20–356 PDF 

Calendar No. 509 

114TH CONGRESS REPORT " ! SENATE 2d Session 114–274 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2017 

JUNE 9, 2016.—Ordered to be printed 

Mr. BLUNT, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

[To accompany S. 3040] 

The Committee on Appropriations reports the bill (S. 3040) making appropriations for Departments of Labor, Health and Human 

Services, and Education, and related agencies for the fiscal year 

ending September 30, 2017, and for other purposes, reports favorably thereon without amendment and recommends that the bill do 

pass. 

Amounts to new budget authority 

Total of bill as reported to the Senate ....................$932,211,568,000 

Amount of 2016 appropriations ............................... 888,428,751,000 

Amount of 2017 budget estimate ............................ 933,107,118,000 

Bill as recommended to Senate compared to: 

2016 appropriations .......................................... ∂43,782,817,000 

2017 budget estimate ........................................ ¥895,550,000 
(2) 

C O N T E N T S 

Page 

List of Abbreviations ............................................................................................... 4 

Summary of Budget Estimates and Committee Recommendations .................... 8 

Overview ............................................................................................................ 8 

National Institutes of Health .......................................................................... 9 

Combating Opioid Abuse ................................................................................. 10 

Promoting College Affordability and Completion .......................................... 11 

Improving Fiscal Accountability ...................................................................... 11 

Increasing the Efficiency and Cost Effectiveness of Government ................ 12 

Guidance Documents ........................................................................................ 14 

Other Highlights of the Bill ............................................................................. 14 

Title I: Department of Labor: 

Employment and Training Administration .................................................... 17 

Employee Benefits Security Administration .................................................. 27 

Pension Benefit Guaranty Corporation .......................................................... 27 

Wage and Hour Division .................................................................................. 28 

Office of Labor-Management Standards ......................................................... 29 

Office of Federal Contract Compliance Programs .......................................... 29 

Office of Workers’ Compensation Programs ................................................... 29 

Occupational Safety and Health Administration ........................................... 32 

Mine Safety and Health Administration ........................................................ 34 

Bureau of Labor Statistics ............................................................................... 35 

Office of Disability Employment Policy .......................................................... 35 

Departmental Management ............................................................................. 36 

General Provisions ........................................................................................... 39 

Title II: Department of Health and Human Services: 

Health Resources and Services Administration ............................................. 41 

Centers for Disease Control and Prevention .................................................. 59 

National Institutes of Health .......................................................................... 81 

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

Agency for Healthcare Research and Quality ................................................ 124 

Centers for Medicare and Medicaid Services ................................................. 126 

Administration for Children and Families ..................................................... 135 

Administration for Community Living ........................................................... 144 

Office of the Secretary ...................................................................................... 151 

General Provisions ........................................................................................... 163 

Title III: Department of Education: 

Education for the Disadvantaged .................................................................... 165 

Impact Aid ......................................................................................................... 168 

School Improvement Programs ........................................................................ 169 

Indian Education .............................................................................................. 173 

Innovation and Improvement .......................................................................... 174 

Safe Schools and Citizenship Education ......................................................... 178 

English Language Acquisition ......................................................................... 179 

Special Education ............................................................................................. 180 

Rehabilitation Services .................................................................................... 182 

Special Institutions for Persons With Disabilities: 

American Printing House for the Blind ................................................... 183 

National Technical Institute for the Deaf ............................................... 184 

Gallaudet University ................................................................................. 184 

Career, Technical, and Adult Education ........................................................ 184 

Student Financial Assistance .......................................................................... 185 

Student Aid Administration ............................................................................ 187 

Higher Education ............................................................................................. 189 

Howard University ........................................................................................... 194 
Page

3 

Title III—Continued 

College Housing and Academic Facilities Loans Program ............................ 194 

Historically Black College and University Capital Financing Program 

Account .......................................................................................................... 194 

Institute of Education Sciences ....................................................................... 195 

Departmental Management: 

Program Administration ........................................................................... 197 

Office for Civil Rights ............................................................................... 199 

Office of the Inspector General ................................................................ 199 

General Provisions ........................................................................................... 199 

Title IV: Related Agencies: 

Committee for Purchase From People Who Are Blind or Severely Disabled ............................................................................................................... 201 

Corporation for National and Community Service ........................................ 201 

Corporation for Public Broadcasting ............................................................... 204 

Federal Mediation and Conciliation Service .................................................. 205 

Federal Mine Safety and Health Review Commission .................................. 205 

Institute of Museum and Library Services ..................................................... 206 

Medicaid and CHIP Payment and Access Commission ................................. 206 

Medicare Payment Advisory Commission ...................................................... 207 

National Council on Disability ........................................................................ 207 

National Labor Relations Board ...................................................................... 207 

National Mediation Board ............................................................................... 208 

Occupational Safety and Health Review Commission ................................... 208 

Railroad Retirement Board .............................................................................. 208 

Social Security Administration ........................................................................ 209 

Title V: General Provisions ..................................................................................... 215 

Compliance With Paragraph 7, Rule XVI of the Standing Rules of the Senate .......................................................................................................................... 217 

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

Senate ................................................................................................................... 217 

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

Senate ................................................................................................................... 218 

Budgetary Impact of Bill ......................................................................................... 224 

Comparative Statement of New Budget Authority ............................................... 225 
(4) 

LIST OF ABBREVIATIONS 

ACA—Patient Protection and Affordable Care Act 

ACL—Administration for Community Living 

ADAP—AIDS Drug Assistance Program 

AHEC—Area Health Education Center 

AHRQ—Agency for Healthcare Research and Quality 

AP—Advanced Placement 

APH—American Printing House for the Blind 

ARRA—American Recovery and Reinvestment Act of 2009 

ASH—Assistant Secretary for Health 

ASPR—Assistant Secretary for Preparedness and Response 

BARDA—Biomedical Advanced Research and Development Authority 

BCA—Budget Control Act of 2011 

BLS—Bureau of Labor Statistics 

CAN—Cures Acceleration Network 

CCAMPIS—Child Care Access Means Parents in School 

CCDBG—Child Care and Development Block Grant 

CDC—Centers for Disease Control and Prevention 

CHAFL—College Housing and Academic Facilities Loans 

CHC—Community Health Center 

CHGME—Children’s Hospitals Graduate Medical Education 

CJ—Congressional Justification of Estimates for Appropriations 

Committees 

CMHS—Center for Mental Health Services 

CMS—Centers for Medicare and Medicaid Services 

CNCS—Corporation for National and Community Service 

CPB—Corporation for Public Broadcasting 

CSAP—Center for Substance Abuse Prevention 

CSAT—Center for Substance Abuse Treatment 

CSBG—Community Services Block Grant 

CSEOA—Community Service Employment for Older Americans 

DOD—Department of Defense 

DOE—Department of Energy 

DOL—Department of Labor 

EBSA—Employee Benefits Security Administration 

EEOICPA—Energy Employees Occupational Illness Compensation Program Act 

ERISA—Employee Retirement Income Security Act of 1974 

ESEA—Elementary and Secondary Education Act 

ETA—Employment and Training Administration 

FDA—Food and Drug Administration 

FEMA—Federal Emergency Management Agency 

FIC—Fogarty International Center 

FIE—Fund for the Improvement of Education 

FIPSE—Fund for the Improvement of Postsecondary Education 

FMCS—Federal Mediation and Coalition Service 
5 

FMSHRC—Federal Mine Safety and Health Review Commission 

FTE—full-time equivalent 

FWS—Federal Work Study 

GAANN—Graduate Assistance in Areas of National Need 

GAO—Government Accountability Office 

GEAR UP—Gaining Early Awareness and Readiness for Undergraduate Programs 

HBCUs—Historically Black Colleges and Universities 

HCERA—Health Care and Education Reconciliation Act of 2010 

HCFAC—Health Care Fraud and Abuse Control 

HEA—Higher Education Act 

HELP—Health, Education, Labor, and Pensions 

HHS—Health and Human Services 

HRSA—Health Resources and Services Administration 

IC—Institute and Center 

IDeA—Institutional Development Award 

IDEA—Individuals with Disabilities Education Act 

IES—Institute of Education Sciences 

IMLS—Institute of Museum and Library Services 

IOM—Institute of Medicine 

LEA—local educational agency 

LIHEAP—Low Income Home Energy Assistance Program 

MACPAC—Medicaid and CHIP Payment and Access Commission 

MCH—Maternal and Child Health 

MedPAC—Medicare Payment Advisory Commission 

MSHA—Mine Safety and Health Administration 

NAEP—National Assessment of Educational Progress 

NAGB—National Assessment Governing Board 

NCATS—National Center for Advancing Transitional Sciences 

NCBDDD—National Center on Birth Defects and Developmental 

Disabilities 

NCES—National Center for Education Statistics 

NCHS—National Center for Health Statistics 

NCI—National Cancer Institute 

NEI—National Eye Institute 

NHGRI—National Human Genome Research Institute 

NHLBI—National Heart, Lung, and Blood Institute 

NIA—National Institute on Aging 

NIAAA—National Institute on Alcohol Abuse and Alcoholism 

NIAID—National Institute of Allergy and Infectious Disease 

NIAMS—National Institute of Arthritis and Musculoskeletal and 

Skin Diseases 

NIBIB—National Institute of Biomedical Imaging and Bioengineering 

NICHD—Eunice Kennedy Shriver National Institute of Child 

Health and Human Development 

NIDA—National Institute on Drug Abuse 

NIDCD—National Institute on Deafness and Other Communication Disorders 

NIDCR—National Institute of Dental and Craniofacial Research 

NIDDK—National Institute of Diabetes and Digestive and Kidney Disease 

NIDRR—National Institute on Disability and Rehabilitation Research 
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NIEHS—National Institute of Environmental Health Sciences 

NIGMS—National Institute of General Medical Sciences 

NIH—National Institutes of Health 

NIMH—National Institute on Mental Health 

NIMHD—National Institute on Minority Health and Health Disparities 

NINDS—National Institute of Neurological Disorders and Stroke 

NINR—National Institute of Nursing Research 

NLM—National Library of Medicine 

NLRB—National Labor Relations Board 

NSF—National Science Foundation 

NSIP—Nutrition Services Incentives Program 

NTID—National Technical Institute for the Deaf 

NFP—Not-for-Profit 

OAR—Office of AIDS Research 

OCR—Office for Civil Rights 

ODEP—Office of Disability Employment Policy 

OFCCP—Office of Federal Contract Compliance Programs 

OIG—Office of the Inspector General 

OLMS—Office of Labor-Management Standards 

OMB—Office of Management and Budget 

OMH—Office of Minority Health 

OMHA—Office of Medicare Hearings and Appeals 

ONC—Office of the National Coordinator for Health Information 

Technology 

ORR—Office of Refugee Resettlement 

ORWH—Office of Research on Women’s Health 

OSEP—Office of Special Education Programs 

OSHA—Occupational Safety and Health Administration 

OWCP—Office of Workers’ Compensation Programs 

OWH—Office of Women’s Health 

PAIMI—protection and advocacy for individuals with mental illness 

PATH—Projects for Assistance in Transition From Homelessness 

PBGC—Pension Benefit Guaranty Corporation 

PHS—Public Health Service 

PPH Fund—Prevention and Public Health Fund 

PRNS—Programs of Regional and National Significance 

PROMISE—Promoting School Readiness of Minors in SSI 

RSA—Rehabilitation Services Administration 

SAMHSA—Substance Abuse and Mental Health Services Administration 

SAPT—Substance Abuse Prevention and Treatment 

SEA—State educational agency 

SEOG—Supplemental Educational Opportunity Grant 

SIG—School Improvement Grants 

SPRANS—Special Projects of Regional and National Significance 

SSA—Social Security Administration 

SSBG—Social Services Block Grant 

SSI—Supplemental Security Income 

STEM—science, technology, engineering, and mathematics 

TB—tuberculosis 

TBI—traumatic brain injury 

TIF—Teacher Incentive Fund 
7 

TIVAS—Title IV Additional Servicers 

UAC—unaccompanied alien children 

UCEDD—University Center for Excellence in Developmental 

Disabilities 

UI—unemployment insurance 

USAID—U.S. Agency for International Development 

VETS—Veterans’ Employment and Training Services 

VISTA—Volunteers in Service to America 

VR—Vocational Rehabilitation 

WANTO—Women in Apprenticeship and Non-Traditional Occupations 

WHD—Wage and Hour Division 

WIA—Workforce Investment Act 

WIF—Workforce Innovation Fund 

WISEWOMAN—Well-Integrated Screening and Evaluation for 

Women Across the Nation 
(8) 

SUMMARY OF BUDGET ESTIMATES AND COMMITTEE 

RECOMMENDATIONS 

For fiscal year 2017, the Committee recommends total budget au- thority of $932,211,568,000 for the Departments of Labor, Health 

and Human Services, and Education, and Related Agencies. This 

amount includes $161,857,000,000 in current year discretionary 

funding subject to discretionary spending caps and $1,960,000,000 

in cap adjustments for healthcare fraud and abuse control and for 

program integrity at the Social Security Administration, in accordance with the allocation for this bill. 

Fiscal year 2016 levels cited in this report reflect the enacted 

amounts in Public Law 114–113, the Consolidated Appropriations 

Act, 2016, adjusted for comparability. 

OVERVIEW

The Labor, Health and Human Services, and Education, and Related Agencies [Labor-HHS-Education] appropriations bill constitutes the largest share of non-defense discretionary spending, 31 

percent of the total in fiscal year 2017. Total spending in this bill 

subject to discretionary spending caps is $270,000,000 below the 

comparable fiscal year 2016 level. This level has required the Committee to make difficult funding decisions and consider the appropriate role and jurisdiction of Federal programs. 

The Committee notes that the administration’s budget requests 

for large programmatic increases, offset by reductions in core discretionary funding programs, continue to add financial pressure on 

existing programs and operations throughout the bill. This is especially true for the Department of Health and Human Services, 

whose budget request shifted nearly $3,000,000,000 in traditionally 

discretionary funded programs out of the annual appropriations 

process without knowing whether there is a path forward to fill 

those holes with new streams of mandatory funding. Had the Committee accepted the Department’s budget request, it would have required a $1,000,000,000 cut to the National Institutes of Health 

[NIH], $150,000,000 cut to Community Health Centers, and the 

elimination of the Children’s Hospital Graduate Medical Education 

program. Further, the administration requested increases for critical health activities, historically funded through discretionary appropriations, such as programs focused on fighting the growing 

opioid epidemic, mental health treatment, and critical medical research programs, such as advancing precision medicine, on the 

mandatory side of the ledger. 

The Committee recommendation prioritizes funding for programs 

adhering to the spirit and letter of the discretionary caps agreed 

to in the Bipartisan Budget Act of 2015. The priorities and considerations of the Committee in developing this bill are summarized 

in the section below: 
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NATIONAL INSTITUTES OF HEALTH

The Committee recommendation includes $34,084,000,000 for the 

NIH, an increase of $2,000,000,000. The Committee strongly believes that in this difficult budget environment that the LaborHHS-Education appropriations bill must continue to prioritize and 

recognize the essential role biomedical research plays in every 

American’s life. 

The Committee rejects the administration’s budget request to reduce discretionary funding for medical research at the NIH by 

$1,000,000,000. A continued commitment to NIH is essential to address our Nation’s growing health concerns, spur medical innovation, sustain America’s competitiveness, and reduce healthcare 

costs. After last year’s historic increase of $2,000,000,000, the largest increase for the NIH in this bill in over a decade, the administration chose to take a step backwards by reducing discretionary 

funding for NIH. Instead of accepting this misguided budget request, the Committee increases funding by $2,000,000,000 above 

fiscal year 2016. 

The Committee recommendation allocates funding to areas holding the most extraordinary promise of scientific advancement, 

while allowing NIH to maintain flexibility to pursue unplanned scientific opportunities and address unforeseen public health needs. 

The Committee recommendation is estimated to support over 

11,200 new and competing grants in fiscal year 2017, an increase 

of 4.2 percent above fiscal year 2016. 

Alzheimer’s Disease.—By 2050, the cost to treat and care for 

those suffering from Alzheimer’s disease is expected to top 

$1,100,000,000,000 a year. To put that figure in perspective, it is 

twice what the Federal Government currently spends to defend the 

Nation. Without a medical breakthrough to prevent, slow, or stop 

the disease, Medicare and Medicaid-related costs could rise nearly 

five-fold. NIH-funded research offers the only hope for finding solutions to successfully manage this disease in the future. Therefore, 

the Committee recommendation includes an increase of 

$400,000,000 for Alzheimer’s disease research, bringing the total 

available in fiscal year 2017 to approximately $1,391,000,000, a 40 

percent increase above fiscal year 2016. 

Brain Research through Advancing Innovative Neurotechnologies 

[BRAIN].—The Committee continues to support the BRAIN Initiative and provides $250,000,000 in fiscal year 2017. This is an increase of $100,000,000 above fiscal year 2016 and $55,000,000 

above the budget request. The BRAIN Initiative is developing a 

more complete understanding of brain function and has the possibility of helping millions of people who suffer from a wide variety 

of neurological and psychiatric disorders such as Parkinson’s disease, schizophrenia, Alzheimer’s disease, depression, and traumatic 

brain injury. 

Precision Medicine.—The Committee provides $300,000,000, an 

increase of $100,000,000 above fiscal year 2016, for the Precision 

Medicine Initiative. Instead of a one-size-fits-all approach, the Precision Medicine Initiative will allow physicians to individualize 

treatment. 
10 

Combating Antibiotic Resistant Bacteria [CARB].—Given the 

threat posed by the spread of antibiotic resistant bacteria, the recommendation includes $463,000,000, an increase of $50,000,000 

above fiscal year 2016, for efforts to develop new antibiotics and 

rapid diagnostic tests. 

COMBATING OPIOID ABUSE

It is estimated that 1.9 million American adults have an opioid 

use disorder related to prescription pain relievers, and 586,000 

have an opioid use disorder related to heroin. According to the Centers for Disease Control and Prevention [CDC], sales from prescription opioids nearly quadrupled between 1999 and 2014 and there 

was a corresponding increase in deaths from prescription opioids, 

claiming more than 165,000 lives. Even more troubling, prescription opioids can act as a gateway drug to heroin use, another form 

of opioids. Approximately 3 out of 4 new heroin users abused prescription opioids before switching to heroin. To stop the spread of 

further opioid abuse, the bill provides $261,000,000, an increase of 

$126,000,000, or 93 percent, above fiscal year 2016, in discretionary 

funding to fight both prescription opioid and heroin abuse: 

Abuse Prevention.—The Committee provides $98,000,000, a $28,000,000 increase above the fiscal year 2016 level, or 40 percent, 

to CDC’s Prescription Drug Overdose program to enhance Statelevel prevention efforts such as increasing adoption of safe opioid 

prescribing guidelines and improving data collection and collaboration among States. 

Drug Treatment, Prevention, and Awareness.—The Committee 

provides $60,000,000 to Substance Abuse and Mental Health Services Administration [SAMHSA] for grants to States to expand access to drug treatment services for those with a dependence on prescription opioids or heroin. This level is a $35,000,000, or 140 percent, increase above fiscal year 2016. Funds will be targeted to 

States that have experienced the greatest increase in treatment admissions for these drugs. 

Overdose Reversal.—The Committee includes $26,000,000 to pre- vent opioid overdose, a $14,000,000, or 117 percent, increase above 

fiscal year 2016. Funds will be used to help States purchase and 

train first responders on emergency devices that rapidly reverse 

the adverse effects of an opioid overdose and to increase awareness 

of the dangers of opioid use to the public. Of this amount, the Committee provides $8,000,000 to prevent opioid overdose-related 

deaths in rural areas. Americans living in rural communities are 

especially vulnerable and more likely to overdose on prescription 

pain killers than those in urban areas, according to CDC. 

Community Health Centers.—Within the funding provided to Community Health Centers, $50,000,000 is allocated for services 

relating to the treatment and prevention of opioid abuse. This investment will help health centers hire over 400 new providers and 

treat approximately 70,000 new patients nationwide. This is in addition to the $94,000,000 in funding that HRSA plans to provide 

Community Health Centers to improve and expand the delivery of 

substance abuse services in health centers for fiscal year 2017, 

with a specific focus on treatment of opioid use disorders in underserved populations. 
11 

In total, the Department is expected to spend $356,000,000 in 

discretionary and mandatory funding for targeted efforts to combat 

opioid abuse in fiscal year 2017. In addition, States have access to 

the Substance Abuse Prevention and Treatment Block Grant, funded at $1,858,079,000 in fiscal year 2017. Finally, the National Institute on Drug Abuse [NIDA] continues its efforts to understand 

addiction, fund research on medications to alleviate pain, support 

efforts to better understand the long-term effects of prescription 

opioid use, and research alternative ways to treat pain. NIDA receives an increase of $52,500,000 in this act. 

PROMOTING COLLEGE AFFORDABILITY AND COMPLETION

The Committee recommendation restores and modifies a provision, eliminated in fiscal year 2011, allowing students to receive 

Pell grants year-round. This will allow a student who has exhausted their Pell grant award for the academic year to receive a 

Pell grant for an additional term, traditionally the summer. 

Currently, full-time students and some part-time students exhaust their full Pell grant after two semesters, or the equivalent. 

Students who wish to continue coursework for an additional term 

during the academic year must use other means to pay for it, such 

as student loans, or not take the additional classes and wait until 

the beginning of the next academic year. This expanded eligibility 

and flexibility in the Pell grant program will provide an incentive 

for students to take classes year-round and stay continuously enrolled, help them stay on track for graduation, accelerate completion of their program, enter or re-enter the workforce faster, and 

graduate with less student debt. This is expected to provide an estimated 1 million students an additional Pell grant, on average, of 

$1,650 for the 2017–2018 academic year. 

In addition, the Committee recommendation is more than sufficient to support the scheduled increase in the maximum Pell grant 

award from $5,815 for the 2016–17 school year to $5,935 for the 

2017–18 school year. 

IMPROVING FISCAL ACCOUNTABILITY

The Committee has an obligation to promote fiscal accountability 

and the effective use of U.S. taxpayer funds. The annual appropriations process affords Congress the opportunity to continuously improve and refine how Government works. Appropriations bills provide oversight of every discretionary program, every year, which 

gives these bills the unique ability to react to changing needs and 

unintended consequences in the intervening years of an authorization bill. 

Taxpayer Transparency.—U.S. taxpayers have a right to know 

how the Federal Government is spending their hard-earned taxpayer dollars—especially when that money is being spent on advertising Federal programs. The Committee recommendation continues a provision to promote Government transparency and accountability by requiring Federal agencies funded in this act to include disclaimers when advertising materials are paid for with 

Federal funds. The Committee expects each agency to include in 

their fiscal year 2018 CJ information detailing how much funding 

was spent on advertising in fiscal year 2017. 
12 

Federal Vehicle Fleet Management.—The General Services Administration [GSA] issues guidance on Federal fleet management, 

but the Federal vehicle fleet is decentralized, with each agency 

maintaining flexibility to manage vehicle utilization as appropriate. 

To provide greater transparency and accountability of funding for 

Federal vehicles, the Committee directs agencies funded in this bill 

to conduct an annual review of fleet utilization during the third 

quarter of each fiscal year. Agencies are directed to provide their 

Offices of Inspectors General [OIGs] with supporting documentation on the method used for determining optimal fleet inventories 

and justification for any deviation from GSA’s Federal Property 

Management Regulations. OIGs shall be responsible for conducting 

annual audits of fleet management practices and making the subsequent results publicly available. 

Public Health Services Act [PHS] Evaluation Transfer.—The 

Committee recommendation continues to ensure that in fiscal year 

2017, no funds will leave NIH via the transfer required by section 

241 of the PHS Act. 

INCREASING THE EFFICIENCY AND COST EFFECTIVENESS OF

GOVERNMENT

The Committee provides funding for a variety of activities aimed 

at reducing fraud, waste, and abuse of taxpayer dollars. These program integrity initiatives have proven to be a wise Federal investment, resulting in billions of dollars of savings each year. In addition, the Committee recommendation provides direction to the Departments on opportunities to take action where Federal programs 

are fragmented or duplicative. The bill advances several initiatives 

to increase the efficiency and cost effectiveness of Government, including: 

Fighting Healthcare Fraud and Abuse.—The Committee includes 

$725,000,000 for the Health Care Fraud and Abuse Control program at CMS. The Committee notes that the latest data demonstrates for every $1 spent on fraud and abuse, $2 is recovered 

by the U.S. Treasury. By utilizing the cap adjustment provided in 

the Budget Control Act, the Committee recommendation will create 

over $10,200,000,000 in savings to the U.S. Treasury over 10 years. 

Inspectors General.—The Committee recommendation provides 

$672,574,000 for the Inspectors General funded in this act to conduct additional audits and investigations of possible waste and 

fraud in Government programs. The Committee appreciates the 

strong working relationships between the Inspectors General and 

the agencies they work with under this Committee’s jurisdiction. 

The Committee reiterates the strong expectation that Inspectors 

General have timely and independent access to all records, reports, 

audits, reviews, documents, papers, recommendations, data and 

data systems, or other materials related to their responsibilities 

under this act and under the Inspector General Act of 1978. Further, the Committee also expects that all agencies funded by this 

act treat electronic data, records, and systems no differently than 

paper-based records and files with respect to access by OIGs unless 

particular electronic systems are clearly and explicitly protected 

from Inspectors General access by statute. 
13 

Preventing Improper Social Security Payments.—The Committee 

recommendation includes $1,819,000,000, a $393,000,000 increase, 

for the Social Security Administration [SSA] to conduct continuing 

disability reviews and SSI program redeterminations of non-medical eligibility and for other program integrity efforts. Combined, 

these activities are estimated to save approximately 

$10,897,000,000 over 10 years in taxpayer dollars by reducing 

waste, fraud, abuse, and improper payments in the Social Security, 

Medicare, and Medicaid programs. 

Strengthening Oversight of Social Security Disability Benefits.— 

The Committee recommendation includes language strengthening 

oversight of Social Security disability programs. Specifically, the 

Committee encourages SSA to expedite efforts to update the medical vocational guidelines used as part of the initial disability determination process and to clarify how the medical improvement 

standard, and exceptions from it, should be applied during continuing disability reviews, as well as revise the treating physician 

rule to reflect changes in healthcare delivery. The Committee also 

supports the agency as it implements recommendations from GAO, 

as outlined in its annual duplication report, to reduce overpayments to individuals receiving concurrent Federal Workers Compensation Act [FECA] payments. 

Taxpayer Accountability.—In recent years, GAO has published 

reports that have exposed 200 areas of potential duplication and 

overlap. These reports have revealed more than 1,100 potentially 

duplicative Federal programs that cost taxpayers billions of dollars 

every year and have identified opportunities to achieve greater efficiency and effectiveness that result in cost savings or enhanced 

revenue collection. While GAO has noted that the Nation has 

achieved significant savings based on these reports, many more efficiencies may be realized. The Committee directs each agency 

funded in this bill to report to the Committee, within 1 year of enactment of this act, on all efforts made to address the duplication 

identified by the annual GAO reports along with identifying substantive challenges and legal barriers to implementing GAO’s recommendations, as well as suggested legislative recommendations 

that could help the agency to further reduce duplication. Given the 

current fiscal environment, it is imperative for Government agencies to increase efficiencies to maximize the effectiveness of agency 

programs. 

Unemployment Insurance Trust Fund Integrity.—The Committee 

provides $115,000,000 for Reemployment Services and Eligibility 

Assessments for fiscal year 2017. Recent data cited by the administration have shown that this program significantly reduces the 

time participating individuals receive unemployment compensation 

payments and reduces the total amount of benefits paid. Claimants 

are more successful in returning to work sooner in jobs with higher 

wages. The data show that $2.60 in savings is produced for every 

$1 in cost under this initiative. Enhanced, in-person assessments 

also play an impactful role in protecting the integrity of the Unemployment Insurance Trust Fund by reducing improper payments 

made to ineligible claimants. 
14 

GUIDANCE DOCUMENTS

The Committee notes that executive branch agencies may, as authorized by the Administrative Procedures Act, issue a variety of 

types of interpretive guidance documents that are exempt from the 

public notice and comment process. However, some have raised 

concerns about the use of guidance documents because while such 

documents are not legally binding, regulated entities may interpret 

them as imposing new legally binding requirements. Further, the 

GAO has found that executive branch agencies could improve procedures for approving, disseminating, and periodically reviewing 

guidance documents. For example, after a sub-agency in the Department of Labor reviewed its guidance to determine if it was relevant and current, the sub-agency was able to reduce its guidance 

by 85 percent. 

Consistent with GAO recommendations, the Committee believes 

Departments and agencies funded in this act need to make more 

progress in adhering to and implementing OMB’s 2007 ‘‘Final Bulletin for Agency Good Guidance Practices,’’ which establishes policies and procedures for the development, issuance, and use of significant guidance documents by executive branch departments and 

agencies. 

The Committee recommends that guidance documents include a 

statement explaining why the agency believes it is appropriate to 

issue guidance about a matter instead of proposing a regulation 

and the specific statutory provisions or regulation(s) the guidance 

is interpreting. The Committee further recommends all guidance 

documents be posted in one place on its Web site as well as on the 

relevant sub-agency Web page. This information should be easily 

accessible for the public to comment on guidance. Finally, when appropriate, guidance should be sent to the Office of Management 

and Budget for review if it is significant. 

OTHER HIGHLIGHTS OF THE BILL

Access to Mental Health Care.—The Committee continues to 

prioritize mental health treatment and services and provides an increase of $80,000,000 to key mental health activities around the 

Nation. The Committee provides an increase of $30,000,000 for the 

Mental Health Block Grant at SAMHSA as well as $50,000,000 to 

expand mental health services in Community Health Centers. 

Apprenticeship Grants.—The Committee recommendation includes $100,000,000, an increase of $10,000,000, for innovative, jobdriven approaches that result in the expansion of Registered Apprenticeship programs to train workers with skills that meet employer and industry workforce needs. 

Charter Schools.—The Committee recommendation includes 

$343,172,000 for the Charter Schools Program, a $10,000,000 increase, to promote school choice and accountability by developing 

and expanding high quality charter schools. 

Child Care.—The Committee recommendation includes 

$2,786,000,000 for the Child Care and Development Block Grant, 

a $25,000,000 increase. This builds on consistent increases in the 

program over the last several years to help States implement important reforms in the recent reauthorization of the program to 
15 

strengthen child care health and safety standards, and improve the 

overall quality of child care programs. 

Children’s Hospitals Graduate Medical Education [CHGME].— The Committee recommendation includes $300,000,000 for 

CHGME, the full authorized level, an increase of $5,000,000 above 

fiscal year 2016. This funding supports freestanding children’s 

teaching hospitals to provide Graduate Medical Education for physicians. 

Community Health Centers [CHC].—The Committee recommendation includes $1,491,522,000 for CHC’s, level with fiscal 

year 2016. Combined with mandatory funding provided in Public 

Law 114–10, the fiscal year 2017 program level is $5,091,522,000. 

The Committee rejects the administration’s proposal to reduce 

funding by $150,000,000. The Committee’s recommendation is projected to support 27 million patients, an increase of approximately 

4 million since 2014, and continues quality improvement activities 

for more than 1,300 health centers operating over 9,000 primary 

sites. 

Head Start.—The Committee recommendation includes 

$9,203,095,000, a $35,000,000 increase for Head Start. This will 

help all Head Start programs keep up with costs, recruit and retain 

highly qualified staff, maintain enrollment, and continue to provide 

high-quality early childhood care and education for children and 

families. 

International Labor Affairs.—The Committee recommendation 

includes $91,125,000, a $5,000,000 increase, to ensure that our 

trading partners around the world are respecting workers’ rights. 

These funds will enable the Bureau of International Labor Affairs 

to increase its monitoring of labor provisions in our trade agreements, support additional grant assistance to address worker 

rights issues, and combat exploitative child labor. 

Job Corps.—Maintaining safe and productive learning environments for the participating youth and staff on the Nation’s Job 

Corps campuses is a high priority. Recent increases in incidents of 

violence and other unsafe behaviors threaten both the well-being of 

people that depend on the program and the effectiveness and viability of the program itself. The largest discretionary increase in 

the bill within the Department of Labor is dedicated to addressing 

the safety and welfare of Job Corps students through physical security enhancements, mental health resources, and other specialized 

staffing. 

Medicare Appeals Process.—The number of cases appealed to the 

Office of Medicare Hearings and Appeals [OMHA] has increased 

1,000 percent over the past 6 years. As of the end of 2015, it takes 

OMHA nearly 700 days to close out an existing appeal. The Committee recommendation includes $112,381,000, a $5,000,000 increase, to OMHA to expand capacity to address the significant 

backlog of appeals. 

Occupational License Portability.—The Committee enhances an 

initiative started in 2016 to reduce barriers created by a lack of 

interstate reciprocity for occupational licenses. Additional funding 

is provided for consortia of States, with technical and other types 

of assistance from the Department of Labor, to evaluate and pursue cooperative approaches to enhance reciprocity or portability of 
16 

occupational licenses across State lines. Such agreements would 

significantly ease barriers to opportunity and reemployment for 

thousands of Americans, especially for military spouses, dislocated 

workers from various industries, and transitioning servicemembers. 

Polio Eradication.—CDC has substantially contributed to the 

more than 99 percent decline in global polio cases from more than 

350,000 cases reported in 1988. Currently, polio remains endemic 

in three countries, Nigeria, Afghanistan and Pakistan. The Committee includes $174,000,000, an increase of $5,000,000, for polio 

eradication. 

Supporting State and Local Flexibility in Elementary and Secondary Education.—The Committee recommendation supports the 

implementation of the Every Student Succeeds Act, the reauthorization of the Elementary and Secondary Education Act, that shifts 

significant responsibility, control, and accountability for schools 

back to States and local school districts. The Committee recommendation includes: 

—$15,409,802,000, a $500,000,000 increase for title I grants to 

LEAs, including consolidated funding from the School Improvement Grants program; —$1,315,603,000, a $10,000,000 increase, for Impact Aid; 

—$11,952,848,000, a $40,000,000 increase, for Individuals with 

Disabilities Education Act State Grants. 

In addition, the Committee recommendation includes 

$300,000,000 for a new Student Support and Academic Enrichment 

formula block grant program. This represents a $22,239,000 increase over the combined fiscal year 2016 funding level of the discrete programs consolidated to create this new formula block grant 

program. 

Telehealth.—The Committee commends the work that is being 

done in the area of Telehealth and the impact it is having on access 

to care for medically underserved and rural populations. In addition to a $1,000,000 increase for the Office for the Advancement of 

Telehealth [OAT] in fiscal year 2017, the Committee’s recommendation includes several initiatives that focus on the success 

of Telehealth networks to increase access, prevent and treat opioid 

abuse, and expand continuing education to medical professionals in 

medically underserved areas. 

Training Assistance to Coal Workers.—The bill continues an initiative dedicating a portion of the Dislocated Worker National Reserve to ensure reemployment and training assistance are provided 

to workers dislocated from coal mines and closely related industries. As job losses mount in the coal industry, it is very important 

that dislocated workers are able to adapt existing skills and learn 

new skills demanded by other growing industries so they can return to work as soon as possible. The bill includes $19,000,000 for 

this initiative. 

Veterans Employment and Training Service.—The Committee 

recommendation includes $274,541,000, an increase of $3,431,000. 

This amount includes a program increase of $2,391,000 to enhance 

the Homeless Veteran’s Reintegration Program which provides an 

array of specialized services to help homeless veterans, such as job 

training, social services, clothing, substance abuse treatment, 

transportation, and housing referrals. 
(17) 

TITLE I 

DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2016 ............................................................................. $3,335,425,000 

Budget estimate, 2017 ........................................................................... 3,525,460,000 

Committee recommendation ................................................................. 3,268,367,000 

The Training and Employment Services account provides funding 

primarily for activities under the Workforce Innovation and Opportunity Act [WIOA], and is a decentralized, integrated system of 

skill training and related services designed to enhance the employment and earnings of economically disadvantaged and dislocated 

workers. Funds provided for many training programs for fiscal year 

2017 will support the program from July 1, 2017, through June 30, 

2018. A portion of this account’s funding, $1,772,000,000, is available on October 1, 2017, for the 2017 program year. 

Any references in this title of the report to the ‘‘Secretary’’ or the 

‘‘Department’’ shall be interpreted to mean the Secretary of Labor 

or the Department of Labor, respectively, unless otherwise noted. 

The Committee strongly encourages the Department to continue 

to work with other Federal agencies to align and streamline employment and training services. In cases where legislation would be 

required to achieve these goals, the President’s budget request 

should include recommendations and specific proposals for consolidation of programs. 

The Committee urges the Department to continue and expand its 

efforts in preparing workers for in-demand occupations through a 

coordinated Federal, State, and local strategy. This strategy should 

include close engagement with employers by all levels of the workforce development system to ensure that provided training services 

align with the demands of those who would hire program participants. 

The Committee encourages the Employment and Training Administration [ETA] to expand its collaborative work with the Institute of Museum and Library Services to assist in the implementation of the WIOA to assist States and local boards in integrating 

the education, employment, and training services provided by public libraries into the workforce investment system. The Committee 

also encourages ETA to continue to invest in building and strengthening partnerships between the one-stop system and public libraries by encouraging applicants for competitive grant opportunities to 

collaborate with public libraries. 
18 

Grants to States 

The Committee recommends $2,636,000,000 for Training and 

Employment Services Grants to States. 

Under WIOA, a local board is given up to 100 percent transfer 

authority between Adult and Dislocated Worker activities upon approval of the Governor. 

The Committee recommendation is consistent with the WIOA authorization regarding the amount of WIOA State grant funding 

that may be reserved by Governors. Therefore, each Governor of a 

State shall reserve not more than 15 percent of the funds allotted 

to a State through the WIOA State grant programs for State-wide 

workforce investment activities. This increased flexibility will assist Governors in meeting unexpected needs, effectively targeting 

pockets of unemployment in their States and fulfilling their oversight and technical assistance responsibilities. 

Adult Employment and Training.—For adult employment and 

training activities, the Committee recommends $782,000,000. 

Formula funding is provided to States and further distributed to 

local workforce investment areas through one-stop centers. The 

program provides employment and training services to disadvantaged, low-skilled, unemployed, and underemployed adults, including veterans. 

Funds are made available in this bill for adult employment and 

training activities in program year 2017, which occurs from July 1, 

2017, through June 30, 2018. The bill provides that $70,000,000 is 

available for obligation on July 1, 2017, and that $712,000,000 is 

available on October 1, 2017. Both categories of funding are available for obligation through June 30, 2018. 

Youth Training.—For youth training activities, the Committee 

recommends $838,000,000. 

The purpose of this program is to provide low-income youth facing barriers to employment with services that prepare them to succeed in the knowledge-based economy. The program provides assistance to youth in achieving academic and employment success 

through improved education and skill competencies, connections to 

employers, mentoring, training, and supportive services. The program also supports summer employment directly linked to academic and occupational learning, incentives for recognition and 

achievement, and activities related to leadership development, citizenship, and community service. Funds are made available for 

youth training activities in program year 2017, which occurs from 

April 1, 2017, through June 30, 2018. 

Dislocated Worker Assistance.—For dislocated worker assistance, 

the Committee recommends $1,016,000,000. 

This program is a State-operated effort that provides training 

services and support to help permanently separated workers return 

to productive unsubsidized employment. In addition, States must 

use State-wide reserve funds for rapid response assistance to help 

workers affected by mass layoffs and plant closures. States must 

also use these funds to carry out additional State-wide employment 

and training activities such as providing technical assistance to 

certain low-performing local areas, evaluating State programs, and 

assisting with the operation of one-stop delivery systems. States 
19 

may also use funds for implementing innovative incumbent and 

dislocated worker training programs. 

Funds made available in this bill support activities in program 

year 2017, which occurs from July 1, 2017, through June 30, 2018. 

The bill provides that $156,000,000 is available for obligation on 

July 1, 2017, and that $860,000,000 is available on October 1, 

2017. Both categories of funding are available for obligation 

through June 30, 2018. 

Federally Administered Programs 

Dislocated Worker Assistance National Reserve.—The Committee 

recommends $220,859,000 for the Dislocated Worker Assistance 

National Reserve, which is available to the Secretary for activities 

such as responding to mass layoffs, plant and/or military base closings, and natural disasters that cannot be otherwise anticipated, as 

well as for technical assistance, training, and demonstration 

projects. 

Funds made available for the National Reserve in this bill support activities in program year 2017. The bill provides that 

$20,859,000 is available for obligation on July 1, 2017, and that 

$200,000,000 is available on October 1, 2017. Both categories of 

funding are available for obligation through September 30, 2018. 

The Committee bill continues a $19,000,000 program within the 

National Reserve initiated in fiscal year 2016 to focus dislocated 

worker training and support for the large numbers of people losing 

jobs in the coal mining and closely related industries. The Department is strongly urged to engage proactively with Workforce Development Boards and other appropriate entities at the State and 

local levels typically involved in applying for and administering National Dislocated Worker Grants to ensure that they are aware of 

the availability of the targeted funds so they will be sought and 

utilized promptly and effectively to assist coal workers in areas 

hardest hit by job loss in that industry. 

Indian and Native American Programs.—The Committee recommends $48,500,000 for Indian and Native American Programs. 

These programs are designed to improve the academic, occupational, and literacy skills of Native Americans, Alaskan Natives, 

and Native Hawaiians to aid the participants in securing permanent, unsubsidized employment. Allowable training services include 

adult basic education, GED attainment, literacy training, English 

language training, as well as the establishment of linkages with remedial education. 

The Committee directs the Department to obligate funding at the 

authorized levels for activities pursuant to section 166(k) of subtitle 

D of title I of the WIOA. 

Migrant and Seasonal Farmworker Programs.—The Committee 

recommends $81,896,000 for migrant and seasonal farmworkers 

programs, which serve members of economically disadvantaged 

families whose principal livelihood is derived from migratory and 

other forms of seasonal farm work, fishing, or logging activities. 

Enrollees and their families are provided with employment, training, and related services intended to prepare them for stable, yearround employment within and outside of the agriculture industry. 
20 

The Committee recommendation provides that $75,885,000 be 

used for State service area grants. The Committee recommendation 

also includes bill language directing that $5,517,000 be used for migrant and seasonal farmworker housing grants, of which not less 

than 70 percent shall be for permanent housing. The principal purpose of these funds is to continue the network of local farmworker 

housing organizations working on permanent housing solutions for 

migrant and seasonal farmworkers. The Committee recommendation also includes $494,000 to be used for section 167 training, 

technical assistance, and related activities, including funds for migrant rest center activities. 

The Committee is concerned by continued labor shortages in the 

agricultural sector. The Committee directs the Department to ensure that agricultural worker training programs funded under Section 167 of WIOA prioritize the development of additional and enhanced skills specifically relevant to continued agricultural work. 

Women in Apprenticeship.—The Committee accepts the administration’s request to eliminate the Women in Apprenticeship program. The Committee notes that the recommendation significantly 

expands funding for the new wide-scale apprenticeship grant program, which includes an element designed to support apprenticeship opportunities for women, minorities, and other under-represented populations more holistically. 

YouthBuild.—The Committee strongly supports the YouthBuild program and recommends $84,534,000 to support its work to target 

at-risk high school dropouts and prepare them with the skills and 

knowledge they need to succeed in a knowledge-based economy. 

Since becoming a Federal program in 1992, YouthBuild has helped 

over 140,000 low-income young people learn valuable, marketable 

job skills by combining educational resources, a supportive environment, and real construction experience with the successful completion of more than 30,000 units of affordable housing for low-income 

communities and over 48 million hours of community service. 

There are currently over 260 YouthBuild programs across the country. 

National Activities 

Reintegration of Ex-Offenders.—The Committee recommends 

$88,078,000 for the Reintegration of Ex-Offenders program. The 

Reintegration of Ex-Offenders program helps prepare and assist 

adult ex-offenders return to their communities through pre-release 

services, mentoring, and case management. The program also provides support, opportunities, education, and training to youth who 

are involved in court and on probation, in aftercare, on parole, or 

who would benefit from alternatives to incarceration or diversion 

from formal judicial proceedings. Programs are carried out directly 

through State and local governmental entities and community 

based organizations, as well as indirectly through intermediary organizations. States are encouraged to continue to support reintegration efforts for ex-offenders with resources available through 

the comprehensive workforce development investment system. The 

Committee directs the Department to use funding to support efforts 

in high-crime, high-poverty areas and, in particular, communities 

that are seeking to address relevant impacts and root causes of 
21 

civil unrest. The Committee directs the Department to require 

grantees to offer training and industry-recognized credentials that 

meet the needs of local, high-demand industries and to establish 

formal partnerships and job-placement services with industry employers. 

The Committee notes that the Federal YouthBuild program competed successfully to receive a Reintegration of Ex-Offenders grant 

in 2011. According to the grant’s final report, after 3 years of operation involving a total of over 500 young ex-offenders, the 

YouthBuild program demonstrated a recidivism rate of only 1 percent according to Department-established performance parameters. 

In fact, the DREAMS YouthBuild program in Brooklyn, which 

served over 200 ex-offenders alone, achieved a zero percent recidivism rate. These results compare very favorably with the average 

recidivism rate commonly ranging from 10 to 15 percent for the Reintegration of Ex-Offenders program according to the CJ. Success 

rates were high in part due to the program’s strategy to engage 

heavily with youth and their parents pre-release. Due to 

YouthBuild’s exemplary performance results, an existing national 

infrastructure including strong and mature community relationships, leveraged private support, and its status as a related Federal 

program, the Committee encourages ETA to consider establishing 

an ongoing, non-competitive, formal partnership between the Reintegration program and YouthBuild with an appropriate portion of 

the Reintegration activity funding. Such a partnership seems likely 

to bolster overall program success rates. 

Evaluation.—The bill continues to use a set-aside funding mechanism to support the evaluation of employment and training programs. Instead of directly providing funds for evaluation, the Committee recommendation supports evaluation activities through a 

0.75 percent set-aside on all training and employment programs, 

including the WIOA formula programs, Job Corps, Community 

Service Employment for Older Americans, the Employment Service, 

and others. The set-aside approach ensures that sufficient funding 

is available to carry out comprehensive evaluation and applied research activities. 

ETA will continue to conduct evaluation and applied research activities in consultation with the Department’s chief evaluation officer, who oversees the evaluation program. Results will inform policy, advance the Department’s mission, and improve its performance-based management initiatives. 

Workforce Data Quality Initiative.—The Committee recommends 

$6,000,000 for the Workforce Data Quality Initiative. Funds are 

used to assist States with incorporating comprehensive workforce 

information into longitudinal data systems being developed in part 

with the support of funding provided by the Department of Education. The initiative is also intended to help improve the quality 

and accessibility of performance data being produced by training 

providers. 

Apprenticeship Grants.—The Committee recommendation includes $100,000,000 to support the ApprenticeshipUSA Initiative, 

an increase of $10,000,000 above fiscal year 2016. This funding will 

support innovative, job-driven approaches that expand apprenticeship programs to train workers with the 21st century skills that 
22 

meet employer and industry workforce needs. The Committee commends the Department for designing a national campaign to engage a broad range of stakeholders, including employers, labor, 

States, education and workforce partners, to expand and diversify 

apprenticeship opportunities across the country. The Committee directs the Department to use funding to support economic development strategies that generate new or leverage existing employer 

demand for apprenticeships. The Committee also directs the Department to build off of the success of the Women Apprentices in 

Non-Traditional Occupations program by requiring States and organizations to engage, recruit, and serve under-represented populations, with a particular emphasis on increasing the representation of women in apprenticeship programs. 

JOB CORPS

Appropriations, 2016 ............................................................................. $1,689,155,000 

Budget estimate, 2017 ........................................................................... 1,754,590,000 

Committee recommendation ................................................................. 1,709,955,000 

The recommendation for operations of Job Corps centers is $1,591,625,000, an increase of $9,800,000 above fiscal year 2016. 

The Committee directs that Job Corps dedicate significant operations funding in fiscal year 2017 to upgrading safety and security 

of Job Corps centers as requested. These investments will include 

improved training to detect security risks, increased security personnel staffing, additional mental health counseling, integrated behavior management approaches, and related activities to improve 

the safety environment at Job Corps centers. A portion of the increase may be dedicated to the modernization of curricula, upgrades of equipment to meet industry standards, and refinement of 

training to provide skills and credentials that are in high demand 

by employers. 

The Committee remains deeply concerned about the issue of student safety on Job Corps campuses across the country as well as 

findings by the Department’s Office of Inspector General [OIG] regarding the enforcement of Job Corps’ disciplinary policies, potentially exposing students to unsafe environments. The Committee 

recognizes the Department has taken important steps toward addressing these issues and strongly urges the Department to take 

fully corrective actions to ensure the safety of students and staff. 

The Committee recommendation for administrative costs is 

$32,330,000. 

The Committee also recommends a total of $86,000,000 in construction, renovation, and acquisition [CRA] funds, an increase of 

$11,000,000 above fiscal year 2016. This amount is available from 

July 1, 2017, to June 30, 2020. The Department is directed to utilize not less than $17,000,000 of the CRA funds to implement urgent targeted security measures at Job Corps centers, including improved access controls, perimeter fencing, security cameras, site 

lighting, and other appropriate measures. The CRA activity recommendation overall includes funds for building rehabilitation and 

replacement, to increase safety and security, to address conditions 

that threaten life or safety, to abate environmentally unsafe conditions, for engineering and contract support services, for center telecommunication upgrades, for contingency funds for emergency re-
23 

pairs, for minor repair and replacement, and for needed major 

equipment. The Committee continues bill language allowing the 

Secretary to transfer up to 15 percent of CRA funds, if necessary, 

to meet the operational needs of Job Corps centers or to achieve administrative efficiencies. The bill continues to require the Secretary 

to notify the House and Senate Committees on Appropriations at 

least 15 days in advance of any transfer. The Committee expects 

any notification to include a justification. 

The Committee supports the Department’s goals to modernize 

curricula, upgrade equipment to meet industry standards, and refine training to provide skills and credentials that are in high demand by employers. To advance these goals, the Committee urges 

Job Corps to require strong, local employer partnerships and workbased learning opportunities for students as part of any Job Corps 

pilot initiative. Additionally, any external review of the Job Corps 

program should also include evaluation of the Job Corps management structure, the procurement process, and the procedures for 

determining or changing which academic and career training programs are offered at Job Corps centers. 

In addition, the Committee urges the Department to be cognizant 

of the competitiveness of Job Corps teacher and instructor salaries 

as well as staff retention and vacancy rates. Finally, funds should 

not be used to award a new contract for operation of a Job Corps 

center, unless the Assistant Secretary of ETA ensures that each of 

the factors listed in section 147(a)(3) of WIOA are applied to the 

procurement process to award a new contract to operate a Job 

Corps center as well as to any decision to restrict competition. 

Gulfport Job Corps Center.—The Committee is encouraged by recent progress made toward the rebuilding of the Gulfport Job Corps 

Center. The Committee expects the Department to have completed 

the section 106 process, finalized the design of the new center, and 

opened a request for contracts as quickly as possible. The Department should continue to remain committed to work to ensure that 

the center is rebuilt and able to return to serving the number of 

young people that it once served while, in the meantime, reserving 

sufficient funds for the restoration of the facility consistent with 

the expectations of the Committee. Given that Congress provided 

emergency appropriations for this purpose shortly after the damage 

caused by Hurricane Katrina, the Committee directs the Department to prioritize the Gulfport Job Corps Center among pending 

construction cases in the Construction, Rehabilitation and Acquisition Account. The Committee requests to be updated on a regular, 

continuing basis on the progress of the administrative steps to complete the design and rehabilitation of this facility. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2016 ............................................................................. $434,371,000 

Budget estimate, 2017 ........................................................................... 434,371,000 

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

Community Service Employment for Older Americans [CSEOA] 

provides part-time employment in community service activities for 

unemployed, low-income persons aged 55 and older. The Committee 

recommendation includes $400,000,000 for CSEOA. 
24 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2016 ............................................................................. $861,000,000 

Budget estimate, 2017 ........................................................................... 849,000,000 

Committee recommendation ................................................................. 849,000,000 

The Committee recommendation includes mandatory funds for 

the Federal unemployment benefits and allowances program that 

assists trade-impacted workers with benefits and services to upgrade skills and retrain in new careers. These benefits and services 

are designed to help participants find a path back into middle-class 

jobs, improve earnings, and increase credential and education 

rates. The Committee recommendation provides for the full operation of the Trade Adjustment Act program in fiscal year 2017 consistent with current law. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriations, 2016 ............................................................................. $3,589,878,000 

Budget estimate, 2017 ........................................................................... 3,631,085,000 

Committee recommendation ................................................................. 3,535,960,000 

The Committee recommendation includes $3,444,394,000 authorized to be drawn from the Employment Security Administration account of the Unemployment Trust Fund and $91,566,000 to be provided from the general fund of the Treasury. 

The funds in this account are used to provide administrative 

grants and assistance to State agencies that administer Federal 

and State unemployment compensation laws and operate the public 

employment service. The Committee recommends a total of $2,712,266,000 for UI activities. For UI State operations, the Committee recommends 

$2,697,019,000. Of these funds, the Committee includes 

$115,000,000 to help address and prevent long-term unemployment 

and reduce improper payments through the Reemployment Services and Eligibility Assessments [RESEA] initiative. 

The request also proposed $35,000,000 of the total be provided 

through a discretionary cap adjustment. The Committee recommendation does not include funding through the proposed cap 

adjustment. 

The Administration’s request of $50,000,000 to fund State consortia to modernize their UI tax and benefit systems is also included in the recommendation. The Committee expects the full 

$50,000,000 to be applied to this purpose. 

The Committee recommendation includes $6,000,000 for the UI 

Integrity Center of Excellence, including $3,000,000 to support an 

integrated data hub and data analytics capacity to help States reduce fraud. 

The Committee recommendation provides no funding for an additional round of State incentive grants related to worker 

misclassification. 

The Committee recommendation provides for a contingency reserve amount should the unemployment workload exceed an average weekly insured claims volume of 2,453,000. 

The Committee recommends $15,247,000 for UI national activities, which will support activities that benefit the entire Federal- 
25 

State UI system, including supporting the continuation of IT upgrades and technical assistance. 

For the Employment Service allotments to States, the Committee 

recommends $671,413,000. This amount includes $21,413,000 in 

general funds together with an authorization to spend 

$650,000,000 from the Employment Security Administration account of the Unemployment Trust Fund. 

The Committee also recommends $19,818,000 for Employment 

Service national activities. The administration of the work opportunity tax credit program accounts for $18,485,000 of the recommended amount; the remainder is for technical assistance and 

training to States. 

For carrying out the Department’s responsibilities related to foreign labor certification activities, the Committee recommends 

$48,028,000. In addition, 5 percent of the revenue from H–1B fees 

is available to the Department for costs associated with processing 

H–1B alien labor certification applications. 

The Committee is concerned about widespread reports of lengthy 

wage determination and application processing delays as well as allegations of instances of enforcement of regulations Congress specifically prohibited in the fiscal year 2016 appropriations act. The 

H–2B program is a critical source of labor for highly seasonal industries including fishing, forestry, tourism, hospitality, recreation, 

and others. The program ensures a legal labor force to fill temporary jobs when an insufficient number of American workers are 

available. However, some requirements currently imposed by the 

Department make the program excessively burdensome and costly 

on employers seeking to legally obtain temporary employees which 

ultimately jeopardizes jobs for American workers dependent on 

these enterprises. General provisions are continued in the bill to 

address these concerns; however, persistent delays in processing 

applications remain. The delays noted in most of the guest worker 

programs have grown so severe that businesses have to forego part 

of their work seasons, resulting in missed or defaulted contracts, 

preventing growth, and ultimately jeopardizing the jobs of dependent American workers. The Committee directs the Department to 

administer and regulate the H–2B program in an efficient manner 

that is consistent with the law, allowing employers to legally seek 

temporary workers at fair and accurate prevailing wages. 

The Committee recommendation includes an amendment to a 

previously existing general provision to authorize ETA to utilize up 

to $20,000,000 of H–1B fee funds to augment staffing for H–2B and 

H–2A foreign labor certification processing, including wage determinations and associated tasks. The Department is directed to use 

no less of this authority than is necessary to eliminate all labor certification backlogs. 

In the determination of prevailing wage for the purposes of the 

H–2B program, the Secretary shall accept private wage surveys 

even in instances where Occupational Employment Statistics [OES] 

survey data are available unless the Secretary determines that the 

methodology and data in the provided survey are not statistically 

supported. The bill continues general provisions related to enforcement of H–2B regulations. 
26 

Additionally, the Committee has been informed of instances in 

which certain job duties related to seafood processing have been 

categorized by the Department into OES wage rate categories that 

may not accurately reflect the work being performed by workers 

normally placed in that category. This type of worker 

misclassification is believed to have resulted in inaccurate prevailing wage determinations for many seafood workers. Therefore, 

the Committee strongly urges the Department to establish an OES 

wage rate category for seafood processing. 

For one-stop career centers and labor market information, the 

Committee recommends $70,153,000. The Committee includes 

$8,500,000 to support the initiative started in fiscal year 2016 to 

establish occupational licensing grants for State consortia to identify, explore, and address areas where licensing requirements create an unnecessary barrier to labor market entry or labor mobility 

where interstate portability of licenses could improve economic opportunity, particularly for dislocated workers, transitioning 

servicemembers, veterans, and military spouses. The Committee 

also encourages the Department to urge participating States to consider ways to increase their recognition of military certifications for 

equivalent private sector skills and occupations to further ease the 

transition of former servicemembers to comparable civilian jobs. 

The Committee requests progress updates as this initiative proceeds. 

These funds also support system capacity building efforts which 

allow the American Job Center network to respond to the needs of 

the job seekers and businesses in the current economy, including 

the Disability Employment Initiative. When reviewing investment 

alternatives for the Disability Employment Initiative in fiscal year 

2017, the Committee directs that the Department strongly consider 

needs in rural, underserved States especially in cases where meaningful applicant partnerships exist with institutions of higher 

learning and the workforce investment system. 

The recommendation also includes $1,500,000 to conduct a requested study and to begin to pilot approaches to modernize and 

streamline data collection for the O*NET and related tools. O*NET 

is a source of labor market information for the workforce development system. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

The Committee bill continues language providing such sums as 

necessary in mandatory funds for this account. The appropriation 

is available to provide advances to several accounts for purposes 

authorized under various Federal and State unemployment compensation laws and the Black Lung Disability Trust Fund, whenever balances in such accounts prove insufficient. 

PROGRAM ADMINISTRATION

Appropriations, 2016 ............................................................................. $154,559,000 

Budget estimate, 2017 ........................................................................... 180,826,000 

Committee recommendation ................................................................. 160,156,000 

The Committee recommendation of $160,156,000 for program administration includes $110,174,000 in general funds and 
27 

$49,982,000 from the Employment Security Administration account 

of the Unemployment Trust Fund. 

General funds in this account pay for the Federal staff needed 

to administer employment and training programs under WIOA, 

OAA, the Trade Act of 1974, and the National Apprenticeship Act. 

Trust funds provide for the Federal administration of employment 

security, training and employment, and executive direction functions. 

Of the funds provided above the fiscal year 2016 level, $3,200,000 is dedicated toward implementation of the integrated 

performance reporting system pursuant to WIOA and the grants 

management system, and $2,160,000 is for Office of Apprenticeship 

for the administration of the new apprenticeship grant program. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $181,000,000 

Budget estimate, 2017 ........................................................................... 205,761,000 

Committee recommendation ................................................................. 181,000,000 

The Committee recommends $181,000,000 for the Employee Benefits Security Administration [EBSA]. EBSA is responsible for the 

enforcement of title I of ERISA in both civil and criminal areas and 

for enforcement of sections 8477 and 8478 of the Federal Employees’ Retirement Security Act of 1986. EBSA administers an integrated program of regulation, compliance assistance and education, 

civil and criminal enforcement, and research and analysis. 

Mental health disorders affected an estimated 43.8 million Americans last year. The Committee believes that the Mental Health 

Parity and Addiction Equity Act of 2008 [MHPAEA] made significant progress ensuring that individuals in need of mental health 

care have access to those services on the same basis as they would 

for other medical care. While MHPAEA has been a strong step towards parity, the Committee believes there is insufficient guidance 

on what constitutes parity under the law. Specific guidance for 

group health plans and health insurance issuers as well as for employers and employees covered by plans governed by the law is particularly needed. The Committee directs the Secretary to coordinate 

with the Secretary of Health and Human Services and prepare annual reports of parity compliance activities in each State. Reports 

shall include inquiries and complaints specific to the MHPAEA, 

and a transparent de-identified report of all enforcement actions. 

Reports also shall include a compliance guide that answers questions raised during the previous year and specific guidelines providing clear interpretations of the law and the final rule. 

PENSION BENEFIT GUARANTY CORPORATION

The Pension Benefit Guaranty Corporation’s [PBGC’s] estimated 

obligations for fiscal year 2017 include single-employer benefit payments of $7,195,000,000, multi-employer financial assistance of 

$315,000,000, and administrative expenses of $519,506,000. Administrative expenses are comprised of three activities: pension insurance activities, pension plan termination expenses, and operational 

support. These expenditures are financed by permanent authority. 
28 

For fiscal year 2016, the Committee accepted the PBGC’s proposal 

to reform the previous administrative apportionment classifications 

from three budget activities to one budget activity to make operations more efficient and improve stewardship of resources. That 

consolidated approach for the three activities is continued, but 

PBGC is directed to continue providing detail every year on the 

three activities in its annual congressional budget justification. 

PBGC requested $98,500,000 for costs associated with the consolidation of three separate headquarters facilities into one upon 

the expiration of existing leases. The consolidation is intended to 

reduce the leased footprint of the agency, increase efficiencies associated with consolidated office space, and reduce overall lease costs. 

The Committee bill provides the requested funds, to be available 

for 5 years and only available for lease replacement costs. Unused 

funds for this purpose will be retained in the revolving fund. 

The PBGC is a wholly owned Government corporation established by ERISA. The law places it within DOL and makes the Secretary the chair of its board of directors. The Corporation receives 

its income primarily from insurance premiums collected from covered pension plans, assets of terminated pension plans, collection 

of employer liabilities imposed by the act, and investment earnings. 

The primary purpose of the PBGC is to guarantee the payment of 

pension plan benefits to participants if covered defined benefit 

plans fail or go out of existence. 

The President’s budget proposes and the bill continues authority 

for a contingency fund for the PBGC that provides additional administrative resources when the number of participants in terminated plans exceeds 100,000. When the trigger is reached, an additional $9,200,000 becomes available through September 30, 2018, 

for every 20,000 additional participants in terminated plans. The 

Committee bill also continues authority allowing the PBGC additional obligation authority for unforeseen and extraordinary pretermination expenses, after approval by OMB and notification of 

the Committees on Appropriations of the House of Representatives 

and the Senate. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $227,500,000 

Budget estimate, 2017 ........................................................................... 276,599,000 

Committee recommendation ................................................................. 227,500,000 

The Committee recommends $227,500,000 for the Wage and 

Hour Division [WHD]. 

WHD is responsible for administering and enforcing laws that 

provide minimum standards for wages and working conditions in 

the United States. The Fair Labor Standards Act [FLSA], employment rights under the Family and Medical Leave Act [FMLA], and 

the Migrant and Seasonal Agricultural Worker Protection Act are 

several of the important laws that WHD is charged with administering and/or enforcing. 
29 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $40,593,000 

Budget estimate, 2017 ........................................................................... 45,691,000 

Committee recommendation ................................................................. 35,529,000 

The Committee recommends $35,529,000 for the Office of LaborManagement Standards [OLMS]. 

OLMS administers the Labor-Management Reporting and Disclosure Act of 1959 and related laws. These laws establish safeguards 

for union democracy and financial integrity. They also require public disclosure by unions, union officers, employers, and others. In 

addition, the Office administers employee protections under federally sponsored transportation programs. 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $105,476,000 

Budget estimate, 2017 ........................................................................... 114,169,000 

Committee recommendation ................................................................. 104,476,000 

The Committee recommends $104,476,000 for the Office of Federal Contract Compliance Programs [OFCCP]. 

This Office protects workers and potential employees of Federal 

contractors from employment discrimination prohibited under Executive Order 11246, section 503 of the Rehabilitation Act of 1973, 

and the Vietnam Era Veterans’ Readjustment Assistance Act of 

1974. 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $115,501,000 

Budget estimate, 2017 ........................................................................... 126,159,000 

Committee recommendation ................................................................. 117,601,000 

The Committee recommends $117,601,000 for the Office of Workers’ Compensation [OWCP]. The bill provides authority to expend 

$2,177,000 from the special fund established by the Longshore and 

Harbor Workers’ Compensation Act. 

OWCP administers four distinct compensation programs: the 

Federal Employees’ Compensation Act [FECA], the Longshore and 

Harbor Workers’ Compensation Act, the Black Lung Benefits programs, and the Energy Employees Occupational Illness Compensation Program. In addition, OWCP houses the Division of Information Technology Management and Services. 

SPECIAL BENEFITS

Appropriations, 2016 ............................................................................. $210,000,000 

Budget estimate, 2017 ........................................................................... 220,000,000 

Committee recommendation ................................................................. 220,000,000 

The Committee recommends $220,000,000 for this account. This 

mandatory appropriation, which is administered by OWCP, primarily provides benefits under FECA. 
30 

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

numbers by individuals filing claims under FECA or the Longshore 

and Harbor Workers’ Compensation Act and its extensions. 

The Committee continues appropriations language that provides 

authority to use FECA funds to reimburse a new employer for a 

portion of the salary of a newly reemployed injured Federal worker. 

FECA funds will be used to reimburse new employers during the 

first 3 years of employment, not to exceed 75 percent of salary in 

the worker’s first year, and declining thereafter. 

The Committee recommendation continues language that allows 

carryover of unobligated balances to be used in the following year 

and that provides authority to draw such sums as are needed after 

August 15 to pay current beneficiaries. Such funds are charged to 

the subsequent year appropriation. 

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

Postal Service, the Tennessee Valley Authority, and other entities 

are required to pay to cover their fair share of the costs of administering the claims filed by their employees under FECA. 

Finally, the Committee maintains language consistent with longstanding interpretations and implementation of this appropriation 

stating that, along with the other compensation statutes already 

specifically enumerated, the appropriation is used to pay obligations that arise under the War Hazards Compensation Act, and the 

appropriation is deposited in the Employees’ Compensation Fund 

and assumes its attributes, namely availability without time limit 

as provided by 5 U.S.C. section 8147. 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2016 ............................................................................. $69,302,000 

Budget estimate, 2017 ........................................................................... 61,319,000 

Committee recommendation ................................................................. 61,319,000 

The Committee recommends a mandatory appropriation of 

$61,319,000 in fiscal year 2017 for special benefits for disabled coal 

miners. This is in addition to the $19,000,000 appropriated last 

year as an advance for the first quarter of fiscal year 2017, for a 

total program level of $80,319,000 in fiscal year 2017. The decrease 

in this account below the fiscal year 2016 level reflects a declining 

beneficiary population. 

These mandatory funds are used to provide monthly benefits to 

coal miners disabled by black lung disease and their widows and 

certain other dependents, as well as to pay related administrative 

costs. 

The Committee also recommends an advance appropriation of 

$16,000,000 for the first quarter of fiscal year 2018. These funds 

will ensure uninterrupted benefit payments to coal miners, their 

widows, and dependents. 
31 

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS

COMPENSATION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $58,552,000 

Budget estimate, 2017 ........................................................................... 59,846,000 

Committee recommendation ................................................................. 59,846,000 

The Committee recommends $59,846,000 for the Division of Energy Employees Occupational Illness Compensation. This is a mandatory appropriation. 

The Division administers EEIOCPA, which provides benefits to 

eligible employees and former employees of the Department of Energy [DOE], its contractors and subcontractors, or to certain survivors of such individuals. The mission also includes delivering 

benefits to certain beneficiaries of the Radiation Exposure Compensation Act. The Division is part of OWCP. 

In fiscal year 2017, the volume of incoming claims under part B 

of EEOICPA is estimated at about 5,300 from DOE employees or 

survivors, and private companies under contract with DOE, who 

suffer from a radiation-related cancer, beryllium-related disease, or 

chronic silicosis as a result of their work in producing or testing 

nuclear weapons. 

Under part E, approximately 4,350 new claims will be received 

during fiscal year 2017. Under this authority, the Department provides benefits to eligible DOE contractor employees who were found 

to have work-related occupational illnesses due to exposure to a 

toxic substance at a DOE facility, or to the employees’ survivors. 

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2016 ............................................................................. $341,467,000 

Budget estimate, 2017 ........................................................................... 371,641,000 

Committee recommendation ................................................................. 371,641,000 

The Committee bill provides an estimated $371,641,000 as requested for this mandatory appropriations account. This estimate 

is comprised of $69,526,000 for administrative expenses and an estimated $302,115,000 for benefit payment and interest costs. 

The Committee bill continues to provide indefinite authority for 

the Black Lung Disability Trust Fund to provide for benefit payments. In addition, the bill provides for transfers from the trust 

fund for administrative expenses for the following Department 

agencies as requested: up to $38,246,000 for the part C costs of the 

Division of Coal Mine Workers’ Compensation Programs; up to 

$30,594,000 for Departmental Management, Salaries and Expenses; and up to $330,000 for Departmental Management, Inspector General. The bill also allows a transfer of up to $356,000 for 

the Department of the Treasury. 

The Trust Fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operation can 

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

are incurred in administering the benefits program and operating 

the trust fund. 
32 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $552,787,000 

Budget estimate, 2017 ........................................................................... 595,023,000 

Committee recommendation ................................................................. 552,787,000 

The Committee recommends $552,787,000 for the Occupational 

Safety and Health Administration [OSHA], which is responsible for 

enforcing the Occupational Safety and Health Act of 1970 in the 

Nation’s workplaces. 

The Committee continues bill language to allow OSHA to retain 

course tuition and fees for training institute courses used for occupational safety and health training and education activities in the 

private sector. The cap established by the bill is $499,000, the same 

as current law. 

The bill retains language that continues to exempt farms employing 10 or fewer people from the provisions of the act with the exception of those farms having a temporary labor camp. The bill also 

retains language exempting small firms in industry classifications 

having a lost workday injury rate less than the national average 

from general schedule safety inspections. 

The exemption of small farming operations from OSHA regulation has been in place since 1976. OSHA clarified the limits of its 

authority to conduct enforcement on small farms in July 2014, particularly regarding post-harvest activities of a farming operation. 

The continued exemption for small farms and recognition of limits 

of the OSHA regulatory authority are critical for family farms. It 

is also important the Department of Agriculture be consulted in 

any future attempts by OSHA to redefine or modify any aspect of 

the small farm exemption. The Committee recommends $100,850,000 for grants to States 

under section 203(g) of the Occupational Safety and Health Act. 

These funds primarily are provided to States that have taken responsibility for administering their own occupational safety and 

health programs for the private sector and/or the public sector. 

State plans must be at least as effective as the Federal program 

and are monitored by OSHA. The Committee bill continues language that allows OSHA to provide grants of up to 50 percent for 

the costs of State plans approved by the agency. 

The Committee believes that OSHA’s worker safety and health 

training and education programs are a critical part of a comprehensive approach to worker protection. Under the program, grants are 

made to various types of organizations representing employers and 

labor organizations for direct training of workers on occupational 

safety and health. The Committee recommendation includes 

$10,537,000 for the OSHA Susan Harwood Training Grant Program and directs OSHA to dedicate no less than $3,500,000 per 

year for the purpose of administering the Voluntary Protection Program [VPP] in its Federal Compliance Assistance budget. OSHA 

shall not reduce funding levels or the number of employees administering the VPP, the Safety and Health Achievement Recognition 

Program [SHARP], or Federal Compliance Assistance, and shall 

not collect any monies from participants for the purpose of administering these programs. 
33 

The Committee recognizes that fewer injuries mean safer, more 

productive workers and lower worker compensation and healthcare 

costs. Statistical evidence for VPP success is impressive. The average VPP worksite has a Days Away Restricted or Transferred 

[DART] case rate of 52 percent below the average for its industry. 

These sites typically do not start out with such low rates. Reductions in injuries and illnesses begin when the site commits to the 

VPP approach to safety and health management and the challenging VPP application process. 

The Committee repeats and emphasizes the concerns stated in 

the joint explanatory statement accompanying the Consolidated 

Appropriations Act, 2016 about OSHA’s use of guidance documents 

to change longstanding OSHA policy. In June and July of 2015, 

OSHA issued three guidance documents related to Executive Order 

13650, ‘‘Improving Chemical Facility Safety and Security.’’ They 

are Process Safety Management of Highly Hazardous Chemicals 

and Covered Concentrations of Listed Appendix A Chemicals, 

RAGAGEP in Safety Process Management Enforcement, and PSM 

Retail Exemption Interim Enforcement Policy. These along with 

other OSHA ‘‘letters of interpretation’’ attempt to change prevailing 

agency policies without proposing regulatory changes, which would 

be governed by the requirements of the Administrative Procedures 

Act (5 U.S.C. 551 et. seq.). OSHA has issued letters of interpretation on substantive policy matters that leave the agency open to liability that can be avoided by going through the proper rulemaking 

process, including notice and period of public comment. OSHA is 

expected to implement agency policy changes through the formal 

regulatory process. 

Therefore, the revised enforcement policy relating to the exemption of retail facilities from coverage of the Process Safety Management of Highly Hazardous Chemicals standard (29 CFR 191 

0.119(a)(2)(i)) issued by the Occupational Safety and Health Administration on July 22, 2015, shall not be enforced nor deemed by 

the Department of Labor to be in effect until: the Bureau of the 

Census establishes a new North American Industry Classification 

System code under Sector 44–45 Retail Trade for Farm Supply Retailers; the Secretary of Labor, acting through the Assistant Secretary of Labor for Occupational Safety and Health, has carried out 

all notice and comment rulemaking procedures and invited meaningful public participation in the rulemaking; and the Secretary, 

acting through the Assistant Secretary of Labor for Occupational 

Safety and Health, arranges for an independent third-party to conduct a cost-benefit analysis of such proposed rule and the Secretary 

includes such analysis in the publication of the proposed rule. 

The Committee understands that, as a result of Executive Order 

13650, Improving Chemical Facility Safety and Security, OSHA is 

considering options to ensure the safety of ammonium nitrate handling and storage. The Committee also understands that there is 

no record thus far of an accidental detonation of ammonium nitrate 

in a situation where a storage facility has been compliant with 

OSHA’s existing regulations at 29 CFR 1910.109(i). The existing 

regulations are based on standards of the National Fire Protection 

Association. Before any new regulations are proposed for the storage of solid ammonium nitrate, the Secretary shall submit a report 
34 

to the Committees on Appropriations of the House Representatives 

and the Senate; the Senate Health, Education, Labor and Pensions 

Committee; and the House Committee on Education and the Workforce that identifies any provisions of OSHA’s current 29 CFR 

1910.109(i) regulations under consideration for update and that 

evaluates the costs and benefits of such changes. 

The Committee is concerned about OSHA’s implementation of 

the Outreach Training Program and its use of Requests for Proposals [RFPs] to change longstanding OSHA policy. Since 2008, 

OSHA has implemented and administered online Outreach Training Program courses via its OSHA Outreach Training Program— 

Online Training Guidance document. Instead of remaining consistent with its own Guidance document, OSHA has twice used the 

RFP process unsuccessfully to specifically limit online distribution 

of the Outreach Training Program. Therefore, the Committee urges 

OSHA to consider recognition of online training as an equivalent 

to classroom training with respect to the Outreach Training Program and improvement of worker safety and health. Further, 

OSHA is urged to seek the meaningful advance participation of policymakers and stakeholders through public meetings and pre-solicitation conferences prior to the issuance of any new or amended 

training RFP for this program. OSHA is directed to provide notification to the Committees on Appropriations of the House of Representatives and the Senate at least 10 days prior to issuance of 

any new or amended RFP specific to Outreach Training Programs. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $375,887,000 

Budget estimate, 2017 ........................................................................... 397,372,000 

Committee recommendation ................................................................. 375,887,000 

The Committee recommendation includes $375,887,000 for the 

Mine Safety and Health Administration [MSHA]. 

MSHA enforces the Federal Mine Safety and Health Act by conducting inspections and special investigations of mine operations, 

promulgating mandatory safety and health standards, cooperating 

with the States in developing effective State programs, and improving training in conjunction with States and the mining industry. 

The bill continues language authorizing MSHA to use up to 

$2,000,000 for mine rescue and recovery activities. It also retains 

the provision allowing the Secretary to use any funds available to 

the Department to provide for the costs of mine rescue and survival 

operations in the event of a major disaster. To prepare properly for 

an actual emergency, the Committee also directs MSHA to continue 

to devote sufficient resources toward a competitive grant activity 

for effective emergency response and recovery training in various 

types of mine conditions. 

The Committee supports MSHA’s ongoing work to improve mine 

rescue communications capabilities. To prepare properly for an actual mine rescue emergency, the Committee directs MSHA to continue to devote sufficient resources towards mine rescue technology 

and, to the extent possible, urges MSHA to expedite progress toward outfitting all five MSHA Mine Rescue teams with advanced 
35 

mine rescue technology. The Committee has been informed that 

there is a discrepancy among States’ interpretations of whether the 

purchase of mine rescue communications equipment is an eligible 

use of State Assistance Training funds. The Committee believes 

that such purchases, when used in part for training purposes which 

are the focus of these funds, are an allowable use and directs 

MSHA to clarify this issue for all training grant recipients. 

In addition, bill language is included to allow the National Mine 

Health and Safety Academy to collect not more than $750,000 for 

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

Bill language also allows MSHA to retain up to $2,499,000 from 

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

these activities. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $609,000,000 

Budget estimate, 2017 ........................................................................... 640,943,000 

Committee recommendation ................................................................. 609,000,000 

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

Labor Statistics [BLS]. This amount includes $65,000,000 from the 

Employment Security Administration account of the Unemployment Trust Fund and $544,000,000 in Federal funds. 

BLS is the principal fact finding agency in the Federal Government in the broad field of labor economics. The Committee recognizes that the Nation requires current, accurate, detailed workforce 

statistics for Federal and non-Federal data users as provided by 

BLS. 

