81–835 PDF 

Calendar No. 128 

113TH CONGRESS REPORT " ! SENATE 1st Session 113–71 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL, 2014 

JULY 11, 2013.—Ordered to be printed 

Mr. HARKIN, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

[To accompany S. 1284] 

The Committee on Appropriations reports the bill (S. 1284) making appropriations for Departments of Labor, Health and Human 

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

ending September 30, 2014, and for other purposes, reports favorably thereon and recommends that the bill do pass. 

Amounts in new budget authority 

Total of bill as reported to the Senate ............. $783,365,379,000 

Amount of 2013 appropriations 1 2 .................... 757,440,498,000 

Amount of 2014 budget estimate ...................... 787,803,163,000 

Bill as recommended to Senate compared to— 

2013 appropriations .................................... ∂25,924,881,000 

2014 budget estimate ................................. ¥4,437,784,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25. 

2 Includes emergency funding of $825,000,000 in the Disaster Relief Appropriations Act, 2013 (division A 

of Public Law 113–2). 
(2) 

C O N T E N T S 

Page 

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

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

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

Reducing Healthcare Costs .............................................................................. 8 

Early Childhood Care and Education ............................................................. 9 

Improving Fiscal Accountability ...................................................................... 10 

Promoting Policy Reform ................................................................................. 11 

Prevention ......................................................................................................... 11 

Reducing Violence—Now is the Time ............................................................. 12 

Assisting People With Disabilities .................................................................. 13 

Helping America’s Workers ............................................................................. 13 

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

Title I: Department of Labor: 

Employment and Training Administration .................................................... 16 

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 ................................................... 30 

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

Mine Safety and Health Administration ........................................................ 33 

Bureau of Labor Statistics ............................................................................... 34 

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 .................................................. 58 

National Institutes of Health .......................................................................... 83 

Substance Abuse and Mental Health Services Administration .................... 111 

Agency for Healthcare Research and Quality ................................................ 119 

Centers for Medicare and Medicaid Services ................................................. 122 

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

Administration for Community Living ........................................................... 140 

Office of the Secretary ...................................................................................... 145 

General Provisions ........................................................................................... 155 

Title III: Department of Education: 

Education for the Disadvantaged .................................................................... 158 

School Readiness .............................................................................................. 161 

Impact Aid ......................................................................................................... 162 

School Improvement Programs ........................................................................ 163 

Indian Education .............................................................................................. 168 

Innovation and Improvement .......................................................................... 169 

Safe Schools and Citizenship Education ......................................................... 176 

English Language Acquisition ......................................................................... 177 

Special Education ............................................................................................. 178 

Rehabilitation Services and Disability Research ........................................... 181 

Special Institutions for Persons With Disabilities: 

American Printing House for the Blind ................................................... 185 

National Technical Institute for the Deaf ............................................... 185 

Gallaudet University ................................................................................. 186 

Career, Technical, and Adult Education ........................................................ 186 

Student Financial Assistance .......................................................................... 188 
Page

3 

Title III—Continued 

Student Aid Administration ............................................................................ 191 

Higher Education ............................................................................................. 192 

Howard University ........................................................................................... 199 

College Housing and Academic Facilities Loans Program ............................ 200 

Historically Black College and University Capital Financing Program 

Account .......................................................................................................... 200 

Institute of Education Sciences ....................................................................... 201 

Departmental Management: 

Program Administration ........................................................................... 203 

Office for Civil Rights ............................................................................... 204 

Office of the Inspector General ................................................................ 205 

General Provisions ........................................................................................... 205 

Title IV: Related Agencies: 

Committee for Purchase From People Who Are Blind or Severely Disabled ............................................................................................................... 207 

Corporation for National and Community Service ........................................ 207 

Corporation for Public Broadcasting ............................................................... 212 

Federal Mediation and Conciliation Service .................................................. 212 

Federal Mine Safety and Health Review Commission .................................. 212 

Institute of Museum and Library Services ..................................................... 213 

Medicaid and CHIP Payment and Access Commission ................................. 214 

Medicare Payment Advisory Commission ...................................................... 214 

National Council on Disability ........................................................................ 214 

National Health Care Workforce Commission ............................................... 215 

National Labor Relations Board ...................................................................... 215 

National Mediation Board ............................................................................... 215 

Occupational Safety and Health Review Commission ................................... 216 

Railroad Retirement Board .............................................................................. 216 

Social Security Administration ........................................................................ 217 

Title V: General Provisions ..................................................................................... 222 

Compliance With Paragraph 7, Rule XVI of the Standing Rules of the 

Senate ................................................................................................................... 224 

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

Senate ................................................................................................................... 225 

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

Senate ................................................................................................................... 225 

Budgetary Impact of Bill ......................................................................................... 232 

Comparative Statement of New Budget Authority ............................................... 233 
(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 

AoA—Administration on Aging 

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 

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 

FMSHRC—Federal Mine Safety and Health Review Commission 
5 

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 

HFFI—Healthy Foods Financing Initiative 

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 
6 

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 

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 

UAC—unaccompanied alien children 
7 

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 2014, the Committee recommends total budget authority of $783,365,379,000 for the Departments of Labor, Health 

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

amount includes $164,330,000,000 in current year discretionary 

funding and $1,253,000,000 in cap adjustments for healthcare 

fraud and abuse and for program integrity at the Social Security 

Administration, in accordance with the allocation for this bill. 

Fiscal year 2013 levels cited in this report reflect the enacted 

amounts in Public Law 113–6, the Consolidated and Further Continuing Appropriations Act, 2013. They do not reflect the March 1, 

2013, sequester of funds required under Public Law 112–25 (the 

Budget Control Act of 2011) or agency transfers and 

reprogrammings that are allowed in Public Law 113–6 and that 

have occurred since that law’s enactment. Where applicable, the 

fiscal year 2013 levels include emergency funding in the Disaster 

Relief Appropriations Act, 2013. 

OVERVIEW

The Labor, Health and Human Services, and Education, and Related Agencies appropriations bill constitutes the largest of the 

nondefense Federal appropriations bills. But even more noteworthy 

than the size of the bill is the breadth of the critical services that 

are funded by this legislation, which range from medical research 

to job training, from home energy assistance to mental health, from 

early childhood care and education to the operations of the Social 

Security Administration. 

Balancing the competing priorities in this bill is always difficult, 

but especially so at a time when discretionary spending as a share 

of the overall economy has dropped to historically low levels. The 

Committee has examined all of the programs in this bill and recommended what it believes is an appropriate level for each of 

them, within the limits of the bill’s allocation. Details are included 

in the report. 

Several themes permeate the Committee’s recommendation, described below. All funding comparisons are to fiscal year 2013 levels. 

REDUCING HEALTHCARE COSTS

The Nation’s fiscal health is inextricably linked to our ability to 

curb the cost of healthcare. The Affordable Care Act, enacted in 

2010, is vital to that effort. But this appropriations bill also plays 

a critical role—by supporting the ACA’s implementation, promoting 

efforts to prevent chronic diseases, and increasing funding for medical research. 
9 

Implementing the Affordable Care Act.—The ACA has already resulted in historic savings for the Federal Government and for 

American families. More than 6.3 million Medicare beneficiaries 

have saved more than $6,100,000,000 on prescription drugs. In 

2012 alone, consumers also saved $2,000,000,000 because of provisions to review premium rates and to require insurers to provide 

rebates if they do not spend at least 80 percent of premiums on 

care, rather than overhead. In 2013, some 8.5 million Americans 

with health coverage will receive rebates, averaging $100 per family. And the law’s provisions have extended the life of the Medicare 

Trust Fund by 8 years. 

Fiscal year 2014 begins on the same day the ACA will open enrollment for new health coverage in the Health Insurance Marketplace, which will for the first time offer people a single place where 

they can compare the costs and benefits of different health insurance plans and choose the one that fits their needs. The Committee includes $5,217,357,000 for Program Management at the Centers for Medicare and Medicaid Services, the lead 

agency with responsibility for overseeing the ACA. CMS will use 

this funding to run the Marketplace, ensure compliance with the 

Patient’s Bill of Rights and other insurance market rules, and implement additional quality measures to improve healthcare services 

for all Americans. 

Alzheimer’s Disease.—The total payments for healthcare, longterm care, and hospice for people with Alzheimer’s and other dementias are projected to increase from $203,000,000,000 in 2013 to 

a staggering $1,200,000,000,000 in 2050. 

Without a medical breakthrough to prevent, slow, or stop the disease, Medicare and Medicaid costs related to Alzheimer’s could rise 

an estimated 500 percent. Research is desperately needed to bring 

those costs under control. Therefore, the bill includes a significant 

increase for the National Institute on Aging, the NIH Institute 

with the primary responsibility for preventing, treating, and curing 

Alzheimer’s disease. 

The Committee recommendation also includes $20,000,000 for a 

new Alzheimer’s Disease Initiative consisting of $10,500,000 to 

strengthen dementia-capable long-term services and supports, 

$4,200,000 for an outreach campaign to assist caregivers of individuals with Alzheimer’s disease, and $5,300,000 to train healthcare 

providers on how to recognize the signs and symptoms of Alzheimer’s and manage the disease. 

EARLY CHILDHOOD CARE AND EDUCATION

High-quality early childhood care and education has been proven 

to have positive, lasting effects for children and families. It also 

supports the Nation’s long-term economic security by preparing our 

next generation of workers, entrepreneurs, and business leaders. 

The Committee provides a combined increase of $2,561,394,000 for 

the key early childhood care and education programs in this bill: 

Head Start, the Child Care and Development Block Grant, and 

Preschool Development Grants. Together, they address the entire 

age range of birth through 5. 

Head Start.—The Committee recommendation includes 

$9,621,070,000, a $1,635,030,000 increase, for Head Start. This in-
10 

cludes a $1,430,376,000 increase to expand Early Head Start, including the creation of new Early Head Start-Child Care Partnerships, to serve children and families from before birth through age 

3. 

Child Care and Development Block Grant.—The Committee recommendation includes $2,500,000,000, a $176,344,000 increase, for 

CCDBG. This includes a $110,000,000 increase to improve the 

quality of the child care workforce and health and safety standards. 

Preschool Development Grants.—The Committee bill includes 

$750,000,000 for a new program to support States’ efforts to expand or create high-quality preschool systems for 4-year-olds from 

low- and moderate-income families. 

IMPROVING FISCAL ACCOUNTABILITY

The Committee has an obligation to promote the fiscal accountability and effective use of taxpayer dollars. This bill provides funding for several efforts to combat fraud, waste, and abuse within 

Federal programs. 

Healthcare Program Integrity.—Fraud committed against Federal 

healthcare programs diverts critical resources from services that 

are intended for some of the Nation’s most vulnerable populations. 

The Committee includes $640,000,000 for HCFAC activities at 

CMS, more than double the fiscal year 2013 level of $309,170,000. 

Every $1 spent on these activities returns approximately $7.90 to 

the Treasury. At that rate, the level in this bill would return more 

than $5,000,000,000. 

Social Security Program Integrity.—The Committee includes 

$1,197,000,000, a $440,948,000 increase, for Social Security program integrity activities, including continuing disability reviews 

[CDRs] and SSI redeterminations. CDRs and redeterminations 

save $9 and $5, respectively, for each $1 spent by reducing waste, 

fraud, abuse, and improper payments in the Social Security, Medicare, and Medicaid programs. Combined, the Committee recommendation for Social Security program integrity activities is estimated to save $9,600,000,000 over 10 years. 

Unemployment Insurance Program Integrity.—The Committee 

recommendation includes $80,000,000, an increase of approximately $20,000,000, to conduct reemployment and eligibility assessments [REAs] and UI improper payment reviews. This level is 

projected to save State UI trust funds an estimated $315,000,000 

through REAs by helping claimants exit the UI program faster and 

avoid exhausting their benefits. 

Protecting Students and Taxpayers.—The Committee bill includes 

a new provision prohibiting colleges and universities from spending 

Federal educational funding on marketing, recruitment, and advertising. This reform will ensure that Federal resources are targeted 

at educating students as opposed to online advertisements and aggressive recruiting activities, so that both students and taxpayers 

receive a good return on their investment. 

Spending on Conferences.—The Committee helps prevent excessive spending on conferences and other administrative expenses by 

requiring departments, agencies, boards, and commissions funded 

in this bill to report to Inspectors General or senior ethics officials 
11 

on the costs and contracting procedures involved in any conference 

that costs more than $100,000. 

PROMOTING POLICY REFORM

This bill launches or continues several initiatives that will leverage policy reform and transform key Federal services. 

Race to the Top—College Affordability and Completion.—The 

Committee includes $250,000,000 to support a new Race to the Top 

program focused on college affordability and completion. Funding 

will incentivize States to reduce costs for students and families and 

improve academic outcomes. 

Public Access to Federally Funded Research.—In fiscal year 2009, 

Congress required NIH to improve the public’s ability to access taxpayer-funded research by means of an online NIH repository. This 

effort has been highly successful. The Committee includes a new 

general provision that extends the requirement to other agencies 

funded in this bill. 

Investing in Innovation.—The Committee bill provides 

$170,000,000 for the Investing in Innovation education program, 

which allows grantees to develop and test promising new ideas and 

replicate programs that are successful. 

Accelerating Cures.—The Committee bill includes $50,000,000, 

five times the fiscal year 2013 level, for the Cures Acceleration Network, an NIH initiative intended to help speed the translation and 

application of discoveries that have shown signs of success at the 

laboratory level but have not advanced far enough to attract significant investments from the private sector. 

Performance Partnerships for Disconnected Youth.—The Committee bill includes a new authority called Performance Partnerships that will provide States and local communities with unprecedented flexibility to improve services for disconnected youth. Up to 

13 States and/or local communities will be allowed to combine 

funding that they receive through various programs within this bill 

for these pilot projects. 

PREVENTION

Nearly three-quarters of all healthcare costs are attributable to 

chronic diseases, the majority of which are preventable. This bill 

promotes prevention efforts by supporting implementation of the 

ACA, which will enable millions of newly insured Americans to receive preventive screenings; providing discretionary funding for 

programs such as childhood immunizations and cancer screenings; 

and allocating the Prevention and Public Health Fund, which will 

total $1,000,000,000 in fiscal year 2014. 

Key prevention programs listed below are either funded in this 

bill or through transfers from the PPH Fund. 

Community Transformation Grants.—The Committee includes 

$290,000,000, an increase of $143,660,000, for evidence-based public health interventions to reduce obesity and smoking and make 

preventive services more accessible. 

Childhood Immunizations.—The Committee includes 

$579,457,000 for immunization programs. Immunization saves 

$10.20 in direct medical costs for every $1 invested. 
12 

Smoking Prevention.—The Committee includes $202,892,000 for 

the Office of Smoking and Health at CDC. This funding, an increase of $34,698,000, will continue the successful media campaign, 

‘‘Tips From a Former Smoker,’’ and expand State quit-lines. 

Diabetes Prevention Program [DPP].—The Committee includes 

$10,000,000 for the DPP, a set of lifestyle interventions that has 

been proven to reduce the risk of developing diabetes by 58 percent 

in individuals at high risk. 

Elder Falls.—In 2010, 2.3 million older adults were treated in 

emergency departments after a fall, with more than 662,000 of 

these patients being hospitalized. Many of these falls are preventable with lifestyle interventions and appropriate physical supports. 

In a new initiative, the Committee includes $10,000,000 to research 

and implement evidence-based approaches to preventing elderly 

falls. 

REDUCING VIOLENCE—NOW IS THE TIME

The mass shootings last year at an Aurora, Colorado, movie theater and at Sandy Hook Elementary School in Newtown, Connecticut, raised public awareness about the problems of violence 

and mental illness in our communities as perhaps never before. 

There are approximately 30,000 firearm-related homicides and 

suicides in the United States each year, and almost one-quarter of 

14- to 17-year-olds have witnessed a shooting in their lifetime. Research shows that exposure to community violence can impact children’s mental health and development and can substantially increase the likelihood that these children will later commit violent 

acts themselves. Unfortunately, less than half of children and 

adults with diagnosable mental health problems receive the treatment they need. 

Addressing these challenges will require complex, comprehensive 

solutions that are beyond the scope of any single school, community, State, or set of laws. But funding provided in this bill to prevent violence, increase access to mental health treatment, and improve school safety can play an important role. 

Mental Health Services.—The Committee bill includes 

$119,000,000 in new funding to increase access to mental health 

services. This includes: $95,000,000 for the administration’s Now Is 

the Time initiative; $15,000,000 for Mental Health First Aid programs that help identify and respond to individuals showing signs 

of mental illness; $40,000,000 for grants to States to reduce violence in schools and increase the number of students receiving 

mental health services; and $40,000,000 to address shortages in 

the behavioral health workforce. The Committee also includes 

$24,187,000 for a new Mental Health Block Grant set-aside for evidence-based programs that serve individuals with early serious 

mental illness. 

Safe and Healthy Schools.—Research shows that safe, positive 

school environments can help reduce unhealthy student behavior, 

increase academic achievement, and counter the effects that violence can have on students. The Committee bill includes 

$195,191,000 for specific activities to improve learning conditions 

in the Nation’s schools. This amount includes $50,000,000 for a 

new School Climate Transformation Grants program, which will 
13 

train school staff to implement evidence-based strategies to improve school climate; $25,000,000 to help school districts develop, 

implement, and improve their emergency management plans; 

$25,000,000 for Project Prevent, which will help schools in troubled 

communities break the cycle of violence; and up to $8,000,000 for 

Project SERV, which offers education-related services following a 

violent or traumatic event. 

Tracking Violent Deaths.—The National Violent Death Reporting 

System [NVDRS] is an 18-State surveillance system that pulls together information on violent deaths with the aim of developing effective interventions and preventive measures. The Committee bill 

includes $18,465,000, an increase of $15,000,000, to expand 

NVDRS to additional States and communities. 

Public Health Research.—Behind motor vehicle injuries, firearm 

injuries are the second leading cause of injury and mortality in the 

United States. The Committee bill includes $10,000,000 to build 

the public health research base on how to reduce the threat of firearm-related violence. 

ASSISTING PEOPLE WITH DISABILITIES

Special Education.—The Committee bill provides $11,722,946,000, an increase of $168,246,000, under section 611 of 

part B Grants to States for educating students with disabilities between the ages of 3 and 21. The bill also includes $462,710,000, an 

increase of $20,886,000, to support statewide systems of coordinated and early intervention services for children with disabilities 

2 years old and younger, as well as their families. 

Promoting Readiness of Minors in SSI.—The Committee bill continues the PROMISE program, an interagency effort to improve 

outcomes for children, and the families of children, receiving SSI 

benefits. This program, which will award its first grants in late fiscal year 2013, will improve services for these transition-aged youth 

by encouraging State-level innovation and facilitating better coordination that can help young people with disabilities enter and succeed in competitive, integrated employment. 

Special Education Research.—The bill includes $69,905,000, an 

increase of $20,099,000, to support research on how children and 

adults with disabilities learn and how best to meet their educational needs. 

Assistive Technology.—The Committee bill provides $37,500,000, an increase of $4,730,000, for activities to improve occupational and 

educational opportunities and the quality of life for people with disabilities through assistive technology. 

HELPING AMERICA’S WORKERS

Job Training.—The Committee recommendation includes 

$2,683,766,000, an increase of $85,658,000, for Workforce Investment Act Grants to States to provide job training skills and assistance to low-skilled adults, dislocated workers, and low-income 

youth with barriers to employment. 

Paid Leave for Workers.—The Committee bill includes $5,000,000 

to support a new State Paid Leave Fund. The Fund will provide 

planning and implementation grants to States that wish to establish paid leave programs and provide benefits to workers who need 
14 

to take time off for reasons covered under the Family and Medical 

Leave Act. 

Veterans Employment and Training.—The Committee recommendation includes $300,518,000, an increase of $36,611,000, to 

expand employment services to transitioning servicemembers, veterans with disabilities, and their spouses and caregivers. 

Protecting Whistleblowers.—The Committee recommendation includes $567,012,000 for OSHA and targets a $6,042,000 increase 

for its enforcement of whistleblower laws. These laws provide important protections for workers who raise issues in their workplace 

about practices that could impact fellow employees or the public. 

Preventing Misclassifications.—The Committee recommendation 

includes an increase of $14,000,000 to address the misclassification 

of workers as independent contractors. Misclassifications deny 

workers their rights to unemployment benefits, overtime pay, and 

other benefits, and also reduce revenue to the Unemployment, Social Security, and Medicare trust funds, as well as to the Treasury. 

OTHER HIGHLIGHTS OF THE BILL

Pell Grants.—The Committee bill maintains the discretionary portion of the maximum Pell grant award level at $4,860 for the 

2014–2015 school year. Combined with mandatory funding, the 

total maximum award will rise by $140 to $5,785. 

National Institutes of Health.—The Committee bill provides $30,946,776,000, an increase of $307,127,000, to fund biomedical 

research at the 27 Institutes and Centers that comprise NIH. This level will allow NIH to allocate $40,000,000 for the proposed 

new Brain Research through Application of Innovative 

Neurotechnologies [BRAIN] Initiative. 

Community Health Centers.—The Committee bill includes 

$1,574,606,000 for CHCs. Combined with mandatory funding provided in the ACA, the fiscal year 2014 program level for CHCs is 

$3,774,606,000, an increase of $700,000,000. 

Title I (Education for the Disadvantaged).—The Committee includes $14,612,425,000, an increase of $125,000,000, for title I 

grants to LEAs for improving education for low-income students. 

These funds support 90 percent of the 14,000 school districts across 

the Nation. 

Children’s Hospitals Graduate Medical Education.—The Committee recommendation includes $267,313,000 for CHGME, the 

same level as in fiscal year 2013. The Committee rejects the 67 

percent cut to this program proposed by the administration. 

Low Income Home Energy Assistance.—The Committee recommendation includes $3,614,729,000 for LIHEAP and rejects the 

administration’s proposed cut to the program. 

Community Services Block Grant.—The Committee recommendation rejects the administration’s proposed cut to the CSBG and includes $676,003,000 for this program, the same as the fiscal year 

2013 funding level. 

AIDS Drug Assistance Program.—The Committee recommends 

$943,299,000 for ADAP, an increase of $46,797,000. 

Promise Neighborhoods.—Inspired by the Harlem Children’s 

Zone program, Promise Neighborhoods supports cradle-to-career 

services designed to improve educational outcomes for students in 
15 

distressed neighborhoods. The Committee includes $56,754,000 for 

this program. 

Unaccompanied Alien Children.—The Committee includes 

$494,597,000, a $119,509,000 increase, to provide care and services 

for unaccompanied alien children while they await placement with 

a sponsor and adjudication of their immigration status. Such children are often fleeing abuse, trafficking, or other dangerous situations in their home country, 

Social Security Administration.—The Committee recommendation includes $11,965,473,000, a $533,578,000 increase, for SSA’s 

administrative expenses. This includes a $440,948,000 increase for 

program integrity activities and a $92,630,000 increase in core administrative expenses for SSA to keep pace with an aging population and persistently record-high workloads. 

TRIO.—The bill includes $849,932,000, an increase of 

$11,680,000, to help low-income and first generation college students plan, prepare for, and succeed in college through the TRIO 

programs. 
(16) 

TITLE I 

DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

TRAINING AND EMPLOYMENT SERVICES

Appropriations, 2013 1 2 ......................................................................... $3,211,756,000 

Budget estimate, 2014 ........................................................................... 3,387,405,000 

Committee recommendation ................................................................. 3,264,213,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes emergency funding of $25,000,000 in the Disaster Relief Appropriations Act, 2013 

(division A of Public Law 113–2). 

The Training and Employment Services account provides funding 

primarily for activities under WIA, and is comprised of programs 

designed to enhance the employment and earnings of economically 

disadvantaged and dislocated workers, operated through a decentralized system of skill training and related services. Funds provided for fiscal year 2014 will support the program from July 1, 

2014, through June 30, 2015. A portion of this account’s funding, 

$1,772,000,000, is available on October 1, 2014, for the 2014 program year. 

Any reference 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 encourages the Department to continue to work 

with other Federal agencies to align and streamline employment 

and training services. 

The Committee encourages the Department to use grant funds 

and training programs to facilitate solutions to address the shortage in the STEM workforce, such as laboratory professionals. 

STEM fields are central to U.S. economic competitiveness and 

growth, and the Committee urges the Department to continue to 

address gaps in the Nation’s approach to strengthening the STEM 

pipeline. 

Grants to States 

The Committee recommends $2,683,766,000 for Training and 

Employment Services Grants to States. 

As proposed in the budget request, the Committee retains bill 

language that allows a local workforce board to transfer up to 30 

percent between the adult and dislocated worker assistance State 

grant programs, if such transfer is approved by the Governor. In 

addition, a local board may award a contract to an institution of 

higher education or other eligible training provider if the board determines that it would facilitate the training of multiple individuals in high-demand occupations, if such contract does not limit 

customer choice. 
17 

The Committee recommendation modifies current law regarding 

the amount of WIA State grant funding that may be set aside by 

Governors. As proposed in the budget request, the Committee includes bill language authorizing the Governor of a State to reserve 

not more than 7.5 percent of the funds allotted to a State through 

the WIA State grant programs for statewide workforce investment 

activities. The current maximum set-aside in each State is 5 percent. The funding increase provided for the WIA State grant programs in this bill will allow the set-aside to grow without reducing 

funds provided to local areas. 

The Committee notes that GAO Report 12–97, dated January 19, 

2012, found that one of the six identified characteristics of effective 

local public and private workforce partnerships was leadership. 

The Committee encourages the Department to support States, in 

cooperation with local elected officials and local workforce board 

chairs, in the development of high-quality standards for workforce 

development leaders and to support professional development of 

such leaders based on the standards. 

Adult Employment and Training.—For adult employment and 

training activities, the Committee recommends $791,644,000. 

This program is funded by formula to States and further distributed to local workforce investment areas through one-stop centers. 

Three types of services for adults are provided through the one-stop 

system: core services, intensive services, and job training. Core 

services are available to all adults with no eligibility requirements. 

Intensive services are provided to unemployed individuals who are 

not able to find jobs through core services alone. Training services 

may be available to adults who have been determined unable to obtain or retain employment through intensive services. 

The Committee commends the Department for employment outcomes among adult exiters who receive on-the-job training and encourages the Department to continue supporting these efforts and 

increase participation. 

Funds made available in this bill for adult employment and 

training support activities in program year 2014, which occurs from 

July 1, 2014, through June 30, 2015. The bill provides that 

$79,644,000 is available for obligation on July 1, 2014, and that 

$712,000,000 is available on October 1, 2014. Both categories of 

funding are available for obligation through June 30, 2015. 

Youth Training.—For youth training activities, the Committee 

recommends $846,632,000. 

The purpose of this program is to provide eligible youth with assistance in achieving academic and employment success through 

improved education and skill competencies, connections to employers, mentoring, training, and supportive services. The program also 

supports summer employment directly linked to academic and occupational learning, incentives for recognition and achievement, 

and activities related to leadership development, citizenship, and 

community service. Funds made available for youth training support activities in program year 2014, which occurs from April 1, 

2014, through June 30, 2015. 

Dislocated Worker Assistance.—For dislocated worker assistance, 

the Committee recommends $1,045,490,000. 
18 

This program is a State-operated effort that provides core and intensive services, training, and support to help permanently separated workers return to productive unsubsidized employment. In 

addition, States must use statewide reserve funds for rapid response assistance to help workers affected by mass layoffs and 

plant closures. States must also use these funds to carry out additional statewide employment and training activities such as providing technical assistance to certain low-performing local areas, 

evaluating State programs, and assisting with the operation of onestop delivery systems. States may also use funds for implementing 

innovative incumbent and dislocated worker training programs. 

Funds made available in this bill support activities in program 

year 2014, which occurs from July 1, 2014, through June 30, 2015. 

The bill provides that $185,490,000 is available for obligation on 

July 1, 2014, and that $860,000,000 is available on October 1, 

2014. Both categories of funding are available for obligation 

through June 30, 2015. 

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 in this bill support activities in program 

year 2014, which occurs from July 1, 2014, through June 30, 2015. 

The bill provides that $20,859,000 is available for obligation on 

July 1, 2014, and that $200,000,000 is available on October 1, 

2014. Both categories of funding are available for obligation 

through June 30, 2015. 

As proposed in the budget request, the Committee continues bill 

language from previous years authorizing the use of funds under 

the dislocated workers program for projects that provide assistance 

to new entrants in the workforce or incumbent workers and assistance where there have been dislocations across multiple sectors or 

local areas of a State. 

Native American Programs.—The Committee recommends 

$47,467,000 for Native American programs. These programs are 

designed to improve the economic well-being of Native Americans 

through the provision of training, work experience, and other employment-related services and opportunities that are intended to 

aid the participants in securing permanent, unsubsidized employment. 

Migrant and Seasonal Farmworker Programs.—The Committee 

recommends $84,123,000 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 farmwork, 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. 
19 

The Committee recommendation provides that $77,949,000 be 

used for State service area grants. The Committee recommendation 

also includes bill language directing that $5,667,000 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 $507,000 to be used for section 167 training, 

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

Women in Apprenticeship.—The Committee recommends 

$994,000 for activities authorized under the WANTO Act of 1992. 

These funds provide for technical assistance to employers and 

unions to assist them in training, placing, and retraining women 

in nontraditional jobs and occupations. 

YouthBuild.—The Committee recommends $84,530,000 for the 

YouthBuild program. YouthBuild targets at-risk, high school dropouts and prepares them with the skills and knowledge they need 

to succeed in a knowledge-based economy. 

Workforce Innovation Fund.—The Committee recommends 

$49,806,000 for WIF, a program that provides competitive grants 

to test innovative strategies; replicate and expand effective, evidence-based strategies and activities, including sector strategies, 

career pathways, incumbent worker training, and on-the-job training; and align programs and strengthen the workforce system in a 

State or region in order to substantially improve the education and 

employment outcomes for job seekers and workers, youth, including 

individuals up to age 24, and employers. WIF awards are made either to States, in partnership with local workforce investment 

boards, or to local workforce investment boards or consortia of such 

boards that serve a regional labor market. 

The Committee recommendation includes a set-aside of 

$5,000,000 to support a new, interagency initiative to improve services for disconnected youth and the development of performance 

partnership pilots; the budget request includes $10,000,000 for this 

purpose. 

The budget request also includes a $50,000,000 set-aside for 

projects that address the employment needs of veterans. The Committee does not recommend a set-aside for this purpose within 

WIF, but provides a significant increase for the Veterans’ Employment and Training Service account. 

The Committee notes that although the program was created in 

fiscal year 2011, with additional funding appropriated in fiscal 

years 2012 and 2013, the Department did not award the first WIF 

grants until June 2012. The Committee is awaiting the results of 

the initial grants. 

The Committee recommendation includes new bill language, as 

requested by the administration, that allows a portion of the funds 

for WIF to be used for Pay for Success pilots, which will provide 

performance-based awards to States or local governments and notfor-profit organizations providing or arranging services that improve employment and education outcomes for individuals, including those with barriers to employment. The Committee under-
20 

stands that these pilots will be funded only if the Department determines that they could improve outcomes and eligible entities 

show interest. The Committee directs the Department to provide at 

least 15 days’ notice to the Committee before issuing any announcements related to Pay for Success activity. 

The Committee recommendation includes new bill language, as 

requested by the administration, that allows the Secretary to authorize WIF awardees to use a portion of grant funds for evaluation 

purposes if the Department’s chief evaluation officer approves the 

evaluation plan. This is in addition to the 5 percent set-aside made 

available to the Secretary for technical assistance and evaluations. 

The Committee commends ETA for its collaborative work with 

IMLS to integrate the education, employment, and training services provided by public libraries into the workforce development 

system. The Committee encourages ETA to continue to invest in 

building and strengthening partnerships between the one-stop system and public libraries and recommends that ETA encourage applicants for grants under WIF to collaborate with public libraries. 

The budget request includes a general provision that provides 

the Secretary with the authority to waive statutes and regulations 

relating to WIA, the Wagner-Peyser Act, and title I of the Rehabilitation Act when the Secretary believes waivers would substantially 

improve employment and education outcomes. The Committee does 

not include this general provision. 

National Activities 

The Committee remains greatly concerned about the low level of 

literacy and numeracy skills among adult workers. The Committee 

continues to encourage the Department to work with the Department of Education to examine and share best practices to help 

adults with the lowest literacy levels improve their overall skills 

and employment opportunities. The Committee requests a report 

on the Department’s progress in educating the workforce system on 

the effectiveness of adult literacy and basic skills programs that 

have successfully implemented strategies for delivering basic literacy instruction together with occupational training; the report 

should be provided to the Committee no later than March 1, 2014. 

Further, the Committee recommends that these best practices be 

widely disseminated to maximize outreach to programs that would 

be able to implement improved approaches. 

Pilots, Demonstrations, and Research.—The Committee recommends $6,590,000 for pilots, demonstrations, and research authorized by section 171 of WIA to support grants or contracts to 

conduct research, pilots, or demonstrations that foster promising 

practices for national policy application. 

Reintegration of Ex-Offenders.—The Committee recommends 

$80,078,000 for the Reintegration of Ex-Offenders program. The 

budget request includes a $10,000,000 set-aside for Pay for Success 

projects. The Committee recommendation does not include the setaside. 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, 
21 

or 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. 

Within the funds provided, the Committee recommendation in- cludes $20,000,000 for competitive grants to national or regional 

intermediaries for activities that prepare young ex-offenders and 

school dropouts for employment. Priority should be given to 

projects that serve high-crime, high-poverty areas. 

Evaluation.—As proposed in the budget request, the Committee 

recommends using a set-aside funding mechanism to support the 

evaluation of employment and training programs. Instead of directly providing funds for evaluation, the Committee recommendation will support these activities through a 0.5 percent tap on all 

training and employment programs, including the Training and 

Employment Services, Office of Job Corps, Community Service Employment for Older Americans, and State Unemployment Insurance 

and Employment Service Operations. The new set-aside approach 

will ensure that sufficient funding is available to carry out comprehensive evaluation and applied research activities, including 

continued support of the WIA Adult and Dislocated Worker Programs Gold Standard Evaluation. 

The ETA will 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 performancebased 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. Thirty-one States have been awarded grants through 

this program. This funding will expand the initiative to approximately six additional States. 

OFFICE OF JOB CORPS

Appropriations, 2013 1 ........................................................................... $1,699,541,000 

Budget estimate, 2014 ........................................................................... 1,691,923,000 

Committee recommendation ................................................................. 1,706,923,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The recommendation for operations of Job Corps centers is 

$1,586,776,000. The Committee understands that construction on 

the new Job Corps center in Manchester, New Hampshire, will be 

substantially completed in December 2014. The Committee’s recommended level for operations includes funds to ensure that competitively awarded contracts will be in place to keep the process of 

opening the Manchester center on course. 

The Committee remains concerned about the Department’s mismanagement of Job Corps, which resulted in projected costs exceed-
22 

ing the funding provided for the operations account and, most recently, a 12-week freeze on new student enrollment. An OIG audit 

dated May 31, 2013, found that programmatic, budgetary, and 

managerial problems as well as a lack of proper program integrity 

controls contributed to the shortfalls in program years 2011 and 

2012. The Committee directs the Secretary to provide a report no 

later than December 1, 2013, on the progress of the Department’s 

implementation of the OIG recommendations, in addition to the 

new on-board strength model’s impact on projecting program costs. 

The Committee understands that the Department is undertaking 

a full review of the Job Corps Policy and Requirements Handbook 

to improve and update program management and identify potential 

areas for additional cost savings. The Committee supports the Department’s effort in this area and encourages the Department to 

seek input from all stakeholders in Job Corps. The Committee directs the Department to provide a report no later than March 1, 

2014, on the Department’s progress in reviewing and updating the 

handbook. 

The Committee recommendation for administrative costs is 

$30,147,000. This funding will support additional staff to conduct 

financial oversight and monitoring of the Job Corps program. 

The Committee also recommends a total of $90,000,000 in construction, renovation, and acquisition funds. This amount is available from July 1, 2014, to June 30, 2017. The budget request is 

$75,000,000. The Committee notes that an OIG audit report dated 

December 7, 2012, found Job Corps did not address maintenance 

deficiencies in a timely manner and did not sufficiently track and 

monitor obligated funds. The Committee directs the Secretary to 

provide a report no later than June 30, 2014, on the Department’s 

progress in implementing the OIG recommendations to ensure the 

health and safety of students, staff, and visitors as well as making 

improvements to the Funded-not-Corrected system, which center 

contractors use to track and monitor repair deficiencies. 

As requested by the administration, the Committee again includes bill language allowing the Secretary to transfer up to 15 percent of construction, renovation, and acquisition funds, if necessary, 

to meet the operational needs of Job Corps centers or to achieve administrative efficiencies. The Committee includes new bill language 

requiring the Secretary to notify the House and Senate Committees 

on Appropriations at least 15 days in advance of any transfer and 

expects the notification to include a justification. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriations, 2013 1 ........................................................................... $447,355,000 

Budget estimate, 2014 ........................................................................... 380,000,000 

Committee recommendation ................................................................. 447,355,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

As in fiscal years 2012 and 2013, the budget request includes a 

proposal to transfer the CSEOA program to ACL in HHS. The 

Committee again recommends keeping the program in DOL. 

CSEOA provides part-time employment in community service activities for unemployed, low-income persons aged 55 and older. 
23 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriations, 2013 1 ........................................................................... $797,000,000 

Budget estimate, 2014 ........................................................................... 656,000,000 

Committee recommendation ................................................................. 656,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes mandatory funds for 

the Federal unemployment benefits and allowances program that 

assists trade-impacted workers with services including training, income support, employment, case management, and assistance with 

health insurance coverage. The program also includes a wage insurance option for certain workers at least 50 years old. These benefits and services are designed to help trade-impacted participants 

find a path back into middle-class jobs, improve earnings, and increase credential and education rates. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriations, 2013 1 ........................................................................... $4,018,879,000 

Budget estimate, 2014 ........................................................................... 3,825,699,000 

Committee recommendation ................................................................. 3,848,094,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $3,762,198,000 authorized to be drawn from the Employment Security Administration account of the Unemployment Trust Fund and $85,896,000 to be provided from the general fund of the Treasury. 

The funds in this account are used to provide administrative 

grants and assistance to State agencies that administer Federal 

and State unemployment compensation laws and operate the public 

employment service. 

The Committee bill retains language from previous years that 

enables States to use funds appropriated under this account to assist other States if they are impacted by a major disaster declared 

by the President and that permits the Secretary to use funds to 

make payments on behalf of States for the use of the National Directory of New Hires. At the request of one or more States, the Secretary may reallot funds for States to carry out activities that benefit the administration of unemployment compensation laws of a 

requesting State. 

The Committee recommends a total of $2,967,818,000 for UI activities. The budget request is $2,917,872,000. For UI State operations, the Committee recommends $2,931,575,000. These funds 

are available for obligation by States through December 31, 2014. 

The Committee includes new bill language, as proposed by the administration, that allows the Department to make funds used for 

automation acquisitions and for competitive grants awarded to 

States for system improvements, reemployment and eligibility assessments, improper payments and activities to address 

misclassification of workers available for obligation through December 31, 2014. The Committee includes bill language allowing States 

to obligate funds for these activities through September 30, 2016, 

as requested by the administration. 
24 

The Committee recommendation supports investments in UI program integrity activities, including technology-based programs that 

identify and reclaim overpayments. The Committee requests a report no later than March 1, 2014, on the Department’s plan to address the detection and recovery of improper payments, including 

desired outcomes and steps it will take to help States improve their 

performance. The Committee also expects the Secretary to submit 

a report by June 30, 2015, providing the status of the outcomes 

identified in the March 1, 2014, plan. 

As proposed in the budget request, the Committee includes new 

bill language allowing States awarded grants for improved operations or to carry out national activities of the Federal-State UI 

system to award subgrants to other States. This authority provides 

States more flexibility in improving operations and national activities of the UI system. 

The Committee recommendation includes $80,000,000 to conduct 

in-person reemployment and eligibility assessments and UI improper payment reviews and continues bill language allowing the 

Secretary to provide additional funding to support these activities 

if funds become available as the result of a decrease in UI workload activity. This important program integrity initiative has been 

shown to help claimants exit the UI program faster and avoid exhausting UI benefits. The Committee recommendation will fund an 

estimated 1,352,000 reemployment and eligibility assessments, saving State UI Trust Funds an estimated $315,000,000 and expanding the initiative from 42 to 45–50 States. The Committee intends 

for a portion of these or other administrative funds to be used for 

additional technology-based overpayment prevention, detection, 

and collection activities. 

The budget request includes an amendment to the Balanced 

Budget and Emergency Deficit Control Act of 1985 that would provide a discretionary cap adjustment for $20,000,000 of the proposed 

$80,000,000. The Committee recommendation does not use the cap 

adjustment, which has yet to be enacted. 

The Committee recommendation includes new bill language that 

provides $10,000,000 for an award program designed to incentivize 

States to improve misclassification efforts, as requested by the administration. States that are most successful in addressing worker 

misclassification, which denies the Federal and State UI Trust 

Funds hundreds of millions of dollars a year, will be able to use 

these incentive funds to upgrade their misclassification detection 

and enforcement programs. 

The Committee recommendation includes $3,000,000 for continued support of the UI Integrity Center of Excellence. The Center’s 

mission is to develop, implement, and promote innovative integrity 

strategies in the UI program, focusing on the prevention and detection of fraud. 

The Committee includes new bill language, as requested by the 

administration, providing $25,000,000 to assist States in carrying 

out UI demonstration projects as authorized by the Middle Class 

Tax Relief and Job Creation Act of 2012. The authorizing statute 

allows the Secretary to enter into agreements with up to 10 States 

to conduct demonstration projects that test and evaluate measures 
25 

designed to expedite reemployment of individuals receiving UI benefits. 

The Committee recommendation provides for a contingency reserve amount should the unemployment workload exceed an average weekly insured claims volume of 3,357,000, as proposed in the 

budget request. 

For UI national activities, the Committee recommends 

$11,243,000. These funds are directed to activities that benefit the 

Federal-State UI system, including helping States adopt common 

technology-based solutions to improve efficiency and performance 

and supporting training and contracting for actuarial support for 

State trust fund management. 

For the Employment Service allotments to States, the Committee recommends $730,797,000. This amount includes $22,550,000 in 

general funds together with an authorization to spend 

$708,247,000 from the Employment Security Administration account of the Unemployment Trust Fund. The Committee includes 

new bill language requiring that no less than $30,000,000 be used 

to provide targeted reemployment services to UI beneficiaries, as 

requested by the administration. Congress last appropriated funding for reemployment services in ARRA. A recent DOL report to 

Congress found that reemployment services coupled with reemployment and eligibility assessments not only shorten UI duration, but 

also boost employment and earnings for UI claimants. The Committee recommendation continues to support States’ efforts in providing these critical workforce services to UI claimants. The Committee also recommends $20,871,000 for Employment 

Service national activities. The administration of the work opportunity tax credit accounts for $18,485,000 of the recommended 

amount; the balance is for technical assistance, training, and the 

Federal share of State Workforce Agencies Retirement System payments. 

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

$65,262,000. In addition, 5 percent of the revenue from H–1B fees 

is available to the Department for costs associated with processing 

H–1B alien labor certification applications. 

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

Committee recommends $63,346,000. The Committee does not include any funding for the administration’s proposal to co-brand and 

increase public awareness of the one-stop career center system. 

The Committee recommendation includes $8,976,000 for ETA, in 

collaboration with ODEP, to continue to implement their joint plan 

for improving effective and meaningful participation of persons 

with disabilities in the workforce. The Committee expects that 

these funds, in combination with funding available to ODEP, will 

continue to improve the accessibility and accountability of the public workforce development system for individuals with disabilities. 

The Committee recommendation includes new bill language, as 

proposed in the budget request, authorizing the Secretary to collect 

fees for costs associated with additional data collection requested 

by States and local governments, institutions of higher education, 

or nonprofit organizations under the National Agricultural Workers 

Survey, and to retain the proceeds to cover such costs. 
26 

STATE PAID LEAVE FUND

Appropriations, 2013 ............................................................................. ........................... 

Budget estimate, 2014 ........................................................................... $5,000,000 

Committee recommendation ................................................................. 5,000,000 

The Committee recommendation includes $5,000,000 to create a 

new State Paid Leave Fund. Paid leave programs are financed by 

employer and/or employee contributions and offer benefits to workers who must take time off to care for an ill child, spouse, or parent, or to bond with a newborn or recently adopted child. Competitive grants will be awarded to States to support pre-implementation planning, such as research and analysis and financial modeling, as well as to support implementation costs, including information technology, outreach to eligible workers and employers, 

project management, and the development of reporting and performance accountability processes. 

In determining eligibility for funding, the Committee strongly 

urges the Secretary to include States that have passed State paid 

leave laws but have yet to implement programs due to funding constraints, as well as States that have yet to pass paid leave laws but 

are in the planning phase. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

Appropriations, 2013 ............................................................................. ........................... 

Budget estimate, 2014 ........................................................................... $600,000,000 

Committee recommendation ................................................................. 600,000,000 

The Committee recommends and the budget requests such sums 

as are 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. 

The Committee bill includes new language proposed in the budget request to provide advances from this account to the Employment Security Administration account of the Unemployment Trust 

Fund. The language will ensure the Unemployment Trust Fund 

has enough funding to provide loans to States to administer the UI 

and Employment Service programs and Veterans Employment and 

Training programs. 

PROGRAM ADMINISTRATION

Appropriations, 2013 1 ........................................................................... $146,787,000 

Budget estimate, 2014 ........................................................................... 149,617,000 

Committee recommendation ................................................................. 151,602,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation of $151,602,000 for program administration includes $100,994,000 in general funds and 

$50,608,000 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 WIA, 

OAA, the Trade Act of 1974, WANTO, and the National Apprenticeship Act. Trust funds provide for the Federal administration of 
27 

employment security functions under title III of the Social Security 

Act. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $182,787,000 

Budget estimate, 2014 ........................................................................... 179,104,000 

Committee recommendation ................................................................. 176,472,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $176,472,000 for EBSA. 

EBSA plays a critical role in improving health benefits and retirement security for American workers and their families. EBSA 

is responsible for the enforcement of title I of 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. 

Benefits under EBSA’s jurisdiction consist of approximately $7,000,000,000,000 in assets covering approximately 140 million 

participants and beneficiaries. EBSA oversees benefit security for 

an estimated 700,000 private retirement plans, 2.3 million health 

plans, and similar numbers of other welfare benefit plans, such as 

those providing life or disability insurance. 

The Committee directs the Department to work with HHS and 

the Department of the Treasury to revise their joint FAQ regarding 

section 2706 of the ACA, as explained in the HHS title of this report. 

PENSION BENEFIT GUARANTY CORPORATION

PBGC’s estimated obligations for fiscal year 2014 include singleemployer benefit payments of $6,358,000,000, multi-employer financial assistance of $115,000,000, and administrative expenses of 

$505,441,000. Administrative expenses are comprised of three activities: (1) pension insurance activities, $80,000,000; (2) pension 

plan termination expenses, $268,230,000; and (3) operational support, $157,211,000. These expenditures are financed by permanent 

authority. 

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 corporation is to guarantee the payment of pension plan benefits to participants if covered defined 

benefit plans fail or go out of existence. 

The President’s budget proposes to continue authority for a contingency fund for 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, 2015, for 
28 

every 20,000 participants in terminated plans. A trigger also is included for additional investment management fees for plan terminations or asset growth. The bill does not revise this trigger to 

allow additional resources for investment management fees incurred in carrying out the PBGC’s Board-approved investment policy, as proposed in the budget. The Committee bill includes current 

law provisions to ensure that the PBGC can take immediate, uninterrupted action to protect participants’ pension benefits. The Committee expects to be notified immediately of the availability of any 

funds provided by these provisions. 

The Committee bill also continues authority allowing the PBGC 

additional obligation authority for unforeseen and extraordinary 

pre-termination expenses, after approval by OMB and notification 

of the Committees on Appropriations of the House of Representatives and the Senate. 

The Committee is very concerned by the lack of progress in selecting a participant and plan sponsor advocate, a position required 

by Public Law 112–141, which was signed by President Obama on 

July 6, 2012. Among other things, the advocate is expected to act 

as a liaison between PBGC and participants in terminated pension 

plans, ensure that participants receive everything they are entitled 

to under law, and provide plan sponsors with assistance in resolving disputes with PBGC. The Committee expects the PBGC Board 

to move expeditiously in selecting a candidate for this position, 

which should occur as soon as possible but no later than 90 days 

after enactment of this act. The Committee also believes that the 

advocate must be a full-time position reporting directly to the 

PBGC Board given the significant duties required. 

PBGC’s single-employer program protects about 33 million workers and retirees in approximately 24,000 defined benefit pension 

plans. The multi-employer insurance program protects about 10 

million participants in roughly 1,500 plans. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $226,607,000 

Budget estimate, 2014 ........................................................................... 243,254,000 

Committee recommendation ................................................................. 243,254,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $243,254,000 for 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. 

The Committee recommendation includes additional funds over 

the fiscal year 2013 level to address the misclassification of employees as independent contractors and to enforce the FMLA and 

FLSA. 
29 

The Committee also supports the President’s request to provide 

additional resources for WHD to increase its oversight of organizations participating in the special minimum wage program for individuals with disabilities authorized under section 14(c) of the 

FLSA, in order to protect the rights of workers with disabilities. 

The Committee also urges WHD to continue exploring and implementing strategies with ODEP and other Federal agencies to provide additional opportunities for such workers to participate in 

competitive integrated employment. 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $41,206,000 

Budget estimate, 2014 ........................................................................... 46,891,000 

Committee recommendation ................................................................. 41,206,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $41,206,000 for 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, 2013 1 ........................................................................... $104,976,000 

Budget estimate, 2014 ........................................................................... 108,467,000 

Committee recommendation ................................................................. 106,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $106,000,000 for 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. 

Almost 3 years ago, the Department issued an advance notice of 

proposed rulemaking regarding regulations for implementing section 503 of the Rehabilitation Act. The proposal would strengthen 

affirmative action provisions for workers with disabilities under 

section 503, and details specific actions that a contractor must take 

to satisfy its obligations. The Committee strongly supports the administration’s plan to issue a final rule during fiscal year 2013. The 

Committee encourages the Department to make technical assistance regarding the rule available to Federal contractors. 
30 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $117,604,000 

Budget estimate, 2014 ........................................................................... 120,600,000 

Committee recommendation ................................................................. 117,604,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $117,604,000 for OWCP. The bill 

provides authority to expend $2,116,000 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, 2013 ............................................................................. $350,000,000 

Budget estimate, 2014 ........................................................................... 396,000,000 

Committee recommendation ................................................................. 396,000,000 

The Committee recommends $396,000,000 for this account. This 

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

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

account numbers by individuals filing claims under FECA or the 

Longshore and Harbor Workers’ Compensation Act and its extensions. 

The Committee recommends continuation of 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 also 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 also 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 bill includes slightly revised language that allows 

fair share collections to be used to pay for capital investment 

projects and specific initiatives to strengthen compensation fund 

control and oversight. 
31 

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriations, 2013 1 ........................................................................... $182,227,000 

Budget estimate, 2014 ........................................................................... 133,235,000 

Committee recommendation ................................................................. 133,235,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends a mandatory appropriation of 

$98,235,000 in fiscal year 2014 for special benefits for disabled coal 

miners. This is in addition to the $35,000,000 appropriated last 

year as an advance for the first quarter of fiscal year 2014, for a 

total program level of $133,235,000 in fiscal year 2014. The decrease in this account below the fiscal year 2013 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 

$24,000,000 for the first quarter of fiscal year 2015. This amount 

is the same as the budget request. These funds will ensure uninterrupted benefit payments to coal miners, their widows, and dependents. 

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS

COMPENSATION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $52,147,000 

Budget estimate, 2014 ........................................................................... 55,176,000 

Committee recommendation ................................................................. 55,176,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $55,176,000 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 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 2014, the volume of incoming claims under part B 

of EEOICPA is estimated at about 6,500 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 5,900 new claims will be received 

during fiscal year 2014. 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. 
32 

BLACK LUNG DISABILITY TRUST FUND

Appropriations, 2013 1 ........................................................................... $301,006,000 

Budget estimate, 2014 ........................................................................... 316,559,000 

Committee recommendation ................................................................. 316,559,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee bill provides an estimated $316,559,000 for this 

mandatory appropriations account. This estimate is comprised of 

$59,081,000 for administrative expenses and an estimated 

$257,478,000 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: up to $33,033,000 for the part C costs of the Division of 

Coal Mine Workers’ Compensation Programs; up to $25,365,000 for 

Departmental Management, Salaries and Expenses; and up to 

$327,000 for Departmental Management, Inspector General. The 

bill also allows a transfer of up to $356,000 for the Department of 

the Treasury. 

The trust fund pays all black lung compensation/medical and 

survivor benefit expenses when no responsible mine operation can 

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

are incurred in administering the benefits program and operating 

the trust fund. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $563,658,000 

Budget estimate, 2014 ........................................................................... 570,519,000 

Committee recommendation ................................................................. 567,012,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $567,012,000 for 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 

up to $200,000 per fiscal year of tuition fees for training institute 

courses to be used for occupational safety and health training and 

education grants in the private sector. 

The Committee bill retains language that continues to effectively 

exempt farms employing 10 or fewer people from the provisions of 

the act with the exception of those farms having a temporary labor 

camp. The 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 Committee is extremely disappointed by the Department’s 

continued delays in issuing a rule for occupational exposure to silica. The silica rulemaking process is almost a decade old. The administration’s most recent regulatory agenda stated that a notice 

of proposed rulemaking would be issued in May 2013—another in 

a series of deadlines that the Department has failed to meet. The 
33 

Committee directs the Department to issue a notice of proposed 

rulemaking on silica not later than 30 days after enactment of this 

act. The Committee also supports rulemaking for the Injury and 

Prevention Program and the timetable for actions outlined in the 

Department’s January 8, 2013, regulatory agenda. 

The Committee recommends $103,987,000 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, given the continuing fiscal pressures facing State budgets, OSHA should continue its practice of allowing States an extra 

year to match the appropriation provided by this bill for support 

of their State plans, and also should extend the period of expenditure for these funds for an additional quarter. 

The Committee also believes that OSHA’s worker safety and 

health training and education programs, including the grant program that supports such training, are a critical part of a comprehensive approach to worker protection. 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 $10,709,000 for the OSHA Susan Harwood Training Grant 

Program. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $372,547,000 

Budget estimate, 2014 ........................................................................... 380,721,000 

Committee recommendation ................................................................. 380,721,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $380,721,000 for 

MSHA. 

MSHA insures the safety and health of the Nation’s miners by 

conducting inspections and special investigations of mine operations, promulgating mandatory safety and health standards, cooperating with the States in developing effective State programs, 

and improving training in conjunction with States and the mining 

industry. 

The Committee bill continues language authorizing MSHA to use 

up to $2,000,000 for mine rescue and recovery activities. It also retains the provision allowing the Secretary to use any funds available to the Department to provide for the costs of mine rescue and 

survival operations in the event of a major disaster. In order to 

prepare properly for an actual emergency, the Committee also directs MSHA to continue to devote resources toward a competitive 

grant activity for effective emergency response and recovery training in various types of mine conditions. 
34 

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. Bill language also allows MSHA to establish, collect, and retain fees for services related to the analysis of rock dust 

samples. 

As requested by the administration, the Committee includes new 

bill language allowing the Secretary to reallocate up to $3,000,000 

within MSHA’s program lines to support inspections or investigations. The Committee expects to be notified prior to any such reallocation. The Committee also expects that any reallocations will 

not prevent MSHA from addressing important issues that are proposed in the budget request or identified in this report. In addition 

to items identified previously, the priorities include: effective implementation of corrective actions related to the Upper Big Branch internal review; adequate support for MSHA’s instructional capacity 

for training of mine safety and health inspectors and other mine 

safety professionals; and sufficient support for MSHA’s Accountability Program. 

Finally, the bill includes new language intended to support the 

relocation of MSHA’s headquarters by authorizing the transfer of 

necessary funds to the Office of the Solicitor. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $607,852,000 

Budget estimate, 2014 ........................................................................... 613,794,000 

Committee recommendation ................................................................. 609,852,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $609,852,000 for BLS. This amount 

includes $67,041,000 from the Employment Security Administration account of the Unemployment Trust Fund and $542,811,000 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 labor statistics for Federal and non-Federal data 

users. The Nation also requires Government programs to be administered as cost-effectively as possible. However, the current ability 

of the cooperative statistics system to meet those needs is in question. Any weaknesses of this system could reduce the ability of 

State and local regions to effectively plan for recovery, anticipate 

industry demand for workforce needs, and meet other labor market 

information challenges. 

Therefore, the Committee directs the Secretary to commission a 

study of and report on a comprehensive assessment of the proper 

purpose, structure, methods, and operations of the Federal-State 

cooperative statistics system, particularly regarding the appro-
35 

priate roles and responsibilities of BLS, ETA, the State labor market information agencies, and the system’s relationship with the 

Census Bureau, NCES, State workforce agencies, State education 

agencies, and private vendors. 

The Committee believes the National Academies of Science (Committee on National Statistics) and the National Academy of Public 

Administration are well-qualified to produce such a report. The 

Committee requests the release of an interim report within 12 

months of the enactment of this act and a final report within 24 

months of the enactment of this act. The interim report shall contain, at minimum, a rigorous assessment of the Current Employment Statistics Program [CES], including an evaluation of the accuracies of past and present methods for producing initial State 

and metro area CES estimates, identification of the methods most 

likely to produce accurate initial estimates, and recommendations 

for appropriate BLS and State roles and responsibilities in preparing such accurate estimates. The report also should consider 

recommendations for how to improve the collection of this large volume of information, including through the use of technology; coordinate the Federal and State data systems to provide timely, accurate, and geographically detailed information on employment, 

education and training, occupations, and worker skills, as well as 

ease of access and technical assistance; and improve responsiveness 

to the data needs of labor market participants and policymakers at 

the Federal, State, and local levels. 

The Committee directs the Secretary to use such sums as may 

be necessary for this study, allocated equally from funds available 

to the Secretary, BLS, ETA, and the States. The State contribution 

should be made through a set-aside from BLS cooperative system 

grants to States. 

Within available resources, the Committee encourages BLS to 

prioritize work on the Contingent Work Supplement to the Current 

Population Survey. 

OFFICE OF DISABILITY EMPLOYMENT POLICY

Appropriations, 2013 1 ........................................................................... $38,802,000 

Budget estimate, 2014 ........................................................................... 42,432,000 

Committee recommendation ................................................................. 42,432,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $42,432,000 for ODEP. The Committee intends that at least 80 percent of these funds shall be used 

to design and implement research and technical assistance grants 

and contracts to develop policy that reduces barriers to competitive, 

integrated employment for youth and adults with disabilities. 

The mission of ODEP is to provide leadership, develop policy and 

initiatives, and award grants furthering the objective of eliminating 

physical and programmatic barriers to the training and employment of people with disabilities. The Committee strongly supports 

each component of ODEP’s mission and, in particular, urges the 

Secretary to ensure that ODEP carries out its leadership role with 

respect to governmentwide policies related to the training and employment of individuals with disabilities. The Committee believes 

that ODEP should put a high priority on providing support and 
36 

technical assistance to Federal agencies for the implementation of 

Executive Order 13548 regarding the hiring of persons with disabilities. 

The Committee recommendation includes $9,000,000 for ODEP, 

in collaboration with ETA, to continue to implement their joint 

plan for improving effective and meaningful participation of persons with disabilities in the workforce. The Committee expects that 

these funds, in combination with funding available to ETA, will 

continue to improve the accessibility and accountability of the public workforce development system for individuals with disabilities. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $345,661,000 

Budget estimate, 2014 ........................................................................... 347,956,000 

Committee recommendation ................................................................. 346,685,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $346,685,000 for the 

Departmental Management account. Of this amount, $346,359,000 

is available from general funds and $326,000 is available by transfer from the Employment Security account of the Unemployment 

Trust Fund. In addition, $25,365,000 is available by transfer from 

the Black Lung Disability Trust Fund. 

The primary goal of the Department is to protect and promote 

the interests of American workers. 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 Committee continues its support of the Department’s efforts 

to reduce the backlog of mine safety cases before the Federal Mine 

Safety and Health Review Commission [FMSHRC] and to assure 

that the timely processing of cases occurs in the future. 

The Committee directs the Secretary, in conjunction with 

FMSHRC, to provide a joint report to the Committees on Appropriations of the House of Representatives and Senate for reducing 

the number of pending cases and average case processing time to 

appropriate levels by the end of fiscal year 2015. The report should 

fully explain how such levels were determined. It also should establish goals and metrics for determining when the levels will be 

achieved and how they will be maintained in the future. 

The Committee recommendation includes $95,425,000 for the Bureau of International Labor Affairs [ILAB], of which $66,375,000 is 

available for obligation through December 31, 2014. 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 
37 

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 expects ILAB to maintain its current effort on 

programs to combat exploitative child labor. The Committee also 

expects that the integrated child labor and worker rights projects 

proposed in the budget request will have a significant and direct 

child labor component. The bill requires ILAB to spend not more 

than $59,887,000 for programs to combat exploitative child labor 

internationally and not less than $6,488,000 to implement model 

worker rights programs in countries with which the United States 

has trade preference programs or free trade agreements. The bill 

also continues language from last year’s act regarding the authority to fund microfinance activities. 

Additionally, the Committee commends the Department for annually completing the country assessments on commitments to 

eliminate the worst forms of child labor, consistent with the requirements of 19 U.S.C. 2464. The Committee recommendation provides $8,467,000 for program 

evaluation and allows these funds to be available for obligation 

through September 30, 2015. 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 includes requested authority to use up to 0.5 percent of certain 

Department appropriations for evaluation activities identified by 

the chief evaluation officer. The bill language differs slightly from 

last year’s bill by including the Training and Employment Services 

in the list of accounts covered by this authority, as proposed in the 

budget request. The Committee expects to be notified of the 

planned uses of funds derived from this authority. 

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

Women’s Bureau. These funds will enable the Bureau to undertake 

critical work in addressing the pay gap. The Committee continues 

bill language allowing the Bureau to award grants. 

The Committee is very supportive of Executive Order 13548 and 

the Department’s goal to raise the representation of individuals 

with disabilities in its workforce from 7.24 percent in fiscal year 

2010 to 11.3 percent by fiscal year 2016. However, fiscal year 2011 

results suggest the Department is not on pace to meet its goals. 

The Committee encourages the Department to accelerate its efforts 

in this area. 

VETERANS EMPLOYMENT AND TRAINING

Appropriations, 2013 1 ........................................................................... $263,907,000 

Budget estimate, 2014 ........................................................................... 300,518,000 

Committee recommendation ................................................................. 300,518,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation of $300,518,000 for VETS includes $38,185,000 in general revenue funding and $262,333,000 to 

be expended from the Employment Security Administration ac-
38 

count of the Unemployment Trust Fund. The Committee recommendation supports a significant expansion of services to veterans, transitioning servicemembers, and family members. 

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

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 recommendation includes new bill language, as 

proposed in the budget request, specifying funding levels for particular activities, as opposed to providing a lump sum appropriation. The new bill language also allows the Secretary to reallocate 

funds among activities in an amount not to exceed 3 percent of the 

funding from which any reallocation is made. 

The Committee provides $203,081,000 for the Jobs for Veterans 

State Grants [JSVG] program. This funding level will enable the 

Department to increase the level of intensive services provided to 

veterans by Disabled Veterans’ Outreach Program [DVOP] specialists as well as to reach new populations of servicemembers and 

their families in need of employment services. As proposed by the 

administration, the Committee includes new bill language specifying that JSVG funds may be used to provide DVOP and Local 

Veterans’ Employment Representatives [LVER] services to 

transitioning servicemembers 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 provides $14,000,000 for the Transition Assistance Program [TAP]. This funding will support an estimated 5,444 

employment workshops at military installations and in virtual 

classrooms worldwide for exiting servicemembers and spouses. The 

VOW to Hire Heroes Act of 2011 requires TAP services for most 

transitioning servicemembers. 

The Committee recommendation includes $41,838,000 for Federal 

administration costs. This funding level will support outreach to 

major private-sector companies to generate interest in hiring veterans and improve oversight and strengthen protection of veterans’ 

employment rights, among other activities. 

The Committee recommends $38,185,000 for the Homeless Veterans’ Reintegration Program [HVRP] to help homeless veterans 

attain the skills they need to gain meaningful employment. HVRP 

is the only Federal program that focuses exclusively on the employment of veterans who are homeless. 

The Committee recommendation includes $3,414,000 for the National Veterans’ Training Service Institute [NTVI], which provides 

training to Federal staff and veteran service providers. At this recommended level, NTVI will be able to train an estimated 2,210 veteran service providers and meet the new training requirements of 

the Veterans’ Benefits Act of 2010. 
39 

INFORMATION TECHNOLOGY MODERNIZATION

Appropriations, 2013 1 ........................................................................... $19,775,000 

Budget estimate, 2014 ........................................................................... 20,587,000 

Committee recommendation ................................................................. 19,775,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $19,775,000 for the IT Modernization account. Funds available in this account are used for two primary activities. The first is departmental support systems, for 

which $4,898,000 is provided. These funds help align IT investments with the Department’s strategic objectives. The second budget activity, for which $14,877,000 is provided, assists the Department in consolidating and optimizing common IT infrastructure 

services, protecting privacy, and improving timely and efficient 

services to the public. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $83,520,000 

Budget estimate, 2014 ........................................................................... 85,714,000 

Committee recommendation ................................................................. 83,520,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $83,520,000 for the DOL OIG. The 

bill includes $77,634,000 in general funds and authority to transfer 

$5,886,000 from the Employment Security Administration account 

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

$327,000 is available by transfer from the Black Lung Disability 

Trust Fund. 

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 Improvement Act of 1998 may only be used for competitive grants for training in occupations and industries for which 

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

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. 
40 

Section 106. The bill continues a provision prohibiting the Secretary from taking any action to alter the procedure for redesignating local areas under subtitle B of title I of WIA. 

Section 107. The bill modifies 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 173A(f)(2) of the 

WIA. 

Section 108. The bill modifies a provision allowing up to 0.5 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 109. The bill includes a new provision allowing the Secretary to reserve up to 3 percent of funds available under section 

272(b) of the Trade Act of 1974 to conduct evaluations and provide 

technical assistance relating to the activities carried out under the 

Community College and Career Training Grant program and to 

allow grantees to award subgrants. 

Section 110. The bill includes a new provision transferring the 

claims function under several Federal statutes currently performed 

by GAO to DOL. 

Section 111. The bill includes a new provision adjusting the salary cap for the Administrator of the Wage and Hour Division from 

Executive Level V to Executive Level IV. 

Section 112. The bill includes a new provision that provides flexibility with respect to the crossing of H–2B nonimmigrants working 

in the seafood industry and clarifies the Department’s regulatory 

authority with respect to the H–2B visa program. 

Section 113. The bill includes a new provision related to the H– 

2A program. 
(41) 

TITLE II 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

The administration request for HHS reflects a proposal to increase program evaluation transfers under section 241 of the PHS 

Act from 2.5 percent to 3 percent. Through these transfers, PHS 

agencies contribute a percentage of their budget authority to fund 

program evaluation activities throughout the Department. The percentage is specified in section 205 of the title II general provisions. 

The Committee rejects the proposed increase to 3 percent because of the effect on PHS Act agencies that are used as a source 

of evaluation transfers, most notably NIH. The Committee also believes that raising the tap would reduce the transparency of its recommended funding levels. 

For programs that are the source of the transfers, an increase in 

the evaluation tap would effectively cut their funding. With regard 

to NIH, the administration presents its request as an increase of 

approximately $471,000,000 over the fiscal year 2012 level; the effective increase for NIH, after factoring in the proposed tap increase, would actually be approximately $147,000,000 less. There 

are many other examples where the budget request touts significant increases for particular programs without noting that its tap 

proposal would undercut a portion of those increases. For these 

reasons, the Committee maintains the evaluation transfer amount 

at 2.5 percent, the same level as in fiscal year 2013. 

This is the fourth year that the administration has proposed an 

increase in the section 241 tap percentage. The Committee strongly 

discourages a similar increase in the fiscal year 2015 request. 

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, 2013 1 ........................................................................... $1,574,646,000 

Budget estimate, 2014 ........................................................................... 1,566,932,000 

Committee recommendation ................................................................. 1,574,646,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 
42 

The Committee recommendation for the activities of the Bureau 

of Primary Health Care is $1,574,646,000. 

Community Health Centers 

The Committee provides $1,574,606,000 in this bill for the Community Health Centers program. Combined with the 

$2,200,000,000 in mandatory funding appropriated for fiscal year 

2014 in the ACA, the Committee’s recommended program level totals $3,774,606,000. 

Programs supported by this funding include community health 

centers, migrant health centers, healthcare for the homeless, and 

public housing health service grants. The Committee continues to 

support the ongoing effort to increase the number of people who 

have access to medical services at health centers. 

The Committee includes bill language, modified from last year, 

requiring the administration to award all fiscal year 2014 funds by 

September 30, 2014. Such awards shall include $142,000,000 in 

base grant adjustments and not less than $700,000,000 in new access point awards and expanded service awards. These levels assume that funds made available for outreach and enrollment in 

health exchanges in fiscal year 2013 will be awarded as base grant 

adjustments in fiscal year 2014. 

