humans and communicating these results in context is vitally important. The Committee applauds the 

52 

CDC’s efforts in this regard and encourages the agency to continue 

to do so. 

Primary Immunodeficiency Diseases.—In each of last three years, 

Congress has made available funds for CDC to support the national 

physician education and public awareness campaign developed by 

the Jeffrey Modell Foundation. The Committee understands that 

the Foundation has leveraged more than seven dollars from donors 

and the media for every federal dollar appropriated and is a model 

of public-private cooperation. The Committee encourages the CDC 

to expand the reach of the Foundation’s campaign to underserved 

communities, including African-American and Hispanic populations, and has provided sufficient funding to reach that critical 

goal. The Committee also encourages CDC to expand its programmatic activity on primary immune deficiency diseases to include pilot programs focused on newborn screening and school 

wellness. 

Severe Combined Immune Deficiency.—The Committee understands that scientists working in the intramural program at the 

NHGRI have developed the technology to screen newborns for severe combined immune deficiency disease (SCID) or ‘‘the bubble 

boy disease.’’ The Committee commends the CDC for the work 

begun on the development of a newborn screening program for 

SCID. Further, the Committee encourages the CDC to complete the 

development of the program and work in collaboration with relevant voluntary health organizations in developing a treatment 

protocol for any newborns that test positive for SCID. 

Epidemic services and response 

The Committee provides $91,776,000 for epidemic services and 

response, which is the same as the fiscal year 2004 comparable 

level and $709,000 below the request. 

The objectives of the program include the prevention and control 

of epidemics, the maintenance of surveillance systems, the training 

of public health epidemiologists, and the operation of the quarantine program. The program supports the Epidemic Intelligence 

Service program, the publication of the Morbidity and Mortality 

Weekly Report, and a variety of infant and minority health programs. 

Landmine Survivor Network.—The Committee commends CDC 

for its partnership with the Landmine Survivor Network that has 

developed peer support networks for landmine survivors in six 

mine-affected countries around the world. The Committee recommendation assumes continued support for the Network at not 

less than the fiscal year 2004 level. 

Health statistics 

The Committee provides a total of $149,600,000 for health statistics, which is $21,966,000 above the fiscal year 2004 comparable 

level and the same as the request. All funds provided shall be derived from section 241 evaluation set-aside funds, as proposed in 

the request. 

The Health Statistics program is responsible for collecting, interpreting, and disseminating data on the health status of the U.S. 

population and the use of health services. Surveys include the National Vital Statistics System, the National Health Interview SurVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00052 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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vey, the National Survey of Family Growth, the National Health 

and Nutrition Examination Survey, and the National Health Care 

Survey. 

The Committee supports the efforts to strengthen health statistics programs. The Committee is aware that the data systems of 

the National Center for Health Statistics require additional investment in order to sustain ongoing operations as well as to make 

needed improvements in content and technology. The Committee 

recognizes that the data provided by the Center are important to 

the ability of the Congress to set health priorities, evaluate funding 

requests, and provide oversight to the performance of Federal 

health agencies. They are equally important to the day to day planning and management of health programs of CDC and to the biomedical research conducted by NIH. The Committee commends 

Secretary and Director for the increased request and encourages 

each to ensure that continued support of these data systems is provided and to make needed improvements in content and technology. 

HIV/AIDS, STD and TB prevention 

The Committee provides $1,149,330,000 for HIV/AIDS, STD and TB prevention, which is $7,669,000 above the fiscal year 2004 comparable level and $6,031,000 above the request. Of the amount provided, $837,725,000 is for the HIV/AIDS programs, of which 

$142,808,000 is for global HIV/AIDS programs; $172,935,000 is for 

the STD program; and $138,670,000 is for the TB program. 

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

provides funds to state and local health departments to develop 

and implement integrated community prevention plans. The STD 

program awards grants to state and local health departments and 

other nonprofit entities to support a wide variety of public health 

activities to prevent and treat STDs. CDC directly conducts special 

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

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

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

Domestic HIV/AIDS Prevention.—The Committee applauds 

CDC’s steps to emphasize HIV testing to identify infected persons 

who are not aware of their own infection and to get them into 

treatment and prevention services. The Committee encourages the 

CDC to work specifically with federal programs providing reproductive health services to women to implement HIV/AIDS testing and 

counseling as a part of the Advancing HIV Prevention Initiative. 

The Committee is concerned, however, that while support for 

HIV/AIDS has increased over the past decade, CDC estimates that 

there has been no decline in the incidence of HIV, leading to concerns about the effectiveness of these programs. The Committee is 

pleased that the Director has acknowledged the need for greater 

accountability and the establishment of methods of measuring the 

effectiveness of the programs that receive CDC funding. 

The Committee requests that the CDC prepare and submit a report to the Committee by June 1, 2005 outlining the steps CDC has 

taken, or plans to take, to ensure that the programs receiving CDC 

54 

support are effective in preventing the spread of HIV. The Committee requests that the report: (1) demonstrate how the CDC will 

ensure that HIV-prevention program evaluations include verifiable 

data to demonstrate how the funded projects will prevent or reduce 

risk behaviors and disease transmission; (2) describe how the CDC 

will evaluate the impact of both the actual program and its advertising and promotion in eliminating risk taking behaviors; (3) describe how such programs will be evaluated in a scientifically 

sound method to ensure that these programs reduce the transmission rates for sexually transmitted disease (STDs) including 

HIV/AIDS; (4) describe how the CDC will collect and evaluate data 

to demonstrate that each funded program will lower HIV and STD 

rates; and (5) describe how the CDC will make available to the 

public, information on which program and approaches have demonstrated success or failure in preventing the spread of HIV and 

STDs. 

Mother and Child HIV/AIDS Prevention.—The Committee recommendation does not include funds for the Mother and Child 

HIV/AIDS prevention initiative. Funding for this initiative was requested within the Global AIDS Coordinator’s Office at the Department of State. 

Minority HIV/AIDS Initiative.—Within the total provided, the 

Committee expects the CDC to allocate not less than the fiscal year 

2004 level for activities that are targeted to address the growing 

HIV/AIDS epidemic and its disparate impact on communities of 

color, including African Americans, Latinos, Native Americans, 

Asian Americans, Native Hawaiians, and Pacific Islanders. The 

Committee expects CDC to follow the fiscal year 2002 report accompanying this bill regarding the disbursement of these funds. 

Infertility Prevention Program.—The Committee provides an in- crease of $5,000,000 above the FY2004 comparable level to expand 

the infertility prevention activities for uninsured and underinsured 

women. The Committee understands that in six regions, which represent the most highly populated areas, screening activities reach 

only 36 percent of women in need. 

Tuberculosis.—The Committee provides $138,670,000 for Tuberculosis (TB) prevention and control, $2,465,000 above the fiscal 

year 2004 comparable level and $2,269,000 above the request. 

The Committee is pleased with the efforts of the TB control program, which has reduced the number of new TB cases for the past 

ten years but is concerned with the number of new TB cases in foreign-born individuals in the U.S. The Committee urges CDC to 

work with the U.S. Citizenship and Immigration Services (USCIS) 

to develop novel TB screening strategies for individuals emigrating 

from high TB incidence countries. The Committee also encourages 

CDC to consider implementing screening programs for high-risk individuals residing in the U.S. for latent TB. 

The Committee also recognizes that despite increased attention 

to the disease globally, the expansion of DOTS (Directly Observed 

Therapy—Short course) therapeutic regimes, and the widespread 

use of an existing vaccine against TB, TB continues to be a worldwide pandemic. The Committee is aware of modeling studies showing that a modestly effective vaccine (50%–70% efficacious) used in 

combination with drug therapy could save tens of millions of lives, 

and a highly effective vaccine could eventually control the disease. 

55 

The Committee urges the CDC to continue its support for the TB 

vaccine research cooperative agreement in partnership with the 

leading private foundation conducting clinical field site trial work 

on TB vaccines. The Committee expects CDC will provide leadership and technical assistance on field site development and surveillance. 

The Committee understands that State of Oklahoma has a 

unique program, based upon a program that was successful in Florida, of outreach through the Catholic Church community to undocumented workers to better prevent and control TB among foreign-born individuals. CDC is encouraged to work with the State 

of Oklahoma, and other states wishing to participate, to support 

these model programs aimed at preventing and controlling TB in 

the population. The CDC is also encouraged to work with the country of Mexico to help them eradicate this problem within their own 

country. 

Immunization 

The Committee provides a program level of $654,070,000 for im- munization, which is $10,726,000 over the fiscal year 2004 comparable level and $10,000,000 above the request. Of the amount 

provided, $14,000,000 is to be derived from section 241 evaluation 

set-aside funds, as proposed in the request. In addition, the Vaccines for Children (VFC) program is expected to provide 

$1,208,000,000 in vaccine purchases and distribution support in fiscal year 2005. 

Immunization project grants are awarded to States and local 

agencies for planning, developing, and conducting childhood immunization programs including enhancement of the vaccine delivery 

infrastructure. CDC directly maintains a stockpile of vaccines, supports consolidated purchase of vaccines for state and local health 

agencies, and conducts surveillance, investigations, and research 

into the safety and efficacy of new and presently used vaccines. The 

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

Health Insurance Program (SCHIP), the Maternal and Child 

Health Block Grant, and community health centers. 

Meningococcal disease.—The Committee is aware of recent CDC 

efforts to consider increasing information on meningococcal disease 

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

recommends that CDC work to improve education and immunization programs and encourages the CDC to partner with the National Meningitis Association to ensure that all families, especially 

those with adolescents and young adults, are effectively educated 

on this disease, vaccine availability, and all methods of prevention. 

Vaccine Safety Datalink Sharing Program.—The Committee is 

aware of sensitivities about research involving the safety of childhood vaccines. CDC’s Vaccine Safety Datalink Data Sharing Program allows external researchers to assess vaccine safety by analyzing data from managed care organizations. The Committee believes that it is essential that these data be available in a way that 

allows for independent review while at the same time protect confidentiality and comply with regulations for the protection of 

human subjects involved in research. The Committee urges the 

56 

CDC to assure access to these data. The Committee is concerned 

that some of the restrictions placed on outside researchers preclude 

independent researcher from being able to independently validate 

internal research conducted by the CDC’s VSD project team. The 

Committee urges the CDC to reexamine the restrictions placed on 

external researchers so that these researchers may be able to validate the internal researcher’s findings. The Committee recognizes 

that validating research findings requires that external researchers 

also have access to original datasets, not simply final datasets, and 

it directs that the CDC make such datasets available to external 

researchers in such a way as to assure compliance with the privacy 

protections set forth in Title 45, Part 46, Code of Federal Regulations. 

Infectious diseases control 

The Committee provides $398,439,000 for infectious diseases con- trol, which is $28,954,000 above the fiscal year 2004 comparable 

level and $2,340,000 below the request. 

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

methods and techniques, the acceleration of the general application 

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

diseases. 

Within the total provided, not less than $4,000,000 above the fiscal year 2004 comparable level is to continue planned activities and 

expand efforts to prevent and control the West Nile virus. 

Antimicrobial Resistance.—The Committee encourages the CDC 

to expand support for training and education of medical and public 

health personnel related to antimicrobial resistance and public 

health emergencies, including training laboratory personnel in the 

recognition of resistance in pathogens. 

Chronic Fatigue Syndrome.—The Committee is pleased that CDC 

is restoring funds for CFS research and that these funds are being 

used in substantive areas. The Committee encourages CDC to continue the establishment of a national registry to examine such 

things as: studies of etiologic agents, diagnostic markers, natural 

history, and risk factors using specialized molecular epidemiology 

techniques and advanced surveillance methodologies. 

Cooley’s Anemia.—The Committee is pleased with the progress 

that CDC has made with regard to the establishment of a blood 

safety surveillance program for Cooley’s anemia patients, who are 

the largest consumers of red blood cells. As the program moves forward and one time costs are met, the Committee expects CDC to 

direct an increasing amount of the funds available to active patient 

recruitment, education and awareness, and related services. 

Global Disease Detection.—The Committee commends the CDC 

for moving rapidly to improve the capacity for disease detection 

and outbreak response. The Committee believes that the CDC’s 

work in expanding both domestic and international surveillance 

and response capabilities were critical factors in mitigating adverse 

health effects in this country and abroad from outbreaks, such as 

SARS and Monkeypox. The Committee recommendation provides 

an increase of $24,895,000 to further enhance CDC’s global disease 

detection capacity as proposed in the request. 

57 

Hepatitis.—The Committee encourages CDC fully implement the 

National Hepatitis C Prevention Strategy. This prevention strategy 

includes enhancing state and local health department and community-based organizations’ efforts to provide counseling, testing, 

partner notification, health education and medical referral to persons at risk of or infected with hepatitis C, and to enable state 

health departments to establish surveillance systems to monitor 

the burden of disease. While most States have designated a state 

Hepatitis C Coordinator, the Committee is concerned that coordinators are still lacking in 6 states. CDC is urged to work with these 

States to ensure the availability of hepatitis C coordinators. The 

Committee also notes that hepatitis C counseling and testing programs are not universally available, and encourages that CDC address this gap. Further, the Committee is concerned about reports 

that the CDC may reduce the number of Hepatitis C prevention 

demonstration project sites from 15 to 5 in FY2005 and urges the 

Director to continue support for all 15 sites. The Committee also 

encourages more aggressive HCV outreach linkages to care are 

available in all states to those seeking hepatitis C prevention services. Finally, the Committee is pleased that several States, in collaboration with community stakeholders, have developed State 

plans to address hepatitis, but understand that funding has not 

been made available to implement these plans. Funds have been 

included above the request to support and expand the 

abovementioned hepatitis C activities. 

In addition, the Committee is concerned with increasing rates of 

adult infection with hepatitis A and B, and urges that the CDC 

consider launching an expanded vaccination program in response to 

this health issue. 

Lyme Disease.—The Committee continues to be concerned about 

the increase in tick-borne illnesses, including Lyme disease and 

Southern Tick-Associated Rash Illnesses. The Committee urges the 

Director, in collaboration with other relevant Departmental Operating Divisions, to consider the establishment of a comprehensive, 

multi-agency, five-year plan that lays out a blueprint for making 

progress toward effective surveillance, prevention, and control of 

tick-borne illnesses. 

Sepsis.—The Committee understands that sepsis remains a leading cause of death, in part because too few medical personnel know 

how to diagnose and treat it properly. The Committee encourages 

the CDC to work with State health departments to expand surveillance efforts related to sepsis. Furthermore, the Committee encourages the CDC work with relevant voluntary health organizations to 

examine effective means of educating infectious disease physicians, 

emergency room doctors, and critical care nurses, especially those 

in rural and traditionally underserved areas, in use of the new 

guidelines to identify sepsis and improve patient outcomes. 

West Nile Virus.—The Committee supports the CDC’s efforts to 

complete a national plan for West Nile virus response, including 

surveillance, prevention, and control of the virus nationwide. The 

Committee is aware of concerns that political subdivisions of states, 

such as local and county/parish governments have not had the necessary resources to combat outbreaks, even though they have a significant responsibility for response. The Committee urges the DiVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00057 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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rector to factor in the needs of local governments in the allocation 

of West Nile response funds in FY2005. 

Injury prevention and control 

The Committee provides $155,591,000 for the injury control program, which is $2,000,000 above the fiscal year 2004 comparable 

level and $1,712,000 above the request. The injury prevention and 

control program supports intramural research, injury control research centers, extramural research grants, and technical assistance to state and local health departments. 

Gun Control Advocacy.—The Committee recommendation maintains language carried in the fiscal year 2004 bill and prior years 

prohibiting federal funds from being used to lobby for or against 

the passage of specific federal, state or local legislation intended to 

advocate or promote gun control. The Committee understands that 

the CDC’s responsibility in this area is primarily data collection 

and the dissemination of that information and expects that research in this area to be objective and grants to be awarded 

through an impartial, scientific peer review process. The Committee requests that the Director be prepared to report on the steps 

taken to ensure this restriction is followed during the FY2006 

budget hearings. 

National Violent Death Reporting System.—The Committee commends the CDC for working with several academic institutions to 

develop and implement model population-based violent injury reporting systems, and to develop systems that link information from 

law enforcement agencies, medical examiners, and coroners, health 

providers, crime laboratories, and other agencies. The Committee is 

pleased with the progress that has been made towards implementation of a system of more timely, complete, objective and accurate 

information about violent deaths and injuries. The Committee encourages CDC to continue to work with both State and private 

partners in its implementation of this model plan. 

Prevention of Child Maltreatment.—The Committee recommendation includes sufficient funds to support public health surveillance 

and research for child maltreatment prevention programs at not 

less than the FY2004 level. The Committee provides $1,000,000 

above the request for child maltreatment and other intentional injury activities. 

Traumatic Brain Injury.—Within the funds provided, $1,000,000 

above the fiscal year 2004 comparable level is for expanding the activities of the Traumatic Brain Injury program. 

Occupational safety and health 

The Committee provides a program level of $278,587,000 for occupational safety and health, which is the same as the request and 

$1,599,000 above the FY2004 comparable level. Of the amount provided, $41,900,000 is to be derived from section 241 evaluation setaside funds, as proposed in the request. 

This program conducts applied research, develops criteria for occupational safety and health standards, and provides technical 

services to government, labor and industry, including training for 

the prevention of work-related diseases and injuries. This appropriation supports surveillance, health hazard evaluations, intraVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00058 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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mural and extramural research, instrument and methods development, dissemination, and training grants. 

National Occupational Research Agenda (NORA).—The Committee recommendation continues support for research associated 

with NIOSH’s NORA program at not less than the FY2004 level. 

Personal Protective Equipment.—The Committee strongly supports NIOSH’s efforts for program activities in domestic terrorism 

preparedness. The Committee believes significant work must be 

done to continue to protect emergency responders from biological 

and chemical terrorism exposures, as well as industrial accidents. 

Firefighters, emergency medical personnel, and other on-site workers need reliable personal protective equipment, principally protective masks and respirators, but also protective clothing and detection devices to be able to effectively help victims in case of exposure 

to biological or chemical terrorist agents. 

NIOSH has made significant progress in the past year and is to 

be commended for working closely with manufacturers and first-responder representatives to create equipment that will protect our 

nation’s workers. The self-contained breathing apparatus (SCBAs) 

are now approved and on the market, and the upgrade kits for 

items in current service are being approved. NIOSH should investigate the feasibility of the use of the military masks about to be 

surplused as the U.S. military moves to a new mask that NIOSH 

and Fort Detrick are cooperatively creating. 

Preventive health and health services block grant 

The Committee provides $110,000,000 for the preventive health 

and health services block grant, which is $23,298,000 below the fiscal year 2004 comparable level and the budget request. This program provides grants to States by formula for a wide range of public and preventive health activities. 

Public health improvement 

The Committee provides a program level of $128,774,000 for public health improvement, which is $43,788,000 below the fiscal year 

2004 comparable level, and $15,482,000 above the request. Of the 

amount provided, $43,600,000 is to be derived from section 241 

evaluation set-aside funds, as proposed in the request. 

This program funds activities designed to close the Nation’s gap 

in public health capacity and strengthen the practice of public 

health at the front lines, develop improved interventions and services, help racial and ethnic minority communities mobilize and organize their resources to support effective and sustainable programs that will contribute to the elimination of health disparities, 

and develop and implement national data standards for surveillance reporting. 

Extramural Prevention Research.—The Committee provides 

$483,000 for extramural prevention research. The Committee understands that no new grants will be funded through the program 

in FY2004 and that the grant periods for all but one of the 25 

grants supported expire on September 30, 2004. As a result, 

$483,000 is provided for continuation requirements in FY2005. 

Public Health Research.—The Committee recommendation provides a total of $30,000,000 for public health research. Of this 

60 

amount, $15,000,000 is to be derived from section 241 evaluation 

set-aside funds as proposed in the request. 

Buildings and facilities 

The Committee provides $81,500,000 for buildings and facilities, which is $178,954,000 below the fiscal year 2004 comparable level 

and the same as the request. 

These funds support construction and ongoing maintenance 

projects, as well as essential safety repairs and equipment purchases. The funds provided will support high priority work identified in the CDC’s Buildings and Facilities Master Plan phased 

planning effort. Funds also will be used to support the 2nd year 

costs of replacing the CDC’s Vector Borne Infectious Diseases Laboratory in Ft. Collins, CO. 

The Committee recommendation includes bill language to allow 

the CDC to enter into a single contract or related contracts for the 

full scope of development and construction of facilities. It also carries language included in the Departments of Labor, Health and 

Human Services and Education, and Related Agencies Appropriations Act, 2004 to allow funds appropriated to the CDC to be used 

to enter into a long-term ground lease for construction on non-Federal land, in order to replace their laboratory in the Fort Collins, 

Colorado area. 

Data Security and Storage.—Within the amount provided sufficient funds are available for data center storage infrastructure 

hardware and software upgrades. This funding is to provide further 

for the remote mirroring of information between CDC data centers 

and recovery sites, and to provide heterogeneous connectivity to existing systems in use at the CDC, in order to ensure the protection, 

recovery, and availability of critical resources; as well as to provide 

for enhanced security-specific technologies and services in concert 

with critical infrastructure protection requirements. 

Office of the Director 

The Committee provides $59,173,000 for the activities of the Office of the Director, which is the same as the fiscal year 2004 comparable level and $500,000 below the request. 

The Committee intends this amount to be a ceiling. The Director 

may transfer these funds to non-administrative, programmatic activities at her discretion. 

The Committee recommendation includes a provision, sec. 220 

that reduces funds available for information technology and administrative management by $15,000,000. The Committee included this 

provision to partially offset funds provided within public health improvement to support high priority public health research. The 

Committee expects the Director to submit a report regarding the 

allocation by budget activity of the administrative and information 

technology savings across the CDC prior to the obligation of 

FY2005 public health research funds. 

Cooperative Agreements.—The Committee is concerned that CDC 

is considering altering the cooperative agreement that has effectively supported research, fellowships, training, preparedness and 

other activities at schools of public health over the past 23 years. 

The Schools of Public Health are an integral part of the public 

health infrastructure through preparation of future public health 

61 

leaders and through key research and training activities. The Committee notes that the competitive, peer-reviewed projects funded 

through this mechanism are results-oriented and have positive 

evaluations. The Committee is aware that this cooperative agreement was one of the first such funding models at CDC that allow 

flexibility to meet unanticipated public health needs at the community level and rapidly respond to emerging situations while ensuring accountability and integrity. The Committee expects that CDC 

will not proceed with any modification to this arrangement without 

prior justification and consultation with the Committee. 

Futures Initiative.—The Committee understands that since June 

2003, CDC has been engaged in a strategic planning process called 

the, ‘‘Futures Initiative.’’ The process has yielded a series of organizational recommendations to ensure that CDC will continue to 

have the capacity to effectively and efficiently protect and improve 

the health of the American people. The Committee understands 

that the organizational recommendations may require changes to 

the manner in which funds are appropriated to the CDC and will 

work to incorporate those changes before the funding recommendations for FY2005 are finalized. 

Terrorism 

The Committee provides $1,637,760,000 for CDC terrorism preparedness and response activities within the Public Health and Social Services Emergency Fund (PHSSEF). This is $130,549,000 

above the FY2004 comparable amount and $128,189,000 above the 

request. Within the total provided: $934,300,000 is for State and Local Capacity, including $871,900,000 to be provided to State and local 

health departments through grants and cooperative agreements; 

$142,160,000 is for Upgrading CDC Capacity; $11,300,000 for Anthrax; $100,000,000 for the Biosurveillance Initiative and 

$450,000,000 for the Strategic National Stockpile. 

Poison Control Centers.—For many years the Committee has recognized the importance of the national network of poison control 

centers in the early identification of potential public health incidents and domestic terrorist events. The centers, which operate 

around the clock, have developed a national, real-time data collection, analysis and surveillance capability. The Committee urges the 

CDC to continue to incorporate these unique capabilities and to 

provide sufficient support to enable the centers to participate fully 

in the BioSense program as it develops. 

NATIONAL INSTITUTES OF HEALTH

The Committee provides $28,526,871,000 for the twenty-six appropriations which together fund the programs of the National Institutes of Health (NIH). The total in the bill is $726,823,000 above 

the fiscal year 2004 comparable level and the same as the budget 

request. The bill also includes $47,400,000 in the Public Health 

and Social Services Emergency Fund as requested by the Administration for targeted research activities to develop radiological and 

nuclear threat countermeasures. NIH would manage and oversee 

this work. 

Roadmap.—The Committee endorses the Administration’s proposal of supporting the NIH Roadmap for Biomedical Research at 

62 

a funding level of $236,800,000, from funding contributed by the 

Institutes and Centers based on less than one percent of their 

budgets and out of the Director’s Discretionary Fund. The Committee believes the Roadmap is an important step to moving biomedical research forward to the next level of discovery at a pace 

that hastens its delivery to patients. The Roadmap addresses common needs across all disease areas and should produce research advances that will benefit many diseases and conditions. The Committee expects to be to notified on a quarterly basis if the contribution from the Institutes and Centers or the allocation of funding by 

initiative changes from what is presented in the congressional justification. 

Biodefense.—The Administration’s FY05 budget for NIH includes $1,694,200,000 for bioterrorism activities. The Committee has not 

identified a specific funding level for biodefense research, choosing 

to give the Director of NIH flexibility in determining what share 

of NIH resources should be considered biodefense activities. 

Balance in the research portfolio.—The Committee reiterates its 

longstanding view that NIH should distribute funding on the basis 

of scientific opportunity. The Committee urges the Director and the 

Administration to continue to resist pressures to earmark, set aside 

and otherwise politicize these resources. To enhance NIH’s flexibility to allocate funding based on scientific opportunity, the Committee has attempted to minimize the amount of direction provided 

in the report accompanying the bill. For example, there are no directives to fund particular research mechanisms, such as centers or 

requests for applications, or specific amounts of funding for particular diseases. 

In stating that scientific opportunity should be the basis for allocating research funding, the Committee understands that other factors also are relevant to NIH’s decisions, including such considerations as the infectious nature of a disease, the number of cases 

and deaths associated with a particular disease, the Federal and 

other costs of treating a disease, the years of productive life lost 

due to a particular disease, and the estimated proximity to research breakthroughs. The Committee does not presume to judge 

which criteria should take precedence or carry the greatest weight 

in individual funding decisions, but urges NIH to consider the full 

array of relevant criteria as it constructs its research portfolio. 

AIDS funding.—Consistent with the philosophy outlined above, 

the Committee has chosen not to earmark a specific dollar amount 

for AIDS research. The Committee understands that it would be 

NIH’s intent to allocate AIDS funding consistent with the Director’s recommendations. The Committee understands that this allocation may change before the beginning of the fiscal year. 

The Committee intends that the funds allocated for AIDS should 

be spent in a manner fully consistent with the AIDS research plan 

developed by the Office of AIDS Research (OAR) and expects the 

Director of NIH to use the full authority of his office to ensure that 

this occurs. The Committee has provided the Director of OAR, 

jointly with the Director of NIH, transfer authority to reallocate up 

to three percent of funds designated for AIDS research among Institutes, subject to normal reprogramming procedures. The Committee encourages NIH to use this authority whenever it believes 

that an adjustment in the allocation of AIDS funding between InVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00062 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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stitutes is appropriate to achieve scientific objectives or to facilitate 

promising research efforts. 

The Committee continues to support OAR, its leadership, and its 

coordinated budget planning process and expects the individual institutes, centers and divisions to fully cooperate with OAR’s work. 

The Committee has provided funding for the OAR within the Office 

of the Director and intends that the OAR will maintain its current 

structure and responsibilities, including the allocation of an emergency discretionary fund. 

Conflict of Interest.—The integrity of NIH’s scientists is of paramount importance. The Committee commends NIH for forthrightly 

addressing the issue and supports the NIH proposals announced at 

the June 22 hearing of the House Energy and Commerce Health 

Subcommittee. The proposals, several of which would require regulatory changes, would properly restrict some consulting and other 

outside arrangements while creating a rigorous management process for monitoring the remaining interactions with outside interests. 

NATIONAL CANCER INSTITUTE

The Committee provides $4,870,025,000 for the National Cancer Institute (NCI), which is $130,770,000 above the fiscal year 2004 

comparable level and the same as the budget request. The bill includes language requested by the Administration identifying up to 

$8,000,000 for repairs and improvements to the NCI intramural facility in Frederick, Maryland. 

Mission.—The NCI conducts and supports basic and applied cancer research in early detection, diagnosis, prevention, treatment 

and rehabilitation. NCI provides training support for research scientists, clinicians and educators, and maintains a national network 

of cancer centers, clinical cooperative groups, and community clinical oncology programs, along with cancer prevention and control 

initiatives and outreach programs to rapidly translate basic research findings into clinical practice. 

Prostate cancer.—The Committee recognizes NCI’s commitment 

to prostate cancer research as laid forth in its ‘‘Prostate Cancer Research Plan, FY 2003–FY 2008’’. The Committee requests that NCI 

provide an annual update every January on its progress in prostate 

cancer research as it reflects the goals outlined in the plan for 

years FY04–FY08. 

Pediatric cancer.—To expedite the progress and further improvements in outcomes for children with cancer, the conferees encourage NCI to increase its support of dedicated translational research 

to accelerate the pace of pediatric cancer clinical trials. The conferees also urge NCI to place a significant focus on genomic and 

proteomic approaches to identifying and validating potential molecular targets for therapeutic exploitation and evaluation in a controlled clinical trial setting. The existing, NCI-supported national 

clinical trials infrastructure and network, the Children’s Oncology 

Group, should be the dominant participant in this accelerated effort. 

Pancreatic cancer.—The Committee is concerned that there are 

too few scientists researching pancreatic cancer, which is the country’s fourth leading cause of cancer deaths. Tragically, 99 percent 

of people diagnosed with this disease die within six months. The 

64 

Committee compliments the NCI’s past efforts for increasing the 

research field through its program of a 50 percent formalized extended payline for grants that were 100 percent relevant to pancreatic cancer, an initiative that was an important method for attracting both young and experienced investigators to develop careers in pancreatic cancer. The Committee understands that NCI 

is adjusting this policy for the current year and looks forward to 

learning whether this revised approach is even more successful in 

increasing the number of prostate cancer grants. 

Cancer centers.—The Committee commends NCI on the success 

of its cancer centers program. Given that minority populations suffer disproportionately from virtually every form of cancer, the Committee encourages NCI to give consideration to the establishment 

of a comprehensive center at a minority institution focused on research, treatment, and prevention of cancer in African American 

and other minority communities. 

Neurofibromatosis (NF).—The Committee is pleased that NCI is 

conducting phase II clinical trials of NF1 patients with plexiform 

neurofibromas. Recognizing NF’s connection to many of the most 

common forms of human cancer, the Committee encourages NCI to 

increase its NF research portfolio in such areas as further development of animal models, natural history studies, therapeutic experimentation, and clinical trials. The Committee hopes that NCI will 

aggressively pursue clinical and translational research while still 

maintaining a solid basic research portfolio. 

Liver cancer.—The Committee notes with concern the number of 

people who develop and die from liver cancer. As the symptoms of 

liver cancer often do not appear until the disease is advanced, only 

a small number of liver cancer cases are found in the early stages 

of the disease when they can be easily treated. The Committee is 

aware that NCI, in collaboration with NIDDK, convened an Experts Conference in April, 2004 to help define the most pressing 

areas requiring additional research, professional education and 

public awareness initiatives. The Committee encourages NCI to 

pursue the research initiatives that result from the Conference. 

Kidney cancer.—The Committee is concerned that the incidence 

of kidney cancer has increased significantly over the last decade. 

The Committee encourages NCI to develop a strategic plan to combat kidney cancer, including implementing the NCI Progress Review Group’s (PRG) recommendations in order to bolster research 

efforts to fight this disease. The Committee requests that NCI report in March 2005 on its progress in developing a strategic plan. 

Lymphoma.—Hodgkin’s lymphoma and non-Hodgkin’s lymphoma 

(NHL) represent a serious health burden, because of their persistent high incidence and the inadequate improvement in survival 

rates. The Committee encourages NCI to strengthen its support for 

translational and clinical lymphoma research which can utilize laboratory discoveries in lymphoma biology specifically to develop new 

approaches in the clinic for patients. The Committee recommends 

that NCI evaluate its current investment in lymphoma clinical research and expand or initiate programs that would ensure support 

for translational and clinical research efforts. 

The Committee encourages NCI to enhance and expand its commitment to investigation of the etiology and prevention of 

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plained increase in the incidence of the disease; this epidemic is 

particularly evident in young and middle-aged persons. Evidence 

suggests that these cancers develop from genetic damage caused by 

environmental factors such as chemicals, toxins and ultraviolet 

light, and infectious organisms such as hepatitis C, as well as immune dysfunction. 

Angiogenesis.—The Committee is pleased with the progress of 

angiogenesis research across the institute to involve both intramural and extramural researchers and encourages NCI to continue 

to pursue efforts to establish greater collaboration between 

angiogenesis researchers in the fields of cancer biology and diabetes. The trans-NIH angiogenesis workshop is an important step toward promoting multidisciplinary research on this important topic. 

Blood cancers.—The Committee is pleased that important new 

therapies have been developed for the blood cancers—leukemia, 

lymphoma, and multiple myeloma. Despite the introduction of 

these new therapies—including monoclonal antibody, radioimmunotherapies, and a proteasome inhibitor—far too many Americans still die from the blood cancers. The Leukemia, Lymphoma, 

and Myeloma Progress Review Group, a blue ribbon advisory panel 

of the National Cancer Institute (NCI), recommended in May 2001 

the establishment of new multi-disciplinary and multi-institutional 

structures to shorten the timeline for new blood cancer drug development. The Committee encourages NCI to develop new strategies 

to accelerate the development of new blood cancer therapies, which 

might include, among other options, public-private partnerships, 

multi-disciplinary collaborations, and multi-institutional initiatives. 

NCI should consider flexible uses of current funding mechanisms 

in order to respond to the key recommendation of the blood cancer 

Progress Review Group, which was to reduce dramatically the time 

required to develop new therapies. 

Myelodysplasia and myeloproliferative disorders research.—The 

Committee recognizes NCI’s support for a new research initiative 

in myeloproliferative disorders, which are chronic diseases of bone 

marrow cells that can develop into acute leukemia. The Committee 

encourages NCI and NHLBI to bring together scientific and clinical 

experts in these fields to explore collaborative and crosscutting research mechanisms to further this research agenda. The Committee also urges NCI to utilize the Surveillance, Epidemiology, 

and End Results (SEER) program to collect data on the incidence 

and distribution of these diseases. 

Chronic lymphocytic leukemia (CLL).—This incurable disease is 

the most common form of adult leukemia in the U.S. The Committee encourages NCI to strengthen research efforts into CLL, including improved therapies and their rapid movement from the laboratory to the bedside. The Committee is pleased to learn that the 

unique multidisciplinary and multi-institutional research consortium funded by the Institute for the past five years is proceeding 

with a competing renewal of its initial grant to permit continued 

study of CLL at the cellular and clinical levels. The Committee encourages NCI to consider enhancing the scope of research activities 

funded through the CLL Research Consortium as it works to defeat 

this devastating blood disorder. 

Tuberous sclerosis complex.—Tuberous sclerosis complex (TSC) is 

a genetic disorder that triggers uncontrollable tumor growth in 

66 

multiple organs of the body, including the brain, heart, kidneys, 

lungs, liver, eyes or skin. In light of its similarities to the uncontrolled growth of cancer cells, many scientists believe that determining the cause of tumor growth in TSC could open the way for 

cures and treatments for cancer as well. The Committee encourages NCI to support programs examining the molecular and cellular basis of TSC, and the role of TSC in tumor development. 

Cancer genomics.—The Committee is aware of the potential for 

improved understanding and treatment of cancer presented by the 

use of microarray technology in both basic research and the clinical 

setting. The Committee understands that the use of this technology 

can help accelerate the development of effective cancer drugs, the 

prediction of drug response, and ultimately the early detection and 

improved treatment of cancer. The Committee recommends that 

NCI continue to employ these enabling technologies to identify, 

characterize, and validate the gene pathways that cause cancer and 

that it continue to work cooperatively with public and private sector entities in this effort. 

American Russian Cancer Alliance.—The Committee recognizes 

the contribution of the American Russian Cancer Alliance (ARCA) 

in its pursuit of novel research activities that ultimately benefit 

cancer patients worldwide. The Alliance has brought together the 

scientific strengths, expertise, and particular resources of both nations for the benefit of humankind through its effort to diagnose, 

treat and prevent cancer. The Committee notes in particular the 

unique ARCA projects in molecular imaging and radionuclide therapy that capitalize on the exceptional scientific expertise and technical capabilities of the leading Russian nuclear research centers 

and American cancer centers. The Committee encourages NCI to 

establish a mechanism to support the continued development of 

this collaboration between the United States and Russian cancer 

researchers and to develop a plan to support the necessary infrastructure at U.S. institutions for the Alliance and its activities. 

Bone metastasis study.—The Committee encourages NCI to develop an integrated approach to study bone metastasis, leveraging 

the expertise of cancer and bone biologists, clinical oncologists and 

metastasis experts and representatives from pharmaceutical industry. Key issues to address include the generation of novel models 

which mimic tumor/bone interaction and which delineate mechanisms to determine why tumor cells prefer bone for metastasis. The 

Committee also urges NCI to expand research on osteosarcoma to 

improve survival and quality of life and to prevent metastatic 

osteosarcoma for children and teenagers who develop this cancer. 

Tobacco harm reduction.—The Committee continues to encourage 

research about tobacco products intended to reduce the harm 

caused by cigarette smoking and encourages NCI to expedite its research and review of existing literature regarding tobacco harm reduction. The Committee is particularly interested in what can be 

done from a public policy perspective to reduce tobacco related mortality and morbidity in that ten to fifteen percent of the adult population who cannot or will not quit smoking. The Committee encourages NCI to focus on the difference in harm caused by cigarettes 

versus potential reduced exposure tobacco products and how effective these products are or could be in smoking cessation efforts. 

NCI should consider exploring why Sweden has been so successful 

67 

in reducing smoking and smoking related disease and what has 

been the impact of non-combustion products on smoking cessation 

in Sweden. 

Human embryonic stem cell research.—The Committee understands that NCI will soon begin implementing a human embryonic 

stem cell program. The Committee requests NCI to submit a report 

to the Committee by December 1, 2004 listing the human embryonic stem cell research grants that NCI has awarded, the requests 

for proposals on human embryonic stem cell research that have 

been developed by NCI, and a plan describing how NCI will further 

develop its human embryonic stem cell research program. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

The Committee provides $2,963,953,000 for the National Heart, Lung, and Blood Institute (NHLBI), which is $85,262,000 above the 

fiscal year 2004 comparable level and the same as the budget request. 

Mission.—The National Heart, Lung, and Blood Institute provides leadership for a national research program in diseases of the 

heart, blood vessels, lungs, and blood, in transfusion medicine, and 

in sleep disorders through support of basic, clinical, and population-based and health education research. 

Cardiovascular diseases.—The Committee continues to regard research into the causes, cure, prevention and treatment of heart disease, stroke and other cardiovascular diseases as a top priority. 

Cardiovascular diseases remain the leading cause of death and a 

major cause of permanent disability. The Committee continues to 

believe that an intensive research program in these areas is necessary. 

Cardiovascular health study.—The Committee is aware that the 

Cardiovascular Health Study, initiated in 1987 to determine risk 

factors for development and progression of heart disease, stroke 

and other cardiovascular diseases in nearly 6,000 Americans age 65 

and older, is scheduled to end in 2005. The wide variety and complexity of data and samples collected in the Cardiovascular Health 

Study represent a unique national research resource. The Committee encourages NHLBI to initiate a proposal to stimulate innovative use of Cardiovascular Health Study data and material, provide opportunities for open, efficient use of the information for the 

entire scientific community, and continue follow-up of study participants. 

Heart failure management.—The Committee is concerned that 

heart failure is a major cause of hospitalization and readmission. 

Medicare recipients represent about 65 percent of repeat hospitalizations within one year. Yet, perhaps 50 percent of these hospitalizations are avoidable. The Committee encourages NHLBI to 

consider initiating a randomized trial to evaluate management 

strategies for heart failure patients in terms of their ability to prevent death or hospital readmission. 

Cardiovascular risk in American Indians and Alaskan Natives.— 

The Committee is aware that American Indian and Alaska Native 

communities bear a heavy burden of heart disease, stroke and 

other cardiovascular diseases and few preventive interventions 

have been tested. The Committee encourages NHLBI to evaluate 

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tors such as obesity, diet, smoking, sleep restriction, stress, and 

sedentary lifestyle in the American Indian and Alaskan Native 

populations. 

Tissue engineered blood vessel replacement and repair.—The 

Committee is aware that a need exists to develop alternatives to 

natural blood vessels for the adults who endure heart artery bypass 

surgery and for the children born with complex heart defects who 

need multiple blood vessel grafts. The Committee encourages 

NHLBI to begin an initiative to complement existing tissue engineered research programs to stimulate efforts to ‘‘grow’’ small-diameter, functional blood vessels. 

Cooley’s anemia.—The Committee remains supportive of the focused research effort that is being undertaken by the Thalassemia 

Clinical Research Network, which is comprised of the leading research institutions in the field of thalassemia, or Cooley’s anemia. 

In addition, the Committee suggests that NHLBI should consider 

including patients with related hemoglobinopathies whenever such 

inclusion will enhance the scientific validity of the research being 

conducted. 

Hemophilia.—The Committee commends NHLBI for its leadership in advancing research on bleeding disorders and the complications of these disorders and applauds NHLBI for its efforts, working with private non-profit groups, to support research on improved 

and novel therapies for bleeding disorders. 

Tuberculosis and AIDS interaction.—The Committee supports 

the important research on the interaction of tuberculosis and AIDS 

conducted by the NHLBI AIDS research program and encourages 

NHLBI to strengthen its research in this important area. 

COPD education and prevention program.—The Committee encourages NHLBI to implement an education and prevention program for chronic obstructive pulmonary disease (COPD). In developing such an education and prevention program, NHLBI is encouraged to work closely with patient and physician organizations 

and existing coalitions to coordinate with on-going activities in the 

community. Early identification of those at-risk for or who have 

COPD is essential in the effort to stem the growth of the population with COPD. The Committee encourages NHLBI to enhance 

its efforts in this area, including epidemiological studies of patients 

who are at-risk for or who have this disease as well as a national 

education campaign for providers and the public about COPD. 

Coronary heart disease and diabetes.—The Committee is aware 

that more than 18 million Americans are currently living with diabetes, a chronic condition that can lead to life-threatening illness. 

People with diabetes are two to four times more likely than others 

to develop heart disease and are more likely to die from heart attacks than people who do not have diabetes. Further, patients with 

diabetes may be asymptomatic or present with atypical symptoms 

of coronary heart disease, such as fatigue, indigestion, or shortness 

of breath. This may be due in part to the effects of diabetes on the 

heart, which may blunt the pain response to ischemia. Given the 

significant morbidity and mortality associated with coronary heart 

disease among patients with diabetes, the Committee recognizes 

the importance of diagnosing coronary heart disease in patients 

with diabetes whether or not these patients present with typical 

chest pain symptoms. The Committee encourages NHLBI to deVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00068 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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velop research initiatives to examine coronary artery disease in atrisk patients with diabetes, including studies of high diabetes incidence populations such as African-Americans, Hispanic Americans, 

and Native Americans. The Committee also encourages NHLBI to 

support educational programs directed to health professionals, patients, and the public to raise awareness of increased risk for heart 

disease and stroke for diabetics. 

Juvenile diabetes.—The Committee commends NHLBI and 

NIDDK for launching an initiative to stimulate research on the 

progression of cardiovascular disease, a significant long-term complication of juvenile diabetes. 

Angiogenesis.—The Committee is encouraged with the progress 

of angiogenesis research at the institute and encourages NHLBI to 

collaborate more closely with NCI in this area. 

Wound healing.—The Committee commends the institute for its 

research on the acceleration of vascular disease in type 1 diabetes. 

The Committee also encourages the Institute to be a key player in 

initiatives to advance wound healing, with particular emphasis on 

wounds associated with juvenile diabetes. 

Scleroderma.—The Committee is encouraged by NHLBI’s growing interest in scleroderma, a chronic and progressive disease that 

predominantly strikes women. Scleroderma is disfiguring and can 

be life-threatening, affecting multiple systems including the heart 

and lungs. More research is needed to develop safe, effective treatments and to identify the causes of the complications of 

scleroderma that include pulmonary fibrosis, pulmonary hypertension, myocardial fibrosis, cardiac arrhythmias, pericarditis, and 

Raynaud’s Phenomenon. 

Transmissible spongiform encephalopathies.—The Committee encourages NHLBI to enhance its efforts to develop a diagnostic test 

for TSE that would be suitable for screening the blood supply. Currently, there is no suitable method for identifying TSE-infected 

blood. In addition, the Committee encourages NHLBI to seek new 

technologies and procedures for inactivating blood-borne causative 

agents for human TSEs, further ensuring a safe blood supply. 

Human TSEs, for which there are no known treatments, include 

Creutzfeld-Jakob disease and new variant Creutzfeldt-Jakob disease. 

Pulmonary hypertension.—Pulmonary hypertension (PH) is a 

rare, progressive and fatal disease that predominantly affects 

women, regardless of age or race. PH causes deadly deterioration 

of the heart and lungs and is a secondary condition in many other 

serious disorders such as scleroderma and lupus. The Committee 

continues to view research in this area as a high priority and commends NHLBI’s efforts to promote PH-related research. The Committee encourages the Institute to continue funding for basic research, gene therapy and clinical trials of promising pharmaceuticals, and to take appropriate measures to ensure the submission of high quality proposals in this area. 

Neurofibromatosis (NF).—Significant advances continue to be 

made in research on NF’s implications with heart disease and in 

particular its involvement with hypertension and congenital heart 

disease which together affect over fifty million Americans. Accordingly, the Committee urges NHLBI to enhance its NF research 

portfolio. 

70 

Myelodysplasia and myeloproliferative disorders.—The Committee commends NHLBI for its new research initiatives in 

myelodysplasia (MDS) and myeloproliferative disorders (MPDs), 

which resulted from a recent conference involving the Institute and 

NCI. MPDs and MDS are chronic disease of bone marrow cells that 

can develop into acute leukemia. The Committee encourages 

NHLBI and NCI to bring together scientific and clinical experts in 

this field to explore collaborative research and crosscutting mechanisms to further this research agenda. 

Obstructive sleep apnea.—The Committee commends the Institute for its work on obstructive sleep apnea. This disorder affects 

approximately 80 percent of the elderly and if left untreated it significantly increases risk for hypertension, coronary artery disease, 

heart failure and stroke. The Committee encourages the Institute 

to include surgical treatments in its work to define useful treatments for this disorder. 

Sleep disorders.—The Committee commends the National Center 

on Sleep Disorders Research for its progress and is pleased that the 

Center has sponsored the translational conference, Frontiers of 

Knowledge in Sleep and Sleep Disorders. The Committee encourages the National Center to partner with other Federal agencies, 

such as the Centers for Disease Control and Prevention, as well as 

voluntary organizations, to develop a sleep education and public 

awareness initiative that will provide a forum for dissemination of 

the outcomes of the sleep translational conferences. 

Marfan syndrome.—The Committee commends NHLBI for its 

support of research opportunities to study this life threatening, degenerative genetic disorder. Marfan syndrome is characterized by 

cardiovascular, skeletal and ocular manifestations and its cardiovascular complications result in premature death. Insights gained 

from research in this area can have implications for the understanding of other connective tissue disorders, other genetically mediated diseases, and the larger population of aging adults with thoracic aneurysms of a variety of causes which can lead to aortic dissection. The Committee urges NHLBI to expand its collaborative 

efforts with other institutes to support research in this area. 

Alpha–1 antitrypsin deficiency.—The Committee is aware that 

Alpha–1 antitrypsin deficiency is often misdiagnosed as asthma or 

Chronic Obstructive Pulmonary Disease (COPD). Individuals with 

Alpha–1 exhibit symptoms of advanced emphysema between 30 

and 50 years of age, even in the absence of tobacco use. Alpha–1 

is a major cause of transplantation in adults and a leading cause 

of liver transplantation in children. The Committee commends 

NHLBI for its plans to conduct a state-of-the-science conference on 

Alpha–1 leading towards a five-year research agenda. NHLBI is 

also encouraged to collaborate with NIDDK and other institutes to 

enhance its research portfolio, encourage screening and detection, 

raise public awareness about Alpha–1 and provide appropriate information to health professionals. 

Duchenne muscular dystrophy.—The Committee encourages 

NHLBI, in collaboration with the Office of Rare Diseases, to enhance the research and related activities surrounding pulmonary 

and cardiac complications associated with Duchenne muscular dystrophy. The Committee requests that NHLBI report to the ComVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00070 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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mittee on its approach to this issue not later than January 15, 

2005. 

Primary immunodeficiency diseases.—The Committee understands that NHLBI has begun to work with a national voluntary 

organization as part of a national physician education and public 

awareness campaign for primary immunodeficiency diseases. The 

Committee encourages NHLBI to take further action in this regard 

and to be an active participant in the development of educational 

materials and future conferences, as appropriate. 

Lung repair.—Respiratory failure is often a result of irreversible 

lung injury. This may occur acutely in conditions such as acute respiratory distress syndrome (ARDS) or chronically with disorders 

such as COPD or pulmonary fibrosis. The Committee encourages 

NHLBI to promote the use of stem cells in animal models to study 

lung repair and organogenesis as a method to reverse respiratory 

failure. 

Allied health personnel.—Given the existing and growing shortages of qualified allied health professionals who serve as laboratory 

personnel, NHLBI is encouraged to enhance program activity at research institutions training these individuals, which contributes to 

the alleviation of this problem. 

Von Willebrand Disease.—The Committee encourages NHLBI to 

establish a universal treatment algorithm (after consultation with 

established medical associations) for the treatment of Von 

Willebrand disease. At present there is no accepted treatment algorithm in the United States for this condition. The Committee also 

recognizes that Von Willebrand disease is an under-recognized and 

under-diagnosed disease. The Committee believes that there are instances where women who are suffering from idiopathic 

menorrhagia are needlessly subjected to invasive procedures such 

as hysterectomies. The Committee encourages NHLBI to launch a 

pilot program among obstetricians and gynecologists treating patients, especially young women, with idiopathic menorrhagia to 

provide a blood test for Von Willebrand disease. Such a program 

would act to confirm if a link exists between menorrhagia and Von 

Willebrand disease in addition to providing the benefits of early detection and treatment. 

Heart disease and kidney disease.—There is a well-established 

and significant link between heart disease, hypertension and kidney disease. With 41 million people having decreased kidney function, and in the face of an ever aging population, the need to develop better treatment and prevention strategies to address this 

linkage will only increase over the coming decade. The Committee 

encourages NHLBI to collaborate more fully with NIDDK to develop appropriate research initiatives that can be undertaken cooperatively, and encourages NHLBI to sponsor a workshop on hypertension as it relates to heart and kidney disease with input from 

the renal community to address these issues. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

The Committee provides $394,080,000 for the National Institute 

of Dental and Craniofacial Research (NIDCR), which is $10,798,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. 

72 

Mission.—The NIDCR conducts and supports research and research training to improve craniofacial, oral and dental health. The 

Institute’s programs reflect the genetic, behavioral and environmental factors that result in complex human disease and are clustered into the following areas: inherited disorders; infection and immunity; oral, pharyngeal and laryngeal cancers; chronic and disabling conditions such as bone and joint diseases and chronic pain; 

behavioral science, epidemiology and health promotion; and tissue 

engineering and biomimetics research to improve diagnostics and 

tissue repair and regeneration. 

Scleroderma.—The Committee is encouraged by NIDCR’s interest 

in scleroderma, a chronic and progressive disease that predominantly strikes women. Scleroderma is disfiguring and life-threatening; and effective treatments are lacking. Scleroderma is often 

associated with a number of dental and craniofacial complications. 

The most major and common problems are xerostomia and 

microstomia. Additional concerns are increased frequency of caries, 

periodontal disease, fibrotic changes, fungal infections, 

telangectasia and bone resorption of the mandible. Additional research is needed to develop safe and effective treatments and to 

identify the cause or causes of the serious complications of 

scleroderma. 

Saliva.—The Committee is aware that research on saliva has 

progressed rapidly and holds the potential to be an inexpensive 

non-invasive diagnostic tool for early detection of breast cancer, 

osteoporosis, hepatitis, HIV, and Sjogren’s disease. The Committee 

encourages NIDCR to work cooperatively with NCI and other appropriate institutes in pursuing research initiatives on the development of saliva as a diagnostic tool. 

Biology of bone.—The Committee encourages NIDCR to continue 

to conduct research into the basic biology of bone cells and bone 

matrix and their roles in bone turnover and regeneration. The 

Committee also urges NIDCR to pursue research into the role of 

genes and other agents in restoring skeletal tissue and causing 

skeletal disorders, including fibrous dysplasia and dental abnormalities in Paget’s disease patients. 

Mucolipidosis Type IV.—The Committee urges NIDCR to continue its efforts to create a strain of mice which has the same genetic characteristics as that of humans with this debilitation genetic disorder. This research offers promise for the eventual development of treatments or cures for this and similar genetic disorders 

in humans. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

The Committee provides $1,726,196,000 for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 

which is $54,393,000 above the fiscal year 2004 comparable level 

and the same as the budget request. In addition, $150,000,000 in 

mandatory funds are available for juvenile diabetes research. 

Mission.—The NIDDK supports research in three major disease 

categories: diabetes, endocrinology, and metabolic diseases; digestive diseases and nutrition; and kidney, urologic, and hematologic 

diseases. The NIDDK supports a coordinated program of fundamental and clinical research and demonstration projects relating to 

73 

the causes, prevention, diagnosis, and treatment of diseases within 

these categories. The Institute also supports efforts to transfer the 

knowledge gained from its research program to health professionals, patients, and the general public. 