The Committee understands that BLS is preparing a report requested in last year’s statement of managers that will discuss the 

efforts of BLS to account for and report on all forms of employment 

in the current economy. The Committee notes that the availability 

of data on trends in employment helps inform long-term economic 

policy-making and looks forward to receiving the report later this 

year. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

Appropriations, 2016 ............................................................................. $38,203,000 

Budget estimate, 2017 ........................................................................... 38,544,000 

Committee recommendation ................................................................. 38,203,000 

The Committee recommends $38,203,000 for the Office of Disability Employment Policy to provide leadership, develop policy and 

initiatives, and award grants furthering the objective of eliminating 

physical and programmatic barriers to the training and employment of people with disabilities and to design and implement research and technical assistance grants and contracts to develop policy that reduces barriers to competitive, integrated employment for 

youth and adults with disabilities. 
36 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $334,373,000 

Budget estimate, 2017 ........................................................................... 387,925,000 

Committee recommendation ................................................................. 339,186,000 

The Committee recommendation includes $339,186,000 for the 

Departmental Management account. Of this amount, $338,878,000 

is available from general funds and $308,000 is available by transfer from the Employment Security account of the Unemployment 

Trust Fund. In addition, $30,594,000 is available by transfer from 

the Black Lung Disability Trust Fund. 

The departmental management appropriation pays the salaries 

and related expenses of staff responsible for formulating and overseeing the implementation of departmental policy and management 

activities in support of that goal. In addition, this appropriation includes a variety of operating programs and activities that are not 

involved in departmental management functions, but for which 

other appropriations for salaries and expenses are not suitable. The administration requested $2,620,000 and 15 full time equivalent staff to implement Executive Order 13673. This request is denied by the Committee. The Committee is concerned that the administration proposes to create additional layers of bureaucracy to 

duplicate existing functions of government. Violations of Federal 

labor law are a serious matter. Such violations are already illegal 

by definition, and enforcement mechanisms are already in place to 

adjudicate such cases and to levy punishment as appropriate, up 

to and including debarment. 

The Committee notes that some have raised concerns about the 

Department’s use of guidance documents, including Dear Colleague 

letters, because such documents are not legally binding, but regulated entities may interpret them as such. Accordingly, the Committee recommendation includes new directives in the overview 

section of the Committee Report for each of the Departments and 

agencies included in this bill relating to the use of guidance documents. 

The Committee recommendation includes $91,125,000 for the Bureau of International Labor Affairs [ILAB], of which $61,825,000 is 

available for obligation through December 31, 2017. ILAB’s appropriation is available to help improve working conditions and labor 

standards for workers around the world and carry out ILAB’s statutory mandates and international responsibilities. Funding for 

international programming to eliminate the worst forms of child 

labor should prioritize comprehensive and sustainable initiatives 

that address the root causes of the problem, including lack of education and vocational training opportunities; household poverty; 

lack of data and awareness of the scope and impact of the worst 

forms of child labor; gaps in social protection services; and weak 

enforcement of labor laws, which increase the vulnerability of 

households to the worst forms of child labor. 

The Committee recognizes that the exploitation of children 

around the world remains a serious problem, including in settings 

where children should be safe and protected such as in homes and 

schools. Approximately 115 million children are engaged in haz-
37 

ardous work and 5.5 million children are in forced labor. The Committee notes ILAB’s involvement in the United States Government 

Action Plan on Children in Adversity and requests that the amount 

of funding by objective for the Action Plan on Children in Adversity 

be reported as part of the fiscal year 2018 CJ. 

The Committee expects ILAB to enhance its current effort on 

programs to combat exploitative child labor. The Committee also 

expects that integrated child labor and worker rights projects supported by ILAB funds will have a significant and direct child labor 

component. The bill requires ILAB to spend not more than 

$54,825,000 for programs to combat exploitative child labor internationally and not less than $7,000,000 to implement model worker 

rights programs in countries with which the United States has 

trade preference programs or free trade agreements. 

The Committee understands ILAB’s desire to place labor 

attache ́s in selected U.S. missions abroad and notes that Honduras 

has been established as a first priority. The Committee requests a 

report, not later than 180 days after enactment of this act, from 

the Departments of Labor and State which describes current laborrelated staffing at U.S. missions overseas and the Departments’ coordinated plan for future staffing and support for effective monitoring and enforcement of labor provisions related to free trade 

agreements and trade preference programs, particularly in priority 

countries. 

The Committee recommendation provides $8,040,000 for program 

evaluation and allows these funds to be available for obligation 

through September 30, 2018. The Committee bill also continues the 

authority of the Secretary to transfer these funds to any other account in the Department for evaluation purposes. The Committee 

bill continues authority to use up to 0.75 percent of certain Department appropriations for evaluation activities identified by the chief 

evaluation officer. The Committee expects to be notified of the 

planned uses of funds derived from this authority. 

The Committee directs the Chief Evaluation Officer, in conjunction with the Employee Benefits Security Administration and other 

relevant DOL offices, to submit a report to Congress within 6 

months of enactment of this act that explains the Department’s 

proposal for pilot programs to design, implement, and evaluate new 

and existing models and approaches for benefit portability and the 

ways in which such approaches would differ from currently available retirement plans that originate with employers which can be 

retained or rolled into other personal savings options. 

The recommendation includes $28,834,000 for the Office of the 

Assistant Secretary for Administration and Management. The increase of $421,000 above fiscal year 2016 is provided to cover requested inflationary and built-in costs. 

The recommendation includes $35,336,000 for the Adjudication 

activity, an increase of $3,336,000 above the fiscal year 2016 level. 

The Committee directs that the increase be used to reduce the projected increase in backlogged cases in the Office of Administrative 

Law Judges as requested and of which up to $896,000 may be used 

for built-in inflationary cost increases across the agencies within 

the Adjudication activity. 
38 

The Committee recommendation provides $11,536,000 for the 

Women’s Bureau. The Committee continues bill language allowing 

the Bureau to award grants. The requested program increase to 

support a Paid Leave Grant Program is not included. 

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2016 ............................................................................. $271,110,000 

Budget estimate, 2017 ........................................................................... 285,520,000 

Committee recommendation ................................................................. 274,541,000 

The Committee recommendation of $274,541,000 for the Veterans Employment and Training Service [VETS] includes 

$40,500,000 in general revenue funding and $234,041,000 to be expended from the Employment Security Administration account of 

the Unemployment Trust Fund. 

This account provides resources for VETS to maximize employment opportunities for veterans and transitioning service members, 

including protecting their employment rights. VETS carries out its 

mission through a combination of grants to States, competitive 

grants, and Federal enforcement and oversight. 

The Committee provides $175,000,000 for the Jobs for Veterans 

State Grants [JVSG] program. This funding will enable Disabled 

Veterans’ Outreach Program specialists and Local Veterans’ Employment Representatives to continue providing intensive employment services to veterans and eligible spouses; transitioning service 

members early in their separation from military service; wounded 

warriors recuperating in military treatment facilities or transition 

units; and, spouses and family caregivers to help ensure the family 

has income to provide sufficient support. The Committee maintains 

language providing authority for JVSG funding to be used for data 

systems and contract support to allow for the tracking of participant and performance information. 

The Committee provides $14,600,000 for the Transition Assistance Program [TAP]. This funding will support over 6,000 employment workshops at military installations and in virtual classrooms 

worldwide for exiting service members and spouses. 

The Committee recommendation includes $41,027,000 for Federal 

administration costs. This funding level will support oversight and 

administration of the VETS grant programs, TAP employment 

workshops, and compliance and enforcement activities. 

The Committee recommends $40,500,000 for the Homeless Veterans’ Reintegration Program [HVRP], an increase of $1,891,000, to 

help homeless veterans attain the skills they need to gain meaningful employment. This funding will allow DOL to provide HVRP 

services to as many as 17,000 homeless veterans nationwide, including homeless women veterans. The bill allows Incarcerated 

Veterans’ Transition funds to be awarded through September 30, 

2017, and to serve veterans who have recently been released from 

incarceration but are at-risk of homelessness. 

The Committee recommendation includes $3,414,000 for the National Veterans’ Training Institute, which provides training to Federal staff and veteran service providers. 
39 

INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2016 ............................................................................. $29,778,000 

Budget estimate, 2017 ........................................................................... 63,162,000 

Committee recommendation ................................................................. 18,778,000 

The Committee recommends $18,778,000 for the IT Modernization account. Funds available in this account have been used for 

two primary activities. The first is departmental support systems, 

for which $4,898,000 is provided as requested. The second activity, 

IT Infrastructure Modernization, supports necessary activities associated with the Federal Data Center Consolidation Initiative. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $86,300,000 

Budget estimate, 2017 ........................................................................... 94,541,000 

Committee recommendation ................................................................. 87,721,000 

The Committee recommends $87,721,000 for the DOL OIG. The 

bill includes $82,061,000 in general funds and authority to transfer 

$5,660,000 from the Employment Security Administration account 

of the Unemployment Trust Fund. In addition, an amount of 

$330,000 is available by transfer from the Black Lung Disability 

Trust Fund. 

Through a comprehensive program of audits, investigations, inspections, and program evaluations, OIG attempts to reduce the incidence of fraud, waste, abuse, and mismanagement, and to promote economy, efficiency, and effectiveness. 

GENERAL PROVISIONS

Section 101. The bill continues a provision limiting the use of Job 

Corps funding for compensation of an individual that is not a Federal employee at a rate not to exceed Executive Level II. 

Section 102. The bill continues a provision providing for general 

transfer authority. 

Section 103. The bill continues a provision prohibiting funding 

for the procurement of goods and services utilizing forced or indentured child labor in industries and host countries already identified 

by the Department in accordance with Executive Order 13126. 

Section 104. The bill continues a provision requiring that funds 

available under section 414(c) of the American Competitiveness 

and Workforce Innovation and Opportunity Act may only be used 

for competitive grants that train individuals over the age of 16 who 

are not enrolled in school, in occupations and industries for which 

employers are using H–1B visas to hire foreign workers. Authority 

is included to utilize H–1B fee receipts for the elimination of foreign labor certification processing backlogs. 

Section 105. The bill continues a provision limiting the use of 

ETA funds by a recipient or subrecipient for compensation of an individual at a rate not to exceed Executive Level II. 

Section 106. The bill continues a provision providing the ETA 

with authority to transfer funds provided for technical assistance 

services to grantees to ‘‘Program Administration’’ when it is determined that those services will be more efficiently performed by 

Federal employees. The provision does not apply to section 171 of 
40 

the WIOA. In addition, authority is provided for program integrityrelated activities as requested by the administration. 

Section 107. The bill continues a provision allowing up to 0.75 

percent of discretionary appropriations provided in this act for all 

Department 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. 

Section 108. The bill continues a provision regarding the application of the Fair Labor Standards Act after the occurrence of a 

major disaster. 

Section 109. The bill continues a provision that provides flexibility with respect to the crossing of H–2B nonimmigrants. 

Section 110. The bill continues a provision related to the wage 

methodology under the H–2B program. 

Section 111. The bill continues a provision regarding the threefourths guarantee and definitions of corresponding employment 

and temporary need for purposes of the H–2B program. 

Section 112. The bill continues a provision related to enforcement 

of H–2B program regulations. 
(41) 

TITLE II 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Any references in this title of the report to the ‘‘Secretary’’ or the 

‘‘Department’’ shall be interpreted to mean the Secretary of HHS 

or the Department of HHS, respectively, unless otherwise noted. 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

HRSA activities support programs to provide healthcare services 

for mothers and infants; the underserved, elderly, and homeless; 

rural residents; and disadvantaged minorities. This agency supports cooperative programs in maternal and child health, AIDS 

care, healthcare provider training, and healthcare delivery systems 

and facilities. 

BUREAU OF PRIMARY HEALTH CARE

Appropriations, 2016 ............................................................................. $1,491,522,000 

Budget estimate, 2017 ........................................................................... 1,342,422,000 

Committee recommendation ................................................................. 1,491,522,000 

The Committee recommendation for the activities of the Bureau 

of Primary Health Care is $1,491,522,000. 

Community Health Centers 

The program level for Community Health Centers is 

$5,091,522,000, equal to the amount provided last year. 

The Committee provides $1,491,522,000 in this bill, which is 

combined with $3,600,000,000 in mandatory funding appropriated 

for fiscal year 2017. 

Programs supported by this funding include community health 

centers, migrant health centers, healthcare for the homeless, 

school-based, and public housing health service grants. The Committee continues to support the ongoing effort to increase the number of people who have access to medical services at health centers. 

Health centers play a vital role in ensuring access to primary care 

in underserved areas of the country, including urban, rural, and 

frontier areas. 

The Committee is supportive of ongoing efforts to expand the capacity of community health centers to offer a comprehensive, integrated range of services, through strategic investment in behavioral health, substance abuse, oral health, and other services and 

capacity. The Committee also recognizes the need for capital resources at community health centers to meet increased demand 

and upgrade facilities. The Committee supports administrative 

changes to the HRSA Loan Guarantee Program designed to improve its efficiency and better align the program with other successful Federal loan guarantees, and to increase utilization of this 
42 

tool to leverage outside resources to meet health centers’ capital 

needs. 

The Committee believes that enhanced funding for the technical 

assistance and networking functions available for health centers 

through national and State cooperative agreements and grants is 

critical to the successful operation and expansion of the Health 

Centers program. Funds are available within the amount provided 

to enhance technical assistance and training activities, further 

quality improvement initiatives, and continue the development of 

and support for health center-controlled networks so that new and 

existing centers can improve patient access to quality health services. 

Of the available funding for fiscal year 2017, bill language directs 

that not less than $50,000,000 shall be awarded for services related 

to the treatment, prevention, and awareness of opioid abuse. In addition, not less than $50,000,000 will be awarded for services related to mental health. 

In addition, within the amount provided, the Committee provides 

up to $99,893,000 under the Federal Tort Claims Act [FTCA], 

available until expended. These funds are used to pay judgments 

and settlements, occasional witness fees and expenses, and related 

administrative costs. The Committee intends FTCA coverage funded through this bill to be inclusive of all providers, activities, and 

services included within the health centers’ federally approved 

scope of project. 

Diabetic Retinopathy.—According to the National Eye Institute, 

diabetic retinopathy is highly treatable and even preventable for 

diabetic patients that receive early interventions. As one of the 

major side effects of diabetic patients, the rates of diabetic retinopathy diagnoses are increasing at the same rate as the spike in diabetes diagnoses, an unforeseen issue for urban medical institutions 

that should not be neglected. The Committee encourages HRSA to 

identify assistance to urban medical institutions that currently 

serve underserved populations for diabetic retinopathy. 

Native Hawaiian Health Care.—The Committee expects that no 

less than $14,400,000 be provided for the Native Hawaiian Health 

Care Program. 

Perinatal Transmission of Hepatitis B.—The Committee is 

pleased that HRSA funded an evaluation of intervention strategies 

to eliminate the perinatal transmission of Hepatitis B. The Committee recognizes that a full evaluation of intervention strategies 

will require the training of health care professionals, followed by 

service delivery, data collection, and evaluation. The Committee encourages HRSA to incorporate these recommended intervention 

strategies into the required activities and funding plans for health 

centers. 

Thalassemia.—The Committee supports the important work 

HRSA has funded to establish expert recommendations for patient 

care in three keys areas in thalassemia treatment and to aid the 

development of regional partnership networks related to thalassemia. The Committee looks forward to this work continuing and 

expanding to address more issues related to this patient population, which deals with a particularly challenging rare disorder. 
43 

Tuberculosis [TB].—The Committee notes that the National Action Plan for Combating Drug Resistant Tuberculosis recommends 

the creation of healthcare liaisons between State and local health 

departments and institutions, including health centers that serve 

hard-to-reach groups who are at risk for TB. The Committee looks 

forward to an update on coordination between community health 

centers and State and local TB control programs to help ensure appropriate identification, treatment, and prevention of TB among 

vulnerable populations. 

Free Clinics Medical Malpractice Coverage 

The Committee provides $1,000,000 for payments of claims under 

the FTCA to be made available for free clinic health professionals 

as authorized by section 224(o) of the PHS Act. 

This appropriation extends FTCA coverage to medical volunteers 

in free clinics to expand access to healthcare services to low-income 

individuals in medically underserved areas. 

BUREAU OF HEALTH PROFESSIONS

Appropriations, 2016 ............................................................................. $836,895,000 

Budget estimate, 2017 ........................................................................... 536,745,000 

Committee recommendation ................................................................. 826,806,000 

The Committee recommendation for the activities of the Bureau 

of Health Professions is $826,806,000. 

The Bureau of Health Professions provides policy leadership and 

grant support for health professions workforce development. The 

mission of the Bureau is to identify shortage areas while working 

to make them obsolete. Its programs are intended to ensure that 

the Nation has the right clinicians, with the right skills, working 

where they are needed. 

Health Professions Training.—Given that the Department of 

Health and Human Services recently celebrated the 30th year anniversary of the ‘‘Report of the Secretary’s Task Force on Black and 

Minority Health,’’ commonly called the ‘‘Heckler Report,’’ HRSA is 

encouraged to work with the Office of Minority Health and the Office of Women’s Health to submit a follow up report within 1 year 

after enactment of this act to the Committees on Appropriations of 

the House of Representatives and the Senate to the ‘‘Heckler Report’’ concerning advancements and future courses of action. The 

report should analyze HRSA’s federally funded healthcare workforce programs, their funding, their impact, and ways to further increase diversity in the health professions, as well as increase the 

number of primary health care professionals. 

The Committee recommends that HRSA consider reinstating and 

funding the Student/Resident Experiences and Rotations in Community Health [SEARCH] program which provides opportunities 

for health professions students and residents to serve on multidisciplinary health care teams in underserved communities. 

National Health Service Corps 

The Committee recommendation does not include discretionary 

funding for the National Health Service Corps [Corps], as proposed 

by the administration, due to funding constraints, and because 

funding was included in Public Law 114–10 for fiscal year 2017. 
44 

The Committee strongly supports the Corps’ long and successful 

record of supporting qualified healthcare providers that are dedicated to working in underserved areas with limited access to 

healthcare. 

Nearly 3-in-4 Corps members choose to stay in the area in which 

they serve upon completion of their service, and it is essential to 

ensure that the Committee is supporting the creation and development of health care professionals in rural areas. 

The Committee recognizes that the Corps is an essential tool for 

recruitment and retention of health professionals at community 

health centers, especially given recent expansions of the program. 

The Committee encourages HRSA to increase the proportion of clinicians serving at health centers to improve alignment between 

these two programs and to best leverage investments in Corps 

health professionals. The Committee recognizes that the Secretary 

retains the authority to include additional disciplines in the Corps. 

As such, the Committee urges the Secretary to include pharmacists 

and pediatric subspecialists as eligible recipients of scholarships 

and loan repayments through the program. 

The Committee continues to include section 206 of this act to 

modify the rules governing the Corps to allow every Corps member 

60 days to cancel their contract. 

Training for Diversity 

Centers of Excellence 

The Committee recommends $21,711,000 for the Centers of Excellence [COE] Program. 

The Committee recognizes that the COE Program increases the 

supply and competencies of underrepresented minorities [URM] in 

health professions. Funds support programs of excellence that enhance the academic performance of URM students, support URM 

faculty development, and facilitate research on minority health 

issues. Diversity among medical school students is associated with 

higher levels of cultural sensitivity of all students and greater willingness to serve diverse populations. There is evidence that suggests that minority health professionals are more likely to serve in 

areas with high rates of uninsured and areas of underrepresented 

racial and ethnic groups. 

The Committee commends those institutions with a historic commitment to educating under-represented minority students in the 

health professions. In addition to the ongoing efforts of COEs, the 

Committee encourages HRSA to survey current and former COEs 

for options on how to better address the low representation of 

under-represented minority males in COE’s health professions disciplinary focus areas (medicine, dentistry, pharmacy, and behavioral health). 

Health Careers Opportunity Program 

The Committee eliminates the Health Careers Opportunity Program due to funding constraints. Funding to increase the diversity 

of the health professions workforce in this bill is prioritized by investing in programs that have a more immediate impact on the 
45 

production of health professionals by supporting students who have 

committed to and are in training as healthcare professionals. 

Faculty Loan Repayment 

The Committee provides $1,190,000 for the Faculty Loan Repayment Program. This amount is the same as the fiscal year 2016 enacted level and the budget request. 

Scholarships for Disadvantaged Students 

The Committee provides $49,070,000 for Scholarships for Disadvantaged Students, an increase of $3,100,000 above the fiscal 

year 2016 level. The Committee supports diversity among health 

professionals. This program provides grants to eligible health professions and nursing schools to award scholarships to students 

from disadvantaged backgrounds who have financial need. 

Increased funding will help to meet the demand for scholarship 

support to disadvantaged students who have unmet financial need 

in paying for their health professions education. It is essential that 

disadvantaged students, particularly those from rural or underserved health professional shortage areas, are given the tools to become effective health care professionals by using their knowledge 

of rural healthcare issues and are supported in pursing education 

and training. 

Primary Care Training and Enhancement 

The Committee provides $38,924,000 for Primary Care Training 

and Enhancement programs, which support the expansion of training in internal medicine, family medicine, pediatrics, and physician 

assistance. Funds may be used for developing training programs or 

providing direct financial assistance to students and residents. The 

Committee directs HRSA to prioritize programs that support underserved communities and applicants from disadvantaged backgrounds in any new grant competition in 2017. 

Training in Oral Health Care 

The Committee provides $35,873,000 for Training in Oral Health 

Care programs, which includes not less than $10,000,000 each for 

general and pediatric dentistry. Funds may be used to expand 

training in general dentistry, pediatric dentistry, public health dentistry, dental hygiene, and other oral health access programs. 

Funds may also be used to plan and operate training programs, as 

well as to provide financial assistance to students and residents. 

The agency is directed to provide continuation funding for 

predoctoral and postdoctoral training grants initially awarded in 

fiscal year 2015, and for Section 748 Dental Faculty Loan Program 

grants initially awarded in fiscal year 2016. 

The Committee understands that since the Chief Dental Officer 

[CDO] was created at HRSA, the position has been downgraded to 

Senior Dental Advisor. The Committee strongly encourages HRSA 

to restore the position of Chief Dental Officer with executive level 

authority and resources to oversee and lead HRSA dental programs 

and initiatives. The CDO is also expected to serve as the agency 

representative on oral health issues to international, national, 
46 

State, and/or local government agencies, universities, and oral 

health stakeholder organizations. 

The Committee continues long-standing bill language that prohibits funding for section 340G–1 of the PHS Act. 

Interdisciplinary, Community-Based Linkages 

Area Health Education Centers 

The Committee provides $30,250,000 for Area Health Education 

Centers [AHECs], equal to the fiscal year 2016 level. 

The program links university health science centers with community health service delivery systems to provide training sites for 

students, faculty, and practitioners. The program supports three 

types of projects: core grants to plan and implement programs; special initiative funding for schools that have previously received 

AHEC grants; and model programs to extend AHEC programs with 

50 percent Federal funding. The AHEC community training model 

provides a uniquely appropriate opportunity to bring the training 

of community health workers to scale. HRSA is encouraged to provide technical assistance on and disseminate best practices for 

training community health workers to existing AHECs. The Committee is pleased with AHEC’s efforts to improve access to quality 

healthcare in America’s rural and underserved areas by increasing 

the number of primary healthcare professionals who practice in 

those areas. 

Geriatric Programs 

The Committee provides $38,737,000 for Geriatric Programs. 

The Committee recognizes the importance of geriatric training 

programs incorporating culturally sensitive training programs and 

encourages HRSA to work to ensure training programs are collaborative, interdisciplinary, and culturally competent. 

Behavioral Health Workforce Education and Training Program 

The Committee provides $50,000,000 for Behavioral Health 

Workforce Education and Training Program [BHWET]. The 

BHWET Program is focused on developing and expanding the mental health and substance abuse workforce serving populations 

across the lifespan. As requested by the administration, the Committee transfers the program to HRSA from the Substance Abuse 

and Mental Health Services Administration [SAMHSA]. HRSA will 

continue to leverage SAMHSA’s subject matter expertise in formatting new investments in fiscal year 2017. 

The Committee supports the broadened target populations of 

people to be served by the BHWET program. In light of the new 

competition that will be held in 2017, the Committee directs that 

eligible entities for this program shall include, but is not limited 

to, accredited programs that train masters and clinical doctoral 

level social workers, psychologists, counselors, marriage and family 

therapists, psychiatric mental health nurse practitioners; psychology interns; and behavioral health paraprofessionals. The Committee is concerned about the uneven distribution of funds among 

specialties resulting from the initial grant competition in 2014 and 
47 

therefore directs HRSA to ensure that funding is distributed proportionately among the participating health professions and to consider strategies such as issuing separate funding opportunity announcements for each participating health profession. 

Mental and Behavioral Health Education Training Programs 

The Committee provides $9,916,000 for Mental and Behavioral 

Health Education Training Programs. The programs provide grants 

to higher education institutions and accredited training programs 

to recruit and train professionals and faculty in the fields of social 

work, psychology, psychiatry, marriage and family therapy, substance abuse prevention and treatment, and other areas of mental 

and behavioral health. 

Graduate Psychology Education Program [GPE].—The Committee recognizes the growing need for highly trained behavioral 

health professionals to deliver evidence-based services to vulnerable populations, including the elderly, returning military veterans, 

and those suffering from trauma. The GPE program is the main 

Federal initiative dedicated to the education and training of psychologists. The Committee urges HRSA to explore evidence-based 

approaches to leverage workforce capacity through this program, to 

invest in geropsychology training programs, and to help integrate 

health service psychology trainees at Federally Qualified Health 

Centers. 

When awarding GPE grants, the Committee directs HRSA to 

give priority to Historically Black Colleges and Universities and 

other Minority Serving Institutions that propose GPE projects in 

underserved and rural areas with significant health disparities, 

large minority patient populations, and/or shortages of behavioral 

health providers. 

Health Professions Workforce Information and Analysis 

The Committee provides $4,663,000 for health professions workforce information and analysis. The program provides for the collection and analysis of targeted information on the Nation’s 

healthcare workforce, research on high-priority workforce questions, the development of analytic and research infrastructure, and 

program evaluation and assessment. 

Public Health Workforce Development 

The Committee provides $17,000,000 for Public Health Workforce 

Development. This program line, also called Public Health and Preventive Medicine, funds programs that are authorized in titles III 

and VII of the PHS Act and support awards to schools of medicine, 

osteopathic medicine, public health, and integrative medicine programs. 

The Committee recommendation includes funding for Public 

Health Training Centers and the Preventative Medicine Residency 

with Integrative Health Care program, as requested by the administration. 

Nursing Workforce Development Programs 

The Committee provides $229,472,000 for Nursing Workforce Development programs. The program provides funding to address all 
48 

aspects of nursing workforce demand, including education, practice, 

recruitment, and retention. 

The Committee encourages HRSA to expand the Nurse Corps 

Loan Repayment program by naming free and charitable clinics as 

accepted sites for nurses to work and take advantage of the Nurse 

Corps Loan Repayment program. The Committee supports efforts 

to ensure that affordable medication can be obtained by the neediest patients and urges the inclusion of free and charitable clinics 

as designated sites to provide access to free or low cost prescription 

drugs. 

Children’s Hospitals Graduate Medical Education 

The Committee provides $300,000,000, an increase of $5,000,000, 

for the Children’s Hospitals Graduate Medical Education [CHGME] 

program. The Committee strongly supports the CHGME program 

which provides support for graduate medical education training 

programs in both ambulatory and in-patient settings within freestanding children’s teaching hospitals. CHGME payments are determined by a per-resident formula that includes an amount for direct training costs added to a payment for indirect costs. Payments 

support training of resident physicians as defined by Medicare in 

both ambulatory and inpatient settings. 

The Committee recognizes changes made to the program that 

have increased the number of children’s teaching hospitals eligible 

to apply for funding. The Committee notes the Secretary’s use of 

the authority provided under the current authorization to make 

funding available for hospitals previously ineligible for the program, and urges the Secretary to continue to make such funding 

available in future CHGME application and funding cycles. The 

Committee encourages HRSA to continue its work with the Children’s Hospitals on the development and collection of enhanced 

program performance measures. 

National Practitioner Data Bank 

The Committee provides $18,814,000 for the National Practitioner Data Bank. As mandated by the Health Care Quality Improvement Act, the National Practitioner Data Bank does not receive appropriated funds, but instead is financed by the collection 

of user fees. 

The National Practitioner Data Bank collects certain adverse information, medical malpractice payment history, and information 

related to healthcare fraud and abuse. The data bank is open to 

healthcare agencies and organizations that make licensing and employment decisions. 

MATERNAL AND CHILD HEALTH

Appropriations, 2016 ............................................................................. $845,117,000 

Budget estimate, 2017 ........................................................................... 845,117,000 

Committee recommendation ................................................................. 846,617,000 

The Committee recommendation for the Maternal and Child 

Health [MCH] Bureau is $846,617,000. The mission of the Bureau 

is to improve the physical and mental health, safety, and wellbeing of the Nation’s women, infants, children, adolescents, and 
49 

their families. This population includes fathers and children with 

special healthcare needs. 

Maternal and Child Health Block Grant 

The Committee provides $641,700,000 for the MCH Block Grant, 

which provides a flexible source of funding that allows States to 

target their most urgent maternal and child health needs. The program supports a broad range of activities including: providing prenatal care, well child services, and immunizations; reducing infant 

mortality; preventing injury and violence; expanding access to oral 

healthcare; addressing racial and ethnic disparities; and providing 

comprehensive care through clinics, home visits, and school-based 

health programs. 

The Committee supports programs that provide early, continuous, intensive, and comprehensive child development and family 

support services using evidence-based home visiting models with 

the goal of providing parents with child development knowledge 

and parenting support, provide early detection of developmental 

delays and health issues, prevent child abuse and neglect, and increase children’s school readiness. 

The Committee encourages HRSA to utilize demonstration 

projects to support the implementation of integrating oral health 

and primary care practice. The projects should model the core clinical oral health competencies for non-dental providers that HRSA 

published and initially tested in its 2014 report, ‘‘Integration of 

Oral Health and Primary Care Practice.’’ 

Children’s Health and Development.—Evidence shows that experiences in early childhood have long-term health consequences over 

the course of a person’s life. These experiences are critical for a 

child’s educational, social, physical, and economic well-being. Children living in States with persistently high child poverty rates experience more negative health outcomes than their peers elsewhere. Therefore, the Committee provides an additional $3,500,000 

within the Special Projects of Regional and National Significance 

program and directs HRSA to fund a study focused on systemic 

change that would positively impact the policy of child-health-related institutions and systems in States with the highest levels of 

childhood poverty. A successful program would consider inter- and 

intra-cultural dynamics to yield best practices for areas across the 

nation with diverse populations, persistent poverty, and child 

health outcomes in need of improvement. The end goal of the program should be to yield a model for other States to utilize in improving child health and development outcomes. 

Vision Health.—The Committee is concerned that vision disorders are the leading cause of impaired health in childhood. One 

in four school-aged children has a vision problem significant 

enough to affect learning. The Committee recognizes that early detection can help prevent vision loss and blindness and understands 

many serious ocular conditions in children are treatable if diagnosed at an early stage. Therefore, the Committee commends and 

supports the work of the National Center for Children’s Vision and 

Eye Health, which through partnerships, sound science, and targeted policy initiatives, advances the development of public health 
50 

infrastructure to support a comprehensive, multi-tiered continuum 

of vision care for young children. 

Sickle Cell Anemia 

The Committee provides $4,455,000 for grants and contracts to 

help coordinate service delivery for individuals with sickle cell disease, including genetic counseling and testing; training of health 

professionals; and coordination of education, treatment, and continuity of care programs. 

Autism and Other Developmental Disorders 

The Committee provides $47,099,000 for the Autism and Other 

Developmental Disorders program. The program supports surveillance, early detection, education, and intervention activities on autism and other developmental disorders, as authorized in the Combating Autism Act of 2006. 

Leadership Education in Neurodevelopmental and Related Disabilities [LEND] Programs.—The Committee provides $28,990,000 

for the LEND program to maintain capacity and expand the number of sites to train professionals to diagnose, treat, and provide 

interventions to individuals with autism spectrum disorder authorized by the Combating Autism Act. This funding will help these 

programs initiate or expand their work in the area of interdisciplinary leadership training to meet the needs of children with Autism 

Spectrum Disorders and related developmental disabilities. 

Newborn Screening for Heritable Disorders 

The Committee provides $11,883,000 for the Newborn Heritable 

Disorders Screening program, as described in section 1109 of the 

Newborn Screening Saves Lives Act of 2008. This program provides 

funding to improve States’ ability to provide newborn and child 

screening for heritable disorders. Newborn screening provides early 

identification and follow-up for treatment of infants affected by certain genetic, metabolic, hormonal, and/or functional conditions. 

Healthy Start 

The Committee provides $103,500,000 for the Healthy Start infant mortality initiative. The primary purpose of Healthy Start is 

to reduce infant mortality and generally improve maternal and infant health in at-risk communities. Grants are awarded to State 

and local health departments and nonprofit organizations to conduct an infant mortality review, develop a package of innovative 

health and social services for pregnant women and infants, and 

evaluate these efforts. 

Fetal Infant Mortality Review [FIMR].—The FIMR program is an 

important component of many Healthy Start and local health department initiatives that provide evidence-based interventions 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 FIMR. 
51 

Universal Newborn Hearing Screening and Early Intervention 

The Committee provides $17,818,000 for universal newborn hearing screening and early intervention activities. This program 

awards grants to 53 States and territories that support Statewide 

systems of newborn hearing screening, audiologic diagnostic testing 

before 3 months of age, and enrollment in early intervention programs before the age of 6 months. 

Emergency Medical Services for Children 

The Committee provides $20,162,000 for the Emergency Medical 

Services for Children program which focuses on improving the pediatric components of the emergency medical services system and 

improving the quality of care provided to children in the pre-hospital setting. Funding is available to every State emergency medical services office to improve the quality of emergency care for 

children and to pay for research and dissemination of best practices. 

HIV/AIDS BUREAU

Appropriations, 2016 ............................................................................. $2,322,781,000 

Budget estimate, 2017 ........................................................................... 2,331,781,000 

Committee recommendation ................................................................. 2,293,781,000 

The Committee recommendation includes $2,293,781,000 for the 

HIV/AIDS Bureau. 

The mission of the Bureau is to address the unmet care and 

treatment needs of persons living with HIV/AIDS. The Bureau administers the Ryan White Care Act, which provides a wide range 

of community-based services, including primary and home 

healthcare, case management, substance abuse treatment, mental 

health, and nutritional services. 

Emergency Assistance 

The Committee provides $655,876,000 for emergency assistance 

grants to eligible metropolitan areas disproportionately affected by 

the HIV/AIDS epidemic. 

Grants are provided to metropolitan areas meeting certain criteria. Two-thirds of the funds are awarded by formula, and the remainder is awarded through supplemental competitive grants. 

Comprehensive Care Programs 

The Committee provides $1,315,005,000 for HIV healthcare and 

support services. 

Funds are awarded to States to support HIV service delivery consortia, the provision of home- and community-based care services 

for individuals with HIV disease, continuation of health insurance 

coverage for low-income persons with HIV disease, and support for 

State AIDS drug assistance programs [ADAP]. 

The Committee provides $900,313,000 for AIDS medications in 

ADAP. 
52 

Early Intervention Services 

The Committee provides $201,079,000 for early intervention 

grants. These funds are awarded competitively to primary 

healthcare providers to enhance healthcare services available to 

people at risk of HIV and AIDS. Funds are used for comprehensive 

primary care, including counseling, testing, diagnostic, and therapeutic services. 

Children, Youth, Women, and Families 

The Committee provides $75,088,000 for grants for coordinated 

services to women, infants, children, and youth. The President’s request did not include funding for this program. The Committee 

once again rejects the President’s proposal to consolidate this program with the Early Intervention Services program. 

Funds are awarded to a variety of providers, including community health centers, comprehensive hemophilia centers, county and 

municipal health departments, and other nonprofit communitybased programs that provide comprehensive primary healthcare 

services to populations with or at risk for HIV. 

AIDS Dental Services 

The Committee provides $13,122,000 for the AIDS Dental Services program. This program provides grants to dental schools, dental hygiene schools, and postdoctoral dental education programs to 

assist with the cost of providing unreimbursed oral healthcare to 

patients with HIV. 

The Ryan White Part F program provides for the Dental Reimbursement Program [DRP] which covers the unreimbursed costs of 

providing dental care to persons living with HIV/AIDS. Programs 

qualifying for reimbursement are dental schools, hospitals with 

postdoctoral dental education programs, and colleges with dental 

hygiene programs. 

AIDS Education and Training Centers 

The Committee provides $33,611,000 for AIDS Education and 

Training Centers [AETCs]. AETCs train healthcare practitioners, 

faculty, and students who care for AIDS patients outside of the traditional health professions education venues and support curriculum development on the diagnosis and treatment of HIV infection for health professions schools and training organizations. 

Special Projects of National Significance 

Due to budget constraints, the Committee does not include funding for Special Projects of National Significance. However, the 

Committee continues to preserve the core HIV/AIDS Bureau programs that provide treatment, care, and direct services to patients. 

HEALTH CARE SYSTEMS

Appropriations, 2016 ............................................................................. $103,193,000 

Budget estimate, 2017 ........................................................................... 110,193,000 

Committee recommendation ................................................................. 103,193,000 

The Committee recommendation for the Health Care Systems 

Bureau is $103,193,000. 
53 

The Health Care Systems Bureau protects the public health and 

improves the health of individuals through efforts to support and 

enhance the systems by which healthcare is delivered in America. 

Organ Donation and Transplantation 

The Committee provides $23,549,000 for organ donation and 

transplantation activities. 

Funds support a scientific registry of organ transplant recipients 

and the National Organ Procurement and Transplantation Network to match donors and potential recipients of organs. A portion 

of the appropriated funds may be used to educate the public and 

health professionals about organ donations and transplants and to 

support clearinghouse and technical assistance functions. 

National Cord Blood Inventory 

The Committee provides $11,266,000 for the National Cord Blood 

Inventory. The purpose of this program is to provide funds to cord 

blood banks to build an inventory of the highest quality cord blood 

units for transplantation. 

C.W. Bill Young Cell Transplantation Program 

The Committee provides $22,109,000 for the C.W. Bill Young 

Cell Transplantation Program. 

The Committee continues to support cell transplantation through 

the use of cord blood, bone marrow, peripheral blood stem cells, 

and other sources of stem cells that may be available in the future. 

The Committee appreciates HRSA’s efforts to increase the diversity 

of the registry and the program’s research efforts to improve the 

availability, efficiency, safety, and cost of transplants and the effectiveness of program operations. 

Office of Pharmacy Affairs 

The Committee provides $10,238,000 for the Office of Pharmacy 

Affairs [OPA]. OPA administers the 340B drug pricing program, 

which requires drug manufacturers to provide discounts or rebates 

to a set of programs and hospitals that serve a disproportionate 

share of low-income patients. 

The Committee includes a statutory provision to allow a nominal 

cost recovery fee to fund the program integrity provisions recommended by the inspector general. The fee will be set at 0.1 percent for covered entities and is expected to generate $9,000,000 in 

fiscal year 2018. The Committee expects HRSA to report the estimated and actual amounts generated by the fee in HRSA’s annual 

CJ. 

The 340B statute requires HRSA to make 340B ceiling prices 

available to covered entities through a secure Web site. The Committee urges OPA to complete the development of a transparent 

system to verify the accuracy of the 340B discount or ceiling prices. 

The Committee recognizes that OPA recently published the first, 

comprehensive program guidance. The Committee urges OPA to 

consider carefully the comments received from all stakeholders. 
54 

Poison Control Centers 

The Committee provides $18,846,000 for poison control activities. 

The Poison Control Centers program currently supports a mix of 

grantees. Most serve States; a few serve multi-State regions; and, 

in a handful of cases, more than one grantee serves a single State. 

The Committee recognizes the critical role of Poison Control Centers and the value of its highly effective public-private/local-StateFederal partnership in helping the country address the opioid epidemic, as well as contributing significantly to Congressional goals 

of achieving the most efficient delivery of healthcare services to all 

citizens. 

The Committee commends HRSA for successfully recognizing the 

first accreditation of a Poison Control Center through an approved 

State accrediting body in 2015. This accreditation, executed pursuant to the Poison Center Network Act, demonstrates the viability 

of the State-based accrediting process and makes clear that this 

designation confers the full approval of HRSA on centers successfully utilizing this pathway. The Committee urges HRSA to offer 

assistance to any Poison Control Center seeking State-based accreditation and to approve those deemed to meet standards sufficient to protect public safety. 

National Hansen’s Disease Program 

The Committee includes $15,206,000 for the National Hansen’s 

Disease program. The program consists of inpatient, outpatient, 

long-term care as well as training and research in Baton Rouge, 

Louisiana; a residential facility at Carville, Louisiana; and 11 outpatient clinic sites in the continental United States and Puerto 

Rico. 

National Hansen’s Disease Program Buildings and Facilities 

The Committee provides $122,000 for the repair and maintenance of buildings at the Gillis W. Long Hansen’s Disease Center. 

Payment to Hawaii for Hansen’s Disease Treatment 

The Committee provides $1,857,000 to Hawaii for Hansen’s Disease treatment. Payments are made to the State of Hawaii for the 

medical care and treatment of persons with Hansen’s disease in 

hospital and clinic facilities at Kalaupapa, Molokai, and Honolulu. 

Expenses above the level of appropriated funds are borne by the 

State of Hawaii. 

RURAL HEALTH

Appropriations, 2016 ............................................................................. $149,571,000 

Budget estimate, 2017 ........................................................................... 144,162,000 

Committee recommendation ................................................................. 152,571,000 

The Committee recommendation for Rural Health programs is 

$152,571,000, an increase of $3,000,000 above the fiscal year 2016 

level. 

The Office of Rural Health Policy [ORHP] administers HHS rural 

health programs, coordinates activities related to rural healthcare 

within HHS, and analyzes the possible effects of policy on the more 

than 42 million residents of rural communities. ORHP advises the 
55 

Secretary on the effects of Medicare and Medicaid on rural citizens’ 

access to care, the viability of rural hospitals, and the availability 

of physicians and other health professionals. 

Reliable Energy Supply for Rural Health Facilities.—The Committee recognizes that rural health facilities, including dialysis centers, are often dependent on inconsistent energy supply that can be 

interrupted for days or weeks following severe weather events. The 

lack of consistent power may require that patients travel long distances, often in less than safe conditions, for simple, life-saving 

procedures. This problem can be solved with alternative power generation capacity located at health facilities. The Committee encourages HRSA to design a competitive grant program that would support energy reliability and power generation capacity for qualified 

health and dialysis facilities located outside Metropolitan Statistical Areas or in a Rural Urban Commuting Areas. 

Rural Health Outreach 

The Committee provides $65,500,000 for the Rural Health Out- reach program, $2,000,000 above the fiscal year 2016 level. 

This program supports projects that demonstrate new and innovative modes of outreach in rural areas, such as integration and coordination of health services. The Committee recommendation provides not more than $12,514,000 for Outreach Service Grants; not 

more than $19,412,000 for Rural Network Development Grants; not 

less than $12,000,000 for Delta States Network Grant Program; not 

more than $2,400,000 for Network Planning Grants; and not less 

than $4,148,000 for Small Healthcare Provider Quality Improvement Grants. 

Delta States Rural Development Network Grant Program.—The 

Committee encourages HRSA to consult with the Delta Regional 

Authority [DRA] on the awarding and administration of grants 

under the Delta States Network Grant Program in fiscal year 2017. 

Further, the Committee encourages HRSA to solicit input from 

DRA on the implementation, administration, and monitoring of 

Delta States Network Grant Program in fiscal year 2017. The Committee encourages HRSA to align its awards as closely as possible 

with the DRA’s strategic plan and with DRA economic and community development plans. In addition, of the funds provided, the 

Committee provides $2,000,000 to support HRSA’s collaboration 

with the DRA to develop a pilot program to help underserved rural 

communities identify and better address their health care needs 

and to help small rural hospitals improve their financial and operational performance. Finally, the Committee encourages HRSA to 

participate and collaborate on DRA’s next health strategic plan for 

the Delta Region. The Committee believes that the information the 

DRA collects in the development of that plan will be of substantial 

value to HRSA, and encourages HRSA to provide support to DRA 

for the provision of that information. 

Rural Health Research 

The Committee provides $9,351,000 for the Rural Health Research program. Funds are used for rural health research centers, 

the National Advisory Committee on Rural Health, and a reference 

and information service. Supported activities focus on improving 
56 

the delivery of health services to rural communities and populations. 

Rural Hospital Flexibility Grants 

The Committee provides $41,609,000 for Rural Hospital Flexibility grants and the Small Hospital Improvement Program. Under 

these grant programs, HRSA works with States to provide support 

and technical assistance to critical access hospitals to focus on 

quality and performance improvement and to integrate emergency 

medical services. The Committee recommendation continues to reject the administration’s proposal to eliminate the Small Hospital 

Improvement Program. 

The Committee recognizes the continuing need to provide support for hospitals located in rural and underserved communities. 

The Rural Hospital Flexibility Grant Program has improved access 

for the millions of Americans who reside outside of a reasonable 

scope of a critical access hospital. 

State Offices of Rural Health 

The Committee provides $9,511,000 for State Offices of Rural 

Health. These offices help States strengthen rural healthcare delivery systems by enabling them to coordinate care and improve support and outreach in rural areas. 

Black Lung Clinics 

The Committee provides $6,766,000 for the Black Lung Clinics 

program. This program funds clinics that treat respiratory and pulmonary diseases of active and retired coal miners, steel mill workers, agricultural workers, and others with occupationally related 

respiratory and pulmonary impairments. These clinics reduce the 

incidence of high-cost inpatient treatment for these conditions. 

The Committee is deeply concerned about changes HRSA has 

made to the Black Lung Clinic Grants Program in fiscal year 2014, 

including the adoption of a three-tiered funding system and an 

overall per-applicant cap. These changes to the program have unnecessarily increased the administrative burden on applicants and 

may result in reductions in funding for States and communities 

most in-need of the essential health care services provided by this 

program. The fiscal year 2014 policy violates HRSA regulations 

which require the Secretary to give preference to State agencies, 

account for the number of miners to be served and their needs, and 

evaluate the quality and breadth of services to be provided by a 

prospective grantee. The Secretary is directed to evaluate funding 

levels for applicants based on the needs of the populations those 

applicants will serve and the ability of those applicants to provide 

health care services to miners with respiratory illnesses, with preference given to State agency applications over other applicants in 

that State, without regard to the funding tiers and overall per-applicant funding cap established by the Secretary in fiscal year 

2014. 

Radiation and Exposure Screening and Education Program 

The Committee provides $1,834,000 for activities authorized by 

the Radiation Exposure Compensation Act. This program provides 
57 

grants for the education, prevention, and early detection of 

radiogenic cancers and diseases resulting from exposure to uranium during mining and milling at nuclear test sites. 

Telehealth 

The Committee provides $18,000,000, an increase of $1,000,000 

above the fiscal year 2016 level, for the Office for the Advancement 

of Telehealth [OAT], which promotes the effective use of technologies to improve access to health services for people who are isolated from healthcare and to provide distance education for health 

professionals. 

The Committee strongly supports OAT and their mission to expand high quality medical care to rural communities that do not 

have adequate access to medical providers including many medical 

specialties. 

Extension for Community Health Outcomes [ECHO].—Project 

ECHO is an innovative continuing medical education model that 

uses interactive videoconferencing to link specialist teams with primary care providers in rural and underserved areas. The Committee is encouraged by early implementations of the ECHO model 

in rural communities and requests a report from the Government 

Accountability Office regarding opportunities for increased adoption 

of such models, efficiencies, and potential cost savings, as well as 

ways to improve health care through such models, and field recommendations to advance the use of such models. 

Telehealth Center of Excellence.—The Committee recognizes the 

growing importance of telehealth in delivering high-quality 

healthcare to medically underserved communities in both rural and 

urban areas. The Federal Government’s need for telehealth research and cross-agency coordination has grown as more Federal 

agencies, including HHS, USDA, DOD, VA, and FCC, have developed telehealth programs. Therefore, the Committee directs HRSA 

to develop a plan to create a telehealth center of excellence [COE] 

to test the efficacy of telehealth services in both urban and rural 

geographic locations. The COE would operate varied sites of service, including patients’ homes; examine the benefits to student 

health of school-based telehealth; establish standards and best 

practices for various telehealth modes of delivery, including realtime audio-visual, audio-only, store-and-forward, and remote patient monitoring; pilot new health care delivery models as they 

emerge; test innovative payment models to examine potential cost 

savings to Federal health care spending from telehealth; facilitate 

inter-agency coordination on telehealth issues; and perform any 

other telehealth-related research that is needed. To lead this COE, 

HHS should consider a public academic medical center with demonstrated success, a high volume of annual telehealth visits, and 

established programs that provide telehealth services in medically 

underserved areas with high chronic disease prevalence and high 

poverty rates. The selected site should also have established a reimbursement structure that allows telehealth services to be financially self-sustaining. The Committee requests a written report outlining HRSA’s plans for a telehealth COE within 120 days of enactment of this act. 
58 

Telehealth for the Prevention of Opioid Abuse.—The Committee 

encourages the Office of Rural Health Policy to explore how telehealth networks can improve access to, coordination of, and quality 

of prevention and treatment of the opioid epidemic, especially in 

rural areas. Increased use of telehealth networks will help ensure 

those struggling with a substance use disorder have access to the 

care they need, provide continuing education to rural clinicians and 

emergency medical providers on emerging treatment options, and 

will help patients who are prescribed opioids for pain management 

use them effectively and appropriately. 

Telehealth Resource Centers Grant Program.—The Committee 

recognizes the vital role of existing Telehealth Resource Centers 

across the United States to provide support to healthcare organizations, providers, and networks. In addition, these current centers 

are an important part of the telehealth infrastructure; helping to 

improve access to healthcare and ultimately improve outcomes for 

underserved populations. The Committee recommends that part of 

OAT funding should be used to support increased outreach to providers and communities regarding the benefits of telehealth and 

the availability of technical assistance to support its further adoption. The Committee supports continued funding of the current 12 

regional centers and two National centers in fiscal year 2017. 

Rural Opioid Overdose Reversal Program 

The Committee does not provide funding for this program under 

HRSA, but has provided funds to combat the opioid epidemic in 

rural communities through the Centers for Substance Abuse within 

SAMHSA. 

FAMILY PLANNING

Appropriations, 2016 ............................................................................. $286,479,000 

Budget estimate, 2017 ........................................................................... 300,000,000 

Committee recommendation ................................................................. 286,479,000 

The Committee provides $286,479,000 for the title X Family 

Planning program. This program supports preventive and primary 

healthcare services at clinics nationwide. 

PROGRAM MANAGEMENT

Appropriations, 2016 ............................................................................. $154,000,000 

Budget estimate, 2017 ........................................................................... 157,061,000 

Committee recommendation ................................................................. 154,000,000 

The Committee provides $154,000,000 for program management 

activities. 

The Committee does not include bill language requested by the 

administration to provide additional transfer authority to the Administrator beyond that which is already provided to the Secretary. 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2016 ............................................................................. $244,500,000 

Budget estimate, 2017 ........................................................................... 249,200,000 

Committee recommendation ................................................................. 247,500,000 
59 

The Committee provides that $247,500,000 be released from the 

Vaccine Injury Compensation Trust Fund in fiscal year 2017. Of 

that amount, $7,500,000 is for administrative costs. 

The National Vaccine Injury Compensation program provides 

compensation for individuals with vaccine-associated injuries or 

deaths. Funds are awarded to reimburse medical expenses, lost 

earnings, pain and suffering, legal expenses, and death benefits. 

The Vaccine Injury Compensation Trust Fund is funded by excise 

taxes on certain childhood vaccines. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

The Committee recommendation provides a program level of 

$7,115,106,000 in this bill for the Centers for Disease Control and 

Prevention [CDC], which includes $55,358,000 in mandatory funds 

under the terms of the Energy Employees Occupational Illness 

Compensation Program Act [EEOICPA], $891,300,000 in transfers 

from the Prevention and Public Health [PPH] Fund, and 

$15,000,000 in Public Health and Social Services Emergency Fund 

[PHSSEF] unobligated balances from pandemic influenza supplemental appropriations. 

The activities of CDC focus on several major priorities: providing 

core public health functions; responding to urgent health threats; 

monitoring the Nation’s health using sound scientific methods; assuring the Nation’s preparedness for emerging infectious diseases 

and potential pandemics; and providing leadership in the implementation of nationwide prevention strategies that are conducive to 

improving and maintaining health. 

IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2016 ............................................................................. $798,405,000 

Budget estimate, 2017 ........................................................................... 748,066,000 

Committee recommendation ................................................................. 798,405,000 

The Committee recommendation for the activities of the National 

Center for Immunization and Respiratory Diseases is $798,405,000, 

which includes $324,350,000 in transfers from the PPH Fund and 

$15,000,000 in transfers from PHSSEF unobligated balances. 

The mission of the National Center for Immunization and Respiratory Diseases is the prevention of disease, disability, and death 

through immunization and by control of respiratory and related 

diseases. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Section 317 Immunization Program .............................................. 610,847 560,508 610,847 

National Immunization Survey (non-add) ............................. 12,864 12,864 12,864 

Influenza Planning and Response ................................................. 187,558 187,558 187,558 

Cost Estimates.—The Committee is pleased with CDC’s report on 

estimated funding needs of the Section 317 Immunization Program 

and requests that the report be updated and submitted not later 

than February 1, 2017, to reflect fiscal year 2018 cost estimates. 
60 

The updated report should also include an estimate of optimum 

State and local 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. 

Influenza.—The Committee provides the same level of budget authority as in fiscal year 2016 and directs the Department to use 

$15,000,000 in pandemic influenza supplemental balances to support CDC’s global influenza activity. The Committee expects in the 

future that CDC and the Department will clearly identify in budget 

documents when and how supplemental appropriations are used. 

In particular, the Committee expects to be notified if any additional 

balances are used by CDC in fiscal year 2017. 

Immunizations.—The Committee rejects the reduction to the Section 317 Immunization Program proposed by the Administration 

and provides funding at last year’s level to enhance core activities 

including the infrastructure for the Vaccines for Children program. 

The Committee believes a strong public health immunization infrastructure is critical for ensuring high vaccination coverage levels, 

preventing vaccine-preventable diseases, and responding to outbreaks. During the 2015 measles outbreak, funds from this program supported State and local health departments in rapid response, public health communication, data gathering, and 

diagnostics. 

HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND

TUBERCULOSIS PREVENTION

Appropriations, 2016 ............................................................................. $1,122,278,000 

Budget estimate, 2017 ........................................................................... 1,127,278,000 

Committee recommendation ................................................................. 1,112,278,000 

The Committee recommendation for the activities of the National 

Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases 

[STDs], and TB Prevention is $1,112,278,000. 

The Center administers CDC’s activities on HIV/AIDS, viral hepatitis, STDs, and TB, with the exception of the Global AIDS program, which is housed in the Center on Global Health. 

The Committee recommends funding for the following activities 

in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee recommendation 

Domestic HIV/AIDS Prevention and Research ................................ 788,712 788,712 788,712 

HIV Prevention by Health Department .................................. 397,161 397,161 397,161 

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

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

National, Regional, Local, Community & Other Organizations .................................................................................. 135,401 135,401 135,401 

School Health ........................................................................ 33,081 33,081 33,081 

Viral Hepatitis ................................................................................ 34,000 39,000 34,000 

Sexually Transmitted Infections ..................................................... 157,310 157,310 152,310 

Tuberculosis ................................................................................... 142,256 142,256 137,256 

Hepatitis B.—The Committee is concerned that even with a Hepatitis B vaccine that is 95 percent effective, CDC estimates that 

there are up to 2 million Americans infected with Hepatitis B, with 
61 

over 19,500 new infections occurring each year and more than 10 

deaths each day as a direct result of Hepatitis B. The Committee 

encourages CDC to prioritize the acceleration of Hepatitis B interventions within its Viral Hepatitis program. 

HIV Screening.—The Committee continues to support CDC grant 

programs that work to reduce the rate of undiagnosed persons 

among those infected with HIV, increase linkage to care, and increase viral suppression. The Committee acknowledges geographic 

disparities in rates of undiagnosed persons among those infected, 

viral suppression, and death rates based on the findings in the 

2015 CDC HIV State Prevention Progress Report. The Committee 

requests that CDC partner closely with States to improve diagnosis 

rates among the undiagnosed and improve viral suppression rates, 

focusing specifically on States with the lowest scores on these outcome measures and with States who need to improve collection of 

complete laboratory data to measure viral suppression. 

Tuberculosis [TB].—The Committee applauds CDC for its leadership role in the President’s National Action Plan for Combating 

Multi Drug Resistant TB. The Committee encourages the Director 

to prioritize implementation of the action plan, including the plan’s 

objective to explore the development of a national stockpile of TB 

drugs and diagnostics and ensure that State and local TB control 

programs have adequate resources to pursue the plan’s goals. 

Viral Hepatitis Prevention Coordinators.—The Committee recognizes the importance of the Viral Hepatitis Prevention Coordinator 

[VHPC] program as the only source of Federal expertise on hepatitis prevention for States. The Committee encourages the Division 

of Viral Hepatitis to expand efforts within current resources in jurisdictions not currently funded, including U.S. territories, to build 

the Federal response for all impacted areas by providing technical 

assistance to VHPCs for the provision of core prevention services 

such as screening, testing, linking to care, education, and surveillance. 

Viral Hepatitis Screening.—The Committee continues to support 

hepatitis screening activities and encourages CDC to prioritize 

screening programs in medically underserved and minority communities. Point-of-care testing allows for utilization of effective and innovative screening technology in a variety of health care settings. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2016 ............................................................................. $579,885,000 

Budget estimate, 2017 ........................................................................... 629,485,000 

Committee recommendation ................................................................. 578,885,000 

The Committee recommendation for the activities of the National 

Center for Emerging and Zoonotic Diseases is $578,885,000, which 

includes $52,000,000 in transfers from PPH Fund. 

The National Center for Emerging and Zoonotic Infectious Diseases aims to detect, prevent, and control infectious diseases from 

spreading, whether they are naturally occurring, unintentional, or 

the result of terrorism. 

The Committee recommendation includes funding for the following activities in the following amounts: 
62 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Core Infectious Diseases ............................................................... 393,313 427,913 396,313 

Antibiotic Resistance Initiative ............................................. 160,000 200,000 163,000 

Lab Safety and Quality ......................................................... 8,000 8,000 8,000 

Vector-borne Diseases .......................................................... 26,410 26,410 26,410 

Lyme Disease ........................................................................ 10,663 10,663 10,663 

Prion Disease ........................................................................ 6,000 6,000 6,000 

Chronic Fatigue Syndrome .................................................... 5,400 ............................ 5,400 

Emerging Infectious Diseases .............................................. 147,000 147,000 147,000 

All Other Infectious Diseases ............................................... 29,840 29,840 29,840 

Food Safety .................................................................................... 52,000 52,000 48,000 

National HealthCare Safety Network ............................................. 21,000 21,000 21,000 

Quarantine ..................................................................................... 31,572 46,572 31,572 

Advanced Molecular Detection ....................................................... 30,000 30,000 30,000 

Epidemiology and Lab Capacity Program ..................................... 40,000 40,000 40,000 

Healthcare-Associated Infections .................................................. 12,000 12,000 12,000 

Antibiotic Stewardship.—The Committee commends CDC on its 

efforts to improve antibiotic use, specifically its work to align the 

complementary work of antibiotic stewardship and early sepsis recognition. The Committee directs CDC to continue this dual approach for improving antibiotic use. 

Combating Antibiotic Resistant Bacteria [CARB].—The Committee continues to support the CARB initiative and provides 

$163,000,000 for this effort. The Committee recognizes the importance of addressing antibiotic-resistant bacteria through a ‘‘One 

Health’’ approach, simultaneously combating antibiotic resistance 

in human, animal, and environmental settings. The Committee directs CDC to competitively award research activities that address 

aspects of antibiotic resistance related to ‘‘One Health’’ among entities, including public academic medical centers, veterinary schools 

with agricultural extension services, and State public health departments whose proposals are in line with CDC’s strategy for addressing antibiotic resistant bacteria. CDC shall provide an updated spend plan to the Committee within 30 days after enactment 

of this act and include an update on these efforts in the fiscal year 

2018 CJ. 

The Committee encourages CDC to develop a national capacity 

to identify and catalog microbial genome sequences, paying attention to antibiotic-resistant microbes. The CDC should continue to 

pursue research opportunities in the area of antimicrobial stewardship in diverse healthcare settings and encourage regional collaborations to study the most effective strategies to improve antibiotic 

prescribing and stewardship. 

Emerging and Zoonotic Infections Diseases.—The Committee encourages CDC to continue improving a comprehensive outbreak response, including leveraging existing Federal and State investments to work with research universities with expertise in disease 

detection, surveillance, containment, and early vaccine development response capabilities. 

National Healthcare Safety Network.—The Committee notes that 

each year, hospital acquired catheter associated urinary tract infections [CAUTIs] results in the death of 15,000 patients. The Committee urges the CDC to examine existing evidence regarding the 

use of stents to address CAUTIs and issue appropriate communica-
63 

tions to hospitals, including an update to its 2009 guidelines to prevent CAUTIs if necessary. The Committee also notes that treatment gaps in healthcare associated infections persist across nonhospital health care settings. The Committee recognizes that the 

National Healthcare Safety Network started collecting data from 

ambulatory surgical centers and encourages CDC to continue to expand its data collection efforts to additional providers in non-hospital settings. 

Prion Diseases.—The Committee commends the work of the National Prion Disease Pathology Surveillance Center and supports 

its work developing better diagnostic tools. Prion diseases are a 

group of fatal neurodegenerative disorders causing dementia. 

Creutzfeldt-Jakob disease is one of the more devastating types of 

prion disease that can be transmitted from disease carriers by tissue transplants or from ingesting beef contaminated with Bovine 

Spongiform Encephalopathy, more commonly known as ‘‘mad cow’’ 

disease. The Center monitors all human and animal prion diseases, 

identifies the origin, and together with CDC develops more efficient 

diagnostic methods to prevent spreading into the human population. 

Responding to Emerging Threats.—The Epidemiology and Laboratory Capacity for Infectious Diseases Program [ELC] strengthens the epidemiologic and laboratory capacity in 50 States, six local 

health departments, and eight territories. This funding provides 

critical support to epidemiologists and laboratory scientists who are 

instrumental in discovering and responding to various food and 

vector-borne outbreaks. The Committee provides funding for ELC 

grants to sustain core surveillance capacity and ensure that State 

and local epidemiologists are equipped to respond rapidly to emerging threats including antimicrobial resistant superbugs and the 

Zika virus. 

Sepsis.—The Committee is pleased that the CDC addressed sepsis as a priority within the CARB initiative in its fiscal year 2017 

CJ. The Committee supports the CDC’s goals to scale up the evaluation of sepsis surveillance to help track national sepsis rates, assess the impact of prevention and treatment initiatives, and enable 

comparisons between health care facilities to identify problem 

areas. The Committee requests a breakdown of funding used for 

sepsis awareness, prevention, and treatment across CDC programs 

in the fiscal year 2018 CJ. 

Vector Borne Diseases.—The Committee notes the importance of 

the Epidemiology and Lab Capacity program to help protect the nation from Zika, West Nile, Lyme disease, and other bacterial and 

viral diseases caused by mosquitos, ticks, and other arthropods. 

CDC is encouraged to allocate the maximum amount possible to 

support evidence-based efforts at the Federal, State, and local public health agencies and labs for arbovirus control, testing, and reporting. In particular, the Committee encourages CDC to focus research on tick borne illnesses, including Lyme disease and Rocky 

Mountain Spotted Fever, which have increased significantly in the 

past decade. 
64 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2016 ............................................................................. $1,177,096,000 

Budget estimate, 2017 ........................................................................... 1,117,145,000 

Committee recommendation ................................................................. 1,064,646,000 

The Committee recommendation for the activities of the National 

Center for Chronic Disease Prevention and Health Promotion is 

$1,064,646,000, which includes $337,950,000 in transfers from the 

PPH Fund. 

The mission of the National Center for Chronic Disease Prevention is to provide national leadership in promoting health and wellbeing through prevention and control of chronic diseases. Nearly 

one-half of all American adults have at least one chronic illness; 

such diseases account for nearly 70 percent of all U.S. deaths and 

three-quarters of all healthcare costs in the United States. 

Within the total provided for the National Center for Chronic 

Disease Prevention and Health Promotion, the following amounts 

are available for the following categories of funding: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Tobacco .......................................................................................... 210,000 210,000 210,000 

Nutrition, Physical Activity and Obesity ........................................ 49,920 49,920 49,920 

High Obesity Rate Counties (non-add) ................................ 10,000 10,000 10,000 

School Health ................................................................................. 15,400 15,400 15,400 

Health Promotion ........................................................................... 14,025 14,025 14,025 

Community Health Promotion ............................................... ............................ ............................ ............................

Glaucoma .............................................................................. 3,300 3,300 3,300 

Visual Screening Education .................................................. 525 525 525 

Alzheimer’s Disease .............................................................. 3,500 3,500 3,500 

Inflammatory Bowel Disease ................................................ 750 750 750 

Interstitial Cystitis ................................................................ 850 850 850 

Excessive Alcohol Use ........................................................... 3,000 3,000 3,000 

Chronic Kidney Disease ........................................................ 2,100 2,100 2,100 

Prevention Research Centers ......................................................... 25,461 25,461 25,461 

Heart Disease and Stroke .............................................................. 160,037 160,037 130,037 

Diabetes ......................................................................................... 170,129 170,129 140,129 

National Diabetes Prevention Program .......................................... 20,000 20,000 20,000 

Cancer Prevention and Control ...................................................... 356,174 302,173 356,174 

Breast and Cervical Cancer ................................................. 210,000 169,204 210,000 

WISEWOMAN (non-add) ................................................ 21,120 21,120 21,120 

Breast Cancer Awareness for Young Women ....................... 4,960 4,960 4,960 

Cancer Registries .................................................................. 49,440 49,440 49,440 

Colorectal Cancer .................................................................. 43,294 39,515 43,294 

Comprehensive Cancer ......................................................... 19,675 19,675 19,675 

Johanna’s Law ...................................................................... 5,500 5,500 5,500 

Ovarian Cancer ..................................................................... 7,500 7,500 7,500 

Prostate Cancer .................................................................... 13,205 ............................ 13,205 

Skin Cancer ........................................................................... 2,125 2,125 2,125 

Cancer Survivorship Resource Center .................................. 475 475 475 

Other ..................................................................................... ............................ 3,779 ............................

Oral Health ..................................................................................... 18,000 18,000 16,000 

Safe Motherhood/Infant Health ...................................................... 46,000 46,000 46,000 

Arthritis .......................................................................................... 11,000 11,000 11,000 

Epilepsy .......................................................................................... 8,000 8,000 8,500 

National Lupus Registry ................................................................ 6,000 6,000 6,000 

Racial and Ethnic Approach to Community Health ...................... 50,950 30,000 ............................

Partnerships to Improve Community Health ................................. ............................ ............................ ............................

Million Hearts ................................................................................. 4,000 4,000 4,000 

Workplace Wellness ........................................................................ ............................ ............................ ............................

National Early Child Care Collaboratives ...................................... 4,000 4,000 4,000 

Hospitals Promoting Breastfeeding ............................................... 8,000 8,000 8,000 
65 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Good Health and Wellness in Indian Country ............................... ............................ 15,000 ............................

Alzheimer’s and Healthy Aging.—The Committee commends the 

Healthy Brain Initiative for its leadership in bringing attention to 

the public health crisis of Alzheimer’s disease. The Committee encourages CDC to continue implementing the action steps listed in 

the updated Road Map, including working towards a consensus on 

the mortality burden of the disease. 

Asthma.—The Committee applauds CDC’s 6 « 18 Initiative and its 

recognition that asthma is one of the most common and costly 

health conditions in the United States. Twenty-four million Americans have asthma, including 6.3 million children. The annual direct 

healthcare costs and lost productivity attributed to asthma total 

$56,000,000,000. The Committee understands that better coordination of public health and health systems interventions are necessary to reduce the disease burden of asthma, and encourages increased collaboration with payers. 

Atopic Dermatitis [AD].—The Committee understands that AD is 

the most severe and long-lasting form of eczema impacting as 

many as one out of every four children and 7–8 million adults in 

the United States. The Committee recognizes that AD is a potentially debilitating condition which can severely compromise a person’s quality of life, and yet, there is a lack of understanding into 

what causes AD and how it can be managed, treated, and, ultimately, prevented. The Committee recognizes that there are continued gaps in data on eczema and atopic dermatitis in adults, particularly regarding prevalence rates and linkages between 

comorbidities including asthma and food allergies. The Committee 

encourages the Center on Chronic Disease Prevention and Health 

Promotion to collaborate with the National Center for Health Statistics to identify survey instruments that could be used to obtain 

better data and begin to fill these gaps. 

Breast and Cervical Cancer Early Detection Program.—The Committee again rejects the administration’s proposed funding reduction to the Breast and Cervical Cancer early detection program and 

provides funding at the fiscal year 2016 level. The Committee notes 

that, in 2017, roughly 2.6 million women aged 40–64 will remain 

uninsured and eligible for breast cancer screening services under 

this program. Similarly, 5.7 million women aged 21–64 will remain 

uninsured in 2017 and eligible for cervical cancer screening 

through the Breast and Cervical Cancer Early Detection Program. 

This program remains critical for women across the country and 

has shown strong success in specifically providing low-income, uninsured, and underinsured women with the lifesaving preventive 

services they need. 

Cancer Screening in Minority Populations.—The Committee remains concerned about the disparity in cancer screening and treatment in minority and medically underserved populations. CDC is 

encouraged to employ novel partnerships with both cancer providers and community leaders in community-based outreach efforts, such as those in faith-based organizations, clinics, and rec-
66 

reational centers, designed to improve early detection and prevention in regions of the country that have high numbers of economically disadvantaged minorities. 

Cancer Survivor Resource Center.—Recognizing there are more 

than 14,500,000 cancer survivors in the United States, the Committee encourages the CDC to invest in evidence-based physical activity and wellness programs for cancer survivors. Evidence-based 

physical activity programs have been shown to improve survivors’ 

overall quality of life, increase cardiovascular endurance, decrease 

cancer-related fatigue, and help them meet or exceed recommended 

amounts of physical activity. 

Children in Adversity.—The Committee recognizes that CDC is a 

key implementing partner of the United States Government Action 

Plan on Children in Adversity’s three principle objectives. The 

Committee fully supports the use of funds provided to the CDC 

through this act for activities that the agency has identified as 

being necessary to link representative data to effective, sustainable, and scalable action, and thus ensure that: (1) the percentage 

of children achieving age-appropriate growth and developmental 

milestones are increased; (2) the percentage of children living outside of family care is reduced; and (3) the percentage of children 

experiencing violence, exploitation, abuse, and neglect is reduced. 

The Committee directs the CDC to collaborate with USAID, 

PEPFAR, and the Department of Labor to ensure monitoring and 

evaluation is aligned for all of the Action Plan’s objectives. The 

Committee asks that the annual Public Law 109–95 report to Congress display the amount of funding by objective to the Action Plan 

on Children in Adversity. 

Chronic Fatigue Syndrome.—The Committee applauds the CDC’s 

efforts to collaborate with disease experts in its multi-site study. 

The Committee is pleased that the National Academy of Medicine 

[NAM] has clarified the disease definition and that the NAM and 

the CFS Advisory Committee have made recommendations to educate the medical community. The Committee encourages CDC to leverage those recommendations to provide new clinical guidelines 

and to execute a broad-based medical education campaign. To address the critical lack of access to clinical care, the Committee encourages CDC to work with the NIH and other agencies within the 

Department to find creative ways to support a clinical care component to regional Centers of Excellence. 

Chronic Pain.—The Committee commends CDC for including 

chronic pain in the Healthy People 2020 initiative. The Committee 

encourages CDC to analyze data collected from the chronic pain 

questions included in the 2016 National Health Interview Survey, 

make this information available to the public, and expand the topic 

area on chronic pain in the Healthy People 2030 initiative. The 

Committee further encourages the CDC to address the public 

health epidemic of chronic pain by making information and current 

statistics on chronic pain publicly available through the CDC Vital 

Signs reports. 

Colorectal Cancer.—The Committee rejects the administration’s 

proposed funding reduction to this program and emphasizes the 

importance of continuing to provide screenings for low-income, un-
67 

insured, and underinsured adults who may not have benefited from 

the ACA. 

Community Grants.—The Committee eliminated the Partnerships to Improve Community Health [PICH] in the fiscal year 2016 

agreement. To lessen the disruption during PICH close out, last 

year the agreement directed CDC to shift fiscal year 2016 continuation costs to two chronic disease budget lines, $30,000,000 to 

Heart Disease and Stroke and $30,000,000 to Diabetes. In fiscal 

year 2017, PICH close out will be completed. Therefore, the Committee has removed funds from these two chronic disease budget 

lines and directs that no funds shall be used for continuing PICH 

activities. Within 120 days of enactment of this act, the Division of 

Community Health shall provide a report to the Committee on 

evaluation plans for PICH following the final year of funding in fiscal year 2016. 

Community Prevention.—The Committee requests that, within 

120 days of enactment of this act, CDC shall provide the Committee any evaluation data or analysis related to previous investments in community prevention and health promotion, including 

Communities Putting Prevention to Work and the Community 

Transformation Grant programs. This report shall summarize previous funding histories, list projects and activities funded, and provide specific evidence-based data on how these projects advanced 

public health. 

Diabetes Prevention Program.—The Committee recommendation 

includes $20,000,000, the same as fiscal year 2016, for the Diabetes 

Prevention Program. This program promoting lifestyle interventions has proven to reduce the risk of developing diabetes by 58 

percent in individuals at high risk. 

Division of Diabetes Translation [DDT].—The Committee recognizes the work of CDC’s DDT to address the diabetes epidemic and 

encourages CDC to continue to ensure that the prevention needs of 

those Americans with, and at risk for, diabetes and prediabetes are 

met. The Committee believes these activities must include clear 

outcomes and ensure transparency and accountability that demonstrate how funding was used to support diabetes prevention and 

specifically how diabetes funding reached State and local communities. Additionally, the Committee encourages CDC to support the 

translation of research into better prevention and care, as well as 

the National Diabetes Education Program, the expansion of diabetes surveillance, and other DDT activities. 

Early Child Care Collaboratives.—The Committee recognizes 

that the early care and education setting is an important one for 

promoting healthy habits in young children. The Committee provides $4,000,000 to the National Early Child Care Collaboratives to 

enable training of early care and education providers in implementation of healthy eating and physical activity best practices, including strategies for engaging families. Funds will also support technical assistance for integration of healthy eating and physical activity best practices into existing State and local professional development systems Early Care and Education settings and health initiatives. 

Electronic Cigarettes.—The Committee notes a rise in usage of 

electronic cigarettes, or e-cigarettes, by U.S. middle and high school 
68 

students. The Committee is aware of an ongoing NAM study on the 

health effects from e-cigarettes and recommendations for future 

federally funded research. The Committee looks forward to the results and recommendations from the study. 

Epilepsy in Rural Areas.—Over 2,000,000 individuals in the 

United States have epilepsy and, while new cases are most common among young children, the onset of epilepsy can occur at any 

age. The Committee has included an increase of $500,000 from last 

year’s level for CDC to expand telehealth and educational training 

programs for rural and underserved areas that reach school nurses, 

child care personnel, first responders, and care providers for seniors, to recognize and respond appropriately to seizures caused by 

epilepsy or result from trauma and other acute chronic illness. 

Given the link between epilepsy and Tuberous Sclerosis Complex, 

the Committee also supports efforts to increase awareness of Tuberous Sclerosis Complex clinical trials and effective therapeutics, 

and encourages the CDC to update the study of all-cause mortality 

of persons diagnosed with TSC. 

Heart Disease and Stroke Prevention.—The Committee supports 

the Division for Heart Disease and Stroke Prevention’s efforts 

against cardiovascular disease and supports the Paul Coverdell National Acute Stroke Registry and the projects within State and 

Local Public Health Actions to Prevent Obesity, Diabetes, and 

Heart Disease, and Stroke. 

Heart Valve Disease.—The Committee understands that heart 

valve disease can be debilitating and if not treated properly can result in heart failure, sudden cardiac arrest, and death. The Committee encourages CDC to include information on valve disease on 

its Web site and to help bring public awareness to this disease. The 

Committee encourages CDC to engage with patient and research 

organizations to explore collaborative ways to integrate information 

about the warning signs, symptoms, and risk factors of valve disease into CDC’s existing programs. 

High Obesity Rate Counties.—The Committee remains concerned 

about the growing body of evidence suggesting that obesity is one 

of the most significant challenges facing the public health system. 

If this epidemic continues unabated, obesity and the many complications it causes will increase the disease burden among Americans, particularly youth. The Committee continues to include 

$10,000,000 to support the rural extension and outreach services 

grants for rural counties with an obesity prevalence of over 40 percent. The Committee expects CDC to work with State and local 

public health departments to support measurable outcomes 

through evidenced-based obesity research, intervention, and prevention programs. Grants should combine basic, clinical, and population research to better understand and treat the metabolic, medical, surgical, environmental, and societal implications of obesity in 

cooperation with partners that have existing outreach capacity to 

develop and implement educational and intervention programs. 

CDC should focus its efforts in areas of the country with the highest burden of obesity and with the comorbidities of hypertension, 

cardiac disease, and diabetes from county level data in the Behavioral Risk Factor Surveillance System. The Committee encourages 
69 

CDC to only support activities that are supported by scientific evidence. 

Inflammatory Bowel Disease [IBD].—The Committee commends 

CDC for exploring the burden of IBD and communicating these results to the public. Little is known about the impact of IBD on minority and underserved populations, and the Committee encourages 

CDC to complement its existing epidemiological study with a focus 

on these populations. 

Interstitial Cystitis [IC].—The Committee recommendation for interstitial cystitis activities provides support for the ongoing epidemiology study, as well as education, outreach, and public awareness activities. 