In addition, within the amount provided, the Committee provides 

up to $94,893,000 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. 

Native Hawaiian Health Care.—The Committee includes sufficient funding in the Community Health Centers program to support healthcare activities funded under the Native Hawaiian 

Health Care Program, which is specifically cited in the bill. The 

Committee expects that not less than the fiscal year 2013 level be 

provided for these activities in fiscal year 2014. 

Free Clinics Medical Malpractice Coverage 

The Committee provides $40,000 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 in order to expand access to healthcare services to 

low-income individuals in medically underserved areas. 

BUREAU OF HEALTH PROFESSIONS

Appropriations, 2013 1 ........................................................................... $731,548,000 

Budget estimate, 2014 ........................................................................... 540,804,000 

Committee recommendation ................................................................. 773,190,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation for the activities of the Bureau 

of Health Professions is $773,190,000. In addition, the Committee 
43 

recommends transferring $30,300,000 to the Bureau from the PPH 

Fund. 

The total program level assumed in this bill for the Bureau is 

$803,490,000. 

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. 

The Committee notes that section 223 of this act modifies the 

rules governing National Health Service Corps contracts, which are 

administered in the Bureau of Health Professions. The authorization for this program allows contract cancellations up to 45 days 

prior to the end of the current fiscal year, which was intended to 

give HHS time to redirect those funds to new contracts before the 

available funding expired. NHSC now makes contracts on a rolling 

basis throughout the year with funds that do not expire. Under the 

rolling award system, Corps members who sign contracts in January have 7 months to cancel, while Corps members who sign up in 

September are not given the opportunity to cancel. Section 223 will 

allow every Corps member 60 days to cancel their contract. 

Training for Diversity 

Centers of Excellence 

The Committee provides $22,863,000 for the Centers of Excellence program. Institutions that are designated as centers of excellence are private institutions whose mission is to train disadvantaged minority health professionals for service in underserved 

areas. Funds are used for the recruitment and retention of students, faculty training, and institutional improvements. 

The Committee continues to support the Centers of Excellence 

program and the financial stability it has provided for the schools 

that participate. However, the Committee is concerned by reports 

that recent award amounts were based in large part on the amount 

of funding requested by each school, resulting in large, unexpected 

cuts for some of the schools and large increases for others. The 

Committee directs HRSA to institute an award review process that 

focuses more fully on the merits of the requested activities. The 

Committee expects HRSA to report back to the Committees on Appropriations of the House of Representatives and the Senate on the 

implementation of this process in the fiscal year 2015 budget justification. 

Health Careers Opportunity Program 

The Committee provides $14,942,000 for the Health Careers Opportunity Program [HCOP]. The purpose of this program is to create an educational pipeline to increase the number of individuals 

from educationally or economically disadvantaged backgrounds who 

enter the health and allied health professions. HCOP supports activities for disadvantaged students through formal academic and 

research training and student enhancement services. 
44 

The Committee encourages HRSA to refocus the program on 

reaching undergraduate and post-baccalaureate students. 

Faculty Loan Repayment 

The Committee provides $1,253,000 for the Faculty Loan Repayment program. This program provides for the repayment of education loans for individuals from disadvantaged backgrounds who 

are health professions students or graduates and who have agreed 

to serve for at least 2 years as a faculty member of a health professions school. 

Scholarships for Disadvantaged Students 

The Committee provides $47,357,000 for the Scholarships for 

Disadvantaged Students program. This program provides grants to 

health professions schools for student scholarships to individuals 

who are from disadvantaged backgrounds and are enrolled as fulltime students in such schools. 

Primary Care Training and Enhancement 

The Committee provides $50,962,000 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 once again urges HRSA to prioritize the training 

of physician assistants and includes bill language allowing HRSA 

to increase funding for this activity. 

Pediatric Loan Repayment 

The Committee recommends $5,000,000 to create a new loan repayment program for pediatric specialties, as authorized in section 

775 of the PHS Act. 

The Committee is concerned that shortages of child mental 

health providers and pediatric subspecialists are more severe than 

the shortages that exist for general pediatricians. Available fellowship positions are left unfilled because of the burden of student 

loans for specialty training. The Committee recommendation in 

this bill will fund 64 initial 2-year loan repayment awards for eligible providers working in underserved areas. The Committee urges 

HRSA to prioritize pediatric specialties aimed at mental and behavioral health services in implementing this program. 

Training in Oral Health Care 

The Committee recommends $32,654,000 for Training in Oral 

Health Care programs. 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 Committee recommendation includes not less than 

$8,000,000 each for general and pediatric dentistry. The Committee 

encourages HRSA to focus on training programs that target vulnerable populations in risk-based clinical disease management of all 

populations. 
45 

The Committee urges HRSA to work with CMS on the evaluation 

of additional models for expanding access to oral healthcare. Such 

models should include emergency room diversion programs and efforts under State law to deploy and evaluate new provider types. 

Interdisciplinary, Community-Based Linkages 

Area Health Education Centers 

The Committee provides $30,025,000 for AHECs, which link 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 Committee is pleased by HRSA’s collaboration with 

SAMHSA to develop and replicate community health worker programs that integrate primary care and behavioral health. HRSA 

should include in the fiscal year 2015 budget justification a report 

on progress made in this initiative. 

Geriatric Education 

The Committee provides $30,629,000 for Geriatric Education programs. Geriatric programs include: Geriatric Education Centers, 

the Geriatric Academic Career Awards program, and the Geriatric 

Training for Physicians, Dentists, and Behavioral and Mental 

Health Professionals program. 

The Committee reiterates its support for geriatric education and 

the effort to ensure that the wider primary care provider community has the skills and training to provide high-quality and coordinated care to older adults. The Committee looks forward to receiving the report HRSA is compiling to detail the ways in which geriatric training content is being integrated into primary care training 

in HRSA-supported institutions. 

In addition, the Committee recommendation transfers $5,300,000 

from the PPH Fund to train health professionals on issues related 

to Alzheimer’s disease. These funds are awarded to Geriatric Education Centers for outreach and education efforts to enhance 

healthcare providers’ knowledge of the disease, improve detection 

and early intervention, and improve care for people with Alzheimer’s disease and their caregivers. 

Mental and Behavioral Health 

The Committee provides $3,916,000 for Mental and Behavioral 

Health programs. These programs provide grants to higher education institutions and accredited training programs to recruit and 

train professionals and faculty in the fields of social work, psychology, psychiatry, marriage and family therapy, substance abuse 

prevention and treatment, and other areas of mental and behavioral health. 

Graduate Psychology Education.—The Committee supports the 

Secretary’s initiative to increase the number of psychologists pursuing clinical work with high-need and high-demand populations. 
46 

These populations are defined as rural, vulnerable, and/or underserved populations, as well as veterans, military personnel, and 

their families. While the Committee commends the emphasis on 

programs targeting veteran and military personnel population centers, the Committee is concerned that many servicemembers reintegrate into civilian life in communities that are rural and far 

from military and veteran facilities. As such, the Committee encourages HRSA to maintain a strong commitment to underserved 

areas generally. 

Social Work Training Program.—The Committee recognizes the 

importance of social workers and their contribution to family planning and maternal and child health outcomes, particularly in lowincome communities. The Committee intends the increase in this 

program to be used to continue and expand the Leadership Training in Social Work program, formerly funded in the Maternal Child 

Health Bureau of HRSA. This program annually funds three centers of excellence at schools of social work to help develop the next 

generation of social workers and provide critical leadership, resources, and training. The Leadership Training in Social Work program has successfully recruited many qualified minority candidates 

for long-term training, and graduates have taken faculty positions 

in schools of social work, pursued careers in policy and research, 

and become local leaders in direct service. The Committee directs 

the Bureau of Health Professions to work with the Maternal Child 

Health Bureau to ensure a smooth transition for grantees. 

Health Professions Workforce Information and Analysis 

The Committee recommends $5,000,000 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 $35,177,000 for Public Health Workforce 

Development, including $10,177,000 in budget authority and 

$25,000,000 in transfers from the PPH Fund. 

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. 

Funds are used to expand and improve residency training programs, and provide financial assistance to trainees enrolled in such 

programs. 

The Committee recommendation includes $3,813,000 for preventive medicine residencies. 

Integrative Medicine.—The Committee includes $3,502,000 for existing programs related to integrative medicine and $2,000,000 for 

a new competitive opportunity to improve residency programs in 

integrative medicine. The Committee intends the new funding to be 

used to award a national center of excellence on integrative primary care for the purpose of developing and disseminating best 

practices for integrative medicine training for physicians and 
47 

nurses. HRSA should select a nonprofit entity with a strong record 

of leadership in the field of integrative medicine curriculum development, with experience in both publishing and working with residency programs. 

Nursing Workforce Development Programs 

The Committee provides $251,099,000 for Nursing Workforce Development programs. The Committee recommendation is sufficient 

to fund all nursing programs at the level requested in the budget, 

which provides an increase of $19,672,000 for Advanced Education 

Nursing. 

Within funds available for the Nursing Education and Retention program, the Committee intends that no less than $5,000,000 be 

awarded to nurse-managed health centers. 

The Committee remains concerned that waiting lists for admission to nursing school are limiting our Nation’s ability to address 

the nursing shortage. For that reason, the Committee continues to 

place a strong priority on filling vacant nursing faculty positions, 

the majority of which require either a Ph.D. or a doctorate of nursing practice. The Committee encourages the Division of Nursing to 

prioritize this level of training and create incentives for students 

to pursue teaching as a career. 

Children’s Hospitals Graduate Medical Education 

The Committee provides $267,313,000 for the CHGME program. 

The program 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. 

National Practitioner Data Bank 

The Committee provides $28,016,000 for the National Practitioner Data Bank. As in previous years, bill language is included 

to ensure that user fees are collected to cover all costs of processing 

requests and providing such information to data bank users. 

The National Practitioner Data Bank collects certain adverse information, medical malpractice payment history, and information 

related to healthcare fraud and abuse. The data bank is open to 

healthcare agencies and organizations that make licensing and employment decisions. 

MATERNAL AND CHILD HEALTH BUREAU

Appropriations, 2013 1 ........................................................................... $860,252,000 

Budget estimate, 2014 ........................................................................... 824,861,000 

Committee recommendation ................................................................. 858,600,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation for the MCH Bureau is 

$858,600,000. The President’s request includes an additional 

$28,494,000 in transfers from the PPH Fund; the Committee recommendation for this account does not include any such transfers. 
48 

The mission of the Bureau is to improve the physical and mental 

health, safety, and well-being of the Nation’s women, infants, children, adolescents, and their families. This population includes fathers and children with special healthcare needs. 

Maternal and Child Health Block Grant 

The Committee provides $643,807,000 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 includes bill language requiring that the State 

grant portion of the block grant be funded at no less than 

$554,890,000. The fiscal year 2013 level is $554,171,000. The budget request is $549,729,000. 

The Committee also includes bill language identifying 

$78,641,000 for the Title V SPRANS set-aside. Within that total, 

the Committee recommendation includes sufficient funding to fully 

fund the set-asides for oral health, epilepsy, sickle cell anemia, and 

fetal alcohol syndrome at the level requested in the budget. 

Hemophilia.—The Committee commends HRSA on its work to establish models of hemophilia care in a culturally sensitive, familycentered coordinated manner. The National Hemophilia Program is 

a model system for caring for high-cost, chronic conditions. The 

Committee encourages HRSA to share best practices with CMS, 

particularly those regarding transitioning care from adolescence to 

adulthood. 

Oral Health.—The Committee recognizes the key role that Maternal and Child Health Centers in Pediatric Dentistry provide in 

preparing dentists with dual training in pediatric dentistry and 

dental public health, fostering academic leadership, and developing 

expertise in the treatment of children with special healthcare 

needs. The Committee encourages HRSA to provide incentives for 

these centers to leverage resources to strengthen and expand their 

activities. 

Perinatal Hepatitis B.—The Committee is pleased at the progress 

that has been made in reducing perinatal hepatitis B transmission 

and commends HRSA for the ongoing review of best practices. The 

Committee notes that the 2010 rate of transmission was the lowest 

on record and well below the Healthy People 2010 goal. However, 

given the availability of an effective post-exposure prophylaxis protocol, the Committee believes that the elimination of all perinatal 

transmission is a goal worth pursuing. In view of the large number 

of at-risk women being seen in HRSA-funded settings, the Committee urges HRSA to move expeditiously to integrate the best 

practices identified in the review into routine practice. In addition, 

HRSA is encouraged to validate further best practices to prevent 

perinatal hepatitis B transmission, particularly in high-risk ethnic 

communities disproportionately impacted by chronic hepatitis B. 
49 

Social Work Training Program.—The Committee recognizes the 

importance of social workers and their contribution to family planning and maternal and child health outcomes, particularly in lowincome communities. The Committee has included funding in the 

Bureau of Health Professions to continue and expand the Leadership Training Program in Social Work, which annually funds three 

centers of excellence at schools of social work to help develop the 

next generation of social workers and to provide critical leadership, 

resources, and training. The Committee directs the MCH Bureau 

to work with the Bureau of Health Professions to ensure a smooth 

transition for the program’s grantees. 

Sickle Cell Anemia 

The Committee provides $4,770,000 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. 

Traumatic Brain Injury 

The Committee provides $9,760,000 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 no less than the fiscal year 2013 funding 

level for protection and advocacy services, as authorized under section 1305 of Public Law 106–310. 

Autism and Other Developmental Disorders 

The Committee provides $47,142,000 for the Autism and Other 

Developmental Disorders initiative. 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. 

The Committee directs HRSA to fund research on evidence-based 

practices for interventions for individuals with autism and other 

developmental disabilities, for development of guidelines for those 

interventions, and for information dissemination at no less than 

fiscal year 2013 levels. 

Leadership Education in Neurodevelopmental and Related Disabilities [LEND].—The Committee directs that HRSA provide no 

less than the fiscal year 2013 level for LEND programs to maintain 

their capacity to train professionals to diagnose, treat, and provide 

interventions to individuals with autism spectrum disorders. 

Newborn Screening for Heritable Disorders 

The Committee provides $9,913,000 in budget authority for the 

Newborn Heritable Disorders Screening program, as described in 

section 1109 of the Newborn Screening Saves Lives Act of 2008. 

The budget request is funded entirely through transfers from the 

PPH Fund. 
50 

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 $103,532,000 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. 

Public-Private Partnerships.—The Committee commends Healthy 

Start for engaging in public-private partnerships that identify best 

practices and lead to continuous quality improvement within the 

program. The Committee encourages HRSA to continue to evaluate 

rigorously the Healthy Start program and these partnerships. 

Stillbirth and Sudden Unexpected Infant Deaths [SUIDs].—The 

Committee notes that racial disparities in stillbirth and SUIDs persist and significantly contribute to the more than 25,000 stillbirths 

and over 4,000 SUIDs each year. HRSA is encouraged to support 

training and assistance that will enhance cooperative partnerships 

among local community health professionals, public health officers, 

community advocates, and consumers to address racial disparities 

in SUIDs and stillbirth. In addition, the Committee continues to 

support HRSA’s efforts to review cases of stillbirth and SUIDs at 

a local level, especially to identify better ways to address racial disparities. 

Universal Newborn Hearing Screening and Early Intervention 

The Committee provides $18,660,000 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 $21,116,000 for the Emergency Medical 

Services for Children [EMSC] 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 prehospital 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. 

The Committee commends HRSA for initiating a demonstration 

project in fiscal year 2012 to support innovative models to increase 

pediatric care in rural and tribal communities. The Committee also 

applauds the EMSC program for its collaboration with other Federal agencies in order to achieve EMS systemwide improvements. 
51 

Finally, the Committee remains strongly supportive of the Pediatric Emergency Care Applied Research Network. 

HIV/AIDS BUREAU

Appropriations, 2013 1 ........................................................................... $2,342,623,000 

Budget estimate, 2014 ........................................................................... 2,412,178,000 

Committee recommendation ................................................................. 2,393,951,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $2,393,951,000 for the 

HIV/AIDS Bureau, including $25,000,000 in transfers under section 

241 of the PHS Act. 

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. 

HIV Testing, Linkage, and Adherence.—The Committee is aware 

that, despite the demonstrated success of treatment-as-prevention 

programs, less than half of all Americans with HIV are on 

antiretroviral treatment. The Committee believes that the key 

steps to ending the HIV/AIDS epidemic include finding those people who are unaware of their HIV-positive status, linking all Americans with HIV/AIDS to care and treatment, and retaining them in 

that care and treatment. The Committee urges HRSA within its 

Ryan White SPRANS portfolio to focus on the development of systemic approaches aimed at ensuring viral load suppression. 

Emergency Assistance 

The Committee provides $669,915,000 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. 

The Committee notes that the provision requiring HRSA to 

transfer funds from part A to part B of the Ryan White Care Act 

as a result of the four transitional grant areas that changed status 

in fiscal year 2011 has expired. Therefore, the Committee expects 

HRSA to transfer no funds in fiscal year 2014 related to transitional grant areas. 

Comprehensive Care Programs 

The Committee provides $1,369,327,000 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. 

The Committee includes bill language providing $943,299,000 for 

AIDS medications in ADAP. This funding level is sufficient to continue the activities funded through HHS transfers in the previous 
52 

2 fiscal years and provide an increase of $11,797,000. The Committee intends that the increase provided for ADAP be awarded according to the statutory formula. 

Early Intervention Services 

The Committee provides $204,765,000 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 $77,013,000 for grants for coordinated 

services to women, infants, children, and youth. 

Funds are awarded to community health centers, family planning agencies, comprehensive hemophilia centers, county and municipal health departments, and other nonprofit community-based 

programs that provide comprehensive primary healthcare services 

to populations with or at risk for HIV. 

AIDS Dental Services 

The Committee provides $13,458,000 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. 

AIDS Education and Training Centers 

The Committee provides $34,473,000 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. 

HEALTH CARE SYSTEMS BUREAU

Appropriations, 2013 1 ........................................................................... $101,299,000 

Budget estimate, 2014 ........................................................................... 83,836,000 

Committee recommendation ................................................................. 103,515,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation for the Health Care Systems 

Bureau is $103,515,000. 

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 $26,015,000 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 
53 

educate the public and health professionals about organ donations 

and transplants and to support agency staff providing clearinghouse and technical assistance functions. 

National Cord Blood Inventory 

The Committee provides $11,864,000 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 $23,283,000 for the C.W. Bill Young 

Cell Transplantation Program. 

The Committee continues to strongly 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 $4,463,000 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 remains strongly committed to OPA’s plans to 

develop a transparent system to verify the accuracy of the 340B 

ceiling price. Therefore, the Committee again includes a statutory 

provision, requested by the administration, to allow a nominal cost 

recovery fee to fund the implementation of program integrity provisions recommended by the inspector general and included in the 

ACA. The fee will be set at 0.1 percent for covered entities and is 

expected to generate $6,000,000 in fiscal year 2014. The Committee 

expects HRSA to report the expected and actual amounts generated 

by the fee in HRSA’s annual budget justification. 

More than simply an individual discount program, the 340B program was designed to help safety net providers maintain, improve, 

and expand patient access to healthcare services generally. In establishing the program in 1992, Congress explicitly stated that the 

340B program was intended to ‘‘enable entities to stretch scarce 

Federal resources as far as possible.’’ As OPA continues to improve 

and enhance oversight of the 340B program, the Committee urges 

OPA to implement policies that maximize the healthcare safety net 

and expand patient access to healthcare. 

The Committee continues to note that there is currently no way 

for eligible entities to know if they are paying manufacturers the 

correct prices for 340B drugs. The ACA requires HRSA to make 

340B ceiling prices available to covered entities through a secure 

Web site. Given that the new cost recovery fee is being paid by 

340B participating entities, the Committee directs HRSA to make 

this Web site the first activity funded by the fee. 
54 

The Committee commends HRSA for delaying the enforcement of 

the group purchasing exclusion guidance promulgated on February 

7, 2013, but remains concerned by HRSA’s broad interpretation of 

the term ‘‘covered outpatient drug.’’ The Committee urges HRSA to 

create an understanding of the term that is more specific to the 

340B program. This would allow 340B-participating entities to use 

other available purchasing methods to obtain access to non-340B 

drugs at a lower cost. 

Poison Control Centers 

The Committee provides $19,793,000 for poison control activities. 

The Poison Control Centers program currently supports a mix of 

grantees. Most serve States; a few serve multistate regions; and, in 

a handful of cases, more than one grantee serves a single State. 

Poison control centers respond to nearly 4 million public and 

healthcare professional poisoning, toxic exposure, and adverse drug 

event emergency calls annually. It is estimated that the avoidance 

of these unnecessary hospitalizations save more than 

$1,200,000,000 in healthcare costs annually, of which nearly 

$700,000,000 of these savings accrue to the benefit of the Federal 

Medicare and Medicaid programs. The Committee believes these 

savings can be substantially increased through enhanced awareness of poison control centers by all Medicare and Medicaid participants. The Committee encourages the Secretary to engage in discussions with the Nation’s poison control centers to develop a plan 

to achieve these possible additional Medicare and Medicaid cost 

savings. 

National Hansen’s Disease Program 

The Committee includes $16,013,000 for the National Hansen’s 

Disease program. The program consists of inpatient, outpatient, 

and long-term care and training and research in Baton Rouge, Louisiana; a residential facility at Carville, Louisiana; and 11 outpatient clinic sites in the continental United States and Puerto 

Rico. 

National Hansen’s Disease Program Buildings and Facilities 

The Committee provides $128,000 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 $1,956,000 for Hansen’s disease services. 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, 2013 1 ........................................................................... $139,288,000 

Budget estimate, 2014 ........................................................................... 122,232,000 

Committee recommendation ................................................................. 141,798,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 
55 

The Committee recommendation for Rural Health programs is $141,798,000. 

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 62 million residents of rural communities. ORHP advises the 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. 

The Committee commends ORHP for its increased collaboration 

with the Department of Veterans Affairs and other agencies of the 

Federal Government. ORHP has significant experience in the areas 

of information technology, workforce recruitment and retention, 

and improved access to care. The Committee urges ORHP to continue providing its expertise across the government in ways that 

improve healthcare delivery in rural areas. The Committee directs 

the Administrator to report to Congress in the fiscal year 2015 

budget justification on ORHP’s efforts in this area. 

Rural Health Outreach 

The Committee provides $55,442,000 for the Rural Health Outreach program. 

This program supports projects that demonstrate new and innovative models of outreach in rural areas, such as integration and 

coordination of health services. 

The Committee recommendation includes sufficient funding to 

continue the five key program areas identified in the President’s 

budget: outreach services grants, rural network development 

grants, network planning grants, small healthcare provider quality 

improvement grants, and the Delta States network grant program. 

The Committee commends HRSA on its work to develop a generalizable formula to allow rural communities to measure the economic impact of their health investment. The Committee is gratified to learn that $1.50 is generated in the community for every $1 

invested by HRSA in rural health outreach. 

Frontier Extended Stay Clinics.—The Committee is aware that 

the Frontier Extended Stay Clinic demonstration concluded in 

April 2013. The Committee urges HRSA to assist clinics in maintaining their infrastructure while they wait for CMS’ evaluation of 

data from the demonstration. 

Native American Graduate Education.—The Committee is aware 

of significant needs in rural areas of the country for health professionals and in particular those areas that have significant populations of Native Americans. The Committee encourages HRSA to 

work with institutions in these areas to help them identify appropriate graduate health professions training programs for the need. 

Oral Health.—The Committee remains concerned about the unnecessary use of hospital emergency rooms [ERs] for relief but not 

resolution of oral health maladies. The 2012 report ‘‘A Costly Dental Destination’’ estimates that 830,590 emergency room visits were 

made across the country in 2009 because of preventable dental 

problems. The Committee is aware of several successful community-wide programs that have effectively reduced ER visits for oral 

health patients. The Committee urges HRSA to compile best prac-
56 

tices related to reductions in emergency dental care and disseminate that information to small and rural hospitals. In addition, 

HRSA is encouraged to work with CMS and AHRQ to identify gaps 

in knowledge related to these prevention initiatives. 

Rural Health Research 

The Committee provides $9,847,000 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 

the delivery of health services to rural communities and populations. 

Rural Hospital Flexibility Grants 

The Committee provides $40,958,000 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 rejects the proposed elimination 

of the Small Hospital Improvement Program. 

The Committee commends HRSA for its work on telehealth and 

electronic health records in rural hospitals, with a focus on mental 

healthcare for veterans. The Committee modifies previous bill language to give HRSA flexibility to determine future needs in this 

area. 

Rural Access to Emergency Devices 

The Committee provides $5,000,000 for the Rural Access to 

Emergency Devices program. Funding is used to purchase automated external defibrillators, place them in public areas where cardiac arrests are likely to occur, and train lay rescuers and first responders in their use. 

The Committee intends this appropriation to fund the rural program authorized in section 413 of the PHS Act and the community 

access demonstration authorized in section 313. Funding will be 

used to buy automated external defibrillators, put them in public 

areas where cardiac arrests are likely to occur, and train lay rescuers and first responders in their use. 

State Offices of Rural Health 

The Committee provides $10,016,000 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 $7,125,000 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. 
57 

Radiation and Exposure Screening and Education Program 

The Committee provides $1,931,000 for activities authorized by 

the Radiation Exposure Compensation Act. This program provides 

grants for the education, prevention, and early detection of 

radiogenic cancers and diseases resulting from exposure to uranium during mining and milling at nuclear test sites. 

Telehealth 

The Committee provides $11,479,000 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 commends OAT for expanding adult mental 

health services to 204 communities and pediatric/adolescent mental 

health services to 239 communities where access to such services 

did not exist prior to receiving Federal telehealth funding. The 

Committee remains strongly supportive of the emphasis OAT has 

placed on expanding access to mental health services. 

FAMILY PLANNING

Appropriations, 2013 1 ........................................................................... $296,244,000 

Budget estimate, 2014 ........................................................................... 327,402,000 

Committee recommendation ................................................................. 327,402,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee provides $327,402,000 for the Title X Family 

Planning program. This program supports preventive and primary 

healthcare services at clinics nationwide through four key functions: (1) providing individuals with comprehensive family planning 

and related preventive health services, including all FDA-approved 

methods of contraception; (2) training for family planning clinic 

personnel; (3) data collection and research aimed at improving the 

delivery of services; and (4) information dissemination and community-based education and outreach activities. 

The Committee recognizes the ongoing need to support publicly 

funded family planning services and supplies during and after implementation of the ACA. Although health reform will result in the 

expansion of insurance coverage, patients seeking family planning 

and reproductive health services often have privacy concerns that 

inhibit the full use of coverage. Many of these patients will turn 

to safety-net settings, such as title X-funded health centers, for 

care. Public funding for family planning remains a cost-effective 

means of providing essential health services and will be important 

to Federal and State efforts to implement the ACA. 

Infrastructure.—As essential community providers, title X clinics 

provide primary and preventive care services, including cancer 

screenings and family planning services, to nearly 5 million women 

and men each year. The Committee supports the use of title X program funds for infrastructure investments, including for health information technology, to ensure women’s health providers can keep 

pace with the increased demand for reproductive health services. 

Tiered Subgranting.—The Committee is aware that some traditional grantees of the title X program are implementing newly 
58 

tiered approaches which base subgranting decisions on criteria that 

are unrelated to the performance outcomes of the program. The 

Committee directs HRSA to give funding preference to applicants 

with plans that show that a wide range of providers are eligible for 

subgrants and that funding decisions will be made solely on the 

ability of a clinic to achieve the best possible outcomes for the population served. 

PROGRAM MANAGEMENT

Appropriations, 2013 1 ........................................................................... $161,186,000 

Budget estimate, 2014 ........................................................................... 161,794,000 

Committee recommendation ................................................................. 161,794,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee provides $161,794,000 for program management 

activities. 

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM

Appropriations, 2013 1 ........................................................................... $2,830,000 

Budget estimate, 2014 ........................................................................... 2,807,000 

Committee recommendation ................................................................. 2,807,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $2,807,000 for the Health Education 

Assistance Loan [HEAL] program. 

The Committee bill includes a general provision (section 522) to 

transfer the administration of the HEAL program to the Department of Education, as requested by the administration. 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriations, 2013 1 ........................................................................... $241,464,000 

Budget estimate, 2014 ........................................................................... 241,477,000 

Committee recommendation ................................................................. 241,464,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee provides that $241,464,000 be released from the 

Vaccine Injury Compensation Trust Fund in fiscal year 2014. Of 

that amount, $6,464,000 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 $6,183,769,000 in this bill for CDC, including $371,357,000 in transfers under section 241 

of the PHS Act and $55,358,000 in mandatory funds under the 

terms of EEOICPA. In addition, the Committee recommends 

$839,000,000 in transfers from the PPH Fund. 

The total program level recommended for CDC is $7,022,769,000. 

The fiscal year 2013 program level is $6,547,169,000 and the 

budget request is $6,644,640,000. The budget request includes 
59 

$617,664,000 in transfers under section 241 of the PHS Act and 

$755,110,000 in transfers from the PPH Fund. 

The activities of CDC focus on several major priorities: providing 

core public health functions; responding to urgent health threats; 

monitoring the Nation’s health using sound scientific methods; 

building the Nation’s health infrastructure; 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. The Committee has deleted references to title 

VII of the PHS Act throughout CDC’s appropriation, as requested 

by the President’s budget, in recognition of the fact that activities 

authorized in title VII are outside the scope of CDC’s mission. 

The funding levels for the fiscal year 2014 budget request are not 

easily comparable to the fiscal year 2013 and Committee-recommended levels. The President proposes to implement the Working Capital Fund [WCF] through each individual program line. The 

Committee rejects that approach and recommends implementing 

the WCF through a transfer of funds in the first quarter of fiscal 

year 2014, in accordance with statutory transfer provisions provided in the fiscal year 2013 continuing resolution and this bill. For 

that reason, prior year and Committee-recommended funding levels 

for each activity reflect the programmatic costs of such activities, 

and the total business service costs for CDC are appropriated separately in the CDC-wide appropriation. In contrast, the President’s 

request assumes business service costs are built into each funded 

activity at the level of that activity’s business service consumption 

in fiscal year 2011. In many cases, a proposed increase for an activity in the budget request simply reflects the addition of the existing 

business service cost. 

IMMUNIZATION AND RESPIRATORY DISEASES

Appropriations, 2013 1 ........................................................................... $587,959,000 

Budget estimate, 2014 2 ......................................................................... 681,560,000 

Committee recommendation ................................................................. 587,959,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $35,915,000 in business service funding. 

The Committee recommendation for the activities of the National 

Center for Immunization and Respiratory Diseases is $587,959,000; 

this amount includes $12,864,000 in transfers available under section 241 of the PHS Act. 

In addition, the Committee recommends transferring 

$150,000,000 to the Center from the PPH Fund. The President’s 

budget proposed transferring $72,460,000 from the PPH Fund; 

$90,883,000 was transferred from the PPH Fund in fiscal year 

2013. 

The total program level recommended for the Center is 

$737,959,000. 

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. 
60 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Immunization ....................................................................................... 520,340 580,959 579,457 

National Immunization Survey (non-add) ................................... (12,864 ) (12,864 ) (12,864 ) 

Influenza Planning and Response ....................................................... 158,502 173,061 158,502 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 2 Includes $35,915 in funds from the Working Capital Fund realignment. 

Cost Estimates.—The Committee requests an updated report on 

Federal immunization programs no later than February 1, 2014, to 

reflect fiscal year 2015 cost estimates, optimum funding to support 

State and local operations, and a continued discussion of the evolving role of Federal programs as expanded coverage for vaccination 

becomes more available from private and public sources. 

Exemption Rates.—The Committee urges CDC to continue working with State and local governments to ensure that the universal 

immunization recommendations, as defined by the Advisory Committee on Immunization Practices, are implemented. The Committee encourages CDC to work with States to track exemption 

rates and assess the impact that exemptions may have on vaccinepreventable disease rates. CDC should provide to State and local 

health officials, the provider community, and the public, scientifically accurate information on vaccines and vaccine-preventable 

diseases that is presented in culturally and linguistically appropriate manners. 

Public Health Role.—As more individuals have access to vaccines 

through health insurance coverage, the Committee believes that 

the public health role in vaccination will shift but not diminish. 

The Nation’s public health immunization infrastructure will be 

called upon to ensure the quality and safety of our vaccines, monitor increasing vaccination rates and remaining gaps, provide 

science-based education on vaccine risks and benefits, and respond 

to outbreaks. The Committee has combined the funding amounts 

for section 317 vaccine purchase with funding for program implementation and accountability to allow CDC maximum flexibility to 

increase quality and safety activities as insurance coverage rates 

change over time. The Committee urges CDC to use this flexibility 

to shift resources to better reflect the changing public health role. 

Specifically, the Committee recommends that CDC increase resources to: (1) modernize immunization information systems; (2) 

prepare public health departments for changes in the healthcare 

delivery system, including new billing procedures related to privately insured patients; (3) strengthen the evidence base to inform 

immunization policy; and (4) improve program monitoring, including vaccine-preventable disease surveillance, vaccine coverage assessment, adverse event reporting, and laboratory training. The 

Committee directs that intramural costs within the immunization 

be funded at the fiscal year 2013 level. 

Vaccine Purchase Formula Change.—The Committee supports 

CDC’s policy decision to limit the conditions under which fully insured individuals may receive vaccines purchased through section 
61 

317 funds. The Committee believes that section 317 should be the 

payer of last resort for vaccination. However, the Committee has 

some concerns about the administration’s plan to change from a 

vaccine purchase allocation formula that is based strictly on each 

State’s total population to a formula based on Census estimates of 

each State’s uninsured population. The Committee notes that this 

change would inadvertently penalize uninsured and underinsured 

individuals in States that are using all available tools to insure 

their populace. The Committee urges CDC to develop a component 

in the formula that would provide an incentive to States to administer section 317-funded vaccines in a way that addresses coverage 

gaps which cannot be filled with other available Federal programs. 

HIV, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND

TUBERCULOSIS PREVENTION

Appropriations, 2013 1 ........................................................................... $1,097,823,000 

Budget estimate, 2014 2 ......................................................................... 1,176,942,000 

Committee recommendation ................................................................. 1,097,823,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $53,030,000 in business service funding. 

The Committee recommendation for the activities of the National 

Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases 

[STDs], and TB Prevention is $1,097,823,000. 

In addition, the Committee recommends transferring $10,000,000 

to the Center from the PPH Fund. The President’s budget did not 

recommend transferring funds from the PPH Fund; however, the 

budget request did propose a transfer of $3,000,000 under section 

241 of the PHS Act. 

The total program level recommended for the Center is 

$1,107,823,000. 

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 2013 

comparable 1

Fiscal year 2014 

request 2

Committee 

recommendation 

HIV Prevention by Health Department ....................................................... 334,422 399,744 392,636 

National Programs To Identify and Reach High Risk Populations ........... ........................ 400,985 362,189 

HIV School Health ...................................................................................... 29,778 35,395 29,778 

HIV Surveillance ......................................................................................... 116,797 ........................ ........................

Enhanced HIV Testing Initiative ................................................................ 64,918 ........................ ........................

Improving HIV Program Effectiveness ....................................................... 101,649 ........................ ........................

National, Regional, Local, Community and Other Organizations .............. 137,039 ........................ ........................

Viral Hepatitis ............................................................................................ 19,640 31,410 29,640

Sexually Transmitted Infections ................................................................. 153,523 161,710 153,523 

Tuberculosis ............................................................................................... 140,057 147,698 140,057 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $53,030 in funds from the Working Capital Fund realignment. 

Hepatitis C Prevention.—The Committee is concerned by increasing rates of new hepatitis C infections that are associated with the 

injection of prescription opioids and heroin, particularly among 

young people. The Committee encourages the Division of Viral Hep-
62 

atitis to continue coordinating efforts with the Assistant Secretary 

for Health, SAMHSA, and NIDA to address these outbreaks by disseminating timely information on evidence-based prevention strategies and providing technical assistance to health departments and 

community-based organizations. 

HIV Prevention.—The Committee accepts the administration proposal to realign and consolidate the various funding streams that 

are awarded to State health departments for the surveillance and 

prevention of HIV. The Committee believes this consolidation will 

allow needed flexibility while the public health system adapts to 

the expansion of preventive services brought about by the implementation of the ACA. The Committee requests that CDC provide 

an accurate picture of how States are using this additional flexibility in future budget justifications. 

Liver Disease.—Liver diseases of all kinds have a significant impact on the health and well-being of Americans. The Committee 

notes that liver diseases are addressed by several Centers of CDC. 

For example, public health efforts around hepatitis are housed in 

this Center, but fatty liver disease is associated with obesity, the 

prevention of which is led by the Center on Chronic Diseases. The 

Committee encourages CDC to consider ways to coordinate public 

health efforts on liver diseases across Centers. 

Viral Hepatitis Screening.—The Committee urges CDC to 

prioritize testing activities and initiatives to identify people infected with asymptomatic forms of hepatitis. The Committee further encourages CDC to conduct prevention research to identify 

and disseminate best practices for implementing viral hepatitis 

screening, including new tests and testing procedures, standards of 

preventive care, and prompt linkage of persons testing positive for 

viral hepatitis to needed medical management and treatment. CDC 

should investigate opportunities to make purchasing options for 

hepatitis testing supplies more streamlined and efficient. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriations, 2013 1 ........................................................................... $252,043,000 

Budget estimate, 2014 2 ......................................................................... 380,664,000 

Committee recommendation ................................................................. 283,237,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $57,917,000 in business service funding. 

The Committee recommendation for the activities of the National 

Center for Emerging and Zoonotic Diseases is $283,237,000. In addition, the Committee recommends transferring $52,000,000 to the 

Center from the PPH Fund. The President’s budget proposed transferring $51,750,000 from the PPH Fund; $44,174,000 was transferred from the PPH Fund in fiscal year 2013. 

The total program level recommended for the Center is 

$335,237,000. 

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: 
63 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Infectious Disease Core Funding ............................................................... 19,789 24,339 19,789 

Vector-borne Diseases ............................................................................... 23,044 28,326 23,044 

Lyme Disease ............................................................................................. 8,702 10,701 9,702 

Prion Disease ............................................................................................. 4,960 6,089 4,960 

Chronic Fatigue Syndrome ......................................................................... 4,699 5,778 4,699 

Emerging Infectious Diseases ................................................................... 123,147 151,521 123,147 

Food Safety ................................................................................................ 27,067 49,223 35,067

National HealthCare Safety Network ......................................................... 14,814 31,562 16,814 

Quarantine ................................................................................................. 25,821 33,125 26,015

Advanced Molecular Detection ................................................................... ........................ 40,000 20,000 

Epidemiology and Laboratory Improvement program ................................ 32,424 40,000 40,000 

Healthcare-Associated Infections .............................................................. 11,750 11,750 12,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $57,917 in funds from the Working Capital Fund realignment. 

Advanced Molecular Detection.—The Committee strongly supports CDC’s mission to improve our Nation’s capability to detect 

and treat infectious diseases and food-borne illnesses. Therefore, 

the Committee recommendation includes the full amount requested 

for improving pathogen identification, enhancing sustainable laboratory information systems, and improving modeling and early 

recognition of pathogens, as the first investment in CDC’s proposed 

5-year initiative. The Committee recommends that CDC use the 

first year of funding to begin building the science base of this initiative before funding the coordination of States. In starting this 

initiative, the Committee notes that this is a focused, time-limited 

effort on a particular genetic sequencing capability that has implications across many of CDC’s program areas. To the extent that 

this capability reveals a potential advance that is limited to an 

issue area covered by other programs and Centers of CDC, the 

Committee expects CDC to transition the research and implementation of that new technique to the relevant condition-specific and 

laboratory support programs of CDC. The Committee strongly supports ongoing innovation in all programs of CDC and intends this 

initiative to strengthen that commitment across the agency. 

Antibiotic Resistance.—The Committee commends CDC for committing to develop the report requested in fiscal year 2013 on the 

available data on antibiotic consumption and resistance trends. The 

Committee recognizes that the report requires substantial effort 

and looks forward to receiving it on CDC’s proposed timetable. 

Antimicrobial Resistance.—The Committee urges CDC to work 

with State health departments to expand the work of prevention 

collaboratives, which seek to interrupt and prevent the transmission of significant antibiotic-resistant pathogens across 

healthcare settings. CDC, with the collaboratives, should evaluate 

the impact of possible interventions on hospital readmissions, 

healthcare-associated infection rates, or other measures relevant to 

health or economic activity. CDC and the Prevention Epicenters 

are encouraged to continue evaluating interventions to prevent or 

limit the development of antimicrobial resistance, facilitating public health research on the prevention and control of resistant organisms, and assessing the appropriateness of current surveillance 

and prevention programs in healthcare and institutional settings. 
64 

Epidemiology Laboratory Capacity [ELC] Cooperative Agreement.—The Committee is aware that some confusion exists between the ELC program funding and the ELC cooperative agreement. The ELC cooperative agreement is a flexible funding mechanism that is used to award ELC program funds to States, and is 

also used to award funds that are appropriated for a variety of condition-specific activities in this report. To eliminate this unnecessary and unhelpful confusion, the Committee has renamed the ELC 

program ‘‘the Epidemiology and Laboratory Improvement program’’. The Committee intends this to be a clarifying change only. 

CDC should maintain the prior purpose, award mechanism, and allocation of this funding. 

Food Safety.—The Committee recommendation includes additional funding to maintain appropriate staffing levels and enhance 

laboratory capacity in States to identify food-borne illnesses and effectively confine outbreaks. Further, the Committee continues to 

support the integrated Food Safety Centers of Excellence. These 

Centers, housed within State health departments, serve a critical 

role in developing and disseminating best practices and tools in 

food safety surveillance and outbreak response. 

Healthcare-Associated Infections [HAIs].—Researchers estimate 

that excess medical costs from HAIs in U.S. hospitals range from 

$28,000,000,000 to $33,000,000,000 every year. The Committee continues to support the monitoring, response, and prevention efforts 

that have led to promising reductions in HAIs in recent years. The 

Committee recommendation is sufficient to expand the National 

Healthcare Safety Network, an HAI surveillance system used by 

over 5,000 facilities, including hospitals in all 50 States and nonhospital settings throughout the country. 

Infectious Diseases.—The core Infectious Disease program provides funding to States to identify and monitor the occurrence of 

known infectious diseases, identify newly emerging infectious diseases, and identify and respond to outbreaks. The Committee notes 

that this funding has supported the public health response in virtually every major infectious disease outbreak in recent years. 

Quarantine.—The Committee recommendation includes a new 

provision, requested by the administration, to reimburse States for 

the cost of isolation and quarantine. The Committee modifies the 

requested statutory language to limit reimbursement to the costs 

States incur following a Federal quarantine order, rather than reimburse States for quarantines that originate under State laws. 

Unsafe Injection Practices.—The Committee remains troubled by 

outbreaks of and ongoing public exposure to life-threatening infections and bacteria caused by unsafe injection practices in 

healthcare facilities, including the misuse of vials and syringes. 

Outbreaks are entirely preventable when evidence-based infection 

control practices are followed. CDC is encouraged to continue its injection safety activities, including provider education and awareness, detection, tracking, and response. The Committee encourages 

broader outreach to healthcare providers and State and local 

health departments to disseminate the standards-based resources 

and toolkits that were created through previous investments of this 

Committee and through the PPH Fund. The Committee is aware 

that CMS is collecting additional data on infection control proce-
65 

dures of ambulatory surgical centers, beginning in fiscal year 2013, 

and encourages CDC to collaborate with CMS to analyze this data 

and use it to target prevention resources more effectively. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriations, 2013 1 ........................................................................... $755,079,000 

Budget estimate, 2014 2 ......................................................................... 620,189,000 

Committee recommendation ................................................................. 774,831,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $43,939,000 in business service funding. 

The Committee recommendation for the activities of the National 

Center for Chronic Disease Prevention and Health Promotion is 

$774,831,000. In addition, the Committee recommends transferring 

$485,700,000 to the Center from the PPH Fund. The President’s 

budget proposed transferring $415,904,000 from the PPH Fund; 

$233,033,000 was transferred from the PPH Fund in fiscal year 

2013. 

The total program level recommended in this bill for the Center 

is $1,260,531,000. 

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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Tobacco ................................................................................................ 168,194 212,360 202,892 

Chronic Disease State Grants: 

Heart Disease and Stroke ........................................................... 54,881 58,870 54,881 

Diabetes ...................................................................................... 64,323 69,260 64,323 

School Health .............................................................................. 13,499 14,703 17,199 

Food Allergy (non-add) ...................................................... (486 ) .......................... (486 ) 

National School Food Marketing Assessment (non-add) .. .......................... .......................... (1,700 ) 

Nutrition, Physical Activity and Obesity ..................................... 42,763 47,400 51,311 

National Diabetes Prevention Program ................................................ .......................... 10,000 10,000 

Community Health Promotion .............................................................. 6,096 6,636 6,096 

Glaucoma ............................................................................................. 3,313 3,591 3,313 

Visual Screening Education ................................................................. 507 551 507 

Alzheimer’s Disease ............................................................................. 1,799 1,949 1,799 

Inflammatory Bowel Disease ............................................................... 676 733 676 

Interstitial Cystitis ............................................................................... 650 704 650 

Excessive Alcohol Use .......................................................................... 2,436 2,647 2,436 

Chronic Kidney Disease ....................................................................... 2,078 2,251 2,078 

Oral Health ........................................................................................... 14,619 15,921 15,000 

Safe Motherhood/Infant Health ............................................................ 43,727 49,322 43,727 

Prevention Research Centers ............................................................... 24,325 25,041 27,869 

Breast and Cervical Cancer ................................................................ 204,427 184,560 204,427 

WISEWOMAN (non-add) ............................................................... (20,594 ) (21,413 ) (20,594 ) 

Breast Cancer Awareness for Young Women ...................................... 4,872 5,067 4,872 

Cancer Registries ................................................................................. 49,928 51,915 49,928 

Colorectal Cancer ................................................................................. 42,756 40,577 42,756 

Comprehensive Cancer State Grants ................................................... 20,165 20,967 20,165 

Johanna’s Law ..................................................................................... 4,962 5,161 4,962 
66 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Ovarian Cancer .................................................................................... 4,873 5,068 4,873 

Prostate Cancer ................................................................................... 13,092 13,612 13,092 

Skin Cancer .......................................................................................... 2,135 2,219 2,135 

Cancer Survivorship Resource Center ................................................. 494 514 494 

Arthritis and Other Chronic Diseases .................................................. 25,152 26,654 25,152 

Arthritis ....................................................................................... 12,979 .......................... 12,979 

Epilepsy ....................................................................................... 7,743 .......................... 7,743 

National Lupus Patient Registry ................................................. 4,430 .......................... 4,430 

Racial and Ethnic Approach to Community Health ............................ 13,916 .......................... 53,916 

Community Transformation Grants ...................................................... 146,340 146,340 290,000 

Obesity Prevention in High-Obesity Regions ....................................... .......................... .......................... 5,000 

Million Hearts ....................................................................................... 4,612 5,000 5,000 

Workplace Wellness .............................................................................. .......................... .......................... 10,000 

Let’s Move—National Early Child Care Collaboratives ...................... 4,000 4,000 4,000 

Breastfeeding Promotion and Support ................................................ 2,500 2,500 15,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $43,939 in funds from the Working Capital Fund realignment. 

Breast and Cervical Cancer Screening.—While the Committee 

understands that more women will have insurance in fiscal year 

2014 and thus more women will have access to breast and cervical 

cancer screening through their coverage, this program remains vitally important for the outreach and education it provides on the 

need for screening. Such efforts will be critical to ensuring that 

newly insured women actually receive these life-saving services. 

For that reason, the Committee includes the provision requested by 

the administration to eliminate the cap on State outreach activities; however, while the administration proposed giving this needed 

flexibility to just 10 States, the Committee recommends that it 

should be provided to all States. 

Cardiomyopathy.—The Committee continues to support CDC’s efforts to track the rates of sudden cardiac arrest [SCA], develop evidence-based prevention strategies for SCA deaths in youth, and 

disseminate information to schools, coaches, and parents. 

Coordinated Chronic Disease Funding.—The Committee commends CDC on the release of the February 2013 funding opportunity announcement [FOA] ‘‘State Public Health Actions to Prevention and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health.’’ This announcement 

implements an approach requested by the Committee for the past 

3 years. 

The Committee is aware that ensuring some level of chronic disease funding to all States, combined with the implementation of 

overall funding cuts in fiscal year 2013, resulted in drastic reductions for some States. The Committee recommendation includes additional funding in the Nutrition, Physical Activity, and Obesity, 

and School Health programs to increase the base grant component 

of the coordinated FOA. This investment, when combined with the 

$6,000,000 CDC awarded to all States in fiscal year 2013 to align 

the timing of these four grants, should increase each State’s annual 

award by an average of $440,000. This level is sufficient to reduce 

by over two-thirds the number of States funded below the level 

they were awarded in fiscal year 2012. 
67 

The Committee believes this approach will achieve three important goals: better align the distribution of CDC funding to chronic 

disease rates in the States, increase the ability of State health officials to move beyond planning activities into implementation of 

prevention strategies, and improve health outcomes for all Americans. CDC is expected to demonstrate that funds are spent in the 

amounts allocated and for the purposes specified in this report. 

Colorectal Cancer.—The Committee requests a report detailing 

CDC’s activities in each State regarding colorectal cancer. 

Community Transformation Grants [CTGs].—The Committee recommendation includes an additional $143,660,000 above the fiscal 

year 2013 level for CTGs. The Committee directs CDC to award 

this funding in another round of community grants in fiscal year 

2014. The Committee directs CDC to give a priority to communities 

that request funding to implement ‘‘Blue Zone’’ goals and strategies, in particular multi-sector approaches to public health interventions in areas such as transportation, agriculture, and housing. 

Blue Zones implement evidence-based practices identified in groups 

and cultures from around the world where people live measurably 

longer lives. In addition, priority should be given to communities 

and clusters of contiguous communities that are economically disadvantaged and whose residents have disproportionately poor 

health outcomes. 

Diabetes.—The Committee remains impressed by the implementation of the evidence-based National Diabetes Prevention Program 

[DPP] and includes $10,000,000 to expand the use of this model. 

The Committee notes that approximately one-third of people with 

diabetes do not know that they have it, while another 57 million 

have pre-diabetes and are at high risk for developing this deadly 

disease. The Committee directs CDC to ensure that diabetes prevention activities are conducted by all States within the coordinated chronic disease efforts. 

Diet and Nutrition.—The Committee believes that attention to 

the flavor of food is critical to inspiring the consumption of healthy 

and nutritious food. For that reason, the Committee continues to 

strongly support CDC’s initiatives to develop training resources for 

foodservice professionals and employees on the preparation of foods 

that are healthful, flavorful, and delivered in the most cost-effective 

manner. In particular, CDC is encouraged to produce and disseminate digital media instruction on best practices for delivering 

healthy meals in large volume settings. 

Epilepsy.—The Committee applauds the CDC epilepsy program 

for the progress it has made in advancing a public health agenda 

that seeks to improve the lives of people living with this disease. 

The Committee encourages CDC to continue expanding collaborations and addressing the recommendations of the 2012 IOM report 

‘‘Epilepsy Across the Spectrum: Promoting Health and Understanding.’’ 

Heart Disease and Stroke.—The Committee continues to support 

strongly the Paul Coverdell National Acute Stroke Registry. In addition, the Committee eagerly anticipates the upcoming release of 

data from the NCHS heart attack follow-up study, funded with 

PPH funding beginning in fiscal year 2011. Through this study, 

CDC is reviewing past medical records of individuals who are treat-
68 

ed for heart attack in emergency rooms, to determine if patterns 

exist for earlier intervention. CDC is directed to move expeditiously 

to incorporate any lessons learned into the State programs. 

Inflammatory Bowel Disease.—The Committee continues to 

prioritize CDC’s inflammatory bowel disease epidemiology study, 

and requests a report on the ongoing activities in this important 

area. 

Interstitial Cystitis.—The Committee commends CDC’s work to 

raise awareness of interstitial cystitis, particularly as emerging epidemiology data indicates that this condition is underdiagnosed in 

the male population. The Committee continues to prioritize the Interstitial Cystitis Education and Awareness Program and encourages CDC to partner with the advocacy community on this issue. 

Lupus Patient Registry.—The Committee applauds the efforts of 

the National Lupus Patient Registry. The Committee recommendation includes funding to conduct cohort and burden of illness studies to help study long-term outcomes, socioeconomic burdens, and 

mortality associated with lupus. Given the complexity of and difficulty in diagnosing the disease, the Committee is concerned that 

individuals with lupus could be missing from the registries. To address this concern, the Committee urges CDC to develop a national 

campaign focused on healthcare provider education and improved 

public understanding of lupus. The Committee directs CDC to work 

with the Office of Minority Health to ensure that all provider education efforts are coordinated and not duplicative. 

Maternal Mortality Reviews.—The Committee continues to support CDC’s work to standardize core data sets for State-based maternal mortality reviews, which identify deaths, review associated 

factors, and take action to institute changes to decrease pregnancyrelated and pregnancy-associated mortality. The Committee looks 

forward to the dissemination of the final case abstraction form in 

the coming year. 

National Early Care and Education Collaboratives.—According to 

statistics published in the Journal of American Medical Association, over a quarter of children aged 2 to 5 are overweight or obese. 

An estimated 12 million children spend time in early care and education [ECE] settings on a regular basis. The Committee recommendation includes $4,000,000 to continue the highly successful 

collaboratives, which assist ECE providers in six States adopt policies and practices related to nutrition, breastfeeding support, physical activity, and screen time. 

National School Food Marketing Assessment.—The Committee 

continues to be concerned that more than one-third of children and 

adolescents in the United States are overweight or obese. The Committee commends CDC for expanding the 2014 School Health Policies and Practices Study [SHPPS] to include additional questions 

related to food and beverage marketing. In support of this effort, 

the Committee recommendation for School Health includes an additional $1,700,000 in transfers from the PPH Fund for a SHPPS follow-up observational study related to food marketing. 

The primary objective of this follow-up component to the study 

shall be to assess the extent and types of marketing in elementary 

and secondary schools and on school grounds related to food and 

beverages. Coupled with the 2014 SHPPS questionnaire, this com-
69 

ponent shall assess ways through which foods and beverages are 

marketed to children in schools, including but not limited to brand 

and product logos, names, or information on educational materials, 

school supplies, displays, signage, equipment, buses, and other 

school property; educational incentive programs; label redemption 

programs; in-school media; free samples and coupons; branded 

fundraising activities; market research activities; and product displays and placements. The Committee further directs CDC to integrate the observational data into the 2014 SHPPS fact sheets and 

make publicly available a fact sheet on food marketing. The Committee encourages CDC to make the observational data available to 

external researchers to the greatest extent possible. 

Obesity Outreach.—While some indicators show slight drops in 

obesity rates recently, the Committee remains concerned that there 

has been little change in the areas where the problem is worst, 

particularly in rural areas. The Committee recommendation includes $5,000,000 in PPH Fund competitive funding to conduct 

pilot programs that focus on the use of existing extension and outreach services in the counties with the highest prevalence of obesity. All counties with an obesity prevalence of over 40 percent, as 

determined by CDC’s latest county level data in the Behavioral 

Risk Factor Surveillance System, shall be eligible to participate in 

this extension and outreach program. 

Office on Smoking and Health [OSH].—The Committee expects 

OSH to transfer at least the same amount it did in fiscal year 2013 

to the Environmental Health Laboratory. The Committee notes 

that this transfer is to be provided to the lab in a manner that supplements and in no way replaces existing funding for tobacco-related activities. The Committee is pleased with the reported results 

of the OSH media campaign, ‘‘Tips from Former Smokers.’’ In its 

first year, the Tips campaign generated more than 207,000 additional calls to State quitlines and more than 510,000 hits to 

www.smokefree.gov, the Government’s Web site offering quit assistance. Research has shown that at least five to six smokers try 

to quit on their own for every one person who calls a quitline. The 

Committee expects OSH to commit at least the same amount in fiscal year 2014 for a media campaign and quitlines as it did in fiscal 

year 2013. 

Oral Health.—The Committee recommendation includes funding 

for States to strengthen their capacities to assess the prevalence of 

oral diseases and to target resources and interventions, such as 

community prevention and school-linked sealant programs, to the 

underserved. The Committee is pleased with CDC’s work on the 

new communications plan related to prevention initiatives, and includes additional funding to implement the plan. The Committee 

continues to support the development of an oral health literacy program in response to recommendations from the IOM. 

Ovarian Cancer.—Within the funds provided for Johanna’s Law, 

up to $1,000,000 shall be used for a review of the state of the 

science on ovarian cancer. To conduct this review, CDC should engage all relevant operating divisions of HHS, as well as stakeholders and experts from the private and nonprofit sectors. The review should include: an evaluation and summary of the existing 

state of the science; an assessment of existing government initia-
70 

tives; and identification of and recommendations for other public 

and private sector efforts that would help the Nation make 

progress in reducing the incidence and mortality of ovarian cancer. 

In addition, the Committee requests an update in the fiscal year 

2015 budget justification on CDC’s effort to integrate ovarian cancer into other related programs at the CDC. 

Psoriasis.—The Committee commends CDC on the release of the 

report ‘‘Developing and Addressing the Public Health Agenda for 

Psoriasis and Psoriatic Arthritis,’’ funded under the jurisdiction of 

this Committee in fiscal year 2010 and released in February 2013. 

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 implement this agenda. 

Racial and Ethnic Approaches to Community Health [REACH].— 

The Committee strongly supports the REACH model of partnering 

with communities that are underserved and often disaffected, both 

to identify health disparities of concern to the community and then 

to implement community-based, evidence-based, and culturally 

competent approaches to reduce or eliminate those disparities. The 

Committee believes that REACH complements the CTG program 

by providing a more intense partnership with the leadership of 

communities that suffer from marked health disparities. Due to the 

relative lack of resources and organizing capacity, these communities need a longer engagement, with more intense community 

planning, smaller match requirements, and more significant technical assistance. For that reason, the Committee directs CDC to 

implement the model of REACH that existed prior to 2012, when 

CDC began supporting shorter commitments with a smaller level 

of funding. 

Safe Motherhood Initiative.—Although nearly 50 percent of all 

premature births have no known cause, there are prevention strategies that work, such as reducing early elective deliveries. Funding 

is provided to maintain current preterm birth research and prevention initiatives. 

School-Based Food Allergy Guidelines.—Deaths from 

anaphylactic reactions to food allergens are entirely preventable. 

Nevertheless, these tragedies continue to occur when epinephrine 

is not readily accessible for prompt administration or bystanders 

are not adequately prepared to respond. Many State legislatures 

have passed or are considering legislation to require or allow 

schools to stock epinephrine. The Committee recommendation includes funding to support the dissemination and implementation of 

the food allergy school guidelines, which CDC is expected to issue 

this fall. CDC is encouraged to consider making epinephrine purchase an allowable use of School Health funds, subject to terms 

and conditions related to storage and appropriate use. 

WISEWOMAN.—The Committee is aware that CDC is undertaking an open competition for WISEWOMAN, allowing new States 

to apply for the first time since 2008 and requiring all 20 funded 

States to recompete. WISEWOMAN helps uninsured and underinsured low-income women avoid heart disease and stroke by providing preventive health services, referrals to local healthcare pro-
71 

viders, and lifestyle counseling and behavioral interventions tailored to particular factors. 

NATIONAL CENTER ON BIRTH DEFECTS, DEVELOPMENTAL

DISABILITIES, DISABILITY AND HEALTH

Appropriations, 2013 1 ........................................................................... $137,051,000 

Budget estimate, 2014 2 ......................................................................... 67,148,000 

Committee recommendation ................................................................. 123,483,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $11,205,000 in business service funding. 

The Committee recommendation for the activities of the National 

Center on Birth Defects and Developmental Disabilities [NCBDDD] 

is $123,483,000. The budget requests an additional $74,796,000 in 

transfers from the PPH Fund. 

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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee recommendation 

Birth Defects .......................................................................................... 20,157 21,798 18,352 

Fetal Death (non-add) .................................................................. (806 ) ........................ (806 ) 

Fetal Alcohol Syndrome .......................................................................... 9,845 10,789 9,845 

Folic Acid ............................................................................................... 2,774 3,160 2,774 

Infant Health .......................................................................................... 7,854 8,899 7,854 

Autism .................................................................................................... 21,228 23,098 21,228 

Disability, Development, and Health ..................................................... 17,748 18,941 17,748 

Limb Loss ............................................................................................... 2,815 3,095 2,600 

Tourette Syndrome ................................................................................. 1,695 1,842 1,695 

Early Hearing Detection and Intervention ............................................. 10,612 11,253 10,612 

Muscular Dystrophy ................................................................................ 5,818 6,364 5,818 

Paralysis Resource Center ..................................................................... 6,689 ........................ ..........................

Attention Deficit Hyperactivity Disorder ................................................. 1,712 1,828 1,712 

Fragile X ................................................................................................. 1,678 1,802 1,678 

Spina Bifida ........................................................................................... 5,725 6,265 5,725 

Congenital Heart Failure ........................................................................ 1,986 2,138 2,986 

Thallasemia ............................................................................................ 1,856 ........................ 1,856 

Public Health Approach to Blood Disorders .......................................... 226 20,672 4,000 

Hemophilia ............................................................................................. 16,633 ........................ 7,000 

CDC Activities ............................................................................... .......................... ........................ 2,000 

Hemophilia Treatment Centers ..................................................... .......................... ........................ 5,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $11,205 in funds from the Working Capital Fund realignment. 

Congenital Heart Defects [CHDs].—CHDs continue to be the most 

common birth defect and leading cause of infant mortality in the 

United States. Even those who receive successful intervention will 

need lifelong, costly, specialized cardiac care. Estimates suggest 

there are over 2 million people alive today with CHDs. The Committee commends CDC for its increasing efforts to address the lifelong needs of this growing population, particularly in collaboration 

with other Federal agencies and private organizations. However, 

the Committee is concerned that there continues to be a lack of rig-
72 

orous epidemiological and longitudinal data on individuals of all 

ages with CHDs and includes funding to continue initial efforts to 

compile this information. The Committee provides $3,000,000 to 

collect and analyze nationally representative, population-based epidemiological and longitudinal data on infants, children, and adults, 

with the goal of improving estimates of CHD incidence, prevalence, 

and disease burden, which can be used to better assess the public 

health impact of this condition. 

Duchenne Care Considerations.—The Committee recognizes the 

value the Duchenne ‘‘Care Considerations’’ guidelines have had in 

improving the standardization of care and quality of life for patients with Duchenne muscular dystrophy and in extending the 

lifespan of Duchenne patients. The Committee encourages CDC, in 

collaboration with other Federal health agencies, to issue updated 

care recommendations and to develop new adult care recommendations expeditiously. Further, the Committee encourages CDC to 

evaluate whether outcomes are improved by care that is consistent 

with the existing guidelines. 

Fragile X and Fragile X-Associated Disorders [FXD].—The Committee continues to support CDC’s efforts to identify and define the 

population impacted by FXD, with the goal of understanding the 

public health impact of these conditions. Given the connection between fragile X syndrome and autism, the prospect of targeted 

treatments for both conditions, and current budgetary constraints, 

the Committee urges CDC to explore ways to create greater efficiency and synergy between programs addressing each condition. 

Hemophilia Treatment Centers.—The Committee is disappointed 

that funds appropriated specifically to address hemophilia have 

been used to develop public health approaches to other blood disorders. The Committee recommendation for hemophilia more closely aligns to a true accounting of funds spent on hemophilia and the 

Committee expects no further diversion of funds. The Committee 

includes sufficient funding to maintain and expand the surveillance 

and research activities of the national network of hemophilia treatment centers and CDC’s national outreach and prevention programs on hemophilia. The CDC hemophilia programs provide critical information to better understand risk factors for complications 

and identify high-risk populations for prevention measures. 

Limb Loss Resource Center.—The Committee is disappointed to 

learn that $1,000,000 appropriated for outreach and education on 

limb loss has been diverted to support broad activities that may not 

be of benefit to individuals who have lost a limb. The Committee 

directs that CDC allocate the full $2,600,000 provided herein for a 

limb loss resource center to that activity in fiscal year 2014. 

Paralysis Resource Center.—The Committee has transferred 

funding for the Paralysis Resource Center program to ACL, as requested by the administration. The Committee expects CDC to 

work with ACL to ensure a smooth transition for grantees and 

those served by this program. 

Public Health Approach to Blood Disorders.—The Committee includes $4,000,000 to support broad public health approaches to 

blood disorders. 
73 

Spina Bifida.—The Committee recommendation includes sufficient funding to continue the patient registry on spina bifida to improve the efficacy and quality of care for people with this disease. 

Tourette Syndrome.—The Committee commends CDC for its national public health education and research program on Tourette 

syndrome. The Committee intends that funds be used to continue 

to educate physicians, educators, clinicians, allied professionals, 

and the general public about the disorder and to improve scientific 

knowledge on prevalence, risk factors and co-morbidities of 

Tourette syndrome. 

Tuberous Sclerosis Complex [TSC].— Because TSC is a leading 

genetic cause of more prevalent neurological disorders such as autism and epilepsy, the Committee encourages CDC to incorporate 

information about TSC in CDC’s surveillance systems for those 

conditions. 

PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriations, 2013 1 ........................................................................... $391,495,000 

Budget estimate, 2014 2 ......................................................................... 469,305,000 

Committee recommendation ................................................................. 391,495,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $55,721,000 in business service funding. 

The Committee recommendation for Public Health Scientific 

Services is $391,495,000. This amount includes $247,769,000 in 

transfers available under section 241 of the PHS Act, the same 

amount as was transferred in fiscal year 2013. The President’s 

budget proposed $324,889,000 in section 241 transfers. 

In addition, the Committee recommends transferring $58,100,000 

to these activities from the PPH Fund. The President’s budget proposed transferring $70,000,000 from the PPH Fund; $51,501,000 

was transferred from the PPH Fund in fiscal year 2013. 

The total program level recommended in this bill for these services is $449,595,000. 

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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Health Statistics ........................................................................................ 138,683 181,475 138,683 

Guide to Community Preventive Services .................................................. 7,378 10,000 7,400 

Public Health Research ............................................................................. ........................ 5,000 ........................

Surveillance, Epidemiology, and PH Informatics ....................................... 245,459 275,799 251,945 

Public Health Workforce and Career Development .................................... 51,476 67,031 51,567 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $55,721 in funds from the Working Capital Fund realignment. 
74 

Integrated Public Health Surveillance.—The Committee believes 

that significant opportunities exist to create scientific, administrative, and fiscal efficiencies in the reporting of public health surveillance data as a result of the widespread adoption of electronic 

health records. For that reason, the Committee directs CDC to develop a comprehensive plan for public health surveillance that includes the advantages, costs, and barriers to integrated surveillance approaches, along with specific recommendations for increasing the efficiency of State and local health reports to CDC. The Director shall work with State and local health officials to submit the 

report not later than 180 days after the date of enactment of this 

act. The report should include full consideration of information 

technology platforms that would allow data brokering, validation, 

access, analysis, and visualization tools to be shared within the 

public health community and that would establish an integrated 

approach for sharing of State and local data across CDC surveillance programs. The Committee notes that some States and local 

jurisdictions have invested significant resources in developing surveillance systems in advance of this effort. CDC’s plan should build 

off those investments and identify ways that jurisdictions can plan 

future modifications to those systems 

Vital Statistics.—The Committee recommendation includes sufficient funding to collect 12 months of vital statistics data within the 

calendar year. In addition, the Committee notes that standard certificates of births and deaths were finalized 10 years ago, yet 10 

States have not fully adopted the 2003 modifications. The Committee urges CDC to survey States about their reasons for and 

against adoption, prior to engaging in any process to update the 

certificates again. The Committee remains committed to expansions in the quality and timeliness of vital statistics data, which 

can help prevent identity theft and the fraudulent use of Federal 

and State benefits. 

ENVIRONMENTAL HEALTH

Appropriations, 2013 1 ........................................................................... $104,819,000 

Budget estimate, 2014 2 ......................................................................... 126,126,000 

Committee recommendation ................................................................. 113,827,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $18,235,000 in business service funding. 

The Committee recommendation for the National Center for Environmental Health is $113,827,000. 

In addition, the Committee recommends transferring $39,200,000 

to the Center from the PPH Fund. The President’s budget proposed 

transferring $29,000,000 from the PPH Fund; $20,740,000 was 

transferred from the PPH Fund in fiscal year 2013. 

The total program level recommended in the bill for this Center 

is $153,027,000. 

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 

getting into people and to what degree. The Center also determines 
75 

whether these substances are harmful to humans and at what level 

of exposure. 

The Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Environmental Health Laboratory .............................................................. 42,310 50,607 46,510 

Core Operations ................................................................................ 34,534 50,607 34,534 

Newborn Screening Quality Assurance ............................................. 6,813 ........................ 6,813 

Newborn Screening for SCID ............................................................. 963 ........................ 963 

Chronic Disease Biomarkers ............................................................. ........................ ........................ 4,200 

Environmental Health Research ................................................................ 12,337 42,096 12,337 

Safe Water ................................................................................................. 7,097 ........................ 7,097 

ALS Registry ............................................................................................... 5,859 ........................ 6,859 

Built Environment & Health Initiative ....................................................... 2,624 3,132 2,624 

Climate Change ......................................................................................... 7,346 8,165 7,346 

Environmental and Health Outcome Tracking Network ............................. 20,740 29,000 35,000 

Asthma ....................................................................................................... 25,254 28,435 25,254 

Healthy Homes/Childhood Lead Poisoning ................................................ 1,992 4,988 10,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $18,235 in funds from the Working Capital Fund realignment. 