Juvenile diabetes.—The Committee is pleased that the Immune 

Tolerance Network (ITN) and the TrialNet diabetes trial network 

have established a joint evaluation process, which allows the same 

proposals to be considered simultaneously by both networks. The 

Committee hopes that TrialNet will be able to use some of the expertise and structure already established at the ITN in the design/ 

execution of the TrialNet trials, especially if any mechanistic studies are being performed. The Committee requests that TrialNet 

provides a report on the progress made by the network thus far, 

and comments on any plans for internal/external evaluation, which 

should promote the effective operation of the network. The Committee encourages TrialNet to expedite their proposal review and 

implementation processes. In addition, the Committee recommends 

that TrialNet consider funding of Phase I studies in order to fill in 

the scientific gap between basic discoveries and clinical trials to 

generate more extensive opportunities for translational research 

within the field of juvenile diabetes. 

Irritable bowel syndrome.—The Committee remains concerned 

about the increasing frequency of irritable bowel syndrome (IBS), 

a chronic complex of disorders that malign the digestive system. 

This common disorder strikes people from all walks of life affecting 

between 25 to 45 million Americans and results in significant 

human suffering and disability. The Committee encourages NIDDK 

to support irritable bowel syndrome/functional bowel disorders research and to give priority consideration to funding grants that will 

continue to increase the IBS portfolio. The Committee requests 

that NIDDK actively pursue the development of a strategic plan for 

IBS research, and would like to receive a report on the progress 

made by NIDDK to develop this plan in next year’s hearings. 

Inflammatory bowel disease.—The Committee has been encouraged in recent years by discoveries related to Crohn’s disease and 

ulcerative colitis, collectively known as inflammatory bowel disease 

(IBD). These extremely complex disorders represent the major 

cause of morbidity and mortality from intestinal illness. The Committee commends NIDDK for its strong leadership in this area and 

encourages the Institute to continue to give priority consideration 

to the following areas of IBD research: (1) investigation into the 

cellular, molecular and genetic structure of IBD, (2) identification 

of the genes that determine susceptibility or resistance to IBD in 

various patient subgroups, and (3) translation of basic research 

findings into patient clinical trials as outlined in the research agenda developed by the scientific community entitled, ‘‘Challenges in 

Inflammatory Bowel Disease.’’ Finally, the Committee also encourages NIDDK to continue to strengthen its partnership with the 

IBD community on innovative research projects. 

Interstitial cystitis.—The Committee is pleased by the unprecedented scientific advances in the area of interstitial cystitis (IC) research, particularly in the area of urinary markers. The Committee 

understands that this progress is due in large part to investments 

in basic science research. Therefore, the Committee encourages 

NIDDK to continue to aggressively support IC-specific basic science 

74 

initiatives, particularly through program announcements. The 

Committee also encourages NIDDK to work closely with the IC patient community on developing and funding an IC awareness campaign for both the public and professional community, as well as 

to host a consensus conference on the definition of IC. The absence 

of a uniform definition which accurately captures the condition and 

the affected population is negatively impacting patients in terms of 

diagnosis and treatment as well as researchers in terms of literature review and their research activities. The Committee was 

very encouraged by the progress reported at the 2003 NIDDK-sponsored scientific symposium on IC and encourages NIDDK to further 

this scientific momentum by hosting the next international symposium on IC in 2005. 

Incontinence.—Many otherwise healthy, active individuals suffer 

from incontinence. Fecal incontinence, also called bowel incontinence, affects people of all ages and is associated with a wide variety of causes. The Committee encourages NIDDK to develop a 

standardization of scales to measure incontinence severity and 

quality of life and to develop strategies for primary prevention of 

fecal incontinence associated with childbirth. 

Scleroderma.—The Committee encourages NIDDK to support 

scleroderma-relevant research. Scleroderma is a chronic and progressive disease that predominantly strikes women. It is estimated 

that ninety percent of patients with systemic sclerosis have gastrointestinal (GI) involvement and that of that number fifty percent 

have clinically significant manifestations. GI involvement can 

manifest as gastroesophageal reflux disease, dysphagia, Barrett’s 

esophagus, gastroparesis, ‘‘watermelon stomach’’, malabsorption, 

and fibrosis of the small and large intestines. Renal crisis affects 

twenty percent of those with systemic sclerosis often within the 

first five years after diagnosis. More research is needed in order to 

develop safe and effective treatments and to identify the cause or 

causes of the complications of scleroderma. 

Acute liver failure.—The Committee is pleased that NIDDK has 

funded an Acute Liver Failure Study Group (ALFSG) that will improve medical knowledge necessary to prevent and treat acute liver 

failure. The Committee is pleased with the progress of the ALFSG, 

and encourages increased attention to pediatric issues. 

Auto-immune liver diseases.—These diseases are the primary indication for liver transplantation in adolescents. The Committee 

encourages targeted research to improve the prevention and treatment of auto-immune liver diseases in children. 

Alpha-1 antitrypsin deficiency.—The Committee is aware that 

alpha–1 antitrypsin deficiency liver disease is a leading cause of 

pediatric transplantation and can manifest at any age. The Committee is encouraged that NIDDK has invested in research on this 

devastating disorder. The Committee encourages NIDDK to maintain its research funding and encourages NIDDK to collaborate 

with NHLBI and other institutes to enhance its research portfolio, 

encourage screening and detection, raise public awareness about 

alpha-1 and provide appropriate information to health professionals. 

Fatty liver disease.—The Committee notes that there is an 

emerging obesity-related chronic liver disease—nonalcoholic fatty 

liver disease, which may affect as many as one in every four adults 

75 

over the age of eighteen. This diagnosis encompasses a spectrum 

of severity, with many cases evolving into non-alcoholic 

steatohepatitis (NASH) and, ultimately, cirrhosis. NASH-related 

liver disease has already become an important indicator for liver 

transplantation, and, in the absence of better treatments, the need 

for NASH-related liver transplantation will increase significantly 

over time. The Committee appreciates NIDDK’s existing programs 

in this area but encourages additional basic and clinical research 

focused both on interventions needed to prevent the onset of NASH 

and improved protocols for treatment of established cases. The 

Committee also suggests that the Institute review opportunities to 

expand current clinical programs, where appropriate, to permit the 

enrollment and follow up of larger numbers of patients. Finally, the 

Committee suggests a public awareness campaign with a voluntary 

health agency to address this growing and preventable public 

health problem. 

Pediatric liver transplant—national database and registry.—The 

Committee is pleased that NIDDK has funded the Studies in Pediatric Liver Transplantation Registry. This database and registry 

follow the natural history of infants and children who receive liver 

transplants until they are eighteen years of age. This National 

Database and Registry will permit more hypothesis testing and 

outcomes research to determine both the health and financial impact of liver transplants on the child and the child’s family. 

Hepatitis C in children.—The Committee is pleased that NIDDK 

has launched a pediatric hepatitis C trial that will permit long 

term follow up of children enrolled in treatment protocols, particularly as these treatment regimens impact the growth and development of the children. The Committee looks forward to being informed about the progress of this trial at upcoming appropriations 

hearings. 

Hepatitis B conference.—Hepatitis B remains a common cause of 

acute hepatitis affecting 1,250,000 Americans. Among the Asian 

and Pacific Island populations the rate of infection rate is even 

higher, affecting up to 15 percent of individuals. In order to address this health issue, the Committee encourages NIDDK to convene an expert panel in FY 2005 to reach consensus on the best 

treatment protocols. 

Kidney disease clinical research.—The Committee previously 

noted the problem in conducting kidney disease research due to 

lack of a permanent infrastructure, such as a Clinical Trials Cooperative Group. The Committee wishes to command NIDDK for its 

leadership in moving forward in this area, by holding an initial 

workshop and developing strategies that will strengthen kidney research. The Committee encourages NIDDK to work with the renal 

community to continue these efforts in important research areas 

such as hypertension, uremic toxicity, diabetic nephropathy and 

transplant—immunology. 

Pediatric kidney disease.—Chronic kidney disease is the ninth 

leading cause of death and one of the costliest illnesses in the U.S. 

Although significant strides have been made in understanding kidney disease in adults, much less is known about its manifestations 

in children. This breach has taken on greater significance in recent 

years as the number of children who are overweight and obese has 

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76 

tes, hypertension and chronic kidney disease in this population. 

Given the long-term implications of diabetes-related kidney problems initiating in childhood, NIDDK is encouraged to undertake 

longitudinal studies of the natural history, prevention and treatment of kidney disease in type 2 diabetes and its antecedents in 

children and adolescents. The Committee is pleased that NIDDK 

has assigned priority to clinical studies related to the treatment of 

focal segmental glomerulosclerosis, the most common acquired 

cause of kidney disease in children, and to longitudinal epidemiological studies of children. In both instances, NIDDK is encouraged 

to support ancillary studies aimed at discovering new prevention 

and treatment strategies for children. 

Polycystic kidney disease.—The Committee is pleased that a series of synergistic events in PKD research has culminated in the 

development of therapies to potentially halt disease progression for 

the 600,000 Americans who suffer from PKD. Key to such therapies 

is the discovery that an existing drug controlling other abnormal 

fluid-retention diseases in humans also retards the production of 

cysts and disease progression in all forms of PKD in the laboratory. 

Also, the NIDDK funded CRISP study for PKD proves the value of 

innovative imaging methods to measure disease progression, thus 

reducing by forty-fold the number of patients needed to adequately 

assess clinical research outcomes. Moreover, the possibility that future PKD clinical trials can be conducted simultaneously with 

other research protocols under the NIDDK funded Halt-PKD Interventional Trials infrastructure, is also encouraging. The Committee 

has encouraged public-private research partnerships, thus in this 

instance the collaborative efforts by the NIDDK, patient advocacy 

and industry organizations, are positive examples of how new 

strategies to energize clinical research enterprises has the potential 

to benefit PKD sufferers, save billions of Federal dollars otherwise 

paid by Medicare and Medicaid for renal replacement therapy and 

free-up several thousand spots on the kidney transplant waiting 

list. Given these exciting scientific developments, the Committee 

encourages NIDDK to aggressively pursue clinical trials regarding 

these recent breakthroughs and to expand its infrastructure for 

PKD clinical research, while expeditiously implementing the new 

PKD Strategic Plan it recently developed. 

Glomerular injury research.—The Committee is pleased with 

NIDDK’s glomerular injury research initiatives, including a clinical 

trial for patients with focal segmental glomerulosclerosis. The Committee understands that in addition to the clinical trial, NIDDK is 

collaborating on a joint research program with a voluntary foundation to include basic and genetic studies. Further, the Committee 

is aware that NIDDK is sponsoring a scientific conference on glomerular injury research, and is hopeful that this important workshop will lead to a broader scope of activities and initiatives on glomerular disease research. 

Tuberous sclerosis complex.—Tuberous sclerosis complex (TSC) is 

a genetic disorder that triggers uncontrollable tumor growth in 

multiple organs of the body including the kidneys, where patients 

are at risk for polycystic kidney disease, cancer or, most commonly, 

benign growths known as angiomyolipoma that can result in kidney failure. The Committee encourages NIDDK to support studies 

77 

examining the molecular and cellular basis of these manifestations 

of TSC as well as pre-clinical and clinical studies. 

Celiac disease.—The Committee commends NIDDK for recognizing the lack of understanding, and under-diagnosis of the genetic, autoimmune disorder, Celiac disease (CD), and for including 

CD in the NIH Consensus Development Program for 2004. Although readily diagnosed in European countries, it takes on average eleven years for Americans to be properly diagnosed. Delays in 

diagnosis place individuals at risk for osteoporosis, anemia, miscarriages, and small bowel cancer. Current evidence demonstrates 

that CD is the most common genetic disorder in the world, with a 

treatment—strict, gluten-free diet—that can be managed almost 

exclusively by the individual, or family. Education about CD is 

needed for health care professionals and patients. The Committee 

encourages NIDDK to coordinate informational and educational 

programs directed at health professionals, patients and the public 

to raise awareness and understanding about CD, and the need for 

early diagnosis. 

Osteoporosis.—The Committee encourages NIDDK, in concert 

with other NIH institutes, to increase research into disease-related 

osteoporosis and/or bone disorders. NIDDK should consider supporting research on the role of genetics, the effects of these diseases 

on bone turnover and altered bone metabolism, the impact of environmental and lifestyle factors, their effects on bone quality and 

fracture incidence, the role of bone marrow changes, the use of 

agents to increase bone mass, and the therapeutic use of new technologies to combat osteoporosis. 

Digestive diseases.—Diseases of the digestive system continue to 

affect more than one-half of all Americans at some time in their 

lives. Serious disorders such as colorectal cancer, inflammatory 

bowel disease, irritable bowel syndrome, hemochromatosis, celiac 

disease, and hepatitis take a tremendous toll in terms of human 

suffering, mortality, and economic burden. The Committee commends NIDDK on the success of its Digestive Disease Centers program in addressing a wide range of disorders. The Committee continues to encourage NIDDK to expand this important program, 

with an increased emphasis on irritable bowel syndrome. 

Cystic fibrosis.—Advances have been achieved in the treatment 

of cystic fibrosis (CF), resulting in significant improvements in life 

expectancy for individuals with CF. This progress can be attributed 

to strong public and private sector investment in CF research, including clinical trials evaluating a wide range of possible new 

treatments. The Committee encourages NIDDK to continue its support for CF researchers engaged in basic and clinical CF research. 

Mucopolysaccharidosis (MPS).—The Committee recognizes the 

efforts of NIDDK to enhance research efforts to achieve a greater 

understanding of and pursue development of effective therapies for 

MPS disorders. In addition to the general overall support of broadbased MPS research, the Committee supports studying bone and 

joint disease in MPS disorders. Research into the underlying 

pathophysiology of bone and joint lesions, the gene mutations and 

substrates that are stored and potential therapeutic approaches 

should also be studied. The Committee encourages NIDDK’s continued efforts to collaborate with NIAMS on bone and joint research 

in lysosomal storage disorders. 

78 

Gastroesophogeal reflux disease (GERD).—The Committee is 

aware of new research which indicates a controlled carbohydrate 

diet may dramatically reduce the incidence of gastroesophogeal 

reflux (heartburn). The Committee encourages NIDDK to support 

research into the effectiveness of this approach in treating GERD. 

Adhesion related disorder.—This little known condition commonly leads to abnormal attachments between the organs inside 

the abdomen. The adhesions generally are composed of scar tissue 

resulting from previous operations. Very little is known about why 

adhesions form more aggressively in some people. Diagnosis of the 

disease is typically difficult, and surgical correction is often unsuccessful. The Committee encourages NIDDK to investigate this disease, supporting research to find treaments and understand causation and to communicate these findings to broaden knowledge of 

the disease in the medical community. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

The Committee provides $1,545,623,000 for the National Institute of Neurological Disorders and Stroke (NINDS), which is 

$44,416,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The NINDS supports and conducts basic and clinical 

neurological research and research training to increase understanding of the brain and improve the prevention and treatment of 

neurological and neuromuscular disorders. The NINDS mission encompasses over 600 disorders, including stroke; head and spinal 

cord injury; epilepsy; multiple sclerosis; and neurodegenerative disorders such as Parkinson’s disease. 

Stroke.—The Committee continues to regard research into the 

causes, cure, prevention, treatment and rehabilitation of stroke as 

a major concern for our nation and urges NINDS to make stroke 

a top priority. The Committee commends NINDS for convening a 

Stroke Progress Review Group that subsequently developed and released a 2002 report identifying critical gaps in stroke knowledge 

and outlining research priorities and resource priorities. 

Epilepsy.—Epilepsy remains a major, unsolved public health 

problem affecting the lives of millions of Americans and their families. The Committee seeks intensified efforts by the Institute to 

produce breakthroughs in the prevention, treatment, and eventual 

cure of epilepsy. The Committee applauds the development of 

benchmarks for epilepsy research resulting from the ‘‘Curing Epilepsy: Focus on the Future’’ conference held in March, 2000 and encourages the Institute to address important research issues raised 

at the ‘‘Living Well with Epilepsy II’’ conference held in July, 2003. 

The Committee encourages NINDS to develop specific research 

plans and goals for the anti-epileptic drug development program. 

The Committee requests the Institute for an update on its plans to 

advance these areas of research at the fiscal year 2006 appropriations hearing. 

Alzheimer’s disease.—NINDS continues to play an integral role in 

widening the scientific base of knowledge about Alzheimer’s disease. One emerging theme in the study of Alzheimer’s disease and 

other neurodegenerative diseases such as Parkinson’s and Huntington’s disease, is the overlap researchers have observed in the pathology underlying these conditions. Scientific reports are showing 

79 

evidence that these disorders may be caused by similar abnormalities in protein folding and accumulation. On another front, working 

with NIA in the area of immunotherapy for Alzheimer’s disease, 

NINDS has funded a collaborative group of Alzheimer’s disease 

centers that will investigate the differences which may involve the 

production of antibodies that reduce the cellular and behavioral effects of the disease. The Committee encourages NINDS to continue 

to assign a high priority to its Alzheimer’s research portfolio, and 

to continue to work closely with NIA and other institutes. 

Parkinson’s disease.—The Committee encourages NINDS, in addition to pursuing all promising therapeutic avenues, such as gene 

therapy, stem cells, surgical approaches, non-human models, and 

biomarkers, to continue to identify and study neuroprotectant compounds, such as Coenzyme Q10, creatine, and minocycline. Furthermore, the Committee encourages NINDS to work with NIBIB 

to discover a biomarker (particularly a molecular one) for Parkinson’s. Participation by NIBIB in clinical trials could greatly enhance the value of these trials, as imaging technology facilitates a 

better understanding of the physical effects of tested drugs. Finally, 

the Committee commends NINDS for funding the Morris K. Udall 

Parkinson’s Disease Research Centers of Excellence. These centers 

support additional research opportunities and discoveries that will 

lead to improved diagnosis and treatment of patients with Parkinson’s disease. The centers vary in their basic and clinical objectives, 

but together they foster an environment that enhances research effectiveness in a multidisciplinary setting. 

Transmissible spongiform encephalopathies (TSE).—The Committee recognizes the efforts of NINDS, in collaboration with 

NHLBI, to fund contracts for the development of a biological assay 

for TSE. The Committee requests that the Director of the Institute 

be prepared to provide a report on the progress made toward the 

development of a TSE bioassay at the fiscal year 2006 appropriations hearing. The Committee is particularly interested in the success in detecting disease-causing agents in blood, saliva, cerebrospinal fluid, and other bodily fluids, as well as lymphoid tissue, especially tonsils. 

Peripheral neuropathy.—The Committee is aware that an estimated 20 million Americans suffer from peripheral neuropathy, a 

neurological disorder that causes debilitating pain, weakness in the 

arms and legs, and difficulty walking. For most of its victims, the 

only recourse is pain medication, physical therapy or assistive devices to help maintain strength and improve mobility. In light of 

the large number of individuals affected and the attendant costs of 

this disease to society, the Committee encourages NINDS to develop a neuropathy research agenda, coordinated with work being 

done through other institutes, and report how much funding NIH 

is devoting to research in this area. The Committee expects to receive a report on this effort at next year’s hearings. 

Dystonia.—The Committee continues to support the expansion of 

research and treatment developments regarding the neurological 

movement disorder dystonia, the third most common movement 

disorder after tremor and Parkinson’s disease. The Committee encourages NINDS to support research on both focal and generalized 

dystonia, and commends NINDS for its study of the DYT1 gene. 

The Committee commends NINDS for the release with other InstiVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00079 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
80 

tutes of the joint dystonia research program announcement. The 

Committee would like NINDS to be prepared to report on the 

dystonia research portfolio at the FY06 budget hearings. The Committee encourages the Institute to continue its collaboration with 

the dystonia research community in supporting epidemiological 

studies on dystonia and in increasing public and professional 

awareness. 

Spina bifida.—The Committee encourages NINDS to enhance research to address issues related to the outcome of the spina bifida 

conference held in May 2003 and to expand its research efforts in 

the prevention, and treatment of spina bifida and associated secondary conditions. The Director should be prepared to testify on 

NINDS efforts to advance these areas of research at the fiscal year 

2006 appropriations hearing 

Tuberous sclerosis complex.—Tuberous sclerosis complex (TSC) is 

a genetic disorder that triggers uncontrollable tumor growth in 

multiple organs of the body. Its victims—many of whom are infants 

and young children—face a lifetime of suffering with kidney failure, seizures, behavioral disorders, autism and mental retardation. 

Because of the effects of TSC on multiple organ systems, the Committee last year called upon the NIH Director to formulate an NIHwide research agenda. The Committee understands that NINDS 

has been assigned to implement and coordinate that effort. NINDS 

is encouraged to support research examining the molecular and cellular basis of central nervous system manifestations in TSC, including studies examining TSC-associated epilepsy and brain 

tumor formation, and the effect of tubers and seizures on cognition 

and behavior. The Committee looks forward to a report on NINDS’s 

coordinating activities and progress towards implementing the research agenda prior to the FY2006 hearings. 

Neurofibromatosis (NF).—Advances in NF research have linked 

NF to cancer, brain tumors, learning disabilities and heart disease. 

Because NF plays a pivotal role both in disorders of the brain and 

in cancer and because the promise of NF research is now being 

achieved in the testing of potential therapies, the Committee encourages NINDS to enhance its NF clinical and basic research portfolios. The Committee commends NINDS for its leadership role in 

NF research and in coordinating efforts with other Institutes engaged in NF research. The Committee applauds NINDS and the 

Office of Rare Diseases for holding a major conference on NF in December, 2003. The Committee also applauds NINDS on issuing 

major program announcements in fiscal year 2004 pursuing the 

creation of NF research centers and NF translational research. 

Spinal muscular atrophy (SMA).—SMA is the leading genetic 

killer of infants and toddlers. The Committee understands that the 

severity of the disease, its relatively high incidence, and the possibility of imminent treatments have led NINDS to initiate the SMA 

Therapeutics Development Program. The Committee is pleased 

that initial work has begun on the program and encourages NINDS 

to move forward with the mission to develop a treatment for SMA 

to be ready for clinical trials within four years. The Committee further encourages NINDS to develop a strategy for executing effective clinical trials for future therapies. The Committee encourages 

NINDS to integrate therapeutics development efforts with the 

81 

biotech and pharmaceuticals industry, academic medical centers 

and collaborations with voluntary health organizations. 

Down syndrome.—Recently Down syndrome research has begun 

to focus increasingly on understanding the effect the disorder has 

on gene expression, cell function, neurons and neural systems. The 

Committee strongly encourages NINDS to expand its research on 

Down syndrome, particularly as it relates to gene expression in the 

brain and the development of possible biomedical interventions to 

improve cognition, memory, speech, behavior, and to prevent early 

dementia. The Committee further encourages NINDS to assume a 

leadership role in coordinating this research among the Institutes 

and to work closely with NICHD to address the serious shortage 

of mice used for Down syndrome research. 

Mucolipidosis Type IV (ML4).—Since the gene causing this debilitating genetic metabolic disorder has been identified, the Committee encourages NINDS to support both extramural and intramural research which will lead to possible treatments and cures for 

those with ML4. In particular, NINDS is encouraged to conduct research involving other organisms which bear genes resembling the 

one whose mutation in humans causes ML4. 

Mucopolysaccharidosis (MPS).—The Committee encourages 

NINDS to collaborate with all appropriate Institutes and Centers 

to support mucopolysaccharidosis research, to study the blood brain 

barrier as an impediment to treatment, and to use all available 

mechanisms to further stimulate and enhance efforts to better understand and treat MPS disorders. 

Friedreich’s ataxia.—The Committee commends NINDS efforts to 

translate research from bench to bedside, collaborating between its 

intramural and extramural programs and with patient advocacy 

groups to bring promising basic research into clinical applications 

so treatments can be developed. The Committee further notes that 

NINDS co-funded and co-hosted with a patient advocacy group this 

year an international scientific conference on Friedreich’s ataxia, 

bringing together one hundred leading scientists from twelve countries to share insights and accelerate progress toward treatments 

for this disease. The Committee commends NINDS for these types 

of collaborative, translational efforts. 

Neuronal ceroid lipofuscinoses (NCLs).—The Committee encourages NINDS to support research projects on NCLs, focusing particularly on Batten Disease. The Committee is pleased by recent 

scientific conferences focusing on NCLs and encourages NINDS to 

continue to sponsor these gatherings. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

The Committee provides $4,440,007,000 for the National Institute of Allergy and Infectious Diseases (NIAID), which is 

$135,445,000 above the fiscal year 2004 comparable level and the 

same as the budget request. $150,000,000 is provided as requested 

in the President’s budget for the construction of extramural biodefense research facilities. No funds were provided for this purpose 

in fiscal year 2004. In addition, bill language is repeated from last 

year that permits the transfer of $100,000,000 to the global AIDS, 

tuberculosis, and malaria fund. 

Mission.—The NIAID supports and conducts basic and clinical 

research and research training programs in infectious diseases 

82 

caused by, or associated with, disorders of the immune system. 

NIAID supported research includes research on acquired immunodeficiency syndrome (AIDS), asthma and allergies, tuberculosis, 

sexually transmitted diseases, tropical diseases, and emerging microbes. The goals of NIAID research are to better understand disease pathogenesis, to improve disease diagnosis, to develop new 

and improved drugs to treat diseases, and to develop new and improved vaccines to prevent disease, many of which significantly affect public health. 

Tuberculosis.—The World Health Organization estimates that 

nearly one billion people will become infected with tuberculosis 

(TB), 200 million will become sick, and 70 million will die worldwide between now and 2020 of this disease. The Committee is 

pleased with NIAID’s efforts to develop an effective TB vaccine. 

The Committee encourages the Institute to continue its TB vaccine 

development work and to expand efforts to develop new drugs to 

treat TB. 

Hemophilia.—The Committee appreciates NIAID’s efforts to improve HIV and hepatitis C virus (HCV) treatment for persons with 

hemophilia or other bleeding disorders and encourages NIAID to 

work with private non-profit groups to strengthen support for research on liver disease progression. 

Hepatitis C vaccine.—The Committee is encouraged to learn that 

a small hepatitis C vaccine human trial has been awarded and 

urges the consideration of other creative approaches and new paradigms, including the development of DNA vaccines. 

Primary immune deficiency diseases.—The Committee notes that 

more than one hundred primary immune deficiency diseases have 

been identified to date. These diseases, which impair the body’s immune system, strike most severely at children, many of whom do 

not survive beyond their teens or early twenties. The Committee 

commends NIAID for the establishment of its primary immunodeficiency disease research consortium in partnership with a private foundation and encourages continued support for this program. 

Inflammatory bowel disease.—The Committee continues to note 

with interest a scientific research agenda for Crohn’s disease and 

ulcerative colitis (collectively known as inflammatory bowel disease) entitled ‘‘Challenges to Inflammatory Bowel Disease (IBD).’’ 

This report identifies strong linkages between the functions of the 

immune system and IBD. The Committee encourages the Institute 

to enhance its support of research focused on the immunology of 

IBD, as well as the interaction of genetics and environmental factors in the development of the disease. 

Asthma.—The Committee is pleased with NIAID’s leadership regarding asthma research and management. The Committee encourages NIAID to continue to improve its focus and effort on asthma 

management, especially as it relates to children. The Committee 

also encourages NIAID to collaborate more aggressively with voluntary health organizations to support asthma prevention, treatment, and research activities. Additionally, recent studies suggest 

that a variety of viral and bacterial agents may play a role in the 

development of asthma. The Committee suggests the Institute expand research into the role that infections and vaccines may play 

in the development of asthma. 

83 

Transplantation research.—The Committee encourages NIAID to 

convene an expert conference to develop a transplantation research 

action plan identifying the most urgently needed research to facilitate an increase in the success of organ transplantation. 

Scleroderma.—The Committee encourages NIAID to conduct research to study the cause and treatment of scleroderma, a chronic 

progressive disease that predominantly strikes women. 

Scleroderma is disfiguring and can be life-threatening, affecting 

multiple systems. More research is needed in order to develop safe, 

effective treatments and to identify the causes of scleroderma and 

its complications. NIAID is encouraged to consider including 

scleroderma as one of the diseases in the Autoimmune Centers of 

Excellence (ACE) program in order to address these important 

questions. 

Atopic dermatitis.—Atopic dermatitis (AD) is one of the most 

common skin disorders experienced in infants and children. Over 

90% of cases are diagnosed before the age of five. Patients with AD 

suffer with chronic skin inflammation and itching that disrupt 

sleep and reduce quality of life. An estimated 17 percent of children 

in the United States have atopic dermatitis, a dramatic increase 

above the pre–1960s level of approximately 3 percent. The reason 

for this increase is unknown, but mirrors the increased rates of 

asthma and requires greater study. Of additional concern, individuals who have active or dormant AD are at high risk for serious 

adverse reaction to the smallpox vaccine. The Committee encourages NIAID to work with NIAMS to spearhead a multidisciplinary, 

multi-institute initiative to encourage investigator-initiated research on AD as it relates to smallpox vaccination as well as the 

progression to asthma and other allergic diseases. 

Nasal aerosol and spray vaccine delivery systems.—Recent developments exploring new routes of immunization such as delivery of 

measles vaccine via aerosol and nasal spray may generate significant savings and result in fewer side effects than immunization by 

injection. The Committee encourages NIAID to support research in 

developing and testing these new approaches, building upon the 

testing already completed in older children, to investigate this delivery method in younger children. 

Meningococcal disease.—Although meningococcal disease is vaccine-preventable in most cases, approximately 30 percent of the 

deaths and disabilities from this bacterial infection are attributed 

to serogroup B, which is not vaccine-preventable. The Committee 

encourages NIAID to increase research efforts to develop an effective, low-cost vaccine against serogroup B that will help protect infants and adolescents. 

Genomics.—The Committee is pleased that NIAID has focused on 

research efforts associated with multiple categories of pathogens. 

The Committee understands that microarray technology has enhanced the progress of pathogen-related research. The Committee 

encourages NIAID to continue to use this technology to further 

support an aggressive agenda of pathogen research activities. 

Condom effectiveness.—The Committee recognizes the interest in 

the June 2000 NIH–STD Condom Report and the attention that 

this report calls to the epidemic of sexually transmitted diseases 

(STDs) that the nation is experiencing. The Committee encourages 

NIH to continue its practice of making advances in STD research 

84 

available to the public and to health practitioners through web 

sites and other publications. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

The Committee provides $1,959,810,000 for the National Institute of General Medical Sciences (NIGMS), which is $54,972,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. 

Mission.—The NIGMS supports research and research training 

in the basic biomedical sciences. Institute grantees, working in 

such fields as cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, and biological chemistry, study normal biological processes to better understand what goes wrong 

when disease occurs. In this way, NIGMS supports the new knowledge, theories, and technologies that can then be applied to the disease-targeted studies supported by other NIH components. NIGMSsupported basic research advances also find applications in the biotechnology and pharmaceutical industries. The Institute’s training 

programs help provide the scientists needed by industry and academia. 

Training programs.—The Committee continues to be pleased 

with the quality of NIGMS’s training programs, particularly those 

that have a special focus on increasing the number of minority scientists, such as the Minority Access to Research Careers (MARC) 

and Minority Biomedical Research Support (MBRS) programs. The 

Committee encourages NIGMS to continue to support these important initiatives, and is particularly pleased that NIGMS has supported biomedical research career opportunity programs for high 

school and undergraduate college students in conjunction with historically black health professions schools. The Committee encourages continued, long-term support of this program. 

NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

The Committee provides $1,280,915,000 for the National Institute of Child Health and Human Development (NICHD), which is 

$38,544,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The NICHD conducts and supports laboratory and 

clinical research on the reproductive, developmental, and behavioral processes that determine and maintain the health and wellbeing of children, adults, families and populations. In addition, research in medical rehabilitation is supported. 

Sudden infant death syndrome.—The Committee is pleased with 

NICHD’s continued efforts to extend the reach of its ‘‘Back to 

Sleep’’ campaign to underserved populations and daycare providers. 

The Committee encourages NICHD to transition from its SIDS 

five-year research plan to a more comprehensive plan focusing on 

SIDS, stillbirth, and miscarriage. The Committee requests that 

NICHD determine an appropriate means of including research on 

these causes of infant mortality into one inclusive plan. 

Prematurity.—The Committee encourages NICHD to support 

genomic and proteomic research in the area of prematurity to hasten a better understanding of the pathophysiology of premature 

birth, discover novel diagnostic biomarkers, and ultimately aid in 

85 

formulating more effective interventional strategies to prevent premature birth. 

Preterm labor and delivery.—The rates of premature birth have 

increased 29 percent since 1981 to over 480,000 babies in 2002. African-American infants are nearly twice as likely as non-Hispanic 

white infants to be born prematurely. Premature birth is the leading cause of death in the first month of life. Premature birth can 

happen to any pregnant woman and the causes of nearly half of all 

preterm births are unknown. The Committee commends NICHD 

for its work on preterm birth and encourages enhanced efforts to 

research the underlying causes of preterm delivery, to identify prevention strategies and improve the treatment and outcomes for infants born preterm. 

Maternal Fetal Medicine Units Network (MFMU).—The Committee was encouraged about the research results from NICHD’ 

Maternal Fetal Medicine Units Network on the identification of a 

therapy, progesterone, that prevents recurrent preterm birth in 

high-risk women. The Committee understands that this is one of 

the first advances in this area, despite extensive efforts over decades. The Committee encourages NICHD to build on this finding 

through continued support of the MFMU Network. 

Stillbirth.—The Committee applauds NICHD efforts in addressing stillbirth, a major public health issue with morbidity equal to 

that of all infant deaths. The Committee understands that NICHD 

has established a cooperative network of clinical centers and a data 

center to address this issue with a standard protocol. The Committee encourages NICHD to strongly support this effort. 

Pediatric liver disease.—The Committee urges the Institute to aggressively pursue opportunities to participate with NIDDK and 

other Institutes in pediatric liver disease research, particularly related to the optimal timing and medical treatment regimens for 

children infected with the hepatitis C virus. The Committee also 

encourages NICHD support of biliary atresia research. 

Spina bifida.—The Committee is pleased that NICHD cosponsored the spina bifida research conference in May 2003 and urges 

adequate follow-up on the conference findings and recommendations. The Committee encourages NICHD to enhance research related to the outcome of the conference and to significantly expand 

its research efforts in the prevention and treatment of spina bifida 

and associated secondary conditions. The Director should be prepared to testify on the Institute’s efforts to advance these areas of 

research at the fiscal year 2006 appropriations hearing. 

Primary immunodeficiency diseases.—The Committee continues 

to be impressed with the dedication of resources by NICHD to address the research and awareness issues that surround this class 

of more than one hundred diseases. The Committee is particularly 

encouraged by the Institute’s research commitment to develop newborn screening procedures for primary immunodeficiency through 

microarray technologies and encourages NICHD to press ahead 

with this initiative. 

Neurofibromatosis (NF).—Learning disabilities occur with high 

frequency in children with NF. Recent advances in NF research describe how the NF gene is related to learning disabilities, advancing the prospects of finding a treatment for learning disabilities not 

only in children with NF but in the general population as well. The 

86 

Committee encourages NICHD to enhance this promising NF research. 

Down syndrome.—The Committee encourages NICHD to enhance 

funding for Down syndromes research as it relates to gene expression of chromosome 21, the effects on cell function and cognition, 

and possible medical treatments to eliminate or reduce the cognitive abnormalities associated with the disorder. The Committee 

is aware of the shortage of mice used in the research of Down syndrome and encourages NICHD to strengthen its support for greater 

production of the Ts65Dn mouse model and for the research and 

development of other mouse models. The Committee also encourages NICHD to work closely with NINDS, NIA, NIH and NHGRI 

to establish a new, multi-year research initiative to fund Down syndrome biomedical research on cognition, behavior and early dementia. 

Limb loss.—The Committee is aware of the development of the 

Amputee Care Center at Walter Reed Army Medical Center to improve the level of care within military medicine for those who are 

injured and lose limbs. The Committee urges NICHD, working 

through the National Center for Medical Rehabilitation Research, 

to work in partnership with Walter Reed to support its efforts to 

conduct clinical research focused on developing new amputee-care 

metrics applicable to the rehabilitation of highly active persons 

with limb loss. Additional clinical research is also needed to better 

understand the applicability of new technology to various segments 

of the limb-loss population, ranging from highly functional military 

personnel who have been injured in Operation Iraqi Freedom to 

older Americans who might not otherwise ambulate with traditional prosthetic technology. Advances have recently been made by 

the private sector to develop breakthrough prosthetic limb technologies which have dramatically improved the functionality, stamina and psycho-social well being of patients, in particular, the 

microprocessor-controlled hydraulic fluid swing and stance phase 

knee device technology. The Committee encourages NICHD to consider supporting this type of research, using all appropriate mechanisms. 

Spinal muscular atrophy.— Spinal muscular atrophy [SMA] is 

the leading genetic killer of infants and toddlers and is the most 

prevalent genetic motor neuron disease. Over 25,000 Americans, 

mostly children, suffer from significant physical disability and impairment as a result of SMA. The Committee encourages NICHD 

to work closely with NINDS to develop collaborations which will 

support the SMA Therapeutics Development project, including an 

expansion of the scope and level of SMA research at NICHD. In addition, NICHD is encouraged to develop formal programs that increase public and professional awareness of SMA. 

National children’s study.—The Committee remains interested in 

the national children’s study, which aims to quantify the impacts 

of a broad range of environmental influences, including physical, 

chemical, biological and social influences, on child health and development. The Committee encourages NICHD to continue to coordinate closely with the CDC, EPA, other institutes and agencies 

and non-Federal partners conducting research on children’s environmental health and development. 

87 

Fragile X.—The Committee believes that the National Center on 

Birth Defects and Developmental Disabilities’ focus on maximizing 

prevention potential, minimizing impact on families and promoting 

early intervention through developmental screening should incorporate individuals affected by fragile X. To support this effort, the 

Committee recommends that NICHD develop a fragile X public 

health program to expand surveillance and epidemiological study of 

fragile X, as well as provide patient and provider outreach on fragile X syndrome and other developmental disabilities. 

Bone diseases.—The Committee encourages NICHD to support 

research on the effects of drugs on the growing skeleton and to 

work to ensure that the impact on the ongoing skeleton is investigated for all therapeutic agents. The Committee also encourages 

NICHD to participate in trans-NIH research about other factors— 

including genetics, diet and exercises—affecting the determination 

of peak bone mass in children with and without the metabolic bone 

diseases of osteoporosis and osteogenesis imperfecta. 

Demographic research.—The Committee commends NICHD for 

its support of demographic research. This research has provided 

critical scientific knowledge on issues such as work-family conflicts, 

family formation and structure, childcare, adolescent health and 

wellness, family and household behavior, the role of maternal employment, and parental involvement on child development. The 

Committee encourages NICHD to continue support for the Population Research Infrastructure program. The diverse research supported by this program has yielded key findings in areas such as 

fertility, health disparities, immigration and migration trends, and 

family dynamics. 

NATIONAL EYE INSTITUTE

The Committee provides $671,578,000 for the National Eye Institute (NEI), which is $18,526,000 above the fiscal year 2004 comparable level and the same as the budget request. 

Mission.—The NEI conducts and supports basic and clinical research, research training, and other programs with respect to 

blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight, and the special health problems and 

needs of individuals who are visually-impaired or blind. In addition, the NEI is responsible for the dissemination of information, 

specifically public and professional education programs aimed at 

the prevention of blindness. 

Gene therapy.—The Committee is aware of progress made in 

demonstrating the effectiveness of gene therapy to reverse and cure 

several retinal diseases, including diabetic retinopathy, macular degeneration, and retinopathy of prematurity. Diabetic retinopathy 

and macular degeneration are leading causes of blindness and visual disability in the United States, with an additional 165,000 people losing their vision each year due to these disorders. Additionally, each year more than 500 infants are blinded by retinopathy 

of prematurity. This gene therapy intervention has been successfully demonstrated in laboratory animals. The Committee encourages the Institute to facilitate clinical trials in primates and humans to further validate gene therapy interventions to reverse and 

cure retinal diseases. 

88 

Juvenile diabetes.—The Committee is aware of the serious problem of retinopathy in individuals with juvenile diabetes and encourages NEI to continue to collaborate with other institutes on efforts to identify the genes for diabetic retinopathy, by collecting 

and analyzing human samples and by developing animal models of 

diabetic retinopathy. 

Ocular albinism.—Ocular albinism is a hereditary, blinding disease that causes severely distorted vision in children. Victims, who 

are usually boys and receive the defective gene from their mother, 

experience nystagmus, photophobia, lack of stereoscopic vision, 

strabismus, and other symptoms which deny these children normal 

vision. In recent years, research has made great strides in the 

search for improved diagnostic tools and treatments. Recently, the 

OA1 gene, responsible for most cases of the disease, was identified, 

and a diagnostic screening test was created to help women determine if they are at risk of passing the disease on to their children. 

As researchers move closer to understanding how this disease 

works and developing potential treatments that could improve the 

vision of children with the condition, the Committee requests NEI 

to be prepared to report on advances in research on ocular albinism 

in the fiscal year 2006 hearing. 

Diabetic retinopathy.—The Committee commends NEI for establishing the Diabetic Retinopathy Clinical Research Network, which 

serves to expedite the evaluation of new approaches to address vision-related complications of diabetes. The Committee encourages 

NEI to continue to enhance its efforts to detect, prevent and treat 

diabetic retinopathy by collaborating with NIBIB on the development and application of scanning technologies that will be affordable and accessible to allow for early detection. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

The Committee provides $650,027,000 for the National Institute of Environmental Health Science (NIEHS), which is $17,635,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. 

Mission.—The NIEHS mission is to reduce the burden of environmentally related illness and dysfunction by understanding how 

environmental exposures affect health, how individuals differ in 

their susceptibility to these effects, and how these susceptibilities 

change over time. This mission is achieved through multidisciplinary biomedical research programs, prevention and intervention 

efforts, and communication strategies that encompass training, 

education, technology transfer, and community outreach. 

Environmental exposures and lung disease.—The Committee is 

pleased to note NIEHS’s support of studies that establish epidemiological links between environmental exposures and the development of lung disease like asthma and COPD. The Committee encourages the Institute to enhance its research into how environmental stimuli interact with the lung to produce lung disease, with 

emphasis on cellular responses to inhaled pollutants and the subsequent cell signaling steps that lead to disease. 

Juvenile diabetes.—The Committee commends NIEHS efforts on 

the Environmental Genome Project (EGP), which seeks to understand how individuals differ in their susceptibility to environmental agents and how these susceptibilities change over time. 

89 

This project may help to identify environmental triggers for diseases such as Type 1 diabetes. The Committee encourages enhanced efforts to interact and coordinate EGP with efforts like 

NIDDK’s Environmental Determinants of Diabetes in the Young 

(TEDDY) Study, to investigate genetic and gene-environment interactions in the development of prediabetic autoimmunity and Type 

1 diabetes. 

Mercury.—In order to properly research gaps in the area of mercury exposure and brain chemistry, and given recent hearings on 

mercury exposure and relationships between autism and Alzheimer’s disease and mercury exposure, NIEHS is encouraged to 

pursue studies of how inorganic mercury and organic mercury compounds (including ethyl, methyl, and other forms of mercury from 

all sources) are processed in the bodies of children and adults. 

NIEHS is also encouraged to support studies of the toxic effects of 

inorganic mercury and organic mercury compounds on the nervous 

systems of young children, adults, and the elderly and methods of 

properly removing mercury and mercury-containing compounds 

from the brains of affected humans. 

Toxic exposure and brain development.—Notwithstanding the Institute of Medicine May 2004 report on autism, the Committee believes it is important to develop a more complete understanding of 

the impact that toxic exposures may have on brain development. 

There is a convergence of findings from tissue culture studies, animal models, and clinical studies of immune dysfunction in children 

with autism that suggests a biological link between genetic sensitivity and damage to developing brains from certain toxins. It is 

important that NIH continue this research to better understand 

the impact that exposures to mercury (including thimerosal) and 

other toxins have on brain development. A more complete understanding of the impact of these exposures through research, including animal models, will help to develop more effective interventions. 

National Toxicology Program.—In order for the Interagency Coordinating Committee for the Validation of Alternative Methods 

(ICCVAM) to carry out its responsibilities under the ICCVAM Authorization Act, the Committee encourages NIEHS to strengthen 

the resources provided for ICCVAM activities in order to ensure 

that new and alternative test methods used or recommended for 

federal regulatory agencies, and those under consideration or 

planned for use within the National Toxicology Program’s toxicity 

testing project, are validated prior to their use. 

Parkinson’s disease.—The Committee encourages NIEHS in collaboration with NINDS to gain a greater understanding of the environmental underpinnings of Parkinson’s disease. The Committee 

also encourages NIEHS to intensify its efforts in the Collaborative 

Centers for Parkinson’s Disease Research Program. This initiative 

facilitates significant collaboration between genetics, clinical medicine, epidemiology, and basic science so that the most promising 

leads may be investigated more quickly in pursuit of a cure or to 

reduce the incidence of harmful toxins. 

90 

NATIONAL INSTITUTE ON AGING

The Committee provides $1,055,666,000 for the National Institute on Aging (NIA), which is $30,912,000 above the fiscal year 

2004 comparable level and the same as the budget request. 

Mission.—The NIA conducts biomedical, behavioral, and social 

research related to the aging process to prevent disease and other 

problems of the aged, and to maintain the health and independence 

of older Americans. 

Alzheimer’s Disease.—The number of Americans with Alzheimer’s—4.5 million today—will increase to between 11.2 million 

and 16 million by 2050. Within a decade, total annual Medicare 

costs for people with Alzheimer’s will increase by almost 55 percent 

to nearly $50 billion. The Committee notes that rapid advances in 

basic science are helping to identify multiple targets for therapies 

that may help slow or halt the progression of Alzheimer’s disease. 

Before these promising advances can be put to use preventing or 

treating the disease, they must be tested and validated in controlled clinical trials. The Committee encourages NIA to launch simultaneous clinical trials on therapies it determines to be most 

promising. The Committee also encourages NIA to work collaboratively with other institutes and the CDC to educate Americans 

about the ways they can maintain their brain as they age. 

Down syndrome.—Research has shown that many people with 

Down syndrome develop the neuropathological findings of Alzheimer’s disease, and that many go on in later life to show cognitive decline. The Committee encourages NIA to study the connection between Alzheimer’s disease and Down syndrome and to work 

closely with NINDS, NICHD, NIMH and NHGRI to establish an 

initiative to support Down syndrome research on improving cognition and preventing early dementia through biomedical treatments. 

End-of-life/palliative care.—The Committee encourages NIA to 

expand research, implementation of insights in practice, and training programs, aiming to understand the mechanisms of disability 

and suffering in fatal chronic illness and to prevent and relieve 

that disability and suffering, particularly with respect to pain management. 

Hematology research.—The Committee remains interested in advancing research opportunities into blood disorders in the elderly 

population. The Committee is particularly concerned that the incidence and prevalence of anemia increases with age; after age 85, 

one-quarter of the population is anemic. Research is needed to better understand the basic biology and adverse quality of life complications of anemia and other blood diseases in the elderly. The 

Committee is supportive of the ongoing collaboration between a voluntary organization and NIA, with the participation of NHLBI, 

NCI and NIDDK, to develop a research agenda in this field. The 

Committee requests a report on the priority research areas identified in anemia in the elderly that offer promising clinical opportunities and the steps to be taken to accelerate research in these 

areas. 

Bone diseases.—The Committee encourages NIA to strengthen 

support of research into the pathophysiology of osteoporosis, 

Paget’s disease and osteogenesis imperfecta. Research is needed in 

91 

the areas of genetics, the role of cell aging and altered metabolism, 

environmental and lifestyle factors, bone responsiveness to weight 

bearing, bone quality and fracture incidence, bone marrow changes, 

new agents to increase bone mass, the therapeutic use of new technology, and the comorbidity of metabolic bone diseases with chronic 

diseases of aging. 

Parkinson’s disease.—The Committee encourages NIA to collaborate with NINDS in developing a greater understanding of the 

overlap in benefits that current research could provide to understanding both Alzheimer’s and Parkinson’s disease. The Committee 

applauds the significant investment by NIA in understanding the 

role of genes, including alpha-synuclein, in the causation and manifestation of Parkinson’s. Work of this nature is critical for better 

comprehension of the disease process, identification of potential 

pharmaceutical agents, improved diagnostic ability, especially during the nearly stages of the disease, and the development of accurate animal models. 

Demographic and economic research.—The Committee commends 

NIA for supporting demographic and economic research and, in 

particular, the NIA Demography of Aging Centers program. This 

program has supported invaluable research to enhance knowledge 

about the well being of older Americans, especially information 

about their health and socioeconomic status, including their income, savings, work, and retirement decisions. The Demography 

Centers are now in a unique position to collaborate with several of 

the NIA Roybal Centers program to help translate findings into 

interventions and improve quality of life for older people. The Committee encourages NIA to continue its support of the demography 

centers program. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

The Committee provides $515,378,000 for the National Institute 

of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 

which is $14,312,000 above the fiscal year 2004 comparable level 

and the same as the budget request. 

Mission.—The NIAMS conducts and supports basic and clinical 

research and research training, and the dissemination of health information on the more than 100 forms of arthritis; osteoporosis and 

other bone diseases; muscle biology and muscle diseases; 

orthopaedic disorders, such as back pain and sports injuries; and 

numerous skin diseases. 

Bone diseases.—The Committee encourages NIAMS to support 

trans-NIH research into all aspects of genetics and gene therapies 

for the treatment of metabolic bone diseases, the role of environmental and lifestyle factors in bone disease, the effects of depression and cardiovascular disease on bone disease, the impact of mechanical loading of bone, and on bone health and osteoporosis in 

special groups, such as non-Caucasian ethnic groups. 

Scoliosis.—The Committee encourages NIAMS, in coordination 

with other institutes, to enhance research relevant to scoliosis to 

identify bio-mechanical causes and to develop genetic strategies to 

prevent the condition. 

Scleroderma.—The Committee is encouraged by NIAMS’s growing interest in scleroderma, a chronic and progressive disease that 

92 

predominantly strikes women. Scleroderma is disfiguring and can 

be life-threatening, and effective treatments are lacking. The Committees encourages NIAMS to collaborate with other institutes, including NHLBI, NIAID, NIDDK, and NIDCR, to generate additional research opportunities for scleroderma to identify genetic 

risk factors and safe and effective treatments. 

Vitiligo treatments for children.—Vitiligo is an environmental 

and genetic auto-immune disease of unknown origin which affects 

about three to six million Americans. Almost fifty percent develop 

the disease in childhood, with the median age of onset at four years 

of age. In its most severe forms, patients have milky white patches 

covering widespread areas of the body due to the loss of pigment 

in these areas. Especially for young children, the physical pain 

caused by severe burns from the harmful effects of sunlight and 

the emotional pain caused by people confusing vitiligo with an infectious disease diminishes the quality of a patient’s life. There are 

no FDA-approved treatments for children. The Committee urges 

NIAMS to enhance research efforts through all available mechanisms, as appropriate, to identify the causes of this disease and develop pediatric treatment options for vitiligo. 

Marfan syndrome.—The Committee commends NIAMS for its collaboration with other institutes to support research on Marfan syndrome, a life-threatening, progressive and degenerative genetic disorder. Marfan syndrome is characterized by cardiovascular, skeletal and ocular manifestations and its cardiovascular complications 

can result in premature death. Insights gained from research in 

this area may have implications for the understanding of other connective tissue disorders, other genetically mediated diseases, and 

the larger population of aging adults with thoracic aneurysms from 

a variety of causes. The Committee encourages NIAMS to focus on 

research opportunities which have the potential to advance nonsurgical treatment options, through all appropriate mechanisms. 

Pemphigus registry.—The Committee encourages NIAMS to consider establishing a national pemphigus registry, which would be 

important to the scientific community and patients in identifying 

the epidemiology, improving the understanding of the potential 

causes, and assessing the value of therapies for this chronic and 

life-threatening autoimmune disease. The Committee requests a report from NIAMS about whether such a registry will be established 

and under what timeframe. 

Tuberous sclerosis complex.—Tuberous sclerosis complex (TSC) is 

a genetic disorder that triggers uncontrollable tumor growth in 

multiple organs of the body, including the skin. The Committee encourages NIAMS to support programs examining the molecular and 

cellular basis of dermatological lesions in TSC as well as the development of non-surgical treatments for skin manifestations. 

Atopic dermatitis.—Atopic dermatitis (AD) is one of the most 

common skin disorders experienced by infants and children. Over 

90 percent of cases are diagnosed before the age of five. Patients 

with AD suffer with chronic skin inflammation and itching that 

disrupt sleep and reduce quality of life. An estimated 17 percent 

of children in the United States have atopic dermatitis, a dramatic 

increase above pre–1960s levels. The reason for this increase is unknown, but mirrors the increased rates of asthma and requires 

greater study. Of additional concern, individuals who have active 

93 

or dormant AD are at high risk for serious adverse reaction to the 

smallpox vaccine. The Committee encourages NIAMS to work with 

NIAID to spearhead an initiative to encourage investigator-initiated research on AD as it relates to smallpox vaccination as well 

as the progression to asthma and other allergic diseases. 

Burden of skin diseases.—The Committee commends NIAMS for 

conducting a workshop on the burden of skin diseases. The participants in the workshop recommended that skin disease-specific 

measures be developed in order to generate data on the incidence, 

prevalence, economic burden and disability attributable to these 

diseases. The Committee encourages NIAMS to continue to work 

with the scientific community to implement the recommendations 

of the workshop participants. 

