30–839 

115TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 115–862 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES 

APPROPRIATIONS BILL, 2019 

JULY 23, 2018.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. COLE, from the Committee on Appropriations, 

submitted the following 

R E P O R T 

together with 

MINORITY VIEWS 

[To accompany H.R. 6470] 

The Committee on Appropriations submits the following report in 

explanation of the accompanying bill making appropriations for the 

Departments of Labor, Health and Human Services (except the 

Food and Drug Administration, the Agency for Toxic Substances 

and Disease Registry and the Indian Health Service), and Education, and the Committee for Purchase from People Who Are 

Blind or Severely Disabled, Corporation for National and Community Service, Corporation for Public Broadcasting, Federal Mediation and Conciliation Service, Federal Mine Safety and Health Review Commission, Institute of Museum and Library Services, Medicaid and CHIP Payment and Access Commission, Medicare Payment Advisory Commission, National Council on Disability, National Labor Relations Board, National Mediation Board, Occupational Safety and Health Review Commission, Railroad Retirement 

Board, and Social Security Administration for the fiscal year ending September 30, 2019, and for other purposes. 

INDEX TO BILL AND REPORT 

Page number 

Bill Report 

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

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

2 

Page number 

Bill Report 

Title I—Department of Labor: 2 5 

Employment and Training Administration ....................................... 2 5 

Employee Benefits Security Administration ..................................... 17 10 

Pension Benefit Guaranty Corporation ............................................. 17 11 

Wage and Hour Division .................................................................... 18 11 

Office of Labor-Management Standards ........................................... 18 12 

Office of Federal Contract Compliance Programs ............................ 19 12 

Office of Workers’ Compensation Programs ..................................... 19 12 

Occupational Safety and Health Administration ............................. 23 14 

Mine Safety and Health Administration ........................................... 26 15 

Bureau of Labor Statistics ................................................................. 28 15 

Office of Disability Employment Policy ............................................. 28 16 

Departmental Management ............................................................... 28 16 

General Provisions .............................................................................. 34 19 

Title II—Department of Health and Human Services: 48 20 

Health Resources and Services Administration ............................... 48 20 

Centers for Disease Control and Prevention .................................... 55 35 

National Institutes of Health ............................................................. 60 52 

Substance Abuse and Mental Health Services Administration ...... 68 77 

Agency for Healthcare Research and Quality ................................... 73 86 

Centers for Medicare & Medicaid Services ....................................... 74 87 

Administration for Children and Families ........................................ 77 102 

Administration for Community Living .............................................. 86 109 

Office of the Secretary ........................................................................ 89 116 

Public Health and Social Services Emergency Fund ................ 92 123 

General Provisions .............................................................................. 94 126 

Title III—Department of Education: 111 129 

Education for the Disadvantaged ...................................................... 111 129 

Impact Aid ........................................................................................... 112 131 

School Improvement Programs .......................................................... 113 132 

Indian Education ................................................................................. 114 135 

Innovation and Improvement ............................................................. 115 136 

Safe Schools and Citizenship Education ........................................... 115 140 

English Language Acquisition ........................................................... 115 141 

Special Education ................................................................................ 116 141 

Rehabilitation Services ....................................................................... 119 143 

Special Institutions for Persons with Disabilities ............................ 120 145 

Career, Technical and Adult Education ............................................ 120 146 

Student Financial Assistance ............................................................. 121 148 

Student Aid Administration ............................................................... 121 149 

Higher Education ................................................................................ 121 150 

Howard University .............................................................................. 122 154 

College Housing and Academic Facilities Loans .............................. 123 155 

Historically Black College and University Capital Financing 

Program Account ............................................................................. 123 155 

Institute of Education Sciences .......................................................... 124 155 

Departmental Management ............................................................... 124 157 

General Provisions .............................................................................. 125 159 

Title IV—Related Agencies: 127 160 

Committee for the Purchase from People Who Are Blind or 

Severely Disabled ............................................................................ 127 160 

Corporation for National and Community Service ........................... 128 161 

Corporation for Public Broadcasting ................................................. 133 163 

Federal Mediation and Conciliation Service ..................................... 134 163 

Federal Mine Safety and Health Review Commission ..................... 135 163 

Institute of Museum and Library Services ....................................... 135 163 

Medicare Payment Advisory Commission ......................................... 136 164 

Medicaid and CHIP Payment and Access Commission ................... 135 165 

National Council on Disability ........................................................... 135 166 

3 

Page number 

Bill Report 

National Labor Relations Board ........................................................ 136 166 

National Mediation Board .................................................................. 139 167 

Occupational Safety and Health Review Commission ..................... 139 167 

Railroad Retirement Board ................................................................ 139 167 

Social Security Administration .......................................................... 141 168 

Title V—General Provisions: 146 173 

House of Representatives Report Requirements .............................. ........ 175 

SUMMARY OF ESTIMATES AND APPROPRIATIONS

The following table compares on a summary basis the appropriations, including trust funds for fiscal year 2019, the budget request 

for fiscal year 2019, and the Committee recommendation for fiscal 

year 2019 in the accompanying bill. 

2019 LABOR, HHS, EDUCATION BILL 

[Discretionary funding in thousands of dollars] 

Budget Activity 

Fiscal Year— 2019 Committee compared to— 

2018 Enacted 2019 Budget 2019 Committee 2018 Enacted 2019 Budget 

Department of Labor ......................... $12,217,573 $10,936,310 $12,128,762 ¥88,811 +1,192,452 

Department of Health and Human 

Services ......................................... 88,157,139 86,726,260 89,290,026 +1,132,887 +2,563,766 

Department of Education .................. 70,867,406 63,201,057 70,784,022 ¥83,384 +7,582,965 

Related Agencies ............................... 15,296,511 13,596,913 14,965,762 ¥330,749 +1,368,849 

GENERAL SUMMARY OF THE BILL

For fiscal year 2019, the Committee recommends a total of 

$179,002,000,000 in current year discretionary funding, including 

offsets and adjustments. The fiscal year 2019 recommendation is 

an increase of $6,000,000 above the fiscal year 2018 enacted level. 

Within the funds provided, the Committee has again focused increases on priority areas that will improve the health, safety and 

job opportunities for Americans of all walks of life. 

First and foremost, the Committee continues to build on the investments made over the past several years in biomedical research 

by increasing funding for the National Institutes of Health (NIH) 

by $1,250,000,000. Within the total increase, the Committee provides an increase of $401,000,000 for Alzheimer’s disease research, 

an increase of $100,000,000 for the Cancer Moonshot, and an increase of $30,000,000 for research to develop a universal influenza 

vaccine. The Committee also expands upon the Down syndrome research initiative established in fiscal year 2018. 

The Committee also continues efforts to support States and local 

communities combat the national scourge of opioid addiction by including an additional $500,000,000 for grants to States. The Committee maintains funding levels for opioid abuse prevention, treatment, and recovery and continues to support robust funding for 

mental and behavioral health. 

To protect public health and the Nation in the event of a bioterrorism attack or other public health emergency, the Committee recommendation includes increases for the Biomedical Research and 

Advanced Development Authority (BARDA), Project BioShield, the 

Strategic National Stockpile, the National Disaster Management 

System, and grants to States and regional coalitions to support 

4 

public health preparedness. Finally, to allow the Secretary of 

Health and Human Services greater flexibility to respond to an imminent public health threat without waiting for Congress to act on 

a supplemental spending bill, the Committee establishes 

$325,000,000 for a new Infectious Disease Rapid Response Reserve 

Fund. These funds will be held until needed in the event of an imminent infectious disease outbreak that threatens the health of 

Americans. 

To invest in workforce training, the Committee provides 

$6,988,602,000 in worker training programs of which 

$2,789,832,000 is for States’ training grants, $150,000,000 is to 

support the Administration’s apprenticeship initiatives, and 

$299,662,000 is for Veterans’ Employment and Training, including 

$50,000,000 for the Homeless Veterans’ Reintegration program, 

and a new initiative in the Transition Assistance Program to connect transitioning service members to apprenticeship opportunities. 

In the area of education, the Committee has included an increase 

of $100,000,000 for Student Support and Academic Enrichment 

grants, bringing this program total to $1,200,000,000. These funds 

can be used flexibly by school districts across the country to meet 

local challenges, whether those be in the area of counseling and 

preventing school based violence or teacher training. The Committee also provides funding for services to assist persons with disabilities live with dignity and support in their local communities. 

In the area of continuing education beyond high school, the Committee includes robust increases for the TRIO, $50,000,000, and 

GEAR UP, $10,000,000, programs to ensure that students from disadvantaged backgrounds have access to a college program. The 

Committee also includes an increase of $115,000,000 for career and 

technical education programs, to ensure that all students have the 

opportunity to continue to develop their skills after high school and 

enter into good paying jobs. Finally, the bill also provides sufficient 

funding to maintain the maximum Pell grant award at $6,095 in 

the 2019–2020 academic year. 

Finally, the Committee bill continues to invest in early childhood 

education by increasing the Head Start program by $50,000,000 

and including $250,000,000 within the Department of Health and 

Human Services for the Preschool Development Grants program. 

The Committee believes that public service is a public trust that 

requires Federal employees to place ethical principles above private 

gain. Federal employees are reminded that they shall not advance 

a personal agenda or give preferential treatment to any outside organization or individual within the government programs that they 

administer. Information that is received by the employee, including 

information from other employees, offices, or Congress should be 

handled in a professional and confidential manner in accordance 

with Code of Federal Regulations regarding the basic obligation of 

public service (5 CFR 2635.101). 

The Committee directs each of the agencies funded by this Act 

to continue to report any funds derived by the agency from nonFederal sources, including user charges and fines, that are authorized by law, to be retained and used by the agency or credited as 

an offset in annual budget submissions. 

5 

TITLE I—DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $10,018,202,000 

Budget request, fiscal year 2019 ....................................................... 8,787,050,000 

Committee Recommendation ............................................................. 9,801,934,000 

Change from enacted level ......................................................... ¥216,268,000 

Change from budget request ...................................................... +1,014,884,000 

The Employment and Training Administration (ETA) administers Federal job training grant programs and Trade Adjustment 

Assistance, and provides funding and oversight for the State Unemployment Insurance and Employment Service system. 

TRAINING AND EMPLOYMENT SERVICES

Appropriation, fiscal year 2018 ......................................................... $3,486,200,000 

Budget request, fiscal year 2019 ....................................................... 3,220,549,000 

Committee Recommendation ............................................................. 3,474,341,000 

Change from enacted level ......................................................... ¥11,859,000 

Change from budget request ...................................................... +253,792,000 

Training and Employment Services provides funding for Federal 

job training programs authorized primarily by the Workforce Innovation and Opportunity Act of 2014 (WIOA). 

Workforce Training.—The Committee reiterates its support for 

efforts by the Department of Labor to improve workforce training 

programs by building partnerships that will better serve participants by connecting them with in-demand jobs and helping to reduce the skills gap. 

Apprenticeship.—The Committee supports the funding and development of industry or sector partnerships as a means of closing the 

skills gap and expanding work-based learning programs and apprenticeships in in-demand industries. 

Licensing.—The Committee continues to support the Department’s efforts to address ways in which harmonizing licensing requirements across States can reduce barriers to labor market entry 

and mobility, including for dislocated workers, transitioning service 

members, and veterans. 

Work Opportunity Tax Credit.—The Committee supports efforts 

by the Department to assist States with the implementation of the 

Qualified Long-Time Unemployment Recipients category and to reduce backlogs of Supplemental Security Income eligibility determinations. 

Information Technology (IT) Consortia.—The Committee continues to be concerned with the challenges faced by Unemployment 

Insurance IT modernization projects being carried out by State consortia. The Committee directs the Department to continue to provide annual reports to the Committees on Appropriations of the 

House of Representatives and the Senate on the status of all consortia projects and to implement appropriate policies and procedures for assessing and funding projects by State consortia. 

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

$845,556,000, which is the same as the fiscal year 2018 enacted 

level and $30,000,000 more than the fiscal year 2019 budget request. 

6 

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

$903,416,000, which is the same as the fiscal year 2018 enacted 

level and $30,000,000 more than the fiscal year 2019 budget request. 

Dislocated Worker Employment and Training Activities.—For 

Dislocated Worker Employment and Training Activities, the Committee recommends $1,240,860,000 which is $20,859,000 less than 

the fiscal year 2018 enacted level and $74,141,000 more than the 

fiscal year 2019 budget request. 

Of the total provided for Dislocated Worker Employment and 

Training Activities, $1,040,860,000 is designated for State grants 

that provide core and intensive services, training, and supportive 

services for dislocated workers. In addition, States use these funds 

for rapid response assistance to help workers affected by mass layoffs and plant closures. 

The remaining $200,000,000 is available for the Dislocated Workers National Reserve (DWNR). The DWNR supports national emergency grants, technical assistance and demonstration projects as 

authorized by WIOA. The Committee recommendation eliminates 

advance appropriations for the DWNR by providing $200,000,000 

in current year funds and rescinding the advance provided in fiscal 

year 2018. No advance is provided for fiscal year 2020. The Committee recommendation includes $30,000,000 to assist dislocated 

workers in areas of the country with the highest rates of poverty. 

Native Americans.—For the Indian and Native American programs, the Committee recommends $55,000,000, which is 

$1,000,000 more than the fiscal year 2018 enacted level. The fiscal 

year 2019 budget request proposed no funding for this program. 

Migrant and Seasonal Farmworkers.—For the National Farmworker Jobs program, the Committee recommends $87,896,000, 

which is the same as the fiscal year 2018 enacted level. The fiscal 

year 2019 budget request proposed no funding for this program. 

YouthBuild.—For the YouthBuild program, the Committee recommends $92,534,000, which is $3,000,000 more than the fiscal 

year 2018 enacted level and $8,000,000 more than the fiscal year 

2019 budget request. 

The Committee is aware of challenges rural and Tribal communities have in applying for YouthBuild grants. The Committee encourages the Department to consider ways more rural and Tribal 

areas can participate in the YouthBuild program. 

Technical Assistance.—The Committee recommends no direct 

funding for technical assistance, which is the same as the fiscal 

year 2018 enacted level and $2,000,000 less than the fiscal year 

2019 budget request. WIOA provides the authority to use DWNR 

funds for technical assistance. 

Reintegration of Ex-Offenders.—The Committee recommends 

$93,079,000 for ex-offender retraining and reintegration activities, 

which is the same as the fiscal year 2018 enacted level and 

$14,755,000 more than the fiscal year 2019 budget request. 

Workforce Data Quality Initiative.—The Committee recommends 

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

same as the fiscal year 2018 enacted level. The fiscal year 2019 

budget request proposed no funding for this program. 

7 

JOB CORPS

Appropriation, fiscal year 2018 ......................................................... $1,718,655,000 

Budget request, fiscal year 2019 ....................................................... 1,296,938,000 

Committee Recommendation ............................................................. 1,718,655,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +421,717,000 

Operations.—For Job Corps Operations, the Committee rec- ommends $1,603,325,000, which is the same as the fiscal year 2018 

enacted level and $413,513,000 more than the fiscal year 2019 

budget request. 

Construction, Rehabilitation, and Acquisition.—The Committee 

recommends $83,000,000 for construction, rehabilitation, and acquisition activities of Job Corps centers, which is the same as the 

fiscal year 2018 enacted level and $7,984,000 more than the fiscal 

year 2019 budget request. 

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

the administrative expenses of the Job Corps program, which is the 

same as the fiscal year 2018 enacted level and $220,000 more than 

the fiscal year 2019 budget request. 

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

quality of their lives through vocational and academic training. 

The Committee continues to be concerned about the safety and 

security of students in the Job Corps program. With amounts provided in the fiscal years 2017 and 2018 Appropriations Acts, a total 

of $25,500,000 has been provided for Job Corps construction to address physical security at Job Corps campuses. The Committee directs the Department to submit a report within 90 days of enactment of this Act, the report should include the amounts and uses 

of funds provided to address physical security needs, planned uses 

of remaining funds, including funds provided in this Act, and an 

estimate of the costs of any remaining needs not addressed within 

current funding levels. 

On December 29, 2017, the Department of Labor Office of Inspector General (DOL–OIG) issued a report entitled ‘‘Job Corps Took 

Action To Mitigate Violence, Drugs, and Other Student Misconduct 

At Centers, But More Needs To Be Done’’ (Report Number: 26–18– 

001–03–370). The Committee directs the Department to work with 

the DOL–OIG to implement all remaining recommendations detailed in the report. 

The Committee is concerned that the Job Corps procurement 

process continues to experience delays or corrective actions that 

have resulted in a number of unnecessary and costly bridge contracts. The Committee directs the Department to review the Job 

Corps contract award process to reduce procurement disruptions, 

bid protests, corrective actions, and the use of bridge contracts. The 

Committee directs the Department to submit a report within 30 

days of the end of the fiscal year to the Committees on Appropriations of the House of Representatives and the Senate, and to the 

authorizing Committees of jurisdiction, with detail on each Job 

Corps contract awarded during the fiscal year, any corrective actions taken, whether the award was protested, the outcome of the 

protest, if a bridge contact was awarded, and whether the bridge 

contract was awarded as a result of an award protest or procurement backlog. 

8 

On March 30, 2018, DOL–OIG issued a report entitled ‘‘Job 

Corps Could Not Demonstrate Beneficial Job Training Outcomes’’ 

(Report Number: 04–18–001–03–370). The Committee is concerned 

with the DOL–OIG finding that Job Corps contractors could not 

demonstrate they had assisted participants in finding jobs for 94 

percent of the placements sampled. The Committee directs ETA to 

work with DOL–OIG to implement the recommendations provided 

in the report, to implement policies necessary to ensure that contractors report accurate and timely data to the Department as required, and to implement program policies that will improve job 

placement outcomes in the Job Corps program. 

The Committee remains concerned with the financial management of the Job Corps program and directs the Department to continue to work with ETA and DOL–OIG to improve financial and 

administrative oversight of the Job Corps program. 

COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS

Appropriation, fiscal year 2018 ......................................................... $400,000,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 400,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +400,000,000 

The Community Service Employment for Older Americans program provides grants to public and private non-profit organizations 

that subsidize part-time work in community service activities for 

unemployed persons aged 55 and older whose family income is 

below 125 percent of the poverty level. 

FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES

Appropriation, fiscal year 2018 ......................................................... $790,000,000 

Budget request, fiscal year 2019 ....................................................... 790,000,000 

Committee Recommendation ............................................................. 790,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... – – – 

The Trade Adjustment Assistance program (TAA) provides assistance to workers adversely affected by international trade. TAA 

provides training, income support, wage subsidies for older workers, job search and relocation allowances to groups of workers who 

file a petition and are certified as eligible to apply for such benefits 

due to job losses resulting from increases in imports or foreign 

trade. 

STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE

OPERATIONS

Appropriation, fiscal year 2018 ......................................................... $3,464,691,000 

Budget request, fiscal year 2019 ....................................................... 3,325,298,000 

Committee Recommendation ............................................................. 3,260,282,000 

Change from enacted level ......................................................... ¥204,409,000 

Change from budget request ...................................................... ¥65,016,000 

The total includes $3,176,216,000 from the Employment Security 

Administration Account from the Unemployment Trust Fund and 

$84,066,000 from the General Fund of the Treasury. These funds 

are used to support the administration of Federal and State unemployment compensation laws. 

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

9 

$2,529,713,000, which is $123,784,000 less than the fiscal year 

2018 enacted level and $24,897,000 more than the fiscal year 2019 

budget request. The total includes $2,515,816,000 for State Unemployment Compensation and $13,897,000 for National Activities. 

The recommendation provides contingency funding for increased 

workloads that States may face in the administration of UI. During 

fiscal year 2019, for every 100,000 increase in the total average 

weekly insured unemployment above 2,030,000, an additional 

$28,600,000 shall be made available from the Unemployment Trust 

Fund. 

On September 26, 2017, DOL–OIG issued a report entitled ‘‘Program Specific Performance Measures are Needed to Better Evaluate the Effectiveness of the Reemployment Services and Eligibility 

Assessment Program’’ (Report Number: 04–17–002–03–315). The 

Committee supports efforts detailed in the report by ETA to provide technical assistance, improve data quality, and assess performance of the Reemployment Services and Eligibility Assessment 

(RESEA) program. The Committee urges ETA to establish appropriate performance measures in order to effectively assess the impact and outcomes of the program. The Committee believes it is 

critical to obtain program data that will allow program administrators and policy-makers to assess the impact of the RESEA program 

on its participants and effectively compare RESEA program outcomes with those of other UI claimants. 

The Committee includes $117,000,000 for the RESEA program, and an additional $33,000,000 is made available pursuant to the 

Bipartisan Budget Act of 2018 (PL 115–123). The Committee continues to support the RESEA program and urges the Department 

to focus its efforts on reducing the rate of improper payments in 

the UI system. 

On June 13, 2017, DOL–OIG issued a report entitled DOL Needs 

to Do More to Reduce Improper Payments and Improve Reporting 

(Report Number 03–17–002–13–001). The Committee notes that 

the rate of improper payments in the UI program exceeds program 

goals and remains among the highest of any Federal program. The 

Committee directs ETA to work with DOL–OIG to implement the 

policies and controls necessary to make significant progress on reducing the rate of improper payments in the UI program. As part 

of this effort, the Committee encourages ETA to use the Unemployment Insurance Integrity Center of Excellence and the Reemployment Services and Eligibility Assessments programs to establish 

better monitoring and control over UI payments. The Committee 

also encourages the Department to promote access to data at entities funded through the UI system, including the Unemployment 

Insurance Integrity Center of Excellence, and the National Directory of New Hires, in order for ETA and DOL–OIG to better conduct their oversight responsibilities. 

The Committee is aware that trade-impacted dislocations are 

geographically sensitive, and that when there is a large worker dislocation, a particular local area or American Job Center (AJC) in 

a local area will experience a surge in the demand for services. The 

Committee urges the Department to continue assisting State agencies and AJCs, as appropriate, with Rapid Response activities to 

provide a surge response to these situations. The Committee also 

expects the Department to work closely with States and local AJCs 

10 

to understand if any difficulties in providing TAA services are related to service capacity issues. 

Employment Service.—The Committee recommends $605,606,000 

for the Employment Service, which is $80,625,000 less than fiscal 

year 2018 enacted level and $85,490,000 less than the fiscal year 

2019 budget request. The Committee directs the Department to 

limit the amount used for State administrative purposes to 20 percent and to ensure funding for client services is maintained at fiscal year 2018 enacted levels. 

Foreign Labor Certification.—The Committee recommends 

$62,310,000 for the Foreign Labor Certification (FLC) program, 

which is the same as the fiscal year 2018 enacted level and 

$118,000 more than the fiscal year 2019 budget request. The recommendation includes $48,028,000 for Federal administration and 

$14,282,000 for grants to States. 

The FLC program administers temporary foreign worker programs including the H–2A and the H–2B temporary visa programs. 

These programs are essential to employers in industries that have 

cyclical peaks or that are seasonal in nature, including agriculture, 

tourism, and hospitality. 

One-Stop Career Centers/Labor Market Information.—The Committee recommends $62,653,000 for One-Stop Career Centers and 

Labor Market Information, which is the same as the fiscal year 

2018 enacted level and $4,541,000 less than the fiscal year 2019 

budget request. 

ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS

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

funds are made available to accounts authorized under Federal and 

State unemployment insurance laws and the Black Lung Disability 

Trust Fund when the balances in such accounts are insufficient. 

PROGRAM ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $158,656,000 

Budget request, fiscal year 2019 ....................................................... 154,265,000 

Committee Recommendation ............................................................. 158,656,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +4,391,000 

The recommendation includes $108,674,000 from the General 

Fund of the Treasury and $49,982,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $181,000,000 

Budget request, fiscal year 2019 ....................................................... 189,500,000 

Committee Recommendation ............................................................. 180,600,000 

Change from enacted level ......................................................... ¥400,000 

Change from budget request ...................................................... ¥8,900,000 

The Employee Benefits Security Administration (EBSA) assures 

the security of retirement, health, and other workplace-related benefits of working Americans. 

The Committee is concerned that several large, private sector 

pension plans are increasingly at risk of becoming insolvent. The 

11 

Committee directs EBSA, in coordination with the Pension Benefit 

Guaranty Corporation (PBGC), to submit a report within 180 days 

of enactment of this Act to the Committee on Appropriations of the 

House of Representatives and the Senate, and to the authorizing 

Committees of jurisdiction, describing EBSA’s efforts to mitigate 

risks to the PBGC system through audits and enforcement activity. 

The Committee directs EBSA to provide information in the fiscal 

year 2020 Congressional Justification on current efforts at the Federal Retirement Thrift Investment Board to increase the participation of women, and minority-owned asset management firms in the 

management of Thrift Savings Plan funds. 

PENSION BENEFIT GUARANTY CORPORATION

Appropriation, fiscal year 2018 ......................................................... $424,417,000 

Budget request, fiscal year 2019 ....................................................... 445,363,000 

Committee Recommendation ............................................................. 445,363,000 

Change from enacted level ......................................................... +20,946,000 

Change from budget request ...................................................... – – – 

The Pension Benefit Guaranty Corporation (PBGC) protects the 

retirement incomes of nearly 40 million American workers in nearly 24,000 private-sector defined benefit pension plans. PBGC was 

created by the Employee Retirement Income Security Act of 1974 

to encourage the continuation and maintenance of private-sector 

defined benefit pension plans, provide timely and uninterrupted 

payment of pension benefits, and keep pension insurance premiums 

at a minimum. 

The recommendation includes bill language that defines Pension 

Benefit Guaranty Corporation’s discretionary authority to incur additional unforeseen and emergency administrative expenses related 

to its multiemployer plan insurance program. 

The Committee directs PBGC to submit reports required by the 

Employee Retirement Income Security Act of 1974 and the Pension 

Protection Act of 2006. 

WAGE AND HOUR DIVISION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $227,500,000 

Budget request, fiscal year 2019 ....................................................... 230,068,000 

Committee Recommendation ............................................................. 225,500,000 

Change from enacted level ......................................................... ¥2,000,000 

Change from budget request ...................................................... ¥4,568,000 

The Wage and Hour Division (WHD) enforces Federal minimum 

wage, overtime pay, recordkeeping, and child labor requirements of 

the Fair Labor Standards Act. WHD also has enforcement and 

other administrative responsibilities related to the Migrant and 

Seasonal Agricultural Worker Protection Act, the Employee Polygraph Protection Act, the Family and Medical Leave Act, the Davis 

Bacon Act, and the Service Contract Act. 

The Committee urges the WHD to consider updating relevant 

guidance, training, handbooks, or field manuals, as necessary, to 

the extent that it will help ensure that enforcement is current and 

consistent with applicable laws and regulations. 

The Committee supports the Executive Order on Exemption from 

Executive Order 13658 for Recreational Services on Federal Lands, 

issued on May 25, 2018, and the exemption prescribed in Section 

12 

2 of the order. Pursuant to Section 3, the Committee expects the 

Department to implement this exemption as soon as possible. 

The Committee notes that many Americans are on waiting lists 

for organ transplants and that waiting lists for kidney transplants 

in particular are very long. Removing barriers to live organ donation can help to significantly increase the number of transplants 

and reduce the amount of time recipients wait for transplants. The 

Committee supports efforts that seek to remove impediments to 

live organ donation for those willing to give the gift of life to others. 

The Committee requests that WHD give notice on its website, or 

in other public communications as appropriate, that living donors 

who are otherwise qualified under the Family Medical Leave Act 

are eligible for family medical leave when they donate solid organs, 

or portions thereof, to another person. 

OFFICE OF LABOR-MANAGEMENT STANDARDS

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $40,187,000 

Budget request, fiscal year 2019 ....................................................... 46,634,000 

Committee Recommendation ............................................................. 42,187,000 

Change from enacted level ......................................................... +2,000,000 

Change from budget request ...................................................... ¥4,447,000 

The Office of Labor Management Standards (OLMS) administers 

the Labor-Management Reporting and Disclosure Act, which establishes safeguards for union democracy and union financial integrity, and requires public disclosure reporting by unions, union officers, employees of unions, labor relations consultants, employers, 

and surety companies. 

The Committee urges OLMS to make more information publically available regarding its enforcement actions, including findings and remedies, as appropriate, in order to improve oversight 

and accountability under the Labor-Management Reporting and 

Disclosure Act. 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $103,476,000 

Budget request, fiscal year 2019 ....................................................... 91,100,000 

Committee Recommendation ............................................................. 99,476,000 

Change from enacted level ......................................................... ¥4,000,000 

Change from budget request ...................................................... +8,376,000 

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

outreach and education to workers and their advocates. 

OFFICE OF WORKERS’ COMPENSATION PROGRAMS

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $117,601,000 

Budget request, fiscal year 2019 ....................................................... 115,282,000 

Committee Recommendation ............................................................. 117,601,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +2,319,000 

13 

The recommendation includes $115,424,000 in General Funds 

from the Treasury and $2,177,000 from the Special Fund established by the Longshore and Harbor Workers’ Compensation Act. 

The Office of Workers’ Compensation Programs (OWCP) administers the Federal Employees’ Compensation Act, the Longshore 

and Harbor Workers’ Compensation Act, the Energy Employees Occupational Illness Compensation Program Act, and the Black Lung 

Benefits Act. These programs provide eligible injured and disabled 

workers and their survivors with compensation, medical benefits, 

and services including rehabilitation, supervision of medical care, 

and technical and advisory counseling. 

The Committee continues to support the efforts of OWCP to reduce fraud and abuse related to the prescription of compound pharmaceuticals and opioids. 

SPECIAL BENEFITS

Appropriation, fiscal year 2018 ......................................................... $220,000,000 

Budget request, fiscal year 2019 ....................................................... 230,000,000 

Committee Recommendation ............................................................. 230,000,000 

Change from enacted level ......................................................... +10,000,000 

Change from budget request ...................................................... – – – 

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

SPECIAL BENEFITS FOR DISABLED COAL MINERS

Appropriation, fiscal year 2018 ......................................................... $70,319,000 

Budget request, fiscal year 2019 ....................................................... 25,319,000 

Committee Recommendation ............................................................. 25,319,000 

Change from enacted level ......................................................... ¥45,000,000 

Change from budget request ...................................................... – – – 

The Committee recommends $25,319,000 for Special Benefits for 

Disabled Coal Miners. This amount is in addition to the 

$15,000,000 appropriated in fiscal year 2018 as an advance for the 

first quarter of fiscal year 2019. The total program level recommendation is $45,000,000 less than the fiscal year 2018 enacted 

level and the same as the fiscal year 2019 budget request. 

These funds provide mandatory benefits to coal miners disabled 

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

and for necessary administrative costs. The Committee recommendation also provides $14,000,000 as an advance appropriation for the first quarter of fiscal year 2020. These funds ensure 

uninterrupted payments to beneficiaries. 

ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL

ILLNESS COMPENSATION FUND

Appropriation, fiscal year 2018 ......................................................... $59,846,000 

Budget request, fiscal year 2019 ....................................................... 59,098,000 

Committee Recommendation ............................................................. 59,098,000 

Change from enacted level ......................................................... ¥748,000 

Change from budget request ...................................................... – – – 

These funds provide mandatory benefits to eligible employees or 

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

DOE; atomic weapons employees who suffer from a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of their work in producing or testing nuclear weapons; and 

14 

uranium workers covered under the Radiation Exposure Compensation Act. 

BLACK LUNG DISABILITY TRUST FUND

Appropriation, fiscal year 2018 ......................................................... $416,561,000 

Budget request, fiscal year 2019 ....................................................... 328,182,000 

Committee Recommendation ............................................................. 328,182,000 

Change from enacted level ......................................................... ¥88,379,000 

Change from budget request ...................................................... – – – 

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

benefits, or when mine employment ceased prior to 1970. The 

Black Lung Disability Trust Fund is financed by an excise tax on 

coal, reimbursements from responsible mine operators, and shortterm advances from the Treasury. The Emergency Economic Stabilization Act of 2008 authorized a restructuring of the Black Lung 

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

are retired. 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $552,787,000 

Budget request, fiscal year 2019 ....................................................... 549,033,000 

Committee Recommendation ............................................................. 545,250,000 

Change from enacted level ......................................................... ¥7,537,000 

Change from budget request ...................................................... ¥3,783,000 

The Occupational Safety and Health Act of 1970 established the 

Occupational Safety and Health Administration (OSHA) to assure 

safe and healthy working conditions by setting and enforcing 

standards and by providing training, outreach, education and assistance. 

Within the total for OHSA, the Committee provides the following 

amounts: 

Budget Activity FY 2019 

Committee 

Safety and Health Standards ......................................................................................................................... $18,000,000 

Federal Enforcement ....................................................................................................................................... 208,000,000 

Whistleblower Programs ................................................................................................................................. 17,500,000 

State Programs ............................................................................................................................................... 100,850,000 

Technical Support ........................................................................................................................................... 24,469,000 

Federal Compliance Assistance ..................................................................................................................... 73,981,000 

State Consultation Grants .............................................................................................................................. 59,500,000 

Training Grants .............................................................................................................................................. 0 

Safety and Health Statistics .......................................................................................................................... 32,900,000 

Executive Direction and Administration ......................................................................................................... 10,050,000 

The Committee urges OSHA to carefully consider public comments submitted in response to OSHA’s proposed regulation on 

Cranes and Derricks in Construction: Operator Certification Extension published by the Department of Labor in the Federal Register 

on August 30, 2017 (82 Fed. Reg. 41184 et seq.). In addition, the 

Committee encourages OSHA to prioritize comments on changes to 

the rule that would relieve regulatory burdens without compromising safety. 

15 

The explanatory statement accompanying the fiscal year 2016 

Consolidated Appropriations Act directed OSHA to notify the Committee on Appropriations of the House of Representatives and the 

Senate 10 days prior to the announcement of any new National, 

Regional, or Local Emphasis Program including the circumstances 

and data used to determine the need for the launch of the new program. The Committee directs OSHA to continue to provide such notices in fiscal year 2019. 

MINE SAFETY AND HEALTH ADMINISTRATION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $373,816,000 

Budget request, fiscal year 2019 ....................................................... 375,906,000 

Committee Recommendation ............................................................. 367,589,000 

Change from enacted level ......................................................... ¥6,227,000 

Change from budget request ...................................................... ¥8,317,000 

The Mine Safety and Health Administration (MSHA) enforces 

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

The Committee continues bill language designating up to 

$2,000,000 for mine rescue recovery activities, and provides for the 

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

of equipment. 

The Committee includes $10,537,000 for State assistance training grants and provides the authority to use such funds for the 

purchase and maintenance of equipment required by the ‘‘Lowering 

Miners’ Exposure to Respirable Coal Mine Dust, Including Continuous Personal Dust Monitors’’ regulation. 

The Committee supports the efforts of MSHA to reemphasize 

compliance assistance programs that help mine operators to improve safety and comply with regulations without the threat of punitive enforcement. 

The Committee appreciates the significant reductions in mining 

injury and illness rates that have been achieved in recent years 

and remains a strong proponent for vigilant mine safety oversight. 

The Committee notes significant worker dislocations and mine closures as a result of economic conditions throughout the mining industry, and in coal mining in particular. The Committee reiterates 

its support for the ongoing effort to bring MSHA enforcement into 

proportion by redistributing resources and activities to the areas 

where mine production is currently occurring. 

The Committee continues to support advances MSHA has made 

in mine rescue technology and communications. The Committee directs MSHA to assess its current mine rescue deployment capability and strategy and discuss ongoing operational and resource 

needs in the fiscal year 2020 Congressional Justification. 

BUREAU OF LABOR STATISTICS

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $612,000,000 

Budget request, fiscal year 2019 ....................................................... 609,386,000 

Committee Recommendation ............................................................. 612,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +2,614,000 

16 

The recommendation includes $547,000,000 from the General 

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

The Bureau of Labor Statistics (BLS) is an independent national 

statistical agency that collects, processes, analyzes, and disseminates essential economic data to the Congress, Federal agencies, 

State and local governments, businesses, and the public. Its principal surveys include the Consumer Price Index and the monthly 

unemployment series. 

Within the total for BLS, the Committee provides the following 

amounts: 

Budget Activity FY 2019 

Committee 

Employment and Unemployment Statistics ................................................................................................... $208,000,000 

Labor Market Information ............................................................................................................................... 65,000,000 

Prices and Cost of Living .............................................................................................................................. 210,000,000 

Compensation and Working Conditions ......................................................................................................... 83,000,000 

Productivity and Technology ........................................................................................................................... 10,800,000 

Executive Direction and Staff Services .......................................................................................................... 35,200,000 

OFFICE OF DISABILITY EMPLOYMENT POLICY

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $38,203,000 

Budget request, fiscal year 2019 ....................................................... 27,000,000 

Committee Recommendation ............................................................. 38,203,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +11,203,000 

Office of Disability Employment Policy provides policy guidance 

and leadership to eliminate employment barriers to people with 

disabilities. 

DEPARTMENTAL MANAGEMENT

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $337,844,000 

Budget request, fiscal year 2019 ....................................................... 261,035,000 

Committee Recommendation ............................................................. 270,444,000 

Change from enacted level ......................................................... -67,400,000 

Change from budget request ...................................................... +9,409,000 

The recommendation includes $270,136,000 from the General 

Fund of the Treasury and $308,000 from the Employment Security 

Administration Account in the Unemployment Trust Fund. The Departmental Management appropriation provides funds for the staff 

responsible for Departmental operations, management, and policy 

development. 

Within the total for Departmental Management, the Committee 

provides the following amounts: 

Budget Activity FY 2019 

Committee 

Program Direction and Support ..................................................................................................................... $29,750,000 

Departmental Evaluation ................................................................................................................................ 8,040,000 

Legal Services ................................................................................................................................................ 124,558,000 

International Labor Affairs ............................................................................................................................. 18,500,000 

Administration and Management ................................................................................................................... 28,450,000 

Adjudication .................................................................................................................................................... 35,000,000 

17 

Budget Activity FY 2019 

Committee 

Women’s Bureau ............................................................................................................................................. 13,750,000 

Civil Rights Activities ..................................................................................................................................... 6,880,000 

Chief Financial Officer ................................................................................................................................... 5,516,000 

On June 13, 2017, DOL–OIG issued a report entitled ‘‘DOL 

Needs to Do More to Reduce Improper Payments and Improve Reporting’’ (Report Number 03–17–002–13–001). The Committee believes that accurate data is an important aspect of reducing improper payments. The Committee appreciates that the Office of the 

Chief Financial Officer agreed with the information presented in 

the report and supports the reevaluation of its Federal Employees’ 

Compensation Act Improper Payments Methodology. 

The Committee directs the Chief Evaluation Officer to focus evaluation efforts on the delivery and efficiency of the Department of 

Labor programs with the goal of providing administrators with the 

information necessary to improve program performance and more 

effectively achieve agency goals. 

The Committee directs the Department to submit its annual Operating Plan to the Committees on Appropriations of the House of 

Representatives and the Senate within the 45-day statutory deadline. 

VETERANS EMPLOYMENT AND TRAINING

Appropriation, fiscal year 2018 ......................................................... $295,041,000 

Budget request, fiscal year 2019 ....................................................... 281,595,000 

Committee Recommendation ............................................................. 299,662,000 

Change from enacted level ......................................................... +4,621,000 

Change from budget request ...................................................... +18,067,000 

The recommendation includes $50,000,000 from the General 

Fund of the Treasury and $249,662,000 from the Employment Security Administration Account in the Unemployment Trust Fund. 

The Veterans Employment and Training (VETS) program serves 

America’s veterans and separating service members by preparing 

them for meaningful careers, providing employment resources and 

expertise, and protecting their employment rights. 

Within the total for VETS, the Committee provides the following 

amounts: 

Budget Activity FY 2019 

Committee 

State Administration Grants ......................................................................................................................... $180,000,000 

Transition Assistance Program ...................................................................................................................... 23,000,000 

Federal Administration ................................................................................................................................... 43,248,000 

Veterans Employment and Training Institute ................................................................................................ 3,414,000 

Homeless Veterans Reintegration Program .................................................................................................... 50,000,000 

The Committee continues to support the VETS program and encourages the Department to pursue opportunities to cooperate with 

other Federal, State, and private enterprises to help the country 

better serve its veterans. 

The Committee includes $3,500,000 for a pilot program within 

the authority of the Transition Assistance Program (TAP) to be 

used by the Secretary, in consultation with the Departments of Defense and Veterans Affairs, to prepare transitioning service members to qualify for apprenticeship programs and to assist them with 

18 

placement services as appropriate. The Committee believes apprenticeships can offer a pathway to a successful career by providing 

broad opportunities for paid, work-based learning, mentorship, 

classroom education or related instruction, and the ability to earn 

industry-recognized credentials in a safe, supervised work environment. The pilot is intended to identify effective approaches to obtaining qualifications and helping to place transitioning service 

members in apprenticeship programs as an additional training opportunity under TAP. The Committee expects the pilot program to 

include a robust evaluation component that will allow program administrators to assess the training strategy and determine, on a 

comparative basis, whether it is an effective approach to help 

transitioning service members enter the civilian workforce. 

The Committee includes $500,000 for the initiation of the HIRE 

Vets Medallion Program authorized by the Honoring Investments 

in Recruiting and Employing American Military Veterans Act of 

2017. 

INFORMATION TECHNOLOGY MODERNIZATION

Appropriation, fiscal year 2018 ......................................................... $20,769,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 29,169,000 

Change from enacted level ......................................................... +8,400,000 

Change from budget request ...................................................... +29,169,000 

Information Technology (IT) Modernization provides a dedicated 

source of funding for Department-wide IT modernization projects 

together with funding through the Department’s Working Capital 

Fund. 

The Committee expects the Department to prioritize projects that 

will result in cost savings by decommissioning legacy systems. 

The Committee directs the Department to assign a qualified 

project manager that is an employee of the Department to each 

modernization project to ensure that IT modernization projects are 

executed effectively, according to Departmental requirements, on 

schedule, and within budget. 

OFFICE OF INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $89,147,000 

Budget request, fiscal year 2019 ....................................................... 87,721,000 

Committee Recommendation ............................................................. 89,147,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +1,426,000 

The recommendation includes $83,487,000 from the General 

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

The DOL–OIG conducts audits of Department programs and operations in order to determine that they comply with the applicable 

laws and regulations, that they use resources effectively, and that 

they are achieving their intended results. 

The Committee supports the DOL–OIG efforts to reduce improper payments in the UI program, and to reduce fraud and abuse 

in the Workers’ Compensation programs related to the prescription 

of compound pharmaceuticals and opioids. 

19 

GENERAL PROVISIONS

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

use of Job Corps funds for the salary of an individual at a rate in 

excess of Executive Level II. 

(TRANSFER OF FUNDS)

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

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

transfer. 

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

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

Sec. 104. The Committee continues a provision related to grants 

made from funds available to the Department under the American 

Competitiveness and Workforce Improvement Act. 

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

(TRANSFER OF FUNDS)

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

to the Employment and Training Administration to Program Administration for technical assistance and program integrity activities. 

(TRANSFER OF FUNDS)

Sec. 107. The Committee continues a provision allowing up to 

0.75 percent of discretionary appropriations provided in this Act for 

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

the Chief Evaluation Officer for evaluation purposes. 

Sec. 108. The Committee continues a provision relating to the 

Fair Labor Standards Act and certain insurance personnel conducting post-disaster activity. 

(RESCISSION)

Sec. 109. The Committee continues a provision rescinding advance appropriations in the Dislocated Workers’ National Reserve 

account. 

Sec. 110. The Committee continues a provision relating to flexibility of H–2B nonimmigrant crossings. 

Sec. 111. The Committee continues a provision relating to the 

Secretary’s security detail. 

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

Working Capital Fund. 

20 

TITLE II—DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $6,736,753,000 

Budget request, fiscal year 2019 ....................................................... 9,559,591,000 

Committee Recommendation ............................................................. 6,540,385,000 

Change from enacted level ......................................................... ¥196,368,000 

Change from budget request ...................................................... ¥3,019,206,000 

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

medically underserved, and special populations; decrease infant 

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

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

PRIMARY HEALTH CARE

Appropriation, fiscal year 2018 ......................................................... $1,626,522,000 

Budget request, fiscal year 2019 ....................................................... 5,091,522,000 

Committee Recommendation ............................................................. 1,526,522,000 

Change from enacted level ......................................................... ¥100,000,000 

Change from budget request ...................................................... ¥3,565,000,000 

Health Centers 

The Committee recommends $1,525,522,000 for the Health Centers program, which is $100,000,000 less than the fiscal year 2018 

enacted level and $3,565,000,000 less than the fiscal year 2019 

budget request. 

The Committee includes bill language providing up to $114,893,000 for the Federal Tort Claims Act program, which is 

the same as the fiscal year 2018 enacted level and $15,000,000 

above the fiscal year 2019 budget request. This program provides 

medical malpractice liability protection to Federally supported 

health centers. 

The Committee provides not less than $20,000,000 for HRSA to 

perform audits and compliance reviews of all health center access 

points, with a goal of conducting a compliance or audit review that 

includes every access point location at least every five years for 

Federally Qualified Health Center Look-Alikes and Health Centers 

receiving a grant under section 330 of the Public Health Service 

Act. HRSA should provide uniform guidance to health center 

project officers, monitor project officer adherence to program guidance, and periodically assess whether program guidance is meeting 

program objectives. HRSA will conduct independent compliance reviews, ensuring all health center access points have policies, procedures, and training to comply with all applicable Federal laws. 

HRSA shall submit quarterly reports to the Committees on Appropriations of the House of Representatives and the Senate containing the results of all audits and compliance reviews of health 

center access points and oversight of health center project officers. 

Home Visiting.—Enhanced integration between health care providers and community programs helps transform the lives of vulnerable babies born to at-risk, first-time mothers. Research has 

shown that partnering first-time mothers with registered nurses or 

other professional that provide ongoing home visits dramatically 

improves the health and well-bring of these families. The ComVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00020 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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mittee encourages HRSA to expand partnerships between Health 

Centers and evidence-based home visiting programs in high need 

areas in order to improve pregnancy, child health and developments, and other health outcomes, all while reducing costs. 

Perinatal Transmission of Hepatitis B.—The Committee is aware 

that the 2017 National Academies of Sciences Engineering and 

Medicine (NASEM) report entitled ‘‘A National Strategy for the 

Elimination of Hepatitis B and C’’ reported that only half of the 

hepatitis B infected women who give birth each year are identified 

for case management, a proportion unchanged since 2000. The 

NASEM report also noted that without intervention about 90 percent of the infants born to HepatitisB infected women contract the 

virus at birth and are therefore at greater risk of premature death 

from liver cancer or cirrhosis later in life. The Committee is therefore pleased that HRSA has implemented a strategy to increase the 

capacity of HRSA funded clinics to address perinatal hepatitis B 

transmission, including the use of telehealth to link experts with 

clinic providers around the US. The Committee requests an update 

on this effort in the fiscal year 2020 Congressional Justification. 

HRSA should include in its update information on the findings and 

recommendations on the effectiveness of this intervention. 

Tuberculosis.—The National Action Plan for Combating Drug Resistant Tuberculosis recommended the creation of health-care liaisons between State and local health departments and institutions, 

including health centers that serve hard-to-reach groups at risk for 

Tuberculosis (TB). The Committee has previously directed the Administrator to report on coordination between health centers and 

State and local TB control programs to help ensure appropriate 

identification, treatment, and prevention of TB among vulnerable 

populations. The Committee requests an update in the fiscal year 

2020 Congressional Justification on this topic. 

Free Clinics Medical Malpractice 

The Committee recommends $1,000,000 for carrying out responsibilities under the Federal Tort Claims Act. This amount is the 

same as fiscal year 2018 enacted level and the fiscal year 2019 

budget request. The program provides medical malpractice coverage to individuals involved in the operation of free clinics in 

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

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

Health Service, and therefore eligible for coverage. 

HEALTH WORKFORCE

Appropriation, fiscal year 2018 ......................................................... $1,060,695,000 

Budget request, fiscal year 2019 ....................................................... 457,798,000 

Committee Recommendation ............................................................. 1,244,006,000 

Change from enacted level ......................................................... +183,311,000 

Change from budget request ...................................................... +786,208,000 

Health Professions 

The Committee recommends $719,006,000 for the health professions programs, which is $26,689,000 below the fiscal year 2018 enacted level and $321,208,000 above the fiscal year 2019 budget request. The Health Professions programs support grants for the deVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00021 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
22 

velopment of the health workforce in fields challenged by a high 

need and insufficient supply of health professionals. Given that colleges and universities serve the dual role of training students and 

carrying out a majority of Federally-funded biomedical research, 

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

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

Budget Activity FY 2019 

Committee 

National Health Service Corps ....................................................................................................................... $105,000,000 

Tribal Set-aside ..................................................................................................................................... 20,000,000 

Rural Set-aside ..................................................................................................................................... 15,000,000 

Health Professions Training for Diversity: 

Centers of Excellence ............................................................................................................................ 23,711,000 

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

Scholarships for Disadvantaged Students ............................................................................................ 48,970,000 

Workforce Information and Analysis .............................................................................................................. 5,663,000 

Primary Care Training and Enhancement ...................................................................................................... 48,924,000 

Oral Health Training Programs ...................................................................................................................... 38,673,000 

Dental Faculty Loan Repayment .................................................................................................................... 2,000,000 

Interdisciplinary Community-based Linkages: 

Area Health Education Centers ............................................................................................................. 38,250,000 

Geriatric Programs ................................................................................................................................ 40,737,000 

Graduate Psychology Education ............................................................................................................ 24,916,000 

Behavioral Health Workforce Education and Training .......................................................................... 82,500,000 

Public Health and Preventive Medicine ......................................................................................................... 17,000,000 

Advanced Education Nursing ......................................................................................................................... 66,581,000 

Nurse Education, Practice, and Retention ..................................................................................................... 41,913,000 

Nursing Workforce Diversity ........................................................................................................................... 17,343,000 

NURSE Corps Scholarship and Loan Repayment ........................................................................................... 87,135,000 

Nursing Faculty Loan Program ....................................................................................................................... 28,500,000 

Primary Care Training and Enhancement 

The Committee encourages HRSA to prioritize funds for the 

training of physician assistants. 

Eating Disorders.—The Committee encourages integration of evidence-based training for health professionals to screen, access, intervene, and refer patients to specialized treatment for the severe 

mental illness of eating disorders as authorized under the 21st 

Century Cures Act (PL 114–255). 

Oral Health Training 

The Committee recommends $38,673,000 for Oral Health Training programs, which is the same as the fiscal year 2018 enacted 

level and $38,673,000 above the fiscal year 2019 budget request. 

These programs serve to increase the number of medical graduates 

from minority and disadvantaged backgrounds and to encourage 

students and residents to choose primary care fields and practice 

in underserved urban and rural areas. 

Within the funds provided, the Committee includes not less than 

$12,000,000 for General Dentistry Programs and not less than 

$12,000,000 for Pediatric Dentistry programs. HRSA is directed to 

provide continuation funding for pre-doctoral and postdoctoral 

training grants initially awarded in fiscal year 2015. 

23 

Dental Faculty Loan Repayment 

The Committee recommends $2,000,000 for the Dental Faculty 

Loan Repayment program, which is the same as the fiscal year 

2018 enacted level and $2,000,000 above the fiscal year 2019 budget request. This program seeks to increase the number of dental 

and dental hygiene faculty in the workforce by assisting dental and 

dental hygiene training programs to attract and retain dental and 

dental hygiene faculty through loan repayment. 

The Committee directs HRSA to provide continuation funding for 

grants initially awarded in fiscal years 2016, 2017, and 2018. The 

Committee strongly supports the work of pediatric dentistry faculty 

supervising residents at dental training institutions providing clinical services in dental clinics located in dental schools, hospitals, 

and community-based affiliated sites. 

Area Health Education Centers 

The Committee has included funding for Area Health Education 

Centers (AHEC) oral health projects that establish primary points 

of service and address the need to help patients find treatment outside of hospital emergency rooms. The Committee is aware that 

some state dental associations have already initiated programs to 

refer emergency room patients to dental networks. HRSA is urged 

to work with those programs. 

The AHEC program facilitates the diversity of the healthcare 

workforce; increases access to healthcare; delivers vital patient 

care; reduces health disparities; improves health outcomes; and increases revenue through creating new jobs and services. AHEC 

centers are improving the distribution of the health professions 

workforce, particularly in rural and underserved areas and preparing health professionals to expand collaborative practice and 

team models of care. The AHEC programs and centers play a critical national role in addressing health care workforce shortages, 

particularly those in primary care through an established infrastructure. The AHEC Program grantees support the recruitment 

and retention of physicians, students, faculty and other primary 

care providers in rural and medically underserved areas by providing local, community-based, interdisciplinary primary care training. 

Graduate Psychology Education 

The Committee recommendation includes $24,916,000 for the 

inter-professional Graduate Psychology Education Program to increase the number of health service psychologists trained to provide integrated services to high-need, underserved populations in 

rural and urban communities. In addressing the opioid epidemic, 

the Committee recognizes the growing need for highly trained mental and behavioral health professionals to deliver evidence-based 

behavioral interventions for pain management. The Committee encourages HRSA to invest in programs that expand access to treatment for substance use disorders in Federally Qualified Health 

Centers. The Committee also encourages HRSA to invest in 

geropsychology training programs and to help integrate health 

service psychology trainees at Federally Qualified Health Centers. 

24 

Behavioral Health Workforce Education and Training 

The Committee recommends $82,500,000 for the Behavioral 

Health Workforce Education and Training Grant Program. This 

program establishes or expands internships or field placement programs in behavioral health serving populations in rural and medically underserved areas. 

Nursing Education, Practice, and Retention 

Veteran’s Bachelor of Science Degree in Nursing.—The Nurse 

Education, Practice, Quality and Retention Program’s Veteran’s 

Bachelor of Science Degree in Nursing has been important in helping our nation’s veterans progress and graduate with a Bachelor of 

Science in Nursing degree. The Committee supports the enacted 

level for these efforts and urges HRSA to continue this vital program, aimed at helping veterans transition to civilian life, removing barriers, and building our nursing workforce. HRSA should either continue to support current grantees or re-compete this program in fiscal year 2019, placing emphasis on institutions that already have a program in place to support these veterans moving 

to nursing careers. 

Children’s Hospitals Graduate Medical Education 

The Committee recommends $325,000,000 for the Children’s Hospitals Graduate Medical Education Payment program, which is 

$10,000,000 more than the fiscal year 2018 enacted level and 

$325,000,000 more than the fiscal year 2019 budget request. The 

Children’s Hospitals Graduate Medical Education Payment program helps eligible hospitals maintain graduate medical education 

programs, which support the training of residents to care for the 

pediatric population and enhance the supply of primary care and 

pediatric medical and surgical subspecialties. 

Graduate Medical Education 

Numerous studies have found evidence of a future shortage of 

physicians, particularly for primary care. To ensure access to care 

for impacted areas, the Committee includes $200,000,000 for grants 

to four year public universities to support expanded and existing 

graduate education programs for health care professions. The Committee includes bill language directing HRSA to prioritize applications from Colleges of Medicine located in States with a projected 

primary care provider shortage. Within the States in the top quartile of primary care provider shortage, HRSA is directed to give additional priority to applications from universities who serve a large 

percentage of Medicaid beneficiaries or are located in States with 

a significant proportion of Federally recognized Tribes. 

National Practitioner Data Bank 

The Committee assumes $18,814,000 for the National Practitioner Data Bank, which is the same as the fiscal year 2018 enacted level and the fiscal year 2019 budget request. The Committee 

recommendation and the fiscal year 2019 budget request assume 

that the data bank will be self-supporting. The Committee continues to include bill language to ensure that user fee collections 

cover the full costs of data bank operations. 