Chronic Disease Biomarkers.—Biomarkers are a uniquely powerful tool to identify high-risk individuals, diagnose disease conditions promptly and accurately, and effectively track prevention and 

treatment efforts. However, biomarkers can only be effective if the 

measurement tool can be standardized and the quality of the testing assured. For example, the Committee is aware of methods to 

screen for cholesterol that examine not just the type of lipid particles but the size. Researchers have demonstrated that this information can be used to better determine the risk for heart disease; 

however, there exists no standard to help clinicians interpret the 

data. As a result, patients who receive advanced cholesterol tests 

can receive dramatically disparate results. CDC’s Environmental 

Health Laboratory is one of the premier institutions for the development of standards and the quality assurance of measuring for 

biomarkers. The Committee recommendation includes funding to 

begin the development of reference methods and materials for several cardiovascular disease biomarkers, including small low-density 

lipoprotein, apolipoprotein D, high-sensitivity C-reactive protein, 

and troponin. In addition, CDC is encouraged to begin development 

of a reference method and reference materials for measurement of 

estrogen. The Committee recognizes both the need for reference 

methods for these biomarkers and the potential return on investment in the form of cost savings for Federal healthcare programs 

including Medicare and Medicaid. 

Healthy Homes and Lead Poisoning Prevention Program.—The 

Committee recommendation includes sufficient funding for national 

surveillance efforts that can better target HUD lead poisoning prevention efforts, technical assistance to local public health officials, 

and national leadership on the science of lead poisoning. 

National Environmental Public Health Tracking Network.—The 

Committee recommendation is sufficient to continue to support the 

23 States and one city that were funded through this program in 

fiscal year 2012. This investment allows State, local, and tribal 
76 

governments to evaluate potential linkages between disease and 

environmental exposures in their areas. The Committee encourages 

CDC to explore the feasibility of creating interoperability between 

the tracking network and major electronic health record systems to 

facilitate a more robust collection of de-identified data from which 

to compare health outcomes with environmental exposures. 

INJURY PREVENTION AND CONTROL

Appropriations, 2013 1 ........................................................................... $137,456,000 

Budget estimate, 2014 2 ......................................................................... 181,585,000 

Committee recommendation ................................................................. 162,456,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $8,611,000 in business service funding. 

The Committee recommendation for the National Center for Injury Prevention and Control is $162,456,000. 

In addition, the Committee recommends transferring $3,000,000 

to the Center from the PPH Fund. The President’s budget included 

a proposed transfer of $5,000,000 under section 241 of the PHS 

Act. 

The total program level recommended in this bill for the Center 

is $165,456,000. 

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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Domestic Violence and Sexual Violence .................................................... 30,989 32,611 30,989 

Youth Violence Prevention ......................................................................... 14,942 15,890 14,942 

Domestic Violence Community Projects ..................................................... 5,402 5,738 5,402 

Rape Prevention ......................................................................................... 39,320 41,729 39,320 

Gun Violence Prevention Research ............................................................ ........................ 10,000 10,000 

National Violent Death Reporting System ................................................. 3,465 23,570 18,465 

Injury Control Research Centers ................................................................ 9,957 10,220 9,957 

Traumatic Brain Injury ............................................................................... 6,016 ........................ 6,016 

Elderly Falls ............................................................................................... 1,955 ........................ 4,955 

All Other Unintentional Injury .................................................................... 22,942 33,794 22,942 

All Other Intentional Injury ........................................................................ 2,468 3,033 2,468 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 2 Includes $8,611 in funds from the Working Capital Fund realignment. 

Falls Prevention Interventions.—The Committee includes 

$3,000,000 from the PPH Fund to expand older adult falls prevention activities at CDC, in coordination with ACL. The Committee 

intends that CDC use the funding to conduct research to evaluate 

and disseminate the most effective fall prevention interventions 

and that ACL use the funding provided that agency to conduct outreach and demonstration programs to expand the implementation 

of effective interventions. 
77 

National Violent Death Reporting System [NVDRS].—The Committee recommendation includes $18,465,000 to allow CDC to expand the NVDRS beyond the current 18 States. NVDRS is a surveillance system that pools information from State and local medical examiners, coroners, law enforcement, crime labs, and vital 

statistics into a single incident record which presents a more complete picture of the circumstances surrounding a violent death. An 

enhanced NVDRS will provide States, communities, and researchers the ability to identify the preventable characteristics of violent 

deaths, including both homicides and suicides, at a more localized 

level. The Committee encourages CDC to plan how best to disseminate the new data on the magnitude, trends, and characteristics of 

violent deaths to prevention researchers, practitioners, and policymakers. The Committee intends this expansion to aid in the development, implementation, and evaluation of violence prevention 

strategies at the national, State, and local levels. 

Sports-Related Injuries.—The Committee is concerned about the 

number and severity of injuries related to sports activities at every 

age and experience level, from professional sports to sports programs for children. While physical activity is an important part of 

a healthy lifestyle and should be promoted as a national public 

health goal, the number of injuries, particularly those related to 

head injury and concussion, is a matter of grave concern. The Committee believes that new developments in sports safety equipment 

can reduce the number of injuries to participants in sports activities. In addition, safer technologies that have already been implemented in one sport can be applied to safety equipment in other 

sports, yielding widespread improvements in safety and injury reduction. For example, the Committee is aware of new designs for 

football helmets aimed at reducing or eliminating the injuries that 

contribute to concussions and traumatic brain injuries. The Committee encourages CDC to test and improve these new helmet designs in cooperation with academic centers, sports sanctioning organizations, and equipment manufacturers. 

TBI.—The Committee encourages CDC to consider supporting 

multidisciplinary approaches to early identification and treatment 

of TBI cases. 

OCCUPATIONAL SAFETY AND HEALTH

Appropriations, 2013 1 ........................................................................... $292,275,000 

Budget estimate, 2014 2 ......................................................................... 271,911,000 

Committee recommendation ................................................................. 292,275,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $32,693,000 in business service funding. 

The Committee recommendation for National Institute for Occupational Safety and Health [NIOSH] programs is $292,275,000; 

this amount includes $110,724,000 in transfers available under section 241 of the PHS Act. 

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 
78 

knowledge gained into products and services that impact workers 

in settings from corporate offices to construction sites to coal mines. 

The Committee recommendation includes funding for the following activities at the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

National Occupational Research Agenda ............................................ 111,365 98,926 111,365 

Education and Research Centers ........................................................ 24,226 .......................... 24,226 

Healthier Workforce Centers ................................................................ 5,007 5,433 5,007 

Mining Research .................................................................................. 52,273 62,374 52,273 

Other Occupational Safety and Health Research ................................ 99,404 105,178 99,404 

Miners Choice (non-add) ............................................................ (645 ) .......................... (645 ) 

National Mesothelioma Registry and Tissue Bank (non-add) ... (1,018 ) .......................... (1,018 ) 

NanoTechnology (non-add) ......................................................... (9,310 ) (11,150 ) (9,310 ) 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 2 Includes $32,693 in funds from the Working Capital Fund realignment 

Facilities.—The Committee is proud of the decade of investments 

made to implement the CDC Master Facilities Plan, which recently 

concluded with the opening of Building 107. One of the strategic 

goals of that plan was to move CDC from leased facilities into federally owned property to reduce facility-related costs to the agency. 

In furtherance of that goal, the Committee directs NIOSH to maximize the use of existing federally owned research facilities and 

property to conduct its work. In particular, the Committee is concerned that NIOSH has expanded its leasing activities while there 

remains unused space it owns. 

Mining Research.—The Committee appreciates the mine research 

data submitted in the ‘‘Significant Items’’ section of the fiscal year 

2014 congressional budget justification and requests that it be updated and included in the NIOSH section of future justifications. 

Mining Research Regional Approaches.—The Committee strongly 

supports mine research done to prevent injury and improve conditions in metal/non-metal mines located predominantly in the western half of the country, including mines in the newly revitalized 

Silver Valley of Idaho, the gold mining areas of Nevada, the platinum area in Montana, the trona mines in Wyoming, and the 

mines of various types in Alaska. In particular, the Committee 

strongly supports the Catastrophic Failure Detection and Prevention, Mining Injury and Disease Prevention, and Mining and Surveillance and Statistical programs. The Committee urges NIOSH to 

coordinate research goals with mine operators and unions in the 

various regions of the country. 

National Occupational Research Agenda [NORA].—The Committee includes no less than the fiscal year 2012 level for the Agriculture, Forestry and Fishing Program within NORA. 

Other Occupational Safety and Health Research.—The Committee appreciates the occupational safety and health research data 

submitted in the ‘‘Significant Items’’ section of the fiscal year 2014 

congressional budget justification and requests that it be updated 

and included in the NIOSH section of future justifications. 

Skin Cancer.—The Committee directs NIOSH to conduct research on the incidence of skin cancers among occupational workers who spend a majority of their work hours in vehicles or equip-
79 

ment operated outdoors. Such vehicles or equipment include trucks, 

transit vehicles, tractors and related farm equipment, and construction equipment. The Committee encourages NIOSH to identify 

technologies to mitigate incidences of skin cancers among this 

group of occupational workers by reducing worker exposure to UVA 

and UVB radiation. 

ENERGY EMPLOYEES OCCUPATIONAL INJURY COMPENSATION ACT

Appropriations, 2013 1 ........................................................................... $55,358,000 

Budget estimate, 2014 ........................................................................... 55,358,000 

Committee recommendation ................................................................. 55,358,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation for EEOICPA is $55,358,000. 

This mandatory funding supports NIOSH scientists who reconstruct radiation dose levels to inform compensation decisions. 

GLOBAL HEALTH

Appropriations, 2013 1 ........................................................................... $346,964,000 

Budget estimate, 2014 2 ......................................................................... 393,024,000 

Committee recommendation ................................................................. 391,964,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $29,014,000 in business service funding. 

The Committee recommends $391,964,000 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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Global AIDS Program ............................................................................... 116,883 131,942 116,883 

Polio Eradication ...................................................................................... 111,094 131,053 146,094 

Other Global Immunization ...................................................................... 48,917 51,950 48,917 

Global Disease Detection and Emergency Response .............................. 41,530 45,580 41,530 

Parasitic Diseases and Malaria .............................................................. 19,334 22,231 19,334 

Global Public Health Capacity Development ........................................... 9,206 10,268 19,206 

National Public Health Institutes (non-add) .................................. ........................ ........................ (10,000 ) 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $29,014 in funds from the Working Capital Fund realignment 

National Public Health Institutes [NPHIs].—In many countries 

around the world, public health functions are spread across varying 

divisions of the ministry of health. Laboratory work, surveillance, 

outbreak response, and budget are often disconnected and fragmented, making public health efforts less efficient and less effective. This fragmentation is a barrier to collaboration among nations 

on preventing the spread of infectious diseases and setting common 

health research goals. NPHIs are science-based organizations that 

administer the public health functions of a government. They use 
80 

evidence to inform health practice and policies, determine the effectiveness of health investments and practices, and provide a locus 

of coordination for donor resources in developing nations. 

The Committee is aware that the International Association of 

National Public Health Institutes has begun to transfer its technical assistance functions to CDC, making CDC the global leader 

on building NHPI capacity around the world. 

The Committee includes a new initiative to support the creation 

of NPHIs in developing countries. The Committee provides 

$10,000,000 to be available over a 2-year period for CDC to work 

in at least five countries. The Committee expects CDC’s engagement to be time-limited, extending from 3 to 5 years. The Committee further expects this initiative to engage countries in all regions of the world; however, the Committee understands that any 

participating country must show a high level of commitment to reorganize its ministry of health in this manner. 

Polio Eradication.—The Committee continues to support strongly 

the worldwide partnership to eradicate endemic polio, which now 

exists in only three countries in the world. The Committee includes 

an increase of $35,000,000, or 32 percent over the fiscal year 2013 

level, in recognition of the difficulty involved in the final phase of 

eradication, including the need for enhanced security measures for 

vaccination workers. Including this investment, this subcommittee 

has provided over $1,700,000,000 since the worldwide eradication 

effort began to ramp up in 1991, with additional Federal resources 

provided through the State and Foreign Operations subcommittee. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriations, 2013 1 ........................................................................... $1,297,248,000 

Budget estimate, 2014 2 ......................................................................... 1,334,316,000 

Committee recommendation ................................................................. 1,292,498,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $52,338,000 in business service funding. 

The Committee recommendation for the Office of Public Health 

Preparedness and Response [PHPR] is $1,292,498,000. 

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 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

State and Local Preparedness and Response Capability ......................... 656,289 658,026 659,719 

Public Health Emergency Preparedness Cooperative Agreement ..... 640,570 658,026 644,000 

Academic Centers for Public Health Preparedness .......................... 7,966 ........................ 7,966 

All Other State and Local Capacity .................................................. 7,753 ........................ 7,753 

CDC Preparedness and Response Capability ............................................ 138,031 166,012 137,177 

Biosense ............................................................................................ 20,692 ........................ 20,692 

Real-time Lab Reporting .................................................................. 8,061 ........................ 8,061 

Core Preparedness and Response .................................................... 109,278 ........................ 108,424 
81 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee recommendation 

Strategic National Stockpile ...................................................................... 502,928 510,278 495,602 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes $52,338 in funds from the Working Capital Fund realignment. 

Public Health Emergency Preparedness Cooperative Agreement.— 

A critical component of protecting and securing our Nation’s public 

health is having State, local, and territorial agencies prepared to 

prevent, detect, respond to, and rapidly recover from a variety of 

threats. The Committee notes that the level recommended is sufficient to return to a minimum State grant level of $5,000,000 once 

the WCF transfer is completely made. 

Coordination.—The Committee encourages CDC to continue efforts to align its preparedness grant programs with programs of the 

Departments of Homeland Security and Transportation that have 

complementary goals. As those efforts progress, the Committee encourages CDC to seek greater efficiencies in applications, reporting, 

and data collection for State and local grantees. 

Strategic National Stockpile.—When the WCF transfer is accounted for, the Committee recommendation is the same level as 

the President’s request for the stockpile. 

CDC-WIDE ACTIVITIES

Appropriations, 2013 1 ........................................................................... $616,854,000 

Budget estimate, 2014 2 ......................................................................... 131,402,000 

Committee recommendation ................................................................. 616,563,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Assumes a realignment of $398,618,000 in business service funding. 

The Committee provides $616,563,000 for public health leadership and support activities at CDC. 

In addition, the Committee includes $41,000,000 in transfers 

from the PPH Fund. The President’s budget proposed transferring 

$41,200,000 from the PPH Fund; $22,585,000 was transferred from 

the PPH Fund in fiscal year 2013. 

The Committee recommendation includes funding for the following activities in the following amounts: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 2

Committee 

recommendation 

Preventive Health and Health Services Block Grant ................................. 79,409 ........................ 79,409 

Business Services Support / Working Capital Fund ................................. 394,004 ........................ 394,004 

Building and Facilities Improvement ........................................................ 24,903 14,591 24,805 

Public Health Leadership and Support ..................................................... 118,538 116,812 118,345 

National Public Health Improvement Initiative ......................................... 21,663 40,200 40,000 

National Prevention Strategy ..................................................................... 922 1,000 1,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes a reduction of $398,618 for the Working Capital Fund realignment. 

The Committee is once again pleased with the progress CDC 

made in improving its congressional budget justification in fiscal 

year 2014, and continues to urge CDC to give a clear accounting 

of how funds are being spent in this annual budget document. In 
82 

particular, the Committee appreciates the detailed information on 

grant awards, staffing levels, and facility needs. In addition, the 

Committee finds helpful the updated statistics on the public health 

need that the funding is requested to address. The Committee encourages CDC to include in each future budget justification a chart 

on the funding level and structure of CDC’s laboratories. The Committee expects progress on transparency to continue as CDC seeks 

additional funding flexibility. 

Buildings and Facilities.—The Committee includes sufficient 

funding for CDC to complete the repairs and improvements identified as necessary in the fiscal year 2014 budget justification. The 

Committee directs CDC to continue to provide updated information 

in this format in all future justification documents. The Committee 

notes that the building and facilities funding is provided in a flexible manner with respect to time limitations, individual project 

budgets, and the variety of activities allowable in a given fiscal 

year, such as acquisition, construction, and repair. When choosing 

among current and prior year available funding for a specific 

project, the Committee encourages CDC to obligate the most restricted funding first, so as to allow maximum flexibility within the 

carryover funding available for the acquisition and equipping of a 

replacement site for the Lake Lynn laboratory. While this flexibility may result in a different source year of available funding for 

mine research lab replacement, the Committee expects that the 

total funding level reserved for this replacement effort be strictly 

maintained. 

Preventive Health and Health Services [PHHS] Block Grant.— The PHHS Block Grant allows each State to address its most critical public health needs. The Committee notes that, in approximately one-third of all States, the PHHS Block Grant is either a 

significant source or the only source of funding to support emergency medical services and trauma systems. 

Transfer Authority.—The Committee declines to provide the additional transfer authority that was requested in the budget for the 

Director of CDC. The Committee notes that section 206 of this act 

provides authority for transfer and reprogramming of CDC’s funds 

within certain parameters and once certain notifications are made. 

In fact, CDC funds were transferred in two separate actions under 

similar authority in fiscal year 2013. The Director of CDC should 

use the authority provided in section 206 of this act to implement 

any transfer of funds he deems necessary. 

Working Capital Fund [WCF].—The Committee is pleased with 

the progress CDC has made to set up the new WCF. The WCF is 

a revolving fund that pays for consolidated business services for 

CDC. The Centers of CDC will pay into the fund according to the 

amount of services they use. CDC is in the process of setting up 

an audited and transparent system, in which the Center directors 

participate in decisionmaking, to determine those amounts. 

The Committee includes funding for the WCF in the CDC-wide 

appropriation along with transfer authority to implement the WCF 

in the first quarter of fiscal year 2014. The Committee included 

statutory language in both the fiscal year 2012 and 2013 appropriation laws to allow CDC to implement the WCF through a 

transfer early in the first quarter of fiscal year 2014. The Com-
83 

mittee continues to direct CDC to implement the WCF in this fashion, and rejects the proposal in the President’s budget to implement 

the WCF by adjusting each individual program, project, and activity level herein. The Committee notes that identical transfer authority was provided in Public Law 113–6 to give CDC the ability 

to plan in advance for this first quarter transfer. If CDC is operating under a continuing resolution in October, the Committee directs CDC to transfer the apportioned amount of the fiscal year 

2014 working capital fund appropriation to each program of CDC 

according to the formula agreed upon for the WCF. 

NATIONAL INSTITUTES OF HEALTH

The mission of NIH is to seek fundamental knowledge about the 

nature and behavior of living systems and then to apply that 

knowledge to enhance human health, lengthen life, and reduce illness and disability. No other entity in the world has performed 

that mission so successfully. Yet there are signs that other countries are beginning to close the gap. 

While China and India are investing heavily in biomedical research, NIH funding has dropped significantly, in real terms, since 

the end of the 5-year doubling in fiscal year 2003. An investigator’s 

chance of winning an NIH grant has fallen from approximately 3 

in 10 a decade ago to roughly 1 in 6 today. At a time when the 

promise for medical advances has never been greater, the Nation 

cannot afford to lose any more ground in the life sciences. The Committee provides $30,954,976,000 for NIH activities with- in the jurisdiction of this bill, including $8,200,000 in transfers 

available under section 241 of the PHS Act. The budget request is 

$31,101,976,000, which the administration has described as approximately $471,000,000 higher than the fiscal year 2012 level. 

However, this proposed increase is smaller than it appears. As explained in the introduction to the HHS title in this report, the administration also proposes to increase the program evaluation tap 

on PHS agencies, including NIH, from 2.5 percent to 3 percent. 

That would effectively cut NIH funding by approximately 

$147,000,000, all of which would be redirected to other operating 

divisions within HHS. The Committee rejects the proposed increase 

in the tap. The Committee’s recommended total for NIH is effectively equal to the budget request. 

NATIONAL CANCER INSTITUTE

Appropriations, 2013 1 ........................................................................... $5,062,039,000 

Budget estimate, 2014 ........................................................................... 5,125,951,000 

Committee recommendation ................................................................. 5,091,885,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $5,091,885,000 

for NCI. Of this amount, $8,000,000 is available for repairs and improvements to the NCI facility in Frederick, Maryland. 

Cancer Centers.—The Committee urges NCI to put a higher priority on linking its designated cancer centers with community 

health providers in order to better reach underserved and rural 

populations with state-of-the-art treatment and care. Strengthening these networks could help reduce disparities in cancer sur-
84 

vival rates among racial, ethnic minority, and rural/non-rural 

groups. 

Gastric Cancer.—The Committee continues to be concerned about 

gastric cancer, particularly among young people, and is pleased 

that gastric cancer has been selected for study under The Cancer 

Genome Atlas [TCGA]. Given that research on gastric cancer is less 

advanced than that of many other cancers, the Committee urges 

NCI to put a priority on helping investigators in this field make 

the best possible use of genomic data from the TCGA. 

Gastrointestinal Stromal Tumor [GIST].—Despite significant 

treatment advances over the past decade, metastatic GIST remains 

largely incurable. The Committee encourages NCI to intensify its 

research on GIST and explore with NCATS whether any drugs that 

have been approved for other uses could be repurposed to treat this 

disease. 

Information Technology.—Certain health behaviors, including 

diet, exercise, and smoking, play a key role in cancer risk. As new 

technologies that may address behavioral risk factors are developed, the Committee urges NCI to expand research opportunities 

into how information technology and telecommunications can be leveraged to reduce these risks. 

Liver Cancer.—The Committee continues to urge NCI to put a 

higher priority on liver cancer research. In particular, the Committee urges the Institute to develop sustaining models of liver cancer for therapeutic drug development as well as to continue work 

in the area of biomarkers and drug discovery. 

Lung Cancer.—The Committee urges NCI to collaborate closely 

with international lung cancer experts to continue to explore ways 

to translate the findings from the National Lung Cancer Screening 

Trial into public health recommendations that will reduce the mortality and morbidity of this deadly form of cancer. 

Melanoma.—The Committee continues to put a high priority on 

melanoma research. The Committee notes that increased 

translational work into wild-type BRAF melanomas, which represent 50 percent of tumors, is critical to spearhead drug development. The recent discoveries of unique mutations in uveal melanoma also warrant additional research. The Committee continues 

to urge research into the mechanisms and early detection of drug 

resistance in BRAF mutant melanoma; further mapping of melanoma genetics and epigenetics; and clinical research into immune 

therapy checkpoint inhibitors, including biomarker research for response and lack of response, mechanistic analyses in patient-derived samples, and the testing of combination therapies that incorporate these inhibitors. The Committee continues to urge NCI to 

support research directed at the biology of tumor initiation and metastasis, risk reduction, and the relative utility of novel early detection strategies. The Committee requests an update in the fiscal 

year 2015 congressional budget justification on NCI’s melanoma research portfolio. 

Metastasis.—Although 90 percent of cancer deaths are associated 

with metastasis, this phenomenon is not widely studied due to its 

complexity and corresponding requirement for the involvement of 

scientists representing multiple disciplines. The Committee encourages NCI to develop a consortium of institutions with expertise in 
85 

cancer metastasis and metastasis genetics to leverage the unique 

strengths of each institution and facilitate progress toward controlling the most deadly attribute of cancer cells. 

Metastasis to Bone.—The Committee urges additional research 

on how to repair bone defects caused by cancer cells. Basic research 

is needed to understand the impact of matrix properties on cell behavior. Translational research is also needed to understand the impact of metastasis on the biomechanical properties of bone and the 

mechanisms by which bone marrow- and tumor-derived cells can 

influence metastatic growth, survival, and therapeutic resistance. 

Minority Population Cancer Rates.—The Committee remains concerned by the disproportionately high cancer rates in minority populations. The Committee requests an update from NCI and NIMHD 

on efforts to address this disparity, including the possibility of establishing centers of excellence focused on research, treatment, prevention, and communication and outreach to minority communities 

for early intervention. 

Neuroblastoma.—The Committee commends NCI for its leadership in convening a consensus panel to revise the international 

neuroblastoma response criteria. The Committee encourages NCI 

to expand its research portfolio on this devastating pediatric cancer 

with a focus on new treatment options for relapse patients. 

Obesity.—Excess body weight is linked to increased risk of primary diagnosis of colon, endometrium, kidney, esophageal, and 

postmenopausal breast cancers. Obesity is also linked to poor prognosis once cancer develops, especially in breast cancer and likely 

for prostate and colon cancer, the three most prevalent cancer 

types. Numerous underserved and minority groups have higher 

than average rates of obesity and as a result they suffer from higher obesity-related morbidity and mortality from cancer compared to 

other groups. Despite this statistic, these groups are typically 

underrepresented in obesity-related cancer prevention trials. In 

particular, nearly 20 percent of adults in the United States reside 

in a rural area, representing one of the largest medically underserved populations in the Nation and among the most understudied 

groups of cancer patients and survivors. The Committee urges NCI 

to focus research efforts on the effects of obesity on cancer outcomes in these underserved groups. 

Ovarian Cancer.—The Committee urges NCI to integrate expertise in cancer biology, drug discovery and development, 

bioinformatics, and pharmacogenomics to advance treatment options for patients with ovarian cancer. The Institute is also encouraged to collaborate with NCATS on drug repurposing efforts. 

Pancreatic Cancer.—The Committee strongly supports the goals 

of the Recalcitrant Cancer Research Act of 2012, a law that provides NCI with the tools to develop a scientific framework for addressing the deadliest forms of cancer, including pancreatic cancer. 

While maintaining the integrity of the peer review system, the scientific framework will enable NCI to capitalize on the full range of 

its expertise, and that of extramural scientists, to assess scientific 

progress against the Nation’s most lethal cancers, starting with 

pancreatic and lung cancer, and to develop a research agenda to reduce morbidity and mortality. The Committee urges the Institute 

to ensure that the final framework for pancreatic cancer fully ad-
86 

dresses all aspects of the statute. The Committee also notes that 

the new law reinforces NCI’s authority to award ‘‘exception funding’’ when relevant to a scientific framework. 

Pediatric Cancer.—The Committee encourages NCI to put a higher priority on pediatric cancer, as cancer remains the leading cause 

of disease-related death in children. More effective and less toxic 

treatments are needed, including materials-based strategies for localized drug delivery. 

Robotic Biorepositories.—To determine the genetic differences in 

the development, progression, and response to treatment of individuals with cancer, biospecimens must be collected and evaluated. As 

more are collected, NCI should consider the application of new 

technologies such as automated robotics to ensure an adequate supply of biospecimens and to promote better standardization of the 

collection process. The introduction of automated processes in biospecimen collection may also help to ensure an adequate supply of 

high-quality human biospecimens from multiethnic communities 

for research to understand and overcome cancer health disparities. 

NCI has established networks for biospecimen collection that can 

be used to assess the application of robotic technology and determine if robotics can improve the functions of the biorepository network. The Committee encourages NCI to consider a pilot robotic 

biorepository project to determine if this technology can enhance 

the goals of NIH programs. 

Slow-Growing Children’s Brain Tumors.—The Committee urges 

NCI to address the shortage of tissue samples for slow-growing 

children’s brain tumors by incentivizing researchers to centralize 

and share such samples, and to support the development of preclinical mouse models and other nonmammalian models for pediatric brain tumors. The Committee requests an update on these 

issues in the fiscal year 2015 congressional budget justification. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE

Appropriations, 2013 1 ........................................................................... $3,072,863,000 

Budget estimate, 2014 ........................................................................... 3,098,508,000 

Committee recommendation ................................................................. 3,077,916,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $3,077,916,000 for 

NHLBI. 

Cardiovascular Disease.—The costs of heart disease, stroke, and 

other forms of cardiovascular disease, in terms of lives lost and resources spent, remain the highest of any disease in the Nation. The 

Committee continues to believe that research against these devastating diseases should be a top NIH priority. The Committee recommends that NHLBI allocate resources for cardiovascular disease 

research according to the priority areas included in the Division of 

Cardiovascular Diseases Strategic Plan. 

Cell-Based Regenerative Treatments.—The Committee commends 

the Institute for its effort to harness the potential of cell-based regenerative treatments to address lung diseases and encourages additional work in this area. 
87 

Centers for Advanced Diagnostics and Experimental Therapeutics 

[CADET].—The Committee applauds the Institute’s efforts to accelerate the translation of basic research findings into clinical advances in respiratory diseases through the CADET program. 

Chronic Obstructive Pulmonary Disease [COPD].—The Committee applauds NHLBI for leading a cross-agency effort to respond 

to COPD, including collaborating with CDC in releasing the firstever, State-by-State prevalence data on this disease. The Committee encourages the Institute to move forward with this important initiative. 

Congenital Heart Defects.—The Committee commends NHLBI for 

its increasing efforts to develop translational research activities related to congenital heart disease through programs such as Bench 

to Bassinet and participation in the Congenital Heart Public 

Health Consortium. The Committee urges NHLBI to continue its 

work with other Federal agencies, as well as professional and patient organizations, to expand collaborative research initiatives and 

other related activities targeted to the diverse life-long needs of individuals living with congenital heart disease. 

Jackson Heart Study.—The Committee continues to recognize the 

efforts of the Jackson Heart Study to work with individuals and 

family members across generations in this longitudinal study of 

cardiovascular disease among African Americans. The Committee 

acknowledges the continued need for comprehensive research to address health disparities and the important implications for such research to all persons threatened by cardiovascular disease. 

Lymphangioleiomyomatosis [LAM].—The Committee continues to 

support 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 on this often fatal lung disease. The Committee commends 

NIH for supporting the MILES trial, which has shown that 

sirolimus suppresses disease activity in patients with moderate 

LAM. Additional controlled trials are needed to determine if the 

disease can be arrested in early stages. The Committee also applauds NHLBI for working with the LAM patient community to organize patient populations in a manner that facilitates clinical research. 

Mind-Body Interventions.—The Committee understands that 

mind-body interventions such as meditation have the potential to 

contribute to the prevention of cardiovascular disease. The Committee urges NHLBI to support multicenter, phase III randomized 

controlled trials, and pilot studies to prepare for such trials, of 

mind-body interventions that have shown promise in phase II trials 

to reduce cardiovascular risk factors, surrogate endpoints, and clinical events such as mortality, nonfatal myocardial infarction, and 

stroke. 

Pediatric Cardiomyopathy.—The Committee urges NHLBI to 

work with private and nonprofit stakeholders to develop and disseminate to the public a research agenda and 3-year strategic plan 

with specific activities to address gaps in research related to the 

causes, screening, diagnosis, and treatment of pediatric cardiomyopathy. Emphasis should be given on children who are at the 

highest risk for cardiomyopathy-related mortality. 
88 

Pulmonary Fibrosis.—The Committee applauds NHLBI for convening a workshop to develop a strategic plan for pulmonary fibrosis and supports efforts to enhance research on this disease. 

Scleroderma.—The Committee recognizes that pulmonary fibrosis 

is a complication of scleroderma and the most common cause of 

death in a diagnosed patient. Therefore, the Committee encourages 

NHLBI to expand scleroderma research related to pulmonary complications and facilitate collaboration and data sharing among 

scleroderma investigators. 

Sleep Disorders.—The Committee continues to support the implementation of the National Sleep Disorders Research Plan, including 

the emphasis on cross-Institute collaborations. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

Appropriations, 2013 1 ........................................................................... $409,889,000 

Budget estimate, 2014 ........................................................................... 411,515,000 

Committee recommendation ................................................................. 409,947,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $409,947,000 for 

NIDCR. 

Temporomandibular Disorders [TMD].—The Committee appreciates the advances that have been made as a result of NIDCR 

funding of research on TMD pain and urges the Institute to continue to lead this effort. Major findings that have emerged confirm 

that TMD is one of several chronic pain conditions co-occurring in 

some patients at odds greater than chance. The Committee strongly urges NIDCR to collaborate with other ICs to address these comorbid conditions. The Committee commends the Institute for 

working with NIAMS and NIBIB to organize the 

Temporomandibular Joint Working Group, which is charged with 

assessing the state of the science on the temporomandibular joint 

and identifying research gaps and future scientific opportunities. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY

DISEASES

Appropriations, 2013 1 ........................................................................... $1,793,450,000 

Budget estimate, 2014 ........................................................................... 1,811,786,000 

Committee recommendation ................................................................. 1,799,745,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,799,745,000 in this 

bill for NIDDK. 

Diabetes.—The Committee recognizes that diabetes is the leading 

cause of both kidney failure and adult-onset blindness. The Committee therefore urges NIDDK to fund basic research to better understand the causes of diabetic kidney and eye disease, as well as 

clinical studies to test potential therapies to prevent and treat 

these ailments. 

Gestational Diabetes.—The Committee recognizes that women 

with gestational diabetes and their babies face long-term health 

consequences as a result of the disease, including an increased risk 

of developing type 2 diabetes. Therefore, the Committee urges 

NIDDK to explore additional opportunities for research on gesta-
89 

tional diabetes, a disease affecting up to 18 percent of all pregnant 

women. 

Functional Gastrointestinal Disorders [FGIDs].—The Committee 

continues to urge NIDDK to engage in multi-Institute collaborations to improve understanding of FGIDs. 

Inflammatory Bowel Disease.—The Committee commends 

NIDDK for its continued support of the Human Microbiome Project 

and urges the Institute to put a high priority on using the results 

to advance the understanding of inflammatory bowel disease and 

its impact on pediatric patients. The Committee requests an update 

on this program in the fiscal year 2015 congressional budget justification. 

Interstitial Cystitis.—The Committee commends NIDDK for its 

leadership in interstitial cystitis research and notes that researchers are making progress to dispel myths about this condition and 

identify potential therapeutic strategies. Recognizing that patients 

turn to a variety of treatments, from pharmaceutical to changes in 

diet and lifestyle, the Committee encourages NIDDK to continue its 

focus on interstitial cystitis research and to partner with NCCAM 

to study the impact of complementary therapies on this condition. 

Obesity.—The Committee supports the NIH strategic plan for 

obesity research, which emphasizes a transdisciplinary approach to 

addressing the growing obesity problem in the United States. However, the Committee believes that additional efforts are needed to 

increase the involvement of high-risk communities in obesity studies and preventative research, particularly in rural areas, among 

low-income and racial minorities. The Committee urges NIH to 

prioritize its efforts on those areas of the country with the highest 

obesity rates by utilizing the existing resources of NIH-funded Nutrition Obesity Research Centers and academic schools of public 

health located in high-risk areas. 

Pancreatitis.—The Committee encourages NIDDK to create a 

long-term scientific framework for pancreatitis including evaluating 

current efforts and making recommendations on ways to accelerate 

progress and improve outcomes. The Committee requests an update on this effort in the fiscal year 2015 congressional budget justification. 

Pediatric Kidney Disease.—The Committee encourages NIDDK to 

assign a higher priority to research that explores pediatric renal 

disease. Because of the unique challenges of recruiting children 

into clinical trials, the Committee urges NIDDK to support research endeavors that include funding for infrastructure and the 

enhancement of collaborative and comparative multicenter, pediatric, prospective clinical/translational trials that improve patient 

outcomes. 

Pelvic Pain.—The Committee is pleased that the Multidisciplinary Approach to the Study of Chronic Pelvic Pain [MAPP] Research Network has moved to its second phase. The Committee encourages NIDDK to continue these activities, including finding new 

treatment approaches, identifying risk factors, and helping to predict which patients may respond to various interventions for interstitial cystitis and other comorbid pelvic pain conditions. 
90 

Prostatitis.—The Committee urges NIDDK to continue the MAPP 

initiative’s support of research on the cause, cure, and prevention 

of prostatitis. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

Appropriations, 2013 1 ........................................................................... $1,623,113,000 

Budget estimate, 2014 ........................................................................... 1,642,619,000 

Committee recommendation ................................................................. 1,631,703,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,631,703,000 for 

NINDS. 

Cerebral Cavernous Malformation [CCM].—The Committee urges 

NINDS to put a higher priority on CCM by coordinating existing 

research and surveillance activities as well as expanding clinical 

and research centers with the potential to manage a multisite clinical drug trial. 

Duchenne Biomarkers.—The Committee recognizes the importance of biomarkers and related surrogate endpoints for application 

in clinical trials of potential therapies for Duchenne muscular dystrophy. Therefore, the Committee urges NINDS, in collaboration 

with the FDA, to develop a plan of action to support the development and qualification of Duchenne biomarkers and to support the 

regulatory science relevant to advancing new technologies to treat 

this disease. 

Epilepsy.—The Committee commends NINDS for its leadership 

in sponsoring the April 2013 conference ‘‘Curing the Epilepsies 

2013: Pathways Forward’’ and for evaluating and guiding progress 

toward finding cures for the epilepsies through the community’s 

epilepsy research benchmarks. The Committee applauds the enhanced focus of the NINDS Anticonvulsant Screening Program on 

developing new compounds to better address the needs of the patients for whom current therapies are not effective and to focus on 

prevention and disease modification. The Committee encourages 

the continuation of the targeted Epilepsy Centers Without Walls 

grants to support multidisciplinary, collaborative research in targeted areas that can advance progress in the prevention, diagnosis, 

and treatment of epilepsy and related comorbidities, including mortality from epilepsy. The Committee also remains supportive of Exceptional Unconventional Research Enabling Knowledge Acceleration [EUREKA] grants and research in epileptogenesis, 

comorbidities, translational research on epilepsies, treatment resistant epilepsy, and sudden unexplained death in epilepsy. Further, the Committee encourages the continuation of the Interagency Collaborative to Advance Research in Epilepsy [ICARE], led 

by NINDS, to coordinate the research efforts of Federal agencies 

and voluntary organizations and to identify areas for collaboration. 

Headache.—The Committee commends NIH for efforts to increase its focus on headache disorders over the past several years, 

especially in encouraging more junior investigators to enter the 

field. However, NIH’s investment in this research is still not commensurate with the enormous disease burden of headache disorders. The Committee encourages intensified efforts to understand 

the causes, prevention, treatment, and eventual cure of headache 
91 

disorders, including migraine, cluster headache, and chronic daily 

headache. In particular, the Committee urges NINDS to follow 

through on the recommendations from the May 2010 NIH Headache Research Planning Workshop by issuing requests for applications and program announcements for fundamental and 

translational research on headache disorders and providing career 

training and transition awards specifically devoted to the investigation of headache disorders. 

Inflammatory Nervous System Disorders.—The Committee urges 

NINDS to pursue expanded research focused on inflammatory disorders impacting the peripheral nervous system such as GuillainBarre ́ syndrome, chronic inflammatory demyelinating 

polyneuropathy, and related conditions. 

Muscular Dystrophy Coordinating Committee [MDCC].—The 

Committee understands that the MDCC’s next meeting is planned 

for August 2013—more than 2 years since the last meeting—and 

that the Action Plan for Muscular Dystrophy has not been updated 

in 5 years. The MDCC’s charter stipulates that meetings of the full 

committee should be held not less than once each fiscal year; the 

Committee strongly urges MDCC to resume a more regular schedule. In addition, the Committee urges the MDCC to review and revise the action plan so that it is relevant to the full range of 

Duchenne patients, including adults and different racial and ethnic 

populations affected by muscular dystrophy, and informed by 

Duchenne patient, caregiver, clinician, and research stakeholders. 

Network for Excellence in Neuroscience Clinical Trials.—The 

Committee is pleased that NINDS plans to expand its support of 

the Network for Excellence in Neuroscience Clinical Trials 

[NeuroNEXT] program. The Committee urges NINDS to increase 

the efficiency of clinical trials conducted through NeuroNEXT, facilitate patient recruitment and retention, and increase the quality 

of the neuroscience trials. 

Stroke.—The Committee continues to commend the effective leadership role of NINDS in stroke research planning and prioritization 

and congratulates the Institute for its efforts that have culminated 

in the identification of nine top areas in stroke prevention, treatment, and recovery research. The Committee urges NINDS to stimulate investment in each of these areas. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Appropriations, 2013 1 ........................................................................... $4,481,730,000 

Budget estimate, 2014 ........................................................................... 4,578,813,000 

Committee recommendation ................................................................. 4,548,383,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $4,548,383,000 for 

NIAID. 

Antibiotic-Resistant Infections.—The Committee remains concerned about the need to develop and approve new antibiotics. The 

Committee urges NIAID to facilitate, through its new antibiotic-resistant bacterial infections clinical research infrastructure, studies 

that lead to new endpoints for serious and life-threatening infections caused by multidrug-resistant pathogens, and in particular 

hospital-acquired and ventilator-associated bacterial pneumonias. 
92 

NIAID also should support research leading to a better understanding of the natural history of pneumonia and other antibioticresistant infections. 

Autoimmune Diseases.—The Committee urges NIAID and the 

Autoimmune Disease Coordinating Committee to establish programs to investigate common biological pathways of autoimmune 

diseases and potential therapies that can broadly prevent and treat 

them. The Committee requests an update on NIAID’s current activities and plans for additional research in the fiscal year 2015 

congressional budget justification. 

Food Allergy.—The Committee is aware of the promising research on oral immunotherapy being funded by the Consortium of 

Food Allergy Research [CoFAR]. The Committee strongly urges 

NIAID to increase both the budget for and the number of institutions funded by CoFAR when the program is renewed. In addition, 

NIH should initiate other mechanisms of support for research and 

career development of investigators focused on food allergy research. The Committee also encourages NIAID to continue its public-private partnerships in support of complementary clinical 

immunological, immunomodulator, mechanistic, and genetic studies 

with private donors and foundations as components of ongoing food 

allergy clinical trials. 

Influenza Antivirals.—The Committee encourages NIAID to invest in research on new antiviral drugs that are easy to use and 

effective against emerging drug-resistant influenza variants, as 

well as influenza diagnostics. NIAID should give special consideration to treatment for the pediatric and obstetric populations. 

Microbicides.—The Committee encourages NIAID to continue coordination with USAID, the State Department, and others to advance the development of antiretroviral-based microbicides. 

Tuberculosis [TB].—The Committee continues to urge NIAID to 

expand its research into the development of new TB diagnostic 

tests, drugs, and vaccines to prevent, detect, and treat TB. In particular, the Committee encourages more research on developing 

shorter treatments for multidrug-resistant TB. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

Appropriations, 2013 1 ........................................................................... $2,425,175,000 

Budget estimate, 2014 ........................................................................... 2,401,011,000 

Committee recommendation ................................................................. 2,435,570,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $2,435,570,000 for 

NIGMS. 

Critical Care.—The Committee recognizes that the burden associated with the provision of care for critically ill patients is expected 

to increase significantly as the population ages. The Committee encourages NIGMS, through the new Office of Emergency Care Research, to heed the recommendations of the Critical Care Societies 

Collaborative in developing future research directions on critical 

care. 

Institutional Development Awards [IDeA].—The Committee continues to recognize the importance of the IDeA program and its 

focus on improving the necessary biomedical research infrastruc-
93 

ture and capacity of research institutions within IDeA States. The 

Committee believes the IDeA program has made a significant contribution to biomedical research and efforts to create a skilled 

workforce in IDeA States. Therefore, the Committee rejects the 

President’s proposal to cut IDeA funding to $225,438,000 and instead recommends $275,957,000, the same as the fiscal year 2012 

level, for this purpose. However, the Committee is concerned that 

the eligibility criteria for IDeA established when the program was 

created 20 years ago are no longer relevant and have led to inequities. No States have been added to or dropped from the list of 

States that are eligible for this funding since 1997. The same 23 

States have been eligible for IDeA for the past 16 years and the 

same 27 States have been ineligible. In addition, the authorizing 

statute says a State’s eligibility for the program is to be determined 

by whether its research institutions have a low aggregate success 

rate, relative to other States, of obtaining NIH funds. But today, 

several IDeA States have higher success rates than those of nonIDeA States. The Committee is aware that the National Academy 

of Sciences [NAS] is conducting a study of the Experimental Program to Stimulate Competitive Research [EPSCoR] and related 

programs, such as IDeA, across the Federal Government. The Committee directs NIH to provide a report to the House and Senate 

Committees on Appropriations, as well as the relevant authorizing 

committees, that responds to the NAS analysis of IDeA and addresses whether changes to its eligibility criteria are warranted. 

The report, which should be delivered no later than 120 days after 

the release of the NAS study, should include a discussion of whether all States that are eligible for EPSCoR should be eligible for 

IDeA. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT

Appropriations, 2013 1 ........................................................................... $1,318,755,000 

Budget estimate, 2014 ........................................................................... 1,339,360,000 

Committee recommendation ................................................................. 1,330,459,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,330,459,000 for 

NICHD. 

Chromosome Abnormalities.—The Committee commends NIH’s 

efforts to categorize genes, which are useful for the diagnosis of 

chromosome abnormalities. The path to treatment requires a greater understanding of gene function as it relates to abnormal gene 

copy number. The Committee again asks NICHD to hold a state of 

the science meeting focused on strategies for devising treatments 

for nonrecurring as well as recurring gene copy number changes. 

The Committee further urges new funding to support other investigators of chromosome abnormalities, particularly those involving 

chromosome 18. 

Demographic Research.—The Committee is pleased that 

NICHD’s recent reorganization and Scientific Vision initiative reflect the integral role that demographic, or population, research 

plays in the Institute’s mission. As such, the Committee urges 

NICHD to include the Population Dynamics branch in all appro-
94 

priate research mechanisms and programs. Further, the Committee 

encourages NICHD to sustain its support of large-scale, longitudinal surveys, particularly the National Longitudinal Survey of Adolescent Health and the Panel Study of Income Dynamics Child 

Supplement Survey. 

Preterm Birth.—The Committee notes that the Institute’s new 

Scientific Vision highlights pregnancy and pregnancy outcomes as 

a priority for NICHD research. The Committee encourages NICHD 

to continue to emphasize its support of extramural preterm birth 

prevention research, the Maternal-Fetal Medicine Units Network, 

the Neonatal Research Network, and the intramural research program related to prematurity. The Committee also encourages 

NICHD to support transdisiplinary science as recommended in the 

Scientific Vision and to fund transdisiplinary research grants to 

study and identify the complex causes of prematurity. 

Psychotropic Medications and Children.—The Committee understands that little is known about the short- and long-term effects 

of psychotropic medications on children’s physical and mental development. The Committee encourages NICHD to undertake a concerted effort to determine the safety and efficacy of these medications in children, and to explore research into the effectiveness of 

evidence-based psychosocial therapies used instead of, or in combination with, psychotropic medications. 

Vulvodynia.—The Committee is pleased with the progress that 

NICHD has made to implement the major recommendations from 

the NIH Research Plan on Vulvodynia, particularly in convening 

the May 2013 workshop to develop research diagnostic criteria. The 

Committee urges NICHD to continue its work with the patient advocacy, medical, and scientific communities to develop these criteria, as well as common data elements to be collected across clinical studies to allow for the comparison of study populations and 

findings. The Committee also encourages the Institute to expand 

the cadre of basic and clinical investigators conducting vulvodynia 

research by helping interested researchers obtain greater expertise 

in pain research methodology and pelvic/urogenital neurobiology; 

encouraging NIH-funded investigators from various fields to expand their research to include vulvodynia; and reissuing a general 

funding opportunity with a special review panel that addresses 

foundational priority areas delineated in the vulvodynia research 

plan. 

NATIONAL EYE INSTITUTE

Appropriations, 2013 1 ........................................................................... $701,307,000 

Budget estimate, 2014 ........................................................................... 699,216,000 

Committee recommendation ................................................................. 701,407,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $701,407,000 for NEI. 

Diabetic Retinopathy.—The Committee understands that diabetic 

eye disease is the leading cause of blindness in working age adults 

and urges NEI to continue its support of the Diabetic Retinopathy 

Clinical Research Network. 

Marfan Syndrome.—The Committee understands the negative 

health effects that Marfan syndrome can have on the human eye 
95 

and vision. The Committee encourages NEI to initiate research activities in this area. 

Usher Syndrome.—The Committee urges NEI to put a higher priority on Usher syndrome, the leading cause of deaf-blindness. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES

Appropriations, 2013 1 ........................................................................... $684,200,000 

Budget estimate, 2014 ........................................................................... 691,348,000 

Committee recommendation ................................................................. 686,753,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $686,753,000 for 

NIEHS. 

Childhood Lead Poisoning.—The Committee understands that 

lead poisoning remains a serious health risk for children, with lifelong developmental consequences, and encourages NIEHS to 

prioritize research in this area. 

Environmental Exposures and Reproductive Health.—Environmental exposures can have significant ramifications for reproductive health, such as infertility, sterility, and birth defects, in addition to causing other serious health conditions including 

osteoporosis, heart attack, and stroke. The Committee believes it is 

critical to examine these ramifications for both men and women. 

NIEHS is urged to place a greater priority on, and invest more 

funding in, environmental, sex-based, reproductive health research. 

National Toxicology Program [NTP].—The Committee urges NTP 

to be highly precise when describing the results of its studies on 

particular extracts of an herbal species to avoid any possible confusion about the relevance of such studies to other extracts of the 

species. The Committee also encourages NTP to reinstitute its 

practice of making available on its Web site a transcript and/or recording of its public meetings. 

NATIONAL INSTITUTE ON AGING

Appropriations, 2013 1 ........................................................................... $1,101,234,000 

Budget estimate, 2014 ........................................................................... 1,193,370,000 

Committee recommendation ................................................................. 1,185,439,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,185,439,000 for 

NIA. 

Alzheimer’s Disease.—The President’s budget calls for an increase 

of $80,000,000 over the fiscal year 2012 level for Alzheimer’s disease research at NIA. In keeping with longstanding practice, the 

Committee does not recommend a specific amount of NIH funding 

for this purpose, or for any other individual disease. Doing so 

would establish a dangerous precedent that could politicize the 

NIH peer review system. Nevertheless, recognizing that Alzheimer’s disease poses a unique and serious threat to the Nation’s 

long-term health and economic stability, the Committee expects 

that a significant portion of the recommended increase for NIA 

should be directed to research on Alzheimer’s. The exact amount 

should be determined by the scientific opportunity of additional research on this disease and the quality of grant applications that 
96 

are submitted for Alzheimer’s relative to those submitted for other 

diseases. The Committee encourages NIA 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 2012. In addition, the Committee continues to urge NIH to take advantage of existing wellcharacterized, longitudinal, population-based cohort studies to provide new insights into risk factors and protective factors related to 

cognitive decline and dementia. The Committee also continues to 

encourage additional research in minority populations that are at 

particularly high risk for cognitive decline and dementia. 

Demographic, Economic, and Behavioral Research.—The Committee recognizes NIA for investing in large-scale longitudinal surveys, including the National Health and Aging Trends Study and 

the Health and Retirement Study. Further, the Committee applauds NIA for contributing to the recent National Academies report ‘‘Shorter Lives, Poorer Health,’’ which found that Americans 

live shorter lives and are in poorer health than people in other 

high-income countries and that behaviors and social circumstances 

are major contributing factors. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN

DISEASES

Appropriations, 2013 1 ........................................................................... $534,715,000 

Budget estimate, 2014 ........................................................................... 540,993,000 

Committee recommendation ................................................................. 537,398,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $537,398,000 for 

NIAMS. 

Heritable Connective Tissue Disorders.—The Committee commends NIAMS for ongoing research efforts into heritable connective tissue disorders like Marfan syndrome. 

Osteogenesis Imperfecta [OI].—The Committee continues to be 

concerned that the impact of OI on adults is not well understood 

and that very few primary care physicians or specialists possess 

training or experience in treating adults with OI. The Committee 

continues to encourage NIAMS to support natural history studies 

of OI and subsequent clinical research activities that will facilitate 

the development of clinical practice guidelines for adults with OI. 

The Committee also urges NIAMS to partner with the relevant professional societies, the OI advocacy community, and other stakeholders to develop opportunities for primary care physicians and 

specialists to receive education and training on providing care to 

adults with OI. 

Scleroderma.—The Committee notes recent advances in 

scleroderma research, particularly in systemic scleroderma, and encourages NIAMS to provide sustained investments in this area. 

Temporomandibular Disorders [TMD].—Many people who have 

TMD suffer from conditions that routinely affect other joints in the 

body, such as trauma, arthritis, and fibromyalgia. However, researchers investigating other joints too often ignore TMD because 

they consider temporomandibular joints to be a subject for dental 

researchers only. The Committee notes that the 
97 

Temporomandibular Joint Working Group has improved collaborations among ICs that should have a role in TMD research but believes that NIAMS, as well as NIBIB, should participate more 

fully, so that NIDCR is not expected to carry the workload alone. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS

Appropriations, 2013 1 ........................................................................... $415,440,000 

Budget estimate, 2014 ........................................................................... 422,936,000 

Committee recommendation ................................................................. 420,125,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $420,125,000 for 

NIDCD. 

Central Auditory Plasticity.—The Committee continues to support research in animals and humans on changes in the functional 

organization of neural circuits along all of the pathways in the 

brain that process sound, following both temporary and permanent 

developmental and adult hearing loss. 

Eustachian Tubes.—The Committee urges NIDCD to conduct additional studies on potential treatments for dysfunctional eustachian tubes. 

Genetic Causes of Communication Disorders.—The Committee 

recommends additional efforts by NIDCD to identify and understand the structure, function, and regulation of genes whose 

mutations are responsible for congenital and age-related deficits. 

Research to develop high-throughput platforms for testing of individuals is also encouraged. 

Hearing Aids and Cochlear Implants.—The Committee strongly 

urges NIDCD to support research grants that could lead to less expensive hearing aids, so such aids could become accessible and affordable to more people. The Committee also supports device research to improve users’ understanding of speech through background noise. In addition, the Committee supports research that 

would enable users of cochlear implants to experience high-quality 

speech and music perception, as well as studies that would improve 

bilateral implants, short electrode implants, and hybrid cochlear 

implant/hearing aids. 

Inner Ear Hair Cell Regeneration.—The Committee is aware of 

advances being made in the identification of cells in the inner ear 

that can be induced or reprogrammed to replace cells lost in deafness. Additional research to understand the processes of possible 

regeneration or transdifferentiation of inner ear hair cells to restore natural hearing is strongly encouraged. The Committee recommends funding to develop this therapeutic approach and move 

it into clinical applications. 

Noise-Induced Hearing Loss.—Hearing loss resulting from noise 

damage represents a major form of acquired deafness. The Committee therefore recommends studies to better understand the 

pathogenesis of noise-induced hearing loss and encourages NIDCD 

to continue to promote public awareness of the importance of protecting hearing from noise, through public service announcements 

or other means. 
98 

Otitis Media.—The Committee encourages NIDCD to accelerate 

its research into susceptibility to and pathogenesis of otitis media 

and its consequences, and into new treatments for chronic and recurrent cases. In particular, the Committee urges studies related to 

genetic risk factors, bacterial biofilms, and the impact of vaccination on disease prevention. 

Presbycusis.—The Committee urges NIDCD to continue to delineate the multiple physiological and neurological processes resulting 

in presbycusis, or age-related hearing loss. 

Tinnitus.—The Committee urges NIDCD to continue basic research on the specific neural dysfunction responsible for tinnitus as 

well as clinical trials to translate basic science into therapies. 

Vestibular Research.—The danger of injury from falls is a health 

hazard, especially in the elderly. Therefore, the Committee urges 

NIDCD to conduct further basic vestibular-system studies to understand the cellular mechanisms involved in the coding of head movements necessary to assure an individual’s ability to maintain balance. 

NATIONAL INSTITUTE OF NURSING RESEARCH

Appropriations, 2013 1 ........................................................................... $144,479,000 

Budget estimate, 2014 ........................................................................... 146,244,000 

Committee recommendation ................................................................. 145,272,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $145,272,000 for 

NINR. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

Appropriations, 2013 1 ........................................................................... $458,600,000 

Budget estimate, 2014 ........................................................................... 463,848,000 

Committee recommendation ................................................................. 460,765,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $460,765,000 for 

NIAAA. 

Functional Integration Initiative.—The Committee applauds the 

Trans-NIH Substance Use, Abuse, and Addiction Functional Integration initiative to help NIAAA, NIDA, NCI, and other ICs work 

more closely together on substance use, abuse, and addiction research. 

NATIONAL INSTITUTE ON DRUG ABUSE

Appropriations, 2013 1 ........................................................................... $1,051,261,000 

Budget estimate, 2014 ........................................................................... 1,071,612,000 

Committee recommendation ................................................................. 1,064,490,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,064,490,000 for 

NIDA. 

Drug Abuse and HIV/AIDS.—The Committee understands that 

drug abuse and addiction continue to fuel the spread of HIV/AIDS 

and that drug abuse prevention and treatment interventions can be 

very effective in reducing HIV risk. Research should continue to ex-
99 

amine every aspect of this relationship. The Committee is also concerned about drug abuse and HIV/AIDS in criminal justice populations. Research efforts to empirically test and expand the ‘‘seek, 

test, treat, and retain’’ paradigm are encouraged. 

Marijuana.—NIDA is encouraged to continue to fund research on 

preventing and treating marijuana abuse and addiction, as well as 

the possible health and policy implications of proposals to implement ‘‘medical marijuana’’ or marijuana legalization programs. 

Pain Medications.—The Committee remains concerned about the 

continued crisis of prescription drug abuse. NIDA is strongly urged 

to continue its support of research on pain, including the development of pain medications with reduced abuse liability. In addition, 

NIDA should continue to fund research to better prevent and treat 

prescription drug abuse. 

NIDAMed.—The Committee is pleased with NIDAMed, the Institute’s physicians outreach initiative. The Committee urges NIDA to 

continue its focus on providing physicians and other medical professionals with the tools and skills they need to incorporate drug 

abuse screening and treatment into their clinical practices. 

Tobacco Addiction.—The Committee applauds the recent 

progress of NIDA-supported researchers toward identifying genetic 

factors that contribute to nicotine dependence and affect the efficacy of smoking cessation treatments. NIDA is urged to continue 

developing evidence-based treatments, medications, and prevention 

strategies to combat nicotine addiction. 

NATIONAL INSTITUTE OF MENTAL HEALTH

Appropriations, 2013 1 ........................................................................... $1,477,304,000 

Budget estimate, 2014 ........................................................................... 1,465,782,000 

Committee recommendation ................................................................. 1,456,041,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,456,041,000 for 

NIMH. The decrease from fiscal year 2013 reflects a shift of AIDS 

research funding to NIAID, not a cut to core NIMH activities. 

Autism.—The Committee continues to urge NIMH to focus on genetic as well as possible environmental causes of autism. 

Autism and Telehealth.—The Committee is aware of the increasing use of telehealth resources in the diagnosis and treatment of 

autism spectrum disorders [ASD]. The NIMH has funded a small 

number of grants to examine whether such technologies can specifically be used to improve ASD diagnosis and treatment in underserved areas of rural States. Given the significant expansion in recent years of telehealth networks in rural States and the potential 

promise of such networks to significantly lower costs while expanding care, the Committee urges NIMH to expand its support of this 

research. 

Premature Mortality.—The Committee continues to be concerned 

about premature mortality and lower life expectancy experienced 

by adults living with serious mental illness as a result of treatable 

medical conditions such as cardiovascular, pulmonary, endocrine, 

and infectious diseases. The Committee urges NIMH to collaborate 

with other Institutes, including NIDDK and NHLBI, on a focused 

research program into the causes and interventions needed to ad-
100 

dress this crisis. The Committee requests an update on this topic 

in the fiscal year 2015 budget justification. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE

Appropriations, 2013 1 ........................................................................... $511,847,000 

Budget estimate, 2014 ........................................................................... 517,319,000 

Committee recommendation ................................................................. 513,881,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $513,881,000 for 

NHGRI. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

Appropriations, 2013 1 ........................................................................... $337,681,000 

Budget estimate, 2014 ........................................................................... 338,892,000 

Committee recommendation ................................................................. 337,728,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $337,728,000 for 

NIBIB. 

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE

MEDICINE

Appropriations, 2013 1 ........................................................................... $127,800,000 

Budget estimate, 2014 ........................................................................... 129,041,000 

Committee recommendation ................................................................. 128,183,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $128,183,000 for 

NCCAM. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

Appropriations, 2013 1 ........................................................................... $275,887,000 

Budget estimate, 2014 ........................................................................... 283,299,000 

Committee recommendation ................................................................. 281,416,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $281,416,000 for 

NIMHD. 

Diabetes in Minorities.—The Committee continues to urge 

NIMHD to support research and other activities with respect to 

pre-diabetes and diabetes, particularly type 2 diabetes, in minority 

populations. 

Mental Health Disparities.—The lack of access to mental health 

services in rural areas presents unique challenges in providing 

services to an especially vulnerable population. Greater poverty 

rates in rural areas, cultural attitudes toward mental illness, and 

limited transportation options all contribute to isolating individuals 

with mental health needs from access to care. In addition, individuals with mental health problems are at greater risk of poverty so 

the situation becomes part of a cycle of poverty and mental illness. 

The use of telemedicine in cooperation with community mental 

health programs in rural areas presents a new and effective way 

of providing for diagnosis and treatment of mental health prob-
101 

lems. The Committee encourages NIMHD to fund research efforts 

to find innovative ways to address mental health disparities in underserved populations, such as telepsychiatry programs, especially 

in designated Psychiatric Manpower Shortage Areas. 

Research Centers in Minority Institutions [RCMI].—The Committee continues to recognize the critical role played by minority 

institutions, especially at the graduate level, in addressing the 

health research and training needs of minority populations. 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. 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 nonminority researchers. The Committee requests that NIH describe in the fiscal year 2015 congressional 

budget justification the extent to which the RCMI program is addressing R01 funding disparities. 

JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN

THE HEALTH SCIENCES

Appropriations, 2013 1 ........................................................................... $69,483,000 

Budget estimate, 2014 ........................................................................... 72,864,000 

Committee recommendation ................................................................. 72,380,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $72,380,000 for the 

Fogarty International Center. 

The Center plays an essential role in global health research and 

training that can both assist developing countries advance their 

own research and health solutions and help the United States form 

partnerships 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. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES

Appropriations, 2013 1 ........................................................................... $574,216,000 

Budget estimate, 2014 ........................................................................... 665,688,000 

Committee recommendation ................................................................. 661,264,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $661,264,000 for 

NCATS. The Committee includes bill language allowing up to 

$50,000,000 of this amount, the same as the budget request, to be 

used for the Cures Acceleration Network [CAN]. The fiscal year 

2013 funding level for CAN is $9,961,000. 

Clinical and Translational Science Awards [CTSAs].—The Committee strongly endorses IOM’s recommendations in its June 2013 

report, ‘‘The CTSA Program at NIH: Opportunities for Advancing 

Clinical and Translational Research.’’ In particular, the Committee 

agrees that NCATS should provide leadership to help the CTSAs 

function more as a network than as a collection of discrete centers; 

only then will the full potential of the program be realized. In addition, the Committee agrees with the IOM that the CTSA program 

should address the full spectrum of clinical and translational re-
102 

search. This should include research on changing behaviors that 

impact the prevention and outcome of diseases and conditions such 

as obesity and type 2 diabetes. 

Cures Acceleration Network.—The Committee encourages NCATS 

to look at existing successful public-private co-investment models 

and partnerships, particularly In-Q–Tel and SEMATECH, in establishing CAN’s strategic focus, operating procedures, and processes. 

Drug Rescue and Repurposing.—NCATS’ drug rescue and 

repurposing initiatives have shown success since the Center’s establishment 2 years ago. Because rescue and repurposing builds 

upon previous research and development efforts, new candidate 

therapies could be ready for clinical trials quickly, advancing the 

timeframe for FDA approval and their integration into healthcare. 

The Committee notes with particular interest the success of The 

Learning Collaborative, which has had significant success employing drug repurposing strategies to rapidly advance new blood cancer therapies. The Committee encourages NCATS to pursue similar 

efforts for other rare diseases and unmet medical needs. 

Guillain-Barre ́ Syndrome [GBS].—The Committee notes that the 

causes of GBS and related inflammatory disorders which impact 

the nervous system remain unknown. The Committee encourages 

ORDR to initiate research activities in this area to improve our scientific understanding of these conditions. 

Hereditary Angioedema [HAE].—The Committee continues to recognize that few treatment options are available for HAE and that 

they are not effective for all patients. The Committee continues to 

encourage the Center to convene a state of the science conference 

on this rare disease. 

Multifocal Motor Neuropathy [MMN].—The Committee understands that ORDR will soon issue a new funding opportunity announcement for the Rare Disease Clinical Research Network. Given 

the importance of appropriate and early diagnosis of patients with 

MMN, the Committee encourages ORDR to give appropriate consideration to approving funding for a consortium for MMN that includes a registry for patients diagnosed with the disease. 

Pulmonary Arterial Hypertension [PAH].—The Committee recognizes that pulmonary arterial hypertension is a rare and often fatal 

condition. The Committee encourages ORDR to expand research in 

this area by collaborating on research projects with the Pulmonary 

Hypertension Clinical Research Network, and the Committee encourages NCATS to consider pursuing indications for current drugs 

that have shown the potential to improve health outcomes for PAH 

patients. 

NATIONAL LIBRARY OF MEDICINE

Appropriations, 2013 1 ........................................................................... $345,163,000 

Budget estimate, 2014 ........................................................................... 390,452,000 

Committee recommendation ................................................................. 387,912,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $387,912,000 for NLM. This amount 

includes $8,200,000 from transfers available under section 241 of 

the PHS Act. Of the funds provided, $4,000,000 is for the improve-
103 

ment of information systems, to remain available until September 

30, 2015. 

Communication of Research Findings.—The Committee is 

pleased that NLM has expanded the readership of NIH 

MedlinePlus magazine and the bilingual NIH MedlinePlus Salud 

magazine, which provide consumers and health professionals easyto-read health information based on the latest NIH-supported research. The Committee urges NLM to continue exploring new avenues of online distribution that extends the publications’ reach to 

the public. 

OFFICE OF THE DIRECTOR

Appropriations, 2013 1 ........................................................................... $1,525,125,000 

Budget estimate, 2014 ........................................................................... 1,473,398,000 

Committee recommendation ................................................................. 1,463,606,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $1,463,606,000 for the 

Office of the Director [OD]. Within this total, $568,151,000 is provided for the Common Fund. 

The Committee includes bill language allowing up to $165,000,000 to be used for continuation of the National Children’s 

Study. The budget request includes $165,000,000 for this purpose 

but does not specify an amount in bill language. 

The Committee does not include bill language requested by the 

administration that would provide additional transfer authority to 

the Director beyond that which is already provided to the Secretary. 

The President’s budget recommends eliminating the Science Education and Partnership Awards [SEPA] program within OD and 

consolidating it within the Education Department as part of a governmentwide reorganization of STEM education activities. The proposed consolidation would also affect the Office of Science Education within OD and several other smaller STEM programs 

throughout NIH. The Committee is not convinced that the quality 

of these programs would be maintained if they were moved to other 

Federal agencies. Therefore, the Committee directs NIH to continue funding these programs in fiscal year 2014. The Committee 

includes sufficient funding within OD to support SEPA and the Office of Science Education. 

Alzheimer’s Disease.—The Committee commends NIH for the recent use of its transfer authority and other means to direct additional funding to research on Alzheimer’s disease within very tight 

budgets, with the goal of finding an effective prevention or treatment by 2025. 

Amyloidosis.—The Committee encourages NIH to continue its research efforts into amyloidosis, a group of rare diseases characterized by abnormally folded protein deposits in tissues. The Committee requests an update in the fiscal year 2015 congressional 

budget justification on the steps taken to understand the causes of 

amyloidosis and efforts to improve the diagnosis and treatment. 

Angiogenesis.—The Committee commends the research NIH is 

conducting on angiogenesis, specifically examining the need to address the lack of predictive markers for angiogenic therapies and 
104 

the prospects for dietary modifications with anti-angiogenic properties to improve cancer prevention. The Committee urges NIH to 

further examine angiogenic predictive markers across NCI, NHLBI, 

NEI, NIDDK, and NICHHD and to also consider focusing on 

angiogenic dietary modifications to reduce cancer risks. 

Basic Research.—The Committee urges the Director to maintain 

the NIH’s current focus on the funding of basic biomedical research. The purpose of basic research is to discover the nature and 

mechanics of disease and identify potential therapeutic avenues 

likely to lead to the prevention and treatment of human disease. 

Without this early scientific investigation, future development of 

treatments and cures would be impossible. 

Biomedical Research Workforce Diversity.—The Committee supports the Director’s efforts to increase racial and ethnic minority 

researchers in the biomedical research workforce through the 

Building Infrastructure Leading to Diversity [BUILD] and the National Research Mentoring Network programs. The Committee encourages NIH to promote partnerships with historically black colleges, universities, medical schools, and other graduate research institutions that have demonstrated a past commitment to this goal 

and proven achievement in recruiting, training, and mentoring racial and ethnic minority researchers. The Committee requests an 

update in the fiscal year 2015 congressional budget justification on 

this effort. 