Psoriasis.—Psoriasis is a chronic, immune-mediated disease that 

affects more than five million Americans. A 1999 NIMH-supported 

study found that patients with psoriasis reported reduction in 

physical and mental functioning comparable to that seen in cancer, 

arthritis, hypertension, heart disease, diabetes, and depression. 

The Committee considers research on psoriasis and psoriatic arthritis important, and is pleased that NIAMS helped create a psoriasis tissue bank from which the first several psoriasis genes have 

been identified. The Committee encourages NIAMS to support additional research into the identification of other genes expected to 

play a role in psoriasis pathogenesis and to strengthen clinical research on potential therapies for psoriasis and psoriatic arthritis. 

Mucolipidosis Type IV (ML4).—The Committee commends NIMH 

for its efforts to create a strain of mice which replicates the genetic 

mutation which in humans causes this debilitating genetic metabolic disorder, and encourages NIMH to complete this work. Now 

that the gene which causes this disorder has been identified, research on such organisms is crucial to the eventual development of 

treatments or cures for this and similar genetic disorders. 

Mucopolysaccharidosis (MPS).—The Committee is aware of 

NIAMS’s recent efforts with NIDDK to facilitate communication between MPS and Lysosomal Storage Disorder investigators with 

bone pathology and connective tissue scientists to examine problematic issues in this area of study. The Committee encourages 

NIAMS to enhance its efforts to directly support and collaborate 

with NIDDK on bone and joint diseases in MPS disorders. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

The Committee provides $393,507,000 for the National Institute 

on Deafness and Other Communication Disorders (NIDCD), which 

is $11,454,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The NIDCD funds and conducts research in human 

communication. Included in its program areas are research and research training in the normal and disordered mechanisms of hearing, balance, smell, taste, voice, speech and language. The Institute 

addresses special biomedical and behavioral problems associated 

with people who have communication impairments or disorders. In 

addition, the NIDCD is actively involved in health promotion and 

disease prevention, dissemination of research results, and supports 

94 

efforts to create devices that substitute for lost and impaired sensory and communication functions. 

Dysphonia.—The Committee continues to be pleased with 

NIDCD’s expanding intramural research program with respect to 

dysphonia. The Committee commends NIDCD on the release of a 

joint program announcement with NINDS, which will lead to a 

more active extramural research effort on dysphonia, and collaboration with other NIH Institutes on this important disorder. The 

Committee requests a report on the number of dysphonia grant 

proposals received and funded as a result of the joint program announcement. 

Inner ear protection, rescue and regeneration.—The Committee 

encourages NIDCD to continue to support research in the areas of 

inner ear protection, rescue, and regeneration, such as noise-induced hearing loss, ototoxicity and hair cell regeneration, as well 

as research on the central auditory system. In addition, NIDCD is 

encouraged to continue research on rehabilitative technologies and 

strategies, leading to improved prevention, treatment and management of hearing loss, tinnitus and dizziness. 

Stuttering.—The Committee received testimony concerning stuttering which affects approximately three million people in this 

country. It was learned that healthy individuals who stutter are 

often labeled as unintelligent, eccentric, mentally ill and/or emotionally disturbed. NIDCD is encouraged to conduct a consensus 

conference to examine the current state of science as well as to 

identify future research opportunities in the field of stuttering and 

to report to the Committee on the outcome of this conference prior 

to next year’s hearings. 

Neurofibromatosis (NF).—NF accounts for approximately five 

percent of genetic forms of deafness and, unlike other genetic forms 

of deafness, NF2-associated deafness is potentially preventable or 

curable if tumor growth is halted before damage has been done to 

the adjacent nerve. Research is now being conducted to cure deafness in NF mice through gene therapy, which could prove beneficial for gene therapy in general and for patients suffering from 

meningiomas and other tumors. The Committee encourages NIDCD 

to enhance its NF research portfolio through all suitable mechanisms, including clinical trials and RFAs. 

NATIONAL INSTITUTE OF NURSING RESEARCH

The Committee provides $139,198,000 for the National Institute 

of Nursing Research (NINR), which is $4,474,000 above the fiscal 

year 2004 comparable level and the same as the budget request. 

Mission.—The NINR supports and conducts scientific research 

and research training to reduce the burden of illness and disability; 

improve health-related quality of life; and establish better approaches to promote health and prevent disease. 

Nurse management of chronic illness.—The Committee is aware 

of the increasing role nurses play in patient education and management of chronic diseases like asthma and chronic obstructive pulmonary disease (COPD). The Committee encourages NINR to partner with other institutes to develop effective patient education and 

management models for nurses to use in the care and management 

of asthma and COPD. 

95 

Health disparities.—The Committee commends NINR for its 

longstanding support of research to reduce health disparities 

among minorities. Along with research in promoting the health of 

minority men, NINR has focused past efforts on identifying risk 

factors and strategies to reduce the high rates of low birth-weight 

babies born to minority women. The Committee encourages NINR 

to expand these efforts to study other women’s health issues and 

to measure health indicators such as physiological, socioeconomic, 

emotional, environmental, cultural, and genetic factors. 

The seventeen recently-initiated Nursing Partnership Centers to 

Reduce Health Disparities are of special interest to the Committee. 

NINR’s goal of bringing together research-intensive schools of nursing and minority-serving schools of nursing into partnerships to 

promote health disparities research and expand the number of minority nurse researchers is commendable. The Committee looks forward to learning more about this creative approach. 

Self-management.—The Committee encourages NINR to continue 

its strong focus on self-management for patients who live with 

chronic illness. Advancing knowledge of technological innovations 

that help people manage their own health and promote their quality of life is a key area for research. 

End-of-life care.—Dissatisfaction with care during the last stages 

of life has been widely reported by recent studies. The Committee 

applauds NINR’s plans to focus on children during the end-of-life, 

especially since the Institute of Medicine recently identified this 

population as being overlooked by research. 

Nurse shortage.—The nursing shortage is of serious concern to 

the Committee, not only because of its effects on the health care 

system, but because it has reduced the number of nurse researchers and educators. NINR’s activities to confront this issue by increasing support for training programs, such as fast-track baccalaureate-to-doctoral training and promotion of careers in patientoriented research, are encouraging. These efforts will play an important role in ensuring an adequate number of nurse researchers 

and faculty for the future. 

Genetics.—Advances in genetics will revolutionize many aspects 

of health and healthcare. The Committee is pleased that NINR is 

integrating genetics into nursing research, practice, and education. 

NINR’s annual eight-week Summer Genetics Institute increases expertise in genetics and conveys genetic knowledge that ranges from 

tailoring drugs according to genotype to providing genetic counseling for individuals and families. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

The Committee provides $441,911,000 for the National Institute 

on Alcohol Abuse and Alcoholism (NIAAA), which is $13,242,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. 

Mission.—The NIAAA supports research to generate new knowledge to answer crucial questions about why people drink; why some 

individuals are vulnerable to alcohol dependence or alcohol-related 

diseases and others are not; the relationship of genetic and environmental factors involved in alcoholism; the mechanisms whereby 

alcohol produces its disabling effects, including organ damage; how 

to prevent alcohol misuse and associated damage and how alcoVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00095 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
96 

holism treatment can be improved. NIAAA addresses these questions through a program of biomedical, behavioral, and epidemiologic research on alcoholism, alcohol abuse, and related problems. 

This program includes various areas of special emphasis such as 

medications development, fetal alcohol syndrome, genetics, and 

moderate drinking. 

Asian American and Pacific Islander (AAPI) populations.—The 

Committee suggests that NIAAA take further steps to meet the research needs of the rapidly growing AAPI populations in the fifty 

states and the six Pacific Island jurisdictions. NIAAA should consider creating an NIAAA Asian American and Pacific Islander 

Workgroup to develop an AAPI research agenda and implementation plan for alcohol and alcohol abuse issues. 

Nonalcoholic steatohepatitis (NASH).—The Committee notes that 

the mechanisms that cause NASH and the treatment protocols that 

are effective with regard to NASH also offer promise for treating 

alcoholic liver disease (ALD). The Committee encourages additional 

research focused on NASH and ALD to address both these diseases 

as well as to further test the hypothesis that the mechanisms causing these diseases are similar. 

Underage rural drinking.—The Committee understands that alcohol is the number one drug of choice among children and adolescents in this country. The Committee commends NIAAA for being 

one of the scientific leaders in developing prevention/intervention 

programs for young people with alcohol and risky behavior problems. It encourages NIAAA to continue to provide leadership in developing model longitudinal prevention/intervention communitybased programs focusing on how individual families, school and 

community networks can help reduce high-risk behavior among 

nine- to fifteen-year olds in rural and small urban areas. The Committee encourages NIAAA to continue to utilize the expertise of 

academic health centers in this effort. 

NATIONAL INSTITUTE ON DRUG ABUSE

The Committee provides $1,012,760,000 for the National Institute on Drug Abuse (NIDA), which is $21,807,000 above the fiscal 

year 2004 comparable level and the same as the budget request. In 

addition, $6,300,000 is made available as requested by the Administration from program evaluation funds to carry out surveys of 

drug abuse. 

Mission.—NIDA-supported science addresses questions about 

drug abuse and addiction, which range from its causes and consequences to its prevention and treatment. NIDA research explores 

how drugs of abuse affect the brain and behavior and develops effective prevention and treatment strategies; the Institute works to 

ensure the transfer of scientific data to policy makers, practitioners, and the public. 

Asian American and Pacific Islander (AAPI) populations.—The 

Committee suggests that NIDA take further steps to meet the research needs of the rapidly growing AAPI populations in the fifty 

states and the six Pacific Island jurisdictions. In particular, AAPI 

research with respect to substance abuse prevention, treatment, 

services and training is needed to help address the public health 

needs of these populations. The NIDA AAPI Workgroup has provided important recommendations to NIDA critical to developing 

97 

the needed body of scientific knowledge regarding AAPIs, and the 

Committee encourages NIDA to consider carefully these recommendations and take action where warranted. 

NATIONAL INSTITUTE OF MENTAL HEALTH

The Committee provides $1,420,609,000 for the National Insti- tute of Mental Health (NIMH), which is $38,835,000 above the fiscal year 2004 comparable level and the same as the budget request. 

Mission.—The NIMH is responsible for research activities that 

seek to improve diagnosis, treatments, and overall quality of care 

for persons with mental illnesses. Disorders of high priority to 

NIMH include schizophrenia, depression and manic depressive illness, obsessive-compulsive disorder, anxiety disorders and other 

mental and behavioral disorders that occur across the lifespan; 

these include childhood mental disorders such as autism and attention-deficit/hyperactivity disorder; eating disorders; Alzheimer’s disease; and other illnesses. NIMH supports and conducts fundamental research in neuroscience, genetics, and behavioral science. 

In addition to laboratory and controlled clinical studies, the NIMH 

supports research on the mental health needs of special populations and health services research. 

Mental health research and the aging.—The Committee is aware 

that demographics will demand a greatly increased focus on mental 

disorders in older persons, and consequently the Committee continues to be interested in supporting funding for late-life mental 

health research at NIMH. The committee encourages NIMH to 

strengthen the resources supporting aging research and to provide 

data on existing funds targeted toward geriatric mental health research. 

Down syndrome.—The Committee encourages NIMH to research 

the mental health symptoms of persons with Down syndrome and 

to investigate risk factors and possible treatments for autism, obsessive-compulsive disorder, attention deficit disorder, anxiety and 

depression. The Committee urges NIMH to include Down syndrome 

in its studies on related disorders and to coordinate its work with 

the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention. The Committee encourages NIMH to work closely with NINDS, NICHD, 

NIA and NHGRI to establish a research initiative to fund Down 

syndrome research relating to cognition and behavior through biomedical interventions. 

Alzheimer’s disease.—Recently, NIMH launched a trial of 

antidepressant medications designed identify the best medication 

regimen of treating the behavioral problems that often occur in Alzheimer patients. Initial results should be available in late 2004. In 

addition, NIMH intramural researchers identified a promising new 

method for early detection of Alzheimer’s disease. Long-term studies now underway will determine whether this biomarker can be 

used as a predictive and diagnostic tool. The Committee encourages 

NIMH to continue to place significant priority on studies of Alzheimer’s disease. 

Parkinson’s disease.—The Committee encourages NIMH to enhance its research on the role of depression in Parkinson’s disease. 

Depression may be a very early symptom of Parkinson’s, sometimes 

appearing before other traditional symptoms. NIMH should also 

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continue its ongoing research into the proper treatment of depression and other serious mental disorders that often co-occur with 

Parkinson’s, such as dementia and anxiety. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

The Committee provides $492,670,000 for the National Human Genome Research Institute (NHGRI), which is $13,597,000 above 

the fiscal year 2004 comparable level and the same as the budget 

request. 

Mission.—NHGRI coordinates extramural and intramural research, as well as research training, in the areas of genomics and 

genetics. The Division of Extramural Research supports research 

on genetic sequences of both human and non-human genomes, 

DNA sequencing technology development, database management 

and analysis, and research on the ethical, legal, and social implications of human genome research. The Division of Intramural Research focuses on applying the tools and technologies of the Human 

Genome Project to understanding the genetic basis of disease and 

developing DNA-based diagnostics and gene-based therapies. 

Targeting disease prevention.—The Committee commends 

NHGRI for creating the Encyclopedia of DNA Elements (ENCODE) 

project, which has a long-term goal of creating a comprehensive 

catalogue of the functional components encoded in the human genome. This project will help scientists mine and fully utilize the 

human sequence, gain a deeper understanding of human biology, 

predict potential disease risk, and stimulate the development of 

new genome technologies as well as strategies for the prevention 

and treatment of disease. The Committee is also pleased with the 

progress of the international haplotype mapping (HapMap) project 

and looks forward to its completion in 2005. In each of these areas, 

the Committee recognizes that advances in the use of new genomic 

technologies, including different types of microarrays, can enhance 

NHGRI’s global leadership in meeting these goals. 

Neurogenomics and neuroinformatics.—The Committee encourages NHGRI to assist private efforts to collect and integrate the 

various repositories of neuroscience information, including brain 

imaging, with genome information and cross-referencing this with 

human disease to advance knowledge along a broad front of 

neurologic, psychiatric and neurodegenerative diseases, their 

causes and cures. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

The Committee provides $297,647,000 for the National Institute 

of Biomedical Imaging and Bioengineering (NIBIB), which is 

$10,518,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The mission of the Institute is to improve health by 

promoting fundamental discoveries, design and development, and 

translation and assessment of technological capabilities in biomedical imaging and bioengineering, enabled by relevant areas of 

information science, physics, chemistry, mathematics, materials 

science, and computer sciences. 

NIBIB growth.—The Committee recognizes the important role of 

new imaging and engineering techniques and technologies both in 

improving health care delivery and enabling progress in biomedical 

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research. The Committee believes that NIBIB has worked effectively with the extramural community to identify important research opportunities and challenges. Through workshops and conferences NIBIB has produced an ambitious research agenda that 

will produce new technologies with clinical applications to a broad 

spectrum of biological processes, disorders, and diseases and across 

organ systems as well as facilitate advanced research in virtually 

all other NIH institutes. The NIH leadership has recognized the 

central role of imaging by including the development of molecular 

imaging and molecular libraries as an initiative in the NIH Roadmap for Medical Research. The important innovations envisioned 

in the imaging and biomedical engineering agenda are unlikely to 

be achieved in the foreseeable future, however, unless additional 

resources are available to NIBIB. Because NIBIB was created at 

the end of the congressional effort to double the NIH budget over 

five years, it faces special challenges as funding growth slows. The 

Committee urges the Director of NIH to give NIBIB special attention so that it can achieve its potential. For that reason, the Committee requests NIH to develop a five-year professional judgment 

budget that would enable NIBIB to grow at an appropriate rate. 

The Committee expects to receive the report by May 1, 2005. 

Bone imaging.—The Committee encourages NIBIB to make new 

bone imaging techniques a primary focus, speeding the development of new imaging modalities that better capture bone quality, 

including bone micro- and macro-architecture, quantification of 

bone mass and crystalline composition, which are necessary to develop diagnostic and treatment therapies for patients with metabolic bone diseases. The Committee encourages NIBIB to participate actively in trans-NIH initiatives that address these priorities. 

Organ imaging.—The Committee encourages the Institute to 

focus on improved tissue and organ imaging technologies and on 

the growth of artificial tissues. Progress in these fields will have 

multiple benefits, including addressing issues such as invasive diagnostic tests now required for liver diseases and the need to address the shortage of livers and other organs available for transplantation. 

Diabetic retinopathy.—The Committee encourages NIBIB to collaborate with NEI on the development and application of scanning 

technologies that will be affordable and accessible to allow for early 

detection of diabetic retinopathy. 

NATIONAL CENTER FOR RESEARCH RESOURCES

The Committee provides $1,094,141,000 for the National Center 

for Research Resources (NCRR), which is $84,917,000 below the fiscal year 2004 comparable level and the same as the budget request. 

The Committee does not include bill language identifying funding 

for extramural facility construction, which is the same as the Administration request. $118,497,000 was provided in fiscal year 2004 

for extramural construction. 

Mission.—The NCRR develops and supports critical research 

technologies and shared resources that underpin biomedical research. The NCRR programs develop a variety of research resources; provide resources for complex biotechnologies, clinical research and specialized primate research; develop research capacity 

100 

in minority institutions; and enhance the science education of precollege students and the general public. 

Institutional development awards (IDeA).—The Committee has 

identified $222,000,000 for this program, which is the same as the 

Administration request and $8,000,000 above the fiscal year 2004 

level. The program is comprised of the Centers of Biomedical Research Excellence (COBRE) program and Biomedical Research Infrastructure Network (BRIN) 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. 

National primate research centers.—The Committee values the 

important role played by the eight national primate centers. In the 

past several years, there has been an extensive expansion of the 

breadth and volume of demands for primate center resources. The 

Committee encourages NCRR to strengthen the base support for 

these centers and to conduct an assessment of primate center resource needs. This assessment should be submitted to the Committee at the time of the FY 2006 budget request. 

Health disparities centers.—The Committee commends NCRR for 

its proposal to establish comprehensive centers for health disparities research and looks forward to learning more about this important new initiative. 

Research centers at minority institutions (RCMI).—The Committee continues to recognize the important role played by minority 

institutions at both the graduate and undergraduate level in addressing the health research and training needs of minority populations. These programs help facilitate the preparation of a new 

generation of scientists at these institutions. The RCMI program 

continues to address these problems. The Committee encourages 

NCRR to strengthen participation from minority institutions. The 

Committee also encourages NCRR to work with minority institutions with a track record of producing minority scholars in science 

and technology. 

General clinical research centers (GCRCs).—The 79 NCRR-funded 

general clinical research centers across the country are important 

to NIH efforts to translate basic science discoveries into vaccines, 

treatments, and cures for disease. Approximately 10,000 researchers use GCRCs each year for patient-oriented research focused on 

a wide variety of diseases. The Committee is concerned that NCRR 

has in the past included activities not related to GCRCs in NCRRreported funding totals for the GCRCs. In the future, the Committee expects NCRR to restrict its reporting to funds that go directly to GCRCs instead of including general clinical research activities in those totals. 

Islet resource centers.—The Committee encourages NCRR to accelerate the efforts of the islet cell resource centers to improve the 

quality and yield of islets, to improve the storage and transportability of islets to enhance regional distribution of these cells, and 

to serve as national resource centers to support national efforts in 

islet transplantation by providing human islets for both basic research and clinical islet transplantation. 

Cystic fibrosis.—NCRR has played a leadership role in providing 

clinical researchers with the tools they need to conduct their research and to undertake and complete clinical trials efficiently. 

101 

NCRR has supported the development of shared resources for clinical researchers, an activity that has strengthened the nation’s clinical research capabilities. The Committee commends NCRR for its 

support of clinical trials networks, including the cystic fibrosis clinical trials network. The Committee suggests that NCRR consider 

supporting a cystic fibrosis biospecimen repository, which would 

serve as an important resource to CF researchers and function as 

a model for other diseases. 

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE

The Committee provides $121,116,000 for the National Center 

for Complementary and Alternative Medicine (NCCAM), which is 

$4,138,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The Center was established to stimulate, develop, and 

support rigorous and relevant research of high quality and open, 

objective inquiry into the safety and effectiveness of complementary 

and alternative medicine practices in order to provide the American 

public with reliable information about these practices. 

Ameliorating liver disease.—The Committee notes that NIDDK 

has completed efforts to synthesize and calibrate the production of 

milk thistle, which will now make possible clinical trials to demonstrate its value in slowing the progression of nonalcoholic 

steatohepatitis and to reduce the side effects of hepatitis C 

interferon treatments. The Committee urges NCCAM to pursue research to demonstrate the value of milk thistle to ameliorate liver 

disease. 

Osteoporosis.—The Committee encourages NCCAM to conduct research on women in their thirties and forties with respect to bone 

health and nutrition, including the use of supplements and 

nutraceuticals, in an effort to determine whether such strategies 

can prevent osteoporosis and fractures in later life. In addition, the 

Committee encourages support for research on the effects of complementary and alternative medicine on bones and pain management in people with metabolic bone diseases. 

Chromium nutrition and diabetes.—Recent research has demonstrated that chromium picolinate can restore normal glucose metabolism by enhancing insulin sensitivity. Impaired insulin sensitivity is a major factor leading to the development of type 2 diabetes and cardiovascular disease. In clinical studies in people with 

type 2 diabetes, chromium supplementation has been shown to significantly reduce elevated blood sugar levels and improve long-term 

blood sugar control. The beneficial effects were predominantly seen 

in populations who were overweight and insulin resistant. Since it 

has been shown that many Native Americans have severely impaired insulin sensitivity and are overweight, a strong case can be 

made to support the hypothesis that chromium supplementation 

can significantly help Native American populations. In addition to 

potential treatment benefits, chromium supplementation in overweight pediatric populations may restore normal glucose metabolism, and thereby reduce or delay the onset of diabetes. Therefore, 

NCCAM is encouraged to expand upon these early findings to support research on chromium supplementation as a safe, effective, 

low cost nutritional therapy for type 2 diabetes. 

102 

Parkinson’s disease.—The Committee encourages NCCAM to continue exploration of the neuroprotective qualities of B vitamins and 

antioxidant phytochemicals in berries via animal models. Research 

with animals has shown that diets containing berry fruits (such as 

blueberries) in addition to B vitamins can forestall and perhaps reverse many of the neurological changes associated with age-related 

neurodegenerative conditions, such as Parkinson’s and Alzheimer’s 

disease. 

NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

The Committee provides $196,780,000 for the National Center on 

Minority Health and Health Disparities (NCMHD), which is 

$5,309,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Mission.—The Center conducts and supports research, training, 

information dissemination and other programs aimed at reducing 

the disproportionately high incidence and prevalence of disease, 

burden of illness and mortality experienced by certain American 

populations, including racial and ethnic minorities and other 

groups, such as the urban and rural poor, with disparate health 

status. 

Cancer in minority communities.—The Committee commends 

NCMHD for its leadership in addressing the disproportionate impact of cancer in minority communities. The Committee encourages 

NCMHD to consider collaborating with NCRR and NCI in supporting the establishment of a cancer center at a historically minority institution focused on research, treatment and prevention of 

cancer in African American and other minority communities. 

Glomerular injury.—The Committee understands that glomerular injury, a group of diseases which affect the filtering mechanisms of the kidney, is more prevalent among African Americans 

than the general population. The Committee encourages NCMHD 

to collaborate with NIDDK to conduct and support research activities related to glomerular injury. 

Latinos.—The Committee recognizes that Latinos are the fastestgrowing ethnic group in the United States and encourages NCMHD 

to increase its training of bilingual and bicultural researchers. The 

Committee encourages NCMHD to focus on research benefiting the 

diverse subgroups of the Latino population. 

Scleroderma.—The Committee encourages NCMHD to support 

research that furthers the understanding of causes and consequences of scleroderma, a chronic, degenerative disease of collagen production, present among African Americans, Hispanic and 

Native American men and women. NCMHD is encouraged to establish epidemiological studies to address the prevalence of 

scleroderma among these populations, as statistics indicate that African Americans have a slightly higher incidence of scleroderma. 

This population is also likely to be diagnosed at a younger age and 

tends to be diagnosed more often with the diffuse form of 

scleroderma. 

Liver disease.—The Committee remains concerned about the disproportionate burden of liver disease among African Americans, 

Hispanics, Asians and Native Americans. Among younger Native 

Americans liver disease is the second major cause of death, and the 

sixth leading cause of death among all Native American age 

103 

groups. Furthermore, among most Asian populations hepatitis B is 

a major cause of death. The Committee encourages NCMHD, in collaboration with NIDDK, to enhance research to improve liver disease treatment effectiveness among minority populations. 

Research endowment.—The Committee commends NCMHD for 

its leadership in addressing the longstanding problem of health status disparities in minority and medically underserved populations. 

The Committee continues to encourage NCMHD to implement its 

successful research endowment program as an ongoing initiative. 

Project EXPORT.—The Committee commends NCMHD for its 

successful ‘‘Project EXPORT’’ initiative and urges continued support for this important program. 

JOHN E. FOGARTY INTERNATIONAL CENTER

The Committee provides $67,182,000 for the Fogarty Inter- national Center (FIC), which is $1,800,000 above the fiscal year 

2004 comparable level and the same as the budget request. 

Mission.—The FIC was established to improve the health of the 

people of the United States and other nations through international cooperation in the biomedical sciences. In support of this 

mission, the FIC pursues the following four goals: mobilize international research efforts against global health threats; advance 

science through international cooperation; develop human resources to meet global research challenges; and provide leadership 

in international science policy and research strategies. 

Chronic obstructive pulmonary disease (COPD).—The Committee 

notes that COPD is the fourth leading cause of death worldwide, 

and encourages the Fogarty International Center to strengthen its 

COPD research and training activities. 

Tuberculosis training.—The Committee is pleased with the 

Fogarty International Center’s efforts to supplement grants in the 

AIDS International Training and Research Program (AITRP) or 

International Training and Research Program in Emerging Infectious Diseases (ERID), which trains tuberculosis experts in the developing world. Given the magnitude of global tuberculosis, the 

Committee encourages FIC to consider developing a specific freestanding TB training program. 

NATIONAL LIBRARY OF MEDICINE

The Committee provides $316,947,000 for the National Library of Medicine (NLM), which is $7,902,000 above the fiscal year 2004 

comparable level and the same as the budget request. In addition, 

$8,200,000 is made available from program evaluation funds as requested by the Administration to support the National Center on 

Health Services Research. The same amount was provided last 

year. 

Mission.—The National Library of Medicine collects, organizes, 

disseminates, and preserves biomedical literature in all forms, regardless of country of origin, language, or historical period. The Library’s collection is widely available; it may be consulted at the 

NLM facility on the NIH campus; items may be requested on interlibrary loan; and the extensive NLM bibliographic databases may 

be searched online by health professionals around the world. NLM 

has a program of outreach to acquaint health professions with 

available NLM services. The Library also is mandated to conduct 

104 

research into biomedical communications and biotechnology; to 

award grants in support of health science libraries and medical 

informatics research and training; and to create specialized information services in such areas as health services research, environmental health, AIDS, hazardous substances, and toxicology. 

Outreach.—The Committee encourages NLM to continue its outreach activities aimed at educating health care professionals and 

the general public about the Library’s products and services, in coordination with medical librarians and other health information 

specialists. 

PubMed Central.—The Committee commends NLM for its leadership in developing PubMed Central, an electronic online repository 

for life science articles. Because of the high level of expertise health 

information specialists have in the organization, collection, and dissemination of medical information, the Committee believes that 

health sciences librarians have a key role to play in the further development of PubMed Central. The Committee encourages NLM to 

work with the medical library community regarding issues related 

to copyright, fair use, peer-review and classification of information 

on PubMed Central. 

Minority health.—The Committee encourages NLM to enhance 

its support of annual conferences sponsored by the minority health 

professions community designed to foster increased interest among 

minority students in the fields of biomedical science and bioinformatics. 

Access to research results.—The Committee is very concerned 

that there is insufficient public access to reports and data resulting 

from NIH-funded research. This situation, which has been exacerbated by the dramatic rise in scientific journal subscription prices, 

is contrary to the best interests of the U.S. taxpayers who paid for 

this research. The Committee is aware of a proposal to make the 

complete text of articles and supplemental materials generated by 

NIH-funded research available on PubMed Central (PMC), the digital library maintained by the National Library of Medicine (NLM). 

The Committee supports this proposal and recommends that NIH 

develop a policy, to apply from FY 2005 forward, requiring that a 

complete electronic copy of any manuscript reporting work supported by NIH grants or contracts be provided to PMC upon acceptance of the manuscript for publication in any scientific journal listed in the NLM’s PubMed directory. Under this proposal, NLM 

would commence making these reports, together with supplemental 

materials, freely and continuously available six months after publication, or immediately in cases in which some or all of the publication costs are paid with NIH grant funds. For this purpose, ‘‘publication costs’’ would include fees charged by a publisher, such as 

color and page charges, or fees for digital distribution. NIH is instructed to submit a report to the Committee by December 1, 2004 

about how it intends to implement this policy, including how it will 

ensure the reservation of rights by the NIH grantee, if required, to 

permit placement of the article in PMC and to allow appropriate 

public uses of this literature. 

OFFICE OF THE DIRECTOR

The Committee provides $359,645,000 for the Office of the Director (OD), which is $32,141,000 above the fiscal year 2004 comVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00104 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
105 

parable level and the same as the budget request. The bill repeats 

language included in prior years authorizing the collection of third 

party payments for the cost of clinical services, providing the Director of NIH with one percent transfer authority, and allocating up 

to $500,000 of funds within the Office of the Director appropriation 

for the Foundation for the National Institutes of Health. 

The Committee provides $70,000,000 within the Office of the Director for the Director’s Discretionary Fund (DDF), which is the 

same as the Administration request and $25,763,000 above the fiscal year 2004 comparable level. $60,000,000 of this funding is intended to be used for Roadmap initiatives. The Committee has repeated last year’s bill language making up to $7,500,000 of this 

total available through the flexible research authority provided in 

section 217 of the Act. 

The Committee includes bill language identifying the maximum 

funding that may be used for Roadmap activities and the method 

of calculating each Institute or Center’s contribution. 

The Committee has not approved the Administration proposal to 

give NIH authority to fund the multi-year cost of grants in the first 

year of their award and has not included the proposed general provision authorizing this action. In a budget with modest increases 

for Institutes, multi-year funding of the awards that are made 

would have an unacceptable impact on the volume of awards. The 

Committee suggests that the Administration not propose this approach without the funding increases necessary to stabilize the 

number of new grants awarded. Multi-year funding should not be 

expanded to grants beyond the limited number of small grants that 

historically are multi-year funded. 

Mission.—The Office of the Director provides leadership to the 

NIH research enterprise and coordinates and directs initiatives 

which cross-cut the NIH. The OD is responsible for the development and management of intramural and extramural research and 

research training policy, the review of program quality and effectiveness, the coordination of selected NIH-wide program activities, 

and the administration of centralized support activities essential to 

operations of the NIH. 

Office of Research on Women’s Health.—The Office of Research 

on Women’s Health (ORWH) works in collaboration with the Institutes and Centers of NIH to promote and foster efforts to address 

gaps in knowledge related to women’s health through the enhancement and expansion of funded research and/or the initiation of new 

investigative studies. The ORWH is responsible for ensuring the inclusion of women in clinical research funded by NIH, including the 

development of a computerized tracking system and the implementation of guidelines on such inclusion. This Office is also involved 

in promoting programs to increase the number of women in biomedical science careers, and in the development of women’s health 

and sex and gender factors in biology as a focus of medical/scientific research. 

The Committee is pleased with the increased focus on irritable 

bowel syndrome (IBS) at the ORWH. It is estimated that between 

25 and 45 million Americans, disproportionately women, suffer 

from IBS. 

Twenty to thirty percent of women in the U.S. of reproductive 

age suffer from uterine fibroids, a benign tumor that affects their 

106 

reproductive health. Research on treatment has been limited, and 

often women have unnecessary hysterectomies when less costly and 

invasive treatments may be possible. In conjunction with NICHD, 

NIEHS, and NCMHD, ORWH is encouraged to intensify and coordinate programs to support research on uterine fibroids. 

Office of AIDS Research.—The Office of AIDS Research (OAR) is 

responsible for coordination of the scientific, budgetary, legislative, 

and policy elements of the NIH AIDS research program. The OAR 

develops a comprehensive plan for NIH AIDS-related research activities which is updated annually. The plan is the basis for the 

President’s budget distribution of AIDS-related funds to the Institutes, and centers within NIH. The Committee expects the Director 

of NIH to use this plan and the budget developed by OAR to guide 

his decisions on the allocation of AIDS funding among the Institutes. The Director of NIH also should use the full authority of his 

office to ensure that the Institutes and Centers spend their AIDS 

research dollars in a manner consistent with the plan. In addition, 

the OAR allocates an emergency AIDS discretionary fund to support research that was not anticipated when budget allocations 

were made. 

The Committee has included the same general provisions in bill 

language that were contained in the 2004 appropriations bill. This 

language permits the Director of OAR, jointly with the Director of 

NIH, to transfer between Institutes and Centers up to three percent of the funding determined by NIH to be related to AIDS research. This authority could be exercised throughout the fiscal year 

subject to normal reprogramming procedures, and is intended to 

give NIH flexibility to adjust the AIDS allocations among Institutes 

if research opportunities and needs should change. The Committee 

also repeats language from last year’s bill making the research 

funds identified by NIH as being AIDS related available to the 

OAR account for transfer to the Institutes. This provision permits 

the flow of funds through the OAR in the spirit of the authorization 

legislation without requiring the Congress to earmark a specific 

dollar amount for AIDS research. 

The Committee encourages OAR to strengthen science-based HIV 

prevention research for African Americans, Latinos, Native Americans, Asian Americans, Native Hawaiians, and Pacific Islanders. 

The Office is also encouraged to focus on existing and developing 

areas of culturally appropriate research that seeks to reduce the 

risk of contracting HIV through high-risk behaviors and the transmission of HIV infection in the targeted minority populations. 

Office of Dietary Supplements.—The Office of Dietary Supplements (ODS) was established in recognition that dietary supplements can have an important impact on the prevention and management of disease and on the maintenance of health. ODS is 

charged with promoting, conducting, and coordinating scientific research within NIH relating to dietary supplements. 

Office of Behavioral and Social Sciences Research.—The Office of 

Behavioral and Social Sciences Research (OBSSR) provides leadership and direction for the development of a trans-NIH plan to increase the scope of and support for behavioral and social science research and in defining an overall strategy for the integration of 

these disciplines across NIH institutes and centers; develops initiatives to stimulate research in the behavioral and social sciences 

107 

arena and integrate a biobehavioral perspective across the research 

areas of NIH; and promotes studies to evaluate the contributions 

of behavioral, social and lifestyle determinants in the development, 

course, treatment, and prevention of illness and related public 

health problems. 

Office of Rare Disease Research.—The Office of Rare Disease Research (ORD) was established in recognition of the need to provide 

a focal point of attention and coordination at NIH for research on 

rare diseases. ORD works with Federal and non-Federal national 

and international organizations concerned with rare disease research and orphan products development; develops a centralized 

database on rare diseases research; and stimulates rare diseases 

research by supporting scientific workshops and symposia to identify research opportunities. 

The Committee commends the Director of NIH and ORD for the 

rapid progress over the past eighteen months since the office was 

created in statute and given additional responsibilities. The Committee appreciates the initiation of the rare disease clinical research network, and encourages research aimed at the development 

of interventions for orphan diseases, including cystic fibrosis. The 

Committee also encourages NIH to pursue exploratory grants and 

proof of concept studies for the development of new therapeutics in 

the treatment of rare diseases and to intensify support of the training of clinical research investigators in rare diseases. 

The Committee is concerned about the development of diagnostic 

tests for rare diseases and requests that ORD evaluate this situation and report to the Committee on what steps have been taken 

to increase NIH involvement in this area. 

The Committee is pleased with the ORD support of the biliary 

atresia research network. The Committee encourages ORD to continue to address rare liver diseases, including primary biliary cirrhosis, primary sclerosing cholangitis, and auto-immune hepatitis. 

Amyloidosis.—The Committee encourages NIH to expand its research efforts into the amyloidoses—a group of rare diseases characterized by abnormally folded protein deposits in tissues. These 

diseases are often fatal and there is no known cure. Treatment involving large-dose intravenous chemotherapy followed by stem cell 

replacement or rescue is effective for many patients, but this procedure is risky, unsuitable for many patients, and not a cure. The 

Committee is aware that NIH has recently created a Trans-NIH 

Working Group on Rare Diseases Research. Accordingly the Committee urges NIH to consider holding a conference led by the Office 

of Rare Diseases with support from NIH institutes and centers 

with a research focus on amyloidosis and related diseases, to assess 

the current state of the science and to determine the next steps to 

increase the understanding, prevention, and treatment of this devastating group of diseases. Results and recommendations from this 

conference should be sent to the Committee before October 1, 2005. 

Public health relevance of awards.—The Committee is encouraged by steps NIH is taking to improve communications regarding 

the public health relevance of its research awards. Specifically, the 

Committee is pleased NIH has proposed a modification to its standard grant application, PHS Form 398, requiring all grantees to include a statement of public health significance. The Committee 

urges the Department and the Office of Management and Budget 

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to approve the proposed revision and support the agency in its efforts to implement this important change in the grant application 

form. 

Cooperation with the Veterans Health Administration.—The Committee believes that closer collaboration with the Veterans Health 

Administration (VHA) will significantly facilitate, accelerate, and 

leverage research to develop more effective treatments and cures 

for liver disease. The Committee notes that the VHA has developed 

a significant database of veterans with hepatitis C that includes 

demographic, diagnostic, laboratory, drug treatment and co-morbidity population statistics that could be used to support NIH-funded research efforts. The Committee is pleased that NIDDK has 

begun efforts to develop a cooperative agreement with the VHA as 

a vehicle for collaborative efforts to facilitate liver disease research 

on a trans-NIH basis. 

Hepatitis C consensus conference implementation.—The Committee notes that the Hepatitis C consensus development conference recommended the creation of a Hepatitis Clinical Research 

Network (HCRN) and commends NIDDK for expanding Hepatitis 

C-related clinical research studies. The Committee requests a report by April 28, 2005 identifying NIH’s response to the original 

recommendations of the Hepatitis C consensus conference. 

NIH roadmap and clinical practice.—The Director of NIH is commended for his Roadmap efforts to re-engineer clinical research as 

currently supported by NIH. The Committee recognizes that it is 

essential that study results be rapidly disseminated into clinical 

practice. The Director is encouraged to work directly with the medical community, including the surgical community, in order to utilize existing networks as a way to accelerate the transfer of information for the treatment of patients. 

Best pharmaceuticals for children.—The Committee recognizes 

the importance of ensuring that drugs are safe and effective for use 

by children. The Committee supports continued implementation by 

NIH of the Best Pharmaceuticals for Children Act of 2002 to support the pediatric testing of off-patent drugs, as well as on-patent 

drugs not being studied through existing mechanisms. In implementing this responsibility, NICHD should act as coordinator for 

all other institutes within NIH for which pediatric pharmacological 

drug research may have therapeutic relevance. NICHD is also encouraged to consult with the Food and Drug Administration to ensure that the studies conducted are designed to yield improved pediatric labeling. The Committee requests NIH to provide an update 

during its annual appropriations testimony on the number of studies supported; the estimated cost of each study undertaken; the 

number of label changes resulting from completed studies; the patent status of the drugs studied; and the number of drugs remaining 

on the priority list. NICHD should focus its resources on encouraging the study of drugs where there is a medical necessity to conduct clinical pediatric studies, consistent with ethical concerns. The 

Committee also urges NICHD to give full consideration to existing 

information that supports the safe use of drugs in children and use 

of conditions contained in the Pediatric Research Equity Act to 

identify drugs for study and to determine the scope and magnitude 

of those studies. 

109 

Clinical research loan repayment program.—The Committee is 

pleased that NIH has moved forward with the clinical research 

loan repayment program. As the program completes its third year, 

the Committee would like to assess outcomes to date as well as 

areas for potential improvement. The Committee requests a report 

profiling award recipients, including their training experience; degrees held; medical/scientific disciplines; academic positions; and 

the funding support by which they were eligible to apply. The report should also include an evaluation of alternative strategies for 

assuring that recipients of loan repayment actually pursue careers 

in clinical research. 

Graduate training in clinical investigation awards.—In an effort 

to reverse the shortage of well-trained clinical investigators, the 

Committee encourages NIH to continue and strengthen support for 

K12 mentored clinical scientist development awards which provide 

tuition and stipend support for students. 

Duchenne/Becker muscular dystrophy.—The Committee notes 

that Duchenne muscular dystrophy (DMD) and its milder form, 

Becker muscular dystrophy (BMD), are the most common, lethal 

genetic childhood disorders known. The Committee urges NINDS, 

in collaboration with NIAMS, to enhance resources to improve 

treatments for patients with muscular dystrophy. The conferees 

strongly encourage NIH to consider funding additional centers of 

excellence and to strengthen the funding for existing centers of excellence. In addition, the Committee notes that the NIH interagency coordinating committee for muscular dystrophy has missed 

its one-year deadline to submit a plan for conducting and supporting research and education on muscular dystrophy. The Committee urges the coordinating committee to finalize and submit this 

plan, as well as include representation from the Department of Defense on the panel, as soon as possible. 

In addition, the Committee encourages NIH to increase its commitment to DMD translational research and clinical trials, separate 

from support in the centers of excellence program. Based on the severity of this disorder, its high incidence in children, and the prospect of important new treatments, the Committee encourages NIH, 

through NINDS and NIAMS, to follow the accelerated model for 

funding DMD translational research that was used for motor neuron diseases, including ALS and SMA. 

Finally, the Committee encourages the institutes to further develop opportunities for clinical trials and to help make available all 

existing and emerging patient care options. The institutes are encouraged to work with other institutes and Federal agencies to develop formal programs that increase public and professional awareness of the disease. The Committee requests that NIH report back 

to the Committee by April, 2005 with a progress report on all aspects of DMD translational and clinical research. 

Autism spectrum disorders.—The Committee is pleased with 

NIH’s autism research matrix and encourages NIH to devote sufficient resources to this research agenda. When implementing the 

autism research matrix, the Committee encourages NIH to coordinate with autism organizations already funding research initiatives 

to ensure the most efficient use of resources. The Committee also 

notes the promise of particular areas cited in the matrix, including 

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genetic and behavioral characterization of the disorder, screening 

and early diagnosis. 

Autism and vaccine.—The Committee continues to be aware of 

concerns about reports of a possible association between the measles component of the measles-mumps-rubella (MMR) vaccine and 

a subset of autism termed autistic entercolitis. The Committee continues its interest in this issue and encourages the Interagency Coordinating Committee to continue to give serious attention to these 

reports. The Committee is aware that research is underway, supported by NIH, and encourages NIH to avoid delays in this research. 

The Committee is also concerned that there is some evidence 

that infant exposures to thimerosal in the 1990s may be related to 

the epidemic of neurodevelopmental disorders in children. CDC’s 

most extensive review of Vaccine Safety Datalink data concluded 

that more research needs to be conducted in this arena to answer 

these questions with certainty and the Committee concurs with the 

need for this continued research. 

The Committee encourages NIH to dedicate significant resources 

to pursue the recommended research initiatives outlined in the Institute of Medicine’s (IOM) Immunization Review. These reports 

have identified the research needed to better understand why a 

number of children suffer severe adverse reactions to childhood 

vaccines. Continuation of this research to develop a better understanding of biological mechanisms is critical for knowing with certainty whether or not thimerosal and other vaccines exposures 

might cause increased risks for some children. 

Microbicides.—Microbicides, a class of products that would be applied topically to prevent HIV, represent a promising prevention 

strategy, with the potential to be especially significant in preventing HIV in women, who now account for more than half of the 

individuals newly infected with HIV globally. Once developed, 

microbicides and vaccines would serve as complementary HIV prevention technologies. The Committee is concerned that microbicide 

research at NIH is currently conducted with no single line of administrative accountability or specific funding coordination. The 

Committee urges NIH to consider establishing a lead office to coordinate research among institutes and with other Federal agencies. 

Autoimmune diseases.—The Committee appreciates the NIH 

Autoimmune Diseases Coordinating Committee (ADCC) and the 

comprehensive Autoimmune Diseases Research Plan it prepared. 

The Autoimmune Diseases Coordinating Committee (with representation from each NIH Institute, Centers for Disease Control and 

Prevention, Food and Drug Administration, Veterans Administration, and patient advocacy organizations) has been effective in fostering collaborative, integrated multi-Institute research on issues 

affecting the entire genetically related family of autoimmune diseases. The ADCC’s effectiveness in promoting inter-Institute collaboration on high priority cross-cutting research identified in the 

Autoimmune Diseases Research Plan has been a significant factor 

in achieving recent advances in the understanding, diagnosis and 

treatment of the autoimmune family of diseases. The Committee 

hopes that NIH will target the high-priority cross-cutting research 

identified in the Autoimmune Diseases Research Plan research. 

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Research infrastructure at minority health professions institutions.—The Committee continues to be pleased with the NIH Director’s implementation of various programs focused on developing research infrastructure at minority health professions institutions. 

The Committee encourages the NIH Director to work closely with 

the Director of the NCMHD to ensure coordination among these 

various mechanisms to partner with minority health professions 

schools to address their infrastructure needs. 

Heart disease, stroke and other cardiovascular diseases.—The 

Committee recognizes that the problems associated with heart disease, stroke and other cardiovascular diseases involve many institutes and centers, including NHLBI, NINDS, NIA, NIDCR, and 

NCRR. The Committee urges the Director of NIH to intensify his 

coordination of cross-cutting research on these diseases in all institutes and centers as appropriate and requests that the Director be 

prepared to report to the Committee on these initiatives in the 

FY2006 budget hearings. 

Vascular biology.—The Committee recognizes the importance of 

advancing research in the field of vascular biology, the study of 

blood and blood vessels and their interactions. Not only is the 

maintenance of the blood supply critical to the functioning of all organs of the body, understanding the mechanisms and treatment of 

diseases that interrupt the blood supply is relevant to all organ 

systems and their disorders. Research into vascular biology can 

provide the scientific basis for new therapies to prevent thrombosis, 

therapies that are important to the prevention and control of heart 

disease, stroke, recurrent fetal loss, and complications associated 

with sickle cell anemia and diabetes, and therapies related to the 

interruption of the blood supply to tumors and cancers. The Committee encourages the NIH director, working with the individual 

institutes and relevant voluntary health organizations, to develop 

a comprehensive NIH-wide approach to identify and pursue research opportunities in this field. 

Parkinson’s disease.—The Committee is interested in the development of NIH’s Parkinson’s disease ‘‘matrix.’’ The Committee encourages NIH to extend the matrix to include concrete steps toward 

better treatments and a cure. Since five years have elapsed since 

the last NIH conference on Parkinson’s disease, the Committee encourages the Director to hold another conference, similar to the one 

held in November of 1999, to examine the path to a cure, working 

with patient advocacy, scientific, and non-profit communities. The 

results of the conference should produce a strategic plan setting 

forth the programs required to secure the earliest possible development of effective therapies, prevention, and a cure for Parkinson’s 

disease. 

Lupus.—Lupus is a disabling and life-threatening autoimmune 

disease which affects more than 1.5 million Americans, 90 percent 

of whom are women. It causes the immune system to attack the 

body’s own cells and organs, including the kidneys, heart, lungs, 

brain, blood and skin. Lupus is two to three times more common 

among African Americans, Native Americans, Hispanics, and 

Asians, than among Caucasians. Lupus is a disease of rampant, 

uncontrolled inflammation caused by multiple genes. Scientists 

know some of the specific proteins that trigger lupus and are approaching a time when new strategies in molecular medicine can 

112 

be applied to improve the function of these proteins and prevent 

lupus flares. Because lupus is a multifaceted disease, the Committee encourages the Director to ensure that all relevant institutes work closely and collaboratively to maximize the output of 

our national investment in lupus research. To ensure that progress 

is maximized, the Committee requests NIH to develop a five-year 

trans-NIH research plan for the full spectrum of lupus research. 

Among the institutes to be involved should be NIAMS, NHLBI, 

NIDDK, NINDS, NIAID, NIEHS, and NCMHD. 

Spina bifida.—The Committee recognizes that spina bifida is the 

leading permanently disabling birth defect in the U.S. and encourages NIH to put a higher priority on research into primary and secondary prevention of this condition. While through research we 

have learned that Spina Bifida is highly preventable through proper nutrition, including appropriate folic acid consumption, too many 

pregnancies are still affected each year by this devastating birth 

defect. The Committee also acknowledges that prevention does not 

assist the more than 70,000 individuals living with spina bifida 

and therefore urges NIH, particularly through NINDS and NICHD, 

to focus research into secondary prevention for spina bifida. 

Tuberous sclerosis complex.—The Committee is aware that NIH 

released a strategic plan for tuberous sclerosis complex (TSC) last 

summer. The Committee encourages NIH to expand the scope of 

this effort to broaden the research to multiple institutes beyond 

NINDS and to emphasize research efforts that are specific to TSC. 

Obesity.—Obesity is epidemic in America today, adding an esti- mated $117 billion to our nation’s health care costs. To combat this 

epidemic, the Committee strongly supports providing Americans 

with safe and effective alternatives for controlling their weight. 

NIH has conducted research on the controlled carbohydrate nutritional approach in the short-term. The Committee commends the 

collaborative efforts of NIH to undertake a more, definitive longterm study of the safety and effectiveness of controlled carbohydrate nutrition. The study, funded by NCCAM, NIDDK and 

NHLBI, is a multi-site, randomized controlled long-term study of 

low- versus higher-carbohydrate diet. The Committee looks forward 

to learning the results of this study when completed. 

Rett syndrome.—Rett syndrome is a genetically inherited neurological disorder seen almost exclusively in females and found in 

many racial and ethnic groups worldwide. It is believed that Rett 

syndrome affects approximately one in ten thousand live births per 

year, although recent discoveries about the underlying genetic 

cause of this disorder may reveal significantly more affected people 

than previously diagnosed. The Committee is very encouraged by 

the most recent advances that have taken place in Rett syndrome 

research. Important breakthroughs in methods to detect previously 

undetected genetic variations and, most importantly, critical new 

discoveries in understanding the genetics of Rett syndrome are 

likely to catapult treatments not only for Rett syndrome but pave 

the way for greater understanding of other neurological impairments ranging from autism to schizophrenia. The Committee applauds the excellent program area developed by the NIH and encourages NIH to continue to target its research efforts to ascertain 

how the genes involved in Rett syndrome and the associated proteins affect other genes and tissues during the development of the 

113 

nervous system. Furthermore, NIH is encouraged to support the 

development of animal models, as well as genotype and phenotype 

investigations of Rett syndrome that could hasten progress in 

eliminating this and other neurologically based disorders The Committee notes there is also need for expanded research on the daily 

problems that affect children with Rett syndrome, including autonomic disorders, such as respiratory, gastrointestinal, circulatory 

and cardiac disorders, seizures, and scoliosis. Additionally, the 

Committee recognizes that research in applied areas such as interventions and technological aids for improved literacy and communication will improve the quality of life for Rett syndrome patients 

and those with other communicative disorders. Since Rett syndrome is a multi-faceted disorder, the Committee encourages NIH 

to partner with existing advocacy groups and to continue to work 

to promote continuity across Institutes in their Rett syndrome research. 

Cystic fibrosis.—The NIH Roadmap identifies the re-engineering 

of the clinical research system as a top priority. One of the strategies that the Roadmap recommends to enhance clinical research is 

establishing clinical trials networks that share informatics and 

other technologies. These networks are envisioned to include a significant number of institutions, in order to facilitate efficient recruitment and rapid enrollment of trial participants. An existing 

clinical trials network for testing therapies for cystic fibrosis (CF) 

includes many of the elements that have been cited in the Roadmap as critical for any model clinical trials system. The CF system 

includes: (1) centralized data management and analysis capability, 

(2) centralized data safety monitoring, and (3) the participation of 

eighteen institutions, which ensures rapid accrual to trials. The 

Committee believes that there are important opportunities for collaboration between NIH and this clinical trials network and encourages NIH to pursue this potential collaboration. One benefit of 

this collaboration would be the ability for NIH to evaluate the impact and benefits of this clinical trials network, its cost efficiencies, 

and the application of its core features to other diseases and in 

other settings. 

Charcot-Marie-Tooth disorder.—Charcot-Marie-Tooth disorder 

(CMT) is one of the most common inherited neurological disorders, 

affecting approximately one in 3,500 people in the United States. 

The Committee is concerned about the prevalence of this disease 

and its effect on people across the age spectrum and recognizes the 

value of CMT research for advancing understanding into other neuromuscular disorders. The Committee encourages NIH to identify 

new research opportunities on CMT that could lead to a relevant 

program announcement or request for applications. The Committee 

requests a report on NIH efforts on CMT and CMT-related disorders by March, 2005. 

Traumatic brain injury.—The Committee encourages NIH to 

build upon its work in brain injury rehabilitation at the National 

Center on Medical Rehabilitation and Research and to continue 

conducting basic research and translational clinical research on 

traumatic brain injury through NINDS. 

Lymphatic system research.—Despite the central role of the lymphatic system in human health and disease, this focus of research 

and medical care has, until recently, been relatively neglected. The 

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Committee believes that scientists and clinical educators should be 

alerted to the scientific opportunities and resources that exist to 

undertake basic and clinical investigation into the role of the lymphatic system in human health and disease. Therefore, the Committee encourages the Trans-NIH Coordinating Committee for the 

Lymphatic System, in collaboration with the OD Office of Communications and relevant institute offices of communications, to implement a comprehensive lymphatic research awareness campaign to 

inform academia, governmental agencies, industry and scientific 

and medical professional organizations and to create a heightened 

comprehension of the central role occupied by the lymphatic system 

in the maintenance of human health. 

