95–419 

114TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 114–195 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS BILL, 2016 

JULY 10, 2015.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. COLE, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 3020] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for the 

Departments of Labor, Health and Human Services (except the 

Food and Drug Administration, the Agency for Toxic Substances 

and Disease Registry and the Indian Health Service), Education, 

Committee for Purchase from People Who Are Blind or Severely 

Disabled, Corporation for National and Community Service, Corporation for Public Broadcasting, Federal Mediation and Conciliation Service, Federal Mine Safety and Health Review Commission, 

Institute of Museum and Library Services, Medicare Payment Advisory Commission, National 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, 2016, and for other purposes. 

INDEX TO BILL AND REPORT 

Page number 

Bill Report 

Summary of Estimates and Appropriation .............................................. ........ 3 

General Summary of the Bill .................................................................... ........ 3 

Title I—Department of Labor: 


rfrederick on DSK6VPTVN1PROD with HEARING
2 

Page number 

Bill Report 

Employment and Training Administration ....................................... 2 6 

Employee Benefits Security Administration ..................................... 15 14 

Pension Benefit Guaranty Corporation ............................................. 15 14 

Wage and Hour Division .................................................................... 16 15 

Office of Labor-Management Standards ........................................... 16 15 

Office of Federal Contract Compliance Programs ............................ 16 16 

Office of Workers’ Compensation Programs ..................................... 17 16 

Occupational Safety and Health Administration ............................. 21 18 

Mine Safety and Health Administration ........................................... 24 21 

Bureau of Labor Statistics ................................................................. 25 23 

Office of Disability Employment Policy ............................................. 26 23 

Departmental Management ............................................................... 26 23 

General Provisions .............................................................................. 30 26 

Title II—Department of Health and Human Services ............................ 39 27 

Health Resources and Services Administration ............................... 39 27 

Centers for Disease Control and Prevention .................................... 43 36 

National Institutes of Health ............................................................. 49 56 

Substance Abuse and Mental Health Services Administration ...... 56 82 

Centers for Medicare and Medicaid Services .................................... 59 87 

Administration for Children and Families ........................................ 64 93 

Administration for Community Living .............................................. 72 99 

Office of Secretary ............................................................................... 75 104 

General Provisions .............................................................................. 79 115 

Title III—Department of Education ......................................................... 99 117 

Education for the Disadvantaged ...................................................... 99 117 

Impact Aid ........................................................................................... 100 120 

School Improvement Programs .......................................................... 111 121 

Indian Education ................................................................................. 103 124 

Innovation and Improvement ............................................................. 103 125 

Safe Schools and Citizenship Education ........................................... 105 127 

English Language Acquisition ........................................................... 106 128 

Special Education ................................................................................ 106 128 

Rehabilitation Services and Disability Research .............................. 109 130 

Special Institutions for Persons with Disabilities ............................ 110 132 

Career, Technical and Adult Education ............................................ 110 133 

Student Financial Assistance ............................................................. 112 134 

Student Aid Administration ............................................................... 112 135 

Higher Education ................................................................................ 112 136 

Howard University .............................................................................. 113 140 

College Housing and Academic Facilities Loans .............................. 113 141 

Historically Black College and University Capital Financing ........ 114 141 

Institute of Education Sciences .......................................................... 114 141 

Departmental Management ............................................................... 115 143 

General Provisions .............................................................................. 116 145 

Title IV—Related Agencies ........................................................................ 121 146 

Committee for the Purchase from People Who Are Blind or Severely Disabled ................................................................................ 121 146 

Corporation for National and Community Service ........................... 122 146 

Corporation for Public Broadcasting ................................................. 126 148 

Federal Mediation and Conciliation Service ..................................... 127 148 

Federal Mine Safety and Health Review Commission ..................... 128 148 

Institute of Museum and Library Services ....................................... 128 148 

Medicare Payment Advisory Commission ......................................... 129 149 

Medicaid and CHIP Payment and Access Commission ................... 129 149 

National Council on Disability ........................................................... 129 149 

National Labor Relations Board ........................................................ 129 149 

National Mediation Board .................................................................. 132 150 

Occupational Safety and Health Review Commission ..................... 132 150 

Railroad Retirement Board ................................................................ 132 150 


rfrederick on DSK6VPTVN1PROD with HEARING
3 

Page number 

Bill Report 

Social Security Administration .......................................................... 134 151 

Title V—General Provisions ...................................................................... 139 154 

House of Representatives Report Requirements .............................. ........ 156 

SUMMARY OF ESTIMATES AND APPROPRIATIONS

The following table compares on a summary basis the appropriations, including trust funds for fiscal year 2016, the budget request 

for fiscal year 2016, and the Committee recommendation for fiscal 

year 2016 in the accompanying bill. 

2016 LABOR, HHS, EDUCATION BILL 

[Discretionary funding in thousands of dollars] 

Budget Activity 

Fiscal Year— 2016 Committee 

compared to— 

2015 

Enacted 

2016 

Budget 

2016 

Committee 2015 

Enacted 

2016 

Budget 

Department of Labor ......................... $11,945,326 $13,179,755 $11,881,960 ($63,366) ($1,297,795) 

Department of Health and Human 

Services ......................................... 71,003,862 75,246,449 71,302,326 298,464 (3,944,123) 

Department of Education .................. 67,135,576 70,747,119 64,224,007 (2,911,569) (6,523,112) 

Related Agencies ............................... 14,177,289 15,045,000 13,754,043 (423,246) (1,290,957) 

GENERAL SUMMARY OF THE BILL

For fiscal year 2016, the Committee recommends a total of 

$154,536,000,000 in current year discretionary funding, including 

offsets and adjustments. The fiscal 2016 recommendation is a decrease of $3,711,000,000 below the fiscal year 2015 level. 

The nation remains mired in a sluggish economy, which many 

economists believe has been exacerbated by runaway government 

spending. In addition, for the first time in our history, American 

debt has recently been downgraded, signifying the urgent need to 

return our fiscal house to order. This bill represents a clear step 

toward returning to fiscal responsibility, while ensuring that funding for critical and high-priority functions is maintained. The Committee bill promotes a pro-job growth fiscal environment by eliminating duplication and ineffective programs, making strategic funding priority choices and continuing to rein in out-of-control spending and regulatory burdens imposed by this Administration on 

small businesses. 

The president’s health care law is one example of how this Administration is making things worse for struggling businesses and 

workers by driving up health costs and making it harder for small 

businesses to hire workers. The only way to change this is by repealing ObamaCare in its entirety. Families should be able to 

make their own choices in health care, visit the doctor of their 

choosing, and receive the health care they and their doctor feel is 

best. Those decisions shouldn’t be made by Washington. 

The Committee bill recognizes this by including provisions ensuring that the Department of Health and Human Services (HHS) 

cannot use any funds to further implement, administer, or enforce 

the misguided health care bill. 

The Committee recommendation reflects the challenges inherent 

in achieving deficit reduction solely through reductions in discreVerDate Sep 11 2014 06:10 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00003 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
4 

tionary spending. Significantly reducing our Federal budget deficit 

and the national debt will not occur until mandatory savings are 

achieved. 

Within the resources provided, the Committee has prioritized key 

public health, biomedical research, education and oversight responsibilities throughout the bill. The Committee recommendation also 

includes good government, pro-life and pro-family provisions, limits 

the overreach of the federal government and reins in out-of-control 

regulatory bodies. 

REDUCTIONS AND TERMINATIONS

In preparing this bill, the Committee scrutinized existing programs and activities to determine which ones could be eliminated 

in order to reduce unnecessary spending and duplicative programs. 

As a result, this bill terminates 26 programs and activities which 

are narrowly targeted toward a small audience or do not represent 

a clear Federal role. 

The bill also consolidates duplicative efforts as it merges the 

Agency for Healthcare Research and Quality (AHRQ) into existing 

HHS agencies. The AHRQ mission and areas of research also exist 

in other HHS agencies. The Committee therefore includes bill language to consolidate these research activities into other agencies in 

a more efficient and effective way to meet the missions of both 

AHRQ and HHS. Specifically, the language provides the Secretary 

with transfer authority to use funds from across the HHS to fund 

the orderly termination of AHRQ. It also allows the National Institutes of Health, the Centers for Disease Control and Prevention, 

the Office of the National Coordinator for Health Information Technology, and Office of the Assistant Secretary for Health to incorporate the AHRQ activities each determines to support its mission, 

within its existing authority. In addition, the language transfers 

the Prevention Public Health Task Force to the Office of the Assistant Secretary for Health. 

SETTING PRIORITIES

As part of its review of existing programs and the budget request, the Committee carefully examined the programs funded in 

this bill, with an eye toward ensuring that scarce and precious taxpayer dollars are spent on essential ‘‘must do’’ priorities rather 

than on ‘‘nice-to-do’’ activities. As a result of that examination, 

high-priority programs have received greater emphasis in this bill, 

while programs that represent less pressing needs or are not basic 

federal responsibilities have been eliminated. 

Protecting Public Health and Biomedical Research 

Funding for the National Institutes of Health (NIH) is funded at 

$100,000,000 above the budget request, to a total of 

$31,184,000,000 in the Committee bill, reflecting the Committee’s 

ongoing emphasis on biomedical research that can lead to lifesaving cures. Within the funds, the Committee supports research 

into Alzheimer’s disease and the precision medicine initiative. 

Given their unique role in protecting public health, the Centers 

for Disease Control and Prevention (CDC) is also given priority for 

funding within the bill. CDC is funded at the budget request, reVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
5 

flecting a 1.6 percent increase with a focus on efforts to prevent 

heart disease, diabetes and stroke, as well as to combat opioid addiction and antibiotic resistance and ensure our country is prepared to defend ourselves from bioterrorism. 

Helping States, Local Governments and Parents to Educate America’s Children 

The Committee recognizes that breaking the cycle of poverty and 

dependence must begin early in life, and that early childhood education is of critical importance in changing the trajectory of a 

child’s life. The Committee has therefore prioritized the Head Start 

program, by providing a $192,000,000 increase targeted toward 

early Head Start initiatives. 

The Committee recommendation also invests in education programs that represent core federal responsibilities. First and foremost among these are special education programs funded under the 

Individuals with Disabilities Education Act (IDEA). When the 

IDEA law was passed in the 1970s, the federal government promised to pay up to 40 percent of the additional costs of educating 

children with special needs. Despite tremendous gains in the late 

1990s, we are still only funding these programs at less than half 

that goal. The Committee bill increases special education grants to 

states by over $500,000,000. This increase is paid for by eliminating narrowly targeted Administration priorities that benefit 

only a few schools or impose one-size-fits-all regulations that are 

unworkable and unauthorized, such as the Investing in Innovation 

Fund and School Improvement Grants. 

The Committee has also included increases for priority programs 

such as charter schools, Impact Aid, TRIO, GEAR UP and special 

institutions. While only constituting a small percentage of total 

education dollars available to school districts, these programs help 

fill gaps and meet the extra needs of certain categories of children 

and students. The Committee has also included increases needed 

to ensure continued administration of student aid and loan programs. 

Four years ago, this Congress met the daunting challenge of preserving the maximum Pell grant award in the face of explosive 

growth in the cost of the program by incorporating several common-sense reforms that produced savings of an estimated 

$11,000,000,000 over the next ten years. These reforms have enabled the Committee to increase the maximum Pell grant award to 

a total of $5,775 (when coupled with mandatory funding) while 

placing this program on sounder financial footing in the future. 

Protecting the Most Vulnerable Americans 

In addition to educating our children and protecting the public 

health, the Committee placed an emphasis on programs that help 

to protect the most vulnerable populations. As such, the bill includes funding for the Low Income Home Energy Assistance Program (LIHEAP) formula grants to States. The bill also maintains 

the Community Services Block Grant program, which provides 

funding to states to provide basic services such as emergency food 

and housing assistance, at the fiscal year 2015 enacted level. The 

Committee has also prioritized funding for Battered Women’s ShelVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
6 

ters, poison control centers, and ‘‘Meals on Wheels’’ nutrition programs. 

Finally, the bill ensures our Nation’s trust responsibilities within 

Indian country are honored by providing increased support for programs serving Native populations, including tribal colleges, nutrition programs, programs for both the elderly and youth, and Indian 

education programs. 

OVERSIGHT

In furtherance of its oversight responsibility, the Committee has 

again requested that major agencies funded in the bill provide information on the status of balances of appropriations, including 

amounts that are unobligated and uncommitted, committed to contracts, grants or other planned obligations, and obligated but unexpended. The Committee experienced delays in receiving this information in the past and found that the agency reports did not provide a comprehensive picture of the status of balances. 

Of particular concern, the Committee found that the agencies 

could not report on the age of balances by year of appropriation. 

As a result, it is not possible to tell whether the balances derive 

from uncommitted or unobligated balances in the immediately 

prior fiscal year or from appropriations acts enacted two, three or 

more years earlier. 

The source year of carryover is important. If balances have languished on the books for multiple fiscal years it is a symptom, at 

best, of administrative inefficiency. Of more concern, it may suggest that the Committee was asked to provide appropriations in excess of the amount required to accomplish program purposes. Given 

the obvious importance of the source year of balances to budget administration, the Committee is puzzled that agencies have not configured internal accounting systems to capture and routinely report 

this information. 

To ensure that all major Departments and agencies report the 

status fund balances in the future, the Committee has continued 

bill language that will compel the Departments of the Education, 

Health and Human Services and Labor prospectively to adopt 

source year accounting for the status of funds for both commitments and obligations. The bill language requires that each begin 

reporting quarterly on the status of balances, including the source 

year of balances. It is the Committee’s intention that the agency reports show the status of balances at the appropriation account 

level, as well as at budget activity or other lower levels where such 

levels are reflected in the Committee’s report accompanying an appropriations act. 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $3,003,314,000 for Training and 

Employment Services (TES), which provides funding for federal 

government job training and employment service programs, authorVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00006 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
7 

ized primarily by the Workforce Innovation and Opportunity Act of 

2014 (WIOA). This recommendation is $136,392,000 less than the 

fiscal year 2015 enacted level (the amount provided by Public Law 

113–235), and $399,117,000 less than the fiscal year 2016 budget 

request. 

Program Year Funding and Advance Appropriations.—Section 

189(g) of the WIOA sets forth a program year funding schedule for 

programs and activities funded under the authority of the WIOA. 

A program year, as defined by WIOA, provides that appropriated 

funds shall not become available for obligation until July 1 of the 

fiscal year in which they are appropriated, and shall remain available until June 30 of the following fiscal year (in the case of youthrelated programs, funding becomes available on April 1). 

The Committee is concerned that the reliance on a funding mechanism that provides more than half of the annual TES appropriations as advance appropriations obscures the true annual cost of 

these federal job training programs and creates additional costs 

and unnecessary burdens on accounting, tracking, guidance, and 

coordination activities at the federal as well as State and local levels. 

The Committee directs the Secretary of Labor to review the current funding mechanism, including the provision of advance appropriations, and to make recommendations in the Department’s fiscal 

year 2017 budget justifications for adjustments that would result 

in cost savings and efficiency gains throughout the Training and 

Employment Services workforce delivery system. 

Governor’s Reserve Fund.—Section 128(a)(1) of the WIOA authorizes the governor of a State to reserve not more than 15 percent 

of the funds allocated to that State in a given fiscal year for Statewide workforce investment activities. The Committee appropriates 

funding under these authorities to meet urgent workforce training 

needs. Despite reductions in the cap for Statewide activities enacted each year since fiscal year 2012, many States continue to carryover high unobligated balances. 

The Committee supports the restoration of the cap on the Governor’s Reserve to the authorized limit of 15 percent. Funding appropriated for State workforce investment activities under WIOA is 

the same as fiscal year 2015 enacted levels and language is included for fiscal year 2016 that increases the cap on the Governor’s 

Reserve from 10 to 11 percent. 

The Committee is appreciative of the establishment of uniform 

performance measures under WIOA and looks forward to allocating 

funding to the workforce development system in future fiscal years 

on the basis of comparative performance results. 

Apprenticeship.—The Committee supports the Department’s promotion and oversight of the National Registered Apprenticeship 

system in cooperation with State Apprenticeship Agencies. Funding 

is not included in fiscal year 2016 for the Department’s proposed 

Apprenticeship Grants program; however, the Committee has included additional funds requested in the Program Administration 

account to continue and expand upon existing programs and to provide technical assistance and oversight to States in order to expand 

the capacity and effectiveness of Registered Apprenticeships 

throughout the country. The Committee is encouraged by research 

on the effectiveness of apprenticeship as a workforce training stratVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
8 

egy and urges the Department to use its evaluation authority to determine the impact and effectiveness of Registered Apprenticeship 

programs. 

Licensing.—The Committee supports the Department’s efforts to 

address ways in which harmonizing licensing requirements across 

States can reduce barriers to labor market entry and mobility including for dislocated workers, transitioning servicemembers, and 

veterans. Funding is not included in fiscal year 2016 for the Department’s proposed licensing grants program; however, the Committee urges the Department to pursue activities within its existing 

authority including providing technical assistance and disseminating guidance and information on best practices to States interested in increasing economic opportunity through reciprocity agreements or other approaches to reducing licensing barriers. 

Evaluation.—The Committee supports rigorous evaluation of the 

Department’s programs, particularly the workforce training programs authorized by WIOA. The Committee provides direct appropriations for program evaluations and continues a general provision, as requested, to transfer funds from specific accounts for purposes of evaluation and increases the cap on the amount the Secretary may transfer from 0.5 to 0.75 percent. 

Evaluations should be targeted in ways that will allow Department administrators to use the results to improve program delivery. 

Administrators in the Employment and Training Administration 

(ETA) must work cooperatively with State officials to ensure that 

program evaluators obtain appropriate and timely data. 

The Committee urges the Department to use its evaluation authority to identify and eliminate areas of duplication and to follow 

through on evaluation findings with budget proposals to allocate 

funding to the programs, projects and activities that demonstrate 

the best results and to improve upon or eliminate those that do 

not. 

Duplication, overlap, and structural inefficiencies throughout the 

workforce development system continue to be a serious concern for 

the Committee. Going back to 2007, the Committee noted (House 

Report 110–231) that there is ‘‘evidence that the core services of 

the adult, dislocated and youth programs at local one-stop career 

centers sometimes overlap with the statewide labor exchange services provided with funds in the state unemployment insurance and 

employment services operations account. This diminishes the overall effectiveness of the two programs by creating unnecessary duplication.’’ 

The Committee is aware that the Department has been working 

with other agencies, specifically the Department of Health and 

Human Services, to evaluate the delivery strategies of certain programs to identify overlap and duplication. The Committee directs 

the Department to continue and expand these efforts and to continue efforts to implement the recommendations of the January, 

2011 GAO report ‘‘Multiple Employment and Training Programs’’ 

(GAO–11–92). 

Infrastructure and Administrative Costs.—The Committee is concerned that the flexibility related to administrative expenses allows 

local workforce investment boards, one-stop career centers and 

other workforce training authorities to classify many administraVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00008 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
9 

tive activities as ‘‘program’’ costs in order to circumvent the 15 percent cap on administrative expenses authorized under WIOA. 

In its response to a 2005 GAO report (GAO–05–650), then Assist- ant Secretary for ETA wrote that of the $4,000,000,000 expended 

on Workforce Investment Act and Wagner-Peyser Employment 

Service programs, ‘‘$1,500,000,000 is spent on ‘infrastructure’ as reported by the States.’’ 

Testimony received by the Committee since that time indicates 

the system, as currently structured, continues to expend the majority of its resources on State and local staff to counsel and help customers with job searches, resume writing, intake interviews, and 

similar activities at the one-stop career centers. While these core 

and intensive services are a value-added function to its customers, 

the workforce development system must be capable of delivering 

more given the amount of taxpayer investment. A transformational 

change in how services are delivered is needed to prevent the system from continuing to evolve into a personnel-heavy bureaucracy 

that lacks the flexibility and expertise to respond to rapidly changing economic conditions and workforce training needs. 

The Committee disagrees that innovative solutions equate to creating new programs at additional taxpayer expense. Rather than 

advancing a more training-focused program, the Department appears to have rested its reform efforts on the creation of new and 

costly programs, such as the Workforce Innovation Fund, Job-Driven Training Fund and Sector Partnerships. These duplicative and 

unauthorized programs undermine the steps Congress took in 

WIOA to consolidate and streamline Federal workforce development efforts. 

The Committee believes that a more fundamental solution is 

needed: A commitment to eliminating duplication and to reducing 

excessive and costly administrative overhead in order to free up the 

resources to train more workers. 

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

$776,736,000, which is the same as the fiscal year 2015 enacted 

level and $38,820,000 less than the fiscal year 2016 budget request. 

Youth Employment and Training Activities.—For Youth Employment and Training Activities, the Committee recommends 

$831,842,000, which is the same as the fiscal year 2015 enacted 

level and $41,574,000 less than the fiscal year 2016 budget request. 

Dislocated Worker Employment and Training Activities.—For 

Dislocated Worker (DW) Employment and Training Activities, the 

Committee recommends $1,089,530,000 which is $146,859,000 less 

than the fiscal year 2015 enacted level and $172,189,000 less than 

the fiscal year 2016 budget request. 

Of the total provided for DW Employment and Training Activities, $1,015,530,000 is designated for State grants that provide core 

and intensive services, training, and supportive services for dislocated workers. In addition, States use these funds for rapid response assistance to help workers affected by mass layoffs and 

plant closures. 

The remaining $74,000,000 is available for the DW National Reserve. The National Reserve supports national emergency grants to 

respond to mass layoffs, plant and/or military base closings, and 

natural disasters. The funds provided are not to be used for other 


rfrederick on DSK6VPTVN1PROD with HEARING
10 

purposes. The Committee recommends that these activities be coordinated with local areas as needs arise. 

The Committee supports efforts by the Department to address 

the training and employment service needs of workers dislocated or 

laid off as a result of declining production in the coal mining industry. 

Native Americans.—For the Indian and Native Americans Program, the Committee recommends $50,000,000, which is $3,918,000 

more than the fiscal year 2015 enacted level and the same as the 

fiscal year 2016 budget request. 

Migrant and Seasonal Farmworkers.—For the National Farmworkers Jobs Program (NFJP), the Committee recommends 

$81,896,000, which is the same as the fiscal year 2015 enacted 

level and the fiscal year 2016 budget request. 

The Committee continues language directing that not less than 

70 percent of program funds be spent on employment and training 

services, together with language that prohibits the Department 

from restricting the provision of ‘‘related assistance’’ services by 

grantees. These provisions ensure that the program primarily addresses the employment and training needs of the target population while allowing grantees to provide related services, such as 

child care and transportation, which are often critical to the stabilization and availability of the farm labor workforce. 

The Committee directs that, of the amounts made available, 

$5,517,000 is targeted for migrant and seasonal farmworker housing grants. The Committee further directs that not less than 70 

percent of this amount be used for permanent housing grants. 

YouthBuild.—For YouthBuild, the Committee recommends 

$82,000,000, which is the $2,311,000 more than the fiscal year 

2015 enacted level and $2,534,000 less than the fiscal year 2016 

budget request. 

YouthBuild is a competitively awarded workforce development 

program that supports disadvantaged young people at risk of longterm unemployment, and effectively connects them with basic, secondary, and post-secondary education, employment training and job 

placement, and personal counseling. Participants split time between the classroom and the construction site—earning high school 

diplomas while providing a valuable community service by constructing or rehabilitating affordable housing in their communities. 

Reintegration of ex-offenders.—The Committee recommends 

$82,078,000 for ex-offender retraining and reintegration activities, 

which is the same as the fiscal year 2015 enacted level and 

$13,000,000 less than the fiscal year 2016 budget request. 

Peer-to-Peer Mentoring.—The Committee recognizes the role of 

peer-to-peer mentoring and counseling in efforts to address employment barriers faced by incarcerated and formerly incarcerated individuals. The Committee urges ETA to incorporate this type of mentoring and counseling in its grant programs. 

Technical Assistance.—The Committee recommends $3,232,000 

for technical assistance activities for the workforce development 

system which is the same as the fiscal year 2016 budget request. 

Technical Assistance funding will be provided to the workforce 

development system in program year 2016 to continue WIOA implementation efforts funded through the Dislocated Worker National Reserve in program year 2015. 


rfrederick on DSK6VPTVN1PROD with HEARING
11 

Workforce Data Quality Initiative.—The Committee recommends 

$6,000,000 for the Workforce Data Quality Initiative, which is 

$2,000,000 more than the fiscal year 2015 enacted level and 

$31,000,000 less than the fiscal year 2016 budget request. 

JOB CORPS

The Committee recommends $1,688,155,000 for Job Corps, which 

is the same as the fiscal year 2015 enacted level and $27,789,000 

less than the fiscal year 2016 budget request. 

Job Corps is a residential education and vocational training program that helps young people ages 16 through 24 improve the 

quality of their lives through vocational and academic training. 

The Committee directs the Department to submit a comprehensive plan to the House and Senate Committees on Appropriations 

at least 60 days prior to initiating the closure of any existing Job 

Corps centers. The plan should identify the centers that will be 

closed, provide the financial and management rationale for closing 

each center, and include a detailed analysis the costs and anticipated savings that will result from closure. 

Operations.—For Job Corps Operations, the Committee recommends $1,580,825,000, which shall be available from July 1, 

2016, through June 30, 2017. This recommendation is the same as 

the fiscal year 2015 enacted level and $17,000,000 less than the fiscal year 2016 budget request. 

The Committee remains concerned about financial oversight of 

the Job Corps program. Semi-annual reports were requested in the 

Explanatory Statement accompanying the fiscal year 2015 Appropriations Act on the Department’s implementation of the recommendations in the Office of Inspector General (OIG) report No. 

22–13–015–03–370 (May 31, 2013) and the OIG report No. 26–14– 

001–03–370 (April 29, 2014). The Committee directs the Department to continue to submit the reports until all OIG recommendations are resolved. 

The Committee directs the Department to conduct a review of financial management policies and procedures and to implement policy changes the Secretary deems appropriate to improve financial 

management of the Job Corps program and to protect public funds 

from waste and misuse. In addition, the Committee directs the Department to propose any recommendations for structural changes 

to the Department’s financial management and oversight of the Job 

Corps program in the fiscal year 2017 budget. 

The Committee remains concerned regarding the safety of students on Job Corps campuses throughout the country. In light of 

recent incidents in several locations, the Committee directs the Department to review and make any necessary changes to safety policies and requirements. 

Construction, Rehabilitation and Acquisition.—The Committee 

recommends $75,000,000 for construction, rehabilitation and acquisition activities of Job Corps centers, which shall be available for 

obligation from July 1, 2016 through June 30, 2019. This recommendation is the same as the fiscal year 2015 enacted level and 

the fiscal year 2016 budget request. 

Administration.—The Committee recommends $32,330,000 for 

the administrative expenses of Job Corps. This recommendation is 


rfrederick on DSK6VPTVN1PROD with HEARING
12 

the same as the fiscal year 2015 enacted level and $10,789,000 less 

than the fiscal year 2016 budget request. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

The Committee recommends $434,371,000 for the Community 

Service Employment for Older Americans (CSEOA) program, which 

shall be available for obligation from July 1, 2016 through June 30, 

2017. This recommendation is the same as the fiscal year 2015 enacted level and the fiscal year 2016 budget request. 

The CSEOA 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. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

The Committee recommends $3,580,123,000 for State Unemployment Insurance and Employment Service Operations. The total includes $3,498,557,000 from the Employment Security Administration Account in the Unemployment Trust Fund and $81,566,000 

from the General Fund of the Treasury. These funds are used to 

support the administration of federal and State unemployment 

compensation laws and to provide assistance to State agencies that 

operate the public Employment Service. 

Unemployment Insurance Operations.—For Unemployment Insurance (UI) Operations, the Committee recommends 

$2,760,097,000. This recommendation is $30,588,000 less than the 

fiscal year 2015 funding level and $137,900,000 less than the fiscal 

year 2016 budget request. The total includes $2,745,550,000 for 

State Operations and $14,547,000 for National Activities. Funding 

provided for State Operations shall be available through December 

31, 2016. Funds used for automation acquisitions shall be available 

for obligation by the States through September 30, 2018. Funds 

used for automation acquisitions by consortia of States shall be 

available for obligation by the States through September 30, 2021. 

The recommendation for State UI Operations includes $150,000,000 to conduct in-person reemployment and eligibility assessments (REA). This recommendation will support the continuation and expansion of the REA program. These assessments are 

intended to reduce improper payments and expedite reemployment 

by assisting beneficiaries in their job search. 

The Committee remains supportive of the REA program as a 

means to reduce waste, fraud, abuse and improper payments. This 

initiative should be viewed not just as a savings mechanism, but 

also as a way to reform the manner in which the States can implement stronger controls over the UI program. The OIG noted in its 

March 31, 2011 review of funding provided in the Recovery Act, 

‘‘DOL’s spending guidance did not direct states to address longterm weaknesses and problems . . . thereby missing an opportunity to create long-standing program improvements.’’ In a report 

issued on January 31, 2012, the OIG further found that ETA had 

failed to establish goals to identify improper payments related to 

federally-funded emergency benefits, and that ‘‘ETA and its regions 

could not objectively measure how well States were doing in identiVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00012 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
13 

fying improper payments related’’ to these benefits. Within the additional funds provided for REAs, the Committee expects that ETA 

will advance comprehensive technology-based overpayment prevention, detection, and collection infrastructure in support of efforts to 

reduce waste, fraud, abuse and improper payments. 

As in previous years, the bill provides for contingency funding for 

increased workloads that States may face in the administration of 

UI. During fiscal year 2016, for every 100,000 increase in the total 

average weekly insured unemployment above 2,957,000, an additional $28,600,000 shall be made available from the Unemployment 

Trust Fund. 

Employment Service Operations.—The Committee recommends 

$664,184,000, for the Employment Service (ES) grants to states. 

This recommendation is the same as the fiscal year 2015 enacted 

level and $400,000,000 less than the fiscal year 2016 budget request. The total includes $642,771,000 from the Employment Security Administration Account in the Unemployment Trust Fund and 

$21,413,000 from the General Fund of the Treasury. Funding for 

ES grants shall be available for obligation from July 1, 2016, 

through June 30, 2017. 

ES grants are authorized by the Wagner-Peyser Act and financed 

through employer taxes. These grants help jobseekers and employers by matching individuals seeking employment to job vacancies. The Committee recommends $19,818,000 for ES National Activities. The recommendation is the same as the fiscal year 2015 enacted level and the fiscal year 2016 budget request. 

Foreign Labor Certification.—The Committee recommends 

$75,871,000 for Foreign Labor Certification (FLC) program. This 

recommendation is $13,561,000 more than the fiscal year 2015 enacted level and the same as the fiscal year 2016 budget request. 

The recommendation includes $61,589,000 for federal administration activities and $14,282,000 for grants to States. 

The FLC program administers foreign visas including the H–2A 

and the H–2B temporary worker programs. These programs are essential to employers in industries that have cyclical peaks or that 

are seasonal in nature, including agriculture, tourism, and hospitality. Nonimmigrant worker programs have provided critical support to these types of industries for many decades. Despite broad 

support and a clear need for these programs, the Department has 

engaged in rulemaking and policy changes that have resulted in far 

reaching and negative impacts on the industries and people these 

programs are intended to serve. Therefore, the Committee directs 

the Department to ensure continuity and viability of these programs in accordance with all applicable laws. 

H–2A.—The H–2A program is a critical source of labor for the 

agricultural industry. The program ensures a legal labor force to 

fill temporary jobs when an insufficient number of American workers are available; however, requirements for cost reimbursement, 

hiring practices, reporting, and wage rates have caused the H–2A 

program to become excessively burdensome and complex. The Committee believes this leads to perverse and counterproductive incentives for illegal immigration. The Committee urges the Department 

to review H2–A regulations and propose changes to streamline the 

process for employers and reduce incentives for farmers to hire immigrant workers illegally. 


rfrederick on DSK6VPTVN1PROD with HEARING
14 

H–2B.—The H–2B program is a critical source of labor for industries including fishing, tourism, hospitality, recreation and seasonal 

activities. The program ensures a legal labor force to fill temporary 

jobs when an insufficient number of American workers are available, however, requirements set forth in a series of proposed regulations makes the program excessively burdensome and complex on 

employers seeking to legally obtain temporary employees. The 

Committee directs the Department to administer and regulate the 

H–2B program in a manner that is consistent with the law, easier 

for employers legally seeking temporary workers at a reasonable 

prevailing wages, and reduces incentives for employers to hire immigrant workers illegally. 

One-Stop Career Centers/Labor Market Information.—The Committee recommends $60,153,000 for One-Stop Career Center and 

Labor Market Information (LMI). This recommendation is the same 

as the fiscal year 2015 enacted level and $20,000,000 less than the 

fiscal year 2016 budget request. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee recommends such sums as necessary for Advances to the Unemployment Trust Fund and Other Funds. The 

appropriation is available to provide advances to several accounts 

for purposes authorized under various federal and State unemployment insurance laws and the Black Lung Disability Trust Fund 

when the balances in such accounts are insufficient. 

PROGRAM ADMINISTRATION

The Committee recommends $158,368,000 for Program Administration. This recommendation is $3,809,000 more than the fiscal 

year 2015 enacted level and $18,196,000 less than the Department’s fiscal year 2016 budget request. The recommendation includes $107,636,000 in funds from the General Fund of the Treasury and $50,732,000 from the Employment Security Administration 

Account in the Unemployment Trust Fund. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $180,699,000 for the Employee Benefits Security Administration (EBSA). This recommendation is 

$301,000 less than the fiscal year 2015 enacted level and 

$26,756,000 less than the fiscal year 2016 budget request. 

The EBSA assures the security of retirement, health and other 

workplace-related benefits of working Americans. 

PENSION BENEFIT GUARANTY CORPORATION

The Committee includes an obligation limitation for administrative expenses of $431,799,000 for the Pension Benefit Guaranty 

Corporation (PBGC). The limitation is $16,405,000 more than the 

fiscal year 2015 enacted level and the same as the fiscal year 2016 

budget request. The recommendation includes bill language that 

defines PBGC’s discretionary authority to incur additional unforeseen and emergency administrative expenses related to its multiemployer plan insurance program. 


rfrederick on DSK6VPTVN1PROD with HEARING
15 

The PBGC was established by Congress to insure the definedbenefit pension plans of working Americans. 

The Committee expects PBGC to submit reports required by the 

Employee Retirement Income Security Act of 1974 and the Pension 

Protection Act of 2006 in a timely manner. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

The Committee recommends $215,500,000 for the Wage and Hour Division (WHD). This recommendation is $12,000,000 less 

than the fiscal year 2015 enacted level and $61,600,000 less than 

the fiscal year 2016 budget request. 

The WHD enforces federal minimum wage, overtime pay, recordkeeping, and child labor requirements of the Fair Labor Standards 

Act. WHD also has enforcement and other administrative responsibilities related to the Migrant and Seasonal Agricultural Worker 

Protection Act, the Employee Polygraph Protection Act, the Family 

and Medical Leave Act, the Davis Bacon Act and the Service Contract Act. 

The Committee directs the Wage and Hour Division to submit a 

report to the House and Senate Committee on Appropriations within 120 days of enactment of this Act on the steps taken to correct 

deficiencies, address recommendations, and improve the process for 

wage determinations for public works projects cited in OIG report 

No. 04–04–003–04–420, (Mar. 30, 2004) and in GAO testimony 

GAO–11–486T (April 14, 2011). 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

The Committee recommends $42,000,000 for the Office of LaborManagement Standards (OLMS). This recommendation is 

$2,871,000 more than the fiscal year 2015 enacted level and 

$4,981,000 less than the fiscal year 2016 budget request. 

OLMS administers the Labor-Management Reporting and Disclosure Act, which establishes safeguards for union democracy and 

union financial integrity, and requires public disclosure reporting 

by unions, union officers, employees of unions, labor relations consultants, employers, and surety companies. 

The Committee is troubled that the Department continues to 

withhold appropriated and obligated transit grant funding to the 

State of California due to the State’s bipartisan 2012 pension reform law, the Public Employee Pension Reform Act (PEPRA). The 

Department contends that PEPRA violates transit worker’s bargaining rights under the Urban Mass Transportation Act of 1964 

[P.L. 88–365, USC Title 49, Chapter 53]. The United States Eastern District Court ruled that the Department has acted in violation 

of the Administrative Procedure Act [P.L. 79–404, 60 Stat. 237] 

and its application of the Urban Mass Transportation Act of 1964 

to justify withholding grants is ‘‘arbitrary’’ and ‘‘capricious.’’ The 

Department’s actions have forced layoffs; deferrals of preventive 

maintenance; delays in planned service expansions and capital improvements; and service cuts statewide, threatening the livelihood 

of the workers the Department claims to protect. The Committee 


rfrederick on DSK6VPTVN1PROD with HEARING
16 

directs the Department to act in accordance with the applicable 

court ruling in effect during the time leading up to the end of the 

fiscal year such that grants may be certified according to the prevailing court order, prior to the funds lapsing, in order to minimize 

further disruption to California’s mass transit providers. 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS

SALARIES AND EXPENSES

The Committee recommends $100,500,000 for the Office of Federal Contract Compliance Programs (OFCCP). This recommendation is $5,976,000 less than the fiscal year 2015 enacted level and 

$13,187,000 less than the fiscal year 2016 budget request. 

The OFCCP ensures equal employment opportunity in the federal contracting community through enforcement, regulatory work, 

outreach and education to workers and their advocates. 

The Committee is concerned about the potential ramifications of 

the proposed Requirement to Report Summary Data on Employee 

Compensation (Compensation Data Collection) regulation (79 FR 

46561, published in the Federal Register on August 8, 2014). Eliminating gender and race-based compensation discrimination is an 

important goal. The Committee understands that OFCCP is seeking input from stakeholders on issues relating to scope, content and 

format of the rule. The Committee urges OFCCP to carefully consider this input and public comments on the proposed rule. The 

Committee believes it is vital to ensure that new data collection requirements have limited costs of compliance for employers, do not 

unnecessarily burden contractors that are not being investigated or 

accused of wrongdoing, and fastidiously protects private and individually identifiable data. 

The Committee is concerned that OFCCP has lost its focus on 

identifying and addressing real discrimination in employment and 

has become hyper-focused on fulfilling quotas instead of equal opportunity by relying on statistics alone in evaluating contractors. 

The Committee believes OFCCP should take steps to use common 

sense in the use of government resources to focus on finding actual 

discriminatory treatment instead of presumed discrimination based 

solely on what OFCCP assumes through statistics. Further, the 

Committee believes that OFCCP should end its reliance on threatening sanctions, including debarment and the costs associated with 

an extremely drawn-out administrative litigation process, to induce 

contractors to waive their legal rights and to enter into conciliation 

agreements that are not justified by the evidence. 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

The Committee recommends $114,842,000 for the Office of Workers’ Compensation Programs (OWCP). This recommendation is 

$1,842,000 more than the fiscal year 2015 enacted level and 

$4,732,000 less than the fiscal year 2016 budget request. The recommendation includes $112,665,000 in General Funds from the 

Treasury the authority to expend $2,177,000 from the Special Fund 

established by the Longshore and Harbor Workers’ Compensation 

Act. 


rfrederick on DSK6VPTVN1PROD with HEARING
17 

The OWCP administers the Federal Employees’ Compensation 

Act, the Longshore and Harbor Workers’ Compensation Act, the 

Energy Employees Occupational Illness Compensation Program 

Act, and the Black Lung Benefits Act. These programs provide eligible injured and disabled workers and their survivors with compensation, medical benefits, and services including rehabilitation, 

supervision of medical care, and technical and advisory counseling. 

SPECIAL BENEFITS

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $210,000,000 for Special Benefits. 

This recommendation is the same as the fiscal year 2015 enacted 

level and the fiscal year 2016 budget request. 

These funds provide mandatory benefits under the Federal Employees’ Compensation Act. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

The Committee recommends $69,302,000 for Special Benefits for 

Disabled Coal Miners. This amount is in addition to the 

$21,000,000 appropriated in fiscal year 2015 as an advance for the 

first quarter of fiscal year 2016. The total program level recommendation of $90,302,000 is $10,960,000 less than the fiscal 

year 2015 enacted level and the same as the fiscal year 2016 budget request. 

These funds provide mandatory benefits to coal miners disabled 

by black lung disease, to their survivors and eligible dependents, 

and for necessary administrative costs. 

The Committee recommendation also provides $19,000,000 as an 

advance appropriation for the first quarter of fiscal year 2017. 

These funds ensure uninterrupted payments to beneficiaries. 

ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL

ILLNESS COMPENSATION FUND

The Committee recommends $58,552,000 for the Energy Employees Occupational Illness Compensation Program. This recommendation is $2,146,000 more than the fiscal year 2015 enacted 

level and the same as the fiscal year 2016 budget request. 

These funds provide mandatory benefits to eligible employees or 

survivors of employees of the Department of Energy (DOE); its contractors and subcontractors; companies that provided beryllium to 

DOE; 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. 

The Committee is concerned about the backlog of claims under 

the Energy Employees Occupational Illness Compensation program 

and urges the Department to review policies and take any necessary steps to streamline the processing of claims for qualified 

beneficiaries. 


rfrederick on DSK6VPTVN1PROD with HEARING
18 

BLACK LUNG DISABILITY TRUST FUND

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends such sums as necessary for payment 

of benefits and interest on advances for the Black Lung Disability 

Trust Fund. The Committee recommends $341,466,000 for the 

Black Lung Disability Trust Fund. This recommendation is 

$15,511,000 more than the fiscal year 2015 enacted level and the 

same as the fiscal year 2016 budget request. 

The Black Lung Disability Trust Fund pays black lung compensation, medical and survivor benefits, and administrative expenses when no mine operator can be assigned liability for such 

benefits, or when mine employment ceased prior to 1970. 

The Black Lung Disability Trust Fund is financed by an excise 

tax on coal, reimbursements from responsible mine operators, and 

short-term advances from the Treasury. The Emergency Economic 

Stabilization Act of 2008 authorized a restructuring of the Black 

Lung Disability Trust Fund debt and required that annual operating surpluses be used to pay down the debt until all remaining 

obligations are retired. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $535,000,000 for the Occupational 

Safety and Health Administration (OSHA). This recommendation is 

$17,787,000 less than the fiscal year 2015 enacted level and 

$57,071,000 less than the fiscal year 2016 request. 

OSHA enforces the Occupational Safety and Health Act of 1970. 

The Committee strongly supports the underlying mission of 

OSHA to promote a safe and healthy work place and protect workers from injury, illness, and death. The Committee disagrees with 

the manner in which this policy is being implemented. The fiscal 

year 2016 budget request states that OSHA supports the Department’s strategic goals and objectives through ‘‘enforcement, standards, whistleblower protection, and compliance assistance and outreach programs.’’ Yet virtually all of the requested funding increase 

for OSHA is proposed for additional enforcement. Compliance assistance remains less than 25 percent of OSHA’s overall budget. 

The Committee believes that overreliance on punitive enforcement at the expense of effective compliance assistance is a flawed 

approach. This approach is costly and overly burdensome on employers and is contrary to the intention of Executive Order 13563 

to create a regulatory system that protects ‘‘public health, welfare, 

safety, and our environment while promoting economic growth, innovation, competitiveness, and job creation.’’ 

The Committee recognizes that enforcement is a necessary component of an effective strategy to improve workplace safety but the 

Department’s overreliance on enforcement has created an unnecessarily hostile environment between the federal government and private enterprises. The Department’s Spring 2015 regulatory agenda 

affirms OSHA’s aggressive, enforcement-focused agenda. Inspections and fines are costly, especially for the small businesses that 

are the primary drivers of job creation. 


rfrederick on DSK6VPTVN1PROD with HEARING
19 

The Committee believes that OSHA should partner with businesses to create safer workplaces. Compliance assistance is an important tool that is underutilized by OSHA. The Committee supports programs like the Voluntary Protection Programs that create 

safer workplaces by increasing compliance and avoiding costly inspections and fines. 

The Committee directs OSHA to reorient its approach and 

refocus its efforts and resources on helping companies to comply 

with workforce safety laws thereby freeing up funds being used for 

inspections and fines to create new jobs. The Committee recommendation for fiscal year 2016 reflects this reorientation. 

The Committee is aware that the statute clearly establishes that 

OSHA must receive an employee complaint to write citations. The 

Committee is concerned that OSHA is proceeding to unilaterally 

change this requirement to expand its own citation authority beyond the legally required complaint requirement. 

Safety and Health Standards.—The Committee recommends 

$20,000,000 for Safety and Health Standards. 

Federal Enforcement.—The Committee recommends $193,000,000 

for Federal Enforcement. 

Whistleblower Programs.—The Committee recommends 

$20,000,000 for Whistleblower Programs. 

State Programs.—The Committee recommends $103,000,000 for 

State Programs. 

Technical Support.—The Committee recommends $24,000,000 for 

Technical Support. 

Compliance Assistance.—The Committee provides $129,000,000 

for federal and State compliance assistance programs. 

The Committee directs OSHA to submit a report to the House 

and Senate Committees on Appropriations within 120 days of enactment assessing the participation, detailed costs and effectiveness of the VPP. 

Federal Assistance.—The Committee recommends $71,000,000 for 

Federal Assistance. 

State Consultation Grants.—The Committee recommends 

$58,000,000 for State Consultation Grants. 

Training Grants.—The Committee continues to support efforts to 

train and educate workers on occupational safety and health hazards within the programs and services currently offered by OSHA’s 

Directorate of Training and Education (DTE), which includes the 

OSHA Training Institute and Education Centers, the revised Outreach Training Program, and the Resource Center Loan Program. 

The Susan Harwood Training Grant Program, the Committee believes, is comparatively inefficient and ineffective in achieving its 

intended purpose, at least in part due to a lack of effective oversight of grantee performance. The Committee recommendation provides no funding for the Susan Harwood Training Grant Program. 

The Committee is concerned that OSHA has shifted its focus in 

recent years toward ‘‘capacity building’’ grants versus ‘‘targeted’’ 

training grants and has effectively done little more than supplant 

the infrastructure needs of the grantees. Not less than 120 days 

after enactment of this Act, OSHA shall provide a report to the 

House and Senate Committees on Appropriations that includes a 

list of Susan Harwood awardees for fiscal years 2013, 2014, and 

2015, the selection criteria used to approve the initial award, and 


rfrederick on DSK6VPTVN1PROD with HEARING
20 

field evaluations for each of these awardees (to the extent the 

grantee was pre-approved for a multi-year grant). OSHA shall also 

make this information available on its website. 

The Committee also directs that financial evaluations of grantees 

and the status of appropriated funds under this program be included in all OSHA evaluations of grantee performance. Should a 

recipient of Susan Harwood training grant funds be unable to fulfill the terms of its grant award or meet minimum performance 

standards, OSHA shall terminate the contract, recapture all remaining funds, and notify the House and Senate Committees on 

Appropriations within 15 days including the name of the grantee, 

reasons for termination, and amounts to be returned to the Treasury. 

Injury and Illness Incidence Rates.—BLS data on injury and illness incidence and fatality rates show a steady decline since 2003. 

While these rates are currently among the lowest on record, the 

most recent data indicates that rates have not significantly declined since 2009. The Committee questions whether the Department’s intensified enforcement efforts since that time are achieving 

the expected results. Furthermore, the Committee notes the trend 

since 2003 has largely occurred in the absence of new regulations. 

The Committee sees no evidence to support the need for sweeping 

new regulations of the kind currently being promulgated by OSHA, 

especially given the significant impact they have on small businesses. 

The Committee questions the necessity of the proposed Injury 

and Illness Prevention Program (I2P2) regulation. The idea of an 

injury and illness program has existed in some variation for more 

than 30 years, and the Department has had voluntary safety and 

health guidelines in place since 1989, which have enabled companies to establish policies and procedures specific to their own workplaces. Still unclear is how this proposed regulation incorporates 

the recommendations from the 1998 panel that was convened to 

consider the Safety and Health Program Standard, the predecessor 

to the I2P2 proposal. This panel cited several criticisms of a federally-mandated safety and health programs and recommended to 

OSHA that it consider various concepts other than just a blanket, 

one-size fits-all regulation. The Committee is concerned that this 

regulation, as currently proposed, would impose additional and 

costly burdens on employers and subject currently effective safety 

programs to a new regulatory regime that may result in more fines 

and penalties but not necessarily safer workplaces. 

National/Regional/Local Emphasis Programs.—The Committee 

is concerned that OSHA’s National Emphasis Program targets employers with exemplary safety records for no other reason than 

sharing a geographical area or industrial sector with an employer 

that has had an accident or otherwise come under OSHA scrutiny. 

The Committee recognizes that OSHA has to target its enforcement 

efforts and focusing on the regions and sectors that have experienced problems is one way to do that. The Committee urges OSHA 

to consider means such as the improved use of statistical analysis 

and other strategies to ensure that employers with excellent safety 

records are not subject to lengthy and costly inspections and enforcement processes without warrant. The Explanatory Statement 

accompanying the fiscal year 2015 Appropriations Act directed 


rfrederick on DSK6VPTVN1PROD with HEARING
21 

OSHA to notify the House and Senate Committees on Appropriations 10 days prior to the announcement of any new National, Regional or Local Emphasis Program including the circumstances and 

data used to determine the need for the launch of the new program. The Committee directs OSHA to continue to provide such notices in fiscal year 2016. 

Crystalline Silica.—The Committee understands that OSHA remains in the process of promulgating regulations to reduce the permissible exposure limit to crystalline silica. The Committee understands that silicosis and other silica-related illnesses are serious 

and can be deadly. The Committee is concerned, however, that 

OSHA has grossly underestimated the costs of implementing the 

proposed new standard. The Committee urges OSHA to delay enforcement of any new standard until it can demonstrate the effectiveness of equipment designed to accurately measure workers’ exposure to silica and until it can demonstrate that methods for reducing workers’ exposure to silica across all applicable industries 

can be feasibly implemented in a cost effective manner. The Explanatory Statement accompanying the fiscal year 2015 Appropriations Act urged OSHA to consider all currently available technology 

as it develops any new standard for workers exposure to silica 

dust. The Committee believes that personal protective equipment 

such as airstream helmets and respirators should be part of an allof-the-above approach to limiting workers’ exposure to respirable 

silica. Employers and workers should have the flexibility to choose 

from all available technologies that are proven to be effective at reducing workers’ exposure to silica rather than the environmental 

control approach put forward in the proposed rule. Lowering workers’ exposure to respirable silica is the goal. The Committee urges 

OSHA to allow the maximum flexibility possible with all currently 

available technology to meet any new standard for workers’ exposure to silica dust. 

Solid Ammonium Nitrate.—The Committee understands that 

OSHA is reviewing its standards related to the storage of ammonium nitrate and urges OSHA to propose any necessary changes 

under existing regulations on Explosives and Blasting Agents (29 

C.F.R. 1910.109) and not to add ammonium nitrate to the list of 

chemicals covered under OSHA’s Process Safety Management 

Standards of Highly Hazardous Chemicals (29 C.F.R. 1910.119). 

The Committee believes that changes to improve the safety of storing ammonium nitrate should be made based on scientific review 

of current standards rather than through a one-size-fits-all approach under OSHA’s Process Safety Management Standards. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

The Committee recommends $371,000,000 for the Mine Safety 

and Health Administration (MSHA). This recommendation is 

$4,887,000 less than the fiscal year 2015 enacted level and 

$23,932,000 less than the fiscal year 2016 budget request. 

MSHA enforces the Federal Mine Safety and Health Act in underground and surface coal mines and metal/non-metal mines. 

The Committee continues bill language designating up to $2,000,000 for mine rescue recovery activities, and provides for the 


rfrederick on DSK6VPTVN1PROD with HEARING
22 

retention of fees up to $2,499,000 for the testing and certification 

of equipment. The Committee includes at least $8,441,000 for State assistance 

training grants under the Educational Policy and Development program. 

The Committee understands that enforcement is an important 

part of protecting the health and safety of miners. The Committee 

is concerned, however, about overreliance on an enforcement-focused strategy that disproportionally impacts small businesses. The 

Committee believes that the Department should do everything possible to assist companies with training and technical support to 

comply with health and safety standards instead of just inspecting 

and fining companies indiscriminately for violations large and 

small. Compliance assistance programs are a vital resource for 

helping smaller employers comply with regulations and improve 

their health and safety programs. The Committee appreciates the 

reductions in mining injury and illness rates that have been 

achieved in recent decades and remains a strong proponent for vigilant mine safety oversight. The Committee believes that MSHA 

needs to offer a more formal voluntary protection program including the ability for mine operators to request compliance inspections 

that do not incur fines for violations. Such a program would increase participation in voluntary inspections, advance the goal of 

improving health and safety in the mining industry, and achieve 

greater compliance with standards without the threat of punitive 

enforcement. 

The Committee supports the significant advances MSHA has 

achieved in mine rescue and communications capabilities. 

The Committee appreciates that MSHA is undertaking an effort 

to redistribute enforcement activity and personnel to reflect the 

changing levels of coal mining production across MSHA regions 

and encourages MSHA to continue review and accelerate these efforts in order to most effectively align enforcement activity with 

current production levels. 

The Committee is aware that rock dust may be used in mining 

operations to suppress coal dust and that recent changes required 

by the MSHA increase the amount of rock dust required and the 

frequency of its application. The Committee notes that this use 

may create the potential for the new Continuous Personal Dust 

Monitors, required by MSHA, to mischaracterize rock dust as coal 

dust, thus subjecting operators to enforcement actions where no 

overexposures to coal dust exist. The Committee notes that an extension on enforcement of the regulation would provide time for 

MSHA to complete its current review of this problem and design 

protocols to prevent the potential for inaccurate compliance determinations. 

The Committee is concerned that MSHA may be expending unnecessary resources by inspecting coal mines that are not in operation more frequently than necessary to reasonably ensure worker 

safety. The Committee directs MSHA to review its policies and procedures for inspecting coal mines not in operation and ensure that 

such guidelines are consistent with statutory requirements and established safety standards. 

The coal mining industry has experienced a period of significant 

decline in recent years and a substantial number of mines have 


rfrederick on DSK6VPTVN1PROD with HEARING
23 

ceased operations or closed as a result. The Committee understands that MSHA has ongoing personnel and training needs but 

urges MSHA to consider how recruitment efforts impact communities that have been the hardest hit by declining mining operations. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

The Committee recommends $609,000,000 for the Bureau of 

Labor Statistics (BLS). This recommendation is $16,788,000 more 

than the fiscal year 2015 enacted level and $23,737,000 less than 

the fiscal year 2016 budget request. The recommendation includes 

$544,000,000 from the General Fund of the Treasury and 

$65,000,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 

BLS is an independent national statistical agency that collects, 

processes, analyzes, and disseminates essential economic data to 

the Congress, federal agencies, State and local governments, businesses, and the general public. Its principal surveys include the 

Consumer Price Index and the monthly unemployment series. 

Employment and Unemployment Statistics.—The Committee recommends $208,000,000 for Employment and Unemployment Statistics. 

Labor Market Information.—The Committee recommends 

$65,000,000 for Labor Market Information. 

Prices and Cost of Living.—The Committee recommends 

$207,000,000 for Prices and Cost of Living. 

Compensation and Working Conditions.—The Committee recommends $83,500,000 for Compensations and Working Conditions. 

Productivity and Technology.—The Committee recommends 

$10,500,000 for Productivity and Technology. 

Executive Direction and Staff Services.—The Committee recommends $35,000,000 for Executive Direction and Staff Services. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES

The Committee recommends $38,203,000 for the Office of Disability Employment Policy (ODEP). This recommendation is 

$297,000 less than the fiscal year 2015 enacted level and the same 

as the fiscal year 2016 budget request. 

ODEP provides policy guidance and leadership to eliminate employment barriers to people with disabilities. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $284,537,000 for Departmental 

Management. This recommendation is $53,392,000 less than the 

fiscal year 2015 enacted level and $91,448,000 less than the fiscal 

year 2016 budget request. The recommendation includes 

$284,229,000 from the General Fund of the Treasury and $308,000 


rfrederick on DSK6VPTVN1PROD with HEARING
24 

from the Employment Security Administration Account in the Unemployment Trust Fund. 

The Departmental Management appropriation provides funds for 

the staff responsible for Departmental operations, management, 

and policy development. The appropriation also includes funding 

for several programs and activities that are not separate appropriations accounts. 

Program Direction and Support.—The Committee recommends 

$31,475,000 for Program Direction and Support. 

Departmental Program Evaluation.—The Committee recommends $8,161,000 for Departmental Program Evaluation. 

Legal Services.—The Committee recommends $128,336,000 for 

Legal Services. 

International Labor Affairs.—The Committee recommends 

$32,000,000 for International Labor Affairs (ILAB). This recommendation is intended to return ILAB to its original mission of 

research, advocacy, and technical assistance. No funding is provided for ILAB grants. 

The Committee is concerned by the findings of GAO in its May 

2014 report, ‘‘International Labor Grants: Labor Should Improve 

Management of Key Award Documentation’’ and in its September 

2014 report, ‘‘International Labor Grants: DOL’s Use of Financial 

and Performance Monitoring Tools Needs to be Strengthened.’’ The 

Committee is not convinced that ILAB has the capacity to effectively manage a large and complex grant program. The Committee 

is also concerned that lack of demand results in funding for 

projects that are at higher risk of not achieving ILAB’s program 

goals. The Committee directs ILAB to implement GAO’s recommendations to provide guidance regarding document retention, 

demonstrate award requirements are met, ensure effective implementation of guidance, and provide guidance regarding the submission and review of financial and performance reports. 

The Committee directs ILAB to maintain funding for its core activities of international research and analysis, and to fulfill Congressional and legal mandates, including the Trade Acts of 2000 

and 2002 and the William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008. The Committee also expects ILAB 

to continue to carry out the administrative requirements of the 

labor provisions of free trade agreements. 

Administration and Management.—The Committee recommends 

$28,839,000 for Administration and Management. 

Adjudication.—The Committee recommends $32,000,000 for Adjudication. 

Women’s Bureau.—The Committee recommends $11,709,000 for 

the Women’s Bureau. 

Civil Rights Activities.—The Committee recommends $6,880,000 

for Civil Rights Activities. 

Chief Financial Officer.—The Committee recommends $5,137,000 

for the Chief Financial Officer. 

VETERANS EMPLOYMENT AND TRAINING

The Committee recommends $271,110,000 for Veterans Employment and Training (VETS) program. This recommendation is 

$1,129,000 more than the fiscal year 2015 enacted level and the 

same as the fiscal year 2016 budget request. The recommendation 


rfrederick on DSK6VPTVN1PROD with HEARING
25 

includes $38,109,000 from the General Fund of the Treasury and 

$233,001,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 

The VETS program serves America’s veterans and separating 

service members by preparing them for meaningful careers, providing employment resources and expertise, and protecting their 

employment rights. 

The Committee continues to be supportive of VETS program and 

wishes to reach and assist as many Veterans as possible. The Committee is also pleased by the efforts of private industry to offer its 

own resources for veterans employment services and encourages 

the Department to pursue opportunities to cooperation with private 

industry to help the country better serve its veterans. 

State Grants.—The Committee recommends $175,000,000 for 

State Grants. 

Transition Assistance Program.—The Committee recommends 

$14,100,000 for the Transition Assistance Program. 

Homeless Veterans’ Reintegration Program.—The Committee recommends $38,109,000 for the Homeless Veterans’ Reintegration 

Program. 

The Committee continues to support Administration efforts to direct grant awards to selective populations in the Veteran community, such as female Veterans, Veterans with families, and transition assistance to incarcerated Veterans. 