BRAIN Initiative.—The Committee strongly commends NIH for 

leading the Brain Research through Application of Innovative 

Neurotechnologies [BRAIN] Initiative, a multi-agency effort that 

also involves the National Science Foundation and the Defense Advanced Research Projects Agency as well as several private sector 

partners. Numerous researchers are already working to accelerate 

the development and application of new technologies that will help 

explain how the brain records, processes, uses, stores, and retrieves 

information. The BRAIN Initiative will help catalyze and integrate 

these efforts. The Committee understands that this work may take 

decades before it results in cures or treatments, but could eventually help unlock the secrets behind diseases such as Alzheimer’s 

and epilepsy. The President’s budget requests $40,000,000 for this 

initiative in fiscal year 2014, to be pooled from several ICs and the 

OD. The Committee supports that amount as an initial investment 

but awaits more detailed budget projections for future years. 

Career Development Awards for Clinical Researchers.—The Committee recommends continued support for ‘‘K’’ awards to ensure the 

next generation of clinical researchers is properly trained. 

Chemical Risk Assessments.—The Committee supports NIH’s 

leadership role in the creation of a new paradigm for chemical risk 

assessment based on the incorporation of advanced molecular biological and computational methods in lieu of animal toxicity tests. 

NIH has indicated that development of this science is critical to 

several of its priorities, from personalized medicine to tackling specific diseases such as cancer and diabetes and including critical initiatives such as BRAIN. The Committee encourages NIH to continue to expand both its intramural and extramural support for the 

use of human biology-based experimental and computational approaches in health research to further define human biology, dis-
105 

ease pathways, and toxicity and to develop tools for their integration into evaluation strategies. Extramural and intramural funding 

should be made available for the evaluation of the relevance and 

reliability of human biology-based and Tox21-related methods and 

prediction tools to assure readiness and utility for regulatory purposes, including pilot studies of pathway-based risk assessments. 

The Committee requests an update on current activities, a plan for 

future activities, and the fiscal year 2014 funding level for this 

area of research in the fiscal year 2015 congressional budget justification. 

Chimpanzees.—The Committee strongly commends NIH for its 

recent decision to substantially reduce the use of chimpanzees in 

NIH-funded biomedical research and designate for retirement most 

of the chimpanzees it currently owns or supports. However, technical changes in NIH’s legal authority are needed to retire additional chimpanzees to the Federal Sanctuary System. Therefore, 

the Committee includes a new general provision that will allow 

NIH to achieve this goal. Specifically, the Chimpanzee Health Improvement, Maintenance and Protection [CHIMP] Act limits the 

amount of financial resources NIH may put toward retiring chimpanzees and caring for them in the Federal Sanctuary System. The 

CHIMP Act does not limit the amount of funding NIH may provide 

for chimpanzees who are not in the Federal Sanctuary System. The 

general provision modifies the CHIMP Act so that NIH funds that 

would otherwise be used to care only for non-Federal Sanctuary 

System chimpanzees can also be used for sanctuary chimpanzees. 

Chronic Fatigue Syndrome [CFS].—The Committee commends 

the Office of Disease Prevention for agreeing to review the case definition for CFS, also known as ME/CFS, as part of an evidencebased methodology workshop. NIH is urged to include experienced 

professionals in the ME/CFS research and clinical fields as well as 

patients and their advocates in this process. Further, the Committee encourages NIH to issue a special funding opportunity to 

spur research into ME/CFS using the clinical specimens collected 

under an NIAID-funded study. This resource could help speed 

diagnostics and better understanding of the pathophysiology of this 

severely disabling condition. 

Congenital Diaphragmatic Hernia [CDH].—The Committee encourages NIH to put a higher priority on CDH research. In particular, the Committee urges NHLBI to investigate the pulmonary 

effects of this birth defect and requests NICHD to support additional research on whether the timing of surgical repair to the diaphragm can increase an infant’s chances of survival. Along with 

ORDR, these two Institutes are also encouraged to promote greater 

research interest in CDH by supporting a scientific meeting on this 

condition. 

Cystic Fibrosis [CF].—The Committee encourages new personalized approaches to CF therapeutics, including new means to identify and characterize the efficacy of multidrug therapy that addresses the mutant protein which is the underlying cause of cystic 

fibrosis in the majority of those with the disease. The Committee 

supports research into nonsense mutations of CF, which impact 

about 10 percent of the CF population. In addition, the Committee 

urges further research into live imaging modalities that are able to 
106 

characterize mucus and monitor mucociliary clearance, defense 

mechanisms at the heart of CF and many other respiratory diseases. 

Down Syndrome.—The Committee applauds NIH for the establishment of the Down Syndrome Patient Registry. The Committee 

urges continued investment and development of the registry to 

fully realize its potential as a tool to stimulate meaningful clinical 

trials and research. The Committee recognizes that investing in 

Down syndrome-focused research has the potential to benefit many 

other diseases and conditions such as Alzheimer’s disease. Therefore, the Committee urges NIH to seek public-private partnerships 

aimed at developing preventive therapies for the dementia associated with both Down syndrome and Alzheimer’s disease. The Committee remains troubled by the stagnant number of investigatordriven research awards given in the area of Down syndrome and 

supports efforts to increase the Federal investment. The Committee 

requests a status update in the fiscal year 2015 congressional 

budget justification. The Committee urges the NIH to continue to 

utilize the Down Syndrome Consortium as it updates and implements the NIH Down Syndrome Research Plan. 

Drug Allergy.—The Committee commends NIAID for leading a 

recent workshop to develop a research agenda on the diagnosis and 

management of patients with drug hypersensitivity. The Committee urges NCATS, NCI, NHLBI, NIAMS, and other relevant Institutes to collaborate with NIAID to support research in this area, 

as there is a critical need for better tools to predict patient drug 

allergies and for improved drug desensitization protocols. The Committee encourages NIH to consider a multi-Institute, multidisciplinary collaborative effort in this area that might include support 

for centers of excellence as well as the development of a patient 

registry. 

Eosinophil-Associated Disorders.—The Committee is pleased that 

NIAID recently convened the Task Force on Research Needs of Eosinophil-Associated Diseases [TREAD], which produced a research 

agenda to improve the diagnosis and treatment of these debilitating and often painful diseases. The Committee urges NIDDK, 

NHLBI, NICHD, NIAMS, and NIMH to join NIAID’s efforts to foster research in this area. 

Fragile X-Associated Disorders [FXD].—The Committee commends NICHD for leading the effort to map the molecular, physiological, biological, and genetic connections between Fragile X (and 

the Fragile X protein) and autism. The Committee urges all ICs 

with Fragile X and autism portfolios to explore these connections 

with the goals of better understanding both conditions and shortening the time it will take to bring effective treatments for both 

conditions to market. The Committee also commends NICHD and 

its NIH partners for leading the effort to update the NIH Research 

Plan on Fragile X Syndrome and Associated Disorders, and urges 

NIH to fully implement the updated recommendations. 

Health Disparities in Children and Adolescents.—The Committee 

urges NIH to put a high priority on improving the health status 

of children and adolescents, especially those living in poverty. 

Hepatitis B.—While hepatitis B is preventable as a result of a 

safe and effective vaccine, this disease is not currently curable for 
107 

those who are already infected. An estimated 800,000 to 1.4 million 

Americans are infected with hepatitis B and most do not know it. 

The Committee urges NIH to move aggressively to research a cure. 

In particular, the Committee urges more work in antiviral drug development and continued support and use of appropriate animal 

models to study the disease. 

Human Microbiome Project.—The Committee commends NIH for 

establishing the Common Fund Human Microbiome Project, which 

has great potential to advance scientific understanding of many important areas of human health, including the immune system, and 

urges NIH to continue to work to understand the basis of healthy 

microbiome-induced immunoregulation and how it is altered in disease. 

Human Tissue Supply.—The Committee continues to urge NIH 

to support its nationwide human tissue and organ procurement 

program. 

Interstitial Cystitis.—The Committee commends ORWH for its 

continued collaborations with NIDDK to support research on interstitial cystitis, which disproportionately affects women. 

Lupus.—The Committee urges the Director to promote collaboration among NIAMS, NIAID, NHLBI, NIDDK, NIEHS, NINDS, 

NICHD, and NIMHD on efforts to expand and intensify genetic, 

clinical, and basic research on lupus. Given the complexity and impact of lupus, the Committee urges a particular focus on understanding the underlying mechanisms of the disease, gene-gene and 

gene-environmental interactions, its relationship to kidney disease, 

biomarkers, pediatric research, and factors related to the health 

disparities and comorbidities associated with lupus. 

Lymphatic Research and Lymphatic Disease.—The Committee 

commends the trans-NIH Coordinating Committee for Lymphatic 

Research [CCLR] and, in particular, NHLBI, NIAID, and NIDDK 

for their efforts to advance research on the lymphatic system and 

medical care for lymphatic diseases. The Committee urges greater 

participation from other Institutes in the CCLR, particularly 

NIAMS, NHGRI, and NIBIB. The Committee encourages the reconvening of a trans-NIH Working Group to evaluate the implementation of the recommendations it made in 2007. Continued efforts 

within the ICs to create support for extramural interdisciplinary 

research training relevant to the lymphatic system in health and 

disease and within the Center for Scientific Review to incorporate 

reviewer expertise in lymphatic biology/disease in the pertinent 

study sections are also requested. 

Mitochondrial Disease.—The Committee commends NIH for supporting a 2-day workshop on ‘‘Translational Research in Primary 

Mitochondrial Diseases,’’ which led to the development of a white 

paper that identifies barriers to progress and makes recommendations for addressing those barriers. NIH has also created a working 

group on mitochondrial disease research with broad participation 

from various Institutes and Centers. The Committee urges NIH to 

expand its mitochondrial research portfolio and fully implement the 

recommendations contained in the white paper. 

Mucopolysaccharidosis [MPS].—The Committee continues to urge 

NIH to put a high priority on better understanding and treating 

MPS and related diseases. The Committee commends NIH for allo-
108 

cating funds to discover, develop, define, and make available for research animal models of human genetic disease. The Committee 

also commends NIDDK for funding gene therapy efforts. Continued 

funding of these grants is critical to understanding these diseases 

and evaluating the efficacy and safety of combination therapies. 

The Committee encourages NINDS, NIDDK, and ORDR to continue supporting the Lysosomal Disease Network. 

National Primate Research Centers [NPRCs].—The Committee 

continues to support NPRCs, which are essential to ensuring the 

availability of nonhuman primate models and the expertise needed 

to help researchers pursue new drugs, treatments, and vaccines. 

Natural Product Collections.—The Committee continues to urge 

NIH to increase access to comprehensive and professionally organized natural product libraries. 

Neurofibromatosis [NF].—The Committee commends NIH for its 

continued support of NF research and again requests an update in 

the fiscal year 2015 congressional budget justification of relevant 

activities at NCI, NHLBI, NINDS, NICHD, NIMH, NIAMS, 

NIDCD, and NEI. 

OppNet.—The Committee commends NIH for its commitment to 

the Basic Behavioral and Social Science Opportunity Network 

[OppNet] initiative launched in 2009. Basic behavioral science research helps improve human health by contributing to our understanding of the complex factors that influence individuals. As fiscal 

year 2014 is the fifth year of this initiative, the Committee requests an update in the fiscal year 2015 congressional budget justification on the contributions made by the initiative along with 

recommendations on how best to continue the program and the 

OppNet mission. 

Overlapping Chronic Pain Conditions.—The Committee continues to strongly support an expanded trans-NIH research effort 

to better understand and identify effective treatments for overlapping chronic pain conditions that disproportionately impact women, 

including chronic fatigue syndrome, endometriosis, fibromyalgia, 

interstitial cystitis, irritable bowel syndrome, chronic headache, 

temporomandibular disorders, and vulvodynia. The Committee 

urges NIH to promptly implement the recommendations from the 

August 2012 NIH scientific workshop on this topic. These include: 

developing a case definition and research diagnostic criteria for 

chronic overlapping pain conditions; leveraging existing patient cohorts, resources, and data repositories to achieve cost savings; conducting prospective population-based epidemiological studies to determine the natural history of and risk factors for onset and progression of disease; developing common data elements, standardized outcome measures, and methods to classify phenotypic subgroups; studying central sensitization as a theme for discovery of 

common mechanisms of disease, diagnostics, and treatment; and 

developing multidisciplinary training programs for scientists and 

clinicians. As no one Institute has the responsibility for addressing 

all overlapping chronic pain conditions, the Committee strongly 

urges multiple Institutes to combine their efforts through centers 

of excellence or other appropriate means of carrying out these recommendations. 
109 

Polycystic Kidney Disease [PKD].—The Committee continues to 

urge NIH to put a high priority on PKD research. 

Pregnancy Health Status.—The Committee commends NIH for 

its work on the relationship between a woman’s health status during pregnancy and her health post-pregnancy. The Committee 

urges NIH to prioritize the joint NICHD–NHLBI funding opportunity ‘‘Pregnancy as a Window to Future Cardiovascular Disease,’’ 

as potential life-threatening conditions such as heart disease can be 

prevented based on clues during a woman’s pregnancy. The Committee also urges NICHD to ensure that short-term studies on lifestyle interventions and treatment for preeclampsia, as well as 

interventional studies that go beyond weight management to include gestational and type 2 diabetes, cardiovascular disease, and 

other chronic diseases, can be translated into longer-term trials 

that will ultimately lead to changes in obstetrical practice which 

result in a healthier population. 

Psoriasis.—The Committee commends NIH for addressing the 

significant public health burden resulting from psoriasis and psoriatic arthritis, the Nation’s most common autoimmune disease. In 

order to address the connection between these diseases and other 

serious, life-threatening comorbid conditions such as cardiovascular 

disease, diabetes, stroke, and cancer, the Committee urges NIH to 

further promote integrated, interdisciplinary research on the inflammatory nature of these diseases. 

Rehabilitation Research.—The Committee recognizes the importance of rehabilitation research and commends the agency for its 

work to evaluate the performance of the National Center for Medical Rehabilitation Research. The Committee further recommends 

that NIH continue to implement the recommendations included in 

the final December 2012 report titled, ‘‘Blue Ribbon Panel on Medical Rehabilitation Research at the NIH.’’ 

Sleep Disorders.—The Committee urges NIH to initiate new 

training programs in sleep and circadian sciences in all relevant 

Institutes and Centers, consistent with the NIH Sleep Disorders 

Research Plan. 

Spinal Muscular Atrophy [SMA] Carrier Screening.—The Committee continues to support the development of a pan-ethnic carrier 

screening program for SMA. The Committee remains concerned 

that contradicting SMA carrier screening recommendations from 

professional societies persist and that this inconsistency creates 

confusion among health professionals and the public. The Committee encourages NHGRI, NICHD, and NINDS to collaborate with 

stakeholders from government, academia, professional societies, advocacy groups, and industry to resolve the discrepancy and develop 

unified and consistent recommendations, guidelines, and educational materials on SMA carrier screening for providers and patients. 

Traumatic Brain Injury [TBI].—The Committee understands 

that current brain imaging technology is inadequate to accurately 

characterize the various degrees of TBI. The Committee urges support for the development of new brain imaging technologies to address this challenge. 

Tuberous Sclerosis Complex [TSC].—The Committee continues to 

encourage NIH to coordinate a multi-Institute approach to finding 
110 

a cure for TSC. NINDS and NCATS should play leading roles, 

given the promising translational potential of new therapeutics for 

treating the neurological conditions of TSC, including autism and 

epilepsy. Other Institutes involved in this collaborative effort 

should include NCI, NIAMS, NHLBI, NIDDK, NINDS, NICHD, 

and NIBIB, as well as ORDR. 

Veterinary Medicine Loan Repayment Programs.—The Committee 

recognizes the important role that doctors of veterinary medicine 

[DVMs] play in the biomedical research enterprise because of their 

background and training in disease processes across all animals, 

including cross-species virus transmission, and animal models. Like 

other medical professionals, a large debt load upon graduation influences their choice to pursue careers in biomedical research. The 

Committee was gratified that eligibility for the loan repayment programs was expanded to include DVMs and would like NIH to report to the Committee if this change increased DVM participation 

in these programs. Given the vital part DMVs play in clinical research, NIH is encouraged to continue to make this eligibility 

change more widely known to potential applicants, ICs, and reviewers. 

OFFICE OF AIDS RESEARCH

OAR coordinates the scientific, budgetary, legislative, and policy 

elements of the NIH AIDS research program. The Committee recommendation does not include a direct appropriation for OAR. Instead, the Director of OAR and the Director of NIH together determine the total for AIDS research within the total NIH appropriation, and the Director of OAR determines and allocates distribution 

of those funds to the ICs and OAR. The recommendation includes 

a general provision permitting the NIH Director and OAR to shift 

up to 3 percent of AIDS research funding among Institutes and 

Centers throughout the year if needs change or unanticipated opportunities arise. 

The Committee commends NIH for supporting the AIDS and 

non-AIDS funding allocations at their current relative rates and 

endorses the continuation of this policy. The Committee recognizes 

that OAR’s AIDS allocation to each IC is based on scientific need 

and opportunity. Therefore, individual IC AIDS budgets may not 

each grow at the same rate, but total AIDS and non-AIDS funding 

will continue to grow at a comparable rate. 

The Committee includes bill language permitting OAR to use up 

to $8,000,000 for construction or renovation of National Primate 

Research Centers. This amount is the same as the fiscal year 2013 

level and the budget request. 

BUILDINGS AND FACILITIES

Appropriations, 2013 1 ........................................................................... $125,093,000 

Budget estimate, 2014 ........................................................................... 126,111,000 

Committee recommendation ................................................................. 125,308,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $125,308,000 for NIH 

buildings and facilities. This funding will remain available for obli-
111 

gation for 5 years. The budget request proposes making the funding available until expended. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

The Committee recommends $3,529,944,000 for SAMHSA. The 

recommendation includes $132,667,000 in transfers available under 

section 241 of the PHS Act. In addition, the Committee recommends transferring $92,000,000 to SAMHSA from the PPH 

Fund. The total program level assumed in this bill for SAMHSA is 

$3,621,944,000. 

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 includes $119,000,000 in new 

funding throughout SAMHSA to increase access to mental health 

services. This includes a total of $95,000,000 for the administration’s Now is the Time initiative. The Committee provides 

$15,000,000 for Mental Health First Aid programs that teach individuals to identify and respond to the signs of mental illness; 

$40,000,000 for Project AWARE State grants, which will focus on 

making schools safer and connecting young people with mental 

health services; and $40,000,000 to address shortages in the behavioral health workforce, including a $5,000,000 increase for the Minority Fellowship program. In addition, the Committee includes a 

new 5 percent setaside within the Community Mental Health Services Block Grant [MHBG] that will allocate $24,187,000 to evidence-based programs addressing the needs of individuals with the 

early signs of serious mental illness. 

The Committee is disappointed that the administration has continued to use the Substance Abuse Prevention and Treatment 

[SAPT] Block Grant and the MHBG as sources for program evaluation transfers pursuant to section 241 of the PHS Act. The Committee directs SAMHSA and the Department to exempt these two 

programs from being used as a source for PHS evaluation transfers 

in fiscal year 2014, as was done prior to fiscal year 2012. 

The Committee does not include new bill language requested by 

the administration that would require States to set aside at least 

3 percent of both the SAPT Block Grant and MHBG to assist providers in improving their enrollment, billing, and business practices. The Committee recognizes the challenges faced by some mental health and substance abuse providers in implementing the ACA 

but notes that States are at varying stages of progress in expanding insurance coverage and increasing access to behavioral health 

services, and therefore may not find this requirement necessary. 

The Committee also notes that enrollment and provider business 

practice activities are allowable block grant activities under current 

law. Rather than impose a new ‘‘one size fits all’’ requirement, the 

Committee believes that rules governing both block grants should 

be as flexible as possible in order to allow States the ability to address their own unique needs related to mental health, substance 

abuse prevention, treatment, and recovery services. 

The Committee is concerned that the combined block grant application for fiscal years 2014–2015 does not make clear that, in the 
112 

absence of congressional action, using funds to improve provider 

enrollment and billing practices is an allowable use of funds but is 

not a requirement. The Committee directs SAMHSA to clarify with 

State mental health and substance abuse authorities which block 

grant activities are required and which are optional. 

CENTER FOR MENTAL HEALTH SERVICES

Appropriations, 2013 1 ........................................................................... $952,260,000 

Budget estimate, 2014 ........................................................................... 1,011,380,000 

Committee recommendation ................................................................. 1,059,282,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $1,059,282,000 for mental health 

services. The recommendation includes $21,039,000 in transfers 

available under section 241 of the PHS Act. In addition, the Committee recommends transferring $27,000,000 to CMHS from the 

PPH Fund. The total program level assumed in this bill for CMHS 

is $1,086,282,000. Included in the recommendation is funding for 

programs of regional and national significance, the MHBG, children’s mental health services, PATH, and PAIMI. 

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

The Committee recommends $357,191,000 for PRNS within 

CMHS. In addition, the Committee recommends that $27,000,000 

be transferred to PRNS from the PPH Fund. The total program 

level assumed in this bill for PRNS at CMHS is $384,191,000. 

These programs address priority mental health needs through developing and applying evidence-based practices, offering training 

and technical assistance, providing targeted capacity expansion 

grants, and changing the delivery system through family, client-oriented, and consumer-run activities. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee recommendation 

CAPACITY: 

Seclusion and Restraint ............................................................... $2,439 $1,149 $1,150 

Youth Violence Prevention ............................................................ 23,110 23,156 23,156 

Project AWARE State Grants ......................................................... ........................ 40,000 40,000 

Mental Health First Aid ................................................................ ........................ 15,000 15,000 

Prevention and Public Health Fund (non-add) ................... ........................ .......................... (15,000 ) 

Healthy Transitions ....................................................................... ........................ 25,000 ..........................

National Child Traumatic Stress Initiative ................................... 45,622 45,714 46,000 

Children and Family Programs ..................................................... 6,461 6,474 6,474 

Consumer and Family Network Grants ......................................... 6,212 4,966 4,966 

MH System Transformation and Health Reform ........................... 10,582 10,603 10,582 

Project LAUNCH ............................................................................. 34,571 34,640 34,640 

Primary and Behavioral Healthcare Integration ........................... 30,687 26,004 65,000 

Prevention and Public Health Fund (non-add) ................... ........................ (26,004 ) ..........................

National Strategy for Suicide Prevention ..................................... ........................ 2,000 2,000 

Prevention and Public Health Fund (non-add) ................... ........................ .......................... (2,000 ) 

Suicide Lifeline ............................................................................. 5,501 5,512 7,212 

Prevention and Public Health Fund (non-add) ................... ........................ .......................... (1,700 ) 

GLS Youth Suicide Prevention (State Grants) .............................. 29,622 29,682 35,500 

Prevention and Public Health (non-add) ............................. ........................ .......................... (5,800 ) 

GLS Youth Suicide Prevention (Campus Grants) ......................... 4,956 4,966 6,500 

Prevention and Public Health Fund (non-add) ................... ........................ .......................... (1,500 ) 
113 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

AI/AN Suicide Prevention Initiative ............................................... 2,933 2,938 2,938 

Homelessness Prevention Programs ............................................. 30,710 30,772 30,772 

Tribal Behavioral Grants ............................................................... ........................ .......................... 5,000 

Minority AIDS ................................................................................. 9,247 22,770 9,247 

Criminal and Juvenile Justice Programs ...................................... 6,658 4,280 4,280 

Grants for Adult Trauma Screening and Brief Intervention ......... ........................ 2,896 2,896 

SCIENCE AND SERVICE: 

GLS Suicide Prevention Resource Center ..................................... 4,938 4,948 6,000 

Prevention and Public Health Fund (non-add) ................... ........................ .......................... (1,000 ) 

Practice Improvement and Training ............................................. 7,847 7,863 7,847 

Primary and Behavioral Healthcare Integration T.A. .................... 1,992 1,996 1,996 

Prevention and Public Health Fund (non-add) ................... ........................ (1,996 ) ..........................

Consumer and Consumer Support T.A. Centers ........................... 1,920 1,923 1,923 

Minority Fellowship Program ......................................................... 5,079 .......................... 8,079 

Disaster Response ........................................................................ 1,050 2,950 1,958 

Homelessness ................................................................................ 2,297 2,302 2,302 

HIV/AIDS Education ....................................................................... 771 773 773 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 

Primary and Behavioral Healthcare Integration.—The Committee 

provides funding for this program through budget authority rather 

than through transfers from the PPH Fund as requested by the administration. The Committee continues to direct SAMHSA to ensure that new Integration grants awarded for fiscal year 2014 are 

funded under the authorities in section 520K of the PHS Act. 

Psychotropic Medications and Children.—The Committee has become increasingly concerned about the safe, appropriate, and effective use of psychotropic medications and children, particularly children in foster care settings. According to a December 2012 GAO report, an alarming 18 percent of foster children are prescribed psychotropic medications, compared with 4.8 percent of privately insured children. The Committee strongly encourages SAMHSA to 

establish meaningful partnerships with Medicaid, the foster care 

program, medical specialty societies, and treatment centers to develop new strategies for treating this vulnerable population. The 

Committee would like an update in next year’s congressional justification on the steps SAMHSA has taken to promote the most effective and appropriate treatment approaches, including the use of 

evidence-based psychosocial therapies instead of, or in combination 

with, psychotropic medications. 

Suicide Prevention in Indian Populations.—In order to address 

the high incidence of substance abuse and suicide in American Indian/Alaska Native [AI/AN] populations, the Committee recommends $5,000,000 for competitively awarded grants targeting 

tribal entities with the highest rates of suicide per capita over the 

past 10 years. The Committee expects funds to be used for effective 

and promising strategies that address the problems of substance 

abuse and suicide and promote mental health among AI/AN young 

people. 

COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT

The Committee recommends $483,744,000 for the MHBG. The 

recommendation includes $21,039,000 in transfers available under 

section 241 of the PHS Act. 
114 

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 does not include bill language requested by the 

administration requiring States to set aside 5 percent of MHBG 

funds for effective mental health prevention and treatment programs. The Committee is concerned that this language is too broad 

to target early treatment services to those who need it most: individuals with serious mental illness. Instead, the Committee bill requires States to set aside 5 percent of their MHBG funds for evidence-based programs that address the needs of individuals with 

early serious mental illness, including psychotic disorders. 

The Committee notes that the majority of individuals with severe 

mental illness experience their first symptoms during adolescence 

or early adulthood. Despite the existence of effective treatments, 

there are often long delays—years, and sometimes decades—between the first onset of symptoms and when people receive help. 

The consequences of delayed treatment can include loss of family 

and social supports, disruption of employment, substance abuse, increased hospitalizations, and reduced prospects for long-term recovery. 

One promising model that seeks to address serious mental illness 

at an early stage is called First Episode Psychosis [FEP], currently 

being used in Canada, the United Kingdom, and Australia. This 

early treatment model may help reduce symptoms, reduce relapse 

rates, and prevent deterioration of cognitive function in individuals 

suffering from psychotic illness. The 5 percent setaside will provide 

$24,817,000 to programs such as FEP. The Committee provides an 

increase to the block grant over the fiscal year 2013 level to help 

States meet this new requirement without losing funding for existing services. The Committee directs SAMHSA to collaborate with 

NIMH in developing guidelines to States regarding effective programs funded by this setaside. 

CHILDREN’S MENTAL HEALTH SERVICES

The Committee recommends $117,315,000 for the Children’s 

Mental Health Services program. This program provides grants 

and technical assistance to support a network of community-based 

services for children and adolescents with serious emotional, behavioral, or mental disorders. Grantees must provide matching funds 

and services must be coordinated with the educational, juvenile 

justice, child welfare, and primary healthcare systems. 

PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS

The Committee recommends $64,794,000 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. 
115 

PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS

The Committee recommends $36,238,000 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. 

CENTER FOR SUBSTANCE ABUSE TREATMENT

Appropriations, 2013 1 ........................................................................... $2,196,938,000 

Budget estimate, 2014 ........................................................................... 2,124,650,000 

Committee recommendation ................................................................. 2,128,307,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $2,128,307,000 for substance abuse 

treatment programs, including programs of regional and national 

significance and the substance abuse prevention and treatment 

block grant to the States. The recommendation includes 

$81,200,000 in transfers available under section 241 of the PHS 

Act. In addition, the Committee recommends transferring 

$50,000,000 to CSAT from the PPH Fund. The total program level 

assumed in this bill for CSAT in fiscal year 2014 is $2,178,307,000. 

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

The Committee recommends $308,451,000 for PRNS within 

CSAT. The recommendation includes $2,000,000 in transfers available under section 241 of the PHS Act. In addition, the Committee 

recommends transferring $50,000,000 to PRNS from the PPH 

Fund. The total program level assumed in this bill for PRNS in fiscal year 2014 is $358,451,000. 

Programs of regional and national significance include activities 

to increase capacity by implementing service improvements using 

proven evidence-based approaches as well as science-to-services activities that promote the identification of practices thought to have 

potential for broad service improvement. 

Within the total provided for PRNS, the Committee recommendation includes funding for the following activities: 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

CAPACITY: 

Opioid Treatment Programs/Regulatory Activities ...................... 8,868 8,746 8,746 

Screening, Brief Intervention and Referral to Treatment ........... 28,135 30,000 52,000 

Section 241 transfer (non-add) ......................................... (2,000 ) .......................... (2,000 ) 

Prevention and Public Health Fund (non-add) ................. .......................... (30,000 ) ..........................

TCE—General ............................................................................. 27,924 13,256 13,256 

Pregnant and Postpartum Women .............................................. 15,938 15,970 15,970 

Strengthening Treatment Access and Retention ........................ 1,668 1,000 1,668 

Recovery Community Services Program ...................................... 2,440 2,562 2,440 

Access to Recovery ..................................................................... 98,071 65,000 50,000 

Prevention and Public Health Fund (non-add) ................. .......................... .......................... (50,000 ) 

Children and Families ................................................................ 30,559 29,678 29,678 

Treatment Systems for Homeless ............................................... 41,488 41,571 41,488 

Minority AIDS ............................................................................... 65,732 52,359 65,732 

Criminal Justice Activities .......................................................... 67,372 65,135 64,446 
116 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee recommendation 

SCIENCE AND SERVICE: 

Addiction Technology Transfer Centers ...................................... 9,046 8,081 9,046 

Minority Fellowship Program ....................................................... 545 .......................... 2,545 

Special Initiatives/Outreach ........................................................ 2,262 1,436 1,436 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

Addiction Technology Transfer Centers [ATTCs].—The Committee continues to direct SAMHSA to ensure ATTCs continue to 

maintain a primary focus on addiction treatment and recovery 

services in order to strengthen the addiction workforce. 

Addiction Workforce.—The Committee notes that several studies 

conducted over the past decade suggest that lack of information 

about the addiction field and the perception that addiction counselors are not viewed as a valued profession appear to be recruitment barriers for the addiction workforce. This is particularly concerning given that the demand for substance abuse services is anticipated to increase in the coming years as a result of the ACA 

and the Mental Health Parity and Addictions Equity Act. The Committee strongly urges SAMHSA to work with community colleges, 

universities, and State substance abuse agencies to develop ways 

to encourage individuals to enter the addiction prevention, treatment, and recovery workforce. 

Drug Treatment Courts.—The Committee continues to direct 

SAMHSA to ensure that all funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. The Committee expects CSAT to ensure that non-State substance abuse agency applicants for any drug treatment court grant in its portfolio continue 

to demonstrate extensive evidence of working directly and extensively with the corresponding State substance abuse agency in the 

planning, implementation, and evaluation of the grant. 

Infectious Disease Testing.—The Committee remains concerned 

by the high incidence of viral hepatitis and HIV among the populations that SAMHSA serves. The Committee encourages SAMHSA 

to continue to support hepatitis and HIV testing within its activities and to utilize rapid tests to encourage patient receipt of results. In addition, SAMHSA is encouraged to continue surveillance 

of these activities in order to monitor the progress of infectious diseases screening. 

Minority AIDS Initiative.—The Committee rejects the administration request to move funds to CMHS from the Minority AIDS 

Initiative administered by CSAT. The Committee urges SAMHSA 

to focus its efforts on building capacity and outreach to individuals 

at risk for or with a primary substance use disorder and to improve 

efforts to identify such individuals to prevent the spread of HIV. 

Screening, Brief Intervention, and Referral to Treatment 

[SBIRT].—The Committee provides funding for SBIRT through 

budget authority rather than through transfers from the PPH Fund 

as requested by the administration. The Committee continues to direct SAMHSA to ensure that funds provided for SBIRT are used 

for existing evidence-based models of providing early intervention 
117 

and treatment services to those at risk of developing substance 

abuse disorders. 

Workforce Development.—The Committee is concerned that only 

50 to 55 percent of addiction counselors hold a master’s degree. 

While 75 percent hold at least a bachelor’s degree, the remainder 

have only a high school diploma or equivalent. The Committee 

urges SAMHSA to work with HRSA to ensure that programs aimed 

at mental health and substance use disorder professionals are 

available to addiction professionals seeking to move from a bachelor’s level to a master’s level. 

SUBSTANCE ABUSE PREVENTION AND TREATMENT BLOCK GRANT

The Committee recommends $1,819,856,000 for the 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. 

Overdose Fatality Prevention.—The Committee is deeply concerned about the increasing number of unintentional overdose 

deaths attributable to prescription and nonprescription opioids. The 

Committee urges SAMHSA to take steps to encourage and support 

the use of SAPT Block Grant funds for opioid safety education and 

training, with a focus on initiatives that improve access of naloxone 

to public health and law enforcement professionals. 

CENTER FOR SUBSTANCE ABUSE PREVENTION

Appropriations, 2013 1 ........................................................................... $185,637,000 

Budget estimate, 2014 ........................................................................... 175,560,000 

Committee recommendation ................................................................. 175,631,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $175,631,000 for CSAP, the sole 

Federal organization with responsibility for improving accessibility 

and quality of substance abuse prevention services. 

PROGRAMS OF REGIONAL AND NATIONAL SIGNIFICANCE

The Committee provides $175,631,000 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 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

CAPACITY: 

Strategic Prevention Framework/Partnership for Success ................ 109,587 109,754 109,754 

Mandatory Drug Testing ................................................................... 5,186 4,906 4,906 

Minority AIDS ..................................................................................... 41,224 41,307 41,307 
118 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

Sober Truth on Preventing Underage Drinking (STOP Act) .............. 6,973 7,000 7,000 

SCIENCE AND SERVICE: 

Fetal Alcohol Spectrum Disorder ...................................................... 9,783 1,000 1,000 

Center for the Application of Prevention Technologies .................... 8,043 7,511 7,511 

Science and Service Program Coordination ..................................... 4,770 4,082 4,082 

Minority Fellowship Program ............................................................. 71 ........................ 71 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 

The Committee recommendation provides $109,754,000 for the 

Strategic Prevention Framework State Incentive Grant [SPFSIG] 

and Partnerships for Success programs. 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. The Committee does not concur 

with SAMHSA’s proposal to allow grantees to use funds to address 

trauma, as this would serve to redirect the program’s purpose. In 

addition, the Committee intends that the specific drug and alcohol 

issues chosen by a grantee should be dictated by its own unique 

needs as reflected by an analysis of community-level epidemiological data. Grantees should emphasize prevention of underage alcohol use or prescription drug abuse only if the data support this 

need. 

Given that youth drug use is on the rise and perceptions of harm 

are waning, 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 programs and strategies and not 

for any other purposes. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriations, 2013 1 ........................................................................... $136,109,000 

Budget estimate, 2014 ........................................................................... 201,119,000 

Committee recommendation ................................................................. 166,724,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $166,724,000 for Health Surveillance and Program Support activities. The recommendation includes $30,428,000 in transfers available under section 241 of the 

PHS Act. In addition, the Committee recommends transferring 

$15,000,000 to this account from the PPH Fund. The total program 

level assumed in this bill for health surveillance and support is 

$181,724,000. 

This activity supports Federal staff and the administrative functions of the agency. It also provides funding to SAMHSA’s surveillance and data collection activities, including national surveys such 

as the National Survey on Drug Use and Health. 

The Committee does not include bill language requested by the 

administration that would provide additional transfer authority to 
119 

the Administrator beyond that which is already provided to the 

Secretary. 

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 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

Health Surveillance .............................................................................. $44,153 $47,428 $47,428 

Section 241 transfer (non-add) .................................................. (27,428 ) (45,428 ) (30,428 ) 

Prevention and Public Health Fund (non-add) .......................... (14,733 ) .......................... (15,000 ) 

Program Management .......................................................................... 76,740 72,729 72,729 

Military Families .................................................................................. 3,486 .......................... ..........................

Public Awareness and Support ............................................................ 13,518 13,571 13,571 

Section 241 transfer (non-add) .................................................. .......................... (13,571 ) ..........................

Performance and Quality Info Systems ............................................... 12,945 12,996 12,996 

Section 241 transfer (non-add) .................................................. .......................... (12,996 ) ..........................

Minority Fellowship Program ................................................................ .......................... 9,395 ..........................

Peer Professional Workforce Development ........................................... .......................... 10,000 ..........................

Mental and Behavioral Education and Training Program .................. .......................... 35,000 35,000 

1 Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed 

under Public Law 113–6. 

Mental and Behavioral Health Education and Training.—The 

Committee recommendation includes $35,000,000 for the joint effort with HRSA to increase the clinical service capacity of the behavioral health workforce through the Mental and Behavioral 

Health Education and Training Grant program. Eligible entities for 

this program shall include accredited programs that train master’s 

level social workers, psychologists, and marriage and family therapists; psychology doctoral interns; and paraprofessionals. 

Minority Fellowships.—The Committee recommendation includes 

$10,695,000 for the Minority Fellowship program, a $5,000,000 increase above the fiscal year 2013 level. The Committee provides 

funding for this program within the three Centers as it has done 

in previous years, rather than in the Health Surveillance and Program Support account as requested by the administration. The 

Committee intends that the increase provided in CSAT for Minority Fellowship be used to increase the number of addiction counselors receiving Master’s level training. 

National Survey on Drug Use and Health [NSDUH].—The Committee is concerned about the exclusion of American Samoa, Guam, 

the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands from NSDUH. The exclusion is especially troubling with respect to Puerto Rico and the U.S. Virgin Islands, which are designated as a high intensity drug trafficking area, because NSDUH 

is a leading evidence-based resource used to measure the effectiveness of Federal drug control policies and programs. The Committee 

encourages SAMHSA to consider fully incorporating each territory 

into the redesign of NSDUH. 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

Appropriations, 2013 1 ........................................................................... $369,053,000 

Budget estimate, 2014 ........................................................................... 333,697,000 

Committee recommendation ................................................................. 364,008,000 

1 Excludes transfers and reprogrammings allowed under Public Law 113–6. 
120 

The Committee provides $364,008,000 for AHRQ through transfers available under section 241 of the PHS Act. In addition, the 

Committee recommends transferring $7,000,000 to AHRQ from the 

PPH Fund. The total program level assumed in this bill for AHRQ 

is $371,008,000. 

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. 

The Committee strongly supports AHRQ’s unique mission within 

the Department to fund health services research that improves patient safety and promotes the delivery of high-quality healthcare. 

Whereas NIH conducts biomedical research to prevent, diagnose, 

and treat diseases, and CDC focuses on population health and community-based interventions, only AHRQ supports research that 

identifies the most effective clinical and system-level interventions, 

prevents medical errors, and promotes the wide-scale adoption of 

proven safety and quality practices throughout the healthcare system. The Committee recognizes the Comprehensive Unit-based 

Safety Program [CUSP] as an example of successful AHRQ-funded 

research aimed at preventing healthcare-associated infections 

[HAIs]. Within 3 months of being implemented in Michigan hospitals, this program reduced the rate of central line-related blood 

stream infections by two-thirds in more than 100 intensive care 

units, and within 18 months saved more than 1,500 lives and nearly $200,000,000. The Committee supports AHRQ’s efforts in fiscal 

year 2014 to expand the implementation of CUSP to include other 

healthcare settings and other HAIs. 

HEALTH COSTS, QUALITY, AND OUTCOMES

The Committee provides $231,384,000 for research on health 

costs, quality, and outcomes [HCQO]. In addition, the Committee 

recommends that $7,000,000 be transferred to HCQO from the 

PPH Fund. The total program level assumed in this bill for HCQO 

is $238,384,000. 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 2013 

appropriation 1

Fiscal year 2014 

request 

Committee recommendation 

Research on Health Costs, Quality, and Outcomes: 

Patient-Centered Health Research ............................................... $16,600 ........................ ..........................

Prevention/Care Management ....................................................... 22,369 $20,704 $22,904 

Prevention and Public Health Fund (non-add) ................... (6,465 ) ........................ (7,000 ) 

Value ............................................................................................. 3,730 3,252 3,252 

Health Information Technology ..................................................... 25,572 25,572 29,572 

Patient Safety ............................................................................... 65,585 62,614 71,584 
121 

[In thousands of dollars] 

Budget activity Fiscal year 2013 

appropriation 1

Fiscal year 2014 

request 

Committee recommendation 

Research Innovations .................................................................... 108,377 88,931 111,072 

1 Excludes transfers and reprogrammings allowed under Public Law 113–6. 

Within the Prevention portfolio, the Committee recommends that $7,000,000 from the PPH Fund be transferred to support the U.S. 

Preventive Services Trust Fund, which works to improve 

healthcare by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, or 

preventive medications. 

Coordination of Health Services Research.—The Committee is 

concerned that the various Federal agencies conducting health 

services research do not sufficiently coordinate their efforts to optimize Federal investments in patient safety, especially regarding 

HAIs. As the lead agency for health services research, the Committee requests that AHRQ examine health services research efforts in patient safety (including HAIs) supported by Federal agencies since fiscal year 2010. In particular, AHRQ should identify research gaps, areas that could be consolidated, and emerging research priorities, and propose strategies for better coordination 

among Federal agencies. The Committee requests that AHRQ report on its findings no later than 1 year after the enactment of this 

act. 

Health IT Safety.—The Committee is aware that the 2011 IOM 

report, ‘‘Health IT and Patient Safety: Building Safer Systems for 

Better Care,’’ found large gaps in our knowledge of how health IT 

impacts overall patient safety. Despite the clear potential for 

health IT to improve overall healthcare quality, patients can be 

harmed if IT systems fail, are poorly designed, or provide bad information. The Committee recommendation includes $4,000,000 for 

AHRQ to research safe health IT practices specifically related to 

the design, implementation, usability, and safe use of these systems. The Committee hopes that this investment will generate new 

evidence on safe health IT practices that would ultimately be used 

by ONC, FDA, CMS, and others to inform certification and other 

policy interventions. 

Healthcare Delivery Systems.—The Committee notes that identifying and disseminating improvements to the design of hospital 

rooms and healthcare facilities has the potential to prevent medical 

errors, reduce associated costs, and save lives. Within the Patient 

Safety portfolio, the Committee includes $5,000,000 for research 

grants authorized by section 933 of the PHS Act. This funding will 

support grants for multidisciplinary teams, consisting of patients 

and their families, clinicians, technology experts, and engineers, to 

develop and test best practices in healthcare delivery. This is a new 

activity that was not funded in fiscal year 2013 or requested by the 

administration. 

Investigator-Initiated Research.—The Committee believes that investigator-initiated research forms the backbone of AHRQ’s ability 

to improve healthcare with creative, groundbreaking approaches to 

ongoing and emerging healthcare issues. Within the Research Innovations portfolio, the Committee provides $45,882,000 for investi-
122 

gator-initiated research. The fiscal year 2013 level for this research 

is $43,364,000 and the administration request is $29,259,000. 

Training Grants.—The Committee continues to be concerned by 

the reduction in training grants for health services researchers. 

The Committee requests an update from AHRQ in next year’s 

budget justification outlining the recent status of ‘‘K’’ and ‘‘T’’ 

awards and other training activities. 

MEDICAL EXPENDITURES PANEL SURVEYS

The Committee provides $63,811,000 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. 

PROGRAM SUPPORT

The Committee recommends $68,813,000 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, 2013 ......................................................................... $178,575,680,000 

Budget estimate, 2014 ...................................................................... 177,872,985,000 

Committee recommendation ............................................................. 177,872,985,000 

The Committee recommends $177,872,985,000 in mandatory 

funding for Grants to States for Medicaid. The fiscal year 2014 recommendation excludes $106,335,631,000 

in fiscal year 2013 advance appropriations for fiscal year 2014. As 

requested by the administration, $103,472,323,000 is provided for 

the first quarter of fiscal year 2015. 

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, 2013 1 ....................................................................... $234,265,790,000 

Budget estimate, 2014 ...................................................................... 255,185,000,000 

Committee recommendation ............................................................. 255,697,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $255,697,000,000 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 
123 

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 $194,565,000,000 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 $58,596,000,000 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 $373,000,000 to be 

transferred to the Supplementary Insurance Trust Fund as the 

general fund share of part D administrative expenses. The Committee recommendation includes $640,000,000 in reimbursements 

to the HCFAC fund. 

REDUCED COST SHARING FOR INDIVIDUALS ENROLLING IN QUALIFIED

HEALTH PLANS

Appropriations, 2013 ............................................................................. ........................... 

Budget estimate, 2014 ........................................................................... $3,977,893,000 

Committee recommendation ................................................................. ........................... 

The Committee recommendation does not include a mandatory 

appropriation, requested by the administration, for reduced cost 

sharing assistance for individuals enrolling in qualified health 

plans purchased through the Health Insurance Marketplace, as 

provided for in sections 1402 and 1412 of the ACA. 

This program helps eligible low- and moderate-income individuals and families afford the out-of-pocket costs associated with 

healthcare services. 

PROGRAM MANAGEMENT

Appropriations, 2013 1 ........................................................................... $3,864,571,000 

Budget estimate, 2014 ........................................................................... 5,217,357,000 

Committee recommendation ................................................................. 5,217,357,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $5,217,357,000 for CMS program 

management, which includes funding for research, program operations, survey and certification programs, and Federal administration. 

Research, Demonstrations, and Evaluations 

The Committee has consolidated the research office into program 

operations, as requested by the President. 

Program Operations 

The Committee recommends $4,011,200,000 for the Program Operations account, which covers a broad range of activities including 
124 

claims processing and program safeguard activities performed by 

Medicare contractors. These contractors also provide information, 

guidance, and technical support to both providers and beneficiaries. 

The Committee includes additional funding for program operations above the fiscal year 2013 level to support expanding workloads due to the enrollment of the baby boom generation in the 

Medicare program and to support the work required of CMS to implement the ACA. 

Fiscal year 2014 begins on the very same day the ACA will open 

enrollment for new health coverage in the Health Insurance Marketplace, which will for the first time offer Americans a single 

place where they can compare the costs and benefits of different 

health insurance plans and choose the one that fits their needs. 

Funding in this bill will be used to oversee the operations in the 

first year of the Marketplace, ensuring that Americans get access 

to affordable health coverage and understand their rights as they 

begin to use that coverage. In addition, CMS will ensure compliance with the Patient’s Bill of Rights and other insurance market 

rules, help States enforce the Medical Loss Ratio regulations, and 

implement additional quality measures to improve healthcare services for all Americans. 

The Committee recommendation also includes funding to continue and expand data initiatives that, for the first time, give consumers information about healthcare costs and utilization. For example, in 2013, CMS released data on what hospitals charge for 

common procedures across the country and data on how much 

Medicare spends on a State-by-State and county-by-county basis. 

Businesses and consumers can use this detailed pricing data to 

make important choices about needed healthcare and health coverage. The Committee believes that this transparency will reduce 

and rationalize healthcare costs in the future. 

Antimicrobial Stewardship.—The Committee continues to be concerned by the growing problem of antimicrobial resistance. The 

Committee encourages CMS to collaborate with participating 

healthcare institutions to develop and implement antimicrobial 

stewardship programs in all healthcare facilities, including hospitals, long-term care facilities, long-term acute care facilities, ambulatory surgical centers, and dialysis centers. 

Community Living.—The Committee encourages CMS and ACL 

to continue their joint expansion and support of home- and community-based services for individuals with disabilities through the 

Money Follows the Person program, the Community First Choice 

Option, and other programs. In support of this effort, the Committee encourages CMS and ACL to provide regulatory guidance 

and technical assistance to States and other interested parties regarding the various Federal tools that have been created to help 

them expand access to home- and community-based long-term services and supports. In addition, the Committee encourages CMS and 

ACL to create an interagency task force on implementing the 

Olmstead decision. 

Critical Access Hospitals.—The Committee requests a list of critical access hospitals that would be re-designated under the administration’s proposal to remove critical access hospital status from 

facilities located less than 10 miles from another hospital. CMS is 
125 

encouraged to work with the Office of Rural Health Policy at HRSA 

to ensure that rural patients maintain access to necessary health 

services. 

Dental Services.—The Committee commends CMS on its plan to 

clarify dental payment policy through a State Medicaid Director 

letter in 2013. CMS is directed to notify the Committee when the 

letter is issued. 

Frontier Health.—The Committee notes that the Frontier Extended Stay Clinic Demonstration program reached its statutorily 

mandated completion in April 2013. The Committee directs CMS to 

submit a report on the outcomes of this demonstration no later 

than 90 days after enactment of this act. In addition, the Committee includes $150,000 for the planned implementation of the 

Frontier Community Health Integration Demonstration program, 

slated to begin in fiscal year 2014. 

Hepatitis C Screening.—The Committee is aware that the U.S. 

Preventive Services Task Force recently recommended that all 

Americans born between 1945 and 1965 receive one-time screening 

for hepatitis C. Given that this population is currently aging into 

Medicare, the Committee urges CMS to include this one-time 

screening in the Welcome to Medicare physical exam. 

Immunization Payment.—The Committee strongly supports efforts to vaccinate Americans for preventable conditions. The Committee is concerned that a new coding rule for preventive services 

when administered in conjunction with immunization may undermine such efforts by discouraging the provision of immunizations 

at well baby and well child visits. The Committee urges CMS to reconsider this change. The Committee directs CMS to submit a report no later than 180 days after the implementation of the new 

coding rule on the impact of the change in policy on immunization 

rates. 

Influenza Vaccine for Healthcare Workers.—The Committee supports the new requirement for acute care hospitals participating in 

the CMS Inpatient Prospective Payment System Hospital Inpatient 

Quality Reporting Program to submit summary data on influenza 

vaccination of healthcare personnel via CDC’s National Healthcare 

Safety Network. The Committee encourages CMS to expand required reporting to all hospitals, skilled nursing facilities, and 

nursing facilities. 

Infusion Pumps.—The Committee encourages CMS to conduct 

further research and analysis that will determine whether small 

volume infusion pumps could be used to improve patient care and 

reduce healthcare costs. 

Integrative Medicine.—The Committee is aware of controlled clinical trials that have shown promising results for mind-body approaches to preventing and treating hypertension, other cardiovascular risk factors, and cardiovascular disease. Additional research is warranted to determine if integrative medicine interventions offer a unique opportunity to improve the quality of care 

while reducing healthcare costs from the Nation’s leading causes of 

death. The Committee encourages CMS to test integrative health 

interventions to determine health outcomes and the potential for 

healthcare savings. In particular, the Committee is supportive of 

research into mind-body interventions for cardiovascular disease 
126 

that have been previously shown in peer-reviewed publications of 

clinical trials to reduce cardiovascular risk factors, mortality, myocardial infarction, and stroke. 

Outpatient Drug Dispensing.—The Committee is strongly committed to eliminating waste in Medicare part D and believes that 

more should be done to reduce wasteful spending on outpatient 

prescription drugs in long-term care facilities. The Committee directs the Administrator of CMS to develop additional proposals designed to encourage short-cycle dispensing of outpatient prescription drugs in long-term care facilities and investigate the effects of 

dispensing fee changes on cost savings in the short-cycle dispensing 

program. These proposals should be submitted to the Committee no 

later than 180 days after enactment of this act. 

Provider Nondiscrimination.—Section 2706 of the ACA prohibits 

certain types of health plans and issuers from discriminating 

against any healthcare provider who is acting within the scope of 

that provider’s license or certification under applicable State law, 

when determining networks of care eligible for reimbursement. The 

goal of this provision is to ensure that patients have the right to 

access covered health services from the full range of providers licensed and certified in their State. The Committee is therefore concerned that the FAQ document issued by HHS, DOL, and the Department of Treasury on April 29, 2013, advises insurers that this 

nondiscrimination provision allows them to exclude from participation whole categories of providers operating under a State license 

or certification. In addition, the FAQ advises insurers that section 

2706 allows discrimination in reimbursement rates based on broad 

‘‘market considerations’’ rather than the more limited exception 

cited in the law for performance and quality measures. Section 

2706 was intended to prohibit exactly these types of discrimination. 

The Committee believes that insurers should be made aware of 

their obligation under section 2706 before their health plans begin 

operating in 2014. The Committee directs HHS to work with DOL 

and the Department of Treasury to correct the FAQ to reflect the 

law and congressional intent within 30 days of enactment of this 

act. 

Research.—The Committee strongly supports the research activities that CMS undertakes to improve the efficiency of payment, delivery, access, and quality of Medicare, Medicaid, and ACA programs. In particular, the Committee supports the proposed increase for the Chronic Conditions Data Warehouse, which makes 

data on chronic disease rates and health utilization trends within 

the beneficiary population available to researchers. In addition, the 

Committee recommendation includes sufficient funding to fulfill the 

President’s request for the Medicare Current Beneficiaries Survey, 

the Research Data Assistance Center, public use data files, and 

Medicaid Analytic Data. 

Treatment of Hard-to-Heal Wounds.—The Committee recommendation includes $500,000 for CMS to initiate a pilot study 

on the health outcomes of new medical technologies for treating 

hard-to-heal wounds. This pilot study should focus on medical technologies that are not currently eligible for reimbursement in CMS 

programs. 
127 

State Survey and Certification 

The Committee recommends $412,353,000 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. 

Infection Control Surveillance in Ambulatory Surgery Centers.— 

The Committee recommendation includes full funding of the President’s requested increase for surveying ambulatory surgical centers 

[ASCs], particularly in the area of infection control surveillance. In 

response to a July 2012 GAO report, CMS committed to collecting 

data using the agency’s ASC Infection Control Surveyor Worksheet. 

The Committee supports this effort and encourages CMS to continue collecting and analyzing the findings from this surveillance 

tool to inform the agency’s education and surveillance efforts moving forward. In addition, the Committee encourages CMS to make 

the aggregate data publicly available to build a better understanding of current and future injection practices in ASCs. 

High-Risk Insurance Pools 

The Committee includes $22,004,000 for High-Risk Insurance 

Pools. This amount is intended to reimburse States for operational 

losses incurred by such pools during the first 6 months of fiscal 

year 2013, which allows a 3-month period for beneficiaries to make 

the transition to the health insurance marketplace. 

Federal Administration 

The Committee recommends $771,800,000 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, 2013 1 ........................................................................... $309,170,000 

Budget estimate, 2014 ........................................................................... 311,000,000 

Committee recommendation 2 ............................................................... 640,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes funding available under program integrity cap adjustment provided by Public Law 

112–25. 

The Committee recommends $640,000,000, to be transferred from 

the Medicare trust funds, for Health Care Fraud and Abuse Control [HCFAC] activities. 

The Committee recommendation includes a base amount of 

$311,000,000 and an additional $329,000,000 through a budget cap 

adjustment authorized by section 251(b) of the Balanced Budget 

and Emergency Deficit Control Act of 1985. 

Funding in this bill, in addition to the $1,320,554,000 in mandatory monies for these activities, will provide a total of 

$1,960,554,000 for HCFAC activities in fiscal year 2014. 

Secure Medicare Card Pilot Project.—The Committee commends 

CMS on the completion of a Medicare smart card pilot project for 
128 

providers. When analysis of the data is complete, CMS is directed 

to submit a report of the findings of this project to the Committees 

on Appropriations. The report should include recommendations on 

further study of smart card use in the beneficiary context. Smart 

card technology may hold promise for reducing identity theft and 

increasing the accuracy of Medicare billing. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Appropriations, 2013 1 ........................................................................... $2,903,752,000 

Budget estimate, 2014 ........................................................................... 2,965,245,000 

Committee recommendation ................................................................. 2,965,245,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $2,965,245,000 in fiscal 

year 2014 mandatory funds for Child Support Enforcement and 

Family Support programs. In addition, the Committee recommends 

$1,250,000,000 in advance funding for the first quarter of fiscal 

year 2015. 

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, 2013 1 ........................................................................... $3,464,729,000 

Budget estimate, 2014 ........................................................................... 3,020,000,000 

Committee recommendation ................................................................. 3,614,729,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $3,614,729,000 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, the same as the fiscal year 2013 level. 

The Committee recommendation provides the full amount for 

LIHEAP under the State formula grant and does not include funding for the contingency fund. The Committee recommendation also 

does not include funding for new energy burden reduction grants 

requested by the administration. 

REFUGEE AND ENTRANT ASSISTANCE

Appropriations, 2013 1 ........................................................................... $1,013,968,000 

Budget estimate, 2014 ........................................................................... 1,123,432,000 

Committee recommendation ................................................................. 1,121,432,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 
129 

The Committee recommends $1,121,432,000 for Refugee and Entrant Assistance programs. These programs provide a variety of 

benefits and services to refugees, asylees, Cuban and Haitian entrants, trafficking victims, and torture victims (collectively referred 

to below as ‘‘refugees’’). The programs also fund temporary shelter 

and services for unaccompanied alien children apprehended by law 

enforcement who are in Federal custody awaiting adjudication of 

their immigration status. 

Transitional and Medical Services 

The Committee recommendation includes $391,477,000 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 incoming refugees as well 

as foster care services to unaccompanied minors. 

Within the total, the Committee recommendation includes not 

less than $65,000,000 for the Voluntary Agencies Matching Grant 

program, which provides grants to resettlement agencies to support 

comprehensive services for arriving refugees with the goal of refugees becoming self-sufficient within their first 4 months in the 

United States. 

Victims of Trafficking 

The Committee recommendation includes $15,775,000 for Victims 

of Trafficking programs. Within this amount, the Committee recommendation includes $12,775,000 for programs serving foreign 

national victims and $3,000,000 for a new program to improve 

services available to U.S. citizens and legal permanent residents 

who are victims of trafficking. 

U.S. citizens and permanent residents who are victims of trafficking, or at risk of becoming victims, are likely to receive services 

from a number of existing programs that serve vulnerable populations, including runaway and homeless youth shelters, domestic 

violence programs, and organizations working within the criminal 

justice system. However, these programs may not have the capacity 

to provide for the unique needs of this particularly vulnerable population. This new funding will increase the capacity of existing programs and the availability of services to all victims of trafficking. 

Social Services 

The Committee recommendation includes $153,407,000 for Social 

Services programs for refugees. These funds include formula and 

discretionary grants to States and nonprofit organizations to provide a variety of employment and support services to recently arrived refugees. 

The Committee continues to strongly encourage ORR to explore 

the use of existing discretionary funds for case management services and emergency housing assistance for particularly vulnerable 

refugee populations. 

Preventive Health 

The Committee recommendation includes $4,730,000 for Preventive Health services for refugees. This program funds grants to co-
130 

ordinate and promote refugees’ access to health screening, treatment, and follow-up services. 

Targeted Assistance 

The Committee recommendation includes $48,401,000 for the 

Targeted Assistance program. This program provides additional 

funds to States with an influx of refugee arrivals and a high concentration of refugees facing difficulties achieving self-sufficiency. 

Unaccompanied Alien Children 

The Committee recommendation includes $494,597,000 for the 

UAC program. The UAC program provides shelter and support 

services to unaccompanied alien children apprehended in the 

United States by the Department of Homeland Security or other 

law enforcement agencies. Children are taken into HHS’ care pending resolution of their claims for relief under U.S. immigration law 

or release to an adult family member or guardian. 

There has been a significant increase in the number of unaccompanied alien children arriving in the United States in recent years, 

from approximately 7,100 in fiscal year 2011 to an estimated 

23,500 in fiscal year 2013. Many of the children placed into HHS’s 

care are fleeing dangerous situations in their home country and are 

victims of severe forms of abuse, neglect, or trafficking. The Committee expects HHS to continue to provide it periodic updates on 

this situation. In addition, the Committee continues to be concerned about the impact of this dramatic increase in the number 

of children on the availability of support services, including access 

to pro bono legal representation, child advocates, social workers, 

physicians, and psychologists. Accordingly, within the total for the 

UAC program, the Committee recommendation includes 

$13,000,000, an approximately $3,327,000 increase over the fiscal 

year 2013 level, for the pro bono legal services initiative. This funding supports legal representation for both released and detained 

children. Given that the vast majority of children are released to 

a family member or sponsor pending resolution of their immigration status, the Committee directs ACF to allocate a significant 

portion of this increase to improve the availability of legal representation for released children. In addition, the Committee recommendation includes $1,000,000 for the child advocate program. 

This program helps protect the interests and rights of the most vulnerable children while awaiting adjudication of their immigration 

status. 

Victims of Torture 

The Committee recommendation includes $13,045,000 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. 
131 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT

BLOCK GRANT

Appropriations, 2013 1 ........................................................................... $2,323,656,000 

Budget estimate, 2014 ........................................................................... 2,478,313,000 

Committee recommendation ................................................................. 2,500,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $2,500,000,000 for the CCDBG, a 

State formula grant that provides financial assistance to low-income families to help pay for child care and to improve the quality 

of child care programs. The Committee recommendation provides $110,000,000 of the increase over the fiscal year 2013 level for formula grants to States, 

tribes, and territories to improve the quality of child care programs. In May 2013 the administration announced new rules to 

strengthen State child care standards and requirements to improve 

the health, safety, and school readiness of children in child care. 

These funds will support these and other efforts to improve the 

quality of child care programs across all States and settings. Funds 

should be used to help States raise the bar on quality, including 

through training, education, and other professional development for 

staff (including coaching, mentoring, and other on-site training and 

technical assistance); technical assistance to help providers become 

licensed and comply with licensing and regulatory requirements; 

scholarships for further education; compensation improvement (including rewards or bonuses) linked to increased credential or degree completion; and improving health and safety standards. States 

should work with their State Early Childhood Advisory Councils in 

coordinating these activities. States applying for these funds should 

provide assurances that funds will be prioritized first in areas with 

significant concentrations of poverty and unemployment and that 

lack access to high-quality early care and education programs, or 

for otherwise underserved populations such as children with disabilities or special needs. Additionally, any use of child assessments should conform to the recommendations of the National Research Council’s reports on early childhood and assessment. Finally, these funds should be used to supplement and not to supplant Federal, State, and local funds otherwise used for these purposes. The Committee directs the remaining $66,344,000 increase over 

the fiscal year 2013 level to the base block grant. In recent years, 

many States have struggled to maintain key child care policies and 

have tightened eligibility requirements, added to waitlists, increased family copayments, and frozen reimbursement rates for 

providers. As a result, fewer families are receiving assistance and 

many that do are struggling to find quality affordable child care options. This increase will help improve low-income families’ access 

to quality affordable child care. 

The Committee recommendation also maintains several existing 

set-asides at their fiscal year 2013 level. This includes $996,000 for 

a national toll-free referral line and Web site to provide child care 

consumer education information to low-income families, including 

information about the quality of child care programs, such as information under a State or local quality rating and improvement sys-
132 

tem, and information to help families access available child care in 

their community through linkages to State and local data sources. 

Funds set aside for quality improvement activities within the block 

grant are in addition to the $110,000,000 in new formula funds described above and the 4 percent quality improvement set-aside established in the authorizing legislation. 

SOCIAL SERVICES BLOCK GRANT

Appropriations, 2013 1 ........................................................................... $1,700,000,000 

Budget estimate, 2014 ........................................................................... 1,700,000,000 

Committee recommendation ................................................................. 1,700,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

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. 

The Committee continues to regard the SSBG as a critical source 

of funding for services that protect children from neglect and 

abuse, including providing foster and respite care, as well as related services for children and families, persons with disabilities, 

and older adults. The Committee recognizes the importance of this 

program, especially in providing mental health and counseling 

services to underserved populations, and recommends continued 

usage and flexibility of these funds for such purposes. 

CHILDREN AND FAMILY SERVICES PROGRAMS

Appropriations, 2013 1 ........................................................................... $9,927,328,000 

Budget estimate, 2014 ........................................................................... 11,088,944,000 

Committee recommendation ................................................................. 11,417,876,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $11,417,876,000 in budget authority 

for Children and Families Services programs, including $5,762,000 

in transfers available under section 241 of the PHS Act. These 

funds support a variety of programs for children, youth, and families; the developmentally disabled; Native Americans; victims of 

child abuse, neglect, and domestic violence; and other vulnerable 

populations. 

Head Start 

The Committee recommendation includes $9,621,070,000 for 

Head Start. Head Start provides grants directly to local public and 

private organizations to provide comprehensive early childhood 

education services to low-income children and their families, from 

before birth to age 5. 

The Committee recommendation includes bill language that restores funding for current grantees to their fiscal year 2012 funding 

level and then further allows for a 1.9 percent cost of living adjustment. This will help current grantees retain and recruit highly 

qualified staff and keep pace with rising costs to maintain highquality services. 

Within the total for Head Start, the Committee recommendation 

also includes $1,430,376,000 to expand Early Head Start services 
133 

through new and existing Early Head Start providers and through 

new Early Head Start-Child Care Partnerships, as requested by 

the administration. Early Head Start, which provides services to 

children and their families from before birth to age 3, currently 

serves less than 5 percent of eligible children, yet research increasingly supports the importance and benefits of high-quality early 

childhood education beginning at the earliest ages, including for 

families before birth. This increase in funding will nearly double 

enrollment in Early Head Start. 

Through Early Head Start-Child Care Partnerships, Early Head 

Start providers will partner with local center and family-based 

child care providers, leveraging current investments through the 

Child Care and Development Fund, to increase the quality of existing child care programs. Early Head Start providers will enter into 

contractual relationships with local child care programs to provide 

training, technical assistance, and funding to raise the bar on the 

quality of those programs to meet Early Head Start program performance standards. The Committee includes bill language specifying that partnering child care providers have 18 months to meet 

such standards before being subject to the requirements of the Designation Renewal System [DRS]. HHS should establish standards 

to ensure that the responsibilities and expectations of the Early 

Head Start provider and partnering child care providers, respectively, are clearly defined. The Committee recommendation also includes bill language specifying that funding for Early Head StartChild Care Partnerships may be used to provide services for children through age 3. 

In awarding Early Head Start expansion funds, the Committee 

urges HHS to prioritize organizations that seek to develop a unified 

birth-to-school-entry continuum through alignment with maternal 

and infant health home visiting programs, State funded pre-K programs, and other federally, State, or locally funded early childhood 

care and education programs. Moreover, HHS should prioritize organizations that seek to work with child care providers across settings, including center and home-based programs. The Committee 

also urges HHS to encourage a wide-range of organizations to 

apply, including States, and new and existing Early Head Start 

providers. Early Head Start expansion funds, including funding for 

Early Head Start-Child Care Partnerships, should be allocated to 

States proportionally based on the number of young children from 

families whose income is below the poverty line. Further, the Secretary shall reserve no less than 3 percent for Indian Head Start 

programs and no less than 4.5 percent for migrant and seasonal 

Head Start programs, to expand services for children and their 

families from before birth through age 3 in those programs. 

Within the total for Head Start, the Committee recommendation 

also includes up to $25,000,000, as requested by the administration, for transition-related costs associated with the Head Start 

DRS. Under the DRS, each year certain Head Start programs are 

required to recompete for continued funding. These funds support 

start-up and other transition-related costs to ensure that new 

grantees are fully operational when an incumbent grant ends. This 

minimizes any disruption in services for children and families. In 

addition, the Committee continues to encourage HHS to consider 
134 

the unique challenges faced by Head Start providers in remote and 

frontier areas when reviewing grantees as part of the DRS. 

Consolidated Runaway and Homeless Youth Program 

The Committee recommendation includes $99,355,000 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. 

The Committee recommendation for runaway and homeless 

youth programs does not include funding for the ‘‘Prevalence, 

Needs and Characteristics of Homeless Youth’’ study, as requested 

by the administration. Instead, the Committee directs new funding 

provided over the fiscal year 2013 level to the core runaway and 

homeless youth programs. The Committee includes $54,636,000 for 

the Basic Centers program and $44,719,000 for the Transitional 

Living program. The fiscal year 2013 level for the Basic Centers 

program is $53,429,000 and the budget request is $53,536,000. The 

fiscal year 2013 level for the Transitional Living program is 

$43,731,000 and the budget request is 43,819,000. 

Education and Prevention Grants To Reduce Sexual Abuse of Runaway Youth 

The Committee recommendation includes $17,865,000 for Education and Prevention Grants to Reduce Sexual Abuse of Runaway 

and Homeless Youth. This program provides competitive grants for 

street-based outreach and education services for runaway and 

homeless youth who are subjected to or are at risk of being subjected to sexual abuse or exploitation. 

Child Abuse Prevention and Treatment State Grants 

The Committee recommendation includes $26,379,000 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 $25,693,000 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 $41,444,000 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 
135 

and improving the coordination between State and communitybased organizations. 

Abandoned Infants Assistance 

The Committee recommendation includes $11,530,000 for the 

Abandoned Infants Assistance program. This program provides discretionary grants to public and private community and faith-based 

organizations to develop, implement, and operate demonstration 

projects that prevent the abandonment of infants and young children impacted by substance abuse and HIV. Funds may be used to 

provide respite care for families and caregivers, allow abandoned 

infants and children to reside with their natural families or in foster care, and carry out residential care programs for abandoned infants and children who are unable to reside with their families or 

be placed in foster care. 

Child Welfare Services 

The Committee recommendation includes $280,088,000 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 $26,039,000 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. 