Johanna’s Law.—The Committee is pleased by the agency’s recent launch of ‘‘Know: BRCA’’ to help increase the public’s awareness of hereditary breast and ovarian cancers and improve understanding the individual risk of having a BRCA mutation. The Committee urges CDC to take steps to integrate components of the ‘‘Inside Knowledge campaign’’ and ‘‘Know: BRCA’’ to the extent possible, to ensure coordination of public health messages related to 

ovarian cancer, leveraging of resources, and maximizing economies 

of scale. 

Lupus Registry.—The Committee continues to support research 

efforts under the National Lupus Patient Registry program, but acknowledges that challenges still remain. Burden of illness studies 

are needed to better understand and evaluate issues such as the 

disease impact on quality of life, productivity, frequency of clinical 

events, natural history, and the direct and indirect costs associated 

with lupus. The Committee encourages CDC to support the lupus 

cohort and burden of illness studies. 

Marfan Syndrome.—The Committee remains concerned that 

structural cardiovascular disorders, such as Marfan syndrome, continue to claim the lives of high school athletes across the country 

who received a sports physical prior to competition. CDC is encouraged to work with patient and professional stakeholders to develop 

minimum screening guidelines that ensure all young athletes are 

appropriately screened for potentially life-threatening structural 

cardiovascular disorders. 

Million Hearts.—The Committee supports the Million Hearts program, a public-private initiative setting goals for our Nation in preventing heart attacks and strokes. These funds support enhanced 

ways to implement the ABCS: aspirin when appropriate, blood 

pressure control, cholesterol management, and smoking cessation, 

as well as activities to increase the use of cardiac rehabilitation, as 

appropriate. 

Mississippi Delta Health Collaborative [MDHC].—The Committee 

commends CDC’s efforts supporting the Mississippi Delta Health 

Collaborative in implementing a successful, evidenced-based strategy to reduce the burden of heart disease and stroke. These advancements were made possible with chronic disease prevention 

interventions through partnerships at the local level, and teambased approaches designed to link communities with clinical care, 

such as education and counseling, medication therapy management, comprehensive medication management, and utilizing health 

information technology to change health outcomes. Taking these 
70 

lessons learned, the Committee wants to build upon the investments and see whether this success can be replicated in other highrisk and underserved areas in the future. Therefore, the Committee 

encourages CDC, working with the Collaborative and relevant 

stakeholders, to reach populations at high risk in the Delta with 

effective interventions while maintaining the current strategy. 

CDC shall consider using lifestyle change intervention models like 

the Diabetes Prevention Program; utilizing local pharmacy schools 

with existing community-based research programs that could focus 

on screenings, medication reviews, medication therapy management, comprehensive medication management, and disseminating 

prevention strategies; and working with communities to establish 

health networks to better coordinate and manage community based 

health initiatives. To reach the target population, the Committee 

encourages CDC to take advantage of rapidly evolving healthcare 

technology by leveraging the resources of States with recognized 

leadership in areas of electronic medical records, telehealth, and innovative delivery of education tools. CDC shall provide an update 

on these activities in the fiscal year 2018 CJ. 

Ovarian Cancer.—The Committee commends the CDC for its 

work to evaluate existing risk assessment tools, which can be used 

to help identify patients with a genetic predisposition to ovarian 

and other cancers, and identify which of these existing tools are 

valid, reliable, and the most user-friendly for providers and patients. The Committee requests that the CDC present the findings 

of this review and provide recommendations with respect to how 

CDC can support the deployment of the tools found to have the 

greatest value and utility in the fiscal year 2018 CJ. 

Pulmonary Hypertension [PH].—The Committee understands 

that PH causes heart failure and death. CDC is encouraged to support education, outreach, and awareness activates that promote 

early and accurate diagnosis of PH. 

Racial and Ethnic Approach to Community Health [REACH].— 

The Committee eliminates the REACH program due to funding 

constraints. Funding continues to be provided to other programs 

that conduct outreach to reduce ethnic disparities in health status. 

Safe Motherhood Initiative.—Preterm birth affects more than 

500,000 babies each year in the United States and is the leading 

cause of neonatal mortality. The Committee commends CDC for 

funding State-based Perinatal Collaboratives that focus on improving birth outcomes using known preventative strategies such as reducing early elective deliveries. 

Sleep Surveillance.—The Committee is pleased by CDC’s work on 

a national public health awareness campaign for sleep. The Committee urges CDC to ensure that funding for surveillance activities 

on sleep disorders and sleep health is maintained in addition to 

these awareness efforts. 

WISEWOMAN.—The Committee lauds the WISEWOMAN program that helps uninsured and under-insured low-income women 

ages 40 to 64 decrease, prevent, or control heart disease and stroke 

by providing preventive health services, referrals to local health 

care providers, lifestyle programs and health counseling services 

tailored to identified risk factors to promote lasting, healthy behavior change. From 2008 through 2014, WISEWOMAN served more 
71 

than 165,000 women and over 90 percent had at least one heart 

disease and stroke risk factor. More than 118,000 evidenced-based 

behavior change services were provided to help reduce heart disease and stroke. 

NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL

DISABILITIES, DISABILITY AND HEALTH

Appropriations, 2016 ............................................................................. $135,610,000 

Budget estimate, 2017 ........................................................................... 135,610,000 

Committee recommendation ................................................................. 137,560,000 

The Committee recommendation for the activities of the National 

Center on Birth Defects and Developmental Disabilities [NCBDDD] 

is $137,560,000. 

This Center improves the health of children and adults by preventing birth defects, developmental disabilities, and complications 

of heredity blood disorders and by promoting optimal child development and health and wellness among children and adults living 

with disabilities. 

Within the total provided, the following amounts are provided for 

the following categories of funding: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Child Health and Development ...................................................... 65,800 65,800 65,800 

Other Birth Defects ............................................................... 19,000 19,000 19,000 

Fetal Death ........................................................................... 900 900 900 

Fetal Alcohol Syndrome ......................................................... 11,000 11,000 11,000 

Folic Acid .............................................................................. 3,150 3,150 3,150 

Infant Health ......................................................................... 8,650 8,650 8,650 

Autism ................................................................................... 23,100 23,100 23,100 

Health and Development with Disabilities .................................... 54,710 54,710 56,660 

Disability and Health ............................................................ 22,050 22,050 24,000 

Tourette Syndrome ................................................................ 2,000 2,000 2,000 

Early Hearing Detection and Intervention ............................ 10,760 10,760 10,760 

Muscular Dystrophy ............................................................... 6,000 6,000 6,000 

Attention Deficit Hyperactivity Disorder ................................ 1,900 1,900 1,900 

Fragile X ................................................................................ 2,000 2,000 2,000 

Spina Bifida .......................................................................... 6,000 6,000 6,000 

Congenital Heart Defects ...................................................... 4,000 4,000 4,000 

Public Health Approach to Blood Disorders .................................. 4,500 4,500 4,500 

Hemophilia CDC Activities ............................................................. 3,500 3,500 3,500 

Hemophilia Treatment Centers ...................................................... 5,000 5,000 5,000 

Thalassemia ................................................................................... 2,100 2,100 2,100 

Cerebral Palsy.—The Committee encourages CDC to build on established surveillance and research methods to support research 

infrastructure focused on Cerebral Palsy across various geographic 

U.S. regions. 

Congenital Heart Disease [CHD].—CHD is the number one cause 

of birth defects in the United States and a leading cause of birth 

defect-related infant mortality. The Committee notes that children 

and adults with CHD require ongoing, specialized cardiac care, and 

there remain gaps in the epidemiological data as children and adolescents transition to adult care. The Committee commends the National Center for Birth Defects and Developmental Disabilities for 

its leadership in addressing CHD and adult CHD surveillance efforts, including on the estimated number of individuals in the 
72 

United States living with CHD, epidemiology of CHD across the 

lifespan, age-specific prevalence, and factors associated with those 

patients who may have dropped out of appropriate specialty care. 

Fetal Alcohol Spectrum Disorders [FASD].—The Committee encourages the CDC to collaborate with State substance abuse agencies to establish a State-Federal partnership on FASD issues. This 

collaboration would involve dissemination of FASD best practices, 

providing technical assistance, and creating State-to-State sharing 

opportunities. 

Fragile X and Associated Disorders.—The Committee commends 

CDC’s efforts to identify and define the population impacted by FX 

and FXD with the goal of understanding the public health impact 

of these conditions. The Committee acknowledges significant 

progress made by the NCBDDD Fragile X Clinical and Research 

Consortium in growing its FORWARD Database and its Patient 

Registry. The CDC is encouraged to continue this effort. The Committee also supports the public-private partnership which resulted 

in the ‘‘Future of Fragile X: Setting the Public Health Research 

Agenda’’ meeting in 2014 and the resulting Funding Opportunity 

Announcement which seeks to use longitudinal data to characterize 

the natural history of Fragile X to improve services and outcomes. 

The Committee encourages the NCBDDD to continue data driven 

public health research to reduce the public health burden of both 

FX and autism. 

Health and Development for Those With Disabilities.—The Committee supports the work of the National Center on Health, Physical Activity and Disability [NCHPAD] and its goal of promoting 

better health for adults and children with disabilities. By mobilizing national networks to provide technical assistance, provide 

community leaders and community organizations with health promotion training, and by disseminating effective strategies and tools 

for disability service providers, NCHPAD plays an important role 

in encouraging a healthier lifestyle for Americans with disabilities. 

Hemophilia.—The Committee has included sufficient funding to 

maintain the Center’s hemophilia programs, which provide critical 

information to better understand risk factors for complications and 

identify high-risk populations for prevention measures. The Committee recognizes the importance of CDC’s research on inhibitors 

and the recommendation that people with hemophilia be tested for 

inhibitors at least annually. The Committee encourages CDC, 

working with stakeholders and the network of hemophilia treatment centers, to implement inhibitor testing across the United 

States and support further research to better understand inhibitors 

and how they can be prevented. 

Improving the Health of People With Intellectual Disabilities.— 

People with disabilities have a high risk of poor health outcomes 

such as obesity, hypertension, and mood disorders such as depression. Therefore, the Committee includes $6,700,000 for the Healthy 

Athletes program. 

Muscular Dystrophy Surveillance.—The Committee is aware of 

the CDC’s established surveillance efforts through the Muscular 

Dystrophy Surveillance, Tracking, and Research Network [MD 

STARnet] and supports the development of a plan to enhance the 

quality and quantity of the data being collected through MD 
73 

STARnet. Additionally, the Committee is interested in the agency’s 

plans to disseminate and implement the updated care standards, 

including for adults with Duchenne and for other forms of muscular dystrophy, and requests a report on this activity 180 days 

after the enactment of this act. The Committee also supports CDC’s 

engagement of multiple Divisions and Centers in the development 

of a Duchenne newborn screening program. 

Spina Bifida.—While spina bifida and related neural tube defects 

are highly preventable through education and adequate daily folic 

acid consumption, it is the most common permanently disabling 

birth defect in the United States. The Committee supports the continuation of the Spina Bifida Clinical Care Monitoring and Tracking program and commends the National Spina Bifida Program in 

serving as a model for programs assisting other individuals living 

with similar complex conditions. The Committee encourages CDC 

to continue the dissemination of information to clinicians, parents, 

and families living with spina bifida. 

Thalassemia.—The Committee commends CDC’s thalassemia 

program and encourages CDC to coordinate the efforts of the treatment centers and the nonprofit patient advocacy community to enhance public and provider awareness about thalassemia prevention 

and treatment. 

Tuberous Sclerosis Complex [TSC].—The Committee encourages 

CDC to take into consideration all the major manifestations of TSC 

in its surveillance network. 

PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2016 ............................................................................. $491,597,000 

Budget estimate, 2017 ........................................................................... 500,631,000 

Committee recommendation ................................................................. 485,000,000 

The Committee recommendation for Public Health Scientific 

Services is $485,000,000. 

This funding supports the work of all of the CDC Centers by 

compiling statistical information to inform public health policy. In 

particular, these activities assure the accuracy and reliability of 

laboratory tests; apply digital information technology to help detect 

and manage diseases, injuries, and syndromes; and develop and inform the public health community on sound public health surveillance, laboratory protocols, and epidemiological practices. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Health Statistics ............................................................................ 160,397 160,397 156,000 

Surveillance, Epidemiology, and PH Informatics ........................... 279,000 283,008 279,000 

Public Health Workforce ................................................................. 52,200 57,226 50,000 

Alzheimer’s Disease and Dementia.—The Committee is aware of 

recent peer-reviewed studies suggesting that more than 500,000 

U.S. deaths each year are attributable to Alzheimer’s disease and 

dementia, far in excess of the deaths reported by the Center each 

year. Such statistics would elevate Alzheimer’s disease from the 

sixth leading cause of death to the third leading cause of death. 
74 

The Committee directs the CDC to make recommendations on ways 

to ensure the accuracy and completeness of measurements of the 

Alzheimer’s disease and dementia death rate and to develop a consensus on the mortality burden of the disease. 

Community Preventive Services Task Force.—The Committee 

notes that the Task Force recommendations provide information 

about evidence-based options that decision makers and stakeholders can consider when determining what best meets the specific needs, preferences, available resources, and constraints of 

their jurisdictions and constituents. These recommendations and 

the reviews of the evidence on which they are based are compiled 

in the Guide to Community Preventive Services. The Committee 

recognizes CDC’s continuing efforts to support the Task Force and 

to conduct dissemination activities that provide information to help 

communities make informed decisions. 

Modernizing Vital Statistics Collection.—While most States now 

or will soon have operational electronic birth and death registration 

systems, many do not have the resources to maximize electronic 

death reporting or to modernize their systems to keep pace with 

new technology. The Committee encourages CDC to support States 

in upgrading antiquated systems and improving the quality and accuracy of vital statistics reporting. 

ENVIRONMENTAL HEALTH

Appropriations, 2016 ............................................................................. $182,303,000 

Budget estimate, 2017 ........................................................................... 182,303,000 

Committee recommendation ................................................................. 182,303,000 

The Committee recommendation for the National Center for Environmental Health is $182,303,000. The Committee recommendation includes $17,000,000 in transfers from the PPH Fund. 

The National Center for Environmental Health addresses emerging pathogens and environmental toxins that pose significant challenges to public health. The Center conducts surveillance and data 

collection to determine which substances in the environment are 

found in people and to what degree. The Center also determines 

whether and at what level of exposure these substances are harmful to humans. 

The Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Environmental Health Laboratory .................................................. 56,000 56,000 56,000 

Newborn Screening Quality Assurance Program .................. 8,300 8,300 8,300 

Newborn Screening for SCID ................................................. 1,200 1,200 1,200 

Other Environmental Health ................................................. 46,500 46,500 46,500 

Environmental Health Activities .................................................... 46,303 46,303 46,303 

Safe Water ............................................................................ 8,600 8,600 8,600 

Amyotrophic Lateral Sclerosis Registry ................................ 10,000 10,000 10,000 

Built Environment & Health Initiative .................................. ............................ ............................ ............................

Climate Change .................................................................... 10,000 10,000 10,000 

All Other Environmental Health ............................................ 17,703 17,703 17,703 

Environmental and Health Outcome Tracking Network ................. 34,000 24,000 34,000 

Asthma ........................................................................................... 29,000 29,000 29,000 

Childhood Lead Poisoning ............................................................. 17,000 17,000 17,000 
75 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Hearing Loss .................................................................................. ............................ 10,000 ............................

Amyotrophic Lateral Sclerosis [ALS] Registry.—The Committee 

commends CDC and the Agency for Toxic Substances and Disease 

Registry [ATSDR] for its continued efforts to maintain and 

strengthen the National ALS Registry and to ensure that the registry supports and advances research into the causes and treatment of ALS and the care of ALS patients. The Committee encourages ATSDR to identify and support additional ways the registry 

can advance ALS treatment development including as a tool to 

identify cohorts for research studies; assess benefit-risk and patient 

preferences; assist in conducting natural history studies; collect patient and caregiver reported outcomes and post-marketing data; 

and identify geographic locations for trial sites based on proximity 

of larger patient populations that meet enrollment criteria. The 

Committee also encourages ATSDR to continue to consult with ALS 

organizations, patients, researchers, the pharmaceutical industry 

and Federal agencies, including NIH, VA, and the FDA, to coordinate efforts and ensure the registry continues to be a resource for 

stakeholders. 

Environmental Health Activities.—The Committee is aware that 

local health departments are involved in a wide array of environmental health activities including groundwater protection, protection of the food supply, pollution prevention, and hazardous waste 

disposal. CDC is urged to ensure that funds are available to State 

and local health departments in communities to address local level 

threats. 

Healthy Housing.—The Committee recognizes the important role 

that healthy housing can play in reducing the risk of numerous 

conditions, including asthma and lead poisoning. CDC is encouraged to continue to support healthy housing activities. 

Lead Poisoning.—The Committee notes that the National Advisory Committee on Childhood Lead Poisoning Prevention was disbanded in 2013. The lead poisoning crisis in Flint, Michigan, demonstrates that this committee is greatly needed by providing a 

forum for convening lead poisoning experts and providing these experts with an official conduit for recommendations to CDC to address emerging lead poisoning problems quickly. CDC is encouraged to re-establish this Committee. CDC is also encouraged to 

prioritize the geocoding and mapping of lead poisoning surveillance 

data, which is inexpensive and makes the data much more accessible to local jurisdictions and agencies serving lead-poisoned children. 

INJURY PREVENTION AND CONTROL

Appropriations, 2016 ............................................................................. $236,059,000 

Budget estimate, 2017 ........................................................................... 268,629,000 

Committee recommendation ................................................................. 264,059,000 

The Committee recommendation for the National Center for Injury Prevention and Control is $264,059,000. 
76 

CDC is the lead Federal agency for injury prevention and control. 

Programs are designed to prevent premature death and disability 

and reduce human suffering and medical costs caused by fires and 

burns, poisoning, drowning, violence, and traffic accidents. The national injury control program at CDC encompasses non-occupational injury and applied research in acute care and rehabilitation 

of the injured. 

The Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Intentional Injury ............................................................................ 97,730 107,730 97,730 

Domestic Violence and Sexual Violence ............................... 32,700 32,700 32,700 

Child Maltreatment ...................................................... 7,250 7,250 7,250 

Youth Violence Prevention .................................................... 15,100 15,100 15,100 

Domestic Violence Community Projects ................................ 5,500 5,500 5,500 

Rape Prevention .................................................................... 44,430 44,430 44,430 

Gun Violence Prevention Research ....................................... ............................ 10,000 ............................

National Violent Death Reporting System ..................................... 16,000 23,570 16,000 

Unintentional Injury ....................................................................... 8,800 8,800 8,800 

Traumatic Brain Injury .......................................................... 6,750 6,750 6,750 

Elderly Falls .......................................................................... 2,050 2,050 2,050 

Injury Prevention Activities ............................................................ 28,950 28,950 28,950 

Prescription Drug Overdose ........................................................... 70,000 80,000 98,000 

Illicit Opioid Use Risk Factors ....................................................... 5,579 5,579 5,579 

Concussion Surveillance ................................................................ ............................ 5,000 ............................

Injury Control Research Centers .................................................... 9,000 9,000 9,000 

Children’s Exposure to Violence.—The Committee believes that 

understanding children’s exposure to violence and its potential impacts on a child’s health and well-being is of critical importance. 

The Committee encourages CDC to continue its collaboration with 

the Office of Juvenile Justice and Delinquency Prevention at the 

Department of Justice on the National Survey of Children’s Exposure to Violence. 

Combating Opioid Abuse.—The Committee includes $98,000,000, 

an increase of $28,000,000 above fiscal year 2016, for the Prescription Drug Overdose [PDO] Prevention for States program. CDC 

shall use this increase, which is $18,000,000 above the administration’s request, to expand its competitive cooperative agreement program that funds States with the greatest burden of opioid 

overdoses and readiness to implement prevention activities and improve interventions that monitor prescribing and dispensing practices, inform clinical practice, and protect high risk patients. The 

Committee notes the strong connection between abuse of prescription opioids and use of other types of opioids like heroin. Activities 

targeting one area will have a significant impact on the other. 

Therefore, funding will support activities such as implementing 

guidelines to improve prescribing behaviors and collecting real-time 

and more accurate data for heroin-related opioid deaths. The Committee urges CDC to require applicants applying for the PDO Prevention for States Program to collaborate with the State substance 

abuse agency or those agencies managing the State’s PDMP to ensure linkages to clinically appropriate substance use disorder services. 
77 

Concussion Surveillance.—The 2013 NAS study ‘‘Sports-Related 

Concussions in Youth: Improving the Science, Changing the Culture’’ recommended that CDC establish and oversee a national surveillance system to accurately determine the incidence of sports-related concussions, including youth ages 5 to 21. The Committee is 

aware of the promising progress CDC has made in creating a comprehensive survey instrument which the agency will be piloting in 

the coming months to prepare for a national survey in the future. 

The Committee supports CDC’s work in this area and urges the 

agency to increase its efforts. 

Opioid Prescribing Guidelines.—The Committee applauds CDC’s 

Guidelines for Prescribing Opioids for Chronic Pain and directs the 

agency to translate the guidelines into succinct, usable formats and 

toolkits accessible to providers across the country. CDC is also directed to broadly disseminate the guidelines and toolkits to promote use among as many providers as possible. The Committee expects CDC to offer technical assistance to States and expand training modules available for continuing medical education credit and 

maintenance of certification to spur uptake of guidelines by professional societies and health systems. CDC is urged to coordinate 

with the Office of the National Coordinator for Health Information 

Technology to develop and disseminate clinical decision support 

tools derived from the opioid prescribing guidelines. CDC is also 

urged to work with the VA and the DOD on implementing these 

guidelines to ensure consistent, high-quality care standards across 

the Federal Government. 

OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2016 ............................................................................. $339,121,000 

Budget estimate, 2017 ........................................................................... 285,621,000 

Committee recommendation ................................................................. 334,121,000 

The Committee recommendation for National Institute for Occupational Safety and Health [NIOSH] programs is $334,121,000. 

NIOSH is the only Federal agency responsible for conducting research and making recommendations for the prevention of work-related illness and injury. The NIOSH mission is implemented by 

conducting basic and applied scientific research and translating the 

knowledge gained into products and services that impact workers 

in settings from corporate offices to construction sites to coal mines. 

Total Worker Health.—The Committee commends CDC’s Total 

Worker Health Program, which aims to promote and protect the 

health and productivity of the American workforce through research and dissemination of innovative and cost-effective tools and 

interventions for American businesses. The Committee commends 

CDC’s work in this area and encourages CDC to continue dissemination of these tools. 

The Committee recommendation includes funding for the following activities at the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

National Occupational Research Agenda ...................................... 115,500 90,500 115,500 

Agriculture, Forestry, Fishing (non-add) ............................... 25,000 ............................ 25,000 

Education and Research Centers .................................................. 28,500 ............................ 28,500 
78 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Personal Protective Technology ...................................................... 20,000 20,000 20,000 

Healthier Workforce Center ............................................................ ............................ ............................ ............................

Mining Research ............................................................................ 61,300 61,300 61,300 

National Mesothelioma Registry and Tissue Bank ........................ 1,100 1,100 1,100 

Other Occupational Safety and Health Research .......................... 112,721 112,721 107,721 

ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2016 ............................................................................. $55,358,000 

Budget estimate, 2017 ........................................................................... 55,358,000 

Committee recommendation ................................................................. 55,358,000 

The Committee recommendation for the Energy Employees Occupational Illness Compensation Program Act [EEOICPA] is 

$55,358,000. This mandatory funding supports NIOSH scientists 

who reconstruct radiation dose levels to inform compensation decisions. 

GLOBAL HEALTH

Appropriations, 2016 ............................................................................. $427,121,000 

Budget estimate, 2017 ........................................................................... 442,121,000 

Committee recommendation ................................................................. 432,121,000 

The Committee recommends $432,121,000 for global health-related activities at CDC. 

The Center for Global Health leads international programs and 

coordinates CDC’s global efforts with the goal of promoting health 

and preventing disease in the United States and abroad. The Center has a particular focus on ensuring rapid detection and response 

to emerging health threats. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee recommendation 

Global HIV/AIDS Program ............................................................... 128,421 128,421 128,421 

Global Immunization Program ....................................................... 219,000 224,000 224,000 

Polio Eradication ................................................................... 169,000 174,000 174,000 

Measles and Other Vaccine Preventable Diseases .............. 50,000 50,000 50,000 

Parasitic Diseases and Malaria. ................................................... 24,500 24,500 24,500 

Global Health Security ................................................................... ............................ 5,000 ............................

Global Disease Detection and Emergency Response .................... 45,400 50,400 45,400 

Global Public Health Capacity Development ................................. 9,800 9,800 9,800 

Antimicrobial Resistance [AMR].—As a result of the increased 

global availability and over-prescription of antimicrobial medicines 

to humans and animals, a number of disease-causing microbes 

have developed resistance to drugs previously used to treat them. 

Yet U.S. efforts to combat AMR may be insufficient, since most resistance emerges in other regions of the world where antimicrobial 

use in people and food animals is rampant and poorly regulated. 

The Committee urges CDC to consider partnering with a coalition 

of hospitals, State public health departments, global health nongovernmental organizations, and biotech companies, among others, 

with the goal of linking global patterns of emerging resistance to 
79 

their impact in U.S. hospitals and clinical settings. Such a coalition 

would attempt to identify the most important factors that contribute to the emergence and the spread of AMR infections worldwide, and how they are spread to the United States. 

Malaria and Parasitic Diseases.—The Committee recognizes the 

important role the Center for Global Health plays in the fight 

against malaria and parasitic diseases. CDC’s crucial monitoring 

and surveillance of transmission, evaluation of interventions for effectiveness and impact, and testing of tools in a real world setting 

are critical to understanding how to scale up global health programs and ensure that our global health investments are smarter, 

better, and not wasteful. The Committee therefore encourages CDC 

to continue to research, monitor, and evaluate efforts for malaria 

and parasitic disease in collaboration with other divisions and 

agencies. 

Polio.—CDC is the lead U.S. agency in the global effort to eradicate polio and currently works with various organizations by providing expertise in training, vaccines, epidemiology, laboratory capacity, and surveillance. Currently, polio is endemic in only three 

countries, Nigeria, Afghanistan, and Pakistan. However, Nigeria 

has not reported a case since August of 2014 and will be declared 

polio free if no cases are reported by August of 2017. The Committee commends these efforts and includes a $5,000,000 increase 

above the fiscal year 2016 level to help eradicate this disease. 

Tropical Disease.—The Committee recognizes the critical role the 

Center and its Vector Borne Disease program play in ongoing efforts to prepare for and fight tropical diseases emerging on U.S. 

soil, such as Dengue, Chikungunya and now Zika. The groundwork 

laid in the Center’s efforts on Dengue and Chikungunya will be 

critical for fighting Zika. The Committee recognizes that without a 

robust Vector Borne Disease program, the United States will be ill 

equipped to monitor and prepare for Zika and new vector-borne infectious disease threats. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2016 ............................................................................. $1,405,000,000 

Budget estimate, 2017 ........................................................................... 1,402,166,000 

Committee recommendation ................................................................. 1,396,800,000 

The Committee recommendation for the Office of Public Health 

Preparedness and Response [PHPR] is $1,396,800,000. 

The mission of PHPR is to build and strengthen national preparedness for public health emergencies including natural, biological, chemical, radiological, and nuclear incidents. PHPR administers national response programs and assets, as well as grants to 

States and localities to enhance preparedness efforts across the 

country. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Public Health Emergency Preparedness Cooperative Agreement .. 660,000 660,000 660,000 

Academic Centers for Public Health Preparedness ....................... 8,200 ............................ ............................

All Other State & Local ................................................................. ............................ ............................ ............................
80 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

BioSense ......................................................................................... 23,000 23,000 23,000 

All Other CDC Preparedness .......................................................... 138,800 144,166 138,800 

Strategic National Stockpile .......................................................... 575,000 575,000 575,000 

Emergency Preparedness.—The Committee continues to request 

detailed information on how State Public Health Emergency Preparedness [PHEP] funding is distributed at the local level by 

States. CDC is encouraged to provide in the fiscal year 2018 CJ an 

update on how much of the Federal PHEP funding is being allocated to local health departments and what basis or formula each 

State is using to make such allocations. 

State and Local Preparedness and Response.—The Committee 

eliminates the Academic Centers for Public Health Preparedness as 

requested by the administration. CDC will continue to support research and training through its Office of Public Health Preparedness and Response. 

Strategic National Stockpile [SNS].—The Committee encourages 

CDC to evaluate the latest approved advances in influenza prevention and antiviral treatment for inclusion in the SNS in preparation for pandemic influenza. Moreover, CDC should consider a comprehensive approach to preparedness through vaccines, diagnostics, 

and antiviral therapeutics. 

U.S. Public Health Capacity and Needs.—The Committee directs 

GAO to issue a report within 180 days of the enactment of this act 

that reviews the U.S. public health system’s current capacity to respond to infectious disease outbreaks, including Federal emergency 

response. The GAO report shall identify response best practices 

based on a review of the responses to recent major global infectious 

disease outbreaks, and provide recommendations about how to ensure that every State public health department has the capacity to 

provide for a minimum necessary level of public health services. 

During the course of their review and preparation of recommendations, GAO shall review the 2012 Institute of Medicine report entitled ‘‘For the Public’s Health: Investing in a Healthier Future.’’ 

CDC-WIDE ACTIVITIES

Appropriations, 2016 ............................................................................. $283,570,000 

Budget estimate, 2017 ........................................................................... 144,791,000 

Committee recommendation ................................................................. 273,570,000 

The Committee provides $113,570,000 for public health leadership and support activities at CDC. 

CDC is encouraged to work with the Department to use the Nonrecurring Expenses Fund for capital projects and National Repair 

and Improvement activities at CDC. 

The recommendation includes $160,000,000 in transfers from the 

PPH Fund. 

The Committee recommendation includes funding for the following activities in the following amounts: 
81 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Preventive Health and Health Services Block Grant ..................... 160,000 ............................ 160,000 

Public Health Leadership and Support ......................................... 113,570 113,570 113,570 

Preventative Health and Health Services Block Grant.—The Committee continues to reject the administration’s proposal to eliminate this program and provides $160,000,000, the same level as in 

fiscal year 2016. These grants are crucial for States because they 

provide enough flexibility necessary to resolve any emerging health 

issues at the local level while tailoring those activities to best address the diverse, complex, and constantly changing local community. 

Underground Mine Safety.—The Committee appreciates the requested timeline submitted by CDC and continues to support a replacement facility for the Lake Lynn Experimental Mine and Laboratory. The Committee directs CDC to utilize prior-year funding 

for the planning and design, land acquisition, construction, and 

equipping of the replacement facility. No later than 180 days after 

enactment, the CDC shall submit a detailed update of its activities 

to date to replace the Lake Lynn facility and accompanying plan 

to complete the timely acquisition of a replacement facility to the 

Committees on Appropriations of the House of Representatives and 

the Senate. 

The Committee does not include bill language requested by the 

administration to provide additional transfer authority to the Director beyond that which is already provided to the Secretary. 

NATIONAL INSTITUTES OF HEALTH

The National Institutes of Health [NIH] is the global leader in medical research. The Committee provides $34,084,000,000 for NIH 

activities within the jurisdiction of this bill, an increase of 

$2,000,000,000, or 6.3 percent, above fiscal year 2016. This includes 

$857,000,000 in transfers available under section 241 of the PHS 

Act. The Committee continues a reform to section 241 allocations 

such that no NIH funding will be removed from NIH under this authority. This reform ensures that section 241 transfers are a benefit to NIH rather than a liability. In addition, it improves the 

transparency of NIH’s budget, so that the enacted total is truly the 

amount the Committee expects to be used for biomedical research. The Committee recommendation provides $300,000,000 in fiscal 

year 2017 from the Department’s Nonrecurring Expenses Fund 

[NEF]. Bill language is included to repurpose this portion of the 

NEF, created in fiscal year 2008, for biomedical research activities 

at the NIH. 

The Committee continues its commitment to funding research on 

Alzheimer’s disease and increases funding by $400,000,000 to a 

total of approximately $1,391,000,000 in fiscal year 2017; increases 

funding for the Precision Medicine Initiative by $100,000,000; increases funding for antibiotic resistance research by $50,000,000; 

and increases funding for the BRAIN Initiative by $100,000,000. In 

addition, funding is provided to ensure that every Institute and 

Center receives an increase above fiscal year 2016 to continue in-
82 

vestments in innovative research that will advance the fundamental knowledge and speed the development of new therapies, 

diagnostics, and preventive measures to improve the health of all 

Americans. Revolutionary discoveries often come from unexpected, 

untargeted research. The Committee continues to support these 

basic advances as well as the clinical and translational research 

that moves basic discoveries from ‘‘bench-to-bedside.’’ 

NATIONAL CANCER INSTITUTE

Appropriations, 2016 ............................................................................. $5,213,509,000 

Budget estimate, 2017 ........................................................................... 5,097,287,000 

Committee recommendation ................................................................. 5,429,769,000 

The Committee recommendation includes $5,429,769,000 for the 

National Cancer Institute [NCI]. Of this amount, $50,000,000 is 

available for repairs and improvements to the NCI facility in Frederick, Maryland. 

Biospecimen Resource Locator.—The Committee appreciates that 

the NCI has developed and supports the Specimen Resource Locator, a searchable database of biospecimen collections. The Committee also appreciates that pediatric cancer biospecimen resources 

are included within the Specimen Resource Locator, and requests 

an update from NCI on pediatric cancer biospecimen collections in 

the fiscal year 2018 CJ. 

Breast Cancer.—Recent advances in breast cancer screening include the introduction of digital mammography [DM] and magnetic 

resonance imaging [MRI] for women at high risk for breast cancer. 

A new technology available for breast cancer screening, 

tomosynthesis [TM], is FDA-approved and being adopted as the 

‘‘standard of care’’ in some markets. Limited trial results to date 

show a strong reduction in false positives and a trend toward more 

cancers diagnosed with TM than with DM. The Committee recommends NCI continue its vital research to help provide breast 

cancer patients and their physicians with a clear, informed picture 

of the role of breast cancer imaging. The Committee encourages 

NCI to conduct a 5-year, large cohort study exploring the validity 

and merits of TM and how it compares to other forms of imaging. 

Cancer Kinome and Ovarian Cancer.—The Committee is aware 

that research into the role of kinases-enzymes in the human genome that regulate an immense variety of cellular function-holds 

the promise to drive the development of new treatments and cures 

for a variety of cancers, including ovarian cancer. NCI is encouraged to support research in this area. 

Cancer and Mitochondria.—The Committee commends NCI for 

its work in establishing a Mitochondrial Model Organisms and Cellular Systems Working Group and for its work to identify needs, 

barriers, and opportunities pertaining to mitochondrial biology relevant to addressing mechanistic questions in cancer. The Committee encourages NCI to continue to support research studies that 

examine the mechanisms by which cancer cells utilize oxidative 

stress in stromal cells to fuel their growth. 

Colorectal Cancer and Inflammatory Bowel Diseases.—The Committee recognizes that left untreated, inflammatory bowel diseases 

can advance to colorectal cancer. The Committee encourages addi-
83 

tional research on the developmental pathway of colorectal cancer 

among patients with IBD. 

Deadliest Cancers.—While overall cancer incidence and death 

rates are declining, the Committee is concerned that there are a 

group of cancers, defined in statute as recalcitrant cancers, whose 

5-year survival rates remains below 50 percent. The Committee applauds the NCI for launching its Molecular Analysis for Therapy 

Choice [MATCH] study, a potentially ground-breaking trial that 

analyzes patients’ tumors to determine whether they contain genetic abnormalities for which a targeted drug exists and assigns 

treatment based on the abnormality. The Committee was pleased 

to learn that a goal of MATCH is to ensure patients with rare cancers represent at least 25 percent of the enrollees in the trial. 

Given the growing toll recalcitrant cancers take on society, and the 

enormous potential MATCH offers for our Nation’s deadliest cancers, the Committee strongly urges NCI to continue to prioritize 

rare cancers within the MATCH trial. 

Cancer and Hereditary Hemorrhagic Telangiectasia [HHT].— HHT is a genetic disorder of the blood vessels, and one variation 

of the disorder, HHT1, is characterized by deficiency in endoglin, 

an angiogenic protein. Recent research has indicated improved survival outcomes for cancer patients who also have HHT1. The Committee encourages NCI to support research investigating whether 

reduced systemic endoglin levels, expected in patients diagnosed 

with HHT1, impacts clinical outcomes for cancer. The Committee 

requests an update in the fiscal year 2018 CJ on the status of research related to this topic. 

Early Detection.—The Committee is pleased to support the NCI’s 

goal of increasing early detection research. Early detection is an 

important means to saving lives and reducing the need for systemic 

treatments which have long-term side effects for many patients. 

Immunotherapy.—Recent NCI research demonstrates that new 

cancer immunotherapy approaches that specifically attack tumor 

cells with characteristics unique to a certain cancer could be effective against a wide range of cancers. The Committee encourages 

NCI to further explore new interventions, such as immunotherapy, 

as a promising new treatment strategy for children with cancer. 

Liver Cancer.—The Committee notes that the number of liver 

cancer cases has more than tripled since 1980 and the death rate 

for this cancer has continued to increase. The Committee continues 

to be concerned with the increasing incidence of liver cancer and 

its low 5-year survival rate. Therefore, the Committee encourages 

NCI to continue to support liver cancer research across its portfolio, including research focused on the development of biomarkers 

to serve as early detection markers of cancer to offer the prospect 

of improved outcomes. 

Melanoma.—Melanoma is the most responsive tumor type to the 

new generation of immune therapies. As many phase 3 trials-the 

essential platform to provide high quality annotated biospecimens 

for biomarker discovery-are launched under the aegis of the NCI, 

and industry has specimens that have not been fully analyzed, the 

Committee urges a coordinated effort to analyze biospecimens 

across NCI and industry trials and treatment type with the most 

advanced technologies. The current Exceptional Responders Initia-
84 

tive has been focused primarily on chemotherapy which has been 

proven to be ineffective in improving outcomes for the majority of 

patients with melanoma. This initiative could be extended to exceptional responders to targeted therapies and/or immunotherapies. 

The Committee continues to encourage efforts to use advances in 

genomic, proteomic, and digital imaging technologies for early detection, research to understand genetic changes that occur in 

melanogenesis and mechanisms that underlie clinical dormancy to 

provide effective means of preventing recurrence. The Committee 

requests an update on these requests in the fiscal year 2018 CJ. 

Metastatic Brain Tumor Research.—The incidence of metastatic 

brain tumors has been increasing, largely due to the fact that more 

Americans are surviving and living longer after treatment for other 

cancer diagnoses. While the increased incidence is a significant 

cause of concern, brain metastases are often treatable if diagnosed 

in a timely manner. The Committee encourages NCI to continue to 

involve stakeholders in the brain tumor community in its research 

efforts to develop strategies that improve our understanding of the 

molecular basis for cancer metastasis to the brain, detection 

through enhanced imaging, early intervention, and treatment. 

Military Hospitals and Cancer Centers Collaboration.—The Committee is aware that formal alliances between American military 

hospitals and NCI-designated cancer centers would provide an 

ideal context to facilitate research on the causes, prevention, and 

treatment of cancer in military personnel and their families. The 

Committee encourages NCI to explore opportunities for collaborative clinical research efforts between American military hospitals 

and NCI-designated cancer centers. The Committee urges NCI to 

focus on populations with significant health disparities, including 

multiethnic populations. 

Ovarian Cancer.—The Committee notes that despite scientific 

advancements, ovarian cancer remains the fifth most prevalent disease for women with 5-year survival rates still below 50 percent. 

The Committee encourages NCI to continue to support clinical 

trials with emerging genomics-driven immunotherapies applied to 

human ovarian cancer, with particular emphasis on treatments 

that target the molecular characteristics of each tumor. The Committee requests an update in the fiscal year 2018 CJ. 

Pancreatic Cancer.—The Scientific Framework for Pancreatic 

Ductal Adenocarcinoma [PDAC] made four important recommendations for expanding pancreatic cancer research: understanding the 

biological relationship between PDAC and diabetes mellitus; evaluating longitudinal screening protocols for biomarkers for early detection of PDAC and its precursors; studying new therapeutic strategies in immunotherapy; and developing new treatment approaches 

that interfere with RAS oncogene-dependent signaling pathways. 

The Committee looks forward to receiving the fiscal year 2018 CJ 

to learn how the specific recommendations included in the report 

are being implemented. 

Pediatric Cancer.—The Committee remains concerned that pediatric cancers remain the leading cause of death by disease past infancy among children in the United States, and that the majority 

of childhood cancer survivors suffer from late effects of cancer 

treatment. The Committee strongly encourages NCI to bolster pedi-
85 

atric cancer research and clinical trials. The Committee urges NCI 

to continue key investments in pediatric oncology research, including clinical studies for children with brain tumors, development of 

the novel pediatric MATCH study, and the important pediatric preclinical testing program evaluating new agents for treating pediatric malignancies. Further, the NCI Director is urged to conduct 

research related to the needs, outcomes, health disparities, and 

barriers of pediatric cancer survivors, with an emphasis on minority or other medically underserved populations. The Committee requests an update 90 days after enactment of this act on specific pediatric cancer initiatives as well as how general cancer research 

will benefit pediatric cancer activities. In addition, the Committee 

expects a further update to be included in the fiscal year 2018 CJ 

on how the NCI is focusing on the unique needs of children. 

Precision Medicine.—The Committee continues to strongly support NCI’s PMI, and provides $70,000,000 to continue its efforts to 

develop effective patient-specific treatments that target the disease’s genetic and molecular abnormalities. NCI has made significant progress in changing the way we understand cancer, advances 

that have and are producing massive amounts of new data. To 

make the fullest use of all of this information, NCI has committed 

resources to launch the Genomic Data Commons to stimulate sharing of information among researchers, and is evaluating the expansion of existing databases and other approaches to data sharing 

with the NCI cloud pilots. NCI and the broader research community recognize that the need for data integration and manipulation 

to make full use of these massive cancer datasets not only entails 

investment in open data hosting, but requires significant investments in scalable, interactive data management that combines imaging, clinical, and molecular datasets. It also requires further data 

standards development to enable discovery, increase accessibility, 

improve interoperability, and promote data reuse and reproducibility, as well as resolve uncertainty in technical variation that 

can arise from different approaches in sample storage, acquiring 

biomaterial, and choices in computational pipelines. It is hoped 

that open sharing on this scale, accessible for research, clinical decision making, and drug development, will accelerate understanding—and more effective treatments—for many cancers. The 

Committee directs NCI to provide a plan, developed in collaboration with its external partners, to the Committee 6 months after 

enactment of this act outlining its efforts to address these questions to effectively build a cancer genomics data ecosystem that enables and promotes data sharing, including schedule and cost estimates. Finally, the Committee notes the importance of NCI clinical 

trials in the area of immuno-oncology. The Committee encourages 

NCI to engage leaders in this emerging field to utilize the network 

of existing comprehensive cancer centers and the National Clinical 

Trials Network to aggressively develop new therapies through clinical trials using engineered T-cells, coordinated research strategies, 

and training initiatives for broad application. Of particular interest 

is the use of precision medicine to develop therapies for late stage 

and other cancers where conventional treatments have proved 

largely ineffective. 
86 

Prostate Cancer.—The Committee is aware of NCI’s ongoing investment in prostate cancer research, and encourages further efforts into treatments for men with advanced disease as well as diagnostic and imaging methodologies common in other hormonedriven cancers with similar disease burden. The Committee encourages NCI to coordinate its response to these needs with other Federal agencies, and collaborators as appropriate, including the Department of Defense, as well as private research foundations and 

advocacy groups. 

Psycho-Social Distress Complications.—According to the Institute 

of Medicine, nearly 50 percent of all cancer patients experience distress. Further, studies suggest that distress in cancer patients 

leads to higher healthcare costs, less compliance with treatment 

pathways, and poorer health outcomes. While significant advancements have been made in biomedical treatments in cancer care, the 

Committee is concerned that the unaddressed psycho-social needs 

of patients are adversely impacting the effectiveness and cost of 

care, as well as the individuals’ overall well-being. The Committee 

encourages NCI to implement distress screenings in the NIH Clinical Center and in NCI-funded clinical trials as appropriate. 

Radiation Oncology.—It is increasingly evident that combination 

therapy-involving radiation therapy, surgery, chemotherapy, 

immunotherapy and/or precision therapy-provides the best treatment options for many cancer patients. The Committee applauds 

the recent funding announcement for Cooperative Agreements to 

Develop Targeted Agents for Use with Systemic Agents Plus Radiotherapy and supports the NCI’s prioritization of breaking down the 

existing silos, fostering a collaboration of the best scientists in farreaching fields. 

Sleep Health and Cancer.—The Committee understands the complex intersection between sleep health and cancer development, 

cancer progression, and remission. The Committee encourages NCI 

to explore the role of sleep in cancer development and progression. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2016 ............................................................................. $3,115,538,000 

Budget estimate, 2017 ........................................................................... 3,069,901,000 

Committee recommendation ................................................................. 3,242,685,000 

The Committee recommendation includes $3,242,685,000 for the 

National Heart, Lung, and Blood Institute [NHLBI]. 

Asthma.—The Committee applauds NHLBI for its efforts to develop better treatments to manage severe asthma as part of the 

Precision Medicine Initiative, and urges the NHLBI to expand 

these efforts. 

Cardiovascular Disease [CVD].—The Committee is aware that for 

certain disease areas, like CVD, rural States and their respective 

patient populations have disproportionately high incidence. In the 

case of cardiovascular disease, high rates of obesity, diabetes, and 

smoking among rural populations create much higher risks for 

acute cardiovascular disease. While the NHLBI has the primary 

lead for research in CVD, other Institutes that include emphasis on 

children or bioengineering have important secondary roles in helping to generate positive research outcomes to combat this disease 

area. For this reason, the Committee urges the NIH to consider 
87 

convening a cross disciplinary, multi-Institute effort to identify 

ways to include rural populations in research and to work with institutions located in heavily rural States. 

Chronic Obstructive Pulmonary Disease [COPD].—The Committee notes NHLBI’s collaboration with the CDC in the development of a COPD action plan and is pleased with the stakeholder 

town hall meeting held recently on the NIH campus to advance its 

completion. The Committee expects CDC and NIH to work together 

to complete the action plan on a timely basis and report bi-annually on the implementation of the plan’s recommendations. Further, 

the Committee remains aware and concerned that Alpha 1 

Antitrypsin Deficiency [Alpha 1] is a major genetic risk factor for 

developing COPD. The Committee, therefore, encourages NHLBI to 

continue to advance Alpha 1 research as part of the overall plan. 

Congenital Heart Disease [CHD].—The Committee commends the 

NHLBI for its continued work to better understand causation and 

appropriate treatment needs for those with the most life threatening congenital heart defects through its biomedical research program ’Bench to Bassinet’ and the critical multi-centered infrastructure of the Pediatric Heart Network. The Committee urges NHLBI 

to continue its work with other Federal agencies and professional 

and patient organizations to expand collaborative research initiatives and other related activities targeted toward prevention and 

treatment of the diverse lifelong needs of children and adults living 

with CHD. 

Cystic Fibrosis [CF].—The Committee encourages advancement 

of cell-based tools to advance new therapies to patients based on 

an individual’s specific CF-causing mutation. These tools may be 

used to develop new personalized approaches to CF therapeutics, 

including new means to identify and characterize the efficacy of 

multidrug therapies that address the mutant CFTR protein, which 

is the underlying cause of CF in the majority of those with the disease. In particular, the Committee supports research into nonsense 

mutations for CF, which truncate the creation of CFTR protein in 

about 10 percent of the CF population and contribute to thousands 

of other genetic diseases. In addition, the Committee urges further 

research into live cell imaging modalities that are able to characterize mucus and monitor mucociliary clearance, the defense mechanisms at the heart of CF, and many other respiratory diseases. 

The Committee encourages funding for new technologies aimed at 

the genetic repair of cystic fibrosis. This includes technologies for 

gene editing, lung stem cell biology and nucleic acid delivery. Such 

technologies are critical for developing therapies to reach all CF patients, especially those with mutations that are not amenable to 

protein manipulation with CFTR modulating therapies. 

Fibrotic Diseases.—The Committee encourages NIH to continue 

to vigorously support research into fibrotic diseases affecting different organs, including the lung, liver, kidney, heart, and skin, 

and to ensure enhanced coordination between its Institutes as they 

conduct necessary, expanded single organ or cross-organ fibrotic 

disease research to save lives and reduce healthcare expenses in future budget years. Furthermore, the Committee encourages NIH to 

explore the creation of a trans-NIH fibrotic disease working group, 

which would bring together key stakeholders at the NIH and else-
88 

where, to evaluate current research efforts and develop strategic 

paths forward to maximize efforts in fibrotic disease research. The 

Committee also directs NIH to include an update in its fiscal year 

2018 CJ on its work relating to idiopathic pulmonary fibrosis following the November 2012 NHLBI workshop, ‘‘Strategic Planning 

for Idiopathic Pulmonary Fibrosis.’’ 

Heart Disease.—The Committee is aware of the enormous and 

growing burden heart disease inflicts on our Nation’s population 

and economy, particularly as the population ages, and strongly encourages NIH to increase its heart research investment commensurate with the impact on public health and scientific opportunities. 

The Committee looks forward to receiving details on the Institute’s 

strategic vision for heart research. 

Hemophilia.—The Committee encourages NHLBI to include rare 

diseases such as hemophilia in its work through the Precision Medicine Initiative. For patients with hemophilia, there is wide variation in disease severity and therapeutic outcomes not readily explained by the disease-causing gene mutations. Genome-wide studies would yield new insights into the pathogenesis of hemophilia 

and patient responses to therapies, benefiting patients with bleeding disorders and broader patient communities. 

Lung Disease.—The Committee applauds NHLBI’s efforts on primary lung disease prevention, from prenatal lung development 

through the aging process. The Committee requests that NHLBI 

report on its efforts to prevent lung disease, which is now the third 

leading cause of death in the United States, in the fiscal year 2018 

CJ. 

Lymphangioleiomyomatosis [LAM].—The Committee remains 

very interested in efforts to find a cure for LAM, a progressive and 

often fatal lung disease in women. The Committee supports both 

intramural and extramural means of expanding research on LAM 

and urges NHLBI to use all available mechanisms as appropriate 

to stimulate a broad range of clinical and basic research. The Committee commends NIH for supporting multi-center LAM trials and 

encourages additional support of such trials. 

Pulmonary Hypertension [PH].—The Committee applauds 

NHLBI for leading research efforts that have helped prolong life for 

individuals affected by PH. NHLBI is encouraged to further study 

the underlying mechanisms of PH, particularly idiopathic pulmonary arterial hypertension, so that additional gains can be made 

that benefit patient health and wellness. 

Sickle Cell Disease [SCD].—The Committee encourages NHLBI 

to devote more research to the study of SCD. Academic medical 

centers located in States with significant populations of sickle cell 

patients have made progress in treating the disease through NIHsponsored clinical trials and through blood and marrow transplantation, which is currently the only therapy that can cure the disease. However, more focused research is needed to augment the 

limited treatment options available. The Committee notes recent 

advances in treatment of SCD and urges the Institute to support 

clinical trials for prenatal and postnatal treatment of SCD, which 

includes multiple promising approaches to eradicate the disease, 

save lives, and reduce dramatically the substantial health care 

costs associated with SCD for children and adults. 
89 

Sleep Phenotypes.—The health consequences of sleep disorders 

such as obstructive sleep apnea and insomnia include increased 

risk of hypertension, cardiovascular disease and obesity. The Committee is encouraged by NHLBI’s efforts to improve our understanding of sleep disorders and urges NHLBI to partner with other 

NIH Institutes to continue advancing research for sleep phenotypes 

and biomarkers that further explore health disparities and the 

intersection between chronic diseases and sleep. 

Thoracic Aortic Disease.—The Committee is concerned by sudden, preventable death caused by thoracic aortic aneurysm and dissection attributed to structural cardiovascular disorders, such as 

Marfan syndrome, and encourages NHLBI to further study the 

mechanisms of disease and opportunities to improve patient health. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2016 ............................................................................. $413,396,000 

Budget estimate, 2017 ........................................................................... 404,560,000 

Committee recommendation ................................................................. 430,544,000 

The Committee recommendation includes $430,544,000 for the 

National Institute of Dental and Craniofacial Research [NIDCR]. 

Dental Materials.—Biomaterials is an important section of biomedical research for practicing dentists. The Committee urges 

NIDCR to continue to invest in the development and innovation of 

dental materials. 

Overlapping Pain Conditions.—The Committee commends the 

NIDCR for its ongoing support for the Orofacial Pain Prospective 

Evaluation and Risk Assessment program, which is yielding valuable information on many physiological aspects of 

temporomandibular disorders and overlapping pain conditions. The 

Committee encourages continued research on overlapping pain conditions and increased collaboration across NIH Institutes on epidemiological, basic, clinical and translational research related to pain 

conditions. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

Appropriations, 2016 ............................................................................. $1,816,310,000 

Budget estimate, 2017 ........................................................................... 1,786,086,000 

Committee recommendation ................................................................. 1,891,652,000 

The Committee recommendation includes $1,891,652,000 for the 

National Institute of Diabetes and Digestive and Kidney Diseases 

[NIDDK]. 

Asian Americans and Diabetes.—The Committee supports targeted research to examine the physiological differences between 

Asian Americans and other populations affected by diabetes with 

the goal of establishing appropriate indices for risk and disease detection, including a specific Body Mass Index cut point to identify 

Asian Americans with, or at risk for, future diabetes. 

Autism.—The Committee urges NIDDK to study the relationship 

between GI diseases and Autism Spectrum Disorders. 

Biomarkers.—The Committee encourages NIDDK to accelerate 

the discovery and validation of biomarkers to aid in designing and 

conducting clinical trials to prevent, treat, and cure type 1 diabetes. The Committee also encourages NIDDK to work with NIAID 
90 

to develop biomarkers specifically related to immune interventions 

for multiple autoimmune diseases, including type 1 diabetes. 

Celiac Disease and Type 1 Diabetes.—The Committee is encouraged by the TEDDY study which has led to discoveries in the risk 

for pediatric celiac disease and the development of type 1 diabetes. 

The Committee urges the Institute to explore the intersection of 

type 1 diabetes with celiac disease prevention. 

Diabetes.—The Committee recognizes the important work of 

NIDDK, the lead Federal agency conducting research to find a cure 

for diabetes and improve diabetes care. The Committee recognizes 

the success of NIDDK-supported research in the development of essential tools to manage diabetes, including insulin pumps and 

blood glucose monitors, ongoing development of artificial pancreas 

technologies, and new and better medications to treat diabetes. The 

Committee urges NIDDK to commit resources commensurate with 

the severity and escalating costs of the epidemic to further diabetes 

research that will build upon these past successes, improve prevention and treatment, and bring the Nation closer to a cure. 

Gestational Diabetes.—The Committee recognizes the importance 

of research funded by the NIDDK related to gestational diabetes, 

a disease affecting up to 9.2 percent of all pregnant women. Given 

that both women with gestational diabetes and their babies face 

long-term health consequences as a result of the disease, such as 

increased risk of developing type 2 diabetes, the Committee urges 

NIDDK to explore additional opportunities for research on gestational diabetes. 

Inflammatory Bowel Disease Genetics Consortium.—The Committee is pleased by NIDDK’s work on the Inflammatory Bowel 

Disease Genetics Consortium and supports this ongoing initiative. 

The Committee also urges NIDDK to expand its portfolio on pediatric IBD research through existing and new initiatives. 

Interstitial Cystitis.—The Committee is pleased that the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research 

Network is leading to novel and multidisciplinary efforts to study 

interstitial cystitis and has the potential to have a particularly 

positive impact on women’s health. 

Irritable Bowel Syndrome [IBS].—The Committee is encouraged 

by the work of NIDDK to explore symptoms of IBS among various 

patient populations and urges NIDDK to further explore the etiology of IBS and the efficacy of treatments for IBS symptoms. 

Liver Disease.—The Committee continues to be concerned by the 

morbidity and mortality of Hepatitis C-related liver disease and the 

development of cirrhosis, liver failure, and liver cancer in chronically infected persons with viral hepatitis. The Committee urges 

NIDDK to enhance multi-Institute collaborations on liver research 

to understand these diseases. The Committee encourages NIDDK 

and NIAID to collaborate research efforts in this area. 

Medical Foods.—The Committee is encouraged by the opening of 

a new Office of Nutrition Research. The Committee requests the 

Office develop research initiatives that explore the impact of medical foods on nutrition and digestive disease management. 

Pancreatitis and Pancreatic Cancer.—The Committee is encouraged by NIDDK’s consortium for the Study of Chronic Pancreatitis 

Diabetes and Pancreatic Cancer in collaboration with NCI. The 
91 

Committee urges additional efforts to utilize the diverse data of patients within the consortium in precision medicine to inform targeted treatment and prevention. 

Pediatric Kidney Disease.—The Committee is encouraged by 

NIDDK’s plans to conduct pilot studies of candidate therapies for 

Pediatric Chronic Kidney Disease. These studies will further optimize study designs for larger trials of new pediatric chronic kidney 

disease treatments. Further, the Committee continues to support 

NIDDK efforts to work collaboratively with other NIH Institutes, 

including the NICHD and NHLBI, to encourage multi-disciplinary 

research for children and young adults with kidney disease. Such 

collaborative efforts will aid in identifying childhood antecedents of 

chronic kidney disease, including modifiable risk factors that could 

be critical to developing interventions for pediatric kidney disease. 

Psychosocial Issues and Chronic Disease Management.—People 

with chronic diseases have an elevated risk of psychosocial issues 

such as depression, anxiety, and eating disorders. These issues correlate with an increase in negative outcomes for disease management. The Committee urges NIDDK to devote resources toward investigating the psychosocial burdens related to chronic diseases, 

particularly as it relates to type 1 diabetes, and identify steps that 

can be taken to help improve disease management. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2016 ............................................................................. $1,695,180,000 

Budget estimate, 2017 ........................................................................... 1,659,416,000 

Committee recommendation ................................................................. 1,803,306,000 

The Committee recommendation includes $1,803,306,000 for the 

National Institute of Neurological Disorders and Stroke [NINDS]. 

Amyotrophic Lateral Sclerosis [ALS].—The Committee strongly 

supports NIH’s research in ALS and encourages NIH to continue 

to support promising ALS research related to IPS cells, whole genome sequencing, biomarkers, precision medicine, natural history 

studies, and translational research that could help identify new 

treatments for the disease. NIH is encouraged to partner with ALS 

organizations and other Federal agencies and programs, including 

the ALS Research Program at DOD, the VA, and the National ALS 

Registry at CDC/ATSDR. The Committee further encourages NIH 

to work with FDA, industry, and other stakeholders to identify opportunities to inform and advance the development of treatments 

for ALS, particularly how the NIH can support Phase II and Phase 

III clinical trials in ALS. 

Cerebral Cavernous Angioma.—The Committee urges HHS agencies [NIH, FDA, and CDC] to work together with the research and 

advocacy community to increase the efficiency and effectiveness of 

the research and clinical drug trials effort. 

Cerebral Palsy [CP].—Over 800,000 Americans are impacted by 

CP and currently there are no identified best practices at diagnosis 

or through the lifespan, organized standards of care, CP Registry, 

or proven therapy protocols. The Committee commends NINDS for 

working with scientists and stakeholders to develop a 5-year, research-focused strategic plan for CP prevention, treatment, and 

cure through the lifespan. The Committee urges NINDS, working 

with other relevant NIH ICs, to strengthen research efforts in sup-
92 

port of the strategic plan to advance basic and translational research for CP, as well as clinical efforts to improve outcomes of diverse impairments and health issues on functioning, participation 

and well-being across the lifespan. 

Duchenne Muscular Dystrophy.—The Committee recommends 

NINDS consider strategies that could lead to the development of 

combinatorial therapies for Duchenne Muscular Dystrophy. The 

Committee supports facilitating clinical trial readiness and establishing research infrastructure needed to conduct high-quality, efficient trials in Duchenne alongside efforts to improve performance 

of clinical trial endpoints and develop and validate biomarkers of 

the disease. The Committee also recognizes that there have been 

significant scientific advances in exon skipping technology since the 

2010 NIH/FDA meeting and urges the NIH, in coordination with 

the FDA and other agencies, to conduct a Duchenne follow-on 

meeting to examine the current state of the science of exon skipping and targeted therapeutics. 

Lyme Disease.—With over 300,000 individuals suffering from 

Lyme disease, especially in rural States across the United States, 

an improved understanding of the disease is essential to the health 

and wellbeing of Americans. In patients who suffer from long-term 

complications associated with Lyme disease, clear treatment pathways are often missed as a result of inaccurate and incomplete 

testing. The Committee urges the NINDS, in coordination with 

CDC, to study the long-term effects of Lyme disease. Specifically, 

the Committee urges NINDS to evaluate the effectiveness of laboratory tests associated with the detection of Borrellia burgdori to 

diagnose the disease early, which can improve the effectiveness of 

treatment. 

Parkinson’s Disease.—The Committee commends NINDS for taking critical steps in identifying priority research recommendations 

to advance research on Parkinson’s disease, which impacts between 

500,000 and 1,500,000 Americans and is the second most prevalent 

neurodegenerative disease in the United States. The Committee 

recognizes that NINDS is prioritizing public health concerns with 

severe gaps in unmet medical needs and supports the research recommendations set forth by the NINDS planning strategy to bring 

us closer to better treatments and a cure for Parkinson’s disease. 

The Committee also encourages NINDS to submit an update of its 

progress on implementing these recommendations in the fiscal year 

2018 CJ. 

Peripheral Neuropathies.—The Committee notes the lack of ongoing research into Guillain-Barre syndrome, chronic inflammatory 

demyelinating polyneuropathy, and related conditions, and encourages NINDS to work with stakeholders to identify research needs 

and develop strategies for supporting critical projects. 

Stroke.—The Committee recognizes the immense burden stroke 

places on our Nation’s population and economy, and strongly support NINDS increase its stroke research efforts. NINDS is also encouraged to continue to implement top priorities identified in the 

2012 planning initiative for stroke prevention, treatment, and recovery research, particularly augmentation of the Stroke Clinical 

Trials Network, including early stroke recovery. 
93 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2016 ............................................................................. $4,715,697,000 

Budget estimate, 2017 ........................................................................... 4,700,548,000 

Committee recommendation ................................................................. 4,961,305,000 

The Committee recommendation includes $4,961,305,000 for the 

National Institute of Allergy and Infectious Diseases [NIAID]. 

Autoimmune Neuropathies.—The Committee encourages NIAID 

to work with NINDS and other ICs to support efforts to gauge the 

state-of-the-science of autoimmune neuropathies research into conditions like Guillain-Barre syndrome and chronic inflammatory 

demyelinating polyneuropathy, and to establish a cross-cutting research plan for this portfolio. 

Combating Antibiotic Resistant Bacteria [CARB].—With the identification of the first case of CRE in the United States last month, 

the Committee remains deeply concerned by the threat posed by 

the rise of antibiotic resistant bacteria. The Committee continues 

to strongly support NIAID’s work related to CARB and includes approximately $463,000,000, an increase of $50,000,000, for NIAID to 

expand efforts to develop new antibiotics and rapid diagnostic tests, 

and build a national genome sequence database on all reported resistant human infections. Critical to the success of these efforts is 

developing a comprehensive understanding of the biological mechanisms that cause or contribute to antibiotic resistance, both in 

terms of resistance due to human activity or by inherent natural 

processes. This fundamental knowledge will enhance efforts to responsibly steward existing antibiotics, develop new antibiotics, and 

repurpose current antibiotics in new ways or combinations. The 

Committee encourages NIH and FDA to convene industry and 

other stakeholders to develop strategies to augment and enhance 

the infrastructure supporting clinical trials of new antibiotics.μThe 

Committee also encourages NIH to continue and expand its collaboration with USDA and CDC to develop a research strategy to promote a fundamental understanding of antibiotic resistance and improving the responsible use of antibiotics in agriculture. The Committee requests an update on these activities in the fiscal year 

2018 CJ. 

Healthcare-Associated Infections [HAIs].—HAIs are estimated to 

occur in 5 percent of all hospitalizations in the United States, resulting in more than 1,700,000 illnesses and 99,000 deaths annually. While HHS has been leading efforts to develop and encourage 

hospitals to implement improved infection control strategies, potential solutions are complicated by the difficulty of removing dangerous pathogens, including multidrug-resistant organisms, from 

the clinical environment by disinfection protocols alone. The Committee has been encouraged by the progress made in reducing central line-associated bloodstream infections and methicillin-resistant 

Staphylococcus aureus bacteremia, but there has been little or no 

improvement since 2009 in, for example, the rates of catheter-associated urinary tract infections and colon surgery surgical site infections [SSI]. Clearly, more action is needed at every level of health 

care to eliminate infections that commonly threaten hospital patients. As efforts to develop a systems approach to decontamination 

increase, one of most promising areas of research is related to tech-
94 

nologies that can provide surfaces with self-disinfection capability. 

Advancements in this area could be greatly beneficial to health outcomes, reduce healthcare expenses, and improve patient life-quality. The Committee encourages NIAID to support efforts to accelerate the development of self-disinfecting medical devices, disinfecting strategies to alleviate SSIs, as well as materials engineering approaches to minimize or prevent the transmission of pathogens from surfaces within clinical care environments. 

Hepatitis B.—The Committee is aware that it is now possible to 

study the entire Hepatitis B virus life cycle, and, therefore, a research program to identify life cycle vulnerabilities. The Committee 

encourages NIAID to collaborate with NIDDK to advance innovative research to discover and develop new therapies and treatments 

to interrupt the life cycle of the Hepatitis B virus to eliminate the 

infection and to help cure this deadly disease. 

Hereditary Angioedema [HAE].—The Committee applauds NIAID 

for co-hosting the Expanding Boundaries of our HAE Knowledge 

Conference and supports its focus on continuing HAE research activities moving forward. 

HIV/AIDS.—The Committee appreciates that NIAID has made 

reducing the incidence of HIV/AIDS, including the development of 

safe and effective vaccines, a high priority. The Committee is aware 

of several promising HIV vaccine candidates, including candidates 

that use novel immunogens and vaccine platforms, such as 

cytomegalovirus [CMV]. The Committee supports NIAID efforts to 

advance such innovative and promising vaccine candidates into 

early clinical testing. 

Tuberculosis [TB].—The Committee encourages NIAID to continue prioritizing and implementing the National Action Plan for 

Combating Multi-drug Resistant Tuberculosis, including addressing 

the Plan’s objectives, and coordinating with other TB research 

agency partners including USAID and CDC. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2016 ............................................................................. $2,512,437,000 

Budget estimate, 2017 ........................................................................... 2,434,144,000 

Committee recommendation ................................................................. 2,633,755,000 

The Committee recommendation includes $2,633,755,000 for the 

National Institute of General Medical Sciences [NIGMS], which includes $857,000,000 in transfers available under section 241 of the 

PHS Act. 

Institutional Development Award [IDeA].—The Committee provides $333,361,000 for the IDeA program, an increase of 

$13,277,000. The IDeA program continues to support high-quality 

research throughout the country and enhances the competitiveness 

of investigators at institutions located in States in which the aggregate success rate for NIH grants has been historically low. Discoveries and medical breakthroughs can come from anywhere, and the 

Committee continues to strongly support the IDeA program, particularly its focus on serving rural and medically underserved communities in IDeA States. In particular, the Committee is concerned 

that many institutions eligible for funding under the National 

Science Foundation’s Experimental Program to Stimulate Competitive Research [EPSCoR] are ineligible to participate in the IDeA 
95 

program. The Committee directs NIGMS to report to the Committee no later than 120 days after enactment of this act with updated IDeA eligibility criteria that would incorporate EPSCoR 

States into the IDeA program. 

Science Education Partnership Awards [SEPA].—SEPA fosters 

important connections between biomedical researchers and K–12 

teachers and their students. These connections establish an education pipeline to careers in biomedical sciences, which is one of the 

most important areas of workforce development for the U.S. economy. Therefore, NIH is directed to continue funding the SEPA program at no less than $17,100,000, the fiscal year 2016 level. Further, because of the central role NIGMS plays in managing programs that support the development of the biomedical research 

workforce, the Committee transfers the SEPA program from OD to 

NIGMS. 

Small Business Research Funding.—The Committee supports the 

initiative to direct small business research funding to IDeA States 

to foster the development of products to advance public health. The 

Committee asks NIGMS to consider allocating funding for one 

shared innovation incubator in each of the four IDeA regions that 

would be competitively bid among IDeA States and would serve 

IDeA States. NIH shall not use funding from its IDeA allocation for 

these grants. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT

Appropriations, 2016 ............................................................................. $1,338,348,000 

Budget estimate, 2017 ........................................................................... 1,316,607,000 

Committee recommendation ................................................................. 1,395,811,000 

The Committee recommendation includes $1,395,811,000 for the 

Eunice Kennedy Shriver National Institute of Child Health and 

Human Development [NICHD]. 

Demographic Research.—The NICHD Population Dynamics 

Branch fosters scientific understanding of changes in human health 

and development at the population level by supporting research 

and research training in demography—the scientific study of 

human populations—and reproductive health. The Committee 

urges NICHD to sustain this research by making a strong investment in its Population Dynamics Centers Research Infrastructure 

Program. Further, the Committee supports NICHD’s efforts to 

make wise investments in large-scale longitudinal scientific surveys 

and prioritize data sharing as a condition of award. Making these 

survey data widely available efficiently promotes and supports 

broad-based scientific research activities on health and development. 

Fragile X.—The Committee commends NICHD for leading the effort to map the molecular, physiological, biological, and genetic connections between fragile X [FX], and the fragile X protein, and autism spectrum disorder. 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 urges the NICHD to explore ways to utilize funding for 

FX and autism in tandem to accelerate the pace of research toward 

identification of the commonality between the two conditions and 
96 

the development of disease modifying treatments that will reduce 

health burdens. 

Intellectual and Developmental Disabilities Research Centers 

[IDDRC].—The Committee recognizes the outstanding contributions of the IDDRCs toward understanding why child development 

goes awry, discovering ways to prevent developmental disabilities, 

and discovering treatments and interventions to improve the lives 

of people with developmental disabilities and their families. The 

Committee urges NICHD to continue to support the IDDRCs to 

conduct basic and translational research to develop effective prevention, treatment, and intervention strategies for children and 

adults with developmental disabilities. 

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, taken together, spans the range of discovery, development, and delivery science is needed to identify the causes of premature birth. The Committee urges NICHD to enhance investments in biomedical and clinical research related to the prevention 

of preterm birth and the care and treatment of preterm infants. 

NATIONAL EYE INSTITUTE

Appropriations, 2016 ............................................................................. $707,998,000 

Budget estimate, 2017 ........................................................................... 687,249,000 

Committee recommendation ................................................................. 740,826,000 

The Committee recommendation includes $740,826,000 for the 

National Eye Institute [NEI]. 

Age-Related Macular Degeneration [AMD].—The Committee recognizes NEI’s leadership in identifying more than 500 genes associated with both common and rare eye diseases. NEI’s International 

AMD Genomics Consortium has now discovered a total of 52 genetic variants that are associated with AMD, located among 34 regions of the human genome called loci, 16 of which had not been 

previously associated with AMD. With past NEI-funded research 

solidifying a link between AMD and genes encoding the complement system, a set of proteins that plays a central part in immune responses and inflammation, the Committee anticipates additional findings from initial research that suggest that a class of 

medications used to treat HIV, called nucleoside reverse 

transcriptase inhibitors [NRTIs], shows promise to treat AMD, and 

may be repurposed to treat other inflammatory disorders. 

Audacious Goals Initiative [AG].—The Committee commends 

NEI’s leadership through its Audacious Goals Initiative, which 

aims to restore vision within the next decade through regeneration 

of the retina by replacing cells that have been damaged by disease 

and injury and restoring their visual connections to the brain. The 

Committee is pleased that NEI has awarded the first set of grants 

associated with novel imaging technologies to help clinicians observe the function of individual neurons in human patients and follow them over time as they test new therapies, and will proceed 

with a second round of awards associated with identifying new factors that control regeneration and comparing the regenerative process among model organisms, rodents, and non-human primates. 
97 

Cataract.—The Committee recognizes that clouding of the eye’s 

lens in cataracts is the leading cause of blindness worldwide. It 

commends recent NEI-funded research that reported on the use of 

the fiber optic-based dynamic light scattering technology, developed 

by NASA, to estimate the level of the structural protein alpha-crystalline in the lens every 6 months in patients at risk for cataracts 

over the course of 3 years. This effort confirmed the correlation of 

the loss of protein with the rate of nuclear cataract progression, enabling clinicians to determine cataract progression and a potential 

time to intervene to prevent their formation. The Committee is also 

pleased that a recent NEI study has identified molecules that restore transparency to the lens in animal models, which could lead 

to therapies being delivered by eye drops, thereby eliminating surgery. 

Diabetic Retinopathy Clinical Research Network.—The Committee commends NEI for the collaborative efforts of the Diabetic 

Retinopathy Clinical Research Network. The Committee acknowledges the importance of clinical trial networks and hopes the NEI 

will maintain the Diabetic Retinopathy Clinical Research Network’s commitment to facilitating clinical research on diabetic retinopathy. The Committee strongly encourages the NEI to build on 

the success of the Diabetic Retinopathy Clinical Research Network 

to expand and extend the scope of the network to include other retinal diseases. 

Glaucoma.—The Committee recognizes the identification of three 

new genes by the NEI Glaucoma Human Genetics Collaboration 

Heritable Overall Operational Database Consortium that are 

strongly associated with primary open-angle glaucoma, the most 

common form of the disease. The finding that variants of these 

genes may alter the protection of the optic nerve from degeneration 

due to oxidative stress increases the total number of genes associated with primary open angle glaucoma to 15, demonstrating that 

the underlying mechanisms of the disease may involve the interaction of many genes with environmental influences. 

Usher Syndrome.—The Committee continues to urge the 

prioritization of Usher syndrome research at NEI. The Committee 

requests an update on NEI and NIDCD basic, clinical, and 

translational research that will lead to additional treatment options and improved patient outcomes for individuals with Usher 

syndrome. The update should include a description of the criteria 

used by NIH to evaluate grant submissions to ensure the 

prioritization of those that accelerate human treatment options 

that would benefit individuals with Usher syndrome. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2016 ............................................................................. $693,533,000 

Budget estimate, 2017 ........................................................................... 681,613,000 

Committee recommendation ................................................................. 722,301,000 

The Committee recommendation includes $722,301,000 for the 

National Institute of Environmental Health Sciences [NIEHS]. 

Autism.—The Committee urges the NIEHS, as the lead agency 

on environmental health research and a member agency of the 

Interagency Autism Coordinating Committee [IACC], to ask the 

IACC to consider research on environmental factors related to au-
98 

tism, including onset patterns, in the upcoming revision to the 

IACC Strategic Plan for Autism Research. In addition, as the lead 

NIH Institute on Autism Spectrum Disorders research, the Committee suggests that NIMH work in coordination with NIEHS to 

assure that research on environmental factors continues to be supported. 

Healthy Housing.—The Committee encourages NIEHS to further 

study the impact healthy housing has on reducing environmental 

exposures that lead to health risks such as asthma and lead poisoning. 

NATIONAL INSTITUTE ON AGING

Appropriations, 2016 ............................................................................. $1,598,246,000 

Budget estimate, 2017 ........................................................................... 1,265,133,000 

Committee recommendation ................................................................. 2,067,138,000 

The Committee recommendation includes $2,067,138,000 for the 

National Institute on Aging [NIA]. 

Alzheimer’s Disease.—The bill includes approximately $1,391,000,000, an increase of $400,000,000 above fiscal year 2016, 

for high-quality research on Alzheimer’s disease, subject to the scientific opportunity presented in the peer review process. NIA is encouraged to continue addressing the research goals set forth in the 

National Plan to Address Alzheimer’s Disease, as well as the recommendations from the Alzheimer’s disease Research Summit in 

2015. Further, the Committee recognizes the importance of wellcharacterized, longitudinal, population-based cohort studies in providing new insights into risk factors related to dementia, with special focus on minority populations where disease burden is greatest. 

As the participants in these studies have aged, much has been 

learned about cognitive decline and the role of mid-life risk factors, 

but key challenges remain, particularly in the identification of biomarkers and in understanding the role of environmental versus genetic factors. The Committee directs NIH to support research involving the subsequent generations of such cohorts, as studying the 

adult children of these extensively characterized cohort members 

may provide new insights into risk identification and accelerated 

prevention efforts. In particular, NIA is encouraged to fund a pilot 

program to test community-based clinical trials for the prevention 

of cognitive decline. Such a longitudinal study should include an 

ethnically representative sample, incorporate genomic and environmental Alzheimer’s disease risk factors and monitor cognitive and 

motor function, disability, and morbidity over time. The Committee 

notes that poor sleep health and sleep disorders progress diseases 

that impair cognitive functioning, such as Alzheimer’s disease. The 

Committee encourages support for research that explores the linkages between sleep cycle, cardiovascular system, and Alzheimer’s 

disease, in an effort to inform prevention. Priority consideration 

should be given to applicants with a NIA designated Alzheimer’s 

Disease Center, Alzheimer’s Disease Accelerating Medicines Partnership award, and at least one Patient-Centered Outcomes Research Institute grant. Finally, the Committee is particularly interested in NIH’s plans to place additional emphasis on high-risk, 

high-reward projects using a DARPA-like approach to goal-oriented 

and milestone-driven research. The Committee believes such an ap-
99 

proach can be particularly valuable in addressing major scientific 

gaps and encourages NIH to establish clear priorities, including 

Alzheimer’s disease and dementia and other high-cost diseases of 

aging, particularly given our national goal of preventing and effectively treating Alzheimer’s disease by 2025. 

Demographic Research.—The Committee is greatly concerned by 

the health and financial threats that dementia-related disorders, 

including Alzheimer’s disease, pose as the U.S. population ages. 