National Veterans’ Employment and Training Service Institute.— The Committee recommends $3,414,000 for the National Veterans’ 

Employment and Training Institute. 

INFORMATION TECHNOLOGY MODERNIZATION

The Committee recommends $29,778,000,000 for Information 

Technology (IT) Modernization. This recommendation is 

$14,384,000 more than the fiscal year 2015 enacted level and 

$89,824,000 less than the fiscal year 2016 budget request. 

While the Committee recognizes there are ongoing modernization 

needs with respect to the Department’s information technology infrastructure, the Committee is concerned that the Department does 

not have sufficient capacity to effectively manage the large increase 

in IT modernization funds proposed in the fiscal year 2016 budget. 

The Committee directs the Department to establish a multi-year 

IT modernization plan that staggers projects over time in a manner 

consistent with the Department’s capacity to effectively oversee 

projects and within available appropriations. The Committee directs the Department to assign a qualified project manager that is 

a full-time employee of the Department to each modernization 

project to ensure that all IT modernization projects are executed effectively, according to Departmental requirements, on time, and 

within budget. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $84,660,000 for the OIG. This recommendation is $3,070,000 more than the fiscal year 2015 enacted 

level and $3,325,000 less than the fiscal year 2016 budget request. 

The recommendation includes $79,000,000 from the General Fund 

of the Treasury and $5,660,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 


rfrederick on DSK6VPTVN1PROD with HEARING
26 

The Committee supports the OIG efforts to combat large-scale, 

multi-state fictitious and fraudulent employer and identity theft 

schemes to defraud the UI program. 

The Committee supports OIG efforts to reduce improper payments in the UI program, an area identified by OMB, based at 

least in part on previous OIG audit work, as being particularly at 

risk for improper payments. 

The Committee supports the OIG’s plan to initiate a long-term, 

cyclical oversight program to independently review, on a prioritized 

basis, individual States’ efforts to identify and recover UI overpayments. 

GENERAL PROVISIONS

Sec. 101. The Committee modifies a provision to prohibit the use 

of Job Corps funds for the salary of an individual at a rate in excess of Executive Level III. 

(TRANSFER OF FUNDS)

Sec. 102. The Committee continues a provision providing the Secretary of Labor with the authority to transfer up to one percent of 

discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such 

transfer. 

Sec. 103. The Committee continues a prohibition on use of funds 

to purchase goods that are in any part produced by indentured children. 

Sec. 104. The Committee continues a provision that grants made 

from funds available to the Department under the American Competitiveness and Workforce Improvement Act shall be used only for 

training activities in the occupations and industries for which employers use the visas that generate these funds, and that related 

activities be limited to those necessary to support such training. 

Sec. 105. The Committee modifies a provision to prohibit recipients of funds provided to the Employment and Training Administration from using such funds for the compensation of any individual at a rate in excess of Executive Level III. 

(TRANSFER OF FUNDS)

Sec. 106. The Committee continues a provision providing the Secretary of Labor with the authority to transfer funds made available 

to the Employment and Training Administration to Program Administration for technical assistance services. 

(TRANSFER OF FUNDS)

Sec. 107. The Committee modifies a provision that allows up to 

0.75 percent of discretionary appropriations provided in this Act for 

specific Department of Labor agencies to be used by the Office of 

the Chief Evaluation Officer for evaluation purposes consistent 

with the terms and conditions in this Act applicable to such office. 

Sec. 108. The Committee modifies a provision relating to flexibility of H–2B nonimmigrant crossings. 


rfrederick on DSK6VPTVN1PROD with HEARING
27 

(TRANSFER OF FUNDS)

Sec. 109. The Committee continues a provision that allows up to 

0.25 percent of discretionary appropriations provided in this Act for 

specific Department of Labor agencies to be used by the Office of 

the Chief Information Officer for authorized information technology 

purposes. 

Sec. 110. The Committee includes a new provision relating to section 147 of the WIOA authorizing competitive procurement of certain Job Corps Civilian Conservation Centers. 

Sec. 111. The Committee includes a new provision relating to the 

Department’s Establishing a Minimum Wage for Contractors regulation. 

Sec. 112. The Committee includes a new provision relating to the 

Department’s proposal to establish a new Office of Labor Compliance within the Departmental Management account. 

Sec. 113. The Committee includes a new provision relating to the 

Department’s Definition of the Term ‘‘Fiduciary’’; Conflict of Interest Rule—Retirement Investment Advice regulation. 

Sec. 114. The Committee includes a new provision relating to the 

‘‘walkaround’’ letter of interpretation issued by the OSHA on February 21, 2013. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

The Committee recommends $6,048,754,000 for Health Resources 

and Services programs, which is $298,530,000 below the fiscal year 

2015 enacted level and $413,423,000 below the budget request. 

The Health Resources and Services Administration (HRSA) supports programs that provide health services to disadvantaged, 

medically underserved, and special populations; decrease infant 

mortality rates; assist in the education of health professionals; and 

provide technical assistance regarding the utilization of health resources and facilities. 

PRIMARY HEALTH CARE

Health Centers 

The Committee recommends $1,491,522,000 for the Health Centers program, which is the same as the fiscal year 2015 enacted 

level and the budget request. 

The Committee includes bill language providing up to 

$99,893,000 for the Federal Tort Claims Act program, which is the 

same as the fiscal year 2015 enacted level and the budget request. 

The program provides medical malpractice liability protection to 

federally supported health centers. 

Perinatal transmission of Hepatitis B.—The Committee is 

pleased that progress is being made to develop and implement a 

strategic plan to reduce the rate of perinatal transmission of hepatitis B. The Committee has urged HRSA to expand efforts to eliminate perinatal transmission of Hepatitis B for the past three fiscal 

years and little progress has been made. The Committee expects 

HRSA to test intervention strategies followed by the adoption of 


rfrederick on DSK6VPTVN1PROD with HEARING
28 

best practices protocols in HRSA funded health care settings as 

soon as feasible in fiscal year 2016. 

Free Clinics Medical Malpractice 

The Committee recommends $100,000 for extension of Federal 

Tort Claims Act (FTCA) coverage for volunteer free clinic health 

care professionals, which is the same as the fiscal year 2015 funding level and the budget request. The program extends FTCA coverage to individuals involved in the operation of free clinics in 

order to expand access to health care services to low-income individuals in medically underserved areas. A free clinic must apply, 

consistent with the provisions applicable to community health centers, to have those individuals ‘‘deemed’’ an employee of the Public 

Health Service, and therefore eligible for coverage under the FTCA. 

HEALTH WORKFORCE

Health Professions 

The Committee recommends $742,670,000 for Health Professions 

programs, which is $8,930,000 below the fiscal year 2015 enacted 

level and $114,150,000 below the requested program level. 

The Bureau of Health Professions supports grants for the development of future workforce in fields challenged by a high need and 

insufficient supply of professionals. Given that colleges and universities serve the dual role of training students and carrying out a 

majority of federally funded biomedical research, the Committee 

believes that they serve as an ideal setting to expose future clinicians to the evidence base that underlies their intended profession. 

Within the total for Health Professions, the Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Health Professions Training for Diversity 

Centers of Excellence ............................................................................................................................ $21,711,000 

Health Careers Opportunity Program .................................................................................................... 14,189,000 

Faculty Loan Repayment ....................................................................................................................... 1,190,000 

Scholarships for Disadvantaged Students ............................................................................................ 45,970,000 

Health Care Workforce Assessment ............................................................................................................... 4,663,000 

Primary Care Training and Enhancement ...................................................................................................... 38,924,000 

Oral Health Training Programs ...................................................................................................................... 34,998,000 

Interdisciplinary, Community-based Linkages 

Area Health Education Centers ............................................................................................................. 30,250,000 

Geriatric Programs ................................................................................................................................ 34,237,000 

Mental and Behavioral Health .............................................................................................................. 9,916,000 

Public Health Workforce Development ........................................................................................................... 10,000,000 

Nursing Workforce Development 

Advanced Education Nursing ................................................................................................................ 63,581,000 

Nursing Workforce Diversity .................................................................................................................. 15,343,000 

Loan Repayment and Scholarship Program .......................................................................................... 81,785,000 

Nurse Education, Practice, and Retention ............................................................................................ 39,913,000 

Nurse Faculty Loan Program ................................................................................................................. 26,500,000 

Comprehensive Geriatric Education ...................................................................................................... 4,500,000 

Health Professions Training for Diversity 

Health Careers Opportunity Program.—The Health Careers Opportunity Program (HCOP) seeks to increase the diversity of the 

health professions workforce by providing grants that improve the 

recruitment and enhance the academic preparation of students 


rfrederick on DSK6VPTVN1PROD with HEARING
29 

from economically and educationally disadvantaged backgrounds 

into the health professions. Greater diversity among health professionals is associated with improved access to care for underserved 

populations, greater patient choice and satisfaction, and better patient-clinician communication. In recent academic years, the program has supported more than 260 grants and more than 13,600 

trainees annually, half of whom are underrepresented minorities 

and more than three quarters come from financially or educationally disadvantaged backgrounds. The Committee believes that the 

program as currently structured holds the greatest promise to 

reach high school, baccalaureate, post-baccalaureate, and graduate 

students to attract them to the health professions to care for underserved populations, in both rural and urban areas, as originally intended by Congress. 

The Committee is concerned with the ability to track outcomes 

for HCOP funding that is invested early in the pipeline. The Committee encourages HRSA to focus the program on high school, collegiate, and post-baccalaureate programs that impact the health care 

professional pipeline. The Committee directs HRSA to work with 

institutions that have historically performed well in producing minority and underrepresented health professionals in order to devise 

a more accurate way to track HCOP students who ultimately become health professionals. 

Primary Care Training and Enhancement 

Interprofessional Education.—The Committee is aware of a growing recognition that interprofessional clinical health programs represent the state of the art in health care. Further, the Committee 

believes inter-professional clinical care teams that include physicians, nurses and other disciplines (such as physician assistants, 

oral health practitioners, behavioral health professionals, allied 

health providers, other practitioners) can achieve better care, better population health and lower costs. Further, the Committee 

shares HRSA’s viewpoint that health organizations and professionals should be trained for a contemporary practice environment 

focused on new and more efficient models of care that include interprofessional and team-based care. Accordingly, in carrying out the 

various workforce programs authorized by Title VII and VIII of the 

Public Health Service Act, and for which funding is provided in 

this bill, the Committee encourages the Bureau of Health Workforce to give preference to competitive applications that include an 

interprofessional education component in their programmatic activities. 

The Committee encourages the Administrator to research Physician Assistant (PA) educational innovation and effectiveness and 

track PA graduate practice patterns and health care outcomes 

when PAs are involved in team-based practice. It is vital that PA 

education and outcomes assessment be a part of efforts to address 

high priority health workforce needs. 

Oral Health Training Programs 

The Committee recommends $34,998,000 for Training in Oral 

Health Care programs, which is $1,070,000 more than the fiscal 

year 2015 enacted level and the budget request. Within the funds 

provided, the Committee intends no less than $10,000,000 for GenVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00029 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
30 

eral Dentistry Programs and no less than $10,000,000 for Pediatric 

Dentistry programs. These programs serve to increase the number 

of medical graduates from minority and disadvantaged backgrounds and to encourage students and residents to choose primary 

care fields and practice in underserved urban and rural areas. 

The Committee urges HRSA to support innovative programs at 

new and established dental schools that will increase access to high 

quality dental services for underserved individuals, particularly 

where training clinics are located proximate to such underserved 

areas. 

Area Health Education Centers (AHEC) 

The Committee encourages HRSA to support AHEC oral health 

projects that establish primary points of service and address the 

need to help patients find treatment outside of hospital emergency 

rooms. The Committee urges HRSA to work with State dental associations that have initiated programs to refer ER patients to dental 

networks. 

The Committee is pleased with the results of AHEC’s efforts to 

improve access to healthcare in rural and underserved areas by increasing the number of primary healthcare professionals who practice in these areas. The Committee requests HRSA to provide an 

update on the AHEC program’s impact to increase the primary 

healthcare workforce and the program’s nationwide activities. 

Mental and Behavioral Health 

The Committee recommendation includes $9,916,000 for the 

interprofessional Graduate Psychology Education Program to increase the number of health service psychologists (including doctoral-level clinical, counseling and school psychologists) trained to 

provide integrated services to high-need underserved populations 

in rural and urban communities. The Committee encourages HRSA 

to build on recent efforts to expand training to increase mental and 

behavioral health services for returning service members, veterans 

and their families, with a strong emphasis on veterans reintegrating into rural civilian communities. Recognizing the growing 

need for highly trained mental and behavioral health professionals 

to deliver evidence-based services to the rapidly aging population, 

the Committee encourages HRSA to invest in geropsychology training programs and to help integrate health service psychology trainees at Federally Qualified Health Centers. 

Children’s Hospitals Graduate Medical Education Payment Program 

The Committee recommends $265,000,000 for the Children’s Hospitals Graduate Medical Education Payment Program, which is the 

same as the fiscal year 2015 enacted level and $165,000,000 more 

than the budget request. 

National Practitioner Data Bank 

The Committee assumes $19,728,000 for the National Practitioner Data Bank for fiscal year 2016, which is $914,000 more than 

the fiscal year 2015 enacted level and the same as the budget request. The Committee recommendation and the budget request assumes that the data bank will be self-supporting with collections 


rfrederick on DSK6VPTVN1PROD with HEARING
31 

of $19,728,000 in user fees. Bill language is continued to ensure 

that user fees are collected to cover the full costs of the data bank 

operations. 

MATERNAL AND CHILD HEALTH

Maternal and Child Health Block Grant 

The Committee recommends $638,200,000 for the Maternal and 

Child Health (MCH) Block Grant, which is $1,200,000 more than 

the 2015 enacted level and the budget request. States use the MCH 

block grant to improve access to care for mothers, children, and 

their families; reduce infant mortality; provide pre- and post-natal 

care; support screening and health assessments for children; and 

provide systems of care for children with special health care needs. 

The Committee continues bill language identifying specific 

amounts for Special Projects of Regional and National Significance 

(SPRANS). The Committee intends that the following amounts be 

provided within SPRANS: 

Budget Activity FY 2016 

Committee 

Set-aside for oral health ................................................................................................................................ $5,000,000 

Set-aside for epilepsy .................................................................................................................................... 3,642,000 

Set-aside for sickle cell disease .................................................................................................................... 2,961,000 

Set-aside for fetal alcohol syndrome demo ................................................................................................... 477,000 

Dental Health Projects.—The Committee recommends $5,000,000 

to encourage HRSA to support early childhood oral health interventions and prevention programs encompassing the medical/dental 

interface, topical fluorides, school and community-based sealant 

programs, and systems working in collaboration with the Women, 

Infants, and Children (WIC) and Head Start programs. 

Fetal Alcohol Syndrome.—The Committee recommends that the 

fetal alcohol syndrome initiative within HRSA address high-risk 

Alaska Native and American Indian populations through a Native 

American-focused collaborative. 

Maternal and Child Health Programs 

In addition to the Maternal and Child Health Block Grant, the 

Maternal and Child Health Bureau at HRSA supports several programs to improve the health of all mothers, children, and their 

families. These programs support activities that develop systemic 

mechanisms for the prevention and treatment of sickle cell disease; 

provide information and research on and promote screening of autism and other developmental disorders; provide newborn and child 

screening of heritable disorders; provide grants to reduce infant 

mortality and improve perinatal outcomes; fund States to conduct 

newborn hearing screening; and provide grants to improve existing 

emergency medical services. 

Within the total for Maternal and Child Health Programs, the 

Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Sickle Cell Anemia Demonstration Program .................................................................................................. $4,455,000 

Autism and other Developmental Disorders .................................................................................................. 47,099,000 

Heritable Disorders ......................................................................................................................................... 13,883,000 

Healthy Start .................................................................................................................................................. 102,000,000 


rfrederick on DSK6VPTVN1PROD with HEARING
32 

Budget Activity FY 2016 

Committee 

Universal Newborn Hearing ............................................................................................................................ 17,818,000 

Emergency Medical Services for Children ...................................................................................................... 20,162,000 

Traumatic Brain Injury 

The Committee has transferred management of the Traumatic 

Brain Injury program to the Administration for Community Living 

(ACL) in recognition of the existence of complimentary programs 

within ACL that the TBI program can leverage the resources of 

and collaborate with. 

Autism and other Developmental Disorders 

The Committee recognizes the importance of enhancing the capacity of existing autism and other developmental disabilities programs and expanding the number of sites and professionals trained 

to diagnose, treat, and provide interventions to individuals with autism spectrum disorders (ASD). Within the total for Autism and 

Other Developmental Disabilities, the Committee provides 

$30,043,000 for the Leadership Education in Neurodevelopmental 

and Related Disabilities (LEND) program to allow the existing programs to maintain their current capacity and expand the number 

of sites and professionals trained to diagnose, treat, and provide 

interventions to individuals with ASD and related developmental 

disabilities. The increased funding should be used to initiate LEND 

programs in States that do not currently have an established program, yet have a high incidence rate of ASD, to ensure children 

with ASD and related developmental disabilities across the country 

have access to the valuable resources that LEND programs provide. 

Heritable Disorders 

The Committee recommends $13,883,000 for the Heritable Disorders program, which is the same as the fiscal year 2015 enacted 

level and the budget request. 

Newborn Screening for SCID and Related Disorders.—The Committee provides level funding to assure that States are able to 

adopt newborn screening for Severe Combined Immune Deficiency 

(SCID) and related disorders. The grantee may also use funding to 

update and disseminate educational materials, enhance public 

awareness of Primary Immunodeficiencies, train healthcare and 

public health professionals, support specialized treatment centers 

accepting newly-diagnosed patients, support patient access to specialized treatment centers and expand the current newborn screening test to include complex mutations causing related life-threatening diseases. 

Healthy Start 

The Committee recommends $102,000,000 for the Healthy Start 

program, which is the same as the fiscal year 2015 enacted level 

as well as the budget request. The program provides discretionary 

grants to communities with high rates of infant mortality to support primary and preventive health care services for mothers and 

their infants. 

Fetal Infant Mortality Review.—The Fetal Infant Mortality Review (FIMR) program is an important component of many Healthy 


rfrederick on DSK6VPTVN1PROD with HEARING
33 

Start Initiatives and providing evidence-based interventions are 

crucial to improving infant health in high risk communities. HRSA 

is encouraged to continue to support the FIMR program with 

Healthy Start funding while educating Healthy Start Programs on 

the successes of the FIMR. 

Transfer from Planned Home Birth to Hospital.—The Committee 

is aware that CDC data shows the rates for out of hospital births 

in the United States have been slowly but steadily increasing since 

2004, and that because of this trend, collaboration within an integrated maternity care system is essential for optimal mother-baby 

outcomes. The Committee believes that all women and families 

planning a home or birth center birth have a right to respectful, 

safe, and seamless consultation, referral, transport and transfer of 

care when necessary. Therefore the Committee directs HRSA to develop a strategy for facilitating ongoing inter-professional dialogue 

and cooperation, and encouraging universal adoption of the Best 

Practice Guidelines for Transfer from Planned Home Birth to Hospital, in order to achieve optimal mother-baby outcomes in all settings and with all providers, and to report back to this Committee 

with an update on its progress. 

Maternal, Infant, and Early Childhood Home Visiting Program 

The Committee encourages HRSA and the Administration for 

Children and Families to continue their collaboration and partnerships to improve health and development outcomes for at—risk 

pregnant women, parents, and young children through evidencebased home visiting programs. 

RYAN WHITE HIV/AIDS PROGRAMS

The Committee recommends $2,318,781,000 for Ryan White HIV/ 

AIDS Programs, which is the same as the fiscal year 2015 enacted 

level and $4,000,000 below the budget request. 

The Ryan White HIV/AIDS programs fund activities to address 

the care and treatment of persons living with HIV/AIDS who are 

either uninsured or underinsured and need assistance to obtain 

treatment. The program provides grants to States and eligible metropolitan areas to improve the quality, availability, and coordination of health care and support services to include access to HIVrelated medications; grants to service providers for early intervention outpatient services; grants to organizations to provide care to 

HIV infected women, infants, children, and youth; and grants to organizations to support the education and training of health care 

providers. 

Within the total for Ryan White HIV/AIDS Programs, the Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Emergency Assistance .................................................................................................................................... $655,876,000 

Comprehensive Care Programs ...................................................................................................................... 1,315,005,000 

AIDS Drug Assistance Program (ADAP) ................................................................................................. (900,313,000) 

Early Intervention Program ............................................................................................................................. 201,079,000 

Children, Youth, Women, and Families .......................................................................................................... 75,008,000 

AIDS Dental Services ...................................................................................................................................... 13,122,000 

Education and Training Centers .................................................................................................................... 33,611,000 


rfrederick on DSK6VPTVN1PROD with HEARING
34 

HEALTH CARE SYSTEMS

The Committee recommends $106,193,000 for Health Care Systems, which is $3,000,000 more than the fiscal year 2015 enacted 

level and $4,000,000 below the budget request. 

The programs within Health Care Systems support national activities that enhance health care delivery in the United States. Activities include maintaining a national system to allocate and distribute donor organs to individuals awaiting transplant; building 

an inventory of cord blood units; maintaining a national system for 

the recruitment of bone marrow donors; operating the 340B drug 

discount system; and operating a national toll-free poison control 

hotline. 

Within the total for Health Care Systems, the Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Organ Transplantation ................................................................................................................................... $23,549,000 

National Cord Blood Inventory ....................................................................................................................... 11,266,000 

Cell Transplantation Program ........................................................................................................................ 22,109,000 

Office of Pharmacy Affairs ............................................................................................................................. 10,238,000 

Poison Control ................................................................................................................................................ 21,846,000 

National Hansen’s Disease Program .............................................................................................................. 15,206,000 

National Hansen’s Disease—Buildings/Facilities ......................................................................................... 122,000 

Hansen’s Payment to Hawaii ......................................................................................................................... 1,857,000 

The Committee is aware of the current insufficient rate of organ 

donation to meet nationwide need. Further, the Committee is concerned that in some circumstances there is significant regional disparity in donation volume. The Committee urges the Secretary to 

allocate resources toward increasing the organ donor pool and coordinate efforts by the Organ Procurement and Transplantation 

Network and the Centers for Medicare and Medicaid Services in regions with disproportionately low numbers of organ donors. The 

Committee directs the Secretary to establish a coordinated initiative to increase the number of donated organs successfully procured 

and transplanted throughout the United States. The Committee requests a report not later than 90 days after enactment regarding 

the Department’s effort to increased the number of organ donors in 

the United States. 

Office of Pharmacy Affairs 

The Committee recommends $10,238,000 for the Office of Pharmacy Affairs, which is the same as the fiscal year 2015 enacted 

level and is $14,500,000 below the budget request. 

The Committee urges OPA to complete the development of the 

secure website intended to verify 340B ceiling prices. The Committee directs OPA to provide a briefing within 30 days of enactment on the progress made to make the secure website available. 

Poison Control Centers 

The Committee recommends $21,846,000 for Poison Control Centers, which is $3,000,000 more than the fiscal year 2015 enacted 

level and the budget request. In 2012 more than 3.3 million poisoning, toxic exposure, drug, food safety and public health emergency calls were managed by the nation’s 55 accredited poison cenVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00034 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
35 

ters an average of more than 9,000 calls per day. Multiple studies 

have demonstrated that accurate assessment and triage of poisoning, drug and toxic exposures by the nation’s poison centers 

save critical healthcare dollars by reducing the severity of illness, 

preventing deaths and avoiding the expense of unnecessary trips to 

emergency departments and the length of hospital stays. HRSA reports that utilization of poison centers by hospitals and health care 

professionals continues to increase as the severity and complexity 

of poisonings and toxic exposures require the need for increased 

toxicological expertise in clinical settings. It is estimated that every 

dollar invested in the national poison center program saves $13.39 

in medical costs and lost productivity, thus generating annual cost 

savings exceeding $1.8 billion. 

RURAL HEALTH

The Committee recommends $147,471,000 for Rural Health programs, which is the same as the fiscal year 2015 enacted level and 

$19,909,000 more than the budget request. 

Rural Health programs provide funding to improve access, quality, and coordination of care in rural communities; for research on 

rural health issues; for the purchase of automatic external 

defibrillators; for technical assistance and recruitment of health 

care providers; for screening activities for individuals affected by 

the mining, transport, and processing of uranium; for the outreach 

and treatment of coal miners and others with occupation-related 

respiratory and pulmonary impairments; and for the expansion of 

telehealth services. 

Within the total for Rural Health activities, the Committee recommends the following amounts: 

Budget Activity FY 2016 Committee 

Rural Outreach Programs ............................................................................................................................... $59,000,000 

Rural Health Research ................................................................................................................................... 9,351,000 

Rural Hospital Flexibility Grants .................................................................................................................... 41,609,000 

Rural/Community Access to Emergency Devices ........................................................................................... 4,500,000 

State Offices of Rural Health ........................................................................................................................ 9,511,000 

Black Lung Clinics ......................................................................................................................................... 6,766,000 

Radiation Exposure Screening and Education ............................................................................................... 1,834,000 

Telehealth ....................................................................................................................................................... 14,900,000 

FAMILY PLANNING

The Committee does not recommend funding for the Family 

Planning program, which is $286,479,000 below the fiscal year 

2015 enacted level and $300,000,000 below the request. 

PROGRAM MANAGEMENT

The Committee recommends $154,000,000 for the cost of federal 

staff and related activities to coordinate, direct, and manage the 

programs of HRSA, which is the same as the fiscal year 2015 enacted level and $3,061,000 below the budget request. 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

The Committee estimates that $237,000,000 will be released 

from the Vaccine Injury Compensation Trust Fund, which is 


rfrederick on DSK6VPTVN1PROD with HEARING
36 

$2,000,000 more than the fiscal year 2015 enacted level and the 

same as 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 will support the liability costs of vaccines administered after September 30, 1988. They will also support the $7,500,000 in costs incurred by HRSA in the operation of 

the program, which is the same as the fiscal year 2015 enacted 

funding level and the budget request. 

CENTERS FOR DISEASE, CONTROL AND PREVENTION

The Committee recommends a program level of $7,010,103,000 

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

is $139,685,000 more than the fiscal year 2015 program level and 

equal to the budget request. The level includes $6,095,803,000 in 

discretionary appropriated dollars in conjunction with $914,300,000 

in transfers from the Prevention and Public Health (PPH) Fund. 

The CDC works with state, local and tribal health authorities 

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

The Committee recommendation increases support to state, local, 

and tribal public health departments in disease areas like Diabetes, Heart Disease and Stroke prevention activity and furthers efforts to reduce prescription drug overdose. The recommendation expands funding to build state, local, and tribal preparedness and response capacity through increased support for the public health 

preparedness infrastructure. It also provides support to expand 

state laboratory capacity to combat antibiotic resistance and other 

infectious diseases and supports flexible funds for states to address 

local and tribal public health issues through the preventative 

health and health services block grant. Globally, the recommendation continues support for the global polio eradication program and 

global public health activities. 

The Committee expects that unless provided for differently in the 

bill or report, CDC will follow the policy, funding source, and levels 

described in its budget request. 

The Committee expects CDC to communicate more clearly in the 

fiscal year 2017 budget request on how all its lab capacity upgrades 

and AMD initiatives are linked to measurable improvements in 

public health and preparedness. 

The Committee understands that due to the timing of the release 

of the budget request, CDC did not include certain information requested in the fiscal year 2015 report. Specifically, the public 

health and preparedness goals and measures for each CDC report 

level program line, grant table data, and other similar items were 

omitted. The Committee expects this information to be transmitted 

as soon as possible. 

The Committee reinforces its expectation for CDC to work with 

state, local and tribal health officials to move forward with the plan 

for a single web-based data collection information technology platform for CDC programs to reduce the voluntary reporting burden 


rfrederick on DSK6VPTVN1PROD with HEARING
37 

on states and reduce CDC’s total operational costs of its independent program data collection actions. 

The Committee remains interested in reducing duplication of effort and overlapping of responsibilities between NIH and CDC. The 

Committee encourages CDC and NIH to more actively coordinate 

on cross-cutting initiatives, ensuring that each agencies focuses on 

its respective core mission. Further the Committee requests an update in the fiscal year 2017 budget request on how each CDC report level program coordinates with the NIH Institutes and Centers (ICs) to share scientific gaps related to activities supported in 

NIH research portfolios. 

IMMUNIZATION AND RESPIRATORY DISEASES

The Committee recommends $758,066,000 for Immunization and 

Respiratory Diseases, which includes $607,781,000 in discretionary 

appropriations, and $150,285,000 in transfers from the PPH Fund. 

The level is $40,339,000 less than the fiscal year 2015 program 

level and $10,000,000 more than the budget request program level. 

Immunization grants are awarded to states and local agencies for 

planning, developing, and conducting childhood, adolescent, and 

adult 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. 

Within the total for Immunization and Respiratory Diseases, the 

Committee recommends the following amounts: 

Budget Activity FY 16 Committee 

Section 317 Immunization Program ............................................................................................................... $585,508,000 

National Immunization Survey .............................................................................................................. 12,864,000 

Influenza Planning & Response ..................................................................................................................... 172,558,000 

Childhood Immunizations.—The Committee requests CDC to include an updated Section 317 Immunization Program report in the 

fiscal year 2017 budget request. The update should include the 

2017 cost estimate, an estimate of State, local, and tribal operations funding, as well as a discussion of the evolving role of the 

317 program as expanded coverage for vaccination becomes available from private and public sources over the next several years. 

The Committee includes a $25,000,000 increase specifically to support the essential infrastructure funding for the state, local, and 

tribal public health departments to deliver the Vaccines for Children program and respond to disease outbreaks. A strong public 

health immunization infrastructure is critical for ensuring high 

vaccination coverage levels, the prevention of vaccine-preventable 

diseases, and for responding to outbreaks. 

HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES AND

TUBERCULOSIS PREVENTION

The Committee recommends $1,117,609,000 for HIV/AIDS, Viral 

Hepatitis, Sexually Transmitted Diseases (STD), and Tuberculosis 

(TB) prevention in discretionary appropriations, which is equal to 


rfrederick on DSK6VPTVN1PROD with HEARING
38 

the fiscal year 2015 level and $44,138,000 less than the budget request. 

The Division of HIV/AIDS Prevention provides national leadership and support for HIV prevention research and the development, implementation, and evaluation of evidence-based HIV prevention programs serving persons affected by, or at risk for, HIV 

infection. Activities include surveillance, epidemiologic and laboratory studies, and prevention activities. CDC provides funds to 

state, local and tribal health departments and community-based organizations to develop and implement integrated community prevention plans. 

Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB 

Prevention, the Committee recommends the following amounts: 

Budget Activity FY 16 Committee 

Domestic HIV/AIDS Prevention and Research ................................................................................................ $786,712,000 

HIV Prevention by Health Departments ................................................................................................. 397,161,000 

HIV Surveillance .................................................................................................................................... 119,861,000 

Activities to Improve Program Effectiveness ........................................................................................ 103,208,000 

National, Regional, Local, Community, and Other Orgs ....................................................................... 135,401,000 

School Health-HIV .................................................................................................................................. 31,081,000 

Viral Hepatitis ................................................................................................................................................ 31,331,000 

Sexually Transmitted Diseases ....................................................................................................................... 157,310,000 

Tuberculosis .................................................................................................................................................... 142,256,000 

Hepatitis C (HCV) Screening.—The Committee commends CDC 

for working to integrate recommended viral hepatitis screening in 

primary care provider services. The Committee urges CDC to continue outreach to underserved populations through screening activities in non-clinical and public health settings. 

HIV Prevention Activities.—The Committee understands most 

CDC HIV prevention funding is distributed to the primary implementers of prevention activities. The Committee requests CDC to 

evaluate its prevention program funding to determine if the current mix successfully reaches the most at-risk individuals to best 

ensure early detection with targeted interventions. Further, the review should examine methods, with available total HIV funding, to 

increase the reliance on state, local, and tribal public health departments and efforts to increase the use of burden of disease as 

a significant criteria factor in making funding allocation decisions 

and awards. The Committee requests an update on this review in 

the fiscal year 2017 budget request. 

HIV Screening.—The Committee is aware of concerns related to 

CDC’s draft HIV screening algorithms that would limit antibody 

testing. The Committee commends CDC for leading the early adoption of advancements in HIV prevention technology but cautions 

CDC to encourage access to a variety of FDA-approved screening 

options including antibody, antigen, oral fluid, and rapid testing 

technologies to facilitate screening in all settings. Further, the 

Committee continues to support HIV status awareness. CDC is encouraged to work with States that scored low on the goals to Increase HIV Testing and Reduce Late State Diagnosis in order to 

improve the rates of persons with HIV that know their status and 

are enabled to seek appropriate care and prevent transmission. 

Tuberculosis (TB) Elimination.—The Committee notes that in 

1987, HHS established an Advisory Committee for the Elimination 

of TB with a goal of TB elimination by the 2010. The Committee 


rfrederick on DSK6VPTVN1PROD with HEARING
39 

requests CDC to review its resource allocation in preparation for 

the fiscal year 2017 budget request to ensure it supports appropriate control that can eventually eliminate TB in the United 

States. Further, the Committee requests an update in the fiscal 

year 2017 budget request on how CDC’s TB program directs resources to state, local, and tribal public health departments to provide for adequate diagnostic, treatment and prevention education 

tools. The update should outline the plan and how the resources in 

the request will accomplish the goal. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

The Committee recommends $512,598,000 for Emerging and 

Zoonotic Infectious Diseases, which includes $460,598,000 in discretionary appropriations and $52,000,000 that is made available from 

amounts in the PPH Fund. The level is which is $107,608,000 more 

than the fiscal year 2015 program level and $186,669,000 less than 

the budget request program level. 

The Emerging and Zoonotic Infectious Disease programs support 

the prevention and control of infectious diseases through surveillance, outbreak investigation and response, research, and prevention. 

Within the total for Emerging and Zoonotic Infectious Diseases, 

the Committee recommends the following amounts: 

Budget Activity FY 16 Committee 

Core Infectious Diseases ................................................................................................................................ $334,598,000 

Emerging Infectious Diseases ............................................................................................................... 136,248,000 

Lab Safety and Quality (non add) ............................................................................................... 8,248,000 

Antibiotic Resistance Initiative ............................................................................................................. 120,000,000 

Emerging and Zoonotic Core Activities ................................................................................................. 29,840,000 

Vector-borne Diseases ........................................................................................................................... 26,410,000 

Lyme Disease ......................................................................................................................................... 10,700,000 

Prion Disease ......................................................................................................................................... 6,000,000 

Chronic Fatigue Syndrome .................................................................................................................... 5,400,000 

Food Safety ..................................................................................................................................................... 48,000,000 

National HealthCare Safety Network .............................................................................................................. 18,000,000 

Quarantine ...................................................................................................................................................... 30,000,000 

Advanced Molecular Detection (AMD) ............................................................................................................ 30,000,000 

Epi and Lab Capacity .................................................................................................................................... 40,000,000 

Healthcare-Associated Infections ................................................................................................................... 12,000,000 

Antimicrobial Resistance.—The Committee expands its support 

for CDC to enhance the regional lab network to improve tracking 

of and response to outbreaks. The Committee expects a significant 

level of support for the state and regional lab capacity and intends 

for funds to support programs with measurable goals and objectives 

that will be reported annually in the budget request for this program. Further, CDC is expected to support states to use evidence 

based approaches to stop the spread of drug-resistant bacteria and 

preserve existing antibiotics. 

Guideline for Disinfection and Sterilization in Healthcare Facilities.—The Committee is concerned that according to the CDC 2014 

National and State Healthcare-Associated Infections Progress Report, the U.S. did not meet the healthcare-associated infection 

(HAI) prevention goals for 2013. The Committee requests that 

within 120 days, CDC shall update its 2008 Guideline for Disinfection and Sterilization in Healthcare Facilities to incorporate more 

recent peer-reviewed literature regarding the role of the healthcare 


rfrederick on DSK6VPTVN1PROD with HEARING
40 

environment in the spread of antibiotic-resistant bacteria and the 

current best practices for containment that have been demonstrated in health facility environments. The Committee understands new technologies now exist that were not considered when 

the guidelines were last updated. 

Hand Hygiene.—The Committee encourages CDC to improve 

hand hygiene habits to help prevent the spread of germs and infectious disease. The Committee requests an update in the fiscal year 

2017 budget request on how CDC has incorporated the use of hand 

sanitizers, including Alcohol Based Hand Rubs (ABHRs), into its 

hand hygiene programs when hand washing is not readably accessible. 

Laboratories.—CDC provides funding for State and Regional laboratories across numerous centers, programs, and initiatives to 

support, increase, enhance, or modernize laboratory capacity. To 

streamline the funding and reduce potential duplication, the Committee directs CDC to consolidate all its State and Regional laboratory funding sources into a single funding line in one CDC Center 

in the fiscal year 2017 budget request and include a CDC-wide consolidated plan with measurable goals and objectives on how CDC 

leverages State and Regional laboratory support and capacity 

across all CDC programs, initiatives, and activities. 

Laboratory Training.—The Committee includes support to enhance CDC’s internal laboratory management and training to improve laboratory safety at CDC laboratories. The Committee requests an update in the fiscal year 2017 budget request on the 

progress made to create and routinely review standard operating 

procedures, laboratory safety, and laboratory worker training. 

Lyme Disease.—The Committee encourages CDC to consider expanding activities related to developing sensitive and more accurate diagnostic tools and tests for Lyme disease, including evaluating emerging diagnostic methods and improving the utilization of 

adequate diagnostic testing; expanding its epidemiological research 

to determine the frequency and nature of the long-term complications of Lyme disease; improving surveillance and reporting of 

Lyme disease to produce more accurate data on its incidence; and 

evaluating the development of a national reporting system. 

Valley Fever.—The Committee commends NIH and CDC on the 

continued joint efforts to combat coccidioidomycosis, also known as 

Valley Fever. Specifically, the Committee supports ongoing efforts 

by NIH and CDC to conduct a Randomized Controlled Trial (RCT) 

to identify an effective treatment for Valley Fever, encourage development of a vaccine, and help increase awareness of this disease 

among medical professionals and the public. The Committee looks 

forward to when patients can begin enrolling in the RCT later this 

year. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

The Committee recommends $1,097,482,000 for Chronic Disease 

Prevention and Health Promotion, which includes $570,467,000 in 

discretionary appropriations and $527,015,000 that is made available from amounts in the PPH Fund. The level is $101,738,000 less 

than the fiscal year 2015 program level and $39,424,000 more than 

the budget request program level. 


rfrederick on DSK6VPTVN1PROD with HEARING
41 

The programs funded through this budget activity provide support for State and community programs, surveillance, prevention 

research, evaluation, and health promotion. 

Within the total provided, the Committee recommends the following amounts for Chronic Disease Prevention and Health Promotion activities: 

Budget Activity FY 16 Committee 

Tobacco ........................................................................................................................................................... $105,492,000 

Nutrition, Physical Activity, and Obesity ........................................................................................................ 49,920,000 

High Obesity Rate Counties .................................................................................................................. 10,000,000 

School Health ................................................................................................................................................. 15,400,000 

Health Promotion ............................................................................................................................................ 20,275,000 

Community Health Promotion ................................................................................................................ 6,350,000 

Glaucoma ............................................................................................................................................... 3,300,000 

Visual Screening Education .................................................................................................................. 525,000 

Alzheimer’s Disease ............................................................................................................................... 3,500,000 

Inflammatory Bowel Disease ................................................................................................................. 750,000 

Interstitial Cystitis ................................................................................................................................. 750,000 

Excessive Alcohol Use ........................................................................................................................... 3,000,000 

Chronic Kidney Disease. ........................................................................................................................ 2,100,000 

Prevention Research Centers ......................................................................................................................... 24,000,000 

Heart Disease and Stroke .............................................................................................................................. 170,000,000 

Diabetes .......................................................................................................................................................... 180,000,000 

National Diabetes Prevention Program .......................................................................................................... 20,000,000 

Cancer Prevention and Control ...................................................................................................................... 348,895,000 

Breast and Cervical Cancer .................................................................................................................. 207,000,000 

WISEWOMAN .................................................................................................................................. 21,120,000 

Breast Cancer Awareness for Young Women ........................................................................................ 4,960,000 

Cancer Registries .................................................................................................................................. 49,440,000 

Colorectal Cancer .................................................................................................................................. 39,515,000 

Comprehensive Cancer .......................................................................................................................... 19,675,000 

Johanna’s Law ....................................................................................................................................... 5,500,000 

Ovarian Cancer ...................................................................................................................................... 7,000,000 

Prostate Cancer ..................................................................................................................................... 13,205,000 

Skin Cancer ........................................................................................................................................... 2,125,000 

Cancer Survivorship Resource Center ................................................................................................... 475,000 

Oral Health ..................................................................................................................................................... 20,000,000 

Safe Motherhood/Infant Health ...................................................................................................................... 46,000,000 

Preterm Birth. ........................................................................................................................................ 2,000,000 

Other Chronic Diseases .................................................................................................................................. 24,000,000 

Arthritis .................................................................................................................................................. 10,000,000 

Epilepsy ................................................................................................................................................. 8,000,000 

National Lupus Patient Registry ........................................................................................................... 6,000,000 

Racial and Ethnic Approach to Community Health ....................................................................................... 50,000,000 

Million Hearts ................................................................................................................................................. 4,000,000 

Workplace Wellness ........................................................................................................................................ 7,500,000 

National Early Child Care Collaboratives ...................................................................................................... 4,000,000 

Hospitals Promoting Breastfeeding ................................................................................................................ 8,000,000 

Burden of Disease.—The Committee expects CDC to use the burden of disease (age-adjusted population) as a significant criteria for 

activities funded through the Chronic Disease programs and to ensure applicants identify the expected level of community burden reductions, tracked, and reported. 

Cardiomyopathy.—The Committee understands the risk of sudden cardiac arrest is highest among those with undiagnosed cardiomyopathy. The Committee continues support to increase awareness 

through appropriate public health mechanisms and encourages 

CDC to consider methods to increase support. The Committee requests an update in the fiscal year 2017 budget request on on-going 

and planned activities related to pediatric cardiomyopathy. 

Community Prevention Grants.—No funds are provided to support the Community Prevention Grants. The Committee recognizes 


rfrederick on DSK6VPTVN1PROD with HEARING
42 

the program supported chronic disease risk factors funded by other 

Chronic Disease program lines. To lessen community disruption 

during program wind down, the Committee encourages fiscal year 

2016 continuation costs of current cities, counties, and tribal grantees shift to the specific Chronic Disease program lines, as long as 

CDC deems these one-time funding activities within the existing 

program’s goals and scope of activity. 

Division of Diabetes Translation (DDT).—The Committee recognizes the work of the DDT to address diabetes. The Committee 

supports efforts to work with public and private organizations to 

prevent and reduce the occurrence of diabetes in Americans. The 

Committee reinforces its desire for CDC to use burden of disease 

as a significant criteria in awarding funds. The Committee urges 

significant resources be put toward DDT’s efforts to expand state, 

local, and tribal community diabetes control and prevention activities. The Committee believes these activities must include clear 

outcomes, ensure transparency and accountability that demonstrate how funding is expected to be used, were used, and 

tracked to ensure prevention funding reached state, local, and tribal communities with the greatest population adjusted burden. 

Division of Oral Health (DOH).—The Committee provides the 

DOH support for enhancements to the State oral health infrastructure grants, national surveillance activities and community prevention programs. The Committee is aware that 20 States were approved but unfunded in the last State infrastructure grant cycle. 

The Committee expects DOH to support clinical and public health 

interventions that target pregnant women and young children at 

highest risk for dental caries. A recent study demonstrates such 

approaches can result in cost-savings to State Medicaid programs. 

We further encourage CDC to work across HHS to improve the coordination of oral health surveillance in a manner that reliably 

measures and reports health outcomes. 

Diabetes.—The Committee understands that Diabetes is now the 

seventh leading cause of death and overall, the risk for death 

among people with diabetes is about twice that of people of similar 

age but without diabetes. Research has shown targeted interventions for modest lifestyle changes in people at highest risk can prevent or delay the onset of type 2 diabetes. For example, lifestyle 

interventions of losing weight and increasing physical activity reduced the development of type 2 diabetes by 58%, and by 71% 

among adults aged 60 years or older. Local communities are a catalyst for diabetes evidence-based health education, self-management 

prevention and awareness. The Committee provided a significant 

increase for Diabetes prevention and control activities. The Committee expects support to target communities with the highest burden of disease, as adjusted for population, and to use risk factor reduction measures. The Committee requests a report in the fiscal 

year 2017 budget request on how the amount of funds provided to 

state, local, and tribal communities with the highest burden. 

Heart Disease and Stroke.—The Committee understands heart 

disease and stroke are the first and fifth leading causes of death 

in the United States. Each year nearly 800,000 people die in the 

U.S. from cardiovascular diseases while 795,000 experience a 

stroke. In addition to the human suffering, the cost on the health 

care system is excessive: some data indicates that in 2011 the total 


rfrederick on DSK6VPTVN1PROD with HEARING
43 

direct and indirect cost for cardiovascular disease and stroke in the 

United States was over $320 billion. However, heart disease and 

stoke are preventable in many cases due to risk factors such as 

high blood pressure and high LDL cholesterol. Local health departments serve as a catalyst for effective evidence-based approaches in 

their communities for heart disease and stroke prevention and 

awareness. The Committee provided a significant increase to support Heart Disease and Stroke prevention at state, local and tribal 

public health departments. The Committee expects support to target communities with the highest burden of disease, as adjusted for 

population, and use risk factor reductions measures. The Committee requests a report in the fiscal year 2017 budget request on 

how the amount of funds provided to state, local, and tribal community with the highest burden. 

Tobacco Prevention.—The Committee notes CDC supports tobacco use and prevention activities throughout numerous programs 

like the Prevention Research Centers and Chronic Disease Prevention activities. The Committee provides funding in the tobacco line 

to primarily focus on underage smoking. Further, CDC is directed 

to consolidate and reduce duplication with other tobacco prevention 

programs and activities. The Committee does not provide support 

for CDC’s tobacco research activity. The NIH has an existing tobacco research portfolio that in fiscal year 2015 is estimated at 

$322,000,000. The CDC shall coordinate with NIH to identify meritorious tobacco research opportunities for NIH to consider through 

its peer-reviewed process and its existing portfolio funding level. 

The Committee requests an analysis in the fiscal year 2017 budget 

request identifying all the CDC programs that provide any funding 

for tobacco control or prevention activities with the name of the 

program and annual tobacco related funding level. 

Inflammatory Bowel Disease.—The Committee continues to support inflammatory bowel disease epidemiology activity and requests 

an update in the fiscal year 2017 budget request on these efforts. 

Further, the Committee encourages CDC to continue exploring the 

disease burden and communicate findings to patients and providers 

in an effort to improve and inform best public health practices. 

National Lupus Patient Registry (NLPR).—The Committee continues to support the NLRP efforts. The Committee expects CDC 

to coordinate with NIH to explore new or revised research methods 

to conduct cohort and burden of illness studies. 

National Early Childcare Collaboratives (NECC).—The Committee continues to support the collaboratives to assist early care 

and education providers. 

National Diabetes Prevention Program (NDPP).—The Committee 

understands the NDPP grantees, such as the YMCA, have leveraged NDPP support to expand the program to other communities. 

For example, the YMCA was awarded a nearly $12,000,000 grant 

over three years from the Center for Medicare and Medicaid to expand the program to 17 communities in an effort to reduce Medicare costs. The Committee significantly increased support for the 

NDPP and expects CDC to continue to encourage awardees to leverage these funds with more collaboration among federal agencies, 

community-based organizations, employers, insurers, health care 

professionals, academia, and other stakeholders. The Committee 

expects CDC to provide all increased funds through competitive 


rfrederick on DSK6VPTVN1PROD with HEARING
44 

process and that funds not be used to support internal CDC functions. The Committee appreciates that CDC has ensured the fidelity of the original Diabetes Prevention Program clinical trial 

through its NDPP by utilizing the evidence-based curricula and 

having program providers report on participant attendance and observed and measured weight loss. The Committee directs CDC to 

continue to ensure accurate results through observed weight measurement. Reliability of this data is critical to ensuring the confidence of various third-party payers. The Committee requests CDC 

to include long-term public health measures, how this program coordinates with other CDC and HHS programs, and the total 

amount of federal, public and private sector funds leveraged to support the NDDP annually in the fiscal year 2017 and future budget 

requests. 

Obesity.—The Committee expands support for the rural extension and outreach services program to support additional grants for 

rural counties with an obesity prevalence of over 40 percent. The 

Committee expects CDC to support childhood obesity interventions 

that are supported by scientific evidence and work with state, local 

and tribal public health departments to support measurable outcomes through evidenced based obesity research, intervention, and 

prevention programs. The program should include a special focus 

on areas with the highest population adjusted burden of obesity 

and with co-morbidities like hypertension, cardiac disease and diabetes. 

Pulmonary Hypertension (PH).—The Committee understands 

some PH patients are not diagnosed until the late stages of the disease. The Committee encourages CDC to work with providers to increase early diagnosis and awareness of the disease and requests 

an update in the fiscal year 2017 budget request on steps taken to 

increase provider awareness of early intervention education. 

Scleroderma.—The Committee encourages CDC efforts to improve awareness and education of rare and potentially life-threatening conditions, like scleroderma. 

Sleep Disorders.—The Committee is aware of CDC’s recent public 

health awareness work on sleep disorders and requests an update 

on these activities. The Committee encourages CDC to review the 

value of a national public health awareness campaign on sleep. 

Special Interest Projects (SIPs).—The Explanatory Statement to 

accompany the fiscal year 2015 Appropriations Act directed CDC to 

ensure funds used to support SIPs be competitively awarded 

through an open process that is available to all qualified entities. 

The Committee remains concerned that SIP funds made available 

through the Prevention Research Centers are not being competed 

from all qualified entities. The Committee requests the Government Accountability Office (GAO) to review the CDC Prevention 

Research Center SIPs in its yearly report and identify duplication 

in work between Federal agencies to consider if CDC has taken 

steps to fully revise its process to ensure open competition. GAO 

should also examine whether any of these programs represent duplication with other CDC or federal agencies/programs engaged in 

the same activities or provide the same service to the same general 

beneficiaries. The Committee further asks GAO to determine if 

there is broad dissemination of applications for the CDC SIPs and 

whether full disclosure occurs annually on who has applied for the 


rfrederick on DSK6VPTVN1PROD with HEARING
45 

funds; what entities were awarded funds; and, descriptions of how 

the final funding decisions were determined. 

The Committee supports the CDC in continuing their important 

work on excessive drinking. However, the Committee notes the 

work on monitoring of youth exposure to alcohol advertising and 

the level of risk faced by youth from exposure to alcohol advertising 

as duplicative with work ongoing in other Federal agencies, specifically, the Federal Trade Commission (FTC) and the National Institutes of Health (NIH), which is currently funding an R01 on alcohol 

marketing and underage drinking. The FTC’s March 2014 Report 

to Congress titled Self-Regulation in the Alcohol Industry was produced to address concerns about underage exposure to alcohol marketing. 

BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES

The Committee recommends $133,510,000 for Birth Defects and 

Developmental Disabilities program level in discretionary appropriations, which is $1,729,000 more than the fiscal year 2015 level 

and the budget request program level. 

This program collects, analyzes, and makes available data on the 

incidence and causes of birth defects and developmental disabilities. 

Within the total, the Committee recommends the following 

amounts for Birth Defects and Developmental Disabilities activities: 

Budget Activity FY 16 Committee 

Child Health and Development ...................................................................................................................... $65,800,000 

Birth Defects ......................................................................................................................................... 19,900,000 

Fetal Death ................................................................................................................................... 900,000 

Fetal Alcohol Syndrome ......................................................................................................................... 11,000,000 

Folic Acid ............................................................................................................................................... 3,150,000 

Infant Health ......................................................................................................................................... 8,650,000 

Autism ................................................................................................................................................... 23,100,000 

Health and Development for People with Disabilities ................................................................................... 52,910,000 

Disability & Health incl. Child Development ........................................................................................ 20,250,000 

Tourette Syndrome ................................................................................................................................. 2,000,000 

Early Hearing Detection and Intervention ............................................................................................. 10,760,000 

Muscular Dystrophy ............................................................................................................................... 6,000,000 

Attention Deficit Hyperactivity Disorder ................................................................................................ 1,900,000 

Fragile X ................................................................................................................................................ 2,000,000 

Spina Bifida .......................................................................................................................................... 6,000,000 

Congenital Heart Failure ....................................................................................................................... 4,000,000 

Blood Disorders .............................................................................................................................................. 14,800,000 

Public Health Approach to Blood Disorders .......................................................................................... 4,500,000 

Hemophilia Activities ............................................................................................................................. 3,500,000 

Hemophilia Treatment Centers .............................................................................................................. 4,800,000 

Thalassemia Blood Disorders ................................................................................................................ 2,000,000 

Duchenne Muscular Dystrophy (DMD).—The Committee notes 

the Muscular Dystrophy CARE Act was amended in the fall of 

2014. The Committee requests an update in the fiscal year 2017 

budget request that describes CDC’s plans and timeframe to enhance its collection of surveillance data across all forms of muscular dystrophy and to develop updated care standards, including 

for adults with Duchenne and for other forms of muscular dystrophy. 

Duchenne Muscular Dystrophy (DMD) Newborn Screening.—The 

Committee understands a successful DMD newborn screening pilot 


rfrederick on DSK6VPTVN1PROD with HEARING
46 

exists. The Committee requests the Center to conduct a comprehensive review and provide an update in the fiscal year 2017 budget 

request on how, if scientifically appropriate, CDC can encourage 

public/private organizations to expand or build on the existing 

model. 

Fetal Alcohol Syndrome (FAS).—The Committee includes increased resources to support an information clearinghouse, expansion of existing national community-based FAS networks, dissemination of evidence-based intervention strategies, and an Alaska Native/Native American-focused collaborative for FAS. 

Fragile X (FXD).—The Committee appreciates that CDC has recognized the public health impact of FXD and its efforts to identify 

and define this population. The Committee encourages CDC to coordinate with NIH and the FXD Clinical & Research Consortium. 

The Committee urges CDC to explore cross-divisional funding opportunities to accelerate data driven public health research to reduce the public health burden of both FXD and autism. 

Prenatal Screening.—The Committee notes that rapid scientific 

advances have brought cell free DNA non-invasive prenatal screening (NIPS) into prenatal care settings. As one of the fastest growing applications of genomic medicine, this test can generate confusion for patients and healthcare providers about the meaning of 

screening results. The Committee requests a report in the fiscal 

year 2017 budget request on how CDC and other HHS agencies ensure patients and providers understand the accuracy of and meaning of screening results and tested-for conditions; possible screening results and technical limits of screenings; appropriate follow-up 

and results communication. The report should also address CDC’s 

role in the development of materials to support the informed consent and patient decision-making and how it is made available to 

providers and patients involved in the decision making. The Committee expects CDC to also describe how the federal government 

works with private organizations through public-private partnerships on these issues. 

Specific Birth Defects.—The Committee appreciates that the Center’s website provides information on a number of birth defects on 

the specific birth defects webpage. The Committee requests a report in the fiscal year 2017 budget request on the criteria to add 

new birth defects, as well as treatments, the target audience of the 

information, how often the information is updated, and how effectiveness of the information is measured and validated to ensure it 

is useful for parents and providers. Finally, the report should explain whether the Center is considering adding new conditions like 

persistent pulmonary hypertension of the newborn and autosomal 

recessive polycystic kidney disease to the list. 

Spina Bifida Program.—The Committee recognizes this complex 

birth defect affects a number of individuals. The Committee encourages CDC to coordinate with NIH on the identification of research gaps and data that is needed to improve prevention interventions. 

ENVIRONMENTAL HEALTH

The Committee recommends $160,580,000 for Environmental 

Health program level, which includes $145,580,000 in discretionary 

appropriations and $15,000,000 that is made available from 


rfrederick on DSK6VPTVN1PROD with HEARING
47 

amounts in the PPH Fund. The level is $18,824,000 less than the 

fiscal year 2015 level and $17,920,000 less than the budget request 

program level. 

The Environmental Health program focuses on preventing disability, disease, and death caused by environmental factors through 

laboratory and field research. 

Within the total, the Committee recommends the following 

amounts for Environmental Health activities: 

Budget Activity FY 16 Committee 

Environmental Health Laboratory ................................................................................................................... $56,000,000 

Newborn Screening Quality Assurance Program ................................................................................... 8,300,000 

Newborn Screening/Severe Combined Immunodeficiency (SCID) Diseases .......................................... 1,200,000 

Environmental Health Activities ..................................................................................................................... 35,580,000 

Environmental Health Activities ............................................................................................................ 17,580,000 

Safe Water ............................................................................................................................................. 8,000,000 

Amyotrophic Lateral Sclerosis (ALS) Registry ....................................................................................... 10,000,000 

Environmental and Health Outcome Tracking Network ................................................................................. 24,000,000 

Asthma ........................................................................................................................................................... 30,000,000 

Childhood Lead Poisoning .............................................................................................................................. 15,000,000 

Environmental Health Activities.—The Committee does not provide support for CDC’s environmental health research. The NIH 

houses the National Institute of Environmental Health Sciences 

(NIEHS) whose mission is to discover how the environment affects 

people in order to promote healthier lives. The CDC shall coordinate with NIEHS to identify meritorious research opportunities for 

it to consider through its peer-reviewed process and within its existing portfolio funding level. Further, no funds are provided to 

support the Building Resilience Against Climate Effects, Climate 

and Health, and Built Environment and Health Initiative program 

activities, which will allow CDC to focus on more direct public 

health activities. 

INJURY PREVENTION AND CONTROL

The Committee recommends $211,300,000 for Injury Prevention 

and Control program level in discretionary funds, which is 

$40,853,000 more than the fiscal year 2015 program level and 

$45,677,000 less than the budget request program level. 

The injury prevention and control program supports intramural 

research, injury control research centers, extramural research 

grants, and technical assistance to state, local, and tribal health 

departments to prevent premature death and disability and to reduce human suffering and medical costs caused by injury and violence. 

Within the total, the Committee recommends the following 

amounts for Injury Prevention and Control activities: 

Budget Activity FY 16 Committee 

Intentional Injury ............................................................................................................................................ $92,300,000 

Domestic Violence and Sexual Violence ................................................................................................ 32,700,000 

Child Maltreatment ...................................................................................................................... 7,250,000 

Youth Violence Prevention ..................................................................................................................... 15,100,000 

Domestic Violence Community Projects ................................................................................................ 5,500,000 

Rape Prevention .................................................................................................................................... 39,000,000 

National Violent Death Reporting System ...................................................................................................... 11,300,000 

Unintentional Injury ........................................................................................................................................ 8,750,000 

Traumatic Brain Injury .......................................................................................................................... 6,750,000 

Elderly Falls ........................................................................................................................................... 2,000,000 


rfrederick on DSK6VPTVN1PROD with HEARING
48 

Budget Activity FY 16 Committee 

Injury Prevention Activities ............................................................................................................................. 28,950,000 

Prescription Drug Overdose Prevention .......................................................................................................... 70,000,000 

Asthma.—The Committee increased support for the National 

Asthma Control Program (NACP) and directs CDC to increase the 

number of states carrying out programmatic activities and use a 

population-adjusted burden of disease criteria as a significant factor for new competitive awards. 