The Committee continues to encourage ACF to work with ACL 

and other HHS agencies to evaluate intergenerational approaches 

for improving outcomes for at-risk youth and families. The Committee strongly encourages HHS to use existing discretionary resources for such initiatives. 

Adoption Opportunities 

The Committee recommends $44,100,000 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. 

Within the total, the Committee recommendation includes 

$7,500,000 for discretionary grants to test intensive and exhaustive 

child-focused adoptive parent recruitment strategies for children in 

foster care. Such intensive recruitment strategies have been shown 

to move foster youth into permanent families at a much higher rate 

than traditional recruitment approaches. These programs should 

focus on children that are hardest to place because of age, dis-
136 

ability, or sibling group membership. In addition, the Committee 

encourages HHS to provide guidance to State child welfare agencies on the use of title IV–E Foster Care and Adoption Assistance 

training funds for the implementation of intensive child-focused recruitment strategies and other evidence-based models that have 

been shown to increase the rate of placement of children in foster 

care, particularly older children, into adoptive families. 

The Committee remains concerned about the availability of postadoption services for children and their adoptive families and 

strongly encourages ACF to increase funding within this program 

explicitly available for such activities. The Committee also directs 

ACF to submit a report by July 31, 2014, on how ACF has used, 

and plans to use, Adoption Opportunities funding to strengthen 

post-adoption services. 

Adoption Incentives 

The Committee recommends $39,268,000 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 $14,762,000 for Social Services and 

Income Maintenance Research, including $5,762,000 funded 

through transfers available under the PHS Act. 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. 

Within the total, as requested by the administration, the Com- mittee recommendation includes $3,000,000 for a rigorous evaluation to examine which features of early care and education programs most influence child and family outcomes, and how those 

features interact with other child, family, and community-level 

characteristics to affect such outcomes. 

Within the total, the Committee recommendation also includes 

$6,000,000 for the National Survey of Child and Adolescent WellBeing, as requested by the administration. 

The Committee recommendation does not include funding requested by the administration for a new initiative addressing financial deterrents to marriage. 

Developmental Disabilities and Voting Access for Individuals with 

Disabilities 

In order to better align disability and aging policies and programs, in 2012 HHS moved the Administration on Developmental 

Disabilities from ACF to the newly established ACL. The Committee supports this administrative change and accordingly funds 

these programs within ACL in fiscal year 2014. 

Native American Programs 

The Committee recommends $48,486,000 for Native American 

programs. These funds support a variety of programs to promote 

self-sufficiency and cultural preservation activities among Native 
137 

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 language immersion programs authorized by section 803C(b)(7)(A)–(C) of the Native American Programs Act, as amended by the Esther Martinez Native 

American Language Preservation Act of 2006. The Committee 

strongly encourages ACF to give priority to grantees with rigorous 

immersion programs. 

Community Services Block Grant 

The Committee recommendation includes $676,003,000 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. 

The Committee rejects the administration’s proposed cut to the 

CSBG and continues to strongly support the program, which provides critical and flexible funding for local organizations that serve 

as a central source of assistance for low-income populations at the 

local level. 

Community Economic Development 

The Committee recommendation includes $29,883,000 for the 

Community Economic Development [CED] program. This program 

provides grants to community development corporations to support 

employment and business development opportunities for low-income individuals. Within the total for the CED program, the Committee recommendation includes up to $10,000,000 for the Healthy 

Foods Financing Initiative [HFFI]. 

The administration proposed eliminating the CED program and 

moving CED funding for HFFI to the Department of the Treasury, 

which also provides funding for HFFI through the Community Development Financial Institutions [CDFI] program. The Committee 

rejects this elimination and continues to allow funding for HFFI 

within the CED program. The Committee strongly encourages continued collaboration between HHS and Treasury but notes that 

HFFI projects funded under CED are distinct from those funded 

under CDFI. 

Within the HFFI program, the Committee encourages ACF to 

promote the establishment of food hubs in local communities. Food 

hubs address challenges in both the distribution and retail of 

healthy foods by connecting local producers to the market. Specifically, food hubs aggregate locally grown products from a group of 

producers and distribute and market them to consumers, whether 

households, retailers, or wholesalers. 

Rural Community Facilities 

The Committee recommendation includes $5,971,000 for the 

Rural Community Facilities program. This program provides 
138 

grants to regional nonprofit organizations to provide training and 

technical assistance to low-income rural communities in developing 

and managing safe and affordable water and wastewater treatment 

facilities. These funds support projects in communities that generally cannot access resources and services through similar programs at the Department of Agriculture and the Environmental 

Protection Agency. 

Assets for Independence 

The Committee recommendation includes $20,000,000 for the Assets for Independence [AFI] program. The AFI program provides 

discretionary grants to organizations to support individual development accounts that encourage low-income individuals to create savings accounts for dedicated purposes, such as buying a home, paying for college, or starting a business. 

In addition, the Committee recommendation includes new bill 

language requested by the administration that will allow HHS to 

recapture unused funds by grantees and reallocate them to new or 

existing projects. AFI grantees are required to match individual 

savings with equal amounts of Federal and non-Federal funds. 

Grantees have 5 years to expend funds but some have struggled to 

encourage enough savings or to provide a sufficient match to be 

able to expend their full grant during that time. 

National Domestic Violence Hotline 

The Committee recommendation includes $4,500,000 for the National Domestic Violence Hotline. This national, toll-free hotline 

provides information and assistance to victims of domestic violence 

24 hours a day. 

Family Violence Prevention and Services 

The Committee recommendation includes $135,000,000 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. The Committee recommends an increase for this 

program, as well as for the National Domestic Violence Hotline, to 

improve the availability of services for victims of domestic violence. 

According to a 2012 survey, on any given day domestic violence 

programs must turn down over 15 percent of requests for services, 

the vast majority of which are for emergency shelter and housing, 

because of a lack of resources. 

Chafee Education and Training Vouchers 

The Committee recommendation includes $45,084,000 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 $1,988,000 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 
139 

to meet social service needs during disasters by helping disaster 

victims prepare recovery plans, referring them to service providers 

and FEMA contacts in order to identify needed assistance, and providing ongoing support and monitoring through the recovery process. 

Program Administration 

The Committee recommendation includes $203,368,000 for the 

Federal costs of administering ACF programs. This amount includes up to $1,368,000 for the Center for Faith-Based and Neighborhood Partnerships. The Committee recommendation for ACF 

program administration does not include costs for administering 

developmental disabilities programs and the Voting Access for Individuals with Disabilities program, which have moved to ACL. 

The Committee urges ACF to ensure that the interests of Hispanic children and families, as well as other underserved populations, are considered throughout their grant programs and processes, including in grant announcements, review panels, and evaluation activities. The Committee directs ACF to provide a report no 

later than March 31, 2014, on its current and planned efforts to 

meet this priority. 

PROMOTING SAFE AND STABLE FAMILIES

Appropriations, 2013 1 ........................................................................... $407,938,000 

Budget estimate, 2014 ........................................................................... 408,065,000 

Committee recommendation ................................................................. 408,065,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $408,065,000 for the Promoting Safe 

and Stable Families program. The Committee recommendation includes $345,000,000 in mandatory funds authorized by the Social 

Security Act and $63,065,000 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. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriations, 2013 1 ........................................................................... $4,817,220,000 

Budget estimate, 2014 ........................................................................... 4,806,000,000 

Committee recommendation ................................................................. 4,806,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $4,806,000,000 in mandatory funds 

for Payments for Foster Care and Permanency. In addition, the 

Committee recommends $2,200,000,000 in advance mandatory 

funding for the first quarter of fiscal year 2015. 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. 
140 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

Appropriations, 2013 1 ........................................................................... $1,467,974,000 

Budget estimate, 2014 ........................................................................... 1,714,755,000 

Committee recommendation ................................................................. 1,716,664,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $1,716,664,000 for ACL, which includes $52,115,000 in Medicare trust funds. In 

addition, the Committee recommends that $31,700,000 be transferred to ACL from the PPH Fund. The total program level assumed in this bill for ACL is $1,748,364,000. Both the budget request and Committee recommendation reflect a consolidated account structure for ACL, which was established by HHS in April 

2012 by combining the organizational components of AoA, the HHS 

Office on Disability, and the Administration on Developmental Disabilities. The fiscal year 2013 total for ACL does not reflect this reorganization, and therefore is not directly comparable to fiscal year 

2014. 

ACL was created with the goal of increasing access to community 

supports 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. 

Home- and Community-Based Supportive Services 

The Committee recommends an appropriation of $366,916,000 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. 

Preventive Health Services 

The Committee recommends $20,944,000 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 $21,797,000 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 
141 

of nursing homes and other long-term care facilities, while the 

elder abuse prevention program targets the elderly community at 

large. 

The Committee urges the Long-term Care Ombudsman program 

to include ombudsman training on the possible dangers of chemical 

and physical restraints, including portable adult bedrails, and how 

to safely minimize their use. 

National Family Caregiver Support Program 

The Committee recommends $153,621,000 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. 

Native American Caregiver Support Program 

The Committee recommendation includes $6,364,000 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 $439,070,000 for 

congregate nutrition services and $216,830,000 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 $160,389,000 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 Department of Agriculture. 

Aging Grants to Indian Tribes and Native Hawaiian Organizations 

The Committee recommends $27,601,000 for grants to Native 

Americans. This program provides grants to eligible tribal organizations for the delivery of nutrition and supportive services to Native Americans. 
142 

Aging Network Support Activities 

The Committee recommends $7,873,000 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. 

Improving Transportation for Older Americans.—The Committee 

is aware of the growing need for transportation services for older 

Americans and urges ACL to support efforts to encourage privatepublic partnerships to carry out section 416 of the OAA. 

Alzheimer’s Disease Demonstration Grants to States 

The Committee recommendation includes $4,002,000 for Alzheimer’s Disease Demonstration Grants to States. This program 

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 $2,490,000 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 $10,000,000 in mandatory funding 

be transferred from the PPH Fund to ACL for the Chronic Disease 

Self-Management Program [CDSMP]. This program assists those 

with chronic disease with managing their conditions and improving 

their health status. Topics covered by the program include nutrition; appropriate use of medications; fitness; and effective communications with healthcare providers. 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 $7,000,000 in mandatory funding 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 coordi-
143 

nation 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. 

Adult Protective Services Demonstrations 

The Committee recommendation includes $8,000,000 for Adult 

Protective Services Demonstrations. This new program, as authorized in the Elder Justice Act, will provide competitive grants to 

States to test and evaluate innovative approaches to preventing 

and responding to elder abuse. The Committee encourages ACL to 

test innovative practices in local communities that develop partnerships across disciplines for the prevention, investigation, and prosecution of abuse, including financial abuse against the elderly. 

Senior Medicare Patrol 

The Committee recommends $9,402,000 for the Senior Medicare 

Patrol program. These funds support a network of retired senior 

volunteers who educate older adults on preventing and identifying 

healthcare fraud and abuse. 

Elder Rights Support Activities 

The Committee recommends $4,088,000 for Elder Rights Support 

activities. This activity supports programs that provide information, training, and technical assistance to legal and aging services 

organizations in order to prevent and detect elder abuse and neglect. 

Aging and Disability Resource Centers 

The Committee recommendation includes $6,444,000 for 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 

The Committee recommendation includes $52,115,000 for State 

Health Insurance Assistance Programs [SHIPs], which provide accurate and understandable health insurance information to Medicare beneficiaries and their families. 

The Committee concurs with the administration’s proposal to 

transfer this grant program to ACL from CMS and includes bill 

language that reflects this transfer. About two-thirds of the 54 

State SHIPs are already administered by State units on aging. 

SHIP activities are aligned with ACL’s mission to develop a comprehensive system of home- and community-based services to help 

seniors maintain their health and independence. 

National Clearinghouse on Long-Term Care Information 

The Committee recommendation includes $3,000,000 for the National Clearinghouse on Long-Term Care Information. The Clear-
144 

inghouse supports activities that raise awareness of public and private options available for long-term care needs. 

Community Service Employment for Older Americans 

The budget request proposes moving the CSEOA program to 

ACL. The Committee rejects that change and continues to provide 

funding for this program in the Department of Labor. 

Paralysis Resource Center 

The Committee recommendation includes $6,700,000 for the Paralysis Resource Center [PRC], which provides comprehensive information and referral services to people living with paralysis and 

their families. The Committee concurs with the administration request to transfer funding and administrative responsibility for the 

PRC from CDC to ACL. The Committee believes the PRC will benefit from ACL’s goals of maximizing the independence and wellbeing of people with disabilities, as well as its ties to disability networks. 

Developmental Disabilities State Councils 

The Committee recommendation includes $74,774,000 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 $40,865,000 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 to 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 $5,235,000 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 $9,317,000 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. 

Human Services Transportation.—The Committee recommendation includes $1,000,000 for a competitive grant or contract for the 
145 

purpose of providing generally available technical assistance to 

local government and nonprofit transportation providers. This assistance should focus on the most cost-effective ways to provide 

transportation assistance to all persons of any age with disabilities. 

The activities should be limited to onsite technical assistance, establishment of a technical assistance Web site, a toll free hotline 

and preparation of technical material. In addition, because of rising 

fuel prices, such technical assistance should include expanding the 

use of accessible, fuel-efficient taxi service for persons with disabilities and those receiving dialysis. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommendation includes $38,792,000 for University Centers for Excellence in Developmental Disabilities 

[UCEDDs]. The UCEDD program supports a network of 67 university-based centers that conduct research, provide interdisciplinary 

education, and develop model services for children and adults with 

disabilities. The centers serve as the major vehicle to translate disability-related research into community practice and to train the 

next cohort of future professionals who will provide services and 

supports to an increasingly diverse population of people with disabilities. 

Program Administration 

The Committee recommends $30,035,000 for program administration at ACL. These funds support salaries and related expenses 

for program management and oversight activities. The Committee 

recommendation includes the administrative costs associated with 

the Administration on Developmental Disabilities and the Office on 

Disability, which are now part of ACL. The fiscal year 2013 level 

does not reflect the administrative costs of these other components 

and therefore is not directly comparable to fiscal year 2014. 

OFFICE OF THE SECRETARY

GENERAL DEPARTMENTAL MANAGEMENT

Appropriations, 2013 1 ........................................................................... $542,585,000 

Budget estimate, 2014 ........................................................................... 421,276,000 

Committee recommendation ................................................................. 517,381,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $517,381,000 for General Departmental Management [GDM]. The recommendation includes 

$70,173,000 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, 
146 

intergovernmental relations, legal services, planning and evaluation, finance and accounting, and external affairs. The Committee recommendation includes $250,000 for continued 

support of the Advisory Council on Alzheimer’s Research, Care, and 

Services. 

Adolescent Health.—The Committee supports the efforts of the 

Office of Adolescent Health [OAH] to improve health and reduce 

risky behaviors among adolescents. The recommendation includes 

not less than $1,500,000 for OAH to coordinate activities within the 

Department with respect to adolescent health, including program 

design and support, trend monitoring and analysis, research 

projects, the training of healthcare professionals, and demonstration projects to improve adolescent health. 

Alzheimer’s Disease.—The Committee strongly supports the National Plan to Address Alzheimer’s Disease and its goal of preventing and effectively treating Alzheimer’s disease by 2025. The 

Committee encourages the Department to include specific annual 

milestones as well as measures to assess progress within each annual report authorized by the National Alzheimer’s Project Act. To 

ensure all appropriate Federal departments and agencies are informing the plan, the Department should consider adding representatives from NCATS and the Office of Science and Technology 

Policy to the Advisory Council on Alzheimer’s Research, Care and 

Services. The Committee also encourages the Department to ensure 

the perspectives of patients with Alzheimer’s disease are represented by establishing a patient representative position to the 

council. 

Asthma.—The Committee is concerned that in the 6 years since 

the release of NIH’s Expert Panel Guidelines for the Diagnosis and 

Management of Asthma, very few children being treated in a primary care setting are receiving in vitro testing or skin testing to 

manage their asthma more effectively with an increased focus on 

achieving and maintaining good asthma control over time. The 

Committee directs the Secretary to report to the Committee within 

60 days of enactment of this act on the barriers to primary care 

adoption of standardized and reproducible allergy tests for children 

and adults with asthma and related conditions. The report should 

recommend actions to remove such barriers to testing, which is a 

critical component of the guidelines. 

Chronic Fatigue Syndrome [CFS].—The Committee endorses the 

Department’s continued support of the CFS Advisory Committee 

and urges accelerated progress to enact its recommendations to 

strengthen research, education, training, care, and services to better address the needs of one million Americans living with CFS. 

Federal E-Health Working Group.—The Committee encourages 

the Secretary to convene a national working group on e-health and 

telemedicine to improve communication, coordination and collaboration among relevant Federal agencies regarding e-health needs, 

standards, Federal goals, and Federal efforts. Such a working 

group should seek to reduce duplication and e-health incompatibility, as well as improve health quality, effectiveness, and outcomes. 

Hiring Individuals With Disabilities.—The Committee is very 

supportive of Executive Order 13548 and the Department’s goal to 
147 

raise the representation of individuals with disabilities in its workforce from 9 percent in fiscal year 2011 to 11 percent by fiscal year 

2015. However, the Committee understands that the Department is 

not on pace to meet this target. The Committee encourages the Department to accelerate its efforts toward achieving the goals of this 

important executive order. 

Immunotherapy and Asthma.—The Committee notes that an 

AHRQ review published earlier this year concluded that allergy 

immunotherapy is an effective treatment for allergic rhinitis, reduces asthma symptoms, lowers the use of asthma medications, 

and improves patient quality of life. Studies have also shown that 

allergy immunotherapy is highly cost-effective and severely underutilized. The Committee encourages the Secretary to develop a 

multi-agency initiative involving the NIH, AHRQ, CMS, and CDC 

to support research that will identify patient, healthcare provider, 

and systems barriers to initiation and adherence to allergy 

immunotherapy and develop interventions to address these problems. 

National Advisory Committee on Children and Disasters.—The 

Committee is concerned about the Nation’s preparedness to meet 

the needs of children and pregnant women during disasters. The 

Committee notes that the Pandemic and All-Hazards Preparedness 

Reauthorization Act of 2013 requires the Secretary to establish a 

National Advisory Committee on Children and Disasters which 

would bring together Federal and non-Federal experts to provide 

advice and recommendations on medical and public health preparedness before, during, and after a disaster or public health 

emergency. The Committee requests a report from the Secretary on 

the status of the National Advisory Committee within 90 days of 

enactment of this act. 

Overdose Prevention.—The Committee notes that accidental 

deaths from overdose, particularly from prescription drugs such as 

opioids, are on the rise and have become the leading cause of preventable death for individuals under the age of 65 in the United 

States. The Committee is concerned that many healthcare professionals, treatment providers and at-risk populations are unaware of 

overdose prevention and reversal strategies. The Committee urges 

the Secretary, in collaboration with other agencies such as 

SAMHSA and CDC, to raise awareness of the symptoms and risk 

factors of overdose, how to deploy naloxone, rescue breathing and 

emergency services for someone experiencing an overdose, and how 

to help individuals make the linkage to treatment and recovery 

services. 

Prescriber Education.—The administration’s ‘‘Prescription Drug 

Abuse Plan’’ called on the Department to work with the Department of Justice and the Office of National Drug Control Policy on 

ways to educate practitioners on safe and proper prescribing of 

opioid painkillers as a prequalification for those individuals obtaining a Drug Enforcement Administration license to prescribe and 

dispense controlled substances. The Committee requests an update 

on these efforts in next year’s congressional justification. 

Urban-Based Network.—The Committee continues to support the 

efforts of the Secretary and other agencies within the Department, 

such as HRSA, AHRQ, CDC, CMS, NIMHD, and the Office of Mi-
148 

nority Health, to support a network of urban-based institutions focused on addressing recruitment and training needs of minority 

and urban underserved populations and reducing health disparities 

in these urban communities. 

Teen Pregnancy Prevention 

The Committee recommendation includes $113,245,000 for the 

Teenage Pregnancy Prevention program. The recommendation includes $8,455,000 in transfers available under section 241 of the 

PHS Act. The Committee provides $104,790,000 in funding for this 

activity through budget authority, rather than through transfers 

from the PPH Fund as requested by the administration. This program supports competitive grants to public and private entities to 

replicate evidence-based teen pregnancy prevention approaches. 

Office of Minority Health 

The Committee recommends $42,560,000 for 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. The Committee recommendation includes $2,000,000 to continue 

the national health education program on lupus for healthcare providers, with the goal of improving diagnosis for those with lupus 

and reducing health disparities. The Committee continues to 

strongly support this program, which is intended to engage 

healthcare providers, educators, and schools of health professions 

in working together to improve lupus diagnosis and treatment 

through education. 

Chronic Kidney Disease [CKD].—The Committee continues to encourage OMH to prioritize early detection and treatment of CKD 

in minority communities to improve health outcomes and eliminate 

these severe health disparities. 

Offices of Minority Health.—The Committee continues to support 

the Department’s implementation of the Action Plan to Reduce Racial and Ethnic Health Disparities, as well as the National Stakeholder Strategy for Achieving Health Equity. The Committee notes 

that the Offices of Minority Health in the Office of the Secretary, 

AHRQ, CDC, CMS, FDA, HRSA, and SAMHSA are charged with 

leading the strategy. 

Abstinence Education 

The Committee recommendation does not include funding for abstinence education. Instead of funding a separate program for this 

purpose, the Committee supports the Teen Pregnancy Prevention 

program, which funds evidence-based strategies to reduce teen 

pregnancy, including those that emphasize abstinence. 

Office of Women’s Health 

The Committee recommends $26,808,000 for 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 
149 

initiatives and develops public-private partnerships, providing leadership and policy direction, in order to address the disparities in 

women’s health. 

The Committee recommendation includes $2,300,000 to continue 

the violence against women’s health initiative. This initiative provides a public health response to abuse by training healthcare providers in interventions that identify, assess, and refer victims of domestic and sexual violence. 

HIV/AIDS in Minority Communities 

The Committee recommends $53,891,000 to address high-priority 

HIV prevention and treatment needs of minority communities 

heavily impacted by HIV/AIDS. The Committee provides funding 

for this activity through budget authority, rather than through 

transfers available under section 241 of the PHS Act as requested 

by the administration. These funds are available to key operating 

divisions of the Department with expertise in HIV/AIDS services to 

assist minority communities with education, community linkages, 

and technical assistance. 

Embryo Donation and Adoption 

The Committee does not provide funding for embryo donation 

and adoption awareness activities. The Committee notes that this 

program has had a limited number of applicants since its inception 

and the administration has been unable to demonstrate its effectiveness. 

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriations, 2013 1 ........................................................................... $71,867,000 

Budget estimate, 2014 ........................................................................... 82,381,000 

Committee recommendation ................................................................. 82,381,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee provides $82,381,000 for OMHA. This Office is 

responsible for hearing Medicare appeals at the administrative law 

judge 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 administrative law judge. The Committee recommendation provides additional 

funding for OMHA to hire more administrative law judge teams 

and increase its capacity to process its rising caseload. 

The Committee is concerned by both the growing backlog of cases 

at OMHA and the high rate of claims overturned by the Office. 

Over half of the cases sent to OMHA are overturned; of the remaining cases, 37 percent are overturned through the departmental appeal process. The Department is urged to work with providers at 

the early stages of the audit process so that only a small number 

of cases are ultimately appealed and the loss of provider time, energy, and resources due to incorrect audit results are limited. 
150 

OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION

TECHNOLOGY

Appropriations, 2013 1 ........................................................................... $61,193,000 

Budget estimate, 2014 ........................................................................... 76,883,000 

Committee recommendation ................................................................. 71,597,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee makes available $71,597,000 to ONC, which includes $51,307,000 in transfers available under section 241 of the 

PHS Act. ONC is responsible for promoting the use of electronic 

health records in clinical practice, coordinating Federal health information systems, and collaborating with the private sector to develop standards for a nationwide interoperable health information 

technology infrastructure. 

The Committee includes new bill language providing ONC with 

the authority to collect and spend user fees authorized in a new 

general provision. These user fees will support its electronic health 

record certification and standards development activities. These activities previously were supported with funding appropriated in the 

American Recovery and Reinvestment Act. This appropriation will 

expire at the end of fiscal year 2013. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $49,983,000 

Budget estimate, 2014 ........................................................................... 68,879,000 

Committee recommendation ................................................................. 59,879,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $59,879,000 for 

the HHS OIG. In addition to discretionary funds provided in this 

act, the Health Insurance Portability and Accountability Act of 

1996 provides a permanent appropriation of $200,279,000 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 contract 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, 2013 1 ........................................................................... $40,857,000 

Budget estimate, 2014 ........................................................................... 42,205,000 

Committee recommendation ................................................................. 42,205,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $42,205,000 for 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. The recommendation will 

allow OCR to strengthen its capacity to enforce Federal standards 
151 

for health information privacy and security called for in the Health 

Insurance Portability and Accountability Act. 

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED

OFFICERS

Appropriations, 2013 ............................................................................. $527,151,000 

Budget estimate, 2014 ........................................................................... 550,372,000 

Committee recommendation ................................................................. 550,372,000 

The Committee provides an estimated $550,372,000 in mandatory funds for Retirement Pay and Medical Benefits for Commissioned Officers of the U.S. Public Health Service [PHS]. 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, 2013 1 2 ......................................................................... $1,799,207,000 

Budget estimate, 2014 ........................................................................... 1,289,530,000 

Committee recommendation ................................................................. 1,304,400,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes emergency funding of $800,000,000 in the Disaster Relief Appropriations Act, 2013 

(division A of Public Law 113–2). 

The Committee recommends $1,304,400,000 for the Public 

Health and Social Services Emergency Fund [PHSSEF]. This appropriation supports the activities of 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. 

Office of the Assistant Secretary for Preparedness and Response 

The Committee recommendation includes $1,065,817,000 for activities administered by ASPR. This Office was created by the Pandemic and All-Hazards Preparedness Act to lead the Department’s 

activities regarding preventing, preparing for, and responding to 

public health emergencies, including disasters and acts of terrorism. 

Public Health Emergency Research.—The Committee recognizes 

that important infectious diseases research often must be conducted during a public health emergency and that the lack of clear 

Federal guidelines in this area presents barriers to researchers. 

The Committee encourages ASPR to consult with the Office for 

Human Research Protections and other HHS offices and agencies 

about establishing a public health emergency research review 

board. ASPR also should work to coordinate and strengthen research capacities between CDC, NIH, FDA, DOD, the VA, and the 

academic medical community. 

Virtual Training.—The Committee continues to note the need for 

realistic virtual reality simulation training technologies at the local 

community level that will help prepare medical responders and 

hospitals for public health emergencies. The Committee encourages 

ASPR to develop core competencies and standardized curricula for 
152 

virtual training using state-of-the-art, simulation medical response 

technology. 

Hospital Preparedness Program 

The Committee’s recommendation includes $254,555,000 for the 

Hospital Preparedness Program. 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. 

Emergency System for Advance Registration of Volunteer 

Health Professionals [ESAR VHP] 

The Committee recommendation includes $505,000 for the ESAR 

VHP program, which has established a national network of health 

professionals who provide assistance during an emergency. Funding will provide technical support to States to continue the program’s mission. 

Biomedical Advanced Research and Development 

The Committee recommendation includes $415,000,000 for advanced research and development. The Committee provides funding 

for BARDA through budget authority rather than through transfers from the Project BioShield Special Reserve Fund [SRF] advance appropriation, as it has done in previous years. BioShield 

SRF balances will expire at the end of fiscal year 2013. 

Anthrax Vaccine.—While the Committee remains concerned 

about the Nation’s preparedness against biological threats, it recognizes that BARDA has made strides in developing and acquiring 

products to combat anthrax, including a next-generation recombinant anthrax vaccine. The Committee encourages the continuation of these targeted efforts toward a clinically advanced and affordable vaccine. 

Antimicrobial Development.—The Committee is aware that CDC 

recently reported a four-fold increase in multidrug-resistant bacteria over the last 10 years. Unfortunately, existing treatment options are limited and few new drugs are likely to become available 

to address these bacterial threats in the near term. The Committee 

strongly encourages BARDA to prioritize its Broad Spectrum Antimicrobial program. 

Strategic Investor 

The Committee recommendation includes $15,000,000 to create 

the Strategic Investor program. This program will provide financial 

support and business expertise to emerging biodefense companies 

that develop medical countermeasures for the Federal stockpile. 

Medical Countermeasure Dispensing 

The Committee recommendation includes $5,000,000 for the 

Medical Countermeasure Dispensing program. Funding provided by 

the Committee will support the continued implementation of the 

National Postal Model, which provides for the delivery of medical 

countermeasures through the U.S. Postal Service during a bioterrorist attack. 
153 

Project BioShield Special Reserve Fund 

The Committee recommendation includes $250,000,000 for the 

Project BioShield SRF. The Committee strongly supports the mission of Project BioShield and intends to continue providing support 

for the procurement of medical countermeasures [MCMs] in future 

fiscal years. The Committee includes a new general provision requested by the administration allowing BARDA to enter into incrementally funded, multiyear contracts for up to 10 years rather than 

the standard limit of 5 years. The new provision also modifies existing multiyear contracting authority by allowing BARDA to repurpose unused termination costs to pay contract invoices in subsequent years. These modifications will allow BARDA to use 

multiyear authority to engage in long-term contracts with companies that develop medical countermeasures. 

The Committee directs BARDA to utilize this new multiyear contracting authority, providing for termination as appropriate in the 

event that funds are not made available in future fiscal years, to 

meet the known current and future national need for particular 

MCMs. The Committee believes that the multiyear contracts will 

provide a clear indicator to industry of the Federal Government’s 

future support for medical countermeasure development, while at 

the same time promoting economy in the administration, performance, and operation of BARDA. The Committee requests that 

BARDA provide a 5-year spend plan for fiscal years 2014–2018, 

which shall be made public, detailing the funding amounts required to support advanced development contracts for these products. 

Other Activities 

The Committee recommendation includes the following amounts 

for the following activities within ASPR: 

—Operations.—$33,213,000; 

—Preparedness and Emergency Operations.—$24,789,000; 

—National Disaster Medical System.—$52,502,000; and 

—Policy and Planning.—$15,253,000. 

Office of the Assistant Secretary for Administration 

The Committee recommends $41,125,000 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. 

Office of the Assistant Secretary for Health 

The Committee recommendation includes $8,979,000 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 $188,479,000 for activities within the Office of the Secretary. 
154 

Pandemic Influenza Preparedness 

The Committee recommendation includes $140,009,000 for Pandemic Influenza Preparedness. Of the total, $32,009,000 is provided 

in annual funding and $108,000,000 in no-year funding. Since fiscal year 2012 the Department’s pandemic flu activities have been 

funded from existing balances from prior supplemental appropriations. However, HHS anticipates spending all of these balances by 

the end of fiscal year 2013. The Committee recommendation will 

support the goals defined in the HHS Pandemic Influenza Plan, 

which includes maintaining the Department’s egg supply program, 

developing new methods for extending the life of vaccines in the 

Strategic National Stockpile, maintaining a fill-finish manufacturing network, and supporting the advancement of vaccine capability in other countries. 

Lease Replacement 

The Committee recommendation includes $41,000,000 for space 

consolidation for several HHS agencies, as well as fit-out costs for 

lease replacement. 

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

The PPH Fund was created in the ACA and provides $13,500,000,000 in mandatory funds over the next 10 years to supplement investments in public health and prevention. The Committee strongly believes that additional resources for prevention 

will improve people’s health and reduce healthcare costs over the 

long term. Recognizing the Committee’s responsibility to determine 

funding levels for community-based prevention and public health 

programs, the ACA specifically gives the Committee authority to 

transfer funds into Federal programs that support the goal of making America healthier. 

In fiscal year 2014, the level appropriated for the fund is $1,000,000,000, the same as the fiscal year 2013 level. The Committee includes bill language in section 220 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: 

Agency Account Program Committee 

recommendation 

HRSA ............... Health Workforce ......................................... Alzheimer’s Disease Education and Outreach.$5,300,000 

HRSA ............... Health Workforce ......................................... Public Health Training Centers ................... 25,000,000 

CDC ................ Immunization and Respiratory Diseases .... Immunization program ................................ 150,000,000 

CDC ................ HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.Viral Hepatitis screening and prevention ... 10,000,000 

CDC ................ Emerging and Zoonotic Infectious Diseases Epidemiology and Laboratory Improvement 

program.

40,000,000 

CDC ................ Emerging and Zoonotic Infectious Diseases Healthcare-Associated Infections ................ 12,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Breastfeeding Promotion and Support program.15,000,000 
155 

Agency Account Program Committee recommendation 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Community Transformation Grants ............. 280,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Diabetes Prevention Program ...................... 10,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.High-Obesity Regions .................................. 5,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Let’s Move (National Early Care and Education Collaboratives).4,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Million Hearts .............................................. 5,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.National School Food Marketing Assessment.1,700,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Nutrition, Physical Activity, Obesity 

Grants.

10,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Office of Smoking and Health .................... 95,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Prevention Research Centers ...................... 10,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Racial and Ethnic Approaches to Community Health.40,000,000 

CDC ................ Chronic Disease Prevention, Health Promotion, and Genomics.Workplace Wellness grants ......................... 10,000,000 

CDC ................ Public Health Scientific Services ................ Guide to Community Preventive Services ... 7,400,000 

CDC ................ Public Health Scientific Services ................ National Center for Health Statistics ......... 35,000,000 

CDC ................ Environmental Health .................................. Chronic Disease Biomarkers ....................... 4,200,000 

CDC ................ Environmental Health .................................. Environmental and Health Outcome Tracking Network.35,000,000 

CDC ................ Injury Prevention and Control ..................... Falls Prevention activities ........................... 3,000,000 

CDC ................ CDC–Wide Activities .................................... National Prevention, Health Promotion and 

Public Health Council.

1,000,000 

CDC ................ CDC–Wide Activities .................................... Public Health Infrastructure grants ............ 40,000,000 

CDC ................ CDC–Wide Activities .................................... Public Health Workforce .............................. 15,700,000 

SAMHSA .......... Mental Health .............................................. Mental Health First Aid ............................... 15,000,000 

SAMHSA .......... Mental Health .............................................. Suicide Prevention ....................................... 12,000,000 

SAMHSA .......... Substance Abuse Treatment ....................... Access to Recovery ...................................... 50,000,000 

SAMHSA .......... Health Surveillance and Program Support.Surveillance activities ................................. 15,000,000 

AHRQ .............. Health Costs, Quality, and Outcomes ......... U.S. Preventive Services Task Force ........... 7,000,000 

ACL ................. Aging and Disability Services Programs .... Alzheimer’s Disease Self-Management ....... 14,700,000 

ACL ................. Aging and Disability Services Programs .... Chronic Disease Self-Management ............. 10,000,000 

ACL ................. Aging and Disability Services Programs .... Falls Prevention ........................................... 7,000,000 

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 that limits the assignment of certain public health personnel. 

Section 203. 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 204. The Committee recommendation continues a provision restricting the Secretary’s use of taps for program evaluation 

activities unless a report is submitted to the Appropriations Committees of the House and Senate on the proposed use of funds. 

Section 205. The Committee recommendation continues a provision authorizing the transfer of up to 2.5 percent of PHS Act funds 

for evaluation activities. 

Section 206. The Committee recommendation continues a provision restricting transfers of appropriated funds and requires a 15- 
156 

day notification to both the House and Senate Appropriations Committees. 

Section 207. The Committee recommendation 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 208. The Committee recommendation retains 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 Institutes and Centers 

consistent with the AIDS research plan. 

Section 209. The Committee recommendation continues a provision regarding requirements for family planning applicants. 

Section 210. The Committee recommendation retains language 

which states that no provider services under title X of the PHS Act 

may be exempt from State laws regarding child abuse. 

Section 211. The Committee recommendation retains language 

which restricts the use of funds to carry out the Medicare Advantage Program if the Secretary denies participation to an otherwise 

eligible entity. 

Section 212. The Committee recommendation modifies a provision which facilitates the expenditure of funds for international 

health activities. 

Section 213. The Committee recommendation continues a provision authorizing the Director of NIH to enter into certain transactions to carry out research in support of the NIH Common Fund. 

Section 214. The Committee continues a provision that permits 

CDC and the Agency for Toxic Substances and Disease Registry to 

transfer funds that are available for Individual Learning Accounts. 

Section 215. The Committee recommendation continues a provision permitting NIH to use up to $3,500,000 per project for improvements and repairs of facilities. 

Section 216. The Committee recommendation includes a provision that transfers funds from NIH to HRSA and AHRQ, to be used 

for National Research Service Awards. 

Section 217. The Committee recommendation includes a new provision allowing continued funding of the Sanctuary System for Surplus Chimpanzees. 

Section 218. The bill continues a provision prohibiting the use of 

funds for lobbying activities related to gun control. 

Section 219. The Committee recommendation modifies a provision requiring a publicly available Web site that details expenditures from the PPH Fund. 

Section 220. The Committee recommendation includes a new 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 221. The Committee recommendation includes a new provision authorizing user fee collections to the Office of the National 

Coordinator for Health Information Technology to support certification and standards activities. 
157 

Section 222. The Committee recommendation includes a new 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 223. The Committee recommendation includes a new provision requiring fiscal year 2015 budget justifications to include 

certain FTE information with respect to ACA. 

Section 224. The bill includes a new general provision allowing 

National Health Service Corps contracts to be canceled up to 60 

days after award. 

Section 225. The Committee recommendation includes a new 

general provision that ensures that NIH has the contracting flexibility it needs to efficiently manage the federally Funded Research 

and Development Center it sponsors while also ensuring that all financial obligations incurred in fiscal year 2014 are fully funded 

with fiscal year 2014 appropriations. 

Section 226. The bill includes a new provision expressing the 

sense of the Senate on income verification for ACA exchange plans. 

Section 227. The bill includes a new provision related to ACA exchange funding transparency. 
(158) 

TITLE III 

DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

Appropriations, 2013 1 ........................................................................... $15,710,221,000 

Budget estimate, 2014 ........................................................................... 15,655,002,000 

Committee recommendation ................................................................. 15,875,231,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $15,875,231,000 

for education for the disadvantaged. 

The President’s budget was based on the administration’s proposal to reauthorize the ESEA, but no such bill has passed the 

Senate. As a result, the Committee bill is based on current law for 

programs authorized under the ESEA. 

The programs in the Education for the Disadvantaged account 

help ensure that poor and low-achieving children are not left behind in the Nation’s effort to raise the academic performance of all 

children and youth. Funds appropriated in this account primarily 

support activities in the 2014–2015 school year. 

Grants to Local Educational Agencies 

Title I Grants to 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 $14,612,425,000 for the Title I 

Grants to LEAs program. Of the funds available for Title I Grants 

to LEAs, up to $4,000,000 shall be available on October 1, 2013, 

and may be transferred to the Census Bureau for poverty updates; 

$3,767,248,000 will become available on July 1, 2014; and 

$10,841,177,000 will become available on October 1, 2014. The 

funds that become available on July 1, 2014, and October 1, 2014, 

will remain available for obligation through September 30, 2015. 

The Committee notes that the biggest barrier for homeless children and youth attempting to enroll in and attend school regularly 

is the lack of transportation. The Committee bill includes a new 

provision clarifying that title I funds may be used to address this 

transportation issue, as well as support homeless liaisons. 

School Improvement Grants 

The Committee recommendation includes $567,485,000 for the 

SIG program. 
159 

The Committee continues authority provided by prior appropriations acts that addresses several issues. First, it continues the expansion of the number of schools that may receive funds through 

the program. This language allows schools to be eligible for SIG if 

they are eligible for title I and have not made adequate yearly 

progress for at least 2 years or are in the State’s lowest quintile 

of performance based on proficiency rates. Second, States may 

make subgrants of not more than $2,000,000 to each participating 

school. And, a set-aside of up to 5 percent of the SIG appropriation 

may be used for national activities. 

The Committee notes that Federal and non-Federal investments 

in school turnaround and comprehensive school reform have identified, developed, or supported research-proven, replicable models for 

struggling schools. Such schools now have a growing number of options to match their needs. Therefore, the Committee bill includes 

new language that will allow schools that receive SIG funds the 

flexibility to choose and implement a research-proven, whole-school 

reform model. 

The bill also provides new flexibility to LEAs that are eligible to 

receive services under the Rural Education Achievement Program 

to modify not more than one element required under a school improvement model. The bill also includes new language allowing 

SEAs, with the approval of the Secretary, the ability to establish 

an alternative State-determined school improvement strategy that 

may be used by LEAs under the SIG program. The purpose of this 

alternative strategy is to allow SEAs to develop their own flexible 

models that can be implemented by LEAs that receive SIG funds. 

The Committee expects that any approach taken with SIG funds 

should address schoolwide factors, whole school culture, the individual needs of the students, and the use of data to inform instruction and provide continuous improvement; ensure that the needs of 

the students are met through the organization of the school, curriculum and instruction, and social and emotional support services; 

and improve teacher and leader effectiveness, including through 

training and support for teachers and school leaders in school improvement efforts and in the needs of students. 

The Committee bill also includes new language that extends the 

availability of SIG funds in order to provide LEAs and schools with 

the time needed to implement effective, sustainable turnaround efforts. The Committee believes that this flexibility should be used 

to provide schools with the opportunity to receive performancebased grant extensions. 

Striving Readers Comprehensive Literacy Program 

The Committee recommends $164,378,000 to continue the Striving Readers Comprehensive Literacy program. 

The Committee bill includes language that continues the competitive portion of the program as it was established in the fiscal 

year 2010 appropriations act. Striving Readers is a birth-through12th grade comprehensive initiative focused on data and assessment, systemic interventions, professional development, and explicit literacy instruction. To strengthen State grantees’ ability to 

improve students’ literacy skills, the Committee directs the Secretary to provide it with a report within 60 days of enactment of 
160 

this act on the Department’s policies and procedures for providing 

timely, evidence-based, and effective technical assistance and support, particularly with regard to State grantees’ evaluation activities. In addition, the program offers an important opportunity to 

test, learn, and share effective policies and practices to strengthen 

student literacy. Therefore, the Committee directs the Secretary to 

utilize the 5 percent set-aside for national activities to implement 

a national evaluation of the Striving Readers program. 

Migrant Education Program 

The Committee recommends $392,450,000 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 migrant agricultural 

workers and fishermen. 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 $50,130,000 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. 

Evaluation 

The Committee recommends $3,028,000 for evaluation of title I 

programs. 

Evaluation funds are used to support large-scale national surveys that examine how the title I program is contributing to student academic achievement. Funds also are used to evaluate State 

assessment and accountability systems and analyze the effectiveness of educational programs supported with title I funds. 

The Committee bill also includes a new general provision in this 

title that clarifies the Department’s authority to reserve up to 0.5 

percent of each ESEA appropriation in the bill, except for titles I 

and III of the ESEA, for evaluation of ESEA programs funded in 

this act. The Department is required to provide the Senate Committees on Appropriations and HELP an operating plan describing 

the proposed uses of this new evaluation authority as well as the 

source appropriation for such activities. In addition, not later than 

45 days prior to the submission of the required operating plan, the 

Department shall brief the Senate Committees on Appropriations 

and HELP on the programs and activities being considered for inclusion in the plan. Further, the Committee expects the Department to include in future congressional budget justifications a discussion of its planned use of this new authority. 
161 

High School Graduation Initiative 

The Committee recommends $48,809,000 for the High School 

Graduation Initiative under title I, part H of the ESEA. 

The High School Graduation Initiative provides competitive 

grants to LEAs or SEAs to implement effective high school graduation and reentry strategies in schools and districts that serve students in grades 6 through 12 and have annual school dropout rates 

that are above their State’s average. Funds also are used for certain national activities, including evaluation, technical assistance, 

and dissemination of information on effective programs and best 

practices. 

Special Programs for Migrant Students 

The Committee recommends $36,526,000 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. 

SCHOOL READINESS

Appropriations, 2013 ............................................................................. ........................... 

Budget estimate, 2014 ........................................................................... $750,000,000 

Committee recommendation ................................................................. 750,000,000 

The Committee recommends $750,000,000 to create a new Preschool Development Grants program. 

This program will award competitive grants to States to support 

their efforts to expand or create high-quality preschool systems for 

4-year-olds from low- and moderate-income families, including children with disabilities. Preschool Development Grants will complement the administration’s Preschool for All proposal, which will 

provide matching mandatory funds to States for improving access 

to such high-quality preschool systems. The Department will award 

two types of grants, one to low-capacity States with small or no 

State-funded preschool programs and another to high-capacity 

States that have a larger State-funded preschool program. These 

grants will help States address fundamental needs including workforce development, quality improvement efforts, and the scale-up of 

proven preschool models. The bill allows States to subgrant funds 

to LEAs and to LEAs in partnership with other early learning providers. The Committee directs the Department to require any use 

of child assessments to conform to the recommendations and cautions of reports by the National Research Council on assessments 

of children. 

This new program, combined with investments in programs administered by HHS, will help improve the quality of early learning 
162 

and development programs for ages birth through 5 and help close 

the achievement gap for children from low-income families. 

IMPACT AID

Appropriations, 2013 1 ........................................................................... $1,288,603,000 

Budget estimate, 2014 ........................................................................... 1,224,239,000 

Committee recommendation ................................................................. 1,290,945,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $1,290,945,000 for the Impact Aid 

program. 

Impact aid provides financial assistance to school districts for the 

costs of educating children when enrollments and the availability 

of revenues from local sources have been adversely affected by the 

presence of Federal activities. 

Children who reside on Federal or Indian lands generally constitute a financial burden on local school systems because these 

lands do not generate property taxes—a major revenue source for 

elementary and secondary education in most communities. In addition, realignments of U.S. military forces at bases across the country often lead to influxes of children into school districts without 

producing the new revenues required to maintain an appropriate 

level of education. 

The Committee bill retains language that provides for continued 

eligibility for students affected by the deployment or death of their 

military parent, as long as these children still attend schools in the 

same school district. 

Basic Support Payments.—The Committee recommends 

$1,153,540,000 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 bill also includes new language that would continue heavily impacted payments through 2014 for LEAs that received such payments in 2009. 

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 

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 $17,441,000 for eligible LEAs for emergency repairs and modernization of school facilities. 

The Committee recommendation includes bill language allowing 

these funds to be awarded entirely through the authorized formula. 

The budget request proposes to award funds on a competitive basis. 

Fiscal year 2012 and 2013 funds were available for distribution 

only under the competitive portion of the program. 
163 

Payments for Federal Property.—The Committee recommends 

$66,813,000 for Payments for Federal Property. These payments 

compensate LEAs in part for revenue lost due to the removal of 

Federal property from local tax rolls. 

The Committee bill includes new language allowing a district to 

carry its section 8002 eligibility to a new school district that was 

formed as a result of district consolidation. 

SCHOOL IMPROVEMENT PROGRAMS

Appropriations, 2013 1 ........................................................................... $4,535,506,000 

Budget estimate, 2014 ........................................................................... 2,028,313,000 

Committee recommendation ................................................................. 4,621,862,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommendation includes $4,621,862,000 for the 

School Improvement Programs account. 

The President’s budget was based on the administration’s proposal to reauthorize the ESEA, but no such bill has passed the 

Senate. As a result, programs in this account are based generally 

on current law, as authorized under the ESEA. 

State Grants for Improving Teacher Quality 

The Committee recommends $2,461,634,000 for State Grants for 

Improving Teacher Quality. 

The appropriation for this program primarily supports activities 

associated with the 2014–2015 academic year. Of the funds provided, $780,193,000 will become available on July 1, 2014, and 

$1,681,441,000 will become available on October 1, 2014. These 

funds will remain available for obligation through September 30, 

2015. 

States and LEAs may use funds for a range of activities related 

to the certification, recruitment, professional development, and 

support of teachers and administrators. Activities may include reforming teacher certification and licensure requirements, addressing alternative routes to State certification of teachers, recruiting 

teachers and principals, and implementing teacher mentoring systems, teacher testing, merit pay, and merit-based performance systems. These funds may also be used by districts to hire teachers 

to reduce class sizes. 

The Committee bill modifies a set-aside for the Supporting Effective Educator Development program, which provides competitive 

awards to national not-for-profit organizations for recruiting, training, or providing professional enhancement activities for teachers 

and school leaders, particularly for high-need schools most likely to 

face shortages in these areas. These funds may be used to support 

such activities in civic learning. The Committee recommends that 

up to 5.5 percent of funds available for State Grants for Improving 

Teacher Quality shall be used for this purpose; in fiscal year 2013, 

the set-aside was 1.5 percent. The bill language also differs slightly 

from prior years by allowing up to 10 percent of the set-aside funds 

to be used for related research, development, evaluation, dissemination, and technical assistance. 
164 

Mathematics and Science Partnerships 

The Committee recommends $149,417,000 for the Mathematics 

and Science Partnerships program. 

At the recommended funding level, the ESEA requires the Department to award grants by formula to States for competitive 

awards to eligible partnerships, which must include an engineering, math, or science department of an institution of higher education and a high-need LEA. Partnerships will seek to improve the 

performance of students in the areas of math and science, including 

engineering, by bringing math and science teachers in elementary 

and secondary schools together with scientists, mathematicians, 

and engineers to increase the teachers’ subject-matter knowledge 

and improve their teaching skills. 

Supplemental Education Grants 

The Committee recommendation includes $17,583,000 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 continues language that allows 

up to 5 percent to be used by FSM and RMI to purchase oversight 

and technical assistance, which may include reimbursement to the 

Departments of Labor, HHS, and Education for such services. 

21st Century Community Learning Centers 

The Committee recommends an appropriation of $1,200,000,000 

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 is aware of a growing interest in extending the 

school day and/or school year as a means of providing additional 

educational opportunities to students. Therefore, the Committee includes new bill language that will give LEAs the option of using 

21st CCLC subgrants for extended learning time programs. LEAs 

will continue to be able to use the funding for high-quality, afterschool, before school, and summer learning programs if they 

choose. 

The Committee believes that SEAs should award grants to highquality programs that address individual student learning needs 

and student well-being. Funded programs should deliver services 

through a variety of high-quality and effective strategies for boosting learning and enrichment including afterschool, before school, 
165 

summer school, or expanded day, week, or year opportunities; align 

with and complement, rather than replicate, the regular school day, 

by offering a range of activities that capture student interest and 

support student engagement to promote higher class attendance, 

reduce risk for retention or dropping out, and foster good health; 

integrate academics, enrichment, and skill development through 

hands-on experiences that make learning relevant and engaging; 

and actively address the specific learning needs and interests of all 

types of students, especially those who may benefit from approaches and experiences not offered in the traditional classroom 

setting. The Committee directs the Department to refrain from giving priority to, showing preference for, or providing direction about 

whether communities should use these funds for afterschool, before 

school, summer school, or expanded school day programs, unless 

specifically requested by SEAs or LEAs. 

The Committee urges the Department to provide guidance and 

technical assistance to States, schools, and community partners on 

how to develop and maintain strong community-school partnerships, particularly in data-sharing arrangements; implement continuous quality improvement processes; and ensure that programs 

meet the needs of individual students. The Committee also urges 

the Department to consult with experts in the field, including State 

and local intermediaries, in creating and providing such guidance 

and technical assistance. The Committee also believes SEAs should 

ensure that local communities receiving 21st CCLC program funds 

identify strategies for students to engage in programs and services 

during the afternoon and early evening hours while most parents 

or guardians are at work. 

The Committee is aware that many States already have the option of using 21st CCLC funding for extended learning time 

through the ESEA–No Child Left Behind waiver process. The Committee directs the Secretary to provide it with a report on the impact of the flexibility provided to SEAs under waiver option 11 on 

the 21st CCLC program. The Department should report on the 

number of children served and the centers/sites offering expanded 

learning in the 3 years preceding the waiver approval and the 3 

years following waiver approval, as well as the number of hours of 

and diversity of programming available to students through such 

grants at each site and the average cost of the programs (per student and per site) before and after waiver approval. All data should 

be provided at the State level. 

State Assessments and Enhanced Assessment Instruments 

The Committee recommends $408,436,000 for the State Assessments and Enhanced Assessment Instruments program. 

This program has two components. The first provides formula 

grants to States to pay the cost of developing and implementing 

standards and assessments required by the ESEA. The Committee 

provides not less than $398,436,000 for this purpose. 

Under the second component—grants for enhanced assessment 

instruments—appropriations in excess of the State assessment program are used for a competitive grant program designed to support 

efforts by States to improve the quality and reliability of their as-
166 

sessment systems. The Committee recommendation for the second 

component is up to $10,000,000. 

Javits Gifted and Talented Education 

The Committee recommends $15,000,000 for the Javits Gifted 

and Talented Students Education program. Funds will be used for 

awards to State and local educational agencies, institutions of higher education, and other public and private agencies for research, 

demonstration, and training activities designed to enhance the capability of elementary and secondary schools to meet the special 

educational needs of gifted and talented students, including those 

from disadvantaged and underrepresented populations. 

Within these funds, the Committee also directs the Department 

to support a National Research Center on the Gifted and Talented. 

Education for Homeless Children and Youth 

For carrying out education activities authorized by title VII, subtitle B of the Stewart B. McKinney Homeless Assistance Act, the 

Committee recommends $65,173,000. 

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. 

The Committee bill also includes language under the Education 

for the Disadvantaged account clarifying the availability of title I 

funds for services to homeless children and youths. 

Training and Advisory Services 

For Training and Advisory Services authorized by title IV of the 

Civil Rights Act, the Committee recommends $6,947,000. 

The funds provided will support awards to operate the 10 regional equity assistance centers [EACs]. Each EAC provides services to school districts upon request. Activities include disseminating information on successful practices and legal requirements 

related to nondiscrimination on the basis of race, color, sex, or national origin in education programs. 

Education for Native Hawaiians 

For programs for the education of Native Hawaiians, the Committee recommends $34,181,000. 

The Committee bill continues a provision that allows funding 

provided by this program to be used for construction. 

Alaska Native Educational Equity 

The Committee recommends $33,185,000 for the Alaska Native 

Educational Equity Assistance program. 

These funds address the severe educational handicaps of Alaska 

Native schoolchildren. Funds are used for the development of sup-
167 

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 is concerned that the fiscal year 2012 competition for this program did not sufficiently recognize the statutory 

provisions related to applications from Alaska Native regional nonprofit organizations or from consortia that include at least one 

Alaska Native regional nonprofit organization. The Committee 

notes that two competitive preference points were awarded for applications from such organizations, and nine points were awarded 

for non-statutory priorities established by the Department. The 

Committee finds this unacceptable and directs the Department to 

more appropriately adhere to sections 7304(c) and 7305(b) of the 

ESEA in all future funding decisions and grant competitions and 

ensure that all grantees have meaningful plans for consultation 

with Alaska Native leaders. 

The Committee also directs the Department to prepare and submit a report, within 180 days of the enactment of this act, on how 

the Department will work to improve consultation with and promote the maximum participation of Alaska Native organizations, 

Alaska Native regional nonprofit organizations, and consortia that 

include at least one Alaska Native regional nonprofit organization 

in the program. The report should also outline steps the Department will take to ensure that all current grantees have meaningful 

plans for consultation with Alaska Native organizations. 

Rural Education 

The Committee recommends $179,193,000 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. 

The Committee notes that almost one-third of the Nation’s 

schools are in rural areas. The GAO and others have noted the 

unique challenges faced by these schools, including recruiting and 

retaining highly qualified teachers; offering access to advanced 

coursework, such as Advanced Placement courses; meeting transportation costs that diminish resources available for academic and 

enrichment programs; and writing successful applications for grant 

competitions given their more limited administrative capacity. The 

Committee is very concerned that the Department has generally 

failed to recognize these challenges over the past 4 years, particularly in some of its grant competitions. The Investing in Innovation 

program offers a welcome departure from this pattern, as the Department altered its competition to provide an absolute priority for 

rural applicants, instead of the competitive preference priority it 

established in the initial competition. The Committee directs the 

Department to immediately take action to improve its record in the 

area of rural education. The Committee requests a report not later 
168 

than 30 days after enactment of this act describing the actions the 

Department has taken and will take to ensure that the needs of 

students in rural schools are effectively met by the programs it administers. The report should specifically address how the Department organizes or will organize itself to ensure rural expertise is 

available to program staff throughout the Department, and strategies the Department is taking or will take to ensure that students 

in rural LEAs are able to benefit from competitive grant opportunities and other resources available through Department’s discretionary appropriations. 

Comprehensive Centers 

The Committee recommends $51,113,000 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. 

The Committee strongly supports the mission of the centers, particularly with regard to their role in helping develop State capacity 

to meet the needs of LEAs and schools. The Committee also believes that the centers play an important part in the Department’s 

system of technical assistance and appreciates the steps the Department has taken to align and coordinate its various technical 

assistance activities. The Committee encourages the Department to 

continue its efforts in coordinating its technical assistance activities and requests that the Department describe these efforts and 

future plans in the fiscal year 2015 congressional budget justification. 

INDIAN EDUCATION

Appropriations, 2013 1 ........................................................................... $130,318,000 

Budget estimate, 2014 ........................................................................... 130,779,000 

Committee recommendation ................................................................. 130,318,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $130,318,000 for Indian education 

programs. 

Grants to Local Educational Agencies 

For grants to LEAs, the Committee recommends $105,710,000. 

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. 
169 

Special Programs for Indian Children 

The Committee recommends $18,948,000 for special programs for 

Indian children. 

Funds are used for demonstration grants to improve Indian student achievement through early childhood education and college 

preparation programs, and for professional development grants for 

training Indians who are preparing to begin careers in teaching 

and school administration. 

National Activities 

The Committee recommends $5,660,000 for national activities. 

Funds will be 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. 

INNOVATION AND IMPROVEMENT

Appropriations, 2013 1 ........................................................................... $1,524,482,000 

Budget estimate, 2014 ........................................................................... 5,699,092,000 

Committee recommendation ................................................................. 1,331,598,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $1,331,598,000 for programs within 

the innovation and improvement account. 

The President’s budget was based on the administration’s proposal to reauthorize the ESEA, but no such bill has passed the 

Senate. As a result, programs in this account are based generally 

on current law. 

Race to the Top 

The Committee recommendation includes $250,000,000 to create 

a new Race to the Top for College Affordability and Completion 

[RTT–CAC] initiative to incentivize State-level postsecondary education reform. State investments in postsecondary education have 

declined over the past several years, shifting the cost burden to 

students and families through higher tuition and fees. At the same 

time, total student loan debt has crossed the $1,000,000,000,000 

mark and average student loan debt has topped nearly $27,000. 

Given that public colleges and universities educate about threequarters of all students, States are in a critical position to reform 

policies that will improve student outcomes and lead to lower costs. 

The RTT–CAC initiative will reward and incentivize States that 

undertake reforms, including: modernizing funding policies that 

incentivize completion and maintaining fiscal support for education; supporting innovative methods of student learning; empowering consumer choice through increased transparency; and, improving the transition from secondary into postsecondary education 

and between institutions of higher education. The majority of funding will flow through States to institutions of higher education and 

support innovative practices that increase productivity and reduce 

costs. The Committee directs the Secretary to prioritize applications that will specifically address college affordability and comple-
170 

tion issues facing low-income, minority, and nontraditional students and students with disabilities. 

Investing in Innovation 

The Committee recommends $170,000,000 for the Investing in 

Innovation program. 

Investing in Innovation, which was established in ARRA, provides funding for replicating education programs that meet the 

highest level of evidence; expanding those with significant levels of 

evidence; and supporting promising practices for which there is 

some level of appropriate research. The Committee supports this 

three-tier evidentiary model and believes that this feature of the 

program should continue to guide future funding opportunities and 

decisions. The Committee also appreciates the absolute priority 

given to rural applicants in previous competitions and believes that 

this priority should continue to be used in the fiscal year 2014 competition. The Committee expects the Department to distribute 

grants equally among the absolute priority categories unless there 

are an insufficient number of qualified grants for a particular category. 

The Committee bill continues language from last year’s bill providing up to 5 percent of the appropriation for this program to be 

used for evaluation and technical assistance. The Committee expects to be notified in advance of the proposed uses of these funds. 

The bill also includes new language providing that funds for this 

program are available until expended. This authority will ensure 

that funds can be used to effectively implement and evaluate program models being tested under this program. 

Effective Teachers and Leaders 

The Committee recommends no funding to create the Effective 

Teachers and Leaders State Grant program. 

The Committee has provided $2,461,634,000 for State Grants for 

Improving Teacher Quality within the School Improvement Programs account. These funds may be used for purposes that are 

similar to those under this proposed program. 

Effective Teaching and Learning: Literacy 

The Committee recommends no funds for the proposed Effective 

Teaching and Learning: Literacy program. Activities supported 

under this proposed program are instead funded under current law. 

The Effective Teaching and Learning: Literacy program would 

provide competitive grants to SEAs, or SEAs in partnership with 

appropriate outside entities, to support development and implementation of comprehensive, evidence-based State and local efforts 

to provide high-quality literacy programs aligned with college- and 

career-ready English language standards. 

Effective Teaching and Learning for a Well-Rounded Education 

The Committee recommends no funds for the proposed Effective 

Teaching and Learning for a Well-Rounded Education program. Activities supported under this proposed program are instead funded 

under current law. 
171 

The Effective Teaching and Learning for a Well-Rounded Education program would provide competitive grants to high-need 

LEAs, SEAs, and institutions of higher education or nonprofit organizations in partnership with one or more high-need LEAs to support the development and expansion of innovative practices to improve teaching and learning across a well-rounded curriculum that 

includes the arts, health education, physical education, foreign languages, civics and government, history, geography, environmental 

education, economics and financial literacy, and other subjects. 

College Pathways and Accelerated Learning 

The Committee recommends no funds for the proposed College 

Pathways and Accelerated Learning program. Activities supported 

under this proposed program are instead funded under current law. 

The College Pathways and Accelerated Learning program would 

support efforts to increase high school graduation rates and preparation for college matriculation and success by providing collegelevel and other accelerated courses and instruction in middle and 

high schools with concentrations of students from low-income families and in high schools with low graduation rates. 

Science, Technology, Engineering, and Mathematics [STEM] Innovation 

The Committee does not recommend creating a new STEM Innovation program, a collection of STEM activities requested by the 

administration. Instead, the bill provides funding for some of the 

same proposed activities through existing programs, including 

$55,000,000 within FIE for STEM Innovation Networks. 

The proposed STEM Innovation initiative is comprised of STEM 

Innovation Networks, STEM Teacher Pathways, the STEM Master 

Teacher Corps, and the Effective Teaching and Learning: STEM 

program. These programs are intended to develop, validate, and 

scale up effective practices in pre-K–12 STEM instruction; increase 

student engagement in STEM subjects; and recruit, prepare, and 

further develop highly effective STEM educators. 

High School Redesign 

The Committee recommends no funds for the proposed High 

School Redesign program because of budget constraints. 

This program would promote the whole school redesign of the 

high school experience in order to provide students with challenging and relevant academic and career-related learning experiences that prepare them for postsecondary education and careers. 

Expanding Educational Options 

The Committee recommends no funding to create the Expanding 

Educational Options program. The program would generally support competitive grants to SEAs, LEAs, charter school authorizers, 

charter management organizations, and other nonprofit organizations to start or expand high-performing charter schools and other 

autonomous public schools. 

The Committee provides resources under current law programs 

that may be used for purposes that are similar to those proposed 

under this new program. 
172 

Transition to Teaching 

The Committee recommends no funds for the Transition to 

Teaching program. 

This program has provided grants to help support efforts to recruit, train, and place nontraditional teaching candidates into 

teaching positions and to support them during their first years in 

the classroom. 

School Leadership 

The Committee recommends $64,049,000 for the School Leadership program. 

The program provides competitive grants to assist high-need 

LEAs to recruit and train principals and assistant principals 

through activities such as professional development and training 

programs. The Committee continues to recognize the critical role 

that district and school leaders and managers play in creating an 

environment that fosters effective teaching and high academic 

achievement for students. The Committee bill includes new language allowing grant funds to be awarded directly to not-for-profit 

organizations and to be used to train district leaders and managers, in addition to school leaders. The Committee bill also includes new language that allows the Secretary to further define eligibility as a high-need LEA. 

Charter Schools 

The Committee recommends a total of $254,326,000 for the support of charter schools. 

The Committee allocates the recommended funding as follows: $175,326,000 for Charter School Grants, up to $11,000,000 for 

State Facilities incentives, not less than $12,000,000 for the Credit 

Enhancement for Charter Schools Facilities program, and up to 

$11,000,000 for national activities designed to support local, State, 

and national efforts to increase the number of high-quality charter 

schools. 

Charter Schools Grants support the planning, development, and 

initial implementation of charter schools. SEAs that have authority 

under State law to approve charter schools are eligible to compete 

for grants. If an eligible SEA does not participate, charter schools 

from the State may apply directly to the Secretary. 

Under the State facilities program, the Department awards 5- 

year competitive grants to States that operate per-pupil facilities 

aid programs for charters schools. Federal funds are used to match 

State-funded programs in order to provide charter schools with additional resources for charter school facilities financing. 

The credit enhancement program provides assistance to help 

charter schools meet their facility needs. Funds are provided on a 

competitive basis to public and nonprofit entities to leverage nonFederal funds that help charter schools obtain school facilities 

through purchase, lease, renovation, and construction. 

The Committee continues bill language that allows the Secretary 

to reserve a portion of the charter school grant funds to make multiple awards to charter management organizations and other entities for the replication and expansion of successful charter school 

models that have a track record of success. In addition, this year’s 
173 

bill requires that not less than $45,000,000 of funds available for 

charter school grants shall be used for this purpose. 

The Committee urges the Department to continue using a portion of the funds available for national activities to address issues 

related to services to students with disabilities enrolled in or interested in enrolling in charter schools, as well as efforts to strengthen charter authorizing practices that will result in a greater share 

of high-quality charter schools. 

The Committee bill also includes new language that allows charter school funds to be used for preschool programs in charter 

schools. 

Magnet Schools Assistance 

The Committee recommends $99,611,000 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, and the purchase of technology, educational materials, and 

equipment. 

Fund for the Improvement of Education 

The Committee recommends an appropriation of $137,644,000 for 

FIE. 

Within programs of national significance, the Committee includes 

$29,000,000 to continue an initiative of competitive awards to national not-for-profit organizations or school libraries for providing 

books and childhood literacy activities to children and families living in high-need communities. The Committee expects no less than 

50 percent of these funds to be awarded to school libraries proposing high-quality projects for increasing access to a wide range 

of print and electronic resources that provide learning opportunities to all students, but particularly those less likely to have access 

to such materials at home. 

The bill also includes $55,000,000 for grants to support STEM 

Innovation Networks. These funds will be used to make competitive awards to LEAs or groups of LEAs, in partnership with institutions of higher education, not-for-profit organizations, museums, 

and businesses, to transform STEM teaching and learning, particularly for high-need students and underrepresented populations, as 

well as support a virtual learning network for STEM educators. 

The goal of the networks is to increase the number of students interested in and prepared for postsecondary education and STEM 

careers. The Committee is particularly interested in approaches 

that will engage students in the early grades. 

The Committee urges the Department to put a priority on reaching underrepresented populations, such as girls and minorities, and 

using nontraditional STEM teaching activities, including robotics 

competitions, as a means of further engaging and inspiring students to pursue further study or careers in STEM education. 
174 

The Committee recommendation also includes $17,000,000 for 

the Improving Mathematics Achievement and Transition to College 

from High School [IMATCH] program. These funds will be used 

jointly with funds provided to NSF for a program using a tieredevidence model, similar to the Investing in Innovation program, 

that seeks to develop, evaluate, and scale up proven practices that 

can help improve teaching and learning in mathematics in the last 

2 years of high school and first 2 years of college. 

The Committee is particularly interested in available funds being 

used to encourage, engage, inspire, and motivate students to enter 

and succeed in the STEM fields. 

The Committee is aware of specialized teacher preparation programs at university-based schools of education that prepare teachers to work in urban school districts and support hands-on science 

and math curriculum in middle schools. These programs provide 

tuition assistance and specialized coursework to teacher candidates 

and partner with local school districts to support co-teaching by 

master teachers, mentorships, and field placements. The Committee supports high-quality programs that focus on meeting the 

needs of children in urban school systems. 

Within programs of national significance, the Committee also 

recommends $2,024,000, combined with funds available through 

the Department’s new Disability Innovation Fund and the Department of Labor, to support interagency strategies to strengthen reengagement activities and outcomes of Federal programs serving 

disconnected youth including through performance partnership pilots, $5,344,000 to continue awards for full-service community 

schools, $1,176,000 for data quality and evaluation initiatives, and 

$100,000 for peer review. It also includes $1,000,000 to continue 

the education facilities clearinghouse, which will provide information on planning, designing, financing, building, maintaining, and 

operating safe, healthy, high-performance educational facilities, including early learning centers. 

Within the amount for FIE, the Committee also includes 

$27,000,000 for the Arts in Education program. The budget request 

includes funds for similar activities under its proposed Effective 

Teaching and Learning for a Well-Rounded Education program, but 

no funds specifically for arts in education. The funding is used for 

competitive awards for national nonprofit organizations engaged in 

arts education, professional development activities, and model arts 

education programs. Funds also are used for evaluation and dissemination activities, as well as to support a partnership with the 

National Endowment for the Arts. 

Teacher Incentive Fund 

The Committee recommendation includes $298,834,000 for TIF. 