Lymphangioleiomyomatosis (LAM).—The Committee remains 

very interested in efforts to find a cure for LAM, a progressive and 

often fatal lung disease of women with no effective treatment. The 

Committee understands that very recent scientific findings have 

presented new treatment approaches for clinical testing, and that 

experimental trials with the drug sirolimus have begun. The Committee encourages NCI, ORD, NINDS and NHLBI to explore opportunities for funding clinical treatment trials through both intramural and extramural means and to use all available mechanisms 

as appropriate, including support of state-of-the-science symposia 

and facilitating access to human tissues, to stimulate a broad range 

of clinical and basic LAM research. The Committee also commends 

NCRR and ORD for their roles in supporting the Rare Lung Disease Consortium. 

Cost-effectiveness research.—Another round of cost increases 

threatens the healthcare delivery system, and many health care experts predict nine percent increases for the foreseeable future. Unfortunately, the same new biomedical research discoveries that provide new remedies for health problems may in some cases contribute to higher health care costs. The Committee recognizes the 

need to ensure that increased investment in biomedical research 

does not price quality health care out of the reach of many Americans. Providers, patients, and health care payers need objective, 

scientific information to understand which new interventions are 

more effective than existing practices, which groups of patients are 

most likely to benefit, the degree of improvement compared to the 

cost, and the relative risks for the patient of alternative interventions. The Director is encouraged to make this type of research a 

higher priority across each of the institutes and centers and report 

to the Committee at the end of fiscal year 2005 a summary of 

grants awarded with a focus on findings related to reducing the 

cost of health care. 

Hyperbaric oxygen therapy (HBOT).—HBOT is currently in widespread use in medical practice. NIH is encouraged to support meritorious research in this area, especially in basic science, in order 

to gather evidence regarding the efficacy of HBOT. In particular, 

studies should consider HBOT as a treatment for various manifestations of reperfusion injury, hemorrhagic shock, trauma injury, 

surgery patients, stroke and dementia. When appropriate, clinical 

studies to test the safety and efficacy of this treatment for a variety 

of conditions should include adult and pediatric populations. NIH 

is also encouraged to work with professional organizations interested in HBOT as this research moves forward. 

115 

Sepsis.—The Committee is aware that sepsis, an overwhelming 

systemic response to infection that leads to organ dysfunction and 

death, kills more than 215,000 Americans every year, with direct 

annual medical costs estimated to exceed $17 billion. Septicemia, 

a form of sepsis that infects the blood, has been identified by the 

Centers for Disease Control as the tenth leading cause of death in 

the United States; sepsis resulting from pneumonia and chemotherapy causes tens of thousands of additional deaths annually. 

Until recently, therapies proved ineffective. New treatments have 

been developed which significantly improve prognosis when sepsis 

is diagnosed in a timely fashion, and new guidelines have been developed to aid health care professionals in identifying the syndrome. Sepsis remains a leading cause of death, however, because 

too few medical personnel know how to identify and diagnose it. To 

improve recognition of sepsis among health care providers, the 

Committee encourages the Office of the Director to work with a national alliance that is focused on sepsis education to create and implement a program to train infectious disease physicians, emergency room doctors, critical care nurses, and oncologists, especially 

those in rural and traditionally underserved areas, in the use of 

the new guidelines to identify sepsis and improve patient outcomes. 

In particular, the Committee requests the support of NIAID, 

NHLBI and NCI in these provider education efforts. 

Ataxia-telangiectasia (A–T).—A–T is a rare, fatal genetic disease 

that affects children, causing progressive loss of muscle control, immune system problems, and a high rate of cancer. Recent advances 

show that A–T research is important not just for patients with A– 

T, but also for more prevalent diseases including cancer and 

neurodegenerative diseases such as Alzheimer’s and Parkinson’s. 

The Committee supports the development of an inter-institute coordinating committee for research on A–T comprised of representatives from all the institutes relevant to A–T, including but not limited to NINDS, NICHD, NCI, NHGRI, NEI, NIA and NHLBI. The 

Committee encourages the inter-institute coordinating committee 

on A–T to conduct workshops with members of the scientific and 

medical communities to identify important, unanswered scientific 

question about A–T and to develop and regularly revise an interinstitute NIH research plan for A–T. 

Sex-based biology.—The Institute of Medicine has released a 

study demonstrating that all biological research must be cognizant 

of the differences that result from the sex of the patient, tissue or 

cell. One of the areas where such differences are most pronounced 

is in the field of neuroscience. For this reason, the Committee encourages the institutes involved in brain research to include sexbased biology as a part of the research conducted and to analyze 

and report research results in this manner, when appropriate. The 

Committee would like a report from the Director on the progress 

of this effort in next year’s hearings. 

Disease collections.—The Committee is aware that NIH has now 

published on its web site spending levels for its entire disease collection. The Committee commends the agency for making this information available and believes it will be of benefit to many advocacy groups and individuals with an interest in NIH’s research 

portfolio. 

116 

BUILDINGS AND FACILITIES

The Committee provides $99,500,000 for buildings and facilities, 

which is $10,528,000 above the fiscal year 2004 comparable level 

and the same as the Administration request. 

Mission.—The Buildings and Facilities appropriation provides for 

the design, construction, improvement, and major repair of clinical, 

laboratory, and office buildings and supporting facilities essential 

to the mission of the National Institutes of Health. The funds in 

this appropriation support the 77 buildings on the main NIH campus in Bethesda, Maryland; the Animal Center in Poolesville, 

Maryland; the National Institute of Environmental Health Sciences 

facility in Research Triangle Park, North Carolina; and other 

smaller facilities throughout the United States. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

The Committee provides a program level of $3,391,663,000 for 

the Substance Abuse and Mental Health Services Administration 

(SAMHSA), which is $40,705,000 above the fiscal year 2004 comparable level and $158,579,000 below the budget request. Within 

the total, $121,303,000 is provided through the evaluation set-aside 

as requested. 

SAMHSA is responsible for supporting mental health and alcohol 

and drug abuse prevention and treatment services nationwide 

through discretionary targeted capacity expansion and knowledge 

application grants, formula block grants to the States and associated technical assistance efforts. The agency consists of three principal centers: the Center for Mental Health Services, the Center for 

Substance Abuse Treatment, and the Center for Substance Abuse 

Prevention. The Office of the Administrator is responsible for overall agency management. 

The Committee expects that no less than the amounts allocated 

in fiscal year 2004 will be spent in fiscal year 2005 for activities 

throughout SAMHSA that are targeted to address the growing 

HIV/AIDS epidemic and its disparate impact on communities of 

color, including African Americans, Latinos, Native Americans, 

Asian Americans, Native Hawaiians, and Pacific Islanders. These 

activities include treatment of mental health disorders related to 

HIV disease and expansion of service capacity of substance abuse 

treatment and prevention programs that provide services to highrisk communities of color. 

The Committee recommends that SAMHSA address the lack of 

culturally competent substance abuse prevention, education, and 

treatment services, including co-occurring disorders, for the over 12 

million Asian American and Pacific Islander (AAPI) populations in 

the 50 States and the six Pacific Islander jurisdictions by developing a comprehensive strategic plan with input from an AAPI 

Workgroup. The majority of the AAPI populations are immigrant, 

refugee, or indigenous Pacific Islanders with limited access to culturally competent substance abuse services. This SAMHSA strategic plan should implement a special AAPI substance abuse initiative to collect data and document underserved populations, facilitate the development of culturally competent services, including 

117 

replication of evidence-based programs whenever AAPI populations 

are underserved, and to develop a cadre of AAPI substance abuse 

professionals. In carrying out the strategic plan, SAMHSA should 

form partnerships with other appropriate HHS agencies as well as 

the Department of Justice and other agencies with knowledge of or 

experience with substance abuse. 

Center for Mental Health Services 

The Committee provides a program level total of $890,754,000 for 

the Center for Mental Health Services (CMHS), which is 

$28,534,000 above the fiscal year 2004 comparable level and 

$21,748,000 below the budget request. Within the total, 

$21,803,000 is provided through the evaluation set-aside as requested. 

Programs of regional and national significance 

The Committee provides $257,420,000 for mental health pro- grams of regional and national significance, which is $16,624,000 

above the fiscal year 2004 comparable level and $13,128,000 below 

the budget request. The program includes studies that identify the 

most effective service delivery practices, knowledge synthesis activities that translate program findings into useful products for the 

field, and knowledge application projects that support adoption of 

exemplary service approaches throughout the country. The Committee provides $20,000,000 for the State incentive grants for transformation, which is $23,732,000 below the budget 

request. The Committee supports the recommendations made in 

the July 2003 New Freedom Commission on Mental Health’s report 

on transforming mental health care in America. These grants will 

support the development of comprehensive State mental health 

plans that will enhance services and supports to persons with mental illnesses. 

Within funds provided, the Committee has included $30,000,000 

for the National Child Traumatic Stress Initiative. This program 

has established 54 treatment development and community service 

centers to treat children who have experienced trauma. It is estimated that up to 40,000 traumatized children and their families 

will directly benefit from services delivered as a result of this initiative. 

The mental health needs of our Nation’s seniors are largely ignored within our mental health system. Outreach to elderly persons conducted in places frequented by seniors, such as senior centers, meals sites, primary care settings and others is needed. The 

Committee recommends that no less than the level provided in fiscal year 2004 be allocated to continue and expand the work that 

SAMHSA began in prior fiscal years to provide evidence-based 

mental health outreach and treatment services to the elderly. 

Within funds provided, the Committee recommends that no less 

than level allocated in fiscal year 2004 be provided for grants for 

jail diversion programs. This program provides grants to States or 

localities, Indian tribes, and tribal organizations, acting directly or 

through agreements with other public or nonprofit entities, to develop and implement programs to divert individuals with a mental 

illness from the criminal justice system to community-based services. 

118 

The Committee notes that while minorities represent 30 percent 

of the population and are projected to increase to 40 percent of the 

population by 2025, they are significantly underrepresented in the 

field of psychology and other professional mental health disciplines. 

The President’s New Freedom Commission on Mental Health stated that the mental health system should be ‘‘making strong efforts 

to recruit, retain, and enhance an ethnically, culturally, and linguistically competent mental health workforce throughout the 

country.’’ Within the funds provided, the Committee has included 

$5,320,000 for the Minority Fellowship Program. 

The Committee recognizes the need to continue to support grants 

to community-based providers operating in traditional and non-traditional settings who provide direct mental health services to racial 

and ethnic minorities suffering from HIV/AIDS and associated 

mental health problems, including dementia and depression, and 

the chronic, progressive neurological disabilities that often accompany HIV/AIDS. Individuals suffering from HIV/AIDS and co-occurring disorders present unique and unmet treatment needs necessitating specialized training for providers. Therefore, within the level 

provided, the Committee has included funding for training mental 

health professionals to provide integrated mental health and substance abuse services for persons suffering from HIV/AIDS and cooccurring disorders. 

The Committee is deeply concerned that 5% to 9% of all children 

suffer from a mental, behavioral or emotional disorder, which, if 

undiagnosed and untreated, can substantially interfere with academic achievement, or lead to student dropout, substance abuse, 

violent behavior, or suicide. In its July 2003 report, the President’s 

New Freedom Commission on Mental Health concluded that greater reliance on early detection, assessment and links with adequate 

treatment and support systems can help avoid or ameliorate these 

outcomes. The report concluded that schools are in a unique position to identify mental health problems in their early stages and 

can provide a link to appropriate services. The report also cited examples of evidence-based screening techniques and tools already 

being utilized by some schools. The Committee is aware that 

SAMHSA is overseeing a very promising pilot study utilizing evidence-based screening techniques and tools to screen and identify 

teenagers who are at risk. The Committee urges SAMHSA to 

evaluate the effectiveness of that pilot study and, if proven successful, expand to additional sites. The Committee expects SAMSHA to 

work in collaboration with the Office of Safe and Drug-free Schools, 

and to report on concrete steps being taken to promote early 

screening and detection programs available in schools prior to the 

fiscal year 2006 appropriations hearings. 

Mental health block grants 

The Committee provides a program level total of $436,070,000 for 

mental health block grants, which is $1,380,000 above the fiscal 

year 2004 comparable level and the same as the budget request. 

The block grants provide funds to States to support mental health 

prevention, treatment, and rehabilitation services. Funds are allocated according to statutory formula among the States that have 

submitted approved annual plans. The Committee notes that the 

mental health block grant funding represents less than 2 percent 

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of total State mental health funding and less than 3 percent of 

State community-based mental health services. Within the total, 

$21,803,000 is provided through the evaluation set-aside as requested. 

Children’s mental health 

The Committee provides $106,013,000 for the grant program for 

comprehensive community mental health services for children with 

serious emotional disturbance, which is $3,659,000 above the fiscal 

year 2004 comparable level and the same as the budget request. 

Funding for this program supports grants and technical assistance 

for community-based services for children and adolescents up to 

age 22 with serious emotional, behavioral, or mental disorders. The 

program assists States and local jurisdictions in developing integrated systems of community care. Each individual served receives 

an individual service plan developed with the participation of the 

family and the child. Grantees are required to provide increasing 

levels of matching funds over the six-year grant period. 

Grants to states for the homeless (PATH) 

The Committee provides $55,251,000 for the grants to States for 

the homeless (PATH) program, which is $5,491,000 above the fiscal 

year 2004 comparable level and the same as the budget request. 

PATH grants to States provide assistance to individuals suffering 

from severe mental illness and/or substance abuse disorders and 

who are homeless or at imminent risk of becoming homeless. 

Grants may be used for outreach, screening and diagnostic treatment services, rehabilitation services, community mental health 

services, alcohol or drug treatment services, training, case management services, supportive and supervisory services in residential 

settings, and a limited set of housing services. 

Samaritan initiative 

The Committee does not provide funding for the Samaritan Initiative. The budget request is $10,000,000. Legislation authorizing 

this program is pending Congressional action. 

Protection and advocacy 

The Committee provides $36,000,000 for the protection and advocacy program, which is $1,380,000 above the budget request and 

the fiscal year 2004 comparable level. This funding is distributed 

to States according to a formula based on population and income 

to assist State-designated independent advocates to provide legal 

assistance to mentally ill individuals during their residence in 

State-operated facilities and for 90 days following their discharge. 

Center for Substance Abuse Treatment 

The Committee provides a program level total of $2,208,454,000 

for the Center for Substance Abuse Treatment (CSAT), which is 

$10,089,000 above the fiscal year 2004 comparable level and 

$140,813,000 below the budget request. Within the total, 

$83,500,000 is provided through the evaluation set-aside as requested. 

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Programs of regional and national significance 

The Committee provides a program level total of $419,219,000 for 

substance abuse treatment programs of regional and national significance, which is the same as the fiscal year 2004 comparable 

level and $97,813,000 below the budget request. Within the total, 

$4,300,000 is provided through the evaluation set-aside as requested. The program supports activities to improve the accountability, capacity and effectiveness of substance abuse treatment 

services and services delivery. These activities include targeted capacity expansion initiatives to help communities respond to serious, 

emerging and unmet treatment needs and best practices initiatives 

to translate science into services through monitoring and accreditation of treatment programs, training, dissemination and knowledge 

application activities. The program promotes the adoption of 

science- and evidence-based treatment practices by developing and 

field-testing new treatment models in order to facilitate the provision of quality treatment services and service delivery. These activities are undertaken in actual service settings rather than laboratories and results are disseminated to State agencies and community treatment providers. The goal is to promote continuous, 

positive treatment service delivery change for those people who use 

and abuse alcohol and drugs. 

The Committee provides $100,000,000 for the Access to Recovery 

(ATR) substance abuse treatment voucher initiative; this is 

$590,000 more than the fiscal year 2004 level and $100,000,000 

below the budget request. The Committee supports the Administration’s commitment to increase substance abuse treatment capacity, 

consumer choice, and comprehensive treatment options and looks 

forward to hearing from SAMHSA about the various State programs once they have been established. While this is the second 

year of funding for this program, due to the funding cycle, first 

year grants have not yet gone out to States. To the extent that 

data become available, the Committee encourages SAMHSA to report to the Committee regularly on the status of the programs in 

those States that receive ATR funding. 

Substance abuse block grants 

The Committee provides a program level total of $1,789,235,000 

for the substance abuse block grants, which is $10,089,000 above 

the fiscal year 2004 comparable level and $43,000,000 less than the 

budget request. Within the total, $79,200,000 is provided through 

the evaluation set-aside as requested. The substance abuse block 

grants provide funds to States to support alcohol and drug abuse 

prevention, treatment, and rehabilitation services. Funds are allocated among the States according to a statutory formula. State applications including comprehensive State Plans must be approved 

annually by SAMHSA as a condition of receiving funds. 

Center for Substance Abuse Prevention 

Programs of regional and national significance 

The Committee provides $200,000,000 for the substance abuse 

prevention programs of regional and national significance, which is 

$3,982,000 above the budget request and $1,542,000 above the fisVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00120 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
121 

cal year 2004 comparable level. The program identifies and disseminates science-based substance abuse prevention approaches. 

Program management and buildings and facilities 

The Committee provides a program level total of $92,455,000 for 

program management and buildings and facilities, of which 

$16,000,000 is provided through the evaluation set-aside as requested. The fiscal year 2005 level is $540,000 above the fiscal year 

2004 comparable level and the same as the budget request. The appropriation provides funding to coordinate, direct, and manage the 

agency’s programs. Funds are used for salaries, benefits, space, 

supplies, equipment, travel and overhead. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

The Committee provides a total of $303,695,000 for the Agency 

for Healthcare Research and Quality (AHRQ), which is the same as 

the fiscal year 2004 comparable level and the budget request. This 

amount is funded from one percent evaluation funding. 

The mission of the Agency is to generate and disseminate information that improves the delivery of health care. Its research goals 

are to determine what works best in clinical practice; improve the 

cost-effective use of health care resources; help consumers make 

more informed choices; and measure and improve the quality of 

care. 

The Committee provides $245,695,000 for research on health 

costs, quality, and outcomes, which is the same as the fiscal year 

2004 comparable level and the budget request. This program identifies the most effective and efficient approaches to organize, deliver, finance, and reimburse health care services; determines how 

the structure of the delivery system, financial incentives, market 

forces, and better information affects the use, quality, and cost of 

health services; and facilitates the translation of research findings 

for providers, patients, plans, purchasers, and policymakers. It also 

funds research that determines what works best in increasing the 

cost effectiveness and appropriateness of clinical practice; supports 

the development of tools to measure and evaluate health outcomes, 

quality of care, and consumer satisfaction with health care system 

performance; and facilitates the translation of information into 

practical uses through the development and dissemination of research databases. 

Within the total for research on health costs, quality, and outcomes, the Committee provides $84,000,000 for patient safety activities, which is $4,500,000 above the fiscal year 2004 comparable 

level and the same as the budget request. This amount includes 

funding for the patient safety hospital information technology initiative. As part of its patient safety activity, the Committee encourages AHRQ to conduct pilot projects to demonstrate the feasibility 

and value of standards-based electronic health care data interchange. 

The Committee commends AHRQ for its collaborative efforts 

with relevant Federal agencies and with public-private sector partnership groups, and urges AHRQ to continue its cooperative efforts 

to accelerate the adoption and use of standards and technology to 

support quality and safety. 

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The Committee encourages AHRQ to continue and strengthen its 

efforts in comparative clinical effectiveness research, as authorized 

by the Medicare Modernization Act of 2003. 

The cost of health care delivery continues to rise with many 

health care experts predicting double digit increases for the foreseeable future. There is some concern that new biomedical research 

discoveries that provide new remedies for health problems may also 

contribute to higher health care costs when they are used inappropriately. The Committee recognizes the need to ensure that increased investment in biomedical research does not price quality 

health care out of reach of many Americans. Providers, patients 

and health care payers need objective, scientific information to understand which new interventions are more effective than existing 

practices, which groups of patients are most likely to benefit, the 

degree of improvement compared to the cost, and the relative risks 

for the patient of alternative interventions. The Committee suggests that AHRQ expand its efforts to support research and clinical 

effectiveness trials that will develop scientific evidence regarding 

the relative effectiveness, outcomes, risks and costs of promising 

new interventions in comparison with existing practices, especially 

those that have the potential to reduce health care costs without 

reducing quality. 

The Committee encourages AHRQ to study and develop recommendations on the need for standards of care for individuals 

with Duchenne muscular dystrophy, allowing for input from external entities, including parent advocacy programs. In addition, the 

Committee recommends that AHRQ conduct a workshop on standards of care for the muscular dystrophies and coordinate this activity with national advocacy organizations dedicated to this condition. 

The Committee encourages AHRQ to evaluate the outcomes, relevant patient care and financial impact of alternative methodologies of utilization and reimbursement of certified surgical assistances (CSAs) as recommended by the Government Accounting Office and report such outcomes to the Committee. 

The Committee is aware of a significant gap in information that 

is available to expectant mothers regarding umbilical cord blood donation. Cord blood transplants are used to treat a number of conditions, especially diseases of the blood and lymph system such as 

leukemia and lymphoma. The Committee encourages AHRQ to 

study and recommend the appropriate point in maternity care at 

which to provide full information on all cord blood donation options. 

The Committee is aware of an increasing number of non-chemotherapy infused biologicals that are under FDA review or are currently available for the treatment of diseases such as multiple sclerosis. The Committee encourages AHRQ to conduct a study examining changes in the market involving infused biologicals. The report should examine issues such as changes in market demand for 

non-chemotherapy infused therapies, whether health care providers 

have adequate capacity to meet increased demand, the cost to providers for meeting increased demands, geographical variations in 

access and meeting demand (including availability, capacity, barriers and variations in cost to rural providers). In addition, the 

Committee requests that the report examine demand for infused 

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therapies by subspecialty including but not limited to neurology, 

hematology and rheumatology. 

The Committee provides $55,300,000 for the Medical Expenditures Panel Surveys (MEPS), which is the same as the fiscal year 

2004 comparable level and the budget request. The MEPS provide 

data for timely national estimates of health care use and expenditures, private and public health insurance coverage, and the availability, costs, and scope of private health insurance benefits. This 

activity also provides data for analysis of changes in behavior as 

a result of market forces or policy changes on health care use, expenditures, and insurance coverage; develops cost/savings estimates of proposed changes in policy; and identifies the impact of 

changes in policy for subgroups of the population. 

For program support, the Committee provides $2,700,000 which 

is the the same as fiscal year 2004 level and the budget request. 

This activity supports the overall direction and management of the 

agency. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

The Committee provides $119,124,488,000 for the Federal share 

of current law State Medicaid costs, which is $11,767,709,000 

below the fiscal year 2004 comparable level and the same as the 

budget request. This amount does not include $58,416,275,000, 

which was advance funded in the fiscal year 2004 appropriation. In 

addition, the Committee provides an advance appropriation of 

$58,517,290,000 for program costs in the first quarter of fiscal year 

2006. The Committee has also included indefinite budget authority 

for unanticipated costs in fiscal year 2005. 

Federal Medicaid grants reimburse States for 50 to 83 percent 

(depending on per capita income) of their expenditures in providing 

health care for individuals whose income and resources fall below 

specified levels. Subject to certain minimum requirements, States 

have broad authority within the law to set eligibility, coverage, and 

payment levels. Over 43 million low-income individuals will receive 

health care services in 2005 under the Medicaid program. State 

costs of administering the program are matched at rates that generally range from 50 to 90 percent, depending upon the type of cost. 

Total funding for Medicaid includes $1,208,296,000 for the entitlement Vaccines for Children program. These funds, which are transferred to the Centers for Disease Control and Prevention for administration, support the costs of immunization for children who 

are on Medicaid, uninsured or underinsured and receiving immunizations at Federally qualified health centers or rural health clinics. 

Payments to health care trust funds 

The Committee provides $114,608,900,000 for the Payments to 

the Health Care Trust Funds account, which is $19,524,800,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. In addition, as proposed by the Administration, the 

Committee provides a new advance mandatory appropriation of 

$5,216,900,000 to support the first-year costs of the Medicare prescription drug program. 

124 

This entitlement account includes the general fund subsidy to 

the Federal Supplementary Medical Insurance Trust Fund for 

Medicare Part B benefits and for Medicare drug benefits and administration as well as other reimbursements to the Federal Hospital Insurance Trust Fund for benefits and related administrative 

costs which have not been financed by payroll taxes or premium 

contributions. The amount provided includes $215,000,000 for program management administrative expenditures, which is 

$13,900,000 above the fiscal year 2004 estimate of the general fund 

share of CMS program management expenses. This general fund 

share will be transferred to the Federal Hospital Insurance Trust 

Fund to reimburse for the funds advanced by the trust fund in fiscal year 2005 to finance the general fund portion of Program Management. 

Program management 

The Committee makes available $2,746,253,000 in trust funds for 

Federal administration of the Medicare and Medicaid programs, 

which is $109,407,000 above the fiscal year 2004 comparable level 

and $126,000 above the budget request. 

Research, demonstration, and evaluation 

The Committee provides $68,400,000 for research, demonstration and evaluation, which is $9,391,000 below the fiscal year 2004 comparable level and $126,000 above the budget request. These funds 

support a variety of studies and demonstrations in such areas as 

monitoring and evaluating health system performance; improving 

health care financing and delivery mechanisms; modernization of 

the Medicare program; the needs of vulnerable populations in the 

areas of health care access, delivery systems, and financing; and information to improve consumer choice and health status. The reduction below last year’s level is primarily due to the funding of 

one-time projects. 

The Committee is supportive of the clinical investigation of pancreatic islet cell transplantation to be implemented as directed by 

the Medicare Modernization Act of 2003. The Committee encourages CMS and NIH to establish and maintain a close collaboration 

that will ensure the success of this important initiative as it is 

launched in October, 2004. The Committee encourages CMS, in 

working with NIH, to ensure that a sufficient number of Medicare 

beneficiaries participate in the clinical investigation so that the results are applicable to the Medicare population with Type 1 diabetes and Medicare is able to make an informed decision regarding 

broader coverage of pancreatic islet transplantation. 

The Committee is concerned about recent CMS data which show 

that less than one-third of Medicare beneficiaries eligible for diabetes self-management training are receiving the care they need. To 

identify the primary barriers to access in urban and rural settings, 

the Committee encourages CMS to conduct demonstrations to determine the effectiveness of diabetes self-management training and 

the various obstacles to access. 

The Committee urges CMS to study the cost-effectiveness of innovative state dental Medicaid programs for children. The study 

should focus on those programs that have reported improvements 

in access to care through innovative designs that have attracted 

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adequate numbers of dentists and assured improved access for patients. 

Medicare operations 

The Committee provides $1,793,879,000 to support Medicare 

claims processing contracts, which is $92,841,000 above the fiscal 

year 2004 comparable level and the same as the budget request. 

The bill includes a general provision implementing the Administration’s proposal to assess user fees to providers that submit incomplete or duplicate claims. The funds made available for Medicare 

operations will be reduced by $155,000,000 upon enactment of this 

provision. $129,000,000 is included within this account to begin implementation of reforms to the Medicare appeals process, of which 

$50,000,000 will be transferred to the Social Security Administration to conduct Medicare appeals hearings. 

Medicare contractors are responsible for paying Medicare providers promptly and accurately. In addition to processing claims, 

contractors also identify and recover Medicare overpayments, as 

well as review claims for questionable utilization patterns and 

medical necessity. Contractors also provide information and technical support both to providers and beneficiaries regarding the administration of the Medicare program. In 2005, contractors are expected to process over billion claims. 

The Committee understands that CMS has waived the five percent cap on transferring funds among functions as part of a pilot 

with three contractors. The Committee recommends that the waiver be extended to all contractors so they have greater flexibility to 

manage their resources in a manner that best matches programmatic needs and address mid-year addenda to budget instructions, new performance requirements and unanticipated increases 

in workload. The Committee requests CMS to report on its plans 

to extend the waiver to all contractors in its fiscal year 2006 congressional justification. 

Revitalization plan 

The Committee provides $24,400,000, to remain available for two 

years, as the second year of investment in CMS’s efforts to make 

significant improvements to key aspects of managing both the 

agency and the Medicare program. This amount is the same as the 

budget request and $5,219,000 below the fiscal year 2004 comparable level. Funding will target systems-related improvements. 

State survey and certification 

The Committee provides $270,392,000 for State inspections of facilities serving Medicare and Medicaid beneficiaries, which is 

$19,140,000 above the fiscal year 2004 comparable level and the 

same as the budget request. 

Survey and certification activities ensure that institutions and 

agencies providing care to Medicare and Medicaid beneficiaries 

meet Federal health, safety and program standards. On-site surveys are conducted by State survey agencies, with a pool of Federal 

surveyors performing random monitoring surveys. Almost 76,000 

surveys and complaint investigations will be performed in fiscal 

year 2005. 

126 

Federal administration 

The Committee provides $589,182,000 to support Federal administrative activities related to the Medicare and Medicaid programs, 

which is $12,036,000 above the fiscal year 2004 comparable level 

and the same as the budget request. This amount includes 

$13,000,000 for the Healthy Start, Grow Smart program as requested by the Administration. The Committee repeats language 

from last year’s enacted bill to identify $78,300,000 for the contract 

costs of the Health-care Integrated General Ledger Accounting System. The Medicare Modernization Act provided an additional 

$1,000,000,000 to CMS for administration of the new programs created. 

The Medicare, Medicaid, and Children’s Health Insurance programs ensure the health care security of approximately 84 million 

beneficiaries. The Federal Administration budget provides funds 

for the staff and operations of CMS to administer these programs. 

The Committee is concerned that CMS has failed to address a 

substantive inequity over current doctor reimbursement levels in 

the California counties of Santa Cruz, Sonoma, Santa Barbara and 

San Diego. CMS continues to assign these counties to geographic 

adjustment factor Locality 99 despite growing evidence that the geographic practice cost index of these counties exceeds the regulatory parameters for Locality 99 designation. The Committee requests CMS to report to the Committee by January 1, 2005 a plan 

to correct this discrepancy via action at the Federal level. 

The Committee recognizes the importance of the State Medicare 

Carrier Advisory Committees (CACs) in the formation of local coverage policies issued by Medicare Part B Carriers. The Committee 

is concerned about the inconsistency of policies issued by Medicare 

Part B carriers in relation to interventional pain management services, and the lack of representation by interventional pain physicians. Given the growing concern over interventional pain management, the Committee believes it is important for the CACs to have 

the information necessary to develop appropriate policies to ensure 

access to pain management interventions that can make a difference in the quality of life for those who suffer from persistent 

pain. The Committee urges CMS to expand the number of required 

specialities to include interventional pain management representation on the state CACs. 

The Committee is concerned that Medicare patients with rare 

diseases may have difficulties accessing care that involves orphan 

drugs. The Committee encourages CMS to carefully consider the 

impact on this population in proposing regulations. The Committee 

encourages the Administrator to solicit the views of the FDA Office 

of Orphan Products Development and the NIH Office of Rare Diseases, as well as stakeholder groups, before determining whether 

an access problem exists or would be made worse by proposed regulations. 

The Committee is concerned about the reimbursement levels that 

the Medicare program provides for immunizations. Many States 

apply these rates to the immunizations for their Medicaid programs, which may affect the availability of childhood immunizations. The Committee encourages CMS to review its Medicare immunization rate policy and consider whether reimbursements 

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should be tied more specifically to the number of immunizations 

administered in a single office visit. 

The Committee supports the proposed Hospital CAHPS patient 

satisfaction survey, which is intended to create comparable public 

reporting of hospitals’ patient perspectives on consumer choice and 

hospital accountability. The Committee is aware that the survey 

may create time and cost burdens for hospitals and encourages 

CMS to be sensitive to these issues as it continues the development 

of the survey. 

The Committee is aware of changes being developed by CMS to 

alter the Medicare coverage policy for power mobility devices including power wheelchairs. The Committee was disturbed earlier 

this year by the examples of claims for this benefit being denied 

by CMS contractors based on an excessively narrow interpretation 

of what constitutes ‘‘nonambulatory.’’ The Committee strongly encourages CMS to use its resources toward development of a coverage policy firmly based on a functional standard of nonambulatory. The Committee believes beneficiaries who cannot perform their basic acts of daily living, toileting, food preparation and 

emergency egress, are nonambulatory and must have access to this 

mobility benefit to function independently. The Committee supports controlling fraud and abuse through requirements that ensure proper substantiation of medical need for this equipment but 

does not support narrowing the definition of nonambulatory to exclude the elderly and disabled dependent on these devices to function in the home. The Committee believes that the medically necessary application of this mobility benefit can save Medicare money 

through cost-avoidance associated with expensive institutional care 

or hospitalization resulting from falls by the growing elderly population. 

The Committee encourages CMS to examine the unintended consequences current reimbursement policies have on restricting access and utilization of oral anti-cancer therapies through the Part 

B drug payment policies. Oral anti-cancer medications can offer 

clinical equivalency if not superiority to infusion therapies while 

providing broader benefits to patients, providers and payers. In 

providing effective cancer treatment, oral anti-cancer drugs benefit 

patients from greater convenience, flexibility and less adverse side 

effects compared to conventional infusion treatment. Payers benefit 

from an overall cost savings to the health system and providers can 

make appropriate treatment decisions without the deterrence of 

economic barriers. Availability of oral anti-cancer therapies may be 

important in rural areas where patients who are appropriate candidates as determined by their physicians may benefit from such 

care. Therefore, CMS is encouraged to evaluate reimbursement 

policies in order to ensure parity for such oral therapies. 

The Committee encourages CMS to develop policies to permit 

independent billing and payments to Certified Paramedic Intercept 

Providers delivering medically necessary and requested advanced 

life support (ALS). Such a policy would apply to services in ambulance transportation operated by public, non-profit or volunteer ambulance entities that qualified under Title XVIII of the Social Security Act and that offer only ‘‘basic life support services.’’ The Certified Paramedic Intercept Provider would not have to bill via the 

ambulance transportation entity, and the ambulance transportation 

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entity could not bill, at the same time, for the advance life support 

intercept. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

The Committee provides $2,873,802,000 for the Child Support 

Enforcement program, the same as the budget request. The bill 

also provides $1,200,000,000 in advance funding for the first quarter of fiscal year 2006 to ensure timely payments for the child support enforcement program, the same as the request. The bill continues to provide estimated funding of $23,000,000 for Payments to 

Territories, the same as the fiscal year 2004 level and the budget 

request. The bill provides $1,000,000 for the repatriation program, 

the same as the fiscal year 2004 level and the budget request. 

LOW-INCOME HOME ENERGY ASSISTANCE

The Committee provides an appropriation of $2,227,000,000 for Low-Income Home Energy Assistance. This is $111,044,000 more 

than the fiscal year 2004 comparable level and $64,700,000 below 

the budget request. The Committee provides $1,900,000,000 of 

these funds through the regular formula program and $100,000,000 

in contingent emergency funding through the Department of 

Health and Human Services and $227,000,000 for weatherization 

assistance grants through the Department of Energy. The budget 

request included $1,800,500,000 in formula grants, $200,000,000 in 

contingent emergency funding, and $291,200,000 in weatherization 

assistance. 

Within the funds provided, $227,000,000 is provided for the 

weatherization assistance program to be transferred to the Department of Energy. This program increases the energy efficiency of 

dwellings owned or occupied by low-income persons to reduce their 

overall total residential energy expenditures. This program had 

been previously funded through the Interior Subcommittee Appropriations Act, but was transferred to the jurisdiction of the Labor, 

HHS, and Education Subcommittee in June of 2004. 

The weatherization assistance program has not been evaluated 

fully in over 10 years. The Committee was pleased by the last evaluation, performed by Oak Ridge National Laboratory (ORNL), and 

encourages the Department of Energy to contract with ORNL for 

an up-to-date assessment. 

The low-income home energy assistance program (LIHEAP), administered by the Department of Health and Human Services, provides assistance to low-income households to help pay the costs of 

home energy. Funds are provided through grants to States, Indian 

Tribes and territories, and are used for summer cooling and winter 

heating/crisis assistance programs. 

REFUGEE AND ENTRANT ASSISTANCE

The Committee provides $491,336,000 for refugee assistance programs. This is $43,738,000 more than the fiscal year 2004 level and 

$18,097,000 more than the budget request. 

In addition, the bill provides the Office of Refugee Resettlement 

(ORR) the authority to carry over unexpended funds from fiscal 

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year 2005 to reimburse the costs of services provided through September 30, 2007 for all programs within ORR’s jurisdiction. 

Transitional and medical services 

The Committee provides $193,577,000 for transitional and med- ical services. This is $24,602,000 more than the fiscal year 2004 

comparable level and the same as the budget request. The transitional and medical services program provides funding for the Stateadministered cash and medical assistance program that assists refugees who are not categorically eligible for TANF or Medicaid, the 

unaccompanied minors program that reimburses States for the cost 

of foster care, and the voluntary agency grant program in which 

participating National refugee resettlement agencies provide resettlement assistance with a combination of Federal and matched 

funds. 

Victims of trafficking 

The Committee provides up to $10,000,000 for the victims of traf- ficking program. This is $91,000 more than the fiscal year 2004 

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

will ensure continued administration of a National network for 

identification, tracking and certification of trafficking victims. 

Social services 

The Committee provides $166,218,000 for social services. This is $15,097,000 more than the budget request and $14,000,000 more 

than the fiscal year 2004 level. Funds are distributed by formula 

as well as through the discretionary grant making process for special projects. The Committee intends that funds provided above the 

request shall be used for Refugee School Impact Grants and for additional assistance in resettling and meeting the needs of the 

Hmong refugees expected to arrive during 2004 and 2005. 

Within the funds provided, the Committee has included $19,000,000 for increased support to communities with large concentrations of Cuban and Haitian refugees of varying ages whose 

cultural differences make assimilation especially difficult, justifying 

a more intense level and longer duration of Federal assistance for 

healthcare and education. 

Preventive health 

The Committee provides $4,835,000 for preventive health services. This is $43,000 more than the fiscal year 2004 comparable 

level and the same as the budget request. These funds are awarded 

to the States to ensure adequate health assessment activities for 

refugees. 

Targeted assistance 

The Committee provides $49,477,000 for the targeted assistance 

program. This is $452,000 more than the fiscal year 2004 comparable level and the same as the budget request. These grants 

provide assistance to areas with high concentrations of refugees. 

Unaccompanied minors 

The Committee provides $54,229,000 for the unaccompanied minors program. This is $1,459,000 more than the fiscal year 2004 

130 

comparable level and the same as the budget request. Funds were 

transferred to the Office of Refugee Resettlement (ORR) in fiscal 

year 2003 from the Immigration and Naturalization Service pursuant to section 462 of the Homeland Security Act. The program is 

designed to provide for the care and placement of unaccompanied 

alien minors who are apprehended in the U.S. pending resolution 

of their claims for relief under U.S. immigration law or released to 

an adult family member or responsible adult guardian. 

The Committee is pleased with the progress that ORR has made 

in taking responsibility for this important program, especially the 

significant improvements in the treatment of unaccompanied alien 

children, including improvements in their placements and in the 

healthcare provided to them. The Committee intends that the 

funds provided by this appropriation be used, in part, to increase 

the number of juvenile coordinators in the program and to continue 

improvements in the provision of healthcare, including mental 

health care, to children in the program. 

The Committee is concerned about some aspects of the transition 

of unaccompanied alien children functions from the INS to ORR, 

especially reports that not all unaccompanied alien children are 

making their way into the custody of ORR as was intended when 

Congress enacted the Homeland Security Act of 2002. The Committee directs ORR, in consultation with all appropriate Federal 

agencies, to report to the Committee within 90 days of the date of 

enactment of this Act, instances since March 1, 2003, in which Federal agencies have not promptly notified ORR that it has unaccompanied alien children in their custody and have not made arrangements for the prompt transfer of such children to ORR’s care. 

The Committee is also aware of reports that the Department of 

Homeland Security (DHS) is not fully cooperating with ORR on release decisions and directs ORR, in cooperation with DHS, to report 

to this Committee on its formal arrangements with DHS on release 

decisions. 

Victims of torture 

The Committee provides $13,000,000 to provide a comprehensive 

program of support for domestic centers and programs for victims 

of torture. This is $3,091,000 more the fiscal year 2004 level and 

$3,000,000 more than the budget request. 

The Committee expects that the Office of Refugee Resettlement 

should give priority to specialized treatment programs that provide 

services for the rehabilitation of victims of torture, including treatment of the physical and psychological effects of torture. To meet 

the need of the over 400,000 victims of torture living in the United 

States, it is critical to invest in specialized treatment programs 

which, in turn, can offer essential training to general health care 

programs throughout the country. 

CHILD CARE AND DEVELOPMENT BLOCK GRANT

The bill includes $2,099,729,000 for the Child Care and Development Block Grant program, an increase of $12,419,000 above the 

fiscal year 2004 comparable level and the same as the budget request. 

The Child Care and Development Block Grant program was 

originally enacted in the Omnibus Budget Reconciliation Act of 

131 

1990 to increase the availability, affordability and quality of child 

care by providing funds to States, Territories and Indian Tribes for 

child care services for low-income families. The authorization for 

mandatory appropriations for childcare in the amount of 

$2,717,000,000 is also requested for fiscal year 2005. 

SOCIAL SERVICES BLOCK GRANT

The Committee provides $1,700,000,000 for the social services 

block grant (SSBG). This is the same as the fiscal year 2004 level 

and the budget request. 

SSBGs are designed to encourage States to furnish a variety of 

social services to needy individuals to prevent and reduce dependency, help individuals achieve and maintain self-sufficiency, prevent or reduce inappropriate institutional care, secure admission or 

referral for institutional care when other forms of care are not appropriate, and prevent neglect, abuse and exploitation of children 

and adults. 

Funds are distributed to the territories in the same ratio such 

funds were allocated in fiscal year 1981. The remainder of the appropriation is distributed to the States and the District of Columbia according to population. 

The bill includes a provision that modifies the percentage of 

funds that a State may transfer between the Social Services Block 

Grant and the Temporary Assistance to Needy Families programs 

to 4.5%. 

CHILDREN AND FAMILY SERVICES PROGRAMS

The Committee provides a program level total of $8,996,145,000 for children and family services programs. This is $144,146,000 

more than the fiscal year 2004 comparable level and $114,380,000 

less than the budget request. Within the total provided, 

$10,482,000 is provided through the evaluation set-aside. This account finances a number of programs aimed at enhancing the wellbeing of the Nation’s children and families, particularly those who 

are disadvantaged or troubled. 

Head Start 

The bill includes $6,898,580,000 for the Head Start program for fiscal year 2005, an increase of $123,732,000 over the fiscal year 

2004 amount and $45,000,000 below the budget request. Of this 

total, the Committee continues the policy of advancing 

$1,400,000,000 of this account into fiscal year 2006. 

Head Start provides comprehensive development services for 

children and their families. Intended for preschoolers from low-income families, the program seeks to foster the development of children and enable them to deal more effectively with both their 

present environment and later responsibilities in school and community life. Head Start programs emphasize cognitive and language development, 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 ten percent of enrollment opportunities in each State are made available to handicapped children. 

Grants to carry out Head Start programs are awarded to public 

and private non-profit agencies. Grantees must contribute 20 perVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00131 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
132 

cent of the total cost of the program; this is usually an in-kind contribution. The Head Start Act does not include a formula for the 

allotment of funds to local grantees; however, it does require that 

87 percent of the appropriation be distributed among States based 

on a statutory formula. In addition, grants, cooperative agreements 

and contracts are awarded in the areas of research, demonstration, 

technical assistance and evaluation from the remaining 13 percent. 

The Committee has learned that while most local grantees are 

working to ensure federal Head Start funds are spent directly on 

preparing disadvantaged children for kindergarten, others appear 

to be billing Head Start for lavish salary and compensation packages for their top executives. In response to this information, the 

Committee has included a general provision limiting the compensation of an individual working in Head Start to the Federal Executive Level II salary. The Committee routinely includes similar language with respect to Job Corps and NIH executives. 

The Committee is aware that only 19% of the children eligible for 

Migrant and Seasonal Head Start (MSHS) are able to access services due to limited funding in contrast to Regional Head Start programs that are able to serve 60% of their eligible children. Existing 

MSHS programs maintain significant wait lists and, in many areas 

of the country, there are not MSHS programs to provide services 

to migrant farmworker children when they move into a state. The 

Committee directs the department, within 90 days of enactment of 

the bill, to provide a plan to the Committee describing how it intends to serve a greater percentage of migrant children. 

The Committee recognizes that there is concern among the educational and Head Start community about the administration of a 

standardized test for 4- and 5-year olds. The Committee directs the 

Department of Health and Human Services to submit the report 

from the independent panel appointed in March of 2004 assessing 

the effectiveness of the National Reporting System no later than 

November 30, 2004. 

The Committee notes that the current Head Start Act includes 

the provision of training and technical assistance in the area of 

family literacy services—a provision that is retained in both House 

and Senate versions of Head Start reauthorization legislation. Absent the enactment of reauthorization legislation, the Committee 

encourages the Secretary to ensure the continuity of the important 

services that are being provided through the Head Start Family 

Literacy Project. 

The Committee encourages the Head Start Bureau and the Maternal and Child Health Bureau to continue and expand their successful interagency agreement to jointly address dental disease. 

Consolidated runaway and homeless youth program 

The Committee provides $89,447,000 for runaway and homeless 

youth activities, an increase of $16,000 more than the fiscal year 

2004 comparable level and the same as the budget request. The 

Runaway, Homeless, and Missing Children Protection Act of 2003 

reauthorized the runaway and homeless youth programs and established a statutory formula distribution between the Basic Center 

Program and the Transitional Living Program. 

The runaway and homeless youth programs provide grants to 

local public and private organizations to establish and operate runVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00132 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
133 

away and homeless youth shelters to address the crisis needs of 

runaway and homeless youth and their families. Grants are used 

to develop or strengthen community-based shelters, which are outside the law enforcement, juvenile justice, child welfare, and mental health systems. 

It is the Committee’s expectation that current transitional living 

program grantees will continue to provide transitional living opportunities and supports to pregnant and parenting homeless youth, 

as is their current practice. To further ensure that pregnant and 

parenting homeless youth are able to access transitional living opportunities and supports in their communities, the Committee encourages the Secretary, acting through the network of federallyfunded runaway and homeless youth training and technical assistance providers, to offer guidance to grantees and others on the programmatic modifications required to address the unique needs of 

pregnant and parenting youth and on the various sources of funding available for residential services to this population. 

Maternity group homes 

The Committee has not included funding for this new program. 

The budget request is $10,000,000. 

The Committee is aware of the need for and shares the Administration’s interest in funding residential services for young mothers 

and their children who are unable to live with their own families 

because of abuse, neglect, or other circumstances. The Committee 

notes that pregnant and parenting youth are currently eligible for 

and served through the Transitional Living Program. 

Prevention grants to reduce abuse of runaway youth 

The Committee provides $15,302,000 for prevention grants to reduce abuse of runaway youth. This is the same as the fiscal year 

2004 level and the budget request. This program is designed to reduce the sexual abuse of runaway youth by providing grants to 

support street-based outreach and education to runaway, homeless, 

and street youth who have been sexually abused or who are at-risk 

of sexual abuse, in order to connect these young people with services so that they have a chance for a safe and healthy future. The 

street outreach program ensures rapid engagement with young people in an effort to prevent the most terrible situations that take 

place when they are subjected to life on the streets—physical and 

sexual abuse, assault, commercial sexual exploitation, disease, 

long-term homelessness, and even death. 

Child abuse State grants and discretionary activities 

For child abuse State grants and discretionary activities, the 

Committee provides $54,570,000. This is $1,519,000 less than the 

fiscal year 2004 level and $13,529,000 less than the budget request. 

Within this total, the recommendation includes $28,484,000 for 

State grants, which is $6,601,000 more than the fiscal year 2004 

level and $13,529,000 less than the budget request and $26,266,000 

for child abuse discretionary activities which is the same as the 

budget request. 

134 

Community-based child abuse prevention 

The Committee provides $43,205,000 for community-based child abuse prevention. This is $10,000,000 more than the fiscal year 

2004 comparable level and $21,797,000 less than the budget request. The Keeping Children and Families Safe Act of 2003 reauthorized and renamed this program and added voluntary home visiting programs as a core local service. Funds are provided to lead 

State agencies and are used to develop, operate, expand, and enhance community-based efforts to strengthen and support families 

in order to prevent child abuse and neglect. 

Abandoned infants assistance 

The Committee provides $12,086,000 for the Abandoned Infants Assistance Act. This is $34,000 more than the fiscal year 2004 comparable level and the same as the budget request. The purpose of 

this program is to provide financial support to public and private 

community and faith-based entities to develop, implement, and operate demonstration projects that will prevent the abandonment of 

infants and young children exposed to HIV/AIDS and drugs; identify and address their needs; assist such children to reside with 

their natural families or in foster care; recruit, train and retain foster parents as well as health and social services personnel; provide 

respite care for families and foster families; and prevent the abandonment of infants and young children. 

Child welfare services and training 

The Committee provides $291,986,000 for child welfare services. This is $2,666,000 more than the fiscal year 2004 comparable level 

and the same as the budget request. This program, authorized by 

title IV B of the Social Security Act, provides grants to States to 

assist public welfare agencies to improve child welfare services. 

State services include preventive intervention in order for children 

to stay in their homes, alternative placement like foster care or 

adoption if it is not possible for children to remain at home, and 

reunification programs so that, if appropriate, children can return 

home. 

The Committee provides $7,470,000 for child welfare training. This is $59,000 more than the fiscal year 2004 level and the same 

as the budget request. The Committee recognizes the need for 

trained, skilled and qualified child welfare service workers. This 

program provides grants to institutions of higher education to develop and improve education and training programs and resources 

for child welfare service providers as well as students seeking degrees in social work. 

Adoption opportunities 

The Committee provides $27,343,000 for adoption opportunities. 

This is $240,000 more than the fiscal year 2004 level and the same 

as the budget request. The Adoption Opportunities Program provides funding specifically targeted to improving the adoption of 

children, particularly those with special needs, and for providing 

for innovative services that support families involved in adoption. 

Minority and low-income foster children are the largest population of foster children nationwide and the hardest to place in 

homes. The Committee recognizes the positive impact of faithVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00134 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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based adoption organizations, such as One Church One Child, who 

specifically target minority populations in underserved communities. By providing adoption services and education to minority 

church communities to be paired with foster children, organizations 

such as One Church One Child bring together families and children 

who may not otherwise have access to adoption services. 

The Committee encourages the Department of Health and 

Human Services to expand funding opportunities for faith-based 

adoption programs such as One Church One Child to enhance their 

capacity to provide community-based counseling and mentoring 

programs to minority and low-income foster children and provide 

case management and wraparound support services to adoptive 

and foster children and their families to promote positive child, 

youth and family development. 

Adoption incentives 

The Committee provides $32,103,000 for the adoption incentives 

program. This is $24,647,000 more than the fiscal year 2004 appropriated level and the same as the budget request. The Adoption 

Promotion Act of 2003 reauthorized this program and now targets 

incentives specifically for older children. Funds are awarded to 

States using three baselines: one for the total number of children 

adopted, one for children with special needs under the age of nine, 

and one for children aged nine and older. The goal of this program 

is to increase the number of adoptions nationwide. 

Adoption awareness 

The Committee provides $12,906,000 for the adoption awareness 

program. This is the $121,000 more than the fiscal year 2004 comparable level and the same as the budget request. This program 

was authorized in the Children’s Health Act of 2000. The adoption 

awareness program provides training to designated staff of eligible 

health centers in providing adoption information and referrals to 

pregnant women on an equal basis with all other courses of action 

included in non-directive counseling to pregnant women. 

Compassion capital fund 

The Committee provides $55,000,000 for the compassion capital 

fund. This is $7,298,000 more than the fiscal year 2004 comparable 

level and $45,000,000 less than the budget request. This program 

supports the creation of grants to public/private partnerships to 

support charitable organizations in expanding or emulating model 

social services agencies and provides capacity-building funds directly to faith- and community-based organizations. 

Social services and income maintenance research 

The Committee provides $5,982,000 for social services and income maintenance research through the evaluation set-aside. This 

is the same level as the budget request and $13,186,000 less than 

the fiscal year 2004 comparable level. The budget request provided 

this funding through direct appropriation. These funds support research, demonstration, evaluation and dissemination activities. 

Areas covered include welfare reform, childcare, and child welfare. 

136 

Developmental disabilities 

For programs authorized by the Developmental Disabilities Assistance and Bill of Rights Act of 2000 as well as by the Help 

America Vote Act, the Committee provides $164,942,000. This is 

$170,000 more than the fiscal year 2004 level and $88,000 more 

than the budget request. The account total includes $73,081,000 for 

allotments to the States to fund State Councils, the same as the 

budget request and the fiscal year 2004 level. These Councils engage in such activities as planning, policy analysis, demonstrations, 

training, outreach, interagency coordination, and public education. 

They do not provide direct services to the developmentally disabled 

population. 

In addition, $38,416,000 will be available to the States to be used 

for operating a protection and advocacy system to protect the legal 

and human rights of the developmentally disabled. This is the 

same as the budget request and the fiscal year 2004 level. 

The Committee provides $15,000,000 for Disabled Voter programs. This is $89,000 more than the fiscal year 2004 level and 

$88,000 more than the budget request. Within the funds provided, 

$10,000,000 is available for payments to States to promote access 

for voters with disabilities and $5,000,000 is available for State 

protection and advocacy systems. The Disabled Voter programs are 

intended to make polling places accessible and provide equal access 

and participation for individuals with disabilities. The protection 

and advocacy program will ensure that individuals can fully participate in the electoral process, including registering to vote, accessing polling places, and casting a vote. 