Gun Research.—The Committee continues the general provision 

to prevent any funds provided from being spent on gun research, 

to include collecting data for potential future research, such as was 

proposed in the budget request for the National Violent Death Reporting System. The Committee notes the budget request for Gun 

Violence Prevention Research is not funded and would be contrary 

to the prohibition. The Committee reminds CDC that the longstanding general provision’s intent is to protect rights granted by 

the Second Amendment. The restriction is to prevent activity that 

would undertake activities (to include data collection) for current or 

future research, including under the title ‘‘gun violence prevention’’, that could be used in any manner to result in a future policy, 

guidelines, or recommendations to limit access to guns, ammunition, or to create a list of gun owners. 

Injury Control Research Centers.—The Committee provides sup- port of at least $11,000,000 within the Injury Prevention Activities 

line to support activities such core operations, evaluation of injury 

control interventions, and training activities within the injury control research centers. 

Prescription Drug Overdose Prevention Activity.—The Committee 

commends CDC for its leadership to expand the efforts on prescription drug overdose. The Committee directs the CDC Director to implement these activities based on population-adjusted burden of 

disease criteria of the mortality data (age adjusted rate) as a significant criteria when distributing funds for the state Prescription 

Drug Overdose Prevention activities and to adhere to all terms and 

conditions identified in the fiscal year statement of mangers accompanying the 2015 Appropriations Act and accompanying statement 

for this program. 

National Vital Statistics System (NVSS).—The Committee continues support for the NVSS which provides data on births, deaths, 

and fetal deaths that are essential for understanding our nation’s 

health. The Committee does not provide any funds to support the 

collection of any gun or firearms data as proposed in the budget request. 

Sepsis.—The Committee encourages CDC to significantly and 

materially increase its public awareness, outreach, and education 

efforts on sepsis, including health provider outreach and other related activities to improve diagnosis and treatment of sepsis. These 

activities should include greater coordination with other federal 

agencies, including the NIH. 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH

(NIOSH)

The Committee recommends $341,100,000 for the National Institute for Occupational Safety and Health (NIOSH) program level 


rfrederick on DSK6VPTVN1PROD with HEARING
49 

with discretionary appropriations, which is $6,237,000 more than 

the fiscal year 2015 program level and $57,682,000 more than the 

budget request program level. 

NIOSH 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, intramural and 

extramural research, instrument and methods development, dissemination, and training grants. 

Within the total for NIOSH, the Committee recommends the following amounts: 

Budget Activity FY 16 Committee 

National Occupational Research Agenda ....................................................................................................... $147,000,000 

Agricultural, Forestry, and Fishing ........................................................................................................ 27,000,000 

Education and Research Centers ................................................................................................................... 28,500,000 

Personal Protective Technology ...................................................................................................................... 20,000,000 

Healthier Workforce Centers ........................................................................................................................... 5,000,000 

Mining Research ............................................................................................................................................. 59,500,000 

National Mesothelioma Registry and Tissue Bank ........................................................................................ 1,100,000 

Other Occupational Safety and Health Research .......................................................................................... 80,000,000 

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

PROGRAM

The Committee recommends $55,358,000 for CDC to administer 

the mandatory Energy Employees Occupational Illness Compensation Program Act (EEOICPA), which is the same as the fiscal year 

2015 funding level and the budget request. 

EEOICPA provides compensation to employees or survivors of 

employees of Department of Energy facilities and private contractors who have been diagnosed with a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of their 

work. NIOSH estimates occupational radiation exposure for cancer 

cases, considers and issues determinations for adding classes of 

workers to the Special Exposure Cohort, and provides administrative support to the Advisory Board on Radiation and Worker 

Health. 

GLOBAL HEALTH

The Committee recommends $426,925,000 for Global Health with 

discretionary appropriations, which is $10,408,000 more than the 

fiscal year 2015 level and $21,167,000 less than the budget request. 

Through its Global Health activities, CDC coordinates, cooperates, participates with, and provides consultation to other nations, 

U.S. agencies, and international organizations to prevent and contain diseases and environmental health problems and to develop 

and apply health promotion activities. In cooperation with ministries of health and other appropriate organizations, CDC tracks 

and assesses evolving global health issues and identifies and develops activities to apply CDC’s technical expertise to be of maximum 

public health benefit. 

Within the total, the Committee recommends the following 

amounts for Global Health activities: 


rfrederick on DSK6VPTVN1PROD with HEARING
50 

Budget Activity FY Committee 

Global AIDS Program ...................................................................................................................................... $128,425,000 

Global Immunization Program ........................................................................................................................ 219,000,000 

Polio Eradication ................................................................................................................................... 169,000,000 

Other Global/Measles ............................................................................................................................ 50,000,000 

Parasitic Diseases and Malaria ..................................................................................................................... 24,500,000 

Global Disease Detection and Emergency Response ..................................................................................... 55,000,000 

Chikungunya.—The Committee is aware of the arrival of 

chikungunya in the Caribbean and encourages CDC to continue its 

work to prepare and monitor any potential arrival of chikungunya 

in the United States. The Committee encourages the National Center for Emerging and Zoonotic Infectious Diseases to work with the 

Center for Global Health on this cross-cutting issue. The Committee requests an update in the fiscal year 2017 budget request 

on CDC actions with respect to the chikungunya outbreak in Puerto Rico. 

Global Health Strategy.—The Committee requests an update on 

how CDC, FDA, and NIH jointly coordinate global health research 

activities with specific measurable metrics used to track the 

progress toward agreed upon global health goals. 

Global Public Health.—The Committee requests the Secretary to 

provide an operating plan for all international activities funded 

through other CDC accounts to the Appropriations Committees of 

the House of Representatives and the Senate. The Committee does 

not support the use of funds for chronic disease prevention or injury prevention activities abroad. 

Neglected Tropical Diseases (NTD).—The Committee notes the 

threat of NTD like Chagas and Dengue are a serious risk from 

mosquito-borne viral diseases. The Committee encourages CDC to 

continue to monitor and evaluate efforts for malaria and NTDs in 

collaboration with other divisions and agencies. The Committee 

urges CDC to work closely with NIH and BARDA to identify research opportunities that can lead to improved diagnostics, treatments and vaccines. The Committee expects CDC to conduct close 

coordination with all its vector borne activities to jointly support 

advances and development of the next generation of tools to address vector and parasite resistance, and to be vigilant in monitoring for new and resurging threats. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

The Committee recommends $1,460,836,000 for Public Health 

Preparedness and Response in discretionary appropriations, which 

is $108,285,000 more than the fiscal year 2015 level and 

$79,018,000 more than the budget request. 

CDC distributes grants to state, local, and territorial public 

health agencies, Centers for Public Health Preparedness, and others to support infrastructure upgrades to respond to all potential 

hazards, including acts of terrorism, infectious disease outbreaks, 

or natural disasters. Funds are used for needs assessments, response planning, training, strengthening epidemiology and surveillance, and upgrading laboratory capacity and communications systems. Activities support the establishment of procedures and response systems, and build the infrastructure necessary to respond 

to a variety of disaster scenarios. 


rfrederick on DSK6VPTVN1PROD with HEARING
51 

Within the total, the Committee recommends the following 

amounts for Public Health Preparedness and Response activities: 

Budget Activity FY 16 Committee 

State and Local Preparedness and Response Capability .............................................................................. $692,700,000 

Public Health Emergency Preparedness Cooperative Agreement ......................................................... 675,000,000 

Academic Centers for Public Health Preparedness .............................................................................. 8,200,000 

All Other State and Local Capacity ...................................................................................................... 9,500,000 

CDC Preparedness and Response .................................................................................................................. 158,000,000 

BioSense ................................................................................................................................................ 23,000,000 

All Other CDC Preparedness and Response ......................................................................................... 135,000,000 

Strategic National Stockpile (SNS) ................................................................................................................ 610,136,000 

Public Health Emergency Preparedness (PHEP) Cooperative 

Agreement Program.—The Committee funding level will enable the 

CDC to restore PHEP capacity in state, local, tribal, and territorial 

health departments and ensure they have the tools to quickly detect, monitor, and respond to health threats. The Committee seeks 

to understand how state PHEP funding is supporting capacity 

building at the state and local levels. The CDC is expected to track 

PHEP capacity goals via the Public Health Emergency Preparedness Index capabilities tool and work with states to agree on cooperative agreement objectives for each state. The Committee requests an update in the fiscal year 2017 budget request on how 

CDC is implementing improved public health preparedness capacity measures. 

SNS Replenishment of Medical Countermeasures.—The Committee understands certain antivirals in the Strategic National 

Stockpile will begin to expire soon. The Committee is concerned the 

2016 budget request was insufficient to fully support the SNS to 

replenish all of the necessary medical countermeasures and to meet 

the government’s established countermeasure requirements and 

contractual obligations with its private sector partners. The Committee directs the Director of CDC to conduct a comprehensive review of the current SNS to ensure an adequate supply of antivirals 

is stockpiled. The review should include: enumeration of the current stockpile; product expiration and/or extension of dating (including cost); cost of replenishment; contract requirements; manufacturing capability including capacity and lead production time 

and methods CDC will employ to distribute a pandemic stockpile. 

The CDC is directed to provide this report to the Committee no 

later than 120 days after the date of enactment of this act. Further, the Committee requests CDC to provide additional detail annually in its budget request beginning in fiscal year 2017 that identifies the total projected costs of all expired or expiring SNS assets 

with the projected allocation of the current year resources and 

budget funding allocated to replacement of expiring assets. Further, the annual SNS budget section shall annotate the annual 

amount of current year and requested funds dedicated to the purchase of new assets, replacement of expiring assets, training, and 

cost of operations separately. 

BUILDINGS AND FACILITIES

The Committee recommends $10,000,000 for CDC buildings and 

facilities in discretionary appropriations, which is equal to the fiscal year 2015 level and the request level. In addition, the ComVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00051 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
52 

mittee understands CDC has more than $12,000,000 in unobligated 

funds in the Individual Learning Accounts not projected to be spent 

and directs these funds to be used to support the replacement of 

the underground and surface coal mine safety and health research 

capacity facility. 

The Committee believes it is critical for CDC to ensure appropriate stewardship of public resources, especially buildings and facilities that provide vital capability to the nation. The Committee 

understands the NIOSH Taft and Hamilton facilities are becoming 

obsolete. The Committee requests an update in the fiscal year 2017 

budget request on CDC’s plan to provide appropriate stewardship 

for these facilities. 

Underground Mine Safety.—The Committee appreciates that 

based on Congressional direction, the Administration is starting to 

take steps to ensure that the mine explosive research capacity that 

was present at the now-closed CDC Lake Lynn, PA facility continues to exist. The Lake Lynn Laboratory and Experimental Mine 

was a unique and critical resource for conducting large scale explosion tests and mine fire research, which are essential components 

of preventing accidents and disasters in the mining industry. 

Therefore, the Committee continues to direct CDC to move forward 

to ensure the capability that was present at that facility is maintained to support mine safety research. Specifically, CDC is directed to provide a plan and updated timeline on the steps to replace the Lake Lynn facility capabilities that will be suitable for 

conducting tests that simulate full scale mine fires and coal dust 

explosions. The Committee requests the plan include the construction schedule and an estimate of the cost for construction, equipment and machinery. The plan shall also identify how the experimental activities are expected to be conducted during the process. 

The Committee expects a report with 90 days of enactment. The 

Committee rejects any proposal to redirect existing resources intended for a new mine safety research center to other CDC facility 

projects and expects this funding to remain available for an alternative site for Lake Lynn. 

PUBLIC HEALTH SCIENTIFIC SERVICES

The Committee recommends $496,597,000 for the Public Health 

Scientific Services program level with discretionary funds that includes funds for the National Center for Health Statistics (NCHS). 

The level is $15,536,000 more than the fiscal year 2015 program 

level and $42,212,000 less than the budget request program level. 

NCHS 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 Health Interview 

Survey (NHIS), the National Health and Nutrition Examination 

Survey (NHANES), the National Health Care Survey, and the National Vital Statistics System (NVSS). 

Within the total, the Committee recommends the following 

amounts for Public Health Scientific Services activities: 

Budget Activity FY 16 Committee 

Health Statistics ............................................................................................................................................. $160,397,000 

Surveillance, Epidemiology, and Informatics ................................................................................................. 284,000,000 

Laboratory Training & Oversight ........................................................................................................... 10,000,000 


rfrederick on DSK6VPTVN1PROD with HEARING
53 

Budget Activity FY 16 Committee 

Public Health Workforce ................................................................................................................................. 52,200,000 

Enhance Laboratory Training & Oversight.—The Committee provides $10,000,000 to support enhanced laboratory training and 

oversight, to include the CDC strengthening the oversight and 

training of CDC’s intramural laboratories. The Committee requests 

CDC to provide an update in the fiscal year 2017 request on the 

number and percentage of its laboratory employees provided with 

annual safety training, standard operating procedures, and other 

recommendations from CDC’s most recent incidents. Further, the 

update should identify all the lab incidents recommendations and 

the status of implementing each recommendation. 

Surveillance, Epidemiology, and PH Informatics.—The Committee reminds the Center that funds specifically requested 

through the PPH and not supported with PPH funds or directly 

specified in the report are not provided. For example, the Committee does not provide support for the Community Guide or the 

operations of the Community Prevention Services Task Force. 

Neurological Diseases Surveillance System.—The Committee requests an update in the fiscal year 2017 budget request describing 

CDC’s role, infrastructure, and tracking systems relative to tracking of epidemiology of neurological diseases, including multiple 

sclerosis. 

CROSS-CUTTING ACTIVITIES

The Committee recommends $283,500,000 for Cross-Cutting Activities program activities, which includes $113,500,000 in discretionary funds and $170,000,000 in PPH funds. The level is 

$9,930,000 more than the fiscal year 2015 comparable program 

level and $169,930,000 more than the comparable budget request 

program level. 

This activity supports several cross-cutting areas within CDC. 

Included is CDC’s leadership and management function, which 

funds the CDC Office of the Director. 

Within the total, the Committee recommends the following 

amounts for Cross-cutting activities: 

Budget Activity FY 16 

Committee 

Preventive Health/Health Services Block Grant ............................................................................................. $170,000,000 

Public Health Leadership and Support .......................................................................................................... 113,500,000 

Preventive Health and Health Services Block Grant (PHHSBG) 

The Committee rejects the Administration’s proposed elimination 

of the PHHSBG. The Committee restores it to a level of 

$170,000,000. For over 30 years, the PHHSBG has been a vital 

source of funding, allowing each State to address its most critical 

public health needs. States use these flexible dollars to offset funding gaps in programs that address the leading causes of death, disability, and to respond to unanticipated or emerging public health 

threats. The Committee expects CDC to provide these flexible 

funds to State public health agencies. Further, States should work 

with local and tribal public health agencies to use these resources 


rfrederick on DSK6VPTVN1PROD with HEARING
54 

to address the most critical public health needs through measurable evidence-based activities. 

Public Health Leadership and Support 

This activity supports CDC’s leadership and management function performed outside the Centers or outside support provided 

through the working capital fund. 

The Committee expects the fiscal year 2017 budget to include 

specific details of each budget activity supported with these funds, 

including functions, mission, full time employees, bonus, travel 

costs, and other typical object class data and information for each 

separate activity supported through the Public Health Leadership 

and Support funding line. The Committee also expects specific performance measures to evaluate the effectiveness of each office and 

function. Finally, for each office and function, the Committee expects the budget will describe clearly what the prior year funds 

supported, the current year projections and proposed budget year 

policy for each activity. 

Advocacy Restrictions.—The Committee requests an update in 

the fiscal year 2017 budget request describing CDC’s current mechanisms and processes to prevent advocacy violations. Further, CDC 

should describe its on-going efforts to educate its staff and recipients to prevent violations. 

Burden of Disease Review.—The Committee appreciates CDC’s 

efforts to provide information on-line about the health profiles for 

all 3,143 counties in the country. The Committee requests the CDC 

Director to review all CDC programs and public health activities; 

where population adjusted burden of disease is not already being 

used as a significant factor for CDC competitive awards, contracts, 

cooperative agreements, or other funding mechanism, to develop a 

timeline and procedures to ensure burden of disease is used as a 

significant criteria for awards, tracking measures, and evaluation 

public health activities. 

CDC Data Collection Duplication.—The Committee requests a report in the fiscal year 2017 budget request detailing its data collection responsibilities and examining potential duplication of effort 

with the National Health and Nutrition Examination Survey 

(NHANES) and American Heart Association. 

CDC Duplication of Research.—The Committee remains concerned that some of CDC’s research efforts may duplicate research 

that more directly falls into the mission of other federal agencies. 

The Committee encourages CDC to conduct a CDC-wide review of 

all its Centers research portfolios in conjunction with NIH and 

other federal agencies research to reduce duplication and enhance 

CDC funding available for more pressing public health activities. 

The Committee requests an update in the fiscal year 2017 request 

on the timeline and process for this review. 

Cross-Border Disease Control.—The Committee requests CDC to 

provide a report in the fiscal year 2017 budget request on how CDC 

coordinates its various programs with State and local public health 

departments to measure, track, control, and manage cross-border 

infectious disease in high volume port cities. 

Director’s Discretionary Funds.—The Committee encourages the 

CDC Director to only use a portion of the funds made available to 

the Director’s Discretionary Fund (DDF) to support additional MidVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00054 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
55 

dle East Respiratory Syndrome (MERS) surveillance or response 

and to support the Antibiotic Resistance initiative. The Committee 

requests, within 30 days after the end of each quarter, a quarterly 

report on DDF obligations and each activity supported. The report 

should include a description of the activity, how this supports a 

high priority need beyond that already provided, and the total CDC 

support for this activity, with the specific DDF funding level. Further, the quarterly reports shall be posted on-line via the CDC 

web-site within 30 days after being released to the Committee. 

Institute of Medicine (IOM) Review.—The Committee is concerned about the focus on the reduction of sodium as a growing 

body of evidence suggest low sodium consumption can lead to 

health problems in healthy individuals. The Committee includes 

bill language that requires the CDC Director to engage the IOM to 

develop a report on the safe sodium intake for healthy individuals 

from the funds provided. The review and report shall determine the 

blood pressure effect and Cardiovascular Disease (CVD) implications for healthy people consuming sodium at 3,000 mg or less per 

day. The Committee expects CDC to not undertake sodium reduction activities below 3,000 mg per day until the science is formally 

considered surrounding healthy and safe sodium intake, especially 

for healthy individuals, and the impact of lower sodium on blood 

pressure (and an extrapolation to health), including direct research 

suggesting a negative impact of lower sodium on health. To ensure 

that the report is free from bias, the Committee recommends that 

panelists be chosen, where possible, from individuals that have not 

previously published on the issue. To the extent that a panelist has 

published, care must be taken to balance that viewpoint with a 

contrary viewpoint. Since the debate involves the modeling and extrapolation of data sets, the committee recommends panelists with 

an expertise in medical statistical analysis. The Committee expects 

the Director to charter the IOM review within 90 days of enactment. 

Transparency.—Sound science, peer review and transparency are 

essential to effective protection of public health. The Committee is 

concerned that data from scientific studies utilized in forming public policy may not be available for public review, even under Freedom of Information Act requests. The Committee believes that if 

public policy is based on a scientific study, that study should be 

available for public review. The Committee urges the CDC to immediately provide, on its website, the data and studies it uses to 

support public policy used by CDC or other federal agencies based 

on CDC studies. 

Tribal Epidemiology Centers (TECs).—The Committee appreciates work undertaken by CDC to engage with representatives 

from Indian Country. Important gains have been made to promote 

greater dialogue between Tribes and the Agency; however, CDC 

has done little to invest in a surveillance system to support respectful and reliable data collection methods. The TECs work in partnership with Tribes to improve the health and well-being of their 

Tribal community members by offering culturally-competent approaches that work toward eliminating health disparities that are 

faced by American Indian and Alaska Native populations. The 

Committee understands most CDC programs incorporate surveillance into their specific program funding lines with funds supVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00055 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
56 

porting state and local health departments. It is unclear to the 

Committee how these funds support surveillance and technical support of public health activity at the tribal or TECs levels. The Committee directs the CDC Director to conduct a review and develop 

an action plan, in consultation with Indian Country, within 180 

days of enactment on actions CDC can undertake to address improved surveillance and measurable public health impacts in tribal 

communities. The report should include how much is currently 

spent to support Tribes and TECs directly from CDC or indirectly 

through other CDC mechanisms like state and public health departments, the public health measures currently in place, specific 

steps to improve tribal public health surveillance, capacity, and 

outcome, the expected annual funding, and how CDC will work 

with TECs to support culturally appropriate approaches. 

Updates.—The Committee requests general updates in the fiscal 

year 2017 budget request for each of the listed topics that describe 

the latest efforts ongoing and planned: 

Advanced Molecular Detection Initiative; 

Asthma; 

Atrial Fibrillation; 

Division of Adolescent and School Health (DASH) to evaluate 

and improve school HIV prevention activities and increase outreach 

strategies; 

Epilepsy; 

Hydrocephalus; 

Interstitial Cystitis; 

National Mesothelioma Patient Registry; 

Neonatal Abstinence Syndrome; 

Nutrients; 

Perinatal Collaboratives; and 

Vision Health Initiative. 

NATIONAL INSTITUTES OF HEALTH

The Committee recommends an appropriation of $31,184,000,000 

for the National Institutes of Health (NIH), which is 

$1,100,000,000 above the fiscal year 2015 level, and $100,000,000 

above the request. The level includes $30,174,000,000 in discretionary appropriations and $1,010,000,000 in PHS Act section 241 

evaluation set-aside (TAP) transfers. The Committee did not include the Administration’s requested bill language to increase the 

TAP, which would have allowed the Secretary to divert an estimated $850,000,000 away from NIH. Consistent with the fiscal 

year 2015 appropriations, all the TAP funds received by NIH are 

allocated to the National Institute of General Medical Sciences 

(NIGMS). This continues to ensure the TAP transfers are a net 

benefit to NIH rather than a liability. The Committee provided 

level is $560,741,000 above the pre-sequester level of 

$30,623,259,000 that NIH received in fiscal year 2012. 

The core mission of NIH is to invest in basic biomedical research 

to uncover new knowledge that can lead to better health and disease cures for everyone. NIH has historically enjoyed a great deal 

of flexibility from Congress as the Committee has not directed 

spending for particular diseases or research out of respect for the 

scientific process. 


rfrederick on DSK6VPTVN1PROD with HEARING
57 

The Committee understands the value of the extramural research community that is composed of scientists, clinicians, and 

other research personnel affiliated with more than 2,600 organizations, including universities, medical schools, hospitals, and other 

research facilities in all 50 states. The Committee encourages NIH 

to restore at least 90 percent of all NIH resources to the extramural community. Further, the Committee expects NIH to continue 

its focus on emerging investigators and first-time renewals of these 

young investigators in an effort to significantly reduce the average 

age of an NIH-supported new investigator. The Committee expects 

NIH to support a consistent NIH-wide inflationary policy across all 

Institutes and Centers (ICs). 

The Committee remains concerned that the number of Ruth L. 

Kirschstein National Research Service Awards declined in fiscal 

year 2014 and is only projected to increase by 15 in fiscal year 

2015. The Committee notes the NIH budget policy is to increase 

the number of training grants to 15,735. The Committee expects to 

adhere to at least this budget policy level for training grants and 

to provide a stipend level that is at least consistent with any fiscal 

year 2016 federal employee pay raise. 

The Committee appreciates NIH’s commitment to ensure NIH is 

not supporting research aligned to the ‘‘Strengthen Health Care’’ 

goal of the HHS Strategic Plan and to other research related to 

data or policy support of Health Reform as these activities do not 

directly relate to NIH’s mission. The Committee directs NIH to continue this policy and commitment. 

The Committee appreciates NIH’s recent movement to start an 

NIH-wide portfolio analysis and strategic planning process. The 

Committee encourages NIH to engage with outside strategic planning experts and the community on this effort to promote the advancement of biomedical science in a manner that builds public 

trust and accountability. Further, the Committee encourages NIH 

to use this tool in a manner that allows for more rigorous oversight 

prior to the awarding of funds to ensure that NIH grants are connected to the core mission and priorities of NIH. 

The bill continues to provide specific funding levels for the Clinical and Translational Science Awards program, the Institutional 

Development Awards program, Cures Acceleration Network, Common Fund, and the National Children’s Study (NCS) in bill language. 

The increase provided to NIH is generally distributed proportionately among NIH Institutes and Centers (ICs). However, additional 

resources were added to specific ICs to support specific initiatives. 

The Committee has provided a $300,000,000 increase for Alzheimer’s disease research initiative in the National Institute on 

Aging and a $85,000,000 increase for the Brain Research through 

Application of Innovative Neurotechnologies (BRAIN) initiative 

spread across the 10 ICs that participate in BRAIN. The Committee also provides the requested level of $200,000,000 for the 

Precision Medicine Initiative (PMI) with $130,000,000 within the 

Common Fund to support the trans-NIH project and $70,000,000 

with National Cancer Institute for specific PMI projects. Finally, 

the Committee also provides the requested $100,000,000 increase 

to support the antibiotic initiative in the National Institute of Allergy and Infectious Diseases (NIAID). 


rfrederick on DSK6VPTVN1PROD with HEARING
58 

The Common Fund is supported as a set-aside within the Office of the Director at $675,639,000, which includes the $12,600,000 to 

support pediatric research as described in the recently enacted 

Gabriella Miller Kids First Research Act. 

NATIONAL CANCER INSTITUTE (NCI)

Mission.—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. The Committee expects the 

Institute to systematically coordinate through other HHS agencies 

to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

The Committee modifies the bill language, as requested by the Administration, to allow NCI to use up to $16,000,000 for repairs and 

improvements at the NCI Frederick Federally Funded Research 

and Development Center in Frederick, MD due to the increasing 

maintenance backlog of this site. 

Breast Cancer.—The Committee is aware of recent news coverage 

highlighting studies about mammography screening for breast cancer that questions the use and validity of screening for discovering 

cancers. Although the majority of scientific studies have corroborated the value of early detection of breast cancers through screening, other studies have concluded that screening sometimes results 

in false positives and over treatment. This has created a less clear 

picture of the benefits of screening and may lead women to avoid 

periodic mammography, an experience some women already view 

as uncomfortable. From 1990 to 2010, deaths from breast cancer 

decreased by 34%. This drop in breast cancer mortality has been 

attributed to both improvements in treatment and earlier detection 

of cancers. However, in 2013, 230,000 new cases of breast cancer 

were diagnosed in the United States and almost 40,000 women 

died from breast cancer. Given the current controversies over 

screening and the need to validate new screening technologies 

versus existing technologies, it is clear that a new, comprehensive 

study of these issues is warranted. The Committee encourages NCI 

to support research to address these issues and to hopefully provide women and physicians with a clearer, more informed picture 

of how breast cancer imaging should be considered as part of the 

overall women’s health care environment and urges the Secretary 

not to implement changes to the breast cancer screening recommendations until this research is completed. 

Cancer Disparities.—The Committee requests NCI and the National Institute on Minority Health and Health Disparities 

(NIMHD) to prepare a joint update for the fiscal year 2017 budget 

request on efforts underway and planned to end this disparity, including activities to focus on research, prevention, and treatment 

of cancer in minority communities. 

Colorectal Cancer.—The Committee encourages support of meritorious scientific research on colorectal cancer to better understand 

the biology of young-onset colorectal cancer. Specifically, the ComVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00058 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
59 

mittee requests an update in the fiscal year 2017 budget request 

related to research activity on the biology of young-onset colorectal 

cancer in adults under the age of 50. 

Gastrointestinal Cancer.—The Committee continues to be concerned about gastric cancer, particularly among young adults and 

supports gastric cancer being studied in The Cancer Genome Atlas 

(TCGA). The Committee notes that research on gastric cancer is 

less advanced than that of many other cancers. The Committee 

therefore encourages NCI to consider requesting applications for 

gastric cancer research that leverages the use of genomic data from 

the TCGA. 

Heavy Ion Cancer Therapy and Research—The Committee understands NCI recently issued a planning grant for a Heavy Ion Therapy and Research. The Committee encourages NCI to coordinate 

with other federal agencies on the need and potential funding 

sources in determining the scientific justification to move forward 

or retrofit any existing facilities. 

Liver Cancer.—The Committee continues to be concerned with 

the lack of a focused liver cancer research program. The NCI is 

urged to support a Specialized Program of Research Excellence on 

liver cancer, as well as liver cancer program projects. The Committee encourages more focus on the development of biomarkers to 

serve as early detection markers of cancer to therefore offer the 

prospect of improved outcomes. 

Melanoma.—The Committee encourages NCI to develop a 5-year 

plan across NCI’s divisions, and coordinate with other federal agencies and advocates to align melanoma research resources. The 

Committee understands the NCI MATCH Trial and Exceptional 

Responders Initiative may provide valuable insight to benefit melanoma subpopulations knowledge and encourages use of these mechanisms. The Committee requests an update in the fiscal year 2017 

budget request on these efforts. 

NCI Designated Cancer Centers.—The Committee requests an 

update in the fiscal year 2017 request on how NCI supports or 

plans to support Institutional Development Award programs in 

states to broaden the NCI designated cancer center representation 

within these states. 

NCI Precision Medicine Initiative (PMI).—The Committee provides the requested funds to support the five-year NCI PMI plan 

that will support activities such as the pediatric MATCH trial, clinical trials for five major cancer types based on genomic driven data, 

liquid biopsies, new models of cancer diagnostics, test targeted 

agents for clinical trials, and the related informatics infrastructure. 

The Committee understands the NCI PMI is a one-time increase of 

$70,000,000 for five years. The Committee requests NCI to provide 

a breakout in the fiscal year 2017 budget request and future years 

with the specific science and funding details with these and NCI 

funds already supporting the PMI activity. The details should include long-term goals, milestones, and annual progress. The Committee encourages NCI, as scientifically feasible, to support existing research networks, especially collaborative efforts among NCIsupported cancer centers and institutions serving historically underserved populations as they have certain attributes of cancer 

genomic data sharing that may be particularly effective. 


rfrederick on DSK6VPTVN1PROD with HEARING
60 

Office of Cancer Survivorship.—The Committee requests a report 

in the fiscal year 2017 budget request on actions planned or ongoing to focus resources and attention to the youngest of cancer 

survivors. 

Pancreatic Cancer.—The Committee encourages NCI to prioritize 

support for meritorious research for pancreatic cancer generally 

and specifically related to early detection of pancreatic cancer. The 

Committee encourages a focus on promising research to test members of high-risk pancreatic cancer families, including non-invasive 

screening methods. The Committee requests an update in the fiscal 

year 2017 budget request on these efforts. 

Pediatric Low Grade Astrocytoma Research (PLGA).—The Committee encourages continued research efforts toward the identification of new therapies for PLGA patients, to include clinical trials. 

The Committee urges NCI and NIH to seek public/private partnerships opportunities on PLGA research. The Committee requests an 

update in the fiscal year 2017 budget request on on-going and 

planned activities across NIH. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

Mission.—NHLBI provides leadership for a national research 

program in diseases of the heart, blood vessels, lungs, and blood, 

in blood resources, and in sleep disorders through support of basic, 

clinical, and population-based research. The Committee expects the 

Institute to systematically coordinate through other HHS agencies 

to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

Chronic Obstructive Pulmonary Disease (COPD).—The Committee commends NHLBI for convening an interagency meeting on 

federal COPD planning. The Committee is eager to review the 

forthcoming peer-reviewed publications and urges NHLBI to move 

forward efforts to address the rising burden of COPD in the U.S. 

Further, the Committee is aware that Alpha 1 Antitrypsin Deficiency (Alpha 1) is a major genetic risk factor for developing COPD. 

The Committee encourages NHLBI to convene a group of expert 

stakeholders and other federal agencies to develop a treatment algorithm for Alpha 1 related disease and a coordinated federal and 

private approach to increase knowledge that can improve the diagnosing of this disease. 

Pulmonary Hypertension (PH).—The Committee applauds 

NHLBI for leading research efforts that have helped prolong life for 

individuals affected by PH and encourages continued research related to the underlying mechanisms of PH, particularly idiopathic 

pulmonary arterial hypertension as additional gains may benefit 

patient health and wellness. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

(NIDCR)

Mission.—The mission of NIDCR is to improve the nation’s oral, 

dental and craniofacial health through research and research training. NIDCR accomplishes its mission by performing and supporting 

basic and clinical research; conducting and funding research training and career development programs to ensure that there is an 

adequate number of talented, well-prepared, and diverse investigators; and coordinating and assisting relevant research and reVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00060 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
61 

search-related activities. The Committee expects the Institute to 

systematically coordinate through other HHS agencies to share 

new scientific information to ensure it reaches the community and 

providers through various other HHS outreach programs. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES (NIDDK)

Mission.—NIDDK supports research in three major disease categories: diabetes, endocrinology, and metabolic diseases; digestive 

diseases and nutrition; and kidney, urologic, and hematologic diseases. NIDDK supports a coordinated program of fundamental and 

clinical research and demonstration projects relating to the causes, 

prevention, diagnosis, and treatment of diseases within these categories. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers through 

various other HHS outreach programs. 

Focal Segmental Glomerulosclerosis (FSGS).—The Committee 

commends NIDDK for partnering with NCATS on the Nephrotic 

Syndrome (NS) Study Network with the goal of developing precision medicine for NS. The Committee encourages continued support for studies on the mechanisms of the FSGS/NS disease process. 

Gestational Diabetes.—The Committee recognizes the importance 

of research related to gestational diabetes and encourages NIDDK 

to continue to support highly meritorious research on gestational 

diabetes. 

Inflammatory Bowel Disease.—The Committee commends 

NIDDK for hosting a conference on inflammatory bowel disease in 

children which could lead to further research in this area. The 

Committee encourages NIDDK to continue efforts to identify the 

etiology of the disease in order to inform the development of cures 

for inflammatory bowel disease. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

(NINDS)

Mission.—NINDS supports and conducts basic, translational, 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. The Committee expects the Institute to systematically coordinate through other HHS agencies to 

share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

Brain Aneurysms.—The Committee notes that brain aneurysm 

research appears to be a lower priority. The Committee requests an 

update in the fiscal year 2017 budget request on on-going and 

planned research related to this issue. 

Brain Research through Advancing Innovative Neurotechnologies 

(BRAIN) Initiative.—The human brain remains one of the greatest 

mysteries in science and one of the greatest challenges in medicine. 

Neurological and psychiatric disorders, such as Alzheimer’s disease, 

Parkinson’s disease, autism, epilepsy, schizophrenia, depression, 


rfrederick on DSK6VPTVN1PROD with HEARING
62 

and traumatic brain injury, exact a tremendous toll on individuals, 

families, and society. The BRAIN initiative, created with a 10-year 

plan, was expected to require an annual budget of at least 

$400,000,000 by fiscal year 2019. The Committee accelerates the 

requested funding for BRAIN to $150,000,000 to ensure the initiative stays on track towards it program goals and objectives. The 

funds are allocated to NINDS, NICHD, NEI, NIA, NIDCD, NIAAA, 

NIDA, NIMH, NIBIB, and NCCIH on the same pro-rata bases as 

provided in the budget request. 

The Committee recognizes initiatives of this nature must maintain adequate funding to assure achievement of the goals and plan 

milestones. The Committee expects NIH to ensure the fiscal year 

2017 request provides an appropriate level of funding to keep on 

this path. Further, the Committee encourages the distribution of a 

reasonable portion of BRAIN research resources through co-funded 

projects in the IDeA program. 

Dystonia Research.—The Committee commends NINDS for its 

leadership of dystonia research. The Committee encourages NINDS 

to continue to prioritize dystonia research that can advance the 

pace of clinical and translational research to find better treatments 

and a cure. 

Hydrocephalus Research.—The Committee encourages NIH, 

under the direction of the NINDS, to conduct a state of the science 

workshop to investigate the status of current federally and non-federal supported hydrocephalus specific research projects. The Committee requests the fiscal year 2017 budget request include a summary of the key recommendations and other findings from the 

workshop. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)

Mission.—NIAID supports and conducts basic, applied, and clinical research and research training programs in infectious, 

immunologic, and allergic diseases. NIAID-supported research includes research on HIV/AIDS, malaria, tuberculosis, sexually transmitted infections, neglected tropical diseases, emerging and reemerging infectious diseases, asthma, allergic and autoimmune diseases, and transplantation. The goals of NIAID research are to increase the understanding of disease pathogenesis and the immune 

system, to improve disease diagnosis, to develop new and improved 

drugs to treat such diseases, and to develop new and improved vaccines and other approaches to prevent such diseases, many of 

which significantly affect public health. The Committee expects the 

Institute to systematically coordinate through other HHS agencies 

to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

National Strategy for Combating Antibiotic Resistant Bacteria 

(CARB).—The Committee directs the Department to work with the 

Departments of Defense, Agriculture, Veterans Affairs and the 

Food and Drug Administration (FDA) to both track and store antibiotic resistance (AbR) genes and the mobile genetic elements from 

AbR bacteria. This information, along with metadata, including geographic information system coordinates describing where they 

were isolated, is essential to monitor emerging AbR bacteria, assess 

their threat to public health and develop mitigation strategies. The 

Committee further directs the Department to include in their fiscal 


rfrederick on DSK6VPTVN1PROD with HEARING
63 

year 2017 request the progress being in implementing the above 

language and the overall CARB national strategy initiative. 

Antibiotic Resistance (AbR).—The Committee provides the re- quested $100,000,000 increase to spur research and development 

related to scientific gaps to reduce AbR and develop new antibiotics. The Committee directs NIAID to work with BARDA to develop a joint plan toward addressing this growing and serious 

threat posed by AbR bacteria. NIAID is encouraged to consider research focused on novel approaches to combat AbR, which may include unique modalities such as antibodies and vaccines, new 

mechanisms, new rapid diagnostics, and a genomic database of reported human infections. The Committee encourages consideration 

of research on novel approaches to antimicrobial resistance like 

unique modalities, new mechanisms, or new antimicrobials. The 

Committee requests NIAID to provide a multi-year AbR research 

and funding plan, developed in conjunction with BARDA, which includes specific goals and annual milestones to support this initiative within 180 days of enactment. 

Biodefense Spend Plan.—The Committee appreciates ASPR’s 

completion of the 5-year spending plan for the medical countermeasure (MCM) enterprise, but notes concerns on the level of detail included in the spend plan for NIAID’s biodefense activities. 

The spend plan offered little insight into the NIAID’s spending priorities for the numerous MCM candidates in its portfolio. The Committee requests NIAID, working with ASPR, to provide more detail 

on NIAID’s future goals for MCM research, including its efforts to 

transition these projects to advanced research at BARDA, and identify how NIAID coordinates with BARDA’s on advanced development and procurement priorities. Further, the Committee requests 

a summary of this information be included in the fiscal year 2017 

budget request. The Committee encourages NIAID to focus on biodefense MCM candidates that have received a Material Threat Determination from the Department of Homeland Security. 

Valley Fever.—The Committee commends NIH and CDC on the 

continued joint efforts to combat coccidioidomycosis, also known as 

Valley Fever. Specifically, the Committee supports ongoing efforts 

by NIH and CDC to conduct a Randomized Controlled Trial (RCT) 

to identify an effective treatment for Valley Fever, encourage development of a vaccine, and help increase awareness of this disease 

among medical professionals and the public. The Committee looks 

forward to when patients can begin enrolling in the RCT later this 

year. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)

Mission.—NIGMS supports research and research training in the 

basic biomedical sciences. Institute grantees, working in such fields 

as cell biology, biophysics, genetics, developmental biology, pharmacology, physiology, biological chemistry, bioinformatics, and computational biology study normal biological processes to better understand what goes wrong when disease occurs. In this way, 

NIGMS supports the development of new knowledge, theories, and 

technologies that can then be applied to the disease-targeted studies supported by other NIH components. NIGMS-supported basic 

research advances also find applications in the biotechnology and 

pharmaceutical industries. The Institute’s training programs help 


rfrederick on DSK6VPTVN1PROD with HEARING
64 

develop scientists needed in industry and academia and increase 

the diversity of the biomedical workforce. The Committee expects 

the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the 

community and providers through the various other HHS outreach 

programs. 

Institutional Development Award (IDeA).—The Committee provides a significant increase to the IDeA program in recognition of 

the success of this program. The Committee expects NIH to ensure 

the program is supported at a level of at least 1 percent of total 

NIH funding in future budget requests. Further, the Committee 

notes the NIH Centers of Biomedical Research Excellence (COBRE) 

is proven to successfully increase the number of new scientists at 

institutions in states eligible for IDeA. The NIH policy has limited 

the number of COBRE institutions in IDeA states. The Committee 

expects NIH and NIGMS Directors to jointly review this policy and 

develop a plan to expand the number of competitively awarded 

COBREs per institution that include shared funding from outside 

NIGMS resources. The Committee requests a summary of the outcome of the review and plan forward in the fiscal year 2017 budget 

request. The Committee expects the NIH Director to ensure all 

Clinical Translations Science Research awardees actively solicit 

interaction with IDeA designated states. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT (NICHD)

Mission.—The NICHD conducts and supports basic, 

translational, and clinical research on the reproductive, developmental, and behavioral processes that determine and maintain— 

and rehabilitation that restores and improves—the health and 

well-being of children, adults, families and populations. The Committee expects the Institute to systematically coordinate through 

other HHS agencies to share new scientific information to ensure 

it reaches the community and providers through the various other 

HHS outreach programs. 

Capacity for Data Collection on Severe Maternal Morbidity.—The 

Committee understands there are no uniform definitions of severe 

maternal morbidity and that uniform definitions would help Federal, State and local agencies and research institutions establish 

standardized and interoperable processes for surveillance, data collection, and research. The Committee encourages NICHD to work 

with CDC to hold a multi-stakeholder consensus workshop to identify uniform definitions for severe maternal morbidity. 

Preterm Birth.—The Committee applauds NICHD’s work with 

leading global health organizations to develop a research agenda 

aimed at reducing preterm birth. Public and privately funded research that spans the range of discovery, development, and delivery 

science is needed in order to identify the causes of premature birth. 

The Committee urges NICHD to continue to invest in biomedical 

and clinical research related to the prevention of preterm birth and 

the care and treatment of preterm infants. 

NATIONAL EYE INSTITUTE (NEI)

Mission.—NEI conducts and supports basic and clinical research, 

research training, and other programs with respect to blinding eye 


rfrederick on DSK6VPTVN1PROD with HEARING
65 

diseases, visual disorders, and mechanisms of visual function, preservation of sight, and the special health problems and needs of individuals who are visually-impaired or blind. The Committee expects NEI to systematically coordinate closely with other HHS 

agencies to share new scientific information, specifically aimed at 

the prevention of blindness and increase awareness to the community and providers through various other HHS outreach programs. 

Accelerate Cures Related to Retina Disease.—The Committee directs NEI to create a challenge program to advance the speed of 

basic research to cure retina disease by creating a forum for the 

NEI Director to survey the field of basic retina research discoveries 

to provide rewards for research not otherwise funded through NEI 

or other NIH supported competitive awards. The Committee expects NEI to provide an update and timeline in the fiscal year 2017 

budget request to describe how the program will be advertised, 

funding allocated, and criteria to evaluate submissions for possible 

challenge rewards to further incentive non-NIH supported researchers to accelerate basic research through this mechanism. The 

Committee further expects NEI to distribute the findings of this 

program widely to the NEI research community to further promote 

the leveraging of federal and non-federally supported retina research. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)

Mission.—The mission of NIEHS is to prevent and reduce the 

burden of human illness and disability by understanding how the 

environment influences the development and progression of human 

disease. In addition, NIEHS is responsible for the research of the 

National Toxicology Program whose mission is to coordinate toxicity testing across the Federal government and to evaluate substances of public health concern. The Committee expects the Institute to systematically coordinate through other HHS agencies to 

share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

NATIONAL INSTITUTE ON AGING (NIA)

Mission.—NIA supports and conducts biomedical, social and behavioral research with respect to the aging process and the diseases and other special problems and needs of older Americans. 

The Committee expects the Institute to systematically coordinate 

through other HHS agencies to share new scientific information to 

ensure it reaches the community and providers through various 

other HHS outreach programs. 

Alzheimer’s Disease.—In 2012, the National Plan to Address Alzheimer’s Disease was released to address the major challenges presented by Alzheimer’s disease by 2025. Since then, although Alzheimer’s research has received annual increases for federally funded Alzheimer’s research, it is still funded less than the annual level 

needed to accomplish the goal of the national Alzheimer’s plan. The 

Committee accelerates funding for Alzheimer’s disease research to 

$886,000,000, an increase of $300,000,000 over fiscal year 2015 as 

an important next step to ensure success of this critical initiative 

to develop preventative treatments and cures. The Committee recognizes that initiatives of this nature must be adequately funded 

to assure achievement of the goals and plan milestones. The ComVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00065 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
66 

mittee expects NIH will ensure the fiscal year 2017 request provides the appropriate level of funding to keep on this path. Further, the Committee encourages the distribution of a reasonable 

portion of Alzheimer’s research support to meritorious IDeA program researchers. 

The Committee requests NIA to convene a working group of 

stakeholders, including patient advocacy organizations and nonprofit funders of Alzheimer’s and dementia research, within 180 

days of enactment of this act to develop possible frameworks and 

strategies for a direct public-private partnership to fund meritorious research proposals on Alzheimer’s Disease that are not supported directly by NIH. NIH shall provide a report annually in its 

fiscal year 2017 and out year budget requests identifying the total 

level of NIH peer-reviewed research supported by qualified thirdparty Alzheimer’s Disease researchers through such a partnership. 

Finally, the Committee notes continued support for Alzheimer’s 

Disease Research Centers. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES (NIAMS)

Mission.—NIAMS conducts and supports basic and clinical research and on the more than 100 forms of arthritis; osteoporosis 

and other bone diseases; muscle biology and muscle diseases; orthopedic disorders, such as back pain and sports injuries; and numerous skin diseases. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

Lupus Research Plan.—The Committee commends NIAMS for 

leading the effort to review the current state of the science, evaluate progress on the existing lupus research plan and develop a new 

action plan for lupus research. The Committee applauds the broad 

solicitation of input across NIH and the greater research and advocacy community, and encourages special attention for efforts in this 

research area. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS (NIDCD)

Mission.—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, NIDCD is actively involved in health promotion and disease prevention, and supports efforts to create devices that substitute for lost and impaired sensory and communication functions. 

The Committee expects the Institute to systematically coordinate 

through other HHS agencies to share new scientific information to 

ensure it reaches the community and providers through the various 

other HHS outreach programs. 


rfrederick on DSK6VPTVN1PROD with HEARING
67 

NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)

Mission.—NINR supports and conducts scientific research and 

research training to reduce the burden of illness and disability; improve health-related quality of life; enhance end-of-life and palliative care; and establish better approaches to promote health and 

prevent disease. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)

Mission.—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 between genetic and 

environmental factors involved in alcoholism; the mechanisms 

whereby alcohol produces its disabling effects, including organ 

damage; how to prevent alcohol abuse and associated damage, especially in the underage population; and how alcoholism treatment 

can be improved. NIAAA addresses these questions through a program of biomedical, behavioral, and epidemiologic research on alcoholism, alcohol abuse, and related problems. The Committee expects the Institute to systematically coordinate through other HHS 

agencies to share new scientific information to ensure it reaches 

the community and providers through the various other HHS outreach programs. 

Fetal Alcohol Syndrome (FAS) Research.—The Committee was 

pleased that NIAAA’s budget request proposed increases in research on how alcohol interferes with human development and the 

various underlying aspects of alcohol-induced fetal damage. The 

Committee encourages NIH to consider the benefits and methods 

to support a clearinghouse and improved coordination with federal 

and private sector partners to best facilitate the translation of 

science into public health promotion strategies and interventions 

benefiting individuals living with FAS. 

NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

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 Committee expects the Institute to systematically coordinate through other HHS 

agencies to share new scientific information to ensure it reaches 

the community and providers through various other HHS outreach 

programs. 

Adolescent Behavioral and Cognitive Development (ABCD).—The 

Committee applauds the Collaborative Research on Addictions at 

NIH initiative and the launch of the ABCD study. Unique in its 

scope and duration, the study will recruit 10,000 youth before they 

begin using alcohol, marijuana, nicotine and other drugs, and follow them over 10 years into early adulthood to assess how substance use affects the trajectory of the developing brain. The Committee commends the study design which will use advanced brain 


rfrederick on DSK6VPTVN1PROD with HEARING
68 

imaging as well as psychological and behavioral research tools to 

evaluate brain structure and function and track substance use, academic achievement, IQ, cognitive skills, and mental health over 

time. 

Medications Development.—The Committee understands NIDA is 

considering new technologies for the development of next-generation pharmaceuticals. For example, NIDA is exploring approaches 

to develop viable immunotherapeutic or biologic (e.g., bioengineered 

enzymes) approaches for treating addiction. The Committee looks 

forward to hearing more about work in this area in the fiscal year 

2017 budget request. 

NIDAMED.—The Committee encourages its support for 

NIDAMED, an initiative designed to reach out to physicians, physicians in training, and other health care professionals to increase 

especially those treating our youth to better recognize the signs 

that lead to drug abuse and addiction. 

Opioid Drug Abuse.—The Committee remains concerned about 

prescription drug abuse, specifically the misuse of orally administered opioid drugs. According to some reports, more than 35 million 

Americans have abused prescription opioids at some point in their 

lifetimes. The June 2011 Institute of Medicine report on relieving 

pain indicates that such abuse and misuse resulted in an annual 

estimated cost to the Nation of $72.5 billion. The Committee expects NIDA to continue to support meritorious scientific activities 

related to research on medications to alleviate pain with reduced 

abuse liability and, as appropriate, to work with private partners 

on innovative research into such medications. In addition, NIDA 

should continue to fund research to better prevent and treat prescription drug abuse and to coordinate with CDC to help identify 

scientific research gaps. The Committee requests an update in the 

fiscal year 2017 budget request on the activities related to addressing the opioid drug abuse problem. 

NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)

Mission.—NIMH is responsible for basic and clinical research 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, which include childhood mental disorders such as autism and attention-deficit/hyperactivity disorder; eating disorders; and other illnesses. 

NIMH supports and conducts fundamental research in neuroscience, genetics, and behavioral science. In addition to laboratory 

and controlled clinical studies, NIMH supports research on the 

mental health needs of special populations and health services research. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers through 

various other HHS outreach programs. 

Community Based Participatory Research (CBPR).—The Committee is aware that CBPR is an applied collaborative approach 

that enables community residents to more actively participate in 

the full spectrum of research. The Committee requests NIMHD to 

provide an update in the fiscal year 2017 budget request on any 


rfrederick on DSK6VPTVN1PROD with HEARING
69 

CBPR activities its supports and the most appropriate role for 

CBPR within the NIMH portfolio. 

Early Detection and Prevention of Psychosis.—The Committee applauds NIMH’s early detection and intervention efforts involving 

psychosis in young people and encourages NIMH to coordinate with 

other ICs to expand these efforts. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)

Mission.—NHGRI provides leadership for the development of resources and technology to accelerate genome research and its application to human health. NHGRI-supported activities include basic 

and translational research to understand the sequence and function of both human and non-human genomes, human genetic variation, and the genetic and environmental basis of disease. Also central to NHGRI research goals are training programs and a strong 

focus on the ethical, legal, and social implications of genomic 

science and medicine. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new 

scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

(NIBIB)

Mission.—The NIBIB mission is to improve human health by 

leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the 

engineering and physical sciences with the life sciences to advance 

basic research and medical care. The Committee expects the Institute to systematically coordinate through other HHS agencies to 

share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

(NIMHD)

Mission.—NIMHD conducts and supports research, training, 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. The Committee expects the Institute to systematically coordinate through other HHS agencies to 

share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs. 

Research Centers in Minority Institutions (RCMIs).—The Committee continues to support RCMIs and expects the RCMIs to receive no less than $55,319,000, which is the fiscal year 2015 level 

plus the general increase provided to NIMHD. 

NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

(NCCIH)

Mission.—NCCIH 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 integrative health (CIH) practices and to train individuals to 


rfrederick on DSK6VPTVN1PROD with HEARING
70 

apply the tools of exacting science to CIH systems and modalities 

in order to provide health care professionals and the American public with reliable information about these practices. The Committee 

expects the Center to systematically coordinate through other HHS 

agencies to share new scientific information to ensure it reaches 

the community and providers through various other HHS outreach 

programs. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)

Mission.—NCATS was established to advance translational 

sciences, coordinating and developing resources that leverage basic 

research in support of translational science and developing partnerships and working cooperatively to foster synergy in ways that do 

not create duplication, redundancy, and competition with industry 

activities. NCATS also includes the Office of Rare Disease Research 

(ORD) that 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 within the authorized mission of NCATS 

to provide an increase focus on 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 expects the NCATS to systematically 

coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers 

through the various other HHS outreach programs. 

Bridging Interventional Development Gaps BrIDGs Program.— The Committee understands the BrIDGs program has supported 

new drug interventions and encourages NCATS to look for opportunities to encourage additional success. 

Clinical and Translational Science Awards (CTSA).—The Committee is pleased that NCATS is implementing recommendations 

from the recent IOM report on the CTSA program. NCATS is encouraged to continue to work closely with the CTSA community 

and related stakeholders moving forward to continue to identify 

emerging opportunities and areas for programmatic improvement. 

Therapeutics for Rare and Neglected Diseases (TRND) Program.—The Committee encourages NCATS to focus on additional 

neglected diseases through the TRND program. The Committee expects NCATS’ contributions to neglected disease research be included in the joint CDC, FDA and NIH global health strategy describing coordination and prioritization of global health research 

activities within the three agencies. 

JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)

Mission.—FIC was established to improve the health of the people of the United States and other nations through international 

collaborations in the biomedical sciences. In support of this mission, the FIC pursues the following four goals: (1) mobilize international research efforts against global health threats; (2) advance 

science through international cooperation; (3) develop human resources to meet global research challenges; and (4) provide leadership in international science policy and research strategies. The 

Committee urges FIC to coordinate systematically and closely with 

other HHS agencies on any efforts to disseminate research results 


rfrederick on DSK6VPTVN1PROD with HEARING
71 

in a manner that uses the various existing HHS outreach programs. 

NATIONAL LIBRARY OF MEDICINE (NLM)

Mission.—The NLM collects and organizes information important 

to biomedicine; serves as a national information resource for medical education, research, and health service activities; enhances access to biomedical literature through electronic services; serves the 

public by providing electronic access to reliable health information 

for consumers; supports and directs the national network of libraries of medicine; provides grants for research in biomedical communications, medical library development, and training health information specialists; conducts and supports research in biomedical 

informatics and computational biology; and creates information resources for genomics, molecular biology, toxicology, medical images, 

environmental health, emergency preparedness and response, and 

health services research. The Committee expects the Institute to 

systematically coordinate through other HHS agencies to share 

new scientific information to ensure it reaches the community and 

providers through various other HHS outreach programs. 

OFFICE OF THE DIRECTOR (OD)

Mission.—The OD provides leadership to the NIH research enterprise and coordinates and directs initiatives that cross-cut NIH. 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 the operations of NIH. The Committee expects OD to establish a systematic process with the ICs 

and HHS agencies to coordinate the dissemination of research results in a manner that uses existing HHS outreach programs and 

prevents duplication from NIH organizations to allow better focus 

of NIH IC funds to support research efforts. 

The Committee expects the NIH Director to ensure all ICs continue to support the pathways to independence program, which 

provides new investigators with mentored grants that convert into 

independent research project grants. In addition, the Committee 

continues to support an increase in new innovator awards, director’s pioneer awards, and the transformative R01 program through 

the Common Fund. 

The Committee has provided bill language for specific funds authorized by the recently enacted Gabriella Miller Kids First Research Act within the Common Fund to support the second year of 

the 10-year Pediatric Research Initiative. Further, to ensure enhanced support for pediatric research, the Committee urges the 

NIH Director to use a portion of the $10,000,000 made available to 

the Director’s Discretionary Fund (DDF) to support additional pediatric research, such the development of cutting edge bioinformatics 

programs for pediatric cancers; tools, methods, and other regulatory science to directly support the data that accelerate drug approval for pediatric patients; or projects that integrate cutting-edge 

technology like bio-microelectromechanical systems (MEMS), biomaterials or portable advanced imaging technologies related to pediatric diseases. The Committee requests, within 30 days after the 


rfrederick on DSK6VPTVN1PROD with HEARING
72 

end of each quarter, a quarterly report on DDF obligations for each 

activity supported. The report should include a description of the 

program, the ICs that will provide the continuation costs and how 

this research serves a high priority. Further, the quarterly reports 

shall be posted on-line via the NIH web-site within 30 days after 

being released to the Committee. 

The Committee expects NIH to continue the longstanding policy 

for Common Fund projects to be short-term, high-impact awards, 

with no projects receiving funding for more than 10 years. The 

Committee appreciates NIH’s efforts to support only bio-medical research within the Common Fund. 

Capstone Awards.—The Committee expects NIH to pursue the 

establishment of new grants, called Capstone Awards. Capstone 

Awards could be made to promote partnership between a senior 

and junior investigator, to provide opportunities for acquiring skills 

needed for transitioning to a new role, or other reasons as determined by the NIH Director in consultation with the IC Directors, 

patient advocacy groups, and industry leaders. The NIH is expected 

to develop a duration and amount for each Capstone Award by the 

NIH Director in consultation with the IC Directors, researchers, 

patient advocacy groups, and industry leaders. 

Grant Review.—The Committee encourages NIH to establish policies for the Director of each IC to review and approve every grant 

awarded by his or her IC. The Committee requests an update in 

the fiscal year 2017 budget request on this endeavor. 

New Innovative Awards.—The Committee encourages NIH to 

continue to support new grant models similar to the Maximizing 

Investigators Research Award (MIRA) program at NIGMS that 

would provide a single award in support of all of the projects in an 

investigator’s lab. The Committee encourages the NIH Director to 

facilitate similar programs in all ICs. 

Marijuana Research.—The Committee is concerned that as more 

states in the nation choose to enact laws that allow access to and 

use of marijuana for medical purposes the fact remains that there 

is no significant body of medical and scientific research validated 

by NIH or NIDA on the actual medical efficacy of marijuana. Consequently, despite anecdotal evidence to the contrary, it is entirely 

possible that Americans may be putting their health at risk when 

using marijuana for medicinal purposes. The Committee believes it 

is time to settle the matter of whether or not marijuana has medical benefits that can be validated and documented by scientific research. The Committee directs the NIH to report back to the Committee within 120 days after enactment with a plan by which the 

NIH could engage the appropriate institutes, including NIDA but 

not only NIDA, but other agencies the Director determines are appropriate (e.g., FDA) to construct long- and short-term studies on 

the potential benefits and detriments of the use of marijuana for 

medical purposes. The marijuana to be used in the studies shall be 

supplied by NIDA for control purposes. 

Quarterly Updates of NIH Operating Plans.—The Committee continues the understanding that the IC mechanism tables serve as 

the NIH operating plans for available resources and requests NIH 

continue to provide quarterly updates of these plans to the Appropriations Committee of the House. 


rfrederick on DSK6VPTVN1PROD with HEARING
73 

Review of Maternal Deprivation Studies.—The Committee is 

aware that prominent experts and animal advocacy organizations 

have raised concerns about the scientific and ethical justifications 

for maternal deprivation studies involving baby monkeys being conducted in both intramural and extramural NIH funded laboratories. The Committee is further aware that the NIH Office of Laboratory Animal Welfare opened an investigation in response to 

these allegations on September 9, 2014. The investigations consulted with research investigators, the USDA, nonhuman primate 

center scientists, veterinarians, animal care staff and other relevant experts. As a result of the investigation, several modifications were made to the protocol and several procedures removed. 