25 

MATERNAL AND CHILD HEALTH

Appropriation, fiscal year 2018 ......................................................... $886,789,000 

Budget request, fiscal year 2019 ....................................................... 1,136,200,000 

Committee Recommendation ............................................................. 893,089,000 

Change from enacted level ......................................................... +6,300,000 

Change from budget request ...................................................... ¥243,111,000 

Maternal and Child Health Block Grant 

The Committee recommends $655,000,000 for the Maternal and 

Child Health Block Grant, which is $3,300,000 more than the fiscal 

year 2018 enacted level and $27,300,000 more than the fiscal year 

2019 budget request. States use the block grant to improve access 

to care for mothers, children, and their families; reduce infant mortality; provide pre- and post-natal care; support screening and 

health assessments for children; and provide systems of care for 

children with special health care needs. 

Neonatal Abstinence Syndrome.—The Committee is alarmed by 

reports that the leading cause of maternal mortality in a growing 

number of States is overdose and suicide, with a direct connection 

to the opioid epidemic. The Committee also recognizes the work 

done to implement the Protecting Our Infants Act of 2015 (PL 114– 

91), which culminated in a strategy to address gaps in research; 

overlaps, duplication, or gaps in the relevant Federal programs; 

and coordination of Federal efforts to address neonatal abstinence 

syndrome with recommendations regarding maternal and child prevention, treatment, and services. An October 2017 GAO report entitled ‘‘Newborn Health: Federal Action Needed to Address Neonatal 

Abstinence Syndrome’’ recommended that HHS expeditiously develop a plan for implementing the recommendations included in the 

strategy. The Committee requests an update in the fiscal year 2020 

Congressional Justification on implementation of recommendations 

outlined in the strategy and identification of barriers to implementation, including specifics on any areas where Congressional action 

is needed. 

Special Projects of Regional and National Significance 

The Committee continues bill language identifying specific 

amounts for Special Projects of Regional and National Significance 

(SPRANS). The Committee provides the following within SPRANS: 

Budget Activity FY 2019 

Committee 

Set-aside for Oral Health ............................................................................................................................... $5,250,000 

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

Set-aside for Sickle Cell Disease ................................................................................................................... 3,000,000 

Set-aside for Fetal Alcohol Syndrome ............................................................................................................ 477,000 

Set-aside for Neonatal Abstinence Syndrome ................................................................................................ 1,300,000 

Alliance for Innovation on Maternal Health.—The Committee is 

aware that more women in the US die from pregnancy complications than in any other developed country, and that the maternal 

mortality rate rose by 26 percent from 2000 to 2014, and continues 

to rise. The Committee recognizes the vital role of the Alliance for 

Innovation on Maternal Health (AIM) in reducing maternal mortality and morbidity in the US by engaging provider organizations, 

State-based health and public health systems, consumer groups, 

and other stakeholders within a national partnership to assist 

26 

State-based teams in implementing evidence-based maternal safety 

bundles. Maternal safety bundles are a set of targeted, straightforward, and evidence-based practices, that, when reliably implemented, improve patient outcomes and reduce maternal mortality 

and severe maternal morbidity. HRSA is encouraged to continue to 

support AIM with adequate funding to meet the growing desire of 

States and hospital systems to participate in the program. 

Cell-free DNA Prenatal Screening.—The Committee recognizes 

the importance the medical genetics workforce plays in delivering 

on the promise of precision medicine, particularly given the unprecedented advances in genetic testing and the rapid and widespread 

application of these tests across all of medicine. Appropriate preand posttest education and counseling are critical for optimal implementation and the avoidance of harm. The Committee requests 

that the GAO conduct a nationwide analysis of the medical genetics 

workforce, to include all medical genetics professionals. GAO’s 

analysis should include a determination as to whether there are 

sufficient qualified professionals for this important and growing 

health need, as well as whether there are particular geographic 

areas of the country that lack access to genetics counseling. 

Childhood Cancer.—The Committee requests that GAO conduct 

a review and submit recommendations to Congress on existing barriers to obtaining and paying for adequate medical care for survivors of childhood cancer. This report would include identifying existing barriers to the availability of complete and coordinated survivorship care for survivors of childhood cancer and make recommendations to provide improved access and payment plans for 

childhood cancer survivorship programs and palliative care, including psychosocial services. 

Hemophilia Treatment Centers.—The Committee provides level 

funding for Hemophilia Treatment Centers. The Regional Hemophilia Network Program uses a regional infrastructure of hemophilia treatment centers to promote and improve the comprehensive care of individuals with hemophilia and related bleeding disorders or clotting disorders. 

Improving Child Health.—The Committee provides level funding 

for the third year of an ongoing study focused on improving child 

health through a statewide system of early childhood developmental screenings and interventions. 

Infant-Toddler Court Teams.—The Committee includes 

$3,000,000, within SPRANS, for the second year of a contract or cooperative agreement to support research-based Infant-Toddler 

Court Teams to change child welfare practices to improve wellbeing for infants, toddlers, and their families. This funding should 

help to build on and continue the work of sites established through 

the Quality Improvement Center for Research-based Infant-Toddler 

Court Teams, including by providing training and technical assistance in support of such court teams’ efforts across the country. 

Oral Health Literacy.—The Committee includes $1,000,000 within SPRANS for HRSA to develop and implement an oral health 

awareness and education campaign across all of the relevant HRSA 

divisions, including the Health Centers Program, Oral Health 

Workforce, Maternal and Child Health, Ryan White HIV/AIDS Program, and Rural Health. The Committee expects HRSA to ensure 

these divisions collaborate in developing and implementing the 

27 

campaign. As part of this campaign, the Committee directs HRSA 

to identify oral health literacy strategies that are evidence-based 

and focused on oral healthcare prevention and education, including 

prevention of oral disease such as early childhood and other caries, 

periodontal disease, and oral cancer. The Committee expects the 

Chief Dental Officer to play a key role in the design, monitoring, 

oversight, and implementation of this project. 

Set-aside for Neonatal Abstinence Syndrome.—The Committee is 

alarmed by the prevalence of Neonatal Abstinence Syndrome 

(NAS), or babies born exposed to opioids and other drugs during 

pregnancy, and the health issues these newborns face. The Committee provides $1,300,000 to address NAS in areas where the reported NAS incidence rate exceeds the national average. 

Set-aside for Oral Health.—The Committee includes 250,000 to 

continue demonstration projects to increase the implementation of 

integrating oral health and primary care practice. The projects 

should model the core clinical oral health competencies for non-dental providers that HRSA published and initially tested in its 2014 

report, ‘‘Integration of Oral Health and Primary Care Practice.’’ 

The Committee expects the Chief Dental Officer to continue to direct the design, monitoring, oversight, and implementation of these 

projects. 

Thalassemia.—HRSA has a long history of supporting thalassemia services. The thalassemia program has been instrumental in 

aiding patients with this inherited blood disorder, especially as 

treatments and best practices have evolved over time. The Committee strongly encourages HRSA to reconstitute this program in 

order to ensure the continued improvement of care and treatment 

options for patients with this complex and debilitating blood disorder. 

Maternal and Child Health Programs 

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

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

families. These programs support activities that develop systemic 

mechanisms for the prevention and treatment of sickle cell disease; 

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

screening of heritable disorders; provide grants to reduce infant 

mortality and improve perinatal outcomes; fund States to conduct 

newborn hearing screening; and provide grants to improve existing 

emergency medical services. 

Within the total for Maternal and Child Health Programs, the 

Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

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

Autism and Other Developmental Disorders .................................................................................................. 52,099,000 

Heritable Disorders ......................................................................................................................................... 16,883,000 

Healthy Start .................................................................................................................................................. 110,500,000 

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

Emergency Medical Services for Children ...................................................................................................... 22,334,000 

Screening and Treatment for Maternal Depression ....................................................................................... 5,000,000 

Pediatric Mental Health Access ..................................................................................................................... 9,000,000 

28 

Autism and Other Developmental Disorders 

The Committee recommends $52,099,000 for Autism and Other 

Developmental Disorders; this funding level is $3,000,000 more 

than the fiscal year 2018 enacted level and $52,099,000 above the 

fiscal year 2019 budget request. These programs seek to improve 

the health and well-being of children and adolescents with autism 

spectrum disorder and other developmental disabilities and to advance best practices for the early identification and treatment of 

autism and related developmental disabilities. 

Leadership Education in Neurodevelopmental and Related Disabilities.—The Committee provides not less than $36,000,000 for 

the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program to maintain the program’s capacity to 

train professionals to screen, diagnose, and provide evidence-based 

interventions to individuals with autism spectrum disorder and 

other developmental disabilities as authorized by the Autism 

CARES Act (PL113–157). This program provides advanced training 

to students and fellows from at least 12 disciplines in the identification, assessment, and treatment of children and youth with a 

wide range of developmental disabilities, including autism. The 52 

LEND network programs in 44 states are making significant 

strides toward improved screening and diagnosis of autism among 

younger children and helping to train healthcare professionals who 

treat a number of different developmental and intellectual disabilities. 

Pediatric Neurodevelopmental Delivery of Care.—The Committee 

encourages the Secretary of HHS to collaborate with public and 

private non-profit organizations with expertise in pediatric 

neurodevelopmental disabilities, including autism, to develop a 

pilot project designed to improve the delivery and coordination of 

care and to lower costs through integrated subspecialty outpatient 

service delivery models that incorporate comprehensive diagnostic 

services and therapeutic care for pediatric neurodevelopmental disability patients, including those with autism. The Committee requests an update on this activity in fiscal year 2020 Congressional 

Justification. 

Heritable Disorders 

The Committee provides $16,883,000 for the Heritable Disorders program, which is $1,000,000 more than the fiscal year 2018 enacted level and $16,883,000 more than the fiscal year 2019 budget 

request. Newborn Screening is a complex public health system that 

relies on coordinated actions by stakeholders, including clinicians, 

hospitals, parents, labs, and public health professionals. HRSA’s 

Heritable Disorders Program supports a number of activities that 

strengthen this system to ensure infants born in every State receive rapid identification, early intervention, and potentially lifesaving treatment. 

Newborn Screening.—Newborn Screening (NBS) is a complex 

public health system that relies on coordinated actions by stakeholders, including clinicians, hospitals, parents, labs, and public 

health professionals. HRSA’s Heritable Disorders Program supports 

a number of activities that strengthen this system to ensure infants born in every State receive rapid identification, early intervention, and potentially life-saving treatment. With new funding 

29 

provided in fiscal year 2019, the Heritable Disorders program will 

support expansion of efforts to add new conditions to state newborn 

screening panels. Beginning in fiscal year 2015, Congress provided 

an additional $2,000,000 to support the wider implementation, education, and awareness of NBS for a single disorder, Severe Combined Immune Deficiency. Forty-five States now universally screen 

infants for that disorder. HRSA will build on that successful program by providing grants to support States with the implementation, education, and awareness of newborn screening for new conditions recently added to the Recommended Uniform Screening 

Panel, including Pompe, Mucopolysaccharidosis I, and X-linked 

adrenoleukodystrophy. The program will also disseminate national, 

regional, and State education and training resources for parents, 

families and providers. 

Pediatric Hospice Care.—The Committee recognizes the importance of pediatric hospice care. The Committee understands the 

unique conditions surrounding pediatric hospice care and grief support for families including the need to support family members, the 

recognition that child death can have more intense and longer 

grieving periods, and the need for development of best practices for 

counseling, support, medication, and other factors impacting the 

end of life experience for children. The Committee encourages 

HRSA through the Heritable Disorders Program to work with experienced hospice providers which are not conflicted by decisions of 

whether to provide hospice or curative treatments in the hospital 

to children nearing the end of life to establish a pilot program 

aimed at developing best practices. 

Severe Combined Immune Deficiency.—Within the amount for 

Heritable Disorders, the Committee provides $2,000,000 for the 

second year of a grant to continue supporting wider implementation, education, and awareness of newborn screening for Severe 

Combined Immune Deficiency. 

Healthy Start 

The Committee recommends $110,500,000 for the Healthy Start 

program, which is the same as the fiscal year 2018 enacted level 

and $7,000,000 more than the fiscal year 2019 budget request. The 

program provides discretionary grants to communities with high 

rates of infant mortality to support primary and preventive health 

care services for mothers and their infants. 

RYAN WHITE HIV/AIDS PROGRAM

Appropriation, fiscal year 2018 ......................................................... $2,318,781,000 

Budget request, fiscal year 2019 ....................................................... 2,260,170,000 

Committee Recommendation ............................................................. 2,318,781,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +58,611,000 

The Ryan White Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) program funds activities to 

address the care and treatment of persons living with HIV/AIDS 

who are either uninsured or underinsured and need assistance to 

obtain treatment. The program provides grants to States and eligible metropolitan areas to improve the quality, availability, and coordination of health care and support services to include access to 

HIV-related medications; grants to service providers for early interVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00029 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
30 

vention outpatient services; grants to organizations to provide care 

to HIV infected women, infants, children, and youth; and grants to 

organizations to support the education and training of health care 

providers. 

Within the total for the Ryan White HIV/AIDS program, the 

Committee provides the following amounts: 

Budget Activity FY 2019 

Committee 

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

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

AIDS Drug Assistance Program ............................................................................................................. 900,313,000 

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

Children, Youth, Women, and Families .......................................................................................................... 75,088,000 

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

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

Special Projects of National Significance ...................................................................................................... 25,000,000 

HEALTH CARE SYSTEMS

Appropriation, fiscal year 2018 ......................................................... $111,693,000 

Budget request, fiscal year 2019 ....................................................... 116,518,000 

Committee Recommendation ............................................................. 121,693,000 

Change from enacted level ......................................................... +10,000,000 

Change from budget request ...................................................... +5,175,000 

These programs support national activities that enhance health 

care delivery in the US. Activities include maintaining a national 

system to allocate and distribute donor organs to individuals awaiting transplant; building an inventory of cord blood units; maintaining a national system for the recruitment of bone marrow donors; 

operating the 340B drug discount program; and operating a national toll-free poison control hotline. 

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

Budget Activity FY 2019 

Committee 

Organ Transplantation ................................................................................................................................... $25,549,000 

National Cord Blood Inventory ....................................................................................................................... 17,266,000 

C.W. Bill Young Cell Transplantation Program .............................................................................................. 25,109,000 

Office of Pharmacy Affairs ............................................................................................................................. 15,238,000 

Poison Control Centers ................................................................................................................................... 22,846,000 

Hansen’s Disease Program ............................................................................................................................ 13,706,000 

Hansen’s Disease Buildings and Facilities ................................................................................................... 122,000 

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

National Cord Blood Inventory 

The Committee recommends $17,266,000 for the National Cord 

Blood Inventory, which is $2,000,000 more than the fiscal year 

2018 enacted level and $5,000,000 more than the fiscal year 2019 

budget request. The National Cord Blood Inventory program builds 

a genetically and ethnically diverse inventory of high-quality umbilical cord blood for transplantation. 

The Committee strongly supports the collection of umbilical cord 

blood, which may be used to treat many blood and bone marrow 

disorders such as leukemia, lymphoma, and sickle cell disease. In 

order to expand access to life-saving transplants, the Committee 

urges HRSA to fund public cord blood bank pilot demonstrations 

that are focused on increasing recruitment of donors and banking 

31 

of cord blood units from diverse populations. In addition, the Committee encourages HRSA to support proposals for novel pilot programs using cord blood and tissue-derived cellular therapies in regenerative therapies. 

C.W. Bill Young Cell Transplantation Program 

The Committee recommends $25,109,000 for the C.W. Bill Young Cell Transplantation program, which is $1,000,000 more than the 

fiscal year 2018 enacted level and $3,000,000 more than the fiscal 

year 2019 budget request. The C.W. Bill Young Cell Transplantation Program provides support to patients who need a bone marrow transplant or umbilical cord blood transplant. A bone marrow 

or cord blood transplant may be needed for some patients who have 

leukemia, lymphoma, sickle cell anemia, or other inherited metabolic or immune system disorders. 

Office of Pharmacy Affairs 

The Committee provides $15,238,000 for the Office of Pharmacy Affairs (OPA), which is $5,000,000 more than the fiscal year 2018 

enacted level and $11,000,000 less than the fiscal year 2019 budget 

request. The Office of Pharmacy Affairs oversees the 340B Drug 

Pricing Program, which requires drug manufacturers to provide 

discounts on outpatient prescription drugs to certain safety net 

health care providers. The Committee includes an increase of $5,000,000 for additional 

oversight of the 340B program. An in-depth examination of the 

340B program by the House Energy and Commerce Committee resulted in a report entitled ‘‘Review of the 340B Drug Pricing Program.’’ The Committee directs HRSA to use additional funds to implement recommendations contained in such report. Specifically, 

the Committee directs HRSA to conduct additional audits of covered entities, finalize guidance to clarify parameters of the 340B 

program, and complete the rulemaking process for areas where 

HRSA has regulatory authority. 

The Committee does not include bill language requesting authority to charge a user fee. The Committee does not include appropriations language seeking additional regulatory authority. The Committee believes such reform of the 340B program is best addressed 

by the authorizing committee of jurisdiction. 

The 340B drug pricing program was designed to help safety net 

providers maintain, improve, and expand patient access to 

healthcare services. Since its enactment in 1992, the 340B program 

has lowered the cost of outpatient drugs to government funded 

health clinics, as well as nonprofit and public hospitals that serve 

a disproportionate share of low-income patients or rural communities whereby these entities are able to provide additional services 

and benefits to the communities they serve with the savings realized. The Committee recognizes the 340B drug pricing program remains important, allowing covered entities to stretch their resources to provide comprehensive services to patients. 

Since the 1990s, the health care landscape and the scope of the 

340B program has evolved significantly. A 2011 GAO report on the 

340B program found HRSA’s guidance on program requirements 

lacked the necessary level of specificity to provide clear direction 

making it difficult for covered entities to self-police or monitor comVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00031 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
32 

pliance. GAO recommended that HRSA release more specific guidance on the definition of an eligible patient and issue guidance to 

further specify the criteria for participating hospitals. The Committee supports HRSA’s continued engagement to provide program 

guidance to covered entities in the 340B program. 

The Committee is aware that the 340B statute requires HRSA to 

make 340B ceiling prices available to covered entities through a secure website and continues to be concerned that OPA has failed to 

meet deadlines to complete work on the secure website. The Committee urges OPA to complete the development of a secure website. 

The Committee directs OPA to issue a report to Congress on its 

progress implementing these security measures. 

Poison Control Centers 

The Committee recommends $22,846,000 for Poison Control Centers, which is $2,000,000 more than the fiscal year 2018 enacted 

level and $4,000,000 more than the fiscal year 2019 budget request. 

This program funds poison centers, a national toll-free number 

(800–222–1222), and implements a nationwide media campaign to 

educate the public and health care providers about poison prevention, poison center services, and the 800 number. 

The Committee recognizes the critical role of this proven national 

public health program and the value of its highly effective publicprivate/local-State-Federal partnership services to all citizens. In 

2015, 2.8 million calls were managed by poison control centers, 

which is an average of approximately 8,000 calls per day. Of these 

calls, 47 percent were related to exposures to children five and 

under, and 22 percent came from health care facilities. Of the approximate 2.2 million poisonings reported in 2015, 67 percent were 

managed at the site of exposure, avoiding unnecessary visits to 

emergency departments. 

Hansen’s Disease Program 

The Committee recommends $15,685,000 for the Hansen’s Disease Program, Hansen’s Disease buildings and facilities, and payment to Hawaii for treatment, which is the same as the fiscal year 

2018 enacted level and $2,175,000 more than the fiscal year 2019 

budget request. The Hansen’s Disease Program provides medical 

care, education, and research for Hansen’s disease (leprosy) and related conditions. 

The Committee understands that the incidence of leprosy in 

some areas has been increasing. With level funding provided for 

this year, the Committee strongly encourages HRSA to sustain its 

contracts with satellite clinics to ensure that essential services are 

provided for these vulnerable patients and to allow treatment for 

patients’ ongoing problems and the timely interventions for new 

complications and for newly diagnosed patients. 

RURAL HEALTH

Appropriation, fiscal year 2018 ......................................................... $290,794,000 

Budget request, fiscal year 2019 ....................................................... 74,911,000 

Committee Recommendation ............................................................. 281,294,000 

Change from enacted level ......................................................... ¥9,500,000 

Change from budget request ...................................................... +206,383,000 

33 

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

rural health issues; for technical assistance and recruitment of 

health care providers; for screening activities for individuals affected by the mining, transport, and processing of uranium; for the 

outreach and treatment of coal miners and others with occupationrelated respiratory and pulmonary impairments; and for the expansion of telehealth services. 

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

Budget Activity FY 2019 

Committee 

Rural Health Outreach Programs ................................................................................................................... $71,500,000 

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

Rural Hospital Flexibility Grants .................................................................................................................... 33,667,000 

Small Hospital Improvement Grants .............................................................................................................. 25,942,000 

State Offices of Rural Health ........................................................................................................................ 11,000,000 

Black Lung Clinics ......................................................................................................................................... 12,000,000 

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

Telehealth ....................................................................................................................................................... 23,500,000 

Rural Communities Opioid Response ............................................................................................................. 82,500,000 

Rural Residency Program ............................................................................................................................... 10,000,000 

Rural Health Outreach Programs 

Rural Health Outreach programs funds activities that improve 

access to and coordination of care in rural communities, with a 

focus on building sustainable health programs that continue beyond Federal funding. Outreach programs focus on supporting 

rural community needs related to issues such as such as behavioral 

health, oral health, care coordination, quality improvement, workforce training, chronic disease management and enhancing the 

rural health care delivery system of rural hospitals, clinics and 

other safety net providers. Programs under this heading include: 

Outreach Service Grants, which focus on improving access care 

in rural communities through the work of community coalitions 

and partnerships. 

Rural Network Development Grants, which support building regional or local partnerships among local hospitals, physicians 

groups, long-term care facilities, and public agencies to improve 

management of scare health care resources. 

Delta States Network Grant Program, which provides network 

development grants to the eight states in Mississippi Delta for network and rural health infrastructure development. 

Network Planning Grants, which bring together key parts of the 

rural healthcare delivery system to target emerging public health 

issues. 

Small Healthcare Provider Quality Improvement Grants, which 

help improve patient care and chronic disease outcomes by assisting rural primary care providers with the implementation of quality improvement activities. 

Rural Hospital Flexibility Grants 

The Committee provides $33,667,000 for the Medicare Rural 

Hospital Flexibility grant program, which provides funding to State 

governments to support critical access hospitals through quality, 

performance, and financial improvements. 

34 

Under the Rural Hospital Flexibility Grants, of the funds provided for section 1820(g)(6) of the Social Security Act, the Committee recommends a transition from supporting telehealth activities to other efforts to improve care for rural veterans, such as 

helping rural hospitals and clinics that seek to serve as access 

points under the Veterans Affairs (VA) Community Care Program 

or other VA-contracted care. 

Small Hospital Improvement Grants 

The Committee provides $25,942,000 for the Small Rural Hospital Improvement Program, this program provides awards through 

States to assist eligible small rural hospitals with software and 

equipment related to quality, reporting, and billing, with a particular focus on transitioning from prospective payment system 

hospitals. 

Telehealth 

Within the funds provided for Telehealth, the agreement continues support for the Telehealth Centers for Excellence, which 

identify best practices, serve as national training resources, and 

test the efficacy of different telehealth clinical applications. 

Given the rising rates of maternal mortality and severe maternal 

morbidity, as well as barriers to access to care in rural areas, the 

Committee encourages HRSA to explore the use of telemedicine for 

high-risk pregnant women to include, but not limited to pregnant 

women with chronic conditions, preeclampsia, or a need to see a 

maternal-fetal medicine specialist. 

FAMILY PLANNING

Appropriation, fiscal year 2018 ......................................................... $286,479,000 

Budget request, fiscal year 2019 ....................................................... 286,479,000 

Committee Recommendation ............................................................. – – – 

Change from enacted level ......................................................... ¥286,479,000 

Change from budget request ...................................................... ¥286,479,000 

The Committee does not recommend funding for the Family 

Planning program. The Family Planning program administers Title 

X of the Public Health Service Act. 

PROGRAM MANAGEMENT

Appropriation, fiscal year 2018 ......................................................... $155,000,000 

Budget request, fiscal year 2019 ....................................................... 151,993,000 

Committee Recommendation ............................................................. 155,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +3,007,000 

Program management supports the cost of Federal staff and related activities to coordinate, direct, and manage the programs of 

HRSA. 

Chief Dental Officer.—The Committee is pleased that HRSA has 

restored the position of Chief Dental Officer (CDO) and looks forward to learning how the agency has ensured that the CDO is 

functioning at an executive level authority with resources to oversee and lead HRSA oral health programs an initiatives. The Committee requests an update in the fiscal year 2020 Congressional 

Justification on how the CDO is serving as the agency representative on oral health issues to international, national, State and/or 

35 

local government agencies, universities, and oral health stakeholder organizations. 

VACCINE INJURY COMPENSATION PROGRAM TRUST FUND

Appropriation, fiscal year 2018 ......................................................... $277,200,000 

Budget request, fiscal year 2019 ....................................................... 317,200,000 

Committee Recommendation ............................................................. 317,200,000 

Change from enacted level ......................................................... +40,000,000 

Change from budget request ...................................................... – – – 

The National Vaccine Injury Compensation Program provides a 

system of compensation for individuals with vaccine-associated injuries or deaths. Funds for claims from vaccines administered on 

or after October 1, 1988 are generated by a per-dose excise tax on 

the sale of selected prescribed vaccines. The Vaccine Injury Compensation Trust Fund receives revenues raised by this tax. Trust 

funds made available will support the liability costs of vaccines administered after September 30, 1988. The Committee recommends $9,200,000 for administration of the 

program, which is the same as the fiscal year 2018 enacted level 

and the fiscal year 2019 budget request. 

CENTERS FOR DISEASE CONTROL AND PREVENTION

Appropriation, fiscal year 2018 ......................................................... $8,301,166,000 

Budget request, fiscal year 2019 ....................................................... 5,660,755,000 

Committee Recommendation ............................................................. 7,685,266,000 

Change from enacted level ......................................................... ¥615,900,000 

Change from budget request ...................................................... +2,024,511,000 

The Committee recommendation for the Centers for Disease Control and Prevention (CDC) program level includes $6,781,908,000 

in discretionary budget authority, $55,358,000 in mandatory funds 

under the terms of the Energy Employees Occupational Illness 

Compensation Program Act, and $848,000,000 in transfers from the 

Prevention and Public Health (PPH) Fund. CDC’s mission is to protect Americans from health, safety, and security threats, which it 

accomplishes by supporting core public health functions at State, 

local, and Tribal health departments, detecting and responding to 

new and emerging health threats, promoting health and safety, 

and providing leadership in the public health workforce. 

IMMUNIZATION AND RESPIRATORY DISEASES

Appropriation, fiscal year 2018 ......................................................... $798,405,000 

Budget request, fiscal year 2019 ....................................................... 700,828,000 

Committee Recommendation ............................................................. 808,405,000 

Change from enacted level ......................................................... +10,000,000 

Change from budget request ...................................................... +107,577,000 

The Committee recommendation includes $484,055,000 in discretionary budget authority and $324,350,000 in transfers from the 

PPH Fund. 

Immunization grants are awarded to State and local public 

health departments for planning, developing, and conducting childhood, adolescent, and adult immunization programs, including enhancement of the vaccine delivery infrastructure. CDC directly 

maintains a stockpile of vaccines, supports consolidated purchase of 

vaccines for State and local health agencies, and conducts surveillance, investigations, and research into the safety and efficacy of 

new and presently-used vaccines. 

36 

Within the total for Immunization and Respiratory Diseases, the 

Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Section 317 Immunization Program ............................................................................................................... $620,847,000 

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

Influenza Planning and Response ................................................................................................................. 187,558,000 

Influenza Vaccine Procurement.—The Committee encourages 

CDC to consider including vaccines produced through recombinant 

DNA technology in addition to traditionally-produced vaccines in 

future solicitations to facilitate the competitive process for all vaccine manufacturers. 

Section 317 Immunization Program.—The Committee believes 

that a strong public health immunization infrastructure is critical 

for ensuring high vaccination coverage levels, preventing the 

spread of vaccine-preventable diseases, and responding to outbreaks. During the 2015 measles outbreak, section 317 funds supported State and local health departments in rapid response, public 

health communication, data gathering, and diagnostics. 

HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND

TUBERCULOSIS PREVENTION

Appropriation, fiscal year 2018 ......................................................... $1,127,278,000 

Budget request, fiscal year 2019 ....................................................... 1,117,278,000 

Committee Recommendation ............................................................. 1,147,278,000 

Change from enacted level ......................................................... +20,000,000 

Change from budget request ...................................................... +30,000,000 

CDC provides national leadership and support for prevention research and the development, implementation, and evaluation of 

evidence-based HIV, viral hepatitis, sexually transmitted diseases 

(STD), and tuberculosis (TB) prevention programs serving persons 

affected by, or at risk for, these infections. Activities include surveillance, epidemiologic and laboratory studies, and prevention activities. CDC provides funds to State, local, and Tribal health departments and community-based organizations to develop and implement integrated community prevention plans. 

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

Prevention, the Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Domestic HIV/AIDS Prevention and Research ................................................................................................ $788,712,000 

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

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

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

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

School Health-HIV .................................................................................................................................. 33,081,000 

Viral Hepatitis ................................................................................................................................................ 39,000,000 

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

Tuberculosis .................................................................................................................................................... 142,256,000 

Elimination Initiative ...................................................................................................................................... 20,000,000 

Elimination Initiative.—The Committee includes $20,000,000 for 

the Infectious Disease Elimination Initiative proposed in the fiscal 

year 2019 budget request. This new initiative will support efforts 

to eliminate new infections such as HIV, hepatitis B virus (HBV), 

hepatitis C virus (HCV), STDs, and TB in high-risk States and juVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00036 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
37 

risdictions, including those with high rates of opioid-related transmission. The Committee requests an update on this new initiative 

within 60 days of enactment of this Act. 

Latent Tuberculosis Infection.—CDC estimates that there are up 

to 13 million individuals in the US with latent TB infection. The 

identification and preventive treatment of individuals with TB infection would prevent future active TB cases, reducing future 

healthcare costs. The Committee again urges the Director to support State and local TB programs to effectively identify and treat 

latent TB infection cases. 

Viral Hepatitis.—The Committee is concerned that as a result of 

the opioid epidemic, infections of viral hepatitis have spiked in 

many parts of the nation, including a 233 percent increase in infections nationwide since 2010. Even though the HBV vaccine is more 

than 90 percent effective, there were over 41,000 new HBV infections in 2016. The Committee notes that the link between viral 

hepatitis infection and primary liver cancer is well-established, 

with up to 60 percent of global liver cancer cases caused by HBV. 

The Committee notes that in 2017 the National Academies of 

Sciences, Engineering, and Medicine (NASEM) report entitled ‘‘A 

National Strategy for the Elimination of Hepatitis B and C’’ made 

a series of recommendations for vaccination, higher rates of diagnosis, care, and treatment. The Committee urges CDC, in cooperation with the leading national viral hepatitis organizations, to develop a plan to implement the NASEM recommendations to achieve 

the goal of the elimination of hepatitis B and C. The Committee 

also requests a report on CDC’s plan for implementation of the 

NASEM recommendations within 90 days of enactment of this Act. 

Viral Hepatitis and Injection Drug Use.—The Committee notes 

that there has been a nationwide increase in new viral hepatitis diagnoses and regional increases in HIV diagnoses attributed to injection drug use associated with the opioid epidemic. Research 

shows that awareness of one’s HIV infection status can increase 

motivation to begin substance use disorder treatment, especially 

when medication-assisted treatment is integrated with 

antiretroviral treatment for HIV patients. The Committee looks forward to working with HHS to ensure opioid resources address the 

overlapping public health testing activities for affected communities. 

EMERGING AND ZOONOTIC INFECTIOUS DISEASES

Appropriation, fiscal year 2018 ......................................................... $614,572,000 

Budget request, fiscal year 2019 ....................................................... 508,328,000 

Committee Recommendation ............................................................. 614,572,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +106,244,000 

The Committee recommendation includes $562,572,000 in discretionary appropriations and $52,000,000 in transfers from the PPH 

Fund. Programs funded under Emerging and Zoonotic Infectious 

Diseases (EZID) support the prevention and control of infectious 

diseases through surveillance, outbreak investigation and response, 

research, and prevention. 

Within the total for EZID, the Committee recommends the following amounts: 

38 

Budget Activity FY 2019 

Committee 

Core Infectious Diseases ................................................................................................................................ $422,000,000 

Emerging Infectious Diseases ............................................................................................................... 155,457,000 

Lab Safety and Quality ......................................................................................................................... 8,000,000 

Antibiotic Resistance Initiative ............................................................................................................. 168,000,000 

All Other Infectious Diseases ................................................................................................................ 29,840,000 

Vector-borne Diseases ........................................................................................................................... 38,603,000 

Lyme Disease ......................................................................................................................................... 10,700,000 

Prion Disease ......................................................................................................................................... 6,000,000 

Chronic Fatigue Syndrome .................................................................................................................... 5,400,000 

Food Safety ..................................................................................................................................................... 58,000,000 

National Health Care Safety Network ............................................................................................................ 21,000,000 

Quarantine ...................................................................................................................................................... 31,572,000 

Advanced Molecular Detection ....................................................................................................................... 30,000,000 

Epidemiology and Laboratory Capacity .......................................................................................................... 40,000,000 

Healthcare-Associated Infections ................................................................................................................... 12,000,000 

Antibiotic Resistance Solutions Initiative.—The Committee recognizes the importance of addressing antibiotic-resistant bacteria 

through a ‘‘One Health’’ approach, simultaneously combating antibiotic resistance in human, animal, and environmental settings. 

The Committee encourages CDC to competitively award research 

activities that address aspects of antibiotic resistance related to 

‘‘OneHealth’’ among entities, including public academic medical 

centers, veterinary schools with agricultural extension services, 

and State public health departments whose proposals are in line 

with CDC’s strategy for addressing antibiotic resistant bacteria. 

The Committee requests that CDC provide an updated spend plan 

to the Committee within 30 days of enactment of this Act and include an update on these efforts in the fiscal year 2020 Congressional Justification. The Committee encourages CDC to prevent 

spread by enhancing State, local, and regional public health capacity to prevent, detect, and respond to new and existing antibiotic 

resistance faster and to develop a national capacity to identify and 

catalog microbial genome sequences, paying attention to antibioticresistant microbes. Finally, the Committee encourages CDC to continue to pursue research opportunities in the area of antimicrobial 

stewardship in diverse healthcare settings and encourage regional 

collaborations to study the most effective strategies to improve antibiotic prescribing and stewardship. 

Eye Health and Safety.—The Committee is aware of CDC’s long 

history in research related to keratitis outbreaks and contact lensrelated infections and applauds the development of the healthy 

contact lens program. The Committee is also aware of concerns 

raised in the medical community regarding rules regulating the 

sale of contact lenses, which are Food and Drug Administration 

(FDA) Class II and III medical devices. Given these developments, 

the Committee directs CDC to update both its 2010 report, Estimated Burden of Keratitis, to include the most recent data available and its 2016 survey and reporting related to risk behaviors for 

contact lens-related eye infections. In addition, the Committee encourages CDC to work with relevant professional societies to leverage data from qualified clinical data registries on contact lens adverse events, including those that do not result in permanent loss 

of vision, to better inform the understanding of the risks associated 

with contact lens wear. 

39 

Nutritional Alternatives to Antibiotic Use.—Each year, approximately 97 million outpatient visits in the US are associated with 

antibiotic prescriptions, with over half of all women acquiring a 

urinary tract infection (UTI) at least once in their lifetime. As 

E.coli, which is responsible for over 80 percent of UTIs, is becoming 

resistant to many antibiotics, the Committee encourages support 

for stewardship efforts that further examine the role that bioactive 

compounds found in certain nutrient dense foods play in reducing 

antibiotic use. The Committee further encourages CDC to continue 

to pursue nutritional alternative opportunities in diverse 

healthcare settings to study the most effective strategies to improve antibiotic prescribing and stewardship. 

Tick-Borne Disease Resources and Guidelines.—The Committee 

encourages CDC to ensure transparency on its website of its physician education programs regarding Lyme disease, including scientific resources and schedules, to solicit input from the treating 

physician community at large regarding such education programs, 

and to include the broad spectrum of scientific viewpoints; to provide written rationale for selection of Lyme and tick-borne diseases 

treatment guidelines it displays on its website; and to intensify 

surveillance of Borrelia infections in non-endemic/non-high-incidence areas. 

Vector-Borne Diseases.—The Committee recognizes the critical 

role that EZID and its Vector-Borne Disease Program play in ongoing efforts to prepare for and fight tropical diseases emerging on 

US soil, such as Dengue, Chikungunya, and Zika. EZID is critical 

to crafting sustainable long-term abilities of States to prepare for 

vector-borne disease such as Zika and West Nile and is the Federal 

government’s only central focus on vector control. 

Vector-Borne Disease Centers of Excellence.—The Committee is 

concerned about the Pacific Northwest being an underserved region 

for funding and representation in the Regional Centers of Excellence in Vector-Borne Diseases network recently established by 

CDC. The ecology, disease transmission dynamics, and resources 

for vector-borne disease training, surveillance, and control in the 

Northwest differ significantly from those in the five regional centers currently funded. The Committee encourages CDC to examine 

options to provide greater coverage the Northwest region for vectorborne disease resources. 

CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION

Appropriation, fiscal year 2018 ......................................................... $1,162,896,000 

Budget request, fiscal year 2019 ....................................................... 939,250,000 

Committee Recommendation ............................................................. 1,205,396,000 

Change from enacted level ......................................................... +42,500,000 

Change from budget request ...................................................... +266,146,000 

The Committee recommendation includes $910,746,000 in discretionary appropriations and $294,650,000 in transfers from the PPH 

Fund. Programs supported within Chronic Disease Prevention and 

Health Promotion (CDPHP) provide national leadership and support for State, Tribal, and community efforts to promote health and 

well-being through the prevention and control of chronic diseases. 

The recommendation for CDPHP maintains the existing program 

line items as they were funded in fiscal year 2018 and does not 

provide funding for the America’s Health Block Grant proposed in 

40 

the fiscal year 2019 budget request. Chronic diseases, such as Alzheimer’s disease, diabetes, heart disease, and stroke, are the leading causes of death and disability in the US and account for 86 

cents of every dollar spent on health care. Many of these conditions 

are largely preventable through improved nutrition and physical 

activity. The Committee supports evidence-based strategies to address public health priorities through proven State-based grant 

programs, utilizing related national organizations for technical assistance, and encourages CDC to continue and expand these successful approaches. 

Within the total provided, the Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Tobacco ........................................................................................................................................................... $210,000,000 

Nutrition, Physical Activity, and Obesity ........................................................................................................ 54,920,000 

High Obesity Rate Counties .................................................................................................................. 15,000,000 

School Health ................................................................................................................................................. 15,400,000 

Health Promotion ............................................................................................................................................ 18,000,000 

Glaucoma ............................................................................................................................................... 4,000,000 

Visual Screening Education .................................................................................................................. 1,000,000 

Alzheimer’s Disease ............................................................................................................................... 4,500,000 

Inflammatory Bowel Disease ................................................................................................................. 1,000,000 

Interstitial Cystitis ................................................................................................................................. 1,000,000 

Excessive Alcohol Use ........................................................................................................................... 4,000,000 

Chronic Kidney Disease ......................................................................................................................... 2,500,000 

Prevention Research Centers ......................................................................................................................... 25,461,000 

Heart Disease and Stroke .............................................................................................................................. 147,062,000 

Diabetes .......................................................................................................................................................... 155,129,000 

National Diabetes Prevention Program .......................................................................................................... 26,800,000 

Cancer Prevention and Control ...................................................................................................................... 367,674,000 

Breast and Cervical Cancer .................................................................................................................. 218,000,000 

WISEWOMAN .................................................................................................................................. 21,120,000 

Breast Cancer Awareness for Young Women ........................................................................................ 4,960,000 

Cancer Registries .................................................................................................................................. 49,440,000 

Colorectal Cancer .................................................................................................................................. 43,294,000 

Comprehensive Cancer .......................................................................................................................... 19,675,000 

Johanna’s Law ....................................................................................................................................... 7,000,000 

Ovarian Cancer ...................................................................................................................................... 9,500,000 

Prostate Cancer ..................................................................................................................................... 13,205,000 

Skin Cancer ........................................................................................................................................... 2,125,000 

Cancer Survivorship Resource Center ................................................................................................... 475,000 

Oral Health ..................................................................................................................................................... 22,000,000 

Safe Motherhood/Infant Health ...................................................................................................................... 50,000,000 

Preterm Birth ......................................................................................................................................... 4,000,000 

Other Chronic Diseases .................................................................................................................................. 26,000,000 

Arthritis .................................................................................................................................................. 13,000,000 

Epilepsy ................................................................................................................................................. 8,500,000 

National Lupus Patient Registry ........................................................................................................... 6,500,000 

Racial and Ethnic Approaches to Community Health ................................................................................... 66,950,000 

Good Health and Wellness in Indian Country ....................................................................................... 32,000,000 

Million Hearts ................................................................................................................................................. 4,000,000 

National Early Child Care Collaboratives ...................................................................................................... 4,000,000 

Hospitals Promoting Breastfeeding ................................................................................................................ 10,000,000 

Alzheimer’s Disease Healthy Brain Initiative.—The Committee 

continues to support the Healthy Brain Initiative, and encourages 

CDC to assist States in collecting cognitive decline and caregiving 

data through the Behavioral Risk Factor Surveillance System and 

implementing the Healthy Brain Initiative’s Public Health Roadmap for State and National Partnerships. 

Chronic Fatigue Syndrome.—The Committee applauds CDC’s efforts to collaborate with disease experts in its multi-site study to 

41 

resolve case definition issues around Myalgic Encephalomyelitis/ 

Chronic Fatigue Syndrome (ME/CFS) and urges CDC to complete 

that effort. The Committee also commends CDC’s recent update of 

its website informing the public about ME/CFS and encourages 

CDC to work with disease experts and patients to continue to better educate healthcare providers about the disease and its appropriate management. However, the Committee is concerned that 

neither the website updates nor CDC’s current plans will address 

the continued medical stigma and misinformation about ME/CFS 

and the critical lack of medical providers. The Committee is also 

concerned that there are fewer than twelve experts in the country. 

The Committee urges CDC to partner with other HHS agencies, 

disease experts, and key medical societies to implement a proactive 

plan to address these issues and find creative ways to bring additional clinicians into the field. 

Chronic Obstructive Pulmonary Disease.—The Committee commends the release of the Chronic Obstructive Pulmonary Disease 

(COPD) National Action Plan and its comprehensive approach to 

confronting the burden of COPD. The Committee encourages CDC 

to begin implementation of the National Action Plan by integrating 

COPD surveillance, research, prevention, and management strategies into its chronic disease efforts. 

Eating Disorders.—The Committee encourages CDC to assist 

States in collecting data by reincluding standard questions on 

unhealthy weight control practices for eating disorders, including 

binge-eating, through the Youth Risk Behavioral Surveillance System. 

Inflammatory Bowel Disease.—The Committee commends CDC 

for supporting epidemiological studies on Irritable Bowel Disease 

(IBD), including a focus on minority and underserved communities. 

The Committee encourages CDC to continue to identify innovative 

approaches, including mixed methods research, for determining the 

incidence and prevalence of IBD. 

Maternal Health Pilot Project.—The Committee is aware that the 

U.S. ranks 30th among 33 nations in infant mortality rates, that 

these statistics disproportionately impact communities of color, and 

that preventing infant mortality is challenging because data is several years old and not consistently captured or analyzed during 

pregnancy. Using real-time data from maternity wards can enable 

public health officials, providers, and communities to provide care 

and address needs during pregnancy that can reduce and prevent 

high infant mortality and morbidity rates. The Committee includes 

$2,000,000 within the total available for Safe Motherhood/Infant 

Health, Preterm Birth Perinatal Collaboratives to develop a maternal health pilot project. This pilot should make use of existing 

State biosurveillance tools to create a real-time database of prenatal and newborn health data, including opioid related concerns, 

such as neonatal abstinence syndrome, during pregnancy and early 

motherhood, to forecast individual risk of infant mortality and morbidity and to establish plans to optimize care and referrals to promising or proven interventions. CDC should focus this pilot on States 

with the highest infant mortality rate. 

Maternal Mortality Review Committees.—The Committee includes $2,000,000 within the total available for Safe Motherhood/ 

Infant Health to support States to implement maternal mortality 

42 

review committees, including promoting best practices and providing technical assistance, training, tools, and resources. 

National Lupus Patient Registry.—The Committee continues to 

support research efforts under the National Lupus Patient Registry 

program and acknowledges that there has been significant progress 

to understand better the epidemiology of lupus. However, the Committee recognizes that challenges and disparities still remain. The 

Committee encourages CDC to focus on studies related to the natural history and pathogenesis of pediatric lupus to understand better the lifetime burden of disease in children and young adults. The 

Committee also encourages CDC and the Lupus Federal Working 

Group to prioritize research into the racial and ethnic disparities 

in lupus. Finally, the Committee encourages the continuing development of lupus self-management programs by current lupus registry cohorts and national voluntary health organizations for adults 

with lupus to improve quality of life and health outcomes. 

Ovarian Cancer.—The Committee is pleased by CDC’s launch of 

Know: BRCA to help increase the public’s awareness of hereditary 

breast and ovarian cancers and improve understanding the individual risk of having a BRCA mutation. The Committee strongly 

encourages CDC to take steps to integrate components of the Inside Knowledge Campaign, which works to increase awareness of 

the signs and symptoms of ovarian and other gynecologic cancers, 

and Know: BRCA to the extent possible, to ensure coordination of 

public health messages related to ovarian cancer, leveraging of resources, and maximizing economies of scale. 

Psoriatic Disease Initiative.—The Committee recognizes the 

growing body of evidence linking psoriatic disease, which impacts 

more than eight million Americans, to other comorbidities such as 

cardiovascular disease, mental health, substance abuse challenges, 

kidney disease, and other conditions. The Committee commends 

CDC for identifying opportunities for expanded research on psoriatic disease in its Public Health Agenda for Psoriasis and Psoriatic 

Arthritis and encourages CDC to support intramural and grantbased research on the comorbidities of psoriatic disease, including 

research that can be done in collaboration with or funded by other 

disease programs such as Arthritis, Cardiovascular Health, or Mental Illness. 

Pulmonary Hypertension.—The Committee is concerned that 

most pulmonary hypertension (PH) patients are not diagnosed for 

many years until the condition has reached a catastrophic stage, 

which leads to significant disability, greatly increased mortality, 

and the need for costly and dramatic medical interventions, such 

as heart-lung transplantation. Considering the availability of effective therapies for early-stage PH, the Committee encourages CDC 

to support education, awareness, and epidemiology activities that 

promote early and accurate diagnosis of PH. 

Racial and Ethnic Approaches to Community Health.—The Committee includes $32,000,000 within Racial and Ethnic Approaches 

to Community Health to significantly expand the Good Health and 

Wellness in Indian Country program. The Good Health initiative 

supports efforts by American Indian and Alaska Native communities to implement holistic and culturally-adapted approaches to 

reduce tobacco use, improve physical activity and nutrition, and inVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00042 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
43 

crease health literacy. The Committee requests an update on CDC’s 

plans for this expansion within 60 days of enactment of this Act. 

Safe Motherhood and Infant Health.—The Committee continues 

to support activities within this line related to maternal and infant 

health, such as State-Based Perinatal Collaboratives and the Pregnancy Risk Assessment Monitoring System, at the fiscal year 2018 

enacted level. The Committee recommendation does not include 

funding for the teen pregnancy prevention cooperative agreement. 

Sepsis.—The Committee encourages CDC to increase its public 

awareness, outreach, and education efforts on sepsis, including 

health provider outreach and other related activities to prevent 

sepsis and improve early recognition and management of sepsis. 

The Committee requests CDC provide a report on its activities to 

improve public awareness of sepsis in the fiscal year 2020 Congressional Justification. 

Type 1 Diabetes and Diabetic Ketoacidosis.—The Committee is 

concerned about the increase in type 1 diabetes and the risk of diabetic ketoacidosis. The Committee encourages CDC to conduct national monitoring and epidemiologic analysis of recent trends and 

determinants in type 1 diabetes and related acute complications, 

including diabetic ketoacidosis, and to educate key stakeholders, 

such as providers and others, on effective diabetes management 

and prevention of acute complications such as diabetic ketoacidosis. 

BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES, AND

HEALTH

Appropriation, fiscal year 2018 ......................................................... $140,560,000 

Budget request, fiscal year 2019 ....................................................... 110,000,000 

Committee Recommendation ............................................................. 150,560,000 

Change from enacted level ......................................................... +10,000,000 

Change from budget request ...................................................... +40,560,000 

This account supports efforts to conduct research on and address 

the causes of birth defects and developmental disabilities, as well 

as reduce the complications of blood disorders and improve the 

health of people with disabilities. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

Child Health and Development ...................................................................................................................... $65,800,000 

Birth Defects ......................................................................................................................................... 19,000,000 

Fetal Death ............................................................................................................................................ 900,000 

Fetal Alcohol Syndrome ......................................................................................................................... 11,000,000 

Folic Acid ............................................................................................................................................... 3,150,000 

Infant Health ......................................................................................................................................... 8,650,000 

Autism ................................................................................................................................................... 23,100,000 

Health and Development for People with Disabilities ................................................................................... 59,660,000 

Disability & Health incl. Child Development ........................................................................................ 27,000,000 

Tourette Syndrome ................................................................................................................................. 2,000,000 

Early Hearing Detection and Intervention ............................................................................................. 10,760,000 

Muscular Dystrophy ............................................................................................................................... 6,000,000 

Attention Deficit Hyperactivity Disorder ................................................................................................ 1,900,000 

Fragile X ................................................................................................................................................ 2,000,000 

Spina Bifida .......................................................................................................................................... 6,000,000 

Congenital Heart Defects ...................................................................................................................... 4,000,000 

Blood Disorders .............................................................................................................................................. 15,100,000 

Public Health Approach to Blood Disorders .......................................................................................... 4,400,000 

Hemophilia Activities ............................................................................................................................. 3,500,000 

Hemophilia Treatment Centers .............................................................................................................. 5,100,000 

44 

Budget Activity FY 2019 

Committee 

Thalassemia .......................................................................................................................................... 2,100,000 

Surveillance for Emerging Threats to Mothers and Babies .......................................................................... 10,000,000 

Duchenne Muscular Dystrophy and Newborn Screening.—The 

Committee continues to be encouraged by efforts to develop a newborn screening test for Duchenne Muscular Dystrophy. The Committee is aware of the successful pilot project in Ohio and supports 

CDC’s plans to consider an additional State pilot. 

Duchenne Muscular Dystrophy Surveillance.—The Committee is 

pleased by the publication of updates of the care standards for 

Duchenne Muscular Dystrophy and encourages CDC to continue 

supporting widespread dissemination of these standards to all appropriate provider audiences. The Committee is also aware of 

CDC’s efforts to support refinement of an ICD 10 code for 

Duchenne and Becker Muscular Dystrophy (DBMD) and requests 

that CDC use MD STARnet to monitor the implementation of the 

code and measure how accurately and effectively the code is being 

applied to known cases of DBMD. 

Fragile X and Fragile X-Associated Disorders.—The Committee 

commends CDC’s efforts to identify and define the population impacted by Fragile X (FX) and all conditions associated with the 

gene mutation with the goal of understanding the public health impact of these conditions. To help this effort, the Committee urges 

the National Center on Birth Defects and Developmental Disabilities (NCBDDD) to support additional strategies to promote earlier 

identification of children with FX, such as newborn screening. The 

Committee acknowledges the significant progress made by 

NCBDDD in growing its FORWARD Database and Patient Registry and extending FORWARD participation to adults with FX. 

This project will have a highly significant impact on understanding 

the natural history of FX throughout the lifespan, and defining 

how to best measure patient outcomes. Given the potential connections among FX, the FX protein, and autism, the prospect of targeted treatments for overlapping characteristics of both conditions, 

the Committee urges the NCBDDD to explore cross-divisional funding opportunities to accelerate data-driven public health research 

to reduce the public health burdens of both FX and autism. 

Health Promotion for People with Disabilities.—The Committee 

supports the activities of the National Center on Health, Physical 

Activity, and Disability (NCHPAD) and its primary goal of promoting better health, wellness, and quality of life for people with 

disabilities. The Committee encourages NCHPAD to implement a 

demonstration project to develop and implement strategies to reduce diabetes and obesity among people with mobility limitations 

in coordination with CDC State Disability and Health Programs. 

Neonatal Abstinence Syndrome Surveillance.—The Committee 

urges CDC to expand its surveillance of adverse infant outcomes 

and long-term developmental outcomes of children who were diagnosed with neonatal abstinence syndrome at birth, as very little is 

currently known about the full impact of prenatal opioid exposure 

or the educational and social challenges that these children face as 

they grow and enter school. The Committee urges CDC to recognize 

the complex nature of this epidemic by studying the impact of polyVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00044 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
45 

substance use as well as opioid use by pregnant women, in addition 

to other factors in the home setting that may affect the development of these children. 

Pre-Term Birth.—Preterm birth affects more than 380,000 babies 

each year in the US and is the leading cause of neonatal mortality. 

The Committee commends CDC for funding six State-based 

Perinatal Collaboratives that focus on improving birth outcomes 

and maternal health and safety using known prevention strategies 

such as reducing early elective deliveries. 

Spina Bifida.—The Committee recognizes that spina bifida is the 

most common permanently disabling birth defect in the US. Each 

year in the US, about 1,500 babies are born with spina bifida, and 

there are an estimated 166,000 individuals living with all forms of 

this complex birth defect. Spina bifida and related neural tube defects are largely but not entirely preventable through education 

and adequate daily folic acid consumption, so it is important to 

identify other risk factors in order to allow more complete prevention of this devastating birth defect. The Committee encourages 

CDC to use funding provided for the National Spina Bifida Program (NSBP) to support the continuation of the National Spina 

Bifida Patient Registry and the Spina Bifida Clinical Care Monitoring and Tracking program. Further, the Committee commends 

the NSBP for serving as a model for programs assisting other individuals living with similar complex conditions and encourages CDC 

to continue to support the dissemination of information to clinicians, parents, and families living with spina bifida. 

Surveillance for Emerging Threats to Mothers and Babies.—The 

Committee includes $10,000,000 for Surveillance for Emerging 

Threats to Mothers and Babies, as proposed in the fiscal year 2019 

budget request. This new initiative will build upon surveillance 

through the Zika pregnancy and infant registry to monitor the 

long-term impact of Zika and can be leveraged for other emerging 

infectious diseases and emerging threats. The Committee requests 

an update on this new initiative within 60 days of enactment of 

this Act. 

Thalassemia.—The Committee is aware of the critical work done 

by CDC’s thalassemia program in connecting patients with this 

rare genetic blood disorder to life-saving resources and treatment 

centers. Thalassemia patients experience serious comorbidities 

which can impact almost every aspect of their lives. The Committee 

requests that the CDC continue collaborating with thalassemia 

treatment centers, non-profits, and patient advocates through this 

program. 

PUBLIC HEALTH SCIENTIFIC SERVICES

Appropriation, fiscal year 2018 ......................................................... $490,397,000 

Budget request, fiscal year 2019 ....................................................... 468,000,000 

Committee Recommendation ............................................................. 495,397,000 

Change from enacted level ......................................................... +5,000,000 

Change from budget request ...................................................... +27,397,000 

This account supports programs that provide leadership and 

training for the public health workforce, support infrastructure to 

modernize public health surveillance, promote and facilitate science 

standards and policies, and improve access to information on disease outbreaks and other threats. 