The Committee provides $11,642,000 for developmental disabilities projects of National significance. This is $81,000 more than 

the fiscal year 2004 funding level and the same as the budget request. 

The Committee provides a total of $26,803,000 for university centers for excellence in developmental disabilities. This is the same 

as the fiscal year 2004 level and the budget request. These are discretionary grants to public or not-for-profit entities associated with 

universities. These grants provide basic operational and administrative core support for these agencies. In addition, these funds 

support interdisciplinary training, community services, research 

and technical assistance and information dissemination. 

Native American programs 

The Committee provides $45,155,000. This is the same as the 

budget request and $2,000 less than the fiscal year 2004 level. The 

Native American program assists Tribal and Village governments, 

Native American institutions and organizations to support and develop stable, diversified local economies. In promoting social and 

economic self-sufficiency, this organization provides financial assistance through direct grants for individual projects, training and 

technical assistance, and research and demonstration programs. 

Community Services 

The Committee provides $710,088,000 for Community Services 

activities. This is $157,738,000 more than the budget request and 

$21,196,000 less than the fiscal year 2004 level. 

137 

State block grant 

For the State Block Grant, the Committee provides $627,500,000. This is $132,554,000 more than the budget request and 

$14,435,000 less than the fiscal year 2004 comparable level. This 

program provides grants to States, territories and Indian Tribes for 

services to meet employment, housing, nutrition, energy, emergency services, and health needs of low-income people. By law, 90 

percent of these funds are passed directly through to local community action agencies that have previously received block grant 

funds. 

The Committee directs the Secretary to prepare a 3-year strategic plan for the Office of Community Services use of Training and 

Technical Assistance funds in the fiscal years 2005–2008. The plan 

should be developed with the guidance of entities experienced in 

providing effective research and training support to the Community 

Services Block Grant agency network and should be provided to the 

Community by no later than June 15, 2005. The Committee further 

encourages Training and Technical Assistance funding appropriated for fiscal year 2005 to be used for activities to carry out corrective action and monitoring activities (including the development 

of reporting systems and electronic data systems) to assist States 

in continuing to improve their local programs. 

Community economic development 

The Committee provides $32,492,000 for community economic de- velopment grants. This is $154,000 more than the fiscal year 2004 

level and the same as the budget request. These activities provide 

assistance to private, locally-initiated community development corporations that sponsor enterprises providing employment, training 

and business development opportunities for low-income residents in 

poor communities. Within the total, $5,481,000 is provided for the 

Job Opportunities for Low-Income Individuals program, which provides competitive grant to non-profit organizations to create new 

employment and business opportunities for TANF recipients and 

other low-income individuals. 

It has come to the attention of the Committee that the Department has established a number of set-asides within the community 

economic development program. Given the limited amount of funds 

available, it is the Committee’s view that the number of set-asides 

should be substantially reduced. Further, the Committee reminds 

the Department that the principal purpose of the program is making grants of qualified community development with a record of 

achievement in working in distressed urban and rural communities. The Committee believes that special emphasis should be 

placed on providing financial and technical assistance to local businesses and start-ups. Finally, the Committee directs that of funds 

allocated for Job Creation Demonstration, not more than $500,000 

be set-aside for program support and technical assistance. 

Individual development account 

The Committee provides $24,912,000 for individual development 

accounts. This is $217,000 more than the fiscal year 2004 level and 

the same as the budget request. Individual development accounts 

are dedicated savings accounts that can be used by families with 

limited means for purchasing a first home, paying for postsecVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00137 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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ondary education or capitalizing a business. The intent of the program is to encourage participants to develop and reinforce strong 

habits for saving money. 501(c)(3) organizations are eligible to 

apply for the funds and applicants must match Federal funds with 

non-Federal funds. 

Rural community facilities 

The Committee provides $7,184,000 for the rural community facilities program. This is the same as the fiscal year 2004 amount. 

No funding was requested for this program. The Committee includes these funds to be used solely for the purpose of improving 

water and wastewater facilities in poor, rural communities. As in 

the past, these funds should be allocated to regional, rural community assistance programs. 

National youth sports program 

The Committee provides $18,000,000 for the National Youth 

Sports program. This is $106,000 more than the fiscal year 2004 

level. No funds were requested for this program. These funds are 

made available to a private, non-profit organization to provide recreational activities for low-income youth, primarily in the summer 

months. College and university athletic facilities are employed in 

the program. 

Community food and nutrition 

The Committee concurs with the budget request not to include 

funding for the Community Food and Nutrition program. The fiscal 

year 2004 funding level for this program is $7,238,000. This program provides grants to public and private agencies to coordinate 

existing food assistance programs, to identify sponsors of child nutrition programs and attempt to initiate new programs and to do 

advocacy work at the State and local levels. 

Violent crime reduction programs 

The Committee provides $125,648,000 for family violence prevention and services and battered women’s shelters. This is the same 

as the budget request and the fiscal year 2004 level. This program 

is designed to assist States and Indian Tribes in efforts to prevent 

family violence and to provide immediate shelter and related assistance for victims of family violence and their dependents, and to 

provide for technical assistance and training relating to family violence programs to State and local public agencies (including law enforcement agencies), nonprofit private organizations, and persons 

seeking such assistance. 

The Committee also includes $3,000,000 to continue funding the 

National Domestic Violence Hotline. This is $18,000 more than the 

fiscal year 2004 level and the same as the budget request. 

Early Learning Fund 

The Committee concurs with the budget request and does not 

provide funding for the Early Learning Fund. The fiscal year 2004 

level for this program is $33,580,000. This program was begun in 

fiscal year 2001 to help facilitate the development of learning readiness in young children. 

139 

Faith-based center 

The Committee provides $1,400,000 for the faith-based center. 

This is the same as the budget request and $14,000 more than the 

fiscal year 2004 level. The center will support implementation of 

faith-based and community initiatives in accordance with the President’s executive order. 

Mentoring children of prisoners 

The Committee provides $50,000,000 for the mentoring children 

of prisoners program. This is $299,000 above the fiscal year 2004 

level and the same as the budget request. This program supports 

competitively awarded grants to States and local governments, Indian tribes and consortia, and faith- and community-based organizations to mentor children of prisoners and those recently released 

from prison. 

Independent living training vouchers 

The Committee provides $50,000,000 for independent living 

training vouchers. This is $5,266,000 more than the fiscal year 

2004 level and $10,000,000 less than the budget request. These 

funds support vouchers for college tuition or vocational training for 

individuals who age out of the foster care system, so they can be 

better prepared to live independently. 

Promotion of responsible fatherhood and healthy marriages 

The Committee does not include funding for the promotion of responsible fatherhood and healthy marriages program. The budget 

request is $50,000,000. Legislation authorizing this program is 

pending Congressional action. 

Abstinence education 

The Committee provides a program level total of $109,546,000 for 

the community-based abstinence education program, which is 

$34,997,000 above the fiscal year 2004 comparable level and 

$76,880,000 below the budget request. Within the total, $4,500,000 

is provided through the evaluation set-aside as requested. The program provides support to public and private entities for implementation of community-based abstinence education programs for adolescents aged 12 through 18. The entire focus of these programs is 

to educate young people and create an environment within communities that supports teen decisions to postpone sexual activity until 

marriage. There is no funding match requirement for these grants. 

The Committee intends that up to five percent of these funds be 

used to provide technical assistance and capacity-building support 

to grantees. 

Within the total for abstinence education, $10,000,000 may be 

used to carry out a National Abstinence Education Campaign. 

Funds were requested for this initiative within the Office of the 

Secretary. The campaign is entitled the ‘‘Responsible Choices Campaign’’ and it will help parents communicate with their children 

about the health risks associated with premarital sexual activity. 

This new initiative will also increase awareness on the importance 

of parental involvement and will develop strategies on strengthening families through effective communication. 

140 

The Committee supports abstinence education (as defined in sections (A) through (H) of Title 5, section 510(b)(2) of the Social Security Act) for adolescents ages 12 through 18, and supports expansion of efforts to present this abstinence message to America’s 

youth. Results from these programs are promising. It is important, 

however, to ensure that America’s youth do not receive mixed messages, or medically inaccurate information. Abstinence messages to 

a group of youth by a grantee must not be diluted by any instructor 

or materials from the same grantee. Nothing in the legislation is 

intended to prevent these adolescents from seeking health information or services. Nothing shall preclude entities that have a public 

health mandate from discussing other forms of sexual conduct or 

providing services, as long as this is conducted in a different setting than where and when the abstinence-only course is being conducted. In allocating grant funds, priority should be given to those 

organizations that have a strong record of support of abstinence 

education as defined in sections (A) through (H) of Title 5, section 

510(b)(2) of the Social Security Act. 

The Committee is committed to studying the effectiveness of abstinence education. In order to track the long-term effects of these 

programs properly, it is necessary to conduct longitudinal studies 

that, for a number of years, follow groups of individual adolescents 

who receive a particular curriculum. Therefore, the Committee provides $4,500,000 of funding under Public Health Service evaluation 

funds to study, track, and evaluate youth who receive such education. If possible, these cohorts should be large enough to provide 

statistically significant results in all major population segments of 

American society, including African-Americans, Asians, Caucasians, Hispanics and Native Americans. They should also be able 

to track socio-economic variables as well. All appropriate parental 

consent, age-appropriateness and privacy guidelines should be followed. Criteria for success should include: prevention and reduction 

of adolescent pregnancies and sexually transmitted disease infection, including both viral and bacterial; age at first sexual-activity 

and intercourse; frequency of sexual activity and intercourse; and 

numbers who postpone sexual activity or intercourse through adolescence. Progress reports should be submitted to Congress annually. 

Program direction 

The Committee provides $190,206,000 for program direction expenses for the Administration for Children and Families. This is 

$12,312,000 more than the fiscal year 2004 level and the same as 

the budget request. 

PROMOTING SAFE AND STABLE FAMILIES

The Committee provides $410,000,000 for the promoting safe and stable families program. This is $5,617,000 more than the fiscal 

year 2004 level and $95,000,000 less than the budget request. 

PAYMENTS TO STATES FOR FOSTER CARE AND ASSISTANCE

The Committee provides $5,037,900,000 for payments to States 

for foster care and adoption assistance. This is $30,400,000 less 

than the fiscal year 2004 level and the same as the budget request. 

The bill also includes an advance appropriation of $1,767,200,000 

141 

for the first quarter of fiscal year 2006 to ensure timely completion 

of first quarter grant awards. 

Of the total appropriation, including the advance appropriation from the prior year, the Committee provides $4,895,500,000 for the 

foster care program to provide maintenance payments to States on 

behalf of children who must live outside their homes. This is the 

same as the budget request and $78,700,000 less than the fiscal 

year 2004 level. 

Within the total appropriation, the Committee provides $1,770,100,000 for adoption assistance. This is $70,400,000 more 

than the fiscal year 2004 level and the same as the budget request. 

This program provides training for parents and State administrative staff as well as payments on behalf of categorically eligible 

children considered difficult to adopt. This annually appropriated 

entitlement is designed to provide alternatives to long, inappropriate stays in foster care by developing permanent placements 

with families. 

Within the total appropriation for this account, the Committee provides $140,000,000 for the independent living program. This is 

the same as the fiscal year 2004 level and the budget request. The 

program is designed to assist foster children age 16 or older to 

make successful transitions to independence. Funds assist children 

to earn high school diplomas, receive vocational training, and obtain training in daily living skills. Funds are awarded to States on 

the basis of the number of children on behalf of whom Federal foster care payments are received. 

ADMINISTRATION ON AGING

AGING SERVICES PROGRAMS

For programs administered by the Administration on Aging, the Committee provides a total of $1,403,479,000. This is $29,562,000 

more than the fiscal year 2004 level and $26,952,000 more than the 

budget request. This account finances all programs under the Older 

Americans Act in this bill, with the exception of the Community 

Services Employment Program, which is administered by the Department of Labor. 

Supportive services and centers 

The Committee provides $357,000,000 for supportive services and 

centers. This is $3,111,000 more than the fiscal year 2004 level and 

the same as the budget request. Funds for supportive services and 

centers are awarded to States and territories for in-home and community-based services for frail elderly persons who are at risk of 

losing their self-sufficiency due to physical or mental impairments. 

The funds contained in the bill will support a variety of activities 

including transportation services, information and assistance, and 

personal care services. 

Preventive health 

The Committee provides $21,919,000 for preventive health services authorized under part F of title III of the Act. This is $129,000 

more than the fiscal year 2004 level and the same as the budget 

request. These funds are awarded to States and territories to support activities that educate older adults about the importance of 

142 

healthy lifestyles and promote healthy behaviors that can prevent 

or delay chronic disease and disability. 

Protection of Vulnerable Older Americans 

The Committee provides $18,559,000 for the protection of vulnerable older Americans, authorized by title VII of the Older Americans Act. This is the same as the budget request and $885,000 less 

than the fiscal year 2004 level. Funding is provided for both the 

long-term care ombudsman program, which protects the rights and 

interests of residents in nursing homes, board and care homes, assisted living facilities and similar adult care facilities, as well as 

for the prevention of elder abuse, neglect, and exploitation program, which trains law enforcement and medical professionals in 

how to recognize and respond to elder abuse. 

National Family Caregiver Support Program 

The Committee provides $157,000,000 for the family caregivers 

program. This is $4,262,000 more than the fiscal year 2004 level 

and $1,488,000 more than the budget request. The family caregiver 

program provides formula grants to States to provide a support 

system in each State for family caregivers. All States are expected 

to put in place five basic system components, including: individualized information on available resources; assistance to families in locating services from private and voluntary agencies; caregiver 

counseling, training and peer support; respite care; and other supplemental services. 

Native American Caregiver Support Program 

The Committee provides $6,355,000 for the Native American 

Caregiver Support Program. This is $37,000 more than the fiscal 

year 2004 level and the same as the budget request. The program 

assists Tribes in providing multifaceted systems of support services 

for family caregivers as well as for grandparents caring for grandchildren. 

Nutrition programs 

For congregate and home delivered meals, as well as the nutrition services incentive program, the Committee provides 

$730,178,000. This is $15,717,000 more than the fiscal year 2004 

level and $11,364,000 more than the budget request. These programs are intended to address some of the difficulties confronting 

older individuals, namely nutrition deficiencies due to inadequate 

income, lack of adequate facilities to prepare food, and social isolation. 

Grants for Native Americans 

The Committee provides $26,612,000 for grants for Native Americans. This is $159,000 more than the fiscal year 2004 level and the 

same as the budget request. Grants are distributed to tribal organizations to be used to help Native American elders remain healthy 

and independent by providing transportation, nutrition, health 

screening and other services. 

143 

Program innovations 

The Committee provides $37,943,000 for program innovations. This is $14,100,000 more than the budget request and $4,434,000 

more than the fiscal year 2004 funding level. Funds under this program are used for competitive grants and contracts to support 

projects that develop new and promising practices to serve older 

adults and their families. 

The Committee provides $3,000,000 for social research into Alzheimer’s disease care options, best practices and other Alzheimer’s 

research priorities that include research into cause, cure and care, 

as well as respite care, assisted living, the impact of intervention 

by social service agencies on victims, and related needs. The Committee recommends this research utilize and give discretion to Area 

Agencies on Aging and their non-profit divisions in municipalities 

with aged populations (over the age of 60) of over 1 million, with 

preference given to the largest population. The Committee also recommends that unique partnerships to affect this research be considered for the selected Area Agency on Aging. 

Aging network support activities 

The Committee provides $13,373,000 for aging network support 

activities, which include five ongoing programs: the Eldercare Locator, Pension Counseling, Senior Medicare Patrols, the National 

Long-Term Care Ombudsman Resource Center, and the National 

Center on Elder Abuse. This is $79,000 more than the fiscal year 

2004 level and the same as the budget request. These established 

programs, which began as demonstration projects, provide critical 

support for the National aging services network. 

Alzheimer’s disease demonstration grants 

The Committee provides $11,500,000 for Alzheimer’s disease 

demonstration grants. This is the same as the budget request and 

$383,000 less than the fiscal year 2004 level. The program provides 

competitive grants to States to help them plan and establish programs to provide models of care to individuals with Alzheimer’s 

disease. Funds are used for respite care and supportive services, 

clearinghouses, training, and administrative costs for State offices. 

White House conference on aging 

The Committee provides $4,558,000 for the White House con- ference on aging. This is $1,774,000 more than the fiscal year 2004 

level and the same as the budget request. The Conference is required to take place no later than December 31, 2005 and will be 

the first such conference of the 21st Century and the fifth in our 

Nation’s history. Past White House conferences on aging have 

prompted the development of many of the programs that represent 

America’s commitment to the elderly. 

Program administration 

The Committee provides $18,482,000 for program administration 

expenses for the Administration on Aging (AoA). This is $1,158,000 

more than the fiscal year 2004 level and the same as the budget 

request. This activity provides administrative and management 

support for all Older Americans Act programs administered by 

AoA. 

144 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

The Committee provides $386,149,000 for general departmental management, which is $26,080,000 above the fiscal year 2004 comparable level and $51,673,000 below the budget request. Included 

in this amount is authority to spend $5,851,000 from the Medicare 

trust funds. In addition, the Office of the Secretary has access to 

$21,552,000 of policy evaluation funding. 

This appropriation supports those activities that are associated 

with the Secretary’s roles as policy officer and general manager of 

the Department. The Office of the Secretary also implements Administration and Congressional directives, and provides assistance, 

direction and coordination to the headquarters, regions and field 

organizations of the Department. This account also supports several small health promotion and disease prevention activities that 

are centrally administered. The Committee includes $5,000,000 as requested by the Administration for the joint Department of Defense and HHS initiative to 

improve the largest women’s hospital in Kabul, Afghanistan and to 

create four satellite teaching clinics. Bill language is included identifying the amount of assistance and citing as authority the Afghanistan Freedom Support Act of 2002. 

Men’s health.—The Committee understands that there is no entity in the Department responsible for the coordination and oversight 

of activities across the agency concerning men’s health. The Committee is aware of reports that men are 25 percent less likely than 

women to receive regular health screenings, and that one of the top 

problems facing men’s health is that men are not likely to visit a 

doctor when they notice a problem. The Committee encourages the 

Secretary to expand departmental disease prevention and health 

promotion activities among men and to give consideration to establishing an office for men’s health, similar to the HHS Office of 

Women’s Health. The Committee expects the Secretary to report 

during the fiscal year 2006 hearings activities that have been undertaken with regard to men’s health. 

Digestive diseases.—The Committee encourages the Secretary to 

consider establishing a national commission on digestive diseases 

composed of scientists and physicians, patient advocates and representatives of federal agencies to (1) study the incidence, duration, 

and mortality rates of digestive diseases, as well as their economic 

impact; (2) evaluate facilities and resources for the diagnosis, prevention, and treatment of such diseases; and (3) develop a longrange plan for the use and organization of national resources to effectively deal with digestive diseases. 

Privacy regulations.—The Committee believes that the Health 

Insurance Portability and Accountability Act (HIPAA) is a valuable 

tool in protecting individual’s medical privacy. The Committee is 

also aware of concerns that overly broad interpretations and misinterpretations of HIPAA have deprived communities of information that affects their well-being and limits their ability to take informed action in response to local health and safety conditions. The 

Committee urges the Secretary of Health and Human Services to 

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145 

mit journalists to report on newsworthy events to the fullest possible extent. 

Amblyopia.—The Committee is concerned that many children in 

the United States have uncorrected vision problems, such as amblyopia, that can lead to difficulty in school and permanent vision 

loss. Amblyopia, also known as ‘‘lazy eye’’, is the leading cause of 

vision loss in young Americans; yet many children do not receive 

timely diagnosis or treatment for the condition. The Committee encourages the Secretary to examine ways to increase the number of 

children who receive a comprehensive eye examination from a licensed optometrist or ophthalmologist in order to reduce vision loss 

in children. 

Underage drinking.—The Committee commends the establishment of the Interagency Coordinating Committee on the Prevention 

of Underage Drinking (ICCPUD) and the issuance of the interim 

report in development of a coordinated plan for combating underage drinking. The Committee strongly encourages the Secretary to 

go forward with these and other related efforts, including work currently underway at SAMHSA on a National media campaign to 

combat underage drinking. 

Memory impairment screening.—The Committee requests a report by March, 2005 on the effectiveness and accuracy of existing 

screening tools to detect early stage memory impairment, along 

with recommendations to expand access to screening in the public 

and private sectors. 

Disease spending.—The Department is instructed to provide the 

Committee with a table detailing total spending by HHS, PHS, and 

NIH in fiscal years 1997 through the present on the following diseases: acute respiratory distress syndrome, arthritis, cancer, chronic obstructive pulmonary disease, depression, diabetes, heart disease, HIV/AIDS, kidney disease, liver disease, pneumonia and influenza, septicemia, and stroke. A functional breakdown of each 

showing the amount spent on research, prevention/education, and 

treatment should also be included for each of the diseases in the 

table. This table should also detail spending in both Medicaid and 

Medicare, as well as approximations for spending by insurance in 

the private sector, and private expenditures by individuals afflicted 

with these diseases. The Committee requests the table be completed no later than the end of February 2005. 

NIH Library of Medicine infrastructure.—The Committee continues to strongly support the work of the National Library of Medicine, the largest medical library in the world and the leader in 

digitized medical information resources. Previously, the Committee 

has taken steps to ensure that adequate funding was available for 

the architectural planning and design of a new NLM building to 

house the National Center for Biotechnology Information and other 

activities related to digital information development. With the preliminary work complete, the Committee urges the Secretary to consider the commitment of necessary resources to begin construction 

of new physical facilities for the NLM to enable it to keep pace 

with the rapid increase in medical publishing and biotechnology information research and development. 

Interactive patient education.—The Committee is aware of interactive, web-based, user-friendly computer programs that have 

promise in making patients active participants and partners in deVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00145 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
146 

cision affecting their health and healthcare. Such innovative use of 

information technology promises substantial advances in more fully 

informing and educating patients and has applications to informed 

consent for surgery and for clinical trials. In addition, it has potential applications to chronic disease management, organ donation, 

and end-of-life care decisions. The Committee encourages the Department through CMS and AHRQ to demonstrate ways in which 

this technology may improve the health care system. 

Reglatory burden.—A major reason for the skyrocketing cost of 

health care is the regulatory burden that government is placing on 

the health care system, often without regard to the costs of that 

regulation. Thirty different federal agencies regulate hospitals and 

medical care, in addition to many other regulations created by local 

and State governments and private-sector accrediting bodies. There 

are at least 132,000 pages of regulation in CMS alone, compared 

to only 93,000 pages of regulation for the tax code. A study by 

Duke University has estimated that at least $128 billion per year 

is wasted by this regulatory burden. These costs are unnecessarily 

being borne by employers and employees through increased health 

care premiums, as well as by taxpayers through higher program 

expenditures. The Committee intends that $2,0000,000 of the policy evaluation 

funds available to the Office of the Assistant Secretary for Planning and Evaluation be used to establish an interagency committee, to be coordinated by HHS and overseen by the Office of 

Management and Budget. The committee’s role will be to examine 

the major regulations governing the health care industry, making 

suggestions regarding where they could be coordinated and simplified to reduce costs and burdens and improve translation of biomedical research into medical practice, while continuing to protect 

patients. The examination should include an economic analysis of 

the major regulations to determine transactional costs of complying 

with regulations. The committee should look at what immediate 

steps can be taken to reduce this costly burden and examine 

longer-term proposals for reducing the regulatory burden. The committee’s findings should be provided to the Appropriations Committee one year from the date of the enactment of this Act. The Assistant Secretary for Planning and Evaluation is requested to notify the Committee fifteen days before committing funds for the 

study. 

In addition to representatives from the various Federal agencies, 

the committee should include representatives from throughout the 

health care industry, including institutional and individual providers, the clinical research sector, academia, and public health. It 

should also include experts in health care economics, hospital administration, and insurance billing practices. 

Office of Minority Health 

The Committee provides $47,236,000 for the Office of Minority 

Health, which is $7,954,000 below the fiscal year 2004 comparable 

amount and the same as the budget request. The Office of Minority 

Health works with Public Health Service agencies and other agencies of the Department in a leadership and policy development role 

to establish goals and coordinate other activities in the Department 

regarding disease prevention, health promotion, service delivery 

147 

and research relating to disadvantaged and minority individuals; 

concludes interagency agreements to stimulate and undertake innovative projects; supports research, demonstration, and evaluation 

projects; and coordinates efforts to promote minority health programs and policies in the voluntary and corporate sectors. The reduction in fiscal year 2005 funding compared to the previous year 

is due to the funding of one-time projects in 2004. 

Health professions.—The Committee continues to recognize the 

need to recruit and train more minorities in the health professions. 

The Committee encourages the Office of Minority Health to support 

annual conferences that have a proven record of increasing the 

number of under-represented minorities entering the health professions. 

Meharry Medical College.—The Committee encourages OMH to 

continue its successful cooperative agreement with Meharry Medical College aimed at meeting the challenges of academic opportunity for disadvantaged students and improving health care services in underserved communities. 

Morehouse School of Medicine.—The Committee encourages 

OMH to consider supporting strategic planning and development 

activities at the Morehouse School of Medicine. 

Charles R. Drew University.—The Committee is concerned about 

issues facing the residency training program at Charles R. Drew 

University and encourages the implementation of a broad HHS effort focused on faculty support to address this problem. 

American Indians/Alaskan Natives.—The Committee commends 

the Department’s participation in the Washington Semester American Indian Program (WINS) and encourages HHS to increase the 

placement of WINS interns in its operating divisions. 

Office on Women’s Health 

The Committee provides $29,103,000 for the Office on Women’s Health, which is $188,000 above the fiscal year 2004 comparable 

level and the same as the budget request. The Office on Women’s 

Health advises the Secretary and provides Department-wide coordination of programs focusing specifically on women’s health. 

Uterine fibroids.—The Committee encourages the Secretary to coordinate an effort among the PHS agencies to disseminate information to educate women and health care providers about the impact 

of uterine fibroids and available treatment options. 

HIV/AIDS in minority communities 

The Committee provides $52,838,000 to be available to the Secretary to transfer to the Department’s operating agencies for specific program activities to address the high-priority HIV prevention 

and treatment needs of minority communities. This is $3,294,000 

above the fiscal year 2004 comparable level and the same as the 

budget request. These funds are to address the growing HIV/AIDS 

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

Within the total provided, the Committee expects that activities 

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

its disproportionate impact upon communities of color, including 

African Americans, Latinos, Native Americans, Asian Americans, 

148 

Native Hawaiians, and Pacific Islanders will be supported at no 

less than last year’s funding level. 

Adolescent Family Life 

The Committee provides $31,229,000 for the Adolescent Family 

Life program, which is $283,000 above the comparable 2004 level 

and $23,120,000 below the budget request. The Committee has provided the requested $23,120,000 increase as part of the abstinence 

education program within the Administration for Children and 

Families. The Committee includes bill language requested by the 

Administration allocating all funds for prevention demonstrations 

to be available for abstinence education activities under section 

510(b)(2) of the Social Security Act. The program provides comprehensive and integrated approaches to the delivery of care services for pregnant and parenting adolescents, and prevention services that promote abstinence from sexual activity among non-parenting teens. 

Health care information technology 

the Committee provides $25,000,000 for the new health care information technology program, which is $25,000,000 below the 

budget request. This program is planned to fund investments in 

the development and utilization of modern information technology 

in both health care and public health. Funds will be available to 

State and local organizations to provide the infrastructure necessary for the exchange of a patient’s health information within 

that area, and with other such organizations nationally. The Committee urges the Secretary to mesh these activities with the AHRQ 

demonstrations presently underway. 

Information technology security and innovation fund 

The Committee provides $14,847,000 for the information technology security and innovation fund, which is the same as the fiscal year 2004 comparable level and $3,553,000 less than the budget 

request. This fund supports HHS enterprise-wide investments in 

such areas as common IT infrastructure services, and security and 

infrastructure to enable common administrative systems. 

OFFICE OF THE INSPECTOR GENERAL

The Committee provides $40,323,000 for the Office of the Inspector General (OIG), which is $1,229,000 above the fiscal year 2004 

level and the same as the budget request. A permanent appropriation for this office is contained in the Health Insurance Portability 

and Accountability Act of 1996. Total funds provided between this 

bill and the permanent appropriation would be $200,323,000 in fiscal year 2005. 

The Office of the Inspector General was created by law to protect 

the integrity of Departmental programs as well as the health and 

welfare of beneficiaries served by those programs. Through a comprehensive program of audits, investigations, inspections and program evaluations, the OIG attempts to reduce the incidence of 

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

efficiency and effectiveness throughout the Department. 

149 

OFFICE FOR CIVIL RIGHTS

The Committee provides $35,357,000 for the Office of Civil 

Rights (OCR), which is $1,456,000 above the fiscal year 2004 level 

and the same as the budget request. This includes authority to 

transfer $3,314,000 from the Medicare trust funds. 

The Office for Civil Rights is responsible for enforcing civil rights 

statutes that prohibit discrimination in health and human services 

programs. OCR implements the civil rights laws through a compliance program designed to generate voluntary compliance among all 

HHS recipients. 

POLICY RESEARCH

The Committee provides $20,750,000 for policy research through 

section 241 evaluation funding authority, which is the same as the 

comparable 2004 level and $8,000,000 below the Administration request. The Policy Research account, authorized by section 1110 of 

the Social Security Act, is the Department’s principal source of policy-relevant data and research on the income sources of low-income 

populations; the impact, effectiveness, and distribution of benefits 

under existing and proposed programs; and other issues that cut 

across agency lines. 

MEDICAL BENEFITS FOR COMMISSIONED OFFICERS

The Committee provides an estimated $330,636,000 for medical 

benefits for commissioned officers of the U.S. Public Health Service. 

This is the same as the Administration request and $8,873,000 

above the fiscal year 2004 comparable amount. 

This account provides for retirement payments to U.S. Public 

Health Service officers who are retired for age, disability or length 

of service; payments to survivors of deceased officers; medical care 

for active duty and retired members and dependents and beneficiaries; and for payments to the Social Security Administration 

for military service credits. 

The Committee repeats language from the fiscal year 2004 appropriations bill clarifying that this account should be used to support the retirement medical cost payments for commissioned corps 

officers rather than the appropriations of the agencies to whom the 

officers are assigned. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

The Committee provides $2,292,247,000 for the public health and 

social services emergency fund for homeland security related activities. In addition, $60,000,000 is provided for activities to ensure 

year-round production capacity of influenza vaccine, bringing the 

total in the Fund to $2,352,247,000. This is $188,244,000 above the 

fiscal year 2004 comparable level and $127,189,000 above the request. 

Within the amount provided for homeland security related activities, the funds are distributed as follows: 

HRSA ...................................................................................................... $542,649,000 

CDC ......................................................................................................... 1,637,760,000 

Office of the Secretary ........................................................................... 64,438,000 

NIH ......................................................................................................... 47,400,000 

150 

Within the funds provided for HRSA, $27,705,000 is to support 

the interdisciplinary health professions training program and 

$514,944,000 is for the National Bioterrorism Hospital Preparedness Program. The Committee does not agree with the reduction in 

funds for hospital preparedness proposed in the request. 

Within the funds provided for the CDC, $934,300,000 is for State 

and Local Capacity, including $871,900,000 to be provided to State 

and local health departments through grants and cooperative 

agreements; $142,160,000 is for Upgrading CDC Capacity; 

$11,300,000 is for Anthrax; and $100,000,000 is for the Biosurveillance Initiative. The Committee does not agree with the reduction 

in State and Local Preparedness funds proposed in the request. 

In addition, $450,000,000 is provided for the Strategic National 

Stockpile. This is $52,400,000 above the FY2004 comparable level 

and $50,000,000 above the request. The Committee does not provide authority to increase funds available to the Stockpile up 

$70,000,000 from funds otherwise available for use by the CDC as 

proposed in the request. 

Academic Health Centers.—The Committee continues to believe 

that significant expertise, capability, and resources exist in academic health centers and that, in large measure, these Centers 

have not been participants in state and local preparedness and response planning. The Committee urges the Secretary to examine 

ways of encouraging recipients of State and Local Preparedness 

funds to ensure that academic health centers are included in the 

planning process, and in making assessments of the capabilities 

and roles that academic health centers can have in enhancing preparedness. 

Anti-infective agents.—The Committee has maintained funds provided in fiscal year 2004 to support research into the discovery, development, and translation of anti-infective agents to combat 

emerging infectious diseases. 

Community Health Centers.—The Committee recognizes the important role community health centers play in terrorism preparedness and response. The Committee is concerned that despite their 

inclusion in the Department’s state plan guidance, community 

health centers and regional primary care associations have not 

been fully included in the state and local decision-making process 

and in the allocation of preparedness resources. The Committee 

urges the Secretary to examine ways of ensuring that recipients of 

State and Local Preparedness funds include community health centers and their associated regional organizations are included in 

both preparedness planning and in resource allocation decisions. 

Physician Contact Database.—The Committee understands the 

urgent need to contact, inform and mobilize physicians in public 

health emergencies and with threats of bioterrorism. The Committee is also aware that CDC is in discussions with the Federation 

of State Medical Boards to develop an automated data system of 

physician contact information to be used for these purposes. Within 

the funding provided, the Committee encourages the Secretary to 

initiate a pilot project in five states. The Committee requests that 

the Secretary be prepared to report on plans for the project during 

the hearings on the FY2006 budget request. 

151 

GENERAL PROVISIONS

Sec. 201. The Committee continues a provision to limit the 

amount available for official reception and representation expenses. 

Sec. 202. The Committee continues a provision to limit the number of Public Health Service employees assigned to assist in child 

survival activities and to work in AIDS programs through and with 

funds provided by the Agency for International Development, the 

United Nations International Children’s Emergency Fund or the 

World Health Organization. 

Sec. 203. The Committee continues a provision to prohibit the 

use of funds to implement section 399F(b) of the Public Health 

Service Act or section 1503 of the NIH Revitalization Act of 1993. 

Sec. 204. The Committee continues a provision to limit the salary 

of an individual through an NIH, AHRQ, or SAMHSA grant or 

other extramural mechanism to not more than the rate of Executive Level I. 

Sec. 205. The Committee includes a provision limiting the compensation of an individual working in Head Start to the Federal 

Executive Level II salary. 

Sec. 206. The Committee continues a provision to prohibit the 

Secretary from using evaluation set-aside funds until the Committee receives a report detailing the planned use of such funds. 

Sec. 207. The Committee continues a provision, although changes 

the percentage provided in the fiscal year 2004 bill, permitting the 

Secretary to use up to 2.3 percent of funds authorized under the 

PHS Act for the evaluation of programs. 

(TRANSFER OF FUNDS)

Sec. 208. The Committee continues a provision permitting the 

Secretary of HHS to transfer up to one percent of any discretionary 

appropriation from an account, with an additional two percent subject to the approval of the Appropriations Committees, but prohibiting any appropriation to increase by more than three percent by 

such transfer. 

Sec. 209. The Committee continues a provision to provide the Director of NIH, jointly with the Director of the Office of AIDS Research, the authority to transfer up to three percent of human immunodeficiency virus funds. 

Sec. 210. The Committee continues a provision to make NIH 

funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Sec. 211. The Committee continues a provision to prohibit the 

use of Title X funds unless the applicant for the award certifies to 

the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides 

counseling to minors on how to resist attempts to coerce minors 

into engaging in sexual activities. 

Sec. 212. The Committee continues a provision related to the 

Medicare+Choice program. 

Sec. 213. The Committee continues a provision stating that no 

provider of services under title X shall be exempt from any State 

law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

152 

Sec. 214. The Committee continues a provision to exempt States 

from Synar provisions if certain funding criteria are met. 

Sec. 215. The Committee continues a provision to allow CDC 

international HIV/AIDS and other infectious disease, chronic and 

environmental disease, and other health activities abroad to be 

spent under the State Department Basic Authorities Act of 1956. 

Sec. 216. The Committee continues a provision to permit the Division of Federal Occupational Health to use personal services contracting to employ professional management/administrative and occupational health professionals. 

Sec. 217. The Committee includes a provision granting authority 

to the Office of the Director of the National Institutes of Health 

(NIH) to enter directly into transactions in order to implement the 

NIH Roadmap and permitting the Director to utilize peer review 

procedures, as appropriate, to obtain assessments of scientific and 

technical merit. 

Sec. 218. The Committee includes a provision rescinding an appropriation provided in the Medicare Modernization Act for a facilities loan fund. The Committee provides funding for these types of 

activities as part of its regular mission and objects to actions taken 

by the authorizing committees that cross this jurisdictional boundary. 

Sec. 219. The Committee includes a provision to permit the Centers for Medicare and Medicaid Services to charge providers who 

forward duplicate or unprocessable Medicare claims $5.00 per 

claim and makes a corresponding $155,000,000 reduction in the 

CMS Program Management Account. 

Sec. 220. The Committee includes a general provision to reduce 

amounts available to the CDC for administrative and related information technology expenses by $15,000,000. 

Sec. 221. The Committee includes a provision prohibiting funds 

from being used to implement CMS inpatient rehabilitation facility 

reimbursement rules (commonly referred to as the 75 percent rule) 

until after an Institute of Medicine study on medical criteria is 

completed. Funding for the CMS Program Management account is 

reduced by $9,000,000 to cover the costs of the study and the moratorium. 

Sec. 222. The Committee includes a provision prohibiting the use 

of funds appropriated to HHS for the purpose of impeding the exchange of information between the CMS actuary and the U.S. Congress. 

TITLE III—DEPARTMENT OF EDUCATION 

The Committee’s recommendations for the Department of Education for fiscal year 2005 will bring total departmental funding to 

$57,681,171,000, the highest level in the agency’s history. The 

Committee notes that, although the federal government contributes 

only about eight percent of all K–12 education spending in the 

United States, the role the federal government plays with regard 

to providing equal opportunity to education for all people in our society is an important one. Therefore, the Committee has focused its 

funding recommendations for K–12 education around the following 

principles: a quality teacher in every classroom; closing the 

achievement gap for poor and minority children by insisting on results; empowering parents; ensuring all third-grade children can 

153 

read; more education, less paperwork; and spending for results. 

With the understanding that the Committee has focused its funding recommendations for K–12 education around the stated principles, which include a quality teacher in every classroom and 

spending for results, the Committee encourages the Department to 

establish an on-line reporting system to allow school districts receiving funds under this Act to submit to the Department by means 

of the Internet, on a voluntary basis, not later than April 30, 2005, 

a report on the school district’s progress toward the following: placing quality teachers in every classroom; rigorous academic standards and curricula; small class sizes; high-quality facilities and libraries; up-to-date textbooks and computer technology; and quality 

guidance counselors. For higher education programs, the Committee has focused its recommendations on funding proven programs that help provide all Americans with the opportunity to further their studies and training and become competitive in the global marketplace. 

The Committee continues to emphasize the importance of developing clear, measurable outcomes for programs within the Department of Education as outlined in the Government Performance and 

Results Act. It is vital that the Committee be provided with information on the actual results achieved by the programs, not simply 

the number of students affected by the program or the quantity of 

materials distributed. Program outcomes should, to the extent possible, focus on the achievement improvements that result to students and teachers in the classroom as a result of the Federal investment. Programs that are able to demonstrate these results over 

time will be considered higher funding priorities than programs 

that are unable to clearly demonstrate their value to the American 

public. 

EDUCATION FOR THE DISADVANTAGED

The bill includes $15,535,735,000 for the disadvantaged pro- grams. This amount is $330,567,000 more than the budget request 

and $1,089,392,000 above the fiscal year 2004 appropriation. Of the 

total amount available, $7,849,390,000 is appropriated for fiscal 

year 2005 for obligation after July 1, 2005 and $7,383,301,000 is 

appropriated for fiscal year 2006 for obligation on or after October 

1, 2005. This appropriation account includes compensatory education programs authorized under title I of the Elementary and 

Secondary Education Act of 1965; and title VIII of the Higher Education Act. 

Grants to local educational agencies 

Of the amounts provided for Title I programs, $7,037,592,000 is 

available for basic grants to local education agencies. This amount 

is the same as last year’s level and the request. The Committee rejects the inclusion of any 100% hold harmless provision because it 

unfairly penalizes underprivileged and immigrant children in 

states with growing populations. 

Funding for concentration grants, which targets funds to Local 

Educational Agencies in counties with high levels of disadvantaged 

children, is $1,365,031,000, the same as last year and the request 

level. The bill includes $2,469,843,000 for targeted grants, an increase of $500,000,000 above last year and $1,676,344,000 below 

154 

the request. A total of $2,469,843,000 is also included for education 

finance incentive grants, $1,676,344,000 above the request and 

$500,000,000 above last year’s level. 

Financial assistance flows to school districts by formula, based in 

part on the number of school-aged children from low-income families. Within districts, local school officials target funds on school attendance areas with the greatest number or percentage of children 

from poor families. Local school districts develop and implement 

their own programs to meet the needs of disadvantaged students. 

Funds under this account will also be used to pay the Federal 

share of State administrative costs for title I programs. The maximum State administration grant is equal to 1 percent of title I 

local educational agency plus State agency grants to the State, or 

$400,000, whichever is greater. These funds are included in the 

grants to local educational agencies account, rather than being a 

separate line item. 

Recent studies have demonstrated that comprehensive school-improvement models, when well implemented, boost student achievement to a greater extent than other interventions designed to serve 

similar student populations. The Committee believes that comprehensive school reform provides an exemplary approach to raising academic achievement, particularly for schools that do not 

make adequate yearly progress under the No Child Left Behind 

Act. The Committee believes that States should utilize their four 

percent school improvement set aside funds, estimated at 

$520,000,000 in fiscal year 2005, to support implementation of CSR 

models with demonstrated success. Further, the Committee intends 

that the Secretary shall notify States that schools currently receiving CSR subgrants shall receive priority for targeted grants and/ 

or technical assistance under section 1003(a) of ESEA. 

In addition, the Committee is concerned that in some cases, 

States have distributed the funds set aside within the title I program for school improvement purposes equally to each school identified in need of improvement. The Committee believes that this is 

resulting in allocations for each school that may be too small to effectively leverage needed reforms. The Committee strongly urges 

States to examine methods for distributing school improvement 

funds that will result in awards of sufficient size and scope to support the initial costs of comprehensive school reforms and to limit 

funding to programs that include each of the reform components 

described in section 1606(a) of the No Child Left Behind Act of 

2001 and have the capacity to improve the academic achievement 

of all students in core academic subjects within participating 

schools. 

Even Start 

The Committee provides $246,910,000 for Even Start, the same 

as last year and $246,910,000 above the request. Even Start provides grants for programs focusing on the education of disadvantaged children, aged 1–7 years, who live in title I target school attendance areas, plus their parents who are eligible to be served 

under the Adult Education Act. These parents are not in school, 

are above the State’s compulsory school attendance age limit, and 

have not earned a high school diploma (or equivalent). Even Start 

155 

funds are allocated to the States, generally in proportion to title I 

basic grants. 

Reading First State Grants 

The bill provides $1,125,000,000 for Reading First State grants, the same as the budget request and $101,077,000 above the fiscal 

year 2004 level. This program provides assistance to states and 

school districts in establishing scientific research-based reading 

programs for children in kindergarten through grade three. The 

program also provides for professional development and other supports to ensure that teachers can identify children at-risk for reading failure and provide the most effective early instruction to overcome specific barriers to reading proficiency. 

Early Reading First 

The bill provides $132,000,000 for Early Reading First, the same as the budget request and an increase of $37,561,000 above the fiscal year 2004 level. This is a competitive grant program targeted 

toward children ages three through five, and would support the development of verbal skills, phonemic awareness, pre-reading development and assistance for professional development for teachers in 

evidence-based strategies of instruction. 

Striving Readers 

The bill provides $100,000,000 for Striving Readers, the same as the budget request and $100,000,000 above last year’s level. Striving Readers will make competitive grants to develop, implement 

and evaluate reading interventions for middle- or high-school students who are reading significantly below grade level. 

Literacy through school libraries 

The bill provides $19,842,000 for literacy through school libraries, the same as the budget request and the fiscal year 2004 level. 

This program helps school districts provide students with increased 

access to up-to-date school library materials, a well-equipped, technologically advanced school library media center, and well-trained, 

and professionally certified school library media specialists. At appropriations of less than $100,000,000 the Department makes competitive awards to districts with a child poverty rate of at least 20 

percent. 

State agency programs: migrant 

The bill includes $393,577,000 for the migrant education program, the same as the budget request and the fiscal year 2004 appropriation. This program supports formula grants to State agencies for the support of special educational and related services to 

children of migratory agricultural workers and fishermen. The purpose of this program is to provide supplementary academic education, remedial or compensatory instruction, English for limited 

English proficient students, testing, plus guidance and counseling. 

State agency programs: neglected and delinquent 

For the State agency program for neglected and delinquent children, the bill includes $48,395,000, the same as the budget request 

and the fiscal year 2004 appropriation. This formula grant program 

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provides services to participants in institutions for juvenile 

delinquents, adult correctional institutions, or institutions for the 

neglected. 

Evaluation 

The Committee provides $9,500,000 for evaluation, $710,000 

above the 2004 appropriation and the same as the budget request. 

Title I evaluation supports large scale national evaluations that examine how title I is contributing to improved student performance 

at the State, local education agency, and school levels. It also supports short-term studies that document promising models and 

other activities to help States and local education agencies implement requirements in the title I statute. 

Comprehensive school reform 

The bill includes $80,000,000 for the Comprehensive School Re- form (CSR) Program, $80,000,000 above the request and 

$153,613,000 below last year’s level, due to budget constraints. The 

CSR program authorizes incentive grants of at least $50,000 per 

year, for 3 years, for schools to implement effective, research-driven 

strategies for schoolwide reform. Recent studies have demonstrated 

that comprehensive school-improvement models, when well implemented, boost student achievement to a greater extent than other 

interventions designed to serve similar student populations. The 

Committee believes that comprehensive school reform provides an 

exemplary approach to raising academic achievement, particularly 

for schools that do not make adequate yearly progress under the 

No Child Left Behind Act. The Committee believes that States 

should utilize their four percent school improvement set aside 

funds, estimated at $520,000,000 in fiscal year 2005, to support implementation of CSR models with demonstrated success. Further, 

the Committee intends that the Secretary shall notify States that 

schools currently receiving CSR subgrants shall receive priority for 

targeted grants and/or technical assistance under section 1003(a) of 

ESEA. 

In addition, the Committee is concerned that in some cases, 

States have merely divided the funds for school improvement purposes by the number of schools identified in need of improvement 

and that this is resulting in allocations for each school that may 

be too small to effectively leverage needed reforms. The Committee 

strongly urges States to examine methods for distributing school 

improvement funds that will result in awards of sufficient size and 

scope to support the initial costs of comprehensive school reforms 

and to limit funding to programs that include each of the reform 

components described in section 1606(a) of the No Child Left Behind Act of 2001 and have the capacity to improve the academic 

achievement of all students in core academic subjects within participating schools. 

Migrant education, high school equivalency program 

The bill includes $22,545,000 for the high school equivalency program. This amount is $3,657,000 above the budget request and the 

fiscal year 2004 level. The high school equivalency program recruits migrant students aged 16 and over and provides academic 

and support services to help those students obtain a high school 

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equivalency certificate and subsequently to gain employment or admission to a postsecondary institution or training program. 

College assistance migrant programs 

The bill includes $15,657,000 for the college assistance migrant 

programs. This amount is the same as the fiscal year 2004 level 

and the budget request. The college assistance migrant program 

(CAMP) provides tutoring and counseling services to first-year, undergraduate migrant students and assists those students in obtaining student financial aid for their remaining undergraduate years. 

IMPACT AID

The bill provides $1,250,893,000 for Federal impact aid programs 

in fiscal year 2005, an increase of $21,366,000 above the fiscal year 

2004 appropriation and the budget request. This account supports 

payments to school districts affected by Federal activities. Impact 

Aid represents a federal responsibility to local schools educating 

children whose families are connected with the military or who live 

on Indian land. 

The bill also includes language ensuring that schools serving the 

children of military personnel continue to receive Impact Aid funds 

when the military parents who live on-base are deployed and the 

child continues to attend the same school and in cases in which an 

on-base military parent is killed while on active duty and the child 

continues to attend the same school. 

Basic support payments 

The bill includes $1,083,687,000 for basic support payments to 

local educational agencies, an increase of $20,000,000 above the fiscal year 2004 appropriation and the budget request. Basic support 

payments compensate school districts for lost tax revenue and are 

made on behalf of Federally-connected children such as children of 

members of the uniformed services who live on Federal property. 

Payments for children with disabilities 

The Committee recommends $50,369,000 for payments on behalf 

of Federally-connected children with disabilities, the same as the 

budget request and the fiscal year 2004 appropriation. These payments compensate school districts for the increased costs of serving 

Federally-connected children with disabilities. 

Facilities maintenance 

The Committee recommends $7,901,000 for facilities maintenance, the same as the fiscal year 2004 amount and the budget request. These capital payments are authorized for maintenance of 

certain facilities owned by the Department of Education. 

Construction 

The Committee recommends $45,936,000 for the construction 

program, the same as the budget request and the fiscal year 2004 

level. This program provides formula and competitive grants to eligible locally owned school districts for building and renovating 

school facilities. 

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Payments for Federal property 

The bill provides $63,000,000 for payments related to Federal 

property, an increase of $1,366,000 above the fiscal year 2004 appropriation and the budget request. Funds are awarded to school 

districts to compensate for lost tax revenue as the result of Federal 

acquisition of real property since 1938. 

SCHOOL IMPROVEMENT PROGRAMS

The bill includes $5,641,401,000 for school improvement programs. This amount is $216,377,000 less than the comparable fiscal year 2004 appropriation and $299,092,000 below the budget request for comparable programs. This appropriation account includes programs authorized under titles II, IV, V, VI, and VII of 

the Elementary and Secondary Education Act; the McKinney-Vento 

Homeless Assistance Act, title IV–A of the Civil Rights Act, and 

section 105 of the Compact of Free Association Amendments Act of 

2003. 

State grants for improving teacher quality 

The bill includes $2,950,000,000 for state grants for improving 

teacher quality, which is $19,874,000 above the budget request and 

the fiscal year 2004 level. This program gives states and districts 

a flexible source of funding with which to meet their particular 

needs in strengthening the skills and knowledge of teachers and 

administrators to enable them to improve student achievement. 

States are authorized to retain 2.5 percent of funds for state activities, including reforming teacher certification, re-certification or licensure requirements; expanding, establishing or improving alternative routes to state certification; carrying out programs that include support during the initial teaching and leadership experience, such as mentoring programs; assisting school districts in effectively recruiting and retaining highly qualified and effective 

teachers and principals; reforming tenure systems; and developing 

professional development programs for principals. 

States send funding to the local level by formula and by competitive grant. Among other things, local uses of funds include initiatives to assist recruitment of principals and fully qualified teachers; 

initiatives to promote retention of highly qualified teachers and 

principals; programs designed to improve the quality of the teacher 

force; teacher opportunity payments; professional development activities; teacher advancement initiatives and hiring fully qualified 

teachers in order to reduce class size. 

The Committee is aware of a report by the Teaching Commission 

which examines current teaching programs and practices in the 

United States and makes several recommendations for areas of improvement. Specifically, the report addresses performance-based 

compensation, teacher preparation, teacher licensure and certification and leadership and support. The Committee urges the Department to share the ideas contained within this report to all 

states receiving grants under the teacher quality program and to 

provide technical assistance to states that have an interest in implementing the Commission’s recommendations. 

The Committee has also been impressed with multivariate, longitudinal value-added analysis of student performance data that is 

159 

being used in some states and school districts and urges all states 

and districts receiving federal funding to examine such models and 

consider their adoption. 

The Committee is aware that funding under the teacher quality 

program can be used for professional development and support for 

principals as well as teachers. The Committee recognizes the 

unique role that the principal plays as the instructional leader and 

CEO of a school, and strongly encourages states and school districts to devote a significant portion of professional development 

funds to providing high-quality, ongoing professional development 

opportunities to principals. Particularly recommended is professional development to enhance principals’ ability to work productively with families, provide staff development to teachers and 

other professionals, and to utilize data in decision-making. The 

Committee also encourages states and school districts to develop 

principals’ professional development that is based on sound research on the most current models of leadership. 

Early childhood educator professional development 

The bill includes $14,814,000 for early childhood educator professional development, the same as the budget request and the fiscal 

year 2004 level. This program provides competitive grants to partnerships to improve the knowledge and skills of early childhood 

educators and caregivers who work in communities that have high 

concentrations of children living in poverty. 

Mathematics and science partnerships 

The bill includes $269,115,000 for mathematics and science part- nerships, the same as the budget request and $120,000,000 above 

the fiscal year 2004 level. This program promotes strong math and 

science teaching skills for elementary and secondary school teachers. Grantees may use program funds to develop rigorous math and 

science curricula, establish distance learning programs, and recruit 

math, science and engineering majors into the teaching profession. 

They may also provide professional development opportunities. 

Grants are made to States by formula based on the number of children aged 5 to 17 who are from families with incomes below the 

poverty line, and States then award the funds competitively to 

partnerships which must include the State agency, and engineering, math or science department of an institution of higher education, and a high-need school district. Other partners may also be 

involved. 

Innovative Education Program Strategies State Grants 

The bill does not include funding for State grants under Innovative Education Program Strategies, a decrease of $296,549,000 

below the budget request and the fiscal year 2004 level. This program provides funding to State and local educational agencies for 

obtaining technology and training in technology related to the implementation of school based reform; acquiring and using educational materials; improving educational services for disadvantaged students; combating illiteracy among children and adults; addressing the educational needs of gifted and talented children; and 

implementing school improvement and parental involvement activities under ESEA Title I. 