NIA is urged to respond by investing in the full spectrum of scientific research, including population research, to address the complex nature of dementia-related disorders and its devastating effects on patients, families, and caregivers. This effort should include sustained investment in large-scale longitudinal studies, such 

as the Health and Retirement Study. The Committee encourages 

NIA to support research and data collection on the causes of widening disparities in health and longevity at older ages, and the role 

of social factors, such as education and income, in the health and 

well-being of older people. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

Appropriations, 2016 ............................................................................. $541,662,000 

Budget estimate, 2017 ........................................................................... 532,753,000 

Committee recommendation ................................................................. 564,131,000 

The Committee recommendation includes $564,131,000 for the 

National Institute of Arthritis and Musculoskeletal and Skin Diseases [NIAMS]. 

Arthritis Disparities.—Research from CDC notes that minority 

groups, including African American and Latino/Hispanic populations, experience higher rates of arthritis-attributable activity 

and work limitations than other populations. The Committee encourages NIAMS to support research to understand these disparities, in collaboration with NIMHD. 

Epidermolysis Bullosa [EB].—The Committee recognizes the 

promising scientific gains made in pursuit of treatments for EB 

and supports the private partners working to advance research towards practical EB treatments. Further research in this area holds 

great promise for both EB and for other skin and connective-tissue 

disorders treatments. The Committee encourages the NIH to continue to support meritorious research and collaboration activities 

related to EB. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

Appropriations, 2016 ............................................................................. $422,936,000 

Budget estimate, 2017 ........................................................................... 416,146,000 

Committee recommendation ................................................................. 441,778,000 

The Committee recommendation includes $441,778,000 for the 

National Institute on Deafness and Other Communication Disorders [NIDCD]. 

Otolaryngology.—The Committee is concerned that research in 

the study of human temporal bone tissues may be jeopardized by 

the loss of technical and pathological expertise in this field. Active 

temporal bone laboratories are largely responsible for the 
100 

pathologic characterizations of many of the diseases that are treated on a frequent basis, including otosclerosis, Meniere’s disease and 

chronic otitis media. However, there are other disorders for which 

the pathology has not been well characterized and the need remains for the active participation of multiple laboratories to develop new techniques to allow for molecular investigations that 

have not been possible in the past. The Committee urges NIDCD 

to work with the otolaryngology community to facilitate new and 

innovative therapies that examine the pathology of the ear and to 

ensure that hypothesis driven research is retained in pathology 

centers. 

Usher Syndrome.—The Committee continues to encourage the 

NIDCD to prioritize Usher syndrome research. The Committee requests an update on NEI and NIDCD basic, clinical, and 

translational research that will lead to additional treatment options and improved patient outcomes for individuals with Usher 

syndrome. The update should include a description of the criteria 

used by NIH to evaluate grant submissions to ensure that 

prioritization of those that accelerate human treatment options 

that would benefit individuals with Usher syndrome. 

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2016 ............................................................................. $145,912,000 

Budget estimate, 2017 ........................................................................... 143,942,000 

Committee recommendation ................................................................. 151,965,000 

The Committee recommendation includes $151,965,000 for the 

National Institute of Nursing Research [NINR]. 

Nursing Research.—The Committee supports NINR’s Strategic 

Plan, Bringing Science to Life, as well as its efforts to bolster the 

new NIH-Wide Strategic Plan. The Committee applauds NINR’s 

aim to enhance health promotion and disease prevention. The Committee supports NINR’s commitment to improving quality-of-life by 

managing symptoms of acute and chronic illness; improving palliative and end-of-life care; enhancing innovation in science and practice; and developing the next generation of nurse scientists. The 

Committee remains particularly interested in NINR’s efforts to invest in young nurse scientists who will produce the evidence to improve quality of care nationally and globally. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2016 ............................................................................. $467,445,000 

Budget estimate, 2017 ........................................................................... 459,578,000 

Committee recommendation ................................................................. 488,782,000 

The Committee recommendation includes $488,782,000 for the 

National Institute on Alcohol Abuse and Alcoholism [NIAAA]. 

Genomic Research and Alcohol Dependence.—The Committee remains concerned about the negative impact of alcohol abuse both 

to individuals struggling with alcoholism and to the budgets of Federal health programs. Research has implicated several gene 

variants that confer risk for Alcohol Use Disorder [AUD] and 

posttraumatic stress, suggesting that there may be shared genetic 

vulnerabilities for these disorders. The Committee encourages the 

NIAAA to capitalize on advances in genetic tools and available 

datasets to gain additional insight into the genetics of co-occurring 
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AUD and posttraumatic stress to inform prevention and treatment 

for affected individuals. NIAAA shall provide a report to the Committee within 180 days after enactment of this act that provides a 

detailed plan on how to move large-scale genetic screening initiatives forward to focus on high-risk populations, including those who 

exhibit alcohol dependency after suffering from post-traumatic 

stress. 

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2016 ............................................................................. $1,050,550,000 

Budget estimate, 2017 ........................................................................... 1,020,459,000 

Committee recommendation ................................................................. 1,103,032,000 

The Committee recommendation includes $1,103,032,000 for the 

National Institute on Drug Abuse [NIDA]. 

Adolescent Brain Development.—The Committee recognizes and 

supports the Adolescent Brain and Cognitive Development [ABCD] 

Study, which will continue to study the dramatic brain development that takes place during adolescence and how the various experiences children are exposed to during this time interact with 

each other and a child’s brain development. As the largest longitudinal brain-imaging study of youth, the ABCD study will follow approximately 10,000 U.S. children from ages 9–10 into early adulthood, and will yield critical insights into the foundational aspects 

of adolescence that shape life trajectories. The Committee requests 

an update on the ABCD study in the fiscal year 2018 CJ. 

Drug Treatment in Justice System Settings.—The Committee understands that providing evidence-based treatment for substance 

use disorders offers a strong alternative for interrupting the drug 

use/criminal justice cycle for offenders with drug problems. NIDA’s 

Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System [JJ-TRIALS] program identifies and 

tests strategies for improving the delivery of evidence-based substance abuse and HIV prevention and treatment services for justice-involved youth. The JJ-TRIALS initiative will provide insight 

into the process by which juvenile justice and other service settings 

can successfully adopt and adapt existing evidence-based programs 

and strategies to improve treatment for at-risk youth. The Committee requests an update on the JJ-TRIALS in the fiscal year 

2018 CJ. 

Expansion of Research on Opioid Alternatives.—The Committee 

remains concerned about the growing epidemic of opioid overdoses. 

The widespread availability of opioid painkillers has contributed to 

the millions of Americans who suffer from addiction disorders. Although NIDA has studied the effectiveness and risks associated 

with long-term opioid use for chronic pain, little research has been 

done to investigate new and alternative treatment options for treating pain, both acute and chronic. The Committee strongly encourages NIDA to expand scientific activities related to research on 

medications used to treat and reduce chronic pain. In doing this, 

NIDA should coordinate with CDC, HHS, VA, FDA, DOD, DEA, industry, experts in the field of pain research and addiction, and the 

medical research community at large, to identify gaps in scientific 

research related to opioid abuse and addiction, and the treatment 

of acute and chronic pain. In addition, NIDA should continue to 
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sponsor research to better understand the effects of long-term prescription opioid use, especially as it relates to the prevention and 

treatment of opioid abuse and addiction. 

Medications Development.—The Committee recognizes that new 

technologies are required for the development of next-generation 

pharmaceuticals. The Committee is encouraged by NIDA’s current 

approaches to develop viable immunotherapeutic or biologic methods for treating addiction. The goal of this research is the development of safe and effective vaccines or antibodies that target specific 

addictive drugs. The Committee is encouraged by this approach; if 

successful, immunotherapies, alone or in combination with other 

medications, behavioral treatments, or enzymatic approaches, 

stand to revolutionize how we treat, and ultimately prevent addiction. 

Opioid Misuse and Addiction.—The Committee appreciates the 

important role that research plays in the various Federal initiatives aimed at addressing the opioid crisis. The Committee urges 

NIDA to continue to fund research on medications to alleviate pain, 

including the development of those with reduced abuse liability, 

and continue to work with industry to fund innovative research 

into such medications. The Committee requests an update in the 

fiscal year 2018 CJ on these initiatives. 

Raising Awareness of Drug Abuse and Addiction Prevention and 

Treatment.—Education is a critical component of any effort to curb 

drug use and addiction, and it must target every segment of society, including healthcare providers, patients, and families. Through 

its NIDAMeD initiative, NIDA is advancing addiction awareness, 

prevention, and treatment in primary care practices through seven 

Centers of Excellence for Physician Information. Intended to serve 

as national models, these centers target physicians-in-training, including medical students and resident physicians in primary care 

specialties. NIDA also developed, in partnership with the Office of 

National Drug Control Policy, two online continuing medical education courses on safe prescribing for pain and managing patients 

who abuse prescription opioids. The Committee is pleased with 

NIDAMed, and urges NIDA to continue its focus on activities to 

provide physicians and other medical professionals with the tools 

and skills needed to incorporate drug abuse screening and treatment into their clinical practices. 

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2016 ............................................................................. $1,518,673,000 

Budget estimate, 2017 ........................................................................... 1,459,700,000 

Committee recommendation ................................................................. 1,619,537,000 

The Committee recommendation includes $1,619,537,000 for the 

National Institute of Mental Health [NIMH]. 

Autism.—As the lead agency on Autism Spectrum Disorders policy, the Committee urges the NIMH to include research on environmental factors related to autism, especially regressive autism, in 

the upcoming revision to the Strategic Plan for Autism Research. 
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NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2016 ............................................................................. $513,227,000 

Budget estimate, 2017 ........................................................................... 509,762,000 

Committee recommendation ................................................................. 534,516,000 

The Committee recommendation includes $534,516,000 for the 

National Human Genome Research Institute [NHGRI]. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2016 ............................................................................. $343,506,000 

Budget estimate, 2017 ........................................................................... 334,025,000 

Committee recommendation ................................................................. 361,062,000 

The Committee recommendation includes $361,062,000 for the 

National Institute of Biomedical Imaging and Bioengineering 

[NIBIB]. 

Healthcare-Associated Infections [HAIs].—HAIs are estimated to 

occur in 5 percent of all hospitalizations in the United States, resulting in more than 1.7 million illnesses and 99,000 deaths annually. While HHS has been leading efforts to develop and encourage 

hospitals to implement improved infection control strategies, potential solutions are complicated by the difficulty of removing dangerous pathogens, including multidrug-resistant organisms, from 

the clinical environment by disinfection protocols alone. The Committee has been encouraged by the progress made in reducing central line-associated bloodstream infections and methicillin-resistant 

Staphylococcus aureus bacteremia, but there has been little or no 

improvement since 2009 in, for example, the rates of catheter-associated urinary tract infections and colon surgery surgical site infections [SSI]. Clearly, more action is needed at every level of health 

care to eliminate infections that commonly threaten hospital patients. As efforts to develop a systems approach to decontamination 

increase, one of most promising areas of research is related to technologies that can provide surfaces with self-disinfection capability. 

Advancements in this area could be greatly beneficial to health outcomes, reduce healthcare expenses, and improve patient life-quality. The Committee encourages NIBIB to support efforts to accelerate the development of self-disinfecting medical devices, disinfecting strategies to alleviate SSIs, as well as materials engineering approaches to minimize or prevent the transmission of pathogens from surfaces within clinical care environments. 

NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

Appropriations, 2016 ............................................................................. $129,941,000 

Budget estimate, 2017 ........................................................................... 126,673,000 

Committee recommendation ................................................................. 136,195,000 

The Committee recommendation includes $136,195,000 for the 

National Center for Complementary and Integrative Health 

[NCCIH]. 

Pain Management.—The Committee is encouraged by the ongoing collaboration between NCCIH, VA, DOD, and other NIH Institutes to develop and test efficacious non-pharmacological approaches to pain management and comorbidities-including opioid 

misuse, abuse, and disorder-in military personnel, veterans, and 

their families. As opioid prescribing rates have increased at the VA 
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in recent years, and opioid abuse has risen among young veterans, 

the Committee believes it is critical to support research on nonpharmacological treatments to ensure the best quality of care for 

our Nation’s veterans and servicemembers, and urges the NIH, VA, 

and DOD to continue this vital research. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2016 ............................................................................. $280,680,000 

Budget estimate, 2017 ........................................................................... 279,680,000 

Committee recommendation ................................................................. 292,323,000 

The Committee recommendation includes $292,323,000 for the 

National Institute on Minority Health and Health Disparities 

[NIMHD]. 

Cohort Studies.—The Committee is aware of novel efforts underway to recruit individuals from racially and ethnically diverse 

backgrounds for participation in the PMI Cohort Program. Information from the cohort will be a broad, powerful resource for researchers working on a variety of important health questions. The Committee applauds NIH’s efforts to partner with HRSA to begin partnerships with several Federally Qualified Health Centers to develop, pilot, and refine approaches for bringing underserved individuals, families, and communities into the PMI Cohort Program. 

The Committee believes that the NIMHD can and should help support these efforts to ensure participation of racially and ethnically 

diverse individuals. 

Research Centers in Minority Institutions.—The Committee continues to recognize the critical role played by minority-serving institutions in addressing minority health and health disparities, 

while also providing training for a diverse health workforce. In particular, the RCMI program fosters the development of new generations of minority scientists for the Nation and provides support for 

crucial gaps in the biomedical workforce pipeline, with each $1 invested being leveraged to generate an additional $5 to $6 in competitive research funding. The RCMI program has the capability to 

promote solutions to the significant gap in R01 grant funding 

among black and other minority researchers when compared to 

non-minority researchers. The Committee remains concerned 

NIMHD may be considering changing RCMI’s configuration and 

funding structure without adequate congressional or stakeholder 

input. Therefore, the Committee directs NIH to maintain the existing vital infrastructure support provided through the RCMI program and make available not less than last year’s level for the 

RCMI program. Further, NIMHD is directed to provide an update 

to the Committee no later than 90 days after enactment of this act 

on any proposed changes to the program and prior to any changes 

being implemented. 

JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN

THE HEALTH SCIENCES

Appropriations, 2016 ............................................................................. $70,117,000 

Budget estimate, 2017 ........................................................................... 69,175,000 

Committee recommendation ................................................................. 73,026,000 

The Committee recommendation includes $73,026,000 for the 

Fogarty International Center [FIC]. 
105 

Global Health Research.—Recent disease outbreaks such as 

Ebola and the flu have shown the importance of the Center’s essential role in global infectious disease health research training and 

health system strengthening. These efforts help developing countries to eventually advance their own research and health solutions 

and tools. FIC also has developed partnerships in countries to fight 

malaria, neglected tropical diseases, and other infectious diseases 

that disproportionately impact the global poor. The Committee 

urges FIC to continue this important work of building relationships 

with scientists abroad to foster a stronger and more effective 

science workforce and health capacity on the ground, and improving the image of the United States through health diplomacy in 

their countries. 

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2016 ............................................................................. $395,684,000 

Budget estimate, 2017 ........................................................................... 395,110,000 

Committee recommendation ................................................................. 412,097,000 

The Committee recommends $412,097,000 for the National Library of Medicine [NLM]. Of the funds provided, $4,000,000 is for 

the improvement of information systems, to remain available until 

September 30, 2018. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2016 ............................................................................. $685,417,000 

Budget estimate, 2017 ........................................................................... 660,131,000 

Committee recommendation ................................................................. 713,849,000 

The Committee recommendation includes $713,849,000 for the 

National Center for Advancing Translational Sciences [NCATS]. 

The Committee includes bill language allowing up to $25,835,000 

of this amount, the same as the budget request and fiscal year 

2016, to be used for the Cures Acceleration Network [CAN]. 

Clinical and Translational Science Awards [CTSA] Program.— 

The Committee includes $520,740,000, an increase of $20,740,000, 

for the CTSA Program. The Committee applauds the success of the 

CTSA Program and recognizes recent NCATS efforts to update the 

program following the recommendations of the Institute of Medicine. NCATS is encouraged to further integrate the CTSA Program 

into the full spectrum of medical research activities at NIH, including collaboration with other ICs, and greater support for the CTSA 

hubs and network. 

OFFICE OF THE DIRECTOR

Appropriations, 2016 ............................................................................. $1,558,600,000 

Budget estimate, 2017 ........................................................................... 1,432,859,000 

Committee recommendation ................................................................. 1,731,152,000 

The Committee recommendation includes $1,731,152,000 for the 

Office of the Director [OD]. Within this total, $790,542,000 is provided for the Common Fund, which includes $230,000,000 for the 

Precision Medicine Initiative, an increase of $100,000,000 above fiscal year 2016. 

Academic Research Enhancement Award [AREA] Program.—The 

Committee believes that biomedical discoveries can occur any-
106 

where, and continues to support programs that foster biomedical 

research and opportunities for students at institutions who may 

not receive significant NIH funding. In particular, the Committee 

continues its long-standing support of the IDeA program. However, 

the Committee notes that many institutions that may benefit from 

the IDeA program are ineligible because they reside in States that 

are EPSCoR States, but not IDeA States. The Committee encourages NIH to enhance support for the AREA program by holding regional workshops to provide guidance on writing and submitting 

R15/AREA applications and on developing institutional capacities 

for undergraduate research. Further, NIH is urged to develop ways 

to improve ties between institutions that receive significant NIH 

funding and AREA-eligible institutions. 

Amyloidosis.—The Committee recommends that NIH continue its 

research efforts into amyloidosis, a group of rare diseases characterized by abnormally folded protein deposits in tissues. Amyloidosis is often fatal and there is no known cure. Current methods 

of treatment are risky and unsuitable for many patients. The Committee requests NIH to update the Committee on the steps taken 

to increase the understanding of the causes of amyloidosis and the 

efforts to improve the diagnosis and treatment of this devastating 

group of diseases. 

Angiogenesis.—The Committee commends the NIH for posting 

the Trans-NIH Angiogenesis Workshop findings. The Committee 

urges NIH to address the needs outlined in the comments including, the establishment of cross-disciplinary collaborations across 

therapeutic fields by NCI, NHLBI, NIDDK, NEI and other institutes, and the creation of a trans-NIH Program Project Grant. The 

Committee further encourages NIH to examine angiogenesis modifying interventions across populations using data to identify differences in response and benefit across age, gender, ethnicity/race/ 

ancestral categories, socioeconomic strata, chronic disease States, 

and genetic background. Specifically, NIH is encouraged to study: 

angiogenesis and metabolism; biomarkers that reflect normal and 

abnormal angiogenesis; epigenetic changes of angiogenesis induced 

by natural stimuli such as diet, physical activity, and lifestyle, as 

well as medications; the effect of angiogenesis regulation on health 

and disease outcomes; the functional connections between 

angiogenesis and other health defense systems in the body (inflammation, regeneration, anti-aging, and immunity). 

Big Data Infrastructure Plan.—Biomedical research has become 

increasingly reliant on growing amounts of digital data, a development with tremendous—and potentially disruptive—promise if this 

data can be used effectively by the research community to enable 

major scientific breakthroughs. Figuring out how to make this possible is one of the biggest issues facing NIH as it pursues ambitious 

initiatives related to cancer, the human brain, Alzheimer’s disease, 

and other challenges. In 2012, NIH began an extramural program 

to provide a framework of pilot programs, centers of excellence, and 

grant opportunities to advance thinking in how to organize, share, 

and use big data. The Committee believes that NIH now needs to 

build on this progress by developing a strategic plan to realize the 

full potential of these efforts for NIH’s Institutes and Centers. The 

Committee directs NIH to provide such a plan to the Committee 
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within 1 year of enactment of this act. This plan should describe 

how NIH intends to make big data sustainable, interoperable, accessible and usable, and include a roadmap to achieve these objectives. The plan should be developed with the input of external partners and stakeholders, and include milestones and estimates of the 

resources that will be necessary to achieve its goals. 

Brain Health.—The Committee supports brain health research, 

education, and care that can be advanced through collaborative and 

interdisciplinary efforts that seek to study issues of cognition 

across the age spectrum with a goal to improve overall community 

health. The Director is strongly encouraged to recognize brain 

health as a top research priority with a special emphasis for initiatives that cross the age continuum and include autism, PTSD/TBI, 

and Alzheimer’s Disease. 

Brain Research through Application of Innovative Neuro-technologies [BRAIN] Initiative.—The Committee continues to strongly support the BRAIN initiative. The bill provides $250,000,000, an 

increase of $100,000,000 above fiscal year 2016, to expand the initiative consistent with the BRAIN 2025 report issued in 2014. The 

Committee is encouraged by the rapid progress the initiative has 

made in dramatically changing the ways we gather data about the 

brain, generating advances in tools for measuring brain structure 

and activity that have the potential to produce massive amounts of 

new data. To prepare for the management of all this information, 

BRAIN has dedicated some of its existing budget to stimulate the 

development of centers for data warehousing, analysis and visualization for each of its defined research areas. However, the Committee believes the need for data integration and manipulation that 

would make full use of these large cross-disciplinary datasets not 

only entails a large investment in open data hosting, but also requires significant investments in interactive data management that 

combines neurophysiological, imaging, clinical, and molecular 

datasets in both human and model organisms. The Committee encourages NIH to work with its Federal, academic and private partners, as well as leaders in the technology sector, to jointly develop 

integrated, user friendly, scalable data analysis hubs for BRAIN 

data as well as methods for tool dissemination. The goal of such an 

effort would be a network that has at its core an interconnected 

open platform of imaging, neurophysiological, behavioral, clinical, 

and molecular data along with the metadata essential for its interpretation. This collaborative effort would guide development and 

sharing of best practices in data acquisition, analysis, and choices 

in computational pipelines. Open sharing on this scale would enable data analysis and visualization across institutional boundaries 

to accelerate understanding of brain function and dysfunction. The 

Committee directs NIH to provide a plan, developed in collaboration with its partners, to the Committee 6 months after enactment 

of this act to create such a network, including schedule and cost 

estimates. 

Building Infrastructure Leading to Diversity [BUILD].—The 

Committee supports the NIH Director’s efforts to reverse the trend 

of underrepresentation of researchers from ethnically diverse backgrounds and continues to be pleased with the commitment to increase the number of minority investigators. The Committee en-
108 

courages NIH to ensure that graduate institutions with a historic 

mission of educating minorities in the health professions and biomedical sciences can participate in the program. 

Burden of Disease.— The Committee expects NIH to consider the 

burden of a disease when setting priorities and developing strategic 

plans across its Institutes and Centers. Diseases such as Alzheimer’s, diabetes, heart disease, and cancer affect a large portion 

of the population, especially the aging population. The impact of 

these diseases on patients and their families are substantial and 

costly. Targeting biomedical research funding toward these diseases is an important strategy to finding better treatments and 

cures. Further, the Committee commends the NIH on the inclusion 

of burden of disease as part of its NIH-Wide Strategic Plan for Fiscal Years 2016–2020. The Plan calls for the relative burdens of individual diseases and medical disorders to be regarded as crucial 

considerations in balancing the priorities of the Federal research 

portfolio. The Committee supports a focus on conditions in need of 

further funding such as chronic pain, including migraine and other 

treatment alternatives for chronic pain. 

Chimpanzees.—The Committee supports NIH in its decision to 

make chimpanzees eligible for retirement from NIH-supported biomedical research and reaffirm its commitment to the care of the 

federally owned and supported chimpanzee population. Consistent 

with that policy, the Committee directs NIH to report its estimated 

timeline for moving chimpanzees to accredited sanctuaries within 

30 days after enactment of this act. In addition, the Committee recognizes the need to provide greater financial support for the lifelong care of federally owned and supported chimpanzees, including 

sanctuary facility capital and care costs. 

Chronic Fatigue Syndrome [CFS].—The Committee is pleased to 

see the 2015 reports from the Institute of Medicine and the NIH’s 

Pathways to Prevention Workshop, along with the recent advances 

in science and renewed interests of researchers, relating to CFS. 

The Committee urges the NIH to collaborate with disease researchers, clinicians, patients, and their advocates to address the historical lack of research and to capitalize on these opportunities to 

make progress on this poorly understood disease. Specifically, the 

Committee encourages NIH to use funding to jumpstart the field 

through a set of intramural and extramural investments that could 

include Funding Opportunity Announcements for biomarkers and 

treatment trials; other investigator-initiated studies, including for 

early-stage research; and support for research to develop consensus 

on a case definition and research standards. 

Chronic Overlapping Pain Conditions.—The Committee notes the 

strong scientific evidence substantiating common disease mechanisms underlying Chronic Overlapping Pain Conditions. However, 

evidence needed to inform practice guidelines is insufficient, sometimes resulting in the misdiagnosis and ineffective and harmful 

treatment of patients with these disorders. A coordinated effort on 

chronic overlapping pain conditions is urgently needed to maximize 

the Federal research investment and inform clinical practice. Research recommendations from the 2012 NIH Workshop on Chronic 

Overlapping Pain Conditions and September 2014 scientific meeting, co-sponsored by various NIH ICs and the TMJ Association, 
109 

should continue to guide the relevant ICs in advancing research 

that spans the basic, translational and clinical research continuum 

to advance scientific understanding of chronic overlapping pain 

conditions, as well as the development and discovery of safe and effective treatments. 

Chronic Pain Research.—The 2011 Institute of Medicine report, 

‘‘Relieving Pain in America,’’ revealed the devastating public health 

crisis of chronic pain, demonstrating that 4-in-10 American adults 

report chronic pain at a cost of $1,600,000,000 per day. The Committee strongly urges NIH to intensify and expand its basic, 

translational, and clinical research effort on chronic pain to elucidate underlying mechanisms of disease, as well as to discover and 

develop safe, effective, non-habit forming drug and non-drug therapies. The Committee encourages the Director to include chronic 

pain in ongoing NIH initiatives that have potential for yielding significant advancements in this area, such as the Precision Medicine 

Initiative, the NIH Common Fund, Advanced Medicines Partnership, BRAIN Initiative, and public-private partnerships within 

NCATS. 

Clinical Center Reorganization.—The Committee notes NIH’s recently announced plans to restructure its Clinical Center [CC] to 

ensure patient safety and care are always its foremost priorities. 

The restructuring follows the advice of a blue ribbon panel tasked 

with assessing the CC and NIH intramural clinical research following a highly critical FDA inspection of the CC Pharmacy in May 

2015. The Committee commends NIH for its efforts to look beyond 

the serious problems in the Pharmacy to assess other aspects of its 

operations. It is understandable that the decentralized nature of 

NIH would lead to fragmented accountability and governance at 

the CC, and the decision to adopt a centralized management structure modeled on the best practices in the Nation’s top hospitals 

makes sense. The Committee directs NIH to continue to provide 

timely updates as these efforts move forward, including providing 

an update in the fiscal year 2018 CJ, including the status of recruitment of the CC’s new management team, the activities of the 

Hospital Board and Office of Research Support and Compliance, 

and adoption of other industry best practices by the CC. 

Duchenne Muscular Dystrophy.—The Committee is aware of the 

updated MD Action Plan released in the winter of 2015, and supports the Plan’s recommendation to expand Duchenne research into 

bone health, endocrine functioning, and cardio-pulmonary functioning. Further, the Committee is encouraged that NIH support 

for earlier stage research in Duchenne muscular dystrophy has successfully resulted in a substantial pipeline of new potential therapeutics. To provide a smooth transition for these projects into clinical development and to increase the potential for success, the 

Committee urges NIH to increase support for late stage preclinical 

and early stage clinical projects; and to consider partnering with 

outside entities, including patient organizations and industry, to facilitate research focused on the rapid identification and qualification of new biomarkers for Duchenne. 

Environmental Influences on Child Health Outcomes Program/ 

National Children’s Study Alternative [ECHO].—The Committee 

continues its support of the ECHO program and the goal to under-
110 

stand the effects of environmental exposures on child health and 

development. Sufficient funding, level with fiscal year 2016, is provided to the OD to continue this program. In particular, the Committee notes its support for the IDeA States Pediatric Clinical 

Trials Network in ECHO which will leverage the infrastructure at 

existing IDeA State centers by embedding clinical trials experts at 

IDeA State locations. This structure will facilitate their partnership with other academic institutions and help address access gaps 

for rural and medically underserved children. 

Fragile X [FX].—The Committee commends NIH for the NICHDled effort that resulted in significant progress in mapping the molecular, physiological, biological, and genetic connections among 

FX, the FX protein, and autism spectrum disorder. Increased focus 

on basic science is needed to identify additional targetable mechanisms of the disease. The Committee urges the Director to support 

expanded natural history studies to supplement the CDC’s efforts, 

and to focus on validating outcome measures and identifying biomarkers. Given the inextricable connection between the FX protein 

and autism, the Committee urges the Director and IC Directors 

with Fragile X and autism portfolios to explore ways to create 

greater efficiency and synergy among these two research tracks to 

accelerate translational research toward a better understanding of 

both conditions and to shorten the time to bring effective treatments to market. Finally, the Committee commends the NIH for its 

previous work to create and update the Research Plan on Fragile 

X Syndrome and Associated Disorders and urges the NICHD to reconvene this group before the end of fiscal year 2017 to discuss updates to the research plan. 

Gabriella Miller Kids First Research Act.—The Committee pro- vides the full budget request of $12,600,000. The Committee requests that NIH provide information on how it has disbursed the 

fiscal year 2016 funding for the Gabriella Miller Kids First Research Act, including any personnel that are responsible for overseeing the allocation of designated research dollars, the criteria 

that NIH employed to ensure awards will advance the objectives of 

the act, and a description of the research projects that were funded 

at the end of fiscal year 2016. This report should also describe the 

criteria and process for grant awards the NIH intends to use for 

fiscal year 2017 and subsequent years of funding under the act. 

Government-Wide Collaborations.—NIH, VA, and DOD collaborate frequently and successfully on various research activities. The 

Committee looks forward to the report in the fiscal year 2018 CJ 

focusing on the cooperative and strategic approach the agencies 

take in areas of biomedical research that overlap to maximize the 

potential of the research. 

Gut Microbiome.—The Committee commends the Office of the Director for its work to partner with NIDDK on the Human 

Microbiome project, which has led to valuable scientific discoveries 

in therapeutic and genetic research on inflammatory bowel diseases. The Committee urges expanded research on predictors and 

modifiable factors that can improve early interventions and treatments, particularly among pediatric and young adult populations. 

Hereditary Hemorrhagic Telangiectasia [HHT].—The Committee 

supports the formation of an HHT coordinating committee of mul-
111 

tiple ICs, including NINDS, NHLBI, NICHD, NHGRI, NIDDK, 

NIBIB, and NCATS. The Committee urges the coordinating committee to initiate a workshop to explore collaborative research opportunities into the diagnosis and treatment of HHT, including efforts to foster translational research in the development of new 

therapeutics for vascular anomalies, the identification of potential 

targets for interrupting pathways to prevent HHT progression, and 

new imaging methods to enable more precise detection of vascular 

malformations. The Committee requests an update in the fiscal 

year 2018 CJ on the status of research related to this topic. 

Human Trisome.—The Committee looks forward to the results of 

NIH’s feasibility report on a multi-year study to examine the molecular, cellular, and physiological mechanisms that predestine individuals born with a third copy of human chromosome 21 to either 

live with—or be protected from—a range of diseases that cause 

nearly 60 percent of U.S. deaths. The Committee encourages NIH 

to focus on whether aspects of the project, from accrual of children 

and adults with T21, to analysis of biological samples at the genetic, epigenetic, biochemical, and cellular levels, to advanced 

bioinformatics analysis of large genomics datasets, fit within the 

priorities set in the NIH research plan published in 2014. 

Imaging.—The Committee notes that imaging research occurs in 

multiple ICs throughout the NIH and is an integral component of 

the BRAIN Initiative. The Committee requests NIH provide an 

overview of imaging research throughout all NIH activities, including collaborations with other HHS and non-HHS agencies. The 

Committee requests this information be included in the fiscal year 

2018 CJ. 

Inclusion of Children.—The Committee appreciates the commitment made by the NIH in its fiscal year 2017 budget request to 

pursue plans to collect age-related inclusion information for research studies to support enhanced analyses and reporting on inclusion by age. Reporting study participation by age will assist the 

Committee, researchers, and other stakeholders in understanding 

whether children as a whole, or particular pediatric subpopulations, are underrepresented in federally funded biomedical research. The Committee believes that the implementation challenges cited by the NIH, including determining the appropriate format for collecting age-related data and establishing meaningful 

age-based categories, are addressable with appropriate expertise 

and stakeholder input. The Committee directs the NIH to develop 

a detailed plan to collect data and report publicly on the actual 

numbers of children and age distribution that are enrolled in its 

clinical studies. 

Infrastructure.—The Committee understands that Federal agencies such as NIH need to maintain and upgrade parts of their physical infrastructure every year. The NIH facilities budget has been 

relatively flat since 2009. Over time, only the most essential maintenance and repairs for health and safety have been addressed, 

leaving an increasing backlog of projects requiring attention. To ensure the Committee is informed of NIH’s critical facility needs and 

inform future infrastructure budgets, the Committee has included 

up to $1,000,000 for NIH to enter into a contract with the National 

Research Council, Division of Engineering and Physical Sciences, to 
112 

prepare a report that assesses the capital needs of NIH’s main 

campus. The report should identify facilities in greatest need of repair, describe the work needed to bring them up to current standards, and include cost estimates for each project. The Committee 

directs NIH to provide the report with its recommendations to the 

House and Senate Committees on Appropriations no later than 1 

year from the date of the contract agreement on the statement of 

work between NIH and the National Research Council. 

Interagency Pain Research.—The Committee encourages the Director to intensify and coordinate fundamental, translational, and 

clinical research with respect to the understanding of pain, the discovery and development of therapies for chronic pain, and the development of alternatives to opioids for effective pain treatments. 

In doing so, the Committee urges the NIH to consider recommendations made by the Federal Pain Research Strategy, an ongoing effort coordinated by the Interagency Pain Research Coordinating 

Committee and the NIHDemographic. 

Lymphatic Research and Lymphatic Disease.—The Committee 

commends the trans-NIH Coordinating Committee for Lymphatic 

Research, which sponsored a historic Lymphatic Symposium in 

2015. The Committee supports building on this momentum by 

growing the cadre of lymphatic researchers through the establishment of extramural interdisciplinary research training programs 

relevant to the lymphatic system in health and disease and by incorporating greater reviewer expertise in lymphatic biology/disease 

in the pertinent standing study sections within the Center for Scientific Review. This research will be instrumental in understanding 

the pivotal role of the lymphatic system in the pathogenesis and/ 

or treatment of cancer metastasis, AIDS, auto-immune diseases, 

obesity, cardiovascular disease, and organ transplantation as well 

as those affected by lymphatic conditions after cancer or those with 

congenital conditions. 

Mitochondrial Disease Research.—The Committee appreciates 

the NIH’s support of the trans-NIH Mitochondrial Disorders Working Group, the North American Mitochondrial Disease Consortium, 

the Mitochondrial Disease Sequence Data Resource Consortium, 

and its support for investigator initiated intramural and extramural studies. The Committee looks forward to the pending publication of a report in follow up to the December 2014 workshop on 

Nutritional Interventions in Primary Mitochondrial Disease that 

will identify a research agenda for evidence-based nutritional interventions for mitochondrial disorders. With the growing recognition 

mitochondrial disease provides a window into understanding and 

treating many conditions that afflict large segments of the population, the Committee strongly encourages the Director to urge an 

aggressive research effort around primary mitochondrial disease as 

well as mitochondrial function and dysfunction. 

National Pediatric Research Network [NPRN].—The Committee 

is aware that the National Pediatric Research Network authorizes 

an innovative model to accelerate research through infrastructure 

consortia across the Nation’s pediatric research institutions. The 

Committee has provided sufficient funding to explore how to carry 

out provisions of the act, as feasible, and requests that NIH update 
113 

the Committee on how it is implementing the goals of the act within 60 days of enactment of this act. 

Natural Products Collections.—The Committee continues to urge 

NIH to increase access to comprehensive and professionally organized natural products libraries. 

Neurofibromatosis [NF].—The Committee supports NIH’s commitment to NF research and treatment at multiple ICs, including 

NCI, NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. 

The Committee encourages NCI to continue to support its NF research portfolio in fundamental basic science, translational research and clinical trials focused on NF. The Committee also encourages the NCI to support NF preclinical mouse models and associated tumor sequencing efforts. Because NF causes brain and 

nerve tumors and is associated with cognitive and behavioral problems, the Committee urges NINDS to continue to support fundamental basic science research on NF relevant to nerve damage and 

repair. Based on emerging findings from numerous researchers 

worldwide demonstrating that children with NF are at significant 

risk for autism, learning disabilities, motor delays, and attention 

deficits, the Committee encourages NINDS, NIMH and NICHD to 

continue to support laboratory-based and clinical investigations in 

these areas. Since NF2 accounts for approximately 5 percent of genetic forms of deafness, the Committee encourages NIDCD to continue its investment in NF2 basic and clinical research. NF1 can 

cause vision loss due to optic gliomas; the Committee encourages 

NEI to continue its investment in NF1 basic and clinical research. 

Neurogenic Bladder and Kidney Disease.—The Committee encourages NIH to study the causes and care of the neurogenic bladder and kidney disease to improve the quality of life of children 

and adults with Spina Bifida; to support research to address issues 

related to the treatment and management of Spina Bifida and associated secondary conditions, such as hydrocephalus; and to support 

research to understand the myriad co-morbid conditions experienced by individuals with Spina Bifida, including those associated 

with both paralysis and developmental delay. 

Nonrecurring Expenses Fund [NEF].—Created in fiscal year 

2008, the NEF permits HHS to transfer unobligated balances of expired discretionary funds into the NEF account for capital acquisitions. For fiscal year 2017, the Committee transfers $300,000,000 

from the NEF to OD for carrying out activities associated with biomedical research. The OD shall provide actual expenditures based 

on activity in the fiscal year 2018 CJ. 

Phelan-McDermid Syndrome.—Phelan-McDermid Syndrome is a 

genetic disorder caused by a partial deletion of chromosome 22 and 

a loss of the SHANK3 gene. The Committee encourages NIH to 

continue its multi-Institute approach to research into the Syndrome and related ‘‘shankopathies.’’ Some topics of interest, if feasible, include the correlation of the syndrome with mental health 

disorders, including autism, schizophrenia, catatonia, and bipolar 

disorder; the study of SHANK3 as a target for better understanding risk factors for mental health problems that occur in adolescence; phenotype studies of the syndrome as a model for studying prodromes as indicators of later manifestations in disorders; 

and gastro-intestinal complications associated with Phelan- 
114 

McDermid Syndrome and related disorders. The Committee requests an update in the fiscal year 2018 CJ on the status of research related to this topic. 

Physician-Scientist Workforce.—The Committee is concerned 

about the impact of the decrease in the number of physician-scientists who can accelerate the translation of science to the treatment of widespread chronic, and currently incurable diseases such 

as diabetes and other diseases. The Committee applauds NIH for 

the actions it has already taken to address barriers that are preventing physician-scientists from entering the biomedical research 

workforce and looks forward to continuing progress on this front. 

The Committee expects a report in the fiscal year 2018 CJ on the 

specific steps NIH has taken and their effect, as well as the path 

forward to implement the recommendations of the Physician-Scientist Workforce Working Group. 

Precision Medicine Initiative [PMI].—The Committee recommendation continues its strong support for PMI by providing 

$230,000,000 to develop a national research cohort of 1 million or 

more U.S. volunteers. This level of funding is $100,000,000 above 

fiscal year 2016, and is in addition to $70,000,000 included in the 

bill for NCI-led PMI for oncology. The Committee is aware that the 

Advisory Committee to the Director in its final report supported 

the inclusion of children in the PMI Cohort Program and recommended that NIH consider how to best incorporate necessary 

safeguards to ensure appropriate enrollment, retention and protections for children. Since much of adult health is rooted in the earliest years, there is great value to including children in the PMICohort Program. The Committee encourages NIH to ensure that 

through the process of awarding funds for the PMI-Cohort Program, that pediatric populations are appropriately included in the 

study. The Committee also encourages NIH to use in vitro clinical 

trials and broader phenotypic data analysis to test how a particular 

cancer or other disease conditions may react to a specific therapy 

or combination of therapies. Finally, the Committee directs NIH to 

provide a report within 6 months of enactment of this act assessing 

PMI plans to safeguard participants’ personal data. 

Research Facilities.—Much of the Nation’s biomedical research 

infrastructure, including laboratories and research facilities at academic institutions and nonprofit research organizations, is outdated or insufficient. For taxpayers to receive full value from their 

considerable investments in biomedical research, scientists must 

have access to appropriate research facilities. Therefore, 

$25,000,000 is provided for grants or contracts to public, nonprofit, 

and not-for-profit entities to expand, remodel, renovate, or alter existing research facilities or construct new research facilities as authorized under 42 U.S.C. section 283k. The Committee urges NIH 

to consider recommendations made by the NIH Working Group on 

Construction of Research Facilities, including making awards that 

are large enough to underwrite the cost of a significant portion of 

newly constructed or renovated facilities. 

Severe Acute Shock and Multi-Organ Failure.—There are an estimated 1,300,000 cases in the United States each year of severe, 

acute shock, which can trigger multi-organ failure, often resulting 

in death. Despite the number of Americans affected by this condi-
115 

tion and the lack of a proven treatment for shock, the Committee 

notes that there is no dedicated Federal research focused on addressing these challenges. The Committee encourages NIH to support research to develop treatments for severe, acute shock, including septic shock, cardiogenic shock, hypovolemic shock, and hemorrhagic shock. 

Temporomandibular Disorders [TMD].—The Committee understands that NIH–funded research has demonstrated that TMD is 

primarily a multisystem disorder with overlapping co-morbid conditions influenced by multiple biological and environmental factors 

rather than solely an orofacial pain condition. However, diagnosis 

and care of patients have not changed to reflect this major paradigm shift. Therefore, the Committee strongly supports research to 

examine the safety and efficacy of current clinical treatments of 

TMD, the burden and costs associated with TMD, and the development of future scientific and clinical, professional and policy directions for TMD. Further, the Committee encourages NIH ICs with 

pertinent expertise on the temporomandibular joint to collaborate 

and implement the recommendations from the Temporomandibular 

Joint in Health and Disease Round Table held in 2013. Research 

to develop safe and effective techniques for joint repair and regeneration is essential. An analysis of problems associated with current joint replacements should provide guidance in these efforts. 

Transfer Authority.—The Committee does not include bill language requested by the administration to provide additional transfer authority to the Director beyond that which is already provided 

to the Secretary. 

Translational Science and Clinical Trials.—The Committee commends NIH’s continued focus on clinical and translational science, 

but is concerned with the need to expand this work to geographic 

regions with the highest burdens of chronic disease, limited access 

to health care providers, and minority populations. By providing 

support for the necessary infrastructure for translational science 

across the spectrum from drug and natural product discovery to 

clinical trial implementation to community and population health, 

citizens with significant needs in these underserved regions will 

benefit. Therefore, NIH is directed to support efforts to build and 

sustain integrated clinical and translational science infrastructure 

to optimize the movement of drug and natural product discoveries 

across the translational spectrum in States where funding has not 

previously been provided, but where there is significant disease 

burden. 

Tuberous Sclerosis Complex [TSC].—The Committee is encouraged by progress on updating NIH’s 2003 TSC Research Plan, including a March 2015 workshop sponsored by NINDS and the Tuberous Sclerosis Alliance that assessed progress and prioritized 

new opportunities for research in TSC. Building on this progress, 

the Committee encourages the Director to coordinate the participation of multiple ICs on a research strategy aimed at addressing the 

numerous medical and neuropsychological burdens associated with 

TSC while deciphering the biology underlying phenotypic heterogeneity. Manifestations of TSC are highly variable among affected 

individuals, and TSC can be a model condition for developing precision medicine approaches to treat each individual’s symptoms to 
116 

maximize the benefit-risk ratio. NIH should encourage research opportunities in the five key areas prioritized by workshop participants: understanding phenotypic heterogeneity in TSC, gaining a 

deeper knowledge of TSC signaling pathways and the cellular consequences of TSC deficiency, improving TSC disease models, developing clinical biomarkers for TSC, and facilitating therapeutics and 

clinical trials research. 

BUILDINGS AND FACILITIES

Appropriations, 2016 ............................................................................. $128,863,000 

Budget estimate, 2017 ........................................................................... 128,863,000 

Committee recommendation ................................................................. 128,863,000 

The Committee recommendation includes $128,863,000 for NIH 

buildings and facilities. This funding will remain available for obligation for 5 years. The Committee does not include the request by 

the administration to make funding available until expended. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

The Committee recommends $3,738,077,000 for the Substance 

Abuse and Mental Health Services Administration [SAMHSA]. The 

recommendation includes $134,667,000 in transfers available under 

section 241 of the PHS Act and $12,000,000 in transfers from the 

PPH Fund. 

SAMHSA is responsible for supporting mental health programs 

and alcohol and other drug abuse prevention and treatment services throughout the country, primarily through categorical grants 

and block grants to States. 

The Committee recommendation continues bill language that instructs the Administrator of SAMHSA and the Secretary to exempt 

the Mental Health Block Grant [MHBG] and the Substance Abuse 

Prevention and Treatment [SAPT] Block Grant from being used as 

a source for the PHS evaluation set-aside in fiscal year 2017. 

MENTAL HEALTH

Appropriations, 2016 ............................................................................. $1,166,987,000 

Budget estimate, 2017 ........................................................................... 1,158,766,000 

Committee recommendation ................................................................. 1,170,037,000 

The Committee recommends $1,170,037,000 for mental health 

services. The recommendation includes $21,039,000 in transfers 

available under section 241 of the PHS Act and $12,000,000 in 

transfers from the PPH Fund. Included in the recommendation is 

funding for programs of regional and national significance [PRNS], 

the MHBG, children’s mental health services, Projects for Assistance in Transition from Homelessness [PATH], and Protection and 

Advocacy for Individuals with Mental Illness [PAIMI]. 

Programs of Regional and National Significance 

The Committee recommends $387,659,000 for PRNS within the 

Center for Mental Health Services [CMHS]. The Committee recommendation includes $12,000,000 in transfers to PRNS from the 

PPH Fund. These programs address priority mental health needs 

by developing and applying evidence-based practices, offering training and technical assistance, providing targeted capacity expansion 
117 

grants, and changing the delivery system through family, client-oriented, and consumer-run activities. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee recommendation 

CAPACITY: 

Seclusion & Restraint ........................................................... 1,147 1,147 1,147 

Youth Violence Prevention .................................................... 23,099 ............................ ............................

Project AWARE State Grants ................................................. 49,902 57,001 57,001 

Mental Health First Aid ........................................................ 14,963 14,963 14,963 

Healthy Transitions ............................................................... 19,951 19,951 19,951 

National Traumatic Stress Network ...................................... 46,887 46,887 46,887 

Children and Family Programs ............................................. 6,458 6,458 6,458 

Consumer and Family Network Grants ................................. 4,954 4,954 4,954 

MH System Transformation and Health Reform ................... 3,779 3,779 3,779 

Project LAUNCH ..................................................................... 34,555 34,555 23,605 

Primary and Behavioral Health Care Integration ................. 49,877 26,004 49,877 

National Strategy for Suicide Prevention ............................. 2,000 30,000 2,000 

Suicide Lifeline ..................................................................... 7,198 7,198 7,198 

GLS—Youth Suicide Prevention—States ............................. 35,427 35,427 35,427 

GLS—Youth Suicide Prevention—Campus .......................... 6,488 6,488 6,488 

AI/AN Suicide Prevention Initiative ....................................... 2,931 2,931 2,931 

Homelessness Prevention Programs ..................................... 30,696 30,696 30,696 

Tribal Behavioral Grants ....................................................... 15,000 15,000 15,000 

Minority AIDS ......................................................................... 9,224 15,935 9,224 

Crisis Systems ...................................................................... ............................ 5,000 ............................

Criminal and Juvenile Justice Programs .............................. 4,269 4,269 4,269 

Assisted Outpatient Treatment ............................................. 15,000 15,000 15,000 

SCIENCE AND SERVICE: 

GLS—Suicide Prevention Resource Center .......................... 5,988 5,988 5,988 

Practice Improvement and Training ..................................... 7,828 7,828 7,828 

Primary and Behavioral Health Care Integration TA ............ 1,991 1,991 1,991 

Consumer & Consumer Support TA Centers ........................ 1,918 1,918 1,918 

Minority Fellowship Program ................................................. 8,059 8,059 8,059 

Disaster Response ................................................................ 1,953 1,953 1,953 

Homelessness ........................................................................ 2,296 2,296 2,296 

HIV/AIDS Education ............................................................... 771 771 771 

Primary and Behavioral Healthcare Integration.—The Committee 

directs SAMHSA to require grantees of the Primary and Behavioral Health Care Integration program to include in their biannual 

National Outcome Measures report a summary of the policies that 

serve as barriers to the provision of integrated care and the specific 

steps the grantee has taken or will take to address such barriers. 

Project Aware.—The Committee strongly supports Project 

AWARE which increases awareness of mental health issues and 

connects young people that have behavioral health issues and their 

families with needed services. The Committee recommendation reflects the administration’s proposal to reallocate funding from 

Youth Violence Prevention to Project AWARE. This shift will allow 

SAMHSA to avoid program duplication. The increase provided will 

support a new cohort of Project AWARE State Education Agency 

awards. Of the amount provided for Project AWARE, the Committee directs SAMHSA to use $10,000,000 for discretionary grants 

to support efforts in high-crime, high-poverty areas and, in particular, communities that are seeking to address relevant impacts 

and root causes of civil unrest. These grants should maintain the 

same focus as fiscal year 2016 grants and continue to be coordi-
118 

nated with the Department of Education grants. The Committee requests a report on progress of fiscal year 2016 grantees 180 days 

after the enactment of this act. 

Project Linking Actions for Unmet Needs in Children’s Health 

[LAUNCH].—The Committee continues to support Project 

LAUNCH activities which promote the wellness of young children 

from birth to age 8 by addressing the physical, social, and emotional, cognitive, and behavioral aspects of their development. The 

Committee provides continuation funding for all existing grant activities. 

Community Mental Health Services Block Grant 

The Committee recommends $562,571,000 for the MHBG. The 

recommendation includes $21,039,000 in transfers available under 

section 241 of the PHS Act. 

The MHBG distributes funds to 59 eligible States and territories 

through a formula based on specified economic and demographic 

factors. Grant applications must include an annual plan for providing comprehensive community mental health services to adults 

with a serious mental illness and children with a serious emotional 

disturbance. 

The Committee recommendation continues bill language requiring that at least 10 percent of the funds for the MHBG program 

be set-aside for evidence-based programs that address the needs of 

individuals with early serious mental illness, including psychotic 

disorders. The Committee commends SAMHSA for its collaboration 

with NIMH on the implementation of this set-aside. The Committee notes that it usually takes 17 years to translate research 

findings into practice and hopes that this joint effort between 

NIMH and SAMHSA may be a model for how to reduce this timeframe. The Committee directs SAMHSA to continue its collaboration with NIMH to ensure that funds from this set-aside are only 

used for programs showing strong evidence of effectiveness and 

that target the first episode of psychosis. SAMHSA shall not expand the use of the set-aside to programs outside of the first episode psychosis. The Committee directs SAMHSA to include in the 

fiscal year 2018 CJ a detailed table showing at a minimum each 

State’s allotment, name of the program being implemented, and a 

short description of the program. 

Children’s Mental Health Services 

The Committee recommends $119,026,000 for the Children’s 

Mental Health Services program. This program provides grants 

and technical assistance to support comprehensive, communitybased systems of care for children and adolescents with serious 

emotional, behavioral, or mental disorders. Grantees must provide 

matching funds and services must be coordinated with the educational, juvenile justice, child welfare, and primary healthcare systems. The Committee has not included bill language requested by 

the administration to set aside up to 10 percent of these funds to 

carry out early interventions for young people at high risk of developing psychosis. While the Committee applauds SAMHSA’s focus 

on this population, it believes further evidence of effectiveness is 

needed before these interventions are widely adopted. 
119 

Projects for Assistance in Transition From Homelessness 

The Committee recommends $64,635,000 for PATH, which addresses the needs of individuals with serious mental illness who 

are experiencing homelessness or are at risk of homelessness. 

Funds are used to provide an array of services, such as screening 

and diagnostic services, emergency assistance, case management, 

and referrals to the most appropriate housing environment. 

Protection and Advocacy for Individuals With Mental Illness 

The Committee recommends $36,146,000 for PAIMI. This program helps ensure that the rights of mentally ill individuals are 

protected while they are patients in all public and private facilities 

or while they are living in the community, including in their own 

homes. Funds are allocated to States according to a formula based 

on population and relative per capita incomes. 

SUBSTANCE ABUSE TREATMENT

Appropriations, 2016 ............................................................................. $2,195,424,000 

Budget estimate, 2017 ........................................................................... 2,186,348,000 

Committee recommendation ................................................................. 2,194,563,000 

The Committee recommends $2,194,563,000 for substance abuse 

treatment programs, including PRNS and the substance abuse prevention and treatment block grant to the States. The recommendation includes $81,200,000 in transfers available under section 241 

of the PHS Act. 

Programs of Regional and National Significance 

The Committee recommends $336,484,000 for PRNS within the 

Center for Substance Abuse Treatment [CSAT]. The recommendation includes $2,000,000 in transfers available under section 241 of 

the PHS Act. 

PRNS include activities to increase capacity by implementing 

service improvements using proven evidence-based approaches as 

well as science-to-services activities that promote the identification 

of practices thought to have potential for broad service improvement. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

CAPACITY: 

Opioid Treatment Programs/Regulatory Activities ................ 8,724 8,724 8,724 

Screening, Brief Intervention, Referral, & Treatment ........... 46,889 30,000 32,000 

Target Capacity Expansion ................................................... 36,303 61,303 71,303 

Medicated Assisted Treatment for Prescription Drug 

and Opioid Addiction (non-add) ............................. 25,000 50,080 60,000 

Buprenorphine Prescribing Authority Demo .......................... ............................ 10,000 ............................

Pregnant & Postpartum Women ........................................... 15,931 15,931 15,931 

Strengthening Treatment Access and Retention .................. ............................ ............................ ............................

Recovery Community Services Program ................................ 2,434 2,434 2,434 

Children and Families .......................................................... 29,605 29,605 29,605 

Treatment Systems for Homeless ......................................... 41,304 36,386 36,386 

Minority AIDS ......................................................................... 65,570 58,859 65,570 

Criminal Justice Activities .................................................... 78,000 61,946 61,946 

Crisis Systems ...................................................................... ............................ 5,000 ............................
120 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

SCIENCE AND SERVICE: 

Addiction Technology Transfer Centers ................................ 9,046 8,081 9,046 

Minority Fellowship Program ................................................. 3,539 3,539 3,539 

Special Initiatives/Outreach .................................................. ............................ ............................ ............................

Addiction Technology Transfer Centers [ATTCs].—The Committee again rejects the administration’s proposal to reduce funding for the ATTCs and instead provides the same funding level as 

fiscal year 2016. The Committee directs SAMHSA to ensure that 

ATTCs maintain a primary focus on addiction treatment and recovery services. 

Combating Opioid Abuse.—Of the amount provided for Targeted 

Capacity Expansion, the Committee includes $60,000,000 for discretionary grants to States for the purpose of expanding treatment 

services to those with heroin or opioid dependence. The Committee 

directs CSAT to ensure that these grants include as an allowable 

use the support of medication assisted treatment and other clinically appropriate services. These grants should target States with 

the highest age adjusted rates of admissions and that have demonstrated a dramatic age adjusted increase in admissions for the 

treatment of opioid use disorders. 

Complex Trauma.—Child traumatic stress occurs when children 

and adolescents are exposed to traumatic events or situations that 

overwhelm their ability to cope and affects tens of thousands of 

children each year. The Committee supports SAMHSA’s current efforts in this area and encourages SAMHSA to explore opportunities 

to address the causes of complex trauma throughout the lifespan. 

Drug Courts.—SAMHSA is directed to ensure that all Drug 

Treatment Court funding is allocated to serve people diagnosed 

with a substance use disorder as their primary condition. SAMHSA 

is further 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. SAMHSA should expand training and technical assistance to drug treatment court grant recipients to ensure evidencebased practices are fully implemented. 

Medication-Assisted Therapy.—The Committee encourages 

SAMHSA to finalize regulations on prescribing buprenorphine to 

treat opioid dependence while supporting strategies to eliminate diversion as expeditiously as possible. 

Opioids State Targeted Response/State Targeted Response Cooperative Agreements.—The Committee recognizes the valuable work 

conducted by Sheriff’s Departments across the country that have 

undertaken a collective effort to enhance the continuum of care for 

incarcerated individuals with substance use disorders. These efforts 

by Sheriff’s Departments that have jail-operation powers and corrections duties serve as a critical component as it relates to a variety of treatment and recovery support services. As SAMHSA works 

to allocate resources for States grappling with the opioid crisis, the 

Committee encourages SAMHSA to consider these efforts for the 

Opioids State Targeted Response grants. 
121 

Oral Fluid Guidelines.—The Committee is pleased with 

SAMHSA’s recommendation of oral fluid as an alternative specimen for drug testing and commends SAMSHA for the progress 

made on issuing oral fluid guidelines for the Federal Workplace 

Drug Testing Programs. The Committee urges SAMSHA to publish 

the guidelines expeditiously and to implement the guidelines in 

partnership with stakeholders and other agencies. 

Pregnant and Postpartum Women [PPW].—The Committee recommendation provides the same level of funding for the PPW program, which supports comprehensive, family-based residential substance use disorder services for pregnant and parenting women, 

their minor children, and other family members. The Committee 

has not included language requested by the administration to support non-residential family-based services through innovation 

grants. The Committee notes that this issue is addressed in reauthorization legislation that is pending in both the House of Representatives and Senate. 

Screening, Brief Intervention, and Referral to Treatment 

[SBIRT].—The Committee is pleased that SAMHSA recently included language in the SBIRT Request for Proposal to allow grantees to focus 20 percent of the funding on individuals between the 

ages of 12 and 18 who are seeking medical services. This will expand opportunities for health care and youth service practitioners 

to engage young people in preventative conversations about substance use, as well as identify and address risky use before it progresses to addiction. The Committee expects SAMHSA to continue 

to encourage applicants to take advantage of this allowable use of 

funds for 12- to 18-year-olds. 

Viral Hepatitis Screening.—The Committee applauds SAMHSA 

for encouraging grantees to screen for viral hepatitis, including the 

use of innovative strategies like rapid testing and urges SAMHSA 

to continue these efforts. The Committee notes the disproportionate 

impact of viral hepatitis among minority populations and the co-infection rate among individuals with HIV/AIDS. The Committee 

urges SAMHSA to work with minority AIDS grantees to incorporate hepatitis screening into programmatic activities. 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends $1,858,079,000 for the Substance 

Abuse Prevention and Treatment Block Grant [SAPT] block grant. 

The recommendation includes $79,200,000 in transfers available 

under section 241 of the PHS Act. The block grant provides funds 

to States to support alcohol and drug abuse prevention, treatment, 

and rehabilitation services. Funds are allocated to States according 

to a formula. 

SUBSTANCE ABUSE PREVENTION

Appropriations, 2016 ............................................................................. $211,219,000 

Budget estimate, 2017 ........................................................................... 211,148,000 

Committee recommendation ................................................................. 225,219,000 

The Committee recommends $225,219,000 for the Center for Substance Abuse Prevention [CSAP], the sole Federal organization 

with responsibility for improving accessibility and quality of substance abuse prevention services. 
122 

The Committee notes that youth drug use continues to be a 

major issue and that perceptions of harm are significantly waning. 

Therefore, the Committee directs that all of the money appropriated explicitly for Substance Abuse Prevention purposes both in 

CSAP’s PRNS lines as well as the funding from the 20 percent prevention set-aside in the SAPT Block Grant be used only for bona 

fide substance abuse prevention activities and not for any other 

purpose. 

Programs of Regional and National Significance 

The Committee provides $225,219,000 for PRNS within CSAP. 

Through these programs, CSAP supports: development of new practice knowledge on substance abuse prevention; identification of 

proven effective models; dissemination of science-based intervention information; State and community capacity building for implementation of proven, effective substance abuse prevention programs; and programs addressing new needs in the prevention system. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

CAPACITY: 

Strategic Prevention Framework/Partnership for Success .... 109,484 109,484 109,484 

Strategic Prevention Framework Rx ...................................... 10,000 10,000 10,000 

Grants to Prevent Prescription Drug/Opioid Overdose ......... 12,000 12,000 26,000 

Mandatory Drug Testing ....................................................... 4,894 4,894 4,894 

Minority AIDS ......................................................................... 41,205 41,205 41,205 

Sober Truth on Preventing Underage Drinking (STOP Act) .. 7,000 7,000 7,000 

National Adult-Oriented Media Public Service Campaign ....................................................................... 1,000 1,000 1,000 

Community-based Coalition Enhancement Grants ...... 5,000 5,000 5,000 

ICCPUD ......................................................................... 1,000 1,000 1,000 

Tribal Behavioral Health Grants ........................................... 15,000 15,000 15,000 

SCIENCE AND SERVICE: 

Fetal Alcohol Spectrum Disorder .......................................... ............................ ............................ ............................

Center for the Application of Prevention Technologies ........ 7,493 7,493 7,493 

Science and Service Program Coordination ......................... 4,072 4,072 4,072 

Minority Fellowship Program ................................................. 71 71 71 

Combating Opioid Abuse.—The Committee provides $26,000,000 

for grants to prevent opioid overdose related deaths. Part of the initiative to Combat Opioid Abuse, this program will help States 

equip and train first responders and other community partners 

with the use of devices that rapidly reverse the effects of opioids. 

Of this amount, the Committee provides $8,000,000 to prevent 

opioid overdose-related deaths in rural areas. People in rural communities are especially vulnerable and more likely to overdose on 

prescription pain killers than people in urban areas, according to 

the CDC. The Committee encourages SAMHSA to work with HRSA 

in the administration of these resources to rural areas. The Committee directs SAMHSA to ensure applicants outline how proposed 

activities in the grant would work with treatment and recovery 

communities in addition to first responders. Furthermore, the Committee provides $10,000,000 for the Strategic Prevention Frame-
123 

work Rx program to increase awareness of opioid abuse and misuse 

in communities. 

Strategic Prevention Framework State Incentive Grant and Partnerships for Success.—The Committee intends that these two programs continue to focus exclusively on: addressing State- and community-level indicators of alcohol, tobacco, and drug use; targeting 

and implementing appropriate universal prevention strategies; 

building infrastructure and capacity; and preventing substance use 

and abuse. 

STOP Act.—The Committee directs that all funds appropriated 

for STOP Act community-based coalition enhancement grants shall 

be used for making grants to eligible communities and not for any 

other purposes or activities. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2016 ............................................................................. $156,306,000 

Budget estimate, 2017 ........................................................................... 173,886,000 

Committee recommendation ................................................................. 148,258,000 

The Committee recommends $148,258,000 for Health Surveillance and Program Support activities. The recommendation includes $32,428,000 in transfers available under section 241 of the 

PHS Act. 

This activity supports Federal staff and the administrative functions of the agency. It also provides funding to SAMHSA’s surveillance and data collection activities, including national surveys such 

as the National Survey on Drug Use and Health. 

Within the total provided for Health Surveillance and Program 

Support, the Committee recommendation includes funding for the 

following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Health Surveillance ........................................................................ 47,258 47,258 47,258 

Program Management .................................................................... 79,559 77,559 77,000 

Performance & Quality Information Systems ................................ 12,918 12,918 10,000 

Public Awareness and Support ...................................................... 15,571 13,482 13,000 

Peer Professional Workforce Development ..................................... ............................ 10,000 ............................

Minority Fellowship Program .......................................................... ............................ ............................ ............................

Behavioral Health Workforce Data ................................................. 1,000 1,000 1,000 

Behavioral Health Workforce Education and Training.—The 

Committee transfers this program to HRSA as requested by the administration. 

Minority Fellowship Program.—The Committee maintains the 

separate accounts for the Minority Fellowship Programs at the 

Center for Mental Health Services, Center for Substance Abuse 

Prevention, and the Center for Substance Abuse Treatment like in 

previous fiscal years and does not consolidate them as proposed by 

SAMHSA. Therefore, funding for these programs is reflected in the 

tables for each of the centers. 

The Committee does not include bill language requested by the 

administration that would provide additional transfer authority to 

the Administrator beyond that which is already provided to the 

Secretary. 
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AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Appropriations, 2016 ............................................................................. $334,000,000 

Budget estimate, 2017 ........................................................................... 363,698,000 

Committee recommendation ................................................................. 324,000,000 

The Committee provides $324,000,000 for the Agency for 

Healthcare Research and Quality [AHRQ]. AHRQ was established 

in 1990 to enhance the quality, appropriateness, and effectiveness 

of health services, as well as access to such services. AHRQ conducts, supports, and disseminates scientific and policy-relevant research on topics such as promoting high-quality care, eliminating 

healthcare disparities, using information technology, and evaluating the effectiveness of clinical services. 

HEALTH COSTS, QUALITY, AND OUTCOMES

The Committee provides $184,279,000 for research on health 

costs, quality, and outcomes [HCQO]. The HCQO research activity 

is focused upon improving clinical practice, improving the 

healthcare system’s capacity to deliver quality care, and tracking 

progress toward health goals through monitoring and evaluation. 

Within the total provided for HCQO, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Research on Health Costs, Quality, and Outcomes: 

Prevention/Care Management ............................................... 11,649 11,649 11,649 

Health Information Technology ............................................. 21,500 22,877 16,500 

Patient Safety Research ....................................................... 74,253 75,977 74,253 

Health Services Research, Data and Dissemination ............ 89,398 113,474 81,877 

Antimicrobial Stewardship.—The Committee supports AHRQ’s 

efforts to develop, improve, and disseminate antimicrobial stewardship interventions to combat the ongoing and serious threat of antimicrobial resistance. AHRQ is directed to work closely with CDC, 

NIH, and other Federal agencies to coordinate efforts to improve 

the use of antibiotics in humans across hospital and community 

settings. 

Consumer Assessment of Healthcare Providers and Systems 

[CAHPS].—The Committee notes that CAHPS surveys are important tools for patients to make more informed decisions about their 

medical care and for providers and insurers to inform quality improvement initiatives and incentives. Patient experience data in 

maternity care is currently not regularly and systematically collected. Therefore, the Committee urges AHRQ to expand its current 

set of surveys and develop a CAHPS survey for maternity care. 

Effective Healthcare Program.—The Committee is aware of 

AHRQ’s interest in expanding the areas of focus for the Horizon 

Scanning System. The Committee believes it is equally important 

for AHRQ to improve the utility of the system by streamlining the 

processes by which it collects information and improving the manner and timeliness that this information is made available to the 

public. Therefore, the Committee requests a report from AHRQ 
125 

within 90 days of enactment regarding how it can better accomplish these objectives. 

Health IT Safety.—The Committee recommendation includes 

$16,500,000 for AHRQ’s work on safe health IT practices specifically related to the design, implementation, usability, and safe use 

of health IT systems. The Committee believes this investment will 

generate new evidence regarding safe health IT practices that will 

ultimately be used by ONC, FDA, CMS, and others to inform policy 

interventions. 

Healthcare-Associated Infections.—Within the Patient Safety 

portfolio, the Committee provides $37,253,000, the same level as in 

fiscal year 2016, for healthcare-associated infection activities. Within this funding level, the Committee includes $10,000,000 for activities as part of the CARB initiative. These funds will support the 

development and expansion of antibiotic stewardship programs specifically focused on ambulatory and long-term care settings. In addition, the Committee directs AHRQ to collaborate with NIH, 

BARDA, CDC, FDA, VA, DOD, and USDA to leverage existing resources to increase capacities for research aimed at developing 

therapeutic treatments, reducing antibiotic use and resistance in 

animals and humans, and implementing effective infection control 

policies. 

Healthcare Delivery Systems.—Within the Patient Safety portfolio, the Committee includes $10,000,000 for Healthcare Delivery 

Systems grants, or ‘‘patient safety learning labs.’’ The purpose of 

these grants is to test new ways of addressing entrenched patient 

safety issues by using a systems engineering approach. 

U.S. Preventative Task Force [USPSTF].—The Committee strongly urges the Secretary to ensure greater transparency and inclusion 

of appropriate physician experts in the development of USPSTF 

recommendations. The Committee is concerned about the lack of 

communication with relevant stakeholders and inconsistency with 

recommendations by other Federal agencies or organizations. 

Therefore, the Committee emphasizes the need for the USPSTF to 

conduct outreach to relevant stakeholders, including provider 

groups, practicing specialists that treat the specific disease or condition under review, and relevant patient and disease advocacy organization before voting on a draft recommendation statement. To 

promote greater transparency, the Committee urges that any final 

recommendation statement include a description of comments received on the draft recommendation statement and relevant recommendations of other Federal agencies and organizations. 

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $68,877,000 for Medical Expenditure 

Panel Surveys [MEPS], which collect detailed information annually 

from households, healthcare providers, and employers regarding 

how Americans use and pay for healthcare. The data from MEPS 

are used to develop estimates of healthcare utilization, expenditures, sources of payment, and the degree of health insurance coverage of the U.S. population. 
126 

PROGRAM SUPPORT

The Committee recommends $70,844,000 for program support. 

This activity funds the overall management of AHRQ, including 

salaries, benefits, and overhead costs such as rent. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Appropriations, 2016 ......................................................................... $243,545,410,000 

Budget estimate, 2017 ...................................................................... 262,003,967,000 

Committee recommendation ............................................................. 262,003,967,000 

The Committee recommends $262,003,967,000 in mandatory 

funding for Grants to States for Medicaid. 

The fiscal year 2017 recommendation excludes $115,582,502,000 

in fiscal year 2016 advance appropriations for fiscal year 2017. As 

requested by the administration, $125,219,452,000 is provided for 

the first quarter of fiscal year 2018. 

The Medicaid program provides medical care for eligible low-income individuals and families. It is administered by each of the 50 

States, the District of Columbia, Puerto Rico, and the territories. 

Federal funds for medical assistance are made available to the 

States according to a formula that determines the appropriate Federal matching rate for State program costs. This matching rate is 

based on the State’s average per capita income relative to the national average and cannot be less than 50 percent. 

PAYMENTS TO HEALTHCARE TRUST FUNDS

Appropriations, 2016 ......................................................................... $283,171,800,000 

Budget estimate, 2017 ...................................................................... 299,187,700,000 

Committee recommendation ............................................................. 299,187,700,000 

The Committee recommends $299,187,700,000 in mandatory 

funding for payments to healthcare trust funds. 

This entitlement account includes the general fund subsidy to 

the Federal Supplementary Medical Insurance Trust Fund for 

Medicare Part B benefits and for Medicare Part D drug benefits 

and administration, plus other reimbursements to the Federal Hospital Insurance Trust Fund for Part A benefits and related administrative costs that have not been financed by payroll taxes or premium contributions. 

The Committee provides $214,944,000,000 for the Federal payment to the Supplementary Medical Insurance Trust Fund. This 

payment provides matching funds for premiums paid by Medicare 

Part B enrollees. 

The Committee further provides $82,512,000,000 for the general 

fund share of benefits paid under Public Law 108–173, the Medicare Prescription Drug, Improvement and Modernization Act of 

2003. As in previous years, the Committee includes bill language 

requested by the administration providing indefinite authority for 

paying the general revenue portion of the Part B premium match 

and provides resources for the Part D drug benefit program in the 

event that the annual appropriation is insufficient. 

The Committee recommendation also includes $405,000,000 to be 

transferred to the Supplementary Insurance Trust Fund as the 
127 

general fund share of Part D administrative expenses. The Committee recommendation includes $299,000,000 in reimbursements 

to the Health Care Fraud and Abuse Control [HCFAC] fund, which 

reflects the portion of the HCFAC spending to be reimbursed by 

the General Fund. 

PROGRAM MANAGEMENT

Appropriations, 2016 ............................................................................. $3,669,744,000 

Budget estimate, 2017 ........................................................................... 4,109,549,000 

Committee recommendation ................................................................. 3,669,744,000 

The Committee recommends $3,669,744,000 for CMS program 

management, which includes funding for research, program operations, survey and certification programs, and Federal administration. 

Research, Demonstrations and Evaluations.—The Committee recommends $20,054,000 for research, demonstrations, and evaluation 

activities. 

Program Operations 

The Committee recommends $2,519,823,000 for the Program Operations account, which covers a broad range of activities including 

claims processing and program safeguard activities performed by 

Medicare contractors. These contractors also provide information, 

guidance, and technical support to both providers and beneficiaries. 

ACA Notifications.—The Committee continues bill language requiring the administration to provide detailed enrollment figures to 

the Committees on Appropriations of the House of Representatives 

and the Senate not less than two full business days before any public release of the information. 

Access to Mental Health Care.—The Committee continues to 

prioritize mental health treatment and services and provides an increase within the bill for these programs. The Committee provides 

an increase of $30,000,000 for the Mental Health Block Grant at 

SAMHSA as well as $50,000,000 to expand mental health services 

in Community Health Centers around the Nation. While these programs remain fundamental components of the mental and behavioral health system, the Committee notes that without access to 

these services, many Americans suffering from mental or behavioral health issues will continue to go untreated. The Committee 

strongly urges CMS to pursue initiatives that expand access to 

quality care and increase parity for mental health services. 

Adult Immunization Quality Measures.—The Committee is aware 

that CMS is working to close gaps in quality measures to improve 

care delivery and patient outcomes, including reducing racial and 

ethnic health disparities. Adult immunization quality measures are 

one area where more work is needed as noted in the August 2014, 

the National Quality Forum [NQF] report entitled ‘‘Priority Setting 

for Healthcare Performance Measurement: Addressing Performance 

Measure Gaps for Adult Immunization’’. The Committee recommends CMS partner with the Core Measures Collaborative and 

NQF’s Measure Application Partnership to address the current 

gaps in adult immunization measures and ensure the reflect current best practices. The Committee requests a report from CMS no 

later than 18 months following enactment on the steps the agency 
128 

has taken to expand and improve quality measures applicable to 

adult immunization under Medicare and Medicaid, including an action plan to disseminate measures to enable widespread adoption. 

Air Ambulance Services and Payment Structures.—The Committee directs the GAO to submit a report to the Committees on 

Appropriations of the House of Representatives and the Senate no 

later than 12 months after the enactment of this act on air ambulance services and payment structures. The report should include 

analysis of the following costs: maintenance of aircrafts; medical 

supplies; fuel; employee expenses; recurring training relating to 

aviation, maintenance, communication, and clinical; rent and utilities; communications; travel; hull and aviation liability insurance, 

life insurance, and professional malpractice insurance; marketing; 

supplies; overhead support; aircraft ownership expenses; safety enhancement capital costs; and safety enhancement recurring costs, 

as well as the amounts charged to individuals who utilize these 

services. The report should reflect regional, State, demographic, 

and urban/rural/super rural differences; coverage maps for rotor 

and fixed winged services; number of providers vs. number of 

transports over the last decade broken out by year and by region; 

health plans accepted, including Medicare, Medicaid, and standalone air medical transport insurance, and type and amount of coverage; number of air ambulance providers that accept Medicare reimbursement, number of carriers that in network agreements with 

health insurance providers, and out of network carriers; whether 

health insurance, including Medicare and Medicaid, reimbursements cover costs and which air ambulance providers balance bill 

those receiving services; differences in rates, costs, and frequency 

for transports from accident sites in comparison to rates, costs, and 

frequency for facility-to-facility transports; differences in emergency 

rates, costs, and frequency in comparison to non-emergency, or 

chartered, rates, costs, and frequency; evaluate costs/reimbursement rates relative to quality of aircraft and services provided; and 

startup costs and fixed and variable costs. Finally, the report 

should also include analysis of the disproportionate share of superrural air ambulance utilization as a ratio of all super-rural ambulance usage in comparison to rural air ambulance utilization as a 

ratio of all rural ambulance usage, including the factors leading to 

an increased super-rural proportion of use of air ambulance services and whether the increased use is justified. 

Ambulance Moratorium.—The Committee supports CMS’ efforts 

to extend home health and ambulance moratoriums to curb and 

prevent waste, fraud, and abuse. The Committee encourages CMS 

to continue to ensure patients have appropriate access to care 

while weighing additional extensions. 

American Board of Interventional Pain Physicians [ABIPP].—The 

ABIPP has extensive training requirements and a credentialing 

process that requires primary board certification from the American Board of Medical Specialties [ABMS]. The Committee encourages CMS to consider ABIPP specialty certification as equivalent to 

certifications recognized by ABMS, including, but not limited to accreditation, licensing, participation in Managed Care Organizations 

and Accountable Care Organizations and privileges to practice 

interventional pain management. 
129 

Appropriate Use Criteria [AUC] for Certain Imaging Services.— 

In section 218(b) of Public Law 113–93, Congress instructed CMS 

to promote the use of AUC for certain imaging services in the 

Medicare program. This language was intended to support the 

study and adoption of clinical decision support systems, which can 

be integrated into electronic health records. In seeking to implement section 218(b), the Committee encourages CMS to focus on 

consultation with clinical guidelines when ordering advanced imaging tests before instituting prior authorization. The Committee encourages CMS to continue to support the use of AUC by closing 

knowledge gaps with health care professionals on how to apply 

AUC when choosing an imaging text. 

Assistive Technology Act Programs Reutilization Program.—The 

Committee is encouraged that several State Medicaid Programs 

have developed assistive technology and durable medical equipment reuse programs. These programs retrieve and refurbish devices that were purchased with Medicaid funds, but are no longer 

being used by Medicaid recipients or other sources. Refurbished 

equipment may be reassigned to Medicaid members as a priority 

or to other eligible individuals who are disabled or elderly. CMS 

should encourage State Medicaid programs to partner with State 

Assistive Technology Act Programs to develop and implement reutilization programs with a goal of containing Medicaid costs. 

Cancer Screening Technologies.—The Committee believes it is 

critical for Medicare beneficiaries to have access to high-quality 

preventive services, including innovative cancer screening tests. To 

help maintain robust access to quality preventive cancer care, the 

Committee requests that CMS, when considering Medicare quality 

measurements, work with stakeholders, as appropriate, to ensure 

that cancer screening technologies are reviewed in a timely manner. 

Caregiver Counseling and Supportive Services.—The Committee 

is aware of a body of evidence that suggests defined counseling and 

supportive services delivered to family (non-paid) caregivers of 

Medicare beneficiaries with Alzheimer’s disease and dementia can 

substantially delay beneficiary placement in an institutional care 

setting and reduce Federal expenditures associated with such care. 