46 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

Health Statistics ............................................................................................................................................. $160,397,000 

Surveillance, Epidemiology, and Informatics ................................................................................................. 284,000,000 

Laboratory Training and Oversight ....................................................................................................... 5,000,000 

Public Health Workforce ................................................................................................................................. 51,000,000 

National Neurological Conditions Surveillance System.—The 

Committee provides $5,000,000 within the total for Surveillance, 

Epidemiology, and Informatics for the establishment of the National Neurological Conditions Surveillance System (NNCSS), 

which was authorized in the 21st Century Cures Act (PS 114–255). 

This funding will support CDC to enhance and expand existing infrastructure and activities to conduct surveillance of neurological 

conditions. The NNCSS will provide for the collection and storage 

of key information on incidence and prevalence of subset of neurological diseases in the U.S. 

Surveillance Data Platform.—The Committee encourages CDC to 

continue the efforts started with the development of the Surveillance Data Platform by using this program to modernize the surveillance infrastructure of the over 100 surveillance applications at 

CDC, leveraging and supporting initiatives in CDC’s 2014 Surveillance Strategy. This would be an important step forward for CDC 

in modernizing their critical data collection systems that will allow 

for better data sharing and analysis on a common platform that 

will help reduce redundancy and maintenance. 

ENVIRONMENTAL HEALTH

Appropriation, fiscal year 2018 ......................................................... $205,750,000 

Budget request, fiscal year 2019 ....................................................... 157,000,000 

Committee Recommendation ............................................................. 201,350,000 

Change from enacted level ......................................................... ¥4,400,000 

Change from budget request ...................................................... +44,350,000 

The Committee recommendation includes $184,350,000 in discretionary appropriations and $17,000,000 in transfers from the PPH 

Fund. 

Programs supported within Environmental Health conduct surveillance and data collection to detect and address emerging pathogens and environmental toxins that pose significant challenges to 

public health, as well as determine whether and at what level of 

exposure these substances are harmful to humans. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

Environmental Health Laboratory ................................................................................................................... $68,750,000 

Newborn Screening Quality Assurance Program ................................................................................... 19,000,000 

Newborn Screening/Severe Combined Immunodeficiency Diseases ...................................................... 1,250,000 

Environmental Health Activities ..................................................................................................................... 34,600,000 

Environmental Health Activities ............................................................................................................ 16,000,000 

Safe Water ............................................................................................................................................. 8,600,000 

Amyotrophic Lateral Sclerosis (ALS) Registry ....................................................................................... 10,000,000 

Climate Change ..................................................................................................................................... 0 

Environmental and Health Outcome Tracking Network ................................................................................. 34,000,000 

Asthma ........................................................................................................................................................... 29,000,000 

47 

Budget Activity FY 2019 

Committee 

Childhood Lead Poisoning .............................................................................................................................. 35,000,000 

Harmful Algal Blooms.—The Committee supports the work that 

CDC is doing to conduct surveillance for and report health concerns 

related to harmful algal blooms and urges CDC to continue this 

work and (1) to provide more outreach to State and local public 

health officials to use these surveillance and reporting systems, 

and (2) to work with other agencies, including the Environmental 

Protection Agency, National Oceanic and Atmospheric Administration, and United States Geological Survey, to integrate disparate 

sets of data to allow for a broader understanding of the spatial and 

temporal dynamics of the environmental and health impacts of 

harmful algal blooms. 

Intermountain West Wildfire Smoke Health Monitoring.—The 

Committee is concerned with the public health impact of the everincreasing number and severity of wildfires in the Intermountain 

West, noting increased long-term hospital admissions due to respiratory symptoms and chronic obstructive pulmonary disease. 

Through CDC’s Environmental Public Health Tracking Network, 

grantees are using data on wildfires to educate residents in affected areas about ways to protect their health during wildfires. 

The Committee continues to encourage the use of the tracking network to better understand the impact of wildfires in the Intermountain West and inform health policymakers and resource managers. 

Lyme Disease.—The Committee encourages CDC to consider expanding activities related to developing sensitive and more accurate diagnostic tools and tests for Lyme disease and evaluating the 

development of a national reporting system. 

National Asthma Control Program.—The Committee encourages 

CDC to continue its 6 | 18 Initiative efforts which promote evidencebased asthma medical management and strategies aimed at improving access and adherence to the 2007 National Asthma Education and Prevention Program. 

Newborn Screening Quality Assurance Program.—The Committee 

is aware that State laboratories need specialized support to begin 

screening for additional newborn conditions and recognizes CDC’s 

expertise in working with laboratories to implement accurate newborn screening tests. The Committee supports the Newborn Screening Quality Assurance Program to support State laboratories as 

they implement screening for new disorders. The Committee encourage CDC to support evaluation of testing methods for new conditions, expansion of CDC’s quality assurance materials, and funding to States for critical 335,200,000 and development of tests for 

rare conditions. 

INJURY PREVENTION AND CONTROL

Appropriation, fiscal year 2018 ......................................................... $648,559,000 

Budget request, fiscal year 2019 ....................................................... 266,309,000 

Committee Recommendation ............................................................. 690,559,000 

Change from enacted level ......................................................... +42,000,000 

Change from budget request ...................................................... +424,250,000 

48 

Programs supported within Injury Prevention and Control provide national leadership on violence and injury prevention, conduct 

research and surveillance, and promote evidence-based strategies 

to inform real-world solutions to prevent premature death and disability and to reduce human suffering and medical costs caused by 

injury and violence. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

Intentional Injury ............................................................................................................................................ $102,730,000 

Domestic Violence and Sexual Violence ................................................................................................ 32,700,000 

Child Maltreatment ...................................................................................................................... 7,250,000 

Youth Violence Prevention ..................................................................................................................... 15,100,000 

Domestic Violence Community Projects ................................................................................................ 5,500,000 

Rape Prevention .................................................................................................................................... 49,430,000 

National Violent Death Reporting System ...................................................................................................... 23,500,000 

Unintentional Injury ........................................................................................................................................ 8,800,000 

Traumatic Brain Injury .......................................................................................................................... 6,750,000 

Elderly Falls ........................................................................................................................................... 2,050,000 

Injury Prevention Activities ............................................................................................................................. 28,950,000 

Opioid Overdose Prevention and Surveillance ............................................................................................... 515,579,000 

Injury Control Research Centers .................................................................................................................... 11,000,000 

Child Sexual Abuse Prevention.—It is estimated that 15 to 25 

percent of girls and five to 10 percent of boys will experience child 

sexual abuse. While the Federal government has invested in treatment for victims and punishment for offenders, the Committee believes that more emphasis should be placed on prevention. The 

Committee requests that the Center report on its current activities 

related to the development and evaluation of primary public health 

interventions targeting child sexual abuse. Additionally, the Committee requests that the Center identify gaps in research that can 

be filled to promote child sexual abuse primary prevention. The 

Committee requests this report within 180 days of enactment of 

this Act. 

Core State Violence and Injury Prevention Program.—The Core 

State Violence and Injury Prevention Program (Core SVIPP) is the 

only program of its kind in the US that uses research-based evidence to identify the most effective strategies to prevent injuries 

caused by accidents or violence. To further strengthen State decision-making and support allocation of funds to high burden areas, 

the Committee encourages CDC to explore ways in which States 

can utilize Core SVIPP funds to implement, evaluate, and disseminate effective violence and injury prevention programs and policies 

beyond the four core focus areas selected by CDC. 

Gun Research.—The Committee continues a general provision to 

prevent funds from being used to advocate for or promote gun control. 

Opioid Overdose Surveillance.—The Committee continues to support the use of data to support forecasting of opioid-related overdose risk, including by geographic region. The Committee encourages CDC to initiate a demonstration project in States experiencing 

the highest rates of opioid-related overdose to use data to develop 

forecasts that public health officials can use to intervene and prevent overdoses. 

49 

Prescription Drug Overdose.—The Committee commends CDC for 

its leadership on combatting prescription and opioid drug 

overdoses. The Committee encourages CDC to implement these activities based on population-adjusted burden of disease criteria, including mortality data (age-adjusted rate), as significant criteria 

when distributing funds for the State PDO Prevention activities. 

The Committee assumes these funds will be distributed via a competitive mechanism and not merely a mathematical formula or 

standard allocation to each State. Further, the Committee strongly 

encourages CDC to support local prevention activity to determine 

the effectiveness of medication-approved treatment modalities in 

treating heroin and prescription drug abuse and reducing diversion 

of buprenorphine for illicit purposes. 

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH

Appropriation, fiscal year 2018 ......................................................... $335,200,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 339,200,000 

Change from enacted level ......................................................... +4,000,000 

Change from budget request ...................................................... +339,200,000 

The National Institute for Occupational Safety and Health 

(NIOSH) conducts applied research, develops criteria for occupational safety and health standards, and provides technical services 

to government, labor, and industry, including training for the prevention of work-related diseases and injuries. This appropriation 

supports surveillance, health hazard evaluations, intramural and 

extramural research, instrument and methods development, dissemination, and training grants. 

The Committee does not move NIOSH into NIH, as proposed in 

the budget request. The Committee believes NIOSH’s mission does 

not align with NIH’s focus on biomedical research and is better 

achieved within CDC. 

Within the total for NIOSH, the Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

National Occupational Research Agenda ....................................................................................................... $118,000,000 

Agricultural, Forestry, and Fishing ........................................................................................................ 27,500,000 

Education and Research Centers ................................................................................................................... 31,000,000 

Personal Protective Technology ...................................................................................................................... 20,000,000 

Mining Research ............................................................................................................................................. 59,500,000 

National Mesothelioma Registry and Tissue Bank ........................................................................................ 1,100,000 

Other Occupational Safety and Health Research .......................................................................................... 109,600,000 

ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION

PROGRAM

Appropriation, fiscal year 2018 ......................................................... $55,358,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 55,358,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +55,358,000 

The Energy Employees Occupational Illness Compensation Program (EEOICPA) provides compensation to employees and survivors of employees of Department of Energy facilities and private 

contractors who have been diagnosed with a radiation-related cancer, beryllium-related disease, or chronic silicosis as a result of 

50 

their work. NIOSH estimates occupational radiation exposure for 

cancer cases, considers and issues determinations for adding classes of workers to the Special Exposure Cohort, and provides administrative support to the Advisory Board on Radiation and Worker 

Health. 

The Committee does not move EEOICPA into NIH, as proposed 

in the budget request. The Committee believes EEOICPA’s mission 

does not align with NIH’s focus on biomedical research and is better achieved within CDC. 

GLOBAL HEALTH

Appropriation, fiscal year 2018 ......................................................... $488,621,000 

Budget request, fiscal year 2019 ....................................................... 408,762,000 

Committee Recommendation ............................................................. 488,621,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +79,859,000 

Through its Global Health activities, CDC coordinates, cooperates with, participates with, and provides consultation to other nations, Federal agencies, and international organizations to prevent 

and contain diseases and environmental health problems and to develop and apply health promotion activities. In cooperation with 

ministries of health and other appropriate organizations, CDC 

tracks and assesses evolving global health issues and identifies and 

develops activities to apply CDC’s technical expertise. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

Global AIDS Program ...................................................................................................................................... $128,421,000 

Global Immunization Program ........................................................................................................................ $226,000,000 

Polio Eradication ................................................................................................................................... $176,000,000 

Other Global/Measles ............................................................................................................................ $50,000,000 

Parasitic Diseases and Malaria ..................................................................................................................... $26,000,000 

Global Disease Detection and Emergency Response ..................................................................................... $108,200,000 

Global Public Health Capacity Development ................................................................................................. $9,800,000 

Global Health Security and Global Health Research.—The Committee supports CDC’s work to protect American and global health 

security through programs that detect, prevent, and respond to infectious disease and other health threats. As emerging infectious 

diseases like Ebola and Zika represent perpetual challenges for the 

US health system, the Committee supports continued and enhanced work in health research, innovation, capacity-building for 

disease research, detection, and surveillance, and robust monitoring and evaluation systems at home and abroad. 

Soil Transmitted Helminth and Related ‘‘Diseases of Poverty’’.— 

The Committee provides $1,500.00, the same as fiscal year 2018, 

for surveillance, source remediation, and clinical care aimed at reducing Soil Transmitted Helminth infection in areas not being addressed by the current outreach. 

PUBLIC HEALTH PREPAREDNESS AND RESPONSE

Appropriation, fiscal year 2018 ......................................................... $1,450,000,000 

Budget request, fiscal year 2019 ....................................................... 800,000,000 

Committee Recommendation ............................................................. 860,000,000 

Change from enacted level ......................................................... ¥590,000,000 

Change from budget request ...................................................... +60,000,000 

51 

The Public Health Preparedness and Response (PHPR) account 

supports programs that build and strengthen national preparedness for public health emergencies, both naturally-occurring and intentional. PHPR supports needs assessments, response planning, 

training, epidemiology and surveillance, and upgrades for laboratory capacity and communications systems. 

Within the total, the Committee recommends the following 

amounts: 

Budget Activity FY 2019 

Committee 

State and Local Preparedness and Response Capability .............................................................................. $698,200,000 

Public Health Emergency Preparedness Cooperative Agreement ......................................................... 690,000,000 

Academic Centers for Public Health Preparedness .............................................................................. 8,200,000 

CDC Preparedness and Response .................................................................................................................. 161,800,000 

BioSense ................................................................................................................................................ 23,000,000 

All Other CDC Preparedness and Response ......................................................................................... 138,800,000 

Strategic National Stockpile (SNS) ................................................................................................................ 0 

Strategic National Stockpile.—The Committee includes funding 

for the Strategic National Stockpile (SNS) in the Office of the Assistant Secretary for Preparedness and Response, as requested in 

the fiscal year 2019 budget request. The Committee expects that 

this organizational change will continue to include a significant 

role for CDC in providing scientific expertise in decision-making related to procurement of countermeasures as well as maintaining 

strong relationships with State and local public health departments 

to facilitate efficient deployment of countermeasures in public 

health emergencies. 

BUILDINGS AND FACILITIES

Appropriation, fiscal year 2018 ......................................................... $510,000,000 

Budget request, fiscal year 2019 ....................................................... 30,000,000 

Committee Recommendation ............................................................. 30,000,000 

Change from enacted level ......................................................... ¥480,000,000 

Change from budget request ...................................................... – – – 

This account supports capital projects as well as repairs and improvements to restore, maintain, and improve CDC’s assets at facilities in seven States and San Juan, Puerto Rico. 

The Committee continues language from fiscal year 2018 to allow 

CDC to retain unobligated funds in the Individual Learning Accounts from departed employees to support the replacement of the 

underground and surface coal mine safety and health research facility. 

CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT

Appropriation, fiscal year 2018 ......................................................... $273,570,000 

Budget request, fiscal year 2019 ....................................................... 155,000,000 

Committee Recommendation ............................................................. 598,570,000 

Change from enacted level ......................................................... +325,000,000 

Change from budget request ...................................................... +443,570,000 

The Committee recommendation includes $438,570,000 in discretionary funds and $160,000,000 in transfers from the PPH Fund. 

This account supports public health leadership and support activities at CDC. 

Within the total, the Committee recommends the following 

amounts: 

52 

Budget Activity FY 2019 

Committee 

Preventive Health and Health Services Block Grant ..................................................................................... $160,000,000 

Public Health Leadership and Support .......................................................................................................... 113,570,000 

Infectious Disease Rapid Response Reserve Fund ........................................................................................ 300,000,000 

Biomonitoring.—The Committee directs CDC to examine how to 

utilize Biomonitoring Equivalents, or similar methods, to interpret 

and communicate human biomonitoring results from the National 

Biomonitoring Program in a health risk assessment context, including an estimate of the resources needed, and report their findings 

to the Committee within 90 days of enactment of this Act. 

Foundation for the CDC.—The Committee directs the Foundation 

for the Centers for Disease Control and Prevention (‘‘Foundation’’) 

to abide by section 399G(h)(7) of the Public Health Service Act by 

including in the Foundation’s annual report the source and amount 

of all monetary gifts to the Foundation, as well as the source and 

description of all gifts of real or personal property. Each annual report shall disclose a specification of any restrictions on the purposes for which gifts to the Foundation may be used. The annual 

report shall not list ‘‘anonymous’’ as a source for any gift that includes a specification of any restrictions on the purpose for which 

the gift may be used. 

Infectious Disease Rapid Response Reserve Fund.—The Committee recommendation includes $325,000,000 within this account 

for a new Infectious Diseases Rapid Response Reserve Fund. The 

Reserve Fund, in which funds will be available until expended, will 

provide an immediate source of funding to quickly respond to a future, imminent infectious disease crisis that endangers American 

lives without waiting for Congress to act on a supplemental funding bill. Bill language establishing the Reserve Fund is included in 

section 228 of the General Provisions for this Title. 

Public Health Information.—The Committee notes limited information is available which compares controlled substances transactions reported to the Drug Enforcement Administration (DEA) 

with available public health information collected by the CDC. The 

Committee encourages CDC to incorporate on its website addressing opioid overdose, DEA data from the Automated Reports and 

Consolidated Ordering System Retail Drug Summary Report. The 

Committee further encourages CDC to include an interactive map 

to view current data provided by the DEA displaying the amount 

of grams of fentanyl, hydrocodone, oxycodone and other controlled 

substances that have been shipped to each State. The website 

should also include accessible and frequently updated CDC data on 

overdose death rates and the incidence rates of HIV, Hepatitis A, 

B, and C for each State in an interactive manner that allows users 

to compare on the same page, the amounts of drugs distributed 

with public health morbidities. The Committee requests an update 

on this effort in the fiscal year 2020 Congressional Justification. 

NATIONAL INSTITUTES OF HEALTH

Appropriation, fiscal year 2018 ......................................................... $37,084,000,000 

Budget request, fiscal year 2019 ....................................................... 34,588,391,000 

Committee Recommendation ............................................................. 38,334,000,000 

Change from enacted level ......................................................... +1,250,000,000 

Change from budget request ...................................................... +3,745,609,000 

53 

The Committee recommendation for the National Institutes of 

Health (NIH) program level includes $37,661,129,000 in discretionary appropriations and $922,871,000 in Public Health Service 

Act section 241 evaluation set-aside transfers. Within the total discretionary appropriation, the Committee recommendation includes 

$711,000,000 in budget authority authorized in the 21st Century 

Cures Act (PL 114–255). 

The mission of NIH is to seek fundamental knowledge about the 

nature and behavior of living systems and the application of that 

knowledge to enhance health, lengthen life, and reduce illness and 

disability. NIH conducts and supports research to understand the 

basic biology of human health and disease; applies this understanding towards designing new approaches for preventing, diagnosing, and treating disease and disability; and ensures that these 

approaches are widely available. 

The recommendation provides the following funding increases: 

$401,000,000 for Alzheimer’s disease research; $100,000,000 for the 

Cancer Moonshot Initiative; $147,000,000 for the ‘‘All of Us’’ precision medicine initiative; $29,000,000 for the Brain Research 

through Application of Innovative Neurotechnologies (BRAIN) Initiative; $15,000,000 for combating antibiotic-resistant bacteria; 

$30,000,000 for the development of a universal influenza vaccine; 

and $15,000,000 for Institutional Development Awards. The Committee also continues and expands upon the trans-NIH Down syndrome research initiative that was established in fiscal year 2018. 

The Committee recommendation also provides an increase for every 

Institute and Center (IC) to support innovative research to advance 

fundamental knowledge and speed the development of new therapies and diagnostics to improve the health of all Americans. 

The Committee expects the 3.4 percent increase of funds over the 

fiscal year 2018 enacted level to support an increase in the number 

of new and competing Research Project Grants, with a focus on 

early-stage investigators and investigators seeking first-time renewals. The Committee expects NIH to provide a stipend level increase to training grantees that is consistent with any fiscal year 

2019 Federal employee pay raise. The Committee continues to provide in bill language funding levels for Clinical and Translational 

Science Awards, Institutional Development Awards (IDeA), the 

Cures Acceleration Network, the Common Fund, and the Environmental Influences on Child Health Outcomes study. 

The Committee recommendation does not include the general 

provision proposed in the fiscal year 2019 budget request to limit 

the percentage of a researcher’s salary that may be paid for using 

NIH grant funds, as the impact of this policy change is unclear. 

The Committee requests an analysis of the projected impact of such 

a policy change on the number and average cost of NIH grants, as 

well as on academic institutions, in the fiscal year 2020 Congressional Justification. 

NATIONAL CANCER INSTITUTE (NCI)

Appropriation, fiscal year 2018 ......................................................... $5,964,800,000 

Budget request, fiscal year 2019 ....................................................... 5,626,312,000 

Committee Recommendation ............................................................. 6,136,037,000 

Change from enacted level ......................................................... +471,237,000 

Change from budget request ...................................................... +509,725,000 

54 

Mission.—NCI leads, conducts, and supports cancer research 

across the nation to advance scientific knowledge and help all people live longer, healthier lives. 

Access to Clinical Trials.—The Committee supports NCI’s efforts 

to improve equitable patient access to and participation in cancer 

clinical trials at NCI and NCI-designated Cancer Centers across 

the country, including an emphasis on patient enrollment, retention, and minority participation in those trials. The Committee believes that an underappreciated cause of low enrollment into cancer 

clinical trials is the barrier that ancillary cost of participation creates, especially for underserved and minority communities. This 

creates an access issue for many patients who could participate in 

clinical trials in order to take advantage of the medical advances 

trials offer as an alternative to hospice. The Committee directs NCI 

to implement a new pilot initiative to investigate the impact of providing navigation and direct patient expense reimbursement associated with participation in cancer clinical trials on cancer clinical 

trial enrollment, retention, patient outcomes, and research outcomes, including among underrepresented and minority communities. NCI is encouraged to develop the pilot research program in 

consultation with NCI-designated Cancer Centers, the National 

Clinical Trials Network, the NCI Community Research Program, 

and non-profit foundations currently working in this area. The 

Committee requests a description of NCI’s plans for this pilot program within 90 days of enactment of this Act. 

Cancer Immunotherapy.—The Committee continues to be encouraged by new breakthroughs in cancer immunotherapy, which are 

revolutionizing treatments for a growing number of cancers. This 

includes remarkable improvement in outcomes for an increasing 

number of cancer patients. In some cases, however, the side effects 

of such treatments are far different than those associated with 

chemotherapy. Early recognition and management of cancer 

immunotherapy-related side effects can result in resolution of these 

side effects before permanent damage is done, and allows for continued cancer treatment. As more patients benefit from cancer 

immunotherapy, recognizing and treating possible side effects will 

take on greater urgency. Therefore, the Committee urges NCI to 

prioritize research and education on the underlying mechanisms of 

cancer immunotherapy toxicities. 

Cancer Moonshot.—The Committee recommendation directs NIH 

to transfer $400,000,000 from the NIH Innovation Account to NCI 

to support the Cancer Moonshot initiative. These funds were authorized in the 21st Century Cures Act (PL 114–255). 

Children’s Oncology Group.—The Committee continues to support the important work of the Children’s Oncology Group and 

other pediatric research efforts to advance drug development. Pediatric cancer patients and their families rely heavily on the trials 

run by the Children’s Oncology Group. The vast majority of childhood cancer patients are enrolled in trials conducted by the Children’s Oncology Group and advances in treatment are dependent 

on the cancer research community’s ability to conduct trials quickly 

and enroll as many pediatric patients as possible. 

Collaboration Between Agencies Regarding Pediatric Investigation 

of Appropriate New Drugs.—The Committee recognizes that Title V 

of the Food and Drug Administration Reauthorization Act (FDARA) 

55 

amended the Pediatric Research Equity Act to support the early 

evaluation of potentially effective drugs by requiring pediatric investigation of appropriate new drugs intended for adults with cancer. The law directs the FDA, in collaboration with the NCI, to establish, publish, and regularly update a list of molecular targets 

considered on the basis of data the Agency determines to be adequate, to be substantially relevant to the growth or progression of 

pediatric cancers, and that may trigger the requirement for pediatric investigations. The Committee encourages NCI to collaborate 

with FDA as well as the patient community, providers, and manufacturers, and conduct a transparent and inclusive process to implement FDARA in a timely manner. 

Deadliest Cancers.—The Committee remains concerned that 

while more effective screening methods and treatments have lowered overall cancer incidence and death rates, there are still very 

few early detection and treatment tools for ‘‘recalcitrant cancers’’, 

defined in statute as those whose five-year survival rate is below 

50 percent. These cancers account for nearly half of all cancer 

deaths in the US and include cancers of the brain, esophagus, liver, 

lung, ovary, pancreas, and stomach. Given the toll these types of 

cancer exact on society and the lack of tools currently available to 

help patients, the Committee urges NCI to continue to support research with an emphasis on developing improved screening and 

early detection tools and more effective treatments. The Committee 

requests an update in the fiscal year 2020 Congressional Justification on the Requests for Applications NCI issued in fiscal years 

2017 and 2018 and funding awarded to specifically advance these 

goals. 

Gynecologic Cancer Clinical Trials.—The Committee supports 

continued investment in Federally-funded clinical trials for 

gynecologic cancers. Gynecologic cancers include ovarian, cervical, 

uterine, vaginal, and vulvar cancer. Given the high mortality rates 

for certain gynecologic cancers, the Committee requests NCI provide an update on access to gynecologic cancer clinical trials its fiscal year 2020 Congressional Justification. 

IDeA States and Cancer Trials.—The Committee recognizes that 

NCI supports clinical trials across the country through its National 

Clinical Trials Network (NCTN) and the NCI Community Oncology 

Research Program (NCORP). The Committee believes, however, 

that there are more opportunities for academic medical centers in 

IDeA States to become engaged in these networks. Therefore, the 

Committee encourages NCI to coordinate with the National Institute of General Medical Sciences (NIGMS) to help IDeA states that 

do not currently have NCORP or NCTN awards build capacity in 

these regions to conduct cancer clinical trials. The Committee also 

encourages NCI to continue to support NCORP in its mission to increase diversity among patients participating in NCI clinical trials, 

especially with regard to rural and minority populations. Finally, 

the Committee urges NCI, in consultation with NIGMS, to encourage collaboration between IDeA awardees and existing NCI designate cancer centers, NCTN lead sites, and NCORP sites. 

Metastatic Cancer Research.—The Committee recognizes that the 

incidence of and mortality rates for liver cancer have risen over the 

past decade and that comorbid conditions such as hepatitis continue to be risk factors for liver cancer. The Committee commends 

56 

the Cancer Moonshot and encourages continued support for its implementation. 

Office of Cancer Survivorship.—The Committee recognizes that 

the needs of childhood cancer survivors are unique. By 2020, there 

will be at least 500,000 childhood cancer survivors in the US. Twothirds of childhood cancer survivors suffer from at least one health 

problem caused from their treatment. The Committee urges NCI to 

continue to support childhood cancer survivorship, including research on survivorship following targeted and immune-therapies as 

well as a standard of care. The research should focus on the specific needs for childhood cancer survivors such as psycho-social 

treatments. 

Pancreatic and Other Recalcitrant Cancers.—Pancreatic cancer is 

currently the third leading cause of cancer-related death in the US, 

claiming the lives of over 44,000 Americans annually. Despite 

progress in combating other forms of cancer, pancreatic cancer remains the only major cancer with a five-year survival rate in the 

single digits, at 9 percent, in large part because there are no reliable early detection methods or effective treatment options. The 

Committee urges NCI to continue to support research with an emphasis on developing improved screening and early detection tools 

and more effective treatments. The Committee specifically requests 

an update on the pancreatic cancer scientific framework in the fiscal year 2020 Congressional Justification, including a description of 

ongoing and planned future research in this area. 

Pediatric Rare Cancer.—After accidents, cancer is the second 

leading cause of death in children ages one to fourteen. In 2018 

alone, cancer will affect over 15,000 children and adolescents, and 

most of those diagnoses will be for rare forms which lack therapeutic options. While children face dozens of cancers, only one pediatric-specific cancer has a targeted therapeutic. Moreover, children 

with cancer can suffer more severe side effects from aggressive 

treatments than adult patients. The Committee strongly encourages NIH to expand funding for research that may contribute to 

the development of new treatments for pediatric rare cancers. 

TheCommittee notes the ongoing research and development work 

in this field by private industry and encourages NIH to work with 

the private sector to promote a focus on rapidly developing and delivering treatments for rare cancers. 

Precision Oncology.—The Committee recognizes the potential for 

significant advancements in cancer treatments from the NCI– 

MATCH (Molecular Analysis for Therapy Choice) trial, which remains the central pillar of the precision medicine research focused 

on oncology for cancers that are unresponsive to standard interventions. The Committee requests that NCI provide an update on precision medicine activities in the fiscal year 2020 Congressional Justification. 

Prostate Cancer.—The Committee is concerned that prostate cancer lacks treatments for men with advancing disease as well as 

adequate diagnostic and imaging methodologies common in other 

hormone-driven cancers with similar disease burden. In order to 

ensure Federal resources are leveraged to the greatest extent possible, the Committee encourages NCI to coordinate its response to 

these needs with other Federal agencies, including the Department 

57 

of Defense, as well as private research foundations and advocacy 

groups. 

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

Appropriation, fiscal year 2018 ......................................................... $3,383,201,000 

Budget request, fiscal year 2019 ....................................................... 3,112,032,000 

Committee Recommendation ............................................................. 3,423,604,000 

Change from enacted level ......................................................... +40,403,000 

Change from budget request ...................................................... +311,572,000 

Mission.—NHLBI provides global leadership for a research, 

training, and education program to promote the prevention and 

treatment of heart, lung, and blood disorders and enhance the 

health of all individuals so that they can live longer and more fulfilling lives. 

Alzheimer’s Disease and Vascular Dementia.—The Committee 

recognizes the value that well-characterized, longitudinal, population-based cohort studies provide in bringing to light more information about the risk factors related to dementia. By studying participants and their descendants over time, much can be learned 

about cognitive decline and early biomarkers that will help us understand the role of environmental versus genetic factors in disease 

development and progression. The Committee commends the 

NHLBI for its work to follow its current and future cohort study 

participants for the development and progression of risk factors 

and to detect signs of cognitive decline in order to provide new insights into risk identification and accelerated prevention efforts. 

Congenital Heart Disease.—The Committee commends NHLBI 

for its continued work to better understand causation and appropriate treatments for those with the most life-threatening congenital heart defects through its biomedical research program 

Bench to Bassinet and the critical multi-centered infrastructure of 

the Pediatric Heart Network. The Committee urges NHLBI to continue its work with other Federal agencies and professional and patient organizations to expand collaborative activities targeted toward prevention and treatment of the diverse lifelong needs of children and adults living with congenital heart disease. The Committee requests a report on these efforts in the fiscal year 2020 

Congressional Justification. 

General Cardiac Research.—The Committee encourages NIH to 

pursue highly translational basic and clinical research that will 

have a near-term impact on health care of aging populations in 

States with high numbers of patients with cancer suffering from 

cardiovascular complications of chemotherapy, severe peripheral 

vascular disease, genetic cardiac diseases, and clotting disorders 

associated with aging and cardiac arrhythmias. Research should be 

conducted across the disciplines of medicine, immunology, imaging, 

chemistry, biomedical engineering, physics, statistics, mathematics, 

and entrepreneurship to design new drugs and drug delivery systems and strategies that are safer, more effective, and improve patient compliance, while seeking to move technologies from bench to 

bedside with private partners and local health care and community 

organizations. 

National Chronic Obstructive Pulmonary Disease Action Plan.— 

The Committee notes NHLBI’s role in crafting the National Chronic Obstructive Pulmonary Disease Action Plan. NHLBI is encourVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00057 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
58 

aged to continue this important work by supporting additional research activities and collaborating with other Public Health Service 

agencies to facilitate implementation of the plan’s recommendations. 

Pulmonary Hypertension.—The Committee recognizes NHLBI’s 

work to advance research into pulmonary hypertension, especially 

with regard to idiopathic pulmonary arterial hypertension. The 

Committee encourages NHLBI to continue working with stakeholders to advance these critical research priorities. 

Sickle Cell Disease Research.—The Committee encourages 

NHLBI to devote more research to the study of sickle cell disease. 

Academic medical centers located in States with significant populations of sickle cell patients have made progress in treating the 

disease through NIH-sponsored clinical trials and through blood 

and marrow transplantation, which is currently the only therapy 

that can cure the disease. However, more focused research is needed to augment the limited treatment options available. 

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

(NIDCR)

Appropriation, fiscal year 2018 ......................................................... $447,735,000 

Budget request, fiscal year 2019 ....................................................... 413,196,000 

Committee Recommendation ............................................................. 453,082,000 

Change from enacted level ......................................................... +5,347,000 

Change from budget request ...................................................... +39,886,000 

Mission.—The mission of NIDCR is to improve dental, oral, and 

craniofacial health through research, research training, and the 

dissemination of health information. 

Biodevices.—The Committee is pleased that NIDCR is exploring 

how to leverage oral biodevices for overall health, including developing tools to detect bone loss. The Committee encourages NIDCR 

to continue focusing on novel products, such as imaging technologies and dental restorative materials, which can improve individuals’ oral and overall health and well-being. 

NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND

KIDNEY DISEASES (NIDDK)

Appropriation, fiscal year 2018 ......................................................... $2,120,797,000 

Budget request, fiscal year 2019 ....................................................... 1,965,434,000 

Committee Recommendation ............................................................. 2,144,333,000 

Change from enacted level ......................................................... +23,536,000 

Change from budget request ...................................................... +178,899,000 

Mission.—The NIDDK mission is to conduct and support medical 

research and research training and disseminate science-based information on diabetes and other endocrine and metabolic diseases; 

digestive diseases, nutritional disorders, and obesity; and kidney, 

urologic, and hematologic diseases, to improve people’s health and 

quality of life. 

End-Stage Renal Disease.—The Committee recognizes NIDDK’s 

accomplishments in supporting critical kidney research, including 

research on end-stage renal disease. The Committee notes the recent GAO report on research funding and encourages NIDDK to 

continue working with stakeholders to disseminate critical information and discuss new opportunities for research. 

Hepatitis B.—The Committee notes that the Hepatitis B virus 

(HBV) research community convened a virtual consensus conVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00058 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
59 

ference that resulted in articles published in 2018 in two peer reviewed scientific journals identifying the most urgent research 

questions that must be answered to find a cure for HBV. The Committee urges NIDDK to pursue multiple critical research opportunities towards improved treatments and a cure for HBV and to provide an update in the fiscal year 2020 Congressional Justification. 

Inflammatory Bowel Disease.—The Committee is pleased by 

NIDDK’s support of research into inflammatory bowel diseases and 

notes recent CDC prevalence data, which suggests inflammatory 

bowel disease (IBD) is twice as prevalent as originally thought. The 

Committee encourages NIDDK to respond to these findings by providing enhanced support for research on IBD. Research should include a focus on the environmental triggers and epigenetics of IBD 

as well as interventions for the rising prevalence of IBD, and be 

targeted at both pediatric and adult patients. 

Pediatric Kidney Disease.—The Committee is encouraged by the 

research funded by NIDDK on pediatric kidney disease. However, 

the Committee continues to urge the NIDDK to plan and work toward multicenter clinical trials and translational studies that will 

focus on the unique needs of children with kidney disease. Pediatric patients and the entire pediatric nephrology community have 

benefited extensively from the previous two large pediatric focused 

clinical studies, RIVUR and CKiD. These studies not only addressed important clinical questions but also established large biorepositories and databases, which can be used by the research community to gain important additional knowledge from the study populations. The Committee also encourages NIDDK to fund research 

aimed at establishing new prognostic indicators such as genomics 

and personalized medicine, novel diagnostics, and therapeutics that 

may help further understanding in pediatric kidney disease that 

may also lead to breakthroughs and applications in adult kidney 

disease. The Committee requests that NIDDK report back in the 

fiscal year 2020 Congressional Justification on the progress made 

towards additional pediatric focused clinical studies. 

Technology and Ophthalmic Disorders.—The Committee notes 

that the specific use of technology, such as web-based telemedicine 

software, centralized reading centers, hand-held fundus cameras, 

photography training programs, and internet-based storage and 

transmission of images can efficiently detect early signs of diabetic 

retinopathy and glaucoma in rural and underserved populations. 

NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

(NINDS)

Appropriation, fiscal year 2018 ......................................................... $2,145,149,000 

Budget request, fiscal year 2019 ....................................................... 1,838,556,000 

Committee Recommendation ............................................................. 2,228,780,000 

Change from enacted level ......................................................... +83,631,000 

Change from budget request ...................................................... +390,224,000 

Mission.—The NINDS mission is to seek fundamental knowledge 

about the brain and nervous system and use that knowledge to reduce the burden of neurological disease. 

BRAIN Initiative.—The Committee recommendation includes bill 

language transferring $57,500,000 from the NIH Innovation Account to NINDS to support the BRAIN Initiative. These funds were 

authorized in the 21st Century Cures Act (PL 114–255). The ComVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00059 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
60 

mittee recognizes the importance of neuroscience research funded 

by NIH, which is fueling a vital scientific endeavor and is the essential foundation for understanding and treating diseases that impact over 100 million Americans each year. The Committee also 

commends NIH for its successful implementation of the BRAIN Initiative, and for its 5 year partnership with an array of agencies. 

This collaborative effort is revolutionizing the understanding of 

how neural components and their dynamic interactions result in 

complex behaviors, cognition, and disease, while accelerating the 

development of transformative tools to explore the brain in unprecedented ways making information previously beyond reach accessible. The Committee encourages NIH to continue to build off its 

5 years of success as a leader and partner on the BRAIN Initiative 

bringing together various disciplines and funding meritorious research to advance our knowledge of the brain. 

Non-Addictive Pain Treatments.—The Committee is aware that 

many people who suffer from acute pain are exposed to opioids, 

leading to addiction, and many others who suffer from chronic pain 

turn to opioids for relief because they lack alternative pain treatments and management. This is a particular challenge in Appalachia. The Committee encourages NINDS to prioritize the development of non-addictive treatments for pain, recognizing that there 

are regions of the country with high per capita rates of opioid 

deaths. 

Opioids.—The Committee commends NIH for launching the 

HEAL (Helping to End Addiction Long-Term) Initiative, a transNIH effort to speed scientific solutions to stem the national opioid 

public health crisis. This initiative will build on extensive, well-established NIH research, including basic science of the complex neurological pathways involved in pain and addiction, implement 

science to develop and test treatment models, and research to integrate behavioral interventions with medication-assisted treatment 

for opioid use disorder. The Committee continues to support opioidrelated research at NINDS and expects NINDS to expand this research in fiscal year 2019. 

Stroke Research.—The Committee continues its concern that 

stroke inflicts a vast burden, including topping per capita spending 

for all chronic conditions in the Medicare fee-for-service program. 

The Committee encourages NINDS to prioritize and implement robust investment to spur, strengthen, accelerate, and coordinate 

stroke research. This investment should focus on expediting novel 

basic, clinical and translational research by all available and appropriate mechanisms. The Committee encourages NINDS to intensify enactment of top stroke priorities, including prevention, 

endovascular therapy, early stroke recovery, and tele-rehabilitation. 

Traumatic Brain Injury.—The Committee understands that regenerative medicine research, including the use of adult stem cells, 

tissue engineered scaffolds, and means to promote neuroplasticity, 

may play an important role in the treatment of traumatic brain injury (TBI) and stroke. The Committee strongly encourages NINDS 

to work with the National Institute on Aging and other relevant 

ICs to ensure a robust and coordinated portfolio of research on how 

to leverage regenerative medicine research in the treatment of TBI 

and stroke. The Committee requests an update in the fiscal year 

61 

2020 Congressional Justification on efforts in these specific areas 

of research. 

NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)

Appropriation, fiscal year 2018 ......................................................... $5,260,210,000 

Budget request, fiscal year 2019 ....................................................... 4,761,948,000 

Committee Recommendation ............................................................. 5,368,029,000 

Change from enacted level ......................................................... +107,819,000 

Change from budget request ...................................................... +606,081,000 

Mission.—The NIAID mission is to conduct and support basic 

and applied research to better understand, treat, and ultimately 

prevent infectious, immunologic, and allergic diseases. 

Combating Antibiotic-Resistant Bacteria.—The Committee recommendation includes at least $538,000,000 within NIAID for research related to combating antibiotic-resistant bacteria. Many infectious organisms have adapted to the drugs designed to kill them, 

making the products less effective. Because most bacteria, viruses, 

and other microbes multiply rapidly, they can quickly evolve and 

develop resistance to antimicrobial drugs. Overusing or misusing 

antimicrobial drugs can make resistance develop even faster. These 

funds enable NIAID to support research on antimicrobial (drug) resistance, including basic research on how microbes develop resistance, new and faster diagnostics, and clinical trials designed to find 

new vaccines and treatments effective against drug-resistant microbes. The Committee requests an update on these activities in 

the fiscal year 2020 Congressional Justification. 

Hepatitis B.—The Committee notes that both the World Health 

Organization in 2016 and the National Academies of Science, Engineering, and Medicine in 2017 declared that the elimination of 

Hepatitis B virus (HBV) is possible. In the U.S., one in 20 Americans have been infected and more than two million are chronically 

infected with acute infections. The Committee further notes that 

the link between HBV infection and primary liver cancer is well established, with up to 60 percent of global liver cancer cases caused 

by HBV. The Committee requests that NIAID develop and lead an 

inter-institute working group, to include representation from NCI, 

NIDDK, and the National Institute on Minority Health and Health 

Disparities (NIMHD), to coordinate their research agendas and infrastructure to find a cure for HBV. The Committee requests a report on these efforts within 90 days of enactment of this Act. Additionally, the Committee urges NIAID to issue targeted calls for 

HBV research to fund the many critical research opportunities 

identified by the scientific community in the Roadmap for a Cure 

and report to the Committee on Appropriations of the House of 

Representatives and the Senate within 90 days of enactment of this 

Act NIAID’s research plan to pursue a cure for HBV. 

Microbicides.—The Committee recognizes that with NIH and 

United States Agency for International Development (USAID) leadership, research has shown the potential for antiretroviral (ARV) 

drugs to prevent HIV infection in women. The Committee encourages NIAID to continue coordination with USAID, the Department 

of State, and others to advance ARV-based microbicide development efforts with the goal of enabling regulatory approval of the 

first safe and effective microbicide for women and supporting an acVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00061 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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tive ARV-based microbicide pipeline to produce additional solutions 

to prevent HIV and to help end the epidemic. 

Tick-Borne Diseases.—The Committee encourages NIAID to intensify research on Lyme and other tick-borne diseases, including 

research that will increase understanding of the full range of processes that cause Lyme disease infection, including any possible 

mechanisms of persistent infection as well as potential treatments 

for Lyme disease. This should include research on the 

pathophysiology of infection with Borrelia burgdorferi and Borrelia 

mayonii, as well as the development of more sensitive and accurate 

diagnostic tests for Lyme and other tick-borne diseases, including 

next-generation polymerase chain reaction and new testing methodologies such as proteomics and metabolomics. 

Universal Influenza Vaccine.—The Committee directs NIAID to 

allocate at least $140,000,000 to support basic, translational, and 

clinical research to develop a universal influenza vaccine. This 

funding supports research to develop an influenza vaccine that provides robust, long-lasting protection against multiple subtypes of 

flu, rather than a select few. Such a vaccine would eliminate the 

need to update and administer the seasonal flu vaccine each year 

and could provide protection against newly emerging flu strains, 

potentially including those that could cause a flu pandemic. The 

Committee requests an update on these efforts within 60 days of 

enactment of this Act. 

NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)

Appropriation, fiscal year 2018 ......................................................... $2,785,400,000 

Budget request, fiscal year 2019 ....................................................... 2,572,669,000 

Committee Recommendation ............................................................. 2,818,667,000 

Change from enacted level ......................................................... +33,267,000 

Change from budget request ...................................................... +245,998,000 

Mission.—NIGMS supports basic research that increases our understanding of biological processes and lays the foundation for advances in disease diagnosis, treatment, and prevention. 

Institutional Development Awards.—The Committee provides $365,575,000 for the Institutional Development Awards (IDeA) program. IDeA supports high-quality research and investigators 

throughout the country in States in which the success rate for NIH 

grants has been historically low. 

Native American Research Centers for Health.—The Committee 

commends NIGMS for supporting the Native American Research 

Centers for Health program, which provides opportunities for 

Tribes and Tribal organizations to build the capacity to support research, research training, and faculty development to address 

health disparities in American Indian/Alaska Native communities. 

EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH

AND HUMAN DEVELOPMENT (NICHD)

Appropriation, fiscal year 2018 ......................................................... $1,452,006,000 

Budget request, fiscal year 2019 ....................................................... 1,339,592,000 

Committee Recommendation ............................................................. 1,469,346,000 

Change from enacted level ......................................................... +17,340,000 

Change from budget request ...................................................... +129,754,000 

Mission.—NICHD investigates human development throughout 

the entire life process, with a focus on understanding disabilities 

and important events that occur during pregnancy. 

63 

Endometriosis.—The Committee is aware that endometriosis is a 

serious chronic condition that impacts one in ten women in the US 

between the ages of 10 and 49. Women with this condition can suffer up to ten years before being properly diagnosed, often due to 

lack of awareness and limited treatment options available. The 

Committee encourages NICHD to develop a report on the current 

state of endometriosis. Further, the Committee encourages NICHD, 

through research and in collaboration with CDC, to continue to 

support education, outreach, and awareness to promote early and 

accurate diagnosis of endometriosis. 

Long-Term and Developmental Health Effects of Zika.—The Committee recognizes the unique nature of NICHD research into how 

the Zika virus infection affects pregnancy and the long-term and 

developmental health effects on children exposed to the Zika virus. 

The Committee urges NICHD to prioritize investment in long-term 

and developmental health effects of the Zika virus as the fight 

against the virus continues. 

Neonatal Abstinence Syndrome.—The Committee recognizes the 

importance of developing evidenced-based treatment protocols for 

babies with neonatal abstinence syndrome (NAS). The Committee 

requests that the NICHD provide a report to the Committee on existing research regarding evidence based-treatment protocols for 

both full-term and premature babies with NAS and recommendations for future research within 90 days of enactment of this Act. 

Pre-Term Birth.—Preterm birth affects approximately 380,000 

babies each year in the U.S. and is the leading cause of infant mortality. The Committee applauds NICHD’s research portfolio spanning the range of discovery, development, and delivery of science 

in order to identify the causes of premature birth and infant mortality. The Committee encourages NICHD to continue to provide 

robust support to extramural preterm birth prevention research, 

the Maternal-Fetal Medicine Units Network, the Neonatal Research Network, and the intramural research program related to 

prematurity. 

Rehabilitation Research.—The Committee recognizes the significant challenges faced by patients with neurological impairments 

who live in rural areas, where access to assistive devices, medical 

advice, and community resources can be limited. Proper rehabilitation, with the help of patient ‘‘navigators’’, is critical to improving 

patients’ quality of life and preventing further, and more costly, 

health problems. The Committee encourages the National Center 

for Medical Rehabilitation Research to provide greater support for 

research efforts on assistive health technology, particularly in underserved rural settings. 

Task Force on Research in Pregnant Women and Lactating 

Women.—The Committee looks forward to the Task Force’s report 

to the Secretary and Congress in September 2018, and continues 

to encourage and support the important work of the Task Force to 

ensure that pregnant and lactating women are included in research, and that consumers and health care professionals have upto-date and accurate information on the safety and efficacy of drugs 

that women are taking while pregnant or breastfeeding. 

64 

NATIONAL EYE INSTITUTE (NEI)

Appropriation, fiscal year 2018 ......................................................... $772,317,000 

Budget request, fiscal year 2019 ....................................................... 711,015,000 

Committee Recommendation ............................................................. 781,540,000 

Change from enacted level ......................................................... +9,223,000 

Change from budget request ...................................................... +70,525,000 

Mission.—NEI conducts and supports basic and clinical research, 

research training, and other programs with respect to blinding eye 

diseases, visual disorders, and mechanisms of visual function, preservation of sight, and the special health problems and needs of individuals who are visually-impaired or blind. 

Blepharospasm.—The Committee is pleased that NEI is expanding research on blepharospasm, a form of dystonia. The Committee 

encourages NEI to work with NINDS and stakeholders on cross 

cutting research opportunities that affect all forms of dystonia. 

Neuromyelitis Optica Spectrum Disorder.—The Committee directs NEI to provide an update in the fiscal year 2020 Congressional Justification on research related to Neuromyelitis Optica 

Spectrum Disorder (NMO/SD), a rare autoimmune disease that 

causes blindness and/or paralysis. The Committee strongly encourages NEI to work with other ICs, including NINDS and NIAID, to 

support basic research into the causes and treatment of NMO/SD. 

NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)

Appropriation, fiscal year 2018 ......................................................... $751,143,000 

Budget request, fiscal year 2019 ....................................................... 693,199,000 

Committee Recommendation ............................................................. 760,113,000 

Change from enacted level ......................................................... +8,970,000 

Change from budget request ...................................................... +66,914,000 

Mission.—NIEHS’ mission is to discover how the environment affects people in order to promote healthier lives. 

NATIONAL INSTITUTE ON AGING (NIA)

Appropriation, fiscal year 2018 ......................................................... $2,574,091,000 

Budget request, fiscal year 2019 ....................................................... 1,988,200,000 

Committee Recommendation ............................................................. 3,005,831,000 

Change from enacted level ......................................................... +431,740,000 

Change from budget request ...................................................... +1,017,631,000 

Mission.—NIA’s mission is to understand the nature of aging and 

the aging process, and diseases and conditions associated with 

growing older, in order to extend the healthy, active years of life. 

Alzheimer’s Disease.—In recognition that Alzheimer’s disease 

poses a serious threat to the nation’s long-term health and economic stability, the Committee recommends a total of at least 

$2,250,000,000 for Alzheimer’s disease research. NIA should continue to address the research goals set forth in the National Plan 

to Address Alzheimer’s disease, as well as the recommendations 

from the Alzheimer’s disease Research Summit in 2015. 

Alzheimer’s Disease Disparities.—The Committee commends the 

NIA for its leadership in supporting longitudinal, population-based 

cohort studies into the causes of dementia. Because rural, poor, and 

minority populations may be at enhanced risk for dementia, the 

value and application of these studies is enhanced when they include individuals from various geographic, ethnic, socio-economic 

and generational backgrounds. The Committee encourages NIA to 

65 

diversify its cohort studies, with the specific goal of better understanding disease burden and biomarkers by race and geographic region. Additionally, the Committee is concerned about the racial and 

ethnic disparities that exist in Alzheimer’s disease diagnoses and 

encourages NIA to support research exploring the disproportionate 

impact Alzheimer’s disease has on people of color, particularly African Americans who are two times more likely to develop late-onset 

Alzheimer’s disease than whites. 

Azheimer’s Disease Research Data.—The Committee is aware the 

advances in information technology make possible the ability to 

share research results broadly within the scientific community that 

seeks to develop a treatment for Alzheimer’s. Therefore, the Committee encourages NIA to develop a strategy to share Alzheimer’s 

research data across the research community as effectively and expeditiously as possible. 

Azheimer’s Disease Vaccine.— The Committee recognizes recent 

evidence suggests that the next generation of active or passive vaccines are one of the most promising therapies for efficacious treatment of Alzheimer’s. The Committee encourages NIH to pursue 

these technologies to accelerate the development and testing of 

promising vaccine candidates. 

Caregiver Dementia Initiative.—At any given time, more than 15 

million Americans are providing informal care to an older relative 

with dementia. However, dementia caregivers experience considerable stress and depression and impaired subjective well-being, selfefficacy, and physical health. The Committee encourages NIA to 

fund a pilot community-based peer support program designed to develop an accessible, feasible, and sustainable program that capitalizes on the expertise of former caregivers. Persons who previously 

cared for a person with dementia but have transitioned out of that 

role can provide one-on-one problem-solving, or coaching, for current dementia caregivers. Family care is preferred by both family 

members and persons with dementia themselves, and removes a 

substantial burden from the US healthcare system. 

Healthy Brain Aging.—In the context of NIA’s robust Alzheimer’s 

Disease research portfolio, the Committee recognizes the need to 

understand healthy brain aging and risk factors for Alzheimer’s 

Disease. The Committee encourages NIA to continue to address the 

research goals and recommendations related to healthy brain aging 

and cognitive resilience identified during the NIH’s 2015 Alzheimer’s Policy Summit. 

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND

SKIN DISEASES (NIAMS)

Appropriation, fiscal year 2018 ......................................................... $586,661,000 

Budget request, fiscal year 2019 ....................................................... 545,494,000 

Committee Recommendation ............................................................. 593,663,000 

Change from enacted level ......................................................... +7,002,000 

Change from budget request ...................................................... +48,169,000 

Mission.—NIAMS’ mission is to support research into the causes, 

treatment, and prevention of arthritis and musculoskeletal and 

skin diseases; the training of basic and clinical scientists to carry 

out this research; and the dissemination of information on research 

progress in these diseases. 

66 

Alopecia Areata.—The Committee applauds NIAMS for its leadership in autoimmune research breakthroughs that have advanced 

treatment development for alopecia areata. The Committee requests an update from NIAMS on new alopecia areata research advances in the fiscal year 2020 Congressional Justification. 

Lupus.—The Committee recognizes NIAMS for implementing the 

Action Plan for Lupus Research and for leading the Lupus Federal 

Working Group. The Committee is concerned about the substantial 

racial disparities in the incidence and prevalence of lupus and 

notes that African American women experience the highest lupus 

rate. Therefore, the Committee encourages NIAMS to continue to 

support lupus research, including studies to understand why the 

disease disproportionately affects women of color. 

Mucopolysaccharide Diseases.—Mucopolysaccharide (MPS) diseases are inherited, with death occurring for many in early childhood. This systemic disease causes progressive damage to the 

bones, heart, respiratory system, and brain, causing permanent 

disability and early death. The Committee continues to urge NIH 

to put a high priority on better understanding and treating MPS 

diseases. The Committee commends NIH for allocating funds to 

discover, develop, define, and make available for research animal 

models of human genetic disease. The Committee encourages expanded research of treatments for neurological, chronic inflammation, cardiovascular and skeletal manifestations of MPS, with an 

emphasis on gene therapy. The Committee thanks NCATS, 

NINDS, and NIDDK for again funding the Lysosomal Disease Network through the Rare Disease Clinical Network and for funding 

lysosomal research meetings. The Committee encourages NIH to 

expand support to incentivize MPS research. Understanding the 

manifestations and treatments of both the skeletal and neurological disease continues to be an area of great unmet need. 

Scleroderma.—The Committee recognizes the work that NIAMS 

is doing to support research of fibrotic disease and continues to encourage prioritizing research including scleroderma. The Committee also encourages NIAMS to work with other ICs on collaborative opportunities where feasible to advance critical research. 

NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION

DISORDERS (NIDCD)

Appropriation, fiscal year 2018 ......................................................... $459,974,000 

Budget request, fiscal year 2019 ....................................................... 423,992,000 

Committee Recommendation ............................................................. 465,467,000 

Change from enacted level ......................................................... +5,493,000 

Change from budget request ...................................................... +41,475,000 

Mission.—NIDCD conducts and supports biomedical and behavioral research and research training in the normal and disordered 

processes of hearing, balance, taste, smell, voice, speech, and language. NIDCD also conducts and supports research and research 

training related to disease prevention and health promotion; addresses special biomedical and behavioral problems associated with 

people who have communication impairments or disorders; and 

supports efforts to create devices which substitute for lost and impaired sensory and communication function. 

Spasmodic Dysphonia.—The Committee continues to encourage 

NIDCD to expand research on spasmodic dysphonia, a form of 

67 

dystonia. The Committee also encourages NIDCD to meet with 

stakeholders to link research with the needs of the community. 

NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)

Appropriation, fiscal year 2018 ......................................................... $158,033,000 

Budget request, fiscal year 2019 ....................................................... 145,842,000 

Committee Recommendation ............................................................. 159,920,000 

Change from enacted level ......................................................... +1,887,000 

Change from budget request ...................................................... +14,078,000 

Mission.—The mission of NINR is to promote and improve the 

health of individuals, families, and communities. To achieve this 

mission, NINR supports and conducts clinical and basic research 

and research training on health and illness, research that spans 

and integrates the behavioral and biological sciences, and develops 

the scientific basis for clinical practice. 

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)

Appropriation, fiscal year 2018 ......................................................... $509,573,000 

Budget request, fiscal year 2019 ....................................................... 469,109,000 

Committee Recommendation ............................................................. 515,658,000 

Change from enacted level ......................................................... +6,085,000 

Change from budget request ...................................................... +46,549,000 

Mission.—NIAAA’s mission is to generate and disseminate fundamental knowledge about the effects of alcohol on health and 

well-being, and apply that knowledge to improve diagnosis, prevention, and treatment of alcohol-related problems, including alcohol 

use disorder, across the lifespan. 

NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)

Appropriation, fiscal year 2018 ......................................................... $1,383,603,000 

Budget request, fiscal year 2019 ....................................................... 1,137,403,000 

Committee Recommendation ............................................................. 1,400,126,000 

Change from enacted level ......................................................... +16,523,000 

Change from budget request ...................................................... +262,723,000 

Mission.—NIDA’s mission is to advance science on the causes 

and consequences of drug use and addiction and to apply that 

knowledge to improve individual and public health. 

Neonatal Abstinence Syndrome.—The Committee recognizes the 

importance of research and prevention, identification, and treatment of prenatal opioid exposure and neonatal abstinence syndrome. The Committee encourages NIDA to ensure the review process includes appropriate focus on geographic locations where the 

problem is particularly acute or two or fewer treatment programs 

are available. The Committee encourages NIH, based on appropriate scientific review, to support meritorious research opportunities for institutions offering clinical services to women, particularly 

women from rural areas, who are at risk for opioid dependence and 

opioid exposure during pregnancy and for infants born with neonatal abstinence syndrome. 

Opioids.—The Committee commends NIH for launching the 

HEAL (Helping to End Addiction Long-Term) Initiative, a transNIH effort to speed scientific solutions to stem the national opioid 

public health crisis. This Initiative will build on extensive, well-established NIH research, including basic science of the complex neurological pathways involved in pain and addiction, implementation 

science to develop and test treatment models, and research to inteVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00067 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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grate behavioral interventions with medication-assisted treatment 

for opioid use disorder. The Committee continues to support opioidrelated research at NIDA and expects NIDA to expand this research in fiscal year 2019. 

The Committee continues to be extremely concerned about the 

epidemic of prescription opioids, heroin, and synthetic opioid use, 

addiction, and overdose in the US. Approximately 144 people die 

each day in this country from opioid overdose, making it one of the 

most common causes of non-disease-related deaths for adolescents 

and young adults. This crisis has been exacerbated by the availability of fentanyl and its analogs in many communities. The Committee appreciates the important role that research can and should 

play in the various Federal initiatives aimed at this crisis. The 

Committee urges NIDA to continue funding research on medication 

development to alleviate pain, especially the development of medications with reduced abuse liability, and to report on what we 

know regarding the transition from opioid analgesics to heroin and 

synthetic opioid abuse and addiction within affected populations. 

Raising Awareness and Engaging the Medical Community in 

Drug Abuse and Addiction Prevention and Treatment.—The Committee notes that education is a critical component of any effort to 

curb drug use and addiction, and it must target every segment of 

society, including healthcare providers (doctors, nurses, dentists, 

and pharmacists), patients, and families. Medical professionals 

must be in the forefront of efforts to curb the opioid crisis. The 

Committee continues to be pleased with the NIDAMED initiative, 

targeting physicians-in-training, including medical students and 

resident physicians in primary care specialties (e.g., internal medicine, family practice, and pediatrics). The Committee encourages 

NIDA to continue its efforts in this space, providing physicians and 

other medical professionals with the tools and skills needed to incorporate drug abuse screening and treatment into their clinical 

practices. The Committee encourages NIDA and CDC to develop 

strategies for increasing participation in its online continuing medical education course on safe prescribing for pain and managing patients who abuse prescription opioids. The Committee also encourages NIDA and CDC to develop strategies for increasing participation in its online continuing medical education courses on safe prescribing for pain and managing patients who abuse prescription 

opioids. 

NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)

Appropriation, fiscal year 2018 ......................................................... $1,711,775,000 

Budget request, fiscal year 2019 ....................................................... 1,612,192,000 

Committee Recommendation ............................................................. 1,790,231,000 

Change from enacted level ......................................................... +78,456,000 

Change from budget request ...................................................... +178,039,000 

Mission.—NIMH’s mission is to transform the understanding and 

treatment of mental illnesses through basic and clinical research, 

paving the way for prevention, recovery, and cure. 

BRAIN Initiative.—The Committee recommendation includes bill 

language transferring $57,500,000 from the NIH Innovation Account to NIMH to support the BRAINInitiative. These funds are 

authorized by the 21st Century Cures Act (PL 114–255). The Committee recognizes the importance of NIH funded neuroscience reVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00068 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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search, which is fueling a vital scientific endeavor and is the essential foundation for understanding and treating diseases that impact 

over 100 million Americans each year. The Committee also commends the NIH for its successful implementation of the BRAIN Initiative, and for its five year partnership with an array of agencies. 

This collaborative effort is revolutionizing our understanding of 

how neural components and their dynamic interactions result in 

complex behaviors, cognition, and disease, while accelerating the 

development of transformative tools to explore the brain in unprecedented ways making information previously beyond reach accessible. The Committee encourages NIH to continue to build off its 

five years of success as a leader and partner on the BRAIN Initiative bringing together various disciplines and funding meritorious 

research to advance knowledge of the brain. 

Eating Disorder Research.—Eating disorders are a serious mental illness that affect 30 million Americans during their lifetime 

and has the highest mortality rate of any psychiatric illness. The 

Committee encourages NIH to continue to support eating disorders 

research, with a focus on applied research in prevention, early 

identification, and innovative treatment. 

NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)

Appropriation, fiscal year 2018 ......................................................... $556,881,000 

Budget request, fiscal year 2019 ....................................................... 512,979,000 

Committee Recommendation ............................................................. 563,531,000 

Change from enacted level ......................................................... +6,650,000 

Change from budget request ...................................................... +50,552,000 

Mission.—NHGRI’s mission is to accelerate scientific and medical 

breakthroughs that improve human health by driving cutting-edge 

research, developing new technologies, and studying the impact of 

genomics on society. 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING

(NIBIB)

Appropriation, fiscal year 2018 ......................................................... $377,871,000 

Budget request, fiscal year 2019 ....................................................... 346,550,000 

Committee Recommendation ............................................................. 382,384,000 

Change from enacted level ......................................................... +4,513,000 

Change from budget request ...................................................... +35,834,000 

Mission.—The NIBIB mission is to improve health by leading the 

development and accelerating the application of biomedical technologies. 

NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES

(NIMHD)

Appropriation, fiscal year 2018 ......................................................... $303,200,000 

Budget request, fiscal year 2019 ....................................................... 280,545,000 

Committee Recommendation ............................................................. 306,821,000 

Change from enacted level ......................................................... +3,621,000 

Change from budget request ...................................................... +26,276,000 

Mission.—NIMHD’s mission is to lead scientific research to improve minority health and reduce health disparities. 

Focal Segmental Glomerulosclerosis Research.—The Committee 

recognizes the work that NIMHD and NIDDK are doing to address 

the connection between the APOL1 gene and the onset of Focal 

Segmental Glomerulosclerosis (FSGS). The Committee encourages 

70 

NIMHD to work with community stakeholders caring for the affected population to identify areas of collaboration. 

Hepatitis B.—The Committee notes that half of all HBV patients 

in the US are immigrant Asian-Americans or Pacific Islanders, 

though these groups only accounts for about six percent of the population. Further, among African immigrants, the prevalence of 

chronic HBV is about 10 percent. The Committee urges NIMHD to 

fund research to test scale-up model programs that increase HBV 

awareness, knowledge, testing and linkage to care for treatment 

among the disproportionately HBV-impacted communities. 

NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH

(NCCIH)

Appropriation, fiscal year 2018 ......................................................... $142,184,000 

Budget request, fiscal year 2019 ....................................................... 130,717,000 

Committee Recommendation ............................................................. 143,882,000 

Change from enacted level ......................................................... +1,698,000 

Change from budget request ...................................................... +13,165,000 

Mission.—The mission of NCCIH is to define, through rigorous 

scientific investigation, the usefulness and safety of complementary 

and integrative health interventions and their roles in improving 

health and health care. 

NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)

Appropriation, fiscal year 2018 ......................................................... $742,354,000 

Budget request, fiscal year 2019 ....................................................... 685,087,000 

Committee Recommendation ............................................................. 751,219,000 

Change from enacted level ......................................................... +8,865,000 

Change from budget request ...................................................... +66,132,000 

Mission.—NCATS was established to transform the translational 

process so that new treatments and cures for disease can be delivered to patients faster. 

Clinical and Translational Science Awards.—The Committee expects NIH to fund Clinical and Translational Science Awards 

(CTSAs) at not less than the level provided in fiscal year 2018. 

Rural Health Outcomes and Health Disparities.—The Committee 

notes translational science and education is critical to developing 

new treatments and healthcare approaches that can be disseminated to underserved and special populations to improve health 

outcomes across the life span. The Committee continues and encourages NCATS, through its CTSA program, to enhance its commitment to the value of translational science and funding for universities to continue to innovate by leveraging statewide resources 

and capabilities to improve rural health outcomes and eliminate 

health disparities. The Committee requests an update on the actions within the CTSA program to improve rural health outcomes 

and health disparities in the fiscal year 2020 Congressional Justification. 

JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)

Appropriation, fiscal year 2018 ......................................................... $75,733,000 

Budget request, fiscal year 2019 ....................................................... 70,084,000 

Committee Recommendation ............................................................. 76,637,000 

Change from enacted level ......................................................... +904,000 

Change from budget request ...................................................... +6,553,000 

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Mission.—FIC’s mission is to support and facilitate global health 

research conducted by US and international investigators, building 

partnerships between health research institutions in the US and 

abroad, and training the next generation of scientists to address 

global health needs. 

NATIONAL LIBRARY OF MEDICINE (NLM)

Appropriation, fiscal year 2018 ......................................................... $428,553,000 

Budget request, fiscal year 2019 ....................................................... 395,493,000 

Committee Recommendation ............................................................. 433,671,000 

Change from enacted level ......................................................... +5,118,000 

Change from budget request ...................................................... +38,178,000 

Mission.—The NLM collects and organizes information important 

to biomedicine; serves as a national information resource for medical education, research, and health service activities; enhances access to biomedical literature through electronic services; serves the 

public by providing electronic access to reliable health information 

for consumers; supports and directs the national network of libraries of medicine; provides grants for research in biomedical communications, medical library development, and training health information specialists; conducts and supports research in biomedical 

informatics and computational biology; and creates information resources for genomics, molecular biology, toxicology, medical images, 

environmental health, emergency preparedness and response, and 

health services research. 

OFFICE OF THE DIRECTOR (OD)

Appropriation, fiscal year 2018 ......................................................... $1,803,293,000 

Budget request, fiscal year 2019 ....................................................... 1,795,706,000 

Committee Recommendation ............................................................. 1,902,828,000 

Change from enacted level ......................................................... +99,535,000 

Change from budget request ...................................................... +107,122,000 

Mission.—The OD provides leadership to the NIH research enterprise and coordinates and directs initiatives that crosscut NIH. OD 

is responsible for the development and management of intramural 

and extramural research and research training policy, the review 

of program quality and effectiveness, the coordination of selected 

NIH-wide program activities, and the administration of centralized 

support activities essential to the operations of NIH. 

Common Fund.—The Committee recommends $601,613,000 for 

the Common Fund (CF), and an additional $12,600,000 provided to 

support the Gabriella Miller Kids First Research Act for the fifth 

year of the ten-year Pediatric Research Initiative. NIH is expected 

to continue the longstanding CF policy for projects to be shortterm, high-impact awards, with no projects receiving funding for 

more than ten years. 

Environmental Influences on Child Health Outcomes.—The Committee continues to recognize the importance of investigating the 

effects of environmental exposures on child health and development. The Environmental Influences on Child Health Outcomes 

(ECHO) Project has the potential to greatly increase understanding 

of these critical determinants of health across the lifespan, through 

its observational cohorts and the IDeA States Pediatric Clinical 

Trials Network. The Committee encourages continued communication about the program’s progress toward goals, milestones, and 

projected funding estimates with both external stakeholders and 

72 

Congress. Within 180 days of enactment of this Act, the Committee 

directs NIH to submit and make public a summary of progress 

made to date, including an analysis of the composition of the funded cohort studies, the capacity of the Network to conduct trials 

among rural and underserved children, and the short- and longterm goals of the program. 

Undiagnosed Diseases Network.— The Committee continues to 

support the Undiagnosed Diseases Network (UDN) and urges UDN 

to continue efforts to enhance access to patients, caregivers, and 

other stakeholders as well as make information obtained through 

the UDN available to Federal agencies. 

Multi-Institute Research Issues 

Adult Stem Cell Technology.—The Committee continues to recognize adult stem cell technology (including induced pluripotent stem 

cells, mesenchymal stem cells, and other types of adult stem cells) 

as a critical tool in the realm of personalized medicine. The Committee notes that adult stem cells provide promising opportunities 

to develop sources of cells with great therapeutic value and potential for curing human diseases. The Committee also recognizes that 

basic science leads to pre-clinical studies and clinical trials, which 

may in turn generate new diagnostics, treatments and cures. The 

Committee encourages NIH to further explore additional basic 

science opportunities. The Committee requests an update in the fiscal year 2020 Congressional Justification on NIH efforts to foster 

basic research on adult stem cell technology, including through collaborative consortiums and other approaches to leveraging existing 

research capabilities to further advance scientific knowledge. 

Amyloidosis.—The Committee encourages NIH to continue to expand its research efforts into amyloidosis, a group of rare diseases 

characterized by abnormally folded protein deposits in tissues. Amyloidosis is often fatal and there is no known cure. Current methods of treatment are risky and unsuitable for many patients. The 

Committee requests that NIH provide an update on the steps taken 

to increase the understanding of the causes of amyloidosis and the 

measures taken to improve the diagnosis and treatment of this 

devastating group of diseases in the fiscal year 2020 Congressional 

Justification. 

Angelman Syndrome.—The Committee recognizes the promising 

scientific gains made in the pursuit of treatments for Angelman 

Syndrome. The Committee applauds the significant contributions of 

the Angelman Syndrome Natural History Study, funded by NIH, 

and the private partners working diligently to advance the growing 

body of Angelman Syndrome research towards practical treatments. Further research in this area holds great promise for both 

Angelman Syndrome and forms of autism also linked to 

misexpression of the UBE3A gene. With two innovative new treatments poised for clinical trials, the Committee urges NIH to support Angelman Syndrome research, and specifically to advance research in the roles of the UBE3A gene in brain functions. 

Chronic Fatigue Syndrome.—The Committee is pleased that NIH 

has begun to expedite research into Chronic Fatigue Syndrome. 

The Committee urges NIH to collaborate with disease experts and 

the patient community to identify additional opportunities to expedite progress on this understudied disease. Specifically, the ComVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00072 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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mittee encourages NIH to increase research to (1) identify underlying causes of the illness to enable therapies that would effectively 

prevent or treat the illness, (2) identify biological markers linked 

to the various forms of the illness to optimize selection of specific 

patient subgroups for trials, (3) increase investigator-initiated studies and early-stage investigator awards, and (4) develop mechanisms to incentivize researchers to enter the field. 

Cystic Fibrosis.—The Committee applauds the work of NIH to 

support research aimed at correcting the genetic defect that causes 

cystic fibrosis (CF), including recent Requests for Applications that 

will advance the fields of gene editing, lung stem cell biology, and 

nucleic acid delivery. Cystic fibrosis is a rare, life-threatening genetic disease that impacts the lungs and digestive system. There 

are more than 1,700 mutations that cause CF, some of which may 

only be effectively overcome through genetic repair approaches. The 

Committee also encourages the continuation of collaborative initiatives to overcome current barriers to implementing genetic repair 

approaches for treating human diseases. One such project, a joint 

workshop between the NHLBI and the Cystic Fibrosis Foundation, 

focused on identifying barriers and proposing solutions to deliver 

gene editing technologies to the lungs of people with CF as a 

means to cure the disease. 

Duchenne Muscular Dystrophy.—Duchenne muscular dystrophy 

is a severe type of muscular dystrophy for which there is no cure 

and for which the average life expectancy is 26 years. The Committee strongly encourages NIH to significantly expand its support 

for research on Duchenne muscular dystrophy. 

Epidermolysis Bullosa.—The Committee encourages NIH to continue to support research and coordination of activities with respect 

to epidermolysis bullosa and related connective tissue disorders. 

Fibrosis.—The Committee recognizes NIH for their work on addressing the need for coordination across ICs on fibrotic research. 

The Committee encourages NIH to continue working across ICs 

and with stakeholders to advance critical priorities. 

Food Allergies.—Food allergies affect 15 million Americans, can 

be life threatening, and have no cure. Currently, the Consortium 

of Food Allergy Research network includes seven clinical sites/centers. In addition, approximately 10 other NIH-supported centers 

are conducting basic, translational, and clinical research on food allergies. The Committee encourages NIH to expand its clinical research network to add new centers of excellence in food allergy 

clinical care and to select such centers from those with a proven 

expertise in food allergy research. 

Food is Medicine.—The Committee recognizes the important role 

of nutrition in health outcomes and encourages OD to work with 

relevant ICs, including NIDDK, NHLBI, NIA, and NICHD, to report on the research that has been conducted on Food is Medicinerelated topics. This may include, but is not limited to, medicallytailored meals, medical nutrition therapy, produce prescription programs, the role of proper nutrition in aging, and the role of proper 

nutrition in reproductive health. The Committee further encourages additional collaboration among the ICs on these topics. 

Foundation for the NIH.—The Committee directs the Foundation 

for the National Institutes of Health (‘‘Foundation’’) to abide by section 499(j)(4) of the Public Health Service Act by including in the 

74 

Foundation’s annual report the source and amount of all monetary 

gifts to the Foundation, as well as the source and description of all 

gifts of real or personal property. Each annual report shall disclose 

a specification of any restrictions on the purposes for which gifts 

to the Foundation may be used. The annual report shall not list 

‘‘anonymous’’ as a source for any gift that includes a specification 

of any restrictions on the purpose for which the gift may be used. 

Fragile X.—The Committee commends NIH for supporting research to understand the nature of fragile X (FX) and its association with other conditions such as autism. The Committee encourages NIH to continue to fund at least three FX research centers, 

supporting interdisciplinary research in important new areas. The 

Committee urges NIH to assure that the FX research centers program includes clinical and translational research that directly addresses the needs of affected children and their families, and that 

applicants for new centers may propose clinical trials as part of 

their research portfolio. Given the inextricable connection between 

the FX protein and autism, the Committee urges the Director and 

his counterparts at each IC with an FX and autism portfolio to explore ways to create greater efficiency and synergy among these 

two research tracks to accelerate translational research toward a 

better understanding of both conditions and to shorten the time to 

bring effective treatments for both conditions to market including 

the funding for clinical trials for both disorders. 

Headache Disorders.—The Committee encourages NIH to 

prioritize fundamental, translational, and clinical research on 

headache disorders. In 2016, 36 million Americans experienced a 

migraine attack, 12 million suffered from chronic daily headaches, 

and millions further were affected by cluster headaches, post-traumatic headaches, or other disabling headache disorders. 

Heavy Ion Cancer Therapy and Research.—The Committee supports NIH’s continued exploration of advanced therapeutic cancer 

research, specifically heavy ion irradiation technology. This technology will introduce a novel treatment option to cancer patients 

that is currently not available in the US. The Committee supports 

NIH’s work with the heavy ion planning grant recipients to further 

advance access to novel heavy ion treatment within the US. The 

Committee encourages NIH to explore further the establishment of 

a state-of-the-art heavy ion research facility in the US. Furthermore, the Committee encourages NIH to work with the Departments of Defense and Energy, and other applicable Federal agencies to equip the first US heavy ion research center. The Committee urges NIH to capitalize on the expertise and potential of the 

heavy ion facility planning grant recipients in order to foster a 

multidisciplinary approach and advance heavy ion research that 

would produce novel, cutting edge treatments for cancer patients. 

Lymphangioleiomyomatosis.—The Committee requests an update 

on Lymphangioleiomyomatosis research in the fiscal year 2020 

Congressional Justification. 

Mitochondrial Disease Research.—The Committee understands 

that no fewer than 17 ICs are involved in research efforts related 

to mitochondrial disease and dysfunction. The Committee appreciates the NIH’s support of the trans-NIH Mitochondrial Disorders 

Working Group, the North American Mitochondrial Disease Consortium, the Mitochondrial Disease Sequence Data Resource ConVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00074 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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sortium, and its support for investigator-initiated intramural and 

extramural studies. The Committee encourages NIH to continue its 

efforts to ensure that individuals with mitochondrial disease participate in both the All of Us research program and the ECHO 

study. The Committee understands that the NIH is funding research relevant to mitochondrial disease through the Office of Research Infrastructure Programs (ORIP). The Committee encourages 

the Director to promote mitochondrial disease research within 

ORIP and to provide an update to the Committee in the fiscal year 

2020 Congressional Justification on progress made through this research. The Committee applauds the efforts made by the agency’s 

Office of Dietary Supplements (ODS) on nutritional interventions 

for those with mitochondrial disease and requests the agency include mitochondrial disease as a focus of its future practice and to 

reengage its trans-NIH research through the ODS on these issues. 

The Committee further encourages the Director to competitively 

fund mitochondrial disease centers of excellence that combine a 

critical mass of clinical care and research on mitochondrial disease. 

Neurofibromatosis.—The Committee supports efforts to increase 

funding and resources for Neurofibromatosis (NF) research and 

treatment at multiple NIH ICs, including NCI, NINDS, NIDCD, 

NHLBI, NICHD, NIMH, NCATS, and NEI. Children and adults 

with NF are at significant risk for the development of many forms 

of cancer. The Committee encourages NCI to increase its NF research portfolio in fundamental basic science, translational research and clinical trials focused on NF. The Committee also encourages the NCI to support NF centers, NF clinical trials consortia, NF preclinical mouse models consortia and NF-associated 

tumor sequencing efforts. Because NF causes brain and nerve tumors and is associated with cognitive and behavioral problems, the 

Committee urges NINDS to continue to aggressively fund fundamental basic science research on NF relevant to nerve damage and 

repair. Based on emerging findings from numerous researchers 

worldwide demonstrating that children with NF are at significant 

risk for autism, learning disabilities, motor delays, and attention 

deficits, the Committee encourages NINDS, NIMH, and NICHD to 

expand their investments in laboratory-based and clinical investigations in these areas. Since NF2 accounts for approximately five 

percent of genetic forms of deafness, the Committee encourages 

NIDCD to expand its investment in NF2 basic and clinical research. NF1 can cause vision loss due to optic gliomas, the Committee encourages NEI to expand its investment in NF1 basic and 

clinical research. 

Office of AIDS Research.— The Committee encourages the Offie 

to strategically focus resources allocated to AIDS research towards 

the highest quality peer reviewed projects aimed at finding a cure, 

creating a vaccine, and developing better treatments for the disease. 

Pediatric Precision Medicine.—The Committee recognizes the potential that precision medicine holds for all populations, including 

children, and encourages NIH to prioritize timely and meaningful 

enrollment for the pediatric population, including healthy children 

and those with rare disease, in the All of Us research program. The 

Committee is encouraged that NIH impaneled a Child Enrollment 

Scientific Vision Working Group, which released a report that idenVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00075 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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tifies scientific opportunities relevant to child health. The Committee requests an update within 30 days of enactment of this Act 

on: (1) the timing for the Special Populations Committee to provide 

recommendations regarding the practical considerations of child enrollment and data collection involving children, (2) plans to ensure 

that the research cohort includes a sufficient number of children to 

make meaningful studies possible, (3) the target date for enrollment to commence, and (4) how enrollment strategies will include 

input from pediatric stakeholders across the country with experience in pediatric clinical trial enrollment. 

Polycystic Ovary Syndrome.—The Committee recognizes the significant health burden of Polycystic Ovary Syndrome (PCOS), 

which has reproductive, metabolic, and mental health manifestations. The exact causes of PCOS are unknown at this time; however, PCOS is the most common cause of female infertility, affecting up to 10 to 15 percent of women, depending on diagnostic criteria used. To date, 70 percent of NIH’s investment in PCOS has 

focused on the reproductive implications of the syndrome, and the 

Committee commends NICHD for its leadership in PCOS research. 

The Committee requests that NIH also focus on comorbidities associated with PCOS, as they contribute to increased health care costs 

and negative health outcomes. The Committee requests that 

NICHD, in consultation with the relevant NIH ICs, including 

NIDDK, NHLBI, NCI, the Office of Research on Women’s Health, 

NIMH, and NICHD, report on the research that has been conducted on PCOS and its comorbidities to date in the fiscal year 

2020 Congressional Justification. The Committee further urges 

these ICs to support investigator-initiated studies and early-stage 

investigator awards, and mechanisms to incentivize researchers to 

enter the field. 

Transformative High-Resolution Cryo-Electron Microscopy.—The 

Committee commends NIH on its initial investment in the Transformative High Resolution Cryo-Electron Microscopy (Cryo-EM) 

program. The recent Nobel Prize for chemistry was awarded for the 

development of Cryo-EM research funded by NIH. The Committee 

urges the NIH to expand the number of national service centers 

and training opportunities to further refine and advance Cryo-EM 

research. The Committee directs NIH to provide an update of these 

efforts in the fiscal year 2020 Congressional Justification. 

Trisomy 21.—The Committee applauds the NIH for significantly 

increasing its investment in Down syndrome research and for the 

NIH Director’s leadership in advancing the trans-NIH initiative the 

Committee included in the fiscal year 2018 appropriation. The 

Committee directs NIH to continue to make new investments in 

Down syndrom research that prioritize funding for both new research grants that will significantly expand the current pipeline of 

Down syndrom research, as well as the implementation of the new 

trans-NIH intiative. In addition, the Committee encourages NIH to 

prioritize funding for research to improve the health and 

neurodevelopment of individuals with Down syndrome and typical 

individuals at risk for immune system dyregulation, Alzheimer’s 

disease, cancer, cardiovascular disease, and autism. 

Valley Fever.—The Committee understands that based on the 

recommendation of the independent Data and Safety Monitoring 

Board (DSMB) for the Valley Fever Randomized Controlled Trial 

77 

(RCT), NIAID has halted enrollment in the RCT due to lack of patient enrollment, primarily those with Valley Fever. In light of this, 

the DSMB recommended revising the study protocol. Accordingly, 

the Committee directs NIAID to expeditiously revise the study design to address the critical need for effective treatment of Valley 

Fever in order to restart enrolling patients before the end of 2018, 

including increasing the number of participating healthcare provider enrollment sites. Furthermore, the Committee directs NIAID 

to work with stakeholders to develop and implement a plan to 

maximize the number of health care provider patient enrollment 

sites and raise awareness of this study with the broader public 

with the goal of increasing patient enrollment. The Committee requests regular updates on the Valley Fever RCT revisions on quarterly basis until patient enrollment is restarted, as well as a report 

on maximizing health care provider enrollment sites and public 

awareness plans to increase patient enrollment in the revised RCT 

within 90 days of enactment of this Act. 

BUILDINGS AND FACILITIES

Appropriation, fiscal year 2018 ......................................................... $128,863,000 

Budget request, fiscal year 2019 ....................................................... 200,000,000 

Committee Recommendation ............................................................. 200,000,000 

Change from enacted level ......................................................... +71,137,000 

Change from budget request ...................................................... – – – 

Mission.—This account provides for the design, construction, improvement, and major repair of clinical, laboratory, and office 

buildings and supporting facilities essential to the mission of the 

NIH. The funds in this appropriation support the buildings on the 

main NIH campus in Bethesda, Maryland; the Animal Center in 

Poolesville, Maryland; the NIEHS facility in Research Triangle 

Park, North Carolina; and other smaller facilities throughout the 

US. 

NIH INNOVATION ACCOUNT

This account supports NIH programs authorized in the 21st Century Cures Act (PL 114–255). 

All of Us.—Within the total for this account, the Committee includes $186,000,000 for the All of Us precision medicine initiative. 

The Committee expects that NIH will also include at least 

$251,000,000 in budget authority from other NIH ICs to support 

this initiative. 

Regenerative Medicine.—Within the total for this account, the 

Committee includes $10,000,000 for Regenerative Medicine. 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $5,158,994,000 

Budget request, fiscal year 2019 ....................................................... 3,546,552,000 

Committee Recommendation ............................................................. 5,681,993,000 

Change from enacted level ......................................................... +522,999,000 

Change from budget request ...................................................... +2,135,441,000 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of 

Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to 

78 

reduce the impact of substance abuse and mental illness on America’s communities. 

The Committee continues to include bill language that exempts 

the Mental Health Block Grant and the Substance Abuse Prevention and Treatment Block Grant as a source for the Public Health 

Service Act section 241 evaluation set-aside in fiscal year 2019. 

The Committee does not include the requested bill language allowing the Assistant Secretary for Mental Health and Substance 

Use to transfer three percent or less of funds between any of 

SAMHSA’s accounts. 

The Committee continues to strongly encourage SAMHSA to ensure States are engaging meaningfully with Tribal populations in 

the planning and use of block grant funds. SAMHSA is also encouraged to share best practices across States. 

Where permitted in the authorizing statute, the Committee directs SAMHSA when issuing new funding opportunity announcements, to include as an eligible applicant: States, political subdivisions of States (local government/ communities/ municipalities), Indian Tribes or Tribal organizations, or other public or nonprofit entities or organizations. The Committee encourages SAMHSA to provide outreach and technical assistance to ensure the maximum 

level of awareness and participation in new grant announcements. 

MENTAL HEALTH

Appropriation, fiscal year 2018 ......................................................... $1,487,011,000 

Budget request, fiscal year 2019 ....................................................... 1,064,922,000 

Committee Recommendation ............................................................. 1,414,510,000 

Change from enacted level ......................................................... ¥72,501,000 

Change from budget request ...................................................... +349,588,000 

Within the total provided for Mental Health Programs of Regional and National Significance, the Committee provides the following amounts: 

Budget Activity FY 2019 

Committee 

Capacity: 

Seclusion and Restraint ........................................................................................................................ $1,147,000 

Project AWARE ....................................................................................................................................... 71,000,000 

Mental Health Awareness Training ....................................................................................................... 19,963,000 

Healthy Transitions ................................................................................................................................ 25,951,000 

Infant and Early Childhood Mental Health ........................................................................................... 5,000,000 

Children and Family Programs ............................................................................................................. 7,229,000 

Consumer and Family Network Grants ................................................................................................. 4,954,000 

Project LAUNCH ..................................................................................................................................... 23,605,000 

Mental Health System Transformation .................................................................................................. 3,779,000 

Primary and Behavioral Health Care Integration ................................................................................. 49,877,000 

National Strategy for Suicide Prevention .............................................................................................. 13,500,000 

Zero Suicide .................................................................................................................................. 11,500,000 

American Indian and Alaska Native Set-Aside ................................................................... 2,500,000 

Suicide Lifeline ...................................................................................................................................... 7,198,000 

Garrett Lee Smith-Youth Suicide Prevention: 

State Grants ................................................................................................................................. 35,427,000 

Campus Grants ............................................................................................................................ 6,488,000 

American Indian and Alaska Native Suicide Prevention ...................................................................... 2,931,000 

Tribal Behavioral Health Grants ........................................................................................................... 20,000,000 

Homeless Prevention Programs ............................................................................................................. 30,696,000 

Minority AIDS ......................................................................................................................................... 9,224,000 

Criminal and Juvenile Justice Programs ............................................................................................... 14,269,000 

Assisted Outpatient Treatment ............................................................................................................. 15,000,000 

Assertive Community Treatment for Individuals with Serious Mental Illness ..................................... 15,000,000 

79 

Budget Activity FY 2019 

Committee 

Science and Service: 

Garrett Lee Smith-Suicide Prevention Resource Center ....................................................................... 5,988,000 

Practice Improvement and Training ...................................................................................................... 7,828,000 

Consumer and Consumer Support Technical Assistance Centers ........................................................ 1,918,000 

Primary and Behavioral Health Care Integration Technical Assistance .............................................. 1,991,000 

Minority Fellowship Program ................................................................................................................. 8,059,000 

Disaster Response ................................................................................................................................. 1,953,000 

Homelessness ........................................................................................................................................ 2,296,000 

Assertive Community Treatment.—The Committee provides $15,000,000 for this program, which is authorized by section 9015 

of the 21st Century Cures Act (PL 114–255). 

Mental Health Awareness Training.—The Committee is pleased 

with the progress of the Mental Health Awareness Training program, which has trained more than one million Americans to recognize the signs and symptoms of common mental disorders. In continuing competitive funding opportunities, SAMHSA is directed to 

include as eligible grantees local law enforcement agencies, fire departments, and emergency medical units with a special emphasis 

on training for crisis de-escalation techniques. SAMHSA is also encouraged to allow training for veterans, armed services personnel, 

and their family members. Consistent with the authorization, 

funds are directed to support grants for evidence-based programs 

that provide training and education on recognizing the signs and 

symptoms of mental illness, resources available in the community 

for individuals with a mental illness, and safely de-escalating crisis 

situations involving individuals with a mental illness. 

Project AWARE.—The Committee includes $71,000,000 for 

Project AWARE State grants. These grants are awarded to State 

Education Agencies to promote comprehensive, coordinated, an integrated efforts to make schools safer and increase access to mental 

health services. Project AWARE supports several strategies for addressing mental health in schools: supports for mental wellness in 

education settings, building awareness of mental health issues, and 

early intervention with coordinated supports. 

Suicide Prevention.—The Committee recognizes the rising rate of 

suicide and notes that family and friends are often in the best position to recognize the warning signs of suicide and to help an atrisk individual get treatment. The Committee urges SAMHSA to 

develop and disseminate programs to provide specialized training 

and resources on identifying and responding to people at risk of 

suicide for families and friends of at-risk individuals. 

Mental Health Block Grant 

The Committee recommends a total of $722,571,000 for the Mental Health Block Grant, which is the same as the fiscal year 2018 

enacted program level and $160,000,000 above the fiscal year 2019 

budget request program level. The block grant provides funds to 

States to support mental illness prevention, treatment, and rehabilitation services. Funds are allocated according to a statutory formula among the States that have submitted approved annual 

plans. 

The Committee continues the ten percent set-aside within the 

Mental Health Block Grant for evidence-based programs that address the needs of individuals with early serious mental illness, inVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00079 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
80 

cluding psychotic disorders. The Committee expects SAMHSA to 

continue its collaboration with the National Institute of Mental 

Health to encourage States to use this block grant funding to support programs that demonstrate strong evidence of effectiveness. 

National Child Traumatic Stress Initiative 

The Committee recommends $63,887,000 for the National Child 

Traumatic Stress Initiative, which is $10,000,000 more than the 

fiscal year 2018 enacted level and $15,000,000 above the fiscal year 

2019 budget request. The National Child Traumatic Stress Initiative aims to improve behavioral health services and interventions 

for children and adolescents exposed to traumatic events. SAMHSA 

has provided funding for a national network of grantees known as 

the National Child Traumatic Stress Network to develop and promote effective community practices for children and adolescents exposed to a wide array of traumatic events. 

Children’s Mental Health 

The Committee recommends $125,000,000 for the Children’s 

Mental Health program, which is the same as the fiscal year 2018 

enacted level and $5,974,000 above the fiscal year 2019 budget request. Funding for this program supports grants and technical assistance for community-based services for children and adolescents 

with serious emotional, behavioral, or mental disorders. The program assists States and local jurisdictions in developing integrated 

systems of community care. 

Projects for Assistance in Transition from Homelessness 

The Committee recommends $64,635,000 for the Projects for Assistance in Transition from Homelessness (PATH) program, which 

is the same as the fiscal year 2018 enacted level and the fiscal year 

2019 budget request. The PATH program supports grants to States 

and territories for assistance to individuals suffering from severe 

mental illness and/or substance abuse disorders and who are homeless or at imminent risk of becoming homeless. Grants may be used 

for outreach, screening and diagnostic treatment services, rehabilitation services, community mental health services, alcohol or drug 

treatment services, training, case management services, supportive 

and supervisory services in residential settings, and a limited set 

of housing services. 

Protection and Advocacy for Individuals with Mental Illness 

The Committee recommends $36,146,000 for the Protection and 

Advocacy for Individuals with Mental Illness program, which is the 

same as the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. This program serves to ensure that the rights of 

mentally ill individuals are protected while they are patients in all 

public and private facilities or while they are living in the community. Funds are allocated to States according to a formula based on 

population and relative per capita incomes. 

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SUBSTANCE ABUSE TREATMENT

Appropriation, fiscal year 2018 ............................................. $3,263,506,000 

Budget request, fiscal year 2019 ........................................... 2,113,397,000 

Committee Recommendation ................................................. 3,853,506,000 

Change from enacted level ............................................. +590,000,000 

Change from budget request .......................................... +1,740,109,000 

Substance Abuse Prevention and Treatment Block Grant 

The Committee recommends a program level of $2,358,079,000 

for the Substance Abuse Prevention and Treatment Block Grant, 

which is $500,000,000 more than the fiscal year 2018 enacted program level and the fiscal year 2019 budget request program level. 

The Substance Abuse Prevention and Treatment Block Grant provides funds to States to support alcohol and drug abuse prevention, 

treatment, and rehabilitation services. The Committee recognizes 

the critical role the block grant plays in State systems across the 

country. 

Within the total provided for Programs of Regional and National 

Significance, the Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Capacity: 

Opioid Treatment Programs and Regulatory Activities ......................................................................... $32,724,000 

Medical Provider Education on Opioid Treatment ....................................................................... 24,000,000 

Reducing Underage Drinking through Screening and Brief Intervention ............................................. 2,000,000 

PHS Evaluation Funds .................................................................................................................. 2,000,000 

Targeted Capacity Expansion—General ............................................................................................... 125,192,000 

Medication-Assisted Treatment .................................................................................................... 114,000,000 

Tribal Set-aside ................................................................................................................... 15,000,000 

Grants to Prevent Prescription Drug/Opioid Overdose .......................................................................... 12,000,000 

First Responder Training ....................................................................................................................... 36,000,000 

Rural Focus .................................................................................................................................. 18,000,000 

Pregnant and Postpartum Women ........................................................................................................ 29,931,000 

Recovery Community Services Program ................................................................................................ 2,434,000 

Children and Families ........................................................................................................................... 29,605,000 

Treatment Systems for Homeless .......................................................................................................... 36,386,000 

Minority AIDS ......................................................................................................................................... 65,570,000 

Criminal Justice Activities ..................................................................................................................... 99,000,000 

Drug Courts .................................................................................................................................. 80,000,000 

Improving Access to Overdose Treatment ............................................................................................. 1,000,000 

Building Communities of Recovery ....................................................................................................... 10,000,000 

Science and Service: 

Addiction Technology Transfer Centers ................................................................................................. 9,046,000 

Minority Fellowship Program ................................................................................................................. 4,539,000 

Medical Provider Education on Opioid Treatment 

The Committee provides $24,000,000 for carrying out medical 

and other healthcare practitioner education. The Committee directs 

SAMHSA to provide grants to medical schools, schools of nursing, 

social work, physician assistants, and other colleges and universities to ensure that training in the field of substance use disorders, including opioid use disorders, is incorporated into the 

standard curriculum of the university programs. Activities should 

include both didactic and hands on training for students. Funds 

should support Drug Addiction Treatment Act of 2000 waiver training for designated practitioners to be able to engage in office based 

treatment for substance use disorders, including opioid use disorders. The Committee expects training and practice requirements 

to be consistent with section 303(g)(2) of the Controlled Substances 

82 

Act, including diversion control, relapse prevention, overdose reversal, detoxification, and the clinical use of FDA-approved medications. These grants are expected to generate a well-equipped workforce to address the behavioral health needs of individuals across 

the country and ultimately close the substance use disorder treatment gap. 

Screening, Brief Intervention and Referral to Treatment 

The Committee does not provide funding for Screening, Brief Intervention and Referral to Treatment, which is $30,000,000 

below the fiscal year 2018 enacted program level, and the same as 

the fiscal year 2019 budget request program level. 

Reducing Underage Drinking through Screening and 

Brief Intervention 

The Committee provides $2,000,000 for grants to pediatric health 

care providers in accordance with the specifications outlined in section 9016 of the 21st Century Cures Act (PL 114–255). Training 

grants should focus on screening for underage drinking, opioid use, 

and other drug use. 

Targeted Capacity Expansion 

The Committee recommends $123,192,000 for Targeted Capacity Expansion activities. Of this amount, $114,000,000 is for services 

that address prescription drug abuse and heroin use in high-risk 

communities. Within the $114,000,000, the Committee provides 

$15,000,000 for grants to Indian Tribes, Tribal organizations, or 

consortia. SAMHSA should target funds to grantees located in 

States with the highest rates of admissions and that have demonstrated a dramatic increase in admissions for the treatment of 

opioid use disorders. 

The Center for Substance Abuse Treatment is directed to include 

as an allowable use medication-assisted treatment and other clinically appropriate services to achieve and maintain abstinence from 

all opioids and heroin and prioritize treatment regimens that are 

less susceptible to diversion for illicit purposes. Further, for the additional funds, the Committee directs SAMHSA to prioritize grants 

from nonprofit organizations and political subdivisions of States. 

Grants to Prevent Prescription Drug/Opioid Overdose and 

First Responder Training 

The Committee notes strong concerns about the increasing number of unintentional overdose deaths attributable to prescription 

and nonprescription opioids. SAMHSA is urged to take steps to encourage and support the use of Substance Abuse and Prevention 

Block Grant funds for opioid safety education and training, including initiatives that improve access for licensed healthcare professionals, including paramedics, to emergency devices used to rapidly 

reverse the effects of opioid overdoses. Such initiatives should incorporate robust evidence based intervention training, and facilitate linkage to treatment and recovery services. 

Pregnant and Postpartum Women 

The Committee provides $29,931,000 for Pregnant and 

Postpartum Women, which is the same as the fiscal year 2018 enVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00082 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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acted level and $10,000,000 more than the fiscal year 2019 budget 

request. 

The Committee recognizes the importance of treatment for 

women during pregnancy who are at risk for opioid dependence 

and opioid exposure during pregnancy, and infants born with neonatal abstinence syndrome. A 2015 GAO report stated that the 

most frequently cited program gap was the lack of available treatment programs for pregnant women. There is a need for increased 

available treatment options for pregnant women, especially in 

States with large populations and few treatment programs available. The Committee encourages SAMSHA to provide grants to expand existing treatment programs for women and infants in States 

with fewer than three available programs. 

Substance use during pregnancy, particularly the misuse of 

opioids, has increased in parallel with the national rate of opioid 

misuse. While much attention has been paid to the negative impacts of opioid use on the fetus and newborn, less attention has 

been given to the pregnant woman. The Committee encourages 

cross-HHS collaboration between research and public health programs, as well as engagement with health care providers and patients to ensure that the care and treatment of pregnant women 

with substance use disorder is considered and included in any national efforts to address the opioid epidemic. The Committee requests an update on these efforts in the fiscal year 2020 Congressional Justification. 

Criminal Justice Activities 

The Committee provides $99,000,000 for the Criminal Justice Ac- tivities program, which is $10,000,000 above the fiscal year 2018 

enacted level and $21,000,000 more than the fiscal year 2019 budget request. Of this amount, the Committee directs that not less 

than $80,000,000 will be used exclusively for Drug Court activities. 

Drug 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 directs SAMHSA to ensure that all drug treatment court grant recipients work directly 

with the corresponding State substance abuse agency in the planning, implementation, and evaluation of the grant. The Committee 

further directs SAMHSA to expand training and technical assistance to drug treatment court grant recipients to ensure evidencebased practices are fully implemented. 

Center for Substance Abuse Treatment 

Addiction Medicine Awareness.—SAMHSA, in coordination with 

the Office of National Drug Control Policy, should coordinate efforts among Federal agencies to raise awareness among qualified 

physicians of the opportunity to sit for the addiction medicine subspecialty board exam. In 2016, addiction medicine was recognized 

as an American Board of Medical Specialties (ABMS) subspecialty 

under the American Board of Preventive Medicine. The first ABMS 

addiction medicine board exam was offered in October 2017. While 

the board exam will be open to any American physician with a primary ABMS board certification until 2022, after that time period, 

physicians will need to complete a year-long fellowship program to 

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be qualified to sit for the exam. In five short years, the number of 

accredited and funded addiction medicine fellowship programs and 

slots will be the limiting factor in determining how many addiction 

medicine specialists can receive board certification. It is critical 

that all stakeholders work to maximize funded addiction medicine 

fellowship opportunities before their number begins to limit qualified examinees. 

Continuum of Care.—Evidence demonstrates that efforts to coordinate opioid abuse treatment that promote a continuum of care 

model can produce effective results. Successful examples include 

the development of ‘‘no wrong door’’ treatment models and the use 

of mechanisms to scale-up training and increase the number of 

peer coaches. In addition, the use of mobile app technology to enhance access to services promotes successful treatment outcomes 

and supports long-term relapse prevention. SAMHSA is encouraged 

to ensure that State and local grantees are prioritizing the implementation of coordinated continuum of care approaches. The Committee encourages SAMHSA to support projects of regional and national significance to further develop and validate the effectiveness 

of such approaches. 

Implant Delivery Opioid Deterrent Treatment.—The Committee 

requests an update in the fiscal year 2020 Congressional Justification on SAMHSA’s efforts to increase patient coverage for opioid 

deterrent treatments and expand access of medication assisted 

treatment, including efforts to train more providers in this method 

of treatment. 

Infectious Disease and the Opioid Epidemic.—The Committee 

notes that the prevalence of hepatitis C and human immunodeficiency virus (HlV) have increased along with the opioid epidemic. New research suggests that awareness of one’s infection status can help limit ongoing opioid abuse. The Committee supports 

efforts to address the overlapping public health challenges of hepatitis C and HIV, and requests an update in the fiscal year 2020 

Congressional Justification on efforts to promote screening and 

rapid-testing activities for affected communities. 

Prescription Digital Therapeutics.—The Committee recognizes 

that the emerging field of prescription digital therapeutics is bringing to market clinically validated, Food and Drug Administrationcleared software treatments that improve clinical outcomes for patients living with substance and opioid use disorders. Given the opportunity to increase abstinence and reduce relapse among the over 

21 million American estimated to be struggling with these disorders, the Committee requests that SAMHSA update the January 

2015 Federal Guidelines for Opioid Treatment Programs and consider the role that prescription digital therapeutics can play as part 

of evidence-based treatment standards, and in particular their potential role in meeting the counseling services requirements under 

42 CFR 8.12(f). The Committee requests that SAMHSA include an 

update on this effort in the fiscal year 2020 Congressional Justification. 

85 

SUBSTANCE ABUSE PREVENTION

Appropriation, fiscal year 2018 ......................................................... $248,219,000 

Budget request, fiscal year 2019 ....................................................... 220,885,000 

Committee Recommendation ............................................................. 248,719,000 

Change from enacted level ......................................................... +500,000 

Change from budget request ...................................................... +27,834,000 

Within the total provided for Programs of Regional and National 

Significance, the Committee provides the following amounts: 

Budget Activity FY 2019 

Committee 

Capacity: 

Strategic Prevention Framework ............................................................................................................ $137,484,000 

PHS Evaluation Funds .................................................................................................................. 116,560,000 

Strategic Prevention Framework Rx ............................................................................................. 18,000,000 

PHS Evaluation Funds ......................................................................................................... 18,000,000 

Opioid Prevention Grants ...................................................................................................................... 25,000,000 

PHS Evaluation Funds .................................................................................................................. 25,000,000 

Minority AIDS ......................................................................................................................................... 41,205,000 

PHS Evaluation Funds .................................................................................................................. 41,205,000 

Federal Drug-Free Workplace ................................................................................................................ 4,894,000 

Sober Truth on Preventing Underage Drinking ..................................................................................... 8,000,000 

PHS Evaluation Funds .................................................................................................................. 8,000,000 

National Adult-Oriented Media Public Service Campaign .................................................. 1,000,000 

Community Based Coalition Enhancement Grants ............................................................. 6,000,000 

Interagency Coordinating Committee to Prevent Underage Drinking ................................. 1,000,000 

Tribal Behavioral Health Grants ........................................................................................................... 20,000,000 

PHS Evaluation Funds .................................................................................................................. 20,000,000 

Science and Service: 

Center for the Application of Prevention Technologies ........................................................................ 7,493,000 

Science and Service Program Coordination .......................................................................................... 4,072,000 

Minority Fellowship Program ................................................................................................................. 571,000 

Center for the Application of Prevention Technologies.—The Committee directs the Secretary to expand eligibility for grants under 

SAMHSA Prevention Programs of Regional and National Significance and the corresponding services provided by the Center for 

the Application of Prevention Technologies to private, non-profit, 

regional organizations, including faith-based organizations. The 

broad coalitions orchestrated by these regional organizations are 

uniquely positioned to supplement the work already being done by 

the State, Tribal and community organizations currently authorized for such grants. 

Minority Fellowship Program.—Culturally competent behavioral 

health services are necessary to meet demand and behavioral 

health challenges facing communities across the US, including the 

opioid epidemic. In addition, significant behavioral health disparities persist in diverse communities across the US. There are persistent health disparities between different racial and ethnic populations, and health equity remains a challenge with minorities receiving less mental health and addiction treatment and lower-quality care. To meet this need, the Minority Fellowship Program 

(MFP) has been increasing the number of culturally competent behavioral health professionals providing mental health and substance use disorders services to underserved populations. The MFP 

provides support to behavioral health professionals in the fields of 

psychiatry, psychology, social work, nursing, marriage and family 

therapy, counseling and addictions. The MFP is the only Federal 

program supporting culturally competent mental health and substance use disorders professionals. 

86 

Opioid Prevention Grants.—The Committee notes that substance 

use prevention, to stop misuse of opioids before it starts, has been 

underutilized despite its potential to reduce the pathway to addiction and that the most effective approach to dealing with prevention is comprehensive planning and implementation of multiple 

strategies across multiple sectors of a community. The Committee 

includes $25,000,000 for opioid prevention grants. The Committee 

intends for such grants to enable multi-sector community organizations to receive grants of up to $150,000 to partner with relevant 

community sectors to implement at least one strategy, program, or 

activity across the allowable uses of funds and then evaluate 

progress in reducing population levels of opioid misuse in the community using baseline data, which shall then be collected every two 

years for the target population. Funds may be used for the implementation of an array of strategies, programs, and activities across 

each of the following: reduce access to and availability of opioids; 

change social norms in the community about misusing opioids; 

build skills with scale and scope in parents/caregivers, youth, 

school personnel, the medical community, law enforcement, youth 

serving organizations, fraternal or faith based organizations, and 

the media through targeted education, training, and skills building; 

change community-wide incentives and policies to deter opioid misuse; and implement evidence based substance use prevention programs and curricula in schools and other venues to reach the target population. 

HEALTH SURVEILLANCE AND PROGRAM SUPPORT

Appropriation, fiscal year 2018 ......................................................... $160,258,000 

Budget request, fiscal year 2019 ....................................................... 147,348,000 

Committee Recommendation ............................................................. 165,258,000 

Change from enacted level ......................................................... +5,000,000 

Change from budget request ...................................................... +17,910,000 

The Committee provides the following amounts for Health Surveillance and Program Support: 

Budget Activity FY 2019 

Committee 

Health Surveillance ........................................................................................................................................ $47,258,000 

PHS Evaluation Funds ........................................................................................................................... 30,428,000 

Program Support ............................................................................................................................................ 79,000,000 

Public Awareness and Support ...................................................................................................................... 13,000,000 

Performance and Quality Information Systems ............................................................................................. 10,000,000 

Drug Abuse Warning Network ........................................................................................................................ 15,000,000 

Agency-Wide Initiatives: 

Behavioral Health Workforce Data and Development ........................................................................... 1,000,000 

PHS Evaluation Funds .................................................................................................................. 1,000,000 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY

HEALTHCARE RESEARCH AND QUALITY

Appropriation, fiscal year 2018 ......................................................... $334,000,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 334,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +334,000,000 

The Agency for Healthcare Research and Quality’s (AHRQ) mission is to produce evidence to make health care safer, higher qualVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00086 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
87 

ity, more accessible, equitable, and affordable, and to work within 

HHS and other partners to make sure that the evidence is understood and used. 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. 

Within the total for AHRQ, the agreement includes the following 

amounts: 

Budget Activity FY 2019 

Committee 

Prevention/Care Management ........................................................................................................................ 11,649,000 

Health Information Technology (IT) ................................................................................................................ 16,500,000 

Health IT to Improve Quality ................................................................................................................. 14,500,000 

Patient Safety Research ................................................................................................................................. 70,276,000 

Healthcare-Associated Infections (HAI) Prevention ............................................................................... 36,000,000 

Combating Antibiotic-Resistant Bacteria (non-add within HAI) .......................................................... 10,000,000 

Section 933 Grants ............................................................................................................................... 10,000,000 

Patient Safety and Medical Errors ........................................................................................................ 19,000,000 

Patient Safety Organizations ................................................................................................................. 4,866,000 

Crosscutting Activities Related to Quality, Effectiveness and Efficiency Research ..................................... 94,284,000 

Health Services Contract/IAA Research ................................................................................................ 14,000,000 

Investigator-Initiated Research Grants ................................................................................................. 52,933,000 

Medical Expenditure Panel Survey ................................................................................................................. 69,991,000 

Program Management .................................................................................................................................... 71,300,000 

Sepsis Testing.—AHRQ has been the leader in developing the 

tools and resources to help providers improve their antibiotic stewardship programs. The Committee is concerned that AHRQ has not 

updated several publications related to the use of procalcitonin 

(PCT) tests in sepsis and antibiotic treatment programs in more 

than five years. High sensitive PCT tests are critical tools for initiating and discontinuing antibiotic therapies and play a key role in 

antibiotic stewardship programs. The Committee urges AHRQ to 

collaborate with NIH, HRSA, BARDA, CDC, FDA, and other relevant agencies to review and update their publications with the 

latest FDA approved uses for PCT tests in antibiotic stewardship. 

The Committee requests an update on these activities in the fiscal 

year 2020 Congressional Justification. 

CENTERS FOR MEDICARE AND MEDICAID SERVICES

GRANTS TO STATES FOR MEDICAID

Appropriation, fiscal year 2018 ............................................. *$284,798,384,000 

Budget request, fiscal year 2019 ........................................... 276,236,212,000 

Committee Recommendation ................................................. 276,236,212,000 

Change from enacted level ............................................. ¥8,562,172,000 

Change from budget request .......................................... – – – 

Medicaid provides health coverage eligible populations, including 

eligible low-income adults, children, pregnant women, elderly 

adults, and people with disabilities. Medicaid is administered by 

States, according to Federal requirements. The program is funded 

jointly by States and the Federal government. 

This amount does not include $134,847,759,000, which was provided as advance funding for the first quarter of fiscal year 2019. 

In addition, the Committee recommends an advance appropriation 

of $137,931,797,000 for program costs in the first quarter of fiscal 

year 2020. 

88 

The Committee continues bill language providing indefinite 

budget authority for unanticipated costs in fiscal year 2019. Federal Medicaid grants reimburse States for a portion of their expenditures in providing health care for individuals whose income 

and resources fall below specified levels. Subject to certain minimum requirements, States are provided certain limited authority 

within the law to set eligibility, coverage, and payment levels. 