160 

Education technology 

The bill includes $600,000,000 for Education Technology State Grants. This amount is $91,841,000 below the budget request and 

the comparable fiscal year 2004 level. Under this program, states 

are required to direct ninety-five percent of the funds to school districts for increasing access to technology, especially for high-need 

schools; improving and expanding teacher professional development 

in technology; and promoting innovative state and local initiatives 

using technology to increase academic achievement. 

The Secretary of Education is encouraged to examine in detail 

and assist the advancement of the rapidly-growing use of handheld computer technology and to spread the penetration of the oneto-one (computer-to-student) computing it offers in a school environment, rather than the one-to-many model that prevails in most 

schools, where computers must be shared, thus limiting the advantages to students. Handheld personal computing is rapidly becoming more affordable, enhancing the cost effectiveness of this approach, especially when coupled with wireless technology. 

Supplemental education grants 

The bill provides $12,230,000 for supplemental education grants to the Federated States of Micronesia and $6,100,000 for supplemental education grants to the Republic of the Marshall Islands. 

The Compact of Free Association Amendments Act of 2003 (P.L. 

108–188) discontinued, beginning in fiscal year 2005, most domestic formula grant programs funded by the Departments of Labor, 

Health and Human Services, and Education for the Federated 

States of Micronesia and the Republic of the Marshall Islands. In 

their place, P.L. 108–188 authorized $12,230,000 and $6,100,000 

for these two nations, respectively, for Supplemental Education 

Grants programs, which will provide both countries with the flexibility required to address the unique educational needs of their 

populations. P.L. 108–188 also authorizes both countries to request 

technical assistance from relevant U.S. Cabinet agencies for the 

purpose of transitioning to their own administration of programs. 

The budget request included language transferring fiscal year 

2005 funds from the Departments of Labor, Health and Human 

Services and Education to the Federated States of Micronesia and 

the Republic of the Marshall Islands in amounts equal to amounts 

made available to them in fiscal year 2004 for these same activities. The funds provided by the Committee in this bill are expected 

to equal this total. The bill also includes language allowing the 

Federated States of Micronesia and the Republic of the Marshall 

Islands to reserve up to five percent of their supplemental education grants for technical assistance, administration and oversight 

purposes. 

21st century community learning centers 

The bill provides $999,070,000 for 21st century community learning centers, the same as the budget request and the fiscal year 

2004 level. This program is a formula grant to states. Ninety-five 

percent of funds are distributed on a competitive basis from the 

state to local school districts, community-based organizations and 

other public entities and private organizations. Grantees must target students who attend low-performing schools. Funds may be 

161 

used for before and after school activities that advance student academic achievement including remedial education and academic enrichment activities; math, science, arts, music, entrepreneurial and 

technology education; tutoring and mentoring; recreational activities; and expanded library service hours. 

State assessments 

The bill includes $410,000,000 for state assessments, the same as 

the budget request and $20,000,000 above the fiscal year 2004 

level. This program provides states with funding to develop annual 

assessments and to carry out activities related to ensuring accountability for results in the state’s schools and school districts. 

Javits gifted and talented education 

The bill includes $11,111,000 for gifted and talented education, 

the same as the fiscal year 2004 amount. The President’s budget 

did not propose funding for this program. This program supports 

grants to build and enhance the ability of elementary and secondary schools to meet the needs of gifted and talented students. 

Competitive grants are awarded to states and school districts, institutions or higher education and other public and private entities. 

Foreign language assistance grants 

The bill does not include funding for foreign language assistance 

grants, the same as the budget request. The program was funded 

at $16,546,000 in fiscal year 2004. The program supports competitive grants to school districts and states to increase the quality and 

quantity of elementary and secondary-level foreign language instruction in the United States. 

Education for homeless children and youth 

For the education of homeless children and youth program, the Committee recommends $70,000,000. This level is $10,354,000 

above the budget request and the fiscal year 2004 appropriation. 

Grants are allocated to States in proportion to the total that each 

State receives under the title I program. For local grants, at least 

50 percent must be used for direct services to homeless children 

and youth, including tutoring or remedial or other educational 

services. 

Training and advisory services 

The bill includes $7,243,000 for training and advisory services 

authorized by title IV–A of the Civil Rights Act. This amount is the 

same as the budget request and the same as the fiscal year 2004 

amount. Title IV–A authorizes technical assistance and training 

services for local educational agencies to address problems associated with desegregation on the basis of race, sex, or national origin. 

The Department awards 3-year grants to regional equity assistance 

centers (EACs) located in each of the 10 Department of Education 

regions. The EACs provide services to school districts upon request. 

Typical activities include disseminating information on successful 

education practices and legal requirements related to nondiscrimination on the basis of race, sex, and national origin in educational programs; training designed to develop educators’ skills in 

specific areas, such as the identification of race and sex bias in inVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00161 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
162 

structional materials; increasing the skills of educational personnel 

in dealing with race-based confrontations such as hate crimes; and 

providing technical assistance in the identification and selection of 

appropriate educational programs to meet the needs of limited 

English proficient students. 

Education for Native Hawaiians 

The Committee recommends $33,302,000 for education for Native 

Hawaiians, the same as the budget request and the fiscal year 

2004 amount. A number of programs limited to Native Hawaiians 

are supported with these funds, including a model curriculum 

project, family-based education centers, postsecondary education 

fellowships, gifted and talented education projects, and special education projects for disabled pupils. 

Alaska native education equity 

The Committee recommends $33,302,000 for the Alaska native 

education equity program, the same as the budget request and the 

fiscal year 2004 amount. These funds are used to develop supplemental educational programs to benefit Alaska natives. 

Rural Education 

The bill includes $167,831,000 for rural education programs, the 

same as the fiscal year 2004 level and the budget request. This 

fund includes two programs to assist rural school districts to improve teaching and learning in their schools. The small, rural 

schools achievement program provides funds to rural districts that 

serve a small number of students; the rural and low-income schools 

program provides funds to rural districts that serve concentrations 

of poor students, regardless of the number of students served by 

the district. 

Comprehensive Centers 

The bill includes $57,283,000 for comprehensive centers, the same as the fiscal year 2004 level and $29,629,000 above the budget request. The Committee intends these funds to be used for the 

new comprehensive centers that will provide training, technical assistance, and professional development in reading, mathematics, 

and technology, particularly to schools that fail to meet their 

State’s definition of adequate yearly progress. The Committee intends that the Department proceed quickly with the competition 

and awarding of these centers so that there will be no service disruption to schools through the process of transitioning to the new 

centers. The Committee expects that the new centers will focus 

heavily on assisting school superintendents, principals and teachers to be good consumers of research information and particularly 

help them determine which interventions are based on sound research and are likely to be most effective in their schools. 

INDIAN EDUCATION

The bill includes $120,856,000 for Indian education. This amount 

is the same as the fiscal year 2004 appropriation and the budget 

request. This account supports programs authorized by part A of 

Title VII of the Elementary and Secondary Education Act and section 215 of the Department of Education Organization Act. 

163 

Grants to local educational agencies 

The bill provides $95,933,000 for grants to local education agencies, the same as the budget request and the fiscal year 2004 

amount. This program provides assistance through formula grants 

to school districts and schools supported or operated by the Bureau 

of Indian Affairs. The purpose of this program is to reform elementary and secondary school programs that serve Indian students, including preschool children. Grantees must develop a comprehensive 

plan and assure that the programs they carry out will help Indian 

students reach the same challenging standards that apply to all 

students. This program supplements the regular school program to 

help Indian children sharpen their academic skills, bolster their 

self-confidence, and participate in enrichment activities that would 

otherwise be unavailable. 

Special programs for Indian children 

The Committee recommends $19,753,000 for special programs for 

Indian children, the same as fiscal year 2004 and the budget request. These programs make competitive awards to improve the 

quality of education for Indian students. This program also funds 

a new Indian Teacher Corps, which hopes to train over 1,000 Indian teachers over a five-year period to take positions in schools 

that serve concentrations of Indian children. 

National activities 

The bill provides $5,170,000 for national activities, the same as 

fiscal year 2004 and the budget request. Funds under this authority support research, evaluation and data collection to provide information on the status of education for the Indian population and 

on the effectiveness of Indian education programs. 

INNOVATION AND IMPROVEMENT

The bill includes $669,936,000 for innovation and improvement 

programs. This amount is $432,690,000 less than the comparable 

fiscal year 2004 appropriation and $215,245,000 below the budget 

request for comparable programs. This appropriation account includes programs authorized under part G of title I and portions of 

titles II and V of the Elementary and Secondary Education Act. 

Troops to teachers 

The bill includes $14,912,000 for troops to teachers, the same as 

the budget request and the fiscal year 2004 level. This program is 

designed to assist eligible members of the armed forces to obtain 

certification or licensure as elementary and secondary school teachers, or vocational or technical teachers. The transition to teachers 

program is based on the model of the troops to teachers program 

and would address the need of high-need school districts for highly 

qualified teachers. 

Transition to teaching 

The bill includes $45,295,000 for transition to teaching, the same 

as the budget request and the fiscal year 2004 level. Transition to 

teaching is designed to help mitigate the shortage of qualified licensed or certified teachers in many of our Nation’s schools. The 

164 

program provides grants to help support efforts to recruit, train 

and place talented individuals into teaching positions and to support them during their first years in the classroom. In particular, 

the program focuses on mid-career professionals with substantial 

career experience, and recent college graduates. Grants are made 

on a competitive basis. 

National writing project 

The bill provides $17,894,000 for the National Writing Project, 

the same as the fiscal year 2004 level. The President’s budget did 

not request funding for this program. Funds are provided to the 

National Writing Project, a nonprofit educational organization that 

supports teacher training programs in the effective teaching of 

writing, and supports classroom-level research on teaching writing 

that documents effectiveness in terms of student performance. To 

provide these services, the National Writing Project contracts with 

numerous institutions of higher education and nonprofit education 

providers to operate small teacher training programs. Federal 

funds support 50 percent of the costs of these programs, and recipients must contribute an equal amount. 

Teaching of traditional American history 

The bill does not include funding for the teaching of traditional 

American history, $119,292,000 below the budget request and the 

fiscal year 2004 level. This program supports competitive grants to 

school districts to promote the teaching of American history in elementary and secondary schools as a separate academic subject. 

School leadership 

The bill includes $15,000,000 for school leadership activities, 

$2,654,000 above the fiscal year 2004 level. The President’s budget 

did not propose funding for this program. The program provides 

competitive grants to assist high-need school districts with recruiting, training, and retaining principals and assistant principals. 

Advanced credentialing 

The bill includes $18,391,000 for advanced credentialing, the 

same as the fiscal year 2004 level and $11,391,000 above the budget request. The program authorizes competitive grants to states, 

school districts, the National Board for Professional Teaching 

Standards (NBPTS) working with a district or states, the American 

Board for the Certification of Teacher Excellence working with a 

district or state, or another certification or credentialing organization working with a district or state. The program supports activities to encourage and support teachers seeking advanced certification or credentialing. 

The Committee has included funding to continue the evaluation 

described in the fiscal year 2004 conference agreement relating to 

the National Board for Professional Teaching Standards. The Committee further intends that $10,000,000 of the funds be awarded to 

the National Board for Professional Teaching Standards and that 

$7,000,000 be awarded to the American Board for the Certification 

of Teacher Excellence. 

165 

Charter schools 

The Committee recommends $218,702,000 for support of charter 

schools, the same as the budget request and the fiscal year 2004 

amount. Charter schools are developed and administered by individuals or groups of individuals, which may include teachers, administrators, and parents. These groups enter into charters for operation of their schools, which must be granted exemptions from 

State and local rules that limit flexibility in school operation and 

management. Under this program, grants are made to State educational agencies in States that have charter school laws; the State 

educational agencies will in turn make sub-grants to authorized 

public chartering agencies in partnerships with developers of charter schools. 

Credit enhancement for charter school facilities 

The bill includes $50,000,000 for credit enhancement for charter 

school facilities, $50,000,000 below the budget request and 

$12,721,000 above fiscal year 2004. This program helps charter 

schools meet their facility needs by providing funding on a competitive basis to leverage other funds and help charter schools obtain 

school facilities by means such as purchase, lease and donation. 

Charter schools are more likely than traditional schools to have 

problems obtaining adequate facilities because they are perceived 

as more financially risky than other schools, and unlike traditional 

school districts, charter schools generally lack the ability to issue 

general obligation bonds backed by property taxes. 

Voluntary public school choice 

The bill includes $26,757,000 for voluntary public school choice, 

the same as the budget request and the fiscal year 2004 level. This 

program supports efforts to establish intradistrict and interdistrict 

public school choice programs to provide parents with greater 

choice for their children’s education. Funds are used to make competitive awards to states, school districts or partnerships. 

Magnet schools assistance 

The bill includes $108,640,000 for the magnet schools assistance 

program, the same as the budget request and the fiscal year 2004 

level. The magnet schools assistance program awards competitive 

grants to local educational agencies for use in establishing or operating magnet schools that are part of a desegregation plan approved by a court or by the Department of Education’s Office for 

Civil Rights. A magnet school is defined by the statute as ‘‘a school 

or education center that offers a special curriculum capable of attracting substantial numbers of students of different racial backgrounds.’’ A funding priority is given to local educational agencies 

that did not receive a grant in the preceding fiscal year. 

The Committee is aware that three applications submitted for 

competition in the spring of 2004 were determined to be ineligible 

for consideration. The Committee urges the Secretary to reconsider 

means by which these applications could be considered for funding 

in fiscal year 2004. 

166 

Fund for the improvement of education 

The bill includes $100,000,000 for the fund for the improvement 

of education, $330,270,000 below the fiscal year 2004 level and 

$70,185,000 below the budget request. The fund for the improvement of education has a broad portfolio of activities. Under the 

fund, the Secretary of Education supports activities that identify 

and disseminate innovative educational approaches. Several separate program authorities are included in this line item. Within the 

total, the committee has included $50,000,000 for the following activities: 

All Kinds of Minds, for start-up, expansion and research for the 

Schools Attuned teacher training program; American Film Institute, for a hands-on learning method; Battelle for Kids, for a multistate effort to evaluate and learn the most effective ways for accelerating student academic growth; Carnegie Hall, for K–12 curriculum development; College Summit, for increasing the college 

enrollment rate of low-income youth; EARTH University Foundation, for student scholarships; Education Leaders Council, for expansion of the Following the Leaders program; Foundations for 

Learning Grants authorized by section 5542 of the No Child Left 

Behind Act of 2001, $1,000,000; Girl Scouts of America, for a Math 

and Science program; Institute of Heart Math, for a national demonstration on student standardized testing; Knowledge Is Power 

Program (KIPP), for support for training, instruction and organizational leadership; the Mesorah Heritage Foundation, for translation 

of classic texts; the Milken Family Foundation, for expansion of the 

Teacher Advancement Program into five additional states; Reach 

Out and Read, for expansion on an early literacy program; Special 

Olympics, to promote access to physical education for mentally disabled people worldwide; Starr Commonwealth Foundation, for expansion of the No Disposable Kids initiative; and Teach for America, for expansion of recruitment and training of new teachers to 

low-income areas. 

The Committee has included additional funding for other teacher 

training and reading activities authorized by part D of title V of 

the No Child Left Behind Act of 2001. 

Ready to Learn Television 

The bill includes $22,864,000 for the Ready to Learn Television 

program, the same as the budget request and the fiscal year 2004 

level. Ready to Learn supports the development and distribution of 

educational video programming for preschool children, elementary 

school children and their parents. Only public telecommunications 

entities are eligible to receive awards. 

Dropout prevention programs 

The bill does not include funding for the dropout prevention program, the same as the budget request. This program was funded 

at $4,970,000 in fiscal year 2004. The dropout prevention program 

provides assistance to help schools implement effective school dropout prevention and reentry programs. This program has only been 

funded for two years, and has made only about two dozen awards. 

The Committee notes that districts desiring to implement dropout 

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grams to support such efforts; hence there is no need for a separately funded line-item to accomplish this purpose. 

Ellender fellowships/Close-Up 

The bill includes $1,481,000 for Ellender fellowships, the same as 

the fiscal year 2004 level. The budget did not propose funding for 

this program. The Ellender fellowship program makes an award to 

the Close-Up Foundation of Washington D.C. This organization 

provides fellowships to students from low income families and their 

teachers to enable them to participate with other students and 

teachers for a week of seminars on government and meetings with 

representatives of the three branches of the Federal government. 

Advanced placement test fee program 

The Committee recommends $30,000,000 for advanced placement fees. This recommendation is $21,534,000 below the budget request 

and $6,466,000 above the fiscal year 2004 amount. The advanced 

placement test fee program awards grants to States to enable them 

to cover part or all of the cost of advanced placement test fees of 

low-income students who are enrolled in advanced placement classes and plan to take the advanced placement test. This program also 

supports competitive grants to states, school districts and national 

nonprofit educational agencies for programs that encourage greater 

participation by low-income students in advanced placement 

courses. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

The bill includes $801,369,000 for school improvement programs. This amount is $54,405,000 less than the comparable fiscal year 

2004 appropriation and $37,528,000 below the budget request for 

comparable programs. This appropriation account includes programs authorized under parts of titles II, IV, and V of the Elementary and Secondary Education Act. 

Safe and drug-free schools and communities: State grants 

The Committee bill includes $440,908,000 for the State grants 

program, the same as the budget request and the fiscal year 2004 

level. The program supports State formula grants for comprehensive, integrated approaches to drug and violence prevention. Local 

educational agencies must use their funds to implement a drug and 

violence prevention program for students and employees. 

The Committee is interested in the degree to which school districts are making use of their authority to transfer up to 50 percent 

of their Safe and Drug Free Schools money to the Title I program. 

The Committee urges the Secretary to encourage school districts to 

report these transfers so the resulting funding levels for both programs can be determined and so that local practices across the nation can be better understood. 

The Committee is deeply concerned that between 5% to 9% of all 

children suffer from a mental, behavioral or emotional disorder 

which, if undiagnosed and untreated, can substantially interfere 

with academic achievement, or lead to student drop-out, substance 

abuse, violent behavior, or suicide. In its July 2003 report the 

President’s New Freedom Commission on Mental Health concluded 

that greater reliance on early detection, assessment and links with 

168 

adequate treatment and support systems can help avoid or ameliorate these outcomes. The report concluded that schools are in a 

unique position to identify mental health problems in their early 

stages, and to provide a link to appropriate services, citing examples of evidence-based screening techniques and tools already being 

utilized by some schools. The Committee reiterates language contained in the FY2004 report, and calls upon the Office of Safe and 

Drug Free Schools to work with the Substance Abuse and Mental 

Health Services Administration to take concrete steps to promote 

and help implement early detection and assessment programs in 

our nation’s schools. 

Safe and drug-free schools and communities: national programs 

For the national programs under the Safe and Drug-Free Schools 

and Communities Act, the bill provides $153,767,000, the same as 

the fiscal year 2004 amount and $21,302,000 below the budget request. Under this program, the Secretary of Education administers 

a variety of activities to prevent the illegal use of drugs and violence among, and promote safety and discipline for, students at all 

educational levels, preschool through postsecondary. Within the 

amount provided, the Committee intends that the student drug 

testing pilot program be funded at a level of at least $10,000,000. 

Alcohol abuse reduction 

The bill does not include funding for grants to reduce alcohol 

abuse, the same as the budget request and $29,823,000 below the 

fiscal year 2004 level. This program awards competitive grants to 

districts to develop and implement innovative and effective programs to reduce alcohol abuse in secondary schools. 

Mentoring programs 

The bill includes $49,705,000 for mentoring programs which provide competitive grants to school districts and community-based organizations to promote mentoring programs for children with the 

greatest need. This is $50,295,000 below the budget request and 

the same as the fiscal year 2004 level. 

Character education 

The bill includes $24,961,000 for character education, an increase 

of $270,000 over the fiscal year 2004 level and the budget request. 

This program provides support for the design and implementation 

of character education programs in elementary and secondary 

schools. Grantees may select the elements of character that will be 

taught, and must consider the views of parents and students to be 

served by the program. 

Elementary and secondary school counseling 

The bill includes $33,799,000 for elementary and secondary 

school counseling, the same as the fiscal year 2004 level. The budget did not propose funding for this program. This program provides 

grants to school districts to enable them to establish or expand elementary school and secondary school counseling programs. 

169 

Physical education for progress 

The bill includes $69,587,000 for the physical education for 

progress program, the same as the budget request and the fiscal 

year 2004 level. The Committee expects that funds will be used to 

develop programs that can provide information to states, school districts and other youth organizations on the most effective methods 

for encouraging all students—not simply those who are already 

participating in competitive sports—to develop positive attitudes 

about fitness and increased levels of personal fitness. 

Civic education 

The bill includes $28,642,000 for civic education, the same as the 

fiscal year 2004 level and the budget request. Program funds support the ‘‘We the People’’ and the Cooperative Education Exchange 

programs. ‘‘We the People’’ seeks to promote civic competence and 

responsibility among students. Cooperative Education Exchange 

provides support for education exchange activities in civics and economics between the United States and eligible countries in Central 

and Eastern Europe, the Commonwealth of Independent States, 

any country that was formerly a republic of the Soviet Union, the 

Republic of Ireland, the province of Northern Ireland and developing countries with a democratic form of government. 

State grants for incarcerated youth offenders 

The bill does not include funding for state grants for incarcerated 

youth offenders, the same as the budget request and $24,852,000 

below the fiscal year 2004 level. This program makes grants to 

state correctional agencies to assist and encourage incarcerated 

youths to acquire functional literacy skills and life and job skills. 

ENGLISH LANGUAGE ACQUISITION

The bill includes $681,215,000 for English language acquisition 

programs. This amount is the same as the budget request and the 

comparable fiscal year 2004 appropriation level. 

This program provides formula grants to states to serve limited 

English proficient students. Grants are based on each state’s share 

of the Nation’s limited English proficient and recent immigrant 

student population. Funds under this account also support professional development to increase the pool of teachers prepared to 

serve limited English proficient students and evaluation activities. 

SPECIAL EDUCATION

The bill includes $12,176,101,000 for programs for children with 

disabilities authorized under the Individuals with Disabilities Education Act (IDEA). This funding level is the same as the budget request and $1,015,393,000 above the comparable fiscal year 2004 

appropriation. 

State Grants: Grants to States for special education 

The bill provides $11,068,106,000 for grants to States, which is 

the same as the budget request and $1,000,000,000 above the fiscal 

year 2004 level. Out of the total made available for school year 

2005–2006, $5,655,106,000 is appropriated for fiscal year 2005 for 

170 

obligation after July 1, 2005 and 5,413,000,000 is appropriated for 

fiscal year 2006 for obligation on, or after, October 1, 2005. 

This program provides formula grants to assist the States in 

meeting the excess costs of providing special education and related 

services to children with disabilities. In order to be eligible for 

funds, States must make free appropriate public education available to all children with disabilities. Funds are distributed based 

on the amount that each State received from the fiscal year 1999 

appropriation, and the numbers of children in the general population and who live in poverty in the age range for which each 

State mandates free appropriate public education for children with 

disabilities. 

State grants: Preschool grants 

The bill provides $387,699,000 for preschool grants, the same as 

the fiscal year 2004 level and the budget request. This program 

provides grants to States on the basis of their proportionate share 

of the total number of children in the 3 through 5 age range and 

the number of these children living in poverty. These funds are 

provided in order to assist States to make a free appropriate public 

education available to all children with disabilities in the 3 through 

5 age range. 

State Grants: Grants for infants and families 

The bill provides $466,581,000 for grants for infants and families, $22,218,000 above the fiscal year 2004 level and the same as 

the budget request. This formula grant program assists States in 

developing and implementing statewide systems of coordinated, 

comprehensive, multidisciplinary, interagency programs to make 

available early intervention services to all children with disabilities, aged birth through 2, and their families. 

IDEA National Activities: State improvement 

The bill includes $51,061,000 for State improvement, the same as 

the budget request and the fiscal year 2004 appropriation. This 

program supports competitive grants to State educational agencies 

to assist them, in partnership with parents, teachers, institutions 

of higher education, interest groups, and others, to improve results 

for children with disabilities by reforming and improving their educational, early intervention, and transitional service systems. 

Among these systems are those for professional development, technical assistance, and dissemination of knowledge about best practices. Awards are based on State improvement plans developed by 

the States. 

IDEA National Activities: Technical assistance and dissemination 

The bill includes $52,819,000 for technical assistance and dissemination, the same as the budget request and the fiscal year 

2004 appropriation. This program provides technical assistance and 

information through competitive awards that support institutes, regional resource centers, clearinghouses, and efforts to build State 

and local capacity to make systemic changes and improve results 

for children with disabilities. 

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IDEA National Activities: Personnel preparation 

The bill includes $91,357,000 for personnel preparation, which is 

the same as the budget request and the fiscal year 2004 appropriation. This program supports competitive awards to help address 

State-identified needs for qualified personnel to work with children 

with disabilities, and to ensure that those personnel have the skills 

and knowledge they need to serve those children. Awards focus on 

addressing the need for personnel to serve low-incidence populations and high-incidence populations, leadership personnel, and 

projects of national significance. 

IDEA National Activities: Parent information centers 

The bill includes $26,173,000 for parent information centers, the 

same as the fiscal year 2004 level and the budget request. This program makes awards to parent organizations to support parent 

training and information centers, including community parent resource centers. These centers provide training and information to 

meet the needs of parents of children with disabilities living in the 

areas served by the centers, particularly underserved parents and 

parents of children who may be inappropriately identified. Technical assistance is also provided under this program for developing, 

assisting and coordinating centers receiving assistance under this 

program. 

IDEA National Activities: Technology and media services 

The bill includes $32,305,000 for technology and media services, 

which is $6,824,000 below the fiscal year 2004 appropriation and 

the same as the budget request. This program makes competitive 

awards to support the development, demonstration, and use of 

technology and educational media activities of educational value to 

children with disabilities. 

The bill includes $11,400,000 for Recording for the Blind and 

Dyslexic Inc. These funds support continued production and circulation of recorded textbooks, increased outreach activities to 

print-disabled students and their teachers and accelerated use of 

digital technology. The Committee believes that the funds recommended will enable RFB&D to significantly expand its service 

to students with print disabilities and to continue the digital production and use of its extensive library of educational materials. 

The Committee continues to recognize the importance of very 

small businesses in increasing the quality and cost effectiveness of 

the television-captioning program. As this program transitions into 

a mandated program as authorized by the Telecommunications Act, 

the Department shall give full and fair consideration to the applications for very small businesses. The Committee directs the Department to submit a report to Congress regarding its treatment of 

small and very small businesses no later than April 2005. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

The bill includes $3,054,587,000 for rehabilitation services and 

disability research. This amount is $7,390,000 above the budget request and $43,317,000 above the fiscal year 2004 appropriation. 

The programs in this account are authorized by the Rehabilitation 

172 

Act of 1973, the Helen Keller National Center Act, and the Assistive Technology Act of 1998. 

Vocational rehabilitation grants to States 

For vocational rehabilitation State grants, the bill includes $2,635,845,000, $51,683,000 above fiscal year 2004. This program 

supports basic vocational rehabilitation services through formula 

grants to the States. These grants support a wide range of services 

designed to help persons with physical and mental disabilities prepare for and engage in gainful employment to the extent of their 

capabilities. Emphasis is placed on providing vocational rehabilitation services to persons with the most significant disabilities. 

Client assistance 

The bill includes $11,997,000 for the client assistance program, 

the same as the budget request and the fiscal year 2004 amount. 

A client assistance program is required in each State as a condition 

of receipt of a basic State grant. State formula grants are used to 

help persons with disabilities overcome problems with the service 

delivery system and improve their understanding of services available to them under the Rehabilitation Act. 

Training 

For training personnel to provide rehabilitation services to per- sons with disabilities, the bill includes $39,139,000, the same as 

the budget request and the fiscal year 2004 amount. The program 

supports long-term and short-term training, in-service personnel 

training, and training of interpreters for deaf persons. Projects in 

a broad array of disciplines are funded to ensure that skilled personnel are available to serve the vocational needs of persons with 

disabilities. 

Demonstration and training programs 

The bill includes $18,784,000 for demonstration and training programs, the same as the budget request and $5,502,000 below the 

fiscal year 2004 level. These programs authorize discretionary 

awards on a competitive basis to public and private organizations 

to support demonstrations, direct services, and related activities for 

persons with disabilities. 

Migrant and seasonal farmworkers 

For programs serving migrant and seasonal farmworkers, the bill 

provides $2,321,000, which is the same as the fiscal year 2004 

amount and $2,321,000 above the budget request. This program 

provides discretionary grants to make comprehensive vocational rehabilitation services available to migrant and seasonal farmworkers with vocational disabilities. Projects emphasize outreach 

activities, specialized bilingual rehabilitation counseling, and coordination of vocational rehabilitation services with services from 

other sources. 

Recreational programs 

For recreational programs, the bill provides $2,564,000, the same 

as the fiscal year 2004 amount and $2,564,000 above the budget request. This program provides individuals with recreation and reVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00172 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
173 

lated activities to aid in their employment, mobility, independence, 

socialization, and community integration. Discretionary grants are 

made on a competitive basis to States, public agencies, and nonprofit private organizations, including institutions of higher education. 

Protection and advocacy of individual rights 

For protection and advocacy for persons with disabilities, the bill provides $16,790,000, $2,780,000 below the budget request and the 

same as the fiscal year 2004 level. Grants are awarded to entities 

that have the authority to pursue legal, administrative, and other 

appropriate remedies needed to protect and advocate the rights of 

persons with disabilities. 

Projects with industry 

For projects with industry, the bill provides $21,799,000, the same as the fiscal year 2004 amount and $21,799,000 above the 

budget request. This program is the primary Federal vehicle for 

promoting greater participation of business and industry in the rehabilitation process. The program provides training and experience 

in realistic work settings to persons with disabilities to prepare 

them for employment in the competitive labor market. Awards are 

made to a variety of agencies and organizations, including business 

and industrial corporations, rehabilitation facilities, labor organizations, trade associations, and foundations. 

Supported employment State grants 

For supported employment State grants, the bill includes $37,680,000, which is the same as the fiscal year 2004 amount and 

$37,680,000 above the budget request. These formula grants assist 

States in developing collaborative programs with public agencies 

and nonprofit agencies for training and post-employment services 

leading to supported employment. In supported employment programs, persons with significant disabilities are given special supervision and assistance to enable them to work in an integrated setting. 

Independent living: State grants 

For State grants for independent living, the bill includes 

$25,000,000. This amount is $2,980,000 above the budget request 

and the fiscal year 2004 level. This program supports formula 

grants to the States to provide services for independent living for 

persons with significant disabilities. 

Independent living: centers 

For centers for independent living, the bill provides $75,000,000, 

which is $1,437,000 above the budget request and the fiscal year 

2004 level. Discretionary grants support a network of consumercontrolled, nonresidential, community-based private nonprofit centers that provide a wide range of services to help persons with significant disabilities live more independently in family and community settings. Centers provide information and referral services, 

independent living skills training, peer counseling, and individual 

and systems advocacy. Discretionary grants are made to private 

nonprofit organizations. 

174 

Independent living: services for older blind persons 

For independent living services for older blind individuals, the bill provides $35,000,000. This amount is $3,189,000 above the fiscal year 2004 amount and the budget request. Discretionary grants 

support services for persons 55 years old or over whose severe visual impairment makes gainful employment extremely difficult to 

obtain, but for whom independent living goals are feasible. 

Program improvement 

For program improvement activities, the bill provides $850,000, which is $39,000 below the fiscal year 2004 level and the same as 

the budget request. The program: (1) provides technical assistance 

and consultative services to public and non-profit private agencies 

and organizations; (2) provides short-term training and technical 

instruction; (3) conducts special demonstrations; (4) collects, prepares, publishes and disseminates educational or informational materials; and (5) carries out monitoring and conducts evaluations. 

Evaluation 

The bill includes $1,500,000 for program evaluation, the same as the budget request and $512,000 above the fiscal year 2004 level. 

These funds are used to evaluate the impact and effectiveness of 

individual programs authorized under the Rehabilitation Act. Contracts are awarded on an annual basis for studies to be conducted 

by persons not immediately involved in the administration of the 

programs authorized by the Act. 

Helen Keller National Center 

For the Helen Keller National Center for Deaf-Blind Youth and 

Adults, the bill includes $8,666,000, the same as the fiscal year 

2004 amount and the budget request. These funds are used for the 

operation of the national center for intensive services for deaf-blind 

individuals and their families at Sands Point, New York and a network of 10 regional offices for referral and counseling and technical 

assistance. 

National Institute on Disability and Rehabilitation Research 

The bill includes $106,652,000 for the National Institute on Disability and Rehabilitation Research, the same as the budget request and the fiscal year 2004 level. The Institute supports research, demonstration and training activities that are designed to 

maximize the employment and integration into society of individuals with disabilities of all ages. 

Assistive technology 

For assistive technology activities, the bill provides $15,000,000, $10,943,000 below the fiscal year 2004 amount and the same as the 

budget request. Technology assistance activities are authorized 

under the Assistive Technology Act of 1998. This Act authorizes the 

following activities: discretionary grants to the States to assist 

them in developing statewide programs to facilitate the provision 

of devices for, and services to, persons with disabilities; protection 

and advocacy services related to assistive technology; discretionary 

grants to the states for alternative financing programs; and technical assistance activities. 

175 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

The bill provides $17,000,000 for the American Printing House 

for the Blind, an increase of $597,000 above the fiscal year 2004 

appropriation and the budget request. This appropriation subsidizes the production of educational materials for legally blind persons enrolled in pre-college programs. The Printing House, which 

is chartered by the State of Kentucky, manufactures and maintains 

an inventory of special materials that is distributed free of charge 

to schools and States based on the number of blind students in 

each State. The Printing House also conducts research and field activities to inform educators about the availability of materials and 

how to use them. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

The bill provides $55,790,000 for the National Technical Institute 

for the Deaf (NTID), an increase of $2,307,000 above the comparable fiscal year 2004 amount and $1,987,000 above the request. 

Within the total, $1,685,000 is specified for construction. The NTID 

was established by Congress in 1965 to provide a residential facility for postsecondary technical training and education for deaf persons with the purpose of promoting the employment of deaf individuals. The Institute also conducts applied research and provides 

training in various aspects of deafness. The Secretary of Education 

administers these activities through a contract with the Rochester 

Institute of Technology in Rochester, New York. 

GALLAUDET UNIVERSITY

The bill provides $104,000,000 for Gallaudet University, an increase of $3,795,000 above the fiscal year 2004 appropriation and 

the budget request. Gallaudet is a private, non-profit educational 

institution Federally-chartered in 1864 providing elementary, secondary, undergraduate, and continuing education for deaf persons. 

In addition, the University offers graduate programs in fields related to deafness for deaf and hearing students, conducts various 

research on deafness, and provides public service programs for deaf 

persons. 

VOCATIONAL AND ADULT EDUCATION

The bill includes $2,025,456,000 for vocational and adult education programs. This amount is $76,531,000 below the fiscal year 

2004 appropriation and $423,223,000 above the budget request. 

This appropriation account includes vocational education programs 

authorized by the Carl D. Perkins Vocational and Applied Technology Education Act. The account also includes adult education 

programs originally authorized by the Adult Education Act and reauthorized under the Workforce Investment Act of 1998. 

Vocational education basic grants 

This bill includes $1,215,008,000 for basic grants to States under 

the Carl D. Perkins Vocational and Technical Education Act of 

1998, which is $20,000,000 above the fiscal year 2004 amount and 

$203,008,000 above the comparable budget request. Out of the total 

176 

made available for school year 2004–2005, $424,008,000 is appropriated for fiscal year 2005 for obligation after July 1, 2005 and 

$791,000,000 is appropriated for fiscal year 2006 for obligation on, 

or after, October 1, 2005. 

State grants support a variety of vocational education programs 

developed in accordance with the State plan. The Act concentrates 

federal resources on institutions with high concentrations of low-income students. The populations assisted by Basic Grants range 

from secondary students in pre-vocational courses to adults who 

need retraining to adapt to changing technological and labor markets. 

Tech-prep 

The bill includes $106,665,000 for tech-prep, the same as fiscal 

year 2004. The budget request did not propose separate line item 

funding for this program. This appropriation includes activities 

under title II of the Carl D. Perkins Vocational and Technical Education Act of 1998. The tech-prep education program provides planning and demonstration grants to consortia of local educational 

agencies and postsecondary institutions to develop and operate 

model technical education programs. These programs begin in high 

school and provide students with the mathematical, science, communications and technological skills needed to enter a 2-year associate degree or 2-year certificate program in a given occupational 

field, and to make a successful transition into further postsecondary education or begin their careers. The purpose of tech-prep 

is to develop structural links between secondary and postsecondary 

institutions that integrate academic and vocational education and 

better prepares students to make the transition from school to careers. 

National programs 

For national programs, the Committee provides $11,852,000, 

which is the same as the fiscal year 2004 amount. The budget did 

not request separate funding for this program. This authority supports the conduct and dissemination of research in vocational education, and includes support for the National Centers for Research 

and Dissemination in Career and Technical Education, five regional curriculum coordination centers, and other discretionary research. 

Tech-Prep Education Demonstration 

The bill does not include funding for the Tech-Prep Education 

Demonstration. The President’s budget did not request funding for 

it. Last year this program was funded at $4,939,000. The program 

makes competitive grants to consortia to establish Tech-prep programs in secondary schools located on the sites of community colleges. 

Occupational and Employment Information Program 

The bill does not include funding for the Occupational and Employment Information Program. The President’s budget did not request funding for it. Last year this program was funded at 

$9,382,000. The program provides career information and guidance 

177 

services to students and adults through a network of state agencies. 

State programs for adult education 

For state grants, the Committee recommends $574,372,000, 

which is the same as the fiscal year 2004 amount, and the same 

as the comparable budget request. State formula grants support 

programs to enable all adults to acquire basic literacy skills, to enable those who so desire to complete a secondary education, and to 

make available to adults the means to become more employable, 

productive, and responsible citizens. 

Grants are provided on a formula basis to States under the new 

Adult Education and Family Literacy Act. The formula provides an 

initial allotment of $25,000 for each state and $100,000 to each outlying area, with additional allotments distributed on the basis of 

population aged 16 through 60 who are without a high school diploma or equivalent who are not enrolled in secondary school. 

States may use 12.5 percent of their allotments for state leadership activities and may use an additional 5 percent or $65,000 for 

state administration. States and localities must give priority to 

adult education and literacy activities that are built on a strong 

foundation of research on effective practices and that effectively 

employ technology. Funds are provided on a forward-funded basis. 

The Committee notes that over 40 percent of new adult education 

entrants are seeking English as-a-second language (ESL) services 

and that ESL accounts for 51 percent of all adults receiving adult 

education services and 76 percent of the hours of instruction received. The Committee expects that the funds provided in this program will be used by states with large concentrations of students 

who seek English language proficiency training to meet the needs 

of those individuals. The Committee bill retains language similar 

to that contained in last year’s bill that guarantees a portion of the 

funds will be used to provide civics education services to new immigrants. 

National Programs—National Leadership Activities 

The Committee provides $9,169,000 for national leadership activities. This amount is the same as the fiscal year 2004 level and 

the budget request. Through applied research, development, dissemination, evaluation, and program improvement activities, this 

program assists State efforts to improve the quality of adult education. The funds support such projects as evaluations on the status and effectiveness of adult education programs, national and 

international adult literacy surveys, and technical assistance on 

using technology to improve instruction and administration that 

show promise of contributing to the improvement and expansion of 

adult education. 

National Institute for Literacy 

For the National Institute for Literacy, the bill provides 

$6,692,000, which is the same as the fiscal year 2004 amount and 

the budget request. The Institute supports research and development projects, tracks progress made toward national literacy goals, 

supports research fellowships, disseminates information through a 

178 

national clearinghouse, and coordinates literacy information data 

from national and State sources. 

Smaller learning communities 

The bill includes $101,698,000 for the smaller learning program, $72,269,000 below fiscal year 2004. The Administration did not request funding for this program. The Committee reiterates its 

strong support for the smaller learning communities program but 

was unable to provide additional resources due to budget constraints. As in past years, the bill specifies that these funds shall 

be used only for activities related to the redesign of large high 

schools enrolling 1,000 or more students. 

The Committee requests that the Department fully consult with 

the Appropriations Committees prior to the release of the fiscal 

year 2004 and fiscal year 2005 program guidance for the smaller 

learning communities program. The Committee believes the Department must improve its leadership, outreach and technical assistance for smaller learning communities. Therefore, the Committee requests the Secretary to develop an aggressive plan to ensure that school districts have clear and timely guidance, adequate 

time to apply for federal assistance and to receive such assistance 

well in advance of the start of the school year, sufficient time and 

resources to accomplish the complex task of restructuring high 

schools, access to technical assistance providers with experience in 

establishing smaller learning communities, and a support network 

to share best practices. This plan shall also describe in detail the 

planned allocation of the five percent set aside for national activities for fiscal year 2004 and fiscal year 2005. The Secretary shall 

submit a letter report to the Committee describing this plan not 

later than January 1, 2005. 

Community technology centers 

The bill does not include funding for community technology cen- ters, $9,941,000 below the fiscal year 2004 level and the same as 

the request. The program provides competitive grants to create and 

expand community technology centers that offer disadvantaged 

residents of economically distressed urban and rural communities 

access to information technology and related training. Other Federal programs also exist that fund communities that want to establish and operate technology centers. 

STUDENT FINANCIAL ASSISTANCE

The bill provides $14,755,794,000 for student financial assistance 

programs, an increase of $748,498,000 over the comparable fiscal 

year 2004 appropriation and $57,172,000 above the budget request. 

Pell grants 

The bill maintains the maximum Pell Grant at $4,050, the same 

as the budget request and the comparable fiscal year 2004 amount. 

The bill provides $12,830,000,000 in new budget authority for the 

Pell Grant program, the same as the request and $823,262,000 

above the comparable fiscal year 2004 amount. Pell Grants provide 

portable education vouchers to postsecondary students who may 

use them at any of over 6,000 eligible schools. The bill does not include funding for enhanced Pell grants for state scholars, which the 

179 

administration requested at $33,000,000. The Committee notes 

that this program has not been authorized. 

Federal Supplemental Educational Opportunity Grants 

The bill provides $794,455,000 for federal supplemental edu- cational opportunity grants, $24,000,000 above the request and the 

fiscal year 2004 level. The SEOG program provides grants through 

postsecondary institutions to qualified students who demonstrate 

exceptional financial need. Institutions have broad flexibility within the eligibility criteria for awarding these grants with the exception that priority must be given to Pell Grant recipients. 

Work-study 

The bill provides $998,502,000 for the work-study program, the 

same as the comparable fiscal year 2004 appropriation and the 

budget request. Funding for this program is provided through institutions to students who work part-time to meet the cost of education. Institutions receive funding according to a statutory formula and may allocate it for job location and job development centers. 

Perkins loans capital contributions 

The bill does not include funding for new capital contributions to 

federal Perkins revolving loan funds, the same as the budget request. This program received $98,764,000 in fiscal year 2004. The 

committee is aware that the Perkins program currently has over 

$1,000,000,000 in its revolving fund that can be used to make new 

awards to students. In addition, the Committee believes that the 

combination of a low interest rate environment and the availability 

of the Federal Family Education Loan Program and the Federal Direct Student Loan Program make additional capital contributions 

unnecessary this year. 

Perkins loans cancellations 

The bill provides $66,665,000 for federal Perkins loans cancellations, the same as the budget request and the fiscal year 2004 

amount. The Federal Government reimburses institutional Perkins 

revolving loan funds for loan cancellations permitted under Federal 

law. Loans may be canceled when the borrower pursues a career 

in one of 12 statutorily-designated professions including corrections, medical technical work, and peace corps or VISTA service. 

Leveraging educational assistance partnership 

The bill includes $66,172,000 for the leveraging educational assistance partnership (LEAP) program, the same as the fiscal year 

2004 level and $66,172,000 above the budget request. LEAP provides dollar-for-dollar matching funds to States as an incentive for 

providing need-based grant and work study assistance to eligible 

postsecondary students. Federally supported grants and job earnings are limited to $5,000 per award year for full-time students. By 

law, each State’s allocation is based on its relative share of the 

total national population of students eligible to participate in the 

programs, except that no state is to receive less than it received in 

1979. If LEAP amounts are below this level, each State is allocated 

an amount proportional to the amount of funds it received in 1979. 

180 

If a state does not use all of its allocation, the excess funds are distributed to other States in the same proportion as the original distribution. States must, at a minimum, match LEAP grants dollar 

for dollar with state funds provided through direct state appropriations for this purpose. 

STUDENT AID ADMINISTRATION

The bill includes $120,247,000 in discretionary resources for the 

Student Aid Administration account. The Committee recommendation is $3,520,000 more than the comparable fiscal year 2004 funding level and $19,392,000 below the request, when adjusted for discretionary-scored spending. Funds appropriated to the Student Aid 

Administration account, in addition to mandatory funding available 

through Section 458 of the Higher Education Act, will support the 

Department’s student aid management expenses. The Federal Student Aid Office and the Office of Postsecondary Education have primary responsibility for administering Federal student financial assistance programs. The Committee bill does not include the Administration’s legislative proposal to fund this new account solely 

through annual appropriations. 

HIGHER EDUCATION

The bill provides $1,976,056,000 for higher education programs, a decrease of $116,586,000 below the fiscal year 2004 appropriation 

and $972,000 below the budget request. 

Strengthening institutions 

The bill provides $80,986,000 for the regular strengthening institutions program, the same as the budget request and the fiscal 

year 2004 level. This program provides general operating subsidies 

to institutions with low average educational and general expenditures per student and significant percentages of low-income students. Awards may be used for faculty and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student services. 

Hispanic serving institutions 

The bill provides $95,873,000 for the Hispanic serving institu- tions program, the same as the budget request and $1,880,000 

above the fiscal year 2004 level. The HSI program provides operating subsidies to schools that serve at least 25 percent Hispanic 

students of whom at least half are low-income students. 

Strengthening historically black colleges and universities 

The bill provides $240,500,000 for strengthening historically black colleges and universities (HBCUs), $17,736,000 above the fiscal year 2004 appropriation and the same as the budget request. 

This program provides operating subsidies to accredited, legally 

authorized HBCUs established prior to 1964 whose principal mission is the education of black Americans. Funds may be used to 

support both programs and management and are distributed 

through a formula grant based on the enrollment of Pell Grant recipients, number of graduates, and the number of graduates entering graduate or professional schools in which blacks are underrepresented. The minimum grant is $500,000. 

181 

Strengthening historically black graduate institutions 

The bill provides $58,500,000 for the strengthening historically 

black graduate institutions program, the same as the budget request and $5,400,000 above the fiscal year 2004 appropriation. 

The program provides 5-year grants to the following 18 post-secondary institutions that are specified in section 326(e)(1) of the 

Higher Education Act: Morehouse School of Medicine, Meharry 

Medical School, Charles R. Drew Postgraduate Medical School, 

Clark-Atlanta University, Tuskegee University School of Veterinary Medicine, Xavier University School of Pharmacy, Southern 

University School of Law, Texas Southern University Schools of 

Law and Pharmacy, Florida A&M University School of Pharmaceutical Sciences, North Carolina Central University School of Law, 

Morgan State University qualified graduate program, Hampton 

University qualified graduate program, Alabama A&M qualified 

graduate program, North Carolina A&T State University qualified 

graduate program, University of Maryland Eastern Shore qualified 

graduate program, Jackson State qualified graduate program, Norfolk State University and Tennessee State University. Of the 

amount appropriated, the first $26,600,000 is used to make grants 

to the first 16 institutions listed above. Any amount appropriated 

in excess of $26,600,000 but less than $28,600,000 is used to make 

grants to Norfolk State University and Tennessee State University 

and any remaining appropriation is made available to each of the 

18 institutions based on a formula. Awards may be used for building endowments as well as the same purposes for which the 

strengthening HBCU grants may be used. 

Strengthening Alaska Native and Native Hawaiian-serving institutions 

The Committee recommends $10,935,000 for strengthening Alaska Native and Native Hawaiian-serving institutions, the same as 

the fiscal year 2004 level and $4,798,000 above the budget request. 

Strengthening tribally controlled colleges and universities 

The Committee recommends $23,753,000 for the strengthening 

tribally controlled colleges and universities program, the same as 

the budget request and $466,000 above the fiscal year 2004 level. 

International education and foreign languages studies 

Domestic programs 

The bill provides $93,211,000 for the domestic activities of the 

international education and foreign languages studies programs, 

$4,000,000 above the fiscal year 2004 appropriation and the budget 

request. The program assists graduate and undergraduate foreign 

language and area studies programs and students at institutions of 

postsecondary education. Programs include national resource centers, foreign language and area studies fellowships, undergraduate 

international studies and foreign language programs, international 

research and studies projects, business and international education 

projects, international business education centers, language resource centers, American overseas research centers, and technological innovation and cooperation for foreign information access. In 

182 

general, the Secretary has discretion to allocate funding among 

these various activities. 

The Committee finds that globalization and the war on terrorism 

have increased America’s need for international experts as well as 

for citizens with foreign language skills and global understanding. 

The bill includes $1,500,000 of which $500,000 shall be derived 

from the one percent set aside for Title VI national activities, to 

support a contract with the National Research Council (NRC) of 

the National Academies, through its Division of Behavioral and Social Sciences and Education (DBASSE), for an independent review 

of the Title VI international education and foreign language studies 

and section 102(b)(6) Fulbright-Hays programs. 

The Committee requests that the NRC review the adequacy and 

effectiveness of Title VI and Fulbright-Hays in addressing their 

statutory missions and in building the nation’s international and 

foreign language expertise—particularly as needed for economic, 

foreign affairs and national security purposes. The study should include, but not be limited to, evaluating the performance of these 

programs in: (1) supporting research, education and training in foreign languages and international studies, including opportunities 

for such research, education and training overseas; (2) reducing 

shortages of foreign language and area experts; (3) infusing a foreign language and area studies dimension throughout the educational system and across relevant disciplines including professional education; (4) producing relevant instructional materials 

that meet accepted scholarly standards; (5) advancing uses of new 

technology in foreign language and international studies; (6) addressing business needs for international knowledge and foreign 

language skills; (7) increasing the numbers of underrepresented 

minorities in international service; and (8) conducting public outreach/dissemination to K–12 and higher education, media, government, business, and the general public. The study should convene 

experts and scholars widely accepted in the scholarly community 

with expertise in foreign language and international studies, including international business education. The study may commission the collection of new data and conduct appropriate, rigorous 

analyses of such data. The Committee requests that the NRC submit its final report to the Secretary of Education and the Congress 

not later than two years after date of enactment of this bill, with 

an interim report to be submitted after 15 months. 

Overseas programs 

The bill provides $12,840,000 for the overseas programs in international education and foreign language studies authorized under 

the Mutual Educational and Cultural Exchange Act of 1961, popularly known as the Fulbright-Hays Act. The appropriation is the 

same as the budget request and the fiscal year 2004 appropriation. 

Funding for these programs support group projects abroad, faculty 

research abroad, special bilateral projects, and doctoral dissertation 

research abroad. 

Institute for International Public Policy 

The bill provides $1,629,000 for the Institute for International 

Public Policy, the same as the budget request and the fiscal year 

2004 appropriation. This program provides a grant to an eligible 

183 

recipient to operate the Institute through sub-grantees chosen 

among minority serving institutions. 

Fund for the improvement of postsecondary education 

The Committee recommends $32,011,000 for the fund for the improvement of postsecondary education (FIPSE), the same as the 

budget request and $125,689,000 below the fiscal year 2004 

amount. FIPSE awards grants and contracts to a variety of postsecondary institutions and other organizations to improve the quality 

and delivery of postsecondary education. 

Minority science and engineering improvement 

The bill provides $8,889,000 for the minority science and engineering improvement program (MSEIP), the same as the fiscal year 

2004 appropriation and the budget request. 

The MSEIP program awards grants to improve mathematics, 

science, and engineering programs at institutions serving primarily 

minority students and to increase the number of minority students 

who pursue advanced degrees and careers in those fields. 

Interest subsidy grants 

The bill provides $1,500,000 for interest subsidy grants authorized under section 121 of the Higher Education Act, the same 

amount requested in the budget and $488,000 below the fiscal year 

2004 appropriation. This program provides loan subsidies to higher 

education institutions for facilities acquisition, construction and 

renovation loans taken prior to 1974. All loans will terminate by 

the fiscal year 2013. The authority to initiate new loan subsidy 

commitments was repealed in the 1992 amendments to the Higher 

Education Act. Interest subsidies provide institutions the difference 

between the interest they pay on commercially-obtained loans and 

3 percent of the loan balance. The bill provides funding sufficient 

to meet the Federal Government’s commitments on the loans expected to be in repayment status in fiscal year 2005. 

Tribally controlled postsecondary vocational and technical institutions 

The bill includes $7,185,000 for grants for tribally controlled 

postsecondary vocational and technical institutions, the same as 

the budget request and the fiscal year 2004 amount. This program 

provides grants for the operation and improvement of training programs to ensure continuation and expansion of vocational training 

opportunities for Indian youth. 

TRIO 

The bill provides $842,559,000 for the TRIO programs, 

$10,000,000 above the budget request and the fiscal year 2004 appropriation. The TRIO programs provide a variety of outreach and 

support services to encourage low-income, potential first-generation 

college students to enter and complete college. Discretionary grants 

of up to four or five years are awarded competitively to institutions 

of higher education and other agencies. At least two-thirds of the 

eligible participants in TRIO must be low-income, first-generation 

college students. 