Accordingly, the Committee requests NIH to conduct a review of its 

ethical policies and processes with respect to nonhuman primate 

research subjects, in consultation with outside experts, to ensure it 

has appropriate justification for animal research protocols and to 

provide an update on these efforts in the fiscal year 2017 budget 

request. 

Women’s Health Research.—The Committee appreciates NIH’s recent work to improve the gender balance in pre-clinical research 

and continues to encourage all future NIH-funded research to include both sexes unless there is a specific reason not to include 

them. The Committee requests an update on NIH’s new policy to 

require that both sexes be represented in preclinical research. That 

report should include an analysis of the impact on applications for 

funding in fiscal year 2015, the projected impact in 2016, and 

NIH’s plan to ensure the analysis of data by sex and other subgroup demographics as a part of grant progress reporting and the 

compliance of institute directors for funding studies on sex differences and conditions that predominantly impact women. 

Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI) 

The mission of DPCPSI is to coordinate and facilitate trans-NIH 

research initiatives and emerging areas of scientific opportunities 

and public health challenges. The Division houses these NIH offices: the Office of Research on Women’s Health; the Office of AIDS 

Research; the Office of Dietary Supplements; the Office of Behavioral and Social Sciences Research; the Office of Disease Prevention; and the Office Research Infrastructure Programs. The Committee directs the Director of DPCPSI to develop a trans-NIH strategic approach to improve coordination and facilitation of transNIH research with measurable objectives. The Director should also 

take specific steps with the ICs to strengthen to reduce duplication 

and increase effectiveness and efficiency of research. 

Common Fund.—The Committee is concerned that resources in 

the Common Fund are being moved away from the Pioneer, New 

Innovator, and the Transformative R01 awards. These high risk 

high impact awards have shown great success and the Committee 

expects NIH to use more of these types of awards throughout NIH, 

not less. 

Gabriella Miller Kids First Research Act.—The Committee includes funding within the Common Fund to support the Gabriella 

Miller Kids First Research Act, named after Gabriella Miller, who 

died in 2013 as a result of pediatric cancer. The Committee directs 


rfrederick on DSK6VPTVN1PROD with HEARING
74 

the NIH Director to use at least $12,600,000 of Common Fund resources in fiscal year 2016 to support pediatric research as authorized in the Gabriella Miller Kids First Research Act. The Committee encourages NIH to prioritize research relating to childhood 

cancer within the Kids First program and requests an update in 

the fiscal year 2017 budget request on the 10-year program, 

planned activities, and on-going research. 

Office of Research on Women’s Health 

The Office of Research on Women’s Health (ORWH) works in collaboration with the NIH ICs 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. ORWH is responsible for supporting 

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. ORWH 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 gender factors as a focus in biology. 

Office of AIDS Research 

The Office of AIDS Research (OAR) is authorized to manage 

trans-NIH AIDS research. The Director of OAR and the Director of 

NIH jointly determine the total for AIDS research within the NIH 

appropriation based on scientific need and meritorious scientific opportunity relative to NIH’s overall plan. The Committee expects 

NIH to continue to track NIH AIDS funding. 

The bill continues language permitting OAR to use up to 

$8,000,000 for construction or renovation of facilities, as authorized 

in title XXIII of the Public Health Service Act. 

Office of Dietary Supplements 

The Office of Dietary Supplements (ODS) was established in recognition that dietary supplements can have an important impact 

on prevention and health maintenance. In collaboration with other 

NIH institutes and centers and other federal agencies, ODS works 

to strengthen knowledge about dietary supplements by supporting 

and coordinating scientific research in the field. 

Office of Behavioral and Social Sciences Research 

The Office of Behavioral and Social Sciences Research (OBSSR) 

provides leadership and direction for the development of a transNIH plan to increase the scope of and support for behavioral and 

social sciences research and in defining an overall strategy for the 

integration of these disciplines across NIH institutes and centers; 

develops initiatives to stimulate research in the behavioral and social sciences arena and to integrate a bio-behavioral 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. 


rfrederick on DSK6VPTVN1PROD with HEARING
75 

Office of Science Education 

The Office of Science Education (OSE) plans, develops, and coordinates a comprehensive science education program to strengthen 

and enhance efforts of the NIH to attract young people to biomedical and behavioral science careers and to improve science literacy in both adults and children. The Office develops curriculum 

supplements and other educational materials; maintains a website 

as a central source of information about NIH science education resources; establishes national model programs in public science education, and promotes science education reform as outlined in the 

National Science Education Standards and related guidelines. 

Office of Disease Prevention 

The Office of Disease Prevention (ODP) assesses, facilitates, and 

stimulates research into disease prevention and health promotion 

in collaboration with NIH and other public and private partners, 

and disseminates the results of this research to improve public 

health. ODP produces evidence-based consensus statements addressing controversial medical issues. The Committee expects ODP 

to disseminate consensus statements and disease prevention and 

health promotion information through appropriate HHS outreach 

programs. 

Office of Research Infrastructure Programs 

The Office of Research Infrastructure Programs (ORIP) provides 

support for research and a variety of research infrastructure needs, 

including animal models and facilities; research models, biological 

materials, and human biospecimens; training and career development for veterinarians engaged in research; the acquisition of 

state-of-the-art instrumentation through the Shared and High-End 

Instrumentation Programs; research resources grants to expand, 

re-model, renovate, or alter existing research facilities or to construct new research facilities; and coordinates science education activities. 

Multi-institute Research Issues 

Angelman Syndrome.—The Committee recognizes the promising 

scientific gains made in the pursuit of treatments for angelman 

syndrome. The Committee applauds the contributions of the 

angelman syndrome natural history study and the private partners 

working diligently to advance the growing body of angelman syndrome research towards practical treatments. Further research in 

this area holds great promise for both angelman syndrome and 

forms of autism also linked to misexpression of the UBE3A gene. 

The Committee encourages NIH to support angelman syndrome research and to consider meritorious research. The Committee encourages NIH to leverage Federal funds with public-private partnerships in the areas of angelman syndrome, autism, and UBE3A 

related disorders. 

Anhydramnios.—The Committee requests NIH conduct a state of 

the science on anhydramnios research and possible treatments and 

provide an update in the fiscal year 2017 budget request. 

Basic Biomedical Research.—The Committee urges the NIH Director to continue the traditional focus on basic biomedical research. The purpose of basic research is to discover the nature and 


rfrederick on DSK6VPTVN1PROD with HEARING
76 

mechanics of disease and identify potential therapeutic avenues 

likely to lead to the prevention and treatment of human disease. 

Without this early scientific investigation, future development of 

treatments and cures would be impossible. Basic biomedical research must remain a key component of both the intramural and 

extramural research portfolio at the NIH. The Committee also requests NIH take actions to ensure the percentage of funding in the 

extramural research program on basic research does not fall below 

55 percent of NIH resources. 

Children in NIH Research.—The inclusion of children in clinical 

research is essential to ensure that children benefit from important 

scientific advances. The Committee understands NIH has a formal 

policy mandating the inclusion of children in research relevant to 

child health, but it does not systematically track enrollment data 

to determine if children are actually being enrolled appropriately 

in clinical research. The Committee recognizes that without better 

data collection, the Committee is unable to fully exercise its oversight role and researchers are unable to determine whether children as a whole, or particular pediatric subpopulations, are underrepresented in federally funded biomedical research. The Committee directs NIH to collect data and report publicly on the actual 

numbers of children in the various pediatric age groups that are 

enrolled in its clinical studies. 

Coordination with CDC.—The Committee remains concerned regarding the duplication of efforts and overlapping of responsibilities 

and funding priorities between the NIH and CDC. The Committee 

encourages NIH and CDC to coordinate further on cross-cutting 

initiatives, ensuring that each funds programs within its respective 

core mission. The Committee requests an update in the fiscal year 

2017 budget request how each NIH program coordinates with the 

CDC Centers. 

Clinical Trial Participation.—The Committee encourages NIH to 

further the discussion with organizations that participated in the 

July 2014 NIH Clinical Trial Improvement Workshop as it explores 

methods to improve participation, enrollment, retention, in NIH 

supported clinical trials, especially among underrepresented populations. The Committee requests an update on the steps NIH has 

taken and planned in the fiscal year 2017 budget request. 

Conflict of Interest.—The Committee encourages NIH to review 

and clarify conflict of interest policies to ensure more effective and 

transparent industry/institutional research collaborations. 

Duchenne Muscular Dystrophy.—The Committee requests an update in the fiscal year 2017 budget request on NIH’s plans to implement the recent changes to the Muscular Dystrophy CARE Act 

and summary of the outcome from the latest Muscular Dystrophy 

Coordinating Committee and timeframe for the next two meetings. 

Enhanced NIH Reporting on Research Spending by Disease and 

Affected Populations.—The Committee reiterates its direction identified in the fiscal year 2015 Explanatory Statement for NIH to 

make public, on an annual basis, enhanced RCDC spending data 

with the number of Americans affected by each category of disease 

according to CDC or other federally-sourced data. Further, the 

Committee requests NIH to include the number of Americans living with each disease, annual number of newly diagnosed Americans for each disease, and number of Americans who die from each 


rfrederick on DSK6VPTVN1PROD with HEARING
77 

disease annually. The Committee appreciates that NIH may not 

have all available category data during fiscal year 2016 but expects 

NIH to upload all available data immediately and to have the full 

data set on-line no later than May 1, 2016. The Committee requests an update on the process in the fiscal year 2017 budget request. In addition, the Committee encourages NIH to add pediatric 

cardiomyopathy to the RCDC and spending on the disease for at 

least the last five year and projected forward. 

Fragile X Research.—The Committee commends NICHD for leading the effort to map the molecular, physiological, biological, and 

genetic connections between fragile X (FX), the fragile X protein, 

and autism. The fragile X gene and its protein continue to present 

important insight into discovering the root cause of autism and disease modifying treatments for FX and autism. The Committee encourages NIH to explore ways to utilize FX and autism research in 

tandem to accelerate the pace of research toward identification of 

the commonality between the two conditions and the development 

of disease modifying treatments that will reduce health burdens. 

Hepatitis B.—The Committee encourages NIAID and NIDDK to 

continue their long-standing commitment to advancing the scientific knowledge on hepatitis B and chronic hepatitis B. The Committee urges aggressive discovery to find ways to prevent and develop new therapies for hepatitis B that have the potential to be 

a cure. The Committee requests the NIH Director to consider establishing a hepatitis B specific Integrated Review Group (IRG) to 

review the grant applications associated with hepatitis B. The 

Committee also encourages development of an HBV Cure initiative, 

analogous to the HIV Cure initiative, to coordinate and accelerate 

the development of a cure for those afflicted with HBV. 

New Initiatives.—The Committee is concerned that every year 

new NIH initiatives are announced and that, although new initiatives start at the planned level, over time these projects are not 

supported in the budget requests at levels that will result in 

achievement of initial expectations. The Committee requests NIH 

to provide a table in the fiscal year 2017 and future budget requests with the current year plus five-year planned funding levels 

for each initiative started over the past five years or on-going and 

proposed in the current budget. The table should identify the 

planned budget level provided; a list of participating Institutes and 

Centers (ICs); the linkage to the NIH-wide strategic plan; and percentage of the funds focused on basic science, as a minimum for 

each initiative. 

Reproducibility of Scientific Methods.—The Committee notes that 

the gold standard of good science is the ability of a lab to reproduce 

a method and finding and is therefore continues to be concerned 

with reports that some published biomedical research cannot be 

easily reproduced. The Committee expects NIH to continue to 

stress the importance of experimental rigor and transparency of reporting of research findings in order to enhance the ability of others to replicate them. The Committee requests an update in the fiscal year 2017 budget request on how NIH is measuring the effectiveness of each step NIH has taken to develop and implement best 

practice guidelines to better facilitate the conduct of replicable research and research transparency in the reporting of methods and 

findings. 


rfrederick on DSK6VPTVN1PROD with HEARING
78 

Medication Assisted Treatment (MAT).—The Committee understands that NIDA supports 90 research projects totaling over $41 

million related to MAT that include how to incorporate MAT into 

models of integrated healthcare. The Committee requests an update in the fiscal year 2017 request on research supported across 

NIH related to MAT, with specific review of MAT in primary care 

settings. In addition, the Committee expects NIH to conduct a review to identify the scientific gaps related to MAT research. 

Minority Researchers.—The Committee continues to support the 

development of health professionals and scientists, including minorities, committed to researching and eliminating health disparities. 

Mitochondrial Disease.—The Committee continues to support the 

study of mitochondrial function and primary mitochondrial disease. 

The Committee understands NIH supported a two-day workshop in 

March 2012 on primary mitochondrial diseases, which led to the 

development of a white paper and a working group on 

mitochondrial disease research with broad participation from various ICs. The Committee requests an update on the steps NIH has 

taken, on-going, and planned to further each of the white paper 

recommendations in the fiscal year 2017 budget request. 

National Children’s Study Alternative.—The Committee was disappointed that NIH determined it was not feasible for NIH to implement the National Children’s Study (NCS) as originally conceived. The NCS was intended to be a 25 year longitudinal birth 

cohort observational study with the overall goal of improving child 

health and well-being and identifying antecedents of healthy adulthood by examining the effects of a broad range of environmental, 

behavioral, and biological factors. The Institute of Medicine’s (IOM) 

June 2014 report noted the NCS’ goals and mission had the potential to add to the scientific knowledge of children’s health and development. The Committee directs and provides funding for continuation of the NCS in an alternative form called the National 

Children’s Study Alternative (NCS–A). The NIH is directed to work 

in consultation with pediatric groups to develop a series of alternative research activities that build on NCS data and the overarching goals of the NCS to address the developmental origins of 

health and disease through a series of studies (including longitudinal) that incorporate expertise in biology and epidemiology, integrate basic science, and leverage maternal/infant cohorts, either de 

novo or from extant networks. NIH is expected to focus on at least 

prematurity, obesity, autism, asthma, and pediatric rare diseases 

like cancer. The Committee expects NIH to obtain data, biological 

samples, and specimens that can ultimately improve child health 

and well-being. The Committee understands that such a program 

can be built by leveraging existing cohort studies by expanding or 

adding study components; supporting projects with smaller cohorts 

that can investigate unique, disease-specific questions; expanding 

studies to increase sample size; and using or expanding pediatric 

networks and extant programs to include a focus on pediatric 

health. 

The Committee directs NIH to draw on the lessons learned from 

the NCS as it develops a long-term plan for the NCS–A, and to establish an advisory panel with outside pediatric experts. Within 

180 days of enactment, NIH is directed to submit and make public 


rfrederick on DSK6VPTVN1PROD with HEARING
79 

a NCS–A 10-year plan that includes milestones, goals, objectives, 

and projected funding estimates. The Committee urges NIH to review the plan at least every five years in a manner that obtains 

public input and that allows for flexibility to expand or adjust the 

focus areas based on the state of the science and the best impact 

on children’s health. In addition, NIH shall ensure it establishes 

and maintains a tracking system to ensure these funds do not supplant but supplement other children’s research on-going or planned 

by NIH. Finally, NIH shall report on the NCS–A in the annual 

budget request. 

Neurofibromatosis (NF).—The Committee continues to support 

NF research and treatment at multiple NIH ICs, including NCI, 

NINDS, NIDCD, NHLBI, NICHD and NEI. Children and adults 

with NF are at risk for the development of many forms of cancer. 

The Committee encourages NCI to continue its NF research portfolio in fundamental basic science, translational research and clinical trials focused on NF. The Committee appreciates NCI support 

to centers, clinical trials consortia, preclinical mouse models consortia and other NF-associated tumor sequencing efforts. The Committee encourages NIDCD activities in NF2 basic and clinical research. Further, the Committee notes NF1 can cause vision loss 

due to optic gliomas and encourages NEI to expand its investment 

in NF1 basic and clinical research. 

Pediatric Research Network.—The Committee notes the enactment of the National Pediatric Research Network Act that authorizes a collaborative and multi-institution pediatric research network to accelerate the pace of pediatric disease discovery. The 

Committee requests the NIH Director to provide an update in the 

fiscal year 2017 budget request on the specific steps on-going and 

planned towards the aims of the Act and describe how the network 

can participate in the alternative approach to support the goal of 

increasing biomedical knowledge on children’s diseases to accelerate cures, treatment, and prevention activities as anticipated in 

the National Children’s Study. 

Precision Medicine Initiative (PMI).—The Committee provides 

the requested funds to support the trans-NIH PMI within the Common Fund. The Committee expects to receive a comprehensive plan 

that outlines the way in which NIH plans to execute the PMI, initiative length and how data on human subjects will be protected. 

The NIH shall, as part of the planning for this project, examine 

similar activities being performed by industry, nonprofits, or academia to ensure federal funds are used to fill gaps and not duplicate effort. The PMI plan should consider and evaluate how publicprivate partnership opportunities can be leveraged. Further, the 

plan should include an examination of drug regulatory processes to 

ensure the FDA is positioned to support therapies that may result 

from private or public sector PMI research. 

The plan should also describe the practical application of genetic 

discoveries, including how to support the development of appropriate data analytic tools using genetic data and the consideration 

of pathways involved in chronic diseases. The Committee requests 

NIH to submit the plan within 90 days of enactment. Future funding requests for the PMI are expected to identify how much existing NIH personalized and precision medicine portfolio funds are 

being re-competed annually. The Committee notes that further proVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00079 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
80 

posed NIH initiatives and programs of this nature should be more 

fully developed prior to requesting funds and the funds should be 

specifically identified by IC. 

Prioritization of Funding.—The Committee expects NIH to 

prioritize federal funds for medical research on discovery over outreach and education. The Committee expects NIH to distribute 

funding based on the merit of researchers ideas and productivity, 

without applying discriminatory review requirements to extramural investigations, or creating barriers to funding for research 

institutes or team-based research. The Committee reiterates its desire for NIH to subject intramural resources to the same policies 

and review as extramural researchers. Further, NIH is expected to 

complete and actively use the NIH 5-year scientific strategic plan, 

directed in the fiscal year 2016 Appropriations Act, to prioritize 

funding. The Committee expects NIH to allocate resources through 

a meritoriously based competitive peer review process to best target resources to diseases with the significant opportunity to improve the current or future health of the American population. 

Protecting Human Subject Data.—The Committee reiterates its 

concerns related to the protection of privacy of individuals who are 

the subject of research. The fiscal year 2015 Appropriations Act included statement language directing NIH to include requirements 

related to privacy protections in every grant that involves human 

research, such as the issuance of certificates of confidentiality. The 

Committee provides bill language to require investigators receiving 

NIH funding for new and competing research projects designed to 

generate and analyze large volumes of data derived from human 

research participants to obtain a certificate of confidentiality. Further, the Committee is aware that NIH recognizes that privacy protections will be critical for the success of the PMI and other similar 

genomic research. The Committee requests that no later than 90 

days after enactment, NIH provide a report on specific steps NIH 

can and will take to further protect the privacy of human subjects 

and specific legislative actions that could further protect these individuals who may participate in future NIH supported research. 

Psychotropic Medications and Children.—The Committee encourages NICHD, NIMH, CDC and the FDA to undertake a concerted 

effort to identify the research gaps and work with these agencies 

to determine the safety and efficacy of these medications, and to 

explore research into the biological evidence-base of psychosocial 

interventions that can be used instead of, or in combination with, 

psychotropic medications. 

Translational Research.—The Committee understands NIH has 

undertaken an expansion of translational research and sciences 

over the past several years. The Committee requests an update on 

the specific results of these efforts, current activities, a plan for future activities, and the fiscal year 2013 through 2016 annual NIH 

expenditures on translational sciences in the fiscal year 2017 budget request. Further, the updates should provide the definition for 

Translational Research and how it applies the definition as it 

makes awards to various institutions. 

Undiagnosed Disease Program (UDP).—The Committee continues 

support for the Undiagnosed Disease Network (UDN) within the 

UDP. The Committee requests an update in the fiscal year 2017 

budget request on steps NIH has taken to develop public/private 


rfrederick on DSK6VPTVN1PROD with HEARING
81 

partnership for the UDN and how it can support physicians who 

are handling cases of undiagnosed diseases with new knowledge, 

consistent with applicable privacy laws, including HIPAA privacy 

and security law, through an ability to search for similar cases and 

to network and collaborate with physicians handling similar cases 

in order to accelerate the diagnosis, treatment options, and improve 

patient outcomes across the country. Further, the update should 

describe the criteria NIH uses to allow various level of access to the 

database based on the circumstances of the users’ requirements. 

Usher Syndrome.—The Committee continues to encourage support for research activities to prevent and correct the health related 

issues of Usher Syndrome. The Committee requests an update in 

the fiscal year 2017 budget request on the planned and on-going 

activities related to this syndrome. The update should address the 

funding level and manner in which the various ICs coordinate on 

common goals and objectives. 

Vitiligo.—The Committee is concerned that although vitiligo is 

not a terminal or debilitating disease, it nonetheless can have serious effects on the lives of those afflicted with this skin-discoloring 

condition. The Committee is further concerned that this may lead 

to other conditions that have not been thoroughly considered including the impact on behavior and mental health consequences. 

The Committee requests an update in the fiscal year 2017 budget 

request on the epidemiology of the disease including incidence, 

causal factors, any associations with racial populations and hereditary occurrence. The update should include planned and on-going 

medical research to move towards a cure. 

Young Investigators.—The Committee directs NIH to report on 

actions it has taken to lower the median age at which investigators 

receive their first R01 awards within 120 days of enactment. In addition, the NIH shall submit an accompanying plan outlining concrete steps to lower the median age at which individuals receive 

their first R01 award. The Committee urges NIH to convene a 

working group of stakeholders from academia, young researchers, 

industry leaders, and government officials to move forward on this 

goal. 

Updates.—In addition the specific interest items, the Committee 

requests general updates in the fiscal year 2017 budget request for 

each of the listed disease, condition, or topic to describe the latest 

efforts ongoing and planned: 

Administrative Burden Workgroup; 

Aging Demographic Research; 

Alcohol Dependence; 

Amyloidosis; 

Atrial Fibrillation; 

Behavioral Science Research in NIMH; 

Cerebral Palsy; 

Chronic Pelvic Pain; 

Congenital Heart Disease; 

Diabetes; 

Environmental Exposures; 

Global Infections Disease Health Research; 

Kennedy’s Disease; 

Kidney Disease; 

Interstitial Cystitis; 


rfrederick on DSK6VPTVN1PROD with HEARING
82 

Lymphangioleiomyomatosis; 

Microbicides to Prevent HIV/AIDS; 

Neglected Tropical Diseases; 

NCI Scientific Frameworks for pancreatic ductal adenocarcinoma; 

NCI Pancreatic Ductal Adenocarcinoma Progress Working Group; 

Nanovaccines; 

NIH Workforce Study; 

Preterm Birth; 

Preeclampsia; 

Pulmonary Atresia; 

Science, Technology, Education and Mathematics (to include specific actions related to Hispanic Serving Institutions, and other minority serving institutions); 

Sickle Cell Research; 

Sleep and Circadian Health; 

Scleroderma; 

Spina Bifida; 

Study Sections Pediatric Expertise; 

Stroke-Induced Respiratory Dysfunction; and 

Sturge-Weber Syndrome. 

BUILDINGS AND FACILITIES

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 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. 

The Committee notes NIH has a significant backlog of maintenance and repairs. The Committee encourages NIH and HHS to develop a coordinated plan to address the backlog with the Office of 

Management and Budget in the fiscal year 2017 congressional 

budget request. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

The Committee recommends $3,642,710,000 for the Substance 

Abuse and Mental Health Services Administration (SAMHSA), 

which is $22,998,000 more than the fiscal year 2015 enacted program level and $21,577,000 below the requested program level. 

The Committee includes bill language directing the Administrator of SAMHSA and the Secretary to exempt the Mental Health 

Block Grant and the Substance Abuse Prevention and Treatment 

Block Grant as a source for the PHS evaluation set-aside in fiscal 

year 2016. 

The Committee does not include the requested bill language allowing the Administrator to transfer three percent or less of funds 

between any of the SAMHSA accounts. 


rfrederick on DSK6VPTVN1PROD with HEARING
83 

MENTAL HEALTH

The Committee recommends $1,073,975,000 for Mental Health 

Services, which is $5,000,000 below the fiscal year 2015 enacted 

program level and $1,308,000 more than the requested program 

level. 

Within the total provided for Mental Health Programs of Regional and National Significance, the Committee recommends the 

following amounts: 

Budget Activity FY 2016 

Committee 

Capacity: 

Seclusion and Restraint ........................................................................................................................ $1,147,000 

Youth Violence Prevention ..................................................................................................................... 23,099,000 

National Child Traumatic Stress Initiative ........................................................................................... 45,887,000 

Project Aware State Grants ................................................................................................................... 39,902,000 

Mental Health First Aid ......................................................................................................................... 14,963,000 

Healthy Transitions ................................................................................................................................ 19,951,000 

Children and Family Programs ............................................................................................................. 6,458,000 

Consumer and Family Network Grants ................................................................................................. 4,954,000 

MH System Transformation & Health Reform ....................................................................................... 3,779,000 

Project LAUNCH ..................................................................................................................................... 34,555,000 

Primary and Behavioral Health Integration .......................................................................................... 43,000,000 

National Strategy for Suicide Prevention .............................................................................................. 2,000,000 

Suicide Lifeline ...................................................................................................................................... 7,198,000 

Garrett Lee Smith—Youth Suicide Prevention 

State Grants ................................................................................................................................. 47,427,000 

Campus Grants ............................................................................................................................ 6,488,000 

Homeless Prevention Programs ............................................................................................................. 28,696,000 

Minority AIDS ......................................................................................................................................... 8,224,000 

Alaskan-Indian/American Native Suicide Prevention ............................................................................ 2,931,000 

Tribal Behavioral Health Intervention Grants ....................................................................................... 15,000,000 

Criminal and Juvenile Justice Programs ............................................................................................... 4,269,000 

Science to Service:.

Garrett Lee Smith—Suicide Resource Center ...................................................................................... 6,681,000 

Consumer & Consumer Support TACenters .......................................................................................... 1,918,000 

Primary & Behavioral Health Care Integ. TA ........................................................................................ 1,991,000 

Minority Fellowship Program ................................................................................................................. 8,059,000 

Disaster Response. ................................................................................................................................ 1,953,000 

Homelessness ........................................................................................................................................ 2,296,000 

HIV/AIDS Education ............................................................................................................................... 771,000 

Childhood Trauma.— The Committee appreciates SAMSHA’s ongoing support of the National Child Traumatic Stress Network. A 

recent report, Childhood Adversity Narratives, makes clear that 

childhood trauma is an all-encompassing and costly national public 

health problem contributing directly to serious mental and medical 

conditions. The Committee encourages SAMSHA to more broadly 

disseminate information regarding evidence-based interventions for 

the prevention and treatment of childhood trauma so more children 

can benefit from proven practices. 

Mental Health First Aid.—The Committee directs SAMHSA to 

make competitive funding opportunities for this program available 

to all qualified community mental health education programs. Consistent with a broad public safety approach, SAMHSA is directed 

to include as eligible grantees local law enforcement agencies, fire 

departments, emergency medical services units and hospital systems. SAMHSA is encouraged to allow training for veterans, armed 

services personnel and their family members within the Mental 

Health First Aid program. 


rfrederick on DSK6VPTVN1PROD with HEARING
84 

Tribal Behavioral Health Grants.—The Committee is recommending an overall total of $32,931,000 to support the expansion 

of suicide prevention, overall mental health and substance abuse 

prevention activities for Native American youth. The Committee 

expects SAMHSA to ensure that the activities conducted under the 

American Indian and Alaskan Native Suicide Prevention program 

are effectively coordinated with the Tribal Behavioral Health 

Grants (TBHG). These two grant programs must work as an integrated whole to accomplish the goal of reducing suicides and drug 

abuse amongst Native American youth. Prior to the announcement 

of the TBHG grant opportunities, SAMHSA is directed to brief the 

Committee regarding the criteria for grant awards. Following the 

award of the grants, SAMHSA is directed to provide a briefing 

within 120 days to review the progress made and any unforeseen 

challenges that arise. 

Mental Health Block Grant 

The Committee recommends a total of $482,571,000 for the Mental Health Block Grant, which is the same as the fiscal year 2015 

enacted program level and the budget request. The block grant provides funds to States to support mental illness prevention, treatment, and rehabilitation services. Funds are allocated according to 

a statutory formula among the States that have submitted approved annual plans. 

The Committee continues the five percent set-aside within the 

Mental Health Block Grant for evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders. The Committee expects SAMHSA to 

continue its collaboration with the National Institute of Mental 

Health to encourage States to use this block grant funding to support programs that demonstrate strong evidence of effectiveness. 

Children’s Mental Health 

The Committee recommends $117,026,000 for the Children’s 

Mental Health Services program, which is the same as the fiscal 

year 2015 enacted level and the budget request. Funding for this 

program supports grants and technical assistance for communitybased services for children and adolescents up with serious emotional, behavioral, or mental disorders. The program assists States 

and local jurisdictions in developing integrated systems of community care. 

Projects for Assistance in Transition from Homelessness 

The Committee recommends $54,635,000 for the Projects for Assistance in Transition from Homelessness (PATH) program, which 

is $10,000,000 below the fiscal year 2015 enacted level and the 

budget request. The PATH program supports grants to States and 

territories to 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. 


rfrederick on DSK6VPTVN1PROD with HEARING
85 

Protection and Advocacy for Individuals with Mental Illness 

The Committee recommends $36,146,000 for the Protection and 

Advocacy program, which is the same as the fiscal year 2015 enacted level and the budget request. This program serves to ensure 

that the rights of mentally ill individuals are protected while they 

are patients in all public and private facilities or while they are living in the community. Funds are allocated to States according to 

a formula based on population and relative per capita incomes. 

SUBSTANCE ABUSE TREATMENT

The Committee recommends $2,196,856,000 for Substance Abuse 

Treatment programs, which is $12,998,000 more than the fiscal 

year 2015 enacted program level and $56,299,000 more than the 

requested program level. 

Within the total provided for Programs of Regional and National 

Significance, the Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Capacity: 

Opioid Treatment Programs/Reg Activities ........................................................................................... $8,724,000 

Screening, Brief Intervention, Referral, and Treatment (SBIRT) ................................................................... 46,889,000 

Targeted Capacity Expansion—General ........................................................................................................ 36,303,000 

Pregnant and Postpartum Women ................................................................................................................. 15,931,000 

Strengthening Treatment Access and Retention ........................................................................................... 1,000,000 

Recovery Community Services Program ......................................................................................................... 2,434,000 

Access to Recovery ......................................................................................................................................... 38,223,000 

Children and Families .................................................................................................................................... 29,605,000 

Treatment Systems for Homeless ................................................................................................................... 41,304,000 

Minority AIDS .................................................................................................................................................. 65,570,000 

Criminal Justice Activities .............................................................................................................................. 78,000,000 

Science to Service: 

Addiction Technology Transfer Grants .................................................................................................. 9,046,000 

Minority Fellowship Program ................................................................................................................. 2,539,000 

Special Initiatives/Outreach .................................................................................................................. 1,432,000 

Addiction Technology Transfer Centers (ATTCs).—The Committee once again rejects the Administration’s request to reduce 

funding for the ATTCs. SAMHSA is directed to ensure that ATTCs 

maintain a primary focus on addiction treatment and recovery 

services. 

Targeted Capacity Expansion.—The Committee recommends 

$36,303,000 for Targeted Capacity Expansion activities, which is 

$13,100,000 more than the fiscal year 2015 enacted level and the 

same as the budget request. Together with the $12,000,000 increase provided in the Consolidated and Further Continuing Appropriations Act of fiscal year 2015, this additional funding is provided 

to increase the number of States from 11 to 22 that are receiving 

funding to expand services that address prescription drug abuse 

and heroin use in high-risk communities. The Committee expects 

SAMHSA to provide a briefing within 45 days of enactment regarding how it intends to execute these activities and carry out the two 

mandates described below. 

The United States has seen a 500 percent increase in admissions 

to treatment for prescription drug abuse since 2000. Moreover, according to a recent study, 28 states saw an increase in admissions 

to treatment for heroin dependence during the past two years. The 

fiscal year 2015 Consolidated and Further Continuing AppropriaVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00085 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
86 

tions Act provided funding for Targeted Capacity Expansion specifically for prescription drug and heroin treatment. The Center for 

Substance Abuse Treatment is directed to include as an allowable 

use medication-assisted treatment and other clinically appropriate 

services to achieve and maintain abstinence from all opioids and 

heroin and prioritize treatment regimes that are less susceptible to 

diversion for illicit purposes. 

Since the passage of the Drug Addiction Treatment Act of 2000, 

SAMHSA has led the nation in educating physicians, patients and 

treatment systems on the use of medication-assisted treatment. To 

keep pace with advancements in science and research, SAMHSA is 

directed to update all of its public-facing information and treatment 

locators such that all evidence-based innovations in counseling, recovery support, and abstinence-based relapse prevention medication-assisted treatments are fully incorporated. 

Criminal Justice Activities.—The Committee provides 

$78,000,000 for the Criminal Justice Activities program and expects that no less than $60,000,000 will be used exclusively for 

Drug Court activities. 

Drug Treatment Courts.—The Committee continues to direct 

SAMHSA to ensure that all funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. SAMHSA is directed to ensure that all drug treatment court grant recipients 

work directly with the corresponding State substance abuse agency 

in the planning, implementation, and evaluation of the grant. The 

Committee further directs SAHMHSA to expand training and technical assistance to drug treatment court grant recipients to ensure 

evidence-based practices are fully implemented. 

Oral Fluid Drug Testing.—The Committee supports the development of oral fluid as an alternative specimen for drug testing and 

commends SAMHSA for the progress made to issue oral fluid 

guidelines for the Federal Workplace Drug Testing Programs. The 

Committee urges SAMHSA to publish the guidelines expeditiously 

and to implement the guidelines in partnership with stakeholders. 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends $1,819,856,000 in discretionary 

budget authority, which is the same as the fiscal year 2015 enacted 

program level and the requested program level. The Substance 

Abuse Prevention and Treatment (SAPT) Block Grant provides 

funds to States to support alcohol and drug abuse prevention, 

treatment, and rehabilitation services. 

SUBSTANCE ABUSE PREVENTION

The Committee recommends $190,219,000 for the Substance 

Abuse Prevention programs, which is $15,000,000 more than the 

fiscal year 2015 enacted level and $20,699,000 below the budget request. 

Within the total provided for Programs of Regional and National 

Significance, the Committee recommends the following amounts: 


rfrederick on DSK6VPTVN1PROD with HEARING
87 

Budget Activity FY 2016 

Committee 

Capacity: 

Strategic Prevention Framework ............................................................................................................ $109,484,000 

Minority AIDS ......................................................................................................................................... 41,205,000 

Mandatory Drug Testing ........................................................................................................................ 4,894,000 

Sober Truth on Preventing (STOP) Underage Drinking ......................................................................... 7,000,000 

Tribal Behavioral Health ....................................................................................................................... 15,000,000 

Science to Service: 

Fetal Alcohol Spectrum Disorder ........................................................................................................... 1,000,000 

Center for the Application of Prevention Technologies ........................................................................ 7,493,000 

Science & Service Program Coordination ............................................................................................. 4,072,000 

Minority Fellowship Program ................................................................................................................. 71,000 

HEALTH SURVEILLANCE AND SUPPORT

The Committee recommends $181,660,000 for Health Surveillance and Support, which is the same as the fiscal year 2015 enacted program level and $53,485,000 below the requested program 

level. 

Within the total provided for Health Surveillance and Support, 

the Committee recommends the following amounts: 

Budget Activity FY 2016 

Committee 

Health Surveillance ........................................................................................................................................ $47,258,000 

Program Management .................................................................................................................................... 72,002,000 

Behavioral Health Workforce .......................................................................................................................... 35,000,000 

Public Awareness and Support ...................................................................................................................... 13,482,000 

Performance & Quality Info. Systems ............................................................................................................ 12,918,000 

Behavioral Health Workforce Data ................................................................................................................. 1,000,000 

Mental and Behavioral Health Education and Training Program.—Within the amount available for Health Surveillance Support, the Committee recommends $35,000,000 for the joint 

SAMHSA HRSA Mental and Behavioral Health Education and 

Training Grant Program. Eligible entities for this program shall include accredited programs that train Master’s level social workers, 

psychologists, counselors, marriage and family therapists, psychology doctoral interns, as well as behavioral health paraprofessionals. The Committee directs SAMHSA to share information concerning pending grant opportunity announcements with State licensing organizations and all the relevant professional associations. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

The Committee recommends $243,545,410,000 for the Federal 

share of current law State Medicaid costs, which is $8,936,494,000 

more than fiscal year 2015 enacted level and the same as the budget request. This amount does not include $113,272,140,000, which 

was advance funded for the first quarter of fiscal year 2016. In addition, the Committee recommends an advance appropriation of 

$115,582,502,000 for program costs in the first quarter of fiscal 

year 2016. The Committee continues indefinite budget authority 

bill language for unanticipated costs in fiscal year 2016. 

Federal Medicaid grants reimburse States for a portion of their 

expenditures in providing health care for individuals whose income 

and resources fall below specified levels. Subject to certain minVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00087 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
88 

imum requirements, states are provided certain limited authority 

within the law to set eligibility, coverage, and payment levels. 

PAYMENTS TO THE HEALTH CARE TRUST FUNDS

The Committee recommends $283,171,800,000 for the Payments 

to the Health Care Trust Funds account, which supports Medicare 

Part B and prescription drug benefits in fiscal year 2016. This 

amount is $23,959,800,000 more than the fiscal year 2015 enacted 

level and equal to the budget request. This entitlement account includes the general fund subsidy to the Federal Supplementary 

Medical Insurance Trust Fund for Medicare Part B benefits, and 

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 Committee continues bill language providing indefinite authority to pay the general revenue portion of the Medicare Part B premium match and 

providing resources for the Medicare Part D drug benefit program 

in the event that the annual appropriation is insufficient. 

PROGRAM MANAGEMENT

The Committee makes available $3,325,690,000 in trust funds for 

Federal Administration of the Medicare and Medicaid programs, 

which is $344,054,000 less than the fiscal year 2015 enacted level 

and $919,496,000 less than the budget request. This activity supports the two largest Federal health care programs, Medicare and 

Medicaid, along with the Children’s Health Insurance Program 

(CHIP) and the Medicare prescription drug program. The Committee does not support the consumer information and insurance 

oversight functions. The Committee provides resources in the program operations line to support the Medicare current beneficiary 

survey. The bill includes language to prohibit funding the research, 

demonstration, and evaluation line within Program Management 

account. 

Program Operations 

The Committee recommends $2,195,823,000 for Program Operations to support activities used to administer the Medicare program, primarily to pay contractors to process providers’ claims, to 

fund beneficiary outreach and education, to maintain information 

technology (IT) infrastructure needed to support various claims 

processing systems and to continue programmatic improvements. 

Access to Home Health Care.—The Committee is aware that the 

current requirement that home health plans be solely certified by 

a physician has resulted in problems with access to home health 

care. The Committee urges CMS to insure access to home health 

care by considering methods to waive the requirement that home 

health plans be solely certified by a physician. 

Alzheimer’s.—The Committee is concerned the CMS guidelines 

limit access to Positron Emission Tomography (PET) scans for diagnosing Alzheimer’s disease. The Committee strongly urges CMS to 

review its reimbursement guidance, based on current scientific information on the value of PET testing for diagnosis of Alzheimer’s. 

Colorectal Cancer Screening.—The Committee understands that 

regardless of the fact that colorectal cancer screening by 


rfrederick on DSK6VPTVN1PROD with HEARING
89 

colonoscopy has an A grade from the U.S. Preventive Services Task 

Force, CMS has determined that it does not have authority to 

waive Medicare beneficiary coinsurance for a colorectal cancer 

screening colonoscopy when a polyp or other tissue is removed during the preventive screening. The Committee requests an update in 

the fiscal year 2017 budget request outlining the rationale for this 

determination, to include why CMS believes it does not the waiver 

authority. Further, the Committee requests the update describe 

CMS’s rationale related to the coverage of virtual colonoscopy. 

Coding System.—The Committee is concerned that implementation of the ICD 10 coding system will place a hardship on physicians and in particular those in small practices. The Committee 

urges the Secretary to work with medical providers to establish a 

hardship exemption for those practices that would be harmed by 

the change. 

CMS Test Environment for Testing Industry Solutions.—The 

Committee requests an update in the fiscal year 2017 budget request on how it is using this initiative to test IT solutions. 

Durable Medical Equipment, Prosthetics, Orthotics and Suppliers 

(DMEPOS).—The Committee is aware of concerns related to the 

potential negative impact on rural beneficiary access and rural providers from the Home Respiratory Therapy Rule. The Committee 

requests CMS to provide its detailed analysis and assumptions related to this rule’s impact on rural provides and rural beneficiary 

access within 180 days after enactment. Further, the Committee 

urges CMS to delay the rule and to work with the community to 

address its concerns before any further action. 

Disproportionate Share Hospital (DSH).—The Committee is concerned with the lack of an appeals process for hospitals on Medicare payment determinations to correct errors with DSH payments 

for uncompensated care. The Committee requests CMS to provide 

an update in the fiscal year 2017 budget request on the judicial 

and administrative review processes available for hospitals to address payment error related to DSH payments. 

The Committee also is concerned that the Secretary has not addressed the financial impacts of CMS’s one-year policy change in 

2014 regarding hospital mergers where the new owner accepts assignment of the provider agreement. The Committee requests a report within 90 days on how this issue is being resolved. 

Long-Term Care Hospitals (LTCHs).—The Committee is concerned about recent actions taken by CMS forcing approximately 

30 grandfathered LTCHs to abide by costly and inefficient rules, 

thereby preventing these hospitals from achieving the CMS goal of 

integrating the delivery of care between hospitals. This is contrary 

to the intent of the Balanced Budget Act of 1997 that clearly 

grandfathered existing co-located LTCHs to be exempt from the 

hospital within hospital regulations of 1995. The Committee requests CMS to provide justification in the fiscal year 2017 budget 

request describing why these grandfathered hospitals are held to 

regulations inconsistent with the intent of the original legislation. 

Health Insurance Exchange Transparency.—The Committee continues to include bill language in section 223 that requires CMS to 

provide cost information for the following categories: Federal Payroll and Other Administrative Costs; Exchange related Information 

Technology [IT]; Non IT Program Costs, including Health Plan 


rfrederick on DSK6VPTVN1PROD with HEARING
90 

Benefit and Rate Review, Exchange Oversight, Payment and Financial Management, Eligibility and Enrollment; Consumer Information and Outreach, including the Call Center, Navigator Grants 

and Consumer Education and Outreach; Exchange Quality Review; 

Small Business Health Options Program [SHOP] and Employer Activities; and Other Exchange Activities. Cost Information should be 

provided for each fiscal year since the enactment of the Patient 

Protection and Affordable Care Act (Public Law 111–148). CMS is 

also required to include the estimated costs for fiscal year 2017. 

Medicaid 1115 Waivers.—The Committee is concerned that CMS 

has not acted in a timely manner to approve a number of state applications for Medicaid 1115 waivers. The Committee requests 

CMS to report on the status of all pending Medicaid section 1115 

waivers in the fiscal year 2017 budget request. 

Fraud, Waste, and Abuse.—The Committee requests a update in 

the fiscal year 2017 request on the CMS process, across all operations, to ensure CMS maintains a focus on preventing improper 

payments and paying claims right the first time. The Committee 

requests the update include the metric to measure prevention in 

lieu of the ‘‘pay and chase’’ typical measures reported by CMS. 

Medicare Star Quality Rating System’s (Stars).—The Committee 

understands that the CMS is near finalizing the Advance Notice of 

Methodological Changes for Calendar Year (CY) 2016 for Medicare 

Advantage (MA) Capitation Rates, Part C and Part D Payment 

Policies. The CMS 2016 Call Letter proposes to adjust the methodology for accounting for low-income individuals who represent a 

significant portion of plan membership. The Committee encourages 

CMS not to remove plans from markets until they identify a methodology that appropriately judges all plans. Further, concerns are 

noted that the new methodology may harm plans that have made 

significant investments in assisting those with high levels of chronic conditions. The Committee urges CMS to address these concerns 

in the final Call Letter. 

Medicare Secondary Payer (MSP) Claims.—The Committee notes 

concern that CMS erroneously refers disputed MSP claims to the 

Treasury Department to seek repayment of secondary payer funds 

from small and large businesses and insurers for health care payments subject to a secondary source of payment. In some cases the 

responsibility for or amount of payment is disputed. Rather than 

permit entities with disputed claims due process and an opportunity to resolve their differences with the Agency, CMS regularly 

refers the debts to the Treasury for collection as ‘‘final claims.’’ The 

Committee requests CMS to provide an update in the fiscal year 

2017 budget request on the process CMS uses prior to submitting 

such claims and alternative steps that could be used to prevent erroneous referrals to the Treasury. 

Medicare Survey and Certification.—The Committee is concerned 

by the number of preventable medication errors in hospitals. The 

Committee encourages CMS to review its guidelines and standards 

to support the reduction of human error in the medication administration process. 

Mental Health Crisis Stabilization Code.—The Committee requests CMS to provide an update in the fiscal year 2017 budget request on the CPT codes for Crisis Stabilization to support. Further 

the update should describe how the CPT codes can be used to supVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00090 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
91 

port Psychiatric Emergency Department facilities, to include training. 

Ophthalmology Services.—The Committee requests an update in 

the fiscal year 2017 budget request on how CMS ensures Federallydesignated medically underserved areas have access to sufficient 

ophthalmology services necessary to ensure that at risk individuals 

not suffer preventable vision loss and blindness. 

Psychotropic Drugs and Children.—The Committee is aware of 

the Department’s efforts to reduce the inappropriate use of psychotropic medications with children and adolescents in foster care. In 

addition to the potential for serious long-term health and developmental problems for children, this alarming pattern has dramatically increased Medicaid costs. CMS is urged to examine research 

into reasons for this disparity, including whether current reimbursement policy incentivizes reliance on medication rather than 

evidence-based psychosocial therapies instead of, or in combination 

with, psychotropic medications. 

Recovery Audit Contractors (RACs).—The Committee is concerned that the unintended consequences of RAC audits conducted 

by the CMS contractors continue to reduce patient access to care 

and are jeopardizing the economic viability of upstanding small 

businesses and critical health care providers. The fiscal year 2015 

Appropriations Act included language directing HHS to develop a 

strategy and take steps to improve consistency, transparency, and 

processing of the appeals. It is imperative that a reasonable balance be found that allows CMS to eliminate true fraud and abuse 

while not slowing payment to providers so significantly that they 

cannot function. The Committee includes bill language to redirect 

all offsetting collections derived from the RACs be used to educate 

health care providers on how to reduce errors and on the program 

integrity and compliance audits; for the Office of Medicare Hearings and Appeals (OMHA) to reduce its backlog; and to establish 

a process to provide feedback from the OMHA to CMS to reduce 

the claims overturn rate from claims elevated to the OMHA. The 

Committee notes concern over the use of contingency fee based payment for entities that contract with State Medicaid programs to 

conduct RAC audits; specifically, in cases where extrapolation audits are conducted. The audits should be done in a manner that is 

valid and statistically sound. The Committee requests CMS continue to monitor the return on investment for compensating auditors on a contingency fee basis, review contractor audit practices, 

and provide the Committee with its findings in the fiscal year 2017 

budget request. The Committee looks forward to the forthcoming 

plan and expects the fiscal year 2017 budget request include an update to the plan’s goals, timeline, and measurable annual milestones to address concerns with the RACs and significantly reduce 

the appeal wait times in a manner that does not propose to charge 

the providers for appealing. Finally, the Committee reiterates its 

request for CMS to publish in the fiscal year 2017 budget request, 

and future years, a CMS actuarial report that estimates the dollar 

level of improper payments by year and the actual and estimated 

recovery of each year’s improper payments, and the percentage of 

each year’s recovered level compared to the estimate of improper 

payments. 


rfrederick on DSK6VPTVN1PROD with HEARING
92 

Risk Corridor.—The Committee continues the fiscal year 2015 

bill language to prevent the CMS Program Management appropriation account from being used to support risk corridors payments. 

Robotic Stereotactic Radiosurgery.—The Committee was encouraged by the CMS decision in the fiscal year 2015 Medicare Physician Fee Schedule Final Rule (79 Fed. Reg. 67548) to maintain G 

codes and contractor pricing for robotic stereotactic radiosurgery 

procedures performed in a freestanding setting. The Committee 

urges CMS to maintain the current coding and payment methodology for at least three years to provide stability while determining 

the most appropriate policy for this important treatment option. 

Treatment Resistance Depression (TRD).—The Committee encourages CMS to review available meritorious peer reviewed literature 

to determine if additional therapies exist for safe and effective 

treatment of TRD that could be considered for CMS coverage determinations. 

Two Midnights Rule.—The Committee is concerned with the potential negative impact to Medicare beneficiaries if CMS continues 

to move forward with its proposed ‘‘Two Midnights’’ rule that was 

introduced and implemented through the fiscal year 2014 Inpatient 

Prospective Payment System regulation. The Committee requests 

the Secretary to review the negative consequences of the Two Midnights rule and work with impacted stakeholders on alternative options. 

Prescription Drug Report.—The Committee directs the Secretary 

of Health and Human Services, in consultation with the Secretary 

of the Veterans Administration, to submit a report to the Committee on Appropriations of the House of Representatives not later 

than 120 days after the date of the enactment of the Bill to which 

this Committee Report pertains regarding price changes of prescription drugs since 2003. The report should include prescription 

drug prices (net of rebates) paid by Federal programs for the 10 

most frequently prescribed drugs and the 10 highest-cost drugs 

under the following: 

(1) The Medicare program under part B of title XVIII of the Social Security Act. 

(2) The Medicare prescription drug program under part D of title 

XVIII of the Social Security Act. 

(3) The Medicaid program under title XIX of the Social Security 

Act. 

(4) The Veterans Administration. 

(5) In countries bordering the United States and, as available, 

other nations. 

In addition, the report should include total annual costs to the 

Medicare program under part B of title XVIII of the Social Security 

Act, the Medicare prescription drug program under part D of title 

XVIII of such Act, the Medicaid program under title XIX of such 

Act, and the Veterans Administration for all prescription drugs. 

And finally, the Secretary of Health and Human Services shall review how the Federal Government has achieved competitive cost 

reductions for drugs since 2001. 

Federal Administration 

The Committee recommends $732,533,000 to support Federal Administrative activities related to the Medicare and Medicaid proVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00092 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
93 

grams, which is equal to the fiscal year 2015 enacted level and 

$51,067,000 less than the budget request. The Federal Administration funding supports CMS staff, along with operating and administrative expenses for planning, developing, managing, and evaluating healthcare financing programs and policies. 

The Committee appreciates the information in the CMS budget 

request. However, the Committee expects CMS to provide the additional items and enhanced Congressional notice described in the 

statement accompanying the fiscal year 2015 Appropriations Act. 

The Committee reminds HHS and CMS to ensure that all tables 

include the prior year actual, current year request level, current 

year actual (based on the operating plan) and budget request year 

level. 

HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT

The Committee recommendations includes $672,000,000, to be 

transferred from the Medicare trust funds, for Health Care Fraud 

and Abuse Control (HCFAC) activities. This includes a base 

amount of $311,000,000 and an additional $361,000,000 through a 

budget cap adjustment authorized by section 251(b) of the Balanced 

Budget and Emergency Deficit Control Act of 1985. The HCFAC 

funds support activities conducted by CMS, the HHS Inspector 

General, and the Department of Justice. The level is equal to the 

fiscal year 2015 enacted level and $34,000,000 less than the budget 

request. This funding is in addition to other mandatory funding 

through authorizing legislation. The funding will provide resources 

to continue efforts for Medicaid program integrity activities, for 

safeguarding the Medicare prescription drug benefit and the Medicare Advantage program, and for program integrity efforts carried 

out by the Department of Justice. The bill includes language to ensure the Secretary fully funds the senior Medicare patrol program 

administered through the Administration for Community Living 

from the level provided in this account. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

The Committee recommends $3,256,743,000 for the Child Support Enforcement and Family Support programs, which is 

$818,220,000 more than the fiscal year 2015 enacted level and the 

same as the budget request. The Committee also recommends 

$1,300,000,000 in advance funding, as requested, for the first quarter of fiscal year 2017 to ensure timely payments for Child Support 

Enforcement programs. These programs support state-administered 

programs of financial assistance and services for low-income families to promote their economic security and self-sufficiency. 

LOW INCOME HOME ENERGY ASSISTANCE

The Committee recommends $3,365,304,000 for the Low Income 

Home Energy Assistance Program (LIHEAP), which is $25,000,000 

below the fiscal year 2015 enacted level and the budget request. 

Within the amount provided, the Committee recommends 

$3,365,304,000 exclusively for the State formula grants. 


rfrederick on DSK6VPTVN1PROD with HEARING
94 

Within the amount available for formula grants, the Committee recommends up to $2,988,000 for program integrity initiatives. The 

funding will allow additional technical assistance both on the State 

and federal level for program training, and monitoring of program 

activities for compliance with internal controls, policies, and procedures. 

REFUGEE AND ENTRANT ASSISTANCE

The Committee recommends $1,429,884,000 for Refugee and Entrant Assistance programs, which is $130,000,000 below the fiscal 

year 2015 enacted level and $198,728,000 below the budget request. 

The Office of Refugee Resettlement (ORR) programs are designed 

to help refugees, asylees, Cuban and Haitian entrants, and trafficking victims become employed and self-sufficient. These programs also provide for care of unaccompanied immigrant children 

in federal custody and victims of torture. 

Within the total, the Committee recommends the following 

amounts for Refugee and Entrant Assistance programs: 

Budget Activity FY 2016 

Committee 

Transitional and Medical Services ................................................................................................................. $383,266,000 

Victims of Trafficking ..................................................................................................................................... 15,755,000 

Social Services ............................................................................................................................................... 149,927,000 

Preventive Health ........................................................................................................................................... 4,600,000 

Targeted Assistance ....................................................................................................................................... 47,601,000 

Unaccompanied Minors .................................................................................................................................. 818,000,000 

Victims of Torture ........................................................................................................................................... 10,735,000 

Refugees and Unaccompanied Minors 

Victims of Trafficking Services.—For all programs for victims of 

trafficking as authorized by section 107(b) of Public Law 106–386, 

as amended, the Committee directs the Department to provide an 

annual consolidated report to the House Appropriations Committee, the House Foreign Affairs Committee, and the House Energy and Commerce Committee on the percent of funds spent on 

food, housing, clothing, mental health screening and therapy, legal 

assistance, employability services, and health screening and medical services. For health screening and medical services, the Department is directed to include specific information regarding the 

types of services provided or referred and the names of the entities 

providing such medical services. For each of the entities providing 

medical services, the Department shall record the amount of money 

expended on each type of medical service provided. The Department is directed to make this information available annually and 

more frequently by request. 

Healthcare and Education Costs of Illegal Immigration.—The 

Committee is concerned with the significant healthcare and education costs to State and local communities resulting from illegal 

immigration. These costs are especially high in States along the 

southern border of the United States. The Committee directs the 

Department of Education and the Department of Health and 

Human Services to provide all available federal resources to assist 

State and local governments with these increased costs that are a 

direct result of federal law or policy. The Committee further directs 


rfrederick on DSK6VPTVN1PROD with HEARING
95 

the Departments to provide a report to the House Appropriations 

Subcommittee on Labor, Health and Human Services, and Education, the Subcommittee on Commerce, Justice, Science and the 

Subcommittee on Homeland Security within 90 days of enactment 

on the costs borne by State and local governments and the federal 

government for providing health and education services to individuals without legal immigration status, to include those who qualified under the President’s November 20, 2014 executive immigration action. The report should cover the costs incurred over the 

course of fiscal years 2014 and 2015 and include projected costs for 

fiscal years 2016 through 2020. The report shall also include an accounting of the federal resources that have been and will be directed in each year to cover these added expenses. 

School Impact Grants.—The Committee continues to support the 

School Impact Grants to enable vulnerable children to integrate in 

their new schools and communities. These services are critical to 

help children overcome primary and secondary trauma and behavioral and emotional obstacles to learning so they can rebuild their 

lives. The Committee also recommends that the Office of Refugee 

Resettlement (ORR) make School Impact Grant funds available to 

serve all children in ORR’s care to fully participate in educational 

opportunities and provide local schools with the support they need 

in fiscal year 2016 and beyond. 

Preferred Communities Program.—The Committee is encouraged 

that ORR integrates long-term intensive case management services 

for vulnerable refugee populations and secondary migrants through 

the Preferred Communities Program. The Committee has provided 

sufficient funds for case management services for vulnerable refugees, and encourages ORR to include victims of torture, womenheaded households, refugees who are disabled or have serious medical issues, and other vulnerable refugees. Extended case management services will help to ensure refugees achieve self-sufficiency 

and integrate into their new communities. 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT

BLOCK GRANT

The Committee recommends $2,435,000,000 for the discretionary 

portion of the Child Care and Development Block Grant (CCDBG), 

which is the same as the fiscal year 2015 enacted level and 

$370,149,000 below the budget request. 

SOCIAL SERVICES BLOCK GRANT

The Committee recommends $1,700,000,000 for the Social Services Block Grant (SSBG), which is the same as the fiscal year 2015 

enacted level and the budget request. Funds are distributed to 

States by formula grants and States have the flexibility to determine what services and activities are supported, provided they are 

targeted at a broad set of goals, including reducing or eliminating 

poverty, achieving or maintaining self-sufficiency, and preventing 

neglect and abuse. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

The Children and Families Services programs fund activities 

serving children, youth, families, the developmentally disabled, NaVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00095 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
96 

tive Americans, victims of child abuse and neglect and domestic violence, and other vulnerable populations. 

The Committee recommendation below for ‘‘Social Services/Income Maintenance Research’’ includes $750,000 for the Secretary to 

enter into an agreement with the National Academy of Sciences to 

provide an evidence-based, non-partisan analysis of the macroeconomic, health, and crime/social costs of child poverty, to study 

current efforts aimed at reducing poverty, and to propose recommendations with the goal of reducing the number of children living in poverty in the United States by half in 10 years. 

Within the total, the Committee recommends the following 

amounts for Children and Families Services Programs: 

Budget Activity FY 2016 

Committee 

Programs for Children, Youth, and Families 

Head Start ............................................................................................................................................. $8,790,095,000 

Runaway/Homeless Youth ..................................................................................................................... 97,000,000 

Abuse of Runaway Youth Prevention .................................................................................................... 17,141,000 

State Child Abuse Prevention ............................................................................................................... 25,310,000 

Discretionary Child Abuse Prevention ................................................................................................... 28,744,000 

Community-based Child Abuse Prevention ........................................................................................... 39,764,000 

Abandoned Infants Assistance .............................................................................................................. 11,063,000 

Child Welfare Services .......................................................................................................................... 268,735,000 

Child Welfare Training .......................................................................................................................... 15,984,000 

Adoption Opportunities .......................................................................................................................... 39,100,000 

Adoption Incentives ............................................................................................................................... 37,943,000 

Social Services/Income Maintenance Research .................................................................................... 5,762,000 

Native American Programs .................................................................................................................... 50,000,000 

Community Services 

Community Services Block Grant .......................................................................................................... 674,000,000 

Economic Development .......................................................................................................................... 29,883,000 

Rural Community Facilities ................................................................................................................... 6,500,000 

Individual Development Account Initiative ........................................................................................... 18,950,000 

Domestic Violence Hotline .............................................................................................................................. 4,500,000 

Family Violence/Battered Women’s Shelters .................................................................................................. 145,000,000 

Independent Living Training Vouchers ........................................................................................................... 43,257,000 

Faith-Based Center ........................................................................................................................................ 1,299,000 

Disaster Human Services Case Management ................................................................................................ 1,864,000 

Program Direction ........................................................................................................................................... 199,701,000 

Head Start 

The Committee recommends $8,790,095,000 for the Head Start 

program, which is $192,000,000 more than the fiscal year 2015 enacted level and $1,327,611,000 below the budget request. Within 

the total for Head Start, the Committee recommendation supports 

a 0.5 percent cost-of-living adjustment and includes $25,000,000 for 

the Designation Renewal System. Additionally, the Committee recommends $650,000,000 for Early Head Start (EHS) grants within 

the total for fiscal year 2016, which is $150,000,000 more than the 

fiscal year 2015 enacted level and the same as the budget request. 