The Committee is concerned about the current and anticipated 

Medicare and Medicaid costs associated with Alzheimer’s disease 

and recommends that CMS, in consultation with ACL, consider a 

pilot or demonstration program to evaluate the impact of such evidence-based Alzheimer’s caregiver support models could have on 

the Medicare and Medicaid programs. 

Complex Rehabilitation Technology.—The Committee encourages 

CMS to ensure that individuals with severe disabilities, including 

those with cerebral palsy, muscular dystrophy, multiple sclerosis, 

and spinal cord injuries, who are entitled to Medicare benefits have 

adequate information on how to access complex rehabilitation technology that appropriately addresses their unique needs. 

Critical Access Hospitals [CAH].—The Committee is disappointed 

that the administration continues to propose eliminating CAH status from facilities located less than 10 miles from another hospital 

and reducing the reimbursement rate from 101 percent to 100 percent of reasonable cost. A recent Health Affairs study reviewed the 
130 

impact of similar minimum distance requirements and found that 

currently 37.6 percent of CAHs had a negative operating margin, 

and if such a distance requirement went into effect, it would rise 

to 75.6 percent. If a CAH lost its designation, it would be forced 

under the applicable prospective payment systems which are designed for larger facilities, not small, low volume rural hospitals. 

The results of the study underscore the importance of factoring 

clinical expertise, physician distribution, availability of telehealth, 

sufficient volume to maintain key services, and the needs of underserved populations. Coupled with over regulation, decreased reimbursements, and workforce shortages, CAHs would be forced to 

close without their designation, causing patients to travel farther, 

forego preventative care, and ultimately cost more in CMS 

healthcare expenditures. 

CT Colongraphy.—Due to the proven life and cost-savings of preventative screening for colorectal cancer, the Committee encourages 

CMS to consider covering CT Colonography as a Medicare-covered 

colorectal cancer screening test under section 1861(pp)(1) of the Social Security Act. 

Diabetes Technologies.—Diabetes technologies known as continuous glucose monitors [CGM] have been shown in clinical trials to 

improve health care outcomes of people with type 1 diabetes and 

reduce the risk of low blood sugar emergencies which can lead to 

hospitalizations. These technologies are recommended by national 

diabetes guidelines and covered by 95 percent of private health 

plans. Medicare, however, does not cover CGM technologies, leaving seniors vulnerable. The Committee encourages Medicare to 

modernize its policies to cover CGM technologies to ensure access 

for those with type 1 diabetes or those entering Medicare who have 

benefitted from the technology under their prior health plan. 

Electrodiagnostic Tests.—The Committee requests an update 

from CMS submitted to the Committees on Appropriations of the 

House of Representatives and the Senate on the three recommendations proposed by the 2014 OIG Report: ‘‘Questionable 

Billing for Medicare Electrodiagnostic Tests’’. 

Evaluation and Management Research.—The Committee recognizes that both traditional and innovative payment models rely on 

traditional fee-for-service as a foundation for physician payment. 

The existing outpatient evaluation and management service codes 

do not adequately capture the range of outpatient evaluation and 

management work performed by cognitive physicians. The Committee encourages CMS to commission the research necessary to 

understand, on the basis of newly collected data, what occurs during and following an outpatient evaluation and management service. Once complete, CMS should use these findings to develop new 

outpatient service codes and the associated documentation requirements. This research model can then be used to revise the other 

evaluation and management code families. The Committee expects 

a report submitted to the Committees on Appropriations of the 

House of Representatives and the Senate on the status of this research in the fiscal year 2018 CJ. 

Graduate Medical Education [GME].—Communities throughout 

the country, particularly those in rural areas, struggle with physician shortages, particularly with access to primary care and mental 
131 

health care. GME serves as the final step in a physician’s training, 

and Medicare provides the majority of public financing for GME. 

The Committee is concerned that current public financing for GME 

does not adequately address the needs of all communities or the 

changing demands of the health care system. The Committee directs CMS to submit a report to Congress, no later than 180 days 

after the enactment of this act, on what steps can be taken under 

current law to address physician shortages. 

Health Insurance Exchange Transparency.—The Committee continues bill language 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 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 2018. 

Home Dialysis.—The Committee encourages CMS to review, 

streamline, and update the Medicare Administrative Contractor 

waiver requirements to incorporate a fair and transparent process 

to granting waivers for use of remote monitoring and management 

technologies. The Committee requests a report on the status of the 

review and update process within 180 days of the enactment of this 

act. 

Intrathecal Pain Pumps.—The Committee is concerned that recent changes to Medicare billing practice may restrict patient access to intrathecal pain pumps as an option for pain management 

in States where the boards of pharmacy prohibit sale of compounded solutions from a pharmacist to a physician. Therefore, the 

Committee directs the Secretary, in consultation with relevant 

stakeholders, to conduct a study of the effect of this billing practice 

change on patient access in these States. The Secretary shall submit the report within 6 months after enactment of this act to the 

Committees on Appropriations of the House of Representatives and 

the Senate with recommendations rectifying any identified limits to 

patient access to intrathecal pain pump medication. 

Medicare Advantage.— The Committee is concerned that the formula to determine Medicare Advantage reimbursement rates is calculated based on the per capita cost of coverage to beneficiaries enrolled in Medicare Part A and/or Part B. However, where there is 

high enrollment in Medicare Advantage, a relatively large proportion of Medicare beneficiaries without Part B coverage, and relatively lower fee-for-service costs, Medicare Advantage reimbursement rates may be better based on the per capita cost of coverage 

to beneficiaries enrolled in both Medicare Parts A and B. The Committee encourages CMS to consider more accurate adjustments for 

fiscal year 2018. 

Out of Network Emergency Care.—The Committee believes that 

beneficiary protections are important to reduce the financial expo-
132 

sure of patients who receive emergency care outside of their insurance network. The Committee is concerned that the Center for 

Consumer Information and Insurance Oversight [CCIIO] has not 

provided sufficient clarity on how to determine the ‘‘Usual, Customary & Reasonable’’ [UCR] amount and encourages that CCIIO 

publish clarifying guidance. 

Part D Billing of Vaccines.—The Committee is aware that Medicare Part B covers vaccines for several serious vaccine-preventable 

diseases, including influenza, pneumonia, and Hepatitis B for atrisk patients. However, a growing number of other vaccines are 

only covered under Medicare’s pharmacy benefit, which can be 

challenging and burdensome for Part B providers to bill. This can 

impede beneficiary access to the full complement of vaccines recommended by the Advisory Committee on Immunization Practices. 

The Committee encourages CMS to prioritize the establishment 

and deployment of a Web-based system to facilitate access to information regarding Part D coverage criteria for vaccines and streamline billing for Part D vaccines. Such a system should reduce administrative burdens by enabling physicians to search plan coverage and allow electronic submission claims for vaccines and vaccine administration directly to Part D plans. The Committee requests a report within 1 year of enactment submitted to the Committee detailing implementation, including health care professional 

education efforts among health care professionals and utilization 

rates of recommended Part D vaccines among Medicare beneficiaries. 

Pre-Dispute Arbitration SNF.—The Committee is aware that 

CMS has proposed regulations that would restrict or prohibit predispute arbitration agreements in skilled nursing facilities. The 

Committee urges CMS to more thoroughly study the impact of restricting pre-dispute arbitration agreements before taking further 

action. 

Prosthetic Coverage.—The Committee recognizes that Medicare 

payments for all prosthetics, and especially the newer advanced 

technologies, have declined over each of the years 2010–2014. The 

Committee encourages CMS to consult broadly with clinicians, patient groups, and the prosthetics field regarding revisions to the 

draft Local Coverage Determination, prior to publishing an updated draft policy for public comment. 

Recovery Audit Contractors [RAC].—The Committee directs the 

Medicare appeals intra-agency working group to provide quarterly 

updates to the Committees on Appropriations of the House of Representatives and the Senate reflecting the total number of appeals 

filed, appeals pending, and appeals disposed of for all four levels 

of the appeals process. The quarterly updates should include a 

breakout of RAC and non-RAC claims, an update on RAC contracting and how new RAC requirements have affected the rate of 

appeals. 

Relative Values Under the Medicare Physician Fee Schedule.— 

The Committee encourages the Secretary to increase the representation of actively practicing board certified primary care physicians 

on any advisory board, working group, task force or panel that is 

charged with formulating recommendations to any annual updates 

involving physician work standards. 
133 

Risk Corridor Program.—The agreement continues bill language 

to prevent the CMS Program Management appropriation account 

from being used to support risk corridor payments. The agreement 

directs CMS to provide a report starting with plan year 2014 and 

continuing through the duration of the program to the Committees 

on Appropriations of the House of Representatives and the Senate 

detailing the receipts and transfer of payments for the Risk Corridor Program. 

Robotic Stereotactic Radiosurgery.—The Committee was encouraged by CMS’ decision to reverse the National Correct Coding Initiative [NCCI] procedure edit regarding the provision of robotic 

radiosurgery. With this decision, CMS recognizes the safety and 

value of dosimetry calculations in radiation oncology. However, the 

Committee remains concerned that the cuts to robotic stereotactic 

radiosurgery threatens its viability in both the hospital and freestanding center setting. The Committee encourages CMS not to 

make further changes to these services in the freestanding center 

as CMS complies with Public Law 114–115. 

Rural Health.—While nearly a quarter of the U.S. population 

lives in rural areas, access to CAHs continues to be a challenge for 

many residents as these hospitals face significant financial challenges. The majority of rural residents are older, poorer, and less 

likely to have employer sponsored health plans. As a result, if a 

rural hospital closes, many patients end up driving long distances 

to see a doctor, forgo seeking medical care, or even worse, wait 

until it is too late to seek proper medical attention. These patients 

spend more money out of pocket to travel and miss out on routine 

preventative care which will end up increasing healthcare costs in 

the long run. The Committee continues to direct CMS to work with 

HRSA’s Office of Rural Health and provide an update in the fiscal 

year 2018 CJ on actions taken to alleviate the disproportionate impact of regulations, reimbursement cuts, and workforce issues on 

rural hospitals. 

Smart Medicare Card.—The Committee encourages CMS to continue to explore smart card technology for Medicare beneficiaries 

and providers to increase quality of care, reduce identity theft, and 

increase the accuracy of Medicare billing. 

Third Party Premium Assistance.—The Committee remains concerned that CMS guidance on qualified health plan third party 

payment remains unclear and is being interpreted as prohibiting 

premium assistance by nonprofit organizations. CMS is encouraged 

to continue to clarify language and consider outlining specific instances when third-party payment premium assistance should be 

accepted. 

Use of Opioid Drugs to Manage Chronic Pain.—The Committee 

understands that opioid pain medications are used and are often 

essential in the appropriate management of acute and chronic pain. 

Given the national problem of misuse and abuse of prescription 

opioid pain medications, the Committee encourages CMS to increase awareness of alternative pain management strategies to 

opioids to reduce opioid monotherapy in appropriate cases. 

Use of Social Security Numbers on Medicare Beneficiaries’ 

Cards.—Under Public Law 114–10, Congress prohibits the use of 

Social Security numbers on Medicare beneficiary cards. The Com-
134 

mittee urges CMS to work expeditiously to remove Social Security 

numbers from Medicare cards as directed in Public Law 114–10. 

The Committee directs CMS to provide an update on the progress 

of this initiative in their fiscal year 2018 CJ. 

Vial Size.—Within 90 days of enactment of this act, CMS shall 

enter into an agreement with the Health and Medicine Division of 

the National Academies of Sciences, Engineering, and Medicine 

[the Academies] to conduct a study on the Federal healthcare costs, 

safety, and quality concerns associated with discarded drugs that 

results from weight-based dosing of medicines contained in singledose vials. As part of this study, the Academies should assess factors such as patient safety; storage/shipping issues; FDA guidance; 

CDC guidelines to biopharmaceutical manufacturers; and the Federal cost of discarded drugs. Stakeholders, including CMS, FDA, 

CDC, DOD, IHS, VA, specialty physicians [including rural practitioners], specialty clinics [including rural clinics], patient groups, 

biopharmaceutical manufacturers, health insurance companies, and 

healthcare distributors/wholesalers shall be consulted. The Committee directs this report, which shall include recommendations to 

Congress, to be submitted to the Committees on Appropriations of 

the House of Representatives and the Senate no later than 12 

months after the contract date. 

State Survey and Certification 

The Committee recommends $397,334,000 for State Survey and 

Certification activities, which ensure that institutions and agencies 

providing care to Medicare and Medicaid beneficiaries meet Federal health, safety, and program standards. On-site surveys are 

conducted by State survey agencies, with a pool of Federal surveyors performing random monitoring surveys. 

The Committee continues to support CMS collecting and analyzing the findings from this surveillance tool to inform the agency’s education and surveillance efforts moving forward. 

Federal Administration 

The Committee recommends $732,533,000 for Federal Administration, which funds the majority of CMS’ staff and operating expenses for routine activities such as planning, implementing, evaluating, and ensuring accountability in the programs administered by 

CMS. 

HEALTH CARE FRAUD AND ABUSE CONTROL

Appropriations, 2016 ............................................................................. $681,000,000 

Budget estimate, 2017 ........................................................................... 725,000,000 

Committee recommendation ................................................................. 725,000,000 

The Committee recommends $725,000,000, to be transferred from 

the Medicare trust funds, for Health Care Fraud and Abuse Control [HCFAC] activities. The latest data demonstrate for every 

$1.00 spent on fraud and abuse, $2 is recovered by the Treasury. 

By utilizing the cap adjustment provided in the Budget Control 

Act, the Committee recommendation will create over 

$10,200,000,000 in savings to the U.S. Treasury over 10 years. 

The Committee recommendation includes a base amount of 

$311,000,000 and an additional $414,000,000 through a budget cap 
135 

adjustment authorized by section 251(b) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

Senior Medicare Patrol Program.—The bill includes language to 

fully fund 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

Appropriations, 2016 ............................................................................. $2,944,906,000 

Budget estimate, 2017 ........................................................................... 3,010,631,000 

Committee recommendation ................................................................. 3,010,631,000 

The Committee recommendation includes $3,010,631,000 in fiscal 

year 2017 mandatory funds for Child Support Enforcement and 

Family Support programs. In addition, the Committee recommends 

$1,400,000,000 in advance funding for the first quarter of fiscal 

year 2018. 

These funds support States’ efforts to promote the self-sufficiency 

and economic security of low-income families, including administrative expenses matching funds and incentive payments to States for 

child support enforcement; grants to States to help establish and 

administer access and visitation programs between noncustodial 

parents and their children; payments to territories for benefits to 

certain aged, blind, or disabled individuals; and temporary benefits 

for certain repatriated citizens. 

LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

Appropriations, 2016 ............................................................................. $3,390,304,000 

Budget estimate, 2017 ........................................................................... 3,000,304,000 

Committee recommendation ................................................................. 3,390,304,000 

The Committee recommendation includes $3,390,304,000 for 

LIHEAP, which provides home heating and cooling assistance to 

low-income households, generally in the form of payments to energy vendors on behalf of the recipient. Within the total, the Committee recommendation includes up to $2,988,000 for program integrity and oversight efforts. 

REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2016 ............................................................................. $1,674,691,000 

Budget estimate, 2017 ........................................................................... 2,249,860,000 

Committee recommendation ................................................................. 1,674,691,000 

The Committee recommends $1,674,691,000 for Refugee and Entrant Assistance programs. These programs provide a variety of 

benefits and services to refugees, asylees, Cuban and Haitian entrants, immigrants arriving on Special Immigrant Visas, trafficking 

victims, and torture victims (collectively referred to below as ‘‘refugees’’). These programs also provide temporary care and services 

for unaccompanied children apprehended by the Department of 

Homeland Security or other law enforcement agencies, who have no 

lawful immigration status in the United States until they can be 

placed with a parent, guardian, or other sponsor while awaiting adjudication of their immigration status. 
136 

Transitional and Medical Services 

The Committee recommendation includes $490,000,000 for Transitional and Medical Services [TAMS]. This program provides 

grants to States and nonprofit organizations to provide up to 8 

months of cash and medical assistance to arriving refugees, as well 

as foster care services to unaccompanied minors. 

The Committee notes that there is considerable uncertainty in 

the estimates of costs for this program, which depend heavily on 

the number of refugees admitted and entering the United States, 

as well as estimates of financial, medical, and foster care costs of 

arriving refugees. In addition, there are significant prior-year unobligated balances available within ORR that may be used for the 

TAMS program. Congress has provided extended availability for 

funds appropriated in this account specifically to account for uncertainties in this program. The Committee will consider future funding needs as more data becomes available. 

Victims of Trafficking 

The Committee recommendation includes $18,755,000 for Victims 

of Trafficking programs. These programs support a national network of organizations that provide a variety of services—including 

case management, counseling, benefit coordination, and housing assistance—for victims of commercial sex and forced labor trafficking. 

Within the total, the Committee recommendation includes 

$13,000,000 for services for foreign national victims, and 

$5,755,000 to improve services available for U.S. citizens and legal 

permanent residents, the same as the fiscal year 2016 funding levels. The Committee recommendation also includes continued funding for a national human trafficking resource center, and includes 

bill language clarifying that funds can continue to be used for these 

activities. 

Social Services 

The Committee recommendation includes $155,000,000 for Social 

Services programs for refugees. These funds include both formula 

and discretionary grants to States and nonprofit organizations to 

provide a variety of employment and support services to recently 

arrived refugees. 

Preferred Communities.—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. Extended case management services help to ensure refugees achieve self-sufficiency and integrate 

into their new communities. 

Preventive Health 

The Committee recommendation includes $4,600,000 for Preventive Health services for refugees. This program funds competitive 

grants to States to provide newly arrived refugees health orientation and education services, referrals for medical and mental 

health services, and access to ongoing healthcare. 
137 

Targeted Assistance 

The Committee recommendation includes $47,601,000 for the 

Targeted Assistance program. This program provides additional 

funds to States and counties with the greatest number of refugee 

arrivals and high concentrations of refugees facing difficulties 

achieving self-sufficiency. 

Unaccompanied Children 

The Committee recommendation includes $948,000,000 for the 

Unaccompanied Children [UC] program. The UC program provides 

temporary shelter and basic services to children who have no lawful immigration status in the United States and who have been apprehended in the United States by the Department of Homeland 

Security or other law enforcement agencies without a parent or 

guardian. HHS takes custody of the children until they can be 

placed with a parent or guardian living in the United States pending resolution of their immigration status, or until their immigration status otherwise changes. 

Similar to the TAMS program, there is considerable uncertainty 

in the estimates of costs for this program, which depend heavily on 

the number of unaccompanied children coming to the United States 

and referred to HHS. There are also significant prior-year unobligated balances available for use under this program that may be 

used in fiscal year 2016 and 2017. The amount of unobligated balances available in fiscal year 2017, which will directly impact the 

amount of new budget authority needed for fiscal year 2017, will 

depend on costs in fiscal year 2016, for which there is also considerable uncertainty. The Committee will consider future funding 

needs for this program as more data becomes available. 

The Committee notes that HHS is responsible for providing postrelease services, including home visits, for certain children it places 

with a sponsor pending adjudication of their immigration status. 

The Committee strongly encourages HHS to continue efforts to improve its process for providing post-release services to ensure that 

children are placed in safe, appropriate environments. 

Victims of Torture 

The Committee recommendation includes $10,735,000 for the 

Victims of Torture program. This program provides treatment, social, and legal services to victims of torture and training to 

healthcare providers on treating the physical and psychological effects of torture. 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT

BLOCK GRANT

Appropriations, 2016 ............................................................................. $2,761,000,000 

Budget estimate, 2017 ........................................................................... 2,961,672,000 

Committee recommendation ................................................................. 2,786,000,000 

The Committee recommends $2,786,000,000 for the Child Care 

and Development Block Grant [CCDBG], a formula grant to States 

that provides financial assistance to families to help pay for child 

care, and otherwise improve the quality of child care programs. 
138 

The CCBDG Act of 2014 included a new set-aside requiring 

States to reserve a specified percentage of funding for improving 

the quality of infant and toddler child care. This replaces a similar 

set-aside previously included in appropriations language. Accordingly, the Committee recommendation removes the set-aside previously included in appropriations language. 

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2016 ............................................................................. $1,700,000,000 

Budget estimate, 2017 ........................................................................... 1,700,000,000 

Committee recommendation ................................................................. 1,700,000,000 

The Committee recommends $1,700,000,000 in mandatory funds 

for the SSBG, a flexible source of funding that allows States to provide a diverse array of services to low-income children and families, 

the disabled, and the elderly. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriations, 2016 ............................................................................. $11,234,268,000 

Budget estimate, 2017 ........................................................................... 11,725,057,000 

Committee recommendation ................................................................. 11,214,935,000 

The Committee recommends $11,214,935,000 for Children and 

Family Services programs. These funds support a variety of programs for children, youth, and families; Native Americans; victims 

of child abuse, neglect, and domestic violence; and other vulnerable 

populations. 

The Committee directs the Department, in conjunction with the 

Department of Education, to conduct the review of all federally 

funded early childhood education programs required by section 

9213 of the Every Student Succeeds Act, to develop a plan for the 

elimination of overlapping programs, determine if activities conducted by States using grant funds from Race to the Top and Preschool Development Grants have led to a better utilization of resources, and make recommendations to Congress for streamlining 

all such programs. 

Head Start 

The Committee recommendation includes $9,203,095,000 for 

Head Start. Head Start provides grants directly to local organizations to provide comprehensive early childhood education services 

to children and their families, from before birth to age 5. The Committee recommendation includes a $35,000,000 increase 

to support increases for all current Head Start programs which will 

help programs keep up with costs, recruit and support highly qualified staff, maintain enrollment levels, and continue to provide highquality, comprehensive services for children and families. 

Within the total for Head Start, in addition to funds otherwise 

available for Early Head Start, the Committee recommendation includes $635,000,000, the same as the fiscal year 2016 level, to support the continuation of Early Head Start Expansion and Child 

Care Partnerships grants. The Committee continues to direct HHS 

to give equal priority to grantees providing more traditional Early 

Head Start services and those forming child care partnerships. The 

Committee continues to support this partnership model but such 

partnerships will not be viable in every community and in many 
139 

places it may be more appropriate to simply provide traditional 

Early Head Start services. 

Within the total for Head Start, the Committee recommendation 

also includes up to $25,000,000, the same as the comparable fiscal 

year 2016 level and the budget request, for transition-related costs 

associated with the Head Start Designation Renewal System 

[DRS]. HHS is in the process of evaluating the DRS, including its 

validity, its sensitivity in differentiating lower performing programs from higher performing programs, and its role in improving 

the quality of Head Start programs. The Committee looks forward 

to the results of this evaluation. In addition, the Committee encourages HHS to continue to consider the unique challenges faced 

by Head Start grantees in remote and frontier areas when reviewing such grantees’ compliance with health and dental screening requirements as part of the DRS. 

The Committee continues to support efforts to expand the duration of Head Start services. Research increasingly indicates that expanding the duration of services, including lengthening the school 

day and school year, is critical to increasing and sustaining the 

benefits of early childhood programs. However, the Committee directs HHS to ensure that as part of the effort to expand the duration of services, grantees continue to have flexibility to meet the 

needs of their local community, and to fund other quality improvement activities that may be necessary to improve the quality of 

programs prior to expanding the duration of services. 

Preschool Development Grants 

The Committee recommendation includes $250,000,000 for Preschool Development Grants. The Every Student Succeeds Act 

moves this program from the Department of Education to HHS, 

and the Committee recommendation is consistent with that move. 

Funding for Preschool Development Grants in fiscal year 2016 is 

shown in HHS for comparability. 

The Preschool Development Grants program provides competitive 

grants to States to develop or expand preschool programs for 4-year 

olds from low- and moderate-income families. This fiscal year 2017 

funding will support the continuation costs for the fourth and final 

year of existing State grants. 

Consolidated Runaway and Homeless Youth Program 

The Committee recommendation includes $101,980,000 for the 

Consolidated Runaway and Homeless Youth program. This program supports the Basic Centers program, which provides temporary shelter, counseling, and after-care services to runaway and 

homeless youth under age 18 and their families; the Transitional 

Living Program, which provides longer-term shelter and services 

for older youth; and a national toll-free runaway and homeless 

youth crisis hotline. 

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth 

The Committee recommendation includes $17,141,000 for Education and Prevention Grants to Reduce Sexual Abuse of Runaway 

and Homeless Youth. This program provides competitive grants for 
140 

street-based outreach and education services for runaway and 

homeless youth who are subjected to, or are at risk of being subjected to, sexual abuse or exploitation. 

Child Abuse Prevention and Treatment State Grants 

The Committee recommendation includes $25,310,000 for the 

Child Abuse Prevention and Treatment State Grant program. This 

program provides formula grants to States to improve their child 

protective service systems. 

Child Abuse Discretionary Activities 

The Committee recommendation includes $33,000,000 for Child 

Abuse Discretionary Activities. This program supports discretionary grants for research, demonstration, and technical assistance to increase the knowledge base of evidence-based practices 

and to disseminate information to State and local child welfare programs. 

Community-Based Child Abuse Prevention 

The Committee recommendation includes $39,764,000 for the 

Community-Based Child Abuse Prevention program. This program 

provides formula grants to States that then disburse funds to local, 

community-based organizations to improve local child abuse prevention and treatment efforts, including providing direct services 

and improving the coordination between State and communitybased organizations. 

Child Welfare Services 

The Committee recommendation includes $268,735,000 for Child 

Welfare Services. This formula grant program helps State and tribal public welfare agencies improve their child welfare services with 

the goal of keeping families together. These funds help States and 

tribes provide a continuum of services that prevent child neglect, 

abuse or exploitation; allow children to remain with their families, 

when appropriate; promote the safety and permanence of children 

in foster care and adoptive families; and provide training and professional development to the child welfare workforce. 

Child Welfare Research, Training, and Demonstration 

The Committee recommendation includes $17,984,000 for child 

welfare research, training, and demonstration projects. This program provides grants to public and nonprofit organizations for 

demonstration projects that encourage experimental and promising 

types of child welfare services, as well as projects that improve 

education and training programs for child welfare service providers. 

National Survey of Child and Adolescent Well-Being.—The Committee recommendation includes funding within this program for 

HHS to continue the National Survey of Child and Adolescent 

Well-Being. This survey provides critical, nationally representative, 

longitudinal data on children who have been involved in State child 

protective services programs. This helps examine the current characteristics and needs of children and families involved with child 
141 

protective services, and evaluate the impact of interventions to improve child and family well-being. 

Adoption Opportunities 

The Committee recommends $39,100,000 for the Adoption Opportunities program. This program funds discretionary grants to help 

facilitate the elimination of barriers to adoption and provide technical assistance to help States increase the number of children 

adopted, particularly children with special needs. 

The Committee encourages ACF to fund activities to improve 

hospital-based adoption support services for pregnant and expectant mothers, including training for hospital staff and doctors. Such 

activities would help ensure that mothers who wish to make an 

adoption have access to trained staff and comprehensive supports 

throughout the adoption process. 

Adoption Incentives 

The Committee recommends $37,943,000 for the Adoption Incentives program. This program provides formula-based incentive payments to States to encourage them to increase the number of adoptions of children from the foster care system, with an emphasis on 

children who are the hardest to place. 

Social Services and Income Maintenance Research 

The Committee recommends $6,512,000 for Social Services and 

Income Maintenance Research. These funds support research and 

evaluation of cost-effective programs that increase the stability and 

economic independence of families and contribute to the healthy 

development of children and youth. 

Native American Programs 

The Committee recommends $50,000,000 for Native American 

programs. These funds support a variety of programs to promote 

self-sufficiency and cultural preservation activities among Native 

American, Native Hawaiian, Alaska Native, and Pacific Islander 

organizations and communities. 

Within the total, the Committee recommendation includes 

$12,000,000 for Native American language preservation activities, 

including no less than $4,000,000 for Native American language 

nests and survival schools, as authorized by sections 803C(b)(7)(A)– 

(B) of the Native American Programs Act. The Committee directs 

HHS to give priority to programs with the most rigorous immersion 

programs. 

Community Services Block Grant 

The Committee recommendation includes $715,000,000 for the 

Community Services Block Grant [CSBG]. The CSBG is a formula 

grant to States and Indian tribes to provide a wide range of services to alleviate causes of poverty in communities and to assist lowincome individuals in becoming self-sufficient. States are required 

to pass on at least 90 percent of these funds to local communitybased organizations, the vast majority of which are community action agencies. 
142 

Community Economic Development 

The Committee recommendation does not include funding for the 

Community Economic Development [CED] program, as proposed by 

the administration. The President’s budget proposed eliminating 

this program because it is similar or duplicative of programs administered by other agencies, including the Department of Treasury. 

Rural Community Facilities 

The Committee recommendation does not include funding for the 

Rural Community Facilities program, as proposed by the administration. The President’s budget proposed eliminating this program 

because it is similar or duplicative of programs administered by 

other agencies, including the Department of Agriculture and Environmental Protection Agency. 

Assets for Independence 

The Committee recommendation does not include funding for the 

Assets for Independence program. This program was created in 

1998 as a demonstration program to test the impact of individual 

development accounts on a range of outcomes for low-income individuals and families. 

National Domestic Violence Hotline 

The Committee recommendation includes $8,250,000 for the National Domestic Violence Hotline. This national, toll-free hotline 

provides critical emergency assistance and information to victims of 

domestic violence 24 hours a day. 

Family Violence Prevention and Services 

The Committee recommendation includes $151,000,000 for Family Violence Prevention and Services programs. These funds support programs to prevent family violence and provide immediate 

shelter and related assistance for victims of domestic violence and 

their dependents. 

Chafee Education and Training Vouchers 

The Committee recommendation includes $43,257,000 for the 

Chafee Education and Training Voucher program. This program 

supports vouchers to foster care youth to help pay for expenses related to postsecondary education and vocational training. 

Disaster Human Services Case Management 

The Committee recommends $1,864,000 for Disaster Human 

Services Case Management. This program assists States in establishing the capacity to provide case management services in a timely manner in the event of a disaster. It ensures that States are able 

to meet social service needs during disasters by helping disaster 

victims prepare recovery plans, referring them to service providers 

and FEMA contacts to identify needed assistance, and providing 

ongoing support and monitoring through the recovery process. 
143 

Program Administration 

The Committee recommendation includes $205,000,000 for the 

Federal costs of administering ACF programs. 

CHILDREN’S RESEARCH AND TECHNICAL ASSISTANCE

Appropriations, 2016 ............................................................................. ........................... 

Budget estimate, 2017 ........................................................................... $10,000,000 

Committee recommendation ................................................................. ........................... 

The Committee recommendation does not include new discretionary funding for Children’s Research and Technical Assistance. 

This program receives dedicated mandatory funding to carry out 

authorized activities. 

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2016 ............................................................................. $404,765,000 

Budget estimate, 2017 ........................................................................... 424,765,000 

Committee recommendation ................................................................. 384,765,000 

The Committee recommends $384,765,000 for the Promoting Safe 

and Stable Families program. The Committee recommendation includes $325,000,000 in mandatory funds authorized by the Social 

Security Act and $59,765,000 in discretionary appropriations. 

This program supports activities that can prevent the emergence 

of family crises that might require the temporary or permanent removal of a child from his or her home. Grants allow States to operate coordinated programs of family preservation services, time-limited family reunification services, community-based family support 

services, and adoption promotion and support services. 

The Committee notes that the authorization for Promoting Safe 

and Stable Families expiries in fiscal year 2016. Mandatory funding for certain activities within this account are not assumed to 

continue in the CBO baseline. Accordingly, the Committee recommendation does not include funding for those activities. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2016 ............................................................................. $5,298,000,000 

Budget estimate, 2017 ........................................................................... 5,764,000,000 

Committee recommendation ................................................................. 5,764,000,000 

The Committee recommends $5,764,000,000 in mandatory funds 

for Payments for Foster Care and Permanency. In addition, the 

Committee recommends $2,500,000,000 in advance mandatory 

funding for the first quarter of fiscal year 2018. These funds support programs that assist States with the costs of maintaining eligible children in foster care, prepare children for living on their 

own, assist relatives with legal guardianship of eligible children, 

and find and support adoptive homes for children with special 

needs. 

The Committee notes that older youth in the foster care system 

or aging out of the foster care system have extremely high rates 

of homelessness. There are many steps that State and local child 

welfare agencies can take to help prevent homelessness for these 

youth, and to help prevent child abuse and neglect, including extending foster care payments for youth up to age 21 and better coordinating with programs supported by the Department of Housing 
144 

and Urban Development, the Department of Labor, and the Department of Education. The Committee strongly encourages HHS 

to provide States and localities with guidance and examples of best 

practices for using extended foster care payments to help maintain 

housing stability. The Committee further encourages HHS to develop, in coordination with the U.S. Interagency Council on Homelessness, comprehensive guidance on transition planning for youth 

exiting the foster care system including lessons from the Youth At 

Risk of Homelessness Planning Grants; best practices regarding 

seeking legal permanency and permanent connections to caring 

adults for youth nearing the end of eligibility for foster care; example transition plans; and guidance about the Federal funding 

sources available to assist with the transition process for youth 

exiting foster care including housing and supportive services such 

as tenancy supports, basic living skills development, behavioral 

health, and connections to education and employment. The Committee directs HHS to report to the House and Senate Committees 

on Appropriations within 120 days of enactment of this act on the 

actions it has taken, as well as future actions it will undertake, to 

implement these directives. 

Ensuring Timely Mental Health Screenings and Assessments for 

Children in Foster Care.—The Committee strongly encourages 

HHS to provide guidance to States to improve mental health 

screenings and services for children in foster care. Specifically, the 

Committee strongly encourages HHS to require, as part of the 

State plan required under section 422 of the Social Security Act, 

that a child receives an initial health screening within 30 days of 

entry into foster care and, if an initial mental health issue is identified, the child receives a comprehensive assessment in mental 

health within 60 days. 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2016 ............................................................................. $1,992,550,000 

Budget estimate, 2017 ........................................................................... 2,020,994,000 

Committee recommendation ................................................................. 1,935,435,000 

The Committee recommends an appropriation of $1,935,435,000 

for the Administration for Community Living [ACL]. The Committee recommendation also includes $27,700,000 to be transferred 

to ACL from the PPH Fund. 

ACL was created with the goal of increasing access to community 

support for older Americans and people with disabilities. It is 

charged with administering programs authorized under the Older 

Americans Act [OAA] and the Developmental Disabilities Act, as 

well as promoting community living policies throughout the Federal Government for older Americans and people with disabilities. 

The Committee understands that ACL has proposed to expand 

the administrative capacity of the formula grant programs by 

transferring up to 2 percent from the State grants to support new 

staff. The Committee recognizes that this additional capacity may 

enhance program oversight and performance. However, the Committee is concerned about the disproportionate impact the transfer 

may have on grantees in the smaller formula programs, particu-
145 

larly those authorized under the Development Disabilities Assistance and Bill of Rights Act. The Committee urges ACL to more 

thoughtfully examine the impact of the proposed transfer on the 

smaller programs before taking further action. 

Home- and Community-Based Supportive Services 

The Committee recommends an appropriation of $347,724,000 for 

the Home- and Community-Based Supportive Services program. 

This program provides formula grants to States and territories to 

fund a wide range of social services that enable seniors to remain 

independent and in their homes for as long as possible. State agencies on aging award funds to designated area agencies on aging 

that, in turn, make awards to local service providers. This activity 

supports services such as transportation, adult day care, physical 

fitness programs, and in-home assistance such as personal care and 

homemaker assistance. The Committee directs ACL to work with 

States to prioritize innovative service models, like naturally occurring retirement communities [NORCs], which help older Americans 

remain independent as they age. The Committee notes that 

NORCs, and similar settings, are a more cost-effective alternative 

to long-term care that enables older Americans to be more engaged 

in their communities while living at home. 

Preventive Health Services 

The Committee recommends $19,848,000 for Preventive Health 

Services. This program funds activities such as medication management and enhanced fitness and wellness programs. These programs 

help seniors stay healthy and avoid chronic disease, thus reducing 

the need for costly medical interventions. The Committee maintains bill language that requires States to use these funds to support evidence-based models that enhance the wellness of seniors. 

Protection of Vulnerable Older Americans 

The Committee recommends $20,658,000 for grants to States for 

the Long-term Care Ombudsman program and the Prevention of 

Elder Abuse program. Both programs provide formula grants to 

States to prevent the abuse, neglect, and exploitation of older individuals. The ombudsman program focuses on the needs of residents 

of nursing homes and other long-term care facilities, while the 

elder abuse prevention program targets the elderly community at 

large. 

National Family Caregiver Support Program 

The Committee recommends $150,586,000 for the National Family Caregiver Support program. Funds appropriated for this activity 

establish a multifaceted support system in each State for family 

caregivers, allowing them to care for their loved ones at home for 

as long as possible. States may use funding to provide information 

to caregivers about available services, assistance to caregivers in 

gaining access to services, caregiver counseling and training, respite care to enable caregivers to be temporarily relieved from their 

caregiving responsibilities, and limited supplemental services that 

fill remaining service gaps. 
146 

Native American Caregiver Support Program 

The Committee recommendation includes $7,531,000 to carry out 

the Native American Caregiver Support program. 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 disability, as well as for grandparents caring 

for grandchildren. 

Congregate and Home-Delivered Nutrition Services 

The Committee recommends an appropriation of $448,342,000 for 

congregate nutrition services and $226,342,000 for home-delivered 

meals. These programs address the nutritional needs of older individuals, thus helping them to stay healthy and reduce their risk of 

disability. Funded projects must make home-delivered and congregate meals available at least once a day, 5 days a week, and 

each meal must meet a minimum of one-third of daily dietary requirements. While States receive separate allotments of funds for 

congregate meals, home-delivered meals, and supportive services, 

they have flexibility to transfer funds between these programs. 

Nutrition Services Incentives Program.—The Committee recommendation includes $160,069,000 for the Nutrition Services Incentives Program [NSIP]. NSIP augments funding for congregate 

and home-delivered meals provided to older adults. States and 

tribes may choose to receive all or part of their funding in the form 

of commodities from the USDA. 

Aging Grants to Indian Tribes and Native Hawaiian Organizations 

The Committee recommends $26,158,000 for grants to Native 

Americans. This program provides grants to eligible tribal organizations for the delivery of nutrition and supportive services to Native Americans. 

Aging Network Support Activities 

The Committee recommends $9,961,000 for Aging Network Support activities. These funds support activities that expand public 

understanding of aging and the aging process, apply social research 

and analysis to improve access to and delivery of services for older 

individuals, test innovative ideas and programs, and provide technical assistance to agencies that administer programs authorized 

by the OAA. 

Within funding for the Aging Network Support Activities, the 

Committee supports the continuation of the National Alzheimer’s 

Call Center, which is available in all States, 24-hours a day, 7 days 

a week, year-round, to provide expert advice, crisis counseling, care 

consultation and information referral services in at least 140 languages, for persons with Alzheimer’s disease, their family members 

and informal caregivers. 

The Committee also includes $2,500,000 to help provide supportive services for aging Holocaust survivors in the United States. 

Alzheimer’s Disease Demonstration Grants to States 

The Committee recommendation includes $4,800,000 for Alzheimer’s Disease Demonstration Grants to States. This program 
147 

funds competitive grants to States to test and implement new models of care for individuals with Alzheimer’s disease. 

Alzheimer’s Disease Initiative 

The Committee recommends $14,700,000 in mandatory funding 

be transferred from the PPH Fund to ACL for the Alzheimer’s Disease Initiative. Of the total, $10,500,000 is provided to expand the 

availability of home- and community-based dementia services and 

supports. The remaining $4,200,000 is provided for a public awareness outreach campaign regarding Alzheimer’s disease. 

Lifespan Respite Care 

The Committee recommends $3,360,000 for the Lifespan Respite 

Care program. The Lifespan Respite Care program provides grants 

to States to expand respite care services to family caregivers, improve the local coordination of respite care resources, and improve 

access to and quality of respite care services, thereby reducing family caregiver strain. 

Chronic Disease Self-Management Program 

The Committee recommends $8,000,000 be transferred from the 

PPH Fund to ACL for the Chronic Disease Self-Management Program [CDSMP]. This program assists those with chronic disease 

manage their conditions and improve their health status. Topics 

covered by the program include nutrition; appropriate use of medications; fitness; and effective communications with healthcare providers. CDSMP has been shown through multiple studies to result 

in significant and measurable improvements in health and quality 

of life, as well as reductions in hospitalizations and emergency 

room visits. 

Elder Falls Prevention 

The Committee recommends that $5,000,000 be transferred from 

the PPH Fund for Elder Falls Prevention activities at ACL. Preventing falls will help seniors stay independent and in their homes 

and avoid costly hospitalizations and hip fractures, which frequently lead to nursing home placement. The Committee intends 

that these funds should be used in coordination with CDC for public education about the risk of these falls, as well as implementation and dissemination of community-based strategies that have 

been proven to reduce the incidence of falls among seniors. 

Elder Rights Support Activities 

The Committee recommends $13,874,000, an increase of 

$2,000,000 above fiscal year 2016, for Elder Rights Support activities, including $10,000,000 for the Elder Justice Initiative. These 

activities support programs that provide information, training, and 

technical assistance to legal and aging services organizations in 

order to prevent and detect elder abuse and neglect. 

Elder Justice Initiative.—The Committee is aware of the work 

being carried out by the Elder Justice Coordinating Council 

[EJCC], where the Department is a permanent member, and remains supportive of efforts to help protect older adults from all 

forms of abuse, including through increasing public awareness to 
148 

occurrences of elder abuse and the dissemination of information 

about how members of the public may obtain services. Through the 

work of the EJCC, the Committee encourages the Department of 

Justice to work with the Secretary of the HHS, and other relevant 

agencies, to develop a national elder justice awareness campaign. 

Aging and Disability Resource Centers 

The Committee recommendation includes $6,119,000 for Aging 

and Disability Resource Centers [ADRCs]. These centers provide 

information, one-on-one counseling, and access for individuals to 

learn about their long-term services and support options with the 

goal of allowing seniors and individuals with disabilities to maintain their independence. The Committee urges ACL to improve coordination among ADRCs, area agencies on aging, and centers for 

independent living to ensure that there is ‘‘no wrong door’’ to access 

services. 

State Health Insurance Assistance Program 

Due to budget constraints, the Committee recommendation does 

not include funding for the State Health Insurance Assistance Program. The Committee expects ACL, in coordination with CMS and 

States, to continue to provide accurate and understandable health 

insurance information to Medicare beneficiaries and their families 

through existing HHS programs that support these activities. 

Paralysis Resource Center 

The Committee recommendation includes $7,700,000 for the Paralysis Resource Center, which provides comprehensive information 

and referral services to people living with paralysis and their families. These resources and services focus on the promotion of independence and quality of life for the over 6,000,000 Americans living 

with paralysis. 

Limb Loss 

The Committee provides $2,810,000 for the Limb Loss program, 

which supports programs and activities to improve the health of 

people with limb loss and promote their well-being, quality of life, 

prevent disease, and provide support to their families and caregivers. 

Traumatic Brain Injury 

The Committee provides $9,321,000 for the Traumatic Brain Injury program. The program supports implementation and planning 

grants to States for coordination and improvement of services to individuals and families with traumatic brain injuries. Such services 

can include: pre-hospital care, emergency department care, hospital 

care, rehabilitation, transitional services, education, employment, 

long-term support, and protection and advocacy services. 

The Committee includes not less than the fiscal year 2016 funding level for protection and advocacy services, as authorized under 

section 1305 of Public Law 106–310. 
149 

Developmental Disabilities State Councils 

The Committee recommendation includes $73,000,000 for State 

councils on developmental disabilities. These councils work to develop, improve, and expand the system of services and supports for 

people with developmental disabilities at the State and local level. 

Councils engage in activities such as training, educating the public, 

building capacity, and advocating for change in State policies with 

the goal of furthering the inclusion and integration of individuals 

with developmental disabilities in all aspects of community life. 

Developmental Disabilities Protection and Advocacy 

The Committee recommendation includes $38,734,000 for protection and advocacy programs for people with developmental disabilities. This formula grant program provides funds to States to establish and maintain protection and advocacy systems that protect the 

legal and human rights of persons with developmental disabilities 

who are receiving treatment, services, or rehabilitation. 

Voting Access for Individuals With Disabilities 

The Committee recommendation includes $4,963,000 to improve 

voting access for individuals with disabilities. This program provides grants to protection and advocacy organizations to ensure 

that individuals with disabilities have the opportunity to participate in every step of the electoral process, including registering to 

vote, accessing polling places, and casting a vote. 

Developmental Disabilities Projects of National Significance 

The Committee recommendation includes $10,000,000 for 

projects of national significance to assist persons with developmental disabilities. This program funds grants and contracts that 

develop new technologies and demonstrate innovative methods to 

support the independence, productivity, and integration into the 

community of persons with developmental disabilities. 

Technical Assistance.—The Committee provides $575,000 for 

technical assistance and training for the State Councils on Developmental Disabilities. 

Transportation.—The Committee includes $1,000,000 to fund 

transportation assistance activities for older adults and persons 

with disabilities. These activities should focus on the most cost-effective and sustainable strategies that can be replicated to other 

communities. The Committee is pleased with the Inclusive Community Transportation program’s efforts to integrate rural transit systems for individuals with disabilities and older adults to access 

health care services, paratransit, multiple transportation providers, 

and other critical community based supports. These small community demonstration grants should be designed to include the perspectives of individuals with disabilities and older adults in the 

transportation system and service design. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommendation includes $38,619,000 for the 

University Centers for Excellence in Developmental Disabilities 

[UCEDDs], a network of 67 centers that are interdisciplinary education, research and public service units of a university system or 
150 

public or nonprofit entities associated with universities. The funding will keep the national network of Centers strong and able to 

assist States to initiate collaborative research, education, training, 

and service efforts that help States to implement ESSA and WIOA, 

thereby ensuring that youth with disabilities successfully complete 

elementary school and transition from school to postsecondary education and/or integrated employment. The funding will also allow 

the Centers to continue to respond to emerging and emergent national issues such as assisting in ongoing developmental monitoring, especially for children exposed to lead and other environmental teratogens, and for infants exposed to the Zika virus with 

its resulting complications. 

Independent Living 

The Committee recommendation includes $101,183,000 for the 

Independent Living Program. This program helps ensure that individuals with disabilities can live a productive and independent life 

in society. Funding supports States sustain, improve, and expand 

independent living services and establish and support a network of 

centers for independent living. 

National Institute on Disability, Independent Living, and Rehabilitation Research 

The Committee recommendation includes $103,970,000 for the 

National Institute on Disability, Independent Living, and Rehabilitation Research [NIDILRR]. The NIDILRR supports research and 

activities that help to maximize the full potential of individuals 

with disabilities in employment, independent living, and social activities. 

The Committee recognizes that there is a significant opportunity 

over the next decade for the Department to simultaneously lower 

healthcare costs and improve quality of life for the older adult and 

disabled population by embracing the rapidly growing shift to technology solutions for daily living. These solutions are poised to extend the ability to live independently into advanced age, and ‘‘age 

in place’’, helping to bridge the ‘‘care gap’’ so that older and disabled adults might avoid nursing homes and other institutionalized 

care as long as possible, while also remaining connected to their 

families and communities. 

The Committee encourages the NIDILRR to continue to support 

research and activities that help older or disabled adults, including 

those in rural and tribal communities, to increase, maintain, or improve their functional capabilities. To that end, the Committee supports increased investment in university research to harness technological advances that improve health, maximize community engagement, encourage productivity, and preserve independence 

among older individuals and their families. Special emphasis 

should be given to research projects that seek to develop technologies that allow for independent living, seek to address aging 

and disabled populations, and target rural, frontier, and tribal communities as they stand to benefit the most from home and community-delivered technologies that reduce isolation, increase safety 

and well-being, prevent falls and related injuries, and maximize 

mobility. 
151 

Assistive Technology 

The Committee recommendation includes $32,000,000 for Assistive Technology [AT]. AT provides States with funding to support 

individuals with disabilities of all ages to obtain devices and services that will increase, maintain, or improve their functional capabilities. 

The Committee also includes report language directing CMS to 

work with ACL to encourage Assistive Technology Reutilization 

programs at the State level. 

Program Administration 

The Committee recommends $40,063,000 for program administration at ACL. These funds support salaries and related expenses 

for program management and oversight activities. 

Muscular Dystrophy.—The Committee is aware that the ACL is 

included in the Muscular Dystrophy Coordinating Committee 

under the Muscular Dystrophy CARE Act Amendments enacted in 

September 2014. The Committee supports programs and initiatives 

focused on the transitions of persons with Duchenne into adulthood. The Committee requests a report within 180 days of enactment of this act on the administration’s plans to conduct comprehensive studies focused on demonstrating the cost-effectiveness 

of independent living programs and supports for persons living 

with various forms of muscular dystrophy. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2016 ............................................................................. $520,837,000 

Budget estimate, 2017 ........................................................................... 544,890,000 

Committee recommendation ................................................................. 509,747,000 

The Committee recommends $509,747,000 for General Departmental Management [GDM]. The recommendation includes 

$64,828,000 in transfers available under section 241 of the PHS 

Act. 

This appropriation supports activities that are associated with 

the Secretary’s role as policy officer and general manager of the 

Department. It supports health activities performed by the Office 

of the Assistant Secretary for Health [ASH], including the Office of 

the Surgeon General. GDM funds also support the Department’s 

centralized services carried out by several Office of the Secretary 

staff divisions, including personnel management, administrative 

and management services, information resources management, 

intergovernmental relations, legal services, planning and evaluation, finance and accounting, and external affairs. 

Alzheimer’s Education Campaign.—Although many medical organizations recommend early documented diagnosis and prompt 

treatment of Alzheimer’s to assure safety and provide timely advice 

to patients and their families, several studies have concluded that 

many physicians lack sufficient training and experience in assessing and treating Alzheimer’s disease. The Committee directs the 

Secretary to plan and implement a comprehensive outreach and 

education campaign directed at physicians, practitioners, patients, 

and caregivers with a goal of increasing information going to pa-
152 

tients who are members of racial and ethnic minority groups. The 

campaign shall include dissemination of the following information: 

(1) Early detection and diagnosis of Alzheimer’s confers many benefits; (2) What the criteria and guidelines are for diagnosis of Alzheimer’s disease; (3) Comprehensive care planning improves the 

quality of long term Alzheimer’s outcomes and may slow or prevent 

cognitive impairment, improve management of accompanying 

chronic conditions, increase access to medical and non-medical 

treatment, provide access to support services, allow time for financial planning and building a care team, and increase treatment options such as enrollment in clinical trials; and (4) Any other information the Secretary determines appropriate. 

The information from the comprehensive Alzheimer’s education 

initiative shall be posted on the Web sites of relevant Federal agencies, including OWH, OMH, and the Office of Rural Health Policy, 

and shared with providers and advocacy organizations. The campaign shall not specify, or be designed as a tool to limit the health 

care providers available to patients. In developing the information 

to be disseminated, the Secretary shall consult with appropriate 

medical societies and patient advocate organizations for Alzheimer’s disease, and with patient advocate organizations representing racial and ethnic minority groups with a special emphasis on African American and Hispanic populations. 

The Committee directs the Secretary to submit to the Committees on Appropriations of the House of Representatives and Senate, 

the Committee on Finance of the Senate, and the Committee on 

Ways and Means and the Committee on Energy and Commerce of 

the House of Representatives an annual report describing the activities carried out under this section during the preceding fiscal 

year, and an evaluation of the extent to which such activities have 

been effective in improving the health and well-being of racial and 

ethnic minority groups. 

Antibiotic Resistance.—The Committee supports the CARB initiative that strengthens efforts to prevent, detect, and control illness 

and deaths related to infections caused by antibiotic resistant bacteria. The Committee directs the Department to continue to work 

with DOD, USDA, VA, and FDA to broaden and expand efforts to 

track and store both antibiotic resistant bacteria genes and the mobile genetic elements from antibiotic resistant bacteria along with 

metadata. The Committee also recognizes the importance of basic 

and applied research toward the development of new vaccines as a 

way to prevent future antibiotic resistance through infection prevention and control. The Committee urges the Secretary to 

prioritize this research as part of its strategy to combat antibiotic 

resistance. The Committee also urges the Secretary to consider the 

use of existing vaccines in antibiotic stewardship efforts to help 

mitigate new resistance development. The Department shall include in the fiscal year 2018 CJ a detailed update on the progress 

being made to implement the CARB national strategy. 

Antimicrobial Usage, Risks, and Prevention.—The Committee is 

deeply concerned about the continued misuse of dangerous chemicals and unapproved animal drugs in aquaculture production in developing countries. Findings highlighted in a November 30, 2008, 

report by the Food and Drug Administration [FDA] cited clear sci-
153 

entific evidence that the application of certain compounds during 

the various stages of production may result in carcinogenic, mutagenic and other negative effects to human health. The Secretary, 

in coordination with FDA, CDC, and other relevant Federal agencies, is directed to submit to the Committees on Appropriations 

within 180 days after enactment of this act a report on the current 

risks of unapproved substances used in foreign imported aquaculture and an updated assessment of the human health impacts 

associated with these risks. 

Breast Cancer Patient Education Campaign.—The Committee 

continues to prioritize education and awareness related to breast 

cancer and appreciates that this remains a priority for the Secretary. The Committee encourages the Secretary to continue updating outreach materials designed to inform breast cancer patients 

anticipating surgery about the availability and coverage of breast 

reconstruction, prostheses, and other options, with a focus on informing patients who are members of racial and ethnic minority 

groups. 

Chronic Pain.—The Committee remains concerned about the 

public health epidemic of chronic pain. The Committee is pleased 

with the Department’s release of the National Pain Strategy and 

encourages the Secretary to begin implementation efforts across all 

relevant HHS agencies and in coordination with the DOD and VA. 

Dietary Guidelines.—The Committee encourages HHS to work 

with related agencies to ensure that Dietary Guidelines are consistent with Federal nutrition policy, education, outreach, and food 

assistance programs. The Department should include an update on 

these efforts in its fiscal year 2018 CJ. 

E-Health and Telemedicine.—The Committee encourages the Secretary to convene a national working group on e-health and telemedicine to communicate, coordinate, and collaborate on e-health 

needs, standards, Federal goals, and Federal efforts. Such a working group would reduce duplication and e-health incompatibility, as 

well as improve health quality, effectiveness, and outcomes. 

Federal Anaphylaxis Policy.—The Committee recognizes that immediate access to epinephrine is the primary and most effective 

treatment for anaphylaxis. It is also critically important that epinephrine be readily available wherever allergic triggers for anaphylaxis are present. Access to epinephrine auto-injectors within the 

first 5 minutes of an anaphylactic event can be life-saving. The 

Committee encourages Federal Occupational Health to engage with 

patient groups, healthcare professionals and manufacturers to develop recommendations for a program to address treatment for anaphylaxis in Federal buildings, parks, and other federally controlled facilities. 

Geroscience.—The Committee commends NIA’s leadership of the 

Trans-NIH Geroscience Interest Group, which promotes coordinated discussion and action on NIH-funded geroscience research to 

reduce the burden of age-related diseases. The Committee remains 

concerned over the rates of chronic disease in the older adult population and recognizes that accelerated breakthroughs from 

geroscience research into the biological basis of aging is essential 

to targeting changes that take place as a result of aging. The Committee urges the Secretary to consider establishing an Interagency 
154 

Geroscience Research Coordination Committee [IGRCC] comprised 

of representatives from the NIA, NIAMS, the NCI, the NEI, 

NHLBI, NINDS, NIGMS, NHGRI, CDC, FDA, DOD, VA, and EPA. 

The goal of the IGRCC would be to identify and direct grants for 

new geroscience research. 

Global Health Research Strategy.—The Committee requests an 

update on how CDC, FDA, BARDA, and NIH—including NCATS— 

jointly coordinate global health research activities with specific 

measurable metrics used to track progress toward agreed upon 

health goals. 

Guidance Documents.—The Committee notes that some have 

raised concerns about the Department’s use of guidance documents, 

including Dear Colleague letters, because such documents are not 

legally binding, but regulated entities may interpret them as such. 

Accordingly, the Committee recommendation includes new directives in the overview section of the Committee report for each of 

the Departments and agencies included in this bill relating to the 

use of guidance documents. 

High-Containment Transport.—The need to transport patients 

quickly, safely, and without transmitting highly infectious diseases 

was an identified need during the 2014 Ebola outbreak. The Committee requests a report within 180 days after enactment of this 

act on how the Department is preparing for other events that may 

require the transport of highly contagious patients. 

Nonrecurring Expenses Fund [NEF].—The Department is directed to include in its fiscal year 2018 CJ the amount of expired 

unobligated balances available for transfer to the NEF and the 

amount of any such balances transferred to the NEF. This should 

include actual or estimated amounts for the prior, current, and future budget years. The description should include specific projects, 

costs, project total cost, and years expected to complete as well as 

the specific projects supported in the current year. 

Open Access to Federal Research.—The Committee has received 

reports by the Office of Science and Technology Policy’s [OSTP] on 

the progress of all Federal agencies in developing and implementing policies to increase public access to Federally funded scientific research. The Committee is pleased by the progress, but previously instructed OSTP to have plans approved from all relevant 

Departments’ and Agencies’ plans in this act’s jurisdiction approved 

by the end of calendar year 2014 with implementation occurring by 

January 1, 2016. Agencies funded in this act are instructed to continue providing quarterly reports to the Committees on Appropriations of the House of Representatives and Senate to keep Congress 

apprised of the remaining progress needed to make federally funded research accessible to the public as expeditiously as possible. 

Opioid Use and Abuse.—The Committee notes that opiate use 

and addiction continue to pose epidemic-sized challenges in the 

United States. To increase access to life-saving anti-addiction medication, the Secretary is urged to consider whether naloxone should 

cease to be a prescription-only drug and be more readily available 

as a behind-the-counter drug. The Committee also urges the Secretary to convene or coordinate an interagency working group to 

encourage States and local governments to increase opportunities 

for disposal of opiates and to reduce opportunities for abuse, such 
155 

as by establishing opioid dispensing limits at hospital emergency 

departments and other locations. The Secretary should take all appropriate action to increase access to treatment of opioid use disorders, including medication-assisted treatment. 

Prenatal Opioid Use Disorders and Neonatal Abstinence Syndrome.—The Committee is aware that the Protecting Our Infants 

Act of 2015 requires the Secretary to conduct a review of the Department’s planning and coordination activities related to prenatal 

opioid use disorders and neonatal abstinence syndrome, as well as 

address gaps in research and treatment. The act also requires the 

Secretary to develop recommendations for preventing and treating 

prenatal opioid use disorders and neonatal abstinence syndrome. 

The Committee urges the Secretary to ensure that the report and 

recommendations required by the act are submitted within the 

timeframe required by the act. 

Pulmonary Hypertension [PH].—The Committee is concerned 

that most PH patients are not diagnosed for many years until the 

condition has reached a catastrophic stage, which leads to significant disability, greatly increased mortality, and the need for costly 

and dramatic medical interventions, such as heart-lung transplantation. Given the availability of effective therapies for early-stage 

PH, the Department is encouraged to work across agencies and 

with the patient and professional community to prepare recommendations to improve early diagnosis and treatment of PH. 

Seafood Sustainability.—The Committee prohibits the Department from using or recommending third party, nongovernmental 

certification for seafood sustainability. 

Tuberculosis [TB].—The Committee notes the release of the 

President’s National Action Plan for Combating Multi Drug Resistant TB in December 2016. The Committee urges the Secretary to 

prioritize implementation of the plan in coordination with the Federal TB Task Force, CDC, and NIH. 

United States/Mexico Border.—The Committee notes that in 

2015, almost 181,000,000 people crossed this border, often to work 

or visit family, and were infected with, or were exposed to, serious 

infectious diseases. The Committee urges the Department to continue its efforts to conduct border infectious disease surveillance in 

order to identify and implement needed prevention and treatment. 

Such activity could focus on priority surveillance, epidemiology and 

preparedness activities along the borders in order to be able to respond to potential outbreaks and epidemics, including those caused 

by potential bioterrorism agents. 

Teen Pregnancy Prevention 

The Committee recommendation includes $107,800,000 for the 

Teen Pregnancy Prevention [TPP] program. This program supports 

competitive grants to public and private entities to replicate evidence-based teen pregnancy prevention approaches. 

The Committee notes that the eligibility criteria for the most recent 5-year grant cycle for the TPP program was changed significantly from the previous grant cycle. To reflect a shift toward a collective impact strategy, prospective grantees were required to meet 

a minimum threshold of 700 youth to be served across three implementation sites. As a result, some communities, particularly those 
156 

in rural areas, were excluded from consideration due to their smaller youth population and lack of implementation sites. These communities, with a single or very few youth-serving agencies, have 

limited ability to form the kind of community collaboration required by the Office of Adolescent Health. The Committee requests 

that HHS submit a report to the Committees on Appropriations of 

the House of Representatives and Senate on the differences between communities funded during the first grant cycle of the TPP 

program compared to the second, with a focus on the type of grantee location (urban, rural, or suburban), population size, and capacity to form a collective impact strategy. 

Office of Minority Health 

The Committee recommends $50,000,000 for the Office of Minority Health [OMH]. This Office focuses on strategies designed to decrease health disparities and to improve the health status of racial 

and ethnic minority populations in the United States. OMH establishes goals and coordinates all departmental activity related to improving health outcomes for disadvantaged and minority individuals. 

HIV Community-Based Testing Programs.—The Committee recognizes that several community-based programs have encouraged 

individuals at risk for HIV/AIDS to utilize FDA-approved homebased HIV testing technology to monitor their HIV status. The 

Committee urges the OMH to consider pilot or demonstration program within existing resources to gauge the effectiveness of this 

approach. 

HIV/AIDS and Hepatitis C.—The Committee continues to be 

concerned about the HIV/AIDS epidemic in the African American 

community, and is aware of the concurrent high rates of co-infection with Hepatitis C as outlined by the HHS 2015 Forum on Hepatitis C in African American Communities. The Committee urges 

OMH to work aggressively to address opportunities to reduce the 

burden of HIV/AIDS and Hepatitis C by exploring partnerships for 

screening and implementing community engagement programs. 

Lupus Initiative.—The Committee continues to support the OMH 

National Health Education Lupus Program and its efforts to develop a clinical trial education and implementation plan for lupus. 

The action plan will focus on developing public-private and community partnerships, evaluating current minority clinical trial education and participation programs, and developing a research plan 

for creating new clinical trial education models in lupus. This will 

inform the development of the broader actionable lupus clinical 

trial education plan. 

Sexual Risk Avoidance 

The Committee recommends $15,000,000 for sexual risk avoidance education. This is a competitive grant program that funds evidenced based abstinence models for adolescents. 

Funding for competitive grants for sexual risk avoidance shall 

use medically accurate information referenced to peer-reviewed 

publications by educational, scientific, governmental, or health organizations; implement an evidence-based approach; and teach the 

benefits associated with self-regulation, success sequencing for pov-
157 

erty prevention, healthy relationships, goal setting, and resisting 

sexual coercion, dating violence, and other youth risk behaviors. 

Office of the Surgeon General 

The Committee understands that the Surgeon General has announced and is in the process of creating a Report on Substance 

Use, Addiction, and Health. Given the current national opioid epidemic, the Committee looks forward to the report focusing on 

opioid research and providing recommendations for future direction 

on best practices to address opioid abuse. 

The Committee urges the Surgeon General to develop a report on 

improving the health of America’s children. Too many children still 

live in poverty, affecting their ability to be healthy, to succeed in 

school, and to raise healthy families themselves. A report by the 

Surgeon General on improving the health of children could increase 

awareness and generate additional effort on ameliorating this problem. 

Office of Women’s Health 

The Committee recommends $29,000,000 for the Office of Women’s Health [OWH]. This office develops, stimulates, and coordinates women’s health research, healthcare services, and public and 

healthcare professional education across the Department. It advances important crosscutting initiatives and develops public-private partnerships, providing leadership and policy direction to address the disparities in women’s health. 

The Committee recommendation includes $3,100,000 to combat 

violence against women through the State partnership initiative. 

This program provides funding to State-level public and private 

health programs to partner with domestic and sexual violence organizations to improve healthcare providers’ ability to help victims of 

violence and improve prevention programs. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2016 ............................................................................. $107,381,000 

Budget estimate, 2017 ........................................................................... 120,000,000 

Committee recommendation ................................................................. 112,381,000 

The Committee provides $112,381,000 for the Office of Medicare 

Hearings and Appeals [OMHA]. This Office is responsible for hearing Medicare appeals at the Administrative Law Judge [ALJ] level, 

which is the third level of Medicare claims appeals. OMHA ensures 

that Medicare beneficiaries who are dissatisfied with the initial decisions about their benefits or eligibility can appeal and exercise 

their right to a hearing in front of an ALJ. 

Appeals Backlog.—The Committee continues to be concerned over 

the substantial backlog in the number of cases pending before ALJs 

at OMHA. In fiscal year 2016, the Committee provided an increase 

of $20,000,000 over fiscal year 2015 level and provides $5,000,000 

in additional funding in fiscal year 2017. The Committee directs 

OMHA to use the additional funds provided to address the current 

backlog and requests a spend plan within 30 days after enactment 

of this act. This spend plan should include an estimate of total appeals that will be processed in fiscal years 2016–2018 with the re-
158 

sources available. This estimate should include the effect of administrative actions taken to reduce the backlog. 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

Appropriations, 2016 ............................................................................. $60,367,000 

Budget estimate, 2017 ........................................................................... 82,000,000 

Committee recommendation ................................................................. 60,367,000 

The Committee makes available $60,367,000 to the Office of the 

National Coordinator for Health Information Technology [ONC]. 

The Committee provides funding for ONC entirely through budget 

authority. ONC is responsible for promoting the use of electronic 

health records in clinical practice, coordinating Federal health information systems, and collaborating with the private sector to develop standards for a nationwide interoperable health information 

technology infrastructure. 

Electronic Health Records.—The Committee believes HHS’ work 

to encourage the adoption of electronic health records has provided 

important new opportunities to improve the quality, safety, and 

cost-effectiveness of health care. The Secretary is directed to further this work by studying approaches to improve person-centered 

healthcare through patient access to health information. That work 

should examine accurate and timely record matching so that all 

EHR systems are collecting the information necessary for a fully 

interoperable system that protects patients from identity mismatch 

errors, but also considers patient privacy and security. 

Immunization Information Systems [IIS].—The threat of disease 

outbreaks and the ongoing work to target outreach to under immunized communities underscores the importance of maintaining robust immunization information systems [IIS]. The Committee is 

aware of the Immunization Registry Data Exchange and the Consumer Access Immunization Registry pilot projects exploring ways 

to improve the efficiency and effectiveness of IIS. The Committee 

encourages ONC to continue these pilots and requests a report to 

the Committee from ONC no later than 180 days after enactment 

of this act with findings, results, and recommendations from the 

pilot studies. The Committee encourages ONC to partner with CDC 

and other relevant HHS partners to leverage knowledge and enhance education and information sharing opportunities between 

registry system administrators and related State and local personnel. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $75,000,000 

Budget estimate, 2017 ........................................................................... 85,000,000 

Committee recommendation ................................................................. 75,000,000 

The Committee recommends $75,000,000 for the HHS Office of 

Inspector General [OIG]. In addition to discretionary funds provided in this act, the Health Insurance Portability and Accountability Act of 1996 provides a permanent appropriation of 

$334,097,000 for OIG. 

OIG conducts audits, investigations, and evaluations of the programs administered by the Department’s operating and staff divisions, including the recipients of the Department’s grant and con-
159 

tract funds. In doing so, OIG addresses issues of waste, fraud, and 

abuse and makes recommendations to improve the efficiency and 

effectiveness of the Department’s programs and operations. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2016 ............................................................................. $38,798,000 

Budget estimate, 2017 ........................................................................... 42,705,000 

Committee recommendation ................................................................. 38,798,000 

The Committee recommends $38,798,000 for the Office for Civil 

Rights [OCR], which is responsible for enforcing civil rights-related 

statutes in healthcare and human services programs. To enforce 

these statutes, OCR investigates complaints of discrimination, conducts program reviews to correct discriminatory practices, and implements programs to generate voluntary compliance among providers and constituency groups of health and human services. 

Pending Complaints.—OCR is tasked with ensuring that individuals are not subject to unlawful discrimination in healthcare programs. Yet, for nearly 3 years, since September 2014, three Weldon 

Amendment cases have been filed with OCR without resolution. 

Therefore, the Committee directs OCR to properly investigate the 

pending cases and urges OCR to resolve the pending cases expeditiously. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

Appropriations, 2016 ............................................................................. $586,188,000 

Budget estimate, 2017 ........................................................................... 630,408,000 

Committee recommendation ................................................................. 630,408,000 

The Committee provides an estimated $630,408,000 in mandatory funds for Retirement Pay and Medical Benefits for Commissioned Officers of the U.S. Public Health Service. This account provides for retirement payments to PHS officers who are retired due 

to age, disability, or length of service; payments to survivors of deceased officers; and medical care to Active Duty and retired officers, as well as their dependents. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriations, 2016 ............................................................................. $1,532,958,000 

Budget estimate, 2017 ........................................................................... 1,431,117,000 

Committee recommendation ................................................................. 1,532,958,000 

The Committee recommends $1,532,958,000 for the Public 

Health and Social Services Emergency Fund, which includes 

$15,000,000 in transfers from PHSSEF unobligated funds. This appropriation supports the activities of the Assistant Secretary for 

Preparedness and Response [ASPR] and other components within 

the Office of the Secretary to prepare for the health consequences 

of bioterrorism and other public health emergencies, including pandemic influenza. It also provides funding for the Department’s 

cybersecurity efforts. 

The Committee does not include bill language requested by the 

administration that would provide additional transfer authority beyond that which is already provided to the Secretary. 
160 

Office of the Assistant Secretary for Preparedness and Response 

The Committee recommendation includes $1,396,628,000 for activities administered by ASPR. This Office was created by the Pandemic and All-Hazards Preparedness Act [PAHPA] to lead the Department’s activities regarding preventing, preparing for, and responding to public health emergencies, including disasters and acts 

of terrorism. 

National Disaster Medical System.—The Committee continues 

bill language providing coverage under the Federal Employees 

Compensation Act for National Disaster Medical System intermittent employees who are activated for training or deployment. 

Trauma Service Availability and Systems Development.—The 

Committee continues to support efforts to improve trauma center 

sustainability and service availability in rural, exurban, suburban, 

and urban locations. The Committee encourages ASPR to develop 

a proposal for how trauma center improvements could be made in 

these areas to address problems with trauma care resiliency and 

reach to unserved populations. In doing so, ASPR should incorporate its analysis of the ability of existing trauma care infrastructure to respond to mass casualty events in a variety of geographic 

locations previously requested by the Committee. 

Hospital Preparedness Program 

The Committee’s recommendation includes $254,555,000 for the 

Hospital Preparedness Program [HPP]. This program provides 

grants to States to build healthcare coalitions that enhance regional and local hospital preparedness and improve overall surge 

capacity in public health emergencies. The Committee recognizes 

the importance of this program in helping communities respond to 

tragic events and believes this funding should be carefully coordinated within communities to continue to provide our Nation’s hospitals and emergency responders the necessary tools to respond 

quickly and collaboratively to these and other public health emergencies that are inevitable in our Nation’s communities. 

Bioweapon Response Assessment.—The Blue Ribbon Study Panel 

on Biodefense, published in October 2015, noted that ‘‘certain requirements associated with highly infectious diseases and low frequency biological events fit well within hospital disaster preparedness frameworks designed to address earthquakes, hurricanes, and 

other disasters, but other requirements do not.’’ The Committee believes that understanding the unique requirements necessary to respond to a biological attack will help improve our preparedness. 

For this reason, within 120 days of enactment, the Committee requests that the ASPR submit an assessment to the Committees on 

Appropriations of the House of Representatives and Senate of the 

unique response requirements for biological weapons attacks, including attacks that may result in mass fatalities. The assessment 

should also note the role of other Federal agencies in the response. 

Rural Areas.—The Committee encourages ASPR to ensure that 

hospital systems in remote and rural areas are benefiting from this 

program and are prepared in cases of emergencies, epidemics, or 

natural disasters. 
161 

Biomedical Advanced Research and Development Authority 

[BARDA] 

The Committee recommendation includes $511,700,000 for advanced research and development. 

The Committee commends BARDA for supporting advanced development efforts of industry to develop vaccines, diagnostics, 

drugs, and therapeutics to minimize serious threats of infectious 

disease and urges BARDA to continue to invest in the development 

of countermeasures for infectious diseases through the CARB initiative and the Emerging Infectious Disease program. 

Blood Platelet.—The Committee is aware of BARDA’s investigation into blood platelet-derived medical counter-measures as a hemostatic agent, and urges BARDA to expand its research to address the opportunities that cell stabilization of blood platelets provides, including radiation exposure remediation, acute burn healing, drug delivery, hemorrhagic fevers, and diagnostic imaging. 

Equine Hyperimmune Globulin.—Antibody preparations, produced from horse serum or plasma, have been used over the past 

century for the treatment of humans suffering from a variety of infectious diseases, intoxications, or envenomations. However, adverse reactions limited its use to the most life threatening of situations. The Committee is aware of recent improvements in processing techniques that reduce risks by as many as two orders of 

magnitude. The Committee encourages BARDA to explore the viability of developing medical countermeasures using equine 

hyperimmune globulin. 

Project BioShield Special Reserve Fund 

The Committee recommendation includes $510,000,000 for the 

Project BioShield Special Reserve Fund. The Committee is committed to ensuring the Nation is adequately prepared against 

chemical, biological, radiological, and nuclear attacks. The Committee recognizes a public-private partnership to develop medical 

countermeasures [MCMs] is required to successfully prepare and 

defend the Nation against these threats. Where there is little or no 

commercial market, the Committee supports the goal of Government financing providing a market guarantee 

Other Activities 

The Committee recommendation includes the following amounts 

for the following activities within ASPR: 

—Operations.—$30,938,000; 

—Preparedness and Emergency Operations.—$24,654,000; 

—National Disaster Medical System.—$49,904,000; and 

—Policy and Planning.—$14,877,000. 

Office of the Assistant Secretary for Administration 

The Committee recommends $50,860,000 for information technology cybersecurity in the Office of the Assistant Secretary for Administration. These funds provide for continuous monitoring and 

security incident response coordination for the Department’s computer systems and networks. 
162 

Office of the Assistant Secretary for Health/Medical Reserve Corps 

The Committee recommendation includes $6,000,000 for the 

Medical Reserve Corps program in ASH. This program is a national network of local volunteers who work to strengthen the public health infrastructure and preparedness capabilities of their communities. 

Office of the Secretary 

The Committee recommendation includes $79,470,000 for activities within the Office of the Secretary. 

Pandemic Influenza Preparedness 

The Committee recommendation includes $72,000,000 for Pandemic Influenza Preparedness. Of the total, $17,000,000 is provided 

in annual funding, $40,000,000 in no-year funding, and 

$15,000,000 in transfers from PHSSEF unobligated balances. 

Emergency Supplemental Pandemic Influenza Balances.—The 

Committee requests a detailed summary from ASPR in its fiscal 

year 2018 CJ about the level of unspent pandemic influenza supplemental balances. This summary should include an analysis of 

how funds have been spent over the previous 3 fiscal years and 

how any remaining funds will be allocated. 

Office of Security and Strategic Information 

The Committee includes $7,470,000 for the Office of Security and 

Strategic Information to maintain the security of the Department’s 

personnel, systems, and critical infrastructure. 

PREVENTION AND PUBLIC HEALTH FUND

In fiscal year 2017, the level transferred from the fund after accounting for sequestration is $931,000,000. The Committee includes 

bill language in section 221 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: 

[Dollars in thousands] 

Agency Account Program Committee 

recommendation 

ACL ........................ Aging and Disability Services Programs Alzheimer’s Disease Prevention Education and Outreach.14,700 

ACL ........................ Aging and Disability Services Programs Chronic Disease Self Management ....... 8,000 

ACL ........................ Aging and Disability Services Programs Falls Prevention ..................................... 5,000 

CDC ....................... Immunization and Respiratory Diseases Section 317 Immunization Grants ......... 324,350 

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.

Office of Smoking and Health (Tobacco 

Prevention/Media & Quit Lines).

175,950 

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.73,000 

CDC ....................... Chronic Disease Prevention and Health 

Promotion.

Diabetes ................................................. 73,000 
163 

[Dollars in thousands] 

Agency Account Program Committee 

recommendation 

CDC ....................... Chronic Disease Prevention and Health 

Promotion.

Early Care Collaboratives ...................... 4,000 

CDC ....................... Environmental Health ............................ Lead Poisoning Prevention .................... 17,000 

CDC ....................... CDC-Wide Activities ............................... Preventive Health and Health Services 

Block Grants.

160,000 

SAMHSA ................. Mental Health ........................................ Suicide Prevention (Garrett Lee Smith) 12,000 

GENERAL PROVISIONS

Section 201. The bill continues a provision placing a $50,000 ceiling on official representation expenses. 

Section 202. The bill continues a provision limiting the use of 

certain grant funds to pay individuals more than an annual rate 

of Executive Level II. 

Section 203. The bill continues a provision restricting the Secretary’s use of taps for program evaluation activities unless a report is submitted to the Appropriations Committees of the House 

of Representatives and the Senate on the proposed use of funds. 

Section 204. The bill continues a provision authorizing the transfer of up to 2.6 percent of PHS Act funds for evaluation activities. 

Section 205. The bill continues a provision restricting transfers 

of appropriated funds and requires a 15-day notification to the 

Committees on Appropriations of the House of Representatives and 

the Senate Appropriations Committees. 

Section 206. The bill continues a general provision allowing National Health Service Corps contracts to be canceled up to 60 days 

after award. 

Section 207. The bill continues a provision regarding requirements for family planning applicants. 

Section 208. The bill continues language which states that no 

provider services under title X of the PHS Act may be exempt from 

State laws regarding child abuse. 

Section 209. The bill continues language which restricts the use 

of funds to carry out the Medicare Advantage Program if the Secretary denies participation to an otherwise eligible entity. 