184 

GEAR UP 

The bill includes $318,230,000 for the GEAR UP program, 

$20,000,000 above last year’s level and the budget request. GEAR 

UP provides grants to states and partnerships of low-income middle and high schools, institutions of higher education and community organizations to target entire grades of students and give 

them the skills and encouragement to successfully pursue postsecondary education. The Committee bill provides a sixth and final 

year award to grantees first funded in 2000, while continuing all 

other funded projects. The Committee also intends that these funds 

be available to eligible 1999 grantees that opt to apply for new 

grant awards upon completion of the original award. The Committee believes that grants should be awarded on an annual basis 

and expects the Department to consult with the Committee on Appropriations of both the House and the Senate prior to the announcement of any new grant competition. 

Byrd scholarships 

The bill does not include funding for the Byrd scholarships program, $40,758,000 below the budget request and the fiscal year 

2004 appropriation. The Byrd scholarship program provides formula grants to States to award $1,500 scholarships to students 

who demonstrate academic excellence in high school. 

Javits fellowships 

The Committee recommends $9,876,000 for the Javits fellowship 

program, the same as the budget request and the fiscal year 2004 

appropriation. Under the Javits program, institutions receive Federal support to make fellowship awards to students pursuing doctoral study in the arts, humanities, and social sciences. 

Graduate assistance in areas of national need program 

The Committee recommends $30,616,000 for the graduate assistance in areas of national need (GAANN) program, the same as the 

budget request and the fiscal year 2004 appropriation. The GAANN 

program awards grants to institutions of higher education to provide fellowships to economically disadvantaged students who have 

demonstrated academic excellence and who are pursuing graduate 

education in designated areas of national need. 

Teacher quality enhancement grants 

The Committee recommends $88,888,000 for teacher quality enhancement grants, the same as the budget request and the fiscal 

year 2004 appropriation. Teacher quality enhancement grants have 

three components: state grants, partnership grants and recruitment grants. By statute, state and partnership grants each receive 

45 percent of the appropriation, and recruitment grants receive 10 

percent. 

Under the state grant component, states apply to receive up to 

three years of funding to improve the quality of their teaching force 

through promoting reform activities such as teacher licensing and 

certification, accountability for high quality teacher preparation 

and professional development and recruiting teachers for high-need 

schools. States must match 50 percent of the federal award. 

185 

Under the partnership component, partnerships apply to receive 

a five-year grant to strengthen the capacity of K–12 educators in 

designing and implementing effective teacher education programs, 

and by increasing collaboration among these practitioners and departments of arts and sciences and schools of education at institutions of higher education. Partnerships must match 25 percent of 

the federal grant in the first year, 35 percent in the second year, 

and 50 percent for the remaining years. 

The recruitment component supports the efforts to reduce shortages of qualified teachers in high-need school districts. States or 

partnerships may apply to receive these grants. 

The Committee believes that colleges of education play a key role 

in improving teacher quality. The Committee urges colleges receiving teacher quality enhancement grants to consider the recommendations made by the Teaching Commission, including recruiting stronger students from all major fields of study, requiring 

education majors to receive at least a minor in an academic subject 

in addition to education, using research-based practices and pedagogy and offering opportunities to learn and observe in a real world 

setting. 

Child care access means parents in school 

The Committee recommends $16,099,000 for child care access 

means parents in school program, the same as the budget request 

and the fiscal year 2004 appropriation. Under this program, institutions may receive discretionary grants of up to four years to support or establish a campus-based childcare program primarily serving the needs of low-income students enrolled at the institution. 

Priority is given to childcare programs that leverage significant 

local or institutional resources and utilize a sliding fee scale. 

Grants can only be used to supplement childcare services or start 

new programs. 

Demonstration projects to ensure quality higher education for students with disabilities 

The Committee does not recommend funding for demonstration 

projects in disabilities, the same as the budget request. The program was funded at $6,913,000 in fiscal year 2004. 

This program provides discretionary grants for three years to 

support model demonstration projects that provide technical assistance and professional development activities for faculty and administrators in institutions of higher education in order to provide students with disabilities a high-quality postsecondary education. A 

number of models have now been developed and are being disseminated to other institutions. 

Underground railroad program 

The Committee does not recommend funding for the underground 

railroad program, which is the same as the budget request. This 

program was funded at $2,222,000 in fiscal year 2004. The underground railroad program provides grants to non-profit institutions 

to research, display, interpret and collect artifacts relating to the 

history of the underground railroad. 

186 

GPRA data/HEA program evaluation 

The Committee recommends $988,000 for program evaluation 

and development of data required under the Government Performance and Results Act for Higher Education programs administered 

by the Department. This is the same as the fiscal year 2004 appropriation and the budget request. 

The Committee understands that for many higher education programs, baseline and performance indicator data are sparse, nonexistent or difficult to collect. Funding under this activity will support the Department in developing high-quality data as required 

under the Government Performance and Results Act. 

Olympic Scholarships 

The bill includes $988,000 for Olympic Scholarships, the same as 

the fiscal year 2004 level. The budget did not request funding for 

this program. This program provides financial assistance to athletes who are training at the U.S. Olympic Education Center or one 

of the U.S. Olympic Training Centers and who are pursuing a postsecondary education at an institution of higher education. 

HOWARD UNIVERSITY

The bill provides $243,893,000 for Howard University, $5,130,000 

above the budget request and the fiscal year 2004 appropriation. 

The bill includes a minimum of $3,552,000 for the endowment, 

which is the same as the current level. 

Howard University is a ‘‘Research I’’ university located in the 

District of Columbia. Direct appropriations for Howard University 

are authorized by 20 U.S.C. 123, originally enacted in 1867. Howard University provides undergraduate liberal arts, graduate and 

professional instruction to approximately 11,000 students from all 

50 States. Masters degrees are offered in over 55 fields and Doctor 

of Philosophy degrees in 26 fields. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

The bill provides $578,000 for the Federal administration of the 

college housing and academic facilities loan (CHAFL) program, the 

Higher Educational Facilities Loans program and the College 

Housing Loans program, the same as the budget request and 

$191,000 below the fiscal year 2004 appropriation. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL AND

FINANCING PROGRAM

Federal administration 

The bill provides $212,000 for the administration of the historically black college and university capital financing program authorized under part D of title III of the Higher Education Act, $3,000 

above the fiscal year 2004 appropriation and the same as the budget request. The program is intended to make capital available for 

repair and renovation of facilities at historically black colleges and 

universities. In exceptional circumstances, capital provided under 

the program can be used for construction or acquisition of facilities. 

187 

Bond subsidies 

Under the HBCU capital program, a private, for-profit ‘‘designated bonding authority’’ issues construction bonds to raise capital for loans to historically black colleges and universities for construction projects. The Department provides insurance for these 

bonds, guaranteeing full payment of principal and interest to bond 

holders. Federally insured bonds and unpaid interest are limited by 

statute to $375,000,000. The letter of credit limitation establishes 

the total amount of bonds which can be issued by the designated 

bonding authority. The credit limitation must be explicitly stated 

in an appropriation Act according to the authorizing legislation. 

INSTITUTE OF EDUCATION SCIENCES

The bill includes $526,804,000 for the Institute of Education 

Sciences. This amount is $77,183,000 above the budget request, 

and $30,069,000 above the fiscal year 2004 level. This account supports education research, statistics, and assessment activities. 

Research 

This bill includes $165,518,000 for educational research, the 

same as the fiscal year 2004 level and $19,482,000 below the budget request. The Institute of Education Sciences supports research, 

development and national dissemination activities that are aimed 

at expanding fundamental knowledge of education and promoting 

the use of research and development findings in the design of efforts to improve education. 

The Committee is concerned that the research and development 

centers required by the Education Sciences Reform Act of 2002 

(ESRA) be able to fulfill their statutory mission to ‘‘carry out specific, long-term research activities that are consistent with the priorities and mission of the Institute, and are approved by the Director’’ (20 USC 9533) concerning the topics of critical national interest on which each center is focused. In particular, the Committee 

believes that the funding levels announced for the center competitions completed in 2004 may, in some cases, be insufficient. The 

Committee directs the Director of the Institute of Education 

Sciences (IES) to consider means at his disposal to increase the 

funding of centers when additional funding would enhance their 

contributions to the mission of IES. This includes providing grant 

supplements to expand projects or to launch new projects within 

the scope of center’s grant, and working actively with centers to encourage their application for funds for research grants available 

through other research competitions held by IES. 

Statistics 

This bill includes $91,664,000 for the activities of the National 

Center for Education Statistics, exclusive of the National Assessment of Educational Progress. This amount is the same as the 

budget request and the fiscal year 2004 level. 

Statistics activities are authorized under the Education Sciences 

Reform Act of 2002, title I of P.L. 107–279. The Center collects, 

analyzes, and reports statistics on all levels of education in the 

United States. Activities are carried out directly and through 

grants and contracts. Major publications include ‘‘The Condition of 

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Education’’ and ‘‘Digest of Education Statistics.’’ Other products include projections of enrollments, teacher supply and demand, and 

educational expenditures. Technical assistance to state and local 

education agencies and postsecondary institutions is provided. 

International comparisons are authorized. 

Regional educational laboratories 

The Committee has included $66,665,000 for the regional educational laboratories. This amount is the same as the fiscal year 

2004 level. The budget request did not include funding for this program. The Committee believes that the regional educational laboratories can play a key role in supporting the achievement of all children by focusing and aligning their work to help states and education practitioners implement the requirements contained in the 

No Child Left Behind Act (NCLB). This assistance should include 

product development, applied research, technical assistance and 

professional development. The Committee intends that each regional educational laboratory identify priority NCLB issues in their 

designated region and provide assistance with the implementation 

of NCLB. Particular focus should be placed on helping states and 

schools implement the provisions contained in the Highly Qualified 

Teacher regulations. 

IDEA National Activities: Research and innovation 

The bill includes $78,125,000 for research and innovation, the 

same as the fiscal year 2004 level and the budget request. This program supports competitive awards to produce and advance the use 

of knowledge to improve services and results for children with disabilities. The program focuses on producing new knowledge, integrating research and practice and improving the use of knowledge. 

Statewide data systems 

The bill includes $30,000,000 for a program to award grants, on 

a competitive basis, to State educational agencies to enable such 

agencies to design, develop, and implement statewide, longitudinal 

data systems to efficiently and accurately manage, analyze, 

disaggregate, and use individual student data, consistent with the 

No Child Left Behind Act. The budget did not request funding for 

this program and it was not funded in fiscal year 2004. 

Assessment 

This bill includes $94,832,000 for the National Assessment of 

Educational Progress, the same as the budget request, and $69,000 

above the fiscal year 2004 level. The Assessment is authorized 

under section 303 of the National Assessment of Educational 

Progress Authorization Act, and is the only nationally representative survey of educational ability and achievement of American students. The primary goal of the Assessment is to determine and report the status and trends of the knowledge and skills of students, 

subject by subject. Subject areas assessed in the past have included 

reading, writing, mathematics, science, and history, as well as citizenship, literature, art, and music. The Assessment is operated by 

contractors through competitive awards made by the National Center for Education Statistics; a National Assessment Governing 

Board formulates the policy guidelines for the program. Within the 

189 

amounts provided, $5,129,000 is for the National Assessment Governing Board. 

DEPARTMENTAL MANAGEMENT

The bill includes $559,093,000 for departmental management 

(salaries and expenses) at the Department of Education. This 

amount is $3,785,000 above the fiscal year 2004 appropriation and 

$14,062,000 below the budget request. These activities are authorized by the Department of Education Organization Act, P.L. 96–88, 

and include costs associated with the management and operations 

of the Department as well as separate costs associated with the Office for Civil Rights and the Office of the Inspector General. 

The Committee continues to be pleased with the emphasis the 

Department’s senior management team has placed on complying 

with the Government Performance and Results Act. The Committee 

expects the Department to continue to develop and refine GPRA 

measures for all programs, focusing particularly on student 

achievement outcomes. 

The Committee is aware that regional offices of the Department 

of Education are conducting ongoing audits of various institutions 

of higher education. The Committee is interested in the outcomes 

of past audits and therefore directs the Secretary to provide a report to the Committee on Appropriations of both the House and the 

Senate no later than six weeks after the date of enactment of this 

Act with the following information: a list of every institution placed 

on reimbursement since 1995 by the Dallas or Chicago regional 

student financial aid offices, along with the date on which the 

school went on reimbursement and the date on which the matter 

was resolved and the reason it was resolved. The report should include how many schools were required to do a 100% audit of any 

school year and how many of those schools went on to be placed 

on reimbursement. The report should also note if a school put on 

reimbursement was subsequently closed and the date on which 

that occurred. 

Executive Order 13270 directed federal agencies to take steps to 

enhance access to federal opportunities and resources for American 

Indian/Alaska Native students from tribal colleges and other postsecondary schools. The Committee believes that the Washington 

Semester American Indian Program (WINS) is an excellent way to 

advance the goals of Executive Order 13270, and strongly urges the 

Secretary to maximize the number of agencies that participate in 

the WINS program. 

Program administration 

The bill includes $421,055,000 for program administration. This 

amount is $676,000 above the fiscal year 2004 appropriation and 

$8,723,000 below the budget request. These funds support the staff 

and other costs of administering programs and activities at the Department. Items include personnel compensation and health, retirement and other benefits as well as travel, rent, telephones, utilities, postage fees, data processing, printing, equipment, supplies, 

technology training, consultants and other contractual services. 

190 

Office for Civil Rights 

The bill includes $90,248,000 for the salaries and expenses of the 

Office for Civil Rights. This amount is $1,943,000 above the fiscal 

year 2004 appropriation and $2,553,000 below the budget request. 

This Office is responsible for enforcing laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, 

membership in a patriotic society, and age in all programs and institutions that receive funds from the Department. These laws extend to 50 State educational agencies, 16,000 local educational 

agencies, 3,500 institutions of higher education, as well as to proprietary schools, State rehabilitation agencies, libraries, and other 

institutions receiving Federal funds. 

Office of the Inspector General 

The bill includes $47,790,000 for the Office of the Inspector General. This amount is $1,166,000 above the fiscal year 2004 appropriation and $2,786,000 below the budget request. This Office has 

authority to inquire into all program and administrative activities 

of the Department as well as into related activities of grant and 

contract recipients. It conducts audits and investigations to determine compliance with applicable laws and regulations, to check alleged fraud and abuse, efficiency of operations, and effectiveness of 

results. 

GENERAL PROVISIONS

Sec. 301. The Committee continues a provision which prohibits 

funds under this Act from being used for the transportation of students or teachers in order to overcome racial imbalances or to carry 

out a plan of racial desegregation. 

Sec. 302. The Committee continues a provision which prohibits 

funds under this Act from being used to require the transportation 

of any student to a school other than the school which is nearest 

the student’s home in order to comply with title VI of the Civil 

Rights Act of 1964. 

Sec. 303. The Committee continues a provision which prohibits 

funds under this Act from being used to prevent the implementation of programs of voluntary prayer and meditation in public 

schools. 

Sec. 304. The Committee continues a provision which allows up 

to 1 percent of any discretionary funds appropriated for the Department of Education to be transferred between appropriations accounts, provided that no appropriation is increased by more than 

3 percent by any such transfer. This provision requires the Secretary to notify the Appropriations Committees of both Houses of 

Congress at least 15 days in advance of a transfer. 

Sec. 305. The Committee includes a provision making a technical 

change to the Impact Aid Program to extend the application deadline for applying for section 8002 federal property payments from 

FY 2005 to FY 2007. 

Sec. 306. The Committee recently became aware of a policy 

change implemented by the Department of Education regarding 

consolidation loans. The Committee believes that the proper forum 

for any such change is within the reauthorization of the Higher 

Education Act of 1965. The Committee therefore directs the SecVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00190 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
191 

retary to make no change to these policies while the Committee on 

Education and the Workforce is in the process of this reauthorization. Further, the Committee directs the Secretary to withdraw the 

Secretary’s dear colleague letter dated April 29, 2004, regarding 

consolidation loans and to remove any restriction on the Department’s servicer in the processing of loan verification certificates. 

TITLE IV—RELATED AGENCIES 

ARMED FORCES RETIREMENT HOME

The bill provides authority to expend $61,195,000 from the 

Armed Forces Retirement Home Trust Fund for operations and 

capital activities at the United States Soldiers’ and Airmen’s Home 

and the United States Naval Home, a decrease of $3,699,000 below 

the comparable fiscal year 2004 appropriation and the same as the 

budget request. 

Operations 

The bill provides authority to expend $57,195,000 from the 

Armed Forces Retirement Home Trust Fund for operations of the 

United States Soldiers’ and Airmen’s Home and the United States 

Naval Home, a decrease of $5,728,000 above the comparable fiscal 

year 2004 appropriation and the same as the budget request. 

Capital outlay 

The bill provides authority to expend $4,000,000 from the Armed 

Forces Retirement Home Trust Fund for capital activities at the 

Soldiers’ and Airmen’s Home and the United States Naval Home, 

an increase of $2,029,000 above the comparable fiscal year 2004 appropriation and the same as the budget request. 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

The bill provides $4,672,000 for the Committee for Purchase 

From People Who Are Blind or Severely Disabled, a decrease of 

$53,000 below the comparable fiscal year 2004 appropriation and 

the same as the budget request. 

The Committee for Purchase From People Who Are Blind or Severely Disabled was established by the Wagner-O’Day Act of 1938 

as amended. Its primary objective is to increase the employment 

opportunities for people who are blind or have other severe disabilities and, whenever possible, to prepare them to engage in competitive employment. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

DOMESTIC VOLUNTEER SERVICE PROGRAMS

The bill provides $353,197,000 for the Domestic Volunteer Service Programs that are administered by the Corporation for National 

and Community Service. The recommended amount is $1,143,000 

below the fiscal year 2004 appropriation and $22,138,000 below the 

budget request. Appropriations for these programs are not authorized in law for fiscal year 2005. Funding for the Americorps program that is also administered by the Corporation for National and 

192 

Community Service is provided in the VA/HUD and Independent 

Agencies appropriations bill. 

The Committee emphasizes the importance of developing clear, 

measurable outcomes for programs within the purview of the Corporation as outlined in the Government Performance and Results 

Act. It is vital that the Committee be provided with information on 

the actual results achieved by the programs, not simply the number of volunteers participating in the program or the number of 

hours served. Program outcomes should, to the extent possible, 

focus on the actual improvements in the health, safety, education, 

and quality of life of individuals in the community as a result of 

the Federal investment. Programs that are able to demonstrate 

these results over time will be considered higher funding priorities 

than programs that are unable to clearly demonstrate their value 

to the American public. 

VISTA 

The bill provides $93,731,000 for the Volunteers in Service to 

America (VISTA) program, the same as the fiscal year 2004 level 

and $2,697,000 below the budget request. The VISTA program supports individuals who recruit volunteers and organize community 

volunteer activities but who do not provide direct volunteer services. 

Special Volunteer Programs 

The bill includes $5,000,000 for special volunteer programs authorized under section 122 part C of title I of the Domestic Volunteer Service Act of 1973, $4,876,000 below the fiscal year 2004 level 

and $10,000,000 below the budget request. 

These funds are to be used to place volunteers in community activities that are targeted specifically at contributing to homeland 

defense. Grants will be made to states and community organizations on a competitive basis and will support public and nonprofit 

agencies’ efforts in the areas of public safety, public health, and 

disaster relief and preparedness. The Committee intends that these 

funds be used to support volunteer efforts across the population, 

and not simply focus on recruiting seniors. 

National Senior Volunteer Corps 

The bill provides a total of $216,466,000 for the National Senior 

Volunteer Corps, $2,202,000 above the fiscal year 2004 level and 

$8,078,000 below the budget request. 

The bill provides $112,323,000 for the Foster Grandparents program, $2,202,000 above the fiscal year 2004 levels and $5,623,000 

above the budget request. This program provides volunteer service 

opportunities for low-income people aged 60 and over. 

The bill provides $45,987,000 for the Senior Companion program, 

the same as the fiscal year 2004 appropriation and $576,000 below 

the budget request. The program provides project grants to private, 

non-profit organizations and State and local public agencies to offer 

volunteer service opportunities to low-income individuals aged 60 

and over. These volunteers assist older adults with physical, mental or emotional impairments that put them at risk for institutionalization. 

193 

The bill provides $58,156,000 for the Retired Senior Volunteer 

Program (RSVP), the same as the fiscal year 2004 appropriation 

and $11,728,000 below the budget request. This program provides 

part-time volunteer service opportunities for low-income individuals aged 55 and over to recruit volunteers and organize volunteer 

activities relating to a variety of social needs. 

The bill does not include funding for senior demonstration programs, the same as the fiscal year 2004 level and $1,397,000 above 

the budget request. 

Program administration 

The bill provides $38,000,000 for program administration, 

$1,531,000 above the fiscal year 2004 appropriation and $1,363,000 

below the budget request. 

CORPORATION FOR PUBLIC BROADCASTING

The Committee has provided $400,000,000 in advance funding 

for fiscal year 2007 for the Corporation for Public Broadcasting 

(CPB). The Administration did not request any advance funding. 

The Committee has included authority for CPB to spend up to 

$20,000,000 in fiscal year 2005 funds for CPB digital conversion activities. The Committee has also included authority for CPB to 

spend up to $60,000,000 on the Satellite Interconnection system. 

The Committee commends the Independent Television Service 

(ITVS), through its collaboration with the Corporation for Public 

Broadcasting (CPB), for its continuing success in diversifying programming on public television. The Committee was pleased that 

the last contract between ITVS and CPB was a multi-year one and 

contained increases to ITVS in line with historic funding percentages. The Committee urges that the next contract again be made 

on a multi-year basis and contain appropriate increases for the 

ITVS basic production grant and for costs associated with producing the series, Independent Lens. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

The bill provides $43,964,000 for the Federal Mediation and Conciliation Service (FMCS), an increase of $835,000 above the comparable fiscal year 2004 appropriation the same as the budget request. 

The FMCS attempts to prevent and minimize labor-management 

disputes having a significant impact on interstate commerce or national defense, except in the railroad and airline industries. The 

agency convenes boards of inquiry appointed by the President in 

emergency disputes and conducts dispute mediation, preventive 

mediation, and arbitration. In addition, the Service offers alternative dispute resolution services and training to other Federal 

agencies to reduce litigation costs and speed Federal administrative 

proceedings. 

The bill also includes provisions first enacted in the fiscal year 

1996 Appropriations Act granting the agency the authority to accept gifts and to charge fees for certain services. The Committee 

understands that the Youth Violence Prevention and Conflict Resolution Program under the Federal Mediation and Conciliation Service (FMCS) has received $500,000 for the past two years for onVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00193 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
194 

going expenses related to partnerships with local schools and universities to provide youth violence education and awareness services. Specifically, the Committee recognizes the success that this 

program has had in providing schools, after school programs, universities with computer technology to gather information designed 

to identify factors for school conflict and youth violence within their 

community. Through this program, schools are able to partner with 

FMCS to develop solutions to address the problems that affect their 

specific youth population. The Committee believes that this program should be evaluated for future funding increases to be able 

to offer these services to more than the 12 locations nationwide 

currently participating. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

The bill provides $7,813,000 for the Federal Mine Safety and 

Health Review Commission, $85,000 above the fiscal year 2004 

level and the same as the budget request. The Commission is responsible for reviewing the enforcement activities of the Secretary 

of Labor under the Federal Mine Safety and Health Act. The Commission’s administrative law judges hear and decide cases initiated 

by the Secretary of Labor, mine operators, or miners. The fivemember Commission hears appeals from administrative law judge 

decisions, rules on petitions for discretionary review, and may direct, of its own initiative, review of cases that present unusual 

questions of law. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

The Committee recommends $261,743,000 for the Institute of 

Museum and Library Services. This is $497,000 below the fiscal 

year 2004 level and the same as the budget request. The Institute 

makes state formula grants for library services and discretionary 

national grants for joint library and museum projects. 

For Library Services, the Committee recommends $169,958,000 

for State grants and $3,675,000 for library services to Native Americans and Native Hawaiians. The Committee recommends 

$16,500,000 for national leadership grants. The Committee continues to support and commend the 21st Century Librarian Initiative that recruits and educates librarians and has included the full 

amount requested, $23,000,000 for this purpose. 

For Museum Services, the Committee recommends $20,700,000 

for the museums for America program, $450,000 for museum assessment programs; $3,630,000 for Conservation programs; 

$12,000,000 for National Leadership projects; and $644,000 for Native American Museum Services. 

The Committee recommends $11,186,000 for program administration, the same as the budget request. 

MEDICARE PAYMENT ADVISORY COMMISSION

The Committee recommends $9,905,000 for the Medicare Payment Advisory Commission, an increase of $660,000 above the comparable fiscal year 2004 appropriation and the budget request. The 

Commission advises Congress on matters of physician and hospital 

reimbursement under the Medicare and Medicaid programs. 

195 

NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE

The Committee recommends $1,000,000 for the National Commission on Libraries and Information Science. This is $6,000 above 

the fiscal year 2004 level and the same as the budget request. 

NATIONAL COUNCIL ON DISABILITY

The bill provides $2,873,000 for the National Council on Dis- ability (NCD), a decrease of $148,000 below the comparable fiscal 

year 2004 level appropriation and the same as the budget request. 

The Council monitors implementation of the Americans with Disabilities Act and makes recommendations to the President, the 

Congress, the Rehabilitation Services Administration, and the National Institute on Disability and Rehabilitation Research on public 

policy issues of concern to individuals with disabilities. 

NATIONAL LABOR RELATIONS BOARD

The bill provides $248,785,000 for the National Labor Relations Board (NLRB). This is $6,152,000 above the fiscal year 2004 level 

and the same as the budget request. The NLRB receives, investigates, and prosecutes unfair labor practice charges filed by businesses, labor unions, and individuals. It also schedules and conducts representation elections. The five-member Board considers 

cases in which an administrative law judge decisions are appealed. 

In 1959, Congress passed a law to give the NLRB jurisdiction 

over businesses to settle labor disputes between unions and management based on gross receipts. Once a business’ gross receipts 

pass a certain threshold, it is subject to NLRB intervention. Businesses below the threshold are subject to actions under State laws, 

instead of the NLRB. 

The Committee is aware of concerns over the backlog of cases before the NLRB. The Committee requests that the Board investigate 

the causes of this backlog, and report on options for reducing the 

backlog, including raising the jurisdictional thresholds of the 

Board. 

NATIONAL MEDIATION BOARD

The bill provides $11,635,000 for the National Mediation Board 

(NMB), $281,000 above the comparable fiscal year 2004 appropriation and the same as the budget request. The NMB mediates labor 

disputes between employees and railroad and airline carriers subject to the Railway Labor Act. The Board also resolves representation disputes involving labor organizations seeking to represent 

railroad or airline employees. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

The bill provides $10,516,000 for the Occupational Safety and 

Health Review Commission, $711,000 above the fiscal year 2004 

level and the same as the budget request. The Commission adjudicates contested citations issues by the Occupational Safety and 

Health Administration against employers for violations of safety 

and health standards. The Commission’s administrative law judges 

settle and decide cases at the initial level of review. The agency’s 

three appointed Commissioners also review cases, issue rulings on 

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complicated issues, and may direct review of any decision by an administrative law judge. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS ACCOUNT

The bill provides $108,000,000 for dual benefits, a decrease of 

$10,298,000 below the comparable fiscal year 2004 appropriation 

and the same as the budget request. These funds are used to pay 

dual benefits to those retirees receiving both railroad retirement 

and social security benefits. The bill includes a provision permitting a portion of these funds to be derived from income tax receipts 

on dual benefits as authorized by law. The Railroad Retirement 

Board estimates that approximately $8,000,000 may be derived in 

this manner. 

FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNT

The bill provides $150,000 for the interest earned on unnegotiated checks, the same as the budget request and the comparable 

amount provided for fiscal year 2004. 

LIMITATION ON ADMINISTRATION

The bill provides a consolidated limitation of $102,202,000 on the 

expenditure of railroad retirement and railroad unemployment 

trust funds for administrative expenses of the Railroad Retirement 

Board, the same as the comparable fiscal year 2004 appropriation 

and a decrease of $398,000 below the budget request. The bill includes a provision from the fiscal year 1999 Appropriations Act prohibiting the transfer of resources formerly identified in a Memorandum of Understanding from the RRB to the Inspector General. 

The Railroad Retirement Board (RRB) administers comprehensive retirement-survivor and unemployment-sickness insurance 

benefit programs for railroad workers and their families. This account limits the amount of funds in the railroad retirement and 

railroad unemployment insurance trust funds that may be used by 

the RRB for administrative expenses. The Committee prohibits 

funds from the railroad retirement trust fund from being spent on 

any charges over and above the actual cost of administering the 

trust fund, including commercial rental rates. 

The bill includes language (Sec. 517) limiting the availability of 

funds to the Railroad Retirement Board to enter into an arrangement with a nongovernmental financial institution to serve as disbursing agent for benefits payable under the Railroad Retirement 

Act of 1974. 

The Committee is pleased with the management of the Board 

and reiterates its interest in quickly and comprehensively implementing the Government Performance and Results Act. 

LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

The bill provides authority to expend $6,561,000 from the railroad retirement and railroad unemployment insurance trust funds 

for the Office of Inspector General, the same as the comparable fiscal year 2004 appropriation and a decrease of $639,000 below the 

budget request. This account provides funding for the Inspector 

197 

General to conduct and supervise audits and investigations of programs and operations of the Board. 

The Committee compliments the work of the Office of the Inspector General of the Railroad Retirement Board for their work in obtaining information on actual collections, offsets, and funds put to 

better use as required in House Report 105–635. This information 

is of great use to the Committee and the Committee understands 

the difficulty encountered by the OIG in obtaining it. The Committee expects that the Office of Inspector General will continue to 

report the information to it. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

The Committee provides $20,454,000 for mandatory payments 

necessary to compensate the Old Age and Survivors Insurance 

(OASI) and Disability Insurance (DI) Trust Funds for special payments to certain uninsured persons (for which no payroll tax is received), costs incurred for administration of pension reform activities and interest lost on the value of benefit checks issued but not 

negotiated. This appropriation restores the trust funds to the position they would have been in had they not borne these costs properly charged to the general funds. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

The Committee provides $28,578,829,000 for the Supplemental 

Security Income (SSI) program. The Committee also provides 

$10,930,000,000 in advance funding for the first quarter of fiscal 

year 2006. 

Beneficiary services 

In addition to Federal benefits, the Social Security Administration (SSA) administers a program of supplementary State benefits 

for those States that choose to participate. The funds are also used 

to reimburse the trust funds for the administrative costs of the program. The Committee provides $45,929,000 for beneficiary services, 

the same as the budget request, with the total appropriations for 

SSI. This funding reimburses State vocational rehabilitation services agencies for successful rehabilitation of SSI recipients. 

Research and demonstration 

Within the appropriation for SSI, the Committee provides $27,000,000 for research and demonstration activities conducted 

under section 1110 of the Social Security Act. 

Administration 

Within the appropriation for SSI, the Committee provides 

$2,986,900,000 for payment to the Social Security trust funds for 

the SSI Program’s share of SSA’s base administrative expenses. 

LIMITATION ON ADMINISTRATIVE EXPENSES

The bill provides a limitation on administrative expenses for the 

Social Security Administration (SSA) of $8,674,100,000 to be funded from the Social Security and Medicare trust funds. This is 

$480,926,000 more than the fiscal year 2004 level and $82,900,000 

198 

less than the budget request. The Committee does not provide the 

contingency reserve from the HI/SMI trust funds as requested. 

The Committee notes the success of the third party verifier pilot 

program, designed to detect identity fraud and false Social Security 

Number (SSN) usage. Over 7% of the SSNs processed through the 

current program have come back as a ‘‘no match,’’ meaning that 

the program has been successful in discovering identity fraud, as 

intended. The Committee encourages SSA to continue the pilot program and requests that SSA notify the Committee 180 days prior 

to any possible elimination of this program. 

The Committee is pleased with the initiative the Social Security 

Administration has started in examining the population with limb 

loss who could return to work with proper prosthetic and orthotics 

care. The Committee encourages the Ticket-to-Work initiative to 

continue to pursue this vital area. 

SOCIAL SECURITY ADVISORY BOARD

The bill provides that not less than $2,000,000 within the limitation on administrative expenses shall be available for the Social Security Advisory Board, $200,000 more than the fiscal year 2004 

level and the same as the budget request. 

User fees 

In addition to other amounts provided in the bill, the Committee 

provides an additional limitation of $124,000,000 for administrative 

activities funded from user fees. This is $4,000,000 more than the 

fiscal year 2004 level and the same as the request. 

OFFICE OF INSPECTOR GENERAL

The bill provides $91,107,000 for the Office of the Inspector General (OIG), $3,428,000 more than the fiscal year 2004 level and 

$893,000 less than the budget request. The bill also provides authority to expend $65,359,000 from the Social Security trust funds 

for activities conducted by the Inspector General, $2,035,000 more 

than the fiscal year 2004 level and $641,000 less than the budget 

request. 

TITLE V—GENERAL PROVISIONS 

Sec. 501. The Committee continues a provision to allow the Secretaries of Labor, Health and Human Services, and Education to 

transfer unexpended balances of prior appropriations to accounts 

corresponding to current appropriations to be used for the same 

purpose and for the same periods of time for which they were originally appropriated. 

Sec. 502. The Committee continues a provision to prohibit the obligation of funds beyond the current fiscal year unless expressly so 

provided. 

Sec. 503. The Committee continues a provision to prohibit appropriated funds to be used to support or defeat legislation pending 

before the Congress or any State legislature, except in presentation 

to the Congress or any State legislature itself. 

Sec. 504. The Committee continues a provision to limit the 

amount available for official reception and representation expenses 

for the Secretaries of Labor and Education, the Director of the FedVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00198 Fmt 6659 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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eral Mediation and Conciliation Service, and the Chairman of the 

National Mediation Board. 

Sec. 505. The Committee continues a provision to prohibit funds 

to be used to carry out a needle distribution program. 

Sec. 506. The Committee continues a Sense of the Congress provision related to buy American-made products. 

Sec. 507. The Committee continues a provision to require grantees receiving Federal funds to clearly state the percentage of the 

total cost of the program or project that will be financed with Federal money. 

Sec. 508. The Committee continues a provision to prohibit appropriated funds to be used for any abortion. 

Sec. 509. The Committee continues a provision to provide exceptions for Sec. 508 and adds a limitation prohibiting funds from the 

bill to be made available to a Federal, State or local government 

or program if they discriminate against institutional or individual 

health care entities if they do not provide, pay for, or refer for abortions. 

Sec. 510. The Committee continues a provision to prohibit the 

use of funds in the Act concerning research involving human embryos. However, this language should not be construed to limit federal support for research involving human embryonic stem cells 

listed on an NIH registry and carried out in accordance with policy 

outlined by the President. 

Sec. 511. The Committee continues a provision to prohibit the 

use of funds for any activity that promotes the legalization of any 

drug or substance included in schedule I of the schedules of controlled substances. 

Sec. 512. The Committee continues a provision related to annual 

reports to the Secretary of Labor. 

Sec. 513. The Committee continues a provision to prohibit the 

use of funds to promulgate or adopt any final standard providing 

for a unique health identifier until legislation is enacted specifically approving the standard. 

Sec. 514. The Committee continues a provision that prohibits the 

transfer of funds from this Act except by authority provided in this 

Act or another appropriation Act. 

Sec. 515. The Committee includes a provision to limit funds in 

the bill for public libraries to those libraries that comply with the 

requirements of the Children’s Internet Protection Act. 

Sec. 516. The Committee includes a provision to limit technology 

funds in the bill for elementary and secondary schools to those 

schools that comply with the requirements of the Children’s Internet Protection Act. 

Sec. 517. The Committee includes language limiting the availability of funds to the Railroad Retirement Board to enter into an 

arrangement with a nongovernmental financial institution to serve 

as disbursing agent for benefits payable under the Railroad Retirement Act of 1974. 

Sec. 518. The Committee includes a new provision clarifying the 

procedures for reprogramming of funds. The Committee notes that 

reprogramming procedures had heretofore been included in the Report. However, adherence to the reprogramming procedures by 

Agencies funded in this Act has varied widely, including one recent 

example where the Committee was notified of a reprogramming 

200 

through a press release. The Committee also notes that this provision is consistent with reprogramming language included in other 

bills within the Committee’s jurisdiction. 

CONSTITUTIONAL AUTHORITY

Clause 3(d)(1) of rule XIII of the Rules of the House of Representatives states that: 

Each report of a committee on a public bill or public joint resolution shall contain the following: 

(1) A statement citing the specific powers granted to Congress in 

the Constitution to enact the law proposed by the bill or joint resolution. 

The Committee on Appropriations bases its authority to report 

this legislation on Clause 7 of Section 9 of Article I of the Constitution of the United States of America which states: 

No money shall be drawn from the Treasury but in consequence 

of Appropriations made by law * * *. 

Appropriations contained in this Act are made pursuant to this 

specific power granted by the Constitution. 

COMPARISON WITH BUDGET RESOLUTION

Clause 3(c)(2) of rule XIII of the Rules of the House of Representatives requires an explanation of compliance with section 

308(a)(1)(A) of the Congressional Budget Act of 1974 (Public Law 

93–344), as amended, which requires that the report accompanying 

a bill providing new budget authority contain a statement detailing 

how the authority compares with the report submitted under section 302 of the Act for the most recently agreed to concurrent resolution on the budget for the fiscal year. This information follows: 

[In millions of dollars] 

302(b) allocation This bill 

Budget authority Outlays Budget authority Outlays 

Discretionary ................................................... 142,526 141,117 142,526 141,117 

Mandatory ....................................................... 342,503 342,402 342,503 342,402 

In accordance with the Congressional Budget Act of 1974 (Public 

Law 93–344), as amended, the following information was provided 

to the Committee by the Congressional Budget Office: 

FIVE-YEAR PROJECTIONS

In compliance with section 308(a)(1)(B) of the Congressional 

Budget Act of 1974 (Public Law 93–344), as amended, the following 

table contains five-year projections associated with the budget authority provided in the accompanying bill: 

[In millions of dollars] 

Budget authority ................................................................................ 399,114 

Outlays: 

2005 1 ............................................................................................ 317,066 

2006 .............................................................................................. 60,666 

2007 .............................................................................................. 16,788 

2008 .............................................................................................. 3,825 

2009 and future years ................................................................. 602 

1 Excludes outlays from prior year budget authority. 

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FINANCIAL ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

In accordance with section 308(a)(1)(C) of the Congressional 

Budget Act of 1974 (Public Law 93–344), as amended, the financial 

assistance to State and local governments is as follows: 

[In millions of dollars] 

Budget authority ................................................................................ 185,515 

Outlays ................................................................................................ 14,710 

TRANSFER OF FUNDS

Pursuant to clause 3(f)(2), rule XIII of the Rules of the House of 

Representatives, the following table is submitted describing the 

transfers of funds provided in the accompanying bill. 

The table shows, by Department and agency, the appropriations 

affected by such transfers. 

APPROPRIATION TRANSFERS RECOMMENDED IN THE BILL 

Account to which transfer is made Amount Account from which transfer is made Amount 

Department of Labor: Department of Labor: 

Special Benefits .................................... (1) Postal Service ............................................ (1) 

Various Agencies 1 ................................. ...................... Energy Employees Occupational Illness 

Compensation Fund 1.

......................

Employment Standards Administration—Salaries and Expenses.$32,646,000 Black Lung Disability Trust Fund ............. $32,646,000 

Departmental Management—Salaries 

and Expenses.

23,705,000 Black Lung Disability Trust Fund ............. 23,705,000 

Office of Inspector General ................... 342,000 Black Lung Disability Trust Fund ............. 342,000 

Department of Health and Human Services: 

National Institutes of Health: 

International Assistance Programs: 

National Institute of Allergy and Infectious Disease.100,000,000 Global Fund to Fight HIV/AIDS, Malaria, 

and Tuberculosis.

100,000,000 

Department of Energy: Department of Health and Human Services: 

Administration for Children and Families: 

Weatherization Assistance Program ...... 227,000,000 Low-Income Home Energy Assistance ....... 227,000,000 

Related Agencies: 

Social Security Administration: 

Office of Inspector General .......... 65,359,000 Federal Old-Age and Survivors Insurance 

Trust Fund and Federal Disability Insurance Trust Fund.

65,359,000 

Department of Health and Human Services: 

Centers for Medicare and Medicaid Services: 

Office of Hearings and Appeals .. 50,000,000 Program Management ............................... 50,000,000 

1 Such sums. 

RESCISSIONS

Pursuant to clause 3(f)(2), rule XIII of the Rules of the House of 

Representatives, the following table is submitted describing the rescissions recommended in the accompanying bill. 

COMPLIANCE WITH RULE XIII, CL. 3(E) (RAMSEYER RULE) 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

existing law in which no change is proposed is shown in roman): 

* * * * * * * 

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CHANGES IN APPLICATION OF EXISTING LAW

Pursuant to clause 3, rule XIII of the Rules of the House of Representatives, the following statements are submitted describing the 

effect of provisions in the accompanying bill which may directly or 

indirectly change the application of existing law. 

In some instances the bill includes appropriations for certain ongoing programs which are not yet authorized for fiscal year 2004. 

The bill provides that appropriations shall remain available for 

more than one year for some programs for which the basic authorizing legislation does not presently authorize such extended availability. 

In various places in the bill, the Committee has earmarked funds 

within appropriation accounts in order to fund specific sections of 

a law. Whether these actions constitute a change in the application 

of existing law is subject to individual interpretation, but the Committee felt that this fact should be mentioned. 

In several instances, the bill provides advance appropriations for 

fiscal year 2006 for programs for which such advances are not authorized by law. 

TITLE I—DEPARTMENT OF LABOR 

TRAINING AND EMPLOYMENT SERVICES

Language prohibiting the use of funds from any other appropriation to provide meal services at or for Job Corps centers. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Language allowing the use of funds for amortization payments to 

States which had independent retirement plans in their State employment service agencies prior to 1980. 

Language allowing the Labor Department to withhold from State 

allotments funds available for penalty mail under the WagnerPeyser Act. 

Language providing that funds in this Act for one-stop career 

centers and unemployment insurance national activities may be 

used for contracts, grants or agreements with non-State entities. 

Language providing that funds in this Act may be used by the 

States for integrated Employment Service and Unemployment Insurance automation efforts. 

EMPLOYMENT STANDARDS ADMINISTRATION

SALARIES AND EXPENSES

Language authorizing the Secretary of Labor to accept and spend 

all sums of money ordered to be paid to the Secretary, in accordance with the terms of a Consent Judgment in U.S. District Court 

for the Northern Mariana Islands. 

Language authorizing the Secretary of Labor to collect user fees 

for processing certain applications and issuing certain certificates 

and registrations under the Fair Labor Standards Act and the Migrant and Seasonal Agricultural Worker Protection Act. 

203 

SPECIAL BENEFITS

Language providing funds may be used under the Federal Employees’ Compensation Act in which the Secretary of Labor may reimburse an employer, who is not the employer at the time of injury, for portions of the salary of a reemployed, disabled beneficiary. 

Language allowing the Secretary of Labor to transfer certain administrative funds from the Postal Service fund and certain other 

government corporations and agencies related to the administration of the Federal Employees’ Compensation Act. 

Language allowing the Secretary of Labor to require any person 

filing a claim for benefits under the Federal Employees’ Compensation Act or the Longshore and Harbor Workers’ Compensation Act 

to provide such identifying information as the Secretary may require, including a Social Security number. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Language establishing a maximum amount available for grants 

to States under the Occupational Safety and Health Act, which 

grants shall be no less than 50 percent of the costs of State programs required to be incurred under plans approved by the Secretary under section 18 of the Act. 

Language authorizing the Occupational Safety and Health Administration to retain and spend up to $750,000 of training institute course tuition fees for training and education grants. 

Language allowing the Secretary of Labor to collect and retain 

fees for services provided to Nationally Recognized Testing Laboratories. 

Language prohibiting OSHA from obligating or expending any of 

these funds to enforce the annual fit test requirement of the General Industry Respiratory Protection Standard with respect to exposure to tuberculosis. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Language allowing the Mine Safety and Health Administration 

to collect up to $750,000 at the National Mine Health and Safety 

Academy for room, board, tuition, and the sale of training materials, otherwise authorized by law to be collected, to be available 

for mine safety and health education and training activities, notwithstanding 31 U.S.C. 3302. 

Language allowing the Mine Safety and Health Administration 

to accept land, buildings, equipment, and other contributions from 

public and private sources; to prosecute projects in cooperation 

with other agencies, Federal, State, or private; and to promote 

health and safety education and training in the mining community 

through cooperative programs with States, industry, and safety associations. 

Language allowing the Secretary of Labor to use any funds available to the Department to provide for the costs of mine rescue and 

survival operations in the event of major disasters. 

204 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Language providing that no funds made available by this Act 

may be used by the Solicitor of Labor to participate in a review in 

any United States court of appeals of any decision made by the 

Benefits Review Board under section 21 of the Longshore and Harbor Workers’ Compensation Act where such participation is precluded by the decision of the Supreme Court in Director, Office of 

Workers’ Compensation Programs v. Newport News Shipbuilding, 

115 S. Ct. 1278 (1995), notwithstanding any provisions to the contrary contained in Rule 15 of the Federal Rules of Appellate Procedure. 

Language providing that any decision under the Longshore Act 

pending before the Benefits Review Board for more than one year 

shall be considered affirmed by the Board and shall be considered 

the final order of the Board. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HEALTH RESOURCES AND SERVICES

Language providing that $39,740,000 from general revenues, notwithstanding section 1820(j) of the Social Security Act, shall be 

available for carrying out the Medicare rural hospital flexibility 

grants program under section 1820 of such Act. 

Language providing that in addition to fees authorized by section 

427(b) of the Health Care Quality Improvement Act of 1986, fees 

shall be collected for the full disclosure of information under the 

Act sufficient to recover the full costs of operating the National 

Practitioner Data Bank, and shall remain available until expended 

to carry out that Act. 

Language providing that fees collected under the Health Care 

Fraud and Abuse Data Collection Program shall be sufficient to recover the full costs of operating the program, and shall remain 

available until expended to carry out that Act. 

Language providing that all pregnancy counseling under the 

family planning program shall be nondirective. 

Language making $25,000,000 available under section 241 of the 

Public Health Service Act to fund special programs for the care and 

treatment of individuals with HIV disease. 

Funds are set aside for special projects of regional and national 

significance under section 501(a)(2) of the Social Security Act which 

shall not be counted toward compliance with the allocation required in section 502(a)(1) of the Act and which shall be used only 

for making competitive grants to provide abstinence education. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

Language permitting the Centers for Disease Control and Prevention to purchase and insure official motor vehicles in foreign 

countries. 

205 

Language providing the Centers for Disease Control and Prevention to purchase, hire, maintain and operate aircraft. Language providing that $81,500,000 is available until expended 

for equipment and construction and renovation of facilities. Language providing that $142,808,000 is available until September 30, 2006 for International HIV/AIDS. 

Language providing that collections from user fees may be credited to the Centers for Disease Control and Prevention appropriation. 

Language making specific amounts under section 241 of the Public Health Service Act available to carry out: National Immunization Surveys; National Center for health Statistics surveys; information systems standards development and architecture and applications-based research used at local public health levels; Public 

Health Research; and the National Occupational Research Agenda. 

Language allowing the Director of the Centers for Disease Control and Prevention to redirect certain funds appropriated under 

Public Law 101–502. 

Language providing that not to exceed $12,500,000 may be made 

available for grants under section 1509 of the Public Health Service 

Act to not more than 15 States, tribes, or tribal organizations. 

Language permitting the Centers for Disease Control and Prevention to proceed with property acquisition, including a long-term 

ground lease for construction on non-federal land, for construction 

of a replacement laboratory in the Ft. Collins, Colorado area. 

Language permitting the Centers for Disease Control and Prevention to enter into a single contract or related contracts for the 

full scope of development and construction of facilities, subject to 

available appropriations. 

NATIONAL INSTITUTES OF HEALTH

Language allowing the transfer of $100,000,000 to International 

Assistance Programs, ‘‘Global Fund to Fight HIV/AIDS, Malaria, 

and Tuberculosis,’’ to remain available until expended. 

NATIONAL INSTITUTE ON DRUG ABUSE

Language making $6,300,000 available under section 241 of the 

Public Health Service Act to carry out national surveys on drug 

abuse and related analysis. 

NATIONAL LIBRARY OF MEDICINE

Language providing that the National Library of Medicine may 

enter into certain personal services contracts. Language making $8,200,000 available under section 241 of the 

Public Health Service Act to carry out National Information Center 

on Health Services Research and Health Care Technology and related health services. 

OFFICE OF THE DIRECTOR

Language providing that the National Institutes of Health is authorized to collect third party payments for the cost of the clinical 

services that are incurred in NIH research facilities and that such 

payments shall be credited to the NIH Management Fund and 

shall remain available for one fiscal year after they are deposited. 

206 

Language providing the Director of NIH authority to transfer 

funds between appropriation accounts in this or any other Act. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

Language making specific amounts available under section 241 of 

the Public Health Service Act to fund technical assistance, National 

data, data collection and evaluation activities; $16,000,000 to carry 

out national surveys on drug abuse; and, $4,300,000 for substance 

abuse treatment programs. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Language is included to permit the Agency for Healthcare Research and Quality to retain and expend amounts received from 

Freedom of Information Act fees, reimbursable and interagency 

agreements and the sale of data tapes. 

Language making amounts under section 241 of the Public 

Health Service Act available to carry out agency activities. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

A provision that in the administration of title XIX of the Social 

Security Act, payments to a state for any quarter may be made 

with respect to a State plan or plan amendment in effect during 

any such quarter, if submitted in, or prior to, such quarter and approved in that or any such subsequent quarter. 

PROGRAM MANAGEMENT

A provision that all funds collected in accordance with section 

353 of the Public Health Service Act, together with such sums as 

may be collected from authorized user fees, administrative fees collected relative to Medicare overpayment recovery activities, and the 

sale of data, shall be available for expenditure by the Center for 

Medicare and Medicaid Services. 

Language allowing fees charged in accordance with 31 U.S.C. 

9701 to be credited to the Centers for Medicare and Medicaid Services administrative account. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Language providing that the sum of the amounts available to a 

State with respect to expenditures under title IV–A of the Social 

Security Act in fiscal year 1997 under this appropriation and under 

such title IV–A as amended by the Personal Responsibility and 

Work Opportunity Reconciliation Act of 1996 shall not exceed the 

limitations under section 116(b) of such Act. 

207 

SOCIAL SERVICES BLOCK GRANT

Language providing that States may transfer up to 10 percent of 

Temporary Assistance for Needy Family funds to the Social Services Block Grant. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Language making $5,982,000 available under section 241 of the 

Public Health Service Act to carry out provisions of section 1110 of 

the Social Security Act. 

Language providing that unexpended Community Services Block 

Grant funds may be carried over to the next fiscal year by local 

grantees. 

Language making $4,500,000 available under section 241 of the 

Public Health Service Act to carry out evaluations of adolescent 

pregnancy prevention approaches. 

POLICY RESEARCH

Language making amounts under section 241 of the Public 

Health Service Act available to carry out agency activities. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Language permitting the Centers for Disease Control and Prevention to exempt from any personnel ceiling applicable to the 

Agency both civilian and Commissioned Officers detailed to the 

States, municipalities, or other organizations under authority of 

section 214 of the Public Health Service Act for purposes related 

to homeland security during the period of detail or assignment. 

Language transferring to the Secretary of Health and Human 

Services the functions, assets, unexpended balances, and liabilities 

of the Strategic National Stockpile, including the functions of the 

Secretary of Homeland Security relating thereto, while retaining 

the right of both Secretaries to deploy the Stockpile when deemed 

appropriate. 

TITLE III—DEPARTMENT OF EDUCATION 

IMPACT AID

Language ensuring that schools serving the children of military 

personnel continue to receive Impact Aid funds when the military 

parents who live on-base are deployed and the child continues to 

attend the same school and in cases in which an on-base military 

parent is killed while on active duty and the child continues to attend the same school. 

SCHOOL IMPROVEMENT PROGRAMS

Language allowing the Republic of the Marshall Islands and the 

Federated States of Micronesia to reserve up to five percent of their 

supplemental education grants for technical assistance, administration and oversight purposes. 

VOCATIONAL AND ADULT EDUCATION

Language stating that a portion of the amount provided for Adult 

Education State Grants shall be for integrated English literacy and 

208 

civics education services to immigrants and other limited English 

proficient populations, and specifying the distribution of such 

funds. 

STUDENT FINANCIAL ASSISTANCE

Language providing that the maximum Pell grant a student may 

receive in the 2004–2005 academic year shall be $4,050. 

HIGHER EDUCATION

Language providing that funds are available to fund fellowships 

for academic year 2005–2006 under part A, subpart 1 of title VII 

of the Higher Education Act of 1965, under the terms and conditions of part A, subpart 1. 

Language providing that notwithstanding any other provision of 

law, funds made available to carry out title VI of the Higher Education Act and section 102(b)(6) of the Mutual Educational and 

Cultural Exchange Act of 1961 may be used to support visits and 

study in foreign countries by individuals who are participating in 

advanced foreign language training and international studies in 

areas that are vital to United States national security and who 

plan to apply their language skills and knowledge of these countries in the fields of government, the professions, or international 

development. 

HOWARD UNIVERSITY

Language providing that Howard University shall use not less 

than $3,600,000 for the endowment program pursuant to the Howard University Endowment Act. 