PAYMENTS TO THE HEALTH CARE TRUST FUNDS

Appropriation, fiscal year 2018 ................................... $323,497,300,000 

Budget request, fiscal year 2019 ................................. 378,343,800,000 

Committee Recommendation ....................................... 378,343,800,000 

Change from enacted level ................................... +54,846,500,000 

Change from budget request ................................ – – – 

This account includes the general fund subsidy to the Federal 

Supplementary Medical Insurance Trust Fund for Medicare Part B 

benefits, and Medicare drug benefits and administration, as well as 

other reimbursements to the Federal Hospital Insurance Trust 

Fund for benefits and related to administrative costs, which have 

not been financed by payroll taxes or premium contributions. The 

Committee continues bill language providing indefinite authority to 

pay the general revenue portion of the Medicare Part B premium 

match and providing resources for the Medicare Part D drug benefit program in the event that the annual appropriation is insufficient. 

PROGRAM MANAGEMENT

Appropriation, fiscal year 2018 ......................................................... $3,669,744,000 

Budget request, fiscal year 2019 ....................................................... 3,543,879,000 

Committee Recommendation ............................................................. 3,502,024,000 

Change from enacted level ......................................................... ¥167,720,000 

Change from budget request ...................................................... ¥41,855,000 

Program Operations 

The Committee recommends $2,402,089,000 for Program Operations to support activities used to administer the programs under 

the Centers for Medicare & Medicaid Services (CMS), fund beneficiary outreach and education, maintain information technology infrastructure needed to support various claims processing systems, 

and continue other programmatic improvements. 

Addressing Regional Disparities in Medicare Access.—The Committee notes increasingly large regional disparities in the Medicare 

Area Wage index and is concerned that such disparities are negatively impacting the ability of hospitals to provide necessary, timely, and evidence based care to individuals entitled to benefits under 

part A or enrolled under part B of title XVIII of the Social Security 

Act. When developing regulations under section 1886 of the Social 

Security Act, the Committee encourages the Secretary to take into 

account ideas and suggested reforms for the area wage index stated 

in the comments received as part of the request for public comments on wage index disparities published in the proposed rule entitled ‘‘Medicare Program; Hospital Inpatient Prospective Payment 

Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes 

and Fiscal Year 2019 Rates; Proposed Quality Reporting Requirements for Specific Providers; Proposed Medicare and Medicaid 

89 

Electronic Health Record Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting 

Requirements; and Physician Certification and Recertification of 

Claims’’ (83 Fed. Reg. 20372). In addition, CMS is directed to submit a report to the Committees on Appropriations of the House of 

Representatives and Senate, and the authorizing Committees of jurisdiction, with an analysis of the ideas and suggested reforms received as part of the request for public comments on the area wage 

index published in such rule. The report should also analyze data 

that may demonstrate disparities resulting from the current area 

wage index calculation under Inpatient Prospective Payment System payments. Additionally, the report should analyze solutions 

presented by commenters and present possible solutions identified 

by CMS to rectify such disparities identified through such information collected under the request for public comments. Such report 

shall be provided not later than 180 days after enactment of this 

Act. 

Adult Immunization Rates.—The Committee recognizes the importance of vaccines in preventing diseases that can result in increased morbidity and mortality, particularly among the Medicare 

population, and is concerned about the underutilization of adult 

vaccinations in this population. The Committee strongly encourages CMS to work toward achievement of the Healthy People 2020 

goals to increase the percentage of adults [aged 65 or older] who 

receive recommended vaccinations. In particular, CMS is encouraged to: 1) incorporate the National Vaccine Advisory Committee 

Standards for Adult Immunization Practice in provider outreach 

and educational materials pertaining to the Initial Preventive 

Physical Examination under Medicare and Annual Wellness Visits, 

including but not limited to the Medicare Learning Network Educational Tools, The ABCs of the Initial Preventive Physical Examination and The ABCs of The Annual Wellness Visit; 2) support development and implementation of electronic health records and 

other technologies, such as reminder recall programs, that can 

identify Medicare beneficiaries who have not received recommended vaccinations and remind those beneficiaries and their 

providers to adhere to vaccination schedules; and 3) to work with 

CDC and other relevant stakeholders to develop guidance for electronic health record systems to provide consistency and ensure 

greater interoperability between electronic health records and State 

and local immunization information systems and improve the value 

and reduce the burden of reporting for Medicare providers. 

Agents Used for Cosmetic Purposes or Hair Growth.—Section 

5008 of the 21st Century Cures Act (PL 114–255) eliminated Federal Medicaid matching funds for prescription drugs used for cosmetic purposes or hair growth unless they are determined to be 

‘‘medically necessary’’. The Committee appreciates the important 

role of the physician in deciding medical necessity for prescription 

drugs used for hair growth, particularly in regards to patients 

within State Medicaid programs. The Committee encourages CMS 

to provide further guidance to States on this issue, including 

whether medical conditions that cause hair loss, such as the autoimmune disease alopecia areata and thyroid disease, are medically 

necessary and allow Medicaid coverage for hair loss products for 

90 

Medicaid patients suffering from these diseases. The Committee requests an update on this effort in the fiscal year 2020 Congressional Justification. 

Ambulatory Surgical Centers.—CMS is directed to submit a report to the Committees on Appropriations of the House of Representatives and Senate, and the authorizing committees of jurisdiction, on the migration of procedures to ambulatory surgical centers (ASCs). The report should evaluate volume changes in hospital 

outpatient departments and ASCs for procedures that have been 

added to the ambulatory surgical center payable list since 2008. 

For procedures that have not shown any significant volume shift, 

the report will evaluate factors that may be limiting migration into 

ASCs as well as potential incentives for ownership of certain Medicare sites based on reimbursement disparity. 

Breast Prostehtics.—Congress enacted the Women’s Health and 

Cancer Rights Act in 1998. This law requires health plans that provide mastectomy converage to also provide coverage for surgical 

breast reconstruction. For some women, reconstructive surgery is 

not an option. For women who do not receive reconstructive surgery, CMS provides coverage for a prefabricated breast prosthetic. 

However, these prosthetics can be difficult for regular and normal 

use. The Committee supports efforts by CMS to evaluate the coverage determinations concerning custom fabricatged prosthetics. 

Burden Reduction and Improved Coordination of the Medicare 

Program.—The Committee is concerned about the lack of coordination between the Center for Medicare and the Center for Clinical 

Standards and Quality (CCSQ) within CMS. CCSQ is responsible 

for activities, functions, and duties that create administrative burden on providers who serve Medicare beneficiaries. In order to ensure there is sufficient coordination across components in CMS that 

impact Medicare, the Committee urges the Director of Medicare to 

oversee all activities, functions, and duties of the Center for Clinical Standards and Quality of the Centers for Medicare & Medicaid 

Services that relate to activities, functions, and duties of the Center for Medicare and the Medicare program under title XVIII of the 

Social Security Act, including but not limited to activities, functions, and duties relating to Medicare coverage, conditions of participation, and quality measures applied under the Medicare program. The Committee requests an update on these activities in the 

fiscal year 2020 Congressional Justification. 

Cardiac Quality Measures.—The Committee requests CMS provide an update in the fiscal year 2020 Congressional Justification 

on the inclusion of quality measures to assign accountability of the 

prevention of conditions and complications that are commonly associated with cardiac procedures, such as perioperative hemorrhage. 

Center for Medicare and Medicaid Innovation.—The Center for 

Medicare and Medicaid Innovation (CMMI) was created in the Patient Protection and Affordable Care Act (PL 111–148) to test new 

payment models. CMMI previously overstepped its authority by 

proposing simultaneously to make near nationwide, mandatory 

changes, including compulsory participation of providers to the 

Medicare program without appropriate debate or input from Congress or Medicare providers and beneficiaries. CMS recently released a set of principles for CMMI that would ensure CMMI 

serves as an actual testing ground, not a place to insert full-scale 

91 

policy changes by circumventing Congress. The Committee supports these actions, and urges CMS to formalize a process for testing CMMI models, and provide more transparency on the impact 

of CMMI demonstrations on patient access, care quality, and 

health care costs in the annual report to Congress. Insofar as 

CMMI is utilized for the advancement of alternative payment models in the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (PL 114–10), the Committee expects that 

CMMI will work closely with the Physician Technical Advisory 

Committee (PTAC) to ensure input from PTAC. The Committee 

also believes models recommended by PTAC and approved by the 

Secretary should be given priority in testing with the input of 

PTAC. 

Chief Dental Officer.—The Committee is concerned that the Chief 

Dental Officer position at CMS has been vacant since October 

2017. Without a dentist to oversee oral health issues in Medicare 

and Medicaid, this vacancy leaves a significant gap of clinical oral 

health expertise within CMS. Medicaid provides oral health services to millions of children, pregnant women, and adults across the 

country. The Early Periodic Screening, Diagnosis and Treatment 

program requires dental services to be provided to beneficiaries eligible for the program. The Children’s Health Insurance Program 

also requires dental services as part of the benefit package available to children. A licensed dentist clinician is an invaluable resource to these programs and CMS’ growing oral health strategy to 

expand access to care. This position can also be utilized to study 

the potential benefits of periodontal care for patients suffering from 

chronic renal conditions. The Committee urges CMS to move forward with filling this vacancy. 

Clinical Laboratory Fee Schedule.—Inconsistencies in panel testing reimbursement in Medicare should be resolved to prevent 

wasteful government spending. The Committee encourages the Administrator of CMS to develop and issue a panel pricing policy that 

ensures the agency is not paying more for a single clinical diagnostic laboratory test, or a group of individual clinical diagnostic 

laboratory tests, than it would for a clinical diagnostic laboratory 

testing panel that tests for the same analyte(s). The Committee encourages the Administrator to apply the policy to all types of test 

panels. 

Colorectal Cancer Screening.—The Committee is encouraged by 

the inclusion of the proposal in the President’s Budget to address 

the inequity in beneficiary cost sharing for screening colonoscopies. 

The Committee urges CMS to align its interpretation of the 

colorectal cancer screening cost-sharing requirements for Medicare 

beneficiaries with the policy of colorectal cancer cost-sharing requirements for other Federally-funded health programs. The Committee also urges CMS to consider coverage of blood tests that 

could serve to deter or immediately recommend the need for 

colonoscopy so as to increase the number of patients that go in for 

testing and decrease the amount of late-stage colon cancer diagnoses. 

Community Benefits Provided by Hospitals.—The Committee requests from GAO an update to the GAO Report entitled ‘‘Nonprofit, 

For-Profit, and Government Hospitals: Uncompensated Care and 

Other Community Benefits’’ (GAO–05–743T). 

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Community Participatory Health Dashboard.—The Committee 

strongly encourages effort by CMS and CDC to devise a strategy 

on how to construct a decision-support tool that includes Geographic Information System epidemiologic data paired with Medicaid and other health program claims data that can contribute to 

community-participatory health prevention efforts. The effort would 

serve as a guide for HHS agencies to collaborate to construct a 

dashboard for community use to evaluate rates of disease and the 

associated costs. 

Competitive Bidding Program for Durable Medical Equipment, 

Prosthetics, Orthotics, and Supplies.—The Committee notes concern 

over CMS’ management of the competitive bidding program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. The 

Committee strongly supports efforts by CMS to bring greater transparency and oversight. The Committee supports efforts in upcoming proposed rulemaking to ensure continued access for rural 

areas. 

Congressional Justification.—The Committee directs CMS to include in the fiscal year 2020 Congressional Justification a table for 

current law estimates for all CMS administered programs listed in 

the table at the back of this report. 

Contractor Oversight.—The Committee expects CMS to increase 

oversight of contractors who are tasked with audit of claims, including Zone Program Integrity Contractor, Medicare Administrative Contractor, and Qualified Independent Contractor. CMS 

should have a formal process to review appeals to ensure CMS 

guidance is properly followed. The Committee remains concerned 

with the degree of independence given to contractors to determine 

sample methodology for claim review and assessing penalties. The 

Committee believes CMS should have standard protocols to ensure 

consistent principles are applied by contractors in all regions and 

for all levels of the appeal process. The Committee expects an update on this effort in the fiscal year 2020 Congressional Justification. 

Critical Access Hospitals.—The Committee supports Critical Access Hospitals (CAH). Reduced reimbursement could impede the 

hospital’s ability to properly provide care to local residents. Prior 

to implementation of a change in reimbursement policy, the Committee encourages CMS to engage with stakeholders to ensure the 

change would not negatively impact a CAH’s ability to fully operate. 

Diabetic Retinal Exams.—According to the CDC, diabetes-related 

blindness costs the Nation about $500 million annually. The Committee recognizes that as more Medicare beneficiaries are diagnosed with diabetes, diabetic retinopathy remains a concern, and 

change is required to eradicate this leading cause of severe vision 

loss and blindness. Non-compliance is driving preventable blindness. Experts recommend that all individuals diagnosed with diabetes should be examined for eye health, yet failure to receive annual diabetic retinal exams is common. The Committee urges CMS 

to update its policy to make diabetic retinal exams more accessible 

to diabetic patients in primary care settings, through the use of 

digital retinal imaging with remote specialist interpretation. 

Direct and Indirect Remuneration.—The Committee is aware 

that CMS has put forth a Request for Information as part of the 

93 

2019 proposed Part D rule. The Committee understands any specific policy changes must occur through a future notice and comment rulemaking and urges the Secretary to consider the impact 

this proposal will have on seniors’ premiums and the taxpayer, as 

well as its potential to reveal competitively sensitive information. 

The Committee requests an update on this topic in the fiscal year 

2020 Congressional Justification. 

Disaster Impacted Areas.—The Committee strongly supports efforts to increase access to care for local hospitals located in areas 

impacted by a National disaster. Storm damage to facilities and infrastructure can significantly impede a community’s access to primary, emergency, and specialty care. CMS should take necessary 

administrative action to ensure the existing physical infrastructure 

for health care facilities is effectively utilized to provide for necessary care in disaster impacted communities. 

Drug Pricing Report.—The Committee directs the Secretary of 

Health and Human Services to submit a report to the Committee 

on appropriations of the House of Representatives not later than 

120 days after the date of the enactment of the Bill to which this 

Committee Report pertains regarding price changes of prescription 

drugs since 2008. The report should include comparative prescription drug prices (net of rebates) paid by the following programs for 

the 10 most frequently prescribed drugs and the 10 highest-cost 

drugs for each of the following: 

(1) The Medicare program under part B of title XVIII of the 

Social Security Act. 

(2) The Medicare prescription drug program under part D of 

title XVIII of the Social Security Act. 

(3) The Medicaid program under title XIX of the Social Security Act. 

(4) The Department of Veterans Affairs. 

The report should also provide a breakdown of the comparative 

prices (net of rebates) for each of the 10 most frequently prescribed 

drugs and the 10 highest-cost drugs between ambulatory settings 

and retail settings. 

Under Medicare Part D, the report should detail gross Part D 

drug costs and net Part D drug costs and the Direct and Indirect 

Remuneration for the 10 most frequently prescribed drugs and the 

10 highest-cost drugs. 

In addition, the report should include total annual costs due to 

prescription drugs to the Medicare program under part B of title 

XVIII of the Social Security Act, the Medicare prescription drug 

program under part D of title XVIII of such Act, and the Medicaid 

program under title XIX of such Act. 

Finally, the report should list the drugs that have been registered for sale by the Food and Drug Administration (FDA) in the 

past five years that have benefited significantly from government 

grants or research subsidies in either the pre-clinical or clinical 

stages of development, as well as the price (net of rebates) and 

total spending in Medicare and Medicaid for each of those drugs. 

Geographic Practice Cost Index.—The Committee supports efforts 

by CMS to create a more transparent process for the development 

of a Geographic Practice Cost Index (GPCI). The Committee believes more transparency is needed to understand the methodology 

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ess that accounts for variables in a GPCI that lead to fair reimbursement for rural States. 

Health Insurance Information.—The Committee supports efforts 

by CMS to utilize private sector solutions for information on health 

insurance options. 

Hospital Acquired Pressure Ulcers.—The Committee understands 

data released in October 2017 by the CMS Office of Enterprise 

Data and Analytics identified that hospital discharges of patients 

with pressure ulcers have increased by over 58 percent between the 

first quarter of 2016 and 2017. In addition, HHS research shows 

that hospital-acquired pressure ulcers and their associated complications have led to roughly 60,000 patient deaths per year. 

These statistics are deeply concerning. The Hospital-Acquired Condition (HAC) Reduction Program requires CMS to reduce payments 

for hospitals that rank among the lowest-performing 25 percent of 

hospitals with regard to HACs, but it also allows the Administration to adjust the Domain 1 and Domain 2 formulas used for that 

calculation. Given this adjustment ability, the Committee requests 

CMS provide information in the fiscal year 2020 Congressional Justification on steps CMS is taking to review the formulas and any 

other actions they are taking to reverse the trend of increased hospital-acquired pressure ulcers. 

Hospital Based Nursing.—The Committee encourages CMS to address the ability of hospital-based nursing programs to maintain 

their pass-through payments in light of conflicting eligibility requirements established by national and regional higher education 

accrediting bodies. The CMS pass-through payments are essential 

for hospital-based nursing programs to continue to produce welleducated nurses and address areas of national need and underserved populations. The Committee requests that CMS provide an 

update in the fiscal year 2020 Congressional Justification on efforts 

to remedy this policy discrepancy. 

Hospital Surveys.—The Committee commends CMS for ensuring 

standards for safety and quality are maintained for the health of 

Medicare beneficiaries. The Committee is concerned with revisions 

to the State Operation Manual described in S&C Memo: 17–44–All 

Hospitals. In this Memorandum, CMS mandates a new standard 

for a hospital survey, and retroactively applies this standard to facilities for the prior 12 months. The Committee believes such a 

change is rulemaking and subject to a notice and comment period. 

The Committee notes CMS had to issue two additional memorandums to clarify the new policy. Such revisions serve as evidence 

that the change in policy warrants time for stakeholders to prepare. The Committee has concerns that hospitals did not receive 

notice and requests that CMS provide justification for why notice 

was not provided for hospitals through notice and comment rulemaking. 

Impact of Tobacco Cessation on Medicaid.—The Committee notes 

that Medicaid coverage of tobacco cessation nonprescription drugs 

may assist individuals in efforts to limit tobacco usage, which could 

result in savings to the Medicaid program. The Committee requests 

an update in the fiscal year 2020 Congressional Justification on the 

possible impact of such a coverage change, including any assoicated 

savings. 

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Kidney Dialysis Payment and Transplant Services.—The Committee is aware of an unintended issue within Medicare coverage 

of kidney dialysis and kidney transplant services regarding anti-rejection medication known as immunosuppressive drugs. Currently 

the Medicare program pays for a large share of the medication 

needed to prevent rejecting a transplanted kidney but coverage of 

these drugs for non-aged, non-disabled beneficiaries is limited to 

three years from the date of the transplant. Recipients who cannot 

afford the high cost of the drugs sometimes resort to skipping doses 

and stretching medication resulting in diminished kidney function 

and ultimately rejection, returning the patient to years of dialysis 

and another kidney transplant. The Committee encourages CMS to 

commission a study to determine the cost of effectiveness of the 

current policy of restrictive coverage for these lifesaving immunosuppressive medications by analyzing the long-term cost of dialysis 

for patients who have received a kidney transplant and subsequent 

transplants due to the lack of access to anti-rejection medications. 

The Committee also encourages CMS to consider all possible payment models for dialysis patients considering the immense amount 

of data showing the benefits of greater care management for this 

population. 

KidneyX.—KidneyX stimulates the commercialization of new 

therapies while providing a catalyst for investment by the private 

market in three specific ways that are not currently addressed by 

market forces or Federal efforts: de-risks the commercialization 

process by fostering coordination among NIH, FDA, and CMS to 

provide a clear, predictable path towards commercialization, provides non-dilutive funding to seed, incent, and accelerate breakthroughs to promising innovators, selected through a competitive 

process, and offers participating innovators access to investors and 

business experts and repositions the kidney space as an attractive 

and untapped market. While the first round of seed funding focuses 

on the development and commercialization of an artificial kidney, 

the portfolio will expand to include diagnostics, other devices, medications, and patient-centered tools to more effectively and efficiently manage kidney diseases. Revenue generated from breakthrough commercialized developments will be cycled back to support KidneyX, funding future therapies without the need for additional public investment beyond the first five years. Similar publicprivate accelerators, like the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, have shown great success in 

catalyzing private sector investment. KidneyX is a true public-private partnership: the private sector is committed to providing 

matching funds to achieve the total $250 million required for the 

first five years. To date, $25 million has been committed to 

KidneyX from the private sector. KidneyX will issue its first round 

of seed funding using private contributions in 2018. 

Lactation Support.—The Committee recognizes the important 

health and economic benefits of breastfeeding, which may reduce 

the rate of common and costly diseases in infants, acute and chronic diseases later in life, and provides important health benefits to 

mothers. The Committee also recognizes that certain medical conditions and time restrictions make low-cost breastfeeding supplies, 

such as hand pumps, insufficient for the needs of many mothers. 

The reimbursement rate offered by many public and private health 

96 

insurance providers is less than the cost of high quality pumps, 

which include an electric motor, replaceable parts that meet the 

anatomical needs of each mother, and optimal suction and cycling. 

The Committee encourages HHS to work with stakeholders to better provide women up-to-date information on how to access quality 

counseling, education, and breastfeeding equipment and supplies, 

including a list of in-network lactation consultants or other trained 

health care providers. HHS should also include information in the 

fiscal year 2020 Congressional Justification on how health insurers 

have implemented comprehensive lactation services, what standards they use to set reimbursement rates for breastfeeding supplies, and what best practices currently exist to provide coverage 

to help women breastfeed. 

Lymphedema Compression Garments.—Nearly two million Medicare beneficiaries lack equal access to Lymphedema Compression 

Garments. The Department of Veterans Affairs and the TRICARE 

program provide coverage for compression garments used to treat 

lymphedema, as do 42 states and the District of Columbia as part 

of their Medicaid programs, yet the Medicare program does not 

provide access to these garments for Medicare beneficiaries. The 

Committee notes CMS decision memorandum (CAG–00016N) encourages patients to use compression garments to prevent re-accumulation of fluid. In order to ensure equal access to care and adherence to CMS’ recommendations, the Committee strongly encourages CMS to take necessary steps to ensure Medicare beneficiaries 

have access to Lymphedema Compression Garments. The Committee requests an update on this effort in the fiscal year 2020 

Congressional Justification. 

Medicaid 1115 Waiver.—The Committee continues to note concern regarding the process for approval for section 1115 Medicaid 

demonstrations. The Committee expects a collaborative process between CMS and States. These demonstrations serve as vital links 

to care for vulnerable populations. The Committee strongly encourages CMS to engage with States who have outstanding requests. 

Moreover, the Committee encourages CMS to give priority to requests that seek to ensure access to physician residency training 

and education for underserved and rural populations. 

Medicare Star Quality Rating System.—The Committee is concerned that the CMS Star Ratings system does not accurately rate 

plans that serve a larger proportion of dual eligible beneficiaries. 

Further, the Committee understands that as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (PL 

113–185), the Assistant Secretary for Planning and Evaluation 

(ASPE) is conducting a study examining the effect of socioeconomic 

status on quality measures and resource use and other measures. 

CMS should not remove plans from markets based on three consecutive years of low star scores until the ASPE study is completed 

and the recommendations are implemented. 

Medication Diversion.—The Committee understands the important role of medication-assisted treatment for beneficiaries with 

opioid use disorder. At the same time, several State and Federal 

authorities report rising rates of diversion of these FDA-approved 

medications. The Committee requests CMS evaluate diversion data 

from the Drug Enforcement Administration and State sources to 

determine the scope of this problem and submit an update in the 

97 

fiscal year 2020 Congressional Justification. CMS should discuss 

specifically efforts to reduce division of prescriptions. 

Muscular Dystrophy.—The Committee is aware of the addition of 

the new ICD–10 code for Duchenne/Becker to the CMS FY 2019 

Codding Addenda. The Committee requests a report on utilization 

for the newly established ICD–10 code, as compared to the former 

broader ICD–10 code in the fiscal year 2020 Congressional Justification. 

Naloxone.—Naloxone is a community-use overdose reversal agent 

that can be ingested through the nose. Some have recommended coprescription of naloxone and opioids as a tool in mitigating the risk 

of overdose death. Studies within the Department of Veterans Affairs have determined co-prescriptions can reduce long-term opioid 

use by 39 percent. The Committee requests an update in the fiscal 

year 2020 Congressional Justification on efforts by CMS to address 

access to naloxone for identified at-risk populations. 

National Health Expenditures.—The Committee requests that 

CMS include a detailed explanation in its fiscal year 2020 Congressional Justification of CMS’ methodology for including data in the 

National Health Expenditure (NHE) database, and an analysis of 

how CMS-published data compares to other comparable information on health expenditures. The Committee remains concerned 

there are discrepancies between CMS estimates and industry surveys suggesting that CMS’ method may understate the actual 

growth of private health insurance and total health spending at the 

household level. If private health spending is underreported in 

NHE, estimates of total health US spending may be too low as 

well. 

National Vaccine Advisory Committee.—Historically, disparities 

in childhood immunization rates have been reported in the US, 

with lower rates among children living in poverty, among urban 

children, and among black and Hispanic children. Children living 

below the Federal poverty level have lower coverage with many 

vaccinations compared to children living at or above the Federal 

poverty level since at least 2009. The CDC estimates that based on 

2015 data an estimated 32.9 percent of US children aged 19–35 

months were living below the poverty level. The Committee requests, as part of the fiscal year 2020 Congressional Justification, 

the National Vaccine Advisory Committee, in coordination with 

CMS, to review data and provide to the Committee: the number of 

children under the age of 35 months that received childhood vaccinations and an assessment on the extent to which individuals 

under the age of 35 months received vaccinations according to the 

vaccine schedule recommendation put forth by CDC. 

Out of Network Emergency Care.—The Committee is concerned 

the Center for Consumer Information and Insurance Oversight 

(CCIIO) has not provided sufficient clarity on how to determine the 

‘‘Usual, Customary & Reasonable’’ (UCR) amount in its final rule 

for patient protections (80 Fed. Reg. 72191). Therefore, the Committee requests CCIIO publish guidance, which may come in the 

form of Frequently Asked Questions, clarifying what constitutes 

the UCR amount using a transparent and fair standard, such as 

an independent unbiased charge database. 

Patient Access to Medically Necessary Foods.—The Committee 

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ponent of managing a variety of serious medical conditions. The 

Committee notes that patients continue to face a variety of access 

challenges related to coverage and reimbursement with many individuals and families being forced to pay for essential medical foods 

out-of-pocket. The Committee notes the recent action taken by 

TRICARE to advance proper coverage for medical foods and encourages CMS to work proactively with the stakeholder community to 

identify and address improper barriers to access. 

Physician Disclosure.—The Committee encourages the Secretary 

to clarify that medical text books and journal article re-publications 

are considered as non-reportable transfers and permissible under 

the patient education exclusion as intended by Congress. The Committee believes these publications serve as direct patient education 

and should not be subject to reporting requirements of section 

1128G of the Social Security Act. 

Physician-Owned Hospitals.—The Committee notes physicianowned hospitals provide high quality healthcare to local communities. The Committee supports efforts by CMS to demonstrate the 

additional value these hospitals are able to provide to beneficiaries. 

Pneumococcal Vaccinations.—The Committee is concerned about 

the underutilization of pneumococcal vaccinations for adults and in 

particular high risk adults where rates do not exceed 20 percent. 

The Committee strongly urges CMS to work toward achievement of 

the Healthy People 2020 goals to reduce invasive pneumococcal infections and increase the percentage of adults, aged 65 or older, 

who are vaccinated against pneumococcal disease. CMS is encouraged to support development and implementation of electronic 

health records and other technologies, such as reminder recall programs, to identify Medicare beneficiaries who have not received the 

full course of pneumococcal vaccinations and remind those beneficiaries and their providers to adhere to the recommendations. 

Prescription Drugs.—The Committee supports efforts to improve 

patient access to prescription drugs. The Committee is encouraged 

by recent proposals to lower costs for beneficiaries, generate savings for the Federal government, and increase access to medication 

for Medicare beneficiaries. As CMS evaluates options for the Prescription Drug Benefit Program, the Committee expects adherence 

to the noninterference clause, which ensures robust competition 

and beneficiary value. 

Preliminary Determinations.—CMS previously granted ‘‘preliminary determinations’’ to hospitals to be designated as a Critical Access Hospitals (CAH). Following CMS guidance, these facilities 

made preparations to receive a final CAH designation, including 

paying for expensive upgrades and an on-site survey. Subsequently, 

CMS revised its guidance for attaining CAH designation. Due to 

the length of time required to comply with the requirements included in the preliminary determination, facilities that were 

deemed in compliance by CMS proceeded to comply with CMS 

guidance, but were then subsequently denied final CAH status due 

to the change in CMS policy regarding CAH designation. The Committee requests that CMS monitor affected facilities and their local 

communities to help ensure access to care. 

Qualified Clincial Data Registries.—The Committee supports the 

development and utilization of Qualified Clincal Data Registries as 

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pose of testing innovate payment and service delivery models. The 

Committee requests and update in the fiscal year 2020 Congressional Justification regarding compliance with section 105(b) of the 

Medicare Access and CHIP Reauthorization Act of 2015 (PL 114– 

10) and how CMS will support data that is real-time. 

Quality Payment Program.—The Committee understands numerous physicians were ineligible to receive reimbursement from the 

Quality Payment Program (QPP) due to changes to their tax identification number (TIN) made between August 31st and December 

31st, 2017. Claims changes to the TIN that took place in this time 

frame were ineligible and could not be retroactively reimbursed due 

to technological shortcomings. The Committee encourages CMS to 

review the QPP’s procedures and report back to the Committee in 

the fiscal year 2020 Congressional Justification on proposals for 

necessary improvements to ensure qualified physicians are not denied reimbursement regardless of their employment start date. 

Readmission Rates.—The Committee is supportive of efforts 

within CMS to reduce readmission rates among high-risk seniors 

living in communities challenged by poverty, poor health literacy, 

health disparities or non-compliance with treatment regimens. In 

particular, flexible, community-based multi-payer arrangements 

have encouraged health and social service providers to combine efforts in tailoring services to these at-risk populations. The Committee encourages CMS to work with community-based organizations to help identify best practices and transition them to Medicare’s value-based purchasing initiatives. 

Recovery Audit Contractors.—The Committee acknowledges that 

the Medicare Trust Funds are at risk of insolvency and that Recovery Audit Contractors are an industry best practice that play an 

important role in preventing wasteful government spending. CMS 

should continue to utilize private sector best practices, such as recovery auditing, to address Medicare improper payments to the 

fullest extent. 

Renal Replacement Therapy.—The Committee requests CMS provide an update in the fiscal year 2020 Congressional Justification 

on efforts to inform the healthcare community that new renal replacement therapy codes are available for reporting and encourage 

such code use to support additional research in the acute kidney 

injury population. 

Robotic Stereotactic Radiosurgery.—The Committee remains concerned that inadequate payment for robotic stereotactic 

radiosurgery threatens its viability in both the hospital and freestanding center setting. The Committee encourages CMS and contractors administering the Medicare Part B program not to make 

further changes to these services (G0339 and G0340) in the freestanding center as CMS complies with the Patient Access and 

Medicare Protection Act (PL 114–115). 

Rural Health Clinics.—The Committee continues to encourage 

CMS to engage States and other stakeholders on outstanding 

issues of payment recoupment, as it relates to CMS-designated 

Rural Health Clinics. The Committee strongly supports the Rural 

Health Clinic program, which increases access to primary care 

services for Medicaid and Medicare patients in rural communities. 

Rural Nursing Homes.—Long-term services and supports are 

critical for the care and wellbeing of our senior population. Skilled 

100 

nursing facilities play an instrumental role in providing this care 

for some of the most vulnerable Americans. Particularly in rural 

areas, ensuring continued access to high-quality nursing facility 

care in an individual’s home community is an ever-increasing challenge. Similar to Medicaid’s prioritization of funding for Critical Access Hospitals, adequate reimbursement helps preserve access to 

skilled nursing facility care in our country’s rural and frontier regions. The Committee requests an update in the fiscal year 2020 

Congressional Justification on CMS’ efforts to support rural nursing facilities. 

Sepsis Testing.—In the United States, more than 1.5 million people are diagnosed with sepsis resulting in approximately 250,000 

deaths each year. CMS current SEP–1 guidelines for treating septic 

patients are controversial and need to take into account evolving 

practices including the use of FDA approved tests for biomarkers 

like procalcitonin. SEP–1 is highly prescriptive, replaces physician’s discretion over care, and could lead to excessive antibiotic 

use. The Committee urges CMS to reevaluate their SEP–1 policy 

taking into account expanded FDA approvals for biomarker tests 

like procalcitonin in conjunction with its impact on antibiotic stewardship. CMS is also to identify the direct and indirect cost of 

treating sepsis patients on its Medicaid and Medicare programs. 

The Committee requests an update on these activities in the fiscal 

year 2020 Congressional Justification. 

Sexually Transmitted Diseases.—The Committee notes an increase in sexually transmitted diseases, particularly in pregnant 

women and young adults. To address this public health issue the 

Committee supports efforts to target at-risk and vulnerable populations. The Committee supports collaboration with CDC to address 

appropriate screening and treatment for these conditions. 

Technology and Ophthalmic Disorders.—The Committee notes 

that the specific use of technology, such as web-based telemedicine 

software, centralized reading centers, hand-held fundus cameras, 

photography training programs, and internet-based storage and 

transmission of images can efficiently detect early signs of diabetic 

retinopathy and glaucoma in rural and underserved populations. 

Telehealth and the Pediatric Population.—The Committee recognizes the potential for telehealth to help meet the needs of patients 

and families across the country, including in both rural and urban 

areas. The Committee encourages CMS to identify and share with 

States best practices regarding ways in which telehealth and remote patient monitoring can be leveraged through the Medicaid 

and CHIP programs, particularly for the pediatric population. This 

could include identification of barriers to pediatric telehealth coverage, as well as ways to address those barriers. 

Tribal Governance.—The Secretary, in coordination with the Indian Health Service, CMS, and CDC, is urged to facilitate and support partnerships with Tribes and medical colleges and universities 

as opportunites arise, in order to foster leadership development, 

build organizations to better deliver and coordinate high-quality 

care, and to support systems of care and prevention that can have 

a positive outcome on the health of the community and cost of care. 

Tribal Sovereignty.—Federally-recognized Indian Tribes are sovereign nations residing within a State. Moreover, Indian Tribes are 

political, sovereign entities to which the Federal government owes 

101 

a trust responsibility. As a result of this responsibility, the Federal 

government has consistently held Indian Tribes as a unique group 

when applying Federal law and policy. Congress has routinely codified this relationship, most notably in the provision of health care 

by establishing a health system for Tribal populations exclusively. 

In addition, the Federal government has enacted exemptions to ensure States would not bear the burden of additional costs. Specifically, the Social Security Act provides a 100 percent Federal match 

for Medicaid services provided by an Indian or by an Indian Health 

Service or Tribally-operated facility. No discretionary action taken 

by any Administration can impede the direct relationship between 

the Federal government and the provision of health care for Indian 

Tribes. 

Volume Decrease Payment.—The Committee notes that a change 

in the Medicare Administrative Contractor (MAC) should not negatively impact provider payment. The Committee encourages CMS 

to ensure consistent policy and guidance is provided to all MACs 

to ensure overpayment notices to providers are processed promptly. 

The Committee supports efforts by CMS to encourage MACs to reduce the interval of time between the identification of an overpayment and official notice sent to the provider. 

Federal Administration 

The Committee recommends $702,601,000 for Federal Administration activities related to the Medicare and Medicaid programs, 

which is $29,932,000 below the fiscal year 2018 enacted level and 

the same as the fiscal year 2019 budget request. The Federal Administration funding supports CMS staff, along with operating and 

administrative expenses for planning, developing, managing, and 

evaluating healthcare financing programs and policies. 

Health Insurance Exchange Transparency.—The Committee continues to include bill language requiring CMS to provide cost information for the following categories: Federal Payroll and Other Administrative Costs; Exchange related Information Technology (IT); 

Non IT Program Costs, including Health Plan Bid Review, Management and Oversight; Payment and Financial Management; Eligibility and Enrollment; Consumer Information and Outreach, including the Call Center, Navigator Grants, and Consumer Education and Outreach; Exchange Quality Review; Small Business 

Health Options Program and Employer Activities; and Other Marketplace Activities. Cost information should be provided for each 

fiscal year since the enactment of the Patient Protection and Affordable Care Act (Public Law 111–148). CMS is also required to 

include the estimated costs for fiscal year 2020. 

HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT

Appropriation, fiscal year 2018 ......................................................... $745,000,000 

Budget request, fiscal year 2019 ....................................................... 770,000,000 

Committee Recommendation ............................................................. 765,000,000 

Change from enacted level ......................................................... +20,000,000 

Change from budget request ...................................................... ¥5,000,000 

This includes a base amount of $311,000,000 and an additional 

$454,000,000 through a discretionary budget cap adjustment authorized under section 251(b) of the Balanced Budget and Emergency Deficit Control Act of 1985. The Health Care Fraud and 

102 

Abuse Control Account (HCFAC) funds support activities conducted 

by CMS, the HHS Office of Inspector General, and the Department 

of Justice. This level is $20,000,000 above the fiscal year 2018 enacted level and $5,000,000 below the fiscal year 2019 budget request. 

This funding is in addition to other mandatory funding provided 

through authorizing legislation. The funding will provide resources 

to continue efforts for Medicaid program integrity activities, for 

safeguarding the Medicare prescription drug benefit and the Medicare Advantage program, and for program integrity efforts related 

to these programs carried out by the Department of Justice. 

The Committee continues to include bill language to ensure the 

Secretary funds the Senior Medicare Patrol Program administered 

by the Administration for Community Living from funds provided 

to this account. 

The Committee expects all recipients of funds from the Health 

Care Fraud and Abuse Control Account, the Centers for Medicare 

& Medicaid Services, the Department of Health and Human Services Office of Inspector General, and the Department of Justice, to 

use funds for efforts to address fraud and abuse as described in 

section 1128C of the Social Security Act. 

ADMINISTRATION FOR CHILDREN AND FAMILIES

PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND

FAMILY SUPPORT PROGRAMS

Appropriation, fiscal year 2018 ......................................................... $2,995,400,000 

Budget request, fiscal year 2019 ....................................................... 2,922,247,000 

Committee Recommendation ............................................................. 2,922,247,000 

Change from enacted level ......................................................... ¥73,153,000 

Change from budget request ...................................................... – – – 

The Committee also recommends $1,400,000,000 in advance 

funding, as requested, for the first quarter of fiscal year 2020 to ensure timely payments for Child Support Enforcement programs. 

These programs support State-administered programs of financial 

assistance and services for low-income families to promote their 

economic security and self-sufficiency. 

LOW INCOME HOME ENERGY ASSISTANCE

Appropriation, fiscal year 2018 ......................................................... $3,640,304,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 3,640,304,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +3,640,304,000 

Within the amount available for formula grants, the Committee 

recommends up to $2,988,000 for technical assistance, training, 

and monitoring of program activities. The Low Income Home Energy Assistance Program supports eligible families and households 

through programs providing assistance with energy costs. 

REFUGEE AND ENTRANT ASSISTANCE

Appropriation, fiscal year 2018 ......................................................... $1,864,936,000 

Budget request, fiscal year 2019 ....................................................... 1,792,311,000 

Committee Recommendation ............................................................. 1,864,936,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +72,625,000 

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The Office of Refugee Resettlement programs are designed to 

help refugees, asylees, Cuban and Haitian entrants, and trafficking 

victims become employed and self-sufficient. These programs also 

provide for care of unaccompanied immigrant children in Federal 

custody and victims of torture. 

Within the total, the Committee recommends the following: 

Budget Activity FY 2019 

Committee 

Transitional and Medical Services ................................................................................................................. $320,000,000 

Victims of Trafficking ..................................................................................................................................... 23,755,000 

Refugee Support Services .............................................................................................................................. 207,201,000 

Unaccompanied Children ............................................................................................................................... 1,303,245,000 

Victims of Torture ........................................................................................................................................... 10,735,000 

National Human Trafficking Training and Assistance Center.— 

The Committee directs the Administration for Children and Families to increase funding for the National Human Trafficking Hotline. 

Facility Oversight.—The Committee expects the Office of Refugee 

Resettlement (ORR) to maintain strict oversight of all ORR-funded 

care provider facilities and to report and correct violations of Federal, State, or local codes related to standards of childcare or the 

wellbeing of children. The Committee directs ORR, within 90 days 

of the enactment of this Act, to submit a report to the Committee 

detailing the number and nature of facility violations, and the 

steps it is taking to work with grantees to address and prevent 

such infractions. 

IG Report.—Within 30 days of enactment, the Inspector General 

shall report to the Committee on the implementation of and any 

interagency coordination associated with the previous policy of separating migrant families, the Executive Order issued on June 20, 

2018 entitled ‘Affording Congress an Opportunity to Address Family Separation,’ and efforts made to reunify families separated 

under the previous family separation policy. 

Unaccompanied Children.—The Committee supports oversight 

efforts relating to forced family separation and efforts to mitigate 

the trauma experienced by separated children. 

The Committee directs the Office of Refugee Resettlement (ORR) 

to comply with its legally mandated duties as outlined in Section 

462 of the Homeland Security Act of 2002, Section 235 of the William Wilberforce Trafficking Victims Protection Reauthorization 

Act of 2008, and the 1997 Flores settlement agreement. 

Unaccompanied Children.—The Committee directs that in cases 

of separation, within 24 hours, parents, legal guardians, or other 

relatives shall be informed of the whereabouts of their children and 

children shall be informed of the whereabouts of their parents, 

legal guardians, or other relatives, except in cases of suspected 

abuse or trafficking. 

The Committee also directs the Secretary of HHS to work in collaboration with the Secretary of DHS to submit a report to the 

Committees on Appropriations of the House of Representatives and 

of the Senate within 60 days of this bill’s enactment detailing actions it has taken and will take and policies it has implemented 

and will implement to facilitate: (1) the ability of separated children to make contact and maintain communication with their sepaVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00103 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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rated parents, relatives, legal guardians, or primary caregivers (for 

tender-age and non-verbal children, this should include methods to 

facilitate in-person visits and video chats); (2) the ability of family 

members residing abroad to utilize the hotline to receive information on the status and location of separated children; and (3) the 

coordinated reunification and post-release support of a separated 

child and adult family member, when it is in the best interest of 

the child. 

Protection of DNA.—The Committee understands that DNA testing is being used for the purpose of reunifying families that were 

separated by the Department of Homeland Security. The Committee directs the Office of Refugee Resettlement (ORR) to ensure 

the protection of privacy and genetic material, data, or information 

of children, parents, and of all individuals being tested and their 

relatives. The Committee prohibits any governmental agency or 

private entity from accessing using, or storing any genetic material, 

data, or information collected in this reunification effort, including 

for the purpose of criminal or immigration enforcement. Any genetic material, data, and information obtained should be fully destroyed after testing and the probability of a genetic relationship 

is calculated. The entities conducting the DNA testing shall obtain 

the consent of any individual over age 18 prior to testing, and shall 

make every effort to obtain the consent of a guardian prior to testing on anyone under age 18. 

PAYMENTS TO STATES FOR THE CHILD CARE AND

DEVELOPMENT BLOCK GRANT

Appropriation, fiscal year 2018 ......................................................... $5,226,000,000 

Budget request, fiscal year 2019 ....................................................... 3,006,000,000 

Committee Recommendation ............................................................. 5,226,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +2,220,000,000 

The Child Care and Development Block Grant provides funds according to a formula to States, territories, and Tribes to provide financial assistance to help low-income working families and families 

engaged in training or education activities access child care and to 

improve the quality of child care for all children. 

The Committee includes $100,000,000 in bill language for competitive grants to States, territories, Tribes, local governments, and 

public entities to develop, implement, and evaluate models of providing care for working families in rural communities, families 

needing child care on an emergency basis, and families with nontraditional work hours. 

The Committee recognizes that many child care providers are 

small business owners and therefore may need support to strengthen business operations. Accordingly, the committee recognizes that 

Child Care and Development Block Grant (CCDBG) funds could be 

used to strengthen the business practices of child care providers to 

expand the supply and improve the quality of child care services. 

Areas of support for child care providers may include, but are not 

limited to, such practices related to fiscal management, budgeting, 

record-keeping, hiring, developing, and retaining qualified staff, 

risk management, community relationships, marketing and public 

relations, and parent-provider communications, including who delivers the training, education and/or technical assistance. AccordVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00104 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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ingly, the Committee supports efforts by the Office of Child Care 

to report on its efforts to support States with strengthening business practices of child care providers, including available data on 

the average salaries and retention of child care staff by State and 

type of care, in the biennial Childcare Development Fund Report 

to Congress required by Section 658L of the CCDBG. 

SOCIAL SERVICES BLOCK GRANT

Appropriation, fiscal year 2018 ......................................................... $1,700,000,000 

Budget request, fiscal year 2019 ....................................................... 1,785,000,000 

Committee Recommendation ............................................................. 1,700,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥85,000,000 

The Social Services Block Grants provides grants to States by 

formula. States have the flexibility to determine what services and 

activities are supported, provided they are targeted at a broad set 

of goals, including reducing or eliminating poverty, achieving or 

maintaining self-sufficiency, and preventing neglect, abuse, or exploitation of children and adults. 

CHILDREN AND FAMILIES SERVICES PROGRAMS

Appropriation, fiscal year 2018 ......................................................... $12,022,225,000 

Budget request, fiscal year 2019 ....................................................... 10,323,890,000 

Committee Recommendation ............................................................. 12,122,225,000 

Change from enacted level ......................................................... +100,000,000 

Change from budget request ...................................................... +1,798,335,000 

The Children and Families Services programs fund activities 

serving children, youth, families, the developmentally disabled, Native Americans, victims of child abuse and neglect and domestic violence, and other vulnerable populations. 

The Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Programs for Children, Youth, and Families: 

Head Start ............................................................................................................................................. $9,913,095,000 

Early Head Start-Child Care Partnerships ................................................................................... 780,000,000 

Preschool Development Grants .............................................................................................................. 250,000,000 

Runaway/Homeless Youth ..................................................................................................................... 104,280,000 

Abuse of Runaway Youth Prevention .................................................................................................... 17,141,000 

State Child Abuse Prevention ............................................................................................................... 85,310,000 

Discretionary Child Abuse Prevention ................................................................................................... 33,000,000 

Community-based Child Abuse Prevention ........................................................................................... 39,764,000 

Child Welfare Services .......................................................................................................................... 278,735,000 

Child Welfare Training .......................................................................................................................... 17,984,000 

Adoption Opportunities .......................................................................................................................... 39,100,000 

Adoption Incentives ............................................................................................................................... 80,000,000 

Social Services/Income Maintenance Research .................................................................................... 6,512,000 

Native American Programs .................................................................................................................... 55,050,000 

Community Services: 

Community Services Block Grant .......................................................................................................... 750,000,000 

Community Economic Development ...................................................................................................... 19,883,000 

Rural Community Facilities ................................................................................................................... 10,000,000 

Domestic Violence Hotline .............................................................................................................................. 9,250,000 

Family Violence/Battered Women’s Shelters .................................................................................................. 160,000,000 

Independent Living Training Vouchers ........................................................................................................... 43,257,000 

Disaster Human Services Case Management ................................................................................................ 1,864,000 

Program Direction ........................................................................................................................................... 208,000,000 

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Head Start 

The Committee recommends $9,913,095,000 for the Head Start 

program, which is $50,000,000 above the fiscal year 2018 enacted 

level and $638,095,000 above the fiscal year 2019 budget request. 

Within the total for Head Start, the Committee recommends 

$25,000,000 for a cost-of-living adjustment and includes 

$25,000,000 for the Designation Renewal System. Head Start promotes school readiness of children under 5 from low-income families through education, health, social and other services. 

In addition, the Committee recommends $780,000,000 for Early 

Head Start-Child Care Partnership grants, which is $25,000,000 

above the fiscal year 2018 enacted level and $780,000,000 above 

the fiscal year 2019 budget request. The Early Head Start-Child 

Care Partnership program brings together Early Head Start and 

child care through layering of funding to provide comprehensive 

and continuous services to low-income infants, toddlers, and their 

families. The program enhances developmental services and supports for low-income infants and toddlers, and their families, by 

providing strong relationship-based experiences and preparing 

them for the transition into Head Start and preschool. 

The Committee notes that HHS is in the process of reviewing 

public comments on proposed changes to the Designation Renewal 

System (DRS), which is a key tool in ensuring strong standards. 

The Committee is also aware of concerns regarding the use of the 

CLASS lowest 10 percent provision in appropriately identifying 

grantees subject to re-competition. The Committee encourages HHS 

to complete this review promptly, and to maintain high standards, 

strong accountability, and transparency to grantees and the public, 

while ensuring the integrity of program evaluation measures. 

Preschool Development Grants 

The Committee recommends $250,000,000 for Preschool Development Grants, which is the same as the fiscal year 2018 enacted 

level and $250,000,000 above the fiscal year 2019 budget request. 

This program provides grants to States to build State and local capacity to provide preschool for 4-year-olds from low- and moderateincome families. Research confirms that high-quality preschool improves school readiness and long-term academic success of children 

by supporting their academic and social-emotional skills. Support 

for this grant is an important step to building a globally competitive 21st century workforce. 

Child Abuse Discretionary Activities 

Child Abuse Hotline.—The Committee notes the lack of knowledge regarding effective and appropriate text-based intervention 

and education services for child abuse victims and concerned adults 

as this new communications channel becomes more prevalent. 

Therefore, the Committee provides $1,500,000 for an extramural 

grant to develop and expand text capabilities and protocols for a 

national child abuse hotline to determine best practices in appropriate communication, identity verification, privacy protection, and 

resource sharing with youth seeking assistance. 

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Native American Programs 

The Committee recommends $55,050,000 for Native American 

Programs, which is $1,000,000 above fiscal year 2018 enacted level 

and $3,000,000 above the fiscal year 2019 budget request. These 

programs assist Tribal and village governments and Native American institutions and organizations in their efforts to support and 

develop stable, diversified local economies. Tribes and non-profit organizations use funds to develop and implement sustainable community-based social and economic programs and services to improve the well-being of Native people. 

Within the total, the Committee recommendation includes 

$12,000,000 for Native American language preservation activities, 

including $3,000,000 for Generation Indigenous, which focuses on 

improving Native American language instruction across the educational continuum. The Committee provides not less than 

$4,000,000 for language immersion programs as 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 the Administration for Children and Families to give priority to grantees 

with rigorous immersion programs. 

Community Services Programs 

Community Services Block Grant.—The Committee recommends 

$750,000,000 for the Community Services Block Grant, which is 

$35,000,000 more than the fiscal year 2018 enacted level and 

$715,000,000 more than the fiscal year 2019 budget request. The 

Community Services Block Grant provides funds to alleviate the 

causes and conditions of poverty in communities. 

Community Economic Development.—The Committee recommends $19,883,000 for the Community Economic Development 

Grants, which is the same as the fiscal year 2018 enacted level and 

$19,883,000 more than the fiscal year 2019 budget request. Community Economic Development is a grant program, which funds 

Community Development Corporations. Community Development 

Corporations seek to address the economic needs of low-income individuals and families through the creation of sustainable business 

development and employment opportunities. 

Rural Community Facilities Development.—The Committee recommends $10,000,000 for the Rural Community Facilities program, 

which is $2,000,000 more than the fiscal year 2018 enacted level, 

and $10,000,000 more than the fiscal year 2019 budget request. 

Rural Community Development is a grant program that works with 

regional and Tribal organizations to manage safe water systems in 

rural communities. 

Family Violence Prevention and Battered Women’s Shelters 

The Committee recommends $160,000,000 for the Family Violence Prevention and Battered Women’s Shelters programs, which 

is the same as the fiscal year 2018 enacted level and $9,000,000 

above the fiscal year 2019 budget request. The Family Violence 

Prevention and Services Act programs provide funding to support 

the prevention of incidents of family violence, domestic violence, 

and dating violence, and provide the immediate shelter and supportive services for adult and youth victims (and their dependents). 

108 

PROMOTING SAFE AND STABLE FAMILIES

Appropriation, fiscal year 2018 ......................................................... $444,765,000 

Budget request, fiscal year 2019 ....................................................... 534,765,000 

Committee Recommendation ............................................................. 404,765,000 

Change from enacted level ......................................................... ¥40,000,000 

Change from budget request ...................................................... ¥130,000,000 

The Committee recommends $345,000,000 in mandatory funds 

for the Promoting Safe and Stable Families program, which is the 

same as the fiscal year 2018 enacted level and $20,000,000 below 

the fiscal year 2019 budget request. The Committee also recommends $59,765,000 in discretionary funds for this program, 

which is $40,000,000 below the fiscal year 2018 enacted level and 

$150,000,000 below the fiscal year 2019 budget request. This program enables each State to operate a coordinated program of family preservation services, community-based family support services, 

time-limited reunification services, and adoption promotion and 

support services. States receive funds based on their share of children in all States receiving food stamp benefits. 

PAYMENTS FOR FOSTER CARE AND PERMANENCY

Appropriation, fiscal year 2018 ......................................................... $6,225,000,000 

Budget request, fiscal year 2019 ....................................................... 6,035,000,000 

Committee Recommendation ............................................................. 6,035,000,000 

Change from enacted level ......................................................... ¥190,000,000 

Change from budget request ...................................................... – – – 

The Committee also recommends an advance appropriation of 

$2,800,000,000 for the first quarter of fiscal year 2020 to ensure 

timely completion of first quarter grant awards. 

Within the total, the Committee recommends $5,329,000,000 for 

the Foster Care program, which is $208,000,000 below the fiscal 

year 2018 enacted level and the same as the fiscal year 2019 budget request. This program provides funds to States for foster care 

maintenance payments for children living in foster care. These 

funds also reimburse States for administrative costs to manage the 

program and training for staff and parents. 

Within the total, the Committee recommends $3,063,000,000 for 

Adoption Assistance, which is $196,000,000 more than the fiscal 

year 2018 enacted level and the same as the fiscal year 2019 budget request. This program provides funds to States to subsidize families who adopt children with special needs, such as older children, 

a member of a minority or sibling group, or children with physical, 

mental, and emotional disabilities. In addition, the program provides training for adoptive parents and State administrative staff. 

This annually appropriated entitlement provides alternatives to 

long, inappropriate stays in foster care by developing permanent 

placements with families. 

Within the total, the Committee recommends $203,000,000 for 

the Kinship Guardianship Assistance program, which is 

$22,000,000 more than the fiscal year 2018 enacted level and the 

same as the fiscal year 2019 budget request. This program provides 

subsidies to a relative taking legal guardianship of a child for 

whom being returned home or adoption are not appropriate permanency options. 

Finally, within the total, the Committee recommends 

$140,000,000 for the Independent Living program, which is the 

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same as the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. This program assists foster children age 16 or older 

make successful transitions to independence. Funds support a variety of services, including educational assistance, career exploration, 

vocational training, job placement, life skills training, home management, health services, substance abuse prevention, preventive 

health activities, and room and board. Each State receives funds 

based on the number of children on whose behalf the State receives 

Federal Foster Care Payments. 

ADMINISTRATION FOR COMMUNITY LIVING

AGING AND DISABILITY SERVICES PROGRAMS

Appropriation, fiscal year 2018 ......................................................... $2,144,215,000 

Budget request, fiscal year 2019 ....................................................... 1,818,681,000 

Committee Recommendation ............................................................. 2,186,732,000 

Change from enacted level ......................................................... +42,517,000 

Change from budget request ...................................................... +368,051,000 

Created in 2012, the Administration for Community Living 

(ACL) brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability to serve as 

the Federal agency responsible for increasing access to community 

supports, while focusing attention and resources on the unique 

needs of older Americans and people with disabilities across the 

lifespan. 