Section 210. The bill continues a provision prohibiting the use of 

funds for lobbying activities related to gun control. 

Section 211. The bill continues a provision that limits the assignment of certain public health personnel. 

Section 212. The bill continues a provision which facilitates the 

expenditure of funds for international health activities. 

Section 213. The bill continues a provision permitting the transfer of up to 3 percent of AIDS funds among ICs by the Director of 

NIH and the Director of the Office of AIDS Research at NIH. 

Section 214. The bill continues language which requires that the 

use of AIDS research funds be determined jointly by the Director 

of NIH and the Director of the Office of AIDS Research and that 

those funds be allocated directly to the Office of AIDS Research for 

distribution to the ICs consistent with the AIDS research plan. 

Section 215. The bill continues a provision authorizing the Director of NIH to enter into certain transactions to carry out research 

in support of the NIH Common Fund. 
164 

Section 216. The bill continues a provision permitting NIH to use up to $45,000,000 per project for improvements and repairs of facilities. 

Section 217. The bill continues a provision that transfers funds 

from NIH to HRSA and AHRQ, to be used for National Research 

Service Awards. 

Section 218. The bill continues a provision related to third party 

payments to NIH. 

Section 219. The bill continues a provision that provides BARDA 

with authority to enter into a multiyear contract for up to 10 years 

and to repurpose unused termination costs to pay contract invoices. 

Section 220. The bill continues a provision requiring a publicly 

available Web site that details expenditures from the PPH Fund. 

Section 221. The bill continues a provision transferring mandatory funds from section 4002 of the Patient Protection and Affordable Care Act to accounts within the Department for activities outlined under the heading ‘‘Prevention and Public Health Fund’’ in 

this report. 

Section 222. The bill continues a provision requiring CJs to include certain FTE information with respect to ACA. 

Section 223. The bill continues a provision related to ACA exchange funding transparency. 

Section 224. The bill continues a provision related to notifications 

for ACA enrollment and Community Health Centers awards. 

Section 225. The bill continues a provision prohibiting funds for 

the Risk Corridor program. 

Section 226. The bill continues a provision for Medicare and 

Medicaid expenses. 

Section 227. The bill restates a requirement for HHS to conduct 

an analysis of the ACA’s impact on eligibility for certain discretionary programs. 

Section 228. The bill continues a provision related to breast cancer screening recommendations. 

Section 229. The bill includes new language on care management 

for Alzheimer’s disease. 

Section 230. The bill includes new language on medical marijuana. 
(165) 

TITLE III 

DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

Appropriations, 2016 ............................................................................. $16,043,790,000 

Budget estimate, 2017 ........................................................................... 16,043,790,000 

Committee recommendation ................................................................. 16,093,790,000 

The Committee recommends an appropriation of $16,093,790,000 

for education for the disadvantaged. 

The programs in the Education for the Disadvantaged account 

provide a foundation of support to help ensure that all children receive a high-quality education. Funds appropriated in this account 

primarily support activities in the 2017–2018 school year. 

Grants to Local Educational Agencies 

Title I grants to local educational agencies [LEAs] provide supplemental education funding, especially in high-poverty areas, for 

local programs that provide extra academic support to help raise 

the achievement of eligible students or, in the case of schoolwide 

programs, help all students in high-poverty schools meet challenging State academic standards. Title I grants are distributed 

through four formulas: basic, concentration, targeted, and education finance incentive grant. 

The Committee recommends $15,409,802,000 for the title I 

grants to LEAs program. Of the funds available for title I grants 

to LEAs, up to $3,984,000 shall be available on October 1, 2016 for 

transfer to the Census Bureau for poverty updates; $4,564,641,000 

will become available on July 1, 2017; and $10,841,177,000 will become available on October 1, 2017. The funds that become available on July 1, 2017, and October 1, 2017, will remain available for 

obligation through September 30, 2018. 

Consistent with the Every Student Succeeds Act [ESSA], the reauthorization of the Elementary and Secondary Education Act 

[ESEA], the Committee recommendation consolidates funding for 

the School Improvement Grants [SIG] program into title I grants 

to LEAs. In eliminating SIG, ESSA increases the amount States 

must reserve from their title I allocation for schools identified for 

improvement, from 4 percent under the previous authorization to 

7 percent (or, if higher, the amount States reserved in fiscal year 

2016 plus their fiscal year 2016 SIG allocation). 

ESSA shifts significant responsibility, authority, and accountability for schools, including school improvement efforts, back to 

States and LEAs. The Committee recommendation includes a total 

increase of $500,000,000 for title I grants to LEAs, including the 

consolidation of SIG, building on the $500,000,000 increase provided in fiscal year 2016, to help States implement ESSA. Com-
166 

bined, the Committee recommendation is $397,484,000 more than 

the authorized level, which will provide sufficient funding through 

authorized set-asides to help States implement comprehensive and 

targeted support and improvement efforts for schools identified for 

improvement, while also protecting funding for LEAs, and allowing 

for significantly more funding for LEAs than envisioned in reauthorization. The Committee recommendation does not include appropriations language requested by the administration increasing 

the amount set-aside for comprehensive support and improvement 

activities or targeted support and improvement activities. 

Report on Community Eligibility Program.—The Committee requests the Department, in collaboration with the Department of 

Agriculture, submit a report to the Committee as well as the Education and the Workforce Committee of the House of Representatives, and the Health, Education, Labor and Pensions Committee 

of the Senate, within 180 days that describes the impact of the 

Community Eligibility Program on accountability provisions of the 

ESEA, including how it impacts school rankings under 1113(a)(3), 

and how disadvantaged students are incorporated into State accountability systems under sections 1111(c) and (d) and how their 

performance is reported under subsection (h). 

Parent and Family Engagement.—The Committee notes that 

ESSA includes several provisions promoting parent and family engagement in schools and their children’s education, including requiring LEAs to reserve at least 1 percent of title I funds for such 

activities. The Committee strongly supports these activities, and 

the use of funds for these purposes. 

Report on Improving Conditions for Student Learning.—The 

Committee believes that improving conditions for student learning 

is vital for student success and notes that ESSA requires States to 

submit plans to the Secretary that describe how SEAs will support 

LEAs in improving conditions for student learning, including 

through reducing the use of aversive behavioral interventions that 

compromise student health and safety, such as seclusion and restraint. The Committee requests that the Secretary prepare a report on State-identified efforts to reduce such interventions and 

other completed and planned activities of the Department on this 

issue. 

School Improvement Grants 

The Committee recommendation does not include funding for the 

SIG program. Consistent with ESSA, the Committee recommendation eliminates this program and consolidates the funding into title 

I grants to LEAs. 

Comprehensive Literacy State Development Grants 

The Committee recommendation includes $190,000,000 for the 

Comprehensive Literacy State Development Grants program. This 

program, formerly the Striving Readers Comprehensive Literacy 

program, was newly authorized in ESSA and provides competitive 

grants to State educational agencies [SEAs] that then subgrant at 

least 95 percent of such funds to eligible entities to support efforts 

to improve literacy instruction in high-need schools and early edu-
167 

cation programs in a State for each of several age bands ranging 

from birth through 12th grade. 

The Committee notes that under the new authorization of this 

program, home-based early childhood literacy programs are identified as eligible entities. The Committee encourages the Department 

to provide clear guidance that States may subgrant funds to such 

programs. 

Innovative Approaches to Literacy 

The Committee recommendation includes $27,000,000 for the Innovative Approaches to Literacy program. This program was funded under the authority in the Fund for the Improvement of Education [FIE] in fiscal year 2016, but was separately authorized in 

ESSA. 

The Innovative Approaches to Literacy program provides competitive grants to national not-for-profit organizations and school libraries for providing books and childhood literacy activities to children and families living in high-need communities. 

The Committee continues to direct the Department to reserve no 

less than 50 percent of funds under this program for grants to develop and enhance effective school library programs, which may include providing professional development to school librarians, 

books, and up-to-date materials to high-need schools. School library 

programs increase access to a wide range of print and electronic resources, and provide learning opportunities for all students, particularly those who are less likely to have access to such materials 

at home. In addition, the Committee directs the Department to ensure that grants are distributed among eligible entities that will 

serve geographically diverse areas, including rural areas. 

Migrant Education Program 

The Committee recommends $374,751,000 for the title I Migrant 

Education program. 

This funding supports grants to SEAs for programs to meet the 

special educational needs of the children of migratory agricultural 

workers or migratory fishworkers. Funding also supports activities 

to improve interstate and intrastate coordination of migrant education programs, as well as identify and improve services to the migrant student population. 

Neglected and Delinquent 

The Committee recommends $47,614,000 for the title I Neglected 

and Delinquent program. 

This program provides financial assistance to SEAs for education 

services to neglected and delinquent children and youth in Staterun institutions and for juveniles in adult correctional institutions. 

States are authorized to set aside at least 15 percent, but not more 

than 30 percent, of their Neglected and Delinquent funds to help 

students in State-operated institutions make the transition into locally operated programs and to support the successful reentry of 

youth offenders who are age 20 or younger and have received a secondary school diploma or its recognized equivalent. 
168 

Special Programs for Migrant Students 

The Committee recommends $44,623,000 for Special Programs 

for Migrant Students, which consist of HEP and CAMP. 

HEP projects are 5-year grants to institutions of higher education and other nonprofit organizations to recruit migrant students ages 16 and older and provide the academic and support 

services needed to help them obtain a high school equivalency certificate and subsequently gain employment, attain admission to a 

postsecondary institution or a job training program, or join the 

military. 

CAMP projects are 5-year grants to institutions of higher education and nonprofit organizations to provide tutoring, counseling, 

and financial assistance to migrant students during their first year 

of postsecondary education. 

IMPACT AID

Appropriations, 2016 ............................................................................. $1,305,603,000 

Budget estimate, 2017 ........................................................................... 1,305,603,000 

Committee recommendation ................................................................. 1,315,603,000 

The Committee recommends $1,315,603,000 for the Impact Aid 

program. 

Impact Aid provides financial assistance to school districts affected by the presence of Federal activities and federally owned 

land. These school districts face unique challenges because they 

must educate children living on federally owned land, such as military bases, while federally owned property is also exempt from 

local taxes, a primary source of revenue for local school districts. 

The Committee bill retains language that provides for continued 

eligibility for students affected by the deployment or death of their 

military parent, as long as these children still attend schools in the 

same school district. 

Basic Support Payments.—The Committee recommends 

$1,176,233,000 for the Basic Support Payments program. Under 

this statutory formula, payments are made on behalf of all categories of federally connected children, with a priority placed on 

making payments first to heavily impacted school districts and providing any remaining funds for regular basic support payments. 

The Committee is concerned that the Department is not notifying 

school districts in a timely advanced manner of changes in their 

Impact Aid eligibility status. Hold harmless provisions in ESEA 

and timely enactment of appropriations bills would provide school 

districts with adequate time to adjust to significant changes in 

funding. The Committee directs the Department to enhance its 

communication with school districts about significant payment decreases likely in the coming school year, particularly those that are 

likely to enter hold harmless provisions for a given school year. 

Payments for Children With Disabilities.—The Committee bill includes $48,316,000 for Payments for Children With Disabilities. 

Under this program, additional payments are made for certain federally connected children eligible for services under IDEA. 

Facilities Maintenance.—The Committee recommends $4,835,000 

for Facilities Maintenance. This activity provides funding for emergency repairs and comprehensive capital improvements to certain 
169 

school facilities owned by the Department and used by LEAs to 

serve federally connected military dependent students. Funds appropriated for this purpose are available until expended. 

Construction.—The Committee recommends $17,406,000 for eligible LEAs for emergency repairs and modernization of school facilities. 

The Committee recommendation includes bill language allowing 

these funds to be awarded entirely on a competitive basis and be 

available for obligation through September 30, 2018, as requested 

by the administration. 

Payments for Federal Property.—The Committee recommends 

$68,813,000 for Payments for Federal Property. These payments 

compensate LEAs specifically for revenue lost due to the removal 

of Federal property from local tax rolls, regardless of whether any 

federally connected children attend schools in the district. The 

budget request proposed eliminating this program. The Committee 

recommendation again rejects this elimination and continues to 

note that this funding represents a key component of fulfilling the 

Federal Government’s commitment to school districts impacted by 

the presence of federally owned land. 

SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2016 ............................................................................. $4,433,629,000 

Budget estimate, 2017 ........................................................................... 4,558,409,000 

Committee recommendation ................................................................. 4,177,239,000 

The Committee recommendation includes $4,177,239,000 for the 

School Improvement Programs account. 

Supporting Effective Instruction State Grants 

The Committee recommends $2,055,830,000 for Supporting Effective Instruction State Grants. The fiscal year 2016 appropriation 

for this program included $93,993,000 in funding set-aside for the 

Supporting Effective Educator Development [SEED] program. 

ESSA reauthorized SEED as a stand-alone program and the Committee’s fiscal year 2017 recommendation for SEED is included in 

the Innovation and Improvement account. 

The appropriation for this program primarily supports activities 

associated with the 2017–2018 academic year. Of the funds provided, $374,389,000 will become available on July 1, 2017, and 

$1,681,441,000 will become available on October 1, 2017. These 

funds will remain available for obligation through September 30, 

2018. 

States and LEAs may use funds for a range of activities related 

to the certification, recruitment, professional development, and 

support of teachers and administrators. Activities may include reforming teacher certification and licensure requirements, addressing alternative routes to State certification of teachers, recruiting 

teachers and principals, and implementing teacher mentoring systems, teacher testing, merit pay, and merit-based performance systems. These funds may also be used by districts to hire teachers 

to reduce class sizes. 

ESSA includes new provisions to promote the use of title I and 

title II funds to support principals and school leaders, including an 

optional 3 percent set-aside of title II–A funds for such activities. 
170 

Many States already use these funds to support principals and 

school leaders but all States would benefit from clear guidance and 

examples of how States and LEAs could best use these funds to 

support effective strategies in this area. Therefore, the Committee 

strongly encourages the Department to issue guidance on the importance of strong school leadership, and how States can use existing resources to support principals and school leadership, including 

examples of best practices. 

Mathematics and Science Partnerships 

The Committee recommendation does not include funding for 

Mathematics and Science Partnerships. ESSA eliminated this program and consolidated the funding into a new Student Support and 

Academic Enrichment Grants program. The Committee recommendation is consistent with this consolidation. 

Supplemental Education Grants 

The Committee recommendation includes $16,699,000 for supplemental education grants to the Republic of Marshall Islands [RMI] 

and the Federated States of Micronesia [FSM]. 

This grant program was authorized by the Compact of Free Association Amendments Act of 2003. These funds will be transferred 

from the Department to the Secretary of the Interior for grants to 

these entities. The Committee bill includes language requested in 

the budget that allows the Secretary of Education to reserve 5 percent of these funds to provide FSM and RMI with technical assistance. 

21st Century Community Learning Centers 

The Committee recommends an appropriation of $1,050,000,000 

for the 21st Century Community Learning Centers [21st CCLC] 

program. 

Funds are allocated to States by formula, which in turn, award 

at least 95 percent of their allocations to LEAs, community-based 

organizations, and other public and private entities. Grantees use 

these resources to establish or expand community learning centers 

that provide activities offering significant extended learning opportunities, such as before- and after-school programs, recreational activities, drug and violence prevention, and family literacy programs 

for students and related services to their families. Centers must 

target their services to students who attend schools that are eligible to operate a schoolwide program under title I of the ESEA or 

serve high percentages of students from low-income families. 

The Committee notes that ESSA reduced the authorized funding 

level of the 21st CCLC program below the previously authorized 

level and below the fiscal year 2015 appropriated level, the last enacted appropriation prior to passage of ESSA. Accordingly, the 

Committee recommends a reduced funding level for this program. 

State Assessments Grants 

The Committee recommends $378,000,000 for the State Assessments Grants program. 

This program provides formula grants to States for developing 

and implementing standards and assessments required by the 
171 

ESEA and helping States and LEAs carry out audits of their assessment systems to eliminate low-quality or duplicative assessments. It also provides competitive grants to States, including consortia of States, to improve the quality, validity, and reliability of 

academic assessments. 

Reducing Duplicative and Redundant Assessments.—The Committee strongly supports the steps that Congress took last year in 

ESSA to help address the issue of over testing in schools. The Committee appreciates the Department’s guidance issued earlier this 

year that identifies Federal funding available to help States and 

LEAs address the issue this school year. The Committee requests 

that the Department report to Congress, no later than 90 days 

after the enactment of this act, on the concrete steps it has already 

taken and plans to take during this year to help States and LEAs 

reduce the number of duplicative and redundant assessments and 

the amount of classroom time spent on unnecessary test preparation, rather than teaching and learning. 

Education for Homeless Children and Youth 

For carrying out education activities authorized by title VII, subtitle B of the McKinney-Vento Homeless Assistance Act, the Committee recommends $77,000,000. 

This program provides assistance to each State to support an office of the coordinator of education for homeless children and 

youth, to develop and implement State plans for educating homeless children, and to make subgrants to LEAs to support the education of those children. Grants are made to States based on the 

total that each State receives in title I grants to LEAs. 

Under the McKinney-Vento Homeless Children and Youth Program, SEAs must ensure that homeless children and youth have 

equal access to the same free public education, including a public 

preschool education, as is provided to other children and youth. 

Training and Advisory Services 

For Training and Advisory Services authorized by title IV of the 

Civil Rights Act, the Committee recommends $6,575,000. 

The funds provided will support awards to operate regional equity assistance centers [EACs]. Each EAC provides services to 

school districts upon request. Activities include disseminating information on successful practices and legal requirements related to 

nondiscrimination on the basis of race, color, sex, or national origin 

in education programs. 

Native Hawaiian Education 

The Committee recommendation includes $33,397,000 for Native 

Hawaiian Education. 

The Committee bill continues a provision that allows funding 

provided by this program to be used for construction. 

Alaska Native Education 

The Committee recommends $32,453,000 for the Alaska Native 

Education. 

These funds address the severe educational handicaps of Alaska 

Native schoolchildren. Funds are used for the development of sup-
172 

plemental educational programs to benefit Alaska Natives. The 

Committee bill continues language that allows funding provided by 

this program to be used for construction. The Committee bill also 

includes language overriding the authorizing statute’s requirement 

to make noncompetitive awards to certain organizations. 

The Committee directs the Department to ensure that Alaska 

Native tribes, Alaska Native regional nonprofits, and Alaska Native corporations have the maximum opportunity to successfully 

compete for grants under this program by providing these entities 

multiple opportunities for technical assistance in developing successful applications for these funds, both in Alaska and via various 

forms of telecommunications, and to make every effort to ensure 

that Alaska Natives and Alaskans represent a significant proportion of peer reviewers for grant applications submitted in fiscal 

year 2017. 

Rural Education 

The Committee recommends $175,840,000 for rural education 

programs. 

The Committee expects that rural education funding will be 

equally divided between the Small, Rural School Achievement Program, which provides funds to LEAs that serve a small number of 

students, and the Rural and Low-Income School Program, which 

provides funds to LEAs that serve concentrations of poor students, 

regardless of the number of students served. 

Comprehensive Centers 

The Committee recommends $51,445,000 for the Comprehensive 

Centers program. 

These funds provide support to a network of comprehensive centers that are operated by research organizations, agencies, institutions of higher education, or partnerships thereof, and provide 

training and technical assistance on various issues to States, LEAs, 

and schools as identified through needs assessments undertaken in 

each region. The system currently includes 15 regional centers, 

which are charged with providing intensive technical assistance to 

SEAs to increase their capacity to assist LEAs and schools with 

meeting the goals of the ESEA, and 7 content centers, which are 

organized by topic area. 

In fiscal year 2017, the Department is scheduled to hold a competition to fund a new cohort of comprehensive centers. With the 

passage of ESSA, this new cohort of comprehensive centers will reflect changing priorities and the expanded role and responsibilities 

of States under reauthorization. The Committee directs the Department to brief the Committee within 30 days of enactment on how 

they plan to ensure this new cohort of comprehensive centers will 

provide a well-coordinated, accessible, and robust technical assistance system for SEAs. 

In selecting priorities for a new cohort of comprehensive centers, 

the Committee directs the Department to recognize the unique 

challenges affecting rural schools, and strongly encourages the Department to establish at least one university-led center in a State 

with a significant percentage of students in rural schools. Such a 

center could focus on rural education and provide assistance to 
173 

rural districts, including those that serve high poverty and minority students. 

The Committee recommendation includes continued support for a 

comprehensive center, first funded in fiscal year 2016 and as authorized in ESSA, on students at risk of not attaining full literacy 

skills due to a disability, including dyslexia, or developmental 

delay. 

Student Support and Academic Enrichment Grants 

The Committee recommendation includes $300,000,000 for Student Support and Academic Enrichment Grants. This new program 

provides formula grants to States, which then sub-grant to LEAs, 

to help support activities to provide students with a well-rounded 

education, ensure safe and supportive learning environments, and 

use technology to improve instruction. This program was created by 

consolidating funding for several previously individually authorized 

programs. The combined fiscal year 2016 funding level of the programs eliminated and consolidated into this new formula block 

grant was $277,761,000. The Committee recommendation represents a $22,239,000 increase above the fiscal year 2016 level. 

The Committee notes that funds available under this program 

may be used for local activities that may include programs that 

build skills in STEM, including computer science, and that foster 

innovation in learning by supporting nontraditional STEM education teaching methods. The Committee believes that such activities, including robotics competitions through partnerships with 

local schools and nonprofit organizations, will help further engage 

and inspire students to pursue further study or careers in STEM. 

In conducting a needs assessment pursuant to section 4106(d) of 

the ESEA, the Committee encourages States to work with LEAs in 

identifying already available and appropriate local data and 

metrics, which may include incidence and prevalence of the issues 

and behaviors that are appropriate to be addressed by the program, 

such as drug use and bullying. 

INDIAN EDUCATION

Appropriations, 2016 ............................................................................. $143,939,000 

Budget estimate, 2017 ........................................................................... 174,939,000 

Committee recommendation ................................................................. 143,939,000 

The Committee recommends $143,939,000 for Indian education 

programs. 

Grants to Local Educational Agencies 

For grants to LEAs, the Committee recommends $100,381,000. 

These funds provide financial support to elementary and secondary 

school programs that serve Indian students, including preschool 

children. Funds are awarded on a formula basis to LEAs, schools 

supported and operated by the Department of the Interior/Bureau 

of Indian Education, and in some cases directly to Indian tribes. 

Special Programs for Indian Children 

The Committee recommends $37,993,000 for special programs for 

Indian children. 
174 

Funds are used for demonstration grants to improve Indian student achievement from early childhood education through college 

preparation programs, and for professional development grants for 

training Indians who are preparing to begin careers in teaching 

and school administration. 

National Activities 

The Committee recommends $5,565,000 for national activities. 

Funds are used to expand efforts to improve research, evaluation, 

and data collection on the status and effectiveness of Indian education programs, and to continue grants to tribal educational departments for education administration and planning. 

The Committee notes that there are significant cognitive, psychological, and academic benefits that result from Native American 

language immersion programs. Schools where the indigenous language is the primary language of instruction have a strong, positive 

effect on the educational and social outcomes of American Indian, 

Alaska Native, and Native Hawaiian students compared to schools 

where Native students are taught in English. In addition, language 

education programs are essential for tribal self-determination. The 

Committee supports the dedication of resources for language maintenance and preservation activities. The Committee intends that 

funds available for carrying out section 6133 of the ESEA be allocated to all types of eligible entities in a way that supports the 

most extensive possible distribution across geography and language 

diversity and support both existing and new Native language immersion programs and schools. Further, the Committee directs the 

Department to give the same consideration to applicants that propose to provide partial immersion schools and programs as to full 

immersion, as the local tribes, schools, and other applicants know 

best what type of program will most effectively assist their youth 

to succeed. 

INNOVATION AND IMPROVEMENT

Appropriations, 2016 ............................................................................. $894,226,000 

Budget estimate, 2017 ........................................................................... 1,411,556,000 

Committee recommendation ................................................................. 942,743,000 

The Committee recommends $942,743,000 for programs within 

the Innovation and Improvement account. 

Education Innovation and Research 

The Committee recommendation includes $120,000,000 for the 

Education Innovation and Research [EIR] program. This program, 

newly authorized in ESSA, supports the creation, development, implementation, replication, and scaling up of evidence-based, fieldinitiated innovations designed to improve student achievement and 

attainment for high-need students. EIR incorporates a tiered evidence framework that provides early-phase, mid-phase, and expansion and replication grants. This supports interventions throughout 

the pipeline, from smaller grants for early stage projects that are 

willing to undergo rigorous evaluation to test their efficacy to larger grants to scale-up proven-effective interventions that have demonstrated significant impacts through multiple rigorous evaluations. 
175 

The Committee recommendation does not include funding or bill 

language requested by the administration for a new Advanced Research Projects Agency—Education program. 

School Leader Recruitment and Support 

The Committee recommendation includes $16,368,000 for the 

School Leader Recruitment and Support program, which funds activities to improve the recruitment, placement, support, and retention of effective principals and other school leaders in high-need 

schools. 

Charter School Program 

The Committee recommends $343,172,000 for the Charter School 

Program. This program supports the start-up, replication, and expansion of high-quality charter schools. 

Within the total, the Committee recommendation includes 

$204,000,000 for grants to State entities to support high-quality 

charter schools, including for grants directly to charter school developers in a State if no State entity receives a grant; $100,000,000 

for grants to charter management organizations for the replication 

and expansion of high-quality charter schools; $26,000,000 for facilities financing assistance, of which not less than $16,000,000 

shall be for the per-pupil facilities aid program; and not less than 

$11,000,000 for national activities to provide technical assistance, 

disseminate best practices, and evaluate the impact of the charter 

school program. 

Magnet Schools Assistance 

The Committee recommends $96,647,000 for the Magnet Schools 

Assistance program. 

This program supports grants to LEAs to establish and operate 

magnet schools that are part of a court-ordered or federally approved voluntary desegregation plan. Magnet schools are designed 

to attract substantial numbers of students from different social, 

economic, ethnic, and racial backgrounds. Grantees may use funds 

for planning and promotional materials; salaries of instructional 

staff; transportation, as long as such expenses are sustainable beyond the grant period and not a significant portion of the grant; 

and the purchase of technology, educational materials, and equipment. 

Fund for the Improvement of Education 

The Committee recommendation does not include funding for 

FIE, which was eliminated in ESSA. For comparability, funding for 

programs funded under FIE in fiscal year 2016 that were separately authorized in ESSA are shown as separate programs in both 

fiscal year 2016 and fiscal year 2017. 

Arts in Education 

The Committee recommendation includes $27,000,000 for the 

Arts in Education program. The funding is used for competitive 

awards for national nonprofit organizations engaged in arts education, professional development activities, and model arts edu-
176 

cation programs. Funds also are used for evaluation and dissemination activities. 

Javits Gifted and Talented Students 

The Committee recommendation includes $12,000,000 for the 

Javits Gifted and Talented Students Education program. Funds are 

used for awards to State and local educational agencies, institutions of higher education, and other public and private agencies for 

research, demonstration, and technical assistance activities designed to enhance the capability of elementary and secondary 

schools to meet the special educational needs of gifted and talented 

students, including those from disadvantaged and underrepresented populations. 

American History and Civics Academies 

The Committee recommendation includes $1,815,000 for American History and Civics Academies. Presidential Academies for the 

Teaching of American History and Civics offer residential workshops to elementary and secondary school teachers to strengthen 

their knowledge through instruction and interaction with primary 

scholars and accomplished teachers in these fields. The Congressional Academies for Students of American History and Civics provide similar workshops to students to enrich their understanding 

of American history and civics. 

Teacher and School Leader Incentive Grants 

The Committee recommendation includes $213,000,000 for 

Teacher and School Leader Incentive Grants. 

This program, newly authorized in ESSA and the successor to 

the Teacher Incentive Fund, provides competitive grants to eligible 

entities to develop, implement, improve, or expand human capital 

management systems or performance-based compensation systems 

in schools. Funds can be used for a wide-range of activities, including developing or improving evaluation and support systems that 

are based in part on student achievement; providing principals 

with necessary tools to make school-level decisions; implementing 

a differentiated salary structure based on a variety of factors; improving the recruitment and retaining of effective teachers, principals, and other school leaders; and instituting career advancement opportunities that reward effective teachers, principals and 

other school leaders. 

Ready-To-Learn Television 

The Committee recommendation includes $25,741,000 for the 

Ready-to-Learn Television program. 

This program is designed to facilitate student academic achievement by leveraging the power and reach of public television to develop and distribute educational video programming for preschool 

and elementary school children and their parents. 

Advanced Placement 

The Committee recommendation does not include funding for Advanced Placement [AP] programs. ESSA eliminated the AP program and consolidated the funding into a new Student Support and 
177 

Academic Enrichment Grants program. The Committee recommendation is consistent with this consolidation. 

Supporting Effective Educator Development 

The Committee recommendation includes $87,000,000 for the 

Supporting Effective Educator Development [SEED] program. 

SEED provides competitive grants to improve teacher and principal 

effectiveness by supporting pathways that help teachers, principals, 

or other school leaders with non-traditional preparation and certification obtain employment in underserved LEAs; providing evidence-based professional development; and making services and 

learning opportunities freely available to LEAs. 

This program was formerly funded as a set-aside of the title II 

Teacher Quality State Grants program. ESSA authorized SEED as 

a separate program and the Committee recommendation is consistent with that authorization. 

The Committee notes that funding provided in fiscal year 2016 

for this program, as a set-aside of the former title II Teacher Quality State Grants program, and funding provided in this bill for a 

separately authorized SEED program is all available through September 30, 2017. The Committee directs the Department to manage these appropriations efficiently, in a manner that is beneficial 

to all potential grantees and simplifies administration of the program. Further, the Committee directs the Department to ensure a 

smooth transition in program costs from fiscal year 2017 through 

fiscal year 2018. 

Within the total for SEED, the Committee includes funding for 

a competitive award to establish a consortium of university-led centers operating in multiple States, to improve academic preparation 

and college readiness, including the college-and-career pipeline, of 

rural youth. Such a consortium would increase access to workshops 

and partnerships for new and experienced educators, and should 

support teachers in all grade levels and across disciplines, kindergarten through university, as well as students, families, and community members, in high-need rural areas. University-led centers 

would be able to focus on the specific needs of local rural communities, schools, teachers, and students in their State. Specific activities could include professional development and on-site programming for teachers and school administrators throughout the year, 

youth writing and literacy programs, and community-based workshops. 

STEM Master Teacher Corps 

The Committee recommendation does not include funding for the 

STEM Master Teacher Corps program, a new program authorized 

in ESSA. 

Stronger Together 

The Committee recommendation does not include funding for 

Stronger Together, a new, unauthorized program. 

Next Generation High Schools 

The Committee recommendation does not include funding for 

Next Generation High Schools, a new, unauthorized program. 
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Computer Science for All Development Grants 

The Committee recommendation does not include funding for 

Computer Science for All Development Grants, a new, unauthorized program. However, the Committee notes the Student Support 

and Academic Enrichment Grants program authorizes a range of 

activities to support well-rounded educational opportunities including computer science. 

Teach to Lead 

The Committee recommendation does not include funding for 

Teach to Lead, a new, unauthorized program. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Appropriations, 2016 ............................................................................. $254,815,000 

Budget estimate, 2017 ........................................................................... 228,000,000 

Committee recommendation ................................................................. 143,254,000 

The Committee recommends a total of $143,254,000 for activities 

to promote safe schools, healthy students, and citizenship education. 

Promise Neighborhoods 

The Committee recommendation includes $73,254,000 for the 

Promise Neighborhoods program. This program awards competitive 

grants to not-for-profit, community-based organizations for the development of comprehensive neighborhood programs designed to 

combat the effects of poverty and improve educational and life outcomes for children and youth, from birth through college. Each 

Promise Neighborhood grantee serves a high-poverty urban neighborhood or rural community. 

The Committee strongly believes that Promise Neighborhoods 

grantees may need more than 5 years to implement the transformational reforms and demonstrate the results in underserved 

communities envisioned by this program. ESSA, which authorizes 

Promise Neighborhoods as a stand-alone program, allows the Department to extend Promise Neighborhoods grants for a period of 

up to 2 years. This bill extends that authority to grants made 

under the previous authorization of the program. The Committee 

directs the Department to use that authority to extend funding for 

current high-quality Promise Neighborhoods programs operating in 

underserved areas that have demonstrated promising results 

through their initial implementation grant and propose to continue 

pursuing ambitious goals through continued innovative activities 

during such extension of their award. Further, the Committee directs the Department to ensure that in any new grant competition, 

the Department gives equal weight to new and current programs, 

including grantees proposing to continue programs operating in a 

particular neighborhood or community, provided they can demonstrate successful outcomes and justify the need for continued 

funding. 

School Safety National Activities 

The Committee recommendation includes $70,000,000 for the national activities portion of the Safe and Drug-Free Schools and 
179 

Communities program, including up to $5,000,000 for Project 

SERV. This funding will help schools address the consequences of 

their students witnessing or beingthe victim of violence and other 

root causes of unhealthy school climates. The Committee recommendation includes sufficient funding for Project SERV to help 

restore a stable and safe learning environment for schools, students 

and educators who have experienced violent or traumatic situations, including through the provision of extended services grants. The Committee recommendation includes $5,000,000 to continue 

an initiative started in fiscal year 2016 to improve school-based 

services for children in communities that have experienced significant episodes of civil unrest. This funding supports the establishment of school-based programs in such communities to address, including through counseling services, the comprehensive educational, behavioral, and mental health needs of youth who have 

experienced significant trauma related to recent events in their 

communities. This program is administered in coordination with 

SAMHSA. 

Elementary and Secondary School Counseling 

The Committee recommendation does not include funding for the 

Elementary and Secondary School Counseling program. ESSA 

eliminated this program and consolidated the funding into a new 

Student Support and Academic Enrichment Grants program. The 

Committee recommendation is consistent with this consolidation. 

Carol M. White Physical Education for Progress Program 

The Committee recommendation does not include funding for the 

physical education program. ESSA eliminated this program and 

consolidated the funding into a new Student Support and Academic 

Enrichment Grants program. The Committee recommendation is 

consistent with this consolidation. 

Full Service Community Schools 

The Committee recommendation does not include funding for 

Full Service Community Schools. This program provides grants to 

LEAs, in partnership with community-based organizations, nonprofits, and other organizations, to provide comprehensive academic, social, and health services for students, student’s families, 

and community members that will result in improved education 

outcomes for children. 

ENGLISH LANGUAGE ACQUISITION

Appropriations, 2016 ............................................................................. $737,400,000 

Budget estimate, 2017 ........................................................................... 800,400,000 

Committee recommendation ................................................................. 737,400,000 

The Committee recommends an appropriation of $737,400,000 for 

the English Language Acquisition program. 

The Department makes formula grants to States based on each 

State’s share of the Nation’s limited-English-proficient and recent 

immigrant student population. The program is designed to increase 

the capacity of States and school districts to address the needs of 

these students. The authorizing statute requires that 6.5 percent of 

the appropriation be used to support national activities, which in-
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clude professional development activities designed to increase the 

number of highly qualified teachers serving limited-English-proficient students; a National Clearinghouse for English Language 

Acquisition and Language Instructional Programs. National activities funds shall be available for 2 years. 

SPECIAL EDUCATION

Appropriations, 2016 ............................................................................. $12,976,858,000 

Budget estimate, 2017 ........................................................................... 13,066,858,000 

Committee recommendation ................................................................. 13,019,358,000 

The Committee recommends an appropriation of $13,019,358,000 

for special education programs. 

Grants to States 

The Committee recommendation includes $11,952,848,000 for 

IDEA Part B Grants to States. This program provides formula 

grants to assist States, outlying areas, and other entities in meeting the costs of providing special education and related services for 

children with disabilities. States pass along most of these funds to 

LEAs, but may reserve some for program monitoring, enforcement, 

technical assistance, and other activities. 

The appropriation for this program primarily supports activities 

associated with the 2017–2018 academic year. Of the funds available for this program, $2,669,465,000 will become available on July 

1, 2017, and $9,283,383,000 will become available on October 1, 

2017. These funds will remain available for obligation through September 30, 2018. 

The Committee recommendation includes bill language continuing several provisions relating to MOE requirements, as requested by the administration. 

Preschool Grants 

The Committee recommends $368,238,000 for Preschool Grants. 

This program provides formula grants to States to assist them in 

making available special education and related services for children 

with disabilities aged 3 through 5. States distribute the bulk of the 

funds to LEAs. States must serve all eligible children with disabilities aged 3 through 5 and have an approved application under the 

IDEA. 

Grants for Infants and Families 

The Committee recommends $458,556,000 for the Grants for Infants and Families program under part C of the IDEA. Part C of 

the IDEA authorizes formula grants to States, outlying areas, and 

other entities to implement State-wide systems for providing early 

intervention services to all children with disabilities, ages 2 and 

younger, and their families. The IDEA also gives States the option 

of extending eligibility for part C services to children 3 and older 

if they were previously served under part C and will continue to 

be served until entrance to kindergarten. 

State Personnel Development 

The Committee recommends $41,630,000 for the State Personnel 

Development program. Ninety percent of funds must be used for 
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professional development activities. The program supports grants 

to SEAs to help them reform and improve their personnel preparation and professional development related to early intervention, 

educational, and transition services that improve outcomes for students with disabilities. The bill includes language proposed in the 

budget request that allows funds under the program to be used for 

program evaluation. 

Technical Assistance and Dissemination 

The Committee recommends $56,928,000 for Technical Assistance and Dissemination. This program supports awards for technical assistance, model demonstration projects, the dissemination 

of useful information, and other activities. Funding supports activities that are designed to improve the services provided under the 

IDEA. 

Within the total, the Committee recommendation includes 

$12,583,000, an increase of $2,500,000 above the fiscal year 2016 

funding level and the budget request, to support activities authorized by the Special Olympics Sport and Empowerment Act, including Project UNIFY. This funding supports efforts to expand Special 

Olympics programs and the design and implementation of Special 

Olympics education programs that can be integrated into classroom 

instruction and are consistent with academic content standards. 

Personnel Preparation 

The Committee recommends $83,700,000 for the Personnel Preparation program. 

Funds support competitive awards to help address State-identified needs for personnel who are qualified to work with children 

with disabilities, including special education teachers and related 

services personnel. The program is required to fund several other 

broad areas, including training leadership personnel and personnel 

who work with children with low-incidence disabilities, and providing enhanced support for beginning special educators. 

Parent Information Centers 

The Committee recommends $27,411,000 for Parent Information 

Centers. 

This program makes awards to parent organizations to support 

parent training and information centers, including community parent resource centers. These centers provide training and information to meet the needs of parents of children with disabilities living 

in the areas served by the centers, particularly underserved parents, and parents of children who may be inappropriately identified. 

Technology and Media Services 

The Committee recommends $30,047,000 for Technology and 

Media Services. This program makes competitive awards to support the development, demonstration, and use of technology and 

educational media activities of value to children with disabilities. 

The Committee recognizes the ongoing progress made with the 

tools and services provided under the Educational Technology, 

Media and Materials program that have allowed more than 
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380,000 students with disabilities free access to more than 325,000 

books in digitally accessible formats. The Committee strongly encourages continued effort to expand this program’s reach to K–12 

students in underserved areas. 

REHABILITATION SERVICES

Appropriations, 2016 ............................................................................. $3,529,605,000 

Budget estimate, 2017 ........................................................................... 3,541,389,000 

Committee recommendation ................................................................. 3,536,389,000 

Vocational Rehabilitation State Grants 

The Committee recommends $3,398,554,000 in mandatory funding for Vocational Rehabilitation [VR] State Grants. 

State Grants assist States in providing a range of services to 

help persons with physical and mental disabilities prepare for and 

engage in meaningful employment. 

The Rehabilitation Act requires that not less than 1 percent and 

not more than 1.5 percent of the appropriation for VR State Grants 

be set aside for Grants for American Indians. 

The Committee recommendation continues bill language allowing 

the Department to use unobligated VR State grant funds that remain available subsequent to the reallottment process, to be used 

for innovative activities to improve outcomes for individuals with 

disabilities, including for the PROMISE initiative. 

Client Assistance State Grants 

The Committee recommends $13,000,000 in discretionary funds 

for Client Assistance State Grants. 

This program funds State formula grants to help VR clients or 

client applicants understand the benefits available to them. States 

must operate client assistance programs to receive VR State Grant 

funds. 

Training 

The Committee recommends $30,188,000 for training rehabilitation personnel. This program supports grants to provide training to 

new VR staff, or upgrade the qualifications of existing staff. 

Demonstration and Training Programs 

The Committee recommendation includes $5,796,000 for demonstration and training programs. These programs support activities designed to increase employment opportunities for individuals 

with disabilities by expanding and improving the availability and 

provision of rehabilitation and other services. 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,650,000 for the Protection and 

Advocacy of Individual Rights program. 

This program provides grants to agencies to protect and advocate 

for the legal and human rights of persons with disabilities who are 

ineligible for the protection and advocacy services available 

through the Developmental Disabilities Assistance and Bill of 

Rights Act or the Protection and Advocacy for Individuals with 

Mental Illness Act. 
183 

Supported Employment State Grants 

The Committee recommendation includes $27,548,000 for the 

Supported Employment State Grants Program. This program supports collaborative programs between States and appropriate public 

and private nonprofit organizations to provide supported employment services for individuals with the most significant disabilities. 

Independent Living Services for Older Individuals Who Are Blind 

The Committee recommends $33,317,000 for Independent Living 

State Grants. 

This program supports assistance to individuals over age 55 to 

help them adjust to their blindness and continue to live independently, including daily living skills training, counseling, community 

integration information and referral, the provision of low-vision 

and communication devices, and low-vision screening. 

Helen Keller National Center 

The Committee recommends $10,336,000 for the Helen Keller 

National Center for Deaf-Blind Youth and Adults. 

The Helen Keller National Center consists of a national headquarters in Sands Point, New York, with a residential training and 

rehabilitation facility where deaf-blind persons receive intensive 

specialized services; a network of 10 regional field offices that provide referral and counseling assistance to deaf-blind persons; and 

an affiliate network of agencies. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2016 ............................................................................. $25,431,000 

Budget estimate, 2017 ........................................................................... 25,431,000 

Committee recommendation ................................................................. 25,431,000 

The Committee recommends $25,431,000 to help support APH. 

APH provides educational materials to students who are legally 

blind and enrolled in programs below the college level. The Federal 

subsidy provides approximately 65 percent of APH’s total sales income. Materials are distributed free of charge to schools and States 

through per capita allotments based on the total number of students who are blind. Materials provided include textbooks and 

other educational aids in Braille, large type, recorded form, and 

computer applications. Appropriated funds may be used for staff 

salaries and expenses, as well as equipment purchases and other 

acquisitions consistent with the purpose of the Act to Promote the 

Education of the Blind. 

The Committee commends APH for the significant progress being 

made through the Resources with Enhanced Accessibility for 

Learning [REAL] Plan toward developing new technologies to 

translate educational materials for delivery to students who are 

blind and visually impaired. These technological advances will provide educational materials to students more quickly than ever before, enhancing opportunities for academic achievement. The Committee continues to support implementation of the REAL plan, and 

includes no less than $475,000 for such activities, the same as the 

fiscal year 2016 level. 
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NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2016 ............................................................................. $70,016,000 

Budget estimate, 2017 ........................................................................... 70,016,000 

Committee recommendation ................................................................. 70,016,000 

The Committee recommends $70,016,000 for the National Technical Institute for the Deaf [NTID]. 

NTID, located on the campus of the Rochester Institute of Technology in Rochester, New York, was created by Congress in 1965 

to provide a residential facility for postsecondary technical training 

and education for persons who are deaf. NTID also provides support services for students who are deaf, trains professionals in the 

field of deafness, and conducts applied research. 

The Committee recommendation includes $2,000,000 in continued funding to support NTIDs operational costs and to continue 

support for at least one regional partnership via a subcontract with 

an external organization consistent with its mission and strategic 

plan. These partnerships enable NTID to expand the geographic 

reach of services and activities supported by the college for individuals who are deaf and hard of hearing. The partnership activities 

include a focus on: promoting training and postsecondary participation in STEM fields; working with NTID faculty to develop postsecondary preparation for students; providing professional development for teachers and developing partnerships with business and 

industry to promote employment opportunities for individuals who 

are deaf and hard of hearing. 

GALLAUDET UNIVERSITY

Appropriations, 2016 ............................................................................. $121,275,000 

Budget estimate, 2017 ........................................................................... 121,275,000 

Committee recommendation ................................................................. 121,275,000 

The Committee recommends $121,275,000 for Gallaudet University. 

Gallaudet University is a private, not-for-profit institution offering undergraduate and continuing education programs for students 

who are deaf, as well as graduate programs in fields related to 

deafness for students who are hearing and deaf. The university 

conducts basic and applied research related to hearing impairments and provides public service programs for the deaf community. 

This funding also supports the Model Secondary School for the 

Deaf, which serves as a laboratory for educational experimentation 

and development; disseminates curricula, materials, and models of 

instruction for students who are deaf; and prepares adolescents 

who are deaf for postsecondary academic or vocational education or 

the workplace. The university’s Kendall Demonstration Elementary 

School develops and provides instruction for children from infancy 

through age 15. 

CAREER, TECHNICAL, AND ADULT EDUCATION

Appropriations, 2016 ............................................................................. $1,720,686,000 

Budget estimate, 2017 ........................................................................... 1,808,686,000 

Committee recommendation ................................................................. 1,720,686,000 
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Career and Technical Education 

The Committee recommends $1,125,019,000 for the Career and 

Technical Education [CTE] account. 

State Grants.—The Committee recommends $1,117,598,000 for 

CTE State grants. The budget request included an increase of 

$75,000,000 for this program for a new American Technical Training Fund, a new competitive grant program as part of a larger reauthorization proposal for the Carl D Perkins Career and Technical 

Education Act. The Committee recommendation does not include 

funding for this activity. 

Funds provided under the State grant program assist States, localities, and outlying areas to expand and improve their CTE program and help ensure equal access to CTE for populations with 

special needs. Persons assisted range from secondary students in 

prevocational courses through adults who need retraining to adapt 

to changing technological and labor market conditions. Funds are 

distributed according to a formula based on State population and 

State per capita income. 

Under the Indian and Hawaiian Natives programs, competitive 

grants are awarded to federally recognized Indian tribes or tribal 

organizations and to organizations primarily serving and representing Hawaiian Natives for services that are additional to what 

these groups receive under other provisions of the Perkins Act. 

Of the funds available for this program, $326,598,000 will become available July 1, 2017, and $791,000,000 will become available on October 1, 2017. These funds will remain available for obligation until September 30, 2018. 

National Programs.—The Committee recommends $7,421,000 to 

support research, development, demonstration, dissemination, evaluation, and assessment of activities aimed at improving the quality 

and effectiveness of CTE. 

Adult Education 

The Committee recommends $595,667,000 for Adult Education 

programs. 

Adult Education State Grants.—The Committee recommendation 

includes $581,955,000 for Adult Education State Grants, which provides grants to States for programs that assist adults in becoming 

literate and in obtaining the skills necessary for employment and 

self-sufficiency. 

National Leadership Activities.—The Committee recommends 

$13,712,000 for adult education national leadership activities. 

STUDENT FINANCIAL ASSISTANCE

Appropriations, 2016 ............................................................................. $24,198,210,000 

Budget estimate, 2017 ........................................................................... 24,198,210,000 

Committee recommendation ................................................................. 24,198,210,000 

The Committee recommends an appropriation of $24,198,210,000 

for programs under the Student Financial Assistance account. 

Federal Pell Grant Program 

The Committee recommends $22,475,352,000 in discretionary 

funding for the Pell grant program. Pell grants provide need-based 
186 

financial assistance that helps undergraduate students and their 

families defray a portion of the costs of postsecondary education. 

Awards are determined according to a statutory need-analysis formula that takes into account a student’s family income and assets, 

household size, and the number of family members, excluding parents, attending postsecondary institutions. 

The Committee recommended funding level is more than sufficient to support an increase in the maximum Pell grant award, 

from $5,815 for the 2016–17 school year to an estimated $5,935 for 

the 2017–18 school year. 

Over the last several years, the Labor-HHS-Education bill has 

appropriated significantly more discretionary funding than has 

been needed to fully fund the Pell grant program. That was in anticipation of future increased costs in the program, which have not 

materialized. Instead, projected costs have significantly, and consistently, decreased year-after-year relative to prior estimates. This 

has resulted in significant current and projected unobligated balances that are expected to persist through fiscal year 2024. CBO’s 

estimate of the fiscal year 2015 Omnibus projected unobligated Pell 

‘‘surplus’’ funding would be exhausted in fiscal year 2016, and 

there would be a $206,000,000 shortfall in funding. In the most recent estimate, with no increase in funding or legislative changes to 

the program in the meantime, CBO now estimates, instead of a 

shortfall in funding, there will be surplus funding of $7,754,000,000 

in fiscal year 2016, that will grow to over $9,000,000,000 by fiscal 

year 2018, and will not be fully exhausted until fiscal year 2025. 

Given the significant unobligated balances in the program, the 

projected balances going forward, and the significant improvement 

in the overall discretionary funding outlook for the program, the 

Committee recommendation restores and modifies a provision previously implemented from the Higher Education Opportunity Act of 

2008 allowing students to receive Pell grants year-round. This provision will allow a student who has exhausted their Pell grant 

award for the academic year, and wishes to enroll in additional 

coursework, to receive a Pell grant for an additional payment period during the academic year, traditionally the summer term. The 

total Pell grant a student may receive during an academic year, 

who is receiving an additional Pell grant under this provision, is 

capped at 150 percent of the maximum Pell grant award. Currently, full-time students and some part-time students exhaust 

their Pell grant award after two semesters or the equivalent. This 

expanded eligibility and flexibility for the Pell grant program will 

provide an incentive for students to take classes year-round and 

stay continuously enrolled. This will help students stay on track for 

graduation or accelerate completion of their program. This provision is expected to provide an estimated 1 million students an average additional Pell grant of $1,650 for the 2017–2018 award year. 

The Committee intends the expanded eligibility to be implemented in such a way to maximize flexibility for institutions of 

higher education and avoid unnecessary administrative burdens associated with the previous implementation of year-round Pell 

grants, while still ensuring the best interests of students. The Committee believes that this can be facilitated by issuing guidance on 

this expanded authority not later than 90 days after enactment of 
187 

this act. The Committee strongly encourages the Department to implement this provision as soon as possible. The Committee also expects the Department to provide reliable data on the implementation of this provision. 

Finally, given the significant decrease in estimated costs compared to estimates used in formulating prior year appropriations, 

the Committee recommendation includes a one-time rescission of 

$1,200,000,000 from unobligated prior-year discretionary balances 

appropriated in the Labor-HHS-Education bill. Based on CBO estimates, after restoring year-round Pell and assuming level funding 

going forward, the discretionary costs of the Pell grant program are 

estimated to be fully funded through fiscal year 2021. This onetime rescission prevents cuts to other programs in this bill serving 

students, children, families, and workers this coming fiscal year, 

while allowing for targeted increases and investments in other critical programs. 

Federal Supplemental Educational Opportunity Grant Program 

The Committee recommends $733,130,000 for the Supplemental 

Educational Opportunity Grant [SEOG] program. 

The SEOG program provides funds to approximately 3,700 postsecondary institutions for need-based grants to more than 1.5 million undergraduate students. Institutions must contribute at least 

25 percent toward SEOG awards. Students qualify for grants of up 

to $4,000 by demonstrating financial need. Priority is given to Pell 

grant recipients with exceptional need. 

Federal Work-Study Program 

The Committee bill provides $989,728,000 for the Federal WorkStudy [FWS] program. 

This program provides grants to approximately 3,300 institutions 

and helps nearly 700,000 undergraduate, graduate, and professional students meet the costs of postsecondary education through 

part-time employment. Institutions must provide at least 25 percent of student earnings. 

Within the total for FWS, the Committee recommendation includes $8,390,000 for the Work Colleges program authorized under 

section 448 of the HEA. 

STUDENT AID ADMINISTRATION

Appropriations, 2016 ............................................................................. $1,551,854,000 

Budget estimate, 2017 ........................................................................... 1,631,990,000 

Committee recommendation ................................................................. 1,546,854,000 

The Committee recommends $1,546,854,000 for the Student Aid 

Administration account. These funds are available until September 

30, 2018, and support the Department’s student aid management 

expenses. 

The Committee recommendation includes $691,643,000 for administrative costs and $855,211,000 for loan servicing activities. 

The Committee directs the Department to continue to provide 

quarterly reports detailing its obligation plan by quarter for student aid administrative activities broken out by servicer and activity. Further, any reallocation of funds between administrative costs 

and servicing activities within this account should be treated as a 
188 

reprogramming of funds, and the Committee should be notified in 

advance of any such changes. 

Student Loan Servicing.—The Committee has serious concerns 

about the Department’s management of the student loan servicing 

system, including how it has adhered to congressional directives, 

intent, and notice requirements in this area. The Department is 

currently in the process of re-competing contracts that will significantly change the current student loan servicing system. The Committee supports the Department’s efforts to improve the student 

loan servicing process by moving to a more simple, consistent, and 

unified experience for all student borrowers and to take steps that 

will reduce student delinquencies and defaults. However, the Committee is concerned that other changes the Department is proposing in the current solicitation could ultimately jeopardize the 

quality of service to student borrowers. The Committee directs the 

Department to ensure that the new student loan servicing contract 

includes the participation of multiple student loan servicers, each 

responsible for all aspects of servicing loans, which would allow the 

Department to allocate loans to different servicers based on performance. The Committee strongly believes this will promote competition and increase incentives for such entities to provide highquality service to student borrowers. The Department should brief 

the Committee on Appropriations of the House of Representatives 

and the Senate, the Senate Committee on Health, Education, 

Labor, and Pensions, and the House Committee on Education and 

the Workforce no less than 15 days prior to releasing a final request for proposals for a new student loan servicing contract. 

Until a new student loan servicing contract is implemented, the 

Committee directs the Department to continue to allocate new student loan accounts to servicers based on performance compared 

against all servicers, utilizing common metrics established by the 

Department. The Committee appreciates recent efforts to work 

with servicers to develop these common metrics. However, the 

Committee remains concerned about the quality of servicing being 

provided to borrowers and servicers’ compliance with the law, and 

expects the Department to adhere to congressional directive to 

produce a common policies and procedures manual that applies to 

all Direct Loan servicers and provides voluntary best practices intended to improve the consistency of servicing for student loan borrowers. Finally, the Committee directs the Department, no later 

than March 1, 2017, to allow Federal student loan borrowers who 

are consolidating their student loans to select from any of the existing student loan servicers to service their new consolidated student 

loans. Furthermore, borrowers who are consolidating their loans 

should have ready access to the aforementioned common performance metrics to help guide their decision for which servicer to select. Allowing the student borrower to select from any of the 

servicers will allow the borrower to remain with their existing 

servicer if they wish to, limit unnecessary disruption for borrowers, 

and provide another incentive for servicers to provide high-quality 

services to student borrowers. 

Federal Student Aid Enforcement Office.—The Committee notes 

that in fiscal year 2016 the Department established an independent enforcement office within the Office of Federal Student 
189 

Aid. However, budget justification materials provide little information about the specific focus of the unit, how it will operate and be 

managed, and how its work will relate to and be coordinated with 

other work being done in FSA, elsewhere in the Department, and 

other enforcement agencies. The Committee appreciates the need to 

ensure students are protected and that there is proper oversight of 

the significant taxpayer investment in Federal student aid. However, the Committee directs the Secretary to ensure that the work 

of this unit is transparent, and not duplicative of other work being 

done at the Department. The Committee directs the Department to 

brief the Committees on Appropriations of the House of Representatives and the Senate, the Senate Health, Education, Labor, and 

Pensions Committee, and House Education and Workforce Committee within 30 days of enactment on the current and planned actions of this new office. Further, the Secretary shall ensure that 

the Chief Operating Officers reports on the operations of the enforcement unit as part of the required reports under section 141 of 

the HEA, including how information is shared internally within 

FSA and between relevant agencies. 

Interagency Task Force on For Profit Colleges.—The Committee 

is concerned about the lack of available public information on a 

task force the Department of Education established on for-profit 

colleges and universities, including the frequency of meetings, contact information, and topics of discussion and the focus on one particular sector of higher education. The Committee directs the Department to brief the Committees on Appropriations of the House 

of Representatives and the Senate, the Senate Health, Education, 

Labor, and Pensions Committee, and House Education and Workforce Committee within 30 days of enactment on the current and 

planned actions of the taskforce, and how it works with and shares 

information with other Federal and State agencies. 

National Student Loan Data System.— The Committee encourages the Department to determine the steps necessary to expand 

the National Student Loan Data System, develop a new system or 

adopt or improve upon an existing system to ensure that borrowers 

have access to all of their student loan information, both Federal 

and private, in one central online location. 

HIGHER EDUCATION

Appropriations, 2016 ............................................................................. $1,982,185,000 

Budget estimate, 2017 ........................................................................... 2,189,200,000 

Committee recommendation ................................................................. 1,986,792,000 

The Committee recommends an appropriation of $1,986,792,000 

for higher education programs. 

Aid for Institutional Development 

The Committee recommends $579,514,000 in discretionary funding for Aid for Institutional Development. These totals do not include separately authorized and appropriated mandatory funding. 

Strengthening Institutions.—The Committee bill recommends 

$86,534,000 to provide competitive, 1-year planning and 5-year development grants for institutions with a significant percentage of 

financially needy students and low educational and general expenditures per student in comparison with similar institutions. Ap-
190 

plicants may use these funds to develop faculty, strengthen academic programs, improve institutional management, and expand 

student services. 

Hispanic-Serving Institutions [HSIs].—The Committee recommends $107,795,000 for competitive grants to institutions at 

which Hispanic students make up at least 25 percent of enrollment. Funds may be used for acquisition, rental, or lease of scientific or laboratory equipment; renovation of instructional facilities; development of faculty; support for academic programs; institutional management; and purchase of educational materials. 

Promoting Postbaccalaureate Opportunities for Hispanic Americans.—The Committee recommends $9,671,000 for competitive, 5- 

year grants to HSIs to help Hispanic Americans gain entry into 

and succeed in graduate study. Institutions may use funding to 

support low-income students through outreach programs; academic 

support services; mentoring and financial assistance; acquisition, 

rental, or lease of scientific or laboratory equipment; construction 

and other facilities improvements; and purchase of educational materials. 

Strengthening Historically Black Colleges and Universities.—The 

Committee recommends $244,694,000 for the Strengthening 

HBCUs program. The program makes formula grants to HBCUs 

that may be used to purchase equipment; construct and renovate 

facilities; develop faculty; support academic programs; strengthen 

institutional management; enhance fundraising activities; provide 

tutoring and counseling services to students; and conduct outreach 

to elementary and secondary school students. 

Strengthening Historically Black Graduate Institutions 

[HBGIs].—The Committee recommends $63,281,000 for the 

Strengthening HBGIs program. This program provides 5-year 

grants to provide scholarships for low-income students and academic and counseling services to improve student success. Funds 

may also be used for construction, maintenance, and renovation activities; the purchase or lease of scientific and laboratory equipment; and the establishment of an endowment. 

Strengthening Predominately Black Institutions [PBIs].—The 

Committee recommends $9,942,000 for the Strengthening PBIs program. This program provides 5-year grants to PBIs to plan and implement programs to enhance the institutions’ capacity to serve 

more low- and middle-income Black American students. 

Strengthening Asian American and Native American Pacific Islander-Serving Institutions [AANAPISIs].—The Committee recommends $3,348,000 for competitive grants to AANAPISIs that 

have an enrollment of undergraduate students that is at least 10 

percent Asian American or Native American Pacific Islander students. Grants may be used to improve their capacity to serve Asian 

American and Native American Pacific Islander students and lowincome individuals. 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions [ANNHs].—The Committee recommends $13,802,000 for the 

Strengthening ANNHs program. 

The purpose of this program is to improve and expand the capacity of institutions serving Alaska Native and Native Hawaiian students and low-income individuals. Funds may be used to plan, de-
191 

velop, and implement activities that encourage faculty and curriculum development; improve administrative management; renovate educational facilities; enhance student services; purchase library and other educational materials; and, provide education or 

counseling services designed to improve the financial and economic 

literacy of students or their families. 

Strengthening Native American-Serving Non-Tribal Institutions.—The Committee recommends $3,348,000 for this program, 

which serves institutions that enroll at least 10 percent Native 

American students and at least 50 percent low-income students. 

This program helps institutions plan, develop, and implement activities that encourage faculty and curriculum development; improve administrative management; renovate educational facilities; 

enhance student services; and purchase library and other educational materials. 

Strengthening Tribally Controlled Colleges and Universities.— 

The Committee recommends $27,599,000 for this program. Tribal 

colleges and universities rely on a portion of the funds provided to 

address developmental needs, including faculty development, curriculum, and student services. 

Strengthening Masters Degree Programs at Historically Black 

Colleges and Universities.—The Committee recommends $9,500,000 

for this program, authorized by section 723 of the HEA. This program provides grants to specified colleges and universities making 

a substantial contribution to graduate education opportunities at 

the masters level in mathematics, engineering, the physical or natural sciences, computer science, information technology, nursing, 

allied health, or other scientific disciplines. 

International Education and Foreign Language Studies 

The bill includes a total of $67,271,000 for International Education and Foreign Language Studies programs. 

Funds are used to increase the number of experts in foreign languages and area or international studies to meet national security 

needs through visits and study in foreign countries. 

Domestic Programs.—The Committee recommends $65,103,000 

for domestic program activities related to international education 

and foreign language studies under title VI of the HEA. Funds are 

used to support centers, programs, and fellowships. The Committee 

urges the Secretary to preserve the program’s longstanding focus 

on activities and institutions that address the Nation’s need for a 

strong training and research capacity in foreign languages and 

international studies, including increasing the pool of international 

experts in areas that are essential to national security and economic competitiveness. 

Overseas Programs.—The Committee recommends $2,168,000 for 

overseas programs authorized under the Mutual Educational and 

Cultural Exchange Act of 1961, popularly known as the FulbrightHays Act. Funding is provided for group, faculty, or doctoral dissertation research abroad as well as special bilateral projects. 

Grants focus on training American instructors and students to improve foreign language and area studies education in the United 

States. 
192 

Fund for the Improvement of Postsecondary Education 

The Committee recommendation does not include funding for the 

Fund for the Improvement of Postsecondary Education. 

Model Comprehensive Transition and Postsecondary Programs for 

Students With Intellectual Disabilities 

The Committee recommendation includes $11,800,000 for competitive grants to postsecondary institutions to support model programs that help students with intellectual disabilities transition to 

and complete college, as authorized by section 767 of the HEA. 

Funds may be used for student support services; academic enrichment, socialization, or independent living; integrated work experiences; and partnerships with LEAs to support students with intellectual disabilities participating in the model program who are still 

eligible for special education and related services under the IDEA. 

Minority Science and Engineering Improvement 

The Committee recommends $9,648,000 for the Minority Science 

and Engineering Improvement program. Funds are used to provide 

discretionary grants to institutions with minority enrollments 

greater than 50 percent to purchase equipment, develop curricula, 

and support advanced faculty training. Grants are intended to improve science and engineering education programs and increase the 

number of minority students in the fields of science, mathematics, 

and engineering. 

Tribally Controlled Postsecondary Career and Technical Institutions 

The Committee recommends $8,286,000 for tribally controlled 

postsecondary vocational institutions. This program provides 

grants for the operation and improvement of tribally controlled 

postsecondary vocational institutions to ensure continued and expanding opportunities for Indian students. 

Federal TRIO Programs 

The Committee recommends $900,000,000 for Federal TRIO programs, which provide a variety of services to improve postsecondary education opportunities for low-income individuals and 

first-generation college students. 

Upward Bound offers disadvantaged high school students academic services to develop the skills and motivation needed to pursue and complete a postsecondary education; Student Support 

Services provides developmental instruction, counseling, summer 

programs, and grant aid to disadvantaged college students to help 

them complete their postsecondary education; Talent Search identifies and counsels individuals between ages 11 and 27 regarding opportunities for completing high school and enrolling in postsecondary education; Educational Opportunity Centers provide information and counseling on available financial and academic assistance to low-income adults who are first-generation college students; 

and the Ronald E. McNair Postbaccalaureate Achievement Program supports research internships, seminars, tutoring, and other 

activities to encourage disadvantaged college students to enroll in 

doctoral programs. 
193 

The Committee recommendation does not include funding for a 

new demonstration program proposed by the administration. The 

Committee also directs the Department, when additional funding is 

provided to non-competing programs based on increased appropriations, to provide the maximum amount of flexibility to such programs in how to best allocate those additional resources under existing authorities. Finally, the Committee directs the Department 

to ensure that fiscal year 2017 grant competitions are announced 

and awarded in a timely manner, to allow grantees sufficient leadtime prior to the beginning of their program-year. 

Gaining Early Awareness and Readiness for Undergraduate Programs 

The Committee recommends $322,754,000 for GEAR UP, which 

provides grants to States and partnerships of colleges, middle and 

high schools, and community organizations to assist cohorts or students in middle and high schools serving a high percentage of lowincome students. Services provided help students prepare for and 

pursue a postsecondary education. 

The Committee continues bill language allowing the Department 

to set aside up to 1.5 percent of the total provided for evaluation 

purposes. 

Graduate Assistance in Areas of National Need and Javits Fellowships 

The Committee recommends $29,293,000 to support the Graduate Assistance in Areas of National Need [GAANN] program. 

GAANN supports fellowships through 3-year competitive grants 

to graduate academic departments and programs in scientific and 

technical fields and other areas of national need as determined by 

the Secretary. Fellowship recipients must have excellent academic 

records and high financial need and must be pursuing doctoral degrees or the highest graduate degrees in their academic field. Each 

fellowship consists of a student stipend to cover living costs and an 

institutional payment to cover each fellow’s tuition and other expenses. Institutions of higher education must match 25 percent of 

the grant amount. 

Teacher Quality Partnership Program 

The Committee recommends $43,092,000 for the Teacher Quality 

Partnership [TQP] program. The budget request consolidates activities supported by this program into a proposed new Teacher 

and Principals Pathways program. The TQP program helps improve the quality of teachers working in high-need schools and 

early childhood education programs by creating model teacher 

preparation and residency programs. 

Within the TQP program, the Committee encourages the Department to consider funding for programs, including those operating 

in HBCUs, focused on increasing the number of high-quality teachers from diverse and underrepresented backgrounds. The Committee further directs the Department to ensure that grants are 

distributed among eligible entities that will serve geographically diverse areas, including rural areas. 
194 

Child Care Access Means Parents in Schools 

The Committee recommendation includes $15,134,000 for the 

Child Care Access Means Parents in Schools program. This program provides competitive grants to institutions of higher education to establish or support campus-based child care programs, to 

help support needs and participation of low-income parents in postsecondary education. 

Teacher and Principal Pathways 

The Committee recommendation does not include funding Teacher and Principal Pathways, a new, unauthorized program. 

HOWARD UNIVERSITY

Appropriations, 2016 ............................................................................. $221,821,000 

Budget estimate, 2017 ........................................................................... 221,821,000 

Committee recommendation ................................................................. 221,821,000 

The Committee recommends an appropriation of $221,821,000 for 

Howard University. Located in the District of Columbia, Howard 

offers undergraduate, graduate, and professional degrees through 

12 schools and colleges. The university also administers the Howard University Hospital. Federal funds from this account support 

approximately 38 percent of the university’s operating costs. The 

Committee recommends, within the funds provided, not less than 

$3,405,000 for the endowment program. 

Howard University Hospital.—Within the funds provided, the 

Committee recommends $27,325,000 for Howard University Hospital. The hospital provides inpatient and outpatient care, as well 

as training in the health professions. It also serves as a major 

acute and ambulatory care center for the District of Columbia and 

functions as a major teaching facility attached to the university. 

The Federal appropriation provides partial funding for the hospital’s operations. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

Appropriations, 2016 ............................................................................. $435,000 

Budget estimate, 2017 ........................................................................... 457,000 

Committee recommendation ................................................................. 435,000 

Federal Administration.—The Committee bill includes $435,000 

for Federal administration of the CHAFL, College Housing Loans, 

and Higher Education Facilities Loans programs. Prior to fiscal 

year 1994, these programs provided financing for the construction, 

reconstruction, and renovation of housing, academic, and other educational facilities. While no new loans have been awarded since fiscal year 1993, costs for administering the outstanding loans will 

continue through 2030. These funds will be used to reimburse the 

Department for administrative expenses incurred in managing the 

existing loan portfolio. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL

FINANCING PROGRAM ACCOUNT

Appropriations, 2016 ............................................................................. $20,484,000 

Budget estimate, 2017 ........................................................................... 20,499,000 

Committee recommendation ................................................................. 20,484,000 
195 

The Committee recommends $20,484,000 for the HBCU Capital 

Financing Program. 

The Committee recommendation includes $20,150,000 to pay the 

loan subsidy costs in guaranteed loan authority under this program. This amount will support an estimated $282,212,855 in new 

loan volume in fiscal year 2017. The remaining $334,000 will be 

used for administrative expenses. 

The HBCU Capital Financing Program makes capital available 

to HBCUs for construction, renovation, and repair of academic facilities by providing a Federal guarantee for private sector construction bonds. Construction loans will be made from the proceeds 

of the sale of the bonds. 

INSTITUTE OF EDUCATION SCIENCES

Appropriations, 2016 ............................................................................. $618,015,000 

Budget estimate, 2017 ........................................................................... 693,818,000 

Committee recommendation ................................................................. 612,525,000 

The Committee recommends $612,525,000 for the Institute of 

Education Sciences [IES]. This account supports education research, development, dissemination, and evaluation; data collection 

and analysis activities; and the assessment of student progress. 

Under the Education Sciences Reform Act of 2002, Congress established IES to provide objective and valid research-driven knowledge that was free of political influence or bias so as to better inform effective education practices at the State and local levels. The 

act required IES, in carrying out its mission, ‘‘to compile statistics, 

develop products, and conduct research, evaluations, and wide dissemination activities in areas of demonstrated national need and 

ensure that such activities conform to high standards of quality, integrity, and accuracy and are objective, secular, neutral, and nonideological and are free of partisan political influence.’’ 

The Committee directs the Director to submit an operating plan 

within 90 days of enactment of this act to the Committees on Appropriations of the House of Representatives and the Senate detailing how IES plans to allocate funding available to the Institute for 

research, evaluation, and other activities authorized under law. 

The Committee is aware of serious concerns about the privacy of 

student data, particularly personally identifiable information [PII]. 

The Committee directs the Department to ensure that its employees, contractors, and grantees, including States that receive funds 

from Statewide Longitudinal Data System grants, adhere to the 

strictest and highest standards for protecting PII. The Committee 

further directs the Department to report to the Committee, as well 

as to the Senate Health, Education, Labor, and Pensions Committee and the House Education and the Workforce Committee, no 

later than one year from the date of enactment of this act, on the 

actions it has taken to comply with this directive. 

RESEARCH, DEVELOPMENT, AND DISSEMINATION

The Committee recommends $190,000,000 for education research, 

development, and national dissemination activities. Funds are 

available for obligation for 2 fiscal years. These funds support activities that are aimed at expanding fundamental knowledge of 
196 

education and promoting the use of research and development findings in the design of efforts to improve education. 

The Committee recognizes the importance of research in guiding 

the implementation of evidence-based practices throughout our 

education system. The Committee is particularly interested in research that addresses the specific needs of diverse rural schools. 

The Committee directs the Department to brief the Committees on 

Appropriations of the Senate and House of Representatives within 

120 days of enactment on how IES is contributing to research in 

this area. 

STATISTICS

The Committee recommends $112,000,000 for data gathering and 

statistical analysis activities at the National Center for Education 

Statistics [NCES]. 

NCES collects, analyzes, and reports statistics on education in 

the United States. Activities are carried out directly and through 

grants and contracts. The Center collects data on educational institutions at all levels, longitudinal data on student progress, and 

data relevant to public policy. NCES also provides technical assistance to SEAs, LEAs, and postsecondary institutions. 

REGIONAL EDUCATIONAL LABORATORIES

The Committee recommends $54,423,000 to continue support for 

the Regional Educational Laboratories program. Funds available in 

this bill will continue to support a network of 10 laboratories. The 

laboratories are responsible for promoting the use and development 

of knowledge and evidence in broad-based systemic strategies to increase student learning and further school improvement efforts. 

The Committee appreciates the efforts of IES to strengthen the 

connections between practitioners and the research community, so 

that federally supported research is timely, relevant, and responsive to the needs of the field. 

RESEARCH AND INNOVATION IN SPECIAL EDUCATION

The Committee recommends $54,000,000 for research and innovation in special education conducted by the National Center for 

Special Education Research. 

The Center addresses gaps in scientific knowledge to improve 

special education and early intervention services and outcomes for 

infants, toddlers, and children with disabilities. Funds provided to 

the Center are available for obligation for 2 fiscal years. 

SPECIAL EDUCATION STUDIES AND EVALUATIONS

The Committee recommends $10,818,000 for special education 

studies and evaluations. 

This program supports competitive grants, contracts, and cooperative agreements to assess the implementation of IDEA. Funds are 

also used to evaluate the effectiveness of State and local efforts to 

deliver special education services and early intervention programs. 

Funds are available for obligation for 2 fiscal years. 
197 

STATEWIDE DATA SYSTEMS

The Committee recommendation includes $34,539,000 for the 

Statewide Data Systems program. 

This program supports competitive grants to SEAs to enable 

such agencies to design, develop, and implement Statewide, longitudinal data systems to manage, analyze, disaggregate, and use individual data for students of all ages. Early childhood, postsecondary, and workforce information systems may be linked to such 

systems or developed with program funds. The Committee believes 

the Department should continue its efforts to ensure every State 

has the base support necessary to develop effective systems. Funds 

are available for obligation for 2 fiscal years. 

ASSESSMENT

The Committee recommends $156,745,000 to provide support for 

the National Assessment of Educational Progress [NAEP], a congressionally mandated assessment created to measure and report 

the educational achievement of American students in a range of 

subjects and analyze trends over time. 

Within the funds appropriated, the Committee recommends 

$7,745,000 for the National Assessment Governing Board [NAGB], 

which is responsible for formulating policy for NAEP. 

The Committee is pleased that the NAGB reinstated assessments 

for 8th and 12th grade students in United States History, Civics, 

and Geography. Previous assessments conducted by NAGB indicate 

that fewer than one in four 4th, 8th, and 12th grade students at 

all grade levels are proficient in United States History. The Committee directs the NAGB to continue administering the assessments in these three areas at least every four years, in accordance 

with the current NAEP schedule. According to this schedule, the 

next administration will be in 2018. 

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION

Appropriations, 2016 ............................................................................. $432,000,000 

Budget estimate, 2017 ........................................................................... 474,827,000 

Committee recommendation ................................................................. 432,000,000 

The Committee recommends $432,000,000 for program administration. 

Funds support personnel compensation and benefits, travel, rent, 

communications, utilities, printing, equipment and supplies, automated data processing, and other services required to award, administer, and monitor Federal education programs. Support for 

program evaluation and studies and advisory councils is also provided under this account. 

The Committee notes that some have raised concerns about the 

Department’s use of guidance documents, including Dear Colleague 

letters, because such documents are not legally binding, but regulated entities may interpret them as such. Accordingly, the Committee recommendation includes new directives in the overview 

section of the Committee Report for each of the Departments and 
198 

agencies included in this bill relating to the use of guidance documents. 

The Committee urges the Secretary to provide clear and coordinated technical assistance and guidance for ESEA student data collection and reporting early in fiscal year 2017, to help States and 

LEAs prepare for the 2017–18 school year, the first full year of implementation of the recent reauthorization of ESEA. This could include highlighting existing best practices in the field, convening 

working groups, hosting webinars, and other methods that will best 

support effective and efficient data collection and reporting. 

Competitive Grant Priorities for Rural Areas.—The Committee 

urges the Department to continue efforts to ensure that competitive 

grants are reaching rural areas and States so that support and solutions developed with Federal funding are relevant to and available in such areas. 

Open Textbooks.—The Committee directs the Department to provide a report to the Committee no later than 180 days after enactment of this act on steps it has taken or plans to take to help 

achieve the highest level of savings possible for students through 

the sustainable, expanded use of open textbooks at institutions of 

higher education and production of the highest quality open textbooks. 

Performance Partnerships.—Performance Partnerships allow 

States and localities to demonstrate better ways of improving outcomes for disconnected youth (low-income people, ages 14–24, who 

are homeless, in foster care, involved in the justice system, or are 

not working or enrolled in an educational institution) by giving 

them additional flexibility in using discretionary funds across multiple Federal programs. States and localities that elect to participate in these pilots will commit to achieving significant improvements in educational, employment and other key outcomes in exchange for this new flexibility. This eases the strain on communities trying to meet the needs of disconnected youth, while advancing the goals of individual Federal programs. In making 

awards under this program the administration shall continue to 

give priority to those communities that have experienced civil unrest. Such events in communities across the Nation have illustrated, in part, the important need to improve opportunities and 

services for disconnected populations, and Performance Partnerships focused in these communities will allow localities to pilot better ways of improving outcomes. The Committee also notes that 

thus far a number of factors have led to a more modest start to utilizing flexibility available to pilot sites. The Committee urges the 

administration to enhance its efforts working with existing and 

new sites on the full range of flexibility that could be employed to 

improve outcomes for youth served through pilot sites. Further, the 

Committee bill also includes language extending the flexibility for 

current and future pilot sites by up to an additional 5 years in recognition of the challenges associated with implementing sustainable, positive change in systems serving this population. Finally, 

the Committee directs the administration to continue to provide 

annual reports providing the following information: detailed summary of all involved pilot programs, overview of how pilots were selected, summary of findings from the various pilots, and rec-
199 

ommendations for Congress on how to apply any best practices 

learned more broadly. 

Pooled Evaluation Authority.—The Committee requests that the 

Department provide a report to the Committees on Appropriations 

on the planned use of pooled evaluation funds under section 8601 

of the ESEA, consistent with the required plan under such section, 

not later than 15 days prior to any transfer of funds. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2016 ............................................................................. $107,000,000 

Budget estimate, 2017 ........................................................................... 137,708,000 

Committee recommendation ................................................................. 110,000,000 

The Committee recommends $110,000,000 for the Office of Civil 

Rights [OCR]. 