The goals of TIF are to improve student achievement by increasing teacher and principal effectiveness; reform compensation systems to reward gains in student achievement; increase the number 

of effective teachers teaching low-income, minority, and disadvantaged students, and students in hard-to-staff subjects; and other activities designed to increase the effectiveness of teachers, principals, and other personnel in high-need schools. 
175 

The Committee is concerned that TIF’s focus has been diverted 

away from its intended purpose, as first authorized by the Department of Education Appropriations Act, 2006, which is specifically 

to develop and implement performance-based teacher and principal 

compensation systems in high-need schools. However, the Department’s final priorities, requirements, definitions, and selection criteria for TIF competitions in fiscal year 2012 greatly expanded 

what Congress intended in creating this program. Therefore, the 

Committee directs the Secretary to restore the original focus of TIF 

by limiting awards to eligible entities in support of innovative approaches at the State and local level to design, implement, and improve performance-based compensation systems for teachers and 

principals in high-need schools. 

Effective Teachers and Leaders Innovation Fund 

The Committee recommends no funding to create the Effective 

Teachers and Leaders Innovation Fund proposed in the budget request. The Committee provides $298,834,000 for the Teacher Incentive 

Fund and additional funds for other current law programs that 

may be used for similar purposes as those proposed under this program. 

Ready-To-Learn Television 

The Committee recommendation includes $27,139,000 for the 

Ready-to-Learn Television program. 

This program is intended to use the power and reach of public 

television to help prepare children, especially disadvantaged children, enter and succeed in school. The ESEA requires that all programming and digital content created under Ready-to-Learn be 

specifically designed for nationwide distribution over public television stations’ digital broadcasting channels and the Internet. The 

act also requires funds to be made available to public telecommunications entities to ensure that these programs and related educational materials are disseminated and distributed to the widest 

possible audience and are made accessible to all Americans. 

Advanced Placement 

The Committee recommends $29,995,000 for AP programs. 

Funds have supported two programs: the AP Test Fee program 

and the AP Incentive [API] program. The purpose of both is to aid 

State and local efforts to increase access to AP and International 

Baccalaureate [IB] classes and tests for low-income students. 

Under the test fee program, the Department makes awards to 

SEAs to enable them to cover part or all of the cost of test fees of 

low-income students who are enrolled in an AP or IB class and 

plan to take an AP or IB test. Under the API program, the Department makes 3-year competitive awards to SEAs, LEAs, or national 

nonprofit educational entities to expand access for low-income individuals to AP programs through activities including teacher training; development of pre-advanced placement courses; coordination 

and articulation between grade levels to prepare students for academic achievement in AP or IB courses; books and supplies; and 

participation in online AP or IB courses. Under the authorizing 
176 

statute, the Department must give priority to funding the test fee 

program. 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Appropriations, 2013 1 ........................................................................... $255,241,000 

Budget estimate, 2014 ........................................................................... 580,000,000 

Committee recommendation ................................................................. 330,481,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends a total of $330,481,000 for activities 

to promote safe schools, healthy students, and citizenship education. 

The President’s budget was based on the administration’s proposal to reauthorize the ESEA, but no such bill has passed the 

Senate. As a result, the Committee bill is based on current law for 

programs authorized under the ESEA. 

Promise Neighborhoods 

The Committee recommends $56,754,000 for the Promise Neighborhoods program. 

Funds are available for obligation through December 31, 2014. 

By providing an extra quarter to obligate these funds, the Committee gives planning grantees sufficient time to develop implementation plans that could be funded by this bill and provides the 

Department ample time to evaluate whether prior-year implementation grantees are making significant progress required to justify 

the receipt of continuation awards. 

Competitive grants are awarded to not-for-profit, communitybased 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. 

Two types of awards are made under this program: 1-year planning grants and implementation grants. Funds for planning grants 

are used by communities to develop a plan for providing a continuum of services and supports for the children and youth in a 

particular neighborhood. Implementation grants are awarded to organizations with feasible plans for achieving the goals of the program. 

Successful, Safe, and Healthy Students 

The Committee recommends no funds for this proposed program, 

which is based on the administration’s reauthorization plan. The 

Committee has allocated funds for related current law programs, as 

described under the individual headings in this account. 

Under this program, the Department would award grants to 

SEAs, title I-eligible LEAs, and their partners for programs designed to improve the school culture and climate; improve students’ 

physical health and well-being; and improve students’ mental 

health and well-being. 
177 

Safe and Drug-Free National Activities 

The Committee recommendation includes $143,000,000 for the 

national activities portion of the Safe and Drug-Free Schools and 

Communities program. This funding, part of the Committee’s violence prevention initiative, will help schools address the consequences of their students witnessing or being the victim of violence and other root causes of unhealthy school climates. 

From the amount available for national activities, the Committee 

recommends $71,500,000 to help schools create positive learning 

environments, including $50,000,000 for a new School Climate 

Transformation Grants program, which will train school staff to 

implement evidence-based strategies, such as positive behavioral 

interventions and supports, to improve school climate. The Committee recommendation also provides $25,000,000 for grants to 

SEAs to help LEAs develop, implement, and improve their emergency management plans; $25,000,000 for Project Prevent, which 

will award grants to LEAs to help schools in troubled communities 

break the cycle of violence; up to $8,000,000, to remain available 

until expended, for Project SERV, which offers education-related 

services following violent or traumatic events; $10,000,000 for other 

national activities; and $3,500,000 for continuation costs related to 

technical assistance contracts awarded in prior years. 

Elementary and Secondary School Counseling 

The Committee recommends $52,191,000 to establish or expand 

counseling programs in elementary and secondary schools. As authorized, at least $40,000,000 must be used to support elementary 

school counseling programs. 

Carol M. White Physical Education for Progress Program 

The Committee recommendation includes $78,536,000 to help 

LEAs and community-based organizations initiate, expand, and improve physical education programs for students in grades K–12. 

This funding will help schools and communities improve their 

structured physical education programs for students and help children develop healthy lifestyles to combat the national epidemic of 

obesity. 

ENGLISH LANGUAGE ACQUISITION

Appropriations, 2013 1 ........................................................................... $730,680,000 

Budget estimate, 2014 ........................................................................... 732,144,000 

Committee recommendation ................................................................. 730,680,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $730,680,000 for 

the English Language Acquisition program. 

The President’s budget was based on the administration’s proposal to reauthorize the ESEA, but no such bill has passed the 

Senate. As a result, the Committee bill is based on current law for 

programs authorized under the ESEA. 

The Department makes formula grants to States based on each 

State’s share of the Nation’s limited-English-proficient and recent 

immigrant student population. The program is designed to increase 
178 

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 include professional development activities designed to increase the 

number of highly qualified teachers serving limited-English-proficient students; a National Clearinghouse for English Language 

Acquisition and Language Instructional Programs; and evaluation 

activities. National activities funds shall be available for 2 years. 

The Committee bill continues language that requires the Secretary to use a 3-year average of the most recent data available 

from the American Community Survey for calculating allocations to 

all States under this program. 

SPECIAL EDUCATION

Appropriations, 2013 1 ........................................................................... $12,615,427,000 

Budget estimate, 2014 ........................................................................... 12,657,307,000 

Committee recommendation ................................................................. 12,803,387,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $12,803,387,000 

for special education programs. 

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 2014–2015 academic year. Of the funds available for this program, $2,439,563,000 will become available on July 

1, 2014, and $9,283,383,000 will become available on October 1, 

2014. These funds will remain available for obligation through September 30, 2015. 

As requested by the administration, the Committee continues bill 

language capping the Department of the Interior set-aside at the 

prior year level, adjusted by the lower of the increase in inflation 

or the change in the appropriation for grants to States. This provision also would prevent a decrease in the amount to be transferred 

in case the funding for this program decreases or does not change. 

The bill also continues language clarifying provisions of the 

IDEA. The first provision clarifies that penalties for violating the 

State maintenance of effort [MOE] under part B of the IDEA shall 

be reallocated to States by formula to those States that did not violate those requirements. The language further clarifies that both 

the reduced State allocations due to penalties paid and increased 

amounts under the reallocation shall not be considered in the current or future years for allocations under the statutory formula. 

These provisions are included in the administration’s budget request. 

The bill also includes new language clarifying that the level of 

effort under part B that an LEA must meet in the year after it fails 

to maintain its fiscal effort is the most recent fiscal year for which 
179 

the LEA met the MOE compliance standard. This language clarifies congressional intent and is consistent with OSEP’s April 4, 

2012, informal guidance letter on the issue. Finally, the bill includes language clarifying that funds reserved under section 611(c) 

of the IDEA may be used to help improve State capacity to meet 

data collection requirements under the IDEA and improve data collection, quality, and use under the act. 

Preschool Grants 

The Committee recommends $372,646,000 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 $462,710,000 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 statewide 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. 

As requested by the administration, the Committee bill includes new language allowing the Department to use up to $2,710,000 for 

incentive grants to States that choose to serve children 3 years old 

until entrance into elementary school. The IDEA currently allows 

up to 15 percent of the amount above $460,000,000 to be used for 

this purpose, which would be too small under the level of the Committee recommendation to effectively serve potentially interested 

States. 

State Personnel Development 

The Committee recommends $43,829,000 for the State Personnel 

Development program. Ninety percent of funds must be used for 

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 $46,688,000 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. 
180 

Personnel Preparation 

The Committee recommends $88,122,000 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 $28,917,000 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 $29,529,000 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. 

PROMISE: Promoting Readiness of Minors in SSI 

As proposed in the budget, the Committee does not continue 

funding for PROMISE in OSEP. Instead, the bill continues support 

for this program by means of unclaimed VR State Grant funds and 

funds provided to SSA. 

The goal of PROMISE is to improve outcomes, such as employment and completion of postsecondary education, of children who 

receive SSI, as well as their families. 

Special Olympics 

The Committee recommendation includes $8,000,000 for Special 

Olympics education activities. Under the Special Olympics Sport 

and Empowerment Act of 2004, the Secretary is authorized to provide financial assistance to Special Olympics for activities that promote its expansion and for the design and implementation of education activities that can be integrated into classroom instruction 

and are consistent with academic content standards. 

Consistent with the President’s budget request, the Committee 

bill clarifies that funds made available under the Special Olympics 

Sport and Empowerment Act of 2004 may be used to support expenses associated with the Special Olympics National and World 

Games hosted in the United States. This language was not included in last year’s bill, but has been included in bills from prior 

years. 

The Committee notes that the Special Olympics National Games 

are held only once every 4 years in the United States and that the 
181 

next National Games are to be held in 2014. Through the spirit of 

sport, the National Games showcase and celebrate the abilities of 

athletes with intellectual disabilities and promote inclusion and acceptance of all people, most especially those with intellectual disabilities. The Committee expresses its support for the National 

Games and recognizes the significant contribution that the Special 

Olympics organization has made to children and adults with intellectual disabilities across America. The Committee intends that up 

to $2,000,000 available under this act be used to support the 

Games. 

REHABILITATION SERVICES AND DISABILITY RESEARCH

Appropriations, 2013 1 ........................................................................... $3,619,762,000 

Budget estimate, 2014 ........................................................................... 3,655,577,000 

Committee recommendation ................................................................. 3,698,174,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

Vocational Rehabilitation State Grants 

The Committee recommends $3,302,053,000 for VR State Grants. 

The Committee recommends the full amount authorized by the Rehabilitation Act of 1973 for this mandatory funding stream. 

Basic 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 in fiscal year 2014 

for VR State Grants be set aside for Grants for American Indians. 

The Committee bill includes language, as requested by the administration, allowing unmatched funds in excess of any funds requested during the reallotment process to support a new Disability 

Innovation Fund [DIF] that will support activities aimed at improving outcomes for individuals with disabilities as defined in section 

7(20)(B) of the Rehabilitation Act, including activities under the 

PROMISE program. Such funds used for these activities will remain available for obligation through September 30, 2015. 

PROMISE was created in fiscal year 2012 with the goal of improving outcomes, such as employment and completion of postsecondary education, of children who receive SSI, as well as their families. Competitive grants will be awarded in the fall of 2013 to a 

small number of States for a period of 5 years. States will use 

funds to improve outcomes, enhance coordination, and increase the 

use of existing services for which children receiving SSI and their 

families are already eligible. 

After covering the costs of PROMISE, the administration requests and the Committee recommends new authority through the 

DIF to provide $5,000,000 to support a new cross-agency initiative 

aimed at improving the educational and employment outcomes for 

disconnected youth with disabilities and providing targeted technical assistance to support performance partnership pilots. The 

Committee expects the initiative to serve youth with disabilities between the ages of 14 and 24 who are homeless, in foster care, involved in the justice system, or are neither employed nor enrolled 

in an educational institution. 
182 

As requested by the administration, the Committee bill also includes new bill language that allows the DIF to support Pay for 

Success pilots, which will provide performance-based awards to 

States or local governments and not-for-profit organizations providing or arranging services that improve education, employment, 

and other key outcomes for youth with disabilities. The Committee 

expects to be notified prior to the issuance of any notice related to 

Pay for Success activity. 

The DIF will also support a joint SSA–ED demonstration targeted at individuals who are likely to be eligible for services under 

the VR State Grant program and at risk of becoming future SSI 

or SSDI beneficiaries. The Committee intends for SSA and ED to 

incentivize State efforts and use various State and Federal programs and funding streams, which could include the VR State 

Grant program, to provide early intervention services aimed at preserving the well-being and work ability of the nonbeneficiaries 

most at risk of becoming severely impaired. The Committee strongly supports demonstrations that are focused on college to career 

pathways. 

The amount of unused VR State Grant funding will not be determined until the end of fiscal year 2014. If an excess amount of 

funds are available after supporting PROMISE and the disconnected youth and SSA–ED initiatives, the Committee expects the 

DIF to support the development of effective, evidence-based strategies to improve the long-term outcomes for people with disabilities. 

The Committee should be notified in advance of announcements related to any additional activities. 

Client Assistance State Grants 

The Committee recommends $12,215,000 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 and 

work with service providers. States must operate client assistance 

programs in order to receive VR State Grant funds. 

Training 

The Committee recommends $35,444,000 for training rehabilitation personnel. The budget request provides $30,188,000 and proposes to eliminate funding for the In-Service Training program. 

The Committee maintains funding for this program. 

Funding for training is intended to ensure that skilled personnel 

are available to serve the rehabilitation needs of individuals with 

disabilities. It supports training, traineeships, and related activities 

designed to increase the numbers of qualified personnel providing 

rehabilitation services. The program awards grants and contracts 

to States and public or not-for-profit agencies and organizations, including institutions of higher education, to pay all or part of the 

cost of conducting training programs. 

Demonstration and Training Programs 

The Committee recommends $6,514,000 for demonstration and 

training programs. 
183 

This program awards grants to States and not-for-profit agencies 

and organizations to develop innovative methods and comprehensive services to help individuals with disabilities achieve satisfactory vocational outcomes. Demonstration programs support projects 

for individuals with a wide array of disabilities. 

The Committee recommendation includes $425,000 for new technical assistance activities designed to promote promising and evidence-based practices to improve postsecondary and employment 

outcomes for youth with disabilities. The technical assistance will 

include practices developed and implemented by RSA’s Transition 

Model Demonstration projects that ended in September 2012. 

The Committee recommendation also includes $750,000 to support a new competition for parent information and training centers, 

which provide information and training on transition planning, the 

adult service system, and strategies that prepare youth for successful employment, postsecondary education, and independent living 

outcomes. The Committee expects RSA to coordinate with OSEP in 

carrying out this activity. 

Migrant and Seasonal Farmworkers 

The Committee recommends $1,259,000 for the Migrant and Seasonal Farmworkers program. The budget request proposes to eliminate this program and to pay continuation costs for fiscal year 2014 

out of funding for the VR State Grant program. 

This program provides grants for comprehensive rehabilitation 

services to migrant and seasonal farmworkers with disabilities and 

their families. 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,995,000 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 protection and advocacy services available through 

the Developmental Disabilities Assistance and Bill of Rights Act or 

the Protection and Advocacy for Individuals with Mental Illness 

Act. 

Supported Employment State Grants 

The Committee recommends $29,010,000 for the Supported Employment State Grant program. The budget request does not include funding for this program. 

Supported Employment State Grants provide assistance to the 

most severely disabled individuals by providing ongoing support 

needed to obtain competitive employment. 

Independent Living State Grants 

The Committee recommends $23,312,000 for Independent Living 

State Grants. 

This program provides formula grants to States to improve independent living services, support the operation of centers for independent living, conduct studies and analysis, and provide training 

and outreach. 
184 

Centers for Independent Living 

The Committee recommends $79,794,000 for Centers for Independent Living. 

These funds support consumer-controlled, cross-disability, nonresidential, community-based centers that are designed and operated within local communities by individuals with disabilities. 

These centers provide an array of independent living services. 

Independent Living Services for Older Individuals Who Are Blind 

The Committee provides $33,951,000 for the Independent Living 

Services for Older Individuals Who Are Blind program. 

Through this program, assistance is provided to persons aged 55 

or older to adjust to their blindness, continue living independently, 

and avoid societal costs associated with dependent care. Services 

most commonly provided by this program are daily living skills 

training, counseling, community integration, information and referral, the provision of low-vision devices and communication devices, 

and low-vision screening. 

Helen Keller National Center 

The Committee recommends $9,127,000 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 11 regional field offices that provide referral and counseling assistance to deaf-blind persons; and 

an affiliate network of agencies. 

National Institute on Disability and Rehabilitation Research 

The Committee recommends $110,000,000 for NIDRR. This funding level includes $1,200,000, as requested by the administration, 

to support research activities that focus on improving employment 

outcomes for people with disabilities. 

NIDRR develops and implements a comprehensive and coordinated approach to the conduct of research, demonstration projects, 

and related activities that enable persons with disabilities to better 

function at work and in the community, including the training of 

persons who provide rehabilitation services or conduct rehabilitation research. The Institute awards competitive grants to support 

research in federally designated priority areas, including rehabilitation research and training centers, rehabilitation engineering research centers, research and demonstration projects, and dissemination and utilization projects. NIDRR also supports field-initiated 

research projects, research training, and fellowships. 

Assistive Technology 

The Committee recommends $37,500,000 for the Assistive Technology program. 

This program is designed to improve occupational and educational opportunities and the quality of life for people of all ages 

with disabilities through increased access to assistive technology 

services and devices. The program supports various activities that 

help States develop comprehensive, consumer-responsive statewide 
185 

programs that increase access to, and the availability of, assistive 

technology devices and services. 

The Committee recommendation will ensure all 50 statewide assistive technology programs, the District of Columbia, and outlying 

areas will receive the minimum grant provided under statute for 

the first time. 

The Committee recommendation includes $31,000,000 for State 

grant activities authorized under section 4 of the Rehabilitation Act 

of 1973, $5,500,000 for protection and advocacy systems authorized 

by section 5, and $1,000,000 for technical assistance activities authorized under section 6. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriations, 2013 1 ........................................................................... $24,456,000 

Budget estimate, 2014 ........................................................................... 24,505,000 

Committee recommendation ................................................................. 24,456,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $24,456,000 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 70 percent of APH’s total sales income. Materials are distributed free of charge to schools and States 

through per capita allotments based on the total number of students who are blind. Materials provided include textbooks and 

other educational aids in Braille, large type, 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 notes that APH has established a digital data action plan that explores new technologies, and is supportive of 

APH’s efforts to improve Braille translation and tactile graphics 

through digital data software. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriations, 2013 1 ........................................................................... $65,291,000 

Budget estimate, 2014 ........................................................................... 65,422,000 

Committee recommendation ................................................................. 66,422,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $66,422,000 for NTID. 

The Committee recommendation for NTID consolidates funds 

into the operations line for NTID and does not include funding for 

construction. The Committee will consider funding for construction 

in the future as needs may warrant. 

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. 
186 

GALLAUDET UNIVERSITY

Appropriations, 2013 1 ........................................................................... $125,265,000 

Budget estimate, 2014 ........................................................................... 117,541,000 

Committee recommendation ................................................................. 118,541,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $118,541,000 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. 

Federal funding also supports the Model Secondary School for 

the Deaf, which serves as a laboratory for educational experimentation and development; disseminates curricula, materials, and 

models of instruction for students who are deaf; and prepares adolescents who are deaf for postsecondary academic or vocational education or the workplace. The university’s Kendall Demonstration 

Elementary School develops and provides instruction for children 

from infancy through age 15. 

The Committee recommendation increases operations funding 

over the fiscal year 2013 level by $1,235,000 but does not include 

funding for construction. Congress appropriated a total of 

$15,934,000 in fiscal years 2012 and 2013 to support construction. 

This funding, combined with approximately $13,000,000 available 

from prior fiscal years, is covering the costs of constructing a new 

200-bed dormitory to house all residential students at the Model 

Secondary School for the Deaf. 

CAREER, TECHNICAL, AND ADULT EDUCATION

Appropriations, 2013 1 ........................................................................... $1,733,680,000 

Budget estimate, 2014 ........................................................................... 1,750,154,000 

Committee recommendation ................................................................. 1,743,949,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

Career and Technical Education 

The Committee recommends $1,135,844,000 for the Career and 

Technical Education [CTE] account. 

State Grants.—The Committee recommends $1,123,030,000 for 

CTE State grants. 

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 
187 

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, $332,030,000 will be- come available July 1, 2014, and $791,000,000 will become available on October 1, 2014. These funds will remain available for obligation until September 30, 2015. 

National Programs.—The Committee recommends $12,814,000 

for national research programs and other national activities, including $5,000,000 for a new dual enrollment initiative that supports CTE career pathways and targets local workforce needs. The 

Committee adds new bill language allowing adult education providers as eligible partners and adult education students as eligible 

participants as well as requiring grantees to use funding to supplement and not supplant other Federal, State, or local public funds 

used for adult education and literacy activities. 

Dual enrollment programs enable high school students and 

adults without a high school equivalency credential to pursue postsecondary education and earn course credit that can be applied to 

a college degree or credential. Research shows dual enrollment programs are associated with gains in college enrollment and credit 

accumulation and higher grades. The Department will make competitive awards that help establish or expand dual enrollment programs through partnerships among institutions of higher education, LEAs that operate high-need public schools or adult education providers, and State and local agencies responsible for secondary and adult education and workforce training. This funding 

will provide students with support services, including tutoring, assistance completing financial aid applications and selecting courses, 

mentoring, career counseling, and assistance transferring from 2- 

year to 4-year institutions of higher education. Funds will also support activities designed for students with limited proficiency in 

English or from groups traditionally underrepresented in postsecondary education, individuals with disabilities, students who are 

homeless or in foster care, or disconnected youth. 

The Committee recommendation includes additional funding for 

this dual enrollment initiative in the Government Performance and 

Results Act [GPRA] Data/HEA Program Evaluation program. 

Adult Education 

The Committee recommends $608,105,000 for Adult Education 

programs. 

Adult Education State Grants.—For adult basic and literacy education State grants, the Committee recommends $593,803,000. 

Funds are used by States for programs to enable adults to acquire basic literacy skills, to enable those who so desire to complete 

a secondary education, and to make available to adults the means 

to become more employable, productive, and responsible citizens. 

The Committee recommendation continues the English literacy 

and civics education State grants set-aside within the adult education State grants appropriation. Within the total, $74,559,000 is 

available to help States or localities affected significantly by immigration and large limited-English populations to implement programs that help immigrants acquire English literacy skills, gain 
188 

knowledge about the rights and responsibilities of citizenship, and 

develop skills that will enable them to navigate key institutions of 

American life. 

National Leadership Activities.—The Committee recommends 

$14,302,000 for national leadership activities, including $3,000,000 

to support new awards for prisoner reentry education models that 

build on the success of the Promoting Reentry Success through 

Continuity of Education Opportunities [PRSCEO] competition. 

PRSCEO was funded in fiscal year 2013 with funds transferred 

from the Department of Justice under an interagency agreement. 

The Committee recommendation will support projects that develop evidence of reentry education’s effectiveness and align with 

the model described in ‘‘A Reentry Education Model: Supporting 

Education and Career Advancement for Low-Skill Individuals in 

Corrections,’’ published by the Department in August 2012. 

STUDENT FINANCIAL ASSISTANCE

Appropriations, 2013 1 ........................................................................... $24,486,210,000 

Budget estimate, 2014 ........................................................................... 24,685,281,000 

Committee recommendation ................................................................. 24,536,210,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $24,536,210,000 

for programs under the Student Financial Assistance account. 

Student Complaint System.—The Committee commends the Department for working with the Department of Veterans Affairs 

[VA], DOD, and the Federal Trade Commission to develop a uniform student complaint system for students receiving Federal education benefits from the VA, DOD, and the Department pursuant 

to Executive Order 13607. The Committee is aware that the Department intends to publicize information on its StudentAid.gov 

Web site on how to submit complaints regarding institutional 

issues by the end of fiscal year 2013. While this is a positive step, 

the complaint system would address Federal education benefits 

alone, and only students who receive such benefits would be likely 

to view the Web site. The complaint system would not address 

other types of deceptive and misleading conduct by institutions. 

The Committee directs the Department to broaden the scope of the 

complaint system and make it more accessible to all students attending institutions of higher education, regardless of their receipt 

of Federal education benefits. The Committee on HELP’s recent investigation into the practices of proprietary institutions of higher 

education demonstrated that students in all sectors of postsecondary education lack a clear understanding of how or where to 

lodge complaints regarding deceptive and misleading conduct and 

other problematic practices, including but not limited to problems 

with accessibility of course materials and the physical plant on college campuses. This kind of a complaint system would be particularly valuable as online postsecondary education programs expand, 

as students in such programs may have no State-specific resource 

for consumer protection. The Committee directs the Department to 

post information on its main Web site about its uniform complaint 

system no later than 6 months after enactment of this act. 
189 

Foster Youth.—The Committee is very concerned that many foster youth who are eligible for postsecondary education and training 

financial aid programs outside of support offered through the Department, including HHS’s John H. Chafee Foster Care Independence Program and the Education and Training Vouchers Program 

for Youths Aging Out of Foster Care, are unaware that this assistance is available to them. The Committee urges the Department to 

inform foster youth, to the extent practicable, of their potential eligibility for additional Federal financial assistance, and post information about these programs on its Web site. The Committee directs the Secretary to submit a report no later than 120 days after 

enactment of this act detailing its outreach efforts to foster youth 

who may be eligible for additional Federal financial aid programs 

and ways in which modifications to the Free Application for Federal Student Aid could assist in these efforts. 

Federal Pell Grant Program 

The Committee recommends $22,778,352,000 in discretionary 

funding for the Pell grant program. This amount will support an 

increase in the maximum Pell grant award from $5,645 in academic year 2013–2014 to a projected level of $5,785 in academic 

year 2014–2015. 

Pell grants provide need-based financial assistance that helps 

undergraduate students and their families defray a portion of the 

costs of postsecondary education and vocational training. Awards 

are determined according to a statutory need-analysis formula that 

takes into account a student’s family income and assets, household 

size, and the number of family members, excluding parents, attending postsecondary institutions. 

More than 9.3 million students are expected to receive a Pell 

grant during the 2014–2015 academic year. Of the 9.4 million students who relied on Pell grants during the 2011–2012 award year, 

74 percent had incomes or came from families with incomes less 

than or equal to $30,000. 

The Pell grant program is funded partly through the discretionary appropriations process and partly through mandatory funding. The HCERA included additional mandatory money for the program to increase the maximum grant by the Consumer Price Index 

[CPI] beginning in academic year 2013–2014 as long as the discretionary portion of the funding is sufficient to support $4,860 of the 

maximum award. The Committee recommendation for fiscal year 

2014 meets that requirement, so it will trigger enough mandatory 

funding to add an estimated $925 ($140 more than in fiscal year 

2013) to the discretionary portion of the award, for a projected total 

maximum award of $5,785. The Department will rely on CPI data 

available at the end of the 2013 calendar year to determine the 

exact increase for academic year 2014–2015. 

Taking into account mandatory funding provided in the fiscal 

year 2012 Consolidated Appropriations Act, plus $9,797,000,000 in 

cumulative surplus budget authority from previous fiscal years, the 

fiscal year 2014 funding level will provide an estimated 

$4,889,000,000 more than is needed to support the discretionary 

base award of $4,860 and trigger the mandatory increase in the 
190 

maximum award. In fiscal year 2015, however, the program will 

face a funding gap of $793,000,000 under current projections. 

Protecting Financial Aid for Students and Taxpayers 

The Committee is disturbed by recent findings that some colleges 

and universities are using Federal student financial assistance 

funding for aggressive marketing, recruitment, and advertising 

rather than for the programs’ intended purpose—to help low- and 

middle-income students access and successfully complete a postsecondary education. 

At a time when Federal resources are scarce and students and 

families across the Nation are struggling to afford a college education, this practice should not be tolerated. 

To that end, the Committee includes a new general provision 

that prohibits all colleges and universities receiving funding 

through the HEA from spending Federal educational program dollars on advertising, marketing, and recruitment. Colleges and universities will continue to be free to spend however much they want 

on these activities; this provision simply stipulates that they cannot use Federal tax dollars intended for education to do so. This 

reform will target Federal resources at educating students, as opposed to online advertisements and aggressive recruiting strategies, and help ensure that both taxpayers and students receive a 

good return on their investment. 

On a related matter, the Committee is aware that some students 

are wasting their Federal financial aid and going into debt to earn 

occupation-related degrees that they cannot use. While postsecondary education institutions as a whole must be accredited in 

order to participate in the Department’s financial aid programs, 

there are no accreditation or licensure requirements for specific 

programs. Some students are paying to attend a program only to 

learn that they cannot take the licensing exam required for entry 

into the workforce because the program is not accredited or licensed. 

To address this problem, the Committee bill includes a new provision requiring postsecondary education programs that prepare 

students for gainful employment in occupations requiring licensing 

or other credentials to meet State licensure requirements and programmatic accreditation in order to be eligible for HEA funding. 

This provision will ensure that students who receive Federal financial aid to enroll in industry-specific programs will be eligible to attain credentials they can actually use to enter their chosen profession. 

Federal Supplemental Educational Opportunity Grant Program 

The Committee recommends $733,130,000 for the SEOG program. 

The SEOG program provides funds to postsecondary institutions 

for need-based grants to 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. 

The budget request recommends reforming the SEOG allocation 

formula to target and incentivize SEOG funding toward institu-
191 

tions that enroll and graduate comparatively high numbers of Pelleligible students and offer low net tuition and fees. The Committee 

supports the proposals in principle but believes they deserve more 

deliberation in Congress. 

Federal Work-Study Program 

The Committee bill provides $1,024,728,000 for the FWS program. The budget request proposes to direct new funds to institutions opting to participate in an enhanced work-study partnership 

with prospective employers. The Committee recommendation does 

not include this proposal. 

The budget request also recommends reforming the FWS allocation formula to target and incentivize funding toward institutions 

that enroll and graduate comparatively high numbers of Pell-eligible students and offer low net tuition and fees. The budget request 

does not include bill language on this proposal. The Committee 

supports the administration’s goals, but believes the proposal deserves more deliberation in Congress. 

This program provided grants to approximately 3,400 institutions 

and helped an estimated 700,000 undergraduate, graduate, and 

professional students meet the costs of postsecondary education 

through part-time employment in academic year 2010–2011. Institutions must provide at least 25 percent of student earnings. 

The Committee recommendation expects the Department to provide $8,390,000 from the FWS program appropriation for the Work 

Colleges program authorized under section 448 of the HEA. This is 

an increase of $2,403,337 over the fiscal year 2013 level. The recommended level is the amount the seven work colleges are capable 

of matching dollar for dollar. 

Federal Perkins Loans 

The Federal Perkins Loan program supports student loan revolving funds built up with capital contributions to nearly 1,700 participating institutions. Institutions use these revolving funds, 

which also include Federal capital contributions [FCCs], institutional contributions equal to one-third of the FCCs, and student repayments, to provide low-interest, subsidized loans that help financially needy students pay the costs of postsecondary education. 

The Committee recommends no new funds for the Perkins Loan 

program. The budget request proposes to restructure the Perkins 

Loan program as a mandatory credit program and to expand institutional participation by up to an additional 2,700 postsecondary 

education institutions. The Committee bill does not include this 

proposal. 

STUDENT AID ADMINISTRATION

Appropriations, 2013 1 ........................................................................... $1,041,301,000 

Budget estimate, 2014 ........................................................................... 1,050,091,000 

Committee recommendation ................................................................. 1,044,301,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $1,044,301,000 for the Student Aid 

Administration account. These funds are available until September 
192 

30, 2015, and support the Department’s student aid management 

expenses. The Committee recommendation includes $727,434,000 for administrative costs and $316,867,000 for loan servicing activities. 

The Committee recommendation will ensure the operational integrity of Federal student aid systems and provide high-quality service 

to student and parent borrowers. 

The budget request includes a new general provision transferring 

the Health Education Assistance Loan program from HHS to the 

Department. The Committee recommendation includes bill language authorizing the transfer and provides $2,807,000 for the 

costs of managing and servicing outstanding loans. 

The Committee directs the Department to continue to provide 

quarterly reports detailing its obligation plan by quarter for spending mandatory and discretionary funding for student aid administrative activities broken out by servicer, activity, and funding 

source. 

HIGHER EDUCATION

Appropriations, 2013 1 ........................................................................... $1,865,915,000 

Budget estimate, 2014 ........................................................................... 2,146,273,000 

Committee recommendation ................................................................. 1,912,615,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $1,912,615,000 

for higher education programs. 

Aid for Institutional Development 

The Committee recommends $530,014,000 for Aid for Institutional Development. 

Strengthening Institutions.—The Committee bill recommends 

$80,462,000 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. Applicants may use these funds to develop faculty, strengthen academic programs, improve institutional management, and expand 

student services. 

Hispanic-Serving Institutions [HSIs].—The Committee recommends $100,231,000 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. In 

addition to the Committee-recommended level, the HCERA provides $100,000,000 of mandatory funding in each fiscal year 

through 2019 to support HSIs in the development of STEM and articulation programs. 

Promoting Postbaccalaureate Opportunities for Hispanic Americans.—The Committee recommends $8,992,000 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 
193 

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 $227,524,000 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. In addition to the 

Committee-recommended level, this program will receive 

$85,000,000 of mandatory funding through the HCERA in each fiscal year through 2019. 

Strengthening Historically Black Graduate Institutions 

[HBGIs].—The Committee recommends $58,840,000 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 $9,244,000 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. In addition 

to the Committee-recommended level, the HCERA provides 

$15,000,000 of mandatory funding in each fiscal year through 2019 

to support programs at PBIs in the areas of STEM; health education; internationalization or globalization; teacher preparation; 

and improving the educational outcomes of African-American 

males. 

Strengthening Asian American and Native American Pacific Islander-Serving Institutions [AANAPISIs].—The Committee recommends $3,113,000 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. In addition to the Committee-recommended 

level, AANAPISIs will receive $5,000,000 of mandatory funding 

through the HCERA in each fiscal year through 2019 to develop 

faculty; strengthen academic programs; improve institutional management; expand student services; and construct classrooms, libraries, laboratories, and other instructional facilities. 

Strengthening Alaska Native and Native Hawaiian-Serving Institutions [ANNHSIs].—The Committee recommends $12,833,000 for 

the Strengthening ANNHSIs program. In addition to the Committee-recommended level, these institutions receive $15,000,000 of 

mandatory funding through the HCERA in each fiscal year through 

2019. 
194 

The purpose of this program is to improve and expand the capacity of institutions serving Alaska Native and Native Hawaiian students and low-income individuals. Funds may be used to plan, develop, and implement activities that encourage faculty and curriculum development; 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 Nontribal Institutions.— The Committee recommends $3,113,000 for this program, which 

serves institutions that enroll at least 10 percent Native American 

students and at least 50 percent low-income students. In addition 

to the Committee-recommended level, these institutions receive 

$5,000,000 of mandatory funding through the HCERA in each fiscal year through 2019 to help 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 $25,662,000 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. In addition to the Committee-recommended level, this program receives $30,000,000 of mandatory 

funding through the HCERA in each fiscal year through 2019. 

International Education and Foreign Language Studies 

The bill includes a total of $80,938,000 for International Education and Foreign Language Studies programs. 

Funds are used to support visits and study in foreign countries 

by individuals who plan to utilize their language skills in areas 

vital to U.S. national security in the fields of government, international development, and the professions. 

Domestic Programs.—The Committee recommends $73,487,000 

for domestic program activities related to international education 

and foreign language studies under title VI of the HEA. This is an 

increase of $7,034,000 over the fiscal year 2013 level. The majority 

of funding will support new awards in the national resource centers, foreign language and area studies fellowships, international 

business education centers, and language resource centers. Funding will also support continuation awards in the American overseas 

research centers as well as new and continuation awards in the 

Undergraduate International Studies and Foreign Language Program. 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. 

The Committee recommendation includes $2,000,000 to support 

new awards authorized by section 604(b) of the HEA. The Committee recognizes that study abroad helps prepare students to func-
195 

tion effectively in a global environment and recommends funding to 

expand access to study abroad, particularly for underserved student populations and to nontraditional destinations, especially in 

developing countries. The Committee expects that competitive 

grants will be awarded under the authority of section 604(b) individually or through partnerships to institutions of higher education 

and public and private not-for-profit agencies and organizations, 

and be consistent with the recommendations of the Commission on 

the Abraham Lincoln Study Abroad Fellowship program that Congress created in Public Law 108–199. 

The Committee urges the Department to support efforts among 

higher education stakeholders in issuing a comprehensive report on 

meeting the goals of the Lincoln Commission on Study Abroad, including hosting a conference on study abroad. The conference 

should address the importance of study abroad in meeting the Department’s international education goals of global competencies, 

educational diplomacy, and program integration and coordination. 

The conference should solicit ideas from the higher education community on how to significantly increase the number of American 

students studying abroad. 

Overseas Programs.—The Committee recommends $7,451,000 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 in 

order to improve foreign language and area studies education in 

the United States. 

Fund for the Improvement of Postsecondary Education 

The Committee recommends $5,852,000 for FIPSE. 

Training for Realtime Writers.—Within the total for FIPSE, the 

Committee recommendation includes $1,126,000 for the Training 

for Realtime Writers program authorized by section 872 of the 

HEA. This program provides grants to institutions of higher education to establish programs to train realtime writers. Eligible activities include curriculum development, student recruitment, distance learning, mentoring, and scholarships. The program places a 

priority on encouraging individuals with disabilities to pursue careers in realtime writing. More than 30 million Americans are considered deaf or hard of hearing, and many require captioning services to participate in mainstream activities and gain access to 

emergency broadcasts. Federal law requires that all television 

broadcasts be closed captioned, and trained captioners help remove 

barriers to full-quality captioning of realtime television programming such as news, weather, and emergency messaging. 

Center for Best Practices To Support Single Parent Students.— 

The Committee recommendation includes $500,000 to support a 

Center for Best Practices to Support Single Parent Students, as authorized by section 741(c) of the HEA, to promote replication of programs that have proven effective at providing postsecondary degree 

completion opportunities to low-income single parents. The Center 

will study and develop best practices, and assist other institutions 
196 

in implementing innovative programs that support this target population. 

Analysis of Federal Regulations and Reporting Requirements on 

Institutions of Higher Education.—The Committee directs 

$1,000,000 for the Secretary to enter into an agreement with the 

National Research Council of the National Academy of Sciences to 

conduct a study on the impacts of Federal regulations and reporting requirements on institutions of higher education as authorized 

under section 1106 of the Higher Education Opportunity Act of 

2008. The study shall include information describing, by agency, 

the number of Federal regulations and reporting requirements affecting institutions of higher education; the estimated time required and costs to institutions of higher education (disaggregated 

by types of institutions) to comply with the regulations and reporting requirements affecting institutions of higher education; and recommendations for consolidating, streamlining, and eliminating redundant and burdensome Federal regulations and reporting requirements affecting institutions of higher education. The study 

should be submitted to the Senate and House Committees on Appropriations, as well as the Committee on HELP and the Committee on Education and the Workforce, not later than 1 year after 

the date of enactment of this act. 

Centers for the Study of Distance Education and Technological 

Advancements.—The Committee recommendation includes 

$2,750,000 to carry out section 741(a)(3) of the HEA to establish no 

less than two Centers for the Study of Distance Education and 

Technological Advancements at institutions of higher education. At 

least one of the centers should have a minority enrollment of no 

less than 15 percent and no two centers shall be located in the 

same State. 

The Committee recognizes the increasing role that online education plays in postsecondary education. Over 6 million college students take at least one online course in a given year, representing 

almost 1 in 3 students nationally. Data are needed to understand 

the outcomes of online learning as well as the factors that impact 

such outcomes. The new centers should collaborate with and provide evaluation of learning outcomes for students attending institutions of higher education across the country and partner with other 

institutions of higher education and organizations interested in online education. 

Model Comprehensive Transition and Postsecondary Programs for 

Students With Intellectual Disabilities 

The Committee recommendation includes $10,935,000 for competitive grants to postsecondary institutions to establish model programs to help students with intellectual disabilities transition to 

and complete college, as authorized by section 769 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. 

Funds also support a national coordinating center that is charged 

with conducting and disseminating research on strategies to pro-
197 

mote positive academic, social, employment, and independent living 

outcomes for students with intellectual disabilities. 

Minority Science and Engineering Improvement 

The Committee recommends $9,447,000 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 $8,114,000 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 $849,932,000 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. 

The last Upward Bound grant competition may have disadvantaged applicants in rural areas. Many of the rural programs that 

were not renewed in the last round are located in areas of extreme 

poverty that would appear to be prime targets for Upward Bound 

grants. The Committee directs the Department to provide an analysis within 60 days of enactment of this act of how selection criteria and outcomes changed in the past Upward Bound grant cycle, 

to determine whether applicants from rural areas were put at a 

disadvantage compared to other applicants. 
198 

Gaining Early Awareness and Readiness for Undergraduate Programs 

The Committee recommends $307,244,000 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 adds new bill language, as requested by the administration, allowing the Department to increase the evaluation 

set-aside from 0.75 percent to 1.5 percent to work with the GEAR 

UP community and grantees to standardize data collection, including through the use of third-party data systems. The increase in 

the evaluation set-aside will build evidence about effective college 

access and completion strategies and inform the HEA reauthorization process in 2014. The Committee directs the Department to 

submit a report to the Senate Committees on Appropriations and 

HELP that provides an update on how GEAR UP evaluation setaside funds are being used and recommendations on how to improve student outcomes; the Committee expects the report no later 

than 6 months after enactment of this act. 

Graduate Assistance in Areas of National Need and Javits Fellowships 

The Committee recommends $30,848,000 to support the GAANN 

and Javits Fellowships programs. 

In fiscal year 2012, Congress consolidated the GAANN and Javits Fellowships programs, as proposed by the administration. The 

Committee recommendation continues bill language allowing funds 

awarded under GAANN to be used to fund continuation costs for 

the Javits Fellowships program. 

GAANN awards competitive grants to graduate academic departments and programs for fellowship support in areas of national 

need as determined by the Secretary. Javits Fellowships are 

awarded to students of superior ability who are pursuing doctoral 

degrees in the arts, humanities, and social sciences. Each fellowship consists of a student stipend to cover living costs and an institutional payment to cover each fellow’s tuition and other expenses. 

Teacher Quality Partnership Program 

The Committee recommends $42,747,000 for the Teacher Quality 

Partnership program. The budget request consolidates activities 

supported by this program into a proposed new Effective Teachers 

and Leaders State Grants authority as part of the administration’s 

plan for reauthorizing the ESEA. The Teacher Quality Partnership 

Program helps improve the quality of teachers working in highneed schools and early childhood education programs by creating 

model teacher preparation and residency programs. 

Child Care Access Means Parents in Schools 

The Committee recommends an appropriation of $15,938,000 for 

CCAMPIS. This program supports the efforts of a growing number 

of nontraditional students who are struggling to complete their college degrees at the same time that they take care of their children. 
199 

Discretionary grants of up to 4 years are made to institutions of 

higher education to support or establish campus-based child care 

programs primarily serving the needs of low-income students enrolled at the institutions. 

GPRA Data/Higher Education Act Program Evaluation 

The Committee recommends $20,606,000 to collect data associated with the GPRA and to evaluate programs authorized by the 

HEA. The Committee recommendation includes $15,000,000 to support a new dual enrollment demonstration program for low-income 

students and evaluate its impact on the success of participants. 

The Committee is concerned that the cost of tuition, fees, and supplies for low-income students and families could be a deterrent to 

the students’ participation in dual enrollment programs that do not 

cover such costs for low-income students. The recommended funding level will support tuition, fees, and supplies for low-income students enrolled in dual enrollment programs who would qualify for 

Pell grants but are not eligible because they do not have a high 

school diploma. Funding for this demonstration is also provided in 

CTE’s National Programs. The Department will give priority to 

dual enrollment programs that demonstrate a cost-effective approach to providing dual enrollment opportunities to low-income 

students. 

Studies on dual enrollment programs have found that student 

participation is positively related to college enrollment and persistence and higher college GPAs. Dual enrollment programs can also 

shorten the time to degree or credential completion and reduce the 

cost of college for students and families. 

The Committee recommendation also includes $2,000,000 to support an evaluation of the dual enrollment projects to test whether 

providing student aid to low-income students increases access to 

dual enrollment programs, and whether the programs improve degree and credential attainment. The Committee also provides $3,606,000 to support program improvement activities and evaluation, including evaluating the impact of loan counseling on borrower behavior; examining the effectiveness of allowing institutions of higher education additional 

funding to support Pell grant students if the students meet certain 

outcome measures of success; and evaluating the impacts of consumer information on making college selection decisions. 

HOWARD UNIVERSITY

Appropriations, 2013 1 ........................................................................... $233,596,000 

Budget estimate, 2014 ........................................................................... 234,064,000 

Committee recommendation ................................................................. 234,064,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $234,064,000 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 43 percent of the university’s projected educational 

and general expenditures, excluding the hospital. The Committee 
200 

recommends, within the funds provided, not less than $3,593,000 

for the endowment program. 

Howard University Hospital.—Within the funds provided, the 

Committee recommends $28,834,000 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, 2013 1 ........................................................................... $458,000 

Budget estimate, 2014 ........................................................................... 459,000 

Committee recommendation ................................................................. 459,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

Federal Administration.—The Committee bill includes $459,000 

for Federal administration of the CHAFL program. These funds 

will be used to reimburse the Department for expenses incurred in 

managing the existing CHAFL loan portfolio. These expenses include salaries and benefits, travel, printing, contracts, and other 

expenses directly related to the administration of the CHAFL program. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL

FINANCING PROGRAM ACCOUNT

Appropriations, 2013 ............................................................................. $20,462,000 

Budget estimate, 2014 ........................................................................... 20,502,000 

Committee recommendation ................................................................. 20,502,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $20,502,000 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 $320,350,000 in new loan volume 

in fiscal year 2014. The remaining $352,000 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. As requested by the administration, the 

Committee retains bill language allowing the program to make 

loans to public and private HBCUs without regard to the limitations within section 344(a) of the HEA. 

The Committee recommendation includes new bill language, as 

proposed in the budget request, that allows the loan subsidy funding to be available for 2 fiscal years. The Department has found 

that the 1-year timeframe to insure loans constrains the planning 

process for new program loans, decreasing the number of projects 

that can be considered for funding and limiting the Department’s 
201 

ability to achieve the statutory mandate of ensuring that loans are 

fairly allocated among as many eligible institutions as possible. 

INSTITUTE OF EDUCATION SCIENCES

Appropriations, 2013 1 ........................................................................... $592,477,000 

Budget estimate, 2014 ........................................................................... 671,073,000 

Committee recommendation ................................................................. 652,937,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $652,937,000 for 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 commends IES for its efforts to improve the 

rigor, relevance, and utilization of education research that leads to 

enhanced education policy and classroom practices. The Committee 

urges IES to consider how it can organize its investment opportunities to bring more focus to solving specific and enduring problems 

of practice in our Nation’s classrooms. The Committee requests 

that IES include in the fiscal year 2015 congressional budget justification the specific changes it will make to bring more focus and 

coherence to its investments and how those changes are expected 

to solve specific problems of practice. To the extent that it believes 

that it is achieving this goal, the Committee requests that IES 

identify and describe the problems of practice that have been 

solved through its investments. 

The Committee directs the Director to submit an operating plan 

within 90 days of enactment of this act detailing how IES plans to 

allocate funding available to the Institute for research, evaluation, 

and other activities authorized under law. 

RESEARCH, DEVELOPMENT, AND DISSEMINATION

The Committee recommends $195,000,000 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 

education and promoting the use of research and development findings in the design of efforts to improve education. 

STATISTICS

The Committee recommends $112,000,000 for data gathering and 

statistical analysis activities at NCES. Increased funds over the fiscal year 2013 level will allow NCES to provide partial support to 
202 

States that would like to benchmark their student performance 

against countries that participate in the Program for International 

Student Assessment. 

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 $57,311,000 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 $69,905,000 for research and innovation in special education conducted by the National Center for 

Special Education Research [NCSER]. This amount should enable 

NCSER to fund roughly $20,000,000 in new awards in fiscal year 

2014. 

The Center addresses gaps in scientific knowledge in order to improve special education and early intervention services and outcomes for infants, toddlers, and children with disabilities. Funds 

provided to the center are available for obligation for 2 fiscal years. 

The Committee commends NCSER for the rigor and relevancy of 

its research. NCSER-supported research has informed early identification, the development and testing of interventions to improve 

school outcomes, and the validation of assessments to help identify 

and monitor the progress of the Nation’s 6 million children with 

disabilities. An investment in research continues to fill a critical 

need to better understand the most effective ways of educating and 

improving school outcomes for those with or at risk for disabilities. 

SPECIAL EDUCATION STUDIES AND EVALUATIONS

The Committee recommends $11,415,000 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. 

STATEWIDE DATA SYSTEMS

The Committee recommendation includes $75,000,000 for the 

Statewide Data Systems program. 
203 

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. The Committee bill allows up to $21,000,000 to be used for 

awards to public or private agencies or organizations to support activities to improve data coordination, quality, and use at the local, 

State, and national levels. The Committee requests that, prior to 

obligating any funds for this purpose, the Department provide to 

the Committee an operating plan describing the proposed purpose 

and use of such funds. 

ASSESSMENT

The Committee recommends $132,306,000 to provide support for 

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 

$7,690,000 for NAGB, which is responsible for formulating policy 

for NAEP. 

DEPARTMENTAL MANAGEMENT

PROGRAM ADMINISTRATION

Appropriations, 2013 1 ........................................................................... $445,366,000 

Budget estimate, 2014 ........................................................................... 463,450,000 

Committee recommendation ................................................................. 447,366,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $447,366,000 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 also is provided under this account. 

The Committee recommendation includes $2,000,000 for building 

modernization activities for the Department. 

The Committee is very supportive of Executive Order 13548 and 

the Department’s goal to raise the representation of individuals 

with disabilities in its workforce from 6.25 percent in fiscal year 

2010 to 9 percent in fiscal year 2015. However, fiscal year 2012 results demonstrate a lack of progress, with representation falling 

below the fiscal year 2011 level. The Committee encourages the Department to accelerate its efforts toward achieving the goals of this 

important executive order. 

The Committee is concerned about the number of children, in 

particular children with disabilities and children of racial and eth-
204 

nic minorities, that are subject to the abusive and potentially deadly application of restraint and seclusion techniques in our Nation’s 

schools. Every child has the right to be safe at school. 

The Committee commends the Department for releasing its ‘‘Restraint and Seclusion: Resource Document.’’ The Committee directs 

the Department to issue guidance that, at minimum, is consistent 

with the 15 principles identified in the Resource Document that 

help ensure that restraint or seclusion in schools should not occur 

except when there is a threat of imminent danger of serious physical harm to the student or others. If these practices are used, they 

must be carried out in a manner that protects the safety of all children and adults at a school. Finally, the Committee requests that 

the Department co-convene with SAMHSA a stakeholder summit 

on reducing and preventing the use of restraint and seclusion in 

schools. 

The Committee is concerned with deficiencies in geography education research and geography education at the elementary and 

secondary education levels. The Committee recognizes that a sound 

understanding of geography is critical to ensuring that the American workforce is qualified for jobs in geospatial technologies and 

other emerging industries. The Committee directs GAO to conduct 

a study on the status of geographic education and the ability of 

U.S. graduates to fill and retain skilled jobs, particularly in 

geospatial technologies. Additionally, recognizing fiscal constraints 

on States and LEAs, the Committee further directs GAO to report 

on the challenges elementary and secondary schools face in providing geographic education with limited resources. 

The Committee is disappointed that the administration failed to 

meet its scheduled March 2013 release date for the notice of proposed rulemaking related to the phasing out of alternate assessments based on modified academic achievement standards. The 

Committee supports this phase-out and believes the administration 

should move forward expeditiously in this rulemaking. 

The Committee appreciates and strongly supports Executive 

Order 13592 related to improving educational outcomes for American Indian and Alaska Native students. The Committee believes 

that the establishment of the Interagency Working Group on American Indian and Alaska Native Education, co-chaired by the Secretaries of Education and the Interior, and Memorandum of Agreement between the two Departments are important steps forward in 

this effort. The Committee requests that the Department include in 

the fiscal year 2015 and future congressional budget justifications 

the goals, benchmarks, and key activities accomplished and 

planned for improving educational outcomes for American Indian 

and Alaska Native students. 

OFFICE FOR CIVIL RIGHTS

Appropriations, 2013 1 ........................................................................... $102,418,000 

Budget estimate, 2014 ........................................................................... 107,500,000 

Committee recommendation ................................................................. 102,418,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $102,418,000 for OCR. 
205 

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 THE INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $59,700,000 

Budget estimate, 2014 ........................................................................... 62,347,000 

Committee recommendation ................................................................. 59,700,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $59,700,000 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 outlying areas to consolidate funds under title V of the ESEA. 

Section 306. The bill continues a provision that allows the Republic of Palau to receive certain Federal funds. 

Section 307. The bill includes a new provision changing the name 

of the Office of Vocational and Adult Education to the Office of Career, Technical, and Adult Education. 

Section 308. The bill contains a new provision that clarifies the 

Department’s authority to reserve up to 0.5 percent of each ESEA 

appropriation in the bill for evaluation of ESEA programs funded 

in this act. These resources are in addition to any funds specifically 

provided for evaluation purposes. 

Section 309. The bill includes a new provision prohibiting all colleges and universities that receive funding through HEA from 

spending Federal educational program dollars on advertising, marketing, and recruitment. 
206 

Section 310. The bill includes a new provision related to eligibility under the Impact Aid program. 

Section 311. The bill includes a new provision concerning licensing, certification, and accreditation requirements for certain postsecondary education programs. 

Section 312. The bill includes a new provision that modifies the 

Free Application for Federal Student Aid and requires the Department to inform foster youth of their eligibility for certain financial 

aid programs. 
(207) 

TITLE IV 

RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR

SEVERELY DISABLED

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $5,364,000 

Budget estimate, 2014 ........................................................................... 5,396,000 

Committee recommendation ................................................................. 5,396,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $5,396,000 for the Committee for 

Purchase from People Who Are Blind or Severely Disabled. 

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. 

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 program level of $1,061,156,000, a level sufficient to maintain the 

number of AmeriCorps members at over 82,000. 

OPERATING EXPENSES

Appropriations, 2013 1 ........................................................................... $748,752,000 

Budget estimate, 2014 ........................................................................... 760,264,000 

Committee recommendation ................................................................. 756,641,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $756,641,000 for the operating expenses of CNCS. 

VOLUNTEERS IN SERVICE TO AMERICA [VISTA]

The Committee recommends $94,820,000 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 
208 

expand programs in housing, employment, health, and economic 

development activities. 

NATIONAL SENIOR VOLUNTEER CORPS

The Committee recommends $207,491,000 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. Programs include the Retired Senior Volunteer Program, the 

Foster Grandparent Program, and the Senior Companion Program. 

The Committee recommendation includes funding for each of the 

Senior Corps programs at no less than fiscal year 2013 levels. 

AMERICORPS STATE AND NATIONAL GRANTS

The Committee recommends $345,800,000 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. 

National Civilian Community Corps [NCCC] 

The Committee recommendation includes $30,000,000 for NCCC. 

The recommended reduction reflects the completion of one-time relocation activities related to the loss of the Perry Point campus in 

Maryland. 

NCCC is a full-time, team-based residential program for men 

and women ages 18 to 24. Members are assigned to one of five 

campuses for a 10-month service commitment. 

INNOVATION, DEMONSTRATION, AND ASSISTANCE ACTIVITIES

The Committee recommendation includes $58,224,000 for innovation, demonstration, and assistance activities. 

Within the funds provided, the Committee recommendation includes $46,724,000 for the Social Innovation Fund authorized 

under section 1807 of the SERVE America Act. The fiscal year 

2013 level is $44,726,000. The budget request is $48,815,000. The 

increase provided is intended to fund Pay for Success pilot programs. The Committee has included statutory language needed for 

this program, identical to language included in the fiscal year 2013 

President’s budget and Senate bill. 

In addition, $5,000,000 is included for the Volunteer Generation 

Fund authorized under section 198P of the SERVE America Act, 

compared to $3,976,000 enacted in fiscal year 2013 and 

$10,000,000 in the budget request. The Committee recommendation 

also provides $1,000,000 for MLK Service Day, which was eliminated by the administration in fiscal year 2013 and not requested 

in the fiscal year 2014 budget request. 

The Committee recommendation includes $1,000,000 for a new 

national initiative on volunteerism. Volunteerism is a type of community service that is distinct from most of the programs of CNCS 
209 

because of its unpaid and intermittent nature. For example, many 

AmeriCorps members build capacity at organizations by recruiting 

and coordinating volunteers for a series of individual projects. The 

AmeriCorps member devotes a year of sustained service, while the 

volunteers come episodically to engage on a particular task. The 

Committee intends for this new effort to build a shared knowledge 

base among CNCS and long standing organizations with deep expertise in volunteer engagement. National volunteer organizations 

include youth sports leagues, youth service organizations, charitable food preparation and delivery organizations, churches, and 

other entities that have large, ever-rotating volunteer pools. The 

Committee believes that CNCS should convene these organizations 

and develop shared resources on recruitment, training, and retention efforts. The Committee expects this initiative to be primarily 

intramural, and expects that it will not be implemented exclusively 

or primarily through intermediary organizations. CNCS should 

build direct partnerships to ensure that the knowledge gained in 

this effort immediately informs the work of all of CNCS’ staff and 

programs. 

EVALUATION

The Committee recommendation includes $5,000,000 for CNCS 

evaluation activities. The Committee intends that part of the increase in evaluation funds be used to continue the Civic Health Assessment, which is funded in Training and Technical Assistance in 

fiscal year 2013. 

The Committee strongly supports efforts of CNCS to evaluate the 

impact of service on both the lives of those served and the lives of 

those serving. In particular, the Committee is pleased to see research progressing on the impact of a service experience on an individual’s employment options. Congress provided for a dramatic expansion of AmeriCorps and VISTA in the American Recovery and 

Reinvestment Act in response to a body of research that shows that 

individuals who graduate college during a recession have reduced 

employment options and earnings that persist throughout their 

lifetimes. The Committee encourages CNCS to consider evaluating 

whether participating in federally funded service programs mitigated the negative effects of graduating during the recent recession, in whole or in part. 

STATE COMMISSION GRANTS

The Committee recommendation includes $15,306,000 for State 

Commission Grants. 

The recommended increase over the budget request reflects the 

Committee’s intention to consolidate the training and technical assistance grants into the State Commission Grants. The Committee 

continues to believe that this consolidation will create efficiencies 

at both the Federal and State levels of government by combining 

two State grants with overlapping purposes. In implementing this 

consolidation, the Committee expects CNCS to develop measures to 

ensure that States adequately train new applicants and newly 

awarded grantees in accountability procedures. 
210 

The Committee deletes a provision added in the fiscal year 2012 bill that lowered the State minimum award to $200,000 from the 

$250,000 level prescribed in the SERVE America Act. 

PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriations, 2013 1 ........................................................................... $211,373,000 

Budget estimate, 2014 ........................................................................... 207,293,000 

Committee recommendation ................................................................. 209,840,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $209,840,000 for 

making payments to the National Service Trust. 

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. 

The recommended funding level is sufficient to support more 

than 82,000 servicemembers. The Committee is aware of significant 

demand for the Education Award-only Program [EAP] and has provided funding above the budget request to address this need. In addition, the Committee notes that community service can be an important strategy in achieving many national and community goals. 

For that reason, the Committee strongly supports the work CNCS 

is doing to partner with other Federal agencies. The Committee believes that EAP awards are a good tool to further those partnerships. 

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $82,677,000 

Budget estimate, 2014 ........................................................................... 87,109,000 

Committee recommendation ................................................................. 88,209,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $88,209,000 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. 

The Committee recommendation rejects the proposed cut to the 

maintenance and improvement of information technology [IT] systems. The Committee feels strongly that antiquated technology at 

CNCS creates unacceptable challenges for oversight, imposes unnecessary burdens in grantee reporting, and reduces the efficiency 

of the programs as a whole. CNCS is directed to place a high priority on the goals and objectives of the CNCS IT Strategic Plan, 

with a particular emphasis on streamlining the grantee reporting 

process. 

The Committee reiterates its strong support for efforts to redesign the outreach activities meant to recruit and support national 

servicemembers with disabilities. The program should build on successful models of integration of persons with disabilities. The Committee directs CNCS to report in the annual congressional budget 

justification the amount for disability training and support activi-
211 

ties proposed for the pending fiscal year, the amount estimated for 

the current fiscal year, and the amount obligated in the 3 prior fiscal years. 

OFFICE OF INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $3,984,000 

Budget estimate, 2014 ........................................................................... 6,466,000 

Committee recommendation ................................................................. 6,466,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends an appropriation of $6,466,000 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. 

The recommended level of funding should allow the IG to hire 

new criminal investigators, criminal analysts, auditors, and audit 

managers. The Committee intends that the OIG fully reclaim the 

responsibilities CNCS temporarily assumed on behalf of the OIG in 

fiscal year 2012. 

ADMINISTRATIVE PROVISIONS

The Committee retains language in previous bills concerning four 

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), and aligning requirements regarding 

the use of Education Awards at GI bill-eligible institutions (section 

404). 

The Committee adds a provision relating to section 189D of the 

National and Community Service Act of 1990, which requires that 

all applicants for federally funded national service positions pass 

through both a criminal history fingerprint check and a check of 

the National Sex Offender Public Registry. Applicants who are considered for positions working with vulnerable populations are required to undergo an FBI check or go through a waiver process if 

that check is not made available to them. The Committee is aware 

that States are the sole entity with the authority to query the FBI 

database and that some States are not conducting this background 

check. This is leading to an unanticipated flood of individual waiver petitions. The Committee rejects the proposal in the President’s 

budget to make the FBI check optional for all except members applying to work with children. Instead, the Committee includes a 

statutory provision (section 405) allowing the required background 

checks to be processed by States under the terms and conditions 

set out for ‘‘volunteers’’ in the National Child Protection Act 

[NCPA]. The Committee notes that the definition of a national 

servicemember who works with vulnerable populations included in 

section 189D falls within the definition of those eligible for background checks under the NCPA; therefore, the Committee views 

this provision as a clarification of existing authorities. The provision also designates State Commissions as eligible recipients of the 

background check information, in addition to the organizations 

which are currently authorized in the NCPA. In some instances in-
212 

volving small and local organizations, the Committee believes that 

a State Commission can better secure this criminal history information. 

CORPORATION FOR PUBLIC BROADCASTING

Appropriations, 2015 ............................................................................. $445,000,000 

Budget estimate, 2016 ........................................................................... 445,000,000 

Committee recommendation, 2016 ....................................................... 445,000,000 

The Committee recommends $445,000,000 for CPB as an advance 

appropriation for fiscal year 2016. Two-year advance funding has 

been in place since 1975 to ensure the independence of public 

broadcasting programming. 

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. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $46,071,000 

Budget estimate, 2014 ........................................................................... 47,620,000 

Committee recommendation ................................................................. 47,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $47,000,000 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, the Committee recommendation includes up to 

$400,000, the same amount as the budget request, for labor-management 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, 2013 1 ........................................................................... $17,569,000 

Budget estimate, 2014 ........................................................................... 16,423,000 

Committee recommendation ................................................................. 17,000,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $17,000,000 for 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 fivemember Commission provides review of the ALJ decisions. 
213 

FMSHRC received a significant increase in funding in fiscal year 

2012, continued in fiscal year 2013, to help address the growing 

backlog of contested mine safety cases appealed to the commission. 

This funding also covered the one-time costs of developing an electronic case processing system and moving FMSHRC to new office 

space. Funds for those costs are no longer required in fiscal year 

2014. The Committee recommendation will allow FMSHRC to increase staffing to continue to reduce the number of pending cases 

and the average time for processing cases. 

The Committee directs FMSHRC, in conjunction with the Department of Labor, to provide a joint report to the Committees on 

Appropriations of the House of Representatives and Senate for reducing the number of pending cases and average case processing 

time to appropriate levels by the end of fiscal year 2015. The report 

should fully explain how such levels were determined. It also 

should establish goals and metrics for determining when the levels 

will be achieved and how they will be maintained in the future. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARIES: GRANTS AND ADMINISTRATION

Appropriations, 2013 1 ........................................................................... $231,490,000 

Budget estimate, 2014 ........................................................................... 225,813,000 

Committee recommendation ................................................................. 231,490,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $231,490,000 for 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 2013 

appropriation 1

Fiscal year 2014 

request 

Committee 

recommendation 

Library Services Technology Act: 

Grants to States ............................................................................... 156,052 150,000 157,266 

Native American Library Services ..................................................... 3,861 3,869 3,869 

National Leadership: Libraries .......................................................... 11,922 13,200 13,200 

Laura Bush 21st Century Librarian .................................................. 12,499 10,000 10,000 

Subtotal, LSTA .............................................................................. 184,335 177,069 184,335 

Museum Services Act:.

Museums for America ....................................................................... 17,994 22,707 21,119 

21st Century Museum Professionals ................................................ 1,965 ........................ ........................

Conservations Project Support .......................................................... 2,608 ........................ ........................

Native American/Hawaiian Museum Services .................................. 924 926 926 

National Leadership: Museums ........................................................ 5,899 7,880 7,880 

Subtotal, MSA ............................................................................... 29,390 31,513 29,925 

African American History and Culture Act ....................................... 1,407 1,410 1,410 

Administration ................................................................................... 14,476 14,000 14,000 

Policy, Research, Program Evaluation, and Statistics ..................... 1,882 1,820 1,820 

1 Does not reflect the March 1, 2013 sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed

under Public Law 113–6, and any other re-alignment of funds. 
214 

Note: Totals may not add due to rounding. 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

Appropriations, 2013 ............................................................................. $5,777,000 

Budget estimate, 2014 ........................................................................... 9,500,000 

Committee recommendation ................................................................. 9,000,000 

The Committee recommends $9,000,000 for 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 build capacity to carry out these 

activities. 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $11,754,000 

Budget estimate, 2014 ........................................................................... 12,087,000 

Committee recommendation ................................................................. 11,954,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $11,954,000 for MedPAC, which 

provides independent policy and technical advice on issues affecting 

the Medicare program. 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $3,251,000 

Budget estimate, 2014 ........................................................................... 3,345,000 

Committee recommendation ................................................................. 3,345,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $3,345,000 for the National Council 

on Disability [NCD]. NCD is mandated to make recommendations 

to the President, Congress, the RSA, and NIDRR 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 reenter the Nation’s workforce and to live independently. 

The Committee directs NCD to study the accessibility of taxicabs 

in the United States and internationally, and to make recommendations about how to increase the number and availability 

of accessible taxicabs in the United States. The Committee also directs NCD, in conjunction with the Access Board, to work with the 

World Bank to develop a safeguard on disability in order to increase the inclusion and opportunities for individuals with disabilities in countries that receive funds from the World Bank. 
215 

NATIONAL HEALTH CARE WORKFORCE COMMISSION

SALARIES AND EXPENSES

Appropriations, 2013 .............................................................................

Budget estimate, 2014 ........................................................................... $3,000,000 

Committee recommendation ................................................................. 3,000,000 

The Committee recommendation includes $3,000,000 for the National Health Care Workforce Commission. This commission will 

serve as a resource to Congress, the President, and State and local 

entities in evaluating healthcare workforce needs, including assessing education and training activities to determine to what extent 

the demand for health workers is being met; identifying barriers to 

improved coordination at the Federal, State, and local levels; and 

recommending changes to address those barriers. 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $277,749,000 

Budget estimate, 2014 ........................................................................... 284,991,000 

Committee recommendation ................................................................. 284,991,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $284,991,000 for the NLRB, which 

administers and enforces the National Labor Relations Act and 

protects employee and employer rights provided under that act. 