The Committee supports efforts to strengthen and expand Head 

Start and Early Head Start and is pleased to see the continuous 

focus on quality improvement through the increasing number of 

teachers with bachelor’s degrees, a reformed monitoring system, 

and the implementation of recompetition to the Head Start program. The Committee strongly encourages the Administration to 

release revised Head Start Program Performance Standards that 

are currently several years deficient. 


rfrederick on DSK6VPTVN1PROD with HEARING
97 

The Committee is additionally pleased with how efficiently the 

Secretary has moved to bring Early Head Start-Child Care Partnership grants online, and continues to support this emerging program. Given the challenges expressed by providers in the field, and 

the collective desire to expand access to high-quality programs immediately, the Committee notes its concern that grants may be restricted to one model design of partnerships. This practice may 

limit the pool of competitive applicants by discouraging diverse locally-designed models, who aim to expand the availability of high 

quality infant and toddler care, from applying. It would also eliminate the opportunity for many providers, especially in rural communities, with few available partner options to compete for these 

funds. The grants, whether for expansion, conversion, or partnerships, should be awarded based on how effectively the model design 

fits the needs of the community in question, versus adherence to 

a partnership model that may be inappropriate to that locality. 

Child Abuse Discretionary Activities 

Within the funding for Child Abuse Discretionary Activities, the 

Committee recommends continued funding for the Quality Improvement Center for Research-Based Infant-Toddler Court Teams 

program. These funds support efforts that bring together the court 

system, child welfare agencies, health professionals, and community leaders to improve current practices in the child welfare system and make better informed decisions on behalf of the child. 

Native American Programs 

The Committee recommends $50,000,000 for Native American 

Programs, which is $3,480,000 more than the fiscal year 2015 enacted level and the same as the request. Within the total, the Committee recommendation includes $12,000,000 for Native American 

language preservation activities, including the requested 

$3,000,000 for the Generation Indigenous initiative focused on improving Native American language instruction across the educational continuum and no less than $4,000,000 for language immersion programs authorized by section 803C(b)(7)(A)–(C) of the 

Native American Programs Act, as amended by the Esther Martinez Native American Language Preservation Act of 2006. The 

Committee strongly encourages ACF to give priority to grantees 

with rigorous immersion programs. 

Community Services 

The Committee recommends $729,333,000 for the Community 

Services programs, which is the same as the fiscal year 2015 enacted level and $36,383,000 more than the budget request. 

Community Economic Development Grants 

The Committee recommends $29,883,000 for Community Economic Development (CED) grants. Community Development Corporations (CDCs) use CED grants to lend and invest in private 

businesses that create jobs for low income people. Program guidelines require that at least 75 percent of the jobs created from CED 

funded projects be filled by low-income individuals. The CED program is the only federal economic development program that requires such targeted job creation. Using CED funds, CDCs have 


rfrederick on DSK6VPTVN1PROD with HEARING
98 

created hundreds of jobs and improved economic opportunity in 

urban and rural communities across the country. 

Family Violence Prevention and Battered Women’s Shelters 

The Committee recommends $145,000,000 for the Family Violence Prevention and Battered Women’s Shelters programs, which 

is $10,000,000 more than the fiscal year 2015 enacted level and is 

$5,000,000 below the budget request. In 2013, domestic violence 

programs funded by the Family Violence Prevention & Services Act 

provided shelter and nonresidential services to more than 

1,300,000 victims. Yet, due to lack of capacity an additional 

186,552 requests for shelter went unmet. This funding increase is 

intended to address the growing demand for emergency family, domestic and dating violence shelter and supportive services. 

PROMOTING SAFE AND STABLE FAMILIES

The Committee recommends $345,000,000 in mandatory funds 

for the Promoting Safe and Stable Families program, which is the 

same as the fiscal year 2015 enacted level and the budget request. 

The Committee also recommends $59,765,000 in discretionary 

funds for this program, which is the same as the fiscal year 2015 

enacted level and is $30,000,000 below the budget request. This 

program enables each State to operate a coordinated program of 

family preservation services, community-based family support services, time-limited reunification services, and adoption promotion 

and support services. States receive funds based on their share of 

children in all States receiving food stamp benefits. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

The Committee recommends $5,478,450,000 for payments to 

States for foster care and adoption assistance, which is 

$646,450,000 more than the fiscal year 2015 enacted level and 

$250,000,000 below the budget request. The Committee also recommends an advance appropriation of $2,300,000,000 for the first 

quarter of fiscal year 2017 to ensure timely completion of first 

quarter grant awards. 

Within the total, the Committee recommends $4,952,550,000 for 

the Foster Care program, which is $663,550,000 below the fiscal 

year 2015 enacted level and the same as the budget request. This 

program provides funds to States for foster care maintenance payments for children living in foster care. These funds also reimburse 

States for administrative costs to manage the program and training 

for staff and parents. 

Within the total, the Committee recommends $2,562,900,000 for 

Adoption Assistance, which is $58,900,000 more than the fiscal 

year 2015 enacted level and the same as the budget request. This 

program provides funds to States to subsidize families who adopt 

children with special needs, such as older children, a member of a 

minority or sibling group, or children with physical, mental, and 

emotional disabilities. In addition, the program provides training 

for adoptive parents and State administrative staff. This annually 

appropriated entitlement provides alternatives to long, inappropriate stays in foster care by developing permanent placements 

with families. 


rfrederick on DSK6VPTVN1PROD with HEARING
99 

Within the total, the Committee recommends $123,000,000 for 

the Kinship Guardianship Assistance program, which is 

$24,000,000 more than the fiscal year 2015 enacted level and the 

same as the budget request. This program provides subsidies to a 

relative taking legal guardianship of a child for whom being returned home or adoption are not appropriate permanency options. 

Finally, within the total, the Committee recommends $140,000,000 for the Independent Living program, which is the 

same as the fiscal year 2015 enacted level and the budget request. 

This program assists foster children age 16 or older make successful transitions to independence. Funds support a variety of services, including educational assistance, career exploration, vocational training, job placement, life skills training, home management, health services, substance abuse prevention, preventive 

health activities, and room and board. Each State receives funds 

based on the number of children on whose behalf the State receives 

Federal Foster Care Payments. 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

The Committee recommends an appropriation of $1,962,058,000 

for the Administration for Community Living (ACL) program level, 

which is $261,102,000 more than the fiscal year 2015 enacted program level and $161,297,000 below the requested program level. 

The recommended funding level for ACL reflects the transfer of the 

Workforce Innovation and Opportunity Act programs from the Department of Education and the Traumatic Brain Injury program 

from HRSA. Moreover, the recommended funding level for the Senior Medicare Patrol Program is provided under the Health Care 

Fraud and Abuse Control Account. 

Home and Community-Based Supportive Services 

The Committee recommends $347,724,000 for Home and Community-Based Supportive Services, which is the same as the fiscal 

year 2015 enacted level and $38,458,000 below the budget request. 

This program provides formula grants to States and territories to 

fund a wide range of social services that enable seniors to remain 

independent in their homes for as long as possible. 

Preventive Health Services 

The Committee recommends $19,848,000 for Preventive Health 

Services, which is the same as the fiscal year 2015 enacted level 

and the budget request. This program funds activities that help 

seniors remain healthy and avoid chronic diseases. 

Protection of Vulnerable Older Americans 

The Committee recommends $20,658,000, which is the same as 

the fiscal year 2015 enacted level and the budget request for grants 

to States for protection of vulnerable older Americans. 

National Family Caregiver Support Program 

The Committee recommends $145,586,000 for the National Caregiver Support program, which is the same as the fiscal year 2015 

enacted level and $5,000,000 below the budget request. This proVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00099 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
100 

gram supports a multifaceted support system in each State for family caregivers. 

Native American Caregiver Support Program 

The Committee recommends $7,531,000 for the Native American 

Caregiver Support program, which is $1,500,000 more than the fiscal year 2015 enacted level and $731,000 more than the budget request. This program provides grants to tribes for the support of 

American Indian, Alaskan Native, and Native Hawaiian families 

caring for older relatives with chronic illness or disabilities. 

Congregate and Home-Delivered Nutrition Services 

The Committee recommends $440,691,000 for Congregate Nutrition Services, which is $2,500,000 more than the fiscal year 2015 

enacted level and $17,400,000 below the budget request. The Committee further recommends $219,897,000 for Home-Delivered Meal 

Services, which is $3,500,000 more the fiscal year 2015 enacted 

level and $16,500,000 below the budget request. 

Nutrition Services Incentives Program 

The Committee recommends $160,069,000 for the Nutrition Services Incentives Program, which is the same as the fiscal year 2015 

enacted level and the budget request. This funding augments programs that provide congregate and home-delivered meals to older 

adults. 

Native American Nutrition and Supportive Services 

The Committee recommends $31,158,000 for Native American 

Nutrition and Supportive Services, which is $5,000,000 more than 

the fiscal year 2015 enacted level and $2,058,000 more than the 

budget request. This program provides grants to tribes to promote 

the delivery of nutrition and home and community-based supportive services to Native American, Alaskan Native, and Native 

Hawaiian elders. 

Aging Network Support Activities 

The Committee recommends $9,961,000 for the Aging Network 

Support Activities, which is the same as the fiscal year 2015 enacted level and the budget request. This program supports activities that expand public understanding of aging and the aging process. The total amount includes $2,500,000 to help provide supportive services for aging Holocaust survivors living in the United 

States. 

Alzheimer’s Disease Supportive Services Program 

The Committee recommends $18,500,000 for the Alzheimer’s Disease Supportive Services Program, which is the same as the 2015 

enacted program level and the requested program level. This program provides competitive matching grants to a limited number of 

States to encourage program innovation and coordination of public 

and private services for people with Alzheimer’s disease and their 

families. 


rfrederick on DSK6VPTVN1PROD with HEARING
101 

Lifespan Respite Care 

The Committee recommends $2,360,000 for Lifespan Respite 

Care, which is the same as the fiscal year 2015 enacted level and 

$2,640,000 below the budget request. The program focuses on easing the burdens of caregiving by providing grants to eligible State 

organizations to improve the quality of, and access to, respite care 

for family caregivers. 

Chronic Disease Self-Management Program 

The Committee recommends $8,000,000 for Chronic Disease SelfManagement program, which is the same as the fiscal year 2015 

enacted level and the budget request. This program supports 

grants to States for low-cost, evidence-based prevention models 

that use state-of-the-art techniques to help those with chronic conditions address issues related to the management of their disease. 

Elder Falls 

The Committee recommends $5,000,000 for the Elder Falls program, which is the same as the fiscal year 2015 enacted program 

level and the requested program level. Fall prevention grants support the promotion and dissemination of prevention tools to be delivered in community settings. 

Elder Rights Support Activities 

The Committee recommends $7,874,000 for Elder Rights Support 

Activities Demonstrations, which is the same as the fiscal year 

2015 enacted level and $21,000,000 below the budget request. This 

program supports efforts that provide information, training, and 

technical assistance to legal and aging services organizations towards the end of preventing and detecting elder abuse and neglect. 

The total amount includes $4,000,000 for Elder Justice to provide 

competitive grants to States to test and evaluate innovative approaches to preventing and responding to elder abuse. 

Aging and Disability Resource Centers 

The Committee recommends $6,119,000 for Aging and Disability 

Resource Centers, which is the same as the fiscal year 2015 enacted level and $13,881,000 below the budget request. These centers provide information, counseling and access for individuals to 

learn about the services and support options available to seniors 

and the disabled so they may retain their independence. 

State Health Insurance Program 

The Committee recommends $52,115,000 for State Health Insurance program, which is the same as the fiscal year 2015 enacted 

level and the budget request. This program provides accurate and 

understandable health insurance information to Medicare beneficiaries and their families. 

Paralysis Resource Center 

The Committee recommends $6,700,000 for the Paralysis Resource Center, which is the same as the fiscal year 2015 enacted 

level and the budget request. The center provides comprehensive 

information and referral services to people living with paralysis 

and their families. 


rfrederick on DSK6VPTVN1PROD with HEARING
102 

Limb Loss 

The Committee recommends $2,810,000 for the Limb Loss pro- gram, which is $10,000 more than the fiscal year 2015 enacted 

level and the same as the budget request. 

Traumatic Brain Injury 

The Committee includes bill language transferring the Traumatic 

Brain Injury (TBI) program from HRSA to ACL. Placing the TBI 

program within ACL will enhance the services available to those 

with traumatic brain injuries by better aligning such services with 

other TBI focused programs and all the resources available to the 

disabled under ACL. The Committee recommends $9,321,000 for 

the TBI program, which is the same as the fiscal year 2015 enacted 

level and the budget request. 

Developmental Disabilities State Councils 

The Committee recommends $71,692,000 for State Councils on 

Developmental Disabilities, which is the same as the fiscal year 

2015 enacted level and the budget request. The State Councils 

work to develop, improve and expand the system of services and 

supports for people with developmental disabilities. 

Developmental Disabilities Protection and Advocacy 

The Committee recommends $38,734,000 for Developmental Disabilities Protection and Advocacy, which is the same as the 2015 

enacted level and the budget request. This formula grant program 

provides funding to States to establish and maintain protection and 

advocacy systems to protect the legal rights of persons with developmental disabilities. 

Voting Access for Individuals With Disabilities 

The Committee recommends $4,963,000 for Voting Access for Individuals With Disabilities program, which is the same as the fiscal 

year 2015 enacted level and the budget request. 

Developmental Disabilities Projects of National Significance 

The Committee recommends $8,857,000 for Developmental Disabilities Projects of National Significance, which is the same as the 

2015 enacted level and $5,643,000 below the budget request. This 

program funds grants and contracts that develop new technologies 

and demonstrate innovative methods to support the independence, 

productivity, and integration of the disabled into the community. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommends $37,674,000 for University Centers 

for Excellence in Developmental Disabilities (UCEDDs), which is 

the same as the fiscal year 2015 enacted level and $945,000 below 

the budget request. 

The Committee continues to support the UCEDD network of 67 

centers that offer interdisciplinary education, research and public 

services within a university system or public or non-profit entity 

associated with a university. The funding provided will allow Centers to assist states to initiate collaborative research, education, 

training, and service efforts to assist youth with disabilities to successfully transition from school to postsecondary education, and/or 


rfrederick on DSK6VPTVN1PROD with HEARING
103 

integrated employment. The funding will also allow the Centers to 

continue to address critical and emerging national needs, such as 

addressing the needs of the rising numbers of individuals on the 

autism spectrum; demonstrating cost effective long term services 

and supports for adults with disabilities and those aging with disabilities; supporting returning veterans; and providing technical assistance to strengthen and support the national network of Centers 

and to disseminate research and best practices nationwide. 

Independent Living 

The Committee recommends $101,183,000 for the Independent Living program, of which $22,878,000 is for the Independent Living 

State Grants program and $78,305,000 is for the Centers for Independent Living program. This funding level is the same as the fiscal year 2015 enacted level and $5,000,000 below the budget request. Independent Living programs maximize the leadership, empowerment, independence and productivity of individuals with disabilities. 

Muscular Dystrophy.—The Committee is aware that the ACL is 

now serving on the Muscular Dystrophy Coordinating Committee 

through the Muscular Dystrophy CARE Act Amendments enacted 

in September 2014. The Committee directs ACL to provide an update on all programs relevant to the Duchenne population, particularly those focused on supporting transitions of persons with 

Duchenne into adulthood. The Committee encourages ACL to develop plans for conducting comprehensive studies focused on evaluating the cost-effectiveness of independent living programs and 

supports for persons living with various forms of muscular dystrophy. 

National Institute on Disability, Independent Living, and Rehabilitation Research 

The Committee recommends $103,970,000 for the National Institute on Disability, Independent Living, and Rehabilitation Research, which is the same as the fiscal year 2015 enacted level and 

$4,030,000 below the request. The National Institute serves to generate knowledge and promote its effective use to enhance the abilities of people with disabilities to perform activities of their choice 

in the community and to expand society’s capacity to provide full 

opportunities for its citizens with disabilities. 

Assistive Technology 

The Committee recommends $33,000,000 for Assistive Technology, which is the same as the fiscal year 2015 enacted level and 

$2,000,000 more than the budget request. Of this amount, the 

Committee provides $2,000,000 for competitive grants to support 

existing and new alternative financing programs that provide for 

the purchase of assistive technology (AT) devices. This funding is 

intended to support the expansion of existing programs and the 

creation of new programs that allow greater access to affordable financing to help people with disabilities purchase the specialized 

technologies required to live independently, to succeed at school 

and work and to otherwise live active and productive lives. Programs that have previously received funding are eligible to compete 

but must report on how the prior funding has been used, including 


rfrederick on DSK6VPTVN1PROD with HEARING
104 

the number of loans extended and individuals served, funding leveraged, and asset development programs created. The Committee 

intends for applicants to incorporate credit building activities into 

their programs, including financial education and information 

about other possible funding sources. Successful applicants must 

emphasize consumer choice and control and build programs that 

will provide financing for the full array of AT devices and services 

and ensure that all people, regardless of type of disability or health 

condition, age, level of income, and residence have access to the 

program. 

Program Administration 

The Committee recommends $40,063,000 for Program Adminis- tration, which is $2,354,000 more than the fiscal year 2015 comparable funding level and the same as the budget request. The recommended funding level reflects the transfer of the Workforce Innovation and Opportunity Act (WIOA) programs from the Department of Education to ACL. The increased funding above the comparably adjusted figure will support the additional grant administrative staff required to support the WIOA programs as well as the 

relocation of ACL’s headquarters to the Switzer Building. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

The Committee recommends a program level total of $419,422,000 for General Departmental Management, which is 

$93,440,000 below the fiscal year 2015 enacted level and 

$139,172,000 below the budget request. Of the funds provided, 

$58,028,000 shall be derived from evaluation set-aside funds available under section 241 of the Public Health Service Act, which is 

$6,800,000 below the fiscal year 2015 set-aside and $8,050,000 

below the budget request. 

This appropriation supports activities that are associated with 

the Secretary’s roles as policy officer and general manager of the 

Department of Health and Human Services. 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. 

In addition, this funding supports the Office of the Surgeon General and several other health promotion and disease prevention activities that are centrally administered. The Committee recommendation does not include funding for the proposed HHS ‘‘Idea 

Lab’’ or the Digital Services Team. 

Administrative and overhead costs.—The Committee is extremely 

troubled by the amount of funds being spent on administrative 

costs throughout the Department, and the fact that the Department routinely skims program funds ‘‘off the top’’ of appropriated 

line items to support central grants management staff and other 

indirect costs. Although these costs are capped at approximately 10 

percent for most grants and contracts, this practice greatly reduces 

the resources available to projects in the field. Difficult economic 

times and flat budgets have exacerbated this problem. The Committee notes that the annual budget justification does not routinely 

provide information on how much, if any, of a line item supports 


rfrederick on DSK6VPTVN1PROD with HEARING
105 

central office overhead versus being used directly in the field for 

grants and contracts.The Committee therefore directs the Department to include in the annual budget justification for fiscal year 

2017, and each year thereafter, the amount and percentage of administrative and overhead costs spent by the Department for each 

program line item. 

Health Reform Oversight.—The Committee understands that the 

lack of effective tracking, monitoring, and feedback systems at 

HHS may be resulting in improper payments of health reform subsidies. The Treasury Inspector General for Tax Administration recently noted, in part, that because the IRS and the Department of 

Health and Human Services are responsible for the administration 

of the Premium Tax Credit (PTC), improper PTC payments can result from weaknesses in either agency’s programs. As a result, the 

IRS cannot effectively assess the risk of PTC improper payments, 

estimate the improper payment rate and dollars, or establish corrective actions to address the causes of and reduce improper PTC 

payments. The Committee understands the Administration has yet 

to identify a definition of ‘‘improper payments’’ for PTC or other 

ACA payments. The Committee directs the Government Accountability Office (GAO) to conduct a comprehensive review of the process and coordination between HHS and Treasury functions and to 

make recommendations to ensure solid processes are in place at 

both front and back ends to prevent improper payments.At a minimum, the review should examine whether HHS is appropriately 

validating the information provided by individuals in any Exchange 

to match the information reported in the prior year IRS data. The 

review should also examine how monthly PTC subsidies paid to insurers are appropriately tracked, monitored, and audited in a manner that provides for timely adjustments due to over/underpayments due to changes in eligibility criteria and the share of the 

monthly premium owed by the policyholder.Finally, the review 

should evaluate how HHS and IRS are jointly using existing authorities to recoup overpayment and to prevent intentional fraud 

and unintentional errors. The Committee expects to receive this report within 120 days of enactment. 

Dietary Guidelines for Americans.—The Secretary, in coordination with the Secretary of Agriculture, is responsible for issuing the 

Dietary Guidelines for Americans every five years. This has traditionally been a science-based process that provides diet and nutrition recommendations according to statutory authority. However, 

the advisory committee selected to provide recommendations for 

consideration as the final 2015 guidelines has included suggestions 

beyond the historical scope of the panel, resulting in controversial, 

agenda-driven recommendations. To preserve the scientific integrity of the dietary guidelines, bill language is included to provide 

transparency to the process and ensure the final recommendations 

are based upon strong scientific evidence and within scope. The 

Committee notes that the advisory committee report is merely a set 

of recommendations and reminds both USDA and HHS that the 

final 2015 Dietary Guidelines for Americans are a product of their 

scientific assessment that must comply with the statute. 

Conscience Protections.—The Committee continues a general provision that has been carried since 2005 relating to the conscience 

protection rights of health care providers. In the Explanatory 


rfrederick on DSK6VPTVN1PROD with HEARING
106 

Statement accompanying the fiscal year 2015 Appropriations Act, 

the Secretary was directed to respond expeditiously to complaints 

regarding violations of this provision. The Committee notes that no 

resolution has been made to date and reiterates its directive that 

such complaints be responded to immediately and that this general 

provision be enforced. 

Needle Exchange Programs.—The Committee maintains its support for federal, state and local efforts to address the abuse of prescription painkillers and other opioids. The Committee is alarmed 

by trends in urban and rural communities which indicate a transition to injection drug use, and supports state and local efforts to 

mitigate the spread of related infections, such as Hepatitis and 

HIV/AIDS, and associated healthcare costs. The Committee believes the determination about whether to implement needle exchange programs remains a quintessentially local function, and 

therefore maintains its prohibition on the use of federal funds for 

the purchase of syringes or sterile needles as a title V general provision. The provision is modified, however, to allow existing programs in hard-hit communities to access federal funds for other 

program elements, including substance use counseling and referral 

to treatment, that support communities in their drive to end the 

cycle of dependency. Eligible programs must demonstrate a need 

for federal support based on actual cases of Hepatitis or HIV/AIDS 

or on conditions posing a significant risk for an outbreak. 

Healthcare Plan Coverage of Abortions.—The committee is aware 

that, while the Affordable Care Act did not prevent taxpayer funding for exchange plans that include elective abortion, it did contain 

a provision requiring that plans covering elective abortion collect 

from each enrollee in the plan a separate payment for elective 

abortion. The Committee is concerned that this payment is not 

being collected separately and Administration-proposed regulations 

would instead allow insurance issuers to collect a single payment. 

In addition the Committee is concerned that consumers are not 

made aware of the abortion payment when shopping for healthcare 

plans. The Committee requests a report within 180 days of enactment outlining what steps are being taken to ensure consumers are 

aware of the abortion payment prior to purchasing a plan and that 

the payment is collected separately. 

Premium Class Travel.—The Committee is aware of recent reports that HHS has experienced a significant increase in the use 

premium class travel, costing taxpayers over $31,000,000, with 

most of the first and business class tickets attributed to waivers 

granted for medical issues. The Committee directs the Secretary to 

evaluate HHS rules related to allowing premium class travel, specifically the appropriate use of medical waiver authority. The Committee also expects the fiscal year 2017 and future budget requests 

to include, for each operating division and the Office of the Secretary, the total number of premium class travel waivers granted 

and the number and percentage of these related to medical waivers. 

Office of the Assistant Secretary for Health 

Assisted Outpatient Treatment Grant Program.—The Committee 

includes $15,000,000 within the Office of the Assistant Secretary 

for Health to implement section 224 of the Protecting Access to 


rfrederick on DSK6VPTVN1PROD with HEARING
107 

Medicare Act of 2014 (Public Law 113–93), the Assisted Outpatient 

Treatment Grant Program for Individuals with Serious Mental Illness (AOT). The Committee is aware that nearly half of individuals 

with schizophrenia or bipolar disorder do not recognize they have 

a mental illness, making it exceedingly difficult for them to follow 

through on a treatment regimen. The AOT program will work with 

families and courts to allow these individuals to obtain treatment 

while continuing to live in their communities and homes. AOT has 

been proven to reduce the imprisonment, homelessness and emergency room visit rate among this population by 70 percent. The 

Committee expects a full report in the fiscal 2017 budget request 

on the implementation and uses of this $15,000,000. 

Viral Hepatitis.—The Committee recognizes the tremendous 

health and financial burden of viral hepatitis. CDC estimates that 

upwards of 5.3 million nationwide are living with hepatitis B or 

hepatitis C (HCV) and 65 75 percent are not aware of their infection. Furthermore it is estimated that the medical costs associated 

with HCV among the 1945 1965 birth cohort many of whom will 

age into the Medicare system at age 65 will rise to $85 billion annually. With the introduction of new screening guidelines and technology, as well as new treatment options, HHS has an unprecedented opportunity to address this national health problem. The 

Committee encourages HHS to continue to implement the Action 

Plan on Viral Hepatitis and to ensure that all appropriate agencies 

are actively involved and coordinated. The Committee encourages 

the HHS Assistant Secretary for Health to work with partners to 

tackle the issue of disease status awareness by leveraging federal 

with non-federal contributions and organizing partnerships with 

stakeholders. 

Privacy Protections.—The Committee notes that the regulations 

issued under the Health Insurance Portability and Accountability 

Act (HIPAA) regarding protection of individually identifiable health 

information are generally more protective of patient privacy than 

the comparable requirements of the Federal Policy for the Protection of Human Subjects, otherwise known as the Common Rule. 

The Committee further notes that the duplicative application of the 

Common Rule and HIPAA regulations is causing confusion and imposing undue burdens on the development of clinical data registries. The Committee encourages the Office of Human Research 

Protections (OHRP) in the Department of Health and Human Services and other Federal agencies and departments that administer 

the Common Rule to adopt an exception to the Common Rule for 

situations where individuals or entities are collecting identifiable 

patient information, but are not engaged in direct human subjects 

intervention or interaction (e.g., clinical studies) and are following 

all the applicable requirements of the HIPPA regulations with respect to protecting the privacy and security of such information. 

Definition of an ‘‘Indian’’.—The Committee recognizes the Federal government’s trust responsibility for providing healthcare for 

American Indians and Alaska Natives. The Committee is aware 

that the definition of who is an ‘‘Indian’’ is inconsistent across various federal health programs, which has led to confusion, increased 

paperwork and even differing determinations of health benefits 

within Indian families themselves. The Committee therefore encourages the Department of Health and Human Services, the InVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00107 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
108 

dian Health Service, and the Department of the Treasury to work 

together to establish a consistent definition of an ‘‘Indian’’ for purposes of providing health benefits. 

Adult Vaccinations.—The Committee is concerned that each year, 

hundreds of thousands of American adults are hospitalized and 

tens of thousands die from diseases that could have been prevented 

by vaccination. It is estimated that the cost of the health burden 

to society from vaccine preventable diseases is approximately $10 

billion annually. In particular, the Committee is concerned that 

many health care workers do not get regularly recommended vaccinations and that adult vaccination rates are particularly low for 

minority groups. Therefore the Committee encourages the Secretary of Health and Human Services to develop an adult vaccine 

strategy that includes assessments of barriers to adult immunizations, and strategies to overcome those barriers, including public 

outreach about the importance of adult immunization and strategies to increase influenza vaccination rates among health care 

workers. 

Breastfeeding.—The Committee is aware of the Surgeon General’s Call to Action to Support Breast Feeding and encourages the 

Secretary to support and expand efforts to guarantee continuity of 

skilled support for breastfeeding between hospitals and health care 

settings in the community. The Committee strongly supports efforts to combat childhood obesity. Research shows that suboptimal 

breastfeeding rates are a significant contributor to our nation’s epidemic of obesity, increasing risks of several acute and chronic diseases and conditions, including diabetes and cardiovascular disease. 

Embryo Adoption Awareness Campaign.—The Committee recommends $1,000,000 for the embryo adoption awareness campaign, 

the same as the fiscal year 2015 enacted level. The budget request 

did not include funding for this program. These funds will be used 

to educate Americans about the existence of frozen human embryos 

(resulting from in-vitro fertilization), which may be available for 

donation/adoption. The Committee includes bill language permitting these funds also to be used to provide medical and administrative services to individuals adopting embryos, deemed necessary for 

such adoptions, consistent with the Code of Federal Regulations. 

HIV/AIDS in Minority Communities.—The Committee recommendation includes $52,224,000 for specific program activities to 

address the high-priority HIV prevention and treatment needs of 

minority communities, the same as the fiscal year 2015 level and 

$1,676,000 below the budget request. These funds are provided to 

promote an effective, culturally competent and linguistically appropriate public health response to the HIV/AIDS epidemic. 

Teen Pregnancy Prevention and Sexual Risk Avoidance.—The 

Committee provides $20,000,000 in budget authority for Teen Pregnancy Prevention Community Grants. Included in the Committee 

recommendation is not less than $10,000,000 for sexual risk avoidance programs. 

In implementing the $20,000,000 provided for teen pregnancy 

prevention and sexual risk avoidance, the Committee encourages 

HHS to provide substantive and practical technical assistance to 

grantees that emphasizes sexual risk avoidance (SRA) in all educational messaging to teens. The Committee notes that such techVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00108 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
109 

nical assistance should be provided during national and regional 

conferences, webinars and one-on-one conversations with funded 

projects. The Committee further encourages SRA-credentialed experts to directly train grantees and HHS staff with oversight of 

these programs on methodologies and best practices in SRA for 

teens. The Committee also encourages HHS to consistently implement a public health model that stresses risk avoidance or a return 

to a lifestyle without risk. 

The Committee notes that adolescents from communities of color 

are disproportionately affected by teenage pregnancy, and that research also shows teenage dating violence and abuse are associated 

with higher levels of teenage pregnancy and unplanned pregnancy. 

Adolescent girls in physically abusive relationships are three times 

more likely to become pregnant than non-abused girls. The Committee encourages the Secretary, through the Office of Adolescent 

Health, to include teen dating violence prevention and healthy relationship strategies within existing adolescent health working 

groups and better integrate preventing violence and abuse as a 

strategy to prevent teen and unplanned pregnancy within communities of color. Additionally, the Committee encourages the Secretary to conduct a review of programs chosen by the Teen Pregnancy Prevention Program and issue a report to determine which 

programs address teen dating violence and healthy relationship 

strategies as a means to prevent teen pregnancy. 

Office of Minority Health 

The Committee provides $56,670,000 for the Office of Minority 

Health (OMH), which is the same as the fiscal year 2015 enacted 

level and the same as the budget request. 

The OMH works with U.S. Public Health Service agencies and 

other agencies of the Department to address the health status and 

quality of life for racial and ethnic minority populations in the 

United States. OMH develops and implements new policies; partners with States, tribes, and communities through cooperative 

agreements; supports research, demonstration, and evaluation 

projects; and disseminates information. 

Hepatitis B.—The Committee is aware that Hepatitis B and liver 

cancer, as caused by the Hepatitis B virus, are the single greatest 

health disparities affecting the Asian and Pacific Islander populations in the United States. Asian Americans, Native Hawaiians, 

and other Pacific Islanders comprise more than one-half of the 2 

million estimated Hepatitis B carriers in the United States and 

consequently have the highest rate of liver cancer among all ethnic 

groups. The Committee urges the OMH to expand outreach and 

preventive Hepatitis B programs specific to Asian and Pacific Islanders and other groups disproportionately affected by Hepatitis 

B. 

Hepatitis C Treatment.—More than three million people in the 

United States are chronically infected with hepatitis C virus (HCV) 

and most do not know it. If untreated, or unsuccessfully treated, 

they are at risk for life-threatening, expensive complications such 

as liver cancer and liver failure. Standard of care for HCV is evolving rapidly with dozens of new, more effective, oral direct-acting 

antivirals available. With the opportunity to improve the health 

outcomes of millions of patients, evidence-based recommendations 


rfrederick on DSK6VPTVN1PROD with HEARING
110 

are needed to help expand the pool of qualified providers and guide 

medical practice in the United States. The Committee urges HHS 

to convene an ongoing, multidisciplinary treatment guidelines 

panel or other mechanism to issue periodically updated recommendations for the treatment of hepatitis C virus (HCV) infection. 

Lupus Health Education Program.—The Committee is aware 

that the 2011 HHS report to Congress highlighted the effect of disparities on lupus patients and reinforced the need for health education efforts. The Committee supports this nationwide effort and 

remains concerned about racial disparities and barriers to early diagnosis of lupus. This debilitating autoimmune disease affects over 

1.5 million persons, 90 percent of whom are women, with disproportionate impact among African Americans, Hispanics, Asians 

and Native Americans. The Committee continues to support this 

national education effort to engage health care providers, educators 

and schools of health professions in working together to improve 

lupus diagnosis and treatment through education and has included 

funding to continue implementation of a national health education 

program on lupus for health care providers with a the goal of improving diagnosis for those with lupus and reducing health disparities. 

Health Disparities Research in Women.—Women of racial and 

ethnic minorities face higher rates of diseases including obesity, 

cancer, diabetes, heart disease, and HIV/AIDS, when compared 

with white women. There is also a disproportionately higher rate 

of pre-term birth among African American women that cannot be 

accounted for by known risk factors. The Committee understands 

that continued and expanded collection of data capturing racial and 

ethnic information is essential in understanding and reducing disparities and encourages the Office of Minority and Women’s Health 

to conduct research into the causes of health disparities and develop and evaluate interventions to address these causes. 

Autism.—The Committee is concerned about recent studies showing that on average, a diagnosis of Autism Spectrum Disorder is 

delayed by almost two years for African American and Hispanic 

children as compared to their Caucasian counterparts. Furthermore, minority children are much more likely to be misdiagnosed 

with conduct-related or adjustment disorders. The Committee directs the Secretary of HHS in carrying out the programs of the 

Combating Autism Reauthorization Act to expand its efforts to address the disparities faced by African American and Hispanic children. The Committee asks that the Secretary include in the reports 

required by the Act the steps being taken to address the needs of 

minority populations. 

Diabetes.—The Committee is concerned by the incidence of diabetes that disproportionately affects minority populations, especially 

the elderly among these populations. Therefore, the Committee encourages OMH to undertake a coordinated approach across all 

HHS operating divisions to translate biomedical research, behavioral research and training programs to bring innovative approaches to diabetes prevention to minority communities. The Committee encourages OMH to develop an extramural grant program 

that specifically focuses on the broad spectrum of diabetes prevention and control, including approaches to predict, prevent, treat 


rfrederick on DSK6VPTVN1PROD with HEARING
111 

and cure diabetes. The Committee is particularly interested in 

studies to predict those at highest risk for Type 2 diabetes accurately, including those utilizing metabolomics and proteomics. 

Female Genital Mutilation Prevention and Education Initiative.— The Committee encourages OWH to support community-based efforts to prevent female genital mutilation (FGM). The Committee 

recognizes that hundreds of thousands of women and girls in the 

U.S. may have been subjected to, or are at risk, of FGM. Prevention, education, and outreach programs to address FGM can complement a need for more diligent law enforcement efforts. The 

Committee recognizes that FGM is illegal in the U.S. and is classified as a human rights violation by the World Health Organization. 

The Committee encourages the OWH to work with other Federal 

agencies in developing a comprehensive prevention, education, and 

outreach plan to stop FGM in the U.S., focusing on communities 

in which FGM is likely to be more prevalent. 

Lupus.—The Committee commends OWH for launching a sustained awareness and education campaign on lupus. The Committee understands that lupus is a serious, complex, debilitating 

chronic autoimmune disease that can cause inflammation and tissue damage to virtually any organ system in the body and impacts 

an estimated 1.5 million Americans. The Committee further understands that public and health professional recognition and understanding of lupus is extremely low, contributing to misdiagnoses or 

late diagnoses that can result in disability or death. 

Sickle Cell.—The Committee encourages HRSA to initiate Sickle 

Cell Trait informational awareness to encourage at risk populations to learn about their SCT status and help persons living 

with SCT understand their status. Information can include the implications for reproductive decision-making, the possibility of negative health outcomes for persons living with SCT and ways to reduce those outcomes, and understanding possible hemoglobin A1C 

test errors for diagnosing or monitoring diabetes and prediabetes. 

Office of Women’s Health.—The Committee includes $31,500,000 

for the Office of Women’s Health, the same as the budget request 

and $640,000 below fiscal year 2015 levels. 

Quick Health Data Online System.—The Committee directs the 

Secretary to continue the operation of the Quick Health Data Online system. The Committee also requests a report with a recommendation on the feasibility of moving the Quick Health Data 

Online system to another HHS agency. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

The Committee provides $87,381,000 for the Office of Medicare 

Hearings and Appeals, which is the same as the fiscal year 2015 

enacted level and $52,619,000 below the budget request. This Office supports hearings at the administrative law judge level, the 

third level of Medicare claims appeals. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

The Committee provides $60,367,000 for the Office of the National Coordinator for Health Information Technology (ONC), 

which is the same as the fiscal year 2015 enacted level. The budget 

proposed to fund this entire office from the evaluation tap. 


rfrederick on DSK6VPTVN1PROD with HEARING
112 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $75,000,000 for the Office of Inspector General (OIG), which is $4,000,000 more than the fiscal year 

2015 enacted level and $8,000,000 less than the budget request. In 

addition, within the Health Care Fraud and Abuse Control 

(HCFAC) program discretionary appropriations for fiscal year 2015, 

the Committee provides the OIG with $67,200,000. Mandatory appropriations for this office also are contained in the HCFAC program and the Health Insurance Portability and Accountability Act 

of 1996. Total funds provided in this bill and other appropriations 

are estimated to be $142,200,000 in fiscal year 2016. 

The Department’s programs touch the lives of virtually every 

American, so too does the oversight responsibility of the OIG. The 

OIG was created 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. 

The Committee expects the OIG to continue to increase its support for discretionary funded HHS activities within resources provided. The Committee understands the OIG is responsible for more 

than 300 programs that spend more than $900 billion. The diversity and complexity of these HHS programs—ranging from health 

care insurance and clinical research to epidemiology, public health 

services and education—have increased over the past decade, 

which increased the importance and challenge of providing oversight. The Committee encourages the OIG’s to continue to improve 

its annual budget request and looks forward to a revised format 

with more details and performance measures related to discretionary oversight. Further, the Committee expects the OIG to continue its oversight of ACA and describe the activity in the fiscal 

year 2016 work plan. 

Within the total provided, the Committee provides sufficient 

funding for the OIG to monitor HHS compliance with the provision 

that prohibits the use of federal funding for lobbying campaigns. 

The Committee remains concerned that certain HHS operating divisions have skirted the prohibition on using taxpayer funding to 

lobby State and or local governments. As such, the Committee requests that the OIG monitor grantee activities to ensure that no 

taxpayer resources are used for lobbying. 

Top-25 Unimplemented Recommendations.—The Committee 

again requests that within 90 days of enactment the OIG provide 

a revised top-25 unimplemented recommendations report under the 

same terms and conditions as described in the Explanatory Statement accompanying the Consolidated Appropriations Act of 2014. 

Health Reform Oversight.—The Committee appreciates the joint 

efforts of the OIG to work with the Treasury Inspector General for 

Tax Administration on reconciliation of the Advance Premium Tax 

Credit. The Committee encourages more and broader collaboration 

on other aspects of health reform and other HHS programs that 

may touch Treasury jurisdictions to reduce, fraud, overpayments, 

and enhance government operations. 


rfrederick on DSK6VPTVN1PROD with HEARING
113 

OFFICE FOR CIVIL RIGHTS

The Committee provides $38,798,000 for the Office for Civil 

Rights (OCR), which is the same as the fiscal year 2015 enacted 

level and $3,907,000 below the budget request. 

The OCR 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. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

The Committee provides for retirement pay and medical benefits 

of Public Health Service Commissioned Officers, for payments 

under the Retired Serviceman’s Family Protection Plan, and for 

medical care of dependents and retired personnel. Total costs are 

estimated to be $586,188,000 for fiscal year 2016, which is 

$23,947,000 above the fiscal year 2015 enacted level and the same 

as the budget request. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

The Committee provides $1,171,523,000 for the Public Health 

and Social Services Emergency Fund to support a comprehensive 

program to prepare for and respond to the health and medical consequences of all public health emergencies, including bioterrorism, 

and support the cybersecurity efforts of the Department of Health 

and Human Services (HHS). This amount is $3,546,000 less than 

the fiscal year 2015 base funding level and $738,458,000 less than 

the budget request. 

Office of the Assistant Secretary for Preparedness and Response 

The Committee provides $1,044,928,000 for activities administered by the Office of the Assistant Secretary for Preparedness and 

Response (ASPR). This amount is $652,000 less than the fiscal year 

2015 funding level and $498,157,000 less than the budget request. 

ASPR is responsible for coordinating national policies and plans for 

medical and public health preparedness and for administering a 

variety of public health preparedness programs, including the National Disaster Medical System, the Hospital Preparedness Cooperative Agreement Grants Program, Project BioShield, and the Office 

of Biomedical Advanced Research and Development Authority. 

Biomedical Advanced Research and Development Authority 

The Committee provides $415,000,000 for the Office of Biomedical Advanced Research and Development Authority (BARDA), 

which is equal to the fiscal year 2015 enacted level and 

$106,732,000 less than the budget request. In addition, the Committee provides $255,000,000 for Project BioShield, which is equal 

to the fiscal year 2015 level and $391,425,000 less the budget request. The funds support acquisitions of medical countermeasures 

to address chemical, biological, radiological, and nuclear (CBRN) 

threats. 

The Committee remains committed to ensuring the nation is adequately prepared against CBRN attacks. Public-private partnership 


rfrederick on DSK6VPTVN1PROD with HEARING
114 

to develop MCMs is required to successfully prepare and defend the 

nation against these threats. The Committee supports the goal of 

a market development where there is little or no existing commercial market. The funds allow for sustained management and funding of critical priorities, facilitate flexible and rapid response to 

emerging threats, and prevent the loss of resources. 

The Committee maintains its commitment to protecting the U.S. 

population from pandemic influenza and other new and emerging 

threats and recognizes a public-private partnership is also required 

to develop MCMs for these threats. The Committee recommends 

$72,000,000 for the ASPR’s pandemic influenza program. This 

funding can support research and development of next generation 

influenza MCMs, preparedness testing and evaluation, and stockpiling. 

The Committee remains concerned about potential gaps in preparedness created by conflicting stockpiling priorities of the 

BARDA and the CDC. 

While the Public Health and Emergency Medical Countermeasure Enterprise (PHEMCE) was established as the interagency 

coordinating body to ensure consensus priorities and smooth transitions, no specific process is in place to prevent gaps in preparedness related to disparate priorities that continue to arise related to 

countermeasure stockpiling. Therefore, the Committee directs 

BARDA and CDC to develop a process to coordinate the ongoing 

stockpiling of medical countermeasures in order to maintain adequate supplies of approved and purchased countermeasures. The 

coordination is important as products transition from the advanced 

research and development phase, where procurement is controlled 

by BARDA, to the approval phase, where procurement responsibility shifts to CDC. The Committee requests an update on this 

stockpiling coordination process between BARDA and CDC in the 

fiscal year 2017 budget request. The Committee provided an increase to the CDC SNS program to better enable the hand off of 

MCM between BARDA and CDC and to better support SNS new 

acquisition and replenishment activity that is required to protect 

the American public. The Committee further expects CDC and 

BARDA leadership to coordinate on the spend plan for the CDC 

SNS funds as part of the improved process. 

The Committee commends the ASPR for delivering the first 

multiyear budget plan. The Committee requests that the multiyear 

budget plan be updated annually and include additional details, 

such as influenza MCM program budgets and life cycle management costs. 

Antibiotic Resistance (AbR).—The Committee recognizes the importance of combating AbR, while funding for BARDA remains focused on its statutory mission to develop CBRN countermeasures, 

BARDA is directed to work closely with CDC and NIAID on the 

government-wide antibiotic resistance activity. The Committee provided support in NIAID and CDC and directs these organizations 

to jointly work with BARDA on coordinated goals, measurable objectives, and funding plans to spur research and development on 

AbR, build AbR laboratory capacity in states, and best leverage the 

funds provided support for evidence based public health activities 

in states on the government-wide effort. The Committee requests 

an update in the fiscal year 2017 budget request on the joint 


rfrederick on DSK6VPTVN1PROD with HEARING
115 

BARDA, NIAID, and CDC goals and measurable objectives to ensure the best leveraging of the funds provided to CDC and NIAID 

on this effort. 

GENERAL PROVISIONS

PREVENTION AND PUBLIC HEALTH TRANSFER TABLE

The Committee continues a provision that directs the transfer of 

all available Prevention and Public Health (PPH) fund. In fiscal 

year 2016 the level appropriated for the fund is $932,000,000 after 

accounting for sequestration. The Committee includes bill language 

in section 218 of this Act that requires that funds be transferred 

within 45 days of enactment of this act to the following accounts, 

for the following activities, and in the following amounts: 

[$ in thousands] 

Agency Account Program FY 2016 Committee 

CDC Immunization and Respiratory Diseases ................ Section 317 Immunization Grants $150,285 

CDC Emerging and Zoonotic Infectious Diseases .......... Epidemiology and Laboratory Capacity Grants.40,000 

CDC Emerging and Zoonotic Infectious Diseases .......... Healthcare Associated Infections 12,000 

CDC Chronic Disease Prevention and Health Promotion Breast Feeding Grants (Hospitals 

Promoting Breastfeeding).

8,000 

CDC Chronic Disease Prevention and Health Promotion Million Hearts Program ................ 4,000 

CDC Chronic Disease Prevention and Health Promotion Heart Disease & Stroke Prevention Program.170,000 

CDC Chronic Disease Prevention and Health Promotion Diabetes ....................................... 180,000 

CDC Chronic Disease Prevention and Health Promotion National Diabetes Prevention Program.10,000 

CDC Chronic Disease Prevention and Health Promotion Breast and Cervical Cancer ........ 104,000 

CDC Chronic Disease Prevention and Health Promotion Colorectal Cancer ........................ 39,515 

CDC Chronic Disease Prevention and Health Promotion Workplace Wellness ..................... 7,500 

CDC Chronic Disease Prevention and Health Promotion Early Care Collaboratives ............ 4,000 

CDC Environmental Health .............................................. Lead Poisoning Prevention .......... 15,000 

CDC CDC-Wide Activities ................................................ Prevention Health and Health 

Services Block Grants.

170,000 

ACL Aging and Disability Services Programs ................ Alzheimer’s Disease Prevention 

Education and Outreach.

12,700 

ACL Aging and Disability Services Programs ................ Falls Prevention ........................... 5,000 

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 modifies a provision to limit the salary 

of an individual through an HHS grant or other extramural mechanism to not more than the rate of Executive Level III. 

Sec. 204. The Committee continues a provision to prohibit the 

Secretary from using evaluation set-aside funds until the Committees on Appropriations of the House of Representatives and the 

Senate receive a report detailing the planned use of such funds. 

Sec. 205. The Committee modifies a provision regarding the enacted level for the PHS evaluation set-aside, reducing it to the lesser of 2.4 percent or $1,068,000,000. 


rfrederick on DSK6VPTVN1PROD with HEARING
116 

(TRANSFER OF FUNDS)

Sec. 206. The Committee continues a provision permitting the 

Secretary of HHS to transfer up to one percent of any discretionary 

funds between appropriations, provided that no appropriation is increased by more than three percent by any such transfer to meet 

emergency needs. Advance notification must be provided to the 

Committees on Appropriations at the program, project, and activity 

level in advance of any transfer. 

(TRANSFER OF FUNDS)

Sec. 207. The Committee continues a provision to provide the Director of NIH, jointly with the Director of the Office of AIDS Research, the authority to transfer up to three percent of human immunodeficiency virus funds. 

(TRANSFER OF FUNDS)

Sec. 208. The Committee continues a provision to make NIH 

funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Sec. 209. 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. 210. The Committee continues a provision stating that no 

provider of services under Title X shall be exempt from any state 

law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

Sec. 211. The Committee continues a provision related to the 

Medicare Advantage program. 

Sec. 212. The Committee continues a provision to allow funding 

for HHS 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. 213. The Committee continues a provision granting authority to the Office of the Director of the NIH to enter directly into 

transactions in order to implement the NIH Common Fund for 

medical research and permitting the Director to utilize peer review 

procedures, as appropriate, to obtain assessments of scientific and 

technical merit. 

Sec. 214. The Committee continues a provision clarifying that 

funds appropriated to NIH institutes and centers may be used for 

minor repairs or improvements to their buildings, up to $3,500,000 

per project with a total limit for NIH of $45,000,000. 

(TRANSFER OF FUNDS)

Sec. 215. The Committee modifies a provision transferring one 

percent of the funding made available for National Institutes of 

Health National Research Service Awards to the Health Resources 

and Services Administration. 

Sec. 216. The Committee continues a provision prohibiting funds 

from being used to advocate or promote gun control. 


rfrederick on DSK6VPTVN1PROD with HEARING
117 

Sec. 217. The Committee continues a provision relating to publicly accessible information regarding uses of funds under section 

4002 of Public Law 111–148. 

Sec. 218. The Committee continues language directing the spending of the Prevention and Public Health fund. 

Sec. 219. The Committee continues the Biomedical Advanced Research and Development Authority ten year contract authority. 

Sec. 220. The Committee continues language requiring HHS to 

include certain information concerning the number of full-time federal employees and contractors working on the ACA in the fiscal 

year 2017 budget request. 

Sec. 221. The Committee continues the 60 day flexibility for National Health Service Corps contract terminations. 

Sec. 222. The Committee continues a provision allowing NIH to 

retain payments for certain research organisms and substances. 

Sec. 223. The Committee continues specific report requirements 

for CMS’s marketplaces activities in the fiscal year 2017 budget request. 

Sec. 224. The Committee continues a provision prohibiting CMS 

Program Account from being used to support risk corridor payments. 

(RESCISSION)

Sec. 225. The Committee includes a new provision rescinding the 

nonrecurring expenses fund. 

Sec. 226. The Committee includes a new provision transferring 

certain functions of the Agency for Healthcare Research and Quality and terminating the agency as a separate entity. 

Sec. 227. The Committee includes a new provision requiring HHS 

to submit an analysis of the impact of section 2713 of the PHS Act 

on discretionary programs. 

Sec. 228. The Committee includes a new provision prohibiting 

funds from being used for patient-centered outcomes research. 

Sec. 229. The Committee includes a new provision prohibiting 

funds from being used for Title X family planning activities. 

Sec. 230. The Committee includes a new provision to prevent 

funding of the Navigator program. 

(RESCISSION)

Sec. 231. The Committee includes a new provision rescinding expired funds under HRSA. 

Sec. 232. The Committee includes a new provision requiring the 

Secretaries of HHS and the Department of Agriculture to develop 

dietary guidelines based on scientific evidence and to provide for 

additional public comment. 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

The Committee recommends $14,869,641,000 for the Education 

for the Disadvantaged programs, which is $666,466,000 below the 

fiscal year 2015 enacted level and $1,722,905,000 below the budget 

request. Of the total amount available, $3,987,006,000 is appropriated for fiscal year 2016 for obligation on or after July 1, 2016 


rfrederick on DSK6VPTVN1PROD with HEARING
118 

and $10,841,177,000 is appropriated for fiscal year 2016 for obligation on or after October 1, 2016. This appropriation account includes compensatory education programs authorized under title I of 

the Elementary and Secondary Education Act of 1965 (ESEA) and 

section 418A of the Higher Education Act. 

Grants to Local Educational Agencies 

For fiscal year 2016, the Committee recommends $14,409,802,000 

for Title I grants to local educational agencies (school districts), 

which is the same as the fiscal year 2015 enacted level and 

$1,000,000,000 below the budget request. Title I grants support the 

ESEA’s accountability system, which emphasizes State standards 

and aligned assessments, and measuring adequate yearly progress 

in reading and math for all students annually in grades three 

through eight, and once in high school. 

Of the amounts provided for Title I programs, $6,459,401,000 is 

available for Basic Grants to Local Educational Agencies (LEAs). 

This amount is the same as the fiscal year 2015 enacted level and 

the budget request. 

Within the amount for Title I Basic Grants, up to $3,984,000 is 

made available to the Secretary of Education on October 1, 2015, 

to obtain annually updated LEA-level poverty data from the Bureau of the Census. 

The Committee recommends $1,362,301,000 for Title I Concentration Grants, which is the same as the fiscal year 2015 enacted level and the budget request. Concentration Grants target 

funds to school districts in which the number of low-income children exceeds 6,500 or 15 percent of the total school-age population. 

The Committee recommends $3,294,050,000 for Title I Targeted 

Grants, which is the same as the fiscal year 2015 enacted level and 

$500,000,000 below the budget request. Targeted Grants provide 

higher payments to school districts with high numbers or percentages of low-income students. 

The Committee recommends $3,294,050,000 for Title I Education 

Finance Incentive Grants (EFIGs), which is the same as the fiscal 

year 2015 enacted level and $500,000,000 below the budget request. EFIGs provide payments to States and school districts that 

incorporate ‘‘equity’’ and ‘‘effort’’ factors to improve the equity of 

State funding systems. 

The Department shall continue to use its existing formula in allocating funds to Bureau of Indian Education schools and to follow 

this practice in any relevant future emergency funding that provides it the same authority and discretion. 

Evaluation 

The Committee does not include a specific appropriation for evaluation of the Title I program, which is $710,000 below the fiscal 

year 2015 enacted level. Instead of appropriating a specific dollar 

amount for this activity, the Committee bill includes language to 

allow the Department to reserve up to 0.5 percent of each ESEA 

appropriation in the bill, except for titles I and III of the ESEA, 

for evaluation of ESEA programs. 


rfrederick on DSK6VPTVN1PROD with HEARING
119 

School Improvement Grants 

The Committee recommends no funding for School Improvement Grants (SIG), which is $505,756,000 below the fiscal year 2015 enacted level and $555,756,000 below the budget request. This formula grant program provides assistance to States and school districts for Title I schools. The Committee is concerned that the Department has implemented this program in an overly prescriptive 

fashion that is not workable, especially in many rural areas. The 

Department has not demonstrated that these models have been effective in turning around low performing schools and has significant concerns about investing additional dollars into such a program in the absence of a reauthorized ESEA. 

Striving Readers 

The Committee recommends no funding for Striving Readers, which is $160,000,000 below the fiscal year 2015 enacted level and 

the budget request. 

State Agency Programs: Migrant 

The Committee recommends $374,751,000 for the State Agency 

Program for Migrant Education, which is the same as the fiscal 

year 2015 enacted level and the budget request. This program supports special educational and related services for children of migrant agricultural workers and fishermen, including: (1) supplementary academic education; (2) remedial or compensatory instruction; (3) English for limited English proficient students; (4) testing; 

(5) guidance counseling; and (6) other activities to promote coordination of services across States for migrant children whose education is interrupted by frequent moves. 

State Agency Programs: Neglected and Delinquent 

For the State Agency Program for Neglected and Delinquent Children, the Committee recommends $47,614,000, which is the 

same as the fiscal year 2015 enacted level and the budget request. 

This formula grant program supports educational services for children and youth under age 21 in institutions for juvenile 

delinquents, adult correctional institutions, or institutions for the 

neglected. A portion of these funds may be used for projects that 

support the successful re-entry of youth offenders into postsecondary and vocational programs. 

Special Programs for Migrant Students 

The Committee recommends $37,474,000 for the Special Programs for Migrant Students, which is the same as the fiscal year 

2015 enacted level and $7,149,000 below the budget request. These 

programs support grants to colleges, universities, and nonprofit organizations to support educational programs designed for students 

who are engaged in migrant and other seasonal farm work. The 

High School Equivalency Program (HEP) recruits migrant students 

age 16 and over and provides academic and support services to 

help those students obtain a high school equivalency certificate and 

subsequently to gain employment or admission to a postsecondary 

institution or training program. The College Assistance Migrant 

Program (CAMP) provides tutoring and counseling services to firstyear, undergraduate migrant students and assists those students 


rfrederick on DSK6VPTVN1PROD with HEARING
120 

in obtaining student financial aid for their remaining undergraduate years. The Committee recommendation assumes the allocation of funds between HEP and CAMP as proposed by the Administration. 

School Readiness 

The Committee provides no funding for the Preschool Development Grants program, which is the same as the 2015 enacted level 

and $750,000,000 below the budget request. While improving the 

availability and quality of early childhood education is a worthwhile goal, the activities proposed by the Administration would 

represent an enormous expansion of the federal role in education. 

Instead of creating new, multi-billion dollar programs, the Committee encourages the Department and other related agencies to 

streamline federal support for early childhood education and care, 

simplify program administration in existing programs, and allow 

States to determine how best to coordinate services. 

The federal government already recognizes the importance of and 

provides a significant investment in programs that support and 

provide early childhood education and care every year. A 2012 Government Accountability Office (GAO) report found 45 such programs across multiple agencies costing taxpayers at least $13.3 billion in fiscal year 2010. 

Furthermore, as noted in the Department of Education’s (the Department’s) budget documents, 40 States and the District of Columbia have established at least one publicly-funded State preschool 

program. The president’s plan would require States to disrupt 

these successful programs to meet prescriptive national benchmarks and standards. 

IMPACT AID

The Committee recommends $1,298,603,000 for federal Impact Aid programs, which is $10,000,000 above the fiscal year 2015 enacted level and the budget request. This account supports payments to school districts affected by federal activities, such as those 

that educate children whose families are connected with the military or who live on Indian land. 

The Committee recognizes that Congress has sought to ensure all 

qualified school districts are able to provide military dependent 

students with a quality education and essential student support 

services. Without proper guidance, school districts are at risk of 

losing funding, which can result in cuts to programs designed to 

address the emotional, psychological, and educational needs of military dependent students. The Committee urges the Department of 

Education to provide school districts with clear and timely guidance on how to measure a school district’s tax rate compared to the 

State average tax rate. 

Basic Support Payments 

The Committee recommends $1,161,233,000 for Basic Support 

Payments to LEAs, which is $10,000,000 above the fiscal year 2015 

enacted level 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. 


rfrederick on DSK6VPTVN1PROD with HEARING
121 

Payments for Children with Disabilities 

The Committee recommends $48,316,000 for Payments for Children with Disabilities, which is the same as the fiscal year 2015 

enacted level and the budget request. These payments compensate 

school districts for the increased costs of serving federally-connected children with disabilities. 