OCR is responsible for the enforcement of laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, and age in all programs and institutions that receive financial assistance from the Department. To carry out this responsibility, OCR investigates and resolves discrimination complaints, 

monitors desegregation and equal educational opportunity plans, 

reviews possible discriminatory practices by recipients of Federal 

education funds, and provides technical assistance to recipients of 

funds to help them meet these civil rights requirements. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $59,256,000 

Budget estimate, 2017 ........................................................................... 61,941,000 

Committee recommendation ................................................................. 59,256,000 

The Committee recommends $59,256,000 for OIG. 

OIG has the authority to investigate all departmental programs 

and administrative activities, including those under contract or 

grant, to prevent and detect fraud and abuse, and to ensure the 

quality and integrity of those programs. The Office investigates alleged misuse of Federal funds and conducts audits to determine 

compliance with laws and regulations, efficiency of operations, and 

effectiveness in achieving program goals. 

GENERAL PROVISIONS

Section 301. The bill continues a provision prohibiting the use of 

funds for the transportation of students or teachers in order to 

overcome racial imbalance. 

Section 302. The bill continues a provision prohibiting the involuntary transportation of students other than to the school nearest 

to the student’s home. 

Section 303. The bill continues a provision prohibiting the use of 

funds to prevent the implementation of programs of voluntary 

prayer and meditation in public schools. 

Section 304. The bill continues a provision giving the Secretary 

authority to transfer up to 1 percent of any discretionary funds between appropriations. 

Section 305. The bill continues a provision that allows the Republic of Palau to receive certain Federal funds. 
200 

Section 306. The bill includes a new provision making evaluation 

funds pooled under section 8601 of the ESEA available for obligation from July 1, 2017 through September 30, 2018. 

Section 307. The bill continues a general provision allowing certain institutions to continue to use endowment income for student 

scholarships. 

Section 308. The bill continues a provision extending authorization of the National Advisory Committee on Institutional Quality 

and Integrity. 

Section 309. The bill continues a provision extending authority to 

provide account maintenance fees to guarantee agencies. 

Section 310. The bill includes a new general provision expanding 

eligibility and flexibility in the Pell grant program relating to yearround Pell grants. 

Section 311. The bill includes a new general provision rescinding 

discretionary unobligated balances from the Pell grant program. 
(201) 

TITLE IV 

RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $6,191,000 

Budget estimate, 2017 ........................................................................... 10,612,000 

Committee recommendation ................................................................. 8,000,000 

The Committee recommends $8,000,000 for the Committee for 

Purchase from People Who Are Blind or Severely Disabled, of 

which no less than $1,000,000 shall be made available for the Office of Inspector General. 

The AbilityOne program provides more than 46,000 blind or severely disabled Americans with employment opportunities each 

year. The primary purpose of this program is to increase the employment opportunities for people who are blind or have other severe disabilities and, whenever possible, to prepare them to engage 

in competitive employment. Encompassing approximately 

$3,000,000,000 in contracts, it is the Federal Government’s largest 

employment program for the severely disabled. The Committee is 

encouraged by the steps the Commission has taken to implement 

the recommendations outlined in the May 2013 GAO report addressing the concerns regarding the oversight of the Central Nonprofit Agencies, the independent contracted organizations which 

administer the program. The Committee directs the Commission to 

provide an update on these efforts to the Committees on Appropriations of the House of Representatives and the Senate within 120 

days of enactment of this act. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

The Corporation for National and Community Service [CNCS], a 

corporation owned by the Federal Government, was established to 

enhance opportunities for national and community service. CNCS 

administers programs authorized under the Domestic Volunteer 

Service Act, the National and Community Service Trust Act, and 

the SERVE America Act. Grants are awarded to States, public and 

private nonprofit organizations, and other entities to create service 

opportunities for students, out-of-school youth, adults, and seniors. 

The Committee recommendation for CNCS provides a total pro- gram level of $1,030,358,000. 

OPERATING EXPENSES

Appropriations, 2016 ............................................................................. $787,929,000 

Budget estimate, 2017 ........................................................................... 794,608,000 

Committee recommendation ................................................................. 736,529,000 
202 

The Committee recommends $736,529,000 for the operating expenses of CNCS. 

Volunteers in Service to America [VISTA] 

The Committee recommends $92,364,000 for VISTA. 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, 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. These programs include the Retired Senior Volunteer Program [RSVP], the Foster Grandparent Program, and the Senior 

Companion Program. 

AmeriCorps State and National Grants 

The Committee recommends $386,010,000 for AmeriCorps State 

and National Grants, which provide funds to local and national organizations and agencies to address community needs in education, 

public safety, health, and the environment. Each of these organizations and agencies, in turn, uses its AmeriCorps funding to recruit, 

place, and supervise AmeriCorps members. AmeriCorps members 

receive a modest living allowance and other benefits proportional 

to their level of time commitment. 

The fiscal year 2016 appropriations act modified a bill language 

provision to allow CNCS to use an authorized set-aside to reserve 

up to 2.5 percent of program funds for evaluation, training, and 

technical assistance. This provision had previously been overridden 

by appropriations language. The Committee directs CNCS to use 

this authority to provide no less than $7,500,000 for training and 

technical assistance activities for State commissions, to expand the 

capacity of current and potential AmeriCorps programs, particularly in underserved areas. 

The Committee continues to strongly encourage CNCS to provide 

AmeriCorps grants to organizations to support activities in communities that have experienced civil unrest. AmeriCorps programs are 

uniquely situated to respond to such sudden crises that have impacted communities across the country but also the challenges underlying them. The Committee strongly supports activities focused 

in this area. 

The Committee notes that over the last several years CNCS has 

begun limiting operating funds for professional corps programs. 

The Committee is concerned that significantly limiting these resources may have an impact on professional corps programs being 

able to provide high-quality services, particularly those operating 

in underserved communities without ready access to other funding 

sources. The Committee directs CNCS to issue clear, extensive 

guidance as part of their fiscal year 2017 request for proposals for 

AmeriCorps grants outlining specifically how grantees can dem-
203 

onstrate and justify the need for operating funds as part of their 

professional corps grant. Further, the Committee directs CNCS to 

provide potential grantees flexibility in justifying this need to ensure these programs are able to provide high-quality services in all 

communities, regardless of the availability of other funding 

sources. Finally, the Committee directs CNCS to provide a report 

to the Committees on Appropriations on how they have awarded 

operating funds as part of professional corps grants from fiscal year 

2010 through fiscal year 2016, including a breakdown of operating 

funds provided by programs operating in different geographic 

areas. 

The Committee has serious concerns about CNCS management 

and oversight of its AmeriCorps programs, including grantee compliance with Federal laws and CNCS regulations. The Committee 

directs CNCS to submit a report to the Committee on what specific 

steps it has taken, and plans to take, to improve oversight of 

AmeriCorps programs, and to ensure compliance with Federal laws 

and regulations. 

The Committee encourages CNCS to work with State service 

commissions, current grantees engaged in service-learning activities, and other relevant stakeholders, to create a plan to support 

activities and programs previously sustained by Learn and Serve 

America. 

National Civilian Community Corps [NCCC] 

The Committee recommendation includes $30,000,000 for NCCC, 

a full-time, team-based residential program for men and women 

ages 18 to 24. Members are assigned to one of five campuses for 

a 10-month service commitment. 

Innovation, Demonstration, and Assistance Activities 

The Committee recommendation includes $5,000,000 for innovation, demonstration, and assistance activities. 

Social Innovation Fund [SIF].—The Committee recommendation 

does not include funding for SIF and instead focuses resources on 

the core national and community service activities at CNCS. 

Volunteer Generation Fund.—Within the total, the Committee 

recommendation includes $3,800,000 for the Volunteer Generation 

Fund authorized under section 198P of the SERVE America Act, 

the same as the comparable fiscal year 2016 funding level. 

Evaluation 

The Committee recommendation includes $4,000,000 for CNCS 

evaluation activities. 

State Commission Grants 

The Committee recommendation includes $17,038,000 for State 

Commission Grants. 

The Committee strongly encourages CNCS to improve coordination with State commissions as part of CNCS’ grant making process, including in announcing the availability and awarding of funds 

under AmeriCorps. State Commissions are a vital local resource 

and primary point of entry for national and community service at 

the local level. Improving coordination between CNCS and local 
204 

State commissions would improve the administration of service 

programs at the local level and promote innovation by supporting 

the organizations that know their communities best. 

PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2016 ............................................................................. $220,000,000 

Budget estimate, 2017 ........................................................................... 206,842,000 

Committee recommendation ................................................................. 206,842,000 

The Committee recommends an appropriation of $206,842,000 for 

making payments to the National Service Trust, as requested by 

the administration. 

The National Service Trust makes payments of Segal education 

awards, pays interest that accrues on qualified student loans for 

AmeriCorps participants during terms of service in approved national service positions, and makes other payments entitled to 

members who serve in the programs of CNCS. 

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $81,737,000 

Budget estimate, 2017 ........................................................................... 89,330,000 

Committee recommendation ................................................................. 81,737,000 

The Committee recommends an appropriation of $81,737,000 for 

CNCS salaries and expenses. The salaries and expenses appropriation provides funds for staff salaries, benefits, travel, training, rent, 

equipment, and other operating expenses necessary for management of CNCS programs and activities. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $5,250,000 

Budget estimate, 2017 ........................................................................... 6,100,000 

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

The Committee recommends an appropriation of $5,250,000 for 

the CNCS OIG. The OIG’s goals are to increase organizational efficiency and effectiveness within the Corporation and to prevent 

fraud, waste, and abuse. 

ADMINISTRATIVE PROVISIONS

The Committee retains language from the fiscal year 2016 appropriations act concerning five administrative provisions: requiring 

the Corporation to make any significant changes to program requirements or policy through rule making (section 401); stipulating 

minimum share requirements (section 402); requiring that donations supplement and not supplant operations (section 403); aligning requirements regarding the use of Education Awards at GI billeligible institutions (section 404); and allowing the required background check of certain applicants to be processed by States under 

terms of the National Child Protection Act (section 405). 

CORPORATION FOR PUBLIC BROADCASTING

Appropriations, 2018 ............................................................................. $445,000,000 

Budget estimate, 2019 ........................................................................... 445,000,000 

Committee recommendation, 2019 ....................................................... 445,000,000 
205 

The Committee recommends $445,000,000 for the Corporation for 

Public Broadcasting [CPB] as an advance appropriation for fiscal 

year 2019. 

The majority of these funds go directly to local public television 

and radio stations to support their programming. CPB funds also 

support the creation of content for radio, television, and other platforms; system support activities that benefit the entire public 

broadcasting community; and CPB’s administrative costs. 

The Committee recommendation includes the additional 

$50,000,000 in fiscal year 2017 requested for the replacement of 

the public broadcasting interconnection system. Technology and 

distribution systems have greatly evolved since Congress established the practice of funding the public television and radio interconnection systems. The Committee is aware that improved technology may enable the public television and radio stations to share 

certain elements of the planned interconnection system, leading to 

greater efficiencies. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $48,748,000 

Budget estimate, 2017 ........................................................................... 50,738,000 

Committee recommendation ................................................................. 48,638,000 

The Committee recommends $48,638,000 for the Federal Mediation and Conciliation Service [FMCS]. FMCS provides mediation, 

conciliation, and arbitration services to labor and management organizations to prevent and minimize work stoppages and promote 

stable labor-management relationships. FMCS is also authorized to 

provide dispute resolution consultation and training to all Federal 

agencies. 

Within the total, FMCS may utilize up to $2,500,000 for labormanagement partnership grants. These grants support innovative 

approaches to collaborative labor-management relationships to resolve potential problems, explore ways to improve productivity, and 

avert serious work stoppages. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $17,085,000 

Budget estimate, 2017 ........................................................................... 17,184,000 

Committee recommendation ................................................................. 17,184,000 

The Committee recommends $17,184,000 for the Federal Mine 

Safety and Health Review Commission [FMSHRC], which provides 

administrative trial and appellate review of legal disputes under 

the Federal Mine Safety and Health Act of 1977. Most cases involve civil penalties proposed by MSHA. FMSHRC’s administrative 

law judges [ALJs] decide cases at the trial level and the five-member Commission provides review of the ALJ’s decisions. In allocating resources and staff, the Committee directs the Commission 

to make reducing the excessive time substantive cases on appeal 

are awaiting a decision a top priority. 
206 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2016 ............................................................................. $230,000,000 

Budget estimate, 2017 ........................................................................... 230,000,000 

Committee recommendation ................................................................. 231,000,000 

The Committee recommends $231,000,000 for the Institute of 

Museum and Library Services [IMLS]. This agency supports programs for museums and libraries that encourage innovation, provide lifelong learning opportunities, promote cultural and civic engagement, and improve access to a variety of services and information. 

Within the total for IMLS, the Committee recommendation includes the amounts below: 

[In thousands of dollars] 

Budget activity Fiscal year 2016 

appropriation 

Fiscal year 2017 

request 

Committee 

recommendation 

Library Services Technology Act (LSTA): 

Grants to States ................................................................... 155,789 154,848 156,103 

Native American Library Services ......................................... 4,063 3,861 3,861 

National Leadership: Libraries .............................................. 13,092 13,720 13,406 

Laura Bush 21st Century Librarian ...................................... 10,000 10,000 10,000 

Subtotal LSTA ................................................................... 182,944 182,429 183,370 

Museum Services Act: 

Museums for America ........................................................... 21,149 20,200 20,392 

Native American/Hawaiian Museum Services ...................... 972 924 924 

National Leadership: Museums ............................................ 7,741 9,120 9,120 

Subtotal, MSA ................................................................... 29,862 30,244 30,436 

African American History and Culture Act .................................... 1,481 1,407 1,481 

Administration ................................................................................ 1,713 1,920 1,713 

Research, Analysis and Data Collection ....................................... 14,000 14,000 14,000 

IMLS Total ......................................................................... 230,000 230,000 231,000 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $7,765,000 

Budget estimate, 2017 ........................................................................... 8,700,000 

Committee recommendation ................................................................. 7,765,000 

The Committee recommends $7,765,000 for the Medicaid and 

CHIP Payment and Access Commission [MACPAC]. This commission was established in the Children’s Health Insurance Program 

Reauthorization Act of 2009 and is tasked with reviewing State 

and Federal Medicaid and Children’s Health Insurance Program 

access and payment policies and making recommendations to Congress, the Secretary of HHS, and the States on a wide range of 

issues affecting those programs. The Committee recommendation 

will allow MACPAC to continue to carry out these activities. 
207 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $11,925,000 

Budget estimate, 2017 ........................................................................... 12,234,000 

Committee recommendation ................................................................. 11,925,000 

The Committee recommends $11,925,000 for the Medicare Payment Advisory Commission [MedPAC], which provides independent 

policy and technical advice on issues affecting the Medicare program. 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $3,250,000 

Budget estimate, 2017 ........................................................................... 3,468,000 

Committee recommendation ................................................................. 3,439,000 

The Committee recommends $3,439,000 for the National Council 

on Disability [NCD]. NCD is mandated to make recommendations 

to the President, Congress, the Rehabilitation Services Administration, and the National Institute on Disability and Rehabilitation 

Research on issues of concern to individuals with disabilities. The 

Council gathers information on the implementation, effectiveness, 

and impact of the Americans with Disabilities Act and examines 

emerging policy issues as they affect persons with disabilities and 

their ability to enter or re-enter the Nation’s workforce and to live 

independently. 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $274,224,000 

Budget estimate, 2017 ........................................................................... 274,695,000 

Committee recommendation ................................................................. 274,224,000 

The Committee recommends $274,224,000 for the National Labor 

Relations Board [NLRB or ‘‘the Board’’], which administers and enforces the National Labor Relations Act and protects employee and 

employer rights provided under that act. 

The Committee is aware of concerns expressed by some employers that employee professional development and mobility may be 

hindered by having collective bargaining units that are limited to 

distinct departments within a workplace. The Committee requests 

the NLRB to report back to the Committee regarding these concerns, and any suggestions to ensure that cross-training and career 

advancement may continue between employees in departments who 

are represented by a union, and employees in departments who are 

not represented by a union. 

In the fiscal year 2016 report, the Committee noted that the 

Board had submitted a diminished, superficial CJ for its appropriations request. In previous years, the NLRB justification had provided far more complete information about workload, performance, 

administrative plans and priorities, and other supporting detail relevant to its annual budget requirements. The Committee requires 

more substantial information about the agencies’ activities and 
208 

needs to appropriate resources among many competing priorities. 

Unfortunately, the Board ignored the Committee’s direction and 

again submitted an incomplete CJ with little justification. The 

Board is once again directed to provide justification for its fiscal 

year 2018 request, including at least as much detail as it has traditionally provided prior to fiscal year 2016. 

ADMINISTRATIVE PROVISIONS

The Committee maintains language from the fiscal year 2016 appropriations act restricting the use of electronic voting (section 

406). 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $13,230,000 

Budget estimate, 2017 ........................................................................... 13,300,000 

Committee recommendation ................................................................. 14,000,000 

The Committee recommends $14,000,000 for the National Mediation Board [NMB], which mediates labor-management relations in 

the railroad and airline industries under the Railway Labor Act. 

The NMB mediates collective bargaining disputes, conducts elections to determine the choice of employee bargaining representatives, and administers arbitration of employee grievances. The bill provides an additional $700,000 above the administration’s request for NMB and directs the additional funds to be used 

for arbitrator salaries and expenses. The Committee is concerned 

about the length of time it takes the NMB to resolve arbitration 

cases, and the impact that the delay has on the individuals served 

by the NMB. The Committee directs the NMB to provide detailed 

information as to how these funds are used and their impact on the 

backlog in the fiscal year 2018 CJ. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriations, 2016 ............................................................................. $12,639,000 

Budget estimate, 2017 ........................................................................... 13,411,000 

Committee recommendation ................................................................. 13,411,000 

The Committee recommends $13,411,000 for the Occupational 

Safety and Health Review Commission [OSHRC]. OSHRC serves as 

a court to resolve disputes between OSHA and employers charged 

with violations of health and safety standards enforced by OSHA. 

RAILROAD RETIREMENT BOARD

The Railroad Retirement Board [RRB] administers the retirement/survivor and unemployment/sickness insurance benefit programs for railroad workers and their families under the Railroad 

Retirement Act and Railroad Unemployment Insurance Act. 

DUAL BENEFITS PAYMENTS ACCOUNT

Appropriations, 2016 ............................................................................. $29,000,000 

Budget estimate, 2017 ........................................................................... 25,000,000 

Committee recommendation ................................................................. 25,000,000 
209 

The Committee recommends $25,000,000 for the Dual Benefits 

Payments Account. This amount includes an estimated $2,000,000 

derived from income taxes on vested dual benefits. This appropriation provides for vested dual benefit payments to beneficiaries covered under both the railroad retirement and Social Security systems. 

FEDERAL PAYMENTS TO THE RAILROAD RETIREMENT ACCOUNTS

Appropriations, 2016 ............................................................................. $150,000 

Budget estimate, 2017 ........................................................................... 150,000 

Committee recommendation ................................................................. 150,000 

The Committee recommends $150,000 for Federal Payments to 

the Railroad Retirement Account. These funds reimburse the railroad retirement trust funds for interest earned on non-negotiated 

checks. 

LIMITATION ON ADMINISTRATION

Appropriations, 2016 ............................................................................. $111,225,000 

Budget estimate, 2017 ........................................................................... 122,499,000 

Committee recommendation ................................................................. 113,500,000 

The Committee recommends $113,500,000 for RRB’s costs associated with the administration of railroad retirement/survivor and 

unemployment/sickness benefit programs. This account limits the 

amount of funds in the railroad retirement and railroad unemployment insurance trust funds that may be used by the Board for administrative expenses. 

The Committee maintains bill language giving RRB the authority to hire new attorneys in the excepted service. 

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $8,437,000 

Budget estimate, 2017 ........................................................................... 10,499,000 

Committee recommendation ................................................................. 10,000,000 

The Committee recommends $10,000,000 for the RRB OIG. This 

Office conducts audits and investigations to protect the integrity of 

the RRB trust funds and provides comprehensive oversight of all 

RRB operations and programs. 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriations, 2016 ............................................................................. $11,400,000 

Budget estimate, 2017 ........................................................................... 11,400,000 

Committee recommendation ................................................................. 11,400,000 

The Committee recommends $11,400,000 in mandatory funds for 

payments to Social Security trust funds. This account reimburses 

the Old Age and Survivors Insurance [OASI] and Disability Insurance [DI] trust funds for special payments to certain uninsured 

persons, costs incurred administering pension reform activities, and 

the value of the interest for benefit checks issued but not negotiated. This appropriation restores the trust funds to the same financial position they would have been in had they not borne these 

costs and they were properly charged to general revenues. 
210 

SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2016 ............................................................................. $46,305,733,000 

Budget estimate, 2017 ........................................................................... 43,824,868,000 

Committee recommendation ................................................................. 43,618,163,000 

The Committee recommends $43,618,163,000 in fiscal year 2017 

mandatory funds for the SSI program. This is in addition to the 

$14,500,000,000 provided in the fiscal year 2016 appropriations act 

for the first quarter of fiscal year 2017. In addition, the Committee 

recommends $15,000,000,000 in advance funding for the first quarter of fiscal year 2018. The SSI program guarantees a minimum 

level of income to individuals who are disabled, blind, or older than 

age 65, and meet certain income and resource limitations. 

Federal Benefit Payments 

The Committee recommendation includes a fiscal year 2017 program level of $52,941,736,000 for Federal benefit payments. This 

will support an average monthly benefit of approximately $561 for 

8,200,000 recipients. 

Beneficiary Services 

The Committee recommendation includes $89,000,000 in new 

mandatory budget authority for beneficiary services. 

These funds reimburse vocational rehabilitation [VR] agencies for 

successfully rehabilitating disabled SSI recipients by helping them 

achieve and sustain productive, self-supporting work activity. 

Funds also support the Ticket to Work program that provides SSI 

recipients with a ticket to offer employment networks [ENs], including VR agencies, in exchange for employment and support services. Instead of reimbursing ENs for specific services, the Ticket to 

Work program pays ENs based on recipients achieving certain 

milestones and outcomes. 

Research and Demonstration 

The Committee recommendation includes $58,000,000 in mandatory funds for research and demonstration projects conducted 

under sections 1110, 1115, and 1144 of the Social Security Act. 

These funds support a variety of research and demonstration 

projects designed to improve the disability process, promote selfsufficiency and assist individuals in returning to work, encourage 

savings and retirement planning through financial literacy, and 

generally provide analytical and data resources for use in preparing and reviewing policy proposals. 

The Committee commends the SSA for developing a pilot to test 

innovative and evidence-based approaches to improving outcomes 

for individuals with disabilities who are eligible for Social Security 

disability benefits as well as youth through the multi-agency 

PROMISE initiative. The Committee strongly encourages SSA to 

consider what is being learned from the PROMISE evaluation in 

order to undertake further demonstration project work for young 

adults with disabilities who are eligible for SSI. In developing this 

initiative, the Committee directs the SSA to work in close consultation with the Departments of Labor, Education and Health and 

Human Services, and nationwide disability and peer advocacy orga-
211 

nizations. The Committee also directs the SSA to submit a report 

to the House and Senate Appropriations Committees no later than 

180 days after the enactment of this act regarding the agency’s 

progress in developing this proposal. 

Administrative Expenses 

The Committee recommendation includes $5,029,427,000 for SSI 

program administrative expenses. This appropriation funds the SSI 

program’s share of administrative expenses incurred through the 

Limitation on Administrative Expenses [LAE] account. 

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriations, 2016 ............................................................................. $12,161,945,000 

Budget estimate, 2017 ........................................................................... 13,064,000,000 

Committee recommendation ................................................................. 12,481,945,000 

The Committee recommends $12,481,945,000 for SSA’s LAE account. This account provides resources for SSA to administer the 

OASI, DI, and SSI programs, and to support CMS in administering 

the Medicare program. The LAE account is funded by the Social 

Security and Medicare trust funds for their share of administrative 

expenses, the general fund for the SSI program’s share of administrative expenses, and applicable user fees. These funds support 

core administrative activities including processing retirement and 

disability claims, conducting hearings to review disability determination appeals, issuing Social Security numbers and cards, processing individuals’ annual earnings information, and ensuring the 

integrity of Social Security programs through continuing disability 

reviews [CDR] and SSI redeterminations of non-medical eligibility. The Committee recommendation includes $1,819,000,000 for program integrity activities, including CDRs and SSI redeterminations 

of non-medical eligibility. This includes $273,000,000 in base funding and $1,546,000,000 in cap adjustment funding allowed under 

the Budget Control Act [BCA]. The Committee recommendation is 

a $393,000,000 increase over the fiscal year 2016 funding level, as 

specified in the BCA. Combined, these activities are estimated to 

save approximately $10,897,000,000 for the Social Security, Medicare, and Medicaid programs by preventing waste, fraud, abuse, 

and improper payments. 

The Committee bill adopts language included in the President’s 

budget allowing these funds to be used for a broader range of program integrity activities identified in the BCA. The bill also removes bill language allowing SSA to use additional non-cap adjustment program integrity funding for the full costs of CDRs and redeterminations given SSA’s budgeting of the full cost for such activities without this additional authority. 

The Committee is supportive of efforts to reduce improper payments and improve program integrity in the SSA’s disability and 

Supplemental Security Income benefits programs. As part of the 

Bipartisan Budget Act of 2015, Congress empowered SSA to enter 

into an information exchange with a payroll data provider to prevent improper payments of such benefits. These programs have 

proven to be beneficial in reducing improper payments for other 

Federal and State benefits programs, and the Committee urges 

SSA to prioritize the utilization of these opportunities. 
212 

Within the funds provided to SSA for continuing disability reviews under titles II and XVI of the Social Security Act and conducting redeterminations of eligibility, the Committee encourages 

SSA to utilize all of the tools available to it from commercial and 

non-commercial entities that collect and maintain data regarding 

employment and wages, to ensure that disability and SSI benefits 

are properly paid and to reduce fraud and abuse. The Committee 

requests an update in the fiscal year 2018 CJ on the progress that 

SSA has made in utilizing additional tools to identify improper 

payments, as well as progress it has made in those efforts. 

Disability Hearing Pilot Program Expansion.—The Committee 

supports SSA’s efforts to reduce the backlog of disability claims 

hearings. Given the successful implementation of the Disability 

Hearing Pilot Program in Region 1, the Committee encourages SSA 

to implement the changes on a nationwide level. The changes 

should include providing advance notice of a hearing date, and requiring claimants to inform SSA or submit written evidence within 

a certain period in advance of the hearing, subject to the good 

cause exception. Furthermore, as recommended in the pilot, SSA 

should consider removing ‘‘new and material evidence’’ as a basis 

for reopening any decision made at the hearing of Appeals Council 

levels for benefits based on disability. The Committee requests a 

report on plans for implementation no later than 60 days after the 

enactment of this act. 

Duplication.—As part of its annual duplication report GAO identified areas within the SSA where there are opportunities to improve efficiency and effectiveness and reduce costs. GAO report 15- 

531 recommends that the SSA evaluate the costs and benefits of 

alternatives for reducing the potential overpayments to individuals 

receiving concurrent Federal Employees’ Compensation Act payments to determine how best to strengthen internal controls. The 

Committee is encouraged by the Administration’s willingness to implement these recommendations, and requests a report on the 

progress of the implementation in the fiscal year 2018 CJ. 

Medical Vocational Guidelines.—The Committee is dedicated to 

ensuring that the disabled have access to needed benefits, and 

strongly encourages SSA to work with us to achieve that goal. The 

Committee continues to be concerned that SSA uses outdated rules 

to determine whether or not a claimant meets SSA’s definition of 

disability. The Committee is encouraged by SSA’s indication that 

they are beginning the regulatory process, having already received 

input from the National Disability Forum, the National Institute of 

Medicine, as well as various aging and employment experts. These 

initial steps are well received by the Committee as we continue to 

work with the Administration to modernize the outdated vocational 

guidelines into a structure that reflects the 21st century labor market. As this is the first significant overhaul of the grid in nearly 

40 years, the Committee requests SSA to submit, no later than 60 

days after the enactment of this act, a report on its ongoing efforts 

to update the grid. In addition, the report shall include a study assessing the feasibility of maintaining a continuous update of the 

medical vocational guidelines every 10 years. 

Muscular Dystrophy.—The Committee is aware that the Social 

Security Administration is included in the Muscular Dystrophy Co-
213 

ordinating Committee under the Muscular Dystrophy CARE Act 

Amendments enacted in September 2014. The Committee expects 

the agency to make data available 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. 

Prioritizing Continuing Disability Reviews To Maximize Cost 

Savings.—While the Committee commends SSA on its continued 

Program Integrity efforts towards becoming current with regards to 

the Continuing Disability Review [CDR] backlog, a recent GAO report found that SSA’s CDR prioritization models fail to maximize 

potential cost savings to the trust funds and the Treasury. Within 

1 year, and every 3 years thereafter, the Committee directs SSA to 

review and update the models for prioritization of CDRs with the 

primary intent of efficiently and effectively maximizing lifetime 

cost savings to the Federal Government, both for the DI trust fund 

and Treasury. A detailed, cost-based explanation for the model’s 

prioritization of different CDR types and justification for any updates made should be included in the annual CDR Report to Congress. 

Reducing the Hearing Backlog.—The Committee is aware of the 

discord between SSA and the ALJ community regarding the implementation of part of SSA’s Compassionate and Responsive Service 

[CARES] plan to reduce the significant hearing backlog at the 

agency. Specifically, there is concern regarding the Administration’s hiring of Administrative Appeals Judges for non-disability 

and remanded cases. The Committee recognizes the need for further discussion regarding this matter and encourages SSA to engage with the ALJ community and appropriate stakeholders to find 

innovative solutions to address hearing wait times, keeping in 

mind the goal of reducing the backlog to serve the over 1.1 million 

individuals and their families awaiting a hearing decision. 

Social Security Advisory Board.—The Committee recommendation includes not less than $2,300,000 for the Social Security Advisory Board. This board advises the Commissioner of Social Security 

and makes recommendations to Congress and the President on 

policies relating to the OASI, DI, and SSI programs. 

The Medical Improvement Standard.—The Committee commends 

SSA for its work to improve program integrity. However, the Committee is concerned, per previous GAO testimony and report findings from the SSA Office of the Inspector General, that confusion 

still exists about the Medical Improvement Standard (MIRS) and 

its exceptions. The Committee directs SSA to submit a report no 

later than 60 days after the enactment of this act on its progress 

in educating Disability Determinations Services in the proper application of the MIRS and its exceptions. 

The Treating Physician Rule.—The Committee expects that in resolving claims for disability insurance, SSA’s consideration of medical evidence should reflect the degree of relevance and familiarity 

each medical source has with the effect of an individual’s medically 

determinable impairment(s) on his or her ability to perform Substantial Gainful Activity [SGA]. Since the Treating Physician rule 

was first published in the Federal Register in 1991, healthcare delivery in the United States has changed significantly and the 
214 

Treating Physician rule no longer reflects the present reality of the 

medical personnel with greatest knowledge of an individual’s physical and/or mental condition. The Committee encourages SSA to 

consider revising the controlling weight doctrine in the Treating 

Physician rule and revising its Acceptable Medical Sources to reflect the new degree of familiarity with their patients, and rigorous 

training of, nurse practitioners, physician assistants, licensed clinical social workers, audiologists, and speech and language pathologists for the particular impairments that they are well-equipped to 

treat. 

User Fees.—Within the total for LAE, the Committee recommendation includes up to $124,000,000 for administrative activities funded from user fees. This includes $123,000,000 in fees collected from States that request SSA to administer State SSI supplementary payments and up to $1,000,000 from fees collected from 

non-attorney claimant representatives. 

Vocational Experts [VE].—The Committee notes that the SSA’s 

OIG has recommended that SSA periodically determine whether 

VE fees are appropriate to obtain the required level of VE service. 

The Committee understands that SSA plans to conduct such a review, including benchmark studies of VE fees paid in the national 

economy and those paid by other governmental and non-governmental organizations, during SSA’s acquisition planning process for 

the contracts to be awarded in fiscal year 2018. The Committee 

looks forward to an update in the fiscal year 2018 CJ regarding 

these studies. 

Work Incentives Planning and Assistance [WIPA] and Protection 

and Advocacy for Beneficiaries of Social Security [PABSS].—The 

Committee recommendation includes $23,000,000 for WIPA and 

$7,000,000 for PABSS, the same as the comparable fiscal year 2016 

levels, respectively. These programs provide valuable services to 

help Social Security disability beneficiaries return to work. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2016 ............................................................................. $105,500,000 

Budget estimate, 2017 ........................................................................... 112,000,000 

Committee recommendation ................................................................. 105,500,000 

The Committee recommends $105,500,000 for SSA’s OIG. This 

includes $75,713,000 funded from the OASI and DI trust funds for 

those programs’ share of OIG’s expenses and $29,787,000 funded 

from general revenues for the SSI program’s share of expenses. 
(215) 

TITLE V 

GENERAL PROVISIONS 

Section 501. The bill continues a provision authorizing transfers 

of unexpended balances. 

Section 502. The bill continues a provision limiting funding to 1- 

year availability unless otherwise specified. 

Section 503. The bill continues a provision limiting lobbying and 

related activities. 

Section 504. The bill continues a provision limiting official representation expenses. 

Section 505. The bill continues a provision clarifying Federal 

funding as a component of State and local grant funds. 

Sections 506 and 507. The bill continues provisions limiting the 

use of funds for abortion. 

Section 508. The bill continues a provision restricting human embryo research. 

Section 509. The bill continues a provision limiting the use of 

funds for promotion of legalization of controlled substances. 

Section 510. The bill continues a provision prohibiting the use of 

funds to promulgate regulations regarding the individual health 

identifier. 

Section 511. The bill continues a provision limiting the use of 

funds to enter into or review contracts with entities subject to the 

requirement in section 4212(d) of title 38, United States Code, if 

the report required by that section has not been submitted. 

Section 512. The bill continues a provision prohibiting the transfer of funds made available in this act to any department, agency, 

or instrumentality of the U.S. Government, except as otherwise 

provided by this or any other act. 

Section 513. The bill continues a provision prohibiting Federal 

funding in this act for libraries unless they are in compliance with 

the Children’s Internet Protection Act. 

Section 514. The bill continues a provision maintaining a procedure for reprogramming of funds. 

Section 515. The bill continues a provision prohibiting candidates 

for scientific advisory committees from having to disclose their political activities. 

Section 516. The bill continues a provision requiring each department and related agency to submit an operating plan. 

Section 517. The bill continues a provision requiring the Secretaries of Labor, Health and Human Services, and Education to submit a report on the number and amounts of contracts, grants, and 

cooperative agreements awarded by the Departments on a noncompetitive basis. 

Section 518. The bill continues a provision prohibiting SSA from 

processing earnings for work performed under a fraudulent social 
216 

security number if based on a conviction for a violation under section 208(a)(6) or (7) of the Social Security Act. 

Section 519. The bill continues a provision prohibiting SSA from 

establishing a totalization agreement with Mexico. 

Section 520. The bill continues a provision regarding funding for 

programs that carry out distribution of sterile needles or syringes. 

Section 521. The bill continues a provision requiring computer 

networks to block pornography. 

Section 522. The bill continues a provision prohibiting funding 

from going to the Association of Community Organizations for Reform Now [ACORN], or any of its affiliates, subsidiaries, allied organizations, or successors. 

Section 523. The bill continues a provision related to reporting 

requirements for conference spending. 

Section 524. The bill continues a provision related to advertisement costs. 

Section 525. The bill continues a modified provision on Performance Partnerships. 

Section 526. The bill continues a provision regarding reporting 

status of balances of appropriations. 

Section 527. The bill includes a new provision reauthorizing the 

Special Olympics Sport and Empowerment Act of 2004. 

Section 528. The bill continues a provision rescinding funds from 

the Independent Payment Advisory Board. 

Section 529. The bill modifies a provision rescinding funds from 

the Children’s Health Insurance Program child enrollment contingency fund. 

Section 530. The bill modifies a provision rescinding funds from 

the Children’s Health Insurance Program regarding State allotments. 

Section 531. The bill includes a new provision rescinding funds 

from the Children’s Health Insurance Program Performance Bonus 

Fund. 

Section 532. The bill includes a new provision regarding the use 

of funds in this act for background checks of school personnel. 
(217) 

COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE 

STANDING RULES OF THE SENATE 

Paragraph 7 of rule XVI requires that Committee reports on general appropriations bills identify each Committee amendment to 

the House bill ‘‘which proposes an item of appropriation which is 

not made to carry out the provisions of an existing law, a treaty 

stipulation, or an act or resolution previously passed by the Senate 

during that session.’’ 

The Committee is filing an original bill, which is not covered 

under this rule, but reports this information in the spirit of full disclosure. 

The Committee recommends funding for the following programs 

and activities which currently lack authorization: Institute of Education Sciences; parts C and D of the Individuals with Disabilities 

Education Act; Special Olympics Sport and Empowerment Act of 

2004; Nurse Education Loan Repayment; Education and Training 

Related to Geriatrics; Mental and Behavioral Health Training; 

Children’s Hospital Graduate Medical Education; Title XVII of the 

PHS Act; Ryan White CARE Act; Universal Newborn Hearing 

Screening; Organ Transplantation; Family Planning; Rural Health 

programs; Traumatic Brain Injury programs; Combating Autism 

Act; Public Health Improvement Act; Healthy Start; Telehealth; 

Health Professions Education Partnership Act; Children’s Health 

Act; Women’s Health Research and Prevention Amendments of 

1998; Birth Defects Prevention, Preventive Health Amendments of 

1993; Substance Abuse and Mental Health Services programs; Low 

Income Home Energy Assistance Program; Refugee and Entrant 

Assistance programs (except for Victims of Trafficking); Head Start; 

Runaway and Homeless Youth programs; Adoption Incentives; Developmental Disabilities programs; Voting Access for Individuals 

with Disabilities; Native American Programs; Community Services 

Block Grant Act programs; National Institutes of Health; Assets for 

Independence; Alzheimer’s Disease Demonstration Grants; Office of 

Disease Prevention and Health Promotion; YouthBuild Transfer 

Act; Assistive Technology Act; Carl D. Perkins Career and Technical Education Improvement Act; Corporation for Public Broadcasting; National Council on Disability; Older Americans Act; Second Chance Act; Work Incentive Planning and Assistance; and Protection and Advocacy for Beneficiaries of Social Security. 

COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Pursuant to paragraph 7(c) of rule XXVI, on June 9, 2016, the 

Committee ordered favorably reported an original bill (S. 3040) 

making appropriations for the Departments of Labor, Health and 

Human Services, and Education, and related agencies for the fiscal 

year ending September 30, 2017, and for other purposes, provided, 
218 

that the bill be subject to amendment and that the bill be consistent with its budget allocation, and provided that the Chairman 

of the Committee or his designee be authorized to offer the substance of the original bill as a Committee amendment in the nature 

of a substitute to the House companion measure, by a recorded vote 

of 29–1, a quorum being present. The vote was as follows: 

Yeas Nays 

Chairman Cochran Mr. Lankford 

Mr. McConnell 

Mr. Shelby 

Mr. Alexander 

Ms. Collins 

Ms. Murkowski 

Mr. Graham 

Mr. Kirk 

Mr. Blunt 

Mr. Moran 

Mr. Hoeven 

Mr. Boozman 

Mrs. Capito 

Mr. Cassidy 

Ms. Mikulski 

Mr. Leahy 

Mrs. Murray 

Mrs. Feinstein 

Mr. Durbin 

Mr. Reed 

Mr. Tester 

Mr. Udall 

Mrs. Shaheen 

Mr. Merkley 

Mr. Coons 

Mr. Schatz 

Ms. Baldwin 

Mr. Murphy 

COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE 

STANDING RULES OF THE SENATE 

Paragraph 12 of rule XXVI requires that Committee reports on 

a bill or a joint resolution repealing or amending any statute include ‘‘(a) the text of the statute or part thereof which is proposed 

to be repealed; and (b) a comparative print of that part of the bill 

or joint resolution making the amendment and of the statute or 

part thereof proposed to be amended, showing by stricken through 

type and italics, parallel columns, or other appropriate typographical devices the omissions and insertions which would be 

made by the bill or joint resolution if enacted in the form recommended by the committee.’’ 

In compliance with this rule, changes in existing law proposed to 

be made by the bill are shown as follows: existing law to be omitted 

is enclosed in black brackets; new matter is printed in italic; and 

existing law in which no change is proposed is shown in roman. 
219 

TITLE 20—EDUCATION 

CHAPTER 28—HIGHER EDUCATION RESOURCES AND 

STUDENT ASSISTANCE 

SUBCHAPTER I—GENERAL PROVISIONS 

PART B—ADDITIONAL GENERAL PROVISIONS

§ 1011c. National Advisory Committee on Institutional Quality and Integrity 

(a) Establishment 

* * * * * * * 

(f) Termination 

The Committee shall terminate on September 30, ø2016¿ 2017. 

* * * * * * * 

SUBCHAPTER IV—STUDENT ASSISTANCE 

PART A—GRANTS TO STUDENTS IN ATTENDANCE AT INSTITUTIONS OF

HIGHER EDUCATION

SUBPART 1—FEDERAL PELL GRANTS

§ 1070a. Federal Pell Grants: amount and determinations; 

applications 

(a) Program authority and method of distribution 

* * * * * * * 

(b) Purpose and amount of grants 

(1) * * * 

(7) ADDITIONAL FUNDS.— 

(A) IN GENERAL.—* * * 

(i) * * * 

* * * * * * * 

(vi) to carry out this section— 

(I) * * * 

* * * * * * * 

(VII) ø$1,574,000,000¿ $1,320,000,000 for fiscal 

year 2017; 

* * * * * * * 

(XI) $1,145,000,000 for fiscal year 2021 and each 

succeeding fiscal year. 

(8)(A) Effective in the 2017–2018 award year and thereafter, the 

Secretary shall award an eligible student not more than one and 

one-half Federal Pell Grants during a single award year to permit 

such student to work toward completion of an eligible program if, 

during that single award year, the student— 

(i) has received a Federal Pell Grant for an award year and 

is enrolled in an eligible program for one or more additional 

payment periods during the same award year that are not otherwise fully covered by the student’s Federal Pell Grant; and 
220 

(ii) is enrolled on at least a half-time basis while receiving 

any funds under this section. 

(B) In the case of a student receiving more than one Federal 

Pell Grant in a single award year under subparagraph (A), the total 

amount of Federal Pell Grants awarded to such student for the 

award year may exceed the maximum basic grant level specified in 

the appropriate appropriations Act for such award year. 

(C) Any period of study covered by a Federal Pell Grant awarded under subparagraph (A) shall be included in determining a student’s duration limit under subsection (c)(5). 

(D) In any case where an eligible student is receiving a Federal 

Pell Grant for a payment period that spans two award years, the 

Secretary shall allow the eligible institution in which the student is 

enrolled to determine the award year to which the additional period 

shall be assigned, as it determines is most beneficial to students. 

* * * * * * * 

PART C—WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM

§ 1087h. Funds for administrative expenses 

(a) Program authority and method of distribution 

(1) Mandatory funds for fiscal year 2006 

* * * * * * * 

(4)Continuing mandatory funds for account maintenance 

fees 

For each of the fiscal years 2007 through ø2016¿ 2017, there 

shall be available to the Secretary, from funds not otherwise appropriated, funds to be obligated for account maintenance fees payable 

to guaranty agencies under part B and calculated in accordance 

with subsection (b). 

TITLE 42—THE PUBLIC HEALTH AND WELFARE 

CHAPTER 7—SOCIAL SECURITY

SUBCHAPTER XVIII—HEALTH INSURANCE FOR AGED AND 

DISABLED 

PART B—SUPPLEMENTARY MEDICAL INSURANCE BENEFITS FOR

AGED AND DISABLED

§ 1395w–4. Payment for physicians’ services 

(a) Payment based on fee schedule 

* * * * * * * 

(b) Establishment of fee schedules 

(1) In general 

* * * * * * * 

(11) Special rule for certain radiation therapy services 

The code definitions, the work relative value units under subsection (c)(2)(C)(i), and the direct inputs for the practice expense 

relative value units under subsection (c)(2)(C)(ii) for radiation 
221 

treatment delivery and related imaging services (identified in 2016 

by HCPCS G-codes G6001 through G6015) for the fee schedule established under this subsection for services furnished in 2017 and 

2018 shall be the same as such definitions, units, and inputs for 

such services for the fee schedule established for services furnished 

in 2016. 

(12) ENCOURAGING CARE MANAGEMENT FOR INDIVIDUALS WITH

ALZHEIMER’S DISEASE OR RELATED DEMENTIAS.— 

(A) IN GENERAL.—In order to care for individuals with Alzheimer’s disease or related dementias the Secretary shall, subject to subparagraphs (B) and (C), make payment (as the Secretary determines to be appropriate) under this section for a 

care planning session furnished on or after January 1, 2018, by 

a physician (as defined in section 1861(r)(1)), physician assistant or nurse practitioner (as defined in section 1861(aa)(5)(A)), 

clinical nurse specialist (as defined in section 1861(aa)(5)(B)), 

or other practitioners deemed appropriate by the Secretary. 

(B) POLICIES RELATING TO PAYMENT.—In carrying out this 

paragraph, the Secretary shall— 

(i) make payment to only one applicable provider for a 

care planning session furnished to a beneficiary diagnosed 

with Alzheimer’s or related dementia; 

(ii) not make payment under subparagraph (A) if such 

payment would be duplicative of payment that is otherwise 

made under this title; and 

(iii) not require that an annual wellness visit (as defined in section 1861(hhh)) or an initial preventive physical 

examination (as defined in section 1861(ww)) be furnished 

as a condition of payment for such care planning session. 

(C) REQUIREMENTS.—A care planning session provided 

under this paragraph shall include the following: 

(i) An explanation of Alzheimer’s disease or related dementias, as well as the expected progression of the disease 

and related dementias as appropriate. 

(ii) Creation of a patient-centered comprehensive care 

plan, as determined appropriate by the Secretary. 

(iii) Information regarding treatment options. 

(iv) A discussion of resources and services available in 

the individual’s community that may reduce the individual’s health risks and promote self-management of Alzheimer’s disease or related dementias. 

(v) Other information, as determined appropriate by 

the Secretary. 

(D) STAKEHOLDER INPUT.—The Secretary shall seek input 

from physicians, practitioners, and other stakeholders regarding the structure of care planning sessions provided under this 

paragraph. 
222 

TITLE 48—TERRITORIES AND INSULAR POSSESSIONS 

CHAPTER 18—MICRONESIA, MARSHALL ISLANDS, AND PALAU

SUBCHAPTER I—MICRONESIA AND MARSHALL ISLANDS 

PART B—APPROVAL AND IMPLEMENTATION OF COMPACTS, AS

AMENDED

§ 1921d. Supplemental provisions 

(a) Domestic program requirements 

* * * * * * * 

(f) Continuing programs and laws 

(1) Federated States of Micronesia and Republic of the 

Marshall Islands 

* * * * * * * 

(A) Emergency and disaster assistance 

* * * * * * * 

(B) Treatment of additional programs 

(i) Consultation 

* * * * * * * 

(ix) Applicability 

The government, institutions, and people of Palau 

shall remain eligible for appropriations and to receive 

grants under the provisions of law specified in clauses (ii) 

and (iii) until the end of fiscal year ø2016¿ 2017, to the extent the government, institutions, and people of Palau 

were so eligible under such provisions in fiscal year 2003. 

SPECIAL OLYMPICS SPORT AND EMPOWERMENT ACT 

OF 2004, PUBLIC LAW 108–406 

SEC. 5. AUTHORIZATION OF APPROPRIATIONS. 

There are authorized to be appropriated— 

(1) for grants, contracts, or cooperative agreements under 

section 3(a), ø$5,500,000 for fiscal year 2005, and such sums 

as may be necessary for each of the 4 succeeding fiscal years;¿ 

such sums as may be necessary for fiscal year 2017 and each 

of the 4 succeeding fiscal years; 

(2) for grants, contracts, or cooperative agreements under 

section 3(b), ø$3,500,000 for fiscal year 2005, and such sums 

as may be necessary for each of the 4 succeeding fiscal years; 

and¿ such sums as may be necessary for fiscal year 2017 and 

each of the 4 succeeding fiscal years; and 

(3) for grants, contracts, or cooperative agreements under 

section 3(c), ø$6,000,000 for each of fiscal years 2005 through 

2009.¿ such sums as may be necessary for fiscal year 2017 and 

each of the 4 succeeding fiscal years. 
223 

CONSOLIDATED APPROPRIATIONS ACT, 2014, 

PUBLIC LAW 113–76 

DIVISION H—DEPARTMENTS OF LABOR, HEALTH AND 

HUMAN SERVICES, AND EDUCATION, AND RELATED 

AGENCIES APPROPRIATIONS ACT, 2014 

TITLE V 

GENERAL PROVISIONS 

SEC. 526. (a) DEFINITIONS.—* * * 

* * * * * * * 

(b) USE OF DISCRETIONARY FUNDS IN øFISCAL YEAR 2014¿ FIS- CAL YEAR 2017.—* * * 

* * * * * * * 

(c) PERFORMANCE PARTNERSHIP AGREEMENTS.* * * 

(1) is entered into between— 

* * * * * * * 

(2) specifies, at a minimum, the following information: 

(A) the length of the Agreement (which shall not extend beyond øSeptember 30, 2018¿ September 30, 2021); 

* * * * * * * 

(e) TRANSFER AUTHORITY.—For the purpose of carrying out the 

Pilot in accordance with the Performance Partnership Agreement, 

and subject to the written approval of the Director of the Office of 

Management and Budget, the head of each participating Federal 

agency may transfer Federal discretionary funds that are being 

used in the Pilot to an account of the lead Federal administering 

agency that includes Federal discretionary funds that are being 

used in the Pilot. Subject to the waiver authority under subsection 

(f), such transferred funds shall remain available for the same purposes for which such funds were originally appropriated: Provided, 

That such transferred funds shall remain available for obligation 

by the Federal Government until the expiration of the period of 

availability for those Federal discretionary funds (which are being 

used in the Pilot) that have the longest period of availability, except that any such transferred funds shall not remain available beyond øSeptember 30, 2018¿ September 30, 2021. 
224 

BUDGETARY IMPACT OF BILL 

PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 

308(A), PUBLIC LAW 93–344, AS AMENDED 

[In millions of dollars] 

Budget authority Outlays 

Committee 

allocation 

Amount 

in bill 

Committee 

allocation 

Amount 

in bill 

Comparison of amounts in the bill with the subcommittee allocation for 2017: Subcommittee on Labor, HHS, Education, 

and Related Agencies: 

Mandatory ............................................................................ 775,898 775,898 775,274 1 775,274 

Discretionary ........................................................................ 161,857 163,817 168,923 1 170,554 

Security ....................................................................... .................... .................... NA NA 

Nonsecurity ................................................................. 161,857 163,817 NA NA 

Projections of outlays associated with the recommendation: 

2017 ..................................................................................... .................... .................... .................... 2 846,261 

2018 ..................................................................................... .................... .................... .................... 74,484 

2019 ..................................................................................... .................... .................... .................... 21,263 

2020 ..................................................................................... .................... .................... .................... 3,575 

2021 and future years ........................................................ .................... .................... .................... 3,260 

Financial assistance to State and local governments for 

2017 ......................................................................................... NA 422,105 NA 2 423,379 

1 Includes outlays from prior-year budget authority. 

2 Excludes outlays from prior-year budget authority. 

NA: Not applicable. 

NOTE.—Consistent with the funding recommended in the bill for continuing disability reviews and redeterminations and for healthcare fraud and abuse control and in accordance with subparagraphs (B) and (C) of section 251(b)(2) of the BBEDCA of 1985, the Committee an- ticipates that the Budget Committee will provide a revised 302(a) allocation for the Committee on Appropriations reflecting an upward adjustment of $1,960,000,000 in budget authority plus associated outlays. 
225 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

Training and Employment Services 

Grants to States: 

Adult Training, current year .............................................................................................................................. 103,556 130,376 70,000 ¥33,556 ¥60,376 

Advance from prior year ........................................................................................................................... (712,000 ) (712,000 ) (712,000 ) ............................ ............................Fiscal year 2018 ....................................................................................................................................... 712,000 712,000 712,000 ............................ ............................

Subtotal ................................................................................................................................................ 815,556 842,376 782,000 ¥33,556 ¥60,376 

Youth Training ................................................................................................................................................... 873,416 902,139 838,000 ¥35,416 ¥64,139 Dislocated Worker Assistance, current year ...................................................................................................... 160,860 243,346 156,000 ¥4,860 ¥87,346 

Advance from prior year ........................................................................................................................... (860,000 ) (860,000 ) (860,000 ) ............................ ............................Fiscal year 2018 ....................................................................................................................................... 860,000 860,000 860,000 ............................ ............................

Subtotal ................................................................................................................................................ 1,020,860 1,103,346 1,016,000 ¥4,860 ¥87,346 Subtotal, Grants to States ................................................................................................................... 2,709,832 2,847,861 2,636,000 ¥73,832 ¥211,861 

Current Year .................................................................................................................................... (1,137,832 ) (1,275,861 ) (1,064,000 ) (¥73,832 ) (¥211,861 ) Fiscal year 2018 .............................................................................................................................. (1,572,000 ) (1,572,000 ) (1,572,000 ) ............................ ............................

National Programs: 

Dislocated Worker Assistance National Reserve: 

Current year .............................................................................................................................................. 20,859 30,859 20,859 ............................ ¥10,000 Advance from prior year ........................................................................................................................... (200,000 ) (200,000 ) (200,000 ) ............................ ............................Fiscal year 2018 ....................................................................................................................................... 200,000 200,000 200,000 ............................ ............................

Subtotal ................................................................................................................................................ 220,859 230,859 220,859 ............................ ¥10,000 Subtotal, Dislocated Worker Assistance .............................................................................................. 1,241,719 1,334,205 1,236,859 ¥4,860 ¥97,346 
226 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Native American Programs ................................................................................................................................ 50,000 52,000 48,500 ¥1,500 ¥3,500 Migrant and Seasonal Farmworker programs ................................................................................................... 81,896 81,896 81,896 ............................ ............................Women in Apprenticeship .................................................................................................................................. 994 ............................ ............................ ¥994 ............................YouthBuild activities ......................................................................................................................................... 84,534 84,534 84,534 ............................ ............................Technical assistance ......................................................................................................................................... 3,232 3,232 2,500 ¥732 ¥732 Reintegration of Ex-Offenders ........................................................................................................................... 88,078 95,078 88,078 ............................ ¥7,000 Workforce Data Quality Initiative ...................................................................................................................... 6,000 40,000 6,000 ............................ ¥34,000 Apprenticeship programs .................................................................................................................................. 90,000 90,000 100,000 ∂10,000 ∂10,000 

Total, National Programs .............................................................................................................................. 625,593 677,599 632,367 ∂6,774 ¥45,232 

Current Year ......................................................................................................................................... (425,593 ) (477,599 ) (432,367 ) (∂6,774 ) (¥45,232 ) Fiscal year 2018 .................................................................................................................................. (200,000 ) (200,000 ) (200,000 ) ............................ ............................

Total, Training and Employment Services [TES] .......................................................................................... 3,335,425 3,525,460 3,268,367 ¥67,058 ¥257,093 

Current Year ......................................................................................................................................... (1,563,425 ) (1,753,460 ) (1,496,367 ) (¥67,058 ) (¥257,093 ) Fiscal year 2018 .................................................................................................................................. (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Job Corps 

Operations .................................................................................................................................................................. 1,581,825 1,608,535 1,591,625 ∂9,800 ¥16,910 Construction, Rehabilitation and Acquisition ............................................................................................................ 75,000 105,000 86,000 ∂11,000 ¥19,000 Administration ............................................................................................................................................................ 32,330 41,055 32,330 ............................ ¥8,725 

Total, Job Corps ............................................................................................................................................ 1,689,155 1,754,590 1,709,955 ∂20,800 ¥44,635 

Current Year ......................................................................................................................................... (1,689,155 ) (1,754,590 ) (1,709,955 ) (∂20,800 ) (¥44,635 ) 

Community Service Employment For Older Americans .............................................................................................. 434,371 434,371 400,000 ¥34,371 ¥34,371 Federal Unemployment Benefits and Allowances (indefinite) ................................................................................... 861,000 849,000 849,000 ¥12,000 ............................

State Unemployment Insurance and Employment Service Operations 

Unemployment Compensation [UI]: 

State Operations ................................................................................................................................................ 2,745,550 2,777,919 2,697,019 ¥48,531 ¥80,900 
227 

National Activities ............................................................................................................................................. 14,547 15,247 15,247 ∂700 ............................

Subtotal, Unemployment Compensation ....................................................................................................... 2,760,097 2,793,166 2,712,266 ¥47,831 ¥80,900 

Employment Service [ES]: 

Allotments to States: 

Federal Funds ........................................................................................................................................... 21,413 21,413 21,413 ............................ ............................Trust Funds .............................................................................................................................................. 658,587 658,587 650,000 ¥8,587 ¥8,587 

Subtotal, Trust Funds .......................................................................................................................... 658,587 658,587 650,000 ¥8,587 ¥8,587 Subtotal, Allotments to States ............................................................................................................ 680,000 680,000 671,413 ¥8,587 ¥8,587 

ES National Activities ........................................................................................................................................ 19,818 19,818 19,818 ............................ ............................

Subtotal, Employment Service ...................................................................................................................... 699,818 699,818 691,231 ¥8,587 ¥8,587 

Federal Funds ...................................................................................................................................... (21,413 ) (21,413 ) (21,413 ) ............................ ............................Trust Funds .......................................................................................................................................... (678,405 ) (678,405 ) (669,818 ) (¥8,587 ) (¥8,587 ) 

Foreign Labor Certification: 

Federal Administration ...................................................................................................................................... 48,028 48,666 48,028 ............................ ¥638 Grants to States ................................................................................................................................................ 14,282 14,282 14,282 ............................ ............................

Subtotal, Foreign Labor Certification ........................................................................................................... 62,310 62,948 62,310 ............................ ¥638 

One-Stop Career Centers/Labor Market Information .................................................................................................. 67,653 75,153 70,153 ∂2,500 ¥5,000 

Total, State UI and ES .................................................................................................................................. 3,589,878 3,631,085 3,535,960 ¥53,918 ¥95,125 

Federal Funds ...................................................................................................................................... (89,066 ) (96,566 ) (91,566 ) (∂2,500 ) (¥5,000 ) Trust Funds .......................................................................................................................................... (3,500,812 ) (3,534,519 ) (3,444,394 ) (¥56,418 ) (¥90,125 ) 

State Paid Leave Fund ............................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Program Administration 

Training and Employment .......................................................................................................................................... 60,074 76,331 63,274 ∂3,200 ¥13,057 

Trust Funds ....................................................................................................................................................... 8,639 10,615 8,639 ............................ ¥1,976 

Employment Security .................................................................................................................................................. 3,469 3,640 3,469 ............................ ¥171 

Trust Funds ....................................................................................................................................................... 39,264 39,821 39,264 ............................ ¥557 

Apprenticeship Services ............................................................................................................................................. 34,000 40,089 36,160 ∂2,160 ¥3,929 Executive Direction ..................................................................................................................................................... 7,034 8,251 7,271 ∂237 ¥980 

Trust Funds ....................................................................................................................................................... 2,079 2,079 2,079 ............................ ............................

Total, Program Administration ...................................................................................................................... 154,559 180,826 160,156 ∂5,597 ¥20,670 
228 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Federal Funds ...................................................................................................................................... (104,577 ) (128,311 ) (110,174 ) (∂5,597 ) (¥18,137 ) Trust Funds .......................................................................................................................................... (49,982 ) (52,515 ) (49,982 ) ............................ (¥2,533 ) 

Total, Employment and Training Administration .......................................................................................... 10,064,388 10,375,332 9,923,438 ¥140,950 ¥451,894 

Federal Funds ...................................................................................................................................... 6,513,594 6,788,298 6,429,062 ¥84,532 ¥359,236 

Current Year ................................................................................................................................ (4,741,594 ) (5,016,298 ) (4,657,062 ) (¥84,532 ) (¥359,236 ) Fiscal year 2018 ......................................................................................................................... (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Trust Funds .......................................................................................................................................... 3,550,794 3,587,034 3,494,376 ¥56,418 ¥92,658 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA] 

Salaries and Expenses 

Enforcement and Participant Assistance ................................................................................................................... 147,400 ............................ 147,400 ............................ ∂147,400 Policy and Compliance Assistance ............................................................................................................................ 26,901 ............................ 26,901 ............................ ∂26,901 Executive Leadership, Program Oversight and Administration ................................................................................. 6,699 ............................ 6,699 ............................ ∂6,699 Employee benefits security programs ........................................................................................................................ ............................ 205,761 ............................ ............................ ¥205,761 

Total, EBSA ................................................................................................................................................... 181,000 205,761 181,000 ............................ ¥24,761 

PENSION BENEFIT GUARANTY CORPORATION (PBGC) 

Pension Benefit Guaranty Corporation Fund 

Consolidated Administrative budget .......................................................................................................................... (431,799 ) (421,006 ) (421,006 ) (¥10,793 ) ............................Operational Support ................................................................................................................................................... ............................ ............................ ............................ ............................ ............................Headquarters space costs .......................................................................................................................................... ............................ (98,500 ) (98,500 ) (∂98,500 ) ............................WAGE AND HOUR DIVISION, Salaries and Expenses .................................................................................................. 227,500 276,599 227,500 ............................ ¥49,099 OFFICE OF LABOR-MANAGEMENT STANDARDS, Salaries and Expenses .................................................................... 40,593 45,691 35,529 ¥5,064 ¥10,162 OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, Salaries and Expenses ................................................. 105,476 114,169 104,476 ¥1,000 ¥9,693 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS 

Salaries and Expenses ............................................................................................................................................... 113,324 123,982 115,424 ∂2,100 ¥8,558 
229 

Trust Funds ....................................................................................................................................................... 2,177 2,177 2,177 ............................ ............................

Total, Salaries and Expenses ....................................................................................................................... 115,501 126,159 117,601 ∂2,100 ¥8,558 

Federal Funds ...................................................................................................................................... (113,324 ) (123,982 ) (115,424 ) (∂2,100 ) (¥8,558 ) Trust Funds .......................................................................................................................................... (2,177 ) (2,177 ) (2,177 ) ............................ ............................

Special Benefits 

Federal Employees’ Compensation Benefits .............................................................................................................. 207,000 217,000 217,000 ∂10,000 ............................Longshore and Harbor Workers’ Benefits ................................................................................................................... 3,000 3,000 3,000 ............................ ............................

Total, Special Benefits .................................................................................................................................. 210,000 220,000 220,000 ∂10,000 ............................

Special Benefits for Disabled Coal Miners 

Benefit Payments ....................................................................................................................................................... 85,000 75,000 75,000 ¥10,000 ............................Administration ............................................................................................................................................................ 5,302 5,319 5,319 ∂17 ............................

Subtotal, Fiscal year 2017 program level .................................................................................................... 90,302 80,319 80,319 ¥9,983 ............................

Less funds advanced in prior year .......................................................................................................... ¥21,000 ¥19,000 ¥19,000 ∂2,000 ............................

Total, Current Year .............................................................................................................................. 69,302 61,319 61,319 ¥7,983 ............................New advances, 1st quarter, fiscal year 2018 ..................................................................................... 19,000 16,000 16,000 ¥3,000 ............................

Total, Special Benefits for Disabled Coal Miners ........................................................................................ 88,302 77,319 77,319 ¥10,983 ............................

Energy Employees Occupational Illness Compensation Fund 

Administrative Expenses ............................................................................................................................................ 58,552 59,846 59,846 ∂1,294 ............................

Black Lung Disability Trust Fund 

Benefit Payments and Interest on Advances ............................................................................................................. 275,261 302,115 302,115 ∂26,854 ............................Workers’ Compensation Programs, Salaries and Expenses ....................................................................................... 35,244 38,246 38,246 ∂3,002 ............................Departmental Management, Salaries and Expenses ................................................................................................. 30,279 30,594 30,594 ∂315 ............................Departmental Management, Inspector General ......................................................................................................... 327 330 330 ∂3 ............................

Subtotal, Black Lung Disability .................................................................................................................... 341,111 371,285 371,285 ∂30,174 ............................

Treasury Department Administrative Costs ............................................................................................................... 356 356 356 ............................ ............................

Total, Black Lung Disability Trust Fund ....................................................................................................... 341,467 371,641 371,641 ∂30,174 ............................Total, Workers’ Compensation Programs ...................................................................................................... 813,822 854,965 846,407 ∂32,585 ¥8,558 
230 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Federal Funds ...................................................................................................................................... 811,645 852,788 844,230 ∂32,585 ¥8,558 

Current year ................................................................................................................................ (792,645 ) (836,788 ) (828,230 ) (∂35,585 ) (¥8,558 ) Fiscal year 2018 ......................................................................................................................... (19,000 ) (16,000 ) (16,000 ) (¥3,000 ) ............................

Trust Funds .......................................................................................................................................... 2,177 2,177 2,177 ............................ ............................

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION [OSHA] 

Salaries and Expenses 

Safety and Health Standards ..................................................................................................................................... 20,000 23,173 18,000 ¥2,000 ¥5,173 Federal Enforcement ................................................................................................................................................... 208,000 225,972 208,000 ............................ ¥17,972 Whistleblower enforcement ......................................................................................................................................... 17,500 21,604 17,500 ............................ ¥4,104 State Programs ........................................................................................................................................................... 100,850 104,337 100,850 ............................ ¥3,487 Technical Support ....................................................................................................................................................... 24,469 25,403 24,469 ............................ ¥934 Compliance Assistance: 

Federal Assistance ............................................................................................................................................ 68,433 72,784 70,981 ∂2,548 ¥1,803 State Consultation Grants ................................................................................................................................. 57,775 59,775 59,500 ∂1,725 ¥275 Training Grants ................................................................................................................................................. 10,537 10,537 10,537 ............................ ............................

Subtotal, Compliance Assistance ................................................................................................................. 136,745 143,096 141,018 ∂4,273 ¥2,078 

Safety and Health Statistics ...................................................................................................................................... 34,250 40,095 32,900 ¥1,350 ¥7,195 Executive Direction and Administration ..................................................................................................................... 10,973 11,343 10,050 ¥923 ¥1,293 

Total, OSHA ................................................................................................................................................... 552,787 595,023 552,787 ............................ ¥42,236 

MINE SAFETY AND HEALTH ADMINISTRATION 

Salaries and Expenses 

Coal Enforcement ....................................................................................................................................................... 167,859 171,768 162,071 ¥5,788 ¥9,697 Metal/Non-Metal Enforcement .................................................................................................................................... 91,697 97,563 94,500 ∂2,803 ¥3,063 Standards Development ............................................................................................................................................. 5,416 6,197 4,500 ¥916 ¥1,697 Assessments ............................................................................................................................................................... 6,976 8,277 6,627 ¥349 ¥1,650 Educational Policy and Development ......................................................................................................................... 36,320 40,419 39,320 ∂3,000 ¥1,099 
231 

Technical Support ....................................................................................................................................................... 33,791 35,041 35,041 ∂1,250 ............................Program Evaluation and Information Resources [PEIR] ............................................................................................ 17,990 21,815 17,990 ............................ ¥3,825 Program Administration ............................................................................................................................................. 15,838 16,292 15,838 ............................ ¥454 

Total, Mine Safety and Health Administration ............................................................................................. 375,887 397,372 375,887 ............................ ¥21,485 Total, Worker Protection Agencies ................................................................................................................ 1,598,744 1,760,774 1,594,780 ¥3,964 ¥165,994 

Federal Funds ...................................................................................................................................... (1,596,567 ) (1,758,597 ) (1,592,603 ) (¥3,964 ) (¥165,994 ) Trust Funds .......................................................................................................................................... (2,177 ) (2,177 ) (2,177 ) ............................ ............................

BUREAU OF LABOR STATISTICS 

Salaries and Expenses 

Employment and Unemployment Statistics ............................................................................................................... 208,000 219,258 208,000 ............................ ¥11,258 Labor Market Information ........................................................................................................................................... 65,000 67,016 65,000 ............................ ¥2,016 Prices and Cost of Living .......................................................................................................................................... 207,000 219,672 207,000 ............................ ¥12,672 Compensation and Working Conditions ..................................................................................................................... 83,500 87,517 83,500 ............................ ¥4,017 Productivity and Technology ....................................................................................................................................... 10,500 10,993 10,500 ............................ ¥493 Executive Direction and Staff Services ...................................................................................................................... 35,000 36,487 35,000 ............................ ¥1,487 

Total, Bureau of Labor Statistics ................................................................................................................. 609,000 640,943 609,000 ............................ ¥31,943 

Federal Funds ...................................................................................................................................... 544,000 573,927 544,000 ............................ ¥29,927 Trust Funds .......................................................................................................................................... 65,000 67,016 65,000 ............................ ¥2,016 

OFFICE OF DISABILITY EMPLOYMENT POLICY 

Salaries and Expenses ............................................................................................................................................... 38,203 38,544 38,203 ............................ ¥341 

DEPARTMENTAL MANAGEMENT 

Salaries and Expenses 

Executive Direction ..................................................................................................................................................... 31,010 37,406 30,250 ¥760 ¥7,156 Departmental Program Evaluation ............................................................................................................................. 8,040 9,500 8,040 ............................ ¥1,460 Legal Services ............................................................................................................................................................ 125,000 140,374 121,745 ¥3,255 ¥18,629 

Trust Funds ....................................................................................................................................................... 308 310 308 ............................ ¥2 

International Labor Affairs ......................................................................................................................................... 86,125 101,230 91,125 ∂5,000 ¥10,105 Administration and Management ............................................................................................................................... 28,413 36,604 28,834 ∂421 ¥7,770 Adjudication ................................................................................................................................................................ 32,000 36,325 35,336 ∂3,336 ¥989 Women’s Bureau ......................................................................................................................................................... 11,536 12,902 11,536 ............................ ¥1,366 Civil Rights Activities ................................................................................................................................................. 6,880 8,041 6,880 ............................ ¥1,161 Chief Financial Officer ............................................................................................................................................... 5,061 5,233 5,132 ∂71 ¥101 
232 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Total, Departmental Management ................................................................................................................ 334,373 387,925 339,186 ∂4,813 ¥48,739 

Federal Funds ...................................................................................................................................... (334,065 ) (387,615 ) (338,878 ) (∂4,813 ) (¥48,737 ) Trust Funds .......................................................................................................................................... (308 ) (310 ) (308 ) ............................ (¥2 ) 

Veterans Employment and Training 

State Administration, Grants ..................................................................................................................................... 175,000 175,000 175,000 ............................ ............................Transition Assistance Program .................................................................................................................................. 14,100 14,600 14,600 ∂500 ............................Federal Administration ............................................................................................................................................... 40,487 42,506 41,027 ∂540 ¥1,479 National Veterans’ Employment and Training Services Institute .............................................................................. 3,414 3,414 3,414 ............................ ............................Homeless Veterans Program ...................................................................................................................................... 38,109 50,000 40,500 ∂2,391 ¥9,500 

Total, Veterans Employment and Training ................................................................................................... 271,110 285,520 274,541 ∂3,431 ¥10,979 

Federal Funds ...................................................................................................................................... 38,109 50,000 40,500 ∂2,391 ¥9,500 Trust Funds .......................................................................................................................................... 233,001 235,520 234,041 ∂1,040 ¥1,479 

IT Modernization 

Departmental support systems .................................................................................................................................. 4,898 4,898 4,898 ............................ ............................Infrastructure technology modernization .................................................................................................................... 24,880 58,264 13,880 ¥11,000 ¥44,384 

Total, IT Modernization ................................................................................................................................. 29,778 63,162 18,778 ¥11,000 ¥44,384 

Office of Inspector General 

Program Activities ...................................................................................................................................................... 80,640 88,881 82,061 ∂1,421 ¥6,820 

Trust Funds ....................................................................................................................................................... 5,660 5,660 5,660 ............................ ............................

Total, Office of Inspector General ................................................................................................................ 86,300 94,541 87,721 ∂1,421 ¥6,820 Total, Departmental Management ................................................................................................................ 721,561 831,148 720,226 ¥1,335 ¥110,922 

Federal Funds ...................................................................................................................................... 482,592 589,658 480,217 ¥2,375 ¥109,441 

Current Year ................................................................................................................................ (482,592 ) (589,658 ) (480,217 ) (¥2,375 ) (¥109,441 ) 
233 

Trust Funds .......................................................................................................................................... 238,969 241,490 240,009 ∂1,040 ¥1,481 

Total, Workforce Investment Act Programs .................................................................................................. 5,023,586 5,280,050 4,978,322 ¥45,264 ¥301,728 

Current Year ......................................................................................................................................... (3,251,586 ) (3,508,050 ) (3,206,322 ) (¥45,264 ) (¥301,728 ) Fiscal year 2018 .................................................................................................................................. (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Total, Title I, Department of Labor ............................................................................................................... 13,730,217 14,375,547 13,614,453 ¥115,764 ¥761,094 

Federal Funds ...................................................................................................................................... 9,873,277 10,477,830 9,812,891 ¥60,386 ¥664,939 

Current Year ................................................................................................................................ (8,082,277 ) (8,689,830 ) (8,024,891 ) (¥57,386 ) (¥664,939 ) Fiscal year 2018 ......................................................................................................................... (1,791,000 ) (1,788,000 ) (1,788,000 ) (¥3,000 ) ............................

Trust Funds .......................................................................................................................................... 3,856,940 3,897,717 3,801,562 ¥55,378 ¥96,155 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA] 

Primary Health Care 

Community Health Centers ........................................................................................................................................ 1,491,422 1,341,422 1,490,522 ¥900 ∂149,100 Free Clinics Medical Malpractice ............................................................................................................................... 100 1,000 1,000 ∂900 ............................

Total, Primary Health Care ........................................................................................................................... 1,491,522 1,342,422 1,491,522 ............................ ∂149,100 

Health Workforce 

National Health Service Corps ................................................................................................................................... ............................ 20,000 ............................ ............................ ¥20,000 Training for Diversity: 

Centers of Excellence ........................................................................................................................................ 21,711 21,711 21,711 ............................ ............................Health Careers Opportunity Program ................................................................................................................ 14,189 14,189 ............................ ¥14,189 ¥14,189 Faculty Loan Repayment ................................................................................................................................... 1,190 1,190 1,190 ............................ ............................Scholarships for Disadvantaged Students ........................................................................................................ 45,970 49,070 49,070 ∂3,100 ............................

Total, Training for Diversity .......................................................................................................................... 83,060 86,160 71,971 ¥11,089 ¥14,189 

Training in Primary Care Medicine ............................................................................................................................ 38,924 38,924 38,924 ............................ ............................Oral Health Training ................................................................................................................................................... 35,873 35,873 35,873 ............................ ............................Interdisciplinary Community-Based Linkages: 

Area Health Education Centers ......................................................................................................................... 30,250 ............................ 30,250 ............................ ∂30,250 Geriatric Programs ............................................................................................................................................ 38,737 38,737 38,737 ............................ ............................

Behavioral Health Workforce Education and Training ............................................................................................... 50,000 56,000 50,000 ............................ ¥6,000 

Mental and Behavorial Health .......................................................................................................................... 9,916 9,916 9,916 ............................ ............................

Total, Interdisciplinary Community Linkages ............................................................................................... 128,903 104,653 128,903 ............................ ∂24,250 
234 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Workforce Information and Analysis .......................................................................................................................... 4,663 4,663 4,663 ............................ ............................Public Health and Preventive Medicine programs ..................................................................................................... 21,000 17,000 17,000 ¥4,000 ............................Nursing Programs: 

Advanced Education Nursing ............................................................................................................................ 64,581 64,581 64,581 ............................ ............................Nurse Education, Practice, and Retention ........................................................................................................ 39,913 39,913 39,913 ............................ ............................Nursing Workforce Diversity .............................................................................................................................. 15,343 15,343 15,343 ............................ ............................Loan Repayment and Scholarship Program ...................................................................................................... 83,135 83,135 83,135 ............................ ............................Nursing Faculty Loan Program .......................................................................................................................... 26,500 26,500 26,500 ............................ ............................

Total, Nursing programs ............................................................................................................................... 229,472 229,472 229,472 ............................ ............................

Children’s Hospitals Graduate Medical Education .................................................................................................... 295,000 ............................ 300,000 ∂5,000 ∂300,000 National Practitioner Data Bank ................................................................................................................................ 18,814 21,037 18,814 ............................ ¥2,223 

User Fees ........................................................................................................................................................... ¥18,814 ¥21,037 ¥18,814 ............................ ∂2,223 

Total, Health Workforce ................................................................................................................................. 836,895 536,745 826,806 ¥10,089 ∂290,061 

Maternal and Child Health 

Maternal and Child Health Block Grant .................................................................................................................... 638,200 638,200 641,700 ∂3,500 ∂3,500 Sickle Cell Anemia Demonstration Program .............................................................................................................. 4,455 4,455 4,455 ............................ ............................Autism and Other Developmental Disorders .............................................................................................................. 47,099 47,099 47,099 ............................ ............................Heritable Disorders ..................................................................................................................................................... 13,883 13,883 11,883 ¥2,000 ¥2,000 Healthy Start .............................................................................................................................................................. 103,500 103,500 103,500 ............................ ............................Universal Newborn Hearing Screening ....................................................................................................................... 17,818 17,818 17,818 ............................ ............................Emergency Medical Services for Children .................................................................................................................. 20,162 20,162 20,162 ............................ ............................

Total, Maternal and Child Health ................................................................................................................. 845,117 845,117 846,617 ∂1,500 ∂1,500 

Ryan White HIV/AIDS Program 

Emergency Assistance ................................................................................................................................................ 655,876 655,876 655,876 ............................ ............................Comprehensive Care Programs .................................................................................................................................. 1,315,005 1,315,005 1,315,005 ............................ ............................
235 

AIDS Drug Assistance Program [ADAP] (NA) .................................................................................................... (900,313 ) (900,313 ) (900,313 ) ............................ ............................