The General Services Administration [GSA] has mandated that 

the NLRB move into a smaller, more flexible office space, consistent with the administration initiative to reduce the Federal 

Government’s footprint. GSA estimates this will cost approximately 

$10,000,000 but is expected to reduce rent costs by approximately 

30 percent, or $4,600,000, annually once completed. The Committee 

recommendation provides sufficient funds to execute the move. 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $13,384,000 

Budget estimate, 2014 ........................................................................... 13,347,000 

Committee recommendation ................................................................. 13,384,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $13,384,000 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 Committee remains concerned about oversight and reporting 

requirements included in the FAA Modernization and Reform Act 

of 2012 and accordingly includes a modest increase over the budget 

request. 
216 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriations, 2013 1 ........................................................................... $11,644,000 

Budget estimate, 2014 ........................................................................... 12,634,000 

Committee recommendation ................................................................. 12,300,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $12,300,000 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, 2013 1 ........................................................................... $50,813,000 

Budget estimate, 2014 ........................................................................... 39,000,000 

Committee recommendation ................................................................. 39,000,000 

The Committee recommends $39,000,000 for the Dual Benefits 

Payments Account. This amount includes an estimated $3,000,000 

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 ACCOUNT

Appropriations, 2013 1 ........................................................................... $150,000 

Budget estimate, 2014 ........................................................................... 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, 2013 1 ........................................................................... $110,927,000 

Budget estimate, 2014 ........................................................................... 111,793,000 

Committee recommendation ................................................................. 110,927,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $110,927,000 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 includes new bill language giving RRB the authority to hire new attorneys in the excepted service. A recently 
217 

identified contradiction between statutes has effectively left RRB 

unable to hire any new attorneys. 

LIMITATION ON THE OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $8,138,000 

Budget estimate, 2014 ........................................................................... 8,877,000 

Committee recommendation ................................................................. 8,638,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $8,638,000 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, 2013 ............................................................................. $20,404,000 

Budget estimate, 2014 ........................................................................... 16,400,000 

Committee recommendation ................................................................. 16,400,000 

The Committee recommends $16,400,000 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. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriations, 2013 ............................................................................. $38,769,285,000 

Budget estimate, 2014 ........................................................................... 40,737,000,000 

Committee recommendation ................................................................. 40,568,741,000 

The Committee recommends $40,568,741,000 in fiscal year 2014 

mandatory funds for the SSI program. In addition, the Committee 

recommends $19,700,000,000 in advance funding for the first quarter of fiscal year 2015. 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 2014 pro- gram level of $55,579,000,000 for Federal benefit payments. This 

will support an average monthly benefit of approximately $556 for 

8.2 million recipients. 

Beneficiary Services 

The Committee recommendation includes $3,000,000 in new 

mandatory budget authority for beneficiary services. Carryover of 

prior year unobligated balances will be sufficient to fund a total estimated fiscal year 2014 program level of $48,000,000. 

These funds reimburse VR agencies for successfully rehabilitating disabled SSI recipients by helping them achieve and sustain 
218 

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 $54,000,000 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. 

Within the total for research and demonstration, the Committee 

recommends $2,500,000, the same amount as the budget request, 

for the PROMISE program. This demonstration program is an 

interagency effort between SSA and the Departments of Education, 

Labor, and HHS to test interventions that improve health, education, postsecondary, employment, and family outcomes for older 

children receiving SSI, and reduce their dependency on the program. In fiscal year 2013 the Department of Education will award 

competitive, multi-year grants to a small number of States that 

propose innovative strategies to improve such outcomes by enhancing coordination between existing programs and services for children ages 14–16 receiving SSI. These funds at SSA will support 

evaluation activities, including providing technical assistance to 

State grantees. 

The Committee believes that promoting public understanding of 

Social Security programs is a critical task for SSA. Therefore, within the total for research and demonstration, the Committee recommendation includes $5,000,000 to test the impact of providing 

community outreach on Social Security programs and benefits, particularly to students, individuals just entering the workforce, and 

new parents. 

Administrative Expenses 

The Committee recommendation includes $4,232,741,000 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, 2013 1 2 ......................................................................... $11,431,895,000 

Budget estimate, 2014 ........................................................................... 11,069,846,000 

Committee recommendation 2 ............................................................... 11,965,473,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 2 Includes funding available under program integrity cap adjustment provided by Public Law 

112–25. 

The Committee recommends $11,965,473,000 for SSA’s LAE account. This account provides resources for SSA to administer the 
219 

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 remains concerned about the impact of persistently high workloads, coupled with recent budget constraints, on 

SSA’s ability to provide quality services. After years of inadequate 

funding in the mid-2000s basic services began to suffer. By 2008 

it took an average of 532 days to process a disability hearing, and 

a substantial number of cases were pending for over 900 and even 

1,000 days. Significant funding increases in fiscal years 2009 and 

2010 allowed SSA to work down this backlog while keeping pace 

with increases in disability claims, and reduce the average disability hearing processing time to 362 days in fiscal year 2012. The 

Committee is deeply concerned that budget constraints are reversing these positive trends and impacting basic services to the American public, while an aging population will continue to put increased demands on the agency. Therefore, the Committee recommendation includes a $533,578,000 increase over the fiscal year 

2013 level to keep pace with rising costs and consistently recordhigh workloads, and to increase program integrity efforts. 

Veterans Affairs [VA] Benefits.—The Committee commends the 

work SSA has done in recent years to improve coordination and 

data sharing with the VA to help improve the VA’s disability 

claims process. The Committee directs SSA to continue to provide 

it with periodic updates on steps taken to continue to improve the 

process. 

Work Incentives Planning and Assistance [WIPA] and Protection 

and Advocacy for Beneficiaries of Social Security [PABSS].—The 

Committee recommendation includes $7,000,000 for WIPA and 

$23,000,000 for PABSS. These programs provide valuable services 

to help Social Security disability beneficiaries return to work. 

Representative Payee Oversight.—SSA assigns representative 

payees when beneficiaries are unable to financially manage their 

own benefit payments. The GAO and SSA’s OIG have consistently 

identified management challenges and intensive administrative requirements with SSA’s oversight of representative payees. The 

Committee strongly encourages SSA to continue to pursue efforts 

to improve representative payee oversight, including continuing to 

partner with outside organizations to identify, investigate, and prevent fraud and abuse. 

Social Security Annual Statements.—The Committee directs SSA 

to resume mailing annual Social Security account statements to all 

eligible individuals over age 25, consistent with section 1143(c)(2) 

of the Social Security Act. These annual statements provide valuable information to workers on their benefits under Social Security 

programs, including allowing workers to check their earning his-
220 

tory and notify SSA of any errors in a timely fashion. Earnings discrepancies identified years later can be complicated and time-consuming to resolve. Due to budget constraints, SSA began limiting 

the mailing of annual Social Security account statements in 2011 

and currently only mails it to workers near retirement over age 60 

and once to younger workers when they turn age 25. 

Field Office Closings.—The Committee remains concerned that in 

recent years SSA has lacked a long-term strategic plan or comprehensive, transparent policies regarding field office closings. The 

Committee directs SSA to submit a report to the Committees on 

Appropriations of the Senate and House of Representatives by 

March 31, 2014, on its policies and procedures for closing and consolidating field offices. In addition, the Committee directs SSA to 

provide a readily available public notice of proposed field office closures to ensure that impacted communities are aware of proposed 

changes, and allow an opportunity for public input. 

Use of Predictive Analytics.—In recent years SSA has begun to 

utilize predictive analytics and other data analysis tools in a number of areas, including in its disability claims process, for example 

through its Quick Disability Determination and Compassionate Allowance initiatives, and program integrity activities. The Committee encourages SSA to continue to explore the expanded use of 

predictive analytic tools in these areas, as well as others, including 

in return-to-work initiatives and representative payee oversight. 

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. 

Program Integrity 

Within the total for LAE, the Committee recommendation includes $1,197,000,000 for program integrity activities. This includes $273,000,000 in base funding and $924,000,000 in cap adjustment funding allowed under the Budget Control Act of 2011. 

These funds support program integrity activities such as CDRs and 

SSI redeterminations which save $9 and $5, respectively, for each 

$1 spent by reducing waste, fraud, abuse, and improper payments 

in Social Security, Medicare, and Medicaid programs. The Committee recommendation for Social Security program integrity activities is expected to save approximately $9,600,000,000 over 10 years 

to those programs. 

The budget request proposes funding the base amount out of discretionary budget authority in fiscal year 2014 but funding an additional $1,227,000,000 out of new mandatory budget authority, for 

a total of $1,500,000,000. Beginning in fiscal year 2015, the administration proposes funding the entire amount for program integrity 

with mandatory funding. The Committee recommends funding all 

program integrity expenses with discretionary budget authority, including utilizing the full cap adjustment allowed under the Budget 

Control Act. 
221 

User Fees 

Within the total for LAE, the Committee recommendation includes up to $174,000,000 for administrative activities funded from 

user fees. This includes $173,000,000 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. 

OFFICE OF THE INSPECTOR GENERAL

Appropriations, 2013 1 ........................................................................... $102,078,000 

Budget estimate, 2014 ........................................................................... 105,733,000 

Committee recommendation ................................................................. 104,670,000 

1Does not reflect the March 1, 2013, sequester of funds under Public Law 112–25 and excludes transfers and reprogrammings allowed under Public Law 113–6. 

The Committee recommends $104,670,000 for SSA’s OIG. This 

includes $74,972,000 funded from the OASI and DI trust funds for 

those programs’ share of OIG’s expenses and $29,698,000 funded 

from general revenues for the SSI program’s share of expenses. 
(222) 

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 the use of funds for a grant or contract exceeding $5,000,000 unless the pro-
223 

spective contractor or grantee makes certain certifications regarding Federal tax liability. 

Section 519. The bill modifies a provision rescinding funds from 

the State Children’s Health Insurance Program performance bonus 

fund. 

Section 520. The bill modifies a provision regarding funding for 

programs that carry out distribution of sterile needles or syringes. 

Section 521. The bill adds a new provision authorizing the transfer of the Health Education Assistance Loan program from the Department of Health and Human Services to the Department of 

Education. 

Section 522. The bill adds a new provision establishing Performance Partnership Pilots related to discretionary funds available in 

this act. 

Section 523. The bill continues a provision requiring departments, agencies, boards, and commissions funded in this act to submit annual reports regarding conferences. 

The Committee directs that expenses associated with the fulfillment of official monitoring, technical assistance, and emergency response duties should not be subject to the reporting requirements 

of this provision. Examples of nonconference related travel include 

outbreak response, audits, inspections, and investigations. 

Section 524. The Committee includes a new provision to promote 

public access to research supported by Federal funding. 
(224) 

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: Elementary and 

Secondary Education Act; Institute of Education Sciences; parts C 

and D of the Individuals with Disabilities Education Act; Special 

Olympics Sport and Empowerment Act of 2004; Workforce Investment Act; Women in Apprenticeship and Non-Traditional Occupations Act; Homeless Veterans Reintegration Program; 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; Family Violence Prevention and Services 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, except for grants for Primary and Behavioral Healthcare Integration; Low Income Home Energy Assistance Program; Refugee and Entrant Assistance programs (except 

for Victims of Trafficking); Child Care and Development Block 

Grant; 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; Rehabilitation Services and Disability Research; 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. 
225 

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

STANDING RULES OF THE SENATE 

Pursuant to paragraph 7(c) of rule XXVI, on July 11, 2013, the 

Committee ordered favorably reported, en bloc, an original bill (S. 

1284) making appropriations for the Departments of Labor, Health 

and Human Services, and Education, and related agencies for the 

year ending September 30, 2014, and for other purposes, and an 

original bill (S. 1283) making appropriations for the Legislative 

Branch for the fiscal year ending September 30, 2014, and for other 

purposes provided, that each bill be subject to amendment and that 

each bill be consistent with the subcommittee funding guidance, by 

a recorded vote of 16–14, a quorum being present. The vote was as 

follows: 

Yeas Nays 

Chairwoman Mikulski Mr. Shelby 

Mr. Leahy Mr. Cochran 

Mr. Harkin Mr. McConnell 

Mrs. Murray Mr. Alexander 

Mrs. Feinstein Ms. Collins 

Mr. Durbin Ms. Murkowski 

Mr. Johnson Mr. Graham 

Ms. Landrieu Mr. Kirk 

Mr. Reed Mr. Coats 

Mr. Pryor Mr. Blunt 

Mr. Tester Mr. Moran 

Mr. Udall Mr. Hoeven 

Mrs. Shaheen Mr. Johanns 

Mr. Merkley Mr. Boozman 

Mr. Begich 

Mr. Coons 

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. 
226 

TITLE 5—GOVERNMENT ORGANIZATION AND 

EMPLOYEES 

CHAPTER 53—PAY RATES AND SYSTEMS 

SUBCHAPTER II—EXECUTIVE SCHEDULE PAY RATES 

§ 5315. Positions at level IV 

Level IV of the Executive Schedule applies to the following positions, for which the annual rate of basic pay shall be the rate determined with respect to such level under chapter 11 of title 2, as 

adjusted by section 5318 of this title: 

* * * * * * * 

Assistant Secretaries of Agriculture (3). 

Assistant Secretaries of Commerce (11). 

Assistant Secretaries of Defense (16). 

Assistant Secretaries of the Air Force (4). 

Assistant Secretaries of the Army (5). 

Assistant Secretaries of the Navy (4). 

Assistant Secretaries of Health and Human Services (6). 

Assistant Secretaries of the Interior (6). 

Assistant Attorneys General (11). 

Assistant Secretaries of Labor (10), one of whom shall be the 

Assistant Secretary of Labor for Veterans’ Employment and 

Training. 

Administrator, Wage and Hour Division, Department of 

Labor. 

Assistant Secretaries of State (24) and 4 other State Department officials to be appointed by the President, by and with 

the advice and consent of the Senate. 

Assistant Secretaries of the Treasury (10). 

* * * * * * * 

§ 5316. Positions at level V 

Level V of the Executive Schedule applies to the following positions, for which the annual rate of basic pay shall be the rate determined with respect to such level under chapter 11 of title 2, as 

adjusted by section 5318 of this title: 

* * * * * * * 

Manpower Administrator, Department of Labor. 

Members, Renegotiation Board. 

Members, Subversive Activities Control Board. 

Assistant Administrator of General Services. 

Director, United States Travel Service, Department of Commerce. 

øAdministrator, Wage and Hour and Public Contracts Division, Department of Labor.¿ 

Assistant Director (Program Planning, Analysis and Research), Office of Economic Opportunity. 

Deputy Director, National Security Agency. 

Director, Bureau of Land Management, Department of the 

Interior. 

Director, National Park Service, Department of the Interior. 
227 

National Export Expansion Coordinator, Department of 

Commerce. 

TITLE 8—ALIENS AND NATIONALITY 

CHAPTER 12—IMMIGRATION AND NATIONALITY 

SUBCHAPTER II—IMMIGRATION 

PART II—ADMISSION QUALIFICATIONS FOR ALIENS; TRAVEL

CONTROL OF CITIZENS AND ALIENS

§ 1184. Admission of nonimmigrants 

(a) Regulations 

* * * * * * * 

(c) Petition of importing employer 

(1) The question of importing any alien as a nonimmigrant 

under subparagraph (H), (L), (O), or (P)(i) of section 1101(a)(15) of 

this title (excluding nonimmigrants under section 

1101(a)(15)(H)(i)(b1) of this title) in any specific case or specific 

cases shall be determined by the Attorney General, after consultation with appropriate agencies of the Government, upon petition of 

the importing employer. Such petition, shall be made and approved 

before the visa is granted. The petition shall be in such form and 

contain such information as the Attorney General shall prescribe. 

The approval of such a petition shall not, of itself, be construed as 

establishing that the alien is a nonimmigrant. For purposes of this 

subsection with respect to nonimmigrants described in section 

1101(a)(15)(H)(ii)(a) of this title, the term ‘‘appropriate agencies of 

Government’’ means the Department of Labor and includes the Department of Agriculture. The provisions of section 1188 of this title 

shall apply to the question of importing any alien as a nonimmigrant under section 1101(a)(15)(H)(ii)(a) of this title. In this 

subsection, the term ‘‘consultation’’ includes, with respect to nonimmigrants described in section 101(a)(15)(H)(ii)(B), the authority 

of the Secretary of Labor to issue labor market determinations, including temporary labor certifications, and to establish regulations 

and policies for such issuance, including determining the appropriate prevailing wage rates for occupations in which such nonimmigrants will be employed. 

(14)(A) * * * 

* * * * * * * 

(B) The Secretary of Homeland Security may delegate to the 

Secretary of Labor, with the agreement of the Secretary of Labor, 

any of the authority given to the Secretary of Homeland Security 

under øsubparagraph (A)(i)¿ subparagraph (A). 
228 

TITLE 20—EDUCATION 

CHAPTER 44—CAREER AND TECHNICAL EDUCATION 

SUBCHAPTER I—CAREER AND TECHNICAL EDUCATION 

ASSISTANCE TO THE STATES 

PART A—ALLOTMENT AND ALLOCATION

§ 2324. National activities 

(a) Program performance information 

* * * * * * * 

(b) Miscellaneous provisions 

(1) Collection of information at reasonable cost 

The Secretary shall take such action as may be necessary 

to secure at reasonable cost the information required by this 

subchapter. To ensure reasonable cost, the Secretary, in consultation with the National Center for Education Statistics, the 

øOffice of Vocational and Adult Education¿ Office of Career, 

Technical, and Adult Education, and an entity assisted under 

section 2328 of this title (if applicable), shall determine the 

methodology to be used and the frequency with which information is to be collected. 

* * * * * * * 

CHAPTER 48—DEPARTMENT OF EDUCATION 

SUBCHAPTER II—ESTABLISHMENT OF THE DEPARTMENT 

§ 3412. Principal officers 

(a) Deputy Secretary of Education 

* * * * * * * 

(b) Assistant Secretaries and General Counsel 

(1) There shall be in the Department— 

(A) * * * 

* * * * * * * 

(C) an øAssistant Secretary for Vocational and Adult Education¿ Assistant Secretary for Career, Technical, and Adult 

Education; 

* * * * * * * 

(h) Coordination of literacy related functions by øAssistant 

Secretary for Vocational and Adult Education¿ Assistant Secretary for Career, Technical, and Adult Education 

The øAssistant Secretary for Vocational and Adult Education¿ 

Assistant Secretary for Career, Technical, and Adult Education, in 

addition to performing such functions as the Secretary may prescribe, shall have responsibility for coordination of all literacy related programs and policy initiatives in the Department. The øAssistant Secretary for Vocational and Adult Education¿ Assistant 
229 

Secretary for Career, Technical, and Adult Education shall assist in 

coordinating the related activities and programs of other Federal 

departments and agencies. 

* * * * * * * 

§ 3416. øOffice of Vocational and Adult Education¿ Office of 

Career, Technical, and Adult Education 

There shall be in the Department an øOffice of Vocational and 

Adult Education¿ Office of Career, Technical, and Adult Education, to be administered by the øAssistant Secretary for Vocational and 

Adult Education¿ Assistant Secretary for Career, Technical, and 

Adult Education appointed under section 3412(b) of this title. The 

Assistant Secretary shall administer such functions affecting øvocational and adult education¿ career, technical, and adult education 

as the Secretary shall delegate, and shall serve as principal adviser 

to the Secretary on matters affecting øvocational and adult education¿ career, technical, and adult education. The Secretary, 

through the Assistant Secretary, shall also provide a unified approach to rural education and rural family education through the 

coordination of programs within the Department and shall work 

with the Federal Interagency Committee on Education to coordinate related activities and programs of other Federal departments 

and agencies. 

TITLE 40—PUBLIC BUILDINGS, PROPERTY, AND WORKS 

PART A—GENERAL

CHAPTER 31—GENERAL 

SUBCHAPTER IV—WAGE RATE REQUIREMENTS 

§ 3144. Authority øof Comptroller General¿ to pay wages and 

list contractors violating contracts 

(a) PAYMENT OF WAGES.— (1) IN GENERAL.—øThe Comptroller General¿ The Secretary of Labor shall pay directly to laborers and mechanics 

from any accrued payments withheld under the terms of a contract any wages found to be due laborers and mechanics under 

this subchapter. 

* * * * * * * 

CHAPTER 37—CONTRACT WORK HOURS AND SAFETY 

STANDARDS 

§ 3703. Report of violations and withholding of amounts for 

unpaid wages and liquidated damages 

(a) REPORTS OF INSPECTORS.— * * * 

* * * * * * * 

(b) WITHHOLDING AMOUNTS.— 

(1) DETERMINING AMOUNT.— * * * 

* * * * * * * 
230 

(3) PAYMENT.—øThe Comptroller General¿ The Secretary 

of Labor shall pay the amount administratively determined to 

be due directly to the laborers and mechanics from amounts 

withheld on account of underpayments of wages if the amount 

withheld is adequate. If the amount withheld is not adequate, 

øthe Comptroller General¿ the Secretary of Labor shall pay an 

equitable proportion of the amount due. 

TITLE 42—THE PUBLIC HEALTH AND WELFARE 

SUBCHAPTER V—HEALTH PROFESSIONS EDUCATION 

PART A—STUDENT LOANS

SUBPART I—INSURED HEALTH EDUCATION ASSISTANCE LOANS TO

GRADUATE STUDENTS

§ 292o. Definitions 

For purposes of this subpart: 

(1) The term ‘‘eligible institution’’ means, with respect to 

a fiscal year, a school of medicine, osteopathic medicine, dentistry, veterinary medicine, optometry, podiatric medicine, 

pharmacy, public health, allied health, or chiropractic, or a 

graduate program in health administration or behavioral and 

mental health practice, including clinical psychology. 

* * * * * * * 

(5)(A) The term ‘‘default rate’’, in the case of an eligible entity, means the percentage constituted by the ratio of— 

(D) For purposes of subparagraph (A), a loan is made with 

respect to an eligible entity if— 

(i) in the case of an eligible institution, the loan was 

made to students of the institution; 

(ii) in the case of an eligible lender, the loan was made 

by the lender; and 

(iii) in the case of a holder, the loan was purchased by 

the holder. 

(6) The term ‘‘Secretary’’ means the Secretary of Education. 

TITLE 48—TERRITORIES AND INSULAR POSSESSIONS 

CHAPTER 18—MICRONESIA, MARSHALL ISLANDS, AND 

PALAU 

SUBCHAPTER I—MICRONESIA AND MARSHALL ISLANDS 

PART A—APPROVAL AND IMPLEMENTATION OF ORIGINAL COMPACT

§ 1921d. Supplemental provisions 

(a) Domestic program requirements 

* * * * * * * 

(f) Continuing programs and laws 
231 

(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 ø2009¿ 2014, 

to the extent the government, institutions, and people 

of Palau were so eligible under such provisions in fiscal year 2003. 

DEPARTMENT OF EDUCATION ORGANIZATION ACT, 

1980, PUBLIC LAW 96–88 

SECTION 1. This Act may be cited as the ‘‘Department of Education Organization Act’’. 

TABLE OF CONTENTS 

TITLE II—ESTABLISHMENT OF THE DEPARTMENT 

Sec. 201. Establishment. 

* * * * * * * 

øSec. 206. Office of Vocational and Adult Education¿ 

Sec. 206. Office of Career, Technical, and Adult Education 
232 

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 

guidance 1

Amount 

in bill 

Committee 

guidance 

Amount 

in bill 

Comparison of amounts in the bill with Committee 

guidance to its subcommittees of amounts for 

2014: Subcommittee on Labor, HHS, Education, and 

Related Agencies: 

Mandatory ............................................................... NA 614,974 NA 2 592,629 

Discretionary ........................................................... 164,330 165,583 NA 2 162,281 

Security .......................................................... .................... .................... NA NA 

Nonsecurity .................................................... 164,330 165,583 NA NA 

Projections of outlays associated with the recommendation: 

2014 ........................................................................ .................... .................... .................... 3 666,735 

2015 ........................................................................ .................... .................... .................... 68,828 

2016 ........................................................................ .................... .................... .................... 17,534 

2017 ........................................................................ .................... .................... .................... 3,113 

2018 and future years ........................................... .................... .................... .................... 648

Financial assistance to State and local governments 

for 

2014 ............................................................................ NA 342,199 NA 315,483 

1 There is no section 302(a) allocation to the Committee on Appropriations for fiscal year 2014. 

2 Includes outlays from prior-year budget authority. 

3 Excludes outlays from prior-year budget authority. 

NA: Not applicable. 
233 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

TITLE I — DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

TRAINING AND EMPLOYMENT SERVICES 

Grants to States: 

Adult Training, current year .............................................................................................................................. 57,269 79,644 79,644 ∂22,375 ............................

Advance from prior year ........................................................................................................................... (712,000 ) (712,000 ) (712,000 ) ............................ ............................Fiscal year 2015 ....................................................................................................................................... 712,000 712,000 712,000 ............................ ............................

Subtotal ................................................................................................................................................ 769,269 791,644 791,644 ∂22,375 ............................

Youth Training ................................................................................................................................................... 822,704 846,632 846,632 ∂23,928 ............................Dislocated Worker Assistance, current year ...................................................................................................... 146,135 185,490 185,490 ∂39,355 ............................

Advance from prior year ........................................................................................................................... (860,000 ) (860,000 ) (860,000 ) ............................ ............................Fiscal year 2015 ....................................................................................................................................... 860,000 860,000 860,000 ............................ ............................

Subtotal ................................................................................................................................................ 1,006,135 1,045,490 1,045,490 ∂39,355 ............................Subtotal, Grants to States ................................................................................................................... 2,598,108 2,683,766 2,683,766 ∂85,658 ............................

Current Year ................................................................................................................................ (1,026,108 ) (1,111,766 ) (1,111,766 ) (∂85,658 ) ............................Fiscal year 2015 ......................................................................................................................... (1,572,000 ) (1,572,000 ) (1,572,000 ) ............................ ............................

Federally Administered Programs: 

Dislocated Worker Assistance National Reserve: 

Current year .............................................................................................................................................. 24,066 20,859 20,859 ¥3,207 ............................Disaster Relief PL 113–2 (Emergency) .................................................................................................... 25,000 ............................ ............................ ¥25,000 ............................Advance from prior year ........................................................................................................................... (199,952 ) (200,000 ) (200,000 ) (∂48 ) ............................Fiscal year 2015 ....................................................................................................................................... 200,000 200,000 200,000 ............................ ............................

Subtotal ................................................................................................................................................ 249,066 220,859 220,859 ¥28,207 ............................Subtotal, Dislocated Worker Assistance .............................................................................................. 1,255,201 1,266,349 1,266,349 ∂11,148 ............................
234 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Native Americans .............................................................................................................................................. 47,467 47,562 47,467 ............................ ¥95 Migrant and Seasonal Farmworker programs ................................................................................................... 84,123 84,291 84,123 ............................ ¥168 Women in Apprenticeship .................................................................................................................................. 994 ............................ 994 ............................ ∂994 YouthBuild activities ......................................................................................................................................... 79,530 79,689 84,530 ∂5,000 ∂4,841 Workforce Innovation Fund ................................................................................................................................ 49,806 150,000 49,806 ............................ ¥100,194 

Subtotal, Federally Administered Programs [FAP] ........................................................................................ 510,986 582,401 487,779 ¥23,207 ¥94,622 

Current Year ......................................................................................................................................... (285,986 ) (382,401 ) (287,779 ) (∂1,793 ) (¥94,622 ) Emergency Appropriations ................................................................................................................... 25,000 ............................ ............................ ¥25,000 ............................Fiscal year 2015 .................................................................................................................................. (200,000 ) (200,000 ) (200,000 ) ............................ ............................

National Activities: 

Pilots, Demonstrations, and Research ..................................................................................................... 6,590 25,000 6,590 ............................ ¥18,410 Reintegration of Ex-Offenders .................................................................................................................. 80,078 90,238 80,078 ............................ ¥10,160 Evaluation ................................................................................................................................................. 9,544 ............................ ............................ ¥9,544 ............................Workforce Data Quality Initiative ............................................................................................................. 6,450 6,000 6,000 ¥450 ............................

Subtotal ................................................................................................................................................ 102,662 121,238 92,668 ¥9,994 ¥28,570 Total, Training and Employment Services [TES] ................................................................................. 3,211,756 3,387,405 3,264,213 ∂52,457 ¥123,192 

Current Year ................................................................................................................................ (1,414,756 ) (1,615,405 ) (1,492,213 ) (∂77,457 ) (¥123,192 ) Emergency appropriations .......................................................................................................... 25,000 ............................ ............................ ¥25,000 ............................Fiscal year 2015 ......................................................................................................................... (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

OFFICE OF JOB CORPS 

Administration ............................................................................................................................................................ 29,019 30,147 30,147 ∂1,128 ............................Operations .................................................................................................................................................................. 1,565,940 1,586,776 1,586,776 ∂20,836 ............................Construction, Rehabilitation and Acquisition ............................................................................................................ 104,582 75,000 90,000 ¥14,582 ∂15,000 

Total, Office of Job Corps ............................................................................................................................. 1,699,541 1,691,923 1,706,923 ∂7,382 ∂15,000 

Current Year ......................................................................................................................................... (1,699,541 ) (1,691,923 ) (1,706,923 ) (∂7,382 ) (∂15,000 ) 
235 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS 1 ................................................................................ 447,355 380,000 447,355 ............................ ∂67,355 FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES ........................................................................................... 797,000 656,000 656,000 ¥141,000 ............................

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT 

SERVICE OPERATIONS 

Unemployment Compensation [UI]: 

State Operations ................................................................................................................................................ 3,158,717 2,881,575 2,931,575 ¥227,142 ∂50,000 Demonstration grants ........................................................................................................................................ ............................ 25,000 25,000 ∂25,000 ............................National Activities ............................................................................................................................................. 11,243 11,297 11,243 ............................ ¥54 

Subtotal, Unemployment Compensation ....................................................................................................... 3,169,960 2,917,872 2,967,818 ¥202,142 ∂49,946 

Employment Service [ES]: 

Allotments to States: 

Federal Funds ........................................................................................................................................... 22,550 22,595 22,550 ............................ ¥45 Trust Funds .............................................................................................................................................. 676,890 708,247 708,247 ∂31,357 ............................

Subtotal ................................................................................................................................................ 699,440 730,842 730,797 ∂31,357 ¥45 

ES National Activities ........................................................................................................................................ 20,871 20,912 20,871 ............................ ¥41 

Subtotal, Employment Service ...................................................................................................................... 720,311 751,754 751,668 ∂31,357 ¥86 

Federal Funds ...................................................................................................................................... (22,550 ) (22,595 ) (22,550 ) ............................ (¥45 ) Trust Funds .......................................................................................................................................... (697,761 ) (729,159 ) (729,118 ) (∂31,357 ) (¥41 ) 

Foreign Labor Certification: 

Federal Administration ...................................................................................................................................... 50,222 50,501 50,222 ............................ ¥279 Grants to States ................................................................................................................................................ 15,040 15,099 15,040 ............................ ¥59 

Subtotal, Foreign Labor Certification ........................................................................................................... 65,262 65,600 65,262 ............................ ¥338 

One-Stop Career Centers/Labor Market Information .................................................................................................. 63,346 90,473 63,346 ............................ ¥27,127 

Total, State UI and ES .................................................................................................................................. 4,018,879 3,825,699 3,848,094 ¥170,785 ∂22,395 

Federal Funds ...................................................................................................................................... (85,896 ) (113,068 ) (85,896 ) ............................ (¥27,172 ) Trust Funds .......................................................................................................................................... (3,932,983 ) (3,712,631 ) (3,762,198 ) (¥170,785 ) (∂49,567 ) 

STATE PAID LEAVE FUND ............................................................................................................................................ ............................ 5,000 5,000 ∂5,000 ............................ADVANCES TO THE UI AND OTHER TRUST FUNDS 2 ................................................................................................... ............................ 600,000 600,000 ∂600,000 ............................

PROGRAM ADMINISTRATION 

Adult Employment and Training ................................................................................................................................ 46,583 ............................ ............................ ¥46,583 ............................
236 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Trust Funds ....................................................................................................................................................... 8,503 ............................ ............................ ¥8,503 ............................

Youth Employment and Training ................................................................................................................................ 12,235 ............................ ............................ ¥12,235 ............................Training and Employment .......................................................................................................................................... ............................ 60,325 60,325 ∂60,325 ............................

Trust Funds ....................................................................................................................................................... ............................ 8,639 8,639 ∂8,639 ............................

Employment Security .................................................................................................................................................. 3,469 3,522 3,522 ∂53 ............................

Trust Funds ....................................................................................................................................................... 39,264 39,856 39,856 ∂592 ............................

Apprenticeship Services ............................................................................................................................................. 27,620 28,015 30,000 ∂2,380 ∂1,985 Executive Direction ..................................................................................................................................................... 7,034 7,147 7,147 ∂113 ............................

Trust Funds ....................................................................................................................................................... 2,079 2,113 2,113 ∂34 ............................

Total, Program Administration ...................................................................................................................... 146,787 149,617 151,602 ∂4,815 ∂1,985 

Federal Funds ...................................................................................................................................... (96,941 ) (99,009 ) (100,994 ) (∂4,053 ) (∂1,985 ) Trust Funds .......................................................................................................................................... (49,846 ) (50,608 ) (50,608 ) (∂762 ) ............................

Total, Employment and Training Admin. [ETA] ............................................................................................ 10,321,318 10,695,644 10,679,187 ∂357,869 ¥16,457 

Federal Funds ...................................................................................................................................... 6,338,489 6,932,405 6,866,381 ∂527,892 ¥66,024 

Current Year ................................................................................................................................ (4,541,489 ) (5,160,405 ) (5,094,381 ) (∂552,892 ) (¥66,024 ) Emergency appropriations .......................................................................................................... 25,000 ............................ ............................ ¥25,000 ............................Fiscal year 2015 ......................................................................................................................... (1,772,000 ) (1,772,000 ) (1,772,000 ) ............................ ............................

Trust Funds .......................................................................................................................................... 3,982,829 3,763,239 3,812,806 ¥170,023 ∂49,567 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION [EBSA] 

SALARIES AND EXPENSES 

Enforcement and Participant Assistance ................................................................................................................... 142,400 146,032 143,400 ∂1,000 ¥2,632 Policy and Compliance Assistance ............................................................................................................................ 33,695 26,329 26,329 ¥7,366 ............................Executive Leadership, Program Oversight and Admin ............................................................................................... 6,692 6,743 6,743 ∂51 ............................

Total, EBSA ................................................................................................................................................... 182,787 179,104 176,472 ¥6,315 ¥2,632 
237 

PENSION BENEFIT GUARANTY CORPORATION (PBGC) 

Pension Insurance Activities ...................................................................................................................................... (87,532 ) (80,000 ) (80,000 ) (¥7,532 ) ............................Pension Plan Termination .......................................................................................................................................... (238,128 ) (268,230 ) (268,230 ) (∂30,102 ) ............................Operational Support ................................................................................................................................................... (151,241 ) (157,211 ) (157,211 ) (∂5,970 ) ............................

Total, PBGC (program level) ......................................................................................................................... (476,901 ) (505,441 ) (505,441 ) (∂28,540 ) ............................

Enforcement of Wage & Hour Standards ................................................................................................................... 226,607 243,254 243,254 ∂16,647 ............................Office of Labor-Management Standards .................................................................................................................... 41,206 46,891 41,206 ............................ ¥5,685 Federal Contractor EEO Standards Enforcement ....................................................................................................... 104,976 108,467 106,000 ∂1,024 ¥2,467 

FEDERAL PROGRAMS FOR WORKERS’ COMPENSATION 

Salaries and Expenses ............................................................................................................................................... 115,488 118,458 115,488 ............................ ¥2,970 

Trust Funds ....................................................................................................................................................... 2,116 2,142 2,116 ............................ ¥26 

Total, Salaries and Expenses ....................................................................................................................... 117,604 120,600 117,604 ............................ ¥2,996 

Federal Funds ...................................................................................................................................... (115,488 ) (118,458 ) (115,488 ) ............................ (¥2,970 ) Trust Funds .......................................................................................................................................... (2,116 ) (2,142 ) (2,116 ) ............................ (¥26 ) 

SPECIAL BENEFITS 

Federal Employees’ Compensation Benefits .............................................................................................................. 347,000 393,000 393,000 ∂46,000 ............................Longshore and Harbor Workers’ Benefits ................................................................................................................... 3,000 3,000 3,000 ............................ ............................

Total, Special Benefits .................................................................................................................................. 350,000 396,000 396,000 ∂46,000 ............................

SPECIAL BENEFITS FOR DISABLED COAL MINERS 

Benefit Payments ....................................................................................................................................................... 177,000 128,000 128,000 ¥49,000 ............................Administration ............................................................................................................................................................ 5,227 5,235 5,235 ∂8 ............................

Subtotal, Fiscal year 2014 program level .................................................................................................... 182,227 133,235 133,235 ¥48,992 ............................

Less funds advanced in prior year ..................................................................................................... ¥41,000 ¥35,000 ¥35,000 ∂6,000 ............................

Total, Current Year, Fiscal Year 2014 .......................................................................................................... 141,227 98,235 98,235 ¥42,992 ............................New advances, 1st quarter fiscal year 2015 ............................................................................................... 40,000 24,000 24,000 ¥16,000 ............................Total, Special Benefits for Disabled Coal Miners ........................................................................................ 181,227 122,235 122,235 ¥58,992 ............................

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS 

COMPENSATION FUND 

Part B Administrative Expenses ................................................................................................................................. 52,147 55,176 55,176 ∂3,029 ............................
238 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

BLACK LUNG DISABILITY TRUST FUND 

Benefit Payments and Interest on Advances ............................................................................................................. 242,200 257,478 257,478 ∂15,278 ............................Workers’ Compensation Programs, Salaries and Expenses ....................................................................................... 32,906 33,033 33,033 ∂127 ............................Departmental Management, Salaries and Expenses ................................................................................................. 25,217 25,365 25,365 ∂148 ............................Departmental Management, Inspector General ......................................................................................................... 327 327 327 ............................ ............................

Subtotal, Black Lung Disability .................................................................................................................... 300,650 316,203 316,203 ∂15,553 ............................

Treasury Department Administrative Costs ............................................................................................................... 356 356 356 ............................ ............................

Total, Black Lung Disability Trust Fund ....................................................................................................... 301,006 316,559 316,559 ∂15,553 ............................Total, Federal Programs for Workers’ Compensation ................................................................................... 1,001,984 1,010,570 1,007,574 ∂5,590 ¥2,996 

Federal Funds ...................................................................................................................................... 999,868 1,008,428 1,005,458 ∂5,590 ¥2,970 

Current year ................................................................................................................................ (959,868 ) (984,428 ) (981,458 ) (∂21,590 ) (¥2,970 ) Fiscal year 2015 ......................................................................................................................... (40,000 ) (24,000 ) (24,000 ) (¥16,000 ) ............................

Trust Funds .......................................................................................................................................... 2,116 2,142 2,116 ............................ ¥26 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) 

SALARIES AND EXPENSES 

Safety and Health Standards ..................................................................................................................................... 19,922 22,071 21,000 ∂1,078 ¥1,071 Federal Enforcement ................................................................................................................................................... 207,337 207,785 207,785 ∂448 ............................Whistleblower enforcement ......................................................................................................................................... 15,841 21,883 21,883 ∂6,042 ............................State Programs ........................................................................................................................................................... 103,987 104,196 103,987 ............................ ¥209 Technical Support ....................................................................................................................................................... 25,768 24,767 24,767 ¥1,001 ............................Compliance Assistance: 

Federal Assistance ............................................................................................................................................ 76,203 75,294 75,294 ¥909 ............................State Consultation Grants ................................................................................................................................. 57,775 57,890 57,775 ............................ ¥115 Training Grants ................................................................................................................................................. 10,687 10,709 10,709 ∂22 ............................
239 

Subtotal, Compliance Assistance ................................................................................................................. 144,665 143,893 143,778 ¥887 ¥115 

Safety and Health Statistics ...................................................................................................................................... 34,670 34,349 32,922 ¥1,748 ¥1,427 Executive Direction and Administration ..................................................................................................................... 11,468 11,575 10,890 ¥578 ¥685 

Total, OSHA ................................................................................................................................................... 563,658 570,519 567,012 ∂3,354 ¥3,507 

MINE SAFETY AND HEALTH ADMINISTRATION 

SALARIES AND EXPENSES 

Coal Enforcement ....................................................................................................................................................... 163,572 168,871 168,871 ∂5,299 ............................Metal/Non-Metal Enforcement .................................................................................................................................... 88,486 92,870 92,870 ∂4,384 ............................Standards Development ............................................................................................................................................. 4,456 5,619 5,619 ∂1,163 ............................Assessments ............................................................................................................................................................... 7,088 8,358 8,358 ∂1,270 ............................Educational Policy and Development ......................................................................................................................... 38,249 29,230 29,230 ¥9,019 ............................Technical Support ....................................................................................................................................................... 33,546 34,113 34,113 ∂567 ............................Program Evaluation and Information Resources [PEIR] ............................................................................................ 18,120 20,268 20,268 ∂2,148 ............................Program Administration ............................................................................................................................................. 19,030 21,392 21,392 ∂2,362 ............................

Total, Mine Safety and Health Administration ............................................................................................. 372,547 380,721 380,721 ∂8,174 ............................Total, Worker Protection Agencies ................................................................................................................ 1,609,385 1,649,556 1,632,269 ∂22,884 ¥17,287 

Federal Funds ...................................................................................................................................... (1,607,269 ) (1,647,414 ) (1,630,153 ) (∂22,884 ) (¥17,261 ) Trust Funds .......................................................................................................................................... (2,116 ) (2,142 ) (2,116 ) ............................ (¥26 ) 

BUREAU OF LABOR STATISTICS 

SALARIES AND EXPENSES 

Employment and Unemployment Statistics ............................................................................................................... 209,854 209,481 210,854 ∂1,000 ∂1,373 Labor Market Information ........................................................................................................................................... 67,041 67,176 67,041 ............................ ¥135 Prices and Cost of Living .......................................................................................................................................... 204,612 209,699 205,612 ∂1,000 ¥4,087 Compensation and Working Conditions ..................................................................................................................... 80,105 82,128 80,105 ............................ ¥2,023 Productivity and Technology ....................................................................................................................................... 12,031 10,313 12,031 ............................ ∂1,718 Executive Direction and Staff Services ...................................................................................................................... 34,209 34,997 34,209 ............................ ¥788 

Total, Bureau of Labor Statistics ................................................................................................................. 607,852 613,794 609,852 ∂2,000 ¥3,942 

Federal Funds ...................................................................................................................................... 540,811 546,618 542,811 ∂2,000 ¥3,807 Trust Funds .......................................................................................................................................... 67,041 67,176 67,041 ............................ ¥135 

OFFICE OF DISABILITY EMPLOYMENT POLICY 

SALARIES AND EXPENSES ........................................................................................................................................... 38,802 42,432 42,432 ∂3,630 ............................
240 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

DEPARTMENTAL MANAGEMENT 

SALARIES AND EXPENSES 

Executive Direction ..................................................................................................................................................... 33,154 31,812 31,812 ¥1,342 ............................Departmental Program Evaluation ............................................................................................................................. 8,467 9,000 8,467 ............................ ¥533 Legal Services ............................................................................................................................................................ 128,619 127,684 127,684 ¥935 ............................

Trust Funds ....................................................................................................................................................... 325 326 326 ∂1 ............................

International Labor Affairs ......................................................................................................................................... 92,125 95,425 95,425 ∂3,300 ............................Administration and Management ............................................................................................................................... 30,221 30,435 30,221 ............................ ¥214 Adjudication ................................................................................................................................................................ 29,113 30,352 29,113 ............................ ¥1,239 Women’s Bureau ......................................................................................................................................................... 11,536 9,214 11,536 ............................ ∂2,322 Civil Rights Activities ................................................................................................................................................. 6,772 8,268 6,772 ............................ ¥1,496 Chief Financial Officer ............................................................................................................................................... 5,329 5,440 5,329 ............................ ¥111 

Total, Salaries and expenses ........................................................................................................................ 345,661 347,956 346,685 ∂1,024 ¥1,271 

Federal Funds ...................................................................................................................................... (345,336 ) (347,630 ) (346,359 ) (∂1,023 ) (¥1,271 ) Trust Funds .......................................................................................................................................... (325 ) (326 ) (326 ) (∂1 ) ............................

VETERANS EMPLOYMENT AND TRAINING 

State Administration, Grants ..................................................................................................................................... 169,852 203,081 203,081 ∂33,229 ............................Transition Assistance Program .................................................................................................................................. 14,242 14,000 14,000 ¥242 ............................Federal Administration ............................................................................................................................................... 38,245 41,838 41,838 ∂3,593 ............................National Veterans Training Institute .......................................................................................................................... 3,459 3,414 3,414 ¥45 ............................Homeless Veterans Program ...................................................................................................................................... 38,109 38,185 38,185 ∂76 ............................Veterans Workforce Investment Programs ................................................................................................................. ............................ ............................ ............................ ............................ ............................

Total, Veterans Employment and Training ................................................................................................... 263,907 300,518 300,518 ∂36,611 ............................

Federal Funds ...................................................................................................................................... 38,109 38,185 38,185 ∂76 ............................Trust Funds .......................................................................................................................................... 225,798 262,333 262,333 ∂36,535 ............................
241 

INFRASTRUCTURE TECHNOLOGY MODERNIZATION 

Departmental support systems .................................................................................................................................. 11,806 4,898 4,898 ¥6,908 ............................Infrastructure technology modernization .................................................................................................................... 7,969 15,689 14,877 ∂6,908 ¥812 

Total, IT Modernization ................................................................................................................................. 19,775 20,587 19,775 ............................ ¥812 

OFFICE OF INSPECTOR GENERAL 

Program Activities ...................................................................................................................................................... 77,634 79,805 77,634 ............................ ¥2,171 

Trust Funds ....................................................................................................................................................... 5,886 5,909 5,886 ............................ ¥23 

Total, Office of Inspector General ................................................................................................................ 83,520 85,714 83,520 ............................ ¥2,194 Total, Departmental Management ................................................................................................................ 712,863 754,775 750,498 ∂37,635 ¥4,277 

Federal Funds ...................................................................................................................................... 480,854 486,207 481,953 ∂1,099 ¥4,254 

Current Year ................................................................................................................................ (480,854 ) (486,207 ) (481,953 ) (∂1,099 ) (¥4,254 ) 

Trust Funds .......................................................................................................................................... 232,009 268,568 268,545 ∂36,536 ¥23 

Total, Title I, Department of Labor ................................................................................................. 14,174,600 14,646,171 14,604,208 ∂429,608 ¥41,963 

Federal Funds ......................................................................................................................... 9,890,605 10,545,046 10,453,700 ∂563,095 ¥91,346 

Current Year .................................................................................................................. (8,053,605 ) (8,749,046 ) (8,657,700 ) (∂604,095 ) (¥91,346 ) Emergency appropriations ............................................................................................. 25,000 ............................ ............................ ¥25,000 ............................Fiscal year 2015 ............................................................................................................ (1,812,000 ) (1,796,000 ) (1,796,000 ) (¥16,000 ) ............................

Trust Funds ............................................................................................................................ 4,283,995 4,101,125 4,150,508 ¥133,487 ∂49,383 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION [HRSA] 

HEALTH RESOURCES AND SERVICES 

Primary Health Care 

Community Health Centers ........................................................................................................................................ 1,574,606 1,566,892 1,574,606 ............................ ∂7,714 Free Clinics Medical Malpractice ............................................................................................................................... 40 40 40 ............................ ............................

Subtotal, Primary Health Care ...................................................................................................................... 1,574,646 1,566,932 1,574,646 ............................ ∂7,714 

Bureau of Health Professions [BHP] 

Health Workforce 

Health Professions, Training for Diversity: 

Centers of Excellence ........................................................................................................................................ 22,863 22,909 22,863 ............................ ¥46 
242 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Health Careers Opportunity Program ................................................................................................................ 14,942 ............................ 14,942 ............................ ∂14,942 Faculty Loan Repayment ................................................................................................................................... 1,253 1,243 1,253 ............................ ∂10 Scholarships for Disadvantaged Students ........................................................................................................ 47,357 47,452 47,357 ............................ ¥95 

Subtotal, Training for Diversity .................................................................................................................... 86,415 71,604 86,415 ............................ ∂14,811 

Training in Primary Care Medicine ............................................................................................................................ 38,884 50,962 50,962 ∂12,078 ............................Pediatric Loan Repayment ......................................................................................................................................... ............................ 5,000 5,000 ∂5,000 ............................Oral Health Training ................................................................................................................................................... 32,654 32,392 32,654 ............................ ∂262 Interdisciplinary Community-Based Linkages: 

Area Health Education Centers ......................................................................................................................... 30,025 ............................ 30,025 ............................ ∂30,025 Geriatric Programs ............................................................................................................................................ 30,877 30,629 30,629 ¥248 ............................Alzheimer’s—Prevention and Public Health Fund 3 ......................................................................................... (1,847 ) (5,300 ) (5,300 ) (∂3,453 ) ............................Mental and Behavorial Health .......................................................................................................................... 2,916 2,892 3,916 ∂1,000 ∂1,024 

Subtotal, Interdisciplinary Community Linkages .......................................................................................... 63,818 33,521 64,570 ∂752 ∂31,049 

Evaluation Tap Funding ....................................................................................................................... ............................ ............................ ............................ ............................ ............................Prevention and Public Health Fund 3 .................................................................................................. 1,847 5,300 5,300 ∂3,453 ............................

Total, Interdisciplinary Community Linkages .................................................................................. 65,665 38,821 69,870 ∂4,205 ∂31,049 

Workforce Information and Analysis .......................................................................................................................... 2,804 5,000 5,000 ∂2,196 ............................Public Health and Preventive Medicine programs ..................................................................................................... 8,177 3,226 10,177 ∂2,000 ∂6,951 

Prevention and Public Health Fund 3 ................................................................................................................ ............................ (4,776 ) (25,000 ) (∂25,000 ) (∂20,224 ) 

Subtotal, Public Health and Preventive Medicine ........................................................................................ 8,177 8,002 35,177 ∂27,000 ∂27,175 

Nursing Programs: 

Advanced Education Nursing ............................................................................................................................ 63,797 83,469 83,469 ∂19,672 ............................Nurse Education, Practice, and Retention ........................................................................................................ 39,499 39,638 39,638 ∂139 ............................Nursing Workforce Diversity .............................................................................................................................. 15,947 15,819 15,819 ¥128 ............................
243 

Loan Repayment and Scholarship Program ...................................................................................................... 82,968 83,135 83,135 ∂167 ............................Comprehensive Geriatric Education .................................................................................................................. 4,521 4,485 4,485 ¥36 ............................Nursing Faculty Loan Program .......................................................................................................................... 24,751 24,553 24,553 ¥198 ............................

Subtotal, Nursing programs ......................................................................................................................... 231,483 251,099 251,099 ∂19,616 ............................

Children’s Hospitals Graduate Medical Education .................................................................................................... 267,313 88,000 267,313 ............................ ∂179,313 National Practitioner Data Bank ................................................................................................................................ 28,016 28,016 28,016 ............................ ............................

User Fees ........................................................................................................................................................... ¥28,016 ¥28,016 ¥28,016 ............................ ............................

Subtotal, Bureau of Health Professions ....................................................................................................... 731,548 540,804 773,190 ∂41,642 ∂232,386 

Prevention and Public Health Fund ..................................................................................................... (1,847 ) (10,076 ) (30,300 ) (∂28,453 ) (∂20,224 ) 

Total, Health Professions Program Level ...................................................................................................... 733,395 550,880 803,490 ∂70,095 ∂252,610 

Maternal and Child Health 

Maternal and Child Health Block Grant .................................................................................................................... 643,807 638,646 643,807 ............................ ∂5,161 Sickle Cell Anemia Demonstration Program .............................................................................................................. 4,703 4,665 4,670 ¥33 ∂5 Traumatic Brain Injury ............................................................................................................................................... 9,840 9,760 9,760 ¥80 ............................Autism and Other Developmental Disorders .............................................................................................................. 47,523 47,142 47,142 ¥381 ............................Heritable Disorders ..................................................................................................................................................... 9,913 ............................ 9,913 ............................ ∂9,913 Heritable Disorders-Prevention and Public Health Fund ........................................................................................... ............................ (9,834 ) ............................ ............................ (¥9,834 ) Healthy Start .............................................................................................................................................................. 104,369 103,532 103,532 ¥837 ............................Universal Newborn Hearing ........................................................................................................................................ 18,811 ............................ 18,660 ¥151 ∂18,660 Universal Newborn Hearing—Prevention and Public Health Fund ........................................................................... ............................ (18,660 ) ............................ ............................ (¥18,660 ) Emergency Medical Services for Children .................................................................................................................. 21,286 21,116 21,116 ¥170 ............................

Subtotal, Maternal and Child Health ........................................................................................................... 860,252 824,861 858,600 ¥1,652 ∂33,739 

Prevention and Public Health Fund ..................................................................................................... ............................ (28,494 ) ............................ ............................ (¥28,494 ) 

Total, Maternal and Child Health Program Level ........................................................................................ 860,252 853,355 858,600 ¥1,652 ∂5,245 

Ryan White HIV/AIDS Program 

Ryan White AIDS Programs: 

Emergency Assistance ....................................................................................................................................... 669,915 666,071 669,915 ............................ ∂3,844 Comprehensive Care Programs ......................................................................................................................... 1,317,999 1,370,827 1,369,327 ∂51,328 ¥1,500 

AIDS Drug Assistance Program [ADAP] (NA) ........................................................................................... (896,502 ) (943,299 ) (943,299 ) (∂46,797 ) ............................

Early Intervention Program ................................................................................................................................ 204,765 225,086 204,765 ............................ ¥20,321 Children, Youth, Women, and Families ............................................................................................................. 77,013 77,167 77,013 ............................ ¥154 AIDS Dental Services ......................................................................................................................................... 13,458 13,485 13,458 ............................ ¥27 
244 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Education and Training Centers ....................................................................................................................... 34,473 34,542 34,473 ............................ ¥69 

Subtotal, Ryan White AIDS programs ........................................................................................................... 2,317,623 2,387,178 2,368,951 ∂51,328 ¥18,227 

Evaluation Tap Funding (NA) .............................................................................................................. (25,000 ) (25,000 ) (25,000 ) ............................ ............................

Total, Ryan White AIDs Program Level ......................................................................................................... (2,342,623 ) (2,412,178 ) (2,393,951 ) (∂51,328 ) (¥18,227 ) 

Health Care Systems 

Organ Transplantation ............................................................................................................................................... 24,799 26,015 26,015 ∂1,216 ............................National Cord Blood Inventory ................................................................................................................................... 11,864 11,887 11,864 ............................ ¥23 Bone Marrow Program ................................................................................................................................................ 23,283 23,330 23,283 ............................ ¥47 Office of Pharmacy Affairs ......................................................................................................................................... 4,463 4,472 4,463 ............................ ¥9 340B Drug Pricing User Fees ..................................................................................................................................... ............................ 6,000 6,000 ∂6,000 ............................

User Fees ........................................................................................................................................................... ............................ ¥6,000 ¥6,000 ¥6,000 ............................

Poison Control ............................................................................................................................................................ 18,793 ............................ 19,793 ∂1,000 ∂19,793 Poison control-Prevention and Public Health Fund 3 ................................................................................................. ............................ (18,830 ) ............................ ............................ (¥18,830 ) Hansen’s Disease Services ......................................................................................................................................... 16,013 16,045 16,013 ............................ ¥32 Buildings and Facilities ............................................................................................................................................. 128 127 128 ............................ ∂1 Payment to Hawaii, treatment of Hansen’s ............................................................................................................... 1,956 1,960 1,956 ............................ ¥4 

Subtotal, Health Care Systems ..................................................................................................................... 101,299 83,836 103,515 ∂2,216 ∂19,679 

Prevention and Public Health Fund ..................................................................................................... ............................ (18,830 ) ............................ ............................ (¥18,830 ) 

Total, Health Care Systems Program Level .................................................................................................. 101,299 102,666 103,515 ∂2,216 ∂849 

Rural Health 

Rural Outreach Grants ............................................................................................................................................... 55,442 55,553 55,442 ............................ ¥111 Rural Health Research/Policy Development ............................................................................................................... 9,847 9,866 9,847 ............................ ¥19 Rural Hospital Flexibility Grants ................................................................................................................................ 40,958 26,200 40,958 ............................ ∂14,758 Rural and Community Access to Emergency Devices ............................................................................................... 2,490 ............................ 5,000 ∂2,510 ∂5,000 State Offices of Rural Health .................................................................................................................................... 10,016 10,036 10,016 ............................ ¥20 
245 

Black Lung Clinics ..................................................................................................................................................... 7,125 7,140 7,125 ............................ ¥15 Radiation Exposure Screening and Education Program ............................................................................................ 1,931 1,935 1,931 ............................ ¥4 Telehealth ................................................................................................................................................................... 11,479 11,502 11,479 ............................ ¥23 

Subtotal, Rural Health .................................................................................................................................. 139,288 122,232 141,798 ∂2,510 ∂19,566 

Family Planning .......................................................................................................................................................... 296,244 327,402 327,402 ∂31,158 ............................Program Management ................................................................................................................................................ 161,186 161,794 161,794 ∂608 ............................

Total, Health resources & services appropriation ........................................................................................ (6,182,086 ) (6,015,039 ) (6,309,896 ) (∂127,810 ) (∂294,857 ) 

HEALTH EDUCATION ASSISTANCE LOANS PROGRAM ACCOUNT 

HEAL Liquidating Account .......................................................................................................................................... (1,000 ) (1,000 ) (1,000 ) ............................ ............................HEAL Program Management ....................................................................................................................................... 2,830 2,807 2,807 ¥23 ............................

Total, HEAL .................................................................................................................................................... 2,830 2,807 2,807 ¥23 ............................

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND 

Post-Fiscal Year 1988 Claims ................................................................................................................................... 235,000 235,000 235,000 ............................ ............................HRSA Administration .................................................................................................................................................. 6,464 6,477 6,464 ............................ ¥13 

Total, Vaccine Injury Compensation Trust Fund .......................................................................................... 241,464 241,477 241,464 ............................ ¥13 Total, Health Resources & Services Administration ..................................................................................... 6,426,380 6,259,323 6,554,167 ∂127,787 ∂294,844 

Evaluation tap funding ........................................................................................................................ (25,000 ) (25,000 ) (25,000 ) ............................ ............................Prevention and Public Health Fund 3 .................................................................................................. (1,847 ) (57,400 ) (30,300 ) (∂28,453 ) (¥27,100 ) 

Total, HRSA program level ............................................................................................................................ (6,453,227 ) (6,341,723 ) (6,609,467 ) (∂156,240 ) (∂267,744 ) 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

DISEASE CONTROL, RESEARCH, AND TRAINING 

Immunization and Respiratory Diseases .................................................................................................................... 575,095 668,696 575,095 ............................ ¥93,601 

Evaluation Tap Funding .................................................................................................................................... (12,864 ) (12,864 ) (12,864 ) ............................ ............................Pandemic Flu balances (Public Law 111–32) .................................................................................................. (11,829 ) ............................ ............................ (¥11,829 ) ............................Prevention and Public Health Fund 3 ................................................................................................................ (90,883 ) (72,460 ) (150,000 ) (∂59,117 ) (∂77,540 ) 

Subtotal ......................................................................................................................................................... (690,671 ) (754,020 ) (737,959 ) (∂47,288 ) (¥16,061 ) 

HIV/AIDS, Viral Hepatitis, STD, and TB Prevention .................................................................................................... 1,097,823 1,173,942 1,097,823 ............................ ¥76,119 

Evaluation Tap Funding .................................................................................................................................... ............................ (3,000 ) ............................ ............................ (¥3,000 ) 
246 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Prevention and Public Health Fund 3 ................................................................................................................ ............................ ............................ (10,000 ) (∂10,000 ) (∂10,000 ) 

Subtotal, HIV/AIDS, Viral Hepathitis, STD & TB ........................................................................................... 1,097,823 1,176,942 1,107,823 ∂10,000 ¥69,119 

Emerging and Zoonotic Infectious Diseases .............................................................................................................. 252,043 380,664 283,237 ∂31,194 ¥97,427 

Prevention and Public Health Fund 3 ................................................................................................................ (44,174 ) (51,750 ) (52,000 ) (∂7,826 ) (∂250 ) 

Subtotal, Emerging and Zoonotic Infectious ................................................................................................ 296,217 432,414 335,237 ∂39,020 ¥97,177 

Chronic Disease Prevention and Health Promotion ................................................................................................... 755,079 620,189 774,831 ∂19,752 ∂154,642 

Evaluation Tap Funding .................................................................................................................................... ............................ ............................ ............................ ............................ ............................Prevention and Public Health Fund 3 ................................................................................................................ (233,033 ) (415,904 ) (485,700 ) (∂252,667 ) (∂69,796 ) 

Subtotal, Chronic Disiease Prevention ......................................................................................................... (988,112 ) (1,036,093 ) (1,260,531 ) (∂272,419 ) (∂224,438 ) 

Birth Defects and Developmental Disabilities ........................................................................................................... 137,051 67,148 123,483 ¥13,568 ∂56,335 

Prevention and Public Health Fund 3 ................................................................................................................ ............................ (74,796 ) ............................ ............................ (¥74,796 ) 

Subtotal, Birth Defects ................................................................................................................................. (137,051 ) (141,944 ) (123,483 ) (¥13,568 ) (¥18,461 ) 

Public Health Scientific Services ............................................................................................................................... 143,726 144,416 143,726 ............................ ¥690 

Evaluation Tap Funding .................................................................................................................................... (247,769 ) (324,889 ) (247,769 ) ............................ (¥77,120 ) Prevention and Public Health Fund 3 ................................................................................................................ (51,501 ) (70,000 ) (58,100 ) (∂6,599 ) (¥11,900 ) 

Subtotal ......................................................................................................................................................... (442,996 ) (539,305 ) (449,595 ) (∂6,599 ) (¥89,710 ) 

Environmental Health ................................................................................................................................................. 104,819 126,126 113,827 ∂9,008 ¥12,299 

Prevention and Public Health Fund 3 ................................................................................................................ (20,740 ) (29,000 ) (39,200 ) (∂18,460 ) (∂10,200 ) 

Subtotal ......................................................................................................................................................... (125,559 ) (155,126 ) (153,027 ) (∂27,468 ) (¥2,099 ) 

Injury Prevention and Control .................................................................................................................................... 137,456 176,585 162,456 ∂25,000 ¥14,129 

Prevention and Public Health Fund 3 ................................................................................................................ ............................ ............................ (3,000 ) (∂3,000 ) (∂3,000 ) 
247 

Evaluation Tap Funding .................................................................................................................................... ............................ (5,000 ) ............................ ............................ (¥5,000 ) 

Subtotal ......................................................................................................................................................... (137,456 ) (181,585 ) (165,456 ) (∂28,000 ) (¥16,129 ) 

National Institute for Occupational Safety & Health 3 .............................................................................................. 181,551 ............................ 181,551 ............................ ∂181,551 

Evaluation Tap Funding .................................................................................................................................... (110,724 ) (271,911 ) (110,724 ) ............................ (¥161,187 ) 

Subtotal ......................................................................................................................................................... (292,275 ) (271,911 ) (292,275 ) ............................ (∂20,364 ) 

Energy Employees Occupational Illness Compensation Program .............................................................................. 55,358 55,358 55,358 ............................ ............................Global Health .............................................................................................................................................................. 346,964 393,024 391,964 ∂45,000 ¥1,060 Public Health Preparedness and Response ............................................................................................................... 1,297,248 1,334,316 1,292,498 ¥4,750 ¥41,818 

Subtotal ......................................................................................................................................................... 1,297,248 1,334,316 1,292,498 ¥4,750 ¥41,818 

CDC-Wide Activities .................................................................................................................................................... 616,854 131,402 616,563 ¥291 ∂485,161 

Prevention and Public Health Fund 3 ................................................................................................................ (22,585 ) (41,200 ) (41,000 ) (∂18,415 ) (¥200 ) 

Subtotal, CDC-Wide Activities ...................................................................................................................... (639,439 ) (172,602 ) (657,563 ) (∂18,124 ) (∂484,961 ) Total, Centers for Disease Control ............................................................................................................... 5,701,067 5,271,866 5,812,412 ∂111,345 ∂540,546 

Discretionary ........................................................................................................................................ 5,645,709 5,216,508 5,757,054 ∂111,345 ∂540,546 Evaluation Tap Funding (NA) .............................................................................................................. (371,357 ) (617,664 ) (371,357 ) ............................ (¥246,307 ) Pandemic Flu balances (Public Law 111–32) .................................................................................... (11,829 ) ............................ ............................ (¥11,829 ) ............................Prevention and Public Health Fund 3 .................................................................................................. (462,916 ) (755,110 ) (839,000 ) (∂376,084 ) (∂83,890 ) 

Total, Centers for Disease Control Program Level ....................................................................................... (6,547,169 ) (6,644,640 ) (7,022,769 ) (∂475,600 ) (∂378,129 ) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute ........................................................................................................................................... 5,062,039 5,125,951 5,091,885 ∂29,846 ¥34,066 National Heart, Lung, and Blood Institute ................................................................................................................ 3,072,863 3,098,508 3,077,916 ∂5,053 ¥20,592 National Institute of Dental & Craniofacial Research .............................................................................................. 409,889 411,515 409,947 ∂58 ¥1,568 National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] ............................................................ 1,793,450 1,811,786 1,799,745 ∂6,295 ¥12,041 National Institute of Neurological Disorders & Stroke .............................................................................................. 1,623,113 1,642,619 1,631,703 ∂8,590 ¥10,916 National Institute of Allergy and Infectious Diseases ............................................................................................... 4,481,730 4,578,813 4,548,383 ∂66,653 ¥30,430 

Global HIV/AIDS Fund Transfer ......................................................................................................................... ............................ ............................ ............................ ............................ ............................

Subtotal, NIAID program level ...................................................................................................................... 4,481,730 4,578,813 4,548,383 ∂66,653 ¥30,430 

National Institute of General Medical Sciences ........................................................................................................ 2,425,175 2,401,011 2,435,570 ∂10,395 ∂34,559 National Institute of Child Health & Human Development ....................................................................................... 1,318,755 1,339,360 1,330,459 ∂11,704 ¥8,901 National Eye Institute ................................................................................................................................................. 701,307 699,216 701,407 ∂100 ∂2,191 
248 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

National Institute of Environmental Health Sciences ................................................................................................ 684,200 691,348 686,753 ∂2,553 ¥4,595 National Institute on Aging ........................................................................................................................................ 1,101,234 1,193,370 1,185,439 ∂84,205 ¥7,931 National Institute of Arthritis and Musculoskeletal and Skin Diseases ................................................................... 534,715 540,993 537,398 ∂2,683 ¥3,595 National Institute on Deafness and Other Communication Disorders ...................................................................... 415,440 422,936 420,125 ∂4,685 ¥2,811 National Institute of Nursing Research ..................................................................................................................... 144,479 146,244 145,272 ∂793 ¥972 National Institute on Alcohol Abuse and Alcoholism ................................................................................................ 458,600 463,848 460,765 ∂2,165 ¥3,083 National Institute on Drug Abuse .............................................................................................................................. 1,051,261 1,071,612 1,064,490 ∂13,229 ¥7,122 National Institute of Mental Health ........................................................................................................................... 1,477,304 1,465,782 1,456,041 ¥21,263 ¥9,741 National Human Genome Research Institute ............................................................................................................. 511,847 517,319 513,881 ∂2,034 ¥3,438 National Institute of Biomedical Imaging and Bioengineering ................................................................................. 337,681 338,892 337,728 ∂47 ¥1,164 National Center for Complementary and Alternative Medicine ................................................................................. 127,800 129,041 128,183 ∂383 ¥858 National Institute on Minority Health and Health Disparities ................................................................................... 275,887 283,299 281,416 ∂5,529 ¥1,883 John E. Fogarty International Center ......................................................................................................................... 69,483 72,864 72,380 ∂2,897 ¥484 National Center for Advancing Translation Sciences ................................................................................................ 574,216 665,688 661,264 ∂87,048 ¥4,424 National Library of Medicine (NLM) ........................................................................................................................... 336,963 382,252 379,712 ∂42,749 ¥2,540 

Evaluation Tap Funding .................................................................................................................................... (8,200 ) (8,200 ) (8,200 ) ............................ ............................

Subtotal ......................................................................................................................................................... 345,163 390,452 387,912 ∂42,749 ¥2,540 

Office of the Director ................................................................................................................................................. 1,525,125 1,473,398 1,463,606 ¥61,519 ¥9,792 

Common fund .................................................................................................................................................... (544,870 ) (572,948 ) (568,151 ) (∂23,281 ) (¥4,797 ) 

Buildings and Facilities ............................................................................................................................................. 125,093 126,111 125,308 ∂215 ¥803 

Total, National Institutes of Health (NIH) .................................................................................................... 30,639,649 31,093,776 30,946,776 ∂307,127 ¥147,000 

Evaluation Tap Funding ....................................................................................................................... (8,200 ) (8,200 ) (8,200 ) ............................ ............................

Total, NIH Program Level .............................................................................................................................. (30,647,849 ) (31,101,976 ) (30,954,976 ) (∂307,127 ) (¥147,000 ) 
249 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION [SAMHSA] 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

Mental Health: 

Programs of Regional and National Significance ............................................................................................ 275,205 333,277 357,191 ∂81,986 ∂23,914 Prevention and Public Health Fund 3 ................................................................................................................ ............................ (28,000 ) (27,000 ) (∂27,000 ) (¥1,000 ) 

Subtotal, PRNS .............................................................................................................................................. (275,205 ) (361,277 ) (384,191 ) (∂108,986 ) (∂22,914 ) 

Mental Health block grant ................................................................................................................................ 437,840 438,717 462,705 ∂24,865 ∂23,988 

Evaluation Tap Funding ........................................................................................................................... (21,039 ) (21,039 ) (21,039 ) ............................ ............................