The Committees recommends funding for the Senior Medicare 

Patrol Program, and provides this funding under the Health Care 

Fraud and Control Abuse Account. 

Home and Community-Based Supportive Services 

The Committee recommends $385,074,000 for Home and Community-Based Supportive Services, which is the same as the fiscal 

year 2018 enacted level and $34,850,000 above the fiscal year 2019 

budget request. This program provides formula grants to States 

and territories to fund a wide range of social services that enable 

seniors to remain independent in their homes for as long as possible. 

Preventive Health Services 

The Committee recommends $24,848,000 for Preventive Health 

Services, which is the same as the fiscal year 2018 enacted level 

and the fiscal year 2019 budget request. This program funds activities that help seniors remain healthy and avoid chronic diseases. 

Protection of Vulnerable Older Americans 

The Committee recommends $21,658,000 for activities to protect 

vulnerable older Americans, which is the same as the fiscal year 

2018 enacted level and $1,030,000 above the fiscal year 2019 budget request. These programs provide grants to States for protection 

of vulnerable older Americans through the Long-Term Care Ombudsman and Prevention of Elder Abuse and Neglect programs. 

110 

Family Caregiver Support Services 

The Committee recommends $180,586,000 for the National Caregiver Support program, which is the same as the fiscal year 2018 

enacted level and $30,000,000 above the fiscal year 2019 budget request. This program supports a multifaceted support system in 

each State for family caregivers. 

Native American Caregiver Support Services 

The Committee recommends $10,556,000 for the Native American Caregiver Support program, which is $1,000,000 above the fiscal year 2018 enacted level and $3,000,000 above the fiscal year 

2019 budget request. This program provides grants to Tribes for 

the support of American Indian, Alaskan Native, and Native Hawaiian families caring for older relatives with chronic illness or disabilities. 

Congregate and Home-Delivered Nutrition Services 

The Committee recommends a total of $896,753,000 for senior 

nutrition. The Committee recommends $490,342,000 for Congregate Nutrition Services, which is the same as the fiscal year 

2018 enacted level and $40,000,000 above the fiscal year 2019 

budget request. The Committee recommends $246,342,000 for 

Home-Delivered Meal Services, which is the same as the fiscal year 

2018 enacted level and $19,000,000 above the fiscal year 2019 

budget request. The Committee recommends $160,069,000 for the 

Nutrition Services Incentives program, which is the same as the 

fiscal year 2018 enacted level and the fiscal year 2019 budget request. These programs help older Americans remain healthy and 

independent in their communities by providing meals and related 

services in a variety of settings (including congregate facilities such 

as senior centers) and via home-delivery to older adults who are 

homebound due to illness, disability, or geographic isolation. 

Native American Nutrition and Supportive Services 

The Committee recommends $35,208,000 for Native American 

Nutrition and Supportive Services, which is $2,000,000 above the 

fiscal year 2018 enacted level and $4,000,000 above the fiscal year 

2019 budget request. This program provides grants to Tribes to 

promote the delivery of nutrition and home and community-based 

supportive services to Native American, Alaskan Native, and Native Hawaiian elders. 

Aging Network Support Activities 

The Committee recommends $17,461,000 for the Aging Network Support Activities, which is $5,000,000 more than the fiscal year 

2018 enacted level and $8,463,000 more than the fiscal year 2019 

budget request. This program supports activities that expand public understanding of aging and the aging process. 

Care Corps Grants.—The Committee recognizes the growing demand for services and supports to help seniors and individuals 

with disabilities live independently in their homes, and the need to 

support family caregivers who facilitate that independence. In addition to existing aging network support activities funded under Section 411 of the Older Americans Act, the Committee includes 

$5,000,000 for grants to public agencies or private nonprofit agenVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00110 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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cies for the purpose of placing volunteers in communities to assist 

family caregivers and/or assist seniors and individuals with disabilities in maintaining independence by providing non-medical care. 

Such grants shall be consistent with the requirements of the Nationwide Program for National and State Background checks on direct patient access employees of long-term care facilities and providers, and the worker displacement and grievance provisions in 

the AmeriCorps program. 

Holocaust Survivor’s Assistance.—The Committee provides not 

less than $5,000,000 for the Holocaust Survivor’s Assistance program. This program provides supportive services for aging Holocaust survivors living in the U.S. 

Alzheimer’s Disease Program 

The Committee recommends $23,500,000 for the Alzheimer’s disease program, which is the same as the 2018 enacted program level 

and $4,010,000 above the fiscal year 2019 budget request. This program provides competitive matching grants to a limited number of 

States to encourage program innovation and coordination of public 

and private services for people with Alzheimer’s disease and their 

families. 

Technology and Caregiver Health.—In 2017, Medicare and Medicaid spent an estimated $175 billion caring for those with Alzheimer’s and other dementias, 68 percent of total costs spent nationally. It is the most expensive disease in America. While medical 

breakthroughs to prevent, slow, or stop the disease are critical, 

interventions that reduce the cost and increase the effectiveness of 

care can be an invaluable method to bend the cost curve. The Committee supports efforts to improve caregiver health through a selfmanagement support system using home-based telehealth technology. Such a system could reduce the cost of institutional health 

care and emergency room visits for individuals with Alzheimer’s 

and Dementia by providing significant support to both the informal 

caregiver and the patient in home-based care. The Committee supports technology solutions that can monitor, assess, guide, educate, 

and provide alerts to enhance both physical and psychosocial dimensions of caregiver’s well-being. 

Lifespan Respite Care 

The Committee recommends $4,110,000 for Lifespan Respite 

Care, which is the same as the fiscal year 2018 enacted level and 

$750,000 above the fiscal year 2019 budget request. The program 

focuses on easing the burdens of caregiving by providing grants to 

eligible State organizations to improve the quality of, and access to, 

respite care for family caregivers. 

Elder Falls 

The Committee recommends $5,000,000 for the Elder Falls program, which is the same as the fiscal year 2018 enacted level and 

$5,000,000 above the fiscal year 2019 budget request. Fall prevention grants support the promotion and dissemination of prevention 

tools delivered in community settings. 

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Chronic Disease Self-Management Program 

The Committee recommends $8,000,000 for the Chronic Disease 

Self-Management program, which is the same as the fiscal year 

2018 enacted level and $8,000,000 above the fiscal year 2019 budget request. This program supports grants to States for low-cost, evidence-based prevention models that use state-of-the-art techniques 

to help those with chronic conditions address issues related to the 

management of their disease. 

Elder Rights Support Activities 

The Committee recommends $15,874,000 for Elder Rights Support Activities, which is the same as the fiscal year 2018 enacted 

level and $4,000,000 above the fiscal year 2019 budget request. 

This program supports efforts that provide information, training, 

and technical assistance to legal and aging services organizations 

towards the end of preventing and detecting elder abuse and neglect. 

Aging and Disability Resource Centers 

The Committee recommends $8,119,000 for Aging and Disability 

Resource Centers, which is the same as the fiscal year 2018 enacted level and $2,000,000 above the fiscal year 2019 budget request. These centers provide information, counseling and access for 

individuals to learn about the services and support options available to seniors and the disabled so they may retain their independence. 

State Health Insurance Assistance Program 

The Committee recommends $49,115,000 for the State Health Insurance Assistance Program, which is the same as the fiscal year 

2018 enacted level and $49,115,000 above the fiscal year 2019 

budget request. The State Health Insurance Assistance Program 

provides Medicare beneficiaries with information, counseling, and 

enrollment assistance. 

Paralysis Resource Center 

The Committee recommends $7,700,000 for the Paralysis Resource Center, which is the same as the fiscal year 2018 enacted 

level and $7,700,000 above the fiscal year 2019 budget request. The 

Paralysis Resource Center offers activities and services aimed at 

increasing independent living for people with paralysis and related 

mobility impairments, and supporting integration into the physical 

and cultural communities in which they live. 

Limb Loss Resource Center 

The Committee recommends $3,500,000 for the Limb Loss Resource Center, which is the same as the fiscal year 2018 enacted 

level and $3,500,000 above the fiscal year 2019 budget request. The 

Limb Loss Resource Center supports a variety of programs and 

services for those living with limb loss, including a national peer 

support program, educational events, training for consumers and 

healthcare professionals, and information and referral services. 

113 

Traumatic Brain Injury 

The Committee recommends $11,321,000 for the Traumatic 

Brain Injury program, which is the same as the fiscal year 2018 

enacted level and $2,000,000 above the fiscal year 2019 budget request. The program provides grants to States for the development 

of a comprehensive, coordinated family and person-centered service 

system at the State and community level for individuals who sustain a traumatic brain injury. 

Developmental Disabilities State Councils 

The Committee recommends $76,000,000 for State Councils on 

Developmental Disabilities, which is the same as the fiscal year 

2018 enacted level and $20,000,000 above the fiscal year 2019 

budget request. The Developmental Disabilities State Councils 

work to develop, improve and expand the system of services and 

supports for people with developmental disabilities. 

Developmental Disabilities Protection and Advocacy 

The Committee recommends $40,734,000 for Developmental Disabilities Protection and Advocacy, which is the same as the 2018 

enacted level and $2,000,000 above the fiscal year 2019 budget request. This formula grant program provides funding to States to establish and maintain protection and advocacy systems to protect 

the legal rights of persons with developmental disabilities. 

The Committee recognizes that the Americans with Disabilities 

Act (ADA) encourages States to administer services for people with 

Intellectual/Developmental Disabilities (I/DD) ‘‘in the most integrated setting appropriate to the needs of qualified individuals 

with disabilities.’’ As a result of enactment of the ADA and the Supreme Court decision in Olmstead v. L.C. (1999), there has been a 

national trend towards deinstitutionalization, whereby individuals 

have been encouraged to move out of State-run and other Federally-funded, certified facilities and into residential settings in their 

respective communities. However, the Committee is aware that 

many family members and legal guardians of individuals residing 

in these facilities have been pressured to move their loved ones into 

the community against their wishes. The Committee is concerned 

about the adequacy of community-based housing and the lack of 

specialized care and support services available in these settings. In 

addition, the Committee notes concern regarding the pace of transfer to community-based settings for some individuals, higher rates 

of abuse and mortality in community settings, and the adequacy of 

opportunities for residents to express views and preferences 

throughout the transfer process. 

The Committee fully supports the ADA’s goal of enabling people 

with I/DD to receive services ‘‘in the most integrated setting appropriate to their needs.’’ However, the Committee also notes that 

Olmstead held that the ADA does not condone or require removing 

individuals from institutional settings when they are unable to 

handle or benefit from a community-based setting and that the 

ADA does not require the imposition of community-based treatment on patients who do not desire it. Congress endorsed the same 

principle in the Developmental Disabilities (DD) Act of 2000. By 

continuing to pursue closure of facilities that are authorized by 

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termediate Care Facilities for Individuals with Intellectual Disabilities program, DD Act programs are also overriding the decisions 

of States on how to best allocate resources. 

The Committee remains concerned that the deinstitutionalization 

stance taken by both Federally-supported DD Act programs and 

the Department of Justice in its related prosecutorial discretion involve impact individuals who may be unable to handle or benefit 

from community integration and do not desire such care. The Committee strongly urges the Department to ensure that DD Act programs properly account for the needs and desires of patients, their 

families and caregivers, and the importance of affording patients 

the proper setting for their care, into enforcement of the Americans 

with Disabilities Act. 

Voting Access for Individuals with Disabilities 

The Committee recommends $6,963,000 for Voting Access for Individuals with Disabilities program, which is the same as the fiscal 

year 2018 enacted level and $2,000,000 above the fiscal year 2019 

budget request. The Voting Access for Individuals with Disabilities 

program authorized by the Help America Vote Act provides formula 

grants to ensure full participation in the electoral process for individuals with disabilities, including registering to vote, casting a 

vote, and accessing polling places. 

Developmental Disabilities Projects of National Significance 

The Committee recommends $12,000,000 for Developmental Disabilities Projects of National Significance, which is the same as the 

fiscal year 2018 enacted level and $10,950,000 above the fiscal year 

2019 budget request. This program funds grants and contracts that 

develop new technologies and demonstrate innovative methods to 

support the independence, productivity, and integration of those 

living with a disability into the community. The Committee recommends not less than $1,000,000 for transportation assistance activities for older adults and persons with disabilities. The transportation activities should focus on the most cost-effective and sustainable strategies that can be replicated to other communities. 

University Centers for Excellence in Developmental Disabilities 

The Committee recommends $40,619,000 for University Centers 

for Excellence in Developmental Disabilities, which is the same as 

the fiscal year 2018 enacted level and $8,073,000 above the fiscal 

year 2019 budget request. The University Centers for Excellence in 

Developmental Disabilities Education, Research, and Service are a 

nationwide network of independent but interlinked centers, representing a national resource for addressing issues, finding solutions, and advancing research related to the needs of individuals 

with developmental disabilities and their families. 

Independent Living 

The Committee recommends $120,000,000 for the Independent 

Living program, of which $27,000,000 is for the Independent Living 

State Grants program and $93,000,000 is for the Centers for Independent Living program. This funding level is $6,817,000 above the 

fiscal year 2018 enacted level and $24,003,000 above the fiscal year 

2019 budget request. Independent Living programs maximize the 

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leadership, empowerment, independence, and productivity of individuals with disabilities. 

The Committee expects ACL to distribute funds as soon as possible. In addition, the Committee strongly supports efforts by ACL 

to engage the grantee and stakeholder community to assist in planning for the grant cycle. 

National Institute on Disability, Independent Living, and 

Rehabilitation Research 

The Committee recommends $104,970,000 for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), which is the same as the fiscal year 2018 enacted level and $104,970,000 above the fiscal year 2019 budget request. NIDILRR generates knowledge and promote its effective use 

to enhance the abilities of people with disabilities to perform activities of their choice in the community and to expand society’s capacity to provide full opportunities for its citizens with disabilities. 

The Committee does not move NIDILRR to NIH, as proposed in 

the fiscal year 2019 budget request. The Committee believes 

NIDILRR’s unique mission to improve the abilities of individuals 

with disabilities is best achieved within ACL. 

Assistive Technology 

The Committee recommends $36,000,000 for Assistive Technology, which is the same as the fiscal year 2018 enacted level and 

$4,061,000 above the fiscal year 2019 budget request. Assistive 

Technology (AT) supports programs providing grants to States for 

addressing assistive technology needs of individuals with disabilities. The goal is to increase awareness of and access to assistive 

technology devices and services that may help with education, employment, daily activities, and inclusion of people with disabilities 

in their communities. 

Of this amount, the Committee provides $2,000,000 for competitive grants to support existing and new alternative financing programs that provide for the purchase of AT devices. The Committee 

intends for this funding to support the expansion of existing programs and the creation of new programs that allow greater access 

to affordable financing to help people with disabilities purchase the 

specialized technologies required to live independently, to succeed 

at school and work and to live active and productive lives. Programs that have previously received funding are eligible to compete 

but must report on how the prior funding has been used, including 

the number of loans extended and individuals served, funding leveraged, and asset development programs created. The Committee 

intends for applicants to incorporate credit-building activities into 

their programs, including financial education and information 

about other possible funding sources. Successful applicants must 

emphasize consumer choice and control and build programs that 

will provide financing for the full array of AT devices and services 

and ensure that all people, regardless of type of disability or health 

condition, age, level of income, and residence have access to the 

program. AT programs maximize the ability of individuals with disabilities of all ages and their family members, guardians, advocates, and authorized representatives to obtain AT devices and AT 

services. 

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Program Administration 

The Committee recommends $41,063,000 for Program Administration, which is the same as the fiscal year 2018 enacted level and 

$3,076,000 above the fiscal year 2019 budget request. This funding 

supports Federal administrative costs associated with administering ACL’s programs. 

The Achieving a Better Live Experience Act of 2014 or ABLE Act 

(PL 113–295) allows individuals and families to save for the purpose of supporting individuals with disabilities in maintaining their 

health, independence, and quality of life. The Committee strongly 

encourages the Administration on Community Living through its 

programs supporting individuals living with a disability to raise 

awareness on the eligibility and benefits of these accounts. The 

Committee requests an update on this effort in the fiscal year 2020 

Congressional Justification. 

OFFICE OF THE SECRETARY

OFFICE OF MEDICARE HEARINGS AND APPEALS

Appropriation, fiscal year 2018 ......................................................... $182,381,000 

Budget request, fiscal year 2019 ....................................................... 112,381,000 

Committee Recommendation ............................................................. 172,381,000 

Change from enacted level ......................................................... ¥10,000,000 

Change from budget request ...................................................... +60,000,000 

This Office supports hearings at the administrative law judge 

level, the third level of Medicare claims appeals. 

Medicare Appeals Backlog.—The Committee is concerned with 

the size the Medicare Appeals Backlog. The Committee supports 

the Office of Medicare Hearings and Appeals to take administrative 

actions that will reduce the number of cases awaiting a hearing 

with an Administrative Law Judge. 

GENERAL DEPARTMENTAL MANAGEMENT

Appropriation, fiscal year 2018 ......................................................... $535,457,000 

Budget request, fiscal year 2019 ....................................................... 342,990,000 

Committee Recommendation ............................................................. 433,290,000 

Change from enacted level ......................................................... ¥102,167,000 

Change from budget request ...................................................... +90,300,000 

Of the funds provided, $53,445,000 shall be derived from evaluation set-aside funds available under section 241 of the Public 

Health Service Act, which is $11,383,000 below the fiscal year 2018 

enacted level and the same as the fiscal year 2019 budget request. 

This appropriation supports activities that are associated with 

the Secretary’s roles as policy officer and general manager of the 

Department of Health and Human Services. The Office of the Secretary also implements administration and Congressional directives, and provides assistance, direction and coordination to the 

headquarters, regions, and field organizations of the department. 

In addition, this funding supports the Office of the Surgeon General and several other health promotion and disease prevention activities that are centrally administered. 

Black Men in the Medical Profession.—The Committee supports 

the efforts of the National Academies of Sciences, Engineering, and 

Medicine to explore the factors that contribute to the low participation of Black men in the medical profession. The Committee urges 

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the Secretary, in collaboration with NIH, to review the proceedings 

of the November 2017 joint workshop on this topic, titled An American Crisis: The Growing Absence of Black Men in Medicine and 

Science: Proceedings of Joint Workshop. The Committee directs the 

Secretary to submit an action plan to address the increasing underrepresentation of Black men in medical schools and in the medical 

profession to the Committee within 180 days of enactment of this 

Act. 

Cybersecurity.—The Committee is concerned about reports that 

indicate hospitals and medical practitioners are not adequately protecting patient records with respect to cyber threats. While laws 

exist to provide such protection, these laws are weakly enforced 

such that there is little accountability for inadequate compliance 

with cybersecurity protocols. The Committee requests the Secretary 

assess the adequacy of current enforcement policy and additional 

measures that may be necessary to hold those who are responsible 

for compliance with existing regulations accountable. 

Early Detection of Brain Aneurysms.—The Committee recognizes 

that although one in 50 Americans have a brain aneurysm, there 

are typically no warning signs or symptoms. Unfortunately, 40 percent of patients will not survive a brain aneurysm hemorrhage. 

Even when an aneurysm has bled, the symptoms are not widely 

known among health care professionals, including first responders 

and emergency room physicians. As a result, individuals who experience a hemorrhage from a brain aneurysm can be easily 

misdiagnosed, potentially missing an opportunity to institute lifesaving treatments. The Committee encourages the Secretary, in 

consultation with appropriate stakeholders—including neurosurgeons, neurologists, neuro-interventional surgeons, emergency 

physicians, brain aneurysm patient advocacy foundations, brain aneurysm survivors, and caregivers—to facilitate the development of 

best practices on brain aneurysm detection and diagnosis for first 

responders, emergency room physicians, primary care physicians, 

nurses, and advanced practice providers. In doing so, the Committee encourages the Secretary to consider incorporating topics 

such as the symptoms of brain aneurysms, evidence-based risk factors for brain aneurysms, appropriate utilization of medical testing 

and diagnostic equipment, and screening recommendations. The 

Committee encourages the Secretary to consult appropriate stakeholders to develop a strategy for disseminating information about 

the best practices and begin implementing this strategy not later 

than one year after the date of enactment of this Act. 

Faith Based Center.—The Committee includes $1,299,000 for the 

Faith Based Center, the same as fiscal year 2018 enacted level and 

the fiscal year 2019 budget request. 

Global Health Research Strategy.—The Committee requests an 

update in the fiscal year 2020 Congressional Justification on how 

CDC, FDA, BARDA, and NIH—including the Fogarty International 

Center—jointly coordinate global health research activities. The update should include specific metrics used to track progress and collaboration toward agreed upon health goals. 

Nonrecurring Expenses Fund.—The Committee directs the Secretary to prioritize completion of projects for the Indian Health 

Service. 

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Privacy in Mental Health Scenarios.—Section 11004 of the 21st 

Century Cures Act (PL 114–255) directed the Secretary of Health 

and Human Services to identify model programs and materials for 

training health care providers regarding the permitted uses and 

disclosures of protected health information of patients seeking or 

undergoing mental or substance use disorder treatment, consistent 

with standards and regulations governing the privacy and security 

of individually identifiable health information under the Social Security Act and the Health Insurance Portability and Accountability 

Act of 1996. In addition, the Secretary was directed to identify a 

model program and materials for training patients and their families regarding their rights to protect and obtain such information. 

The Committee urges the Secretary to submit a report to the Committees on Appropriations of the House of Representatives and the 

Senate within 180 days of enactment of this Act identifying model 

programs and materials addressed in section 11004 of the 21st 

Century Cures Act. 

Tribal Access.—The Committee is concerned that HHS grant programs that address public health issues are not sufficiently accessible to Tribal health departments, and that HHS could do more 

to support the needs for those services in Indian Country. Tribal 

health departments often do not have the funding available for 

public health initiatives such as disease prevention, injury prevention, education, research and wellness promotion. The Committee 

directs the Secretary to report, within 180 days of enactment of 

this Act, on the number of Tribal governments or Tribal consortia 

receiving direct funding, and the total percentage of that funding, 

from public health block grants—including but not limited to the 

Preventive Health and Health Services Block Grant; Community 

Mental Health Services Block Grant; Community Service Block 

Grant; Maternal and Child Health Block Grant; and the Social 

Services Block Grant. In addition, HHS is encouraged to collect 

from the States the percentage of Federal funding from such block 

grants that each State provides to Tribal health departments. 

Tribal Governance.—The Secretary, in coordination with the Indian Health Service, CMS, and CDC, is urged to facilitate and support partnerships with Tribes and medical colleges and universities 

as opportunities arise, in order to foster leadership development, 

build organizations to better deliver and coordinate high-quality 

care, and to support systems of care and prevention that can have 

a positive outcome on the health of the community and cost of care. 

Office of the Assistant Secretary for Health 

Adverse Childhood Experience.—The Committee is concerned 

about the link between adverse childhood experience—such as 

physical abuse, substance misuse in the household, sexual abuse, 

and parental divorce or separation—and negative long-term health 

and behavioral health outcomes, including early initiation of alcohol and tobacco use, substance misuse, teen pregnancy, violence, 

and increased risk of suicide. The Committee directs the Office of 

the Surgeon General to submit a report to the Committees on Appropriations of the House of Representatives and the Senate within 

180 days of enactment of this Act on the connection between adverse childhood experience and negative long-term health outcomes, including future substance misuse. The Committee urges 

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the Office of the Surgeon General to consult with CDC, NIH, 

SAMHSA, and ACF, in the process of developing the report. 

Breast Milk.—The Committee recognizes the importance of 

breast milk in improving health outcomes for babies and mothers. 

The Committee encourages HHS to provide a study within 2 years 

of the date of the enactment of this Act on the impact of recommended breastfeeding rates on health outcomes and healthcare 

costs. HHS, through CDC or AHRQ, should review the most recent 

research (published in the last 5 years) and develop a report that 

could be provided to Congress examining the impact of clinically 

recommended breastfeeding rates on associated Medicaid expenditures, urgent care costs, and direct and indirect medical costs in 

order to inform health care and funding decisions. The Committee 

also encourages the Secretary to ensure that pregnant women have 

access to nutritional guidance, including through the 2020–2025 

edition of the Dietary Guidelines for Americans currently under development, based on the latest scientific research on the health and 

cost benefits of human milk. 

Embryo Adoption Awareness Campaign.—The Committee recommends $1,000,000 for the Embryo Adoption Awareness Campaign, the same as the fiscal year 2018 enacted level and the fiscal 

year 2019 budget request. These funds will be used to educate 

Americans about the existence of frozen human embryos (resulting 

from in-vitro fertilization), which may be available for donation/ 

adoption to help other couples build their families. The Committee 

includes bill language permitting these funds also to be used to 

provide medical and administrative services to individuals adopting 

embryos, deemed necessary for such adoptions, consistent with the 

Code of Federal Regulations. 

Stillbirth.—The Committee is aware that each year about 24,000 

babies are stillborn in the US, approximately 2,000 babies each 

month. According to the CDC, this is about the same number of babies that die during the first year of life and it is more than 10 

times as many deaths as the number that occur from Sudden Infant Death Syndrome (SIDS). Additionally the US has made some 

of the slowest progress of any country in reducing stillbirths, with 

the US rate declining by 0.4 percent per year between 2000 and 

2015, putting us at 155th out of 159 in the world. In order to elevate the issues surrounding stillbirth for consumers and providers, 

the Committee encourages the Surgeon General’s Office to issue a 

Call to Action on Stillbirth that will provide a roadmap for future 

federal efforts to reduce stillbirth rates and eliminate the disparities that surround this condition. 

Sexual Risk Avoidance.—The Committee provides $30,000,000 in 

budget authority for sexual risk avoidance programs, which is 

$5,000,000 above the fiscal year 2018 enacted level and 

$30,000,000 more than the fiscal year 2019 budget request. 

In implementing these funds, it is the intent of the Committee 

that HHS provide substantive and practical technical assistance to 

grantees so they place meaningful emphasis on Sexual Risk Avoidance (SRA) in all educational messaging to teens. The Committee 

notes that such technical assistance should be provided in the following venues: during National and regional conferences, webinars 

and one-on-one conversations with funded projects. The Committee 

further intends that SRA-credentialed experts consult with grantVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00119 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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ees and HHS staff with oversight of these programs on methodologies and best practices in SRA for teens. The Committee also encourages all operating divisions at HHS that implement or inform 

youth programs to implement consistently a public health model 

that stresses risk avoidance or works to return individuals to a lifestyle without risk, particularly as it relates to sexual risk. 

Office of Minority Health 

The Committee provides $56,670,000 for the Office of Minority 

Health (OMH), which is the same as the fiscal year 2018 enacted 

level and $2,714,000 more than the fiscal year 2019 budget request. 

The OMH works with US Public Health Service agencies and other 

agencies of the Department to address the health status and quality of life for racial and ethnic minority populations in the United 

States. OMH develops and implements new policies; partners with 

States, Tribes, and communities through cooperative agreements; 

supports research, demonstration, and evaluation projects; and disseminates information. 

Hepatitis.—The Committee commends OMH for their advancements in the treatment and management of hepatitis and requests 

an update in the fiscal year 2020 Congressional Justification on the 

progress of community partnerships that promote awareness and 

outreach to improve testing, diagnosis, and treatment. 

Hispanic Serving Institutions.—The Committee supports OMH’s 

efforts to enter into or continue cooperative agreements with Hispanic Serving Institution medical schools in addition to their work 

with Historically Black Colleges and Universities medical schools. 

HIV/AIDS.—The Committee continues to be concerned about the 

HIV/AIDS epidemic in the African American and Hispanic communities, and is aware of the concurrent high co-infection rate for 

Hepatitis C. The Committee urges OMH to address opportunities 

to reduce the burden of HIV/AIDS and Hepatitis C by implementing partnerships for screening and community engagement 

programs. 

Lupus.—The Committee is encouraged by research conducted by 

the OMH National Health Education Lupus Program and encourages OMH to optimize that research and utilize other resources 

currently in development to further support populations at highest 

risk—specifically Hispanics, Native Americans, Asians and African 

Americans. The Committee is particularly concerned about the disproportionately high rates of Lupus among African American 

women and other women of color. The Committee recommends collaborating with the lupus community to expand the development of 

linguistically and culturally appropriate tools, resources and materials for these adults and children with lupus, their caregivers and 

health care providers. 

Office on Women’s Health 

The Committee includes $32,140,000 for the Office on Women’s 

Health, which is the same as the fiscal year 2018 enacted level and 

$3,686,000 more than the fiscal year 2019 budget request. 

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OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH

INFORMATION TECHNOLOGY

Appropriation, fiscal year 2018 ......................................................... $60,367,000 

Budget request, fiscal year 2019 ....................................................... 38,381,000 

Committee Recommendation ............................................................. 42,705,000 

Change from enacted level ......................................................... ¥17,662,000 

Change from budget request ...................................................... +4,324,000 

The Office of the National Coordinator (ONC) is the principal 

Federal entity charged with coordinating efforts to implement and 

use health information technology and exchange electronically 

health information. 

Patient Data Matching.—The Committee is aware that one of the 

most significant challenges inhibiting the safe and secure electronic 

exchange of health information is the lack of a consistent patient 

data matching strategy. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, 

a clear mandate was placed on the Nation’s healthcare community 

to adopt electronic health records and health exchange capability. 

Although the committee continues to carry a prohibition against 

HHS using funds to promulgate or adopt any final standard providing for the assignment of a unique health identifier for an individual until such activity is authorized, the Committee notes that 

this limitation does not prohibit HHS from examining the issues 

around patient matching. Accordingly, the Committee continues to 

encourage the Secretary, acting through the ONC and CMS, to provide technical assistance to private-sector-led initiatives to develop 

a coordinated national strategy that will promote patient safety by 

accurately identifying patients to their health information. 

Prescription Drug Monitoring.—The Committee understands that 

the spread of the prescription drug epidemic throughout the Nation 

has made the creation, implementation, and use of State prescription drug monitoring programs (PDMPs) and their ability to communicate with electronic health record (EHR) and electronic prescribing (e-prescribing) systems more important than ever. The 

Committee encourages ONC to continue its support for pilot programs to find usability challenges among PDMP, EHR, and e-prescribing systems; develop and award challenge awards to private 

entities for health information technology innovation; and offer targeted technical assistance to help medical professionals use PDMP, 

EHR, and e-prescribing systems. The Committee further encourages ONC to collaborate and coordinate its efforts with partner 

agencies such as CDC and the Bureau of Justice Assistance in the 

Department of Justice. 

OFFICE OF INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $80,000,000 

Budget request, fiscal year 2019 ....................................................... 80,000,000 

Committee Recommendation ............................................................. 80,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... – – – 

The Office of Inspector General (OIG) serves as an independent 

and objective oversight unit of HHS. OIG carries out activities intended to prevent fraud and abuse and promote economy, efficiency 

and effectiveness of HHS programs and operations. 

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OFFICE FOR CIVIL RIGHTS

Appropriation, fiscal year 2018 ......................................................... $38,798,000 

Budget request, fiscal year 2019 ....................................................... 30,904,000 

Committee Recommendation ............................................................. 38,798,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +7,894,000 

The Office for Civil Rights (OCR) is responsible for enforcing civil 

rights statutes that prohibit discrimination in health and human 

services programs. OCR implements the civil rights laws through 

a compliance program designed to generate voluntary compliance 

among all HHS recipients. 

The Committee strongly supports efforts to investigate violations 

of Federal Conscience Rights statutes. The establishment of a Conscience and Religious Freedom Division is a necessary step to ensure appropriate application of Federal law. The Committee also 

values the vital work done by the Civil Rights Division and Health 

Information Privacy Division. Additional funding through the assessment of civil monetary penalties ensures the work for the 

Health Information Privacy Division will not be reduced. The Committee maintains funding for OCR and increases the program level 

for these divisions. 

Within the resources available to OCR, the Committee provides 

not less than $4,600,000 for the Civil Rights Division, which is 

above the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. From budget authority and offsetting collections, 

the Committee provides not less than $7,500,000 for the Health Information Privacy Division, which is above the fiscal year 2018 enacted level and the fiscal year 2019 budget request. The Committee 

provides not less than $3,000,000 for the Conscience and Religious 

Freedom Division, which is above the fiscal year 2018 enacted level 

and the fiscal year 2019 budget request. 

The Committee commends the Secretary for establishing the Division on Conscience and Religious Liberty within the Office for 

Civil Rights and is encouraged by the proposed rule entitled Protecting Statutory Conscience Rights in Health Care; Delegations of 

Authority. The Committee urges the Administration to finalize the 

rule at the appropriate time. The Committee looks forward to the 

important work the Office for Civil Rights will do to safeguard 

Americans’ civil rights. 

The Committee is concerned that the State of California, State 

of New York, State of Oregon, and State of Washington are requiring insurance providers to cover elective abortions. Furthermore, 

the Committee is aware that the State of California has enacted a 

law that requires pregnancy centers to refer patients for free or 

low-cost state-funded abortions. These laws, policies, and requirements appear to violate the Weldon Amendment, which prevents 

discrimination against health care entities that choose not provide 

abortion coverage. Accordingly, the Committee directs the Secretary to fully investigate and resolve potential violations of the 

Weldon Amendment and report findings back to Congress. 

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RETIREMENT PAY AND MEDICAL BENEFITS FOR

COMMISSIONED OFFICERS

Appropriation, fiscal year 2018 ......................................................... $618,689,000 

Budget request, fiscal year 2019 ....................................................... 629,209,000 

Committee Recommendation ............................................................. 629,209,000 

Change from enacted level ......................................................... +10,520,000 

Change from budget request ...................................................... – – – 

The Committee provides for retirement pay and medical benefits 

of Public Health Service Commissioned Officers, for payments 

under the Retired Serviceman’s Family Protection Plan, and for 

medical care of dependents and retired personnel. 

PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND

Appropriation, fiscal year 2018 ......................................................... $1,953,458,000 

Budget request, fiscal year 2019 ....................................................... 2,303,877,000 

Committee Recommendation ............................................................. 2,813,128,000 

Change from enacted level ......................................................... +859,670,000 

Change from budget request ...................................................... +509,251,000 

This account supports the activities of the Assistant Secretary for 

Preparedness and Response (ASPR) and other components within 

the Office of the Secretary to prevent, prepare for, and respond to 

the health consequences of bioterrorism and other public health 

emergencies, including pandemic influenza. It also includes funding 

for the Department’s cybersecurity efforts. 

Office of the Assistant Secretary for Preparedness and Response 

The Committee provides $2,489,128,000 for activities administered by ASPR. ASPR is responsible for coordinating national policies and plans for medical and public health preparedness and for 

administering a variety of public health preparedness programs. 

National Ebola Training and Education Center.—The Committee 

supports the continued efforts of the National Ebola Training and 

Education Center (NETEC), and recognizes the importance of 

NETEC’s work in preventing, preparing for, and responding to 

Ebola and other special pathogen incidents. 

Regional Disaster Medical Response Demonstration Project.—The 

Committee commends ASPR for its work to develop and evaluate 

regional, coalition-based disaster medical response systems to handle the health impacts of 21st century health security threats. The 

Committee encourages ASPR to leverage the Hospital Preparedness Program and National Disaster Medical System to strengthen 

regional disaster response capabilities by working with States that 

have demonstrated success in creating statewide disaster 

healthcare systems to coordinate patient movement, evacuation, 

and emergency care, particularly in areas with high incidence of 

natural disasters or high risk for deliberate attacks, with the goal 

of establishing best practices and maximizing Federal resources. 

Operations 

The Committee recommends $30,938,000 for Operations. This account supports activities within the Assistant Secretary’s Immediate Office; the Office of the Chief Operating Officer; the Office of 

Acquisitions Management, Contracts, and Grants; and the Office of 

Financial Planning and Analysis. 

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Preparedness and Emergency Operations 

The Committee recommends $24,654,000 for Preparedness and 

Emergency Operations. The Preparedness and Emergency Operations account funds the Office of Emergency Management, which 

support a full spectrum of emergency management responsibilities, 

including planning, coordination, logistics, training, and responding 

to planned events and unplanned incidents. 

National Disaster Medical System 

The Committee recommends $62,404,000 for the National Disaster Medical System (NDMS). NDMS deploys trained medical 

teams to communities impacted by public health and medical emergencies due to natural and man-made incidents. 

Hospital Preparedness Program 

The Committee recommends $279,555,000 for the Hospital Preparedness Program (HPP). HPP supports cooperative agreements 

with State, local, and territorial health departments to build 

healthcare coalitions that improve regional and local hospital preparedness and surge capacity in public health emergencies. 

Biomedical Advanced Research and Development Authority 

The Committee provides $586,700,000 for the Biomedical Advanced Research and Development Authority (BARDA). BARDA 

supports the advanced development of vaccines, drugs, and therapeutics for potential serious public health threats, including chemical, biological, radiological, and nuclear threats, pandemic influenza, and emerging and re-emerging infectious diseases. 

Advanced Blood Pathogen Reduction Technologies.—The Committee commends BARDA for actions taken during the Zika virus 

epidemic to quickly and efficiently accelerate the use of modern 

blood pathogen reduction technologies to improve the safety of the 

nation’s blood supply. The Committee encourages BARDA to continue to give priority to this effort in fiscal year 2019, which if successful will complete development of pathogen reduction technology 

for all transfused blood components as a countermeasure to ensure 

sustainability of the national blood supply as part of emergency 

preparedness for emerging epidemic pathogens. 

Antimicrobial-Resistant Tuberculosis.—The National Strategy for 

Combating Antibiotic-Resistant Bacteria identified drug resistant 

tuberculosis (TB) as a serious threat level pathogen. New diagnostic, treatment, and prevention tools are urgently needed to address this global health threat. The Committee encourages BARDA 

to support the development of new TB diagnostic tests, drugs, and 

vaccines and report on the agency’s efforts in the fiscal year 2020 

Congressional Justification. 

Antimicrobial Technologies.—The Committee notes that efforts to 

combat microbial resistance to traditional treatments is advancing 

faster than current regulatory frameworks. The Committee encourages BARDA to work with entities developing antimicrobial technologies that are not pharmacological in nature. The Committee 

sees particular promise in technologies which alter environments to 

inhibit microbial growth and spread. 

Zika Vaccine Development.—The number of new Zika virus infections has dropped dramatically because much of the population in 

125 

Zika-endemic areas has developed an immunity to the virus. However, like other similar mosquito-borne flaviviruses, the virus is 

likely to reemerge in these areas in several years, and could 

emerge unpredictably in isolated areas in the meantime, including 

within the US. Given the links between Zika virus infections and 

serious birth defects, and the length of time necessary to develop 

vaccines, the Committee believes it is prudent to continue efforts 

to develop a vaccine for the Zika virus. Within the total funding 

provided for BARDA, the Committee directs BARDA to continue to 

support research and development on a vaccine for the Zika virus. 

Policy and Planning 

The Committee recommends $14,877,000 for Policy and Planning. The Office of Policy and Planning leads HHS’ emergency preparedness and response strategic direction and policy coordination. 

Project BioShield Special Reserve Fund 

The Committee provides $780,000,000 for Project BioShield. 

These funds support the acquisition of promising medical countermeasures developed through BARDA contracts for the most serious 

public health threats. 

Strategic National Stockpile 

The Committee provides $710,000,000 for the Strategic National 

Stockpile (SNS) in ASPR. The Committee commends the Department for its efforts to achieve efficiencies in its public health preparedness activities and looks forward to continuing to work with 

the Department to enhance the nation’s preparedness to respond to 

public health threats. The Committee expects that this organizational change will continue to include a significant role for CDC in 

providing scientific expertise in decision-making related to procurement of countermeasures as well as maintaining strong relationships with State and local public health departments to facilitate 

efficient deployment of countermeasures in public health emergencies. Within 60 days of enactment of this Act, the Committee 

requests an update on ASPR’s plans to: 1) maintain funding for 

State and local operational readiness to distribute and dispense 

medical countermeasures from the Stockpile; 2) continue technical 

assistance, support and oversight for State and local health departments’ operational readiness to distribute and dispense medical 

countermeasures from the Stockpile; and 3) incorporate and access 

CDC expertise throughout the Public Health Emergency Medical 

Countermeasures Enterprise, including decisions related to procurement and deployment for the Stockpile. 

Office of the Assistant Secretary for Administration—Cybersecurity 

The Committee provides $60,000,000 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. 

Computer Security Incident Response Center.—HHS established 

the Computer Security Incident Response Center (CSIRC) to serve 

as the primary entity within HHS responsible for maintaining cybersecurity situational awareness and determining the DepartVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00125 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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ment’s overall cybersecurity risk posture. The Committee directs 

HHS to submit a report within 180 days of enactment of this Act 

that includes an analysis and assessment of the effectiveness of the 

CSIRC in ensuring the Department, to include operating and staff 

divisions, is appropriately prepared for and protected against cyber 

threats and incidents. 

Office of Security and Strategic Information 

The Committee provides $8,000,000 for the Office of Security and 

Strategic Information to maintain the security of the Department’s 

personnel, systems, and critical infrastructure. 

Office of Public Health and Science—Medical Reserve Corps 

The Committee provides $6,000,000 for the Medical Reserve 

Corps program, which is a network of local volunteers who work 

to strengthen the public health infrastructure and preparedness capabilities of their communities. 

Pandemic Influenza Preparedness 

The Committee recommends $250,000,000 for the pandemic influenza preparedness program. This funding supports research and 

development of next-generation influenza medical countermeasures, preparedness testing and evaluation, and stockpiling. 

Pandemic Influenza Vaccine.—The Committee remains concerned 

about our nation’s limited ability to rapidly respond to a pandemic 

influenza outbreak and meet the Federal government’s desired goal 

of delivering pandemic vaccines within 12 weeks of the declaration 

of a pandemic. Late-stage pandemic and pre-clinical influenza vaccines are under development that can enhance current rapid response capacity in the US. The Committee encourages ASPR and 

BARDA to support development of promising pre-clinical as well as 

development and acquisition of late-stage vaccine candidates that 

can meet the goal of producing a pandemic vaccine within 12 weeks 

of a declaration. 

GENERAL PROVISIONS

Sec. 201. The Committee continues a provision to limit the 

amount available for official reception and representation expenses. 

Sec. 202. The Committee continues a provision to limit the salary 

of an individual through an HHS grant or other extramural mechanism to not more than the rate of Executive Level II. 

Sec. 203. The Committee continues a provision to prohibit the 

Secretary from using evaluation set-aside funds until the Committees on Appropriations of the House of Representatives and the 

Senate receive a report detailing the planned use of such funds. 

Sec. 204. The Committee continues a provision regarding the 

level for the PHS evaluation set-aside. 

(TRANSFER OF FUNDS)

Sec. 205. The Committee continues a provision permitting the 

Secretary of HHS to transfer up to one percent of any discretionary 

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

emergency needs. Notification must be provided to the Committees 

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on Appropriations at the program, project, and activity level in advance of any such transfer. 

Sec. 206. The Committee continues the 60 day flexibility for National Health Service Corps contract terminations. 

Sec. 207. The Committee continues a provision to prohibit the 

use of Title X funds unless the applicant for the award certifies to 

the Secretary that it encourages family participation in the decision of minors to seek family planning services and that it provides 

counseling to minors on how to resist attempts to coerce minors 

into engaging in sexual activities. 

Sec. 208. The Committee continues a provision stating that no 

provider of services under Title X shall be exempt from any state 

law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

Sec. 209. The Committee continues a provision related to the 

Medicare Advantage program. 

Sec. 210. The Committee continues a provision prohibiting funds 

from being used to advocate or promote gun control. 

Sec. 211. The Committee continues a provision to allow funding 

for HHS international HIV/AIDS and other infectious disease, 

chronic and environmental disease, and other health activities 

abroad to be spent under the State Department Basic Authorities 

Act of 1956. 

Sec. 212. The Committee continues a provision authorizing certain international health activities. 

(TRANSFER OF FUNDS)

Sec. 213. The Committee continues a provision to provide the Director of NIH, jointly with the Director of the Office of AIDS Research, the authority to transfer up to three percent of human immunodeficiency virus funds. 

(TRANSFER OF FUNDS)

Sec. 214. The Committee continues a provision that makes NIH 

funds for human immunodeficiency virus research available to the 

Office of AIDS Research. 

Sec. 215. The Committee continues a provision granting authority to the Office of the Director of the NIH to enter directly into 

transactions in order to implement the NIH Common Fund for 

medical research and permitting the Director to utilize peer review 

procedures, as appropriate, to obtain assessments of scientific and 

technical merit. 

Sec. 216. The Committee continues a provision clarifying that 

funds appropriated to NIH institutes and centers may be used for 

minor repairs or improvements to their buildings, up to $3,500,000 

per project with a total limit for NIH of $45,000,000. 

(TRANSFER OF FUNDS)

Sec. 217. The Committee continues a provision transferring one 

percent of the funding made available for National Institutes of 

Health National Research Service Awards to the Health Resources 

and Services Administration. 

Sec. 218. The Committee continues the Biomedical Advanced Research and Development Authority ten year contract authority. 

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Sec. 219. The Committee continues language requiring HHS to 

include certain information concerning the number of full-time Federal employees and contractors working on the Affordable Care Act 

in the fiscal year 2020 budget request. 

Sec. 220. The Committee continues specific report requirements 

for CMS’s Health Insurance Exchange activities in the fiscal year 

2020 budget request. 

Sec. 221. The Committee continues a provision prohibiting CMS 

Program Management account from being used to support risk corridor payments. 

(TRANSFER OF FUNDS)

Sec. 222. The Committee continues language directing the spending of the Prevention and Public Health fund. 

PREVENTION AND PUBLIC HEALTH FUND

The Committee continues a provision that directs the transfer of 

the Prevention and Public Health Fund. In fiscal year 2019, the 

level appropriated for the fund is $848,000,000 after accounting for 

sequestration. The Committee includes bill language in section 222 

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 Budget Activity FY 2019 

Committee 

CDC ........................... Breastfeeding Grants (Hospitals Promoting Breastfeeding). ................................. 10,000,000 

CDC ........................... Diabetes .................................................................................................................. 76,675,000 

CDC ........................... Epidemiology and Laboratory Capacity Grants ...................................................... 40,000,000 

CDC ........................... Healthcare Associated Infections ........................................................................... 12,000,000 

CDC ........................... Heart Disease and Stroke Prevention Program ...................................................... 73,975,000 

CDC ........................... Million Hearts Program .......................................................................................... 4,000,000 

CDC ........................... Preventive Health and Health Services Block Grant ............................................. 160,000,000 

CDC ........................... Tobacco ................................................................................................................... 126,000,000 

CDC ........................... Section 317 Immunization Grants ......................................................................... 324,350,000 

CDC ........................... Lead Poisoning Prevention ..................................................................................... 17,000,000 

CDC ........................... Early Care Collaboratives ....................................................................................... 4,000,000 

Sec. 223. The Committee modifies a provision relating to breast 

cancer screening. 

Sec. 224. The Committee continues a provision relating to indirect cost negotiated rates. 

(TRANSFER OF FUNDS)

Sec. 225. The Committee continues a provision permitting transfer of funds within NIH, if such funds are related to opioid and 

pain management research. 

(TRANSFER OF FUNDS)

Sec. 226. The Committee includes a new provision for evaluation 

activities within the Administration for Children and Families. 

Sec. 227. The Committee includes a new provision prohibiting 

funds from being used for Title X family planning activities. 

(TRANSFER OF FUNDS)

Sec 228. The Committee includes a new provision establishing an 

Infectious Diseases Rapid Response Reserve Fund in CDC. 

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Sec. 229. The Committee includes a new provision prohibiting 

funds from being used to support the Monograph Programme of the 

International Agency for Research on Cancer unless NIH submits 

a report to Congress outlining transparency and conflict-of-interest 

requirements that are a condition of these awards. 

Sec. 230. The Committee includes a new provision relating to cervical cancer screening. 

Sec. 231. The Committee includes a new provision extending the 

authorization of Small Business Innovation Research pilot programs. 

Sec. 232. The Committee includes a new provision relating to donations for the care of unaccompanied alien children. 

Sec. 233. The Committee includes a new provision relating to reporting of children separated from their parents or legal guardians. 

Sec. 234. The Committee includes a new provision related to a 

plan to reunify children separated from their parents or family 

units. 

Sec. 235. The Committee includes a new provision ensuring that 

efforts are taken to place unaccompanied alien children who are 

siblings together. 

Sec. 236. The Committee includes a new provision requesting a 

monthly report on the status of children separated from their parents or legal guardians. 

TITLE III—DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED

Appropriation, fiscal year 2018 ......................................................... $16,443,790,000 

Budget request, fiscal year 2019 ....................................................... 15,926,790,000 

Committee Recommendation ............................................................. 16,443,790,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +517,000,000 

Of the total amount available, $5,525,990,000 is appropriated for 

fiscal year 2019 for obligation on or after July 1, 2019 and 

$10,841,177,000 is appropriated for fiscal year 2019 for obligation 

on or after October 1, 2019. This appropriation account includes 

compensatory education programs authorized under title I and subpart 2 of part B of title II of the Elementary and Secondary Education Act of 1965 (ESEA) and section 418A of the Higher Education Act. 

Grants to Local Educational Agencies 

For fiscal year 2019, the Committee recommends $15,759,802,000 

for Title I grants to Local Educational Agencies (LEAs or school 

districts). Title I grants provide supplemental education funding for 

activities that offer extra academic support to help students from 

low-income families and in high-poverty schools to meet State academic standards. 

Of the amounts provided for Title I programs, $6,459,401,000 is 

available for Basic Grants to LEAs, which is the same as both the 

fiscal year 2018 enacted level and the fiscal year 2019 budget request. Basic grants are awarded to school districts with at least 10 

low-income children who make up more than two percent of the 

school-age population. 

130 

Within the amount for Title I Basic Grants, up to $5,000,000 is 

made available to the Secretary of Education on October 1, 2018, 

to obtain annually-updated LEA-level poverty data from the Bureau of the Census. 

The Committee recommends $1,362,301,000 for Title I Concentration Grants, which is the same as both the fiscal year 2018 

enacted level and the fiscal year 2019 budget request. Concentration Grants target funds to school districts in which the number of 

low-income children exceeds 6,500 or 15 percent of the total schoolage population. 

The Committee recommends $3,969,050,000 for Title I Targeted 

Grants, which is the same as the fiscal year 2018 enacted level and 

$150,000,000 above the fiscal year 2019 budget request. Targeted 

Grants provide higher payments to school districts with high numbers or percentages of low-income students. 

The Committee recommends $3,969,050,000 for Title I Education 

Finance Incentive Grants (EFIGs), which is the same as the fiscal 

year 2018 enacted level and $150,000,000 above the fiscal year 

2019 budget request. EFIGs provide payments to States and school 

districts that incorporate equity and effort factors to improve the 

equity of State funding systems. 

The Committee notes, within the fiscal year 2019 budget request, 

the inclusion of legislative proposals as well as grants to local educational agencies to implement weighted per-pupil funding systems, including open enrollment systems that allow students to enroll in a public school selected by their parents. However, the Committee notes that such a program has not been authorized. Accordingly, the Committee has not provided funding for such a program 

within this bill. Funding for this approach will be considered 

should it be authorized in law. 

Comprehensive Literacy Development Grants 

The Committee recommends $190,000,000 for Comprehensive 

Literacy Development Grants, which is the same as the fiscal year 

2018 enacted level and $190,000,000 above the fiscal year 2019 

budget request. This program makes competitive grants to States 

to subgrant to school district and/or early education programs to 

improve literacy instruction for disadvantaged students. 

Innovative Approaches to Literacy 

The Committee recommends $27,000,000 for Innovative Approaches to Literacy, the same as the 2018 enacted level and 

$27,000,000 above the fiscal year 2019 budget request. This program provides competitive grants to support school libraries. 

State Agency Programs: Migrant 

The Committee recommends $374,751,000 for the State Agency 

Program for Migrant Education, which is the same as both the fiscal year 2018 enacted level and the fiscal year 2019 budget request. 

This program supports special educational and related services for 

children of migrant agricultural workers and fishermen, including: 

(1) supplementary academic education; (2) remedial or compensatory instruction; (3) English for limited English proficient students; (4) testing; (5)guidance counseling; and (6) other activities to 

131 

promote coordination of services across States for migrant children 

whose education is interrupted by frequent moves. 

State Agency Programs: Neglected and Delinquent 

For the State Agency Program for Neglected and Delinquent Children, the Committee recommends $47,614,000, which is the 

same as both the fiscal year 2018 enacted level and the fiscal year 

2019 budget request. This formula grant program supports educational services for children and youth under age 21 in State-run 

institutions, attending community day programs, and in correctional facilities. A portion of these funds is provided for projects 

that support the successful re-entry of youth offenders into postsecondary and vocational programs. 

Special Programs for Migrant Students 

The Committee recommends $44,623,000 for the Special Programs for Migrant Students, which is the same as both the fiscal 

year 2018 enacted level and the fiscal year 2019 budget request. 

These programs make grants to colleges, universities, and nonprofit organizations to support educational programs designed for 

students who are engaged in migrant and other seasonal farm 

work. The High School Equivalency Program (HEP) recruits migrant students age 16 and over and provides academic and support 

services to help those students obtain a high school equivalency 

certificate and subsequently to gain employment or admission to a 

postsecondary institution or training program. The College Assistance Migrant Program (CAMP) provides tutoring and counseling 

services to first-year, undergraduate migrant students and assists 

those students in obtaining student financial aid for their remaining undergraduate years. The Committee recommendation assumes 

the allocation of funds between HEP and CAMP as proposed by the 

Administration. 

IMPACT AID

Appropriation, fiscal year 2018 ......................................................... $1,414,112,000 

Budget request, fiscal year 2019 ....................................................... 1,259,790,000 

Committee Recommendation ............................................................. 1,466,112,000 

Change from enacted level ......................................................... +52,000,000 

Change from budget request ...................................................... +206,322,000 

This account supports payments to school districts affected by 

Federal activities, such as those that educate children whose families are connected with the military or who live on Indian land. 

The Committee notes that documents supporting the Department’s budget proposal references the possibility of a high-quality 

evaluation which could be used to better understand the economic 

effects of the Federal presence in participating school districts. The 

Committee requests to be kept informed of any steps taken in the 

planning for or development of such a study. 

Basic Support Payments 

The Committee recommends $1,320,242,000 for Basic Support Payments to LEAs, which is $50,000,000 above the fiscal year 2018 

enacted level and $131,009,000 above the fiscal year 2019 budget 

request. Basic Support Payments compensate school districts for 

lost tax revenue and are made on behalf of Federally-connected 

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children, such as children of members of the uniformed services 

who live on Federal property. 

Payments for Children with Disabilities 

The Committee recommends $48,316,000 for Payments for Children with Disabilities, which is the same as both the fiscal year 

2018 enacted level and the fiscal year 2019 budget request. These 

payments compensate school districts for the increased costs of 

serving Federally-connected children with disabilities. 

Facilities Maintenance 

The Committee recommends $4,835,000 for Facilities Maintenance, which is the same as both the fiscal year 2018 enacted level 

and the fiscal year 2019 budget request. These capital payments 

are authorized for maintenance of certain facilities owned by the 

Department. 

Construction 

The Committee recommends $17,406,000 for the Construction 

program, which is the same as both the fiscal year 2018 enacted 

level and the fiscal year 2019 budget request. This program provides competitive grants for building and renovating school facilities to school districts that educate Federally-connected students or 

have Federally-owned land. 

Payments for Federal Property 

The Committee recommends $75,313,000 for Payments for Federal Property, which $2,000,000 above the fiscal year 2018 enacted 

level and $75,313,000 above the fiscal year 2019 budget request. 