Facilities Maintenance 

The Committee recommends $4,835,000 for Facilities Maintenance, which is the same as the fiscal year 2015 enacted level and 

$66,813,000 below the budget request. These capital payments are 

authorized for maintenance of certain facilities owned by the Department. 

Construction 

The Committee recommends $17,406,000 for the Construction 

program, which is the same as the fiscal year 2015 enacted level 

and the budget request. This program provides formula grants for 

building and renovating school facilities to LEAs that educate federally-connected students or have federally-owned land. 

Payments for Federal Property 

The Committee recommends $66,813,000 for Payments for Federal Property, which is the same as the fiscal year 2015 enacted 

level and $66,813,000 above 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 Committee recommends $3,500,720,000 for School Improvement Programs, which is $901,951,000 below the fiscal year 2015 

enacted level and $1,192,451,000 below the budget request. The 

School Improvement account includes programs authorized under 

Titles II, IV, VI, and VII of the ESEA; the McKinney-Vento Homeless Assistance Act; Title IV A of the Civil Rights Act; section 203 

of the Educational Technical Assistance Act of 2002; and section 

105 of the Compact of Free Association Amendments Act of 2003. 

State Grants for Improving Teacher Quality 

The Committee recommends $1,681,441,000 for State Grants for 

Improving Teacher Quality, which is $668,389,000 below the fiscal 

year 2015 enacted level and the budget request. Teacher Quality 

Grants provide States and districts with a flexible source of funding with which to strengthen the skills and knowledge of teachers, 

principals, 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; and expanding, establishing, 

or improving alternative routes to State certification. 

The Committee includes a 3.2 percent set-aside for Supporting 

Effective Educator Development (SEED), which supports competitive awards to national nonprofit organizations to support teacher 

or principal training or professional enhancement activities. 


rfrederick on DSK6VPTVN1PROD with HEARING
122 

The bill includes funding within the SEED set-aside for competitive grants to non-profit organizations with demonstrated effectiveness in the development and implementation of civic learning programs. Priority should be given to applicants that demonstrate innovation, scalability, and a focus on underserved populations, including rural schools and students. 

The bill does not include language included in the fiscal year 

2015 omnibus setting aside up to 8 percent of SEED funds for research, dissemination, evaluation, and technical assistance. 

Educational Technology State Grants 

The Committee recommends no funding for the newly proposed 

Educational Technology State Grants program, which is 

$200,000,000 below the budget request. This program was not 

funded in fiscal year 2015. 

Mathematics and Science Partnerships 

The Committee recommends no funding for Mathematics and Science Partnerships, which is $152,717,000 below the fiscal year 

2015 enacted level and $202,717,000 below the budget request. 

This program provides professional development for math and 

science teachers; these activities can be carried out under other authorities funded in this bill and through other federal agencies such 

as the National Science Foundation. 

Supplemental Education Grants 

The Committee recommends $16,699,000 for Supplemental Education Grants to the Federated States of Micronesia and the Republic of the Marshall Islands, which is the same as the fiscal year 

2015 enacted level and the budget request. The Compact of Free 

Association Amendments Act of 2003 (P.L. 108–188) authorizes 

these entities to receive funding for general education assistance. 

The Committee recommendation includes a consolidated amount 

for Supplemental Education Grants because the underlying statute 

determines the allocation between Micronesia and the Marshall Islands. 

21st Century Community Learning Centers 

The Committee recommends $1,151,673,000 for 21st Century 

Community Learning Centers (CCLC), which is the same as the 

fiscal year 2015 enacted level and the budget request. This program is a formula grant to States, which in turn distribute funds 

on a competitive basis to local school districts, community-based organizations, and other public entities and private organizations. 

Funds may be used for before and after school activities, recreational activities, and expanded library service hours. 

Expanded Learning Time.—The Committee is concerned about 

recent efforts by the Department to offer flexibility waivers for the 

21st Century Community Learning Centers (21st CCLC) that 

would implement expanded learning time by adding time to the 

school day, school week, or school year, by diverting 21st CCLC 

funding away from quality afterschool, before school and summer 

learning programs. Current statute requires 21st CCLC funds be 

spent on quality afterschool, before-school or summer learning programming. The 21st CCLC initiative is the only federal funding 


rfrederick on DSK6VPTVN1PROD with HEARING
123 

source dedicated exclusively to before-school, afterschool and summer learning programs for students attending high-poverty, lowperforming schools. Data demonstrates that quality afterschool programs have a positive impact on a number of measures of student 

academic achievement, positively affecting behavior and discipline 

and helping relieve parents’ worries about their children’s safety 

during the hours when school is out. The Committee notes that 

State and local governments currently have the flexibility to use 

other federal funding for expanded learning time that adds additional time to the school day, school week, or school year. Furthermore, the Committee strongly believes any changes to 21st CCLC 

funding require legislative action in the form of authorization by 

the appropriate congressional committees. Therefore, the Committee has included bill language prohibiting the Department from 

allowing 21st CCLC funds from being used for expanded learning 

time. 

State Assessments 

The Committee recommends $300,000,000 for State Assessments, 

which is $78,000,000 below the fiscal year 2015 enacted level and 

$103,000,000 below the budget request. 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. 

Education for Homeless Children and Youth 

The Committee recommends $65,042,000 for the Education for 

Homeless Children and Youth program, which is the same as the 

fiscal year 2015 enacted level and $6,500,000 below the budget request. The Committee recognizes that without an education, these 

at-risk children and youth are unlikely to obtain the skills they 

need to become productive adults contributing to the economy and 

their communities. Grants are allocated to States in proportion to 

the total 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, remedial or other 

educational services. 

Training and Advisory Services 

The Committee recommends $6,575,000 for Training and Advisory Services authorized by Title IV A of the Civil Rights Act, 

which is the same as the fiscal year 2015 enacted level and the 

budget request. Title IV A authorizes technical assistance and 

training services for LEAs to address problems associated with desegregation on the basis of race, sex, or national origin. The Department awards three-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. 


rfrederick on DSK6VPTVN1PROD with HEARING
124 

Education for Native Hawaiians 

The Committee recommends $33,397,000 for the Education for 

Native Hawaiian program, which is $1,000,000 above the fiscal 

year 2015 level and the same as the budget request. Funds are 

used to provide competitive awards for supplemental education 

services to the Native Hawaiian population. 

Alaska Native Education Equity 

The Committee recommends $32,453,000 for the Alaska Native 

Education Equity program, which is $1,000,000 above the fiscal 

year 2015 level and the same as the budget request. Funds are 

used to provide competitive awards for supplemental education 

services to the Alaska Native population. 

Rural Education 

The Committee recommends $169,840,000 for Rural Education 

programs, which is the same as the fiscal year 2015 enacted level 

and the budget request. There are two programs to assist rural 

school districts with improving teaching and learning in their 

schools: the Small, Rural Schools Achievement program, which provides funds to rural districts that serve a small number of students; and the Rural and Low-Income Schools program that provides funds to rural districts that serve concentrations of poor students, regardless of the number of students served by the district. 

Funds appropriated for Rural Education shall be divided equally 

between these two programs. 

Comprehensive Centers 

The Committee recommends $43,600,000 for Comprehensive 

Centers, which is $4,845,000 below the fiscal year 2015 enacted 

level and $11,845,000 below the budget request. First funded in fiscal year 2005, this grant program currently finances 21 comprehensive centers, including 16 regional centers that are intended to provide technical assistance to State educational agencies within their 

geographic regions in helping to implement provisions of the No 

Child Left Behind Act. The remaining five centers are content centers that are designed to have in-depth knowledge of all aspects of 

school improvement. Each center specializes in one of five content 

areas: assessment and accountability; instruction; teacher quality; 

innovation and improvement; and high schools. 

The Committee bill includes language directing the Secretary to 

ensure that the Bureau of Indian Education has access to services 

provided under this section. 

INDIAN EDUCATION

The Committee recommends $143,939,000 for Indian Education, 

which is $20,000,000 above the fiscal year 2015 enacted level and 

$30,000,000 below the budget request. This account supports programs authorized by part A of title VII of the ESEA. 

Grants to Local Educational Agencies 

The Committee recommends $100,381,000 for Grants to Local 

Educational Agencies, which is the same as the fiscal year 2015 enacted level and the budget request. This program provides assistVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00124 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
125 

ance 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 ensure 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 $37,993,000 for Special Programs for Indian Children, which $20,000,000 above the fiscal year 2015 

enacted level and $30,000,000 below the budget request. These programs make competitive awards to improve the quality of education for Indian students. The program also funds the American 

Indian Teacher Corps and the American Indian Administrator 

Corps to recruit and support American Indians as teachers and 

school administrators. 

Within the total, the Committee recommends $22,890,000 for the 

Native Youth Community Projects, $19,875,000 above the fiscal 

year 2015 enacted level and $30,000,000 below the budget request. 

This program makes competitive awards to support culturally-relevant coordinated strategies to improve college- and career-readiness of Native American youth. 

National Activities 

The Committee recommends $5,565,000 for National Activities, 

which is the same as the fiscal year 2015 enacted level and the 

budget request. Funds under this authority support research, evaluation and data collection to provide information about the educational status of Indian students and the effectiveness of Indian 

education programs. 

State-Tribal Education Partnership Pilot.—The Committee recommends continued funding for the State-Tribal Education Partnership Pilot Program. In this pilot, tribes and States collaborate 

through agreements to implement ESEA programs in public 

schools located on reservations. Indian educators have long called 

for tribal-State-federal partnerships to involve Indian Tribes in 

educating their students and to improve American Indian/Alaska 

Native education outcomes. STEP pilots have, and will continue to, 

assist State and tribal governments to continue delivering the highest quality education for Indian students. 

INNOVATION AND IMPROVEMENT

The Committee recommends $275,000,000 for Innovation and Improvement programs, which is $827,111,000 below the fiscal year 

2015 enacted level and $1,326,559,000 below the budget request. 

This appropriation account includes programs authorized under 

portions of Title V of the ESEA. 

Investing in Innovation 

The Committee recommends no funding for the Investing in Innovation fund, which was established in the American Recovery 


rfrederick on DSK6VPTVN1PROD with HEARING
126 

and Reinvestment Act of 2009 and is not authorized. This amount 

is $120,000,000 below the fiscal year 2015 level and $300,000,000 

below the budget request. In the absence of a new ESEA reauthorization setting forth Congressionally-approved parameters for a 

program such as Investing in Innovation, the Committee does not 

recommend funding for this program. 

Teacher and Principal Pathways 

The Committee recommends no funding for the newly proposed 

Teacher and Principal Pathways program, $138,762,000 below the 

budget request. 

Next Generation High Schools 

The Committee recommends no funding for the newly proposed 

Next Generation High Schools program, $125,000,000 below the 

budget request. This program was not funded in fiscal year 2015. 

Transition to Teaching 

The Committee recommends no funding for Transition to Teaching, which is $13,700,000 below the fiscal year 2015 enacted level 

and the same as the budget request. The Administration proposed 

to consolidate this program into the Teacher and Principal Pathways program in its budget request. 

School Leadership 

The Committee recommends no funding for School Leadership 

activities, which is $16,368,000 below the fiscal year 2015 funding 

and the budget request. The Administration proposed to consolidate this program into the Teacher and Principal Pathways program in its budget request. 

Charter Schools 

The Committee recommends $275,000,000 for support of Charter 

School Grants, which is $21,828,000 above the fiscal year 2015 enacted level and $100,000,000 below the budget request. 

The Charter Schools Grants program encourages education reform by supporting the planning, development, and initial implementation of charter schools. In exchange for a commitment to increase student achievement, charter schools are exempt from many 

statutory and regulatory requirements. The Charter Schools 

Grants program finances grants to State educational agencies 

(SEAs) or, if a State’s SEA chooses not to participate, charter 

school developers to support the development and initial implementation of public charter schools. Facilities Incentive Grants and 

credit enhancement awards help charter schools obtain adequate 

school facilities. These programs work in tandem to support the development and operation of charter schools. 

Magnet Schools Assistance 

The Committee recommends no funds for the Magnet Schools Assistance program, which is $91,647,000 below the fiscal year 2015 

enacted level and the budget request. 


rfrederick on DSK6VPTVN1PROD with HEARING
127 

Fund for the Improvement of Education 

The Committee recommends no funds for the Fund for the Improvement of Education, which is $323,000,000 below the fiscal 

year 2015 enacted level and $166,926,000 below the budget request. In the past, this account has been used to allow the Administration to have a pot of flexible funding for new and often unauthorized initiatives. Given the fiscal constraints facing the Committee, funding is not provided for any of these purposes in this 

bill. 

Teacher Incentive Fund 

The Committee recommends no funding for the Teacher Incentive Fund (TIF), which is $230,000,000 below the fiscal year 2015 

enacted level and $350,000,000 below the budget request. 

Ready to Learn Television 

The Committee recommends no funding for Ready to Learn Television, which is $25,741,000 below the fiscal year 2015 enacted 

level and the budget request. 

Advanced Placement Program 

The Committee recommends no funding for the Advanced Placement program, which is $28,483,000 below the fiscal year 2015 enacted level and the budget request. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

The Committee recommends $56,754,000 for Safe Schools and 

Citizenship Education programs, which is $166,561,000 below the 

fiscal year 2015 enacted level and $292,807,000 below the budget 

request. This appropriation account includes programs authorized 

under parts of Titles IV and V of the ESEA. 

Promise Neighborhoods 

The Committee recommends $56,754,000 for Promise Neighborhoods, which is the same as the fiscal year 2015 level and 

$93,246,000 below the budget request. Promise Neighborhoods supports grants to nonprofit, community-based organizations for the 

development of comprehensive neighborhood programs designed to 

combat the effects of poverty and improve educational outcomes for 

children and youth, from birth through college. 

Safe and Drug-Free Schools and Communities: National Activities 

The Committee recommends no funding for National Activities, 

which is $70,000,000 below the fiscal year 2015 enacted level and 

$90,000,000 below the budget request. 

Elementary and Secondary School Counseling 

The Committee recommends no funding for Elementary and Secondary School Counseling, which is $49,561,000 below the fiscal 

year 2015 enacted level and the budget request. 


rfrederick on DSK6VPTVN1PROD with HEARING
128 

Carol M. White Physical Education Program 

The Committee recommends no funding for this program, which 

is $47,000,000 below the fiscal year 2015 enacted level and 

$60,000,000 below the budget request. 

ENGLISH LANGUAGE ACQUISITION

The Committee recommends $737,400,000 for the English Language Acquisition program, which is the same as the fiscal year 

2015 enacted level and $36,000,000 below the budget request. Of 

this amount provided for the 2016–2017 academic year, funds are 

appropriated for obligation on or after July 1, 2016 and available 

through September 30, 2017. The bill continues language to calculate all State awards based on a three-year average of data from 

the American Community Survey. 

This program provides formula grants to States to serve limited 

English proficient (LEP) students. Grants are based on each State’s 

share of the national LEP and recent immigrant student population. Funds under this account also support professional development to increase the pool of teachers prepared to serve LEP students as well as evaluation activities. 

SPECIAL EDUCATION

The Committee recommends $13,024,510,000 for programs authorized under the Individuals with Disabilities Education Act 

(IDEA) for children with disabilities. This is $502,152,000 above 

the fiscal year 2015 enacted level and $202,152,000 above the 

budget request. Of the total amount available, $3,367,611,000 is 

available for obligation on July 1, 2016, and $9,424,183,000 is 

available for obligation on October 1, 2016. These grants help 

States and localities pay for a free appropriate education for 6.6 

million students with disabilities aged 3 through 21 years. 

Grants to States 

The Committee recommends $12,000,000,000 for Part B Grants 

to States, which is $502,152,000 above the fiscal year 2015 enacted 

level and $327,152,000 above the budget request. This program 

provides formula grants to assist States in meeting the costs of providing special education and related services to children with disabilities. States generally transfer most of the funds to LEAs; however, they can reserve some funds for program monitoring, technical assistance, and other related activities. In order to be eligible 

for funds, States must make free appropriate public education 

available to all children with disabilities. 

The Committee includes bill language excluding any amount by 

which a State’s allocation is reduced for failure to meet the maintenance of effort threshold from being used to calculate the State’s 

allocation under section 611(d) of the IDEA in subsequent years. 

The Committee also includes bill language directing the Secretary 

to distribute any reduction in a State’s allocation under said section to all other States based on the formula established under section 611(d), excluding those States that are penalized. 


rfrederick on DSK6VPTVN1PROD with HEARING
129 

Preschool Grants 

The Committee recommends $353,238,000 for Preschool Grants, 

which is the same as the fiscal year 2015 enacted level and 

$50,000,000 below the budget request. These funds provide additional assistance to States to help them make free, appropriate 

public education available to children with disabilities ages three 

through five. 

Grants for Infants and Families 

The Committee recommends $438,556,000 for Grants for Infants 

and Families, which is the same as the fiscal year 2015 enacted 

level and $65,000,000 below the budget request. These funds provide additional assistance to States to help them make free, appropriate public education available to children with disabilities from 

birth through age two. 

IDEA National Activities 

The Committee recommends $232,716,000 for the IDEA National 

Activities program, which is the same as the fiscal year 2015 enacted level and $10,000,000 below the budget request. The IDEA 

National Activities programs support State efforts to improve early 

intervention and education results for children with disabilities. 

State Personnel Development.—The Committee recommends 

$41,630,000 for State Personnel Development, which is the same as 

the fiscal year 2015 enacted level and the budget request. This program supports grants to States to assist with improving personnel 

preparation and professional development related to early intervention and educational and transition services that improve outcomes 

for students with disabilities. 

Technical Assistance and Dissemination.—The Committee recommends $51,928,000 for Technical Assistance and Dissemination, 

which is the same as the fiscal year 2015 enacted level and 

$10,000,000 below the budget request. This program provides funding for technical assistance, demonstration projects, and information dissemination. These funds support efforts by State and local 

educational agencies, institutions of higher education, and other 

entities to build State and local capacity to make systemic changes 

and improve results for children with disabilities. 

Personnel Preparation.—The Committee recommends 

$83,700,000 for Personnel Preparation, which is the same as the 

fiscal year 2015 enacted level and the budget request. 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 necessary skills 

and knowledge to serve children with special needs. Awards focus 

on addressing the need for leadership and personnel to serve lowincidence populations. 

Parent Information Centers.—The Committee recommends 

$27,411,000 for Parent Information Centers, which is the same as 

the fiscal year 2015 enacted 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 


rfrederick on DSK6VPTVN1PROD with HEARING
130 

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. 

Technology and Media Services.—The Committee recommends 

$28,047,000 for Technology and Media Services, which is the same 

as the fiscal year 2015 enacted level and 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. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

The Committee recommends $3,529,605,000 for Rehabilitation 

Services and Disability Research, which is $180,248,000 below the 

fiscal year 2015 enacted level and $2,504,000 below the budget request. The programs in this account are authorized by the Rehabilitation Act of 1973 and the Helen Keller National Center Act. 

Vocational Rehabilitation State Grants.—The Committee recommends $3,391,770,000 for Vocational Rehabilitation (VR) State 

Grants, which is $56,696,000 above the fiscal year 2015 enacted 

level and the same as the budget request. 

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. The Committee’s recommendation provides the cost-ofliving adjustment for Vocational Rehabilitation Grants to States, as 

authorized. 

The Committee does not include language allowing Vocational 

Rehabilitation State grant unmatched funds in excess of any funds 

requested during the reallotment process to be available for the 

Promoting Readiness of Minors in Supplemental Security Income 

program. 

Client Assistance State Grants 

The Committee recommends $13,000,000 for Client Assistance 

State Grants, which is the same as the fiscal year 2015 enacted 

level and the budget request. Client Assistance State Grants support services for eligible individuals and applicants of the VR State 

Grants program, and other programs, projects, and services funded 

under the Rehabilitation Act. These 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 

The Committee recommends $30,188,000 for the Training program, which is the same as the fiscal year 2015 enacted level and 

the budget request. The program supports long-term and shortterm 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. The Committee does 


rfrederick on DSK6VPTVN1PROD with HEARING
131 

not include the proposal in the budget request to shift funding from 

the In-Service Training program from this account to the Vocational Rehabilitation State Grants account. 

Demonstration and Training Programs 

The Committee recommends $5,796,000 for Demonstration and 

Training Programs, which is the same as the fiscal year 2015 enacted level the budget request. 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. 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,650,000 for Protection and Advocacy of Individual Rights, which is the same as the fiscal year 

2015 enacted level and the budget request. Grants are awarded to 

entities that have the authority to pursue legal, administrative, 

and other appropriate remedies to protect and advocate for the 

rights of persons with disabilities. 

Supported Employment State Grants 

The Committee recommends $27,548,000 for Supported Employment State Grants, which is the same as the fiscal year 2015 enacted level and $3,000,000 below 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 the most significant disabilities 

are given special supervision and assistance to enable them to 

work in an integrated setting. 

Independent Living 

The Committee recommends $33,317,000 for Independent Living Programs, which is $101,183,000 below the fiscal year 2015 enacted level and the same as the budget request. These programs 

provide services to individuals with disabilities to maximize their 

independence and productivity, and to help them integrate into the 

mainstream of American society. 

Independent Living State Grants.—The Committee recommends 

no funding within the Department for Independent Living State 

Grants. The Workforce Innovation and Opportunity Act of 2014 

(WIOA) transferred this program to the Department of Health and 

Human Services (HHS). 

Centers for Independent Living.—The Committee recommends no 

funding within the Department for Centers for Independent Living. 

The WIOA transferred this program to HHS. 

Independent Living Services for Older Individuals Who Are 

Blind.—The Committee recommends $33,317,000 for Independent 

Living Services for Older Individuals Who Are Blind, which the 

same as the fiscal year 2015 enacted level and the budget request. 

Funds are distributed to States according to a formula based on the 

population of individuals who are 55 or older, and provide support 

for services to 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. 


rfrederick on DSK6VPTVN1PROD with HEARING
132 

Helen Keller National Center 

The Committee recommends $10,336,000 for the Helen Keller 

National Center for Deaf-Blind Youth and Adults, which is 

$1,209,000 above the fiscal year 2015 enacted level and $496,000 

above the budget request. These funds are used for the operation 

of a national center that provides intensive services for deaf-blind 

individuals and their families at Sands Point, New York, and a network of ten regional offices that provide referral, counseling, transition services, and technical assistance to service providers. 

National Institute on Disability and Rehabilitation Research 

The Committee recommends no funding within the Department 

for the National Institute on Disability and Rehabilitation Research. The WIOA transferred this program to HHS. 

Assistive Technology 

The Committee recommends no funding within the Department 

for Assistive Technology. The WIOA transferred this program to 

HHS. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

The Committee recommends $214,722,000 for Special Institutions for Persons with Disabilities, which is $2,500,000 above the 

fiscal year 2015 enacted level and the budget request. 

AMERICAN PRINTING HOUSE FOR THE BLIND

The Committee recommends $25,431,000 for the American Printing House for the Blind, which is $500,000 above the fiscal year 

2015 enacted level and the budget request. This funding subsidizes 

the production of educational materials for legally blind persons enrolled in pre-college programs. The Printing House, which is chartered by the Commonwealth of Kentucky, manufactures and maintains an inventory of educational materials in accessible formats 

that are 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. 

The Committee recognizes that students who are blind or have 

a vision loss must have equal access to the same educational content and should receive that information at the same time as their 

sighted peers if they are to achieve academically. The transition 

from print to digital publishing poses significant challenges for producers of accessible educational materials—especially conveying information via tactile graphics and image descriptions. To address 

this concern, the Committee encourages the Department to support 

the Resources with Enhanced Accessibility for Learning (REAL) 

Plan implemented by the American Printing House for the Blind. 

REAL will provide new advances in software and hardware technology to ensure that students with vision loss receive high quality 

educational materials, in a timely manner, in the appropriate formats required to meet individual student learning needs. 


rfrederick on DSK6VPTVN1PROD with HEARING
133 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

The Committee recommends $68,016,000 for the National Technical Institute for the Deaf, which is $1,000,000 above the fiscal 

year 2015 enacted level and the budget request. The National 

Technical Institute for the Deaf 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 these 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 Committee recommends $121,275,000 for Gallaudet University, which is $1,000,000 above the fiscal year 2015 enacted level 

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 research on deafness, 

and provides public service programs for deaf persons. 

CAREER, TECHNICAL, AND ADULT EDUCATION

The Committee recommends $1,700,609,000 for Career, Technical, and Adult Education programs, which is $7,077,000 below 

the fiscal year 2015 enacted level and $215,077,000 below the 

budget request. This account includes vocational education programs authorized by the Carl D. Perkins Career and Technical 

Education Act of 2006 and the Adult Education and Family Literacy Act (AEFLA). 

Career and Technical Education: State Grants 

The Committee recommends $1,117,598,000 for Career and Technical Education: State Grants, which is the same as the fiscal year 

2015 enacted level and $200,000,000 below the budget request. 

Funds are made available for obligation on October 1, 2016. 

State Grants support a variety of career and technical education 

programs developed in accordance with the State plan. The act focuses federal resources on institutions with high concentrations of 

low-income students. The populations assisted by State Grants 

range from secondary students in pre-vocational courses to adults 

who need retraining to adapt to changing technological and labor 

markets. Funding for State Grants will continue support for Stateof-the art career and technical training to approximately 6 million 

students in secondary schools and more than 4 million students in 

community and technical colleges. 

The Committee includes no funding for the newly proposed 

American Technical Training Fund, $200,000,000 below the budget 

request. This program was not funded in fiscal year 2015. 


rfrederick on DSK6VPTVN1PROD with HEARING
134 

National Programs 

The Committee recommends $3,816,000 for National programs, 

which is $3,605,000 below the fiscal year 2015 enacted level and 

$5,605,000 below the budget request. This authority supports the 

conduct and dissemination of research in career and technical education. It also includes support for the National Centers for Research and Dissemination in Career and Technical Education and 

other discretionary research. 

Adult Basic and Literacy Education State Grants 

The Committee recommends $568,955,000 for Adult Basic and 

Literacy Education State Grants, which is the same as the fiscal 

year 2015 enacted level and the budget request. State formula 

grants, authorized under the AEFLA, support programs to enable 

all adults to acquire basic literacy skills, to enable those who so desire to complete secondary education, and to make available to 

adults the means to become more employable, productive, and responsible citizens. 

The bill also specifies that the set aside for English literacy and 

civics education State grants within the adult education program 

shall be $71,439,000 in fiscal year 2016, the same as the fiscal year 

2015 enacted level. 

Adult Education National Leadership Activities 

The Committee recommends $10,240,000 for National Leadership 

Activities, which is $3,472,000 below the fiscal year 2015 enacted 

level and $9,472,000 below the budget request. This program supports applied research, development, dissemination, evaluation, 

and program improvement efforts to strengthen the quality of adult 

education services. 

STUDENT FINANCIAL ASSISTANCE

The Committee recommends $23,828,210,000 for Student Financial Assistance programs, which is $370,000,000 below the fiscal 

year 2015 enacted level and the budget request. 

Pell Grants 

The Committee recommends $22,105,352,000 for the Pell Grant 

program, which is $370,000,000 below the fiscal year 2015 enacted 

level and the budget request. These funds will support Pell grants 

to students for the 2016–17 academic year. 

The Congressional Budget Office estimates that the budget authority provided in this bill is sufficient to maintain the discretionary portion of the maximum Pell Grant award at $4,860. When 

combined with the mandatory add-on of $1,055, this will result in 

a $5,915 maximum Pell Grant in the 2016–17 academic year. 

Pell Grants help to ensure access to higher educational opportunities for low- and middle-income students by providing need-based 

financial assistance. Grants are determined according to a statutory formula, which considers income, assets, household size, and 

the number of family members in college, among other factors. Pell 

Grants are the foundation of federal postsecondary student aid programs. 


rfrederick on DSK6VPTVN1PROD with HEARING
135 

In the past decade, Pell Grant spending has exploded. Expansions included in the College Cost Reduction and Access Act of 

2007, the Higher Education Opportunity Act of 2008, the stimulus 

bill in 2009, and the Student Aid and Fiscal Responsibility Act of 

2011 created an unsustainable situation that had recently put the 

program on a path toward bankruptcy. Numerous expansions, coupled with a dramatic rise in the number of eligible students due 

to the recession, caused the cost of discretionary Pell Grants to 

nearly double, from $16.1 billion in 2008 to over $31 billion in 

2014. To address these challenges while maintaining the maximum 

Pell award, the Committee included responsible, common-sense reforms in the Consolidated Appropriations Act, 2012. As a result of 

these measures, the Pell Grant program has experienced a surplus 

in recent fiscal years. The Committee recommendation uses this 

surplus along with the funds appropriated in this bill to maintain 

the maximum Pell Grant award in the 2016–17 academic year. 

However, the Committee notes with concern that the Pell Grant 

program will again face a significant fiscal shortfall in future years 

without further reforms to make the program more efficient and 

targeted to the students and families that are most in need. 

Federal Supplemental Educational Opportunity Grants 

The Committee recommends $733,130,000 for this program, 

which is the same as the fiscal year 2015 enacted level and the 

budget request. Supplemental Educational Opportunity Grants 

(SEOG) provide funds to postsecondary institutions for need-based 

grants of up to $4,000 to undergraduate students, with priority 

given to students who are Pell-eligible. Approximately 65 percent 

of dependent recipients have annual family incomes under $30,000 

and nearly 80 percent of independent SEOG recipients have annual 

family incomes under $20,000. Institutions must contribute a 25 

percent match toward their Supplemental Educational Opportunity 

Grant allocation. 

Federal Work-Study 

The Committee recommends $989,728,000 for the Federal WorkStudy program, which is the same as the fiscal year 2015 enacted 

level and the budget request. Federal Work-Study funds are provided through institutions to students who work part-time. The 

funds assist with paying for the cost of education. Approximately 

3,400 colleges and universities receive funding, according to a statutory formula, and may allocate it for job location and job development centers. Work-study jobs must pay at least the federal minimum wage and institutions must provide 25 percent of student 

earnings. 

Within the total funding level for the Federal Work-Study program, the Committee recommends $8,390,000 for the Work Colleges program, which is the same as the fiscal year 2015 enacted 

level. The Work Colleges program is authorized under section 448 

of the Higher Education Act. 

STUDENT AID ADMINISTRATION

The Committee recommends $1,446,924,000 for Student Aid Administration (SAA), which is $50,000,000 above the fiscal year 2015 

enacted level and $134,930,000 below the budget request. Programs 


rfrederick on DSK6VPTVN1PROD with HEARING
136 

administered under this account include Pell Grants, campus-based 

programs, Teacher Education Assistance for College and Higher 

Education (TEACH) grants, and federal student loan programs. 

Salaries and Expenses.—Within the total provided for Student Aid Administration, the Committee recommends $675,224,000 for 

salaries and expenses, which is the same as the 2015 enacted level 

and $51,419,000 below the budget request. 

Loan Servicing Activities.—Within the total provided for SAA, the Committee recommends $771,700,000 for Loan Servicing Activities, which is the same as the 2015 enacted level and 

$83,511,000 below the budget request. 

Private Collection Agencies.—The Committee recognizes the importance of the Department’s contracts with private collection agencies (PCAs) to encouraging the timely repayment of federal student 

loans. The oversight and management of these contracts should be 

performed in a fair and consistent manner to ensure the rights of 

borrowers are paramount and to protect American taxpayers. However, the Committee is concerned about the current state of the 

contracting process with the PCAs and the Department. During the 

last contract period, the department relied on 22 PCAs to assist 

borrowers in rehabilitating their defaulted student loans and resuming timely payments. In anticipation of these contracts ending 

in April 2015, the Department awarded extensions to only 5 of the 

22 companies, effectively reducing the pool of PCAs by almost 80 

percent until the new contract period begins. The Committee is 

concerned that this sharp drop in the number PCAs could lead to 

poor administration and customer care for students and result in 

fewer rehabilitations and repayments of federal student loans. 

Within 60 days after the enactment of this Act, the Department is 

directed to submit a report to the House Appropriations Committee 

on how it plans to ensure proper oversight and management of the 

defaulted student loan portfolio and conduct effective monitoring of 

interactions between borrowers and the PCAs. 

HIGHER EDUCATION

The Committee recommends $1,909,042,000 for Higher Edu- cation programs, which is $15,797,000 below the fiscal year 2015 

enacted level and $163,003,000 below the budget request. 

Strengthening Institutions 

The Committee recommends $82,071,000 for the Part A, 

Strengthening Institutions program, which is $1,609,000 above the 

fiscal year 2015 enacted level and the budget request. This program provides competitive grants for general operating subsidies to 

institutions with low average educational and general expenditures 

per student and significant percentages of low-income students. 

Funds may be used for faculty and academic program development, 

management, joint use of libraries and laboratories, acquisition of 

equipment, and student services. 

Strengthening Hispanic-Serving Institutions 

The Committee recommends $102,236,000 for the Hispanic-Serving Institutions program, which is $2,005,000 above the fiscal year 

2015 enacted level and the budget request. The Hispanic-Serving 

Institutions program provides operating subsidies to schools that 


rfrederick on DSK6VPTVN1PROD with HEARING
137 

serve at least 25 percent Hispanic students. Funds may be used for 

faculty and academic program development, management, joint use 

of libraries and laboratories, acquisition of equipment, and student 

services. 

Promoting Postbaccalaureate Opportunities for Hispanic Americans 

The Committee recommends $9,172,000 for the Promoting 

Postbaccalaureate Opportunities for Hispanic Americans program, 

which is $180,000 above the fiscal year 2015 enacted level and 

$1,393,000 below the budget request. This program provides expanded post baccalaureate educational opportunities for the academic attainment of Hispanic and low income students. In addition, it expands academic offerings and enhances program quality 

at institutions of higher education educating the majority of Hispanic college students. 

Strengthening Historically Black Colleges and Universities 

The Committee recommends $232,074,000 for Strengthening Historically Black Colleges and Universities (HBCUs), which is 

$4,550,000 above the fiscal year 2015 enacted level and the budget 

request. This program provides operating subsidies to accredited, 

historically black colleges and universities that were established 

prior to 1964, with the principal mission of educating black Americans. Funds 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. 

Strengthening Historically Black Graduate Institutions 

The Committee recommends $60,017,000 for the Strengthening 

Historically Black Graduate Institutions program, which is 

$1,177,000 above the fiscal year 2015 enacted level and the budget 

request. The program provides five-year grants to 18 postsecondary 

institutions that are specified in section 326(e)(1) of the Higher 

Education Act. Funds may be used to build endowments, provide 

scholarships and fellowships, and to assist students with the enrollment and completion of post baccalaureate and professional degrees. 

Strengthening Predominantly Black Institutions 

The Committee recommends $9,429,000 for the Strengthening 

Predominantly Black Institutions (PBIs) program, which is 

$185,000 above the fiscal year 2015 enacted level and the budget 

request. 

Strengthening Asian American and Native American Pacific-Islander-Serving Institutions 

The Committee recommends $3,175,000 for the Asian American 

Pacific Islander program, which is $62,000 above the fiscal year 

2015 enacted level and the budget request. This program provides 

grants to undergraduate institutions that have an undergraduate 

student enrollment of at least ten percent Asian American or Native American Pacific Islander. 


rfrederick on DSK6VPTVN1PROD with HEARING
138 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions 

The Committee recommends $13,090,000 for the Strengthening 

Alaska Native and Native Hawaiian-Serving Institutions program, 

which is $257,000 above the fiscal year 2015 enacted level and the 

budget request, to provide competitive grants to improve capacity 

to serve Alaska Native and Native Hawaiian students. 

Native American Serving Non-Tribal Institutions 

The Committee recommends $3,175,000 for the Native American 

Serving Non-Tribal Institutions program, which is $62,000 above 

the fiscal year 2015 enacted level and the budget request. 

Strengthening Tribally Controlled Colleges and Universities 

The Committee recommends $30,000,000 for the Strengthening 

Tribally Controlled Colleges and Universities program, which is 

$4,338,000 above the fiscal year 2015 enacted level and the budget 

request. 

International Education and Foreign Language Studies 

Domestic Programs.—The Committee recommends $65,103,000 

for the Domestic Programs of the International Education and Foreign Languages Studies program, which is the same as the fiscal 

year 2015 enacted level and $2,000,000 below the budget request. 

Authorized by title VI of the Higher Education Act, these 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. 

Overseas Programs.—The Committee recommends $7,061,000 for 

the Overseas Programs of the International Education, which is the 

same as the fiscal year 2015 enacted level and $2,000,000 below 

the budget request. Funding for these programs support group 

projects, faculty research, special bilateral research, and doctoral 

dissertation research conducted abroad. 

Fund for the Improvement of Postsecondary Education 

The Committee recommends no funding for the Fund for the Improvement of Postsecondary Education (FIPSE), which is 

$67,775,000 below the fiscal year 2015 enacted level and the same 

as the budget request. This program awards grants and contracts 

to a variety of postsecondary institutions and other organizations 

to improve the quality and delivery of postsecondary education. In 

the past, this account has been used primarily to allow the Administration to have a pot of flexible funding for new and often unauthorized initiatives. Given the fiscal constraints facing the Committee, funding is not provided for any of these purposes in this 

bill. 

First in the World 

The Committee recommends no funding for the First in the 

World program. This program was funded within FIPSE in fiscal 


rfrederick on DSK6VPTVN1PROD with HEARING
139 

year 2015. The request included $200,000,000 for this program in 

a new budget line. 

Postsecondary Programs for Students with Intellectual Disabilities 

The Committee recommends $11,800,000 for Postsecondary Programs for Students with Intellectual Disabilities, which is the same 

as the fiscal year 2015 level and the budget request. This program, 

first funded in fiscal year 2011, supports grants to create model 

transition programs for students with intellectual disabilities. 

Minority Science and Engineering Improvement 

The Committee recommends $8,971,000 for the Minority Science 

and Engineering Improvement Program, which is the same as the 

fiscal year 2015 enacted level and the budget request. The Minority 

Science and Engineering Improvement 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. 

Tribally Controlled Postsecondary Career and Technical Institutions 

The Committee recommends $8,705,000 for this program, which 

is $1,000,000 above the fiscal year 2015 enacted level and the 

budget request. This program provides competitive grants to tribally controlled postsecondary career and technical institutions to 

provide career and technical education to Native American students. 

Federal TRIO Programs 

The Committee recommends $900,000,000 for TRIO programs, 

which is $60,248,000 above the fiscal year 2015 enacted level and 

$40,248,000 above the budget request. 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. The bill does not 

include funding for the TRIO Demonstration Initiative proposed by 

the Department in the budget request. 

GEAR UP 

The Committee recommends $322,754,000 for the GEAR UP program, which is $21,115,000 above the fiscal year 2015 enacted 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, encouragement, and 

scholarships to successfully pursue postsecondary education. 

The Committee bill continues language allowing the Department 

to maintain the Gaining Early Awareness and Readiness for Undergraduate Programs (GEAR UP) evaluation set-aside at 1.5 percent to work with the GEAR UP community and grantees to standVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00139 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
140 

ardize data collection, including through the use of third-party data 

systems. 

Graduate Assistance in Areas of National Need 

The Committee recommends $25,075,000 for the Graduate Assistance in Areas of National Need program, which is $4,218,000 

below the fiscal year 2015 enacted level and the budget request. 

Funds are included to fully cover the cost of grants made in prior 

years. The 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, 

such as the sciences, mathematics, engineering, and nursing. 

Teacher Quality Partnerships Grants 

The Committee recommends no funding for Teacher Quality 

Partnerships, which is $40,592,000 below the fiscal year 2015 enacted level and the same as the budget request. The Administration proposed to consolidate this program into the Teacher and 

Principal Pathways program in its budget request. 

Child Care Access Means Parents in School 

The Committee recommends $15,134,000 for the Child Care Access Means Parents in School program, which is the same as the 

fiscal year 2015 enacted level and the budget request. This program helps to ensure that low-income student parents have access 

to postsecondary education and affordable and convenient child 

care. Colleges and universities 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. 

GPRA Data/Higher Education Act Program Evaluation 

The Committee recommends no funding for program evaluation 

and development of data authorized under the Government Performance and Results Act for Higher Education programs administered by the Department. This amount is the same as the fiscal 

year 2015 enacted level and $30,000,000 below the budget request. 

HOWARD UNIVERSITY

The Committee recommends $221,821,000 for Howard University, which is the same as the fiscal year 2015 enacted level and 

the budget request. 

Howard University is a ‘‘Research I’’ university located in the 

District of Columbia. Howard University provides undergraduate 

liberal arts, graduate and professional instruction to over 10,000 

students from all 50 States. 

Within the amount provided, the Committee recommends 

$27,325,000 for the Howard University Hospital, which is the same 

as the fiscal year 2015 enacted level and the budget request. The 

hospital serves as a major acute and ambulatory care center for the 

District of Columbia, and functions as a major teaching facility. 


rfrederick on DSK6VPTVN1PROD with HEARING
141 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

The Committee recommends $435,000 for the federal administration of the College Housing and Academic Facilities Loan program, 

the Higher Educational Facilities Loans program, and the College 

Housing Loans program, which is the same as the fiscal year 2015 

enacted level and $15,000 below the budget request. Previously, 

these programs helped to ensure that postsecondary institutions 

were able to make necessary capital improvements to maintain and 

increase their ability to provide a high-quality education. Since 

1994, no new loans have been made, and the Department’s role has 

been to manage the outstanding loans. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING

PROGRAM ACCOUNT

The Committee recommends $19,430,000 for the Historically 

Black College and University Capital Financing program, which is 

the same as the fiscal year 2015 enacted level and $6,000 below the 

budget request. Funds are available through September 30, 2016. 

The Historically Black Colleges and University Capital Financing 

program is authorized under part D of Title III of the Higher Education Act and makes 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. 

Within the total provided for this program, the Committee recommendation includes $334,000 for the administrative expenses to 

carry out this program and $19,096,000 for loan subsidy costs that 

will be sufficient to guarantee up to $303,593,000 in new loans in 

fiscal year 2015. Funds will also be used to continue technical assistance services to help Historically Black Colleges and Universities improve their financial stability and access to capital markets. 

INSTITUTE OF EDUCATION SCIENCES

The Committee recommends $409,956,000 for the Institute of 

Education Sciences, which is $163,979,000 below the fiscal year 

2015 enacted level and $265,927,000 below the budget request. 

This account supports education research, statistics, dissemination, 

evaluation, and assessment activities. 

Research, Development, and Dissemination 

The Committee recommends $93,144,000 for Research, Development, and Dissemination, which is $86,716,000 below the fiscal 

year 2015 enacted level and $109,129,000 below the budget request. Funds are included to fully cover the cost of grants made in 

prior years. The Institute of Education Sciences (IES) supports research, development, and national dissemination activities that are 

aimed at expanding fundamental knowledge of education and promoting the use of research and development findings in the design 

of efforts to improve education. 

Statistics 

The Committee recommends $103,060,000 for the activities of the 

National Center for Education Statistics (NCES), which is the 


rfrederick on DSK6VPTVN1PROD with HEARING
142 

same as the fiscal year 2015 enacted level and $21,684,000 below 

the budget request. Statistics activities are authorized under title 

I of the Education Sciences Reform Act of 2002. 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 and include projections of enrollments, teacher supply and demand, and educational expenditures. NCES also 

provides technical assistance to State and local educational agencies and postsecondary institutions. 

Regional Educational Laboratories 

The Committee recommends no funding for Regional Educational Laboratories, which is $54,423,000 below the fiscal year 2015 enacted level and the budget request. 

Research in Special Education 

The Committee recommends $35,978,000 for Research in Special Education, which is $18,022,000 below the fiscal year 2015 enacted 

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. 

Special Education Studies and Evaluations 

The Committee recommends $6,000,000 for Special Education Studies and Evaluations, which is $4,818,000 below the fiscal year 

2015 enacted level and $7,000,000 below the budget request. This 

program awards competitive grants, contracts and cooperative 

agreements to assess the implementation of the IDEA and the effectiveness of State and local efforts to provide special education 

and early intervention programs and services to infants, toddlers, 

and children with disabilities. 

Statewide Data Systems 

The Committee recommends $34,539,000 for Statewide Data Systems, which is the same as the fiscal year 2015 enacted level and 

$35,461,000 below the budget request. Competitive grants under 

this authority are made to State educational agencies to help them 

manage, analyze, disaggregate and use student data consistent 

with the ESEA. 

Assessment 

The Committee recommends $137,235,000 for Assessment, which 

is the same as the fiscal year 2015 enacted level and $20,208,000 

below the budget request. This amount includes $8,235,000 for the 

National Assessment Governing Board (NAGB), which is the same 

as the fiscal year 2015 enacted level and $408,000 above the budget 

request. 

The National Assessment of Educational Progress is the only nationally representative and continuing 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, 


rfrederick on DSK6VPTVN1PROD with HEARING
143 

science, and history, as well as citizenship, literature, art, and 

music. The National Assessment of Educational Progress is operated by contractors through competitive awards made by the National Center for Education Statistics. The NAGB formulates the 

policy guidelines for the program. 

DEPARTMENTAL MANAGEMENT

The Committee recommends $569,256,000 for Departmental Management, which is $465,000 above the fiscal year 2015 enacted 

level and $94,780,000 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 

operation of the Department as well as separate costs associated 

with the Office for Civil Rights and the Office of the Inspector General. 

Program Administration 

The Committee recommends $410,000,000 for Program Adminis- tration, which is $1,000,000 below the fiscal year 2015 enacted 

level and $64,089,000 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. The Committee bill does not include funding for 

building modernization. 

Vision and Educational Performance.—One out of four children 

in the United States have some form of low vision and at least two 

million schoolchildren start the school year not being able to see 

clearly. Thousands of schoolchildren from low-income families are 

unable to make the most of their education because they cannot see 

well. Most of these cases of poor vision are due to refractive error 

and are easily corrected. 

The Committee recommends that the Department consider funding programs that identify and provide prescription eyeglasses to 

children from low-income families whose educational performance 

and future vocational success may be hindered because of poor vision. 

Illegal Immigration.—The Committee is concerned with the significant healthcare and education costs to State and local communities resulting from illegal immigration. These costs are especially 

high in States along the southern border of the United States. The 

Committee directs the Department of Education and the Department of Health and Human Services to provide all available federal 

resources to assist State and local governments with these increased costs that are a direct result of federal law or policy. The 

Committee further directs the Departments to provide a report to 

the House Appropriations subcommittee on Labor, Health and 

Human Services, and Education, the subcommittee on Commerce, 

Justice, Science and the subcommittee on Homeland Security within 90 days of enactment on the costs borne by State and local governments and the federal government for providing health and education services to individuals without legal immigration status, to 

include those who qualified under the President’s November 20, 


rfrederick on DSK6VPTVN1PROD with HEARING
144 

2014 executive immigration action. The report shall address the 

costs incurred over the course of fiscal years 2014 and 2015 and include projected costs for fiscal years 2016 through 2020. The report 

shall also include an accounting of the federal resources that have 

been and will be directed in each year to cover these added expenses. 

Interagency Collaboration.—The Committee understands the importance of interagency collaboration in promoting student achievement and ensuring equal access to education. To achieve these 

goals, the Committee directs the Secretary to work jointly with the 

Director of the Institute of Museum and Library Services on initiatives, materials or technology to support educational and workforce 

development activities undertaken by libraries; resource and policy 

approaches to eliminate barriers to fully leveraging the role of libraries and museums in supporting the early learning, literacy, 

lifelong learning, digital literacy, workforce development, and education needs of the people of the United States; and initiatives, materials, or technology to support educational activities undertaken 

by museums. 

Expulsions from Early Education Programs.—The Committee is 

deeply concerned about expulsions and suspensions that occur in 

preschool settings and K-3 classrooms, particularly given the racial 

and gender disparities that exist. This is problematic given the research that indicates these practices can adversely affect development, health and education outcomes. The Committee strongly 

urges the Departments of Education and HHS to highlight evidence-based interventions and identify opportunities, including 

through relevant programs and the provision of technical assistance, that help prevent and severely limit expulsion and suspension practices in preschool settings and K-3 classrooms and ensure 

the safety and well-being of all young children. 

OFFICE FOR CIVIL RIGHTS

The Committee recommends $100,000,000 for the Office for Civil 

Rights, which is the same as the fiscal year 2015 enacted level and 

$30,691,000 below the budget request. The Office for Civil Rights 

is responsible for enforcing laws that prohibit discrimination on the 

basis of race, color, national origin, sex, disability, and age in all 

programs and institutions that receive funds from the Department. 

These laws extend to 50 State educational agencies, 14,000 LEAs, 

and nearly 6,500 institutions of higher education, including proprietary schools. They also extend to 82 State rehabilitation agencies, 

libraries, museums, and other institutions receiving federal funds. 

OFFICE OF THE INSPECTOR GENERAL

The Committee recommends $59,256,000 for the Office of the Inspector General, which is $1,465,000 above the fiscal year 2015 enacted level and the same as 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. 


rfrederick on DSK6VPTVN1PROD with HEARING
145 

GENERAL PROVISIONS

Sec. 301. The Committee continues a provision that prohibits 

funds in 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 that prohibits 

funds in 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 that prohibits 

funds in this act from being used to prevent the implementation of 

programs of voluntary prayer and meditation in public schools. 

(TRANSFER OF FUNDS)

Sec. 304. The Committee continues a provision providing the Secretary of Education with the authority to transfer up to one percent 

of discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such 

transfer. This transfer authority is available only to meet emergency needs, and may not be used to create any new program or 

fund a project or activity that is not otherwise funded in this act. 

All transfers are subject to notification to the Committees on Appropriations of the House of Representatives and the Senate. 

Sec. 305. The Committee continues a provision that allows the 

Outlying Areas to consolidate funds under title V of the ESEA. 

Sec. 306. The Committee continues a provision that permits 

Palau to continue participating in Department of Education and 

other programs pending formal ratification of a new compact agreement. 

Sec. 307. The Committee amends a provision allowing the Department to set aside up to 0.5 percent of ESEA funds for evaluation of ESEA programs to clarify that the Institute of Education 

Sciences is the primary entity to conduct research on and evaluations of these programs. 

Sec. 308. The Committee includes a provision allowing certain institutions to continue to use endowment income for student scholarships. 

Sec. 309. The Committee includes a provision that prohibits the 

Department from moving forward with a regulation that would define ‘‘gainful employment’’ through a series of complex calculations 

that could negatively impact schools and students. 

Sec. 310. The Committee includes a provision that prohibits the 

Department from creating, promulgating, or implementing new 

regulations that set a federal definition of a credit hour. 

Sec. 311. The Committee includes a provision prohibiting funds 

made available in this act from being used to implement, administer, or enforce regulations that dictate how States must authorize 

or license institutions of higher education within the State. 

Sec. 312. The Committee includes a provision prohibiting funds 

made available in this act from being used to develop or implement 

a college rating system. 


rfrederick on DSK6VPTVN1PROD with HEARING
146 

Sec. 313. The Committee includes a provision prohibiting funds 

made available in this act from being used to promulgate or enforce 

teacher preparation regulations. 

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

SALARIES AND EXPENSES

The Committee recommends $5,362,000 for the Committee for 

Purchase From People Who Are Blind or Severely Disabled, which 

is equal to the fiscal year 2015 enacted level and $79,000 below the 

budget request. The Committee is aware of a recent GAO study 

which found that the AbilityOne Commission cannot control how 

central nonprofit agencies, which administer much of the program, 

spend their funds, set and manage performance goals, or set and 

implement governance policies and other internal controls. The 

Committee believes greater oversight is necessary to ensure the 

program is operating in accordance with statutory requirements 

that blind or other severely disabled individuals provide at least 75 

percent of hours or direct labor required for the production or provision of the products or services to Federal government agencies. 

To provide the AbilityOne Commission with greater oversight capacity, the Committee includes bill language requiring AbilityOne 

to enter into contracts with central nonprofit agencies prior to the 

remittance of fees. This will enable AbilityOne to increase auditing, 

oversight and reporting functions in accordance with standard federal procurement policies. The Committee urges the authorizing 

Committees of jurisdiction to consider additional means of program 

oversight, including the appointment of an independent Inspector 

General. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

OPERATING EXPENSES

The Committee recommends $612,527,000 to the Corporation for 

National and Community Service (Corporation) to carry out activities authorized under the Domestic Volunteer Service Act of 1973 

and the National and Community Service Act of 1990. This is 

$145,822,000 below the fiscal year 2015 enacted level and 

$242,681,000 below the budget request. 

Volunteers in Service to America (VISTA) 

The Committee recommends $92,364,000 for VISTA, the same as 

the fiscal year 2015 enacted level and $4,521,000 below the budget 

request. This program provides capacity building for small, community-based organizations with a mission of combating poverty. 

VISTA members raise resources, recruit and organize volunteers, 

and establish and expand programs in housing, employment, 

health, and economic development activities. 

National Senior Volunteer Corps 

The Committee recommends $202,117,000 for the National Senior Volunteer Corps programs, the same as the fiscal year 2015 enVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00146 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
147 

acted level and the budget request. Senior Corps is a collection of 

programs that connect Americans older than the age of 55 with opportunities to contribute their job skills and expertise to community projects and organizations. The breakout of funding by program is as follows: 

[$ in 000] 

National Senior Volunteer Corps FY 2016 

Committee 

Foster Grandparents Program ........................................................................................................................ $107,702 

Senior Companion Program ............................................................................................................................ 45,512 

Retired Senior Volunteer Program .................................................................................................................. 48,903 

Total ....................................................................................................................................................... 202,117 

AmeriCorps State and National Grants 

The Committee recommends $318,046,000 for AmeriCorps State and National Grants, which is $17,384,000 below the fiscal year 

2015 enacted level and $107,059,000 below the budget request. 

This program provides funds to local and national organizations 

and agencies to address community needs in education, public safety, health, and the environment. Within the amount provided, the 

Committee expects the Corporation to maintain funding for competitive grants at the fiscal year 2015 level. 

PAYMENT TO THE NATIONAL SERVICE TRUST

The Committee recommends $50,000,000 for payments to the Na- tional Service Trust, $159,618,000 below the fiscal year 2015 level 

and $187,077,000 below the budget request. The National Service 

Trust makes payments for Segal education awards, pays interest 

that accrues on qualified student loans for AmeriCorps participants 

during terms of service in approved national service positions, and 

makes other payments entitled to members who serve in the programs of the Corporation. 

SALARIES AND EXPENSES

The Committee recommends $20,000,000 for Salaries and Expenses, $61,737,000 below the fiscal year 2015 level and 

$66,176,000 below the budget request. 

OFFICE OF INSPECTOR GENERAL

The Committee recommends $5,250,000 for the Office of Inspector General. 

ADMINISTRATIVE PROVISIONS

Sec. 401. The Committee continues bill language that combines 

separate matching requirements for AmeriCorps grants. 

Sec. 402. The Committee continues bill language related to National Service Trust minimum share requirements. 

Sec. 403. The Committee continues bill language related to donations. 

Sec. 404. The Committee continues bill language related to veterans. 

Sec. 405. The Committee continues bill language related to criminal history background checks. 


rfrederick on DSK6VPTVN1PROD with HEARING
148 

CORPORATION FOR PUBLIC BROADCASTING

The Committee recommends $445,000,000 for the Corporation for 

Public Broadcasting in fiscal year 2018. According to the Public 

Broadcasting Act, one of the greatest priorities of public broadcasting is to address the needs of unserved and underserved audiences, particularly children and minorities. Programming that reflects the histories and perspectives of diverse racial and ethnic 

communities is a core value and responsibility of public broadcasting, therefore the Committee supports continued investment in 

the National Minority Consortia to help accomplish this goal. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

The Committee recommends $48,748,000 for the Federal Mediation and Conciliation Service. This recommendation is $3,082,000 

more than the fiscal year 2015 enacted level and the same as the 

fiscal year 2016 budget request. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

The Committee recommends $17,085,000 for the Federal Mine 

Safety and Health Review Commission. This recommendation is 

$334,000 more than the fiscal year 2015 enacted level and the 

same as the fiscal year 2016 budget request. 

INSTITUTE FOR MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND

ADMINISTRATION

The Committee recommends $227,860,000 for the Institute of 

Museum and Library Services (IMLS), which is the same as the fiscal year 2015 enacted level and $9,568,000 below the budget request. Within the total for IMLS, the Committee recommends the 

following amounts: 

Budget activity This Bill 

This Bill compared to— 

FY 2015 

FY 2016 

Budget 

Request 

Library Services Technology Act (LSTA): 

Grants to States .............................................................. $154,848,000 $0 $348,000 

Native American Library Services .................................... 4,063,000 202,000 0 

National Leadership: Libraries ......................................... 12,200,000 0 ¥5,300,000 

Laura Bush 21st Century Librarian ................................. 10,000,000 0 ¥500,000 

Museum Services Act: 

Museums for America ...................................................... 20,983,000 783,000 ¥474,000 

21st Century Museum Professionals ............................... 0 0 0 

Conservation Project Support .......................................... 0 0 0 

Native American/Hawaiian Museum Services ................. 972,000 48,000 0 

National Leadership: 

Museums .......................................................................... 7,600,000 0 ¥3,568,000 

African American History and Culture Act: 

Museum Grants for African American History and Culture .............................................................................. 1,407,000 0 ¥74,000 

Museum and Library Services Act General Provisions: 

Research, Analysis and Data Collection ......................... 1,787,000 ¥33,000 0 


rfrederick on DSK6VPTVN1PROD with HEARING
149 

Budget activity This Bill 

This Bill compared to— 

FY 2015 

FY 2016 

Budget 

Request 

Administration .................................................................. 14,000,000 ¥1,000,000 0 

Library Services and Technology 

The Grants to State Library Agencies program provides funds to 

State Library Administrative Agencies using a population-based 

formula. 

Program Administration 

The Committee recommends $14,000,000 for Program Adminis- tration, which is the $1,000,000 below the fiscal year 2015 enacted 

level and the same as the budget request. These funds provide administrative and management support for all programs administered by IMLS. Funds are included for office relocation and renovation. Within the funds recommended, the Committee includes 

$1,787,000 for IMLS’ activities in policy, research, and data collection, including functions formerly conducted by the National Commission on Libraries and Information Science. 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

The Committee recommends $11,925,000 for the Medicare Pay- ment Advisory Commission (MedPAC), which is $176,000 more 

than the fiscal year 2015 enacted level and $175,000 less than the 

budget request. 

MEDICAID & CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

The Committee provides $7,765,000 for the Medicaid & CHIP 

Payment and Access Commission, which is $115,000 more than the 

fiscal year 2015 enacted level and $935,000 below the budget request. 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

The Committee recommends $3,250,000 for the National Council 

on Disability, which is the same as the fiscal year 2015 enacted 

level and $182,000 below the budget request. 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

The Committee recommends $200,000,000 for the National Labor 

Relations Board (NLRB). This recommendation is $74,224,000 less 

than the fiscal year 2015 enacted level and $78,000,000 less than 

the fiscal year 2016 budget request. 

The NLRB Inspector General issued a report in April 2011 (Case 

Processing Costs—Report No. OIG–AMR–64–11–02) citing numerous cost efficiencies, including the consolidation of regional offices 


rfrederick on DSK6VPTVN1PROD with HEARING
150 

to streamline operations. The Committee directs NLRB to continue 

its efforts to streamline operations and consolidate regional offices 

to achieve greater efficiencies and cost savings. 

ADMINISTRATIVE PROVISIONS

Sec. 406. The Committee continues a provision relating to electronic voting for purposes of collective bargaining. 