Subtotal, MHBG Program level ............................................................................................................ (458,879 ) (459,756 ) (483,744 ) (∂24,865 ) (∂23,988 ) 

Children’s Mental Health .................................................................................................................................. 117,345 117,315 117,315 ¥30 ............................Grants to States for the Homeless (PATH) ....................................................................................................... 64,665 64,794 64,794 ∂129 ............................Protection and Advocacy ................................................................................................................................... 36,166 36,238 36,238 ∂72 ............................

Subtotal, Mental Health ................................................................................................................................ 931,221 990,341 1,038,243 ∂107,022 ∂47,902 Subtotal, Mental health program level ........................................................................................................ (952,260 ) (1,039,380 ) (1,086,282 ) (∂134,022 ) (∂46,902 ) 

Substance Abuse Treatment: 

Programs of Regional and National Significance ............................................................................................ 398,048 304,794 306,451 ¥91,597 ∂1,657 Prevention and Public Health Fund 3 ................................................................................................................ ............................ (30,000 ) (50,000 ) (∂50,000 ) (∂20,000 ) 

Evaluation Tap Funding ........................................................................................................................... (2,000 ) ............................ (2,000 ) ............................ (∂2,000 ) 

Subtotal, Program level ....................................................................................................................... (400,048 ) (334,794 ) (358,451 ) (¥41,597 ) (∂23,657 ) 

Substance Abuse block grant ........................................................................................................................... 1,717,690 1,748,132 1,740,656 ∂22,966 ¥7,476 

Evaluation Tap Funding ........................................................................................................................... (79,200 ) (71,724 ) (79,200 ) ............................ (∂7,476 ) 

Subtotal, Program level ....................................................................................................................... (1,796,890 ) (1,819,856 ) (1,819,856 ) (∂22,966 ) ............................Subtotal, Substance Abuse Treatment ................................................................................................ 2,115,738 2,052,926 2,047,107 ¥68,631 ¥5,819 Subtotal, Program level ....................................................................................................................... (2,196,938 ) (2,154,650 ) (2,178,307 ) (¥18,631 ) (∂23,657 ) 

Substance Abuse Prevention: 

Programs of Regional and National Significance ............................................................................................ 185,637 175,560 175,631 ¥10,006 ∂71 

Subtotal, Program Level ............................................................................................................................... (185,637 ) (175,560 ) (175,631 ) (¥10,006 ) (∂71 ) 
250 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Health Surveillance and Program Support: 

Health Surveillance, Crosscutting Issues and Support .................................................................................... 108,681 129,124 136,296 ∂27,615 ∂7,172 

Prevention and Public Health Fund ......................................................................................................... (14,733 ) ............................ (15,000 ) (∂267 ) (∂15,000 ) Evaluation Tap Funding (NA) ................................................................................................................... (27,428 ) (71,995 ) (30,428 ) (∂3,000 ) (¥41,567 ) 

Data Requests and Publications ...................................................................................................................... ............................ 1,500 1,500 ∂1,500 ............................User fees ........................................................................................................................................................... ............................ ¥1,500 ¥1,500 ¥1,500 ............................

Total, Health Surveillance Program Level .................................................................................................... 150,842 201,119 181,724 ∂30,882 ¥19,395 Total, SAMHSA ............................................................................................................................................... 3,341,277 3,347,951 3,397,277 ∂56,000 ∂49,326 

Evaluation Tap Funding ....................................................................................................................... (129,667 ) (164,758 ) (132,667 ) (∂3,000 ) (¥32,091 ) Prevention and Public Health Fund 3 .................................................................................................. (14,733 ) (58,000 ) (92,000 ) (∂77,267 ) (∂34,000 ) 

Total, SAMHSA Program Level ...................................................................................................................... (3,485,677 ) (3,570,709 ) (3,621,944 ) (∂136,267 ) (∂51,235 ) 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY [AHRQ] 

HEALTHCARE RESEARCH AND QUALITY 

Research on Health Costs, Quality, and Outcomes: 

Evaluation Tap funding ..................................................................................................................................... (235,768 ) (201,073 ) (231,384 ) (¥4,384 ) (∂30,311 ) Prevention and Public Health Fund 3 ................................................................................................................ (6,465 ) ............................ (7,000 ) (∂535 ) (∂7,000 ) 

Subtotal, Health Costs, Quality, and Outcomes ........................................................................................... (242,233 ) (201,073 ) (238,384 ) (¥3,849 ) (∂37,311 ) 

Medical Expenditures Panel Surveys: 

Evaluation Tap Funding (NA) ............................................................................................................................ (60,700 ) (63,811 ) (63,811 ) (∂3,111 ) ............................

Subtotal, Medical Expenditures Panel Surveys ............................................................................................ (60,700 ) (63,811 ) (63,811 ) (∂3,111 ) ............................

Program Support: 

Evaluation Tap Funding (NA) ............................................................................................................................ (72,585 ) (68,813 ) (68,813 ) (¥3,772 ) ............................
251 

Subtotal ......................................................................................................................................................... (72,585 ) (68,813 ) (68,813 ) (¥3,772 ) ............................

Evaluation Tap Funding (NA) .............................................................................................................. (369,053 ) (333,697 ) (364,008 ) (¥5,045 ) (∂30,311 ) AHRQ, Prevention and Public Health Fund 3 ....................................................................................... (6,465 ) ............................ (7,000 ) (∂535 ) (∂7,000 ) 

Total, AHRQ Program Level ........................................................................................................................... (375,518 ) (333,697 ) (371,008 ) (¥4,510 ) (∂37,311 ) Total, Public Health Service (PHS) appropriation ........................................................................................ 46,108,373 45,972,916 46,710,632 ∂602,259 ∂737,716 Total, Public Health Service Program Level ................................................................................................. (47,510,440 ) (47,993,745 ) (48,581,164 ) (∂1,070,724 ) (∂587,419 ) 

CENTERS FOR MEDICARE AND MEDICAID SERVICES 

GRANTS TO STATES FOR MEDICAID 

Medicaid Current Law Benefits .................................................................................................................................. 249,401,000 263,462,118 263,462,118 ∂14,061,118 ............................State and Local Administration ................................................................................................................................. 16,181,506 16,453,115 16,453,115 ∂271,609 ............................Vaccines for Children ................................................................................................................................................. 3,607,256 4,293,383 4,293,383 ∂686,127 ............................

Subtotal, Medicaid Program Level ................................................................................................................ 269,189,762 284,208,616 284,208,616 ∂15,018,854 ............................

Less funds advanced in prior year ..................................................................................................... ¥90,614,082 ¥106,335,631 ¥106,335,631 ¥15,721,549 ............................

Total, Grants to States for Medicaid ............................................................................................................ 178,575,680 177,872,985 177,872,985 ¥702,695 ............................

New advance, 1st quarter ................................................................................................................... 106,335,631 103,472,323 103,472,323 ¥2,863,308 ............................

PAYMENTS TO HEALTH CARE TRUST FUNDS 

Supplemental Medical Insurance ............................................................................................................................... 181,351,000 194,565,000 194,565,000 ∂13,214,000 ............................Federal Uninsured Payment ....................................................................................................................................... 228,000 204,000 204,000 ¥24,000 ............................Program Management ................................................................................................................................................ 750,000 1,319,000 1,319,000 ∂569,000 ............................General Revenue for Part D Benefit .......................................................................................................................... 51,245,000 58,596,000 58,596,000 ∂7,351,000 ............................General Revenue for Part D Administration .............................................................................................................. 382,000 373,000 373,000 ¥9,000 ............................HCFAC Reimbursement ............................................................................................................................................... 309,790 128,000 640,000 ∂330,210 ∂512,000 

Total, Payments to Trust Funds, Program Level .......................................................................................... 234,265,790 255,185,000 255,697,000 ∂21,431,210 ∂512,000 

Reduced Cost Sharing for Individuals in Qualified Plan .......................................................................................... ............................ 3,977,893 ............................ ............................ ¥3,977,893 

New Advance Fiscal Year 2015 ........................................................................................................................ ............................ 1,420,000 ............................ ............................ ¥1,420,000 

PROGRAM MANAGEMENT 

Research, Demonstration, Evaluation ........................................................................................................................ 21,118 ............................ ............................ ¥21,118 ............................Program operations .................................................................................................................................................... 2,653,582 4,011,200 4,011,200 ∂1,357,618 ............................Program Operations—PPHF 3 (NA) ............................................................................................................................. (453,803 ) ............................ ............................ (¥453,803 ) ............................State Survey and Certification ................................................................................................................................... 374,453 412,353 412,353 ∂37,900 ............................High Risk Insurance Pools ......................................................................................................................................... 44,000 22,004 22,004 ¥21,996 ............................
252 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Federal Administration ............................................................................................................................................... 771,418 771,800 771,800 ∂382 ............................

Total, Program management, Limitation on new BA ................................................................................... 3,864,571 5,217,357 5,217,357 ∂1,352,786 ............................Total, Program management, Program level ................................................................................................ 4,318,374 5,217,357 5,217,357 ∂898,983 ............................

HEALTH CARE FRAUD AND ABUSE CONTROL 

CMS Activities ............................................................................................................................................................ 249,942 251,420 429,846 ∂179,904 ∂178,426 HHS Office of Inspector General ................................................................................................................................ 29,614 29,790 107,541 ∂77,927 ∂77,751 Department of Justice ................................................................................................................................................ 29,614 29,790 102,613 ∂72,999 ∂72,823 

Total, Health Care Fraud and Abuse Control ............................................................................................... 309,170 311,000 640,000 ∂330,830 ∂329,000 Total, Centers for Medicare and Medicaid Services .................................................................................... 523,350,842 547,456,558 542,899,665 ∂19,548,823 ¥4,556,893 

Federal funds ....................................................................................................................................... 519,177,101 541,928,201 537,042,308 ∂17,865,207 ¥4,885,893 

Current year ................................................................................................................................ (412,841,470 ) (437,035,878 ) (433,569,985 ) (∂20,728,515 ) (¥3,465,893 ) New advance, Fiscal year 2015 ................................................................................................. (106,335,631 ) (104,892,323 ) (103,472,323 ) (¥2,863,308 ) (¥1,420,000 ) 

Trust Funds .......................................................................................................................................... 4,173,741 5,528,357 5,857,357 ∂1,683,616 ∂329,000 

ADMINISTRATION FOR CHILDREN AND FAMILIES 

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT PROGRAMS 

Payments to Territories .............................................................................................................................................. 33,000 33,000 33,000 ............................ ............................Repatriation ................................................................................................................................................................ 1,000 1,000 1,000 ............................ ............................

Subtotal, Welfare payments .......................................................................................................................... 34,000 34,000 34,000 ............................ ............................

Child Support Enforcement: 

State and Local Administration ........................................................................................................................ 3,429,973 3,480,340 3,480,340 ∂50,367 ............................Federal Incentive Payments .............................................................................................................................. 529,779 540,905 540,905 ∂11,126 ............................Access and Visitation ........................................................................................................................................ 10,000 10,000 10,000 ............................ ............................
253 

Subtotal, Child Support Enforcement ........................................................................................................... 3,969,752 4,031,245 4,031,245 ∂61,493 ............................Total, Family Support Payments Program Level ........................................................................................... 4,003,752 4,065,245 4,065,245 ∂61,493 ............................

Less funds advanced in previous years .............................................................................................. ¥1,100,000 ¥1,100,000 ¥1,100,000 ............................ ............................

Total, Family Support Payments, current year ............................................................................................. 2,903,752 2,965,245 2,965,245 ∂61,493 ............................

New advance, 1st quarter, Fiscal year 2015 ...................................................................................... 1,100,000 1,250,000 1,250,000 ∂150,000 ............................

LOW-INCOME HOME ENERGY ASSISTANCE [LIHEAP] 

Formula Grants ........................................................................................................................................................... 3,464,729 2,820,000 3,614,729 ∂150,000 ∂794,729 Contingency Fund ....................................................................................................................................................... ............................ 150,000 ............................ ............................ ¥150,000 Energy Reduction Burden Grants ............................................................................................................................... ............................ 50,000 ............................ ............................ ¥50,000 

Total, LIHEAP, Program Level ....................................................................................................................... 3,464,729 3,020,000 3,614,729 ∂150,000 ∂594,729 

REFUGEE AND ENTRANT ASSISTANCE 

Transitional and Medical Services ............................................................................................................................. 411,673 391,477 391,477 ¥20,196 ............................Victims of Trafficking ................................................................................................................................................. 9,755 19,775 15,775 ∂6,020 ¥4,000 Social Services ........................................................................................................................................................... 153,100 153,407 153,407 ∂307 ............................Preventive Health ....................................................................................................................................................... 4,814 4,730 4,730 ¥84 ............................Targeted Assistance ................................................................................................................................................... 48,304 48,401 48,401 ∂97 ............................Unaccompanied Minors .............................................................................................................................................. 375,088 494,597 494,597 ∂119,509 ............................Victims of Torture ....................................................................................................................................................... 11,234 11,045 13,045 ∂1,811 ∂2,000 

Total, Refugee and Entrant Assistance ........................................................................................................ 1,013,968 1,123,432 1,121,432 ∂107,464 ¥2,000 

PAYMENTS TO STATES FOR THE CHILD CARE AND DEVELOPMENT BLOCK GRANT 

Child Care and Development Block Grant ................................................................................................................. 2,323,656 2,478,313 2,500,000 ∂176,344 ∂21,687 SOCIAL SERVICES BLOCK GRANT (TITLE XX) ............................................................................................................. 1,700,000 1,700,000 1,700,000 ............................ ............................

CHILDREN AND FAMILIES SERVICES PROGRAMS 

Programs for Children, Youth and Families: 

Head Start, current funded ............................................................................................................................... 7,986,040 9,621,070 9,621,070 ∂1,635,030 ............................Consolidated Runaway, Homeless Youth Program ........................................................................................... 97,160 100,355 99,355 ∂2,195 ¥1,000 Prevention Grants to Reduce Abuse of Runaway Youth ................................................................................... 17,865 17,901 17,865 ............................ ¥36 Child Abuse State Grants ................................................................................................................................. 26,379 26,432 26,379 ............................ ¥53 Child Abuse Discretionary Activities ................................................................................................................. 25,693 25,744 25,693 ............................ ¥51 Community Based Child Abuse Prevention ....................................................................................................... 41,444 41,527 41,444 ............................ ¥83 Abandoned Infants Assistance .......................................................................................................................... 11,530 11,553 11,530 ............................ ¥23 
254 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Child Welfare Services ...................................................................................................................................... 280,088 280,650 280,088 ............................ ¥562 Child Welfare Training/Innovative Approaches to Foster Care ......................................................................... 26,039 26,092 26,039 ............................ ¥53 Adoption Opportunities ...................................................................................................................................... 39,100 39,179 44,100 ∂5,000 ∂4,921 Adoption Incentive ............................................................................................................................................. 39,268 39,346 39,268 ............................ ¥78 

Social Services and Income Maintenance Research ................................................................................................. ............................ 44,000 9,000 ∂9,000 ¥35,000 

Evaluation Tap Funding .................................................................................................................................... (5,762 ) (5,762 ) (5,762 ) ............................ ............................

Subtotal, Program Level ............................................................................................................................... (5,762 ) (49,762 ) (14,762 ) (∂9,000 ) (¥35,000 ) 

Developmental Disabilities Programs: 

State Councils ................................................................................................................................................... 74,625 ............................ ............................ ¥74,625 ............................Protection and Advocacy ................................................................................................................................... 40,783 ............................ ............................ ¥40,783 ............................Voting Access for Individuals with Disabilities ................................................................................................ 5,225 ............................ ............................ ¥5,225 ............................Developmental Disabilities Projects of National Significance .......................................................................... 8,301 ............................ ............................ ¥8,301 ............................University Centers for Excellence in Developmental Disabilities ..................................................................... 38,714 ............................ ............................ ¥38,714 ............................

Subtotal, Developmental Disabilities Programs ........................................................................................... 167,648 ............................ ............................ ¥167,648 ............................

Native American Programs ......................................................................................................................................... 48,486 48,583 48,486 ............................ ¥97 Community Services: 

Community Services Block Grant Act programs: 

Grants to States for Community Services ............................................................................................... 676,003 350,000 676,003 ............................ ∂326,003 Economic Development ............................................................................................................................. 29,883 ............................ 29,883 ............................ ∂29,883 Rural Community Facilities ...................................................................................................................... 4,971 ............................ 5,971 ∂1,000 ∂5,971 

Subtotal ................................................................................................................................................ 710,857 350,000 711,857 ∂1,000 ∂361,857 

Individual Development Account Initiative .............................................................................................. 19,830 19,469 20,000 ∂170 ∂531 

Subtotal, Community Services ............................................................................................................. 730,687 369,469 731,857 ∂1,170 ∂362,388 

Domestic Violence Hotline .......................................................................................................................................... 3,191 4,500 4,500 ∂1,309 ............................
255 

Family Violence/Battered Women’s Shelters .............................................................................................................. 129,288 135,000 135,000 ∂5,712 ............................Independent Living Training Vouchers ....................................................................................................................... 45,084 45,174 45,084 ............................ ¥90 Faith-Based Center .................................................................................................................................................... 1,368 1,370 1,368 ............................ ¥2 Disaster Human Services Case Management ............................................................................................................ 1,988 1,992 1,988 ............................ ¥4 Program Direction ....................................................................................................................................................... 203,220 203,245 202,000 ¥1,220 ¥1,245 

Total, Children and Families Services Programs ......................................................................................... 9,921,566 11,083,182 11,412,114 ∂1,490,548 ∂328,932 

Current Year ......................................................................................................................................... (9,921,566 ) (11,083,182 ) (11,412,114 ) (∂1,490,548 ) (∂328,932 ) Evaluation Tap Funding ....................................................................................................................... (5,762 ) (5,762 ) (5,762 ) ............................ ............................

Total, Program Level ..................................................................................................................................... (9,927,328 ) (11,088,944 ) (11,417,876 ) (∂1,490,548 ) (∂328,932 ) 

PROMOTING SAFE AND STABLE FAMILIES .................................................................................................................. 345,000 345,000 345,000 ............................ ............................

Discretionary Funds ........................................................................................................................................... 62,938 63,065 63,065 ∂127 ............................

PAYMENTS FOR FOSTER CARE AND PERMANENCY 

Foster Care ................................................................................................................................................................. 4,285,540 4,279,000 4,279,000 ¥6,540 ............................Adoption Assistance ................................................................................................................................................... 2,368,680 2,463,000 2,463,000 ∂94,320 ............................Kinship Guardianship ................................................................................................................................................. 123,000 124,000 124,000 ∂1,000 ............................Independent Living ..................................................................................................................................................... 140,000 140,000 140,000 ............................ ............................

Total, Payments to States ................................................................................................................................. 6,917,220 7,006,000 7,006,000 ∂88,780 ............................

Less Advances from Prior Year ................................................................................................................ ¥2,100,000 ¥2,200,000 ¥2,200,000 ¥100,000 ............................

Total, payments, current year ......................................................................................................... 4,817,220 4,806,000 4,806,000 ¥11,220 ............................New Advance, 1st quarter ............................................................................................................... 2,200,000 2,200,000 2,200,000 ............................ ............................

Total, Administration for Children & Families ......................................................................................... 29,852,829 31,034,237 31,977,585 ∂2,124,756 ∂943,348 

Current year ..................................................................................................................................... (26,552,829 ) (27,584,237 ) (28,527,585 ) (∂1,974,756 ) (∂943,348 ) Fiscal year 2015 .............................................................................................................................. (3,300,000 ) (3,450,000 ) (3,450,000 ) (∂150,000 ) ............................Evaluation Tap Funding .................................................................................................................. (5,762 ) (5,762 ) (5,762 ) ............................ ............................

Total, ACF Program Level ......................................................................................................................... 29,858,591 31,039,999 31,983,347 ∂2,124,756 ∂943,348 

ADMINISTRATION FOR COMMUNITY LIVING 

AGING AND DISABILITY SERVICES PROGRAMS 

Grants to States: 

Home and Community-based Supportive Services ........................................................................................... 366,182 366,916 366,916 ∂734 ............................Preventive Health .............................................................................................................................................. 20,902 20,944 20,944 ∂42 ............................
256 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Protection of Vulnerable Older Americans—Title VII ....................................................................................... 21,754 21,797 21,797 ∂43 ............................

Subtotal ......................................................................................................................................................... 408,838 409,657 409,657 ∂819 ............................

Family Caregivers .............................................................................................................................................. 153,314 153,621 153,621 ∂307 ............................Native American Caregivers Support ................................................................................................................ 6,351 6,364 6,364 ∂13 ............................

Subtotal, Caregivers ..................................................................................................................................... 159,665 159,985 159,985 ∂320 ............................

Nutrition: 

Congregate Meals ..................................................................................................................................... 438,191 439,070 439,070 ∂879 ............................Home Delivered Meals .............................................................................................................................. 216,397 216,830 216,830 ∂433 ............................Nutrition Services Incentive Program ....................................................................................................... 160,069 160,389 160,389 ∂320 ............................

Subtotal ................................................................................................................................................ 814,657 816,289 816,289 ∂1,632 ............................Subtotal, Grants to States ................................................................................................................... 1,383,160 1,385,931 1,385,931 ∂2,771 ............................

Grants for Native Americans ...................................................................................................................................... 27,546 27,601 27,601 ∂55 ............................Aging Network Support Activities ............................................................................................................................... 7,857 7,873 7,873 ∂16 ............................Alzheimer’s Disease Demonstrations ......................................................................................................................... 4,002 9,537 4,002 ............................ ¥5,535 Alzheimer’s Disease Initiative PPHF (NA) .................................................................................................................. (150 ) (14,700 ) (14,700 ) (∂14,550 ) ............................Lifespan Respite Care ................................................................................................................................................ 2,485 2,490 2,490 ∂5 ............................Chronic Disease Self-Management Program ............................................................................................................. ............................ ............................ ............................ ............................ ............................

Prevention and Public Health Fund 3 ................................................................................................................ (7,086 ) (10,000 ) (10,000 ) (∂2,914 ) ............................

Elder Falls .................................................................................................................................................................. ............................ ............................ ............................ ............................ ............................

Prevention and Public Health Fund 3 ................................................................................................................ ............................ ............................ (7,000 ) (∂7,000 ) (∂7,000 ) 

Adult Protective Services Demonstration ................................................................................................................... ............................ 8,000 8,000 ∂8,000 ............................Elder Justice—PPHF (NA) .......................................................................................................................................... (2,000 ) ............................ ............................ (¥2,000 ) ............................Senior Medicare Patrol Program ................................................................................................................................ 9,383 9,402 9,402 ∂19 ............................Elder Rights Support Activities .................................................................................................................................. 4,080 4,088 4,088 ∂8 ............................Aging and Disability Resources ................................................................................................................................. 6,444 ............................ 6,444 ............................ ∂6,444 State Health Insurance Program ................................................................................................................................ ............................ 52,115 52,115 ∂52,115 ............................
257 

National Clearinghouse for Long-Term Care Information .......................................................................................... ............................ 3,000 3,000 ∂3,000 ............................Paralysis Resource Center .......................................................................................................................................... ............................ 6,700 6,700 ∂6,700 ............................Developmental Disabilities Programs: 

State Councils ................................................................................................................................................... ............................ 74,774 74,774 ∂74,774 ............................Protection and Advocacy ................................................................................................................................... ............................ 40,865 40,865 ∂40,865 ............................Voting Access for Individuals with Disabilities ................................................................................................ ............................ 5,235 5,235 ∂5,235 ............................Developmental Disabilities Projects of National Significance .......................................................................... ............................ 8,317 9,317 ∂9,317 ∂1,000 University Centers of Excellence ....................................................................................................................... ............................ 38,792 38,792 ∂38,792 ............................

Subtotal ......................................................................................................................................................... ............................ 167,983 168,983 ∂168,983 ∂1,000 

Program Administration ............................................................................................................................................. 23,017 30,035 30,035 ∂7,018 ............................

Total, Administration for Community Living ................................................................................................ 1,467,974 1,714,755 1,716,664 ∂248,690 ∂1,909 

Federal funds ....................................................................................................................................... 1,467,974 1,662,640 1,664,549 ∂196,575 ∂1,909 Trust Funds .......................................................................................................................................... ............................ (52,115 ) (52,115 ) (∂52,115 ) ............................Prevention and Public Health Fund ..................................................................................................... (9,236 ) (24,700 ) (31,700 ) (∂22,464 ) (∂7,000 ) 

Total, ACL Program Level ............................................................................................................................. 1,477,210 1,739,455 1,748,364 ∂271,154 ∂8,909 

OFFICE OF THE SECRETARY 

GENERAL DEPARTMENTAL MANAGEMENT 

General Departmental Management: 

Federal Funds .................................................................................................................................................... 219,159 234,067 219,159 ............................ ¥14,908 

Subtotal ......................................................................................................................................................... 219,159 234,067 219,159 ............................ ¥14,908 

Teen Pregnancy Prevention Community Grants ......................................................................................................... 104,383 ............................ 104,790 ∂407 ∂104,790 

Prevention and Public Health Fund 3 ................................................................................................................ ............................ (104,790 ) ............................ ............................ (¥104,790 ) 

Teen Pregnancy Prevention approaches Evaluation Tap Funding ............................................................................. (8,455 ) (4,232 ) (8,455 ) ............................ (∂4,223 ) 

Subtotal, Pregnancy Grants .......................................................................................................................... (112,838 ) (109,022 ) (113,245 ) (∂407 ) (∂4,223 ) 

Minority Health ........................................................................................................................................................... 55,670 40,560 42,560 ¥13,110 ∂2,000 Abstinence Education ................................................................................................................................................. 4,981 ............................ ............................ ¥4,981 ............................Office of Women’s Health .......................................................................................................................................... 33,615 26,808 26,808 ¥6,807 ............................Minority HIV/AIDS ........................................................................................................................................................ 53,574 ............................ 53,891 ∂317 ∂53,891 

Evaluation Tap Funding .................................................................................................................................... ............................ (53,891 ) ............................ ............................ (¥53,891 ) 

Embryo Adoption Awareness Campaign ..................................................................................................................... 1,992 ............................ ............................ ¥1,992 ............................Planning and Evaluation, Evaluation Tap Funding ................................................................................................... (60,756 ) (61,718 ) (61,718 ) (∂962 ) ............................
258 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Total, General Departmental Management ................................................................................................... 542,585 421,276 517,381 ¥25,204 ∂96,105 

Federal Funds ...................................................................................................................................... (473,374 ) (301,435 ) (447,208 ) (¥26,166 ) (∂145,773 ) Evaluation Tap Funding (NA) .............................................................................................................. (69,211 ) (119,841 ) (70,173 ) (∂962 ) (¥49,668 ) Prevention and Public Health Fund 3 .................................................................................................. ............................ (104,790 ) ............................ ............................ (¥104,790 ) 

Total, General Departmental Management Program .................................................................................... 542,585 526,066 517,381 ¥25,204 ¥8,685 

OFFICE OF MEDICARE HEARINGS AND APPEALS ........................................................................................................ 71,867 82,381 82,381 ∂10,514 ............................OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY ................................................ 16,382 20,576 20,290 ∂3,908 ¥286 

Evaluation Tap Funding .................................................................................................................................... (44,811 ) (56,307 ) (51,307 ) (∂6,496 ) (¥5,000 ) Certification and Standards .............................................................................................................................. ............................ 1,000 1,000 ∂1,000 ............................

User fees .................................................................................................................................................. ............................ ¥1,000 ¥1,000 ¥1,000 ............................

Total, Program Level ............................................................................................................................ (61,193 ) (76,883 ) (71,597 ) (∂10,404 ) (¥5,286 ) 

OFFICE OF INSPECTOR GENERAL 

Inspector General Federal Funds ............................................................................................................................... 49,983 68,879 59,879 ∂9,896 ¥9,000 

HIPAA/HCFAC funding (NA) ............................................................................................................................... (196,299 ) (200,279 ) (200,279 ) (∂3,980 ) ............................

Total, Inspector General Program Level ....................................................................................................... (246,282 ) (269,158 ) (260,158 ) (∂13,876 ) (¥9,000 ) 

OFFICE FOR CIVIL RIGHTS: 

Federal Funds .................................................................................................................................................... 40,857 42,205 42,205 ∂1,348 ............................

Total, Office for Civil Rights ........................................................................................................................ 40,857 42,205 42,205 ∂1,348 ............................

RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS 

Retirement Payments ................................................................................................................................................. 395,452 415,331 415,331 ∂19,879 ............................Survivors Benefits ...................................................................................................................................................... 31,043 28,239 28,239 ¥2,804 ............................Dependents’ Medical Care ......................................................................................................................................... 100,656 106,802 106,802 ∂6,146 ............................

Total, Medical Benefits for Commissioned Officers ..................................................................................... 527,151 550,372 550,372 ∂23,221 ............................
259 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND 

Assistant Secretary for Preparedness and Response 

Operations .................................................................................................................................................................. 32,925 33,213 33,213 ∂288 ............................Preparedness and Emergency Operations .................................................................................................................. 29,532 24,789 24,789 ¥4,743 ............................National Disaster Medical System ............................................................................................................................. 52,645 52,502 52,502 ¥143 ............................Hospital Preparedness Cooperative Agreement Grants ............................................................................................. 374,007 254,555 254,555 ¥119,452 ............................Emergency Systems for Advanced Registration of Volunteer Health Professionals (ESAR–VHP) ............................. 4,981 505 505 ¥4,476 ............................Biomedical Advanced Research and Development Authority [BARDA] ...................................................................... 415,000 395,130 415,000 ............................ ∂19,870 Medical Countermeasure Strategic Investment Corp ................................................................................................ ............................ 20,000 15,000 ∂15,000 ¥5,000 Medical Countermeasure Dispensing ......................................................................................................................... ............................ 5,000 5,000 ∂5,000 ............................Policy and Planning ................................................................................................................................................... 15,647 15,253 15,253 ¥394 ............................Project BioShield ........................................................................................................................................................ ............................ 250,000 250,000 ∂250,000 ............................

Subtotal, AS for Preparedness and Response .............................................................................................. 924,737 1,050,947 1,065,817 ∂141,080 ∂14,870 

Assistant Secretary for Administration 

Cybersecurity .............................................................................................................................................................. 39,845 41,125 41,125 ∂1,280 ............................

Assistant Secretary for Health 

Medical Reserve Corps ............................................................................................................................................... 11,224 8,979 8,979 ¥2,245 ............................

Office of the Secretary 

Pandemic Influenza Preparedness: 

Available until expended ................................................................................................................................... ............................ 108,000 108,000 ∂108,000 ............................Annual ............................................................................................................................................................... ............................ 32,009 32,009 ∂32,009 ............................

Pandemic Influenza Program Level .......................................................................................................... ............................ 140,009 140,009 ∂140,009 ............................

Office of Security and Strategic Information ............................................................................................................. 6,435 7,470 7,470 ∂1,035 ............................HHS Lease Replacements ........................................................................................................................................... 16,966 41,000 41,000 ∂24,034 ............................Disaster Relief Public Law 113–2 (emergency appropriation) .................................................................................. 800,000 ............................ ............................ ¥800,000 ............................

Subtotal, Office of the Secretary .................................................................................................................. 823,401 188,479 188,479 ¥634,922 ............................Subtotal, Non-pandemic flu/BARDA/BioShield/Parklawn .............................................................................. 1,799,207 1,289,530 1,304,400 ¥494,807 ∂14,870 Total, PHSSEF ................................................................................................................................................ 1,799,207 1,289,530 1,304,400 ¥494,807 ∂14,870 Total, Office of the Secretary ....................................................................................................................... 2,978,821 2,355,378 2,506,735 ¥472,086 ∂151,357 

Federal Funds ...................................................................................................................................... 2,106,954 2,272,997 2,424,354 ∂317,400 ∂151,357 
260 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Federal Funds (emergency) .................................................................................................................. 800,000 ............................ ............................ ¥800,000 ............................Trust Funds .......................................................................................................................................... 71,867 82,381 82,381 ∂10,514 ............................Evaluation Tap Funding (NA) .............................................................................................................. (114,022 ) (176,148 ) (121,480 ) (∂7,458 ) (¥54,668 ) 

Total, Office of the Secretary Program Level .................................................................................. 2,292,843 2,636,316 2,628,215 ∂335,372 ¥8,101 Total, Title II, Dept of Health & Human Services ........................................................................... 603,758,839 628,533,844 625,811,281 ∂22,052,442 ¥2,722,563 Federal Funds .................................................................................................................................. 599,513,231 622,870,991 619,819,428 ∂20,306,197 ¥3,051,563 

Current year ............................................................................................................................ (489,077,600 ) (514,528,668 ) (512,897,105 ) (∂23,819,505 ) (¥1,631,563 ) Current Year (emergency) ...................................................................................................... (800,000 ) ............................ ............................ (¥800,000 ) ............................Fiscal year 2015 ..................................................................................................................... (109,635,631 ) (108,342,323 ) (106,922,323 ) (¥2,713,308 ) (¥1,420,000 ) 

Trust Funds ..................................................................................................................................... 4,245,608 5,662,853 5,991,853 ∂1,746,245 ∂329,000 Pandemic Flu balances (Public Law 111–32) ................................................................................ (11,829 ) ............................ ............................ (¥11,829 ) ............................

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies [LEAs] Basic Grants: 

Advance from prior year .................................................................................................................................... (2,962,510 ) (3,313,597 ) (3,313,597 ) (∂351,087 ) ............................Forward funded ................................................................................................................................................. 3,599,514 2,834,559 3,767,248 ∂167,734 ∂932,689 Current funded .................................................................................................................................................. ............................ ............................ 4,000 ∂4,000 ∂4,000 

Subtotal, Basic grants current year approp ................................................................................................ 3,599,514 2,834,559 3,771,248 ∂171,734 ∂936,689 Subtotal, Basic grants total funds available .............................................................................................. (6,562,024 ) (6,148,156 ) (7,084,845 ) (∂522,821 ) (∂936,689 ) 

Basic Grants Fiscal Year 2015 Advance .......................................................................................................... 2,962,510 3,743,345 2,790,776 ¥171,734 ¥952,569 

Subtotal, Basic grants, program level ......................................................................................................... 6,562,024 6,577,904 6,562,024 ............................ ¥15,880 

Concentration Grants: 

Advance from prior year ........................................................................................................................... (1,362,301 ) (1,293,919 ) (1,293,919 ) (¥68,382 ) ............................Fiscal Year 2015 Advance ....................................................................................................................... 1,362,301 1,362,301 1,362,301 ............................ ............................
261 

Targeted Grants: 

Forward funded ........................................................................................................................................ 23,367 ............................ ............................ ¥23,367 ............................Advance from prior year ........................................................................................................................... (3,258,183 ) (3,116,831 ) (3,116,831 ) (¥141,352 ) ............................Fiscal Year 2015 Advance ....................................................................................................................... 3,258,183 3,288,126 3,344,050 ∂85,867 ∂55,924 

Subtotal (excluding emergencies) ....................................................................................................... 3,281,550 3,288,126 3,344,050 ∂62,500 ∂55,924 

Education Finance Incentive Grants: 

Forward Funded ........................................................................................................................................ 23,367 ............................ ............................ ¥23,367 ............................Advance from prior year ........................................................................................................................... (3,258,183 ) (3,116,831 ) (3,116,831 ) (¥141,352 ) ............................Fiscal Year 2015 Advance ....................................................................................................................... 3,258,183 3,288,126 3,344,050 ∂85,867 ∂55,924 

Subtotal ................................................................................................................................................ 3,281,550 3,288,126 3,344,050 ∂62,500 ∂55,924 Subtotal, Grants to LEAs, program level ............................................................................................. 14,487,425 14,516,457 14,612,425 ∂125,000 ∂95,968 Subtotal, Grants to LEAs, program level ............................................................................................. 14,487,425 14,516,457 14,612,425 ∂125,000 ∂95,968 

School Improvement Grants ....................................................................................................................................... 532,485 658,552 567,485 ∂35,000 ¥91,067 Striving Readers ......................................................................................................................................................... 159,378 ............................ 164,378 ∂5,000 ∂164,378 State Agency Programs: 

Migrant .............................................................................................................................................................. 392,450 393,236 392,450 ............................ ¥786 Neglected and Delinquent/High Risk Youth ...................................................................................................... 50,130 50,231 50,130 ............................ ¥101 

Subtotal, State Agency programs ................................................................................................................. 442,580 443,467 442,580 ............................ ¥887 

Evaluation ................................................................................................................................................................... 3,188 ............................ 3,028 ¥160 ∂3,028 High School Graduation Initiative .............................................................................................................................. 48,712 ............................ 48,809 ∂97 ∂48,809 Migrant Education: 

High School Equivalency Program .................................................................................................................... 36,453 36,526 36,526 ∂73 ............................

Total, Education for the disadvantaged ....................................................................................................... 15,710,221 15,655,002 15,875,231 ∂165,010 ∂220,229 

Current Year ......................................................................................................................................... (4,869,044 ) (3,973,104 ) (5,034,054 ) (∂165,010 ) (∂1,060,950 ) Fiscal year 2015 .................................................................................................................................. (10,841,177 ) (11,681,898 ) (10,841,177 ) ............................ (¥840,721 ) 

Subtotal, Forward Funded ............................................................................................................................. (4,780,691 ) (3,936,578 ) (4,941,691 ) (∂161,000 ) (∂1,005,113 ) 

PRESCHOOL DEVELOPMENT GRANTS .......................................................................................................................... ............................ 750,000 750,000 ∂750,000 ............................

IMPACT AID 

Basic Support Payments ............................................................................................................................................ 1,151,233 1,153,540 1,153,540 ∂2,307 ............................Payments for Children with Disabilities .................................................................................................................... 48,316 48,413 48,316 ............................ ¥97 
262 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Facilities Maintenance (Sec. 8008) ........................................................................................................................... 4,835 4,845 4,835 ............................ ¥10 Construction (Sec. 8007) ........................................................................................................................................... 17,406 17,441 17,441 ∂35 ............................Payments for Federal Property (Sec. 8002) ............................................................................................................... 66,813 ............................ 66,813 ............................ ∂66,813 

Total, Impact aid .......................................................................................................................................... 1,288,603 1,224,239 1,290,945 ∂2,342 ∂66,706 

SCHOOL IMPROVEMENT PROGRAMS 

State Grants for Improving Teacher Quality .............................................................................................................. 780,193 ............................ 780,193 ............................ ∂780,193 

Advance from prior year .................................................................................................................................... (1,681,441 ) (1,681,441 ) (1,681,441 ) ............................ ............................Fiscal year 2015 ................................................................................................................................................ 1,681,441 ............................ 1,681,441 ............................ ∂1,681,441 

Subtotal, State Grants for Improving Teacher Quality, program level ........................................................ 2,461,634 ............................ 2,461,634 ............................ ∂2,461,634 

Mathematics and Science Partnerships .................................................................................................................... 149,417 ............................ 149,417 ............................ ∂149,417 Supplemental Education Grants ................................................................................................................................ 17,583 17,619 17,583 ............................ ¥36 21st Century Community Learning Centers ............................................................................................................... 1,149,370 1,251,673 1,200,000 ∂50,630 ¥51,673 State Assessments/Enhanced Assessment Instruments ............................................................................................ 388,436 389,214 408,436 ∂20,000 ∂19,222 Javits Gifted and Talented Education ........................................................................................................................ ............................ ............................ 15,000 ∂15,000 ∂15,000 Consolidated Runaway and Homeless Youth programs ............................................................................................ 65,042 65,173 65,173 ∂131 ............................Training and Advisory Services (Civil Rights) ........................................................................................................... 6,947 6,962 6,947 ............................ ¥15 Education for Native Hawaiians ................................................................................................................................ 34,113 34,181 34,181 ∂68 ............................Alaska Native Education Equity ................................................................................................................................. 33,119 33,185 33,185 ∂66 ............................Rural Education .......................................................................................................................................................... 178,834 179,193 179,193 ∂359 ............................Comprehensive Centers .............................................................................................................................................. 51,011 51,113 51,113 ∂102 ............................

Total, School improvement programs ........................................................................................................... 4,535,506 2,028,313 4,621,862 ∂86,356 ∂2,593,549 

Current Year ......................................................................................................................................... (2,854,065 ) (2,028,313 ) (2,940,421 ) (∂86,356 ) (∂912,108 ) Fiscal year 2015 .................................................................................................................................. (1,681,441 ) ............................ (1,681,441 ) ............................ (∂1,681,441 ) 

Subtotal, Forward Funded ............................................................................................................................. (2,711,292 ) (1,885,253 ) (2,782,412 ) (∂71,120 ) (∂897,159 ) 

INDIAN EDUCATION 

Grants to Local Educational Agencies ....................................................................................................................... 105,710 105,921 105,710 ............................ ¥211 
263 

Federal Programs: 

Special Programs for Indian Children .............................................................................................................. 18,948 18,986 18,948 ............................ ¥38 National Activities ............................................................................................................................................. 5,660 5,872 5,660 ............................ ¥212 

Subtotal, Federal Programs .......................................................................................................................... 24,608 24,858 24,608 ............................ ¥250 Total, Indian Education ................................................................................................................................ 130,318 130,779 130,318 ............................ ¥461 

INNOVATION AND IMPROVEMENT 

Race to the Top .......................................................................................................................................................... 547,863 1,000,000 250,000 ¥297,863 ¥750,000 Investing in Innovation Fund ..................................................................................................................................... 149,118 215,000 170,000 ∂20,882 ¥45,000 Effective Teachers and Leaders State Grants ........................................................................................................... ............................ 2,466,567 ............................ ............................ ¥2,466,567 Effective Teaching and Learning Literacy ................................................................................................................. ............................ 186,892 ............................ ............................ ¥186,892 Effective Teaching and Learning for a Well Rounded Education ............................................................................. ............................ 75,000 ............................ ............................ ¥75,000 College Pathways and Accelerated ZLearning ........................................................................................................... ............................ 102,200 ............................ ............................ ¥102,200 STEM Innovation ......................................................................................................................................................... ............................ 414,716 ............................ ............................ ¥414,716 High School Redesign ................................................................................................................................................ ............................ 300,000 ............................ ............................ ¥300,000 Expanding Educational Options ................................................................................................................................. ............................ 294,836 ............................ ............................ ¥294,836 Transition to Teaching ............................................................................................................................................... 26,002 ............................ ............................ ¥26,002 ............................School Leadership ...................................................................................................................................................... 29,049 97,994 64,049 ∂35,000 ¥33,945 Charter Schools Grants .............................................................................................................................................. 254,326 ............................ 254,326 ............................ ∂254,326 Magnet Schools Assistance ........................................................................................................................................ 96,512 99,611 99,611 ∂3,099 ............................Fund for the Improvement of Education (FIE) ........................................................................................................... 65,644 46,276 137,644 ∂72,000 ∂91,368 Teacher Incentive Fund .............................................................................................................................................. 298,834 ............................ 298,834 ............................ ∂298,834 Teacher and Leader Innovation Fund ........................................................................................................................ ............................ 400,000 ............................ ............................ ¥400,000 Ready-to-Learn television ........................................................................................................................................... 27,139 ............................ 27,139 ............................ ∂27,139 Advanced Placement .................................................................................................................................................. 29,995 ............................ 29,995 ............................ ∂29,995 

Total, Innovation and Improvement .............................................................................................................. 1,524,482 5,699,092 1,331,598 ¥192,884 ¥4,367,494 

Current Year ......................................................................................................................................... (1,524,482 ) (5,699,092 ) (1,331,598 ) (¥192,884 ) (¥4,367,494 ) 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Successful, Safe and Healthy Students ..................................................................................................................... ............................ 280,000 ............................ ............................ ¥280,000 Promise Neighborhoods .............................................................................................................................................. 59,767 300,000 56,754 ¥3,013 ¥243,246 National Activities ...................................................................................................................................................... 64,747 ............................ 143,000 ∂78,253 ∂143,000 Elementary and Secondary School Counseling .......................................................................................................... 52,191 ............................ 52,191 ............................ ∂52,191 Carol M. White Physical Education Program ............................................................................................................. 78,536 ............................ 78,536 ............................ ∂78,536 

Total, Safe Schools and Citizenship Education ........................................................................................... 255,241 580,000 330,481 ∂75,240 ¥249,519 
264 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

ENGLISH LANGUAGE ACQUISITION 

Current funded ........................................................................................................................................................... 47,494 47,589 47,494 ............................ ¥95 Forward funded .......................................................................................................................................................... 683,186 684,555 683,186 ............................ ¥1,369 

Total, English Language Acquisition ............................................................................................................ 730,680 732,144 730,680 ............................ ¥1,464 

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year ............................................................................................................... 2,271,317 1,453,752 2,439,563 ∂168,246 ∂985,811 

Part B advance from prior year ............................................................................................................... (9,283,383 ) (9,283,383 ) (9,283,383 ) ............................ ............................

Grants to States Part B (Fiscal Year 2015) ..................................................................................................... 9,283,383 10,124,103 9,283,383 ............................ ¥840,720 

Subtotal, program level ................................................................................................................................ 11,554,700 11,577,855 11,722,946 ∂168,246 ∂145,091 

Preschool Grants ............................................................................................................................................... 371,900 372,646 372,646 ∂746 ............................Grants for Infants and Families ....................................................................................................................... 441,824 462,710 462,710 ∂20,886 ............................

Subtotal, program level ................................................................................................................................ 12,368,424 12,413,211 12,558,302 ∂189,878 ∂145,091 

IDEA National Activities (current funded): 

State Personnel Development ............................................................................................................................ 43,829 45,011 43,829 ............................ ¥1,182 Technical Assistance and Dissemination ......................................................................................................... 46,688 46,781 46,688 ............................ ¥93 Personnel Preparation ....................................................................................................................................... 88,122 85,799 88,122 ............................ ∂2,323 Parent Information Centers ............................................................................................................................... 28,859 28,917 28,917 ∂58 ............................Technology and Media Services ........................................................................................................................ 29,529 29,588 29,529 ............................ ¥59 

Subtotal, IDEA special programs .................................................................................................................. 237,027 236,096 237,085 ∂58 ∂989 

Special Olympics Education Programs ...................................................................................................................... 7,984 8,000 8,000 ∂16 ............................PROMISE ..................................................................................................................................................................... 1,992 ............................ ............................ ¥1,992 ............................

Total, Special education ............................................................................................................................... 12,615,427 12,657,307 12,803,387 ∂187,960 ∂146,080 
265 

Current Year ......................................................................................................................................... (3,332,044 ) (2,533,204 ) (3,520,004 ) (∂187,960 ) (∂986,800 ) Fiscal year 2015 .................................................................................................................................. (9,283,383 ) (10,124,103 ) (9,283,383 ) ............................ (¥840,720 ) 

Subtotal, Forward Funded ............................................................................................................................. (3,085,041 ) (2,289,108 ) (3,274,919 ) (∂189,878 ) (∂985,811 ) 

REHABILITATION SERVICES AND DISABILITY RESEARCH 

Vocational Rehabilitation State Grants ..................................................................................................................... 3,230,972 3,302,053 3,302,053 ∂71,081 ............................

Discretionary modification (NA) ........................................................................................................................ ............................ ............................ ............................ ............................ ............................

Subtotal, VR State grants program level ..................................................................................................... 3,230,972 3,302,053 3,302,053 ∂71,081 ............................

Client Assistance State grants .................................................................................................................................. 12,215 12,240 12,215 ............................ ¥25 Training ...................................................................................................................................................................... 35,444 30,188 35,444 ............................ ∂5,256 Demonstration and Training programs ...................................................................................................................... 5,314 5,750 6,514 ∂1,200 ∂764 Migrant and Seasonal Farmworkers .......................................................................................................................... 1,259 ............................ 1,259 ............................ ∂1,259 Protection and Advocacy of Individual Rights [PAIR] ............................................................................................... 17,995 18,031 17,995 ............................ ¥36 Supported Employment State grants ......................................................................................................................... 29,010 ............................ 29,010 ............................ ∂29,010 Independent Living: 

State Grants ...................................................................................................................................................... 23,312 23,359 23,312 ............................ ¥47 Centers .............................................................................................................................................................. 79,794 79,953 79,794 ............................ ¥159 Services for Older Blind Individuals ................................................................................................................. 33,951 34,018 33,951 ............................ ¥67 

Subtotal ......................................................................................................................................................... 137,057 137,330 137,057 ............................ ¥273 

Helen Keller National Center for Deaf/Blind Youth and Adults ................................................................................ 9,127 9,145 9,127 ............................ ¥18 National Inst. Disability and Rehab. Research [NIDRR] ........................................................................................... 108,599 110,000 110,000 ∂1,401 ............................Assistive Technology ................................................................................................................................................... 32,770 30,840 37,500 ∂4,730 ∂6,660 

Subtotal, Discretionary programs ................................................................................................................. 388,790 353,524 396,121 ∂7,331 ∂42,597 Total, Rehabilitation services ....................................................................................................................... 3,619,762 3,655,577 3,698,174 ∂78,412 ∂42,597 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

AMERICAN PRINTING HOUSE FOR THE BLIND ............................................................................................................ 24,456 24,505 24,456 ............................ ¥49 NATIONAL TECHNICAL INSTITUTE FOR THE DEAF [NTID]: 

Operations ......................................................................................................................................................... 65,291 63,422 66,422 ∂1,131 ∂3,000 Construction ...................................................................................................................................................... ............................ 2,000 ............................ ............................ ¥2,000 

Total, NTID .................................................................................................................................................... 65,291 65,422 66,422 ∂1,131 ∂1,000 

GALLAUDET UNIVERSITY: 

Operations ......................................................................................................................................................... 117,306 117,541 118,541 ∂1,235 ∂1,000 
266 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Construction ...................................................................................................................................................... 7,959 ............................ ............................ ¥7,959 ............................

Total, Gallaudet University ........................................................................................................................... 125,265 117,541 118,541 ¥6,724 ∂1,000 Total, Special Institutions for Persons with Disabilities .............................................................................. 215,012 207,468 209,419 ¥5,593 ∂1,951 

CAREER, TECHNICAL AND ADULT EDUCATION 

Career Education: 

Basic State Grants/Secondary & Technical Education State Grants, current funded ..................................... 329,784 332,030 332,030 ∂2,246 ............................

Advance from prior year ........................................................................................................................... (791,000 ) (791,000 ) (791,000 ) ............................ ............................Fiscal year 2015 ....................................................................................................................................... 791,000 791,000 791,000 ............................ ............................

Subtotal, Basic State Grants, program level ...................................................................................... 1,120,784 1,123,030 1,123,030 ∂2,246 ............................

National Programs ............................................................................................................................................. 7,814 17,829 12,814 ∂5,000 ¥5,015 

Subtotal, Career Education ........................................................................................................................... 1,128,598 1,140,859 1,135,844 ∂7,246 ¥5,015 

Adult Education: 

State Grants/Adult Basic and Literacy Education: 

State Grants, current funded ................................................................................................................... 593,803 594,993 593,803 ............................ ¥1,190 

National Leadership Activities ................................................................................................................................... 11,279 14,302 14,302 ∂3,023 ............................

Subtotal, Adult education ............................................................................................................................. 605,082 609,295 608,105 ∂3,023 ¥1,190 Total, Career and adult education ............................................................................................................... 1,733,680 1,750,154 1,743,949 ∂10,269 ¥6,205 

Current Year ......................................................................................................................................... (942,680 ) (959,154 ) (952,949 ) (∂10,269 ) (¥6,205 ) Fiscal year 2015 .................................................................................................................................. (791,000 ) (791,000 ) (791,000 ) ............................ ............................

Subtotal, Forward Funded ............................................................................................................................. (942,680 ) (959,154 ) (952,949 ) (∂10,269 ) (¥6,205 ) 

STUDENT FINANCIAL ASSISTANCE 

Pell Grants—maximum grant (NA) ........................................................................................................................... (4,860 ) (4,860 ) (4,860 ) ............................ ............................
267 

Pell Grants .................................................................................................................................................................. 22,778,352 22,824,000 22,778,352 ............................ ¥45,648 Federal Supplemental Educational Opportunity Grants ............................................................................................. 733,130 734,599 733,130 ............................ ¥1,469 Federal Work Study ..................................................................................................................................................... 974,728 1,126,682 1,024,728 ∂50,000 ¥101,954 

Total, Student Financial Assistance [SFA] ................................................................................................... 24,486,210 24,685,281 24,536,210 ∂50,000 ¥149,071 

STUDENT AID ADMINISTRATION 

Salaries and Expenses ............................................................................................................................................... 698,371 733,224 727,434 ∂29,063 ¥5,790 Servicing Activities ..................................................................................................................................................... 342,930 316,867 316,867 ¥26,063 ............................

Total, Student Aid Administration ................................................................................................................ 1,041,301 1,050,091 1,044,301 ∂3,000 ¥5,790 

HIGHER EDUCATION 

Aid for Institutional Development: 

Strengthening Institutions ................................................................................................................................. 80,462 80,623 80,462 ............................ ¥161 Hispanic Serving Institutions ............................................................................................................................ 100,231 100,432 100,231 ............................ ¥201 Promoting Post-Baccalaureate Opportunities for Hispanic Americans ............................................................ 8,992 9,011 8,992 ............................ ¥19 Strengthening Historically Black Colleges (HBCUs) ......................................................................................... 227,524 227,980 227,524 ............................ ¥456 Strengthening Historically Black Graduate Institutions ................................................................................... 58,840 58,958 58,840 ............................ ¥118 Strengthening Predominantly Black Institutions .............................................................................................. 9,244 9,262 9,244 ............................ ¥18 Asian American Pacific Islander ....................................................................................................................... 3,113 3,119 3,113 ............................ ¥6 Strengthening Alaska Native and Native Hawaiian-Serving Institutions ......................................................... 12,833 12,859 12,833 ............................ ¥26 Strengthening Native American-Serving Nontribal Institutions ........................................................................ 3,113 3,119 3,113 ............................ ¥6 Strengthening Tribal Colleges ........................................................................................................................... 25,662 25,713 25,662 ............................ ¥51 

Subtotal, Aid for Institutional development ................................................................................................. 530,014 531,076 530,014 ............................ ¥1,062 

International Education and Foreign Language: 

Domestic Programs ........................................................................................................................................... 66,453 73,487 73,487 ∂7,034 ............................Overseas Programs ............................................................................................................................................ 7,436 7,451 7,451 ∂15 ............................

Subtotal, International Education & Foreign Lang ...................................................................................... 73,889 80,938 80,938 ∂7,049 ............................

Fund for the Improvement of Postsec. Ed. [FIPSE] ................................................................................................... 3,486 260,000 5,852 ∂2,366 ¥254,148 Postsecondary Program for Students with Intellectual Disabilities .......................................................................... 10,935 ............................ 10,935 ............................ ∂10,935 Minority Science and Engineering Improvement ........................................................................................................ 9,447 9,466 9,447 ............................ ¥19 Tribally Controlled Postsec Voc/Tech Institutions ...................................................................................................... 8,114 8,131 8,114 ............................ ¥17 Federal TRIO Programs ............................................................................................................................................... 838,252 839,932 849,932 ∂11,680 ∂10,000 GEAR UP ..................................................................................................................................................................... 301,639 302,244 307,244 ∂5,605 ∂5,000 Graduate Assistance in Areas of National Need ....................................................................................................... 30,848 30,909 30,848 ............................ ¥61 Teacher Quality Partnerships ..................................................................................................................................... 42,747 ............................ 42,747 ............................ ∂42,747 
268 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Child Care Access Means Parents in School ............................................................................................................. 15,938 15,970 15,938 ............................ ¥32 GPRA Data/HEA Program Evaluation ......................................................................................................................... 606 67,607 20,606 ∂20,000 ¥47,001 

Total, Higher Education ................................................................................................................................ 1,865,915 2,146,273 1,912,615 ∂46,700 ¥233,658 

HOWARD UNIVERSITY 

Academic Program ..................................................................................................................................................... 204,820 205,230 205,230 ∂410 ............................Howard University Hospital ........................................................................................................................................ 28,776 28,834 28,834 ∂58 ............................

Total, Howard University ............................................................................................................................... 233,596 234,064 234,064 ∂468 ............................

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS [CHAFL] ................................................................................ 458 459 459 ∂1 ............................

HBCU CAPITAL FINANCING PROGRAM 

HBCU Federal Administration ..................................................................................................................................... 352 352 352 ............................ ............................HBCU Loan Subsidies ................................................................................................................................................. 20,110 20,150 20,150 ∂40 ............................

Total, HBCU Capital Financing Program ...................................................................................................... 20,462 20,502 20,502 ∂40 ............................

INSTITUTE OF EDUCATION SCIENCES [IES] 

Research, Development and Dissemination ............................................................................................................... 189,407 202,273 195,000 ∂5,593 ¥7,273 Statistics .................................................................................................................................................................... 108,531 122,748 112,000 ∂3,469 ¥10,748 Regional Educational Laboratories ............................................................................................................................ 57,311 57,426 57,311 ............................ ¥115 Research in Special Education .................................................................................................................................. 49,806 59,905 69,905 ∂20,099 ∂10,000 Special Education Studies and Evaluations .............................................................................................................. 11,393 11,415 11,415 ∂22 ............................Statewide Data Systems ............................................................................................................................................ 38,001 85,000 75,000 ∂36,999 ¥10,000 Assessment: 

National Assessment ......................................................................................................................................... 129,356 124,616 124,616 ¥4,740 ............................National Assessment Governing Board ............................................................................................................. 8,672 7,690 7,690 ¥982 ............................
269 

Subtotal, Assessment ................................................................................................................................... 138,028 132,306 132,306 ¥5,722 ............................Total, IES ....................................................................................................................................................... 592,477 671,073 652,937 ∂60,460 ¥18,136 

DEPARTMENTAL MANAGEMENT 

PROGRAM ADMINISTRATION: 

Salaries and Expenses ...................................................................................................................................... 445,366 461,450 445,366 ............................ ¥16,084 Building Modernization ...................................................................................................................................... ............................ 2,000 2,000 ∂2,000 ............................

Total, Program administration ...................................................................................................................... 445,366 463,450 447,366 ∂2,000 ¥16,084 

OFFICE FOR CIVIL RIGHTS .......................................................................................................................................... 102,418 107,500 102,418 ............................ ¥5,082 OFFICE OF THE INSPECTOR GENERAL ........................................................................................................................ 59,700 62,347 59,700 ............................ ¥2,647 

Total, Departmental management ................................................................................................................ 607,484 633,297 609,484 ∂2,000 ¥23,813 Total, Title III, Department of Education ...................................................................................................... 71,206,835 74,511,115 72,526,616 ∂1,319,781 ¥1,984,499 

Current Year ......................................................................................................................................... (48,609,834 ) (51,914,114 ) (49,929,615 ) (∂1,319,781 ) (¥1,984,499 ) Fiscal year 2015 .................................................................................................................................. (22,597,001 ) (22,597,001 ) (22,597,001 ) ............................ ............................

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED ........................................... 5,364 5,396 5,396 ∂32 ............................

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 

OPERATING EXPENSES 

Domestic Volunteer Service Programs: 

Volunteers in Service to America [VISTA] ......................................................................................................... 94,631 94,820 94,820 ∂189 ............................National Senior Volunteer Corps: 

Foster Grandparents Program .................................................................................................................. 110,344 110,565 110,565 ∂221 ............................Senior Companion Program ...................................................................................................................... 46,628 46,722 46,722 ∂94 ............................Retired Senior Volunteer Program ............................................................................................................ 50,104 50,204 50,204 ∂100 ............................

Subtotal, Senior Volunteers ................................................................................................................. 207,076 207,491 207,491 ∂415 ............................Subtotal, Domestic Volunteer Service Programs ................................................................................. 301,707 302,311 302,311 ∂604 ............................

National and Community Service Programs: 

AmeriCorps State and National Grants ............................................................................................................ 343,659 345,800 345,800 ∂2,141 ............................Training and Technical assistance ................................................................................................................... 1,992 600 ............................ ¥1,992 ¥600 Innovation, Assistance, and Other Activities .................................................................................................... 53,174 61,830 58,224 ∂5,050 ¥3,606 
270 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Evaluation .......................................................................................................................................................... 2,988 5,000 5,000 ∂2,012 ............................National Civilian Community Corps .................................................................................................................. 31,818 29,882 30,000 ¥1,818 ∂118 State Commission Grants ................................................................................................................................. 13,414 14,841 15,306 ∂1,892 ∂465 

Subtotal, National & Community Service Programs .................................................................................... 447,045 457,953 454,330 ∂7,285 ¥3,623 Total, Operating expenses ............................................................................................................................ 748,752 760,264 756,641 ∂7,889 ¥3,623 

Payment to the National Service Trust ...................................................................................................................... 211,373 207,293 209,840 ¥1,533 ∂2,547 Salaries and Expenses ............................................................................................................................................... 82,677 87,109 88,209 ∂5,532 ∂1,100 Office of Inspector General ........................................................................................................................................ 3,984 6,466 6,466 ∂2,482 ............................

Total, Corp. for National and Community Service ....................................................................................... 1,046,786 1,061,132 1,061,156 ∂14,370 ∂24 

CORPORATION FOR PUBLIC BROADCASTING: 

Fiscal year 2016 (current) with Fiscal year 2015 comparable ........................................................................ 445,000 445,000 445,000 ............................ ............................Fiscal year 2015 advance with Fiscal year 2014 comparable (NA) ................................................................ (445,000 ) (445,000 ) (445,000 ) ............................ ............................Fiscal year 2014 advance with Fiscal year 2013 comparable (NA) ................................................................ (444,110 ) (445,000 ) (445,000 ) (∂890 ) ............................

Subtotal, Fiscal year 2014 appropriation ..................................................................................................... ............................ ............................ ............................ ............................ ............................

FEDERAL MEDIATION AND CONCILIATION SERVICE .................................................................................................... 46,071 47,620 47,000 ∂929 ¥620 FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION ...................................................................................... 17,569 16,423 17,000 ¥569 ∂577 INSTITUTE OF MUSEUM AND LIBRARY SERVICES ....................................................................................................... 231,490 225,813 231,490 ............................ ∂5,677 MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION ....................................................................................... 5,777 9,500 9,000 ∂3,223 ¥500 MEDICARE PAYMENT ADVISORY COMMISSION ........................................................................................................... 11,754 12,087 11,954 ∂200 ¥133 NATIONAL COUNCIL ON DISABILITY ............................................................................................................................ 3,251 3,345 3,345 ∂94 ............................NATIONAL HEALTH CARE WORKFORCE COMMISSION ................................................................................................. ............................ 3,000 3,000 ∂3,000 ............................NATIONAL LABOR RELATIONS BOARD ......................................................................................................................... 277,749 284,991 284,991 ∂7,242 ............................NATIONAL MEDIATION BOARD ..................................................................................................................................... 13,384 13,347 13,384 ............................ ∂37 OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION ..................................................................................... 11,644 12,634 12,300 ∂656 ¥334 
271 

RAILROAD RETIREMENT BOARD 

Dual Benefits Payments Account ............................................................................................................................... 50,813 39,000 39,000 ¥11,813 ............................Less Income Tax Receipts on Dual Benefits ............................................................................................................. ¥4,000 ¥3,000 ¥3,000 ∂1,000 ............................

Subtotal, Dual Benefits ................................................................................................................................ 46,813 36,000 36,000 ¥10,813 ............................

Federal Payment to the RR Retirement Account ....................................................................................................... 150 150 150 ............................ ............................Limitation on Administration ..................................................................................................................................... 110,927 111,739 110,927 ............................ ¥812 

Inspector General .............................................................................................................................................. 8,138 8,877 8,638 ∂500 ¥239 

SOCIAL SECURITY ADMINISTRATION 

Payments to Social Security Trust Funds .................................................................................................................. 20,404 16,400 16,400 ¥4,004 ............................

SUPPLEMENTAL SECURITY INCOME 

Federal Benefit Payments .......................................................................................................................................... 53,300,000 55,579,000 55,579,000 ∂2,279,000 ............................Mandatory Program Integrity ...................................................................................................................................... ............................ 587,000 ............................ ............................ ¥587,000 Beneficiary Services ................................................................................................................................................... 47,000 3,000 3,000 ¥44,000 ............................Research and Demonstration ..................................................................................................................................... 16,980 54,000 54,000 ∂37,020 ............................Administration ............................................................................................................................................................ 3,605,305 3,814,000 4,232,741 ∂627,436 ∂418,741 

Subtotal, SSI program level .......................................................................................................................... 56,969,285 60,037,000 59,868,741 ∂2,899,456 ¥168,259 

Less funds advanced in prior year ..................................................................................................... ¥18,200,000 ¥19,300,000 ¥19,300,000 ¥1,100,000 ............................

Subtotal, regular SSI current year ................................................................................................................ 38,769,285 40,737,000 40,568,741 ∂1,799,456 ¥168,259 

New advance, 1st quarter, Fiscal year 2015 ...................................................................................... 19,300,000 19,700,000 19,700,000 ∂400,000 ............................

Total, SSI program ........................................................................................................................................ 58,069,285 60,437,000 60,268,741 ∂2,199,456 ¥168,259 

LIMITATION ON ADMINISTRATIVE EXPENSES 

OASDI Trust Funds ..................................................................................................................................................... 5,309,388 5,091,671 5,063,298 ¥246,090 ¥28,373 HI/SMI Trust Funds ..................................................................................................................................................... 2,085,614 1,960,838 1,960,838 ¥124,776 ............................Social Security Advisory Board ................................................................................................................................... 2,142 2,300 2,300 ∂158 ............................SSI .............................................................................................................................................................................. 3,117,329 3,568,037 3,568,037 ∂450,708 ............................

Subtotal, regular LAE .................................................................................................................................... 10,514,473 10,622,846 10,594,473 ∂80,000 ¥28,373 

User Fees: 

SSI User Fee activities ...................................................................................................................................... 160,374 173,000 173,000 ∂12,626 ............................SSPA User Fee Activities ................................................................................................................................... 996 1,000 1,000 ∂4 ............................
272 

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2013 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL 

FOR FISCAL YEAR 2014—Continued 

[In thousands of dollars] 

Item 2013 appropriation Budget estimate Committee recommendation 

Senate Committee recommendation compared with (∂ or ¥) 

2013 appropriation Budget estimate 

Subtotal, User fees ....................................................................................................................................... 161,370 174,000 174,000 ∂12,630 ............................Subtotal, Limitation on administrative expenses ......................................................................................... 10,675,843 10,796,846 10,768,473 ∂92,630 ¥28,373 

Program Integrity Funding: 

OASDI Trust Funds ............................................................................................................................................ 268,076 27,037 532,296 ∂264,220 ∂505,259 SSI ..................................................................................................................................................................... 487,976 245,963 664,704 ∂176,728 ∂418,741 

Subtotal, Program integrity funding ............................................................................................................. 756,052 273,000 1,197,000 ∂440,948 ∂924,000 Total, Limitation on Administrative Expenses .............................................................................................. 11,431,895 11,069,846 11,965,473 ∂533,578 ∂895,627 

OFFICE OF THE INSPECTOR GENERAL 

Federal Funds ............................................................................................................................................................. 28,829 30,000 29,698 ∂869 ¥302 Trust Funds ................................................................................................................................................................ 73,249 75,733 74,972 ∂1,723 ¥761 

Total, Office of the Inspector General .......................................................................................................... 102,078 105,733 104,670 ∂2,592 ¥1,063 

Adjustment: Trust fund transfers from general revenues ......................................................................................... ¥3,605,305 ¥3,814,000 ¥4,232,741 ¥627,436 ¥418,741 

Total, Social Security Administration ........................................................................................................... 66,018,357 67,814,979 68,122,543 ∂2,104,186 ∂307,564 

Federal funds ....................................................................................................................................... 58,279,888 60,657,400 60,488,839 ∂2,208,951 ¥168,561 

Current year ................................................................................................................................ (38,979,888 ) (40,957,400 ) (40,788,839 ) (∂1,808,951 ) (¥168,561 ) New advances, 1st quarter ........................................................................................................ (19,300,000 ) (19,700,000 ) (19,700,000 ) (∂400,000 ) ............................

Trust funds .......................................................................................................................................... 7,738,469 7,157,579 7,633,704 ¥104,765 ∂476,125 

Total, Title IV, Related Agencies .................................................................................................................. 68,300,224 70,112,033 70,423,274 ∂2,123,050 ∂311,241 

Federal Funds ...................................................................................................................................... 60,430,936 62,821,751 62,658,051 ∂2,227,115 ¥163,700 

Current Year ................................................................................................................................ (40,685,936 ) (42,676,751 ) (42,513,051 ) (∂1,827,115 ) (¥163,700 ) Fiscal Year 2015 Advance .......................................................................................................... (19,300,000 ) (19,700,000 ) (19,700,000 ) (∂400,000 ) ............................Fiscal Year 2016 Advance .......................................................................................................... (445,000 ) (445,000 ) (445,000 ) ............................ ............................
273 

Trust Funds .......................................................................................................................................... 7,869,288 7,290,282 7,765,223 ¥104,065 ∂474,941 

Grand Total ................................................................................................................................................... 757,440,498 787,803,163 783,365,379 ∂25,924,881 ¥4,437,784 

1 President’s Budget request these funds in the Admin for community living at HHS. 2 Two year availability. 3 Section 4002 of Public Law 111–148. 

Æ