Funds are awarded to school districts to compensate for lost tax 

revenue as the result of Federal acquisition of real property since 

1938. 

SCHOOL IMPROVEMENT PROGRAMS

Appropriation, fiscal year 2018 ......................................................... $5,158,467,000 

Budget request, fiscal year 2019 ....................................................... 645,214,000 

Committee Recommendation ............................................................. 5,258,467,000 

Change from enacted level ......................................................... +100,000,000 

Change from budget request ...................................................... +4,613,253,000 

The School Improvement account includes programs authorized 

under Titles I, II, IV, VI, and VII of the ESEA; the McKinneyVento Homeless Assistance Act; Title IV-A of the Civil Rights Act; 

section 203 of the Educational Technical Assistance Act of 2002; 

and section 105 of the Compact of Free Association Amendments 

Act of 2003. 

Supporting Effective Instruction State Grants 

The Committee recommends $2,055,830,000 for Supporting Effective Instruction State Grants, which is the same as the fiscal year 

2018 enacted level and $2,055,830,000 above the fiscal year 2019 

budget request. These grants provide States and school districts 

with a flexible source of funding to strengthen the skills and 

knowledge of teachers, principals, and administrators to enable 

them to improve student achievement. 

133 

Supplemental Education Grants 

The Committee recommends $16,699,000 for Supplemental Education Grants to the Federated States of Micronesia and the Republic of the Marshall Islands, which is the same as both the fiscal 

year 2018 enacted level the fiscal year 2019 budget request. The 

Compact of Free Association Amendments Act of 2003 (PL 108– 

188) authorizes these entities to receive funding for general education assistance. The Committee recommendation includes a consolidated amount for Supplemental Education Grants because the 

underlying statute determines the allocation between Micronesia 

and the Marshall Islands. 

21st Century Community Learning Centers 

The Committee recommends $1,211,673,000 for 21st Century 

Community Learning Centers, which the same as the fiscal year 

2018 enacted level and $1,211,673,000 above the fiscal year 2019 

budget request. This program awards formula grants to States, 

which in turn distribute funds on a competitive basis to local school 

districts, nonprofit organizations, and other public entities. Funds 

may be used to provide activities that complement and reinforce 

the regular school-day program for participating students and may 

also fund local activities that are included as part of an expanded 

learning time program. 

State Assessments 

The Committee recommends $378,000,000 for State Assessments, 

which is the same as the fiscal year 2018 enacted level and 

$8,900,000 above the fiscal year 2019 budget request. Funds are 

available to develop and implement academic standards and assessments. The program includes a set-aside for audits to identify 

and eliminate low-quality or duplicative assessments. 

Education for Homeless Children and Youth 

The Committee recommends $85,000,000 for the Education for 

Homeless Children and Youth program, which is the same as the 

fiscal year 2018 enacted level and $8,000,000 above the fiscal year 

2019 budget request. The Committee recognizes that without an 

education, these at-risk children and youth are unlikely to obtain 

the skills they need to become productive adults contributing to the 

economy and their communities. Grants are allocated to States in 

proportion to the total each State receives under the Title I program. 

Training and Advisory Services 

The Committee recommends $6,575,000 for Training and Advisory Services authorized by Title IV–A of the Civil Rights Act, 

which is the same as both the fiscal year 2018 enacted level and 

the fiscal year 2019 budget request. Title IV–A authorizes technical 

assistance and training services for school districts to address problems associated with desegregation on the basis of race, sex, or national origin. The Department awards three-year grants to regional 

Equity Assistance Centers (EACs) located in each of the 10 Department of Education regions. The EACs provide services to school 

districts upon request. Typical activities include disseminating information on successful education practices and legal requirements 

134 

related to nondiscrimination on the basis of race, sex, and national 

origin in educational programs. 

Education for Native Hawaiians 

The Committee recommends $36,397,000 for the Education for 

Native Hawaiian program, which is the same as the fiscal year 

2018 level and $36,397,000 above the fiscal year 2019 budget request. Funds are used to provide competitive awards for supplemental education services to the Native Hawaiian population. 

Alaska Native Education Equity 

The Committee recommends $35,453,000 for the Alaska Native 

Education Equity program, which is the same as the fiscal year 

2018 level and $35,453,000 above the fiscal year 2019 budget request. Funds are used to provide competitive awards for supplemental education services to the Alaska Native population. 

Rural Education 

The Committee recommends $180,840,000 for Rural Education 

programs, which is the same as the fiscal year 2018 enacted level 

and $5,000,000 above the fiscal year 2019 budget request. There 

are two programs to assist rural school districts with improving 

teaching and learning in their schools: the Small, Rural Schools 

Achievement program, which provides funds to rural districts that 

serve a small number of students; and the Rural and Low-Income 

Schools program, which provides funds to rural districts that serve 

concentrations of poor students, regardless of the number of students served by the district. Funds appropriated for Rural Education shall be divided equally between these two programs. 

Comprehensive Centers 

The Committee recommends $52,000,000 for Comprehensive 

Centers, which is the same as the fiscal year 2018 enacted level 

and $52,000,000 above the fiscal year 2019 budget request. This 

grant program currently supports 22 comprehensive centers, including 15 regional centers that provide training, technical assistance, and professional development to build State capacity to provide high-quality education to all students. The remaining seven 

centers specialize in particular content areas. The Committee includes bill language directing the Secretary to ensure that the Bureau of Indian Education (BIE) has access to services provided 

under this section. 

Student Support and Academic Enrichment State Grants 

The Committee recommends $1,200,000,000 for Student Support 

and Academic Enrichment (SSAE) State Grants, which is 

$100,000,000 above the fiscal year 2018 enacted level and 

$1,200,000,000 above the fiscal year 2019 budget request. The 

Every Student Succeeds Act (ESSA) eliminated several narrowlyfocused competitive grant programs and replaced them with this 

new formula grant program. States and school districts have flexibility to focus these resources on locally-determined priorities to 

provide students with access to a well-rounded education, including 

rigorous coursework, and to improve school conditions and the use 

of technology. 

135 

Non-Cognitive Factors.—The Committee notes that programs designed to support non-cognitive factors such as critical thinking 

skills, social skills, work ethic, problem solving, and community responsibility are an eligible use of funds SSAE grants supporting a 

well-rounded education. 

School-Based Mental Health Services.—School districts are encouraged to consider using SSAE grants funds for services that promote mental wellness for all students while assessing and addressing students with more complex needs, including those who may be 

on the pathway to violence. The Committee is aware that access to 

school mental and behavioral health services contribute to improved student learning, a more positive school climate, and increased school safety. The Committee notes that SSAE permits districts to use portions of their allocations to invest in technology solutions that could assist school-based mental health professionals 

in identifying, assessing and tracking treatment for students with 

mental health issues, including monitoring students for signs that 

they are a potential danger to themselves or others. 

School Climate.—The Committee notes that SSAE funds provide 

opportunities to increase students’ access to STEM, computer 

science, music, physical education, the arts, college and career 

counseling, access to Advanced Placement classes, and other wellrounded education programs, which are critical to keeping students 

engaged in school and thriving academically, ultimately supporting 

a positive school climate. 

School Safety Measures.—Through SSAE grants, school districts 

should consider utilizing funds for security hardening measures. 

These security measures can include bullet resistant doors and 

glass with hinge-locking mechanisms, immediate notification systems to emergency 911, mechanisms that provide real time actionable intelligence direct to law enforcement and first responders, or 

installation of distraction devices or other countermeasures administered by law enforcement and first responders. 

INDIAN EDUCATION

Appropriation, fiscal year 2018 ......................................................... $180,239,000 

Budget request, fiscal year 2019 ....................................................... 164,939,000 

Committee Recommendation ............................................................. 180,239,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +15,300,000 

This account supports programs authorized by part A of title VI 

of the ESEA. 

Grants to Local Educational Agencies 

The Committee recommends $105,381,000 for Grants to Local 

Educational Agencies, which is the same as the fiscal year 2018 enacted level and $5,000,000 above the fiscal year 2019 budget request. This program provides assistance through formula grants to 

school districts and schools supported or operated by the Bureau of 

Indian Education. The purpose of this program is to improve elementary and secondary school programs that serve American Indian students, including preschool children. Grantees must develop 

a comprehensive plan and ensure that the programs they carry out 

will help Indian students reach the same challenging standards 

that apply to all students. This program supplements the regular 

136 

school program to help American Indian children sharpen their 

academic skills, bolster their self-confidence, and participate in enrichment activities that would otherwise be unavailable. 

Special Programs for Indian Children 

The Committee recommends $67,993,000 for Special Programs 

for Indian Children, which is the same as the fiscal year 2018 enacted level and $10,000,000 above the fiscal year 2019 budget request. These programs make competitive awards to improve the 

quality of education for American Indian students. The program 

also funds the American Indian Teacher Corps and the American 

Indian Administrator Corps to recruit and support American Indians as teachers and school administrators. 

National Activities 

The Committee recommends $6,865,000 for National Activities, 

which is the same as the fiscal year 2018 enacted level and 

$300,000 above the fiscal year 2019 budget request. Funds under 

this authority support (1) research, evaluation and data collection 

to provide information about the educational status of Indian students and the effectiveness of Indian education programs; (2) 

grants to support Native language immersion schools and programs; and (3) grants to Tribes for education administrative planning, development, and coordination. 

Language Immersion Program.—Within the total for National 

Activities, the Committee continues funding for the Native American and Alaska Native Language Immersion Program at the same 

level as the fiscal year 2019 budget request. This program, which 

was authorized in ESSA, will make grants to maintain and promote the use of Native languages, support Native language education and development, and provide professional development to 

teachers. 

State-Tribal Education Partnership.—The Committee recommends continued funding for the State-Tribal Education Partnership (STEP) program. This program makes grants to Tribes to 

build capacity to assume certain State responsibilities for the administration of ESEA programs. Indian educators have long called 

for Tribal-State-Federal partnerships to involve Indian Tribes in 

educating their students and to improve American Indian education outcomes. STEP programs have, and will continue to, assist 

State and Tribal governments to continue delivering the highest 

quality education for Indian students. 

INNOVATION AND IMPROVEMENT

Appropriation, fiscal year 2018 ......................................................... $982,256,000 

Budget request, fiscal year 2019 ....................................................... 1,777,647,000 

Committee Recommendation ............................................................. 1,058,441,000 

Change from enacted level ......................................................... +76,185,000 

Change from budget request ...................................................... -719,206,000 

This appropriation account includes programs authorized under 

portions of Titles II and IV of the ESEA. 

The Committee is aware of the proposal to include $1,000,000,000 for grants to local educational agencies and nonprofit organizations to implement a program of awarding scholarship to students of low-income families to attend a private or public 

137 

school selected by their families. The Committee notes that such a 

program has not been authorized. Accordingly, the Committee has 

not provided funding for such a program within this bill. Funding 

for this approach will be considered should a program be authorized in law. 

Education Innovation and Research 

The Committee recommends $145,000,000 for the Education Innovation and Research program. This amount is $25,000,000 above 

the fiscal year 2018 enacted level and $35,000,000 below the fiscal 

year 2019 budget request. This program makes competitive grants 

to support the replication and scaling-up of evidence-based education innovations. The funding will support a competition to promote innovation and reform in science, technology, engineering, 

and mathematics (STEM) education, including computer science. 

Coupled with dedicated funding in the Career, Technical, and 

Adult Education account, this increase will help support the Administration’s commitment to STEM education. 

Partnerships with Rural Schools.—The Department is encouraged to work with institutions of higher learning or other relevant 

stakeholders who can partner with rural school districts on STEM 

education, including efforts to bring ‘‘makerspace’’ opportunities to 

schools. 

STEM and Computer Science Education.—The Committee notes 

that funds available under this program may be used by States and 

school districts to provide or strengthen instruction in STEM fields, 

including computer science. The Committee recognizes the importance of funding Pre K–12 computer science education that addresses the enrollment and achievement gap for underrepresented 

students such as minorities, girls, and youth from families living 

at or below the poverty line. Supporting education in the science, 

technology, engineering, arts, and mathematics fields, particularly 

computer science, is critical to ensure that our nation continues to 

lead in innovation. As computer science is a basic skill in the 21st 

century global economy, the Committee encourages the Department 

to support Pre K–12 computer science education to schools across 

the country. 

Teacher and School Leader Incentive Grants 

The Committee recommends $200,000,000 for the Teacher and 

School Leader Incentive Grants program, which is the same as the 

fiscal year 2018 enacted level and $200,000,000 above the fiscal 

year 2019 budget request. This program provides grants to States, 

school districts, and partnerships to develop, implement, improve, 

or expand human capital management systems or performancebased compensation systems in schools. 

American History and Civics Academies 

The Committee recommends $4,700,000 for American History 

and Civics National Activities, which is $3,000,000 above the fiscal 

year 2018 enacted level and $4,700,000 above the fiscal year 2019 

budget request. This program reaches a limited number of teachers 

and students since an academy may select no more than 300 teachers or students for participation. 

138 

American History and Civics National Activities 

The Committee recommends $1,700,000 for American History 

and Civics National Activities, the same as the fiscal year 2018 enacted level and $1,700,000 above the fiscal year 2019 budget request. The Committee recognizes the importance of improving the 

quality of instruction in American history, civics, and geography, 

particularly for schools in underserved rural and urban communities. In recognition of the fact that no one size fits all in effective 

education, and that a variety of approaches are required to meet 

the range of student and community needs, these competitive 

grants will support multiple grantees in making available a menu 

of innovative, effective approaches to teaching American history, 

civics and government, and geography. These validated approaches 

will be available to schools and school districts for their consideration and voluntary use, based on the approach that best meets the 

needs of the students and community. 

Supporting Effective Educator Development 

The Committee recommends $75,000,000 for the Supporting Effective Educator Development (SEED) grant program, which is the 

same as the fiscal year 2018 level and $75,000,000 above the fiscal 

year 2019 budget request. SEED provides competitive grants to Institutions of Higher Education (IHEs), national nonprofit organizations, BIE, and partnerships to support alternative certification 

and other professional development and enrichment activities for 

teachers, principals, and other school leaders. Funds are included 

to fully support continuation costs for grants made in prior years. 

Charter Schools Grants 

The Committee recommends $450,000,000 for Charter Schools 

Grants, which is $50,000,000 above the fiscal year 2018 enacted 

level and $50,000,000 below the fiscal year 2019 budget request. 

The Committee recommends an allocation of funds within this program that aligns with ESSA. 

In exchange for a commitment to increase student achievement, 

charter schools are exempt from many statutory and regulatory requirements. The Charter Schools Grants program awards grants to 

State Educational Agencies (SEAs) or, if a State’s SEA chooses not 

to participate, to charter school developers to support the development and initial implementation of public charter schools. State 

Facilities Incentive Grants and Credit Enhancement for Charter 

School Facilities awards help charter schools obtain adequate 

school facilities. These programs work in tandem to support the development and operation of charter schools. 

Maximizing State Grant Competition Impact.—In the reauthorization of the ESEA, Congress determined that 65 percent of the 

funding for charter schools should go to State grants and, in doing 

so, expanded the use of funds to include replication and expansion 

of high quality charter schools. Funds should be used to support 

high-quality models along with promising new charter schools to 

provide the best education options for students. The Committee 

recommends that the Secretary issue clarifying guidance to ensure 

States understand the flexibility they have to use charter school 

funds to support the growth of high-quality charter schools with a 

demonstrated track record of academic achievement. Guidance 

139 

should clarify that States may look at how to meet strong parent 

demand for new or replicated or expanded charter school models 

when awarding subgrants. The Secretary should also make every 

effort to help States improve authorizing by providing guidance to 

States on utilizing the technical assistance funds. 

Magnet Schools Assistance 

The Committee recommends $105,000,000 for the Magnet 

Schools Assistance program, which is the same as the fiscal year 

2018 enacted level and $7,353,000 above the fiscal year 2019 budget request. This program makes competitive grants to support the 

establishment and operation of magnet schools that are a part of 

a court-ordered or Federally-approved voluntary desegregation 

plan. 

Ready to Learn Programming 

The Committee recommends $27,741,000 for Ready to Learn Programming, which is the same as the fiscal year 2018 enacted level 

and $27,741,000 above the fiscal year 2019 budget request. This 

program supports the development and distribution of educational 

video programming for preschool and elementary school children 

and their parents, caregivers, and teachers. 

Arts in Education 

The Committee recommends $29,000,000 for Arts in Education, 

which is the same as the fiscal year 2018 level and $29,000,000 

above the fiscal year 2019 budget request. This program provides 

competitive grants to support professional development and the development of instructional materials and programming that integrate the arts into the curricula. 

Javits Gifted and Talented Education 

The Committee recommends $12,000,000 for the Javits Gifted 

and Talented Education Program, which is the same as the fiscal 

year 2018 enacted level and $12,000,000 above the 2019 budget request. This program makes grants and contracts to States, schools 

districts, and other organizations to support a coordinated program 

of research, demonstration projects, innovative strategies, and 

other activities to help schools identify gifted and talented students 

and address their unique educational needs. 

Statewide Family Engagement Centers 

The Committee recommends $10,000,000 for Statewide Family 

Engagement Center grants, which is the same as fiscal year 2018 

and $10,000,000 above the 2019 budget request. This program 

makes grants to organizations to provide technical assistance and 

training to State and local educational agencies in the implementation and enhancement of systemic and effective family engagement 

policies, programs, and activities that lead to improvements in student development and academic achievement. 

140 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION

Appropriation, fiscal year 2018 ............................................. $185,754,000 

Budget request, fiscal year 2019 ........................................... 43,000,000 

Committee Recommendation ................................................. 185,754,000 

Change from enacted level ............................................. – – – 

Change from budget request .......................................... +142,754,000 

This appropriation account includes programs authorized under 

parts of Title IV of the ESEA. 

Promise Neighborhoods 

The Committee recommends $78,254,000 for Promise Neighborhoods, which is the same as the fiscal year 2018 enacted level and 

$78,254,000 above the fiscal year 2019 budget request. Promise 

Neighborhoods supports grants to nonprofit, community-based organizations for the development of comprehensive neighborhood 

programs designed to combat the effects of poverty and improve 

educational outcomes for children and youth, from birth through 

college. 

School Safety National Activities 

The Committee recommends $90,000,000 for School Safety National Activities, which is the same as the fiscal year 2018 enacted 

level and $47,000,000 above the fiscal year 2019 budget request. 

The funding will support a new cohort of School Climate Transformation Grants which will enable State or local educational agencies to develop, adopt, or expand to more schools, and support the 

implementation of evidence-based practices to improve behavior 

and school climates. This cohort of grants will be used to focus on 

some of the effects of the opioid epidemic in schools. Funding could 

support evidence-based strategies for prevention of opioid abuse by 

students, we all as addressing the mental health needs of students 

adversely impacted by opioid use in their family or community. The 

Committee urges the Department to prioritize communities that 

have experienced high levels of trauma due to the opioid crisis, as 

described in the fiscal year 2019 budget request. 

The Project School Emergency Response to Violence (Project 

SERV) program provides counseling and referral to mental health 

services as well as other education-related services to LEAs and 

IHEs in which the learning environment has been disrupted by a 

violent or traumatic crisis. The Committee directs the Department 

to report to the Committee on Appropriations of the House of Representatives and the Senate within 180 days of enactment of this 

Act on how fiscal years 2017 and 2018 grant recipients used Project 

SERV funds; recommendations from grant recipients on how the 

program could be improved; and, information on how these funds 

helped them recover from a violent or traumatic crisis. 

Full-Service Community Schools 

The Committee recommends $17,500,000 for Full-Service Community Schools, which is the same as the fiscal year 2018 level and 

$17,500,000 above the fiscal year 2019 budget request. This program makes competitive grants to support school-based comprehensive services for students, families, and communities. 

141 

ENGLISH LANGUAGE ACQUISITION

Appropriation, fiscal year 2018 ......................................................... $737,400,000 

Budget request, fiscal year 2019 ....................................................... 737,400,000 

Committee Recommendation ............................................................. 737,400,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... – – – 

Of this amount provided for the 2019–2020 academic year, funds 

are appropriated for obligation on or after July 1, 2019 and available through September 30, 2020. 

This program provides formula grants to States to serve English 

learner (EL) students. Grants are based on each State’s share of 

the National EL, students and recent immigrant student population. Funds under this account also support professional development to increase the pool of teachers prepared to serve EL students 

activities and the National Clearinghouse for English Language Acquisition. 

SPECIAL EDUCATION

Appropriation, fiscal year 2018 ......................................................... $13,366,184,000 

Budget request, fiscal year 2019 ....................................................... 13,051,775,000 

Committee Recommendation ............................................................. 13,422,651,000 

Change from enacted level ......................................................... +56,467,000 

Change from budget request ...................................................... +370,876,000 

Of the total amount available, $3,709,465,000 is available for obligation on July 1, 2019, and $9,483,383,000 is available for obligation on October 1, 2019. These grants help States and localities pay 

for a free appropriate education for 6.7 million students with disabilities aged 3 through 21. 

Grants to States 

The Committee recommends $12,327,848,000 for Part B Grants 

to States, which is $50,000,000 above the fiscal year 2018 enacted 

level and $325,000,000 above the fiscal year 2019 budget request. 

This program provides formula grants to assist States in meeting 

the costs of providing special education and related services to children with disabilities. States generally transfer most of the funds 

to LEAs; however, they can reserve some funds for program monitoring, technical assistance, and other related activities. In order to 

be eligible for funds, States must make free appropriate public education available to all children with disabilities. 

The Committee continues to include bill language excluding any 

amount by which a State’s allocation is reduced for failure to meet 

the maintenance of effort threshold from being used to calculate 

the State’s allocation under section 611(d) of the Individuals with 

Disabilities Education Act (IDEA) in subsequent years. The Committee also continues to include bill language directing the Secretary to distribute any reduction in a State’s allocation under said 

section to all other States based on the formula established under 

section 611(d), excluding those States that are penalized. 

Preschool Grants 

The Committee recommends $395,000,000 for Preschool Grants, 

which is $13,880,000 above the fiscal year 2018 enacted level and 

$26,762,000 above the fiscal year 2019 budget request. These funds 

provide additional assistance to States to help them make free, apVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00141 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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propriate public education available to children with disabilities 

ages 3 through 5. 

Grants for Infants and Families 

The Committee recommends $470,000,000 for Grants for Infants 

and Families, which is the same as the fiscal year 2018 enacted 

level and $11,444,000 above the fiscal year 2019 budget request. 

These funds provide additional assistance to States to help them 

make free, appropriate public education available to children with 

disabilities from birth through age 2. The Committee notes the Department’s focus on communicating to States that this funding can 

be used to help address the needs of the growing population of infants and toddlers that are likely to require early intervention services due to substance use disorders, including opioid use disorder, 

among parents and families. 

IDEA National Activities 

The Committee recommends $229,803,000 for the IDEA National 

Activities program, which is $7,413,000 below the fiscal year 2018 

enacted level and $7,670,000 above the fiscal year 2019 budget request. The IDEA National Activities programs support State efforts 

to improve early intervention and education results for children 

with disabilities. 

Educational Technology, Media, and Materials.—The Committee 

recommends $28,047,000 for Educational Technology, Media, and 

Materials, which is the same as both the fiscal year 2018 enacted 

level and the fiscal year 2019 budget request. This program makes 

competitive awards to support the development, demonstration, 

and use of technology and educational media activities of educational value to children with disabilities. The Committee recognizes the ongoing progress made with the tools and services provided under this program that have allowed more than 535,000 

students with disabilities free access to more than 600,000 books 

in digitally accessible formats. The Committee strongly encourages 

continued effort to expand this program’s reach to K–12 students 

in underserved areas. 

Parent Information Centers.—The Committee recommends 

$27,411,000 for Parent Information Centers, which is the same as 

both the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. This program makes awards to parent organizations to support Parent Training and Information Centers, including community parent resource centers. These centers provide 

training and information to meet the needs of parents of children 

with disabilities living in the areas served by the centers, particularly underserved parents and parents of children who may be inappropriately identified. Technical assistance is also provided 

under this program for developing, assisting, and coordinating centers receiving assistance under this program. 

Personnel Preparation.—The Committee recommends 

$89,000,000 for Personnel Preparation, which is $5,300,000 above 

both the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. This program supports competitive awards to help 

address State-identified needs for qualified personnel to work with 

children with disabilities, and to ensure that those personnel have 

the necessary skills and knowledge to serve children with special 

143 

needs. Awards focus on addressing the need for leadership and personnel to serve low-incidence populations. Funds are included to 

fully support continuation costs for grants made in prior years. The 

Committee is concerned about a shortage of teachers of deaf students and urges the Department to consider revisiting policy 

changes it has made in recent years which may have exacerbated 

this problem. 

State Personnel Development.—The Committee recommends 

$41,000,000 for State Personnel Development, which is $2,370,000 

above both the fiscal year 2018 enacted level and the fiscal year 

2019 budget request. This program supports grants to States to assist with improving personnel preparation and professional development related to early intervention and educational and transition 

services that improve outcomes for students with disabilities. 

Funds are included to fully support continuation costs for grants 

made in prior years. 

Technical Assistance and Dissemination.—The Committee recommends $44,345,000 for Technical Assistance and Dissemination, 

which is $15,083,000 below the fiscal year 2018 enacted level and 

the same as the fiscal year 2019 budget request. This program provides funding for technical assistance, demonstration projects, and 

information dissemination. These funds support efforts by State 

and local educational agencies, IHEs, and other entities to build 

State and local capacity to make systemic changes and improve results for children with disabilities. Funds are included to fully support continuation costs for grants made in prior years. 

REHABILITATION SERVICES

Appropriation, fiscal year 2018 ............................................. $3,587,130,000 

Budget request, fiscal year 2019 ........................................... 3,634,977,000 

Committee Recommendation ................................................. 3,657,689,000 

Change from enacted level ............................................. +70,559,000 

Change from budget request .......................................... +22,712,000 

The programs in this account are authorized by the Rehabilitation Act of 1973 and the Helen Keller National Center Act. 

The Achieving a Better Live Experience Act of 2014 or ABLE Act 

(PL 113–295) allows individuals and families to save for the purpose of supporting individuals with disabilities in maintaining their 

health, independence, and quality of life. The Committee strongly 

encourages the Department, through its programs supporting individuals living with a disability, to raise awareness on the eligibility 

and benefits of these accounts. 

Vocational Rehabilitation State Grants 

The Committee recommends $3,521,990,000 for Vocational Rehabilitation (VR) State Grants, which is $69,059,000 above the fiscal 

year 2018 enacted level and the same as the fiscal year 2019 budget request. 

This program supports basic vocational rehabilitation services 

through formula grants to States. These grants support a wide 

range of services designed to help persons with physical and mental disabilities prepare for and engage in gainful employment to the 

extent of their capabilities. Emphasis is placed on providing vocational rehabilitation services to persons with the most significant 

disabilities. The Committee’s recommendation provides the cost-ofVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00143 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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living adjustment for Vocational Rehabilitation Grants to States, as 

authorized. 

The Committee is concerned with inconsistencies that have resulted from the Department of Education’s final rule and regulations to implement the Workforce Innovation and Opportunity Act 

as it relates to State VR programs. The Committee is aware of reports of inconsistent implementation of this regulation by State vocational rehabilitation agencies and their work with non-profits 

within the AbilityOne Program and State use programs. 

The Committee encourages the Rehabilitation Services Administration to issue updated guidance to state vocational rehabilitation 

agencies that would (1) require them to give full consideration to 

all employment opportunities at AbilityOne and State use providers, and make determinations on a case-by-case basis with an 

emphasis on the quality of the job placement (i.e. more work hours, 

benefit eligible and overall compensation), and (2) honor a client’s 

informed choice to work with AbilityOne and State use providers. 

Additionally, the Committee encourages the Rehabilitation Services Administration to restore the uncompensated outcomes category (Homemaker Exemption), which would allow individuals experiencing vision loss to have the opportunity to learn important 

life skills and be given the opportunity to regain personal confidence and achieve independence prior to making any decisions 

about reentering the workforce. 

Client Assistance State Grants 

The Committee recommends $13,000,000 for Client Assistance 

State Grants, which is the same as both the fiscal year 2018 enacted level the fiscal year 2019 budget request. Client Assistance 

State Grants support services for eligible individuals and applicants of the VR State Grants program, and other programs, 

projects, and services funded under the Rehabilitation Act. These 

formula grants are used to help persons with disabilities overcome 

problems with the service delivery system and improve their understanding of services available to them under the Rehabilitation Act. 

Training 

The Committee recommends $29,388,000 for the Training program, which is the same as both the fiscal year 2018 enacted level 

and the fiscal year 2019 budget request. The program supports 

long-term and short-term training, in-service personnel training, 

and training of interpreters for deaf persons. Projects in a broad 

array of disciplines are funded to ensure that skilled personnel are 

available to serve the vocational needs of persons with disabilities. 

Funds are included to fully support continuation costs for grants 

made in prior years. 

Demonstration and Training Programs 

The Committee recommends $5,796,000 for Demonstration and 

Training Programs, which is the same as the fiscal year 2018 enacted level and $3,500,000 below the fiscal year 2019 budget request. These programs authorize competitive grants to public and 

private organizations to support demonstrations, direct services, 

and related activities for persons with disabilities. 

145 

Protection and Advocacy of Individual Rights 

The Committee recommends $17,650,000 for Protection and Advocacy of Individual Rights, which is the same as both the fiscal 

year 2018 enacted level and the fiscal year 2019 budget request. 

Grants are awarded to entities that have the authority to pursue 

legal, administrative, and other appropriate remedies to protect 

and advocate for the rights of persons with disabilities. 

Supported Employment State Grants 

The Committee recommends $22,548,000 for Supported Employment State Grants, which is the same as the fiscal year 2018 enacted level and $22,548,000 above the fiscal year 2019 budget request. These formula grants assist States in developing collaborative programs with public agencies and nonprofit agencies for 

training and post-employment services leading to supported employment. In supported employment programs, persons with the 

most significant disabilities are given special supervision and assistance to enable them to work in an integrated setting. 

Independent Living Services for Older Individuals Who Are Blind 

The Committee recommends $33,317,000 for Independent Living 

Services for Older Individuals Who Are Blind, which is the same 

as both the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. Funds are distributed to States according to a formula based on the population of individuals who are 55 or older, 

and provide support for services to persons 55 years old or over 

whose severe visual impairment makes gainful employment extremely difficult to obtain, but for whom independent living goals 

are feasible. 

Helen Keller National Center 

The Committee recommends $14,000,000 for the Helen Keller 

National Center for Deaf-Blind Youth and Adults, which is 

$1,500,000 above the fiscal year 2018 enacted level and $3,664,000 

above the fiscal year 2019 budget request. These funds are used for 

the operation of a national center that provides intensive services 

for deaf-blind individuals and their families at Sands Point, New 

York, and a network of ten regional offices that provide referral, 

counseling, transition services, and technical assistance to service 

providers. 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES

Appropriation, fiscal year 2018 ......................................................... $228,431,000 

Budget request, fiscal year 2019 ....................................................... 216,722,000 

Committee Recommendation ............................................................. 237,792,000 

Change from enacted level ......................................................... +9,361,000 

Change from budget request ...................................................... +21,070,000 

The Committee recommends $237,792,000 for Special Institutions for Persons with Disabilities, which is $9,361,000 above the 

fiscal year 2018 enacted level and $21,070,000 above the fiscal year 

2019 budget request. 

The Achieving a Better Live Experience Act of 2014 or ABLE Act 

(PL 113–295) allows individuals and families to save for the purpose of supporting individuals with disabilities in maintaining their 

health, independence, and quality of life. The Committee strongly 

146 

encourages these Special Institutions, through its programs supporting individuals living with a disability, to raise awareness on 

the eligibility and benefits of these accounts. 

AMERICAN PRINTING HOUSE FOR THE BLIND

Appropriation, fiscal year 2018 ......................................................... $27,431,000 

Budget request, fiscal year 2019 ....................................................... 25,431,000 

Committee Recommendation ............................................................. 28,431,000 

Change from enacted level ......................................................... +1,000,000 

Change from budget request ...................................................... +3,000,000 

This funding subsidizes the production of educational materials 

for legally blind persons enrolled in pre-college programs. The 

American Printing House for the Blind (Printing House), which is 

chartered by the Commonwealth of Kentucky, manufactures and 

maintains an inventory of educational materials in accessible formats that are distributed free of charge to schools and States based 

on the number of blind students in each State. The Printing House 

also conducts research and field activities to inform educators 

about the availability of materials and how to use them. 

NATIONAL TECHNICAL INSTITUTE FOR THE DEAF

Appropriation, fiscal year 2018 ......................................................... $73,000,000 

Budget request, fiscal year 2019 ....................................................... 70,016,000 

Committee Recommendation ............................................................. 75,000,000 

Change from enacted level ......................................................... +2,000,000 

Change from budget request ...................................................... +4,984,000 

Congress established the National Technical Institute for the 

Deaf (Institute) in 1965 to provide a residential facility for postsecondary technical training and education for deaf persons with the 

purpose of promoting the employment of these individuals. The Institute also conducts applied research and provides training related 

to various aspects of deafness. The Secretary of Education administers these activities through a contract with the Rochester Institute of Technology in Rochester, New York. 

GALLAUDET UNIVERSITY

Appropriation, fiscal year 2018 ......................................................... $128,000,000 

Budget request, fiscal year 2019 ....................................................... 121,275,000 

Committee Recommendation ............................................................. 134,361,000 

Change from enacted level ......................................................... +6,361,000 

Change from budget request ...................................................... +13,086,000 

Gallaudet is a private, non-profit educational institution Federally chartered in 1864 providing elementary, secondary, undergraduate, and continuing education for deaf persons. In addition, 

the University offers graduate programs in fields related to deafness for deaf and hearing students, conducts research on deafness, 

and provides public service programs for deaf persons. 

CAREER, TECHNICAL, AND ADULT EDUCATION

Appropriation, fiscal year 2018 ......................................................... $1,830,686,000 

Budget request, fiscal year 2019 ....................................................... 1,637,159,000 

Committee Recommendation ............................................................. 1,945,265,000 

Change from enacted level ......................................................... +114,579,000 

Change from budget request ...................................................... +308,106,000 

147 

This account includes vocational education programs authorized 

by the Carl D. Perkins Career and Technical Education Act of 2006 

and the Adult Education and Family Literacy Act (AEFLA). 

Career and Technical Education: State Grants 

The Committee recommends $1,294,598,000 for Career and Technical Education: State Grants, which is $102,000,000 above the fiscal year 2018 enacted level and $177,000,000 above the fiscal year 

2019 budget request. Funds are made available for obligation on 

October 1, 2019. 

State Grants support a variety of career and technical education 

programs developed in accordance with the State plan. This program focuses Federal resources on institutions with high concentrations of low-income students. The populations assisted by State 

Grants range from secondary students in pre-vocational courses to 

adults who need retraining to adapt to changing technological and 

labor markets. Funding for State Grants will continue support for 

state-of-the art career and technical training to approximately 6 

million students in secondary schools and more than 4 million students in community and technical colleges. 

National Programs 

The Committee recommends $20,000,000 for National Programs, 

which is $12,579,000 above the fiscal year 2018 enacted level and 

the same as the fiscal year 2019 budget request. This authority 

supports the conduct and dissemination of research in career and 

technical education. It also includes support for the National Centers for Research and Dissemination in Career and Technical Education and other discretionary research. The funding will support 

a competition to promote innovation and reform in STEM education, including computer science. Coupled with dedicated funding 

in the Education Innovation and Research account, this increase 

will help support the Administration’s commitment to STEM education. 

Adult Basic and Literacy Education State Grants 

The Committee recommends $616,955,000 for Adult Basic and 

Literacy Education State Grants, which is the same as the fiscal 

year 2018 enacted level and $131,106,000 above the fiscal year 

2019 budget request. State formula grants, authorized under the 

AEFLA, support programs to enable all adults to acquire basic literacy skills, to enable those who so desire to complete secondary 

education, and to make available to adults the means to become 

more employable, productive, and responsible citizens. 

Adult Education National Leadership Activities 

The Committee recommends $13,712,000 for National Leadership 

Activities, which is the same as both the fiscal year 2018 enacted 

level the fiscal year 2019 budget request. This program supports 

applied research, development, dissemination, evaluation, and program improvement efforts to strengthen the quality of adult education services. 

148 

STUDENT FINANCIAL ASSISTANCE

Appropriation, fiscal year 2018 ......................................................... $24,445,352,000 

Budget request, fiscal year 2019 ....................................................... 22,975,352,000 

Committee Recommendation ............................................................. 24,445,352,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +1,470,000,000 

Financial Supports for Students.—The Committee recognizes 

that financial pressures are among the reasons why students are 

unable to complete postsecondary education programs, especially 

for low-income and non-traditional students. The Committee requests the Department to provide a briefing within 180 days of enactment of this Act on what financial supports have the greatest 

impact on student persistence and completion. The Department 

should consider students enrolled in career and technical education 

programs, community colleges, and four-year baccalaureate programs in developing this analysis. 

Pell Grants 

The Committee recommends $22,475,352,000 for the Pell Grant 

program, which is the same as both the fiscal year 2018 enacted 

level and the fiscal year 2019 budget request. These funds will support Pell grants to students for the 2019–2020 academic year. 

The Congressional Budget Office estimates that the budget authority provided in this bill is sufficient to maintain the discretionary portion of the maximum Pell Grant award at $5,035. Combined with mandatory funding streams, the maximum Pell Grant 

in 2019–2020 will be maintained at $6,095. 

Pell Grants help to ensure access to higher educational opportunities for low- and middle-income students by providing need-based 

financial assistance. Grants are determined according to a statutory formula, which considers income, assets, household size, and 

the number of family members in college, among other factors. Pell 

Grants are the foundation of Federal postsecondary student aid 

programs. 

The Committee recommends that the Department take further 

steps to promote year-round Pell, in accordance with the Higher 

Education Opportunity Act of 2008 (PL 110–315), to help students 

to remain continuously enrolled and stay on track for graduation. 

Federal Supplemental Educational Opportunity Grants 

The Committee recommends $840,000,000 for this program, 

which is the same as the fiscal year 2018 enacted level and 

$840,000,000 above the fiscal year 2019 budget request. Supplemental Educational Opportunity Grants (SEOG) provide funds to 

postsecondary institutions for need-based grants of up to $4,000 to 

undergraduate students, with priority given to students who are 

Pell-eligible. Approximately 68 percent of dependent recipients 

have annual family incomes under $30,000 and nearly 74 percent 

of independent SEOG recipients have annual family incomes under 

$20,000. Institutions must contribute a 25 percent match toward 

their SEOG allocation. 

Federal Work-Study 

The Committee recommends $1,130,000,000 for the Federal 

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149 

acted level and $630,000,000 above the fiscal year 2019 budget request. Federal Work-Study funds are provided through institutions 

to students who work part-time. The funds assist with paying for 

the cost of education. Approximately 3,200 colleges and universities 

receive funding, according to a statutory formula, and may allocate 

it for job location and job development centers. Work-study jobs 

must pay at least the Federal minimum wage and institutions 

must provide 25 percent of student earnings. 

Within the total funding level for the Federal Work-Study pro- gram, the Committee recommends $9,625,000 for the Work Colleges program, which is the same as the fiscal year 2018 enacted 

level. The Work Colleges program is authorized under section 448 

of the Higher Education Act (HEA) and supports institutions that 

require all resident students to participate in a work-learning program. 

STUDENT AID ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $1,678,943,000 

Budget request, fiscal year 2019 ....................................................... 1,772,000,000 

Committee Recommendation ............................................................. 1,678,943,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥93,057,000 

Programs administered under the Student Aid Administration 

(SAA) include Pell Grants, campus-based programs, Teacher Education Assistance for College and Higher Education grants, and 

Federal student loan programs. 

Salaries and Expenses.—Within the total provided for SAA, the 

Committee recommends $698,943,000 for salaries and expenses, 

which is the same as the fiscal year 2018 enacted level and 

$63,057,000 below the fiscal year 2019 request. 

Loan Servicing Activities.—Within the total provided for SAA, 

the Committee recommends $980,000,000 for Loan Servicing Activities, which is the same as the fiscal year 2018 enacted level and 

$30,000,000 below the fiscal year 2019 request. 

Small Business Credit.—The Committee directs the Small Business Administration to provide subcontracting small business credit under Department of Education Title IV program contracts 

where the prime contractors’ award subcontracts to small businesses as well as to qualified State or nonprofit entities with expertise in assisting students and borrowers in support of Title IV programs. Under this authority, subcontracts awarded to such entities 

may be counted toward the prime contractor’s small business subcontracting goals as established through subcontracting plans required by 15 U.S.C. 637(d). The Small Business Administration 

may provide this small business credit for the duration of the contracts currently in effect for servicing or collection of student loans 

and for any contracts awarded for support of Title IV programs for 

a period of five years following publication of this report. Such 

State or nonprofit entities must meet the size standard for the 

North American Industry Classification System determined by the 

Contracting Officer to be appropriate for the contract. 

The Department shall coordinate the identification of all prime 

and subcontracts awarded to State and nonprofit entities under 

Title IV program contracts to the Small Business Administration so 

that subcontract reporting may be appropriately monitored. Five 

150 

years after publication of this report, the Small Business Administration, in coordination with the Department of Education, shall 

examine the impact of this provision to small businesses in Title 

IV programs. 

Defaulted Student Loan Debt Collection.—The Committee understands the Department is continuing to consider options for the collection of debt from defaulted student loan borrowers. In considering any new contract award for debt collection services, the Committee encourages the Secretary to allocate new defaulted student 

loan borrower accounts to private collection agencies on the basis 

of their performance compared to all private collection agencies utilizing common performance and compliance metrics and the capacity of each contractor to process new and existing accounts. The 

Committee also encourages the Secretary to share the common performance and compliance metrics with the Committees on Appropriations of the House of Representatives and the Senate, as well 

as authorizing Committees of jurisdiction, and report quarterly to 

such Committees on all contractor performance concerning these 

metrics. 

Free Application for Federal Student Aid.—The Committee encourages the Secretary of Education to translate the Free Application for Federal Student Aid into additional foreign languages and 

to make the translated forms available to applicants and their parents in paper and electronic formats. 

HIGHER EDUCATION

Appropriation, fiscal year 2018 ......................................................... $2,246,551,000 

Budget request, fiscal year 2019 ....................................................... 1,485,848,000 

Committee Recommendation ............................................................. 2,300,551,000 

Change from enacted level ......................................................... +54,000,000 

Change from budget request ...................................................... +814,703,000 

Strengthening Institutions 

The Committee recommends $98,886,000 for the Part A, 

Strengthening Institutions program, which is the same as the fiscal 

year 2018 enacted level and $98,886,000 above the fiscal year 2019 

budget request. This program provides competitive grants for general operating subsidies to institutions with low average educational and general expenditures per student and significant percentages of low-income students. Funds may be used for faculty 

and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student 

services. 

Strengthening Hispanic-Serving Institutions 

The Committee recommends $123,183,000 for the Hispanic-Serving Institutions program, which is the same as the fiscal year 2018 

enacted level and $123,183,000 above the fiscal year 2019 budget 

request. The Hispanic-Serving Institutions program provides operating subsidies to schools that serve at least 25 percent Hispanic 

students. Funds may be used for faculty and academic program development, management, joint use of libraries and laboratories, acquisition of equipment, and student services. 

151 

Promoting Postbaccalaureate Opportunities for Hispanic Americans 

The Committee recommends $11,052,000 for the Promoting 

Postbaccalaureate Opportunities for Hispanic Americans program, 

which is the same as the fiscal year 2018 enacted level and 

$11,052,000 above the fiscal year 2019 budget request. This program provides expanded postbaccalaureate educational opportunities for the academic attainment of Hispanic and low-income students. In addition, it expands academic offerings and enhances program quality at IHEs educating the majority of Hispanic college 

students. 

Strengthening Historically Black Colleges and Universities 

The Committee recommends $279,624,000 for Strengthening Historically Black Colleges and Universities (HBCUs), which is the 

same as the fiscal year 2018 enacted level and $34,930,000 above 

the fiscal year 2019 budget request. This program provides operating subsidies to accredited, historically black colleges and universities that were established prior to 1964, with the principal mission of educating black Americans. Funds are distributed through 

a formula grant based on the enrollment of Pell Grant recipients, 

number of graduates, and the number of graduates entering graduate or professional schools in which blacks are underrepresented. 

Strengthening Historically Black Graduate Institutions 

The Committee recommends $72,314,000 for the Strengthening 

Historically Black Graduate Institutions program, which is the 

same as the fiscal year 2018 enacted level and $9,033,000 above 

the fiscal year 2019 budget request. The program provides five-year 

grants to 18 postsecondary institutions that are specified in section 

326(e)(1) of the Higher Education Act. Institutions may use funds 

to build endowments, provide scholarships and fellowships, and to 

assist students with the enrollment and completion of 

postbaccalaureate and professional degrees. 

Strengthening Predominantly Black Institutions 

The Committee recommends $11,361,000 for the Strengthening 

Predominantly Black Institutions (PBIs) program, which is the 

same as the fiscal year 2018 enacted level and $11,361,000 above 

the fiscal year 2019 budget request. This program provides grants 

to PBIs to increase their capacity to serve the academic needs of 

students. 

Strengthening Asian American and Native American 

Pacific-Islander-Serving Institutions 

The Committee recommends $3,826,000 for the Asian American 

Pacific Islander program, which is the same as the fiscal year 2018 

enacted level and $3,826,000 above the fiscal year 2019 budget request. This program provides grants to undergraduate institutions 

that have an undergraduate student enrollment of at least 10 percent Asian American or Native American Pacific Islander. 

Strengthening Alaska Native and Native Hawaiian-Serving 

Institutions 

The Committee recommends $15,772,000 for the Strengthening 

Alaska Native and Native Hawaiian-Serving Institutions program, 

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which is the same as the fiscal year 2018 enacted level and 

$15,772,000 above the fiscal year 2019 budget request, to provide 

competitive grants to improve capacity to serve Alaska Native and 

Native Hawaiian students. 

Native American Serving Non-Tribal Institutions 

The Committee recommends $3,826,000 for the Native American 

Serving Non-Tribal Institutions program, which is the same as the 

fiscal year 2018 enacted level and $3,826,000 above the fiscal year 

2019 budget request. This program makes grants to IHEs at which 

enrollment is at least 10 percent Native American students and 

that are not Tribally-Controlled Colleges or Universities. 

Strengthening Tribally Controlled Colleges and Universities 

The Committee recommends $31,539,000 for the Strengthening 

Tribally Controlled Colleges and Universities (TCCUs) program, 

which is the same as the fiscal year 2018 enacted level and 

$3,940,000 above the fiscal year 2019 budget request. This program 

makes grants to TCCUs to increase their capacity to serve the academic needs of students. 

Strengthening HBCU Masters Programs 

The Committee recommends $8,571,000 for the Strengthening 

HBCU Masters Programs, which is the same as the fiscal year 

2018 enacted level and $1,071,000 above the fiscal year 2019 budget request. This program provides grants to specified colleges and 

universities making a substantial contribution to graduate education opportunities at the masters level in mathematics, engineering, the physical or natural sciences, computer science, information 

technology, nursing, allied health, or other scientific disciplines. 

The Committee does not support the budget proposal to shift to 

a Consolidated MSI grant program and does not appropriate funds 

for such a program. 

International Education and Foreign Language Studies 

Domestic Programs.—The Committee recommends $65,103,000 

for the Domestic Programs of the International Education and Foreign Languages Studies program, which is the same as the fiscal 

year 2018 enacted level and $65,103,000 above the fiscal year 2019 

budget request. Authorized by title VI of the Higher Education Act, 

these programs include National resource centers, foreign language 

and area studies fellowships, undergraduate international studies 

and foreign language programs, international research and studies 

projects, business and international education projects, international business education centers, language resource centers, 

American overseas research centers, and technological innovation 

and cooperation for foreign information access. 

Overseas Programs.—The Committee recommends $7,061,000 for 

the Overseas Programs, which is the same as the fiscal year 2018 

enacted level and $7,061,000 above the fiscal year 2019 budget request. Funding for these programs support group projects, faculty 

research, special bilateral research, and doctoral dissertation research conducted abroad. 

153 

Postsecondary Programs for Students with Intellectual Disabilities 

The Committee recommends $11,800,000 for Postsecondary Programs for Students with Intellectual Disabilities, which is the same 

as both the fiscal year 2018 level and the fiscal year 2019 budget 

request. This program supports grants to create model transition 

programs into higher education for students with intellectual disabilities. 

Minority Science and Engineering Improvement 

The Committee recommends $11,025,000 for the Minority 

Science and Engineering Improvement Program, which is the same 

as the fiscal year 2018 enacted level and $1,377,000 above the fiscal year 2019 budget request. This program awards grants to improve mathematics, science, and engineering programs at institutions serving primarily minority students and to increase the number of minority students who pursue advanced degrees and careers 

in those fields. 

Tribally Controlled Postsecondary Career and Technical 

Institutions 

The Committee recommends $9,469,000 for this program, which is the same as the fiscal year 2018 enacted level and $1,183,000 

above the fiscal year 2019 budget request. This program provides 

competitive grants to Tribally controlled postsecondary career and 

technical institutions to provide career and technical education to 

Native American students. 

Federal TRIO Programs 

The Committee recommends $1,060,000,000 for TRIO programs, which is $50,000,000 above the fiscal year 2018 enacted level and 

$110,000,000 above the fiscal year 2019 budget request. The TRIO 

programs provide a variety of outreach and support services to encourage low-income, often first-generation college students to enter 

and complete college. Discretionary grants of up to four or five 

years are awarded competitively to IHEs and other nonprofit organizations. At least two thirds of the eligible participants in TRIO 

must be low-income, first-generation college students. 

The Committee rejects the proposal to move from competitive 

grant programs to a single State formula program. The Department was unable to provide any information on the details of how 

the formula grant would be implemented or how accountability for 

performance would be maintained. 

The Committeee is concerned with the Department’s planned al- location of the $60,000,000 increase provided in fiscal year 2018 for 

TRIO, especially given language in the House report which specified the funding should be allocated as it was in fiscal year 2017. 

The Committee expects funding allocations such as these to be included in the Department’s operating plan in future fiscal years. 

Gaining Early Awareness and Readiness for Undergraduate 

Programs 

The Committee recommends $360,000,000 for Gaining Early 

Awareness and Readiness for Undergraduate Programs (GEAR 

UP), which is $10,000,000 above the fiscal year 2018 enacted level 

and $360,000,000 above the fiscal year 2019 budget request. GEAR 

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UP provides grants to States and partnerships of low-income middle and high schools, IHEs, and community organizations to target 

entire grades of students and give them the skills, encouragement, 

and scholarships to pursue successfully postsecondary education. 

The Committee rejects the proposal to consolidate GEAR UP activities into a new formula funded State TRIO program. The Committee continues bill language allowing the Department to maintain the GEAR UP evaluation set-aside at 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. 

Graduate Assistance in Areas of National Need 

The Committee recommends $23,047,000 for the Graduate Assistance in Areas of National Need (GAANN) program, which is the 

same as the fiscal year 2018 enacted level and $23,047,000 above 

the fiscal year 2019 budget request. GAANN provides fellowships 

through grants to degree granting postsecondary institutions, for 

students of high financial need studying in areas of national need. 

The Department consults with appropriate other agencies and organizations to designate the fields of study ‘‘in areas of national 

need’’. Recent examples include computer and informational 

sciences, engineering, nursing, and physics. 

Teacher Quality Partnership Grants 

The Committee recommends $43,092,000 for the Teacher Quality 

Partnerships (TQP) program, which is the same as the fiscal year 

2018 enacted level and $43,092,000 above the fiscal year 2019 

budget request. The TQP program helps improve the quality of 

teachers working in high-need schools and early childhood education programs by creating model teacher preparation and residency programs. 

Child Care Access Means Parents in School 

The Committee recommends $50,000,000 for the Child Care Access Means Parents in School program, which is the same as the 

fiscal year 2018 enacted level and $34,866,000 above the fiscal year 

2019 budget request. This program makes competitive grants to 

colleges and universities to support or establish a campus-based 

childcare program primarily serving the needs of low-income students enrolled at the institution. 

HOWARD UNIVERSITY

Appropriation, fiscal year 2018 ......................................................... $232,518,000 

Budget request, fiscal year 2019 ....................................................... 221,821,000 

Committee Recommendation ............................................................. 232,518,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +10,697,000 

Howard University is a ‘‘Research I’’ university located in the 

District of Columbia. Howard University provides undergraduate 

liberal arts, graduate and professional instruction to over 10,000 

students from all 50 States. 

Within the amount provided, the Committee recommends 

$27,325,000 for the Howard University Hospital, which is the same 

as both the fiscal year 2018 enacted level and $10,697,000 above 

the fiscal year 2019 budget request. The hospital serves as a major 

155 

acute and ambulatory care center for the District of Columbia, and 

functions as a teaching facility. 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM

Appropriation, fiscal year 2018 ......................................................... $435,000 

Budget request, fiscal year 2019 ....................................................... 448,000 

Committee Recommendation ............................................................. 448,000 

Change from enacted level ......................................................... 13,000 

Change from budget request ...................................................... – – – 

Previously, these programs helped to ensure that postsecondary 

institutions were able to make necessary capital improvements to 

maintain and increase their ability to provide a high-quality education. Since 1994, no new loans have been made, and the Department’s role has been to manage the outstanding loans. 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING

PROGRAM ACCOUNT

Appropriation, fiscal year 2018 ......................................................... $30,484,000 

Budget request, fiscal year 2019 ....................................................... 20,489,000 

Committee Recommendation ............................................................. 30,489,000 

Change from enacted level ......................................................... +5,000 

Change from budget request ...................................................... +10,000,000 

The Committee recommends $30,489,000 for the HBCU Capital 

Financing program, which is $5,000 above the fiscal year 2018 enacted level and $10,000,000 above the fiscal year 2019 budget request. Funds are available through September 30, 2019. This program is authorized under part D of Title III of the HEA and makes 

capital available for repair and renovation of facilities at historically black colleges and universities. In exceptional circumstances, 

capital provided under the program can be used for construction or 

acquisition of facilities. 

Within the total provided for this program, the Committee recommendation includes $339,000 for the administrative expenses to 

carry out the program and $20,150,000 for loan subsidy costs that 

will be sufficient to guarantee up to $580,000,000 in new loans in 

fiscal year 2019. Funds will also be used to continue technical assistance services to help HBCUs improve their financial stability 

and access to capital markets. 

INSTITUTE OF EDUCATION SCIENCES

Appropriation, fiscal year 2018 ......................................................... $613,462,000 

Budget request, fiscal year 2019 ....................................................... 521,563,000 

Committee Recommendation ............................................................. 613,462,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +91,899,000 

This account supports education research, statistics, dissemination, evaluation, and assessment activities. 

The Committee rejects the budget request to eliminate the Regional Education Laboratories and Statewide Longitudinal Data 

Systems. 

Research, Development, and Dissemination 

The Committee recommends $192,695,000 for Research, Development, and Dissemination, which is the same as the fiscal year 2018 

enacted level and $5,195,000 above the fiscal year 2019 budget request. This budget account supports research, development, and 

156 

National dissemination activities that are aimed at expanding fundamental knowledge of education and promoting the use of research and development findings in the design of efforts to improve 

education. 

Statistics 

The Committee recommends $109,500,000 for the activities of the 

National Center for Education Statistics (NCES), which is the 

same as fiscal year 2018 enacted level and $3,000,000 below the 

fiscal year 2019 budget request. Statistics activities are authorized 

under title I of the Education Sciences Reform Act of 2002. The 

Center collects, analyzes, and reports statistics on all levels of education in the United States. Activities are carried out directly and 

through grants and contracts and include projections of enrollments, teacher supply and demand, and educational expenditures. 