Sec. 407. The Committee includes a new provision relating to 

regulation of representation-case procedures. 

Sec. 408. The Committee includes a new provision relating to 

joint-employer standards. 

Sec. 409. The Committee includes a new provision relating to jurisdiction over Indian tribes. 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

The Committee recommends $13,230,000 for the National Mediation Board (NMB). This recommendation is $3,000 more than the 

fiscal year 2015 enacted level and the same as the fiscal year 2016 

budget request. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

The Committee recommends $12,639,000 for the Occupational 

Safety and Health Review Commission (OSHRC). This recommendation is $1,000,000 more than the fiscal year 2015 enacted 

level and $573,000 less than the fiscal year 2016 budget request. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

The Committee recommends $29,000,000 for dual benefits, which 

is $5,000,000 less than the fiscal year 2015 enacted level and the 

same as the budget request. This appropriation is authorized by 

the Railroad Retirement Act of 1974 to fund vested dual benefits 

received by railroad retirees who, under prior law, would have become covered by both the railroad retirement system and the Social 

Security system because railroad retirement was not fully coordinated with social security from 1937 to 1974. The Committee 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 

$2,000,000 may be derived in this manner. 

FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS

The Committee recommends $150,000 for the interest earned on 

unnegotiated checks, which is the equal to the fiscal year 2015 

funding level and the budget request. 

LIMITATION ON ADMINISTRATION

The Committee recommends a consolidated limitation of 

$111,225,000 on the expenditure of Railroad Retirement and RailVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00150 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
151 

road Unemployment Trust Funds for administrative expenses of 

the Railroad Retirement Board (RRB), which is the same as the fiscal year 2015 enacted level and $8,693,000 below the budget request. 

The Committee maintains its position that the financial statements and audit of the National Railroad Retirement Investment 

Trust should remain separate from the financial statements and 

audit of the RRB. The Committee notes that the Railroad Retirement and Survivors’ Improvement Act of 2001 mandates that the 

Trust function independently from the RRB. Further, the Act specifically requires a separate audit of the Trust by a nongovernmental auditor and requires that the results of this audit be included in the Trust’s Annual Management Report to Congress. The 

Committee expects that the Trust shall be administered and audited solely in conformance with the Act of 2001. 

The Committee recommends the RRB maintain staffing levels at 

or below 860 FTEs and continue work toward increasing the effectiveness and efficiency of current staff members to decrease or 

eliminate any requirements for staff growth in future years. 

LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

The Committee recommends authority to expend $8,437,000 from 

the Railroad Retirement and Railroad Unemployment Insurance 

Trust Funds for the Office of Inspector General, which is equal to 

the fiscal year 2015 enacted level and $1,013,000 below the budget 

request. The Committee recommends the RRB OIG maintain staffing levels at or below 54 FTEs and continue work toward increasing the effectiveness and efficiency of current staff members to decrease or eliminate any requirements for staff growth in future 

years. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

The Committee recommends $20,400,000 for mandatory payments necessary to compensate the Old Age and Survivors Insurance (OASI) Trust Fund and the Disability Insurance (DI) Trust 

Fund, which is $4,000,000 more than the fiscal year 2015 enacted 

level and the budget request. This appropriation provides reimbursement to the Social Security trust funds for non-trust fund activities. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

The Committee recommends $46,232,978,000 for the Supple- mental Security Income (SSI) program, which is $5,000,000,000 

more than the fiscal year 2015 enacted level and $186,552,000 

below the request level. The Committee recommends 

$14,500,000,000 in advance funding for the first quarter of fiscal 

year 2017, as requested. 

Research and demonstration 

Within the appropriation for SSI, the Committee recommends 

$101,000,000 for the research and demonstration activities, which 

is $18,000,000 more than the fiscal year 2015 enacted level and the 

same as the request level. 


rfrederick on DSK6VPTVN1PROD with HEARING
152 

Disability Early Intervention Initiative.—The Disability Early 

Intervention Initiative will test innovativeand evidence-based approaches to improveoutcomes for individuals with disabilitieswho 

are not yet receiving Social Security disability benefits, but who are 

likely to beeligible for benefits in the future. The intent of this initiative is to provide a multi-pronged approach to assisting such individuals to remain in the workforce. 

The Social Security Administration (SSA) has partnered with the 

National Institutes of Health to create a functional assessment tool 

that is reliable and objective and may inform the disability determination process.One of the major projects of this partnership is 

the Functional Assessment Battery (FAB).The Committee believes 

the FAB tool could serve to provide uniform, objective evidence to 

the disability determination.The Committee notes its concern that 

SSA is currently limiting the use of this tool for only survey research. The Committee directs SSA to test the use of the FAB as 

part of the demonstrations undertaken within the Disability Early 

Intervention Initiative. 

Administration 

Within the appropriation for SSI, the Committee recommends $4,578,978,000, which is the same as fiscal year 2015 enacted level 

and $186,552,000 below the request level for payment to the Social 

Security trust funds for SSI’s share of the base administrative expenses of SSA. 

LIMITATION ON ADMINISTRATIVE EXPENSES

The Committee recommends $11,817,945,000 for the Limitation 

on Administrative Expenses (LAE) account activities to be funded 

from the Social Security and Medicare trust funds, which is 

$12,000,000 more than the 2015 enacted level and $695,055,000 

below the budget request. The LAE funds support SSA operational 

costs to administer the Old Age and Survivors Insurance (OASI), 

Disability Insurance (DI), and Supplemental Security Income (SSI) 

programs, and to support the Centers for Medicare and Medicaid 

Services in administering their programs. 

Work Incentives Planning and Assistance [WIPA] and Protection 

and Advocacy for Beneficiaries of Social Security [PABSS].—The 

Committee recommendation for fiscal year 2016 includes 

$23,000,000 for WIPA and $7,000,000 for PABSS. 

Fraud Risk Performance.—The Committee strongly encourages 

SSA to fully implement the recommendations found within the SSA 

Inspector General report on Fraud Risk Performance Audit. Specifically, the Committee urges SSA to take a risk-based approach to 

combating fraud, be more proactive in addressing and mitigating 

new fraud schemes, and improve the design operating effectiveness 

of anti-fraud measures. Additionally, the Committee directs SSA to 

provide a breakout within 60 days of enactment of the funding 

spent in fiscal year 2015 and the anticipated amount to be spent 

in fiscal year 2016 on anti-fraud activities. This breakout should include activities that SSA is working on in concert with the SSA Office of Inspector General. 

Report on Medical Listings.—SSA employs medical listings to 

make disability determinations, many of which have not been updated for decades. The Committee directs SSA to provide a report 


rfrederick on DSK6VPTVN1PROD with HEARING
153 

within 60 days of enactment to the House Appropriations Subcommittee on Labor, Health and Human Services and Education 

and the House Ways and Means Subcommittee on Social Security 

regarding the number of years since the last update and when the 

agency expects to conduct all of the updates. 

Report on LAE Expenditures.—The Committee directs SSA to 

provide a report to the House Appropriations Subcommittee on 

Labor, Health and Human Services, and Education and the House 

Ways and Means Subcommittee on Social Security within 60 days 

of enactment detailing how much funding was expended on the following categories in fiscal year 2015: 

• Personnel costs by General Schedule grade, Administrative 

Law Judge personnel costs, Senior Executive Service personnel 

costs, reemployed annuitant personnel costs, and personnel 

costs by region 

• Information technology costs broken out by hardware/software technology and upgrade/maintenance costs 

• Physical infrastructure costs by region and office function 

• Overall costs for personnel, time and dollars for the following: 

Æ OASI, DI and SSI 

Æ Other SSA missions, including return to work efforts 

Æ Program integrity work broken out by OASI, DI and SSI 

as well as types of spending (data matching, predictive 

data work and data analytics) 

Æ Disability Determination Services State costs and federal staff costs 

Huntington’s Disease.—The Committee urges the Social Security 

Administration to work with the National Institutes of Health to 

immediately revise the Huntington’s disease (HD) SSDI guidelines, 

used to determine disability for individuals with the disease, to reflect the most up-to-date medical understandings of the physical, 

cognitive, and behavioral symptoms. The Committee understands 

that some believe the current guidelines do not fully recognize the 

emotional and psychological symptoms of Huntington’s disease. 

Some research sources indicate that the emotional and psychological symptoms appear years before physical symptoms are exhibited. The Committee urges SSA to work with NIH to ensure the 

SSDI HD guidelines reflect the most current scientific data. 

Muscular Dystrophy.—The Committee is aware that SSA was 

added to the Muscular Dystrophy Coordinating Committee through 

the Muscular Dystrophy CARE Act Amendments enacted in September 2014. The Committee requests that the agency provide relevant data within the fiscal year 2017 budget request on the rate 

at which persons with Duchenne and Becker Muscular Dystrophy 

utilize SSA programs, particularly those focused on promoting employment and community independence such as the Ticket to Work 

program. 

Social Security Advisory Board 

The Committee recommends that not less than $2,300,000 of the 

LAE funding be available for the Social Security Advisory Board, 

which is the same as the fiscal year 2015 enacted level and 

$100,000 below the budget request. 


rfrederick on DSK6VPTVN1PROD with HEARING
154 

User Fees 

In addition to the other amounts provided, the Committee rec- ommends $137,000,000 for administrative activities funded from 

user fees. Of this amount, $136,000,000 is derived from fees collected from States that request SSA to administer State SSI supplementary payments. 

Continuing Disability Reviews and Redeterminations 

The Committee recommends $1,396,000,000 for program integrity activities. In the wake of multiple large-scale disability fraud 

cases, the Committee believes that successful program integrity activities are vital to maintaining the public’s support for benefit payments to recipients deserving of assistance. 

OFFICE OF THE INSPECTOR GENERAL

(INCLUDING TRANSFER OF FUNDS)

The Committee recommends $108,795,000 for the Office of Inspector General, of which the bill provides authority to expend 

$78,795,000 from the OASI and DI trust funds. 

TITLE V—GENERAL PROVISIONS 

(TRANSFER OF FUNDS)

Sec. 501. The Committee continues a provision allowing 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 prohibiting the 

obligation of funds beyond the current fiscal year unless expressly 

so provided. 

Sec. 503. The Committee continues a provision prohibiting funds 

from being used to support or defeat legislation. 

Sec. 504. The Committee continues a provision limiting the 

amount available for official reception and representation expenses 

for the Secretaries of Labor and Education, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the 

National Mediation Board. 

Sec. 505. The Committee continues a provision requiring 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. 506. The Committee continues a provision prohibiting the 

use of funds for any abortion. 

Sec. 507. The Committee continues a provision providing exceptions to section 506 and a provision prohibiting funds from being 

made available to a Federal agency or program, or to a State or 

local government, if such agency, program or government discriminates against institutional or individual health care entities because they do not provide, pay for, provide coverage of, or refer for 

abortions. 

Sec. 508. The Committee continues a provision prohibiting use of 

funds for certain research involving human embryos. 


rfrederick on DSK6VPTVN1PROD with HEARING
155 

Sec. 509. The Committee continues a provision prohibiting 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. 510. The Committee continues a provision prohibiting 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. 511. The Committee continues a provision related to annual 

reports to the Secretary of Labor. 

Sec. 512. The Committee continues a provision prohibiting transfer of funds made available in this Act except by authority provided 

in this Act or another appropriation Act. 

Sec. 513. The Committee continues a provision to limit funds in 

the bill for public libraries to those that comply with the requirements of the Children’s Internet Protection Act. 

Sec. 514. The Committee continues a provision regarding procedures for reprogramming of funds. 

Sec. 515. The Committee continues a provision pertaining to appointments to scientific advisory committees. 

Sec. 516. The Committee continues a provision requiring each department and related agency funded through this Act to submit an 

operating plan within 45 days of enactment, detailing any funding 

allocations that are different than those specified in this Act, the 

accompanying detailed table, or budget request. 

Sec. 517. The Committee continues a provision requiring the Secretaries of Labor, Health and Human Services, and Education to 

submit a quarterly report to the Committees on Appropriations of 

the House of Representatives and the Senate containing certain information on noncompetitive contracts, grants, and cooperative 

agreements exceeding $500,000 in value. 

Sec. 518. The Committee continues a provision prohibiting use of 

funds to process claims for credit for quarters of coverage based on 

work performed under a Social Security number that was not the 

claimant’s number, where the performance of such work under 

such number has formed the basis for a conviction of the claimant 

of a violation of section 208(a)(6) or (7) of the Social Security Act. 

Sec. 519. The Committee continues a provision prohibiting use of 

funds to implement a Social Security totalization agreement with 

Mexico. 

Sec. 520. The Committee modifies a provision related to needle 

exchange. 

(RESCISSION)

Sec. 521. The Committee rescinds $15,000,000 provided under 

section 3403 [Independent Payment Advisory Board] of Public Law 

111–148. 

Sec. 522. The Committee continues provision requesting quarterly reports on the status of balances of appropriations from the 

Departments of Labor, Health and Human Services and Education 

and the Social Security Administration. 

Sec. 523. The Committee continues a provision prohibiting the 

use of funds for the downloading or exchanging of pornography. 

Sec. 524. The Committee includes a new provision prohibiting 

use of funds to implement, administer, enforce or further the proviVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00155 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
156 

sions of Public Law 111–148 and portions of Public Law 111–152 

with certain exceptions. 

(RESCISSION)

Sec. 525. The Committee rescinds $18,000,000 provided under 

section 1322 [Consumer Operated and Oriented Plan] of Public 

Law 111–148. 

(RESCISSION)

Sec. 526. The Committee rescinds all remaining funds provided 

under section 1005 [Health Insurance Reform Implementation] of 

Public Law 111–152. 

(RESCISSION)

Sec. 527. The Committee rescinds $6,800,000,000 provided under 

section 3021(a) [Center for Medicare and Medicaid Innovation] of 

Public Law 111–148. 

(RESCISSION)

Sec. 528. The Committee rescinds $100,000,000 provided under 

section 6301(e) [Patient-Centered Outcomes Research Trust Fund] 

of Public Law 111–148. 

Sec. 529. The Committee continues a provision that prohibits 

funding from going to the Association of Community Organizations 

for Reform Now (ACORN), or any of its affiliates, subsidiaries, allied organizations, or successors. 

Sec. 530. The Committee includes a new provision relating to 

nondiscrimination with respect to health care entities that refuse 

to participate in abortions and providing conscience protections 

with regard to requirements for coverage of specific items and services. 

Sec. 531. The Committee includes a Spending Reduction Account. 

HOUSE OF REPRESENTATIVES REPORTING REQUIREMENTS

The following materials are submitted in accordance with various 

requirements of the Rules of the House of Representatives: 

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. 

RESCISSION OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the rescissions of unexpended 

balances included in the accompanying bill: 


rfrederick on DSK6VPTVN1PROD with HEARING
157 

RESCISSIONS RECOMMENDED IN THE BILL 

Account Amount 

Department of Health and Human Services 

Nonrecurring Expenses Fund ........................................................................................... Unobligated Balances 

Health Insurance Reform Implementation Fund ............................................................. Unobligated Balances 

Health Resources and Services Administration .............................................................. $445,983 

Consumer Operated and Oriented Plan .......................................................................... 18,000,000 

Center for Medicare and Medicaid Innovation ............................................................... 6,800,000,000 

Independent Payment Advisory Board ............................................................................. 15,000,000 

Patient-Centered Outcomes Research Trust Fund .......................................................... 100,000,000 

TRANSFER OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the transfers of unexpended 

balances included in the accompanying bill: 

TITLE I—DEPARTMENT OF LABOR

Language is included under ‘‘Job Corps’’ permitting the transfer 

of funds for Job Corps Center construction, rehabilitation and acquisition to meet the operational needs of Job Corps Centers or to 

achieve administrative efficiencies. 

Language is included under ‘‘Special Benefits’’ which provides for 

the transfer of such sums as necessary from the ‘‘Postal Service’’ 

account. 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Office of Workers’ Compensation Program, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Office of the Inspector General.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of the 

Treasury.’’ 

Language is included under ‘‘Departmental Management, Salary 

and Expenses’’ authorizing the transfer of funds available for program evaluation to any other account within the Department to 

carry out evaluation activities. 

A general provision is included that allows not to exceed one percent of any discretionary appropriations to be transferred between 

an appropriation of the Department of Labor, provided that no 

such appropriation is increased by more than three percent by such 

transfer. 

A general provision is included authorizes the transfer of funds 

to the ‘‘Employment and Training Administration’’ for technical assistance services to grantees to ‘‘Program Administration.’’ 

A general provision is included that provides for the transfer of 

up to 0.75 percent of funds from each appropriation to carry out 

evaluations of any of the programs or activities from ‘‘Training and 

Employment Services’’, ‘‘Job Corps’’, ‘‘Community Service Employment for Older Americans,’’ ‘‘State Unemployment Insurance and 


rfrederick on DSK6VPTVN1PROD with HEARING
158 

Employment Service Operations’’, ‘‘Employee Benefits Security Administration’’, ‘‘Office of Workers’ Compensation Programs’’, ‘‘Wage 

and Hour Division’’, ‘‘Office of Federal Contract Compliance Programs’’, ‘‘Office of Labor-Management Standards’’, ‘‘Occupational 

Safety and Health Administration’’, ‘‘Mine Safety and Health Administration’’, Office of Disability Employment Policy, ‘‘Bureau of 

International Affairs’’ and ‘‘Women’s Bureau’’ within the Departmental Management, Salaries and Expenses’’ account, and ‘‘Veterans Employment and Training’’ for use by the Office of the Chief 

Evaluation Officer. 

A general provision is included that provides for the transfer of 

up to 0.25 percent of funds from ‘‘Employment and Training Administration Program Administration’’, funding made available for 

Federal administration within ‘‘Job Corps’’, ‘‘Foreign Labor Certification Program Administration’’, ‘‘Employee Benefits Security Administration’’, ‘‘Office of Workers’ Compensation Programs’’, ‘‘Wage 

and Hour Division’’, ‘‘Office of Federal Contract Compliance Programs’’, ‘‘Office of Labor Management Standards’’, ‘‘Occupational 

Safety and Health Administration’’, ‘‘Mine Safety and Health Administration’’, ‘‘Veterans Employment and Training’’, ‘‘Bureau of 

Labor Statistics’’, and ‘‘Office of Disability Employment Policy’’ to 

carry out information technology purchases and upgrades for any 

of the programs or activities funded in this Act. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES

Language is included under ‘‘Centers for Disease Control and 

Prevention, Buildings and Facilities’’ to allow the transfer of prior 

year unobligated Individual Learning Account funds to be transferred to this account to carry out the purpose of this account. 

Language is included under ‘‘National Institutes of Health, Office 

of the Director’’ for the transfer of excess National Children’s Study 

funds to the NIH Institutes and Centers (IC) based a proportional 

formula to carry out biomedical research. 

Language is included under ‘‘Administration for Community Living, Aging and Disability Services Programs’’ for transfer to the 

Secretary of Agriculture to carryout section 311 of the Older Americans Act of 1965. 

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the ‘‘Department of Health and Human Services’’, provided that no appropriation account is increased by more 

than three percent by such transfer. 

A general provision is included that allows the transfer of up to 

three percent among the institutes and centers of the ‘‘National Institutes of Health’’ from amounts identified as pertaining to the 

human immunodeficiency virus. 

A general provision is included that allows the transfer of funding determined to be related to the human immunodeficiency virus 

to the ‘‘Office of AIDS Research’’. 

A general provision is included that transfers one percent of the 

amount made available for ‘‘National Research Service Awards’’ at 

the ‘‘National Institutes of Health’’ to the ‘‘Health Resources and 

Services Administration’’. 


rfrederick on DSK6VPTVN1PROD with HEARING
159 

A general provision is included to direct the transfer of the ‘‘Prevention and Public Health Fund’’ as specified in the explanatory 

statement accompanying this Act. 

A general provision in included to allow the Secretary to transfer 

authority for an orderly termination of the Agency for Healthcare 

Research and Quality agency if another HHS agency has the authority to perform such activity and the agency head determines it 

is appropriate within the scope of the provided bill language. 

TITLE III—DEPARTMENT OF EDUCATION

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the Department of Education, provided that no 

appropriation account is increased by more than three percent by 

such transfer. 

TITLE IV—RELATED AGENCIES

Language is included under Payment to the National Service 

Trust authorizing the transfer of funds from the ‘‘Corporation for 

National and Community Service, Operating Expenses’’ to support 

the activities of national service participants. 

Language is included under ‘‘Social Security Administration’’ authorizing the transfer of up to three percent of the Social Security 

Administration’s ‘‘Limitation on Administration Expenses’’ account 

to be available for purposes of the Office of Inspector General. 

TITLE V—GENERAL PROVISIONS

A general provision is included that allows the Secretaries of 

Labor, Health and Human Services, and Education to transfer balances of prior appropriations to accounts corresponding to current 

appropriations. 

DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED

SPENDING ITEMS

Neither the bill nor the report contains any Congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI. 

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): 

CONSOLIDATED APPROPRIATIONS ACT, 2008 

(Public Law 110–161) 

AN ACT Making appropriations for the Department of State, foreign operations, and 

related programs for the fiscal year ending September 30, 2008, and for other purposes. 

* * * * * * * 


rfrederick on DSK6VPTVN1PROD with HEARING
160 

DIVISION G—DEPARTMENTS OF LABOR, HEALTH AND 

HUMAN SERVICES, AND EDUCATION, AND RELATED 

AGENCIES APPROPRIATIONS ACT, 2008 

* * * * * * * 

TITLE II 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

APPROPRIATIONS ACT, 2008 

* * * * * * * 

GENERAL PROVISIONS

* * * * * * * 

øSec. 223. There is hereby established in the Treasury of the 

United States a fund to be known as the ‘‘Nonrecurring expenses 

fund’’ (the Fund): Provided, That unobligated balances of expired 

discretionary funds appropriated in this or any succeeding fiscal 

year from the General Fund of the Treasury to the Department of 

Health and Human Services by this or any other Act may be transferred (not later than the end of the fifth fiscal year after the last 

fiscal year for which such funds are available for the purposes for 

which appropriated) into the Fund: Provided further, That amounts 

deposited in the Fund shall be available until expended, and in addition to such other funds as may be available for such purposes, 

for capital acquisition necessary for the operation of the Department, including facilities infrastructure and information technology 

infrastructure, subject to approval by the Office of Management 

and Budget: Provided further, That amounts in the Fund may be 

obligated only after the Committees on Appropriations of the House 

of Representatives and the Senate are notified at least 15 days in 

advance of the planned use of funds.¿ 

* * * * * * * 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE II—ADMINISTRATION AND MISCELLANEOUS 

PROVISIONS 

* * * * * * * 

PART B—MISCELLANEOUS PROVISIONS

* * * * * * * 

ABORTION-RELATED DISCRIMINATION IN GOVERNMENTAL ACTIVITIES

REGARDING TRAINING øAND LICENSING OF PHYSICIANS¿, LICENS- ING, AND PRACTICE OF PHYSICIANS AND OTHER HEALTH CARE ENTITIES

SEC. 245. (a) IN GENERAL.—The Federal Government, and any 

State or local government that receives Federal financial assistance, may not subject any health care entity to discrimination on 

the basis that— 


rfrederick on DSK6VPTVN1PROD with HEARING
161 

ø(1) the entity refuses to undergo training in the performance of induced abortions, to require or provide such training, 

to perform such abortions, or to provide referrals for such 

training or such abortions;¿ 

(1) the entity refuses— 

(A) to undergo training in the performance of induced 

abortions; 

(B) to require or provide such training; 

(C) to perform, participate in, provide coverage of, or pay 

for induced abortions; or 

(D) to provide referrals for such training or such abortions; 

(2) the entity refuses to make arrangements for any of the 

activities specified in paragraph (1); or 

(3) the entity attends (or attended) a post-graduate physician 

training program, or any other program of training in the 

health professions, that does not (or did not) perform induced 

abortions or require, provide or refer for training in the performance of induced abortions, or make arrangements for the 

provision of such training. 

(b) ACCREDITATION OF POSTGRADUATE PHYSICIAN TRAINING PROGRAMS.— 

(1) IN GENERAL.—In determining whether to grant a legal 

status to a health care entity (including a license or certificate), or to provide such entity with financial assistance, services or other benefits, the Federal Government, or any State or 

local government that receives Federal financial assistance, 

shall deem accredited any postgraduate physician training program that would be accredited but for the accrediting agency’s 

reliance upon an accreditation østandards¿ standard that requires an entity to perform an induced abortion or require, provide, or refer for training in the performance of induced abortions, or make arrangements for such training, regardless of 

whether such standard provides exceptions or exemptions. The 

government involved shall formulate such regulations or other 

mechanisms, or enter into such agreements with accrediting 

agencies, as are necessary to comply with this subsection. 

(2) RULES OF CONSTRUCTION.— 

(A) IN GENERAL.—With respect to subclauses (I) and (II) 

of section 705(a)(2)(B)(i) (relating to a program of insured 

loans for training in the health professions), the requirements in such subclauses regarding accredited internship 

or residency programs are subject to paragraph (1) of this 

subsection. 

(B) EXCEPTIONS.—This section shall not— 

(i) prevent any health care entity from voluntarily 

electing to be trained, to train, or to arrange for training in the performance of, to perform, or to make referrals for induced abortions; or 

(ii) prevent an accrediting agency or a Federal, State 

or local government from establishing standards of 

medical competency applicable only to those individuals who have voluntarily elected to perform abortions. 


rfrederick on DSK6VPTVN1PROD with HEARING
162 

(c) ADMINISTRATION.—The Secretary shall designate the Director 

of the Office for Civil Rights of the Department of Health and 

Human Services— 

(1) to receive complaints alleging a violation of this section, 

section 1566 of the Patient Protection and Affordable Care Act, 

or any of subsections (b) through (e) of section 401 of the Health 

Programs Extension Act of 1973; and 

(2) to pursue the investigation of such complaints, in coordination with the Attorney General. 

ø(c)¿ (d) DEFINITIONS.—For purposes of this section: 

ø(1) The term ‘‘financial assistance’’, with respect to a government program, includes governmental payments provided 

as reimbursement for carrying out health-related activities. 

ø(2) The term ‘‘health care entity’’ includes an individual 

physician, a postgraduate physician training program, and a 

participant in a program of training in the health professions.¿ 

(1) The term ‘‘financial assistance’’, with respect to a government program, means governmental payments to cover the cost 

of health care services or benefits, or other Federal payments, 

grants, or loans to promote or otherwise facilitate health-related 

activities. 

(2) The term ‘‘health care entity’’ includes an individual physician or other health professional, a postgraduate physician 

training program, a participant in a program of training in the 

health professions, a hospital, a provider-sponsored organization as defined in section 1855(d) of the Social Security Act, a 

health maintenance organization, an accountable care organization, an issuer of health insurance coverage, any other kind of 

health care facility, organization, or plan, and an entity that 

provides or authorizes referrals for health care services. 

(3) The term ‘‘postgraduate physician training program’’ includes a residency training program. 

(4) The term ‘‘State or local government that receives Federal 

financial assistance’’ includes any agency or other governmental 

unit of a State or local government if such government receives 

Federal financial assistance. 

SEC. 245A. CIVIL ACTION FOR CERTAIN VIOLATIONS. 

(a) IN GENERAL.—A qualified party may, in a civil action, obtain 

appropriate relief with regard to a designated violation. 

(b) DEFINITIONS.—In this section— 

(1) the term ‘‘qualified party’’ means— 

(A) the Attorney General; or 

(B) any person or entity adversely affected by the designated violation; and 

(2) the term ‘‘designated violation’’ means an actual or threatened violation of section 245 of this Act, section 1566 of the Patient Protection and Affordable Care Act, or any of subsections 

(b) through (e) of section 401 of the Health Programs Extension 

Act of 1973. 

(c) ADMINISTRATIVE REMEDIES NOT REQUIRED.—An action under 

this section may be commenced, and relief may be granted, without 

regard to whether the party commencing the action has sought or 

exhausted available administrative remedies. 

(d) DEFENDANTS IN ACTIONS UNDER THIS SECTION MAY INCLUDE

GOVERNMENTAL ENTITIES AS WELL AS OTHERS.— 


rfrederick on DSK6VPTVN1PROD with HEARING
163 

(1) IN GENERAL.—An action under this section may be maintained against, among others, a party that is a Federal or State 

governmental entity. Relief in an action under this section may 

include money damages even if the defendant is such a governmental entity. 

(2) DEFINITION.—For the purposes of this subsection, the term 

‘‘State governmental entity’’ means a State, a local government 

within a State, or any agency or other governmental unit or authority of a State or of such a local government. 

(e) NATURE OF RELIEF.—The court shall grant— 

(1) all necessary equitable and legal relief, including, where 

appropriate, declaratory relief and compensatory damages, to 

prevent the occurrence, continuance, or repetition of the designated violation and to compensate for losses resulting from 

the designated violation; and 

(2) to a prevailing plaintiff, reasonable attorneys’ fees and 

litigation expenses as part of the costs. 

* * * * * * * 

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

* * * * * * * 

PART B—FEDERAL-STATE COOPERATION

* * * * * * * 

PROJECT GRANTS FOR PREVENTIVE HEALTH SERVICES

SEC. 317. (a) The Secretary may make grants to States, and in 

consultation with State health authorities, to political subdivisions 

of States and to other public entities to assist them in meeting the 

costs of establishing and maintaining preventive health service programs. 

(b) No grant may be made under subsection (a) unless an application therefor has been submitted to, and approved by, the Secretary. Such an application shall be in such form and be submitted 

in such manner as the Secretary shall by regulation prescribe and 

shall provide— 

(1) a complete description of the type and extent of the program for which the applicant is seeking a grant under subsection (a); 

(2) with respect to each such program (A) the amount of Federal, State, and other funds obligated by the applicant in its 

latest annual accounting period for the provision of such program, (B) a description of the services provided by the applicant in such program in such period, (C) the amount of Federal 

funds needed by the applicant to continue providing such services in such program, and (D) if the applicant proposes changes 

in the provision of the services in such program, the priorities 

of such proposed changes, reasons for such changes, and the 

amount of Federal funds needed by the applicant to make such 

changes; 

(3) assurances satisfactory to the Secretary that the program 

which will be provided with funds under a grant under subVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00163 Fmt 6659 Sfmt 6601 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
164 

section (a) will be provided in a manner consistent with the 

State health plan in effect under section 1524(c) and in those 

cases where the applicant is a State, that such program will 

be provided, where appropriate, in a manner consistent with 

any plans in effect under an application approved under section 315; 

(4) assurances satisfactory to the Secretary that the applicant will provide for such fiscal control and fund accounting 

procedures as the Secretary by regulation prescribes to assure 

the proper disbursement of and accounting for funds received 

under grants under subsection (a); 

(5) assurances satisfactory to the Secretary that the applicant will provide for periodic evaluation of its program or programs; 

(6) assurances satisfactory to the Secretary that the applicant will make such reports (in such form and containing such 

information as the Secretary may by regulation prescribe) as 

the Secretary may reasonably require and keep such records 

and afford such access thereto as the Secretary may find necessary to assure the correctness of, and to verify, such reports; 

(7) assurances satisfactory to the Secretary that the applicant will comply with any other conditions imposed by this section with respect to grants; and 

(8) such other information as the Secretary may by regulation prescribe. 

(c)(1) The Secretary shall not approve an application submitted 

under subsection (b) for a grant for a program for which a grant 

was previously made under subsection (a) unless the Secretary determines— 

(A) the program for which the application was submitted is 

operating effectively to achieve its stated purpose, 

(B) the applicant complied with the assurances provided the 

Secretary when applying for such previous grant, and 

(C) the applicant will comply with the assurances provided 

with the application. 

(2) The Secretary shall review annually the activities undertaken 

by each recipient of a grant under subsection (a) to determine if the 

program assisted by such grant is operating effectively to achieve 

its stated purposes and if the recipient is in compliance with the 

assurances provided the Secretary when applying for such grant. 

(d) The amount of a grant under subsection (a) shall be determined by the Secretary. Payments under such grants may be made 

in advance on the basis of estimates or by the way of reimbursement, with necessary adjustments on account of underpayments or 

overpayments, and in such installments and on such terms and 

conditions as the Secretary finds necessary to carry out the purposes of such grants. 

(e) The Secretary, at the request of a recipient of a grant under 

subsection (a), may reduce the amount of such grant by— 

(1) the fair market value of any supplies (including vaccines 

and other preventive agents) or equipment furnished the grant 

recipient, and 

(2) the amount of the pay, allowances, and travel expenses 

of any officer or employee of the Government when detailed to 


rfrederick on DSK6VPTVN1PROD with HEARING
165 

the grant recipient and the amount of any other costs incurred 

in connection with the detail of such officer or employee. 

When the furnishing of such supplies or equipment or the detail of 

such an officer or employee is for the convenience of and at the request of such grant recipient and for the purpose of carrying out 

a program with respect to which the grant under subsection (a) is 

made. The amount by which any such grant is so reduced shall be 

available for payment by the Secretary of the costs incurred in furnishing the supplies or equipment, or in detailing the personnel, on 

which the reduction of such grant is based, and such amount shall 

be deemed as part of the grant and shall be deemed to have been 

paid to the grant recipient. 

(f)(1) Each recipient of a grant under subsection (a) shall keep 

such records as the Secretary shall by regulation prescribe, including records which fully disclose the amount and disposition by such 

recipient of the proceeds of such grant, the total cost of the undertaking in connection with which such grant was made, and the 

amount of that portion of the cost of the undertaking supplied by 

other sources, and such other records as will facilitate an effective 

audit. 

(2) The Secretary and the Comptroller General of the United 

States, or any of their duly authorized representatives, shall have 

access for the purpose of audit and examination to any books, documents, papers, and records of the recipient of grants under subsection (a) that are pertinent to such grants. 

(g)(1) Nothing in this section shall limit or otherwise restrict the 

use of funds which are granted to a State or to an agency or a political subdivision of a State under provisions of Federal law (other 

than this section) and which are available for the conduct of preventive health service programs from being used on connection 

with programs assisted through grants under subsection (a). 

(2) Nothing in this section shall be construed to require any 

State or any agency or political subdivision of a State to have a 

preventive health service program which would require any person, 

who objects to any treatment provided under such a program, to be 

treated or to have any child or ward treated under such program. 

(h) The Secretary shall include, as part of the report required by 

section 1705, a report on the extent of the problems presented by 

the diseases and conditions referred to in subsection (j) on the 

amount of funds obligated under grants under subsection (a) in the 

preceding fiscal year for each of the programs listed in subsection 

(j); and on the effectiveness of the activities assisted under grants 

under subsection (a) in controlling such diseases and conditions. 

(i) The Secretary may provide technical assistance to States, 

State health authorities, and other public entities in connection 

with the operation of their preventive health service programs. 

(j)(1) Except for grants for immunization programs the authorization of appropriations for which are established in paragraph (2), 

for grants under subsections (a) and (k)(1) for preventive health 

service programs to immunize without charge children, adolescents, 

and adults against vaccine-preventable diseases, there are authorized to be appropriated such sums as may be necessary. Not more 

than 10 percent ot the total amount appropriated under the preceding sentence for any fiscal year shall be available for grants 

under subsection (k)(1) for such fiscal year. 


rfrederick on DSK6VPTVN1PROD with HEARING
166 

(2) For grants under subsection (a) for preventive health service 

programs for the provision without charge of immunizations with 

vaccines approved for use, and recommended for routine use, there 

are authorized to be appropriated such sums as may be necessary. 

(k)(1) The Secretary may make grants to States, political subdivisions of States, and other public and nonprofit private entities for— 

(A) research into the prevention and control of diseases that 

may be prevented through vaccination; 

(B) demonstration projects for the prevention and control of 

such diseases; 

(C) public information and education programs for the prevention and control of such diseases; and 

(D) education, training, and clinical skills improvement activities in the prevention and control of such diseases for 

health professionals (including allied health personnel). 

(2) The Secretary may make grants to States, political subdivisions of States, and other public and nonprofit private entities for— 

(A) research into the prevention and control of diseases and 

conditions; 

(B) demonstration projects for the prevention and control of 

such diseases and conditions; 

(C) public information and education programs for the prevention and control of such diseases and conditions; and 

(D) education, training, and clinical skills improvement activities in the prevention and control of such diseases and conditions for health professionals (including allied health personnel). 

(3) No grant may be made under this subsection unless an application therefor is submitted to the Secretary in such form, at such 

time, and containing such information as the Secretary may by regulation prescribe. 

(4) Subsections (d), (e), and (f) shall apply to grants under this 

subsection in the same manner as such subsections apply to grants 

under subsection (a). 

(l) AUTHORITY TO PURCHASE RECOMMENDED VACCINES FOR

ADULTS.— 

(1) IN GENERAL.—The Secretary may negotiate and enter 

into contracts with manufacturers of vaccines for the purchase 

and delivery of vaccines for adults as provided for under subsection (e). 

(2) STATE PURCHASE.—A State may obtain additional quantities of such adult vaccines (subject to amounts specified to 

the Secretary by the State in advance of negotiations) through 

the purchase of vaccines from manufacturers at the applicable 

price negotiated by the Secretary under this subsection. 

(m) DEMONSTRATION PROGRAM TO IMPROVE IMMUNIZATION COVERAGE.— 

(1) IN GENERAL.—The Secretary, acting through the Director 

of the Centers for Disease Control and Prevention, shall establish a demonstration program to award grants to States to improve the provision of recommended immunizations for children, adolescents, and adults through the use of evidencebased, population-based interventions for high-risk populations. 


rfrederick on DSK6VPTVN1PROD with HEARING
167 

(2) STATE PLAN.—To be eligible for a grant under paragraph 

(1), a State shall submit to the Secretary an application at 

such time, in such manner, and containing such information as 

the Secretary may require, including a State plan that describes the interventions to be implemented under the grant 

and how such interventions match with local needs and capabilities, as determined through consultation with local authorities. 

(3) USE OF FUNDS.—Funds received under a grant under this 

subsection shall be used to implement interventions that are 

recommended by the Task Force on Community Preventive 

Services (as established by the Secretary, acting through the 

Director of the Centers for Disease Control and Prevention) or 

other evidence-based interventions, including— 

(A) providing immunization reminders or recalls for target populations of clients, patients, and consumers; 

(B) educating targeted populations and health care providers concerning immunizations in combination with one 

or more other interventions; 

(C) reducing out-of-pocket costs for families for vaccines 

and their administration; 

(D) carrying out immunization-promoting strategies for 

participants or clients of public programs, including assessments of immunization status, referrals to health care 

providers, education, provision of on-site immunizations, or 

incentives for immunization; 

(E) providing for home visits that promote immunization 

through education, assessments of need, referrals, provision of immunizations, or other services; 

(F) providing reminders or recalls for immunization providers; 

(G) conducting assessments of, and providing feedback 

to, immunization providers; 

(H) any combination of one or more interventions described in this paragraph; or 

(I) immunization information systems to allow all States 

to have electronic databases for immunization records. 

(4) CONSIDERATION.—In awarding grants under this subsection, the Secretary shall consider any reviews or recommendations of the Task Force on Community Preventive 

Services. 

(5) EVALUATION.—Not later than 3 years after the date on 

which a State receives a grant under this subsection, the State 

shall submit to the Secretary an evaluation of progress made 

toward improving immunization coverage rates among highrisk populations within the State. 

(6) REPORT TO CONGRESS.—Not later than 4 years after the 

date of enactment of the Affordable Health Choices Act, the 

Secretary shall submit to Congress a report concerning the effectiveness of the demonstration program established under 

this subsection together with recommendations on whether to 

continue and expand such program. 

(7) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 

to be appropriated to carry out this subsection, such sums as 

may be necessary for each of fiscal years 2010 through 2014. 


rfrederick on DSK6VPTVN1PROD with HEARING
168 

ø(a)¿ (n) PREVENTIVE SERVICES TASK FORCE.— (1) ESTABLISHMENT AND PURPOSE.—øThe Director¿ The Assistant Secretary for Health may periodically convene a Preventive Services Task Force to be composed of individuals with appropriate expertise. Such a task force shall review the scientific 

evidence related to the effectiveness, appropriateness, and costeffectiveness of clinical preventive services for the purpose of 

developing recommendations for the health care community, 

and updating previous clinical preventive recommendations. 

(2) ROLE OF øAGENCY¿ ASSISTANT SECRETARY.—øThe Agency¿ The Assistant Secretary for Health shall provide ongoing 

administrative, research, and technical support for the operations of the Preventive Services Task Force, including coordinating and supporting the dissemination of the recommendations of the Task Force. 

(3) OPERATION.—In carrying out its responsibilities under 

paragraph (1), the Task Force is not subject to the provisions 

of Appendix 2 of title 5, United States Code. 

* * * * * * * 

PATIENT PROTECTION AND AFFORDABLE CARE ACT 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

(a) * * * 

(b) TABLE OF CONTENTS.—The table of contents of this Act is as 

follows: 

* * * * * * * 

TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS 

* * * * * * * 

Subtitle G—Miscellaneous Provisions 

* * * * * * * 

øSec. 1563. Sense of the Senate promoting fiscal responsibility.¿ 

1564. Conforming amendments. 

1565. Sense of the Senate promoting fiscal responsibility. 

1566. Respecting conscience rights in health coverage. 

* * * * * * * 

TITLE I—QUALITY, AFFORDABLE 

HEALTH CARE FOR ALL AMERICANS 

* * * * * * * 

Subtitle G—Miscellaneous Provisions 

* * * * * * * 

SEC. ø1563¿ 1564. CONFORMING AMENDMENTS. 

(a) APPLICABILITY.—Section 2735 of the Public Health Service Act 

(42 U.S.C. 300gg–21), as so redesignated by section 1001(4), is 

amended— 

(1) by striking subsection (a); 


rfrederick on DSK6VPTVN1PROD with HEARING
169 

(2) in subsection (b)— 

(A) in paragraph (1), by striking ‘‘1 through 3’’ and inserting ‘‘1 and 2’’; and 

(B) in paragraph (2)— 

(i) in subparagraph (A), by striking ‘‘subparagraph 

(D)’’ and inserting ‘‘subparagraph (D) or (E)’’; 

(ii) by striking ‘‘1 through 3’’ and inserting ‘‘1 and 

2’’; and 

(iii) by adding at the end the following: 

‘‘(E) ELECTION NOT APPLICABLE.—The election described 

in subparagraph (A) shall not be available with respect to 

the provisions of subparts I and II.’’; 

(3) in subsection (c), by striking ‘‘1 through 3 shall not apply 

to any group’’ and inserting ‘‘1 and 2 shall not apply to any individual coverage or any group’’; and 

(4) in subsection (d)— 

(A) in paragraph (1), by striking ‘‘1 through 3 shall not 

apply to any group’’ and inserting ‘‘1 and 2 shall not apply 

to any individual coverage or any group’’; 

(B) in paragraph (2)— 

(i) in the matter preceding subparagraph (A), by 

striking ‘‘1 through 3 shall not apply to any group’’ 

and inserting ‘‘1 and 2 shall not apply to any individual coverage or any group’’; and 

(ii) in subparagraph (C), by inserting ‘‘or, with respect to individual coverage, under any health insurance coverage maintained by the same health insurance issuer’’; and 

(C) in paragraph (3), by striking ‘‘any group’’ and inserting ‘‘any individual coverage or any group’’. 

(b) DEFINITIONS.—Section 2791(d) of the Public Health Service 

Act (42 U.S.C. 300gg–91(d)) is amended by adding at the end the 

following: 

‘‘(20) QUALIFIED HEALTH PLAN.—The term ‘qualified health 

plan’ has the meaning given such term in section 1301(a) of 

the Patient Protection and Affordable Care Act. 

‘‘(21) EXCHANGE.—The term ‘Exchange’ means an American 

Health Benefit Exchange established under section 1311 of the 

Patient Protection and Affordable Care Act.’’. 

(c) TECHNICAL AND CONFORMING AMENDMENTS.—Title XXVII of 

the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended— 

(1) in section 2704 (42 U.S.C. 300gg), as so redesignated by 

section 1201(2)— 

(A) in subsection (c)— 

(i) in paragraph (2), by striking ‘‘group health plan’’ 

each place that such term appears and inserting 

‘‘group or individual health plan’’; and 

(ii) in paragraph (3)— 

(I) by striking ‘‘group health insurance’’ each 

place that such term appears and inserting ‘‘group 

or individual health insurance’’; and 

(II) in subparagraph (D), by striking ‘‘small or 

large’’ and inserting ‘‘individual or group’’; 


rfrederick on DSK6VPTVN1PROD with HEARING
170 

(B) in subsection (d), by striking ‘‘group health insurance’’ each place that such term appears and inserting 

‘‘group or individual health insurance’’; and 

(C) in subsection (e)(1)(A), by striking ‘‘group health insurance’’ and inserting ‘‘group or individual health insurance’’; 

(2) by striking the second heading for subpart 2 of part A (relating to other requirements); 

(3) in section 2725 (42 U.S.C. 300gg–4), as so redesignated 

by section 1001(2)— 

(A) in subsection (a), by striking ‘‘health insurance 

issuer offering group health insurance coverage’’ and inserting ‘‘health insurance issuer offering group or individual health insurance coverage’’; 

(B) in subsection (b)— 

(i) by striking ‘‘health insurance issuer offering 

group health insurance coverage in connection with a 

group health plan’’ in the matter preceding paragraph 

(1) and inserting ‘‘health insurance issuer offering 

group or individual health insurance coverage’’; and 

(ii) in paragraph (1), by striking ‘‘plan’’ and inserting 

‘‘plan or coverage’’; 

(C) in subsection (c)— 

(i) in paragraph (2), by striking ‘‘group health insurance coverage offered by a health insurance issuer’’ 

and inserting ‘‘health insurance issuer offering group 

or individual health insurance coverage’’; and 

(ii) in paragraph (3), by striking ‘‘issuer’’ and inserting ‘‘health insurance issuer’’; and 

(D) in subsection (e), by striking ‘‘health insurance 

issuer offering group health insurance coverage’’ and inserting ‘‘health insurance issuer offering group or individual health insurance coverage’’; 

(4) in section 2726 (42 U.S.C. 300gg–5), as so redesignated 

by section 1001(2)— 

(A) in subsection (a), by striking ‘‘(or health insurance 

coverage offered in connection with such a plan)’’ each 

place that such term appears and inserting ‘‘or a health insurance issuer offering group or individual health insurance coverage’’; 

(B) in subsection (b), by striking ‘‘(or health insurance 

coverage offered in connection with such a plan)’’ each 

place that such term appears and inserting ‘‘or a health insurance issuer offering group or individual health insurance coverage’’; and 

(C) in subsection (c)— 

(i) in paragraph (1), by striking ‘‘(and group health 

insurance coverage offered in connection with a group 

health plan)’’ and inserting ‘‘and a health insurance 

issuer offering group or individual health insurance 

coverage’’; 

(ii) in paragraph (2), by striking ‘‘(or health insurance coverage offered in connection with such a plan)’’ 

each place that such term appears and inserting ‘‘or a 


rfrederick on DSK6VPTVN1PROD with HEARING
171 

health insurance issuer offering group or individual 

health insurance coverage’’; 

(5) in section 2727 (42 U.S.C. 300gg–6), as so redesignated 

by section 1001(2), by striking ‘‘health insurance issuers providing health insurance coverage in connection with group 

health plans’’ and inserting ‘‘and health insurance issuers offering group or individual health insurance coverage’’; 

(6) in section 2728 (42 U.S.C. 300gg–7), as so redesignated 

by section 1001(2)— 

(A) in subsection (a), by striking ‘‘health insurance coverage offered in connection with such plan’’ and inserting 

‘‘individual health insurance coverage’’; 

(B) in subsection (b)— 

(i) in paragraph (1), by striking ‘‘or a health insurance issuer that provides health insurance coverage in 

connection with a group health plan’’ and inserting ‘‘or 

a health insurance issuer that offers group or individual health insurance coverage’’; 

(ii) in paragraph (2), by striking ‘‘health insurance 

coverage offered in connection with the plan’’ and inserting ‘‘individual health insurance coverage’’; and 

(iii) in paragraph (3), by striking ‘‘health insurance 

coverage offered by an issuer in connection with such 

plan’’ and inserting ‘‘individual health insurance coverage’’; 

(C) in subsection (c), by striking ‘‘health insurance issuer 

providing health insurance coverage in connection with a 

group health plan’’ and inserting ‘‘health insurance issuer 

that offers group or individual health insurance coverage’’; 

and 

(D) in subsection (e)(1), by striking ‘‘health insurance 

coverage offered in connection with such a plan’’ and inserting ‘‘individual health insurance coverage’’; 

(7) by striking the heading for subpart 3; 

(8) in section 2731 (42 U.S.C. 300gg–11), as so redesignated 

by section 1001(3)— 

(A) by striking the section heading and all that follows 

through subsection (b); 

(B) in subsection (c)— 

(i) in paragraph (1)— 

(I) in the matter preceding subparagraph (A), by 

striking ‘‘small group’’ and inserting ‘‘group and 

individual’’; and 

(II) in subparagraph (B)— 

(aa) in the matter preceding clause (i), by 

inserting ‘‘and individuals’’ after ‘‘employers’’; 

(bb) in clause (i), by inserting ‘‘or any additional individuals’’ after ‘‘additional groups’’; 

and 

(cc) in clause (ii), by striking ‘‘without regard to the claims experience of those employers and their employees (and their dependents) or any health status-related factor relating to such’’ and inserting ‘‘and individuals 

without regard to the claims experience of 


rfrederick on DSK6VPTVN1PROD with HEARING
172 

those individuals, employers and their employees (and their dependents) or any health 

status-related factor relating to such individuals’’; and 

(ii) in paragraph (2), by striking ‘‘small group’’ and 

inserting ‘‘group or individual’’; 

(C) in subsection (d)— 

(i) by striking ‘‘small group’’ each place that such appears and inserting ‘‘group or individual’’; and 

(ii) in paragraph (1)(B)— 

(I) by striking ‘‘all employers’’ and inserting ‘‘all 

employers and individuals’’; 

(II) by striking ‘‘those employers’’ and inserting 

‘‘those individuals, employers’’; and 

(III) by striking ‘‘such employees’’ and inserting 

‘‘such individuals, employees’’; 

(D) by striking subsection (e); 

(E) by striking subsection (f); and 

(F) by transferring such section (as amended by this 

paragraph) to appear at the end of section 2702 (as added 

by section 1001(4)); 

(9) in section 2732 (42 U.S.C. 300gg–12), as so redesignated 

by section 1001(3)— 

(A) by striking the section heading and all that follows 

through subsection (a); 

(B) in subsection (b)— 

(i) in the matter preceding paragraph (1), by striking ‘‘group health plan in the small or large group 

market’’ and inserting ‘‘health insurance coverage offered in the group or individual market’’; 

(ii) in paragraph (1), by inserting ‘‘, or individual, as 

applicable,’’ after ‘‘plan sponsor’’; 

(iii) in paragraph (2), by inserting ‘‘, or individual, as 

applicable,’’ after ‘‘plan sponsor’’; and 

(iv) by striking paragraph (3) and inserting the following: 

‘‘(3) VIOLATION OF PARTICIPATION OR CONTRIBUTION RATES.— 

In the case of a group health plan, the plan sponsor has failed 

to comply with a material plan provision relating to employer 

contribution or group participation rules, pursuant to applicable State law.’’; 

(C) in subsection (c)— 

(i) in paragraph (1)— 

(I) in the matter preceding subparagraph (A), by 

striking ‘‘group health insurance coverage offered 

in the small or large group market’’ and inserting 

‘‘group or individual health insurance coverage’’; 

(II) in subparagraph (A), by inserting ‘‘or individual, as applicable,’’ after ‘‘plan sponsor’’; 

(III) in subparagraph (B)— 

(aa) by inserting ‘‘or individual, as applicable,’’ after ‘‘plan sponsor’’; and 

(bb) by inserting ‘‘or individual health insurance coverage’’; and 


rfrederick on DSK6VPTVN1PROD with HEARING
173 

(IV) in subparagraph (C), by inserting ‘‘or individuals, as applicable,’’ after ‘‘those sponsors’’; and 

(ii) in paragraph (2)(A)— 

(I) in the matter preceding clause (i), by striking 

‘‘small group market or the large group market, or 

both markets,’’ and inserting ‘‘individual or group 

market, or all markets,’’; and 

(II) in clause (i), by inserting ‘‘or individual, as 

applicable,’’ after ‘‘plan sponsor’’; and 

(D) by transferring such section (as amended by this 

paragraph) to appear at the end of section 2703 (as added 

by section 1001(4)); 

(10) in section 2733 (42 U.S.C. 300gg–13), as so redesignated 

by section 1001(4)— 

(A) in subsection (a)— 

(i) in the matter preceding paragraph (1), by striking ‘‘small employer’’ and inserting ‘‘small employer or 

an individual’’; 

(ii) in paragraph (1), by inserting ‘‘, or individual, as 

applicable,’’ after ‘‘employer’’ each place that such appears; and 

(iii) in paragraph (2), by striking ‘‘small employer’’ 

and inserting ‘‘employer, or individual, as applicable,’’; 

(B) in subsection (b)— 

(i) in paragraph (1)— 

(I) in the matter preceding subparagraph (A), by 

striking ‘‘small employer’’ and inserting ‘‘employer, 

or individual, as applicable,’’; 

(II) in subparagraph (A), by adding ‘‘and’’ at the 

end; 

(III) by striking subparagraphs (B) and (C); and 

(IV) in subparagraph (D)— 

(aa) by inserting ‘‘, or individual, as applicable,’’ after ‘‘employer’’; and 

(bb) by redesignating such subparagraph as 

subparagraph (B); 

(ii) in paragraph (2)— 

(I) by striking ‘‘small employers’’ each place that 

such term appears and inserting ‘‘employers, or 

individuals, as applicable,’’; and 

(II) by striking ‘‘small employer’’ and inserting 

‘‘employer, or individual, as applicable,’’; and 

(C) by redesignating such section (as amended by this 

paragraph) as section 2709 and transferring such section 

to appear after section 2708 (as added by section 1001(5)); 

(11) by redesignating subpart 4 as subpart 2; 

(12) in section 2735 (42 U.S.C. 300gg–21), as so redesignated 

by section 1001(4)— 

(A) by striking subsection (a); 

(B) by striking ‘‘subparts 1 through 3’’ each place that 

such appears and inserting ‘‘subpart 1’’; 

(C) by redesignating subsections (b) through (e) as subsections (a) through (d), respectively; and 

(D) by redesignating such section (as amended by this 

paragraph) as section 2722; 


rfrederick on DSK6VPTVN1PROD with HEARING
174 

(13) in section 2736 (42 U.S.C. 300gg–22), as so redesignated 

by section 1001(4)— 

(A) in subsection (a)— 

(i) in paragraph (1), by striking ‘‘small or large 

group markets’’ and inserting ‘‘individual or group 

market’’; and 

(ii) in paragraph (2), by inserting ‘‘or individual 

health insurance coverage’’ after ‘‘group health plans’’; 

(B) in subsection (b)(1)(B), by inserting ‘‘individual 

health insurance coverage or’’ after ‘‘respect to’’; and 

(C) by redesignating such section (as amended by this 

paragraph) as section 2723; 

(14) in section 2737(a)(1) (42 U.S.C. 300gg–23), as so redesignated by section 1001(4)— 

(A) by inserting ‘‘individual or’’ before ‘‘group health insurance’’; and 

(B) by redesignating such section(as amended by this 

paragraph) as section 2724; 

(15) in section 2762 (42 U.S.C. 300gg–62)— 

(A) in the section heading by inserting ‘‘AND APPLICA- TION’’ before the period; and 

(B) by adding at the end the following: 

‘‘(c) APPLICATION OF PART A PROVISIONS.— ‘‘(1) IN GENERAL.—The provisions of part A shall apply to 

health insurance issuers providing health insurance coverage 

in the individual market in a State as provided for in such 

part. 

‘‘(2) CLARIFICATION.—To the extent that any provision of this 

part conflicts with a provision of part A with respect to health 

insurance issuers providing health insurance coverage in the 

individual market in a State, the provisions of such part A 

shall apply.’’; and 

(16) in section 2791(e) (42 U.S.C. 300gg–91(e))— 

(A) in paragraph (2), by striking ‘‘51’’ and inserting 

‘‘101’’; and 

(B) in paragraph (4)— 

(i) by striking ‘‘at least 2’’ each place that such appears and inserting ‘‘at least 1’’; and 

(ii) by striking ‘‘50’’ and inserting ‘‘100’’. 

(d) ø42 U.S.C. 18120¿ APPLICATION.—Notwithstanding any other 

provision of the Patient Protection and Affordable Care Act, nothing in such Act (or an amendment made by such Act) shall be construed to— 

(1) prohibit (or authorize the Secretary of Health and Human 

Services to promulgate regulations that prohibit) a group 

health plan or health insurance issuer from carrying out utilization management techniques that are commonly used as of 

the date of enactment of this Act; or 

(2) restrict the application of the amendments made by this 

subtitle. 

(e) TECHNICAL AMENDMENT TO THE EMPLOYEE RETIREMENT IN- COME SECURITY ACT OF 1974.—Subpart B of part 7 of subtitle A 

of title I of the Employee Retirement Income Security Act of 1974 

(29 U.S.C. 1181 et. seq.) is amended, by adding at the end the following: 


rfrederick on DSK6VPTVN1PROD with HEARING
175 

‘‘SEC. 715. ADDITIONAL MARKET REFORMS. 

‘‘(a) GENERAL RULE.—Except as provided in subsection (b)— 

‘‘(1) the provisions of part A of title XXVII of the Public 

Health Service Act (as amended by the Patient Protection and 

Affordable Care Act) shall apply to group health plans, and 

health insurance issuers providing health insurance coverage 

in connection with group health plans, as if included in this 

subpart; and 

‘‘(2) to the extent that any provision of this part conflicts 

with a provision of such part A with respect to group health 

plans, or health insurance issuers providing health insurance 

coverage in connection with group health plans, the provisions 

of such part A shall apply. 

‘‘(b) EXCEPTION.—Notwithstanding subsection (a), the provisions 

of sections 2716 and 2718 of title XXVII of the Public Health Service Act (as amended by the Patient Protection and Affordable Care 

Act) shall not apply with respect to self-insured group health plans, 

and the provisions of this part shall continue to apply to such plans 

as if such sections of the Public Health Service Act (as so amended) 

had not been enacted.’’. 

(f) TECHNICAL AMENDMENT TO THE INTERNAL REVENUE CODE OF

1986.—Subchapter B of chapter 100 of the Internal Revenue Code 

of 1986 is amended by adding at the end the following: 

‘‘SEC. 9815. ADDITIONAL MARKET REFORMS. 

‘‘(a) GENERAL RULE.—Except as provided in subsection (b)— 

‘‘(1) the provisions of part A of title XXVII of the Public 

Health Service Act (as amended by the Patient Protection and 

Affordable Care Act) shall apply to group health plans, and 

health insurance issuers providing health insurance coverage 

in connection with group health plans, as if included in this 

subchapter; and 

‘‘(2) to the extent that any provision of this subchapter conflicts with a provision of such part A with respect to group 

health plans, or health insurance issuers providing health insurance coverage in connection with group health plans, the 

provisions of such part A shall apply. 

‘‘(b) EXCEPTION.—Notwithstanding subsection (a), the provisions 

of sections 2716 and 2718 of title XXVII of the Public Health Service Act (as amended by the Patient Protection and Affordable Care 

Act) shall not apply with respect to self-insured group health plans, 

and the provisions of this subchapter shall continue to apply to 

such plans as if such sections of the Public Health Service Act (as 

so amended) had not been enacted.’’. 