Early Intervention Program ......................................................................................................................................... 205,079 280,167 201,079 ¥4,000 ¥79,088 Children, Youth, Women, and Families ...................................................................................................................... 75,088 ............................ 75,088 ............................ ∂75,088 AIDS Dental Services .................................................................................................................................................. 13,122 13,122 13,122 ............................ ............................Education and Training Centers ................................................................................................................................ 33,611 33,611 33,611 ............................ ............................Special Projects of National Significance .................................................................................................................. 25,000 ............................ ............................ ¥25,000 ............................

Total, Ryan White HIV/AIDS program ............................................................................................................ 2,322,781 2,297,781 2,293,781 ¥29,000 ¥4,000 

(Evaluation Tap Funding) ......................................................................................................................... ............................ (34,000 ) ............................ ............................ (¥34,000 ) 

Health Care Systems 

Organ Transplantation ............................................................................................................................................... 23,549 23,549 23,549 ............................ ............................National Cord Blood Inventory ................................................................................................................................... 11,266 11,266 11,266 ............................ ............................CW Bill Young Cell Transplantation program ............................................................................................................ 22,109 22,109 22,109 ............................ ............................340B Drug Pricing program/Office of Pharmacy Affairs ........................................................................................... 10,238 26,238 19,238 ∂9,000 ¥7,000 

User Fees ........................................................................................................................................................... ............................ ¥9,000 ¥9,000 ¥9,000 ............................

Poison Control ............................................................................................................................................................ 18,846 18,846 18,846 ............................ ............................National Hansen’s Disease Program .......................................................................................................................... 15,206 15,206 15,206 ............................ ............................Hansen’s Disease Program Buildings and Facilities ................................................................................................. 122 122 122 ............................ ............................Payment to Hawaii, Treatment of Hansen’s .............................................................................................................. 1,857 1,857 1,857 ............................ ............................

Total, Health Care Systems .......................................................................................................................... 103,193 110,193 103,193 ............................ ¥7,000 

Rural Health 

Rural Outreach Grants ............................................................................................................................................... 63,500 63,500 65,500 ∂2,000 ∂2,000 Rural Health Research/Policy Development ............................................................................................................... 9,351 9,351 9,351 ............................ ............................Rural Hospital Flexibility Grants ................................................................................................................................ 41,609 26,200 41,609 ............................ ∂15,409 State Offices of Rural Health .................................................................................................................................... 9,511 9,511 9,511 ............................ ............................Black Lung Clinics ..................................................................................................................................................... 6,766 6,766 6,766 ............................ ............................Radiation Exposure Screening and Education Program ............................................................................................ 1,834 1,834 1,834 ............................ ............................Telehealth ................................................................................................................................................................... 17,000 17,000 18,000 ∂1,000 ∂1,000 Rural Opioid Overdose Reversal grant program ........................................................................................................ ............................ 10,000 ............................ ............................ ¥10,000 

Total, Rural Health ....................................................................................................................................... 149,571 144,162 152,571 ∂3,000 ∂8,409 

Family Planning .......................................................................................................................................................... 286,479 300,000 286,479 ............................ ¥13,521 Program Management ................................................................................................................................................ 154,000 157,061 154,000 ............................ ¥3,061 

Vaccine Injury Compensation Program Trust Fund 

Post-fiscal year 1988 Claims .................................................................................................................................... 237,000 240,000 240,000 ∂3,000 ............................
236 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

HRSA Administration .................................................................................................................................................. 7,500 9,200 7,500 ............................ ¥1,700 

Total, Vaccine Injury Compensation Trust Fund .......................................................................................... 244,500 249,200 247,500 ∂3,000 ¥1,700 Total, Health Resources and Services Administration ................................................................................. 6,434,058 5,982,681 6,402,469 ¥31,589 ∂419,788 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

Immunization and Respiratory Diseases .................................................................................................................... 459,055 411,716 459,055 ............................ ∂47,339 

Pandemic Flu balances (Public Law 111–32) .................................................................................................. (15,000 ) ............................ (15,000 ) ............................ (∂15,000 ) Prevention and Public Health Fund 1 ................................................................................................................ (324,350 ) (336,350 ) (324,350 ) ............................ (¥12,000 ) 

Subtotal ......................................................................................................................................................... (798,405 ) (748,066 ) (798,405 ) ............................ (∂50,339 ) 

HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention ......................................... 1,122,278 1,127,278 1,112,278 ¥10,000 ¥15,000 Emerging and Zoonotic Infectious Diseases .............................................................................................................. 527,885 577,485 526,885 ¥1,000 ¥50,600 

Prevention and Public Health Fund 1 ................................................................................................................ (52,000 ) (52,000 ) (52,000 ) ............................ ............................

Subtotal ......................................................................................................................................................... 579,885 629,485 578,885 ¥1,000 ¥50,600 

Chronic Disease Prevention and Health Promotion ................................................................................................... 838,146 679,745 726,696 ¥111,450 ∂46,951 

Prevention and Public Health Fund 1 ................................................................................................................ (338,950 ) (437,400 ) (337,950 ) (¥1,000 ) (¥99,450 ) 

Subtotal ......................................................................................................................................................... 1,177,096 1,117,145 1,064,646 ¥112,450 ¥52,499 

Birth Defects, Developmental Disabilities, Disabilities and Health .......................................................................... 135,610 67,644 137,560 ∂1,950 ∂69,916 

Prevention and Public Health Fund 1 ................................................................................................................ ............................ (67,966 ) ............................ ............................ (¥67,966 ) 

Subtotal ......................................................................................................................................................... 135,610 135,610 137,560 ∂1,950 ∂1,950 

Public Health Scientific Services ............................................................................................................................... 491,597 464,355 485,000 ¥6,597 ∂20,645 

Prevention and Public Health Fund 1 ................................................................................................................ ............................ (36,276 ) ............................ ............................ (¥36,276 ) 

Subtotal ......................................................................................................................................................... (491,597 ) (500,631 ) (485,000 ) (¥6,597 ) (¥15,631 ) 
237 

Environmental Health ................................................................................................................................................. 165,303 167,825 165,303 ............................ ¥2,522 

Prevention and Public Health Fund 1 ................................................................................................................ (17,000 ) (14,478 ) (17,000 ) ............................ (∂2,522 ) 

Subtotal ......................................................................................................................................................... 182,303 182,303 182,303 ............................ ............................

Injury Prevention and Control .................................................................................................................................... 236,059 268,629 264,059 ∂28,000 ¥4,570 National Institute for Occupational Safety and Health ............................................................................................. 339,121 213,621 334,121 ¥5,000 ∂120,500 

Evaluation Tap Funding .................................................................................................................................... ............................ (72,000 ) ............................ ............................ (¥72,000 ) 

Subtotal ......................................................................................................................................................... (339,121 ) (285,621 ) (334,121 ) (¥5,000 ) (∂48,500 ) 

Energy Employees Occupational Illness Compensation Program .............................................................................. 55,358 55,358 55,358 ............................ ............................Global Health .............................................................................................................................................................. 427,121 442,121 432,121 ∂5,000 ¥10,000 

Subtotal ......................................................................................................................................................... (427,121 ) (442,121 ) (432,121 ) (∂5,000 ) (¥10,000 ) 

Public Health Preparedness and Response ............................................................................................................... 1,405,000 1,402,166 1,396,800 ¥8,200 ¥5,366 Buildings and Facilities ............................................................................................................................................. 10,000 31,221 ............................ ¥10,000 ¥31,221 

CDC-Wide Activities and Program Support 

Prevention and Public Health Fund 1 ......................................................................................................................... (160,000 ) ............................ (160,000 ) ............................ (∂160,000 ) Office of the Director ................................................................................................................................................. 113,570 113,570 113,570 ............................ ............................

Subtotal, CDC-Wide Activities ...................................................................................................................... (273,570 ) (113,570 ) (273,570 ) ............................ (∂160,000 ) Total, Centers for Disease Control ............................................................................................................... 6,326,103 6,022,734 6,208,806 ¥117,297 ∂186,072 Pandemic Flu balances (Public Law 111–32) ............................................................................................. (15,000 ) ............................ (15,000 ) ............................ (∂15,000 ) Prevention and Public Health Fund 1 ........................................................................................................... (892,300 ) (944,470 ) (891,300 ) (¥1,000 ) (¥53,170 ) Total, Centers for Disease Control Program Level ....................................................................................... (7,233,403 ) (7,039,204 ) (7,115,106 ) (¥118,297 ) (∂75,902 ) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute ........................................................................................................................................... 5,213,509 5,097,287 5,429,769 ∂216,260 ∂332,482 National Heart, Lung, and Blood Institute ................................................................................................................ 3,113,533 3,069,901 3,242,685 ∂129,152 ∂172,784 National Institute of Dental and Craniofacial Research ........................................................................................... 413,396 404,560 430,544 ∂17,148 ∂25,984 National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] ............................................................ 1,816,310 1,786,086 1,891,652 ∂75,342 ∂105,566 

Juvenile Diabetes (mandatory) .......................................................................................................................... (150,000 ) (150,000 ) (150,000 ) ............................ ............................

Subtotal, NIDDK program level ..................................................................................................................... 1,966,310 1,936,086 2,041,652 ∂75,342 ∂105,566 

National Institute of Neurological Disorders and Stroke ........................................................................................... 1,695,180 1,659,416 1,803,306 ∂108,126 ∂143,890 National Institute of Allergy and Infectious Diseases ............................................................................................... 4,715,697 4,700,548 4,961,305 ∂245,608 ∂260,757 National Institute of General Medical Sciences ........................................................................................................ 1,732,437 1,586,655 1,776,755 ∂44,318 ∂190,100 
238 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Evaluation Tap Funding .................................................................................................................................... (780,000 ) (847,489 ) (857,000 ) (∂77,000 ) (∂9,511 ) 

Subtotal, NGMS program level ..................................................................................................................... 2,512,437 2,434,144 2,633,755 ∂121,318 ∂199,611 

Eunice Kennedy Shriver National Institute of Child Health and Human Development ............................................ 1,338,348 1,316,607 1,395,811 ∂57,463 ∂79,204 National Eye Institute ................................................................................................................................................. 707,998 687,249 740,826 ∂32,828 ∂53,577 National Institute of Environmental Health Sciences ................................................................................................ 693,533 681,613 722,301 ∂28,768 ∂40,688 National Institute on Aging ........................................................................................................................................ 1,598,246 1,265,133 2,067,138 ∂468,892 ∂802,005 National Institute of Arthritis and Musculoskeletal and Skin Diseases ................................................................... 541,662 532,753 564,131 ∂22,469 ∂31,378 National Institute on Deafness and Other Communication Disorders ...................................................................... 422,936 416,146 441,778 ∂18,842 ∂25,632 National Institute of Nursing Research ..................................................................................................................... 145,912 143,942 151,965 ∂6,053 ∂8,023 National Institute on Alcohol Abuse and Alcoholism ................................................................................................ 467,445 459,578 488,782 ∂21,337 ∂29,204 National Institute on Drug Abuse .............................................................................................................................. 1,050,550 1,020,459 1,103,032 ∂52,482 ∂82,573 National Institute of Mental Health ........................................................................................................................... 1,518,673 1,459,700 1,619,537 ∂100,864 ∂159,837 National Human Genome Research Institute ............................................................................................................. 513,227 509,762 534,516 ∂21,289 ∂24,754 National Institute of Biomedical Imaging and Bioengineering ................................................................................. 343,506 334,025 361,062 ∂17,556 ∂27,037 National Center for Complementary and Integrative Health ..................................................................................... 129,941 126,673 136,195 ∂6,254 ∂9,522 National Institute on Minority Health and Health Disparities ................................................................................... 280,680 279,680 292,323 ∂11,643 ∂12,643 John E. Fogarty International Center ......................................................................................................................... 70,117 69,175 73,026 ∂2,909 ∂3,851 National Library of Medicine [NLM] ........................................................................................................................... 395,684 395,110 412,097 ∂16,413 ∂16,987 National Center for Advancing Translational Sciences ............................................................................................. 685,417 660,131 713,849 ∂28,432 ∂53,718 Office of the Director ................................................................................................................................................. 1,571,200 1,445,459 1,443,752 ¥127,448 ¥1,707 

Common Fund (non-add) .................................................................................................................................. (675,639 ) (565,639 ) (790,542 ) (∂114,903 ) (∂224,903 ) Gabriella Miller Kids First Research Act (Common Fund) (non-add) .............................................................. (12,600 ) (12,600 ) (12,600 ) ............................ ............................Transfers from Non-Recurring Expense Fund (non-add) .................................................................................. ............................ ............................ (300,000 ) (∂300,000 ) (∂300,000 ) 

Subtotal ......................................................................................................................................................... 1,571,200 1,445,459 1,743,752 ∂172,552 ∂298,293 

Buildings and Facilities ............................................................................................................................................. 128,863 128,863 128,863 ............................ ............................NIH undistributed ....................................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Total, National Institutes of Health [NIH] .................................................................................................... 31,304,000 30,236,511 32,927,000 ∂1,623,000 ∂2,690,489 
239 

(Evaluation Tap Funding) ......................................................................................................................... (780,000 ) (847,489 ) (857,000 ) (∂77,000 ) (∂9,511 ) (Transfers from Non-Recurring Expense Fund) ........................................................................................ ............................ ............................ (300,000 ) (∂300,000 ) (∂300,000 ) 

Total, NIH Program Level .............................................................................................................................. (32,084,000 ) (31,084,000 ) (34,084,000 ) (∂2,000,000 ) (∂3,000,000 ) 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION [SAMHSA] 

Mental Health 

Programs of Regional and National Significance ..................................................................................................... 402,609 386,388 375,659 ¥26,950 ¥10,729 

Evaluation Tap Funding .................................................................................................................................... ............................ (10,000 ) ............................ ............................ (¥10,000 ) Prevention and Public Health Fund 1 ................................................................................................................ (12,000 ) (10,000 ) (12,000 ) ............................ (∂2,000 ) 

Subtotal ......................................................................................................................................................... 414,609 406,388 387,659 ¥26,950 ¥18,729 

Mental Health block grant ......................................................................................................................................... 511,532 511,532 541,532 ∂30,000 ∂30,000 

Evaluation Tap Funding .................................................................................................................................... (21,039 ) (21,039 ) (21,039 ) ............................ ............................

Subtotal ......................................................................................................................................................... (532,571 ) (532,571 ) (562,571 ) (∂30,000 ) (∂30,000 ) 

Children’s Mental Health ........................................................................................................................................... 119,026 119,026 119,026 ............................ ............................Grants to States for the Homeless (PATH) ................................................................................................................ 64,635 64,635 64,635 ............................ ............................Protection and Advocacy ............................................................................................................................................ 36,146 36,146 36,146 ............................ ............................

Subtotal, Mental Health ................................................................................................................................ 1,133,948 1,117,727 1,136,998 ∂3,050 ∂19,271 

(Evaluation Tap Funding) ......................................................................................................................... (21,039 ) (31,039 ) (21,039 ) ............................ (¥10,000 ) 

Subtotal, Mental Health program level ............................................................................................... (1,166,987 ) (1,158,766 ) (1,170,037 ) (∂3,050 ) (∂11,271 ) 

Substance Abuse Treatment 

Programs of Regional and National Significance ..................................................................................................... 335,345 298,269 334,484 ¥861 ∂36,215 

Evaluation Tap Funding .................................................................................................................................... (2,000 ) (30,000 ) (2,000 ) ............................ (¥28,000 ) 

Subtotal ......................................................................................................................................................... (337,345 ) (328,269 ) (336,484 ) (¥861 ) (∂8,215 ) 

Substance Abuse block grant .................................................................................................................................... 1,778,879 1,778,879 1,778,879 ............................ ............................

Evaluation Tap Funding .................................................................................................................................... (79,200 ) (79,200 ) (79,200 ) ............................ ............................

Subtotal, block grant .................................................................................................................................... (1,858,079 ) (1,858,079 ) (1,858,079 ) ............................ ............................Subtotal, Substance Abuse Treatment ......................................................................................................... 2,114,224 2,077,148 2,113,363 ¥861 ∂36,215 

(Evaluation Tap Funding) ......................................................................................................................... (81,200 ) (109,200 ) (81,200 ) ............................ (¥28,000 ) 

Subtotal, Program level ................................................................................................................................ (2,195,424 ) (2,186,348 ) (2,194,563 ) (¥861 ) (∂8,215 ) 
240 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Substance Abuse Prevention 

Programs of Regional and National Significance ..................................................................................................... 211,219 194,680 225,219 ∂14,000 ∂30,539 

Evaluation Tap Funding .................................................................................................................................... ............................ (16,468 ) ............................ ............................ (¥16,468 ) 

Subtotal ......................................................................................................................................................... 211,219 194,680 225,219 ∂14,000 ∂30,539 

Health Surveillance and Program Support ................................................................................................................ 124,878 99,228 115,830 ¥9,048 ∂16,602 

Evaluation Tap Funding (NA) ............................................................................................................................ (31,428 ) (56,828 ) (32,428 ) (∂1,000 ) (¥24,400 ) Prevention and Public Health Fund 1 ................................................................................................................ ............................ (17,830 ) ............................ ............................ (¥17,830 ) 

Subtotal ......................................................................................................................................................... 156,306 173,886 148,258 ¥8,048 ¥25,628 Total, SAMHSA ............................................................................................................................................... 3,584,269 3,488,783 3,591,410 ∂7,141 ∂102,627 

(Evaluation Tap Funding) ......................................................................................................................... (133,667 ) (213,535 ) (134,667 ) (∂1,000 ) (¥78,868 ) (Prevention and Public Health Fund) 1 .................................................................................................... (12,000 ) (27,830 ) (12,000 ) ............................ (¥15,830 ) 

Total, SAMHSA Program Level ............................................................................................................. (3,729,936 ) (3,730,148 ) (3,738,077 ) (∂8,141 ) (∂7,929 ) 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ] 

Healthcare Research and Quality 

Research on Health Costs, Quality, and Outcomes: 

Federal Funds .................................................................................................................................................... 196,800 140,519 184,279 ¥12,521 ∂43,760 

Evaluation Tap funding ............................................................................................................................ ............................ (83,458 ) ............................ ............................ (¥83,458 ) Patient-Centered Outcomes Research transfer ........................................................................................ ............................ ............................ ............................ ............................ ............................

Subtotal, Health Costs, Quality, and Outcomes .................................................................................. (196,800 ) (223,977 ) (184,279 ) (¥12,521 ) (¥39,698 ) (Evaluation Tap Funding) .................................................................................................................... ............................ (83,458 ) ............................ ............................ (¥83,458 ) 

Medical Expenditures Panel Surveys: 

Federal Funds .................................................................................................................................................... 66,000 68,877 68,877 ∂2,877 ............................
241 

Program Support: 

Federal Funds .................................................................................................................................................... 71,200 70,844 70,844 ¥356 ............................

Total, AHRQ Program Level ........................................................................................................................... (334,000 ) (363,698 ) (324,000 ) (¥10,000 ) (¥39,698 ) 

Federal funds ....................................................................................................................................... (334,000 ) (280,240 ) (324,000 ) (¥10,000 ) (∂43,760 ) (Evaluation Tap Funding) .................................................................................................................... ............................ (83,458 ) ............................ ............................ (¥83,458 ) 

Total, Public Health Service [PHS] appropriation ........................................................................................ 47,982,430 46,010,949 49,453,685 ∂1,471,255 ∂3,442,736 

(Evaluation Tap Funding) ......................................................................................................................... ............................ ............................ ............................ ............................ ............................

Total, Public Health Service Program Level ................................................................................................. (49,815,397 ) (48,233,731 ) (51,363,652 ) (∂1,548,255 ) (∂3,129,921 ) 

CENTERS FOR MEDICARE AND MEDICAID SERVICES 

Grants to States for Medicaid 

Medicaid Current Law Benefits .................................................................................................................................. 334,936,328 354,223,901 354,223,901 ∂19,287,573 ............................State and Local Administration ................................................................................................................................. 17,771,915 18,975,984 18,975,984 ∂1,204,069 ............................Vaccines for Children ................................................................................................................................................. 4,109,307 4,386,584 4,386,584 ∂277,277 ............................

Subtotal, Medicaid Program Level ................................................................................................................ 356,817,550 377,586,469 377,586,469 ∂20,768,919 ............................

Less funds advanced in prior year ..................................................................................................... ¥113,272,140 ¥115,582,502 ¥115,582,502 ¥2,310,362 ............................

Total, Grants to States for Medicaid ............................................................................................................ 243,545,410 262,003,967 262,003,967 ∂18,458,557 ............................

New advance, 1st quarter, fiscal year 2018 .................................................................................. 115,582,502 125,219,452 125,219,452 ∂9,636,950 ............................

Payments to Health Care Trust Funds 

Supplemental Medical Insurance ............................................................................................................................... 198,530,000 214,944,000 214,944,000 ∂16,414,000 ............................Federal Uninsured Payment ....................................................................................................................................... 158,000 147,000 147,000 ¥11,000 ............................Program Management ................................................................................................................................................ 1,044,000 877,500 877,500 ¥166,500 ............................General Revenue for Part D Benefit .......................................................................................................................... 82,453,000 82,512,000 82,512,000 ∂59,000 ............................General Revenue for Part D Administration .............................................................................................................. 691,000 405,000 405,000 ¥286,000 ............................HCFAC Reimbursement ............................................................................................................................................... 291,000 299,000 299,000 ∂8,000 ............................State Low-Income Determination for Part D .............................................................................................................. 4,800 3,200 3,200 ¥1,600 ............................

Total, Payments to Trust Funds, Program Level .......................................................................................... 283,171,800 299,187,700 299,187,700 ∂16,015,900 ............................

Program Management 

Research, Demonstration, Evaluation ........................................................................................................................ 20,054 ............................ 20,054 ............................ ∂20,054 Program Operations .................................................................................................................................................... 2,519,823 2,936,499 2,519,823 ............................ ¥416,676 State Survey and Certification ................................................................................................................................... 397,334 437,200 397,334 ............................ ¥39,866 Federal Administration ............................................................................................................................................... 732,533 735,850 732,533 ............................ ¥3,317 
242 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Total, Program management ........................................................................................................................ 3,669,744 4,109,549 3,669,744 ............................ ¥439,805 

Health Care Fraud and Abuse Control Account 

Centers for Medicare and Medicaid Services ............................................................................................................ 486,120 486,936 486,935 ∂815 ¥1 HHS Office of Inspector General ................................................................................................................................ 67,200 121,824 79,355 ∂12,155 ¥42,469 Medicaid/CHIP ............................................................................................................................................................ 67,200 ............................ 79,355 ∂12,155 ∂79,355 Department of Justice ................................................................................................................................................ 60,480 116,240 79,355 ∂18,875 ¥36,885 

Total, Health Care Fraud and Abuse Control ............................................................................................... 681,000 725,000 725,000 ∂44,000 ............................Total, Centers for Medicare and Medicaid Services .................................................................................... 646,650,456 691,245,668 690,805,863 ∂44,155,407 ¥439,805 

Federal funds ....................................................................................................................................... 642,299,712 686,411,119 686,411,119 ∂44,111,407 ............................

Current year ................................................................................................................................ (526,717,210 ) (561,191,667 ) (561,191,667 ) (∂34,474,457 ) ............................New advance, fiscal year 2018 .................................................................................................. (115,582,502 ) (125,219,452 ) (125,219,452 ) (∂9,636,950 ) ............................

Trust Funds .......................................................................................................................................... 4,350,744 4,834,549 4,394,744 ∂44,000 ¥439,805 

ADMINISTRATION FOR CHILDREN AND FAMILIES [ACF] 

Payments to States for Child Support Enforcement and Family Support Programs 

Payments to Territories .............................................................................................................................................. 33,000 33,000 33,000 ............................ ............................Repatriation ................................................................................................................................................................ 1,000 1,000 1,000 ............................ ............................

Subtotal ......................................................................................................................................................... 34,000 34,000 34,000 ............................ ............................

Child Support Enforcement: 

State and Local Administration ........................................................................................................................ 3,541,359 3,680,840 3,680,840 ∂139,481 ............................Federal Incentive Payments .............................................................................................................................. 519,547 585,791 585,791 ∂66,244 ............................Access and Visitation ........................................................................................................................................ 10,000 10,000 10,000 ............................ ............................

Subtotal, Child Support Enforcement ........................................................................................................... 4,070,906 4,276,631 4,276,631 ∂205,725 ............................Total, Family Support Payments Program Level ........................................................................................... 4,104,906 4,310,631 4,310,631 ∂205,725 ............................
243 

Less funds advanced in previous years .............................................................................................. ¥1,160,000 ¥1,300,000 ¥1,300,000 ¥140,000 ............................

Total, Family Support Payments, current year ............................................................................................. 2,944,906 3,010,631 3,010,631 ∂65,725 ............................

New advance, 1st quarter, fiscal year 2018 .................................................................................. 1,300,000 1,400,000 1,400,000 ∂100,000 ............................

Low Income Home Energy Assistance [LIHEAP] 

Formula Grants ........................................................................................................................................................... 3,390,304 3,000,304 3,390,304 ............................ ∂390,000 Utility Innovation Fund ............................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Total, LIHEAP, Program Level ....................................................................................................................... 3,390,304 3,000,304 3,390,304 ............................ ∂390,000 

Refugee and Entrant Assistance 

Transitional and Medical Services ............................................................................................................................. 490,000 581,357 490,000 ............................ ¥91,357 Victims of Trafficking ................................................................................................................................................. 18,755 22,000 18,755 ............................ ¥3,245 Social Services ........................................................................................................................................................... 155,000 176,927 155,000 ............................ ¥21,927 Preventive Health ....................................................................................................................................................... 4,600 4,600 4,600 ............................ ............................Targeted Assistance ................................................................................................................................................... 47,601 55,601 47,601 ............................ ¥8,000 Unaccompanied Minors .............................................................................................................................................. 948,000 1,226,000 948,000 ............................ ¥278,000 Unaccompanied Minors Contingency Fund ................................................................................................................ ............................ 95,000 ............................ ............................ ¥95,000 

CBO adjustment ................................................................................................................................................ ............................ 65,000 ............................ ............................ ¥65,000 

Subtotal ......................................................................................................................................................... ............................ 160,000 ............................ ............................ ¥160,000 

Victims of Torture ....................................................................................................................................................... 10,735 23,375 10,735 ............................ ¥12,640 

Total, Refugee and Entrant Assistance ........................................................................................................ 1,674,691 2,249,860 1,674,691 ............................ ¥575,169 

Payments to States for the Child Care and Development Block Grant .................................................................... 2,761,000 2,961,672 2,786,000 ∂25,000 ¥175,672 Social Services Block Grant (Title XX) ....................................................................................................................... 1,700,000 1,681,500 1,700,000 ............................ ∂18,500 Social Services Block Grant Research/Evaluation ..................................................................................................... ............................ 18,500 ............................ ............................ ¥18,500 

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

Children and Families Services Programs 

Programs for Children, Youth and Families: 

Head Start, current funded ............................................................................................................................... 9,168,095 9,601,724 9,203,095 ∂35,000 ¥398,629 Preschool Development Grants 3 ....................................................................................................................... 250,000 350,000 250,000 ............................ ¥100,000 Consolidated Runaway, Homeless Youth Program ........................................................................................... 101,980 108,330 101,980 ............................ ¥6,350 Prevention Grants to Reduce Abuse of Runaway Youth ................................................................................... 17,141 17,491 17,141 ............................ ¥350 Child Abuse State Grants ................................................................................................................................. 25,310 25,310 25,310 ............................ ............................Child Abuse Discretionary Activities ................................................................................................................. 33,000 43,744 33,000 ............................ ¥10,744 
244 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Community Based Child Abuse Prevention ....................................................................................................... 39,764 39,764 39,764 ............................ ............................Child Welfare Services ...................................................................................................................................... 268,735 268,735 268,735 ............................ ............................Child Welfare Training, Research, or Demonstration projects ......................................................................... 17,984 21,984 17,984 ............................ ¥4,000 Adoption Opportunities ...................................................................................................................................... 39,100 39,100 39,100 ............................ ............................Adoption Incentive ............................................................................................................................................. 37,943 37,943 37,943 ............................ ............................

Social Services and Income Maintenance Research ................................................................................................. 6,512 10,762 6,512 ............................ ¥4,250 Native American Programs ......................................................................................................................................... 50,000 53,100 50,000 ............................ ¥3,100 Community Services: 

Community Services Block Grant Act programs: 

Grants to States for Community Services ............................................................................................... 715,000 674,000 715,000 ............................ ∂41,000 Economic Development ............................................................................................................................. 29,883 ............................ ............................ ¥29,883 ............................Rural Community Facilities ...................................................................................................................... 6,500 ............................ ............................ ¥6,500 ............................

Subtotal ................................................................................................................................................ 751,383 674,000 715,000 ¥36,383 ∂41,000 

Individual Development Account Initiative .............................................................................................. 18,950 18,950 ............................ ¥18,950 ¥18,950 

Subtotal, Community Services ............................................................................................................. 770,333 692,950 715,000 ¥55,333 ∂22,050 

Domestic Violence Hotline .......................................................................................................................................... 8,250 12,300 8,250 ............................ ¥4,050 Family Violence/Battered Women’s Shelters .............................................................................................................. 150,000 151,000 151,000 ∂1,000 ............................Chafee Education and Training Vouchers ................................................................................................................. 43,257 43,257 43,257 ............................ ............................Faith-Based Center .................................................................................................................................................... ............................ ............................ ............................ ............................ ............................Disaster Human Services Case Management ............................................................................................................ 1,864 1,864 1,864 ............................ ............................Program Direction ....................................................................................................................................................... 205,000 205,699 205,000 ............................ ¥699 

Total, Children and Families Services Programs ......................................................................................... 11,234,268 11,725,057 11,214,935 ¥19,333 ¥510,122 

Children’s Research and Technical Assistance 

Systems Innovation Center and other expenses ........................................................................................................ ............................ 10,000 ............................ ............................ ¥10,000 

(By transfer) ...................................................................................................................................................... ............................ (15,000 ) ............................ ............................ (¥15,000 ) 
245 

Total, Children’s research and technical assistance ................................................................................... ............................ 25,000 ............................ ............................ ¥25,000 

Promoting Safe and Stable Families ......................................................................................................................... 345,000 345,000 325,000 ¥20,000 ¥20,000 

Discretionary Funds ........................................................................................................................................... 59,765 79,765 59,765 ............................ ¥20,000 

Total, Promoting Safe and Stable Families ................................................................................................. 404,765 424,765 384,765 ¥20,000 ¥40,000 

Payments for Foster Care and Permanency 

Foster Care ................................................................................................................................................................. 4,772,100 4,992,000 4,992,000 ∂219,900 ............................Adoption Assistance ................................................................................................................................................... 2,562,900 2,780,000 2,780,000 ∂217,100 ............................Guardianship .............................................................................................................................................................. 123,000 152,000 152,000 ∂29,000 ............................Independent Living ..................................................................................................................................................... 140,000 140,000 140,000 ............................ ............................

Total, Payments to States ............................................................................................................................ 7,598,000 8,064,000 8,064,000 ∂466,000 ............................

Less Advances from Prior Year ................................................................................................................ ¥2,300,000 ¥2,300,000 ¥2,300,000 ............................ ............................

Total, payments, current year .............................................................................................................. 5,298,000 5,764,000 5,764,000 ∂466,000 ............................

New Advance, 1st quarter, fiscal year 2018 .................................................................................. 2,300,000 2,500,000 2,500,000 ∂200,000 ............................

Total, ACF ...................................................................................................................................................... 33,007,934 34,746,289 33,825,326 ∂817,392 ¥920,963 

Current year ......................................................................................................................................... (29,407,934 ) (30,846,289 ) (29,925,326 ) (∂517,392 ) (¥920,963 ) Fiscal year 2018 .................................................................................................................................. (3,600,000 ) (3,900,000 ) (3,900,000 ) (∂300,000 ) ............................

Total, ACF Program Level ............................................................................................................................. 33,007,934 34,761,289 33,825,326 ∂817,392 ¥935,963 

ADMINISTRATION FOR COMMUNITY LIVING 

Aging and Disability Services Programs 

Grants to States: 

Home and Community-based Supportive Services ........................................................................................... 347,724 357,724 347,724 ............................ ¥10,000 Preventive Health .............................................................................................................................................. 19,848 19,848 19,848 ............................ ............................Protection of Vulnerable Older Americans–Title VII .......................................................................................... 20,658 20,658 20,658 ............................ ............................

Subtotal ......................................................................................................................................................... 388,230 398,230 388,230 ............................ ¥10,000 

Family Caregivers .............................................................................................................................................. 150,586 150,586 150,586 ............................ ............................Native American Caregivers Support ................................................................................................................ 7,531 7,531 7,531 ............................ ............................

Subtotal, Caregivers ..................................................................................................................................... 158,117 158,117 158,117 ............................ ............................

Nutrition: 

Congregate Meals ..................................................................................................................................... 448,342 454,091 448,342 ............................ ¥5,749 Home Delivered Meals .............................................................................................................................. 226,342 234,397 226,342 ............................ ¥8,055 
246 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Nutrition Services Incentive Program ....................................................................................................... 160,069 160,069 160,069 ............................ ............................Nutrition Initiative .................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Subtotal ................................................................................................................................................ 834,753 848,557 834,753 ............................ ¥13,804 

Subtotal, Grants to States ............................................................................................................................ 1,381,100 1,404,904 1,381,100 ............................ ¥23,804 

Grants for Native Americans ...................................................................................................................................... 31,158 31,158 26,158 ¥5,000 ¥5,000 Aging Network Support Activities ............................................................................................................................... 9,961 9,961 9,961 ............................ ............................Alzheimer’s Disease Demonstrations ......................................................................................................................... 4,800 4,800 4,800 ............................ ............................

Prevention and Public Health Fund 1 ................................................................................................................ (14,700 ) (14,700 ) (14,700 ) ............................ ............................

Lifespan Respite Care ................................................................................................................................................ 3,360 5,000 3,360 ............................ ¥1,640 Chronic Disease Self-Management Program ............................................................................................................. ............................ ............................ ............................ ............................ ............................

Prevention and Public Health Fund 1 ................................................................................................................ (8,000 ) (8,000 ) (8,000 ) ............................ ............................

Elder Falls Prevention ................................................................................................................................................ ............................ ............................ ............................ ............................ ............................

Prevention and Public Health Fund 1 ................................................................................................................ (5,000 ) (5,000 ) (5,000 ) ............................ ............................

Senior Medicare Patrol Program ................................................................................................................................ ............................ ............................ ............................ ............................ ............................Elder Rights Support Activities .................................................................................................................................. 11,874 13,874 13,874 ∂2,000 ............................Aging and Disability Resources ................................................................................................................................. 6,119 8,119 6,119 ............................ ¥2,000 State Health Insurance Program ................................................................................................................................ 52,115 52,115 ............................ ¥52,115 ¥52,115 National Clearinghouse for Long-Term Care Information .......................................................................................... ............................ ............................ ............................ ............................ ............................Paralysis Resource Center .......................................................................................................................................... 7,700 7,700 7,700 ............................ ............................Limb loss .................................................................................................................................................................... 2,810 2,810 2,810 ............................ ............................Traumatic Brain Injury ............................................................................................................................................... 9,321 9,321 9,321 ............................ ............................Developmental Disabilities Programs: 

State Councils ................................................................................................................................................... 73,000 73,000 73,000 ............................ ............................Protection and Advocacy ................................................................................................................................... 38,734 38,734 38,734 ............................ ............................Voting Access for Individuals with Disabilities ................................................................................................ 4,963 4,963 4,963 ............................ ............................Developmental Disabilities Projects of National Significance .......................................................................... 10,000 10,000 10,000 ............................ ............................University Centers for Excellence in Developmental Disabilities ..................................................................... 38,619 38,619 38,619 ............................ ............................

Subtotal, Developmental Disabilities Programs ........................................................................................... 165,316 165,316 165,316 ............................ ............................
247 

Workforce Innovation and Opportunity Act Independent Living ................................................................................ 101,183 101,183 101,183 ............................ ............................

National Institute on Disability, Independent Living, and Rehabilitation Research ........................................ 103,970 103,970 103,970 ............................ ............................Assistive Technology .......................................................................................................................................... 34,000 32,000 32,000 ¥2,000 ............................

Subtotal, Workforce Innovation and Opportunity Act ................................................................................... 239,153 237,153 237,153 ¥2,000 ............................

Program Administration ............................................................................................................................................. 40,063 41,063 40,063 ............................ ¥1,000 

Total, Administration for Community Living [ACL] ...................................................................................... 1,964,850 1,993,294 1,907,735 ¥57,115 ¥85,559 

Federal funds ....................................................................................................................................... 1,912,735 1,941,179 1,907,735 ¥5,000 ¥33,444 Trust Funds .......................................................................................................................................... (52,115 ) (52,115 ) ............................ (¥52,115 ) (¥52,115 ) 

(Prevention and Public Health Fund) 1 ......................................................................................................... (27,700 ) (27,700 ) (27,700 ) ............................ ............................

Total, ACL program level ..................................................................................................................... 1,992,550 2,020,994 1,935,435 ¥57,115 ¥85,559 

OFFICE OF THE SECRETARY 

General Departmental Management 

General Departmental Management, Federal Funds ................................................................................................. 200,000 214,610 199,620 ¥380 ¥14,990 

Teen Pregnancy Prevention Community Grants ................................................................................................ 101,000 104,790 101,000 ............................ ¥3,790 Evaluation Tap Funding .................................................................................................................................... (6,800 ) (6,800 ) (6,800 ) ............................ ............................

Subtotal, Grants ............................................................................................................................................ (107,800 ) (111,590 ) (107,800 ) ............................ (¥3,790 ) 

Faith-Based Center .................................................................................................................................................... 1,299 1,382 1,299 ............................ ¥83 Sexual Risk Avoidance ............................................................................................................................................... 10,000 ............................ 15,000 ∂5,000 ∂15,000 Minority Health ........................................................................................................................................................... 56,670 56,670 50,000 ¥6,670 ¥6,670 Office of Women’s Health .......................................................................................................................................... 32,140 32,140 29,000 ¥3,140 ¥3,140 Minority HIV/AIDS prevention and treatment ............................................................................................................. 53,900 53,900 48,000 ¥5,900 ¥5,900 Embryo Adoption Awareness Campaign ..................................................................................................................... 1,000 ............................ 1,000 ............................ ∂1,000 Planning and Evaluation, Evaluation Tap Funding ................................................................................................... (58,028 ) (59,278 ) (58,028 ) ............................ (¥1,250 ) 

Subtotal, General Departmental Management ............................................................................................. 456,009 463,492 444,919 ¥11,090 ¥18,573 

DATA Act activities ..................................................................................................................................................... ............................ 10,320 ............................ ............................ ¥10,320 HHS Digital Service Team .......................................................................................................................................... ............................ 5,000 ............................ ............................ ¥5,000 

Total, General Departmental Management ................................................................................................... 456,009 478,812 444,919 ¥11,090 ¥33,893 

Federal Funds ...................................................................................................................................... (456,009 ) (478,812 ) (444,919 ) (¥11,090 ) (¥33,893 ) (Evaluation Tap Funding) .................................................................................................................... (64,828 ) (66,078 ) (64,828 ) ............................ (¥1,250 ) 

Total, General Departmental Management Program .................................................................................... 520,837 544,890 509,747 ¥11,090 ¥35,143 

Office of Medicare Hearings and Appeals ................................................................................................................. 107,381 120,000 112,381 ∂5,000 ¥7,619 Office of the National Coordinator for Health Information Technology ..................................................................... 60,367 ............................ 60,367 ............................ ∂60,367 
248 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Evaluation Tap Funding .................................................................................................................................... ............................ (82,000 ) ............................ ............................ (¥82,000 ) 

Total, Program Level ..................................................................................................................................... (60,367 ) (82,000 ) (60,367 ) ............................ (¥21,633 ) 

Office of Inspector General 

Inspector General Federal Funds ............................................................................................................................... 75,000 85,000 75,000 ............................ ¥10,000 

HCFAC funding (NA) .......................................................................................................................................... (333,893 ) ............................ (334,097 ) (∂204 ) (∂334,097 ) 

Total, Inspector General Program Level ....................................................................................................... (408,893 ) (85,000 ) (409,097 ) (∂204 ) (∂324,097 ) 

Office for Civil Rights 

Federal Funds ............................................................................................................................................................. 38,798 42,705 38,798 ............................ ¥3,907 

Retirement Pay and Medical Benefits for Commissioned Officers 

Retirement Payments ................................................................................................................................................. 441,977 457,459 457,459 ∂15,482 ............................Survivors Benefits ...................................................................................................................................................... 28,603 31,559 31,559 ∂2,956 ............................Dependents’ Medical Care ......................................................................................................................................... 115,608 141,390 141,390 ∂25,782 ............................

Total,Medical Benefits for Commissioned Officers ...................................................................................... 586,188 630,408 630,408 ∂44,220 ............................

Public Health and Social Services Emergency Fund [PHSSEF] 

Assistant Secretary for Preparedness and Response 

Operations .................................................................................................................................................................. 30,938 30,938 30,938 ............................ ............................Preparedness and Emergency Operations .................................................................................................................. 24,654 24,654 24,654 ............................ ............................National Disaster Medical System ............................................................................................................................. 49,904 55,054 49,904 ............................ ¥5,150 Hospital Preparedness Cooperative Agreement Grants: 

Formula Grants .................................................................................................................................................. 254,555 254,555 254,555 ............................ ............................

Biomedical Advanced Research and Development Authority [BARDA] ...................................................................... 511,700 511,700 511,700 ............................ ............................Policy and Planning ................................................................................................................................................... 14,877 14,877 14,877 ............................ ............................
249 

Project BioShield ........................................................................................................................................................ 510,000 350,000 510,000 ............................ ∂160,000 

Subtotal, Preparedness and Response ......................................................................................................... 1,396,628 1,241,778 1,396,628 ............................ ∂154,850 

Assistant Secretary for Administration 

Assistant Secretary for Administration, Cybersecurity ............................................................................................... 50,860 50,860 50,860 ............................ ............................Office of Security and Strategic Information ............................................................................................................. 7,470 7,470 7,470 ............................ ............................

Public Health and Science 

Medical Reserve Corps ............................................................................................................................................... 6,000 6,000 6,000 ............................ ............................Pandemic Influenza Preparedness ............................................................................................................................. 72,000 125,009 57,000 ¥15,000 ¥68,009 Pandemic Flu balances (Public Law 111–32) ........................................................................................................... ............................ ............................ (15,000 ) (∂15,000 ) (∂15,000 ) 

Subtotal, Non-pandemic flu/BioShield/Parklawn/Other construction ........................................................... 950,958 956,108 950,958 ............................ ¥5,150 Total, PHSSEF ................................................................................................................................................ 1,532,958 1,431,117 1,517,958 ¥15,000 ∂86,841 Total, PHSSEF, program level ....................................................................................................................... 1,532,958 1,431,117 1,532,958 ............................ ∂101,841 Total, Office of the Secretary ....................................................................................................................... 2,856,701 2,788,042 2,879,831 ∂23,130 ∂91,789 

Federal Funds ...................................................................................................................................... 2,749,320 2,668,042 2,767,450 ∂18,130 ∂99,408 Trust Funds .......................................................................................................................................... 107,381 120,000 112,381 ∂5,000 ¥7,619 (Evaluation Tap Funding) .................................................................................................................... (64,828 ) (148,078 ) (64,828 ) ............................ (¥83,250 ) 

Total, Office of the Secretary Program Level ............................................................................................... 2,921,529 2,936,120 2,959,659 ∂38,130 ∂23,539 Total, Title II, Health and Human Services .................................................................................................. 732,462,371 776,784,242 778,872,440 ∂46,410,069 ∂2,088,198 

Federal Funds ...................................................................................................................................... 727,944,631 771,768,378 774,357,815 ∂46,413,184 ∂2,589,437 

Current year ................................................................................................................................ (608,762,129 ) (642,648,926 ) (645,238,363 ) (∂36,476,234 ) (∂2,589,437 ) Fiscal year 2018 ......................................................................................................................... (119,182,502 ) (129,119,452 ) (129,119,452 ) (∂9,936,950 ) ............................

Trust Funds .......................................................................................................................................... 4,517,740 5,015,864 4,514,625 ¥3,115 ¥501,239 Pandemic Flu balances (Public Law 111–32) .................................................................................... (15,000 ) ............................ (30,000 ) (∂15,000 ) (∂30,000 ) 

Total, Prevention and Public Health Fund 1 ................................................................................................. (932,000 ) (1,000,000 ) (931,000 ) (¥1,000 ) (¥69,000 ) 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies [LEAs] Basic Grants: 

Advance from prior year .................................................................................................................................... (2,890,776 ) (2,390,776 ) (2,390,776 ) (¥500,000 ) ............................Forward funded ................................................................................................................................................. 4,064,641 4,513,625 4,564,641 ∂500,000 ∂51,016 Current funded .................................................................................................................................................. 3,984 5,000 3,984 ............................ ¥1,016 
250 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Subtotal, Basic grants current year approp ................................................................................................ 4,068,625 4,518,625 4,568,625 ∂500,000 ∂50,000 Subtotal, Basic grants total funds available .............................................................................................. (6,959,401 ) (6,909,401 ) (6,959,401 ) ............................ (∂50,000 ) 

Basic Grants fiscal year 2018 Advance ........................................................................................................... 2,390,776 1,940,776 1,890,776 ¥500,000 ¥50,000 

Subtotal, Basic grants, program level ......................................................................................................... 6,459,401 6,459,401 6,459,401 ............................ ............................

Concentration Grants: 

Advance from prior year ........................................................................................................................... (1,362,301 ) (1,362,301 ) (1,362,301 ) ............................ ............................Fiscal year 2018 Advance ........................................................................................................................ 1,362,301 1,362,301 1,362,301 ............................ ............................

Subtotal ................................................................................................................................................ 1,362,301 1,362,301 1,362,301 ............................ ............................

Targeted Grants: 

Advance from prior year ........................................................................................................................... (3,294,050 ) (3,544,050 ) (3,544,050 ) (∂250,000 ) ............................Fiscal year 2018 Advance ........................................................................................................................ 3,544,050 3,769,050 3,794,050 ∂250,000 ∂25,000 

Subtotal ................................................................................................................................................ 3,544,050 3,769,050 3,794,050 ∂250,000 ∂25,000 

Education Finance Incentive Grants: 

Advance from prior year ........................................................................................................................... (3,294,050 ) (3,544,050 ) (3,544,050 ) (∂250,000 ) ............................Fiscal year 2018 Advance ........................................................................................................................ 3,544,050 3,769,050 3,794,050 ∂250,000 ∂25,000 

Subtotal ................................................................................................................................................ 3,544,050 3,769,050 3,794,050 ∂250,000 ∂25,000 

Subtotal, Grants to LEAs, program level ...................................................................................................... 14,909,802 15,359,802 15,409,802 ∂500,000 ∂50,000 

School Improvement Grants ....................................................................................................................................... 450,000 ............................ ............................ ¥450,000 ............................Innovative Approaches to Literacy ............................................................................................................................. 27,000 27,000 27,000 ............................ ............................Comprehensive literacy development grants (formerly Striving Readers) ................................................................ 190,000 190,000 190,000 ............................ ............................State Agency Programs: 

Migrant .............................................................................................................................................................. 374,751 374,751 374,751 ............................ ............................Neglected and Delinquent/High Risk Youth ...................................................................................................... 47,614 47,614 47,614 ............................ ............................
251 

Subtotal, State Agency programs ................................................................................................................. 422,365 422,365 422,365 ............................ ............................

Migrant Education: 

High School Equivalency Program .................................................................................................................... 44,623 44,623 44,623 ............................ ............................

Total, Education for the disadvantaged ....................................................................................................... 16,043,790 16,043,790 16,093,790 ∂50,000 ∂50,000 

Current Year ......................................................................................................................................... (5,202,613 ) (5,202,613 ) (5,252,613 ) (∂50,000 ) (∂50,000 ) Fiscal year 2018 .................................................................................................................................. (10,841,177 ) (10,841,177 ) (10,841,177 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................................. (5,127,006 ) (5,125,990 ) (5,177,006 ) (∂50,000 ) (∂51,016 ) 

IMPACT AID 

Basic Support Payments ............................................................................................................................................ 1,168,233 1,168,233 1,176,233 ∂8,000 ∂8,000 Payments for Children with Disabilities .................................................................................................................... 48,316 48,316 48,316 ............................ ............................Facilities Maintenance (Sec. 8008) ........................................................................................................................... 4,835 71,648 4,835 ............................ ¥66,813 Construction (Sec. 8007) ........................................................................................................................................... 17,406 17,406 17,406 ............................ ............................Payments for Federal Property (Sec. 8002) ............................................................................................................... 66,813 ............................ 68,813 ∂2,000 ∂68,813 

Total, Impact aid .......................................................................................................................................... 1,305,603 1,305,603 1,315,603 ∂10,000 ∂10,000 

SCHOOL IMPROVEMENT PROGRAMS 

State Grants for Supporting Effective Instruction ..................................................................................................... 668,389 568,559 374,389 ¥294,000 ¥194,170 

Advance from prior year .................................................................................................................................... (1,681,441 ) (1,681,441 ) (1,681,441 ) ............................ ............................Fiscal year 2018 ................................................................................................................................................ 1,681,441 1,681,441 1,681,441 ............................ ............................

Subtotal, State Grants for Improving Teacher Quality, program level ........................................................ 2,349,830 2,250,000 2,055,830 ¥294,000 ¥194,170 

Mathematics and Science Partnerships .................................................................................................................... 152,717 ............................ ............................ ¥152,717 ............................Supplemental Education Grants ................................................................................................................................ 16,699 16,699 16,699 ............................ ............................21st Century Community Learning Centers ............................................................................................................... 1,166,673 1,000,000 1,050,000 ¥116,673 ∂50,000 State Assessments/Enhanced Assessment Instruments ............................................................................................ 378,000 403,000 378,000 ............................ ¥25,000 Education for Homeless Children and Youth ............................................................................................................. 70,000 85,000 77,000 ∂7,000 ¥8,000 Training and Advisory Services (Civil Rights) ........................................................................................................... 6,575 6,575 6,575 ............................ ............................Education for Native Hawaiians ................................................................................................................................ 33,397 33,397 33,397 ............................ ............................Alaska Native Education Equity ................................................................................................................................. 32,453 32,453 32,453 ............................ ............................Rural Education .......................................................................................................................................................... 175,840 175,840 175,840 ............................ ............................Comprehensive Centers .............................................................................................................................................. 51,445 55,445 51,445 ............................ ¥4,000 Student Support and Academic Enrichment grants .................................................................................................. ............................ 500,000 300,000 ∂300,000 ¥200,000 

Total, School Improvement Programs ........................................................................................................... 4,433,629 4,558,409 4,177,239 ¥256,390 ¥381,170 

Current Year ......................................................................................................................................... (2,752,188 ) (2,876,968 ) (2,495,798 ) (¥256,390 ) (¥381,170 ) Fiscal year 2018 .................................................................................................................................. (1,681,441 ) (1,681,441 ) (1,681,441 ) ............................ ............................
252 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Subtotal, Forward Funded ............................................................................................................................. (2,611,619 ) (2,232,399 ) (2,055,229 ) (¥556,390 ) (¥177,170 ) 

INDIAN EDUCATION 

Grants to Local Educational Agencies ....................................................................................................................... 100,381 100,381 100,381 ............................ ............................Federal Programs: 

Special Programs for Indian Children .............................................................................................................. 37,993 67,993 37,993 ............................ ¥30,000 National Activities ............................................................................................................................................. 5,565 6,565 5,565 ............................ ¥1,000 

Subtotal, Federal Programs .......................................................................................................................... 43,558 74,558 43,558 ............................ ¥31,000 Total, Indian Education ................................................................................................................................ 143,939 174,939 143,939 ............................ ¥31,000 

INNOVATION AND IMPROVEMENT 

Education Innovation and Research .......................................................................................................................... 120,000 180,000 120,000 ............................ ¥60,000 STEM Master Teacher Corps ...................................................................................................................................... ............................ 10,000 ............................ ............................ ¥10,000 American History and Civics Academies ................................................................................................................... 1,815 1,815 1,815 ............................ ............................School Leader Recruitment and Support ................................................................................................................... 16,368 30,000 16,368 ............................ ¥13,632 Charter Schools Grants .............................................................................................................................................. 333,172 350,000 343,172 ∂10,000 ¥6,828 Magnet Schools Assistance ........................................................................................................................................ 96,647 115,000 96,647 ............................ ¥18,353 Fund for the Improvement of Education [FIE] ........................................................................................................... 3,000 ............................ ............................ ¥3,000 ............................Teacher and School Leader Incentive Grants ............................................................................................................ 230,000 250,000 213,000 ¥17,000 ¥37,000 Ready-to-Learn television ........................................................................................................................................... 25,741 25,741 25,741 ............................ ............................Advanced Placement .................................................................................................................................................. 28,483 ............................ ............................ ¥28,483 ............................Supporting Effective Educator Development [SEED] ................................................................................................. ............................ 100,000 87,000 ∂87,000 ¥13,000 Art in Education ......................................................................................................................................................... 27,000 27,000 27,000 ............................ ............................Javits Giffted and Talented Students ........................................................................................................................ 12,000 12,000 12,000 ............................ ............................Teach to Lead (proposed legislation) ........................................................................................................................ ............................ 10,000 ............................ ............................ ¥10,000 Stronger Together (proposed legislation) ................................................................................................................... ............................ 120,000 ............................ ............................ ¥120,000 Next Generation High Schools (proposed legislation) ................................................................................................ ............................ 80,000 ............................ ............................ ¥80,000 Computer Science for All Development Grants (proposed legislation) ..................................................................... ............................ 100,000 ............................ ............................ ¥100,000 
253 

Total, Innovation and Improvement .............................................................................................................. 894,226 1,411,556 942,743 ∂48,517 ¥468,813 

Current Year ......................................................................................................................................... (894,226 ) (1,411,556 ) (942,743 ) (∂48,517 ) (¥468,813 ) 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Promise Neighborhoods .............................................................................................................................................. 73,254 128,000 73,254 ............................ ¥54,746 School Safety National Activities ............................................................................................................................... 75,000 90,000 70,000 ¥5,000 ¥20,000 Elementary and Secondary School Counseling .......................................................................................................... 49,561 ............................ ............................ ¥49,561 ............................Carol M. White Physical Education Program ............................................................................................................. 47,000 ............................ ............................ ¥47,000 ............................Full-Service Community Schools ................................................................................................................................ 10,000 10,000 ............................ ¥10,000 ¥10,000 

Total, Safe Schools and Citizenship Education ........................................................................................... 254,815 228,000 143,254 ¥111,561 ¥84,746 

ENGLISH LANGUAGE ACQUISITION 

Current funded ........................................................................................................................................................... 47,931 52,026 47,931 ............................ ¥4,095 Forward funded .......................................................................................................................................................... 689,469 748,374 689,469 ............................ ¥58,905 

Total, English Language Acquisition ............................................................................................................ 737,400 800,400 737,400 ............................ ¥63,000 

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year ............................................................................................................... 2,629,465 2,629,465 2,669,465 ∂40,000 ∂40,000 

Part B advance from prior year ............................................................................................................... (9,283,383 ) (9,283,383 ) (9,283,383 ) ............................ ............................

Grants to States Part B (fiscal year 2018) ...................................................................................................... 9,283,383 9,283,383 9,283,383 ............................ ............................

Subtotal, program level ................................................................................................................................ 11,912,848 11,912,848 11,952,848 ∂40,000 ∂40,000 

Preschool Grants ............................................................................................................................................... 368,238 403,238 368,238 ............................ ¥35,000 Grants for Infants and Families ....................................................................................................................... 458,556 503,556 458,556 ............................ ¥45,000 

Subtotal, program level ................................................................................................................................ 12,739,642 12,819,642 12,779,642 ∂40,000 ¥40,000 

IDEA National Activities (current funded): 

State Personnel Development ............................................................................................................................ 41,630 41,630 41,630 ............................ ............................Technical Assistance and Dissemination (including Special Olympics Education) ......................................... 54,428 64,428 56,928 ∂2,500 ¥7,500 Personnel Preparation ....................................................................................................................................... 83,700 83,700 83,700 ............................ ............................Parent Information Centers ............................................................................................................................... 27,411 27,411 27,411 ............................ ............................Technology and Media Services ........................................................................................................................ 30,047 30,047 30,047 ............................ ............................

Subtotal, IDEA special programs .................................................................................................................. 237,216 247,216 239,716 ∂2,500 ¥7,500 Total, Special education ............................................................................................................................... 12,976,858 13,066,858 13,019,358 ∂42,500 ¥47,500 
254 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Current Year ......................................................................................................................................... (3,693,475 ) (3,783,475 ) (3,735,975 ) (∂42,500 ) (¥47,500 ) Fiscal year 2018 .................................................................................................................................. (9,283,383 ) (9,283,383 ) (9,283,383 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................................. (3,456,259 ) (3,536,259 ) (3,496,259 ) (∂40,000 ) (¥40,000 ) 

REHABILITATION SERVICES AND DISABILITY RESEARCH 

Vocational Rehabilitation State Grants ..................................................................................................................... 3,391,770 3,398,554 3,398,554 ∂6,784 ............................Client Assistance State grants .................................................................................................................................. 13,000 13,000 13,000 ............................ ............................Training ...................................................................................................................................................................... 30,188 30,188 30,188 ............................ ............................Demonstration and Training programs ...................................................................................................................... 5,796 5,796 5,796 ............................ ............................Protection and Advocacy of Individual Rights [PAIR] ............................................................................................... 17,650 17,650 17,650 ............................ ............................Supported Employment State grants ......................................................................................................................... 27,548 30,548 27,548 ............................ ¥3,000 Independent Living: 

Services for Older Blind Individuals ................................................................................................................. 33,317 35,317 33,317 ............................ ¥2,000 

Subtotal ......................................................................................................................................................... 33,317 35,317 33,317 ............................ ¥2,000 

Helen Keller National Center for Deaf/Blind Youth and Adults ................................................................................ 10,336 10,336 10,336 ............................ ............................Assistive Technology ................................................................................................................................................... ............................ ............................ ............................ ............................ ............................

Total, Rehabilitation services ....................................................................................................................... 3,529,605 3,541,389 3,536,389 ∂6,784 ¥5,000 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

American Printing House for the Blind ...................................................................................................................... 25,431 25,431 25,431 ............................ ............................National Technical Institute for the Deaf [NTID]: 

Operations ......................................................................................................................................................... 70,016 70,016 70,016 ............................ ............................

Gallaudet University: 

Operations ......................................................................................................................................................... 121,275 121,275 121,275 ............................ ............................

Total, Gallaudet University ........................................................................................................................... 121,275 121,275 121,275 ............................ ............................Total, Special Institutions for Persons with Disabilities .............................................................................. 216,722 216,722 216,722 ............................ ............................
255 

CAREER, TECHNICAL, AND ADULT EDUCATION 

Career Education: 

Basic State Grants/Secondary & Technical Education State Grants, current funded ..................................... 326,598 401,598 326,598 ............................ ¥75,000 

Advance from prior year ........................................................................................................................... (791,000 ) (791,000 ) (791,000 ) ............................ ............................Fiscal year 2018 ....................................................................................................................................... 791,000 791,000 791,000 ............................ ............................

Subtotal, Basic State Grants, program level ...................................................................................... 1,117,598 1,192,598 1,117,598 ............................ ¥75,000 

National Programs ............................................................................................................................................. 7,421 9,421 7,421 ............................ ¥2,000 

Subtotal, Career Education ........................................................................................................................... 1,125,019 1,202,019 1,125,019 ............................ ¥77,000 

Adult Education: 

State Grants/Adult Basic and Literacy Education: 

State Grants, current funded ................................................................................................................... 581,955 581,955 581,955 ............................ ............................

National Leadership Activities ................................................................................................................................... 13,712 24,712 13,712 ............................ ¥11,000 

Subtotal, Adult education ............................................................................................................................. 595,667 606,667 595,667 ............................ ¥11,000 Total, Career, Technical, and Adult Education ............................................................................................ 1,720,686 1,808,686 1,720,686 ............................ ¥88,000 

Current Year ......................................................................................................................................... (929,686 ) (1,017,686 ) (929,686 ) ............................ (¥88,000 ) Fiscal year 2018 .................................................................................................................................. (791,000 ) (791,000 ) (791,000 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................................. (929,686 ) (1,017,686 ) (929,686 ) ............................ (¥88,000 ) 

STUDENT FINANCIAL ASSISTANCE 

Pell Grants—maximum grant (NA) ........................................................................................................................... (4,860 ) (4,860 ) (4,860 ) ............................ ............................Pell Grants .................................................................................................................................................................. 22,475,352 22,475,352 22,475,352 ............................ ............................Federal Supplemental Educational Opportunity Grants ............................................................................................. 733,130 733,130 733,130 ............................ ............................Federal Work Study ..................................................................................................................................................... 989,728 989,728 989,728 ............................ ............................

Total, Student Financial Assistance [SFA] ................................................................................................... 24,198,210 24,198,210 24,198,210 ............................ ............................

STUDENT AID ADMINISTRATION 

Salaries and Expenses ............................................................................................................................................... 696,643 732,352 691,643 ¥5,000 ¥40,709 Servicing Activities ..................................................................................................................................................... 855,211 899,638 855,211 ............................ ¥44,427 

Total, Student Aid Administration ................................................................................................................ 1,551,854 1,631,990 1,546,854 ¥5,000 ¥85,136 
256 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

HIGHER EDUCATION 

Aid for Institutional Development: 

Strengthening Institutions ................................................................................................................................. 86,534 86,534 86,534 ............................ ............................Hispanic Serving Institutions ............................................................................................................................ 107,795 107,795 107,795 ............................ ............................Promoting Post-Baccalaureate Opportunities for Hispanic Americans ............................................................ 9,671 9,671 9,671 ............................ ............................Strengthening Historically Black Colleges [HBCUs] ......................................................................................... 244,694 244,694 244,694 ............................ ............................Strengthening Historically Black Graduate Institutions ................................................................................... 63,281 63,281 63,281 ............................ ............................Strengthening Predominantly Black Institutions .............................................................................................. 9,942 9,942 9,942 ............................ ............................Asian American Pacific Islander ....................................................................................................................... 3,348 3,348 3,348 ............................ ............................Strengthening Alaska Native and Native Hawaiian-Serving Institutions ......................................................... 13,802 13,802 13,802 ............................ ............................Strengthening Native American-Serving Nontribal Institutions ........................................................................ 3,348 3,348 3,348 ............................ ............................Strengthening Tribal Colleges ........................................................................................................................... 27,599 27,599 27,599 ............................ ............................Strengthening HBCU Masters programs ........................................................................................................... ............................ ............................ 9,500 ∂9,500 ∂9,500 

Subtotal, Aid for Institutional development ................................................................................................. 570,014 570,014 579,514 ∂9,500 ∂9,500 

International Education and Foreign Language: 

Domestic Programs ........................................................................................................................................... 65,103 65,103 65,103 ............................ ............................Overseas Programs ............................................................................................................................................ 7,061 2,168 2,168 ¥4,893 ............................

Subtotal, International Education & Foreign Lang ...................................................................................... 72,164 67,271 67,271 ¥4,893 ............................

Fund for the Improvement of Postsec. Ed. [FIPSE]–First in the World ..................................................................... ............................ 100,000 ............................ ............................ ¥100,000 Postsecondary Program for Students with Intellectual Disabilities .......................................................................... 11,800 11,800 11,800 ............................ ............................Minority Science and Engineering Improvement ........................................................................................................ 9,648 9,648 9,648 ............................ ............................Tribally Controlled Postsec Voc/Tech Institutions ...................................................................................................... 8,286 8,286 8,286 ............................ ............................Federal TRIO Programs ............................................................................................................................................... 900,000 900,000 900,000 ............................ ............................GEAR UP ..................................................................................................................................................................... 322,754 322,754 322,754 ............................ ............................Graduate Assistance in Areas of National Need ....................................................................................................... 29,293 29,293 29,293 ............................ ............................Teacher Quality Partnerships ..................................................................................................................................... 43,092 ............................ 43,092 ............................ ∂43,092 Child Care Access Means Parents in School ............................................................................................................. 15,134 15,134 15,134 ............................ ............................HCBU and Minority-Serving Institutions Innovation for Completion Fund (proposed legislation) ............................ ............................ 30,000 ............................ ............................ ¥30,000 
257 

Teacher and Principal Pathways (proposed legislation) ........................................................................................... ............................ 125,000 ............................ ............................ ¥125,000 

Total, Higher Education ................................................................................................................................ 1,982,185 2,189,200 1,986,792 ∂4,607 ¥202,408 

HOWARD UNIVERSITY 

Academic Program ..................................................................................................................................................... 191,091 191,091 191,091 ............................ ............................Endowment Program .................................................................................................................................................. 3,405 3,405 3,405 ............................ ............................Howard University Hospital ........................................................................................................................................ 27,325 27,325 27,325 ............................ ............................

Total, Howard University ............................................................................................................................... 221,821 221,821 221,821 ............................ ............................

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM ............................................................................ 435 457 435 ............................ ¥22 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY [HBCU] 

CAPITAL FINANCING PROGRAM ACCOUNT 

HBCU Federal Administration ..................................................................................................................................... 334 349 334 ............................ ¥15 HBCU Loan Subsidies ................................................................................................................................................. 20,150 20,150 20,150 ............................ ............................

Total, HBCU Capital Financing Program ...................................................................................................... 20,484 20,499 20,484 ............................ ¥15 

INSTITUTE OF EDUCATION SCIENCES [IES] 

Research, Development and Dissemination ............................................................................................................... 195,000 209,273 190,000 ¥5,000 ¥19,273 Statistics .................................................................................................................................................................... 112,000 125,360 112,000 ............................ ¥13,360 Regional Educational Laboratories ............................................................................................................................ 54,423 54,423 54,423 ............................ ............................Research in Special Education .................................................................................................................................. 54,000 54,000 54,000 ............................ ............................Special Education Studies and Evaluations .............................................................................................................. 10,818 13,000 10,818 ............................ ¥2,182 Statewide Data Systems ............................................................................................................................................ 34,539 81,017 34,539 ............................ ¥46,478 Assessment: 

National Assessment ......................................................................................................................................... 149,000 149,000 149,000 ............................ ............................National Assessment Governing Board ............................................................................................................. 8,235 7,745 7,745 ¥490 ............................

Subtotal, Assessment ................................................................................................................................... 157,235 156,745 156,745 ¥490 ............................Total, IES ....................................................................................................................................................... 618,015 693,818 612,525 ¥5,490 ¥81,293 

DEPARTMENTAL MANAGEMENT 

Program Administration: 

Salaries and Expenses ...................................................................................................................................... 431,000 450,342 431,000 ............................ ¥19,342 Building Modernization ...................................................................................................................................... 1,000 24,485 1,000 ............................ ¥23,485 
258 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Total, Program administration ...................................................................................................................... 432,000 474,827 432,000 ............................ ¥42,827 

Office for Civil Rights ................................................................................................................................................ 107,000 137,708 110,000 ∂3,000 ¥27,708 Office of Inspector General ........................................................................................................................................ 59,256 61,941 59,256 ............................ ¥2,685 

Total, Departmental management ................................................................................................................ 598,256 674,476 601,256 ∂3,000 ¥73,220 Total, Title III, Department of Education ...................................................................................................... 71,448,533 72,786,823 71,235,500 ¥213,033 ¥1,551,323 

Current Year ......................................................................................................................................... (48,851,532 ) (50,189,822 ) (48,638,499 ) (¥213,033 ) (¥1,551,323 ) Fiscal year 2018 .................................................................................................................................. (22,597,001 ) (22,597,001 ) (22,597,001 ) ............................ ............................

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED ........................................... 6,191 10,612 8,000 ∂1,809 ¥2,612 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 

Operating Expenses 

Domestic Volunteer Service Programs: 

Volunteers in Service to America [VISTA] ......................................................................................................... 92,364 95,880 92,364 ............................ ¥3,516 National Senior Volunteer Corps: 

Foster Grandparents Program .................................................................................................................. 107,702 107,702 107,702 ............................ ............................Senior Companion Program ...................................................................................................................... 45,512 45,512 45,512 ............................ ............................Retired Senior Volunteer Program ............................................................................................................ 48,903 48,903 48,903 ............................ ............................

Subtotal, Senior Volunteers ................................................................................................................. 202,117 202,117 202,117 ............................ ............................

Subtotal, Domestic Volunteer Service ........................................................................................................... 294,481 297,997 294,481 ............................ ¥3,516 

National and Community Service Programs: 

AmeriCorps State and National Grants ............................................................................................................ 386,010 386,010 386,010 ............................ ............................Innovation, Assistance, and Other Activities .................................................................................................... 57,400 57,601 5,000 ¥52,400 ¥52,601 Evaluation .......................................................................................................................................................... 4,000 6,000 4,000 ............................ ¥2,000 National Civilian Community Corps [NCCC] ..................................................................................................... 30,000 30,000 30,000 ............................ ............................
259 

State Commission Support Grants .................................................................................................................... 16,038 17,000 17,038 ∂1,000 ∂38 

Subtotal, National and Community Service ................................................................................................. 493,448 496,611 442,048 ¥51,400 ¥54,563 Total, Operating expenses ............................................................................................................................ 787,929 794,608 736,529 ¥51,400 ¥58,079 

National Service Trust ................................................................................................................................................ 220,000 206,842 206,842 ¥13,158 ............................Salaries and Expenses ............................................................................................................................................... 81,737 89,330 81,737 ............................ ¥7,593 Office of Inspector General ........................................................................................................................................ 5,250 6,100 5,250 ............................ ¥850 

Total, Corp. for National and Community Service ....................................................................................... 1,094,916 1,096,880 1,030,358 ¥64,558 ¥66,522 

CORPORATION FOR PUBLIC BROADCASTING: 

Fiscal year 2019 (current) with fiscal year 2017 comparable ........................................................................ 445,000 445,000 445,000 ............................ ............................Fiscal year 2018 advance with fiscal year 2016 comparable (NA) ................................................................. (445,000 ) (445,000 ) (445,000 ) ............................ ............................Fiscal year 2017 advance with fiscal year 2015 comparable (NA) ................................................................. (445,000 ) (445,000 ) (445,000 ) ............................ ............................Public television interconnection system (current) ........................................................................................... 40,000 50,000 50,000 ∂10,000 ............................

FEDERAL MEDIATION AND CONCILIATION SERVICE .................................................................................................... 48,748 50,738 48,638 ¥110 ¥2,100 FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION ...................................................................................... 17,085 17,184 17,184 ∂99 ............................INSTITUTE OF MUSEUM AND LIBRARY SERVICES ....................................................................................................... 230,000 230,000 231,000 ∂1,000 ∂1,000 MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION ....................................................................................... 7,765 8,700 7,765 ............................ ¥935 MEDICARE PAYMENT ADVISORY COMMISSION ........................................................................................................... 11,925 12,234 11,925 ............................ ¥309 NATIONAL COUNCIL ON DISABILITY ............................................................................................................................ 3,250 3,468 3,439 ∂189 ¥29 NATIONAL LABOR RELATIONS BOARD ......................................................................................................................... 274,224 274,695 274,224 ............................ ¥471 NATIONAL MEDIATION BOARD ..................................................................................................................................... 13,230 13,300 14,000 ∂770 ∂700 OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION ..................................................................................... 12,639 13,411 13,411 ∂772 ............................

RAILROAD RETIREMENT BOARD 

Dual Benefits Payments Account ............................................................................................................................... 29,000 25,000 25,000 ¥4,000 ............................Less Income Tax Receipts on Dual Benefits ............................................................................................................. ¥2,000 ¥2,000 ¥2,000 ............................ ............................

Subtotal, Dual Benefits ................................................................................................................................ 27,000 23,000 23,000 ¥4,000 ............................

Federal Payments to the Railroad Retirement Accounts ........................................................................................... 150 150 150 ............................ ............................Limitation on Administration ..................................................................................................................................... 111,225 122,499 113,500 ∂2,275 ¥8,999 Limitation on the Office of Inspector General ........................................................................................................... 8,437 10,499 10,000 ∂1,563 ¥499 

SOCIAL SECURITY ADMINISTRATION 

Payments to Social Security Trust Funds .................................................................................................................. 11,400 11,400 11,400 ............................ ............................

Supplemental Security Income Program 

Federal Benefit Payments .......................................................................................................................................... 60,686,000 52,941,736 52,941,736 ¥7,744,264 ............................
260 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2016 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2017—Continued 

[In thousands of dollars] 

Item 2016 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation 

compared with (∂ or ¥) 

2016 appropriation Budget estimate 

Beneficiary Services ................................................................................................................................................... 70,000 89,000 89,000 ∂19,000 ............................Research and Demonstration ..................................................................................................................................... 101,000 58,000 58,000 ¥43,000 ............................Afghanistan Special Immigrant Visa ......................................................................................................................... ............................ 2,000 ............................ ............................ ¥2,000 Administration ............................................................................................................................................................ 4,648,733 5,234,132 5,029,427 ∂380,694 ¥204,705 

Subtotal, SSI program level .......................................................................................................................... 65,505,733 58,324,868 58,118,163 ¥7,387,570 ¥206,705 

Less funds advanced in prior year ..................................................................................................... ¥19,200,000 ¥14,500,000 ¥14,500,000 ∂4,700,000 ............................

Subtotal, regular SSI current year ................................................................................................................ 46,305,733 43,824,868 43,618,163 ¥2,687,570 ¥206,705 

New advance, 1st quarter, fiscal year 2018 ...................................................................................... 14,500,000 15,000,000 15,000,000 ∂500,000 ............................

Total, SSI program ........................................................................................................................................ 60,805,733 58,824,868 58,618,163 ¥2,187,570 ¥206,705 

Limitation on Administrative Expenses 

OASI/DI Trust Funds ................................................................................................................................................... 5,100,054 5,702,038 5,145,407 ∂45,353 ¥556,631 HI/SMI Trust Funds ..................................................................................................................................................... 1,777,800 2,001,330 1,684,753 ¥93,047 ¥316,577 Social Security Advisory Board ................................................................................................................................... 2,300 2,500 2,300 ............................ ¥200 SSI .............................................................................................................................................................................. 3,718,791 3,415,132 3,706,485 ¥12,306 ∂291,353 

Subtotal, regular LAE .................................................................................................................................... 10,598,945 11,121,000 10,538,945 ¥60,000 ¥582,055 

User Fees: 

SSI User Fee activities ...................................................................................................................................... 136,000 126,000 126,000 ¥10,000 ............................

CBO adjustment ....................................................................................................................................... ............................ ¥3,000 ¥3,000 ¥3,000 ............................

SSPA User Fee Activities ................................................................................................................................... 1,000 1,000 1,000 ............................ ............................

Subtotal, User fees ....................................................................................................................................... 137,000 124,000 124,000 ¥13,000 ............................Subtotal, Limitation on administrative expenses ......................................................................................... 10,735,945 11,245,000 10,662,945 ¥73,000 ¥582,055 

Program Integrity: 

OASDI Trust Funds ............................................................................................................................................ 496,058 1,819,000 496,058 ............................ ¥1,322,942 
261 

SSI ..................................................................................................................................................................... 929,942 ............................ 1,322,942 ∂393,000 ∂1,322,942 

Subtotal, Program integrity funding ............................................................................................................. 1,426,000 1,819,000 1,819,000 ∂393,000 ............................Total, Limitation on Administrative Expenses .............................................................................................. 12,161,945 13,064,000 12,481,945 ∂320,000 ¥582,055 

Office of Inspector General 

Federal Funds ............................................................................................................................................................. 29,787 31,000 29,787 ............................ ¥1,213 Trust Funds ................................................................................................................................................................ 75,713 81,000 75,713 ............................ ¥5,287 

Total, Office of Inspector General ................................................................................................................ 105,500 112,000 105,500 ............................ ¥6,500 

Adjustment: Trust fund transfers from general revenues ......................................................................................... ¥4,648,733 ¥5,234,132 ¥5,029,427 ¥380,694 ∂204,705 

Total, Social Security Administration ........................................................................................................... 68,435,845 66,778,136 66,187,581 ¥2,248,264 ¥590,555 

Federal funds ....................................................................................................................................... 60,983,920 58,991,268 58,783,350 ¥2,200,570 ¥207,918 

Current year ................................................................................................................................ (46,483,920 ) (43,991,268 ) (43,783,350 ) (¥2,700,570 ) (¥207,918 ) New advances, 1st quarter, fiscal year 2018 ............................................................................ (14,500,000 ) (15,000,000 ) (15,000,000 ) (∂500,000 ) ............................

Trust funds .......................................................................................................................................... 7,451,925 7,786,868 7,404,231 ¥47,694 ¥382,637 

Total, Title IV, Related Agencies .................................................................................................................. 70,787,630 69,160,506 68,489,175 ¥2,298,455 ¥671,331 

Federal Funds ...................................................................................................................................... 63,204,118 61,228,406 60,949,519 ¥2,254,599 ¥278,887 

Current Year ................................................................................................................................ (48,259,118 ) (45,783,406 ) (45,504,519 ) (¥2,754,599 ) (¥278,887 ) Current Year (emergency) ........................................................................................................... ............................ ............................ ............................ ............................ ............................Fiscal year 2018 Advance .......................................................................................................... (14,500,000 ) (15,000,000 ) (15,000,000 ) (∂500,000 ) ............................Fiscal year 2018 Advance .......................................................................................................... (445,000 ) (445,000 ) (445,000 ) ............................ ............................

Trust Funds .......................................................................................................................................... 7,583,512 7,932,100 7,539,656 ¥43,856 ¥392,444 

Grand Total, current year ................................................................................................................ 888,428,751 933,107,118 932,211,568 ∂43,782,817 ¥895,550 

1 Section 4002 of Public Law 111–148. 2 Fiscal year 2016 funds of $50 million provided under Substance Abuse and Mental Health Services Administration. Fiscal year 2017 funds proposed under Health Resources and Services Administration. 

Æ