TITLE IV—RELATED AGENCIES 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

Language specifying that none of the funds for activities authorized by section 122 and part C of title I and part E of title II of 

the Domestic Volunteer Service Act of 1973 shall be used to provide 

stipends or other monetary incentives to volunteers or volunteer 

leaders whose incomes exceed 125 percent of the national poverty 

level. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

The bill includes language specifying that notwithstanding 31 

U.S.C. 3302, fees charged by the Federal Mediation and Conciliation Service, up to full-cost recovery, for special training activities 

and for arbitration services shall be credited to and merged with 

its administrative account, and shall remain available until expended; that fees for arbitration services shall be available only for 

education, training, and professional development of the agency 

workforce; and that the Director of the Service is authorized to accept on behalf of the United States gifts of services and real, personal, or other property in the aid of any projects or functions within the Director’s jurisdiction. 

209 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

The bill includes a provision requiring that appropriations to the 

NLRB shall not be available to organize or assist in organizing agricultural laborers or used in connection with investigations, hearings, directives, or orders concerning bargaining units composed of 

agricultural laborers as referred to in 2(3) of the Act of July 5, 1935 

(29 U.S.C. 152), and as amended by the Labor-Management Relations Act, 1947, as amended, and as defined in 3(f) of the Act of 

June 25, 1938 (29 U.S.C. 203), and including in said definition employees engaged in the maintenance and operation of ditches, canals, reservoirs, and waterways, when maintained or operated on 

a mutual non-profit basis and at least 95 per centum of the water 

stored or supplied thereby is used for farming purposes. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

The bill includes language providing that the total amount provided for railroad retirement dual benefits shall be credited to the 

Dual Benefits Payments Account in 12 approximately equal 

amounts on the first day of each month in the fiscal year. 

LIMITATION ON ADMINISTRATION

The bill includes language providing that the Railroad Retirement Board shall determine the allocation of its administrative 

budget between the railroad retirement accounts and the railroad 

unemployment insurance administration fund. 

SOCIAL SECURITY ADMINISTRATION

LIMITATION ON ADMINISTRATIVE EXPENSES

Language providing that unobligated balances at the end of fiscal 

year 2005 shall remain available until expended for the agency’s 

information technology and telecommunications hardware and software infrastructure, including related equipment and non-payroll 

administrative expenses associated solely with this information 

technology and telecommunications infrastructure; language authorizing the use of up to $15,000 for official reception and representation expenses; and language providing that reimbursement 

to the trust funds under this heading for expenditures for official 

time for employees of the Social Security Administration pursuant 

to section 7131 of title 5, United States Code, and for facilities or 

support services for labor organizations pursuant to policies, regulations, or procedures referred to in 7135(b) of such title shall be 

made by the Secretary of the Treasury, with interest, from 

amounts in the general fund not otherwise appropriated, as soon 

as possible after such expenditures are made. 

Language providing that funds may be derived from administration fees collected pursuant to 1616(d) of the Social Security Act or 

212(b)(3) of Public Law 93–66 and that, to the extent that the 

amounts collected pursuant to such sections in fiscal year 2005 exceed $124,000,000, the amounts shall be available in fiscal year 

2006 only to the extent provided in advance in appropriations Acts. 

210 

Language providing that unobligated funds previously appropriated for Federal-State partnerships shall be transferred to the 

Supplemental Security Income Program and remain available until 

expended. 

OFFICE OF INSPECTOR GENERAL

Language permitting the transfer of a certain amount of funds 

into this account from the SSA administrative account provided 

that the Appropriations Committees are promptly notified. 

GENERAL PROVISIONS

Sections 102, 201, 202, 203, 204, 205, 206, 207, 208, 209, 210, 

211, 212, 213, 214, 215, 216, 217, 221, 222, 301, 302, 303, 304, 501, 

504, 507, 508, 509, 510, 511, 512, 513, 514, 516 and 517 of the bill 

are general provisions, most of which have been carried in previous 

appropriations acts, which place limitations on the use of funds in 

the bill or authorize or require certain activities, and which might, 

under some circumstances, be construed as changing the application of existing law. 

DEFINITION OF PROGRAM, PROJECT, AND ACTIVITY

During fiscal year 2005 for purposes of the Balanced Budget and 

Emergency Deficit Control Act of 1985 (Public Law 99–177), as 

amended, the following information provides the definition of the 

term ‘‘program, project, and activity’’ for departments and agencies 

under the jurisdiction of the Labor, Health and Human Services, 

and Education and Related Agencies Subcommittee. The term ‘‘program, project, and activity’’ shall include the most specific level of 

budget items identified in the Departments of Labor, Health and 

Human Services, and Education, and Related Agencies Appropriations Act, 2005, the accompanying House and Senate Committee 

reports, the conference report and accompanying joint explanatory 

statement of the managers of the committee of conference. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

Pursuant to clause 3(c)(4) of rule XIII of the Rules of the House 

of Representatives, the following is a statement of general performance goals and objectives for which this measure authorizes funding: 

The Committee on Appropriations considers program performance, including a program’s success in developing and attaining 

outcome-related goals and objectives, in developing funding recommendations. 

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3 of rule XIII of the Rules of the House of 

Representatives, the following table lists the appropriations in the 

accompanying bill which are not authorized by law: 

211 

Agency/program Last year of authorization Authorization level Appropriations in last 

year of authorization 

Appropriations in this 

bill 

DEPARTMENT OF LABOR 

Employment and Training Administration—Training and Employment Services.

2003 ...................... Such Sums ............ $5,217,070,000 $5,112,728,000 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

HRSA: 

Health Professions, except certain nursing programs.2002 ...................... Such Sums ............ 295,11,000 269,478,000 

Universal Newborn Screening ... 2002 ...................... Such Sums ............ 9,995,000 9,872,000 

Organ Transplantation .............. 1993 ...................... Such Sums ............ 24,990,000 24,632,000 

Rural and Community Access 

to Emergency Devices.

2003 ...................... $25,000,000 .......... 12,500,000 5,000,000 

State Offices of Rural Health ... 2002 ...................... Such Sums ............ 7,996,000 8,390,000 

Trauma Care ............................. 2002 ...................... Such Sums ............ 3,499,000 3,449,000 

Family Planning ........................ 1985 ...................... $158,400,000 ........ 142,500,000 278,283,000 

State Planning Grants for 

Health Care Access.

NA .......................... NA .......................... NA 14,810 

CDC: 

Birth Defects ............................. 2002 ...................... Such Sums ............ 98,040,000 119,214,000 

Cancer Registeries .................... 2003 ...................... Such Sums ............ 45,649,000 49,669,000 

Prostate Cancer ........................ 2004 ...................... Such Sums ............ 15,452,000 15,452,000 

Breast and Cervical Cancer 

Prevention.

2003 ...................... Such Sums ............ 199,371,000 219,533,000 

Wisewoman ............................... 2003 ...................... Such Sums ............ 12,500,000 12,500,000 

Prevention Centers .................... 2003 ...................... Such Sums ............ 26,830,000 26,652,000 

Health statistics ....................... 2003 ...................... Such Sums ............ 25,899,000 149,600,000 

Preventive Health Services 

Block Grant.

1998 ...................... Such Sums ............ 149,092,000 110,000,000 

Sexually Transmitted Diseases 

Grants.

1998 ...................... Such Sums ............ 112,117,000 172,935,000 

Tuberculosis Grants .................. 2002 ...................... Such Sums ............ 132,689,000 138,670,000 

Loan Repayment ....................... 2002 ...................... $500,000 ............... 500,000 500,000 

NIH: 

National Institutes of Health— 

Research Training.

1996 ...................... Such Sums ............ 416,992,000 763,899,000 

National Cancer Institute ......... 1996 ...................... Such Sums ............ 2,248,000,000 4,870,025,000 

National Heart, Lung, and 

Blood Institute.

1996 ...................... Such Sums ............ 1,354,945,000 2,963,953,000 

National Institute on Aging ...... 1996 ...................... Such Sums ............ 453,541,000 1,055,666,000 

National Institute on alcohol 

abuse and Alcoholism.

1994 ...................... Such Sums ............ 185,538,000 441,911,000 

National Institute on Drug 

Abuse.

1994 ...................... Such Sums ............ 424,315,000 1,012,760,000 

National Institute of Mental 

Health.

1994 ...................... Such Sums ............ 613,352,000 1,420,609,000 

National Institute of Biomedical 

Imaging and Bioengineering.

2003 ...................... Such Sums ............ 280,100,000 297,647,000 

National Library of Medicine .... 1996 ...................... Such Sums ............ 140,936,000 316,947,000 

SAMHSA: 

Substance Abuse and Mental 

Health Services Administration programs.

FY 2003 ................. Such Sums ............ 3,158,068,000 3,391,663,000 

ACF: 

Office of Refugee Resettlement, 

except: Unaccompanied Alien 

Children, Victims of Torture, 

and Victims of Trafficking.

FY 2002 ................. Such Sums ............ 439,894,000 414,107,000 

Child Care Development Block 

Grant.

FY 2002 ................. $1,000,000,000 ..... 2,099,994,000 2,099,729,000 

Head Start ................................ FY 2003 ................. Such Sums ............ 6,815,570,000 6,898,580,000 

Native American programs ....... FY 2002 ................. Such Sums ............ 45,946,000 45,155,000 

Community Services Block 

Grant programs.

FY 2003 ................. Such Sums ............ 739,315,000 710,088,000 

Office of the Secretary Adolescent Family Life (Title XX).1985 ...................... $30,000,000 .......... 14,716,000 31,229,000 

212 

Agency/program Last year of authorization Authorization level Appropriations in last 

year of authorization 

Appropriations in this 

bill 

DEPARTMENT OF EDUCATION 

Education for the Disadvantaged— 

Migrant Education.

FY 2003 ................. Such Sums ............ 34,750,000 38,202,000 

Innovation and Improvement—Credit 

Enhancement for Charter School 

Facilities.

FY 2003 ................. Such Sums ............ 24,838,000 50,000,000 

Special Education: 

Grants to States Part B ........... FY 2002 ................. Such Sums ............ 7,528,533 11,068,106,000 

Preschool Grants ....................... FY 2002 ................. Such Sums ............ 390,000,000 387,699,000 

Grants for Infants and Families FY 2002 ................. Such Sums ............ 417,000,000 466,581,000 

IDEA National Activities ............ FY 2002 ................. Such Sums ............ 337,271,000 253,715,000 

Rehabilitation Services and Disability 

Research.

FY 2003 ................. Such Sums ............ 3,013,305,000 3,054,587,000 

Special Institutions for Persons with 

Disabilities: 

National Technical Institute for 

the Deaf.

FY 2003 ................. Such Sums ............ 53,800,000 55,790,000 

Gallaudet University ................. FY 2003 ................. Such Sums ............ 100,800,000 104,000,000 

Vocational and Adult Education ........ FY 2003 ................. Such Sums ............ 2,121,690,000 2,025,456,000 

Student Financial Assistance ............ FY 2004 ................. Such Sums ............ 14,007,296,000 14,755,794,000 

Student Aid Administration ............... FY 2004 ................. Such Sums ............ 116,727,000 120,247,000 

Higher Education: 

Aid for Institutional Development.FY 2004 ................. Such Sums ............ 485,065,000 510,547,000 

International Education and 

Foreign Language.

FY 2004 ................. Such Sums ............ 103,680,000 107,680,000 

Domestic Programs .......... FY 2004 ................. Such Sums ............ 89,211,000 93,211,000 

Institute for International 

Public Policy.

FY 2004 ................. Such Sums ............ 1,629,000 1,629,000 

Fund for Improvement of Post 

Secondary Education.

FY 2004 ................. Such Sums ............ 157,700,000 32,011,000 

Minority Science and Engineering Improvement.FY 2004 ................. Such Sums ............ 8,889,000 8,889,000 

Interest Subsidy Grants ............ FY 2004 ................. Such Sums ............ 1,988,000 1,500,000 

Tribally Controlled Post-Secondary vocational and Technical Institutions.

FY 2004 ................. $4,000,000 ............ 7,185,000 7,185,000 

Federal TRIO Programs ............. FY 2004 ................. Such Sums ............ 832,559,000 842,559,000 

GEAR UP ................................... FY 2004 ................. Such Sums ............ 298,230,000 318,230,000 

Javits Fellowships ..................... FY 2004 ................. Such Sums ............ 9,876,000 9,876,000 

Graduate Assistance in Areas 

of National Need.

FY 2004 ................. Such Sums ............ 30,616,000 30,616,000 

Teacher Quality Enhancement 

Grants.

FY 2004 ................. Such Sums ............ 88,887,000 88,888,000 

Child Care Access Means Parents in School.FY 2004 ................. Such Sums ............ 16,098,000 16,099,000 

GPRA Data/HEA program evaluation.FY 2004 ................. Such Sums ............ 988,000 988,000 

B.J. Stupak Olympic Scholarships.FY 2004 ................. Such Sums ............ 988,000 988,000 

Howard University—Endowment Program.FY 1985 ................. $2,000,000 ............ 2,000,000 3,552,000 

Institute of Education Sciences—Research and Innovation in Special 

Education.

FY 2002 ................. Such Sums ............ 78,380,000 78,125,000 

RELATED AGENCIES 

Corporation for National and Community Service—Domestic Volunteer Service Programs.

FY 1996 ................. Such Sums ............ 198,393,000 353,197,000 

Corporation for Public Broadcasting—FY2005, Interconnection.FY 1993 ................. $200,000,000 ........ 65,327,000 60,000,000 

Corporation for Public Broadcasting—FY2005 Digitization.FY 2001 ................. $20,000,000 .......... 20,000,000 20,000,000 

National Council on Disability ........... FY 2003 ................. Such Sums ............ 2,858,000 2,873,000 

213 

COMPLIANCE WITH RULE XIII, CL. 3(e) (RAMSEYER RULE) 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

SECTION 8002 OF THE ELEMENTARY AND SECONDARY 

EDUCATION ACT OF 1965 

SEC. 8002. PAYMENTS RELATING TO FEDERAL ACQUISITION OF REAL 

PROPERTY. 

(a) * * * 

* * * * * * * 

(m) ELIGIBILITY.— (1) OLD FEDERAL PROPERTY.—Except as provided in paragraph (2), a local educational agency that is eligible to receive 

a payment under this section for Federal property acquired by 

the Federal Government, before the date of the enactment of 

the Impact Aid Reauthorization Act of 2000, shall be eligible 

to receive the payment only if the local educational agency submits an application for a payment under this section not later 

than ø5¿ 7 years after the date of the enactment of such Act. 

(2) COMBINED FEDERAL PROPERTY.—A local educational agency that is eligible to receive a payment under this section for 

Federal property acquired by the Federal Government before 

the date of the enactment of the Impact Aid Reauthorization 

Act of 2000 shall be eligible to receive the payment if— 

(A) * * * 

(B) the local educational agency submits an application 

for a payment under this section not later than ø5¿ 7 

years after the date of acquisition of the Federal property 

acquired after the date of the enactment of such Act. 

(3) NEW FEDERAL PROPERTY.—A local educational agency 

that is eligible to receive a payment under this section for Federal property acquired by the Federal Government after the 

date of the enactment of the Impact Aid Reauthorization Act 

of 2000 shall be eligible to receive the payment only if the local 

educational agency submits an application for a payment 

under this section not later than ø5¿ 7 years after the date of 

acquisition. 

* * * * * * * 

FULL COMMITTEE VOTES

Pursuant to the provisions of clause 3(b) of rule XII of the House 

of Representatives, the results of each rollcall vote on an amendment or on the motion to report, together with the names of those 

voting for and those voting against, are printed below: 

214 

ROLLCALL NO. 1

Date: July 14, 2004. 

Measure: Departments of Labor, Health and Human Services, 

and Education, and Related Agencies Appropiations Bill, FY 2005. 

Motion by: Mr. Obey. 

Description of motion: To increase various Labor, Health and 

Human Services, and Education programs above amounts recommended in the underlying bill; increases are offset by a reduction to tax cuts for certain income groups. 

Results: Rejected—yeas 25; nays 31. 

Members Voting Yea Members Voting Nay 

Mr. Berry Mr. Aderholt 

Mr. Bishop Mr. Bonilla 

Mr. Boyd Mr. Crenshaw 

Mr. Clyburn Mr. Culberson 

Mr. Cramer Mr. Cunningham 

Mr. DeLauro Mr. Doolittle 

Mr. Edwards Mr. Emerson 

Mr. Farr Mr. Frelinghuysen 

Mr. Hinchey Mr. Goode 

Mr. Hoyer Mr. Granger 

Mr. Jackson Mr. Hobson 

Mr. Kennedy Mr. Istook 

Mr. Kilpatrick Mr. Kirk 

Mr. Lowey Mr. Kolbe 

Mr. Mollohan Mr. LaHood 

Mr. Moran Mr. Lewis 

Mr. Murtha Mr. Nethercutt 

Mr. Obey Mr. Northup 

Mr. Olver Mr. Peterson 

Mr. Pastor Mr. Regula 

Mr. Price Mr. Rogers 

Mr. Roybal-Allard Mr. Sherwood 

Mr. Sabo Mr. Simpson 

Mr. Serrano Mr. Taylor 

Mr. Visclosky Mr. Tiahrt 

Mr. Vitter 

Mr. Walsh 

Dr. Weldon 

Mr. Wicker 

Mr. Wolf 

Mr. Young 

215 

ROLLCALL NO. 2

Date: July 14, 2004. 

Measure: Departments of Labor, Health and Human Services, 

and Education, and Related Agencies Appropriations Bill, FY 2005. 

Motion by: Mr. Obey. 

Description of motion: To add language prohibiting the use of 

funds by the Department of Labor to implement or administer any 

change to regulations regarding overtime compensation. 

Results: Rejected—yeas 29; Nays 31. 

Members Voting Yea Members Voting Nay 

Mr. Berry Mr. Aderholt 

Mr. Bishop Mr. Bonilla 

Mr. Boyd Mr. Crenshaw 

Mr. Clyburn Mr. Culberson 

Mr. Cramer Mr. Cunningham 

Ms. DeLauro Mr. Frelinghuysen 

Mr. Dicks Mr. Goode 

Mr. Edwards Ms. Granger 

Mr. Farr Mr. Hobson 

Mr. Fattah Mr. Istook 

Mr. Hinchey Mr. Kingston 

Mr. Hoyer Mr. Knollenberg 

Mr. Jackson Mr. Kolbe 

Ms. Kaptur Mr. LaHood 

Mr. Kennedy Mr. Latham 

Ms. Kilpatrick Mr. Lewis 

Mrs. Lowey Mr. Nethercutt 

Mr. Mollohan Mrs. Northup 

Mr. Moran Mr. Peterson 

Mr. Murtha Mr. Regula 

Mr. Obey Mr. Rogers 

Mr. Olver Mr. Sherwood 

Mr. Pastor Mr. Simpson 

Mr. Price Mr. Taylor 

Mr. Rothman Mr. Tiahrt 

Ms. Roybal-Allard Mr. Vitter 

Mr. Sabo Mr. Walsh 

Mr. Serrano Dr. Weldon 

Mr. Visclosky Mr. Wicker 

Mr. Wolf 

Mr. Young 

216 

ROLLCALL NO. 3

Date: July 14, 2004. 

Measure: Departments of Labor, Health and Human Services, 

and Education, and Related Agencies Appropriations Bill, FY 2005. 

Motion by: Mr. Wicker. 

Description of motion: To add language prohibiting the obligation 

or expenditure of funds to administer or enforce the provisions of 

the General Industry Respiratory Protection Standard to the extent 

that such provisions require annual fit testing of respirators of occupational exposure to tuberculosis. 

Results: Adopted—yeas 35; nays 27. 

Members Voting Yea Members Voting Nay 

Mr. Aderhold Mr. Berry 

Mr. Bonilla Mr. Bishop 

Mr. Crenshaw Mr. Boyd 

Mr. Culberson Ms. DeLauro 

Mr. Cunningham Mr. Dicks 

Mr. Doolittle Mr. Edwards 

Mrs. Emerson Mr. Farr 

Mr. Frelinghuysen Mr. Fattah 

Mr. Goode Mr. Hinchey 

Ms. Granger Mr. Hoyer 

Mr. Hobson Mr. Jackson 

Mr. Istook Ms. Kapture 

Mr. Kingston Mr. Kennedy 

Mr. Kirk Ms. Kilpatrick 

Mr. Knollenberg Mrs. Lowery 

Mr. Kolbe Mr. Mollohan 

Mr. LaHood Mr. Moran 

Mr. Latham Mr. Murtha 

Mr. Lewis Mr. Obey 

Mr. Nethercutt Mr. Olver 

Mr. Northup Mr. Pastor 

Mr. Peterson Mr. Price 

Mr. Regula Mr. Rothman 

Mr. Rogers Ms. Roybal-Allard 

Mr. Sherwood Mr. Sabo 

Mr. Simpson Mr. Serrano 

Mr. Sweeney Mr. Visclosky 

Mr. Taylor 

Mr. Tiahrt 

Mr. Vitter 

Mr. Wamp 

Dr. Weldon 

Mr. Wicker 

Mr. Wolf 

Mr. Young 

217 

ROLLCALL NO. 4

Date: July 14, 2004. 

Measure: Departments of Labor, Health and Human Services, 

and Education, and Related Agencies Appropriations Bill, FY 2005. 

Motion by: Mr. Goode. 

Description of motion: To add language prohibiting the use of 

funds by the Commissioner of Social Security to implement the 

agreement establishing totalization arrangements between the social security system established by title II of the Social Security Act 

and the social security system of Mexico. 

Results: Rejected—yeas 20; nays 36. 

Members Voting Yea Members Voting Nay 

Mr. Culberson Mr. Bishop 

Mr. Doolittle Mr. Bonilla 

Mrs. Emerson Mr. Boyd 

Mr. Goode Mr. Clyburn 

Mr. Istook Mr. Crenshaw 

Mr. Kingston Ms. DeLauro 

Mr. Kolbe Mr. Dicks 

Mr. LaHood Mr. Edwards 

Mr. Peterson Mr. Farr 

Mr. Rogers Mr. Frelinghuysen 

Mr. Sherwood Ms. Granger 

Mr. Simpson Mr. Hinchey 

Mr. Sweeney Mr. Hobson 

Mr. Taylor Mr. Hoyer 

Mr. Tiahrt Mr. Jackson 

Mr. Vitter Mr. Kennedy 

Mr. Wamp Ms. Kilpatrick 

Dr. Weldon Mr. Knollenberg 

Mr. Wolf Mr. Latham 

Mr. Young Mrs. Lowey 

Mr. Mollohan 

Mr. Moran 

Mr. Nethercutt 

Mrs. Northup 

Mr. Obey 

Mr. Olver 

Mr. Pastor 

Mr. Price 

Mr. Regula 

Mr. Rothman 

Ms. Roybal-Allard 

Mr. Sabo 

Mr. Serrano 

Mr. Visclosky 

Mr. Walsh 

Mr. Wicker 

218 


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MINORITY VIEWS OF THE HONORABLE DAVID OBEY, STENY 

HOYER, NITA LOWEY, ROSA DELAURO, JESSE JACKSON, 

JR., PATRICK KENNEDY, AND LUCILLE ROYBAL-ALLARD 

While this bill is a modest improvement over the President’s 

budget request, it fails to meet America’s needs in education, 

health care, medical research, and human services. The bill’s inadequacies, however, are not the fault of the Committee or Chairman 

Regula. This bill’s shortcomings are the direct and foreseeable result of the Majority’s reckless FY 2005 budget resolution which, as 

with each of the budgets the Majority produced over the past three 

years, abandons fiscal discipline, mortgages our nation’s future, 

and makes impossible critical investments that benefit all Americans. It is the product of the skewed priorities of the Majority, who 

value super-sized tax cuts for our wealthiest and most privileged 

citizens over honoring our commitments and protecting our most 

vulnerable citizens. 

Even when provided with an opportunity to change course, the 

Majority held rigidly to its failed budget blueprint. Earlier this 

year, the Majority rejected a Democratic alternative to the FY 2005 

budget that was fiscally responsible and allowed a greater investment in education, health care, and many other critical priorities. 

Then, on June 24, the Majority defeated a Democratic resolution to 

revise the budget resolution that would have made a greater investment in education, training, and health by modestly scaling 

back tax cuts for those with annual incomes of $1 million or more. 

Given the Majority Party’s misguided budgetary choices, shortfalls in appropriations are inevitable. In fact, the Labor-HHS-Education Subcommittee received a relatively good share of an inadequate total, allowing an increase of about $3 billion above the current year. That increase was largely allocated to a few areas: providing $1 billion increases for two high-priority education programs, keeping up with rising costs in the Pell Grant program, partially covering increased research costs at NIH, and funding the 

administrative expenses of the Social Security Administration. 

After doing these things, the subcommittee had more than exhausted the additional funds it was allocated above the FY 2004 

level. Consequently, other priorities in the bill had to be cut. 

EDUCATION—NOT AT THE TOP OF THE CLASS

Next year, K–12 and higher education enrollments will again 

reach record levels. Nearly 55 million students will attend the nation’s elementary and secondary schools—4 million more students 

than in 1995. Full-time college enrollment will reach 16.7 million 

students—14 percent more than a decade ago. 

At the same time that schools are serving more students, the 

stakes are raised higher by the mandates of the No Child Left Behind Act (NCLB). During the 2005 school year, schools must actuVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00281 Fmt 6604 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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ally test each student in grades 3–8 in reading and math or face 

federal sanctions. Student achievement must improve. And, every 

teacher of a core academic subject must become ‘‘highly qualified.’’ 

Against the backdrop of record school enrollments, unprecedented Federal education accountability requirements, and rising 

demand for college assistance, the Committee bill fails to match 

these growing demands with sufficient resources. The bill provides 

a $2.0 billion (3.6 percent) increase over FY 2004 for the Department of Education’s discretionary programs, continuing a downward slide in new discretionary education investments under the 

Bush Administration. 

No Child Left Behind 

While all 50 states and 15,500 school districts are striving to address NCLB’s worthy goals, money remains short in many schools. 

Nonetheless, the Committee bill actually cuts NCLB funding $120 

million below the Administration’s request, while providing only 

$328 million (1.3 percent) more than FY 2004. In total, the bill provides $9.5 billion less than the funding promised in NCLB. 

Fully funding Title 1—which serves low-income children in 

schools with the greatest educational challenges—is the centerpiece 

of federal education reform efforts. Title 1 grants to school districts 

receive a $1 billion (8.1 percent) increase in the Committee bill, the 

same amount as the President’s request. Despite this needed increase, Title 1 appropriations in FY 2005 would still fall $7.2 billion short of the NCLB funding promise—accounting for most of 

the total $9.5 billion NCLB shortfall in the Committee bill. 

A key concept in NCLB is that students who are falling behind 

are able to receive tutoring and a broad array of enrichment services in school and community-based after school centers. Yet the 

Committee bill freezes funding for 21st Century Community Learning Centers at $999 million—only half of the $2.0 billion authorized 

by NCLB. At the $2.0 billion level, an additional 1.3 million children could be served in such communities as Davenport, Iowa, Columbus, Ohio, Greenville, South Carolina, and Salt Lake City, 

Utah, all of which are struggling to keep existing after school centers open to serve children in working families. 

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ample, English language learning assistance for more than 5 million children who must learn to read and speak English is frozen 

at $681 million, the second year in a row—even while these children must meet the same rigorous academic standards as all other 

children. About 6,500 rural school districts will see their Rural 

Educational Achievement Program grants level funded at $168 million, in the aggregate; despite the difficulty they face in recruiting 

and retaining teachers. In addition, investments in school violence 

prevention, substance abuse prevention and school safety activities 

are frozen at $595 million, nearly 10 percent less than the safe and 

drug-free schools funding level three years ago. 

The Committee bill makes only modest investments in a few areas. For example, it provides a $63 million net increase for teacher training in math and science instruction (after accounting for an 

offsetting reduction in NSF support). It provides 1,300 school districts located on or near military bases and other federal facilities 

a $21 million (1.7 percent) increase under the Impact Aid program. 

Further, it rejects the Administration’s proposal to cut vocational 

and career education by $316 million and, instead, provides an increase to offset inflation. 

These modest increases, however, are offset by deep reductions 

in other education initiatives, including the outright elimination of 

22 programs. For example, the Committee bill wipes out the Title 

VI education block grant, although the Administration proposed to 

continue its flexible funding of nearly $300 million to help the nation’s school districts pay for locally identified needs, such as upto-date instructional materials, counseling services, and parental 

involvement activities. Moreover, arts education, teacher training 

to improve American history instruction, drop out prevention, K– 

12 foreign language assistance, and community technology centers 

to bridge the digital divide in low-income communities—all priority 

activities reauthorized in NCLB—are terminated. Because of budget constraints, the bill even denies over $100 million in education 

initiatives requested by the President. 

Special education 

President Bush’s Commission on Excellence in Special Education 

concluded, ‘‘children with disabilities remain those most at risk of 

being left behind.’’ The Committee bill makes progress in fulfilling 

federal commitments in special education by providing a $1 billion 

(9.9 percent) increase over FY 2004 for IDEA Part B State Grants, 

the same amount as the President’s request. Under the Committee 

bill, the federal contribution toward special education costs incurred by the nation’s schools will increase from 18.7 percent in FY 

2004 to 19.8 percent in FY 2005. Nonetheless, the Committee bill 

falls $2.5 billion short of the $13.6 billion promised last year by the 

Majority party when it passed H.R. 1350, the IDEA reauthorization 

bill. 

College assistance 

In today’s increasingly technological society, a college education 

is essential for a good-paying job. For low- and moderate-income 

families, however, the task of sending a child to college—which has 

never been easy—is now a daunting challenge, given an average 26 

284 

percent tuition increase in the last two years at 4-year public colleges and universities. 

The Committee bill, however, makes little progress in making 

college more affordable for disadvantaged students. The bill freezes 

the maximum Pell Grant for low-income college students at $4,050 

for the second year in a row, freezes College Work Study assistance, and cuts Perkins Loans by $99 million below last year’s level. 

College students will receive help with dramatically rising tuition bills only through a $24 million (3.1 percent) increase for Supplemental Educational Opportunity Grants (SEOGs), and a restoration of the $66 million LEAP grants for state need-based student 

financial assistance programs, which the Administration sought to 

eliminate. 

INVESTING LESS IN AMERICA’S LABOR FORCE

For the Department of Labor’s employment and training assistance programs for unemployed Americans, the Committee bill invests $236 million less than the Administration’s request and $40 

million less than last year, despite a loss of 1.8 million private sector jobs since President Bush took office. While the Committee bill provides a $25 million (1.7 percent) increase over FY 2004 to assist dislocated workers affected by mass 

layoffs, it denies 80 percent of the Administration’s $250 million request for the Community College technical training initiative and 

eliminates the $90 million prisoner re-entry initiative due to budget constraints. The bill shaves the Administration’s proposed 2.8 

percent increase for salaries and other operating costs for Job 

Corps, the highly successful initiative that helps hard-core disadvantaged and unemployed youth, to a 1.8 percent increase over 

FY 2004. 

Unemployment remains unacceptably high with 8.0 million 

Americans out of work; however, the Committee bill actually cuts 

assistance for individuals seeking jobs through the Employment 

Service, a building block for the nation’s one-stop employment services delivery system. State Employment Service funding is cut to 

$696 million, a 10 percent reduction below FY 2004 and the lowest 

level in more than 10 years. The Committee bill also rescinds $100 

million in prior funding, as requested by the Administration, for 

the H–1B training grants that help train Americans in high-skill, 

high-wage jobs and reduce the nation’s reliance on foreign workers. 

Further, funding to promote international labor standards and 

combat abusive child labor will be eviscerated with a 68 percent cut 

in the Committee bill, which adds only $5 million to the Administration’s request. The $35.5 million provided in the bill includes 

only $16 million for child labor projects compared with the $82 million allocated in FY 2004. 

FALLING SHORT OF THE PROMISE OF A SAFE AND HEALTHY NATION

For the health-related programs of the Department of HHS, the 

Committee’s bill falls short of what is needed to maintain the 

health care safety net, protect the public health, and advance medical research. 

The measure does substantially increase funding for Community 

Health Centers, expand a Global Disease Detection initiative at 

285 

CDC, and provide modest increases for AIDS drug assistance and 

chronic disease prevention programs. In some respects it is an improvement over the President’s budget—it rejects the Administration’s proposal to cut bio-terrorism preparedness assistance to 

health departments and hospitals, and reduces the President’s proposed cuts in rural health and health professions programs. 

However, a number of health programs are still cut below the 

current-year level by the Committee bill. Examples include the 

Healthy Communities Access Program, several rural health programs, some health professions training programs (especially those 

related to primary care and public health), and block grants for 

public health services. A large number of other programs have 

their funding frozen, often for the second or third year in a row. 

These freezes, while health care costs and the number of people 

needing assistance are continuing to increase, mean real erosion in 

the health care safety net and public health protection. • The Committee bill terminates the Healthy Communities Access Program (HCAP), which makes grants to local consortia of 

hospitals, health centers, and other providers to build better integrated systems of care for the uninsured. This means that roughly 

70 communities will lose their existing three-year grants and about 

35 new grants will not be made. • Rural Health Outreach Grants—which support primary health 

care, dental health, mental health, and telemedicine projects—are 

cut by 24 percent. Grants to improve small rural hospitals are cut 

in half, funding to help rural communities acquire the defibrillators 

that can save the lives of heart attack victims are cut by more than 

half, and a small new program to help improve emergency medical 

services in rural areas is eliminated. • Apart from grants to Health Centers, the bill continues to slow 

erosion of most other health care programs. The Maternal and 

Child Health Block Grant is funded slightly below its level of three 

years earlier, with no increase for rising health care costs, population or anything else. These grants help support prenatal care 

and health and dental services for low-income children, and assist 

children with disabilities and other special health care needs. The 

National Health Service Corps—which helps bring doctors and dentists into under-served areas—receives a bit less than in FY 2003. 

The Ryan White AIDS Care programs (other than drug assistance) 

is also slightly under its FY 2003 level (while the number of AIDS 

patients has been rising by about 7 percent per year), and the Title 

X family planning program is just 1.8 percent above FY 2003. 

• Support for training in primary care medicine and dentisty— 

which is targeted to increasing the number of doctors and dentists 

in rural and other underserved areas—is cut 22 percent below the 

current year by the bill. Support for training in public health and 

preventive medicine is cut 24 percent, despite the difficulties that 

public health departments are having recruiting and retaining 

qualified professionals. 

• The Committee bill does include a small, $5 million (3.5 percent) increase for nurse education and training programs. While a 

step in the right direction, it pales in comparison to the national 

commitment envisioned under the Nurse Reinvestment Act, which 

was aimed at stemming the looming nursing shortage. 

286 

• CDC’s childhood immunization program receives a small but welcome $11 million increase in the Committee bill. However, the 

bill’s FY 2005 level is just 3.4 percent above FY 2002 while the cost 

to immunize a child with all recommended vaccines will have increased 18.5 percent. • Also in CDC, although the bill roughly doubles an important 

Global Disease Detection initiative, funding for ongoing domestic 

activities to control and respond to infectious diseases like West 

Nile Virus, SARS and the flu are increased by just 1.1 percent. • The Committee bill makes a 17.5 percent cut in basic support 

to state and local health departments through the Preventive 

Health and Health Services Block Grant. This funding is used for 

a range of priorities, from health screening to immunization to control of chronic diseases like diabetes and asthma to basic epidemiological investigations and public health laboratory operations. 

For the National Institutes of Health, the Committee bill is identical to the Administration’s budget request. It provides an increase 

of 2.6 percent—which is the smallest in 19 years and significantly 

less than the 3.5 percent needed to cover estimated inflation in biomedical research costs. Although the Administration says that its 

budget (and hence the Committee bill) would produce a small increase in the number of new and re-competing research project 

grants—reversing a decrease that is occurring in FY 2004—it 

achieves that result only by assuming unusually tight limits on the 

average size of research grants, including cuts to ongoing research 

projects below previously committed levels. If grant amounts were 

instead allowed to increase at normal rates, the number of new 

grants would decrease for the second year in a row. Many Members 

have been circulating letters to the Committee urging additional 

funding to accelerate research into diseases like Parkinson’s or Alzheimer’s or cancer. Many of the Members of Congress who have 

signed such letters in fact voted for the Republican budget resolution which has made it impossible for the committee to provide 

funding levels requested in such letters. At the funding level in the 

Committee bill, such increases simply are not possible. 

HELPING AMERICA’S MOST VULNERABLE CITIZENS

For the human services side of the Department of HHS, the 

Committee bill includes increases for Low-Income Home Energy 

Assistance (LIHEAP), Refugee Assistance, Head Start, Abstinenceonly Sex Education, and some programs of the Administration on 

Aging. It also rejects most (but not all) of the cut in the Community 

Services Block Grant proposed by the President. On the whole, 

however, the bill’s human services appropriations fall short of what 

is needed. 

For LIHEAP, the Committee added $111 million above FY 2004, 

as proposed by the President. However, this barely does more than 

reverse a decrease that occurred last year. Sharply higher energy 

prices combined with cold winters have increased the need for 

LIHEAP. These same conditions have also led to growing need for 

the Energy Department’s Weatherization Assistance Program 

(which was recently transferred to the Labor-HHS bill). However, 

the bill includes no increase at all for Weatherization, rejecting the 

$64 million addition proposed by the President. 

287 

The Child Care Block Grant has its funding essentially frozen for 

the third year in a row under the Committee’s bill, meaning a real 

reduction in help for working families. Appropriations for Head 

Start are $45 million less than the amount proposed by the President. Overall funding for the Administration on Aging is up by 2.2 

percent. However, this follows two years of even smaller increases, 

leaving the FY 2005 figure just 4.0 percent above its level three 

years earlier. 

THE DEMOCRATIC ALTERNATIVE

The demands of the war on terrorism, the conflict in Iraq, homeland security needs, and a sluggish economy require a pragmatic 

and responsible approach to America’s budget. Yet, even with all 

these competing needs and challenges, this bill’s shortcomings were 

not fated. 

The budget alternatives that Democrats offered earlier this 

year—including the package of budget resolution revisions that the 

House considered on June 24—would have allowed this Committee 

to make a greater investment in education, health care, medical research, and other pressing needs. Our budget alternatives were 

also fiscally responsible; they would have provided for these national needs and reduced the deficit by modestly reducing tax cuts 

for those with annual incomes above $1 million. 

When this bill was considered by subcommittee and by the full 

Appropriations Committee, amendments were offered mirroring the 

Labor-HHS-Education portion of the Democratic budget proposal. 

These amendments would have added $7.4 billion to the bill, paid 

for by 30 percent reduction in the 2005 tax cuts for people with incomes over $1 million. Instead of tax cuts averaging about 

$127,000, this top-income group would have their tax cuts reduced 

to an average of $89,000. Regrettably, these amendments were defeated on party line votes. Had they been adopted, we could: • Invest $1.5 billion more in Title I instruction to help an 

additional 500,000 low-income and minority children in the 

poorest communities succeed in school; • Invest $200 million more in after school centers so that an 

additional 267,000 children, who are responsible for taking 

care of themselves after school each day, have a safe and nurturing place to go after school; • Invest $1.2 billion more to subsidize the high costs of educating 6.9 million children with disabilities; • Provide a $450 increase in the maximum Pell Grant for 

students with the greatest financial need, and begin to restore 

its purchasing power for more than 5 million low-income students; • Assist an additional 51,000 teachers improve their instructional skills to become highly qualified under NCLB; and • Ensure that 2,500 low-performing schools receive the assistance they were promised to implement effective, comprehensive reforms to raise their academic performance. 

In the area of workforce training, the Democratic amendment would have provided an additional $200 million to support training 

and job placement services for more jobless Americans. And, it 

would have fully restored funding to combat child labor and proVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00287 Fmt 6604 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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mote workers’ rights around the world, which in turn would have 

helped workers here at home. 

On the health and human services side, the Democratic amendment would have allowed us to provide more help to the 45 million 

people without health care, maintain momentum in biomedical research, and restore some of the lost purchasing power in key 

human services programs. For example, the amendment would do 

the following: • Maintain the Healthy Communities Access Program, rather 

than terminating it as under the Committee bill, and add some 

funds to make up for lost ground in programs like the Maternal 

and Child Health Block Grant, Family Planning, and Community 

Mental Health Block Grant. • Avoid any cuts in health professions training programs, add $20 million to the National Health Service Corps to get more doctors and dentists into underserved rural and inner city areas, and 

add $35 million to Nurse Reinvestment Act programs to help stem 

the nursing shortage by providing more scholarships for nursing 

students and more support for nursing schools. • Eliminate the proposed cuts in rural health programs, and add an additional $19 million to better support rural health clinics, hospitals and emergency services. • Provide $50 million to help meet some of the most urgent 

unmet needs for dental care, through grants for rural dental clinics, scholarships and student loan repayment arrangements for 

dentists who locate in underserved areas, and grants and low-interest loans to help dentists who agree to participate in Medicaid establish and expand practices in areas with dental shortages. • Add $500 million to the budget of the National Institutes of 

Health—enough to provide a full inflation adjustment, renew all 

ongoing research grants, and restore the number of new grants to 

the FY 2003 level. This would help maintain momentum in research to find better treatments for diseases like cancer, Parkinson’s disease, and Alzheimer’s. 

• Provide $50 million more for child immunization, to help catch 

up with rising vaccine costs, and also add $50 million to other infectious disease control efforts at CDC (including those aimed at 

HIV/AIDS, tuberculosis, and sexually transmitted diseases). 

• Add $200 million to the Low-Income Home Energy Assistance 

Program to help keep up with rising needs. Between the 2002 and 

2004 winter heating seasons, average home heating costs rose 50 

percent for natural gas users and 54 percent for users of fuel oil. 

As energy prices rise and the economy remains weak, the number 

of households seeking assistance is rising, but the program still 

serves only about 14 percent of the eligible population. 

Provide an additional $70 million for senior citizens’ programs of 

the Administration on Aging, including Meals on Wheels and other 

nutrition programs. 

Budgets are as much about America’s values are they are about 

dollars and cents. By prioritizing massive tax cuts for the wealthiest among us, House Republicans have once again rejected traditional American values of shared sacrifice in difficult times and 

equal opportunity for all Americans. The Majority’s priorities will 

mean less opportunity through education and job training, deVerDate Aug 04 2004 14:04 Sep 08, 2004 Jkt 029011 PO 00000 Frm 00288 Fmt 6604 Sfmt 6602 E:\HR\OC\HR636.XXX HR636
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creased access to health care in rural and other underserved areas, 

and a nation that is less caring toward its most vulnerable children, families, and senior citizens. 

The decisions that have led to this unhappy situation have, in 

fact, already been made by the Republican majority members who 

have voted for the Republican budget resolution and against our efforts to modify it. This bill is the inevitable unhappy result of those 

decisions. The only way to achieve a more favorable final outcome 

is for this bill to move to conference with the Senate and be greatly 

altered to produce a more responsible result. 

DAVID OBEY. 

STENY HOYER. 

NITA LOWEY. 

ROSA L. DELAURO. 

JESSE L. JACKSON, JR. 

PATRICK J. KENNEDY. 

LUCILLE ROYBAL-ALLARD. 

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MINORITY VIEWS OF THE HONORABLE DAVID OBEY, STENY 

HOYER, NITA LOWEY, ROSA DELAURO, JESSE JACKSON, 

JR., PATRICK KENNEDY, AND LUCILLE ROYBAL-ALLARD 

ON THE ADMINISTRATION’S OVERTIME REGULATION 

The Administration is poised—in a few short weeks—to implement the most sweeping, anti-worker revision of the Fair Labor 

Standards Act (FLSA) since its inception in 1938. The overtime pay 

requirements of the FLSA, which guarantee for most workers ‘‘time 

and a half’’ pay for hours worked beyond a standard 40-hour work 

week, are one of the nation’s bedrock worker protections. The 

FLSA’s overtime provisions cover approximately 115 million workers—about 85 percent of the nation’s workforce. 

On August 23rd, 2004, the Department of Labor’s final overtime 

regulations (redefining who is considered a professional, administrative, or executive employee and thereby exempt from overtime 

pay) are slated to go into effect, giving employers a huge windfall 

taken right out of employees’ paychecks. On the eve of Labor Day, 

more than 6 million Americans soon will be getting less pay for 

their labors courtesy of the Bush Administration. 

This anti-worker regulation is just the latest attack on America’s 

workers by this Administration. Since President Bush entered office, 1.8 million private sector jobs have been lost. Despite modest 

job creation in the last few months, some 8.2 million Americans remain unemployed—2.3 million (38 percent) more than when President Bush entered office. Further, more unemployed individuals 

are out of work for longer periods of time. In June 2004, 1.7 million 

individuals had been unemployed for over 6 months—nearly triple 

the number of long-term unemployed at the start of the Administration. 

For families who received overtime pay in 2000, overtime earn- ings accounted for about 25 percent of their income or about $8,400 

a year. Overtime compensation is essential to their ability to pay 

mortgages, medical bills, and make ends meet. Yet, despite the urgent need to halt the Administration’s assault on these workers, 

the House Appropriations Committee rejected, by a party line vote 

of 29 to 31, a Democratic amendment that would have prevented 

the Administration from rolling back the 40-hour workweek. 

Last year, both the House and the Senate voted to stop the Administration from taking away workers’ rights to overtime when 

the Department of Labor issued its initial proposal to strip overtime protections away from 8 million workers. The Senate twice 

adopted amendments offered by Senator TOM HARKIN to prohibit 

the Administration from taking away overtime pay. Last October, 

the House voted to adopt the Obey-Miller Motion to Instruct by a 

vote of 221 to 203. 

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1 Ross Eisenbrey, Economic Policy Institute, ‘‘Longer Hours, Less Pay’’, July 14, 2004. 

qualify anyone from overtime protection, while retaining virtually 

the only positive change in the initial regulation—a long overdue 

and non-controversial increase in the protective salary threshold to 

guarantee overtime rights for low-income workers. Democrats support extending overtime protections to more low-income workers, 

even though the Administration’s proposal fails to provide a true 

inflationary adjustment to the salary threshold. (Moreover, we now 

know that that far fewer workers would actually benefit from this 

change than claimed by the Department of Labor.) 

Yet, despite passage of these measures in the Senate and the 

House—in opposition to all the traditions of the Congress—the Republican leadership stripped the Harkin language from the final 

fiscal year 2004 omnibus appropriations bill, allowing the Department of Labor to proceed with its anti-worker regulation. 

On July 14, the Committee on Appropriations had an opportunity 

to preserve the hard-earned overtime rights for working Americans 

by adopting the Democratic amendment. The Democratic amendment was identical, in effect, to the earlier measures approved by 

both the House and the Senate. It would have prohibited the Department of Labor from implementing the final rule to disqualify 

workers from overtime coverage. At the same time, it would have 

allowed the expansion of overtime rights for low-income workers 

earning up to $23,660 a year, precisely as proposed by the Department of Labor in its final regulation. 

The Democratic amendment would protect more than 6 million 

workers in a broad range of occupations now at risk of losing their 

overtime rights according to estimates made by the Economic Policy Institute (EPI).1 Indeed, an even larger number of workers are 

likely to be harmed by the Administration rule because EPI examined only 10 of the hundreds of occupational categories covered by 

the Bush anti-worker regulation. 

The Democratic amendment would protect: 

• 2.3 million workers who lead teams of other employees assigned to major projects—even if these team leaders have no direct supervisory responsibilities for other employees on the team. 

About 40 percent of employers with 50 or more employees routinely use work teams. Under the Department of Labor’s final 

regulation, however, we can expect even more employers to 

take advantage of this new exemption with enormous negative 

consequences for employees; 

• Nearly 2 million low-level working supervisors in fast food 

restaurants, lodging and retail stores. Under the Department of 

Labor’s final regulation, these employees could lose 100 percent of their overtime eligibility even though only a small percentage of their time is spent on managerial work. For example, low-paid Burger King assistant manager who spends nearly all of his or her time cooking hamburgers and serving customers, with no authority to hire or fire subordinates, could 

lose all of his or her overtime pay. Moreover, it will not be easier for employers to evade the rules by converting hourly employees to exempt salaried employees; 

298 

2 Cheryl A. Russell, Boeing’s director of federal affairs as quoted in The Washington Post, January 29, 2004. 

• More than 1 million employees without a college or graduate degree. These employees will now be exempt from overtime pay as professional employees because employers will be 

able to substitute work experience for a degree under the Department of Labor’s final regulation. 

Moreover, the Department of Labor has not resolved the question 

of whether training in the military can be considered substitute 

work experience. Thus, despite Labor Department denials, many 

veterans employed in engineering, accounting, and technical occupations could lose overtime pay. For example, the Boeing corporation observed, ‘‘* * * many of its most skilled technical workers received a significant portion of their knowledge and training outside 

of the university classroom, typically in a branch of the military 

service * * *’’2; • 30,000 nursery school and Head Start teachers. These already low-paid employees, who currently receive overtime pay 

because their jobs do not require them to exercise sufficient 

discretion and judgment to be considered professional employees, will lose the right to extra pay under the Department of 

Labor’s final regulation; • 160,000 mortgage loan officers and hundreds of thousands 

of additional workers in the financial services industry. These 

employees will lose their overtime rights because of a blanket 

industry exemption in the Department of Labor final regulation for financial service employees who work at such duties as 

collecting customer financial information, providing information and advice about financial products, or marketing financial products; • Nearly 90,000 computer employees, funeral directors and licensed embalmers. These employees will become exempt and 

lose their right to pay under the Department of Labor’s final 

regulation; and • Nearly 400,000 workers earning more than $100,000 annually. Under the Department of Labor final regulation, these 

highly compensated employees will lose overtime pay under a 

new blanket exemption if they perform only a single exempt 

task ‘‘customarily or regularly’’, such as suggesting discipline, 

promotion or assignment of other employees perhaps as infrequently as twice a year. Over time, as incomes grow, the number of employees bumped into this new exclusion from overtime 

pay will increase. 

The Department of Labor failed to hold a single public hearing 

on one of the most controversial regulations in the history of the 

Department, despite receiving 75,280 comments on its proposals. 

Indeed, the Department of Labor even provided information to employers in its initial regulation on how to escape overtime pay requirements as part of a concerted campaign to give employers dozens of new ways—both obvious and subtle—to reclassify workers to 

cut costs. 

Affected employers would have four choices concerning 

potential payroll costs: (1) Adhering to a 40 hour work 

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3Federal Register, Vol. 68, No. 61, March 31, 2003, page 15576. 

4 John Fraser, Monica Gallagher, and Gail Coleman, ‘‘Observations on the Department of Labor’s Final Regulations Defining and Delimiting the [Minimum Wage and Overtime] Exemptions 

for Executive, Administrative, Professional, Outside Sales and Computer Employees’’, July 2004. 5 Ibid. 

week; (2) paying statutory overtime premiums for affected 

workers’ hours worked beyond 40 per week; (3) raising employees’ salaries to levels required for exempt status by the 

proposed rule; or (4) converting salaried employees’ basis 

of pay to an hourly rate (no less than the federal minimum 

wage) that results in virtually no (or only a minimal) 

changes to the total compensation paid to those workers. 

Employers could also change the duties of currently exempt and nonexempt workers to comply with the proposed 

rule.3

The Administration claims that its overtime regulation will 

strengthen and expand overtime protections. The facts say different. Even the Republican-led Senate voted 99 to 0 in favor of the 

amendment offered by Senator Judd Gregg to protect overtime 

rights in 55 job classifications—including blue-collar workers, registered nurses, police officers, and firefighters—because they had 

no confidence in the Administration’s claims. 

The Administration claims that its overtime regulation will reduce costly and lengthy litigation. However, three experts who formerly administered the FLSA in the Department of Labor during 

both Republican and Democratic administration reached exactly 

the opposite conclusion, 

Further, in our view, the Department has written rules 

that are vague and internally inconsistent, and that will 

likely result in a profusion of confusion and court litigation—outcomes that the Department explicitly sought to 

avoid. 4

For example, the former Department of Labor officials observed 

that, 

The team leader provision in new Sec. 541.203(3) is an 

entirely new regulatory concept that is also fraught with 

ambiguity. This provision is not based on case law, but is 

purportedly an attempt to reflect modern workplace practices. . . . Furthermore, the regulations do not address 

the very real possibility that team leaders may be working 

on a number of different short- or long-term projects, simultaneously or in succession, some of which would be 

major and directly related to the performance of management or general business operations and some of which 

would not. Evaluating the team leader’s primary duty in 

that instance will be very difficult at best. Would the employee, for example, move in and out of exempt status from 

one week to the next? How this provision will operate in 

practice can only be imagined, but one can surmise that 

employers will seek to apply this provision to large numbers of employees to whom the exemption was never intended to apply.5

300 

Rather than providing more clarity to protect more workers, the 

Administration’s overtime regulation constituents an open invitation to dispute. The Department of Labor deliberately has replaced 

longstanding, objective criteria by which employers and employees 

could clearly understand who qualifies for overtime pay and who 

does not with ambiguous concepts and criteria. These changes will 

require subjective judgments by employers that no doubt will be 

made based on the employers’ economic interests to the detriment 

of workers. Practically the only instances in which the Labor Department ‘‘clarified’’ the rules are by declaring virtually entire 

classes of workers—for example, financial services workers, insurance claims adjusters, athletic trainers, funeral directors and embalmers, and employees earning more than $100,000—ineligible for 

overtime pay. 

At a time when millions of families feel lucky just to have a job, 

this Committee should have rejected the Administration’s proposed 

pay cut for 6 million American families. By failing to adopt the 

Democratic amendment, the Committee failed to uphold the values 

of working and middle class Americans who simply want a fair 

day’s pay for a hard day’s work. 

DAVID OBEY. 

STENY HOYER. 

NITA LOWEY. 

ROSA L. DELAURO. 

JESSE L. JACKSON, Jr. 

PATRICK J. KENNEDY. 

LUCILLE ROYBAL-ALLARD. 

Æ