* * * * * * * 

SEC. ø1563¿ 1565. SENSE OF THE SENATE PROMOTING FISCAL RESPONSIBILITY. 

(a) FINDINGS.—The Senate makes the following findings: 

(1) Based on Congressional Budget Office (CBO) estimates, 

this Act will reduce the Federal deficit between 2010 and 2019. 

(2) CBO projects this Act will continue to reduce budget deficits after 2019. 

(3) Based on CBO estimates, this Act will extend the solvency of the Medicare HI Trust Fund. 


rfrederick on DSK6VPTVN1PROD with HEARING
176 

(4) This Act will increase the surplus in the Social Security 

Trust Fund, which should be reserved to strengthen the finances of Social Security. 

(5) The initial net savings generated by the Community Living Assistance Services and Supports (CLASS) program are 

necessary to ensure the long-term solvency of that program. 

(b) SENSE OF THE SENATE.—It is the sense of the Senate that— 

(1) the additional surplus in the Social Security Trust Fund 

generated by this Act should be reserved for Social Security 

and not spent in this Act for other purposes; and 

(2) the net savings generated by the CLASS program should 

be reserved for the CLASS program and not spent in this Act 

for other purposes. 

SEC. 1566. RESPECTING CONSCIENCE RIGHTS IN HEALTH CARE COVERAGE. 

(a) IN GENERAL.—Notwithstanding any other provision of this 

title, no provision of this title (and no amendment made by any 

such provision) shall— 

(1) require an individual to purchase individual health insurance coverage that includes coverage of an abortion or other 

item or service to which such individual has a moral or religious objection, or prevent an issuer from offering or issuing, to 

such individual, individual health insurance coverage that excludes such item or service; 

(2) require a sponsor (or, in the case of health insurance coverage offered to students through an institution of higher education, the institution of higher education offering such coverage) to sponsor, purchase, or provide any health benefits coverage or group health plan that includes coverage of an abortion or other item or service to which such sponsor or institution, respectively, has a moral or religious objection, or prevent 

an issuer from offering or issuing to such sponsor or institution, 

respectively, health insurance coverage that excludes such item 

or service; 

(3) require an issuer of health insurance coverage or the sponsor of a group health plan to include, in any such coverage or 

plan, coverage of an abortion or other item or service to which 

such issuer or sponsor has a moral or religious objection; or 

(4) authorize the imposition of a tax, penalty, fee, fine, or 

other sanction, or the imposition of coverage of the item or service to which there is a moral or religious objection, in relation 

to health insurance coverage or a group health plan that excludes an item or service pursuant to this section. 

(b) RESTRICTION ON CONTRARY GOVERNMENTAL ACTION.—No provision in this title (or amendment made by such provision) or law, 

regulation, guideline or other governmental action that implements 

such provision or amendment, or derives its authority therefrom, 

shall be given legal effect to the extent that it violates this section. 

(c) NO EFFECT ON OTHER LAWS.—Nothing in this section shall be 

construed to preempt, modify, or otherwise have any effect on— 

(1) the Civil Rights Act of 1964; 

(2) the Americans with Disabilities Act of 1990; 

(3) the Pregnancy Discrimination Act of 1978; 

(4) the Mental Health Parity Act of 1996; or 


rfrederick on DSK6VPTVN1PROD with HEARING
177 

(5) any other State or Federal law, other than a provision in 

this title (or an amendment made by such provision) or a law, 

regulation, guideline or other governmental action that implements such provision or amendment or derives its authority 

therefrom. 

(d) AGGREGATE ACTUARIAL VALUE.—Nothing in this section shall 

be construed to prohibit the Secretary from issuing regulations or 

other guidance to ensure that health insurance coverage or group 

health plans excluding abortion or other items or services under this 

section shall have an aggregate actuarial value at least equivalent 

to that of health insurance coverage or group health plans at the 

same level of coverage that do not exclude such items or services. 

(e) CONTINUED APPLICATION OF NONDISCRIMINATION RULES.— Nothing in this section shall be construed to permit a health insurance issuer, group health plan, or other health care provider to act 

in a manner inconsistent with subparagraph (B) or (D) of section 

1302(b)(4). 

* * * * * * * 

CHANGES IN THE APPLICATION OF EXISTING LAW

Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of the 

House of Representatives, the following statements are submitted 

describing the effect of provisions in the accompanying bill that directly or indirectly change the application of existing law. 

TITLE I—DEPARTMENT OF LABOR 

Language is included under ‘‘Employment and Training Administration’’ providing amounts available to the Governor for Statewide 

activities not to exceed 11 percent. 

Language is included under ‘‘Employment and Training Administration’’ providing amounts made available for dislocated workers 

may be used for State activities or across multiple local areas 

where workers remain dislocated. 

Language is included under ‘‘Employment and Training Administration’’ providing amounts available for technical assistance activities may be used to provide assistance to new entrants to the workforce and incumbent workers. 

Language is included under ‘‘Employment and Training Administration’’ providing that the Department of Labor may take no action to limit the number or proportion of eligible applicants. 

Language is included under ‘‘Job Corps’’ providing that amounts 

made available for construction and rehabilitation may include acquisition and maintenance of major items of equipment. 

Language is included under ‘‘Job Corps’’ providing authority to 

transfer up to 15 percent of construction and rehabilitation funds 

for operational needs with prior written notice to the Committee 

and that any such transfers are available for obligation through 

June 30, 2017. 

Language is included under ‘‘Job Corps’’ providing that no funds 

from any other appropriation may be used for meal services at Job 

Corps. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for reemployment services and referrals to training for all claimants of unemployment inVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00177 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
178 

surance for ex-service members, for improper payment reviews, and 

for unemployment claimants most likely to exhaust their benefits. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for additional administrative funds from the Unemployment Trust Fund if unemployment 

claims exceed certain levels. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing authority for States to 

use funds to assist other States to carry out authorized activities 

in cases of a major disaster declared by the President under the 

Robert T. Stafford Disaster Relief and Emergency Assistance Act. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments from funds appropriated for States’ 

grants on behalf of States to the entity operating the State Information Data Exchange System. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that appropriations for 

establishing a national one-stop career system may be obligated in 

contracts, grants or agreements with States or non-State entities. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that States awarded 

grants to support national activities of the federal-State unemployment insurance system may award subgrants to other States. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that funds available for 

integrated Unemployment Insurance and Employment Service automation may be used by States notwithstanding Office of Management and Budget Circular A 87. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may reallot funds among States participating in a consortium. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ allowing the Secretary to collect 

fees, to remain available until September 30, 2017, for the costs associated with additional data collection, analyses, and reporting 

services related to the National Agricultural Workers Survey. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing for additional administrative funds if participants with plans terminated during the period exceed a certain 

level. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that obligations may exceed amounts provided 

for unforeseen and extraordinary pretermination expenses or unforeseen and extraordinary multiemployer program expenses if approved by the Office of Management and Budget. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that the Department of Labor may use authority to reimburse an employer who is not the employer at the time 

of injury for portions of the salary of a re-employed, disabled beneficiary. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that funds shall be transferred to the approVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00178 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
179 

priation from entities identified under 5 U.S.C. 8147(c) as determined by the Department of Labor. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that of funds transferred from entities under 5 

U.S.C 8147(c), specified amounts may be used by the Department 

of Labor for maintenance of data and communications systems, 

workload processing, roll disability management and medical review, and program integrity with remaining amounts paid into the 

Treasury. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that the Secretary may prescribe regulations 

requiring identification for the filing of benefit claims. 

Language is included under ‘‘Administrative Expenses, Energy 

Employees Occupational Illness Compensation Fund’’ providing 

that the Secretary may prescribe regulations for requiring identification for the filing of benefit claims. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that up to a certain amount of fees collected from the training institute may be retained and used for related training and education. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that fees collected from Nationally Recognized Testing Laboratories may be used to administer laboratory 

recognition programs that insure safety of equipment used in the 

workplace. 

Language is included under ‘‘Occupational Safety and Health Administration’’ that prohibits enforcement on farming operations of 

10 or fewer employees or of an employer with 10 or fewer employees that is below the national average in specific injury categories 

except under specific exclusions. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected by the 

National Mine Health and Safety Academy and made available for 

mine safety and health education and training. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected from the 

approval and certification of equipment and materials and made 

available for other such activities. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may accept lands, 

buildings, equipment, and other contributions from public and private sources for cooperative projects. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may promote 

health and safety education and training through cooperative 

agreements with States, industry and safety associations. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may recognize the 

Joseph A. Holmes Safety Association as the principal safety association and may provide funds or personnel as officers in local 

chapters or the national organization. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may use funds to 

provide for costs associated with mine rescue and survival operations. 


rfrederick on DSK6VPTVN1PROD with HEARING
180 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that the Bureau of International 

Labor Affairs may operate international labor activities through 

grants, subgrants or other arrangements. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available for program 

evaluation may be used to administer grants for evaluation purposes under certain conditions. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available to the Women’s 

Bureau may be used for grants to service and promote the interests 

of women in the workplace. 

Language is included under ‘‘Veterans Employment and Training’’ providing that up to three percent of States’ grants may be 

used for federal expenditures for data systems and contract support. 

Language is included under ‘‘Veterans Employment and Training’’ providing that funds may be used for support specialists providing intensive services and services to wounded servicemembers. 

Language is included under ‘‘Veterans Employment and Training’’ providing that Department of Labor may reallocate up to three 

percent of funds provided among appropriated accounts. 

Language is included under ‘‘Veterans Employment and Training’’ providing that grants may be awarded through September 30, 

2016. 

Language is included under ‘‘Veterans Employment and Training’’ providing that authorized services to veterans may also be provided to veterans recently released from incarceration. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of Job Corps funds to pay salaries and bonuses at a rate in excess of Executive Level III. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for grants solicited after January 15, 

2014, under section 414(c) of the American Competitiveness and 

Workforce Improvement Act of 1998, for purposes other than competitive grants for training individuals over the age of 16 who are 

not currently enrolled in school in the occupations and industries 

for which employers are using H–1B visas to hire foreign workers. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for Employment and Training Administration programs to be used to pay salaries and bonuses at a 

rate in excess of Executive Level III except under specific exclusions. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from ‘‘Employment 

and Training Administration’’ to ‘‘Program Administration’’ when it 

is determined that services will be more efficiently performed. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from specified accounts to the ‘‘Office of the Chief Evaluation Officer’’ for program 

evaluations. 

Language is included under ‘‘General Provisions’’ providing flexibility of crossing for H–2B nonimmigrant workers. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from specified acVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00180 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
181 

counts to ‘‘Departmental Management’’ for use by the Office of the 

Chief Information Officer. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may use the performance accountability 

system in effect prior to July 1, 2016 for purposes of implementing 

section 147 of the WIOA. 

Language is included under ‘‘General Provisions’’ prohibiting the 

Department of Labor from implementing the ‘‘Establishing a Minimum Wage for Contractors’’ regulation in connection to seasonal 

recreation and equipment rental services on federal property. 

Language is included under ‘‘General Provisions’’ prohibiting the 

Department of Labor from establishing an Office of Labor Compliance. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds to implement the ‘‘Definition of the Term ‘Fiduciary’; Conflict of Interest Rule—Retirement Investment Advice’’ 

regulation. 

Language is included under ‘‘General Provisions’’ providing that 

a third party representative may accompany an OSHA inspector on 

a ‘‘walkaround’’ inspection subject to vote of approval by the employees of an affected worksite. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

Language is included under ‘‘Health Resources and Services Administration—Health Resources and Services’’ providing that fees 

collected for the disclosure of information under the information reporting requirement program authorized by section 1921 of the Social Security Act shall be sufficient to recover the full costs of the 

operation program and shall remain available until expended to 

carry out that Act. 

Language is included under ‘‘Center for Disease Control and Prevention—Public Health Preparedness and Response’’ permitting 

CDC to operate and maintain an aircraft. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing the use of funds to 

support acquisition, renovation, or replacement, of the National Institute Occupational Safety and Health’s underground and surface 

coal mining research capacity. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing the use of all carryover funds to the Individual Learning Accounts to be available to 

support acquisition, renovation, or replacement, of the National Institute for Occupational Safety and Health’s underground and surface coal mining research capacity. 

Language is included under ‘‘National Institutes of Health—Office of the Director’’ that provides NIH shall strengthen human 

subject privacy protections. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ prohibiting the use of funds to 

support Research, Demonstration, and Evaluation activities. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ providing specified funds for Program Operations and the Federal Administration Program. 


rfrederick on DSK6VPTVN1PROD with HEARING
182 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ prohibiting the use of funds to 

support the Center for Consumer Information and Insurance Oversight or activities developed, administered, or implemented by this 

Center. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ specifying the total and use of 

offsetting collections. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Health Care Fraud and Abuse Control Account’’ providing funds to support the full cost of the Senior Medicare Patrol 

program. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ that allows 

SAMHSA to provide technical assistance to communities that do 

not receive grants but want to implement systems of care model 

programs. 

Language is included under ‘‘Administration for Children and 

Families—Children and Families Service Programs’’ providing that 

section 303(a)(2)(A)(i) of the Family Violence Prevention and Services Act shall not apply. 

Language is included transferring the Traumatic Brain Injury 

program and the unobligated balances from the Health Resources 

and Services Administration to the Administration for Community 

Living. 

Language is included prohibiting the use of the funds provided 

in the bill to pursue legal action on behalf of a protection and advocacy system described in section 103 of the Protection and Advocacy for Individuals with Mental Illness Act unless written consent 

is obtained from the named person or their legal guardian. 

Language is included under ‘‘General Departmental Management’’ for competitive grants that implement education in sexual 

risk avoidance using medically accurate information, evidencebased approaches and teach benefits of healthy relationships, goal 

setting and resisting sexual coercion and other youth risk behaviors. 

Section 201 limits the amount available for official reception and 

representation expenses. 

Section 202 limits 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. 

Section 203 limits the salary of an individual through an HHS 

grant or other extramural mechanism to not more than the rate of 

Executive Level III. 

Section 204 prohibits the Secretary from using evaluation setaside funds until the Committees on Appropriations of the House 

of Representatives and the Senate receive a report detailing the 

planned use of such funds. 

Section 205 reduces the PHS evaluation set-aside to the lesser of 

2.4 percent or $1,068,000,000. 

Section 206 permits the Secretary of HHS to transfer up to one 

percent of any discretionary funds between appropriations, provided that no appropriation is increased by more than three perVerDate Sep 11 2014 05:24 Jul 11, 2015 Jkt 095419 PO 00000 Frm 00182 Fmt 6659 Sfmt 6602 E:\HR\OC\HR195.XXX HR195

rfrederick on DSK6VPTVN1PROD with HEARING
183 

cent by any such transfer to meet emergency needs. Advance notification must be provided to the Committees on Appropriations at 

the program, project, and activity level in advance of any transfer. 

Section 207 provides 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. 

Section 208 makes NIH funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Section 209 prohibits 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. 

Section 210 states 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. 

Section 211 provides conscience protections to participants in the 

Medicare Advantage program who chose not to provide, pay for, 

provide coverage of, or provide referrals for abortions. 

Section 212 permits funding for HHS 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. 

Section 213 grants authority to the Office of the Director of the 

NIH to enter directly into transactions in order to implement the 

NIH Common Fund for medical research and permitting the Director to utilize peer review procedures, as appropriate, to obtain assessments of scientific and technical merit. 

Section 214 clarifies that funds appropriated to NIH institutes 

and centers may be used for minor repairs or improvements to 

their buildings, up to $3,500,000 per project with a total limit for 

NIH of $45,000,000. 

Section 215 transfers one percent of the funding made available 

for National Institutes of Health National Research Service Awards 

to the Health Resources and Services Administration. 

Section 216 prohibits funds from being used to advocate or promote gun control. 

Section 217 requires HHS to provide details on its public web 

site related to how the Prevention and Public Health Funds are 

used. 

Section 218 directs the spending of the Prevention and Public 

Health fund. 

Section 219 continues the Biomedical Advanced Research and 

Development Authority ten year contract authority. 

Section 220 requires HHS to include certain information concerning the number of full-time federal employees and contractors 

working on the ACA in the fiscal year 2017 budget request. 

Section 221 continues the 60 day flexibility for National Health 

Service Corps contract terminations. 

Section 222 allows NIH to retain payments for certain research 

organisms and substances. 

Section 223 includes specific report requirements for CMS’s marketplaces activities in the fiscal year 2017 budget request. 

Section 224 prohibits CMS Program Account from being used to 

support risk corridor payments. 


rfrederick on DSK6VPTVN1PROD with HEARING
184 

Section 225 rescinds the nonrecurring expenses fund. 

Section 226 transfers certain functions of the Agency for 

Healthcare Research and Quality and terminating the agency as a 

separate entity. 

Section 227 requires HHS to submit an analysis of the impact of 

section 2713 of the PHS Act on discretionary programs. 

Section 228 prohibits funds from being used for patient-centered 

outcomes research. 

Section 229 prohibits funds from being used for Title X family 

planning activities. 

Section 230 prevents funding of the Navigator program. 

Section 231 rescinds expired funds under HRSA. 

Section 232 requires the Secretaries of HHS and the Department 

of Agriculture to develop dietary guidelines based on scientific evidence and to provide for additional public comment. 

TITLE III—DEPARTMENT OF EDUCATION 

Language is included under ‘‘School Improvement Programs’’ directing the Secretary to ensure that the Bureau of Indian Education has access to services provided by the Comprehensive Centers program. 

Language is included under ‘‘School Improvement Programs’’ prohibiting funds from being used for expanded learning time in the 

21st Century Community Learning Centers program. 

Language is included under ‘‘General Provisions’’ prohibiting the 

Department from moving forward with regulations that would define ‘‘gainful employment’’ or ‘‘credit hour’’ or dictate how States 

must authorize or license institutions of higher education. 

Language is included under ‘‘General Provisions’’ prohibiting 

funds made available in this act from being used to implement a 

college ratings system or teacher preparation regulations. 

TITLE IV—RELATED AGENCIES 

Language is included under ‘‘The Committee for Purchase from 

People Who are Blind or Severely Disabled’’ requiring that certain 

authorized fees be paid directly to the AbilityOne Commission and 

specifying that those fees may be remitted to other organizations 

under contracts that include certain oversight provisions. 

Language is included under ‘‘Federal Mediation and Conciliation 

Service—Salaries and Expenses’’ providing that fees charged for 

special training and other services may be retained and used for 

authorized purposes and that fees for arbitration services may be 

used for training agency personnel only. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the use of electronic voting 

in representation elections. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the implementation or enforcement of the ‘‘Representation-Case Procedures’’ regulation. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the application of a new 

‘‘joint-employer’’ standard. 


rfrederick on DSK6VPTVN1PROD with HEARING
185 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the exertion of jurisdiction 

related to Indian tribes. 

TITLE V—GENERAL PROVISIONS 

Section 501 permits 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. 

Section 502 prohibits the obligation of funds beyond the current 

fiscal year unless expressly so provided. 

Section 503 prohibits funds from being used to support or defeat 

legislation. 

Section 504 limits the amount available for official reception and 

representation expenses for the Secretaries of Labor and Education, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the National Mediation Board. 

Section 505 requires 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. 

Section 506 prohibits the use of funds for any abortion. 

Section 507 provides exceptions to section 506 and a provision 

prohibiting funds from being made available to a Federal agency or 

program, or to a State or local government, if such agency, program 

or government discriminates against institutional or individual 

health care entities because they do not provide, pay for, provide 

coverage of, or refer for abortions. 

Section 508 prohibits use of funds for certain research involving 

human embryos. 

Section 509 prohibits 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. 

Section 510 prohibits use of funds to promulgate or adopt any 

final standard providing for a unique health identifier until legislation is enacted specifically approving the standard. 

Section 511 prohibits funds to be obligated or expended on a contract with an entity that has not submitted a report on qualified 

veteran employees as required under 38 U.S.C. 4212(d). 

Section 512 prohibits any transfer of funds made available in 

this Act except by the authority provided in this Act or another appropriation Act. 

Section 513 limits funds in the bill for public libraries to those 

that comply with the requirements of the Children’s Internet Protection Act. 

Section 514 dictates the procedures for the reprogramming of any 

funds provided in the bill. 

Section 515 continues a provision pertaining to appointments to 

federal scientific advisory committees to prevent the disclosure of 

information like political affiliation of candidates for appointment. 

Section 516 requires each department and related agency funded 

through this Act to submit an operating plan within 45 days of enactment, detailing any funding allocations that are different than 

those specified in this Act, the accompanying detailed table, or 

budget request. 


rfrederick on DSK6VPTVN1PROD with HEARING
186 

Section 517 requires the Secretaries of Labor, Health and 

Human Services, and Education to submit a quarterly report to the 

Committees on Appropriations of the House of Representatives and 

the Senate containing certain information on noncompetitive contracts, grants, and cooperative agreements exceeding $500,000 in 

value. 

Section 518 prohibits use of funds to process claims for credit for 

quarters of coverage based on work performed under a Social Security number that was not the claimant’s number, where the performance of such work under such number has formed the basis for 

a conviction of the claimant of a violation of section 208(a)(6) or (7) 

of the Social Security Act. 

Section 519 prohibits use of funds to implement a Social Security 

totalization agreement with Mexico. 

Section 520 prohibits federal funds for the purchase of syringes 

or sterile needles, but allows communities with rapid increases in 

cases of HIV and Hepatitis to access federal funds for other activities, including substance use counseling and treatment referrals. 

Section 521 rescinds $15,000,000 provided under section 3403 

[Independent Payment Advisory Board] of Public Law 111–148. 

Section 522 requires quarterly reports on the status of balances 

of appropriations from the Departments of Labor, Health and 

Human Services and Education and the Social Security Administration. 

Section 523 prohibits the use of funds for the downloading or exchanging of pornography. 

Section 524 prohibits the use of funds to implement, administer, 

enforce or further the provisions of Public Law 111–148 and portions of Public Law 111–152 with certain exceptions. 

Section 525 rescinds $18,000,000 provided under section 1322 

[Consumer Operated and Oriented Plan] of Public Law 111–148. 

Section 526 rescinds all remaining funds provided under section 

1005 [Health Insurance Reform Implementation] of Public Law 

111–152. 

Section 527 rescinds $6,800,000,000 provided under section 

3021(a) [Center for Medicare and Medicaid Innovation] of Public 

Law 111–148. 

Section 528 rescinds $100,000,000 provided under section 6301(e) 

[Patient-Centered Outcomes Research Trust Fund] of Public Law 

111–148. 

Section 529 prohibits funding from going to the Association of 

Community Organizations for Reform Now (ACORN), or any of its 

affiliates, subsidiaries, allied organizations, or successors. 

Section 530 provides conscience protections with respect to 

health care entities that refuse to participate in abortions and with 

regard to requirements for healthcare coverage of specific items 

and services. 

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3(f)(1)(B) 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 for 

the period concerned (dollars in thousands): 


rfrederick on DSK6VPTVN1PROD with HEARING
187 

Agency/Program Last Year of 

Authorization 

Authorization 

Level 

Appropriations 

in Last Year of 

Authorization 

Appropriations 

in this Bill 

DEPARTMENT OF LABOR 

ETA 

Reintegration of Ex-Offenders (transition 

activities authorized by Second Chance 

Act, 2007).

FY 2010 $20,000,000 ...... $15,000,000 $82,078,000 

Community Service Employment for Older 

Americans.

FY 2011 Such Sums ........ 450,000,000 434,371,000 

Federal Unemployment Benefits and Allowances.Dec. 31, 2014 Such Sums ........ 710,600,000 664,200,000 

VETERANS’ EMPLOYMENT AND TRAINING 

SERVICE 

Homeless Veterans Program ........................ FY 2015 50,000,000 ........ 38,109,000 38,109,000 

DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

HRSA 

Nursing Education Loan Repayment ........... FY 2007 Such Sums ........ 31,055,000 81,785,000 

Faculty Loan Repayment .............................. FY 2014 5,000,000 .......... 1,187,000 1,190,000 

Scholarships for Disadvantaged Students .. FY 2014 Such Sums ........ 44,857,000 45,970,000 

Health Careers Opportunity Program ........... FY 2014 Such Sums ........ 14,153,000 14,189,000 

National Center for Workforce Analysis ....... FY 2014 7,500,000 .......... 4,651,000 4,663,000 

Primary Care Training and Enhancement ... FY 2014 Such Sums ........ 36,831,000 38,924,000 

Oral Health Training Programs .................... FY 2012 25,000,000 ........ 31,928,000 34,998,000 

Area Health Education Centers ................... FY 2014 125,000,000 ...... 30,250,000 30,250,000 

Education & Training—Geriatrics .......................... ............................ 33,237,000 34,237,000 

(Workforce Development) .................... FY 2014 10,800,000.

(Career Incentive Awards) .................. FY 2013 10,000,000.

Mental & Behavioral Health Education ....... FY 2013 35,000,000 ........ 7,896,000 9,916,000 

Nursing Workforce Development 

(Nurse Education, Practice, Retention, 

and Quality Grants).

FY 2014 Such Sums ........ 37,913,000 39,913,000 

(Nurse Faculty Loan Program) ............ FY 2014 Such Sums ........ 24,500,000 26,500,000 

(Comprehensive Geriatric Education) FY 2014 Such Sums ........ 4,350,000 4,500,000 

Sickle Cell .................................................... FY 2009 10,000,000 ........ 4,455,000 4,455,000 

Healthy Start ................................................ FY 2013 Formula ............. 100,746,000 102,000,000 

Emergency Relief—Part A ........................... FY 2013 789,471,000 ...... 649,373,000 655,876,000 

Comprehensive Care—Part B ..................... FY 2013 1,562,169,000 ... 1,314,446,000 1,315,005,000 

Early Intervention—Part C .......................... FY 2013 285,766,000 ...... 205,544,000 201,079,000 

Coordinated Services and Access to Research for Women, Infants, Children and 

Youth—Part D.

FY 2013 87,273,000 ........ 75,088,000 75,088,000 

Special Projects of National Significance— 

Part F.

FY 2013 25,000,000 ........ 25,000,000 25,000,000 

Education and Training Centers—Part F ... FY 2013 42,178,000 ........ 33,275,000 33,611,000 

Dental Reimbursement—Part F .................. FY 2013 15,802,000 ........ 12,991,000 13,122,000 

Organ Transplantation ................................. FY 1993 Such Sums ........ 2,767,000 23,549,000 

Rural Health Outreach Grants ..................... FY 2012 45,000,000 ........ 55,553,000 59,000,000 

Rural/Community Access to Emergency Devices.FY 2006 5,000,000 .......... 1,485,000 4,500,000 

Rural Hospital Flexibility Grants .................. FY 2012 Such Sums ........ 41,040,000 41,609,000 

State Offices of Rural Health ...................... FY 2002 Such Sums ........ 4,000,000 9,511,000 

Telehealth ..................................................... FY 2006 Such Sums ........ 6,814,000 14,900,000 

CDC 

Sexually Transmitted Diseases Grants ........ FY 1998 Such Sums ........ 113,671,000 157,310,000 

National Cancer Registries .......................... FY 2003 Such Sums ........ .............................. 49,440,000 

National Center for Health Statistics .......... FY 2003 Such Sums ........ 125,899,000 160,397,000 

WISEWOMEN ................................................. FY 2003 Such Sums ........ 12,419,000 21,120,000 

Asthma Prevention ....................................... FY 2005 Such Sums ........ 32,422,000 30,000,000 

Folic Acid ..................................................... FY 2005 Such Sums ........ 2,188,000 3,150,000 

Injury Prevention and Control ...................... FY 2005 Such Sums ........ 138,237,000 211,300,000 

Oral Health Promotion ................................. FY 2005 Such Sums ........ 11,204,000 20,000,000 

Safe Motherhood/Infant Health Promotion .. FY 2005 Such Sums ........ 44,738,000 46,000,000 

Birth Defects, Developmental Disability, 

Disability and Health.

FY 2007 Such Sums ........ 122,242,000 133,510,000 

Breast and Cervical Cancer ........................ FY 2012 275,000,000 ...... 204,779,000 207,000,000 

Johanna’s Law ............................................. FY 2012 18,000,000 ........ 4,972,000 4,500,000 

Epidemiology Laboratory Capacity Grants ... FY 2013 190,000,000 ...... 32,424,000 40,000,000 


rfrederick on DSK6VPTVN1PROD with HEARING
188 

Agency/Program Last Year of 

Authorization 

Authorization 

Level 

Appropriations 

in Last Year of 

Authorization 

Appropriations 

in this Bill 

National TB Strategy Grants ........................ FY 2013 243,101,000 ...... 132,997,000 142,256,000 

National Diabetes Prevention Program ........ FY 2014 Such Sums ........ 10,000,000 20,000,000 

Section 317 Immunization ........................... FY 2014 Such Sums ........ 610,847,000 585,508,000 

Lead Poisoning Prevention ........................... FY 2005 Such Sums ........ 36,474,000 15,000,000 

Preventive Health Services Block Grant ...... FY 1998 Such Sums ........ 194,092,000 170,000,000 

NIH 

All 27 Institutes and Centers ...................... FY 2009 Such Sums ........ 30,317,024,000 30,174,000,000 

SAMHSA 

Grants for the Benefit of Homeless Individuals.FY 2003 50,000,000 ........ 16,700,000 28,696,000 

Residential Treatment Programs for Pregnant and Postpartum Women.FY 2003 Such Sums ........ 0 15,931,000 

Priority Substance Abuse Treatment Needs 

of Regional and National Significance.

FY 2003 300,000,000 ...... 322,994,000 377,000,000 

Substance Abuse Treatment Services for 

Children and Adolescents.

FY 2003 40,000,000 ........ 20,000,000 29,605,000 

Priority Substance Abuse Prevention Needs 

of Regional and National Significance.

FY 2003 300,000,000 ...... 138,399,000 190,219,000 

Centers of Excellence on Services for Individuals with FAS and Alcohol-related 

Birth Defects and Treatment.

FY 2003 5,000,000 .......... 2,416,000 1,000,000 

Priority Mental Health Needs of Regional 

and National Significance.

FY 2003 300,000,000 ...... 94,289,000 383,597,000 

Youth Interagency Research, Training, and 

Technical Assistance Centers.

FY 2007 5,000,000 .......... 3,960,000 3,909,000 

Suicide Prevention for Children and Youth FY 2007 35,000,000 ........ 22,779,000 53,915,000 

Grants for Jail Division Programs ............... FY 2003 10,000,000 ........ 6,043,000 4,269,000 

PATH Grants to States ................................. FY 2003 75,000,000 ........ 46,855,000 54,635,000 

Community Mental Health Services for 

Children with Serious Emotional Disturbances.

FY 2003 100,000,000 ...... 96,694,000 117,026,000 

Children and Violence Program ................... FY 2003 100,000,000 ...... 83,035,000 23,099,000 

Grants for Persons who Experienced Violence Related Stress.FY 2003 50,000,000 ........ 20,000,000 45,887,000 

Community Mental Health Services Block 

Grants.

FY 2003 450,000,000 ...... 433,000,000 482,571,000 

Substance Abuse Prevention and Treatment 

Block Grant.

FY 2003 2,000,000,000 ... 1,785,000,000 1,819,856,000 

Protection and Advocacy for Individuals 

with Mental Illness Act.

FY 2003 19,500,000 ........ 32,500,000 36,146,000 

AHRQ 

Research on Health Costs, Quality, and 

Outcomes.

FY 2005 Such Sums ........ 260,695,000 0 

ACF 

Low Income Home Energy Assistance Program.FY 2007 5,100,000,000 ... 2,161,170,000 3,365,304,000 

Children and Families Services Programs 

Adoption Awareness Programs ........... FY 2005 Such Sums ........ 12,453,000 39,100,000 

Native American Programs ................. FY 2002 Such Sums ........ 45,826,000 50,000,000 

Community Services Block Grant ....... FY 2003 Such Sums ........ 645,762,000 674,000,000 

Community Economic Development 

Program.

FY 2003 Formula ............. 27,082,000 29,883,000 

Assets for Independence ..................... FY 2003 25,000,000 ........ 24,827,000 18,950,000 

Refugee and Entrant Assistance 

Transitional and Medical Services ..... FY 2002 Such Sums ........ 227,243,000 383,266,000 

Social Services .................................... FY 2002 Such Sums ........ 158,600,000 149,927,000 

Preventative Health ............................. FY 2002 Such Sums ........ 4,835,000 4,600,000 

Targeted Assistance ............................ FY 2002 Such Sums ........ 49,477,000 47,601,000 

Victims of Torture ............................... FY 2007 25,000,000 ........ 9,817,000 10,735,000 

ACL 

Alzheimer’s Diseases Demonstration ........... FY 2002 Such Sums ........ 11,483,000 18,500,000 

Older Americans Act .................................... FY 2011 Such Sums ........ 1,927,486,000 1,393,958,000 

Lifespan Respite Care ................................. FY 2011 94,810,000 ........ 2,495,000 2,360,000 

Developmental Disabilities .......................... FY 2007 Such Sums ........ 155,115,000 161,920,000 

Elder Justice/ Adult Protective Services ...... FY 2014 129,000,000 ...... 0 46,608,000 


rfrederick on DSK6VPTVN1PROD with HEARING
189 

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—LEA formula grants.FY 2008 25,000,000,000 13,898,875,000 14,409,802,000 

Education for the Disadvantaged—(except 

Grants to LEAs and Special Programs 

for Migrant Students).

FY 2008 Such Sums ........ 1,557,267,000 422,365,000 

Special Programs for Migrant Students ...... FY 2015 Such Sums ........ 37,474,000 37,474,000 

Impact Aid ................................................... FY 2008 Such Sums ........ 1,240,717,000 1,298,603,000 

Indian Education .......................................... FY 2008 Such Sums ........ 119,564,000 143,939,000 

Innovation and Improvement—(except Investing in Innovation).FY 2008 Such Sums ........ 985,518,000 275,000,000 

Safe Schools and Citizenship Education 

(except Promise Neighborhoods).

FY 2008 Such Sums ........ 693,404,000 56,754,000 

English Language Acquisition ..................... FY 2008 Such Sums ........ 700,395,000 737,400,000 

Adult Education ........................................... FY 2004 Such Sums ........ 590,233,000 579,195,000 

Howard University—Endowment Program ... FY 1985 Such Sums ........ 2,000,000 3,405,000 

Institute of Education Sciences ................... FY 2009 Such Sums ........ 617,175,000 409,956,000 

RELATED AGENCIES 

Institute of Museum and Library Services .. FY 2009 Such Sums ........ 274,840,000 227,860,000 

National Council on Disability ..................... FY 2003 Such Sums ........ 3,144,000 3,186,000 

PROGRAM DUPLICATION

Pursuant to section 3(j)(2) of H. Res. 5 (113th Congress), no provision of this bill establishes or reauthorizes a program of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the Government Accountability Office to Congress pursuant to section 21 of 

Public Law 111–139, or a program related to a program identified 

in the most recent Catalog of Federal Domestic Assistance. 

DIRECTED RULE MAKING

The bill does not direct any rule making. 

COMPARISON WITH THE BUDGET RESOLUTION

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and Section 308(a)(1)(A) of the Congressional 

Budget Act of 1974, the following table compares the levels of new 

budget authority provided in the bill with the appropriate allocations under section 302(b) of the Budget Act: 

[In millions of dollars] 

302(b) Allocation This Bill 

Budget Authority Outlays Budget Authority Outlays 

Discretionary .......................................... $154,536 $169,100 $154,536 1$167,196 

Mandatory .............................................. 725,992 726,035 725,992 1$726,035 

1 Includes outlays from prior-year budget authority. 

FIVE YEAR OUTLAY PROJECTIONS

Pursuant to section 308(a)(1)(B) of the Congressional Budget Act 

of 1974, the following table contains five-year projections prepared 

by the Congressional Budget Office of outlays associated with the 

budget authority provided in the accompanying bill: 


rfrederick on DSK6VPTVN1PROD with HEARING
190 

[In millions of dollars] 

Projection of outlays associated with the recommendation: 

2016 ...................................................................................................................................................... 1$794,947 

2017 ...................................................................................................................................................... 66,973 

2018 ...................................................................................................................................................... 14,712 

2019 ...................................................................................................................................................... 4,087 

2020 and future years .......................................................................................................................... 28,182. 

1 Excludes outlays from prior-year budget authority. 

ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

Pursuant to section 308(a)(1)(C) of the Congressional Budget Act 

of 1974, the amounts of financial assistance to State and local governments is as follows: 

[In millions of dollars] 

New budget authority ..................................................................................................................................... $416,526 

Fiscal year 2016 outlays resulting therefrom ................................................................................................ 1395,861 

1 Excludes outlays from prior-year budget authority. 


rfrederick on DSK6VPTVN1PROD with HEARING
191 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 023 here HR195.001
192 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 24 here HR195.002
193 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 25 here HR195.003
194 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 26 here HR195.004
195 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 27 here HR195.005
196 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 28 here HR195.006
197 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 29 here HR195.007
198 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 30 here HR195.008
199 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 31 here HR195.009
200 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 32 here HR195.010
201 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 33 here HR195.011
202 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 34 here HR195.012
203 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 35 here HR195.013
204 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 36 here HR195.014
205 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 37 here HR195.015
206 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 06 here 93762A.001
207 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 07 here 93762A.002
208 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 08 here 93762A.003
209 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 09 here 93762A.004
210 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 010 here 93762A.005
211 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 011 here 93762A.006
212 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 012 here 93762A.007
213 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 013 here 93762A.008
214 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 014 here 93762A.009
215 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 015 here 93762A.010
216 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 016 here 93762A.011
217 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 017 here 93762A.012
218 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 018 here 93762A.013
219 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 019 here 93762A.014
220 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 020 here 93762A.015
221 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 021 here 93762A.016
222 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 022 here 93762A.017
223 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 023 here 93762A.018
224 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 024 here 93762A.019
225 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 025 here 93762A.020
226 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 026 here 93762A.021
227 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 027 here 93762A.022
228 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 028 here 93762A.023
229 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 029 here 93762A.024
230 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 030 here 93762A.025
231 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 031 here 93762A.026
232 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 032 here 93762A.027
233 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 033 here 93762A.028
234 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 034 here 93762A.029
235 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 035 here 93762A.030
236 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 036 here 93762A.031
237 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 037 here 93762A.032
238 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 038 here 93762A.033
239 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 039 here 93762A.034
240 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 040 here 93762A.035
241 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 041 here 93762A.036
242 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 042 here 93762A.037
243 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 043 here 93762A.038
244 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 044 here 93762A.039
245 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 045 here 93762A.040
246 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 046 here 93762A.041
247 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 047 here 93762A.042
248 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 048 here 93762A.043
249 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 049 here 93762A.044
250 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 050 here 93762A.045
251 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 051 here 93762A.046
252 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 052 here 93762A.047
253 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 053 here 93762A.048
254 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 054 here 93762A.049
255 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 055 here 93762A.050
256 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 056 here 93762A.051
257 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 057 here 93762A.052
258 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 058 here 93762A.053
259 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 059 here 93762A.054
260 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 060 here 93762A.055
261 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 061 here 93762A.056
262 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 062 here 93762A.057
263 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 063 here 93762A.058
264 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 064 here 93762A.059
265 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 065 here 93762A.060
266 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 066 here 93762A.061
267 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 067 here 93762A.062
268 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 068 here 93762A.063
269 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 069 here 93762A.064
270 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 070 here 93762A.065
271 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 071 here 93762A.066
272 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 072 here 93762A.067
273 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 073 here 93762A.068
274 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 074 here 93762A.069
275 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 075 here 93762A.070
276 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 076 here 93762A.071
277 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 077 here 93762A.072
278 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 078 here 93762A.073
279 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 079 here 93762A.074
280 


rfrederick on DSK6VPTVN1PROD with HEARINGInsert offset folio 080 here 93762A.075
(281) 

MINORITY VIEWS OF REP. NITA LOWEY AND REP. ROSA 

DELAURO 

We are grateful that Chairman Rogers and Chairman Cole finally held the first full Committee markup of the Labor, Health 

and Human Services, Education, and Related Agencies bill since 

Republicans took control of the House. This bill includes some of 

the nation’s most important investments in domestic programs and 

it deserves an open debate in Committee every year, not once every 

six years. 

The Committee has made a mistake, however, by approving a bill 

that cuts funding for labor, health, education, and community service programs by $3.7 billion compared to the FY 2015 level and by 

$14.6 billion compared to the President’s budget request. 

Budgeting is fundamentally about values. The fact that the 

Labor-HHS-Education subcommittee took the largest dollar cut of 

any appropriations bill this year is a telling indication of the Majority’s priorities. These cuts, with which we strongly disagree, will 

harm children, seniors, women, workers, students, and families. 

We will continue to press this issue until critical funding levels are 

restored. 

The Majority’s litany of cuts includes complete elimination of 

Preschool Development Grants, the Agency for Healthcare Research and Quality (AHRQ), and Title X family planning services 

for low-income women and families. The bill also eliminates 27 

education programs and activities and nearly eliminates the Teen 

Pregnancy Prevention program. 

The bill is fundamentally flawed due to its grossly inadequate 

302(b) allocation and the inclusion of ideological and unnecessary 

riders. 

We must take into account the historical context. In the last five 

years, the Labor-HHS-Education bill has been cut by approximately $20 billion in real terms. This decline led to more than a 

billion dollars in cuts to several critical investments, including Title 

I education grants for low-income children, special education State 

grants, job training programs, and the Centers for Disease Control 

and Prevention (CDC). During this period the National Institutes 

of Health lost more than $3.5 billion. While modest increases of 

$1.1 billion for the NIH and $500 million for Special Education are 

provided, the Majority cuts another $5.3 billion from the remaining 

programs. Under the Majority’s unacceptably low allocation, there 

is no way to sufficiently address funding gaps. Any attempt to fix 

this bill within its current allocation would simply rob Peter to pay 

Paul. 

The bill is also weighed down by ideological riders. It blocks 

funding for the Affordable Care Act (ACA), which would cause 19 

million Americans to lose their health coverage. It also rescinds approximately $7 billion in mandatory funding provided through the 


rfrederick on DSK6VPTVN1PROD with HEARING
282 

ACA. To make matters worse, repealing the Affordable Care Act 

would cost American taxpayers more than $350 billion over 10 

years, according to the nonpartisan Congressional Budget Office. 

In addition, the bill blocks the Department of Education, the Department of Labor, and the National Labor Relations Board from 

enforcing regulations to protect students, workers, and retirees. 

And the Majority continues to impose its rigid ideology by adding 

harmful riders to block funds for family planning services and, 

even worse, to allow employers to deny preventive health services 

to their workers if the employer has a religious or moral objection 

to those services. These provisions would roll back decades of 

progress, as once again the Majority is trying to take away a woman’s right to make her own health care decisions in consultation 

with her doctor and family. 

During markup in the full committee, we offered a series of 

amendments to restore funding to critical programs like early 

childhood education, Title I grants, Pell Grants, job training, health 

research, Medicare program operations, medical countermeasures, 

family planning, teen pregnancy prevention, and community service programs. We are disappointed that the Majority rejected all of 

our proposals. 

But the funding to restore these necessary investments will not 

materialize unless, and until, we undo sequestration. Therefore alternative deficit reduction strategies—like those proposed in the 

President’s budget to eliminate tax breaks and loopholes for special 

interests—must be part of an eventual budget agreement. 

The Majority has made it clear that it is willing to violate the budget caps for defense spending—having added $38 billion in 

Overseas Contingency Operations funding without any spending 

offsets. We simply ask for a similar agreement for critical investments in non-defense discretionary spending, such as labor, health, 

education and community service programs. 

Both Chairman Rogers and Chairman Cole have said they look 

forward to revisiting these allocations when we reach a new budget 

agreement, and we certainly look forward to working with them at 

that point. 

And while the Labor-HHS-Education bill has a great many shortcomings due to its inadequate allocation, we do want to highlight 

some investments that we strongly support and that should be further increased: 

• National Institutes of Health (NIH). The bill includes $31.2 billion for the NIH, an increase of $1.1 billion above the FY 2015 Omnibus. These additional funds will enable the NIH to move forward 

with the Precision Medicine Initiative, the BRAIN Initiative, the 

Combatting Antibiotic Resistant Bacteria (CARB) Initiative, Alzheimer’s research, and to increase the number of research project 

grants for basic science research. Unfortunately, this is still $2.5 

billion below 2010 funding levels after adjusting for inflation. 

• Special Education State Grants. The bill includes $12 billion 

for IDEA Part B State Grants, an increase of $500 million above 

the FY 2015 level. These additional funds will assist States in covering the excess costs of providing special education and services 

to children with disabilities. Unfortunately, this is still $500 million below 2010 funding levels after adjusting for inflation. 


rfrederick on DSK6VPTVN1PROD with HEARING
283 

• TRIO and GEAR UP. The bill includes $900 million for TRIO, 

an increase of $60 million above the FY 2015 level, and a total of 

$323 million for GEAR UP, an increase of $21 million above the 

FY 2015 level. Unfortunately, TRIO and GEAR UP are still $26 

million and $28 million below 2010 funding levels when adjusting 

for inflation. 

• Head Start. The bill includes $8.8 billion for Head Start, an increase of $192 million above the FY 2015 level. However, this 

amount is $1.3 billion below the President’s request. 

Harmful Budget Cuts in the Majority’s bill 

The Labor-HHS-Education bill is called the People’s Bill for a 

reason. It is about providing people with opportunities. The programs we fund level the playing field for low-income children; help 

Americans learn new job skills in a tough economy and access 

higher education; and protect families from public health threats. 

That is why we are so disappointed that the Majority chose this bill 

to bear the brunt of its budget cuts. 

DEPARTMENT OF EDUCATION

The Department of Education alone takes $2.5 billion in net 

cuts—and that is after accounting for a $500 million increase for 

special education State grants. This is a larger cut than in the FY 

2013 across-the-board sequester. The bill eliminates Preschool Development Grants, Mathematics and Science Partnerships, Carol 

M. White Physical Education Program, Magnet School Assistance 

Program, and 23 other programs and activities. 

Department of Education—Program Eliminations 

1 School Improvement Grants 

2 Striving Readers 

3 Title I Evaluation 

4 Preschool Development Grants 

5 Mathematics and Science Partnerships 

6 Investing in Innovation (I3) 

7 Teacher Incentive Fund 

8 Transition to Teaching 

9 School Leadership 

10 Magnet School Assistance Program 

11 Ready to Learn 

12 Advanced Placement 

13 Fund for the Improvement of Education (FIE): Non-Cognitive 

Skills Initiative 

14 FIE: Arts in Education 

15 FIE: Full Service Community Schools 

16 FIE: Education Facilities Clearinghouse 

17 FIE: Innovative Approaches to Literacy 

18 FIE: Javits Gifted and Talented 

19 Safe and Drug-free Schools and Communities National Activities (including ‘‘Now is the Time’’) 

20 Elementary and Secondary School Counseling 

21 Carol M. White Physical Education Program 

22 Special Olympics 


rfrederick on DSK6VPTVN1PROD with HEARING
284 

23 Fund for the Improvement of Postsecondary Education 

(FIPSE): First in the World 

24 FIPSE: Centers of Excellence for Veteran Student Success 

25 FIPSE: National Center for Information and Technical Support for Postsecondary Students with Disabilities 

26 Teacher Quality Partnership 

27 Regional Educational Laboratories 

The elimination of Preschool Development Grants would de-fund 

preschool programs that are creating or expanding high-quality 

preschool programs for low- and moderate-income children in 18 

States. This cut would be particularly painful for the 60,000 children who would lose access to preschool entirely. The United States 

is far behind many countries in providing access to preschool education, and ranks just 25th in the world in its enrollment of 4-yearolds. The need is there, but the resources are not. The elimination 

is particularly troubling given the growing mountain of evidence 

that high-quality early childhood interventions work in reducing inequality and narrowing achievement gaps. As documented by Nobel 

laureate economist James Heckman, these interventions represent 

an excellent return on investment as children are less likely to get 

in trouble with the law, be held back a grade, and need special 

education services. 

We are also concerned that the bill eliminates several programs 

that foster a safe and secure learning environment in our country’s 

most distressed communities, such as the Now is the Time initiative, which supports strategies to reduce gun violence and increase 

access to mental health services; Elementary and Secondary School 

Counseling, which supports the critical role school counselors play 

in helping to create a safe school environment; and the Carol M. 

White Physical Education program. With the prevalence of 

unhealthy body weights among children more than doubling over 

the past 30 years, we should be investing more in physical education, not eliminating the program designed to combat this alarming trend. 

The bill even eliminates Striving Readers—the largest reading 

program for low-income children from birth through grade 12. Universal literacy is the mark of a civilized society. 

The Pell Grant program, which has allowed millions of low- and 

middle-income students to access college and the middle class, loses 

$370 million. This cut represents 15 percent of the total reduction 

to the Department of Education and is proposed without corresponding increases to other student aid programs. 

In the full committee markup, we offered amendments to restore 

funding for education programs that were eliminated and Pell 

Grants. We also offered an amendment to boost funding for early 

childhood programs, including Preschool Development Grants. We 

are disappointed that the Majority blocked all of these efforts. 

DEPARTMENT OF HEALTH AND HUMAN SERVICES

The Department of Health and Human Services does not fare 

much better. Aside from the NIH, it takes a cut of $1.3 billion 

below the FY 2015 level. Family Planning under Title X is zeroed 

out, and Teen Pregnancy Prevention is all but eliminated, facing a 

cut of 93 percent. These cuts will have a devastating impact on 


rfrederick on DSK6VPTVN1PROD with HEARING
285 

women’s health and reproductive choice. The bill also fails to protect victims of human trafficking, despite the President’s request 

for funds, and the acknowledgment on all sides that human trafficking—particularly when it involves children—is a scourge on society. 

The Agency for Healthcare Research and Quality (AHRQ) is 

eliminated. Contrary to the Majority’s talking points, AHRQ is not 

duplicative. While NIH carries out basic research and CDC tracks 

diseases, AHRQ focuses on the delivery of care in health care settings. AHRQ’s work contributed to a 17 percent decline in 

healthcare-associated infections between 2010 and 2013, saving an 

estimated 50,000 lives and avoiding more than a million infections. 

Moreover, this bill shifts AHRQ’s workload to other agencies without providing the necessary funding to carry out the additional responsibilities. CMS Program Management is cut by $650 million below the FY 

2015 level. Now that more than 10 million Americans are receiving 

their health coverage through the Health Insurance Marketplace, 

it is time to stop playing political games with these funds. A cut 

of this magnitude goes beyond funding for the Health Insurance 

Marketplace. It most likely would lead to serious disruptions to 

core Medicare operations, which would hurt our seniors and their 

health care providers. 

The bill fails to meet the President’s request for the Biomedical 

Advanced Research and Development Authority (BARDA), BioShield, and pandemic influenza preparedness. These programs develop and procure drugs and vaccines to prevent or respond to serious public health threats, such as an outbreak of a deadly infectious disease or a terrorist attack. 

And while we appreciate the increase of $192 million for Head 

Start, along with Chairman Cole’s support for early learning programs, funding for Head Start is still $1.3 billion below the President’s request. The Office of Management and Budget has said that 

the House bill could result in 140,000 fewer children in Head Start, 

or in more than 570,000 children in Head Start being denied the 

full-day, full-year services that provide the greatest benefit. 

Similarly, the bill fails to provide an increase for the Child Care 

and Development Block Grant (CCDBG), which means that States 

will not receive funds to implement the quality improvements and 

reforms that were recently enacted in bipartisan child care legislation—nor will we be able to reach the millions of eligible children 

and their families who do not receive any child care assistance due 

to insufficient funds for the CCDBG. 

Once again, we sought to improve the bill by offering amendments to restore funding for AHRQ, Title X Family Planning, Teen 

Pregnancy Prevention, and CMS Program Management. We also 

sought to boost funding for Head Start, CCDBG, and public health 

preparedness. But none of our colleagues across the aisle supported 

these efforts. All were rejected on party line votes. 

DEPARTMENT OF LABOR

The Department of Labor is cut by $205 million. The bill fails to 

make the necessary investments to deal with the fact that twothirds of all jobs are set to require some postsecondary education 


rfrederick on DSK6VPTVN1PROD with HEARING
286 

and training by 2020. In addition, job training for dislocated workers is cut and worker protection agencies face substantial reductions. 

We are disappointed that the bill does not support the President’s request of $100 million for an Apprenticeship Initiative. We 

know the apprenticeship model works, as it develops a highly 

skilled workforce that meets national and local needs and reduces 

turnover costs. And the bill slashes nearly $150 million from grants 

to respond to mass layoffs or natural disasters, which would mean 

less assistance for communities at the time when they need it the 

most. 

We are also disappointed that the bill provides no funding for the 

State Paid Leave Fund. At some point in our working lives, nearly 

all of us will need time off to deal with a serious illness or care 

for a newborn child or aging parent. Yet only 13 percent of American workers have access to paid family leave, which should be a 

fundamental right for all Americans. 

On top of cuts to job training, the bill further cuts funding for 

agencies charged with protecting the health, safety, and benefits of 

American workers. These cuts would leave workers more susceptible to wage theft, along with racial and gender discrimination in 

the workplace. It would also make it more difficult to identify the 

workplaces with the worst records of injuries on the job. 

And finally, all funds for grants through the International Labor 

Affairs Bureau, are eliminated, ending the Department’s efforts to 

help children around the world escape from forced labor and the 

worst forms of child labor. 

In an effort to lessen the harm to American workers and their 

families, we offered amendments to restore funding to job training 

programs, worker protection agencies, and grants to eradicate child 

labor. We also offered amendments to provide funding for an apprenticeship initiative and a State Paid Leave Fund. Once again 

the Majority blocked those proposals. 

RELATED AGENCIES

Among related agencies, the Corporation for National and Community Service, which runs Vista, AmeriCorps and other national 

service organizations, is cut by more than one-third, with no funding for the Social Innovation Fund or the National Civilian Community Corps, and drastic cuts to the National Service Trust. In 

addition to reducing the number of AmeriCorps members, the bill 

de-funds critical disaster relief work. Moreover, the bill cuts the 

agency’s administrative budget by 75 percent, making it unable to 

effectively operate. 

The National Labor Relations Board is cut by more than 25 percent, which would undermine the agency’s ability to carry out its 

legal responsibilities under the National Labor Relations Act. 

While we recognize the Majority disagrees with some of the 

NLRB’s recent decisions, we note that federal courts have upheld 

the NLRB’s rulemaking authority. 

And lastly, the bill provides $695 million less than requested for 

the Social Security Administration’s (SSA) operating expenses. This 

shortfall could lead to reduced field office hours, longer in-office 


rfrederick on DSK6VPTVN1PROD with HEARING
287 

wait times, and phone service delays for those who contact SSA for 

help. 

During markup in the full committee, we tried to restore funding 

for community service programs and the NLRB, and boost funding 

for SSA operating expenses to the President’s request. But our proposals were rejected on party-line votes. 

The Affordable Care Act 

Unfortunately, we also see yet another attempt to block funding 

for the Affordable Care Act, which would cause 19 million Americans to lose their health coverage. 

Let us be clear: the Affordable Care Act is working. It is helping 

millions of families across the country. Americans can no longer be 

denied coverage for pre-existing conditions. Preventive screenings, 

maternity care, and pediatric care are now covered. Women’s 

health has been put on an even footing. Millions of low-income children have healthcare through the Children’s Health Insurance Program. Insurers can no longer subject families to lifetime caps on 

coverage. 

In addition, the Congressional Budget Office has determined that 

repealing the Affordable Care Act would cost American taxpayers 

more than $350 billion over the next decade—and the cost to taxpayers would only increase in subsequent decades. 

We offered an amendment in full committee markup to remove 

this harmful provision. We were disappointed, however, when the 

Majority voted to keep this poison pill. 

Harmful Policy Riders 

The bill rescinds $6.8 billion from the Center for Medicare and 

Medicaid Innovation, which is testing new service delivery and payment models. These tests have already shown promising results, 

through the Pioneer Accountable Care Organization demonstration, 

that will lead to better care and reduced costs in the long run. In 

fact, the Congressional Budget Office estimates that rescinding 

these funds would actually increase the deficit by a net of $31 billion over the next decade. This rescission is the epitome of pennywise, pound-foolish decision-making. 

During markup in the full committee, we tried to save taxpayers 

$31 billion by striking this rescission from the bill. The Majority, 

unfortunately, voted to keep it. 

The bill prohibits the Department of Labor from enforcing rules 

to ensure that financial advisers act in the best interests of their 

clients, and it blocks the Department from protecting taxpayer 

funds from federal contractors with records of serious, willful, repeated, and pervasive labor law violations. It continues the Majority’s assault on workers by stopping the National Labor Relations 

Board from enforcing its own rulings facilitating union elections, 

the responsibilities of joint employers, and the certification of bargaining units. 

The bill also prohibits funds for research into patient-centered 

outcomes, and it blocks some science-based recommendations from 

being included in the next edition of Dietary Guidelines for Americans. The bill also blocks a Department of Education rule related 

to career education programs. 


rfrederick on DSK6VPTVN1PROD with HEARING
288 

This type of legislation does not belong in appropriations bills, so 

we offered a variety of amendments to strike these extraneous provisions. The Majority, once again, chose to keep them. 

Anti-Woman Ideology 

There is no way to say this other than bluntly: this bill is an affront to women and families. It eliminates funding for the Title X 

Family Planning program and tops that off by adding a policy rider 

to block any federal funds from being used for family planning purposes. This elimination of family planning services would have a 

devastating impact on women—especially women in rural communities and low-income women. 

To make matters worse, the funding for Teen Pregnancy Prevention services is cut by more than 90 percent. The Teen Pregnancy 

Prevention Program has achieved great success in reducing teenage 

pregnancy and abortion, as well as in addressing disparities in teen 

pregnancy and birth rates. 

In another shot at women, the bill allows employers to block 

their access to preventive health services if the employers have socalled ‘‘religious or moral’’ objections. Once again the Majority is 

trying to take away a woman’s right to make her own health care 

decisions. This policy rider would give final say to employers, instead of women, on health services such as contraception, infertility 

treatment, prenatal testing, vaccination, testing for HIV/AIDS or 

sexually transmitted diseases, transfusions—or anything else to 

which someone might plausibly (or even implausibly) claim a religious or moral objection. 

These provisions are downright offensive. During markup in the 

full committee, we offered amendments to strike each of the provisions that would limit a woman’s ability to make her own 

healthcare decisions. Quite frankly, we are appalled that our colleagues opposed our efforts. 

Conclusion 

This bill is another example of the Majority’s continued attempt 

to encode their extreme and divisive ideological preferences into 

law, no matter the cost. We ask our colleagues to stop pushing an 

ideological agenda that places the health of millions of women and 

their families at risk. 

Throughout this appropriations season we have heard about difficult choices. But we can make a choice, now, to work together on 

a deal to eliminate sequestration and to fund the government at 

levels that meet the nation’s needs for medical research, public 

health, early childhood education, higher education, and job training, among others. That is a choice we can make. The reality is this 

bill, with its inadequate funding levels and ideological riders, is a 

consequence of Congress choosing inaction over a long-term solution for hard-working Americans. 


rfrederick on DSK6VPTVN1PROD with HEARING
289 

We remain hopeful that this bill can be improved once we receive 

a new allocation and the Majority drops its ideological and unnecessary riders. At that point, we look forward to working with 

Chairman Rogers and Chairman Cole to move forward. 

NITA M. LOWEY. 

ROSA L. DELAURO

Æ 


rfrederick on DSK6VPTVN1PROD with HEARING