NCES also provides technical assistance to State and local educational agencies and postsecondary institutions. 

Data for Puerto Rico.—The Committee recommends that NCES 

collect and publish data for Puerto Rico in the same manner it collects and publishes data for States. 

Regional Educational Laboratories 

The Committee recommends $55,423,000 for Regional Educational Laboratories, which is the same as the fiscal year 2018 enacted level and $55,423,000 above the fiscal year 2019 budget request. This program supports a network of ten laboratories that 

promote the use and development of knowledge and evidence to increase student learning and further school improvement efforts. 

Funds are included to support fully continuation costs for grants 

made in prior years. 

Research in Special Education 

The Committee recommends $56,000,000 for Research in Special 

Education, which is the same as the fiscal year 2018 enacted level 

and $2,000,000 above the fiscal year 2019 budget request. This program supports competitive awards to produce and advance the use 

of knowledge to improve services and results for children with disabilities. The program focuses on producing new knowledge, integrating research and practice, and improving the use of knowledge. 

Special Education Studies and Evaluations 

The Committee recommends $10,818,000 for Special Education 

Studies and Evaluations, which is the same as both the fiscal year 

2018 enacted level and the fiscal year 2019 budget request. This 

program awards competitive grants, contracts and cooperative 

agreements to assess the implementation of the IDEA and the effectiveness of State and local efforts to provide special education 

and early intervention programs and services to infants, toddlers, 

and children with disabilities. 

Statewide Data Systems 

The Committee recommends $32,281,000 for Statewide Data Systems, which is the same as the fiscal year 2018 enacted level and 

$32,281,000 above the fiscal year 2019 budget request. Competitive 

grants under this authority are made to SEAs to help them manVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00156 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
157 

age, analyze, disaggregate and use student data consistent with the 

ESEA. 

Assessment 

The Committee recommends $156,745,000 for Assessment, which 

is the same as both the fiscal year 2018 enacted level and the fiscal 

year 2019 budget request. This amount includes $7,745,000 for the 

National Assessment Governing Board (NAGB), which is the same 

as both the fiscal year 2018 enacted level and the fiscal year 2019 

budget request. 

The National Assessment of Educational Progress (NAEP) is the 

only nationally representative and continuing survey of educational 

ability and achievement of American students. The primary goal of 

the assessment is to determine and report the status and trends 

of the knowledge and skills of students, subject by subject. Subject 

areas assessed in the past have included reading, writing, mathematics, science, history, citizenship, literature, art, and music. The 

NAEP is operated by contractors through competitive awards made 

by the NCES. The NAGB formulates the policy guidelines for the 

program. 

DEPARTMENTAL MANAGEMENT

Appropriation, fiscal year 2018 ......................................................... $608,143,000 

Budget request, fiscal year 2019 ....................................................... 630,113,000 

Committee Recommendation ............................................................. 610,649,000 

Change from enacted level ......................................................... +2,506,000 

Change from budget request ...................................................... ¥19,464,000 

These activities are authorized by the Department of Education 

Organization Act (PL 96–88) and include costs associated with the 

management and operation of the Department as well as separate 

costs associated with the Office for Civil Rights and the Office of 

Inspector General. 

Program Administration 

The Committee recommends $432,506,000 for Program Administration, which is $2,506,000 above the fiscal year 2018 enacted 

level and the same as the fiscal year 2019 budget request. These 

funds support the staff and other costs of administering programs 

and activities at the Department. Items include personnel compensation, health, retirement, and other benefits as well as travel, 

rent, telephones, utilities, postage fees, data processing, printing, 

equipment, supplies, technology training, consultants, and other 

contractual services. 

Developing Tomorrow’s Engineering and Technical Workforce.— 

The Committee recognizes the widespread interest in improving 

STEM education in elementary and secondary schools. Among the 

STEM topics, there is a relative small focus on engineering education and lack of a critical mass of teachers qualified to deliver engineering instruction. However, engineering is important in its application of scientific and mathematical principles to innovation, 

analysis, design, evaluation, and manufacture of machines, processes, and systems. Therefore, the Committee encourages the expansion of engineering initiatives to support, develop, and implement formal and informal engineering education programs in eleVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00157 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
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mentary schools and secondary schools through public-private partnerships. 

Education Costs Related to Illegal Immigration.—The Committee 

requests an update to the report submitted to Congress by the Department of Education on this topic as it appeared in the explanatory statement accompanying division H of the Consolidated Appropriations Act, 2016 (PL 114–113). 

English Learners.—The Committee requests the Department include information on the effectiveness of English Learner (EL) programs in delivering adequate services and accommodations to 

qualified students, disaggregated to the extent possible by EL subgroups, in the fiscal year 2020 Congressional Justification. 

Skills Development in Critical Thinking.—The Committee notes 

the growing trend of the public receiving information in digital formats and the subsequent need for students to be able to develop 

critical thinking and fact-finding skills. The Committee directs the 

Department to provide a briefing within 180 days of enactment of 

this Act on efforts to support students’ ability to assess media information critically and develop civic knowledge. This could include 

developing critical thinking skills, news literacy, investigative journalism, and improved digital literacy. In addition, the Department 

should be prepared to report on how a rigorous program of evaluation could assess effectiveness of proposed methods. 

Social and Emotional Learning Education.—The Committee 

notes interest in Social and Emotional Learning (SEL) programs 

and urges more support for evidence-based programs that promote 

positive youth development that unites the home, school, and community to cultivate capable and healthy young people of strong 

character through the Department of Education’s Office of Elementary and Secondary Education and the Office of Safe and Healthy 

Students as well as other programs that support school counseling. 

The Committee notes that high-quality SEL instruction improves 

academic performance, increases the resistance factors that lead to 

the prevention of drug and alcohol use, and creates stronger connections to the school and community. 

Transparency on Foreign Source Organizations.—The Committee 

is concerned by the potential lack of transparency of certain foreign 

source organizations on institutions of higher education, particularly in circumstances where the laws and customs of the foreign 

source do not respect the principles of free expression and openness 

that may lead to censorship and other threats to academic freedom. 

For that reason, the Committee encourages institutions of higher 

learning to increase the transparency of agreements entered into 

with foreign source organizations. To ensure greater transparency 

regarding the presence of, and contractual relationship between, a 

foreign source organization and a Federally funded institution of 

higher education, the Committee encourages the Secretary to require institutions of higher education to file a disclosure report 

with the Department of any contractual agreements with foreign 

source organizations that do not respect the principles of free expression and openness. Such contracts should be made available to 

the public. 

159 

OFFICE FOR CIVIL RIGHTS

Appropriation, fiscal year 2018 ......................................................... $117,000,000 

Budget request, fiscal year 2019 ....................................................... 107,438,000 

Committee Recommendation ............................................................. 117,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +9,562,000 

The Office for Civil Rights (OCR) is responsible for enforcing 

laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, and age in all programs and institutions that receive funds from the Department. These laws extend 

to 50 State educational agencies, 18,200 LEAs, and nearly 7,200 

IHEs, including proprietary schools. They also extend to 80 State 

rehabilitation agencies, libraries, museums, and other institutions 

receiving Federal funds. 

Expulsions and Suspensions.—The Committee is concerned about 

reports of expulsions and suspensions occurring in preschool settings and K–12 classrooms, and the potential for adverse impacts 

on children’s subsequent developmental and educational outcomes. 

The Committee is particularly interested in reports of racial and 

gender disparity in such expulsions. The Committee therefore 

urges OCR to report information on expulsions and suspensions in 

preschool and elementary and secondary school settings, 

disaggregated to the extent possible by race/ethnicity, sex, disability status, and English Learner status, in the fiscal year 2020 

Congressional Justification. OCR is also encouraged to suggest specific recommendations on evidence-based interventions that can reduced the rates of expulsions and suspensions and identify opportunities to improve school climate. 

OFFICE OF INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $61,143,000 

Budget request, fiscal year 2019 ....................................................... 63,418,000 

Committee Recommendation ............................................................. 61,143,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥2,275,000 

This Office has authority to inquire into all program and administrative activities of the Department as well as into related activities of grant and contract recipients. It conducts audits and investigations to determine compliance with applicable laws and regulations, to check alleged fraud and abuse, efficiency of operations, 

and effectiveness of results. 

Use of Resources.—The Committee urges the Office of Inspector 

General to ensure its focus remains on the primary missions of the 

Office. The Committee cautions the Office, when receiving requests 

from the Department for investigations, to consider the most effective and best use of its resources. 

GENERAL PROVISIONS

Sec. 301. The Committee continues a provision that prohibits 

funds in this Act from being used to prevent the implementation 

of programs of voluntary prayer and meditation in public schools. 

(TRANSFER OF FUNDS)

Sec. 302. The Committee continues a provision providing the Secretary of Education with the authority to transfer up to one percent 

160 

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

transfer. This transfer authority is available only to meet emergency needs, and may not be used to create any new program or 

fund a project or activity that is not otherwise funded in this Act. 

All transfers are subject to notification to the Committees on Appropriations of the House of Representatives and the Senate. 

Sec. 303. The Committee continues to include a provision that 

permits Palau to continue participating in Department of Education and other programs pending formal ratification of a new 

compact agreement. 

Sec. 304. The Committee amends a provision allowing ESEA 

funds consolidated for evaluation purposes to be available from 

July 1, 2019 through September 30, 2020. 

Sec. 305. The Committee includes a provision allowing certain institutions to continue to use endowment income for student scholarships. 

Sec. 306. The Committee continues to include a provision extending the authorization of the National Advisory Committee on Institutional Quality and Integrity. 

Sec. 307. The Committee continues to include a provision extending the authority to provide account maintenance fees to guaranty 

agencies for Federal student loans. 

Sec. 308. The Committee adds a provision which permits the Department of Education to allow universities to service Perkins Loan 

accounts. 

Sec. 309. The Committee includes a new provision related to student loan deferment. 

Sec. 310. The Committee includes a new provision related to performance targets and performance bonuses for Office of Federal 

Student Aid employees. 

TITLE IV—RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE

BLIND OR SEVERELY DISABLED

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $8,250,000 

Budget request, fiscal year 2019 ....................................................... 8,650,000 

Committee Recommendation ............................................................. 8,250,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥400,000 

The Committee believes oversight is necessary to ensure the program is operating in accordance with statutory requirements that 

blind or other severely disabled individuals provide at least 75 percent of hours or direct labor required for the production or provision of the products or services to Federal government agencies. To 

ensure the Committee for Purchase from People Who Are Blind or 

Severely Disabled (AbilityOne Commission) maintains its oversight 

capacity, the Committee continues bill language requiring the 

AbilityOne Commission to establish written agreements with central nonprofit agencies. The written agreements ensure the 

AbilityOne Commission can conduct appropriate audit, oversight, 

161 

and reporting functions in accordance with standard Federal procurement policies. 

Committee for Purchase from People Who Are Blind or Severely 

Disabled—Requested Reports.—The Committee continues to request the reports listed under this heading in House Report 115– 

244. 

Office of Inspector General.—The Committee recommends not 

less than $1,250,000 for the Office of Inspector General. 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE

OPERATING EXPENSES

Appropriation, fiscal year 2018 ......................................................... $1,063,958,000 

Budget request, fiscal year 2019 ....................................................... 122,646,000 

Committee Recommendation ............................................................. 1,063,958,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +941,312,000 

Volunteers in Service to America 

The Committee recommends $92,364,000 for Volunteers in Service to America (VISTA), which is the same as the fiscal year 2018 

enacted level and $87,454,000 above the fiscal year 2019 budget request. This program provides capacity building for small, community-based organizations with a mission of combating poverty. 

VISTA members raise resources, recruit, and organize volunteers, 

and establish and expand programs in housing, employment, 

health, and economic development. 

National Senior Volunteer Corps 

The Committee recommends $202,117,000 for the National Senior Volunteer Corps programs, which is the same as the fiscal year 

2018 enacted level and $201,766,000 above the fiscal year 2019 

budget request. Senior Corps is a collection of programs that connect Americans older than the age of 55 with opportunities to contribute their job skills and expertise to community projects and organizations. The breakout of funding by program is as follows: 

National Senior Volunteer Corps: FY 2019 

Committee 

Foster Grandparents Program ........................................................................................................................ $107,702,000 

Senior Companion Program ............................................................................................................................ 45,512,000 

Retired Senior Volunteer Program .................................................................................................................. 48,903,000 

AmeriCorps State and National Grants 

The Committee recommends $473,148,000 for AmeriCorps State 

and National Grants, which is the same as the fiscal year 2018 enacted level and $446,720,000 above the fiscal year 2019 budget request. This program provides funds to local and national organizations and agencies to address community needs in education, public 

safety, health, and the environment. 

Innovation, Assistance, and Other Activities 

The Committee recommends $7,600,000 for Innovation, Assistance, and Other Activities, which is the same as the fiscal year 

2018 enacted level and $7,600,000 above the fiscal year 2019 budget request. 

162 

Evaluation 

The Committee recommends $4,000,000 for evaluation, which is 

the same as the fiscal year 2018 enacted level and $4,000,000 

above the fiscal year 2019 budget request. These funds support research on program effectiveness. 

National Civilian Community Corps 

The Committee recommends $32,000,000 for National Civilian 

Community Corps, which is the same as the fiscal year 2018 enacted level and $7,913,000 above the fiscal year 2019 budget request. This program supports residential, team-based service opportunities for individuals aged 18–24. 

State Commission Administrative Grants 

The Committee recommends $17,538,000 for State Commission 

Administrative Grants, which is the same as the fiscal year 2018 

enacted level and $17,538,000 above the fiscal year 2019 budget request. Funds are used for formula grants to support State oversight 

of service programs. 

PAYMENT TO THE NATIONAL SERVICE TRUST

Appropriation, fiscal year 2018 ......................................................... $206,842,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 206,842,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +206,842,000 

The National Service Trust makes payments for Segal education 

awards, pays interest that accrues on qualified student loans for 

AmeriCorps participants during terms of service in approved national service positions, and makes other payments entitled to 

members who serve in the programs of the Corporation for National and Community Service. 

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $83,737,000 

Budget request, fiscal year 2019 ....................................................... 87,389,000 

Committee Recommendation ............................................................. 83,737,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥3,652,000 

OFFICE OF INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $5,750,000 

Budget request, fiscal year 2019 ....................................................... 3,568,000 

Committee Recommendation ............................................................. 5,750,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +2,182,000 

ADMINISTRATIVE PROVISIONS

Sec. 401. The Committee continues bill language that combines 

separate matching requirements for AmeriCorps grants. 

Sec. 402. The Committee continues bill language related to National Service Trust minimum share requirements. 

Sec. 403. The Committee continues bill language related to donations. 

Sec. 404. The Committee continues bill language related to veterans. 

163 

Sec. 405. The Committee continues bill language related to criminal history background checks. 

Sec. 406. The Committee continues bill language related to 1,200 

hour service positions. 

CORPORATION FOR PUBLIC BROADCASTING

Appropriation, fiscal year 2018 ......................................................... $465,000,000 

Budget request, fiscal year 2019 ....................................................... – – – 

Committee Recommendation ............................................................. 465,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +465,000,000 

This appropriation will fund content development, community 

services, and other local station and system needs for the Corporation for Public Broadcasting (CPB). 

National Minority Consortia.—According to the Public Broadcasting Act, one of the greatest priorities of public broadcasting is 

to address the ‘‘needs of unserved and underserved audiences, particularly children and minorities.’’ Programming that reflects the 

histories and perspectives of diverse racial and ethnic communities 

is a core value and responsibility of public broadcasting, therefore 

the Committee supports continued investment in the National Minority Consortia to help accomplish this goal. 

FEDERAL MEDIATION AND CONCILIATION SERVICE

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $46,650,000 

Budget request, fiscal year 2019 ....................................................... 47,200,000 

Committee Recommendation ............................................................. 46,800,000 

Change from enacted level ......................................................... +150,000 

Change from budget request ...................................................... ¥400,000 

The Federal Mediation and Conciliation Service promotes labormanagement cooperation through mediation and conflict resolution 

services to industry, government agencies, and communities. 

FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $17,184,000 

Budget request, fiscal year 2019 ....................................................... 17,053,000 

Committee Recommendation ............................................................. 17,124,000 

Change from enacted level ......................................................... ¥60,000 

Change from budget request ...................................................... +71,000 

The Federal Mine Safety and Health Review Commission is an 

independent adjudicative agency that provides administrative trial 

and appellate review of legal disputes arising under the Federal 

Mine Safety and Health Act of 1977. 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES

OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND

ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $240,000,000 

Budget request, fiscal year 2019 ....................................................... 23,000,000 

Committee Recommendation ............................................................. 240,000,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +217,000,000 

164 

Within the total for the Institute of Museum and Library Services (IMLS), the Committee recommends the following amounts: 

Budget Activity FY 2019 

Committee 

Library Services Technology Act: 

Grants to States .................................................................................................................................... $160,803,000 

Native American Library Services ......................................................................................................... 5,063,000 

National Leadership: Libraries .............................................................................................................. 13,406,000 

Laura Bush 21st Century Librarian ...................................................................................................... 10,000,000 

Museum Services Act: 

Museums for America ........................................................................................................................... 22,899,000 

21st Century Museum Professionals ..................................................................................................... 0 

Conservation Project Support ................................................................................................................ 0 

Native American/Hawaiian Museum Service ......................................................................................... 1,472,000 

National Leadership: Museums. ............................................................................................................ 8,113,000 

African American History and Culture Act: 

Museum Grants for African American History and Culture .................................................................. 2,231,000 

Museum and Library Services Act General Provisions: 

Research, Analysis and Data Collection ............................................................................................... 2,013,000 

Program Administration ................................................................................................................................. 14,000,000 

Library Services and Technology 

The Grants to State Library Agencies program provides funds to 

State Library Administrative Agencies using a population-based 

formula. 

Program Administration 

The Committee recommends $14,000,000 for Program Administration, which is the same as the fiscal year 2018 enacted level. 

These funds provide administrative and management support for 

all programs administered by IMLS. The Committee also includes 

$2,013,000 for IMLS’ activities in policy, research, and data collection, including functions formerly conducted by the National Commission on Libraries and Information Science. 

MEDICARE PAYMENT ADVISORY COMMISSION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $12,545,000 

Budget request, fiscal year 2019 ....................................................... 12,471,000 

Committee Recommendation ............................................................. 13,045,000 

Change from enacted level ......................................................... +500,000 

Change from budget request ...................................................... +574,000 

The Medicare Payment Advisory Commission (MedPAC) is an 

independent agency tasked with advising the Congress on issues 

affecting the Medicare program. In addition to advising on payments to private health plans participating in Medicare and providers in Medicare’s traditional fee-for-service program, MedPAC is 

also responsible for providing analysis on access to care, quality of 

care, and other issues affecting Medicare. 

Evaluating Barriers to Care.—The Committee recognizes HHS’s 

recent focus on eliminating unnecessary paperwork burdens, which 

cause barriers to patient care. The Committee notes there are nonphysician practitioners, such as nurse practitioners, that provide 

care for CMS beneficiaries. There may be way to improve or 

streamline the process for certification or authorization of CMS 

rembursed products or services. Specifically, the Committee encourages MedPAC, in consultation with MACPAC, to prepare a report 

165 

that examines the relationship between the physician or post-acute 

care physician and related burdens associated with each provider 

involved in authorizing patients for home health care services, certifying patient’s needs for diabetic shoes, conducting assessments to 

admit patients to skilled nursing facilities, and providing the initial 

certification of patients for hospice care. The Committee further encourages MedPAC to analyze the costs to the Medicare program 

and burdens for patients associated with the multiple step process 

for authorizing and/or certifying for these services, for the two most 

recent years of data available, and to submit a report of its findings 

to the Committees on Appropriations of the House of Representatives and the Senate and the authorizing committees of jurisdiction 

with recommendations that can be pursued to improve the collaboration between physicians and non-physician practitioners in order 

to reduce burdens overall and improve patient care. 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $8,480,000 

Budget request, fiscal year 2019 ....................................................... 8,700,000 

Committee Recommendation ............................................................. 8,480,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... ¥220,000 

The Medicaid and CHIP Payment and Access Commission 

(MACPAC) is an independent agency tasked with advising the Congress on issues affecting Medicaid and the State Children’s Health 

Insurance Program (CHIP). MACPAC conducts policy and data 

analysis on Medicaid and CHIP to support policymakers and support program accountability. 

Puerto Rico.—Recognizing the unique conditions of Puerto Rico, 

the Committee supports efforts by MACPAC to evaluate and assess 

viable options for ensuring long-term sustainable access to care for 

Medicaid beneficiaries in the territory. The Committee encourages 

MACPAC to ensure policy recommendations that may result in additional outlays be accompanied by policy recommendations that 

can result in savings. 

Therapeutic Foster Care Services.—The Committee is concerned 

about the lack of a uniform definition within the Medicaid program 

for therapeutic foster care (TFC) services. A uniform TFC definition 

could improve the ability for more consistent care and treatment. 

The Committee supports efforts by MACPAC to conduct a review 

for the development of an operational TFC definition for the Medicaid program. Further, the review should examine advantages of 

a uniform definition, and include a list of potential services and 

interventions to treat mental illness and trauma that could be considered within the scope of the uniform definition. It is expected 

the report will be completed within 12 months after enactment of 

this Act. The Committee encourages MACPAC to ensure policy recommendations that may result in additional outlays be accompanied by policy recommendations that can result in savings. 

166 

NATIONAL COUNCIL ON DISABILITY

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $3,250,000 

Budget request, fiscal year 2019 ....................................................... 3,211,000 

Committee Recommendation ............................................................. 3,250,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... +39,000 

The National Council Disability (NCD) is an independent Federal 

agency charged with advising the President, Congress, and other 

Federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities. NCD is comprised of a 

team of Presidential and Congressional appointees, an Executive 

Director appointed by the Chair, and a full-time professional staff. 

The Achieving a Better Live Experience Act of 2014 or ABLE Act 

(PL 113–295) allows individuals and families to save for the purpose of supporting individuals with disabilities in maintaining their 

health, independence, and quality of life. The Committee is concerned about the inconsistent guidance provided to ABLE beneficiaries from various Federal agencies that administer needs-based 

assistance programs. As a consequence, participation in State 

ABLE programs suffers. The Committee strongly encourages NCD 

when convening stakeholders to conduct information sessions on 

ABLE accounts. In addition, the Committee directs NCD to serve 

as an interagency coordinator to ensure consistency across Federal 

agencies and programs. NCD through its work with disability organizations should raise awareness on the eligibility and benefits of 

these accounts. 

NATIONAL LABOR RELATIONS BOARD

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $274,224,000 

Budget request, fiscal year 2019 ....................................................... 249,000,000 

Committee Recommendation ............................................................. 261,325,000 

Change from enacted level ......................................................... ¥12,899,000 

Change from budget request ...................................................... +12,325,000 

The National Labor Relations Board is an independent agency 

responsible for enforcing US labor law related to collective bargaining and unfair labor practices, including the National Labor 

Relations Act of 1935. 

ADMINISTRATIVE PROVISIONS

Sec. 407. The Committee continues a provision relating to electronic voting for purposes of collective bargaining. 

Sec. 408. The Committee includes a new provision relating to 

joint-employer standards. 

Sec. 409. The Committee includes a new provision relating to jurisdiction over Indian Tribes. 

167 

NATIONAL MEDIATION BOARD

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $13,800,000 

Budget request, fiscal year 2019 ....................................................... 13,205,000 

Committee Recommendation ............................................................. 13,510,000 

Change from enacted level ......................................................... ¥290,000 

Change from budget request ...................................................... +305,000 

The National Mediation Board is an independent agency that coordinates labor-management relations within the US railroads and 

airlines industries. 

The Committee is aware of the backlog of Section 3 arbitration 

cases and requests an update in the 2020 Congressional Justification on the number of pending cases in each of the past three fiscal 

years, the number of cases filed each year, and any efforts to reduce the backlog of cases. 

The Committee directs the National Mediation Board to report to 

the Committees on Appropriations of the House of Representatives 

and the Senate within 60 days of enactment of this Act on any concurrent postponement of a representation election under the jurisdiction of the National Mediation Board and the national for the 

postponement. 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION

SALARIES AND EXPENSES

Appropriation, fiscal year 2018 ......................................................... $13,225,000 

Budget request, fiscal year 2019 ....................................................... 12,615,000 

Committee Recommendation ............................................................. 12,975,000 

Change from enacted level ......................................................... ¥250,000 

Change from budget request ...................................................... +360,000 

The Occupational Safety and Health Review Commission is an 

independent Federal agency, providing administrative trial and appellate review, created to decide contests of citations or penalties 

resulting from OSHA inspections of American work places. 

RAILROAD RETIREMENT BOARD

DUAL BENEFITS PAYMENTS ACCOUNT

Appropriation, fiscal year 2018 ......................................................... $21,000,000 

Budget request, fiscal year 2019 ....................................................... 18,000,000 

Committee Recommendation ............................................................. 18,000,000 

Change from enacted level ......................................................... ¥3,000,000 

Change from budget request ...................................................... – – – 

This appropriation is authorized by the Railroad Retirement Act 

of 1974 to fund vested dual benefits received by railroad retirees 

who, under prior law, would have become covered by both the railroad retirement system and the Social Security system because 

railroad retirement was not fully coordinated with Social Security 

from 1937 to 1974. The Committee includes a provision permitting 

a portion of these funds to be derived from income tax receipts on 

dual benefits as authorized by law. The Railroad Retirement Board 

estimates that approximately $1,000,000 may be derived in this 

manner. 

168 

FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS

Appropriation, fiscal year 2018 ......................................................... $150,000 

Budget request, fiscal year 2019 ....................................................... 150,000 

Committee Recommendation ............................................................. 150,000 

Change from enacted level ......................................................... – – – 

Change from budget request ...................................................... – – – 

LIMITATION ON ADMINISTRATION

Appropriation, fiscal year 2018 ......................................................... $123,500,000 

Budget request, fiscal year 2019 ....................................................... 115,225,000 

Committee Recommendation ............................................................. 126,000,000 

Change from enacted level ......................................................... +2,500,000 

Change from budget request ...................................................... +10,775,000 

The Committee maintains its position that the financial statements and audit of the National Railroad Retirement Investment 

Trust should remain separate from the financial statements and 

audit of the Railroad Retire Board (RRB). The Committee notes 

that the Railroad Retirement and Survivors’ Improvement Act of 

2001 mandates that the Trust function independently from the 

RRB. Further, the Act specifically requires a separate audit of the 

Trust by a nongovernmental auditor and requires that the results 

of this audit be included in the Trust’s Annual Management Report 

to Congress. The Committee expects that the Trust shall be administered and audited solely in conformance with the Railroad Retirement and Survivors’ Improvement Act of 2001. 

The Committee includes $12,500,000 for the implementation of 

information technology systems modernization efforts. Within 180 

days of enactment of this Act, the Railroad Retirement Board is directed to submit a comprehensive update to the Committees on Appropriations of the House of Representatives and the Senate on 

project status, timelines to completion, and total cost of development. 

LIMITATION ON THE OFFICE OF INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $11,000,000 

Budget request, fiscal year 2019 ....................................................... 8,437,000 

Committee Recommendation ............................................................. 8,500,000 

Change from enacted level ......................................................... ¥2,500,000 

Change from budget request ...................................................... +63,000 

SOCIAL SECURITY ADMINISTRATION

PAYMENTS TO SOCIAL SECURITY TRUST FUNDS

Appropriation, fiscal year 2018 ......................................................... $11,400,000 

Budget request, fiscal year 2019 ....................................................... 11,000,000 

Committee Recommendation ............................................................. 11,000,000 

Change from enacted level ......................................................... ¥400,000 

Change from budget request ...................................................... – – – 

This appropriation provides reimbursement to the Social Security 

trust funds for non-trust fund activities. 

SUPPLEMENTAL SECURITY INCOME PROGRAM

Appropriation, fiscal year 2018 ......................................................... $38,487,277,000 

Budget request, fiscal year 2019 ....................................................... 41,208,000,000 

Committee Recommendation ............................................................. 41,251,000,000 

Change from enacted level ......................................................... +2,763,723,000 

Change from budget request ...................................................... +43,000,000 

169 

The Committee recommends $19,700,000,000 in advance funding 

for the first quarter of fiscal year 2020, as requested. 

Research and Demonstration 

Section 1110 of the Social Security Act provides authority to the 

Social Security Administration (SSA) for conducting research and 

demonstration projects related to SSA’s programs. 

Within the appropriation for Supplemental Security Income (SSI), the Committee recommends $101,000,000 for research and 

demonstration activities, which the same as the fiscal year 2018 

enacted level and the fiscal year 2019 budget request. 

Administration 

Within the appropriation for SSI, the Committee recommends $4,808,000,000, which is $183,277,000 below the fiscal year 2018 

enacted level and $43,000,000 above the fiscal year 2019 budget request level. This funding is for payment to the Social Security trust 

funds for SSI’s share of the administrative expenses of SSA. 

LIMITATION ON ADMINISTRATIVE EXPENSES

Appropriation, fiscal year 2018 ......................................................... $11,018,945,000 

Budget request, fiscal year 2019 ....................................................... 10,575,000,000 

Committee Recommendation ............................................................. 10,739,045,000 

Change from enacted level ......................................................... ¥279,900,000 

Change from budget request ...................................................... +164,045,000 

The Limitation on Administrative Expenses (LAE) funds the administrative and operational costs for administering the Old Age 

and Survivors Insurance, Disability Insurance, and Supplemental 

Security Income programs, and associated costs for support to the 

Centers for Medicare and Medicaid Services in administering their 

programs. 

Within the total for LAE, the Committee provides not less than 

$3,475,000,000 for Field Offices and not more than $1,750,000,000 

for Information Technology. 

Achieving a Better Life Experience Act.—The Achieving a Better 

Life Experience Act of 2014 or ABLE Act (PL 113–295) allows individuals and families to save for the purpose of supporting individuals with disabilities in maintaining their health, independence, 

and quality of life. The Committee is concerned about the inconsistent guidance provided to ABLE beneficiaries from various Federal agencies that administer needs-based assistance programs. As 

a consequence, participation in State ABLE programs suffers. The 

Committee strongly encourages SSA to conduct information sessions on ABLE accounts. In addition, the Committee supports efforts by SSA to disseminate information on the eligibility and benefits of these accounts. The Committee further encourages SSA to 

build relationships with other agencies and government entities 

that support individuals living with a disability to raise awareness, 

understanding, and usage of ABLE accounts. 

Administrative Law Judge Hiring.—SSA’s National Hearing Centers (NHCs) provide SSA with invaluable flexibility and support to 

address the hearings backlog. Understanding the value of this 

flexibility and support, the Committee directs SSA to ensure that 

its upcoming administrative law judge (ALJ) hiring decisions result 

in allocating additional ALJs to NHCs. 

170 

Consultative Exams.—The SSA Inspector General has recommended that all State Disability Determination Service (DDSs) 

periodically assess the feasibility of using a competitively awarded 

contract for Consultative Exams (CEs) to improve program integrity and lower costs (Disability Determination Services’ Use of Volume Consultative Examination Providers, A–07–02–12409, March, 

2003). Similarly, GAO has recommended the use of competitive 

contracts finding that DDSs, and thus SSA, can save millions (Use 

of Competitive Contracts for Consultative Exams Can Save Millions, HRD–90–141, August 1990). The Committee supports efforts 

by SSA to develop a multi-state pilot program, focused on States 

with large disability review backlogs, including high appeals backlog, and continuing disability reviews, to evaluate the use of competitively awarded, multiple State contract(s) for CEs. This contract shall require the vendor to manage the scheduling of CEs; to 

oversee provider credentialing, recruitment, and training; provide 

timely completion of the CEs and reports; and offer quality assurance for completed CE reports. This contract shall also require negotiated fees that are comparable to Medicare rates with volume 

discounts and shall assess savings to SSA, provide fraud prevention and improved provider monitoring by preventing the use of 

providers suspended or debarred from receiving Federal funds, and 

improved exam quality with adequate medical evidence that decreases the number of sustained appeals. The Committee recommends that SSA consult with the Department of Veterans Affairs on its successful demonstration of similar multiple State contracts for disability examinations. 

Disability Case Processing System.—The Committee is aware 

that SSA is undertaking efforts to modernize the Disability Case 

Processing System (DCPS). The Committee notes recent cost overruns of the project. The Committee continues to encourage SSA to 

engage with States to explore all possible options for modernization 

of the case processing system, to align with the needs of each State. 

The Committee continues to request regular updates on the effort 

to upgrade DCPS, the cost and anticipated timeline of the project, 

and efforts by SSA to engage stakeholders, including any barriers 

to implementation. 

Implementation of New Capability Determination Instructions.— 

The Committee recognizes the importance of SSA accurately assessing whether an individual needs a representative payee. SSA’s 

regulations specify that the agency will appoint a representative 

payee in cases where a beneficiary is not able to manage or direct 

the management of his or her Social Security benefits. However, 

the Committee recognizes that generally SSA has only evaluated a 

beneficiary’s ability to manage his or her benefits and has not considered a beneficiary’s ability to direct someone else to manage his 

or her benefits. In 2017, SSA drafted new program instructions for 

its front-line employees in assessing whether an individual is able 

to direct others to manage his or her benefits. Despite the complexity of implementing this policy, and SSA’s lack of experience 

making such evaluations, the instructions were developed without 

input from external stakeholders. The Committee is encouraged by 

the recent steps SSA has taken to gather stakeholder feedback and 

expert advice, including holding a National Disability Forum on 

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icy. However, due to the complexity of this policy and the importance of correctly evaluating the extent to which an individual can 

manage (directly or indirectly) his or her benefits, the Committee 

believes more stakeholder engagement and expert consultation is 

required. The Committee also notes that SSA should consider ways 

to test this new policy to ensure it achieves its goals and can be 

implemented effectively by field office employees before expanding 

it program-wide. Any test of this policy should include specific objectives and metrics to assess the policy’s effectiveness. Given the 

Committee’s continued concerns, the Committee expects that SSA 

will provide the Committees on Appropriations of the House of 

Representatives and the Senate, the Committee on Ways and 

Means of the House of Representatives, and the Committee on Finance of the Senate regular updates and briefings on the agency’s 

plans prior to moving forward with this policy. 

Information Technology.—The Committee requests an update of 

the plan referenced under this heading in House Report 114–699. 

Occupational Information System.—SSA is developing a new Occupational Information System (OIS) that will replace the Dictionary of Occupational Titles as the primary source of occupational 

information used in SSA’s disability adjudication process. SSA expects to begin a new five year data refresh cycle in fiscal year 2018 

and to start using the OIS in 2020. To provide the Committee with 

a better understanding of the project’s costs, the Committee directs 

SSA to include in its annual Report on the Occupational Information System Project the estimated costs for each future fiscal year 

until the project is expected to be completed and the estimated cost 

for a five-year data refresh cycle. 

Pilot Program Metrics.—Pilot programs are valuable opportunities to test the effects of potential process changes but require a 

well thought out design that includes clear objectives and appropriate measures to evaluate the pilot’s effectiveness. Although 

sometimes terms are used interchangeably, the Committee uses the 

term ‘‘pilots’’ as distinct from ‘‘demonstration programs,’’ which relate to programmatic changes, such as changes in eligibility rules. 

In addition, the Committee notes that there is not always a clear 

distinction between what constitutes a pilot, compared to an initiative, or a test. The Committee uses the term ‘‘pilot’’ to encompass 

all efforts to test the effects of process changes. The Committee 

continues to be concerned about pilot programs that lack clear objectives, evaluation plans, or metrics. The Committee expects that, 

prior to undertaking any new pilots, SSA will ensure that it has 

developed a research design that includes clear objectives for the 

pilot and an evaluation plan, including adequate metrics to determine the pilot’s effectiveness. Metrics should be specific, quantifiable measures that can be used to evaluate success. The Committee 

directs SSA to submit a report to the Committees on Appropriations of the House of Representatives and the Senate, the Committee on Ways and Means of the House of Representatives and 

the Committee on Finance of the Senate not later than 90 days 

after the enactment of this act with a description of any new pilot, 

initiative or test of process changes launched in fiscal year 2018, 

or proposed for fiscal year 2019; the objective of the pilot; the plan 

and timeline for evaluation; which SSA components are involved in 

the pilot; and the measures or metrics the SSA will use to deterVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00171 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
172 

mine the pilot’s effectiveness. In addition to the requested information for new pilots, the report should include a list of the SSA’s ongoing pilots, along with the start date for each of these pilots. Similar information should be provided in the fiscal year 2020 Congressional Justification. All SSA pilots should be included in the requested report and justification, including those undertaken as part 

of the Compassionate and Responsive Service (CARES) plan and in 

other parts of the agency. The report (and section in the justification) does not need to include programmatic demonstrations. 

Muscular Dystrophy.—The Committee is aware that SSA is included in the Muscular Dystrophy Coordinating Committee under 

the Muscular Dystrophy CARE Act Amendments enacted in September 2014. The Committee requests SSA to include in the fiscal 

year 2020 Congressional Justification the rate at which persons 

with Duchenne and Becker Muscular Dystrophy utilize SSA programs, particularly those focused on promoting employment and 

community independence such as the Ticket to Work Program. 

Report on LAE Expenditures.—The Committee continues to request the report referenced under this heading in House Report 

114–699 as part of the fiscal year 2020 Congressional Justification. 

Social Security Advisory Board 

The Committee recommends not less than $2,400,000 for the Social Security Advisory Board (SSAB), which is $100,000 above the 

fiscal year 2018 enacted level and the fiscal year 2019 budget request. 

The Committee continues to support SSAB in the development of 

new and innovative ways SSA can achieve its mission and improve 

the quality of service to the public. 

The Committee does not include bill language providing SSAB 

reception and representation authority. The Committee requests 

information on SSAB’s need for such authority in the fiscal year 

2020 Congressional Justification. 

User Fees 

In addition to the other amounts provided, the Committee recommends $135,000,000 for administrative activities funded from 

user fees. Of this amount, $134,000,000 is derived from fees collected from States that request SSA to administer State SSI supplementary payments. The remaining $1,000,000 is derived from 

fees charged to non-attorneys who apply for certification to represent claimants under titles II and XVI of the Social Security Act. 

Continuing Disability Reviews and Redeterminations 

The Committee recommends $1,683,000,000 for program integrity activities. In the wake of multiple large-scale disability fraud 

cases, the Committee believes that successful program integrity activities are vital to maintaining the public’s support for benefit payments to recipients deserving of assistance. The Committee includes bill language transferring $10,000,000 to the Office of the 

Inspector General for the cost of jointly operating co-operative disability investigation units. 

173 

OFFICE OF THE INSPECTOR GENERAL

Appropriation, fiscal year 2018 ......................................................... $105,500,000 

Budget request, fiscal year 2019 ....................................................... 105,500,000 

Committee Recommendation ............................................................. 108,500,000 

Change from enacted level ......................................................... +3,000,000 

Change from budget request ...................................................... +3,000,000 

The Office of the Inspector General (OIG) is responsible for meeting the statutory mission of promoting economy, efficiency, and effectiveness in the administration of SSA programs and operations 

and to prevent and detect fraud, waste, abuse, and mismanagement in such programs and operations. To accomplish this mission, 

the OIG directs, conducts, and supervises audits, evaluations, and 

investigations relating to SSA’s programs and operations. In addition, the OIG searches for and reports on systemic weaknesses in 

SSA programs and operations, and makes recommendations for 

needed improvements and corrective actions. 

TITLE V—GENERAL PROVISIONS 

(TRANSFER OF FUNDS)

Sec. 501. The Committee continues a provision allowing the Secretaries of Labor, Health and Human Services, and Education to 

transfer unexpended balances of prior appropriations to accounts 

corresponding to current appropriations to be used for the same 

purposes and for the same periods of time for which they were 

originally appropriated. 

Sec. 502. The Committee continues a provision prohibiting the 

obligation of funds beyond the current fiscal year unless expressly 

so provided. 

Sec. 503. The Committee continues a provision prohibiting funds 

from being used to support or defeat legislation. 

Sec. 504. The Committee continues a provision limiting the 

amount available for official reception and representation expenses 

for the Secretaries of Labor and Education, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the 

National Mediation Board. 

Sec. 505. The Committee continues a provision requiring grantees receiving Federal funds to clearly state the percentage of the 

total cost of the program or project that will be financed with Federal money. 

Sec. 506. The Committee continues a provision prohibiting the 

use of funds for any abortion. 

Sec. 507. The Committee continues a provision providing exceptions to section 506 and a provision prohibiting funds from being 

made available to a Federal agency or program, or to a State or 

local government, if such agency, program or government discriminates against institutional or individual health care entities because they do not provide, pay for, provide coverage of, or refer for 

abortions. 

Sec. 508. The Committee continues a provision prohibiting use of 

funds for certain research involving human embryos. 

Sec. 509. The Committee continues a provision prohibiting use of 

funds for any activity that promotes the legalization of any drug or 

substance included in schedule I of the schedules of controlled substances. 

174 

Sec. 510. The Committee continues a provision prohibiting use of 

funds to promulgate or adopt any final standard providing for a 

unique health identifier until legislation is enacted specifically approving the standard. 

Sec. 511. The Committee continues a provision related to annual 

reports to the Secretary of Labor. 

Sec. 512. The Committee continues a provision prohibiting transfer of funds made available in this Act except by authority provided 

in this Act or another appropriations Act. 

Sec. 513. The Committee continues a provision to limit funds in 

the bill for public libraries to those that comply with the requirements of the Children’s Internet Protection Act. 

Sec. 514. The Committee continues a provision regarding procedures for reprogramming of funds. 

Sec. 515. The Committee continues a provision pertaining to appointments to scientific advisory committees. 

Sec. 516. The Committee continues a provision requiring each department and related agency funded through this Act to submit an 

operating plan within 45 days of enactment, detailing any funding 

allocations that are different than those specified in this Act, the 

accompanying detailed table, or budget request. 

Sec. 517. The Committee continues a provision requiring the Secretaries of Labor, Health and Human Services, and Education to 

submit a quarterly report to the Committees on Appropriations of 

the House of Representatives and the Senate containing certain information on noncompetitive contracts, grants, and cooperative 

agreements exceeding $500,000 in value. 

Sec. 518. The Committee continues a provision prohibiting the 

use of funds to process claims for credit for quarters of coverage 

based on work performed under a Social Security number that was 

not the claimant’s number, where the performance of such work 

under such number has formed the basis for a conviction of the 

claimant of a violation of section 208(a)(6) or (7) of the Social Security Act. 

Sec. 519. The Committee continues a provision prohibiting the 

use of funds to implement a Social Security totalization agreement 

with Mexico. 

Sec. 520. The Committee modifies a provision related to needle 

exchange. 

Sec. 521. The Committee continues a provision prohibiting the 

use of funds for the downloading or exchanging of pornography. 

Sec. 522. The Committee continues a provision that prohibits 

funding from going to the Association of Community Organizations 

for Reform Now (ACORN), or any of its affiliates, subsidiaries, allied organizations, or successors. 

Sec. 523. The Committee continues a provision relating to reporting requirements for conference expenditures. 

Sec. 524. The Committee continues a provision relating to disclosure of U.S. taxpayer funding for programs used in advertising. 

Sec. 525. The Committee continues a provision relating to performance partnership pilots. 

Sec. 526. The Committee continues provision requesting quarterly reports on the status of balances of appropriations from the 

Departments of Labor, Health and Human Services and Education. 

175 

Sec. 527. The Committee includes a new provision prohibiting 

use of funds to implement, administer, enforce or further the provisions of Public Law 111–148 and portions of public Law 111–152 

with certain exceptions. 

Sec. 528. The Committee includes a new provision prohibiting 

use of funds to implement, administer, enforce or further advance 

the Navigators program. 

(RESCISSION)

Sec. 529. The Committee rescinds $3,345,000,000 in unused 

funds provided under section 2104(a)(22) of the Social Security Act 

for the Children’s Health Insurance Program. 

(RESCISSION)

Sec. 530. The Committee rescinds $400,000,000 from the Nonrecurring Expenses Fund. 

(RESCISSION)

Sec. 531. The Committee permanently rescinds $3,378,613,000 in 

unused funds provided under section 2104(n)(2) of the Social Security Act for the Child Enrollment Contingency Fund. 

Sec. 532. The Committee includes a new provision prohibiting 

use of funds for research on fetal tissue obtained from an induced 

abortion. 

Sec. 533. The Committee includes a new provision restricting 

funding to certain health care entities. 

Sec. 534. The Committee includes a new provision relating to 

conscience protection with respect to health care entities that 

refuse to participate in abortions. 

Sec. 535. The Committee includes a new provision ensuring 

members of the United States Congress may, for oversight purposes, enter facilities used to house unaccompanied alien children. 

Sec. 536. The Committee includes a new provision related to family detention centers. 

Sec. 537. The Committee includes a new provision related to conscience protection with respect to child welfare service providers. 

Sec. 538. The Committee includes a new provision related to administration of medication to unaccompanied alien children. 

Sec. 539. The Committee includes a sense of Congress regarding 

family separation. 

Sec. 540. The Committee includes a new provision related to religious practices of a potential sponsor of unaccompanied alien children. 

Sec. 541. The Committee includes a new provision requesting a 

report related to the communication needs of young unaccompanied 

alien children. 

Sec. 542. The Committee includes a new provision requesting a 

report related to mental health services for unaccompanied alien 

children. 

Sec. 543. The Committee includes a Spending Reduction Account. 

HOUSE OF REPRESENTATIVES REPORTING REQUIREMENTS

The following materials are submitted in accordance with various 

requirements of the Rules of the House of Representatives: 

176 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

Pursuant to clause 3(c)(4) of rule XIII of the Rules of the House 

of Representatives, the following is a statement of general performance goals and objectives for which this measure authorizes funding: The Committee on Appropriations considers program performance, including a program’s success in developing and attaining 

outcome-related goals and objectives, in developing funding recommendations. 

RESCISSION OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the rescissions of unexpended 

balances included in the accompanying bill: 

RESCISSIONS RECOMMENDED IN THE BILL

Account Amount 

Department of Labor: 

Dislocated Workers National Reserve .................................................................................................... $200,000,000 

Department of Health and Human Services: 

Children’s Health Insurance Program ................................................................................................... 3,345,000,000 

Nonrecurring Expenses Fund ................................................................................................................. 400,000,000 

Child Enrollment Contingency Fund ...................................................................................................... 3,378,613,000 

TRANSFER OF FUNDS

Pursuant to clause 3(f)(2) of rule XIII of the Rules of the House 

of Representatives, the following lists the transfers of unexpended 

balances included in the accompanying bill: 

TITLE I

Language is included under ‘‘Job Corps’’ permitting the transfer 

of funds for Job Corps Center construction, rehabilitation and acquisition to meet the operational needs of Job Corps Centers or to 

achieve administrative efficiencies. 

Language is included under ‘‘Special Benefits’’ which provides for 

the transfer of such sums as necessary from the ‘‘Postal Service’’ 

account. 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Office of Workers’ Compensation Program, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Salaries and Expenses.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of 

Labor, Departmental Management, Office of Inspector General.’’ 

Language is included under ‘‘Black Lung Disability Trust Fund’’ 

which provides for the transfer of funds to the ‘‘Department of the 

Treasury.’’ 

Language is included under ‘‘Departmental Management, Salaries and Expenses’’ authorizing the transfer of funds available for 

program evaluation to any other account within the Department to 

carry out evaluation activities. 

177 

A general provision is included permitting up to one percent of 

any discretionary appropriation to be transferred to another appropriation of the Department of Labor, provided that no such appropriation is increased by more than three percent by any such transfer. 

A general provision is included that provides for the transfer of 

funds from the ‘‘Employment and Training Administration’’ for 

technical assistance services to grantees to ‘‘Program Administration,’’ and authorizes the transfer of up 0.5 percent of each discretionary appropriation for ‘‘Employment and Training Administration’’ to carry out program integrity activities subject to certain limitations related to ‘‘Job Corps.’’ 

A general provision is included that provides for the transfer of 

up to 0.75 percent of appropriated funds to carry out program evaluations of ‘‘Training and Employment Services’’, ‘‘Job Corps’’, 

‘‘Community Service Employment for Older Americans,’’ ‘‘State Unemployment Insurance and Employment Service Operations’’, ‘‘Employee Benefits Security Administration’’, ‘‘Office of Workers’ Compensation Programs’’, ‘‘Wage and Hour Division’’, ‘‘Office of Federal 

Contract Compliance Programs’’, ‘‘Office of Labor-Management 

Standards’’, ‘‘Occupational Safety and Health Administration’’, 

‘‘Mine Safety and Health Administration’’, Office of Disability Employment Policy, ‘‘Bureau of International Affairs’’ and ‘‘Women’s 

Bureau’’ within the Departmental Management, Salaries and Expenses’’ account, and ‘‘Veterans Employment and Training’’ for use 

by the Office of the Chief Evaluation Officer. 

TITLE II

Language is included under ‘‘Centers for Disease Control and 

Prevention, Buildings and Facilities’’ to allow the transfer of prior 

year unobligated Individual Learning Account funds to be transferred to this account to carry out the purpose of this account. 

Language is included under ‘‘Administration for Children and 

Families-Refugee and Entrant Assistance’’ permitting transfers 

pursuant to a general provision to increase an appropriation under 

this heading by ten percent. 

Language is included under ‘‘Administration for Community Living, Aging and Disability Services Programs’’ for transfer to the 

Secretary of Agriculture to carryout section 311 of the Older Americans Act of 1965. 

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the ‘‘Department of Health and Human Services’’, provided that no appropriation account is increased by more 

than three percent by such transfer. 

A general provision is included that allows the transfer of up to 

three percent among the institutes and centers of the ‘‘National Institutes of Health’’ from amounts identified as pertaining to the 

human immunodeficiency virus. 

A general provision is included that allows the transfer of funding determined to be related to the human immunodeficiency virus 

to the ‘‘Office of AIDS Research’’. 

A general provision is included that transfers one percent of the 

amount made available for ‘‘National Research Service Awards’’ at 

178 

the ‘‘National Institutes of Health’’ to the ‘‘Health Resources and 

Services Administration’’. 

A general provision is included to direct the transfer of the ‘‘Prevention and Public Health Fund’’ as specified in the committee report accompanying this Act. 

Language is included under ‘‘National Institutes of Health, Innovation Account’’ to allow the transfer of funds to other Institutes 

and Centers to support activities authorized in the 21st Century 

Cures Act (PL 114–255). 

Language is included permitting transfer authority for evaluation activities for discretionary appropriations in the Administration for Children and Families. 

Language is included establishing an Infectious Disease Rapid 

Respond fund for emergency usage by the Secretary under certain 

conditions. 

TITLE III

A general provision is included that allows not to exceed one percent of any discretionary funds to be transferred between appropriation accounts of the Department of Education, provided that no 

appropriation account is increased by more than three percent by 

such transfer. 

TITLE IV

Language is included under Payment to the National Service 

Trust authorizing the transfer of funds from the ‘‘Corporation for 

National and Community Service, Operating Expenses’’ to support 

the activities of national service participants. 

Language is included under ‘‘Social Security Administration’’ authorizing the transfer of up to three percent of the Social Security 

Administration’s ‘‘Limitation on Administration Expenses’’ account 

to be available for purposes of the Office of Inspector General. 

TITLE V

A general provision is included that allows the Secretaries of 

Labor, Health and Human Services, and Education to transfer balances of prior appropriation to accounts corresponding to current 

appropriations. 

DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED

SPENDING ITEMS

Neither the bill nor the report contains any Congressional earmarks, limited tax benefits, or limited tariff benefits as defined in 

clause 9 of rule XXI. 

COMPLIANCE WITH RULE XIII, CL. 3(E) (RAMSEYER RULE)

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

179 

COMPLIANCE WITH RULE XIII, CL. 3(e) (RAMSEYER RULE) 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

DEPARTMENT OF LABOR APPROPRIATIONS ACT, 1958 

Be it enacted by the Senate and House of Representatives of the 

United States of America in Congress assembled, That the following 

sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the Departments of Labor, and Heath, 

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

ending June 30, 1958, namely: 

TITLE I—DEPARTMENT OF LABOR 

OFFICE OF THE SECRETARY

* * * * * * * 

Working capital fund: There is hereby established a working capital fund, to be available without fiscal year limitation, for expenses 

necessary for the maintenance and operation of ø(1) a central reproduction service; (2) a central visual exhibit service; (3) a central 

supply service for supplies and equipment for which adequate 

stocks may be maintained to meet in whole or in part the requirements of the Department; (4) a central tabulating service; (5) telephone, mail and messenger services; (6) a central accounting and 

payroll service; and (7) a central laborers’ service: Provided, That 

any stocks of supplies and equipment on hand or on order shall be 

used to capitalize such fund: Provided further, That such fund shall 

be reimbursed in advance from funds available to bureaus, offices, 

and agencies for which such centralized services are performed at 

rates which will return in full all expenses of operation, including 

reserves for accrued annual leave and depreciation of equipment: 

Provided further, That the Secretary of Labor may transfer annu- ally an amount not to exceed $3,000,000 from unobligated balances 

in the Department’s salaries and expenses accounts, to the unobligated balance of the Working Capital Fund, to be merged with 

such Fund and used for the acquisition of capital equipment and 

the improvement of financial management, information technology 

and other support systems, and to remain available until expended: 

Provided further, That the unobligated balance of the Fund shall not exceed $20,000,000..¿ a comprehensive program of centralized 

services which the Secretary of Labor may prescribe and deem appropriate and advantageous to provide on a reimbursable basis: 

Provided, That such fund may receive advances and reimbursements from funds available to bureaus, offices, and agencies for 

which such centralized services are performed at rates which will 

return in full all expenses of operation, including reserves for accrued annual leave, worker’s compensation, depreciation of capitalized equipment and amortization of human resources software and 

systems (either acquired or donated): Provided further, That the 

Secretary of Labor may transfer annually an amount not to exceed 

$9,000,000 from unobligated balances in the Department’s salaries 

180 

and expenses accounts, to the unobligated balance of the Working 

Capital Fund, to be merged with such Fund and used for the acquisition of capital equipment and the improvement of financial management, information technology and other support systems, and to 

remain available for obligation for an additional five fiscal years: 

Provided further, That such fund may receive reimbursements from 

entities or persons for use of Departmental facilities, including associated utilities and security services, and such reimbursements shall 

be credited to and merged with this fund: Provided further, That 

none of the funds shall be available unless the Chief Information 

Officer of the Department of Labor has submitted a plan, approved 

by the Office of Management and Budget, describing the amounts 

to be transferred by account, the planned use of funds, including descriptions of projects, project status, including any scheduled delays 

and cost overruns, financial expenditures, planned activities, and 

expected benefits, to the Committees on Appropriations of the House 

of Representatives and the Senate by July 31 of the calendar year 

prior to the fiscal year in which the transfer will occur: Provided 

further, That pursuant to section 11319 of title 40, United States 

Code, the Secretary shall ensure that the Department’s Chief Information Officer shall, at a minimum, be a principal advisor to the 

Secretary and a member on any board or governance structure of 

the Department responsible for advising and setting Departmentwide information technology budgets: Provided further, That none 

of the funds available for information technology modernization 

under this section or under the heading ‘‘IT Modernization’’ shall be 

used for information technology modernization projects unless an 

experienced project manager, employed by the Department of Labor, 

is assigned oversight responsibility, including but not limited to, ensuring such projects are completed within established timeframes 

and budgets 

* * * * * * * 

DEPARTMENT OF LABOR, AND HEALTH, EDUCATION, 

AND WELFARE, AND RELATED AGENCIES APPROPRIATIONS ACT, 1970 

Be it enacted by the Senate and House of Representatives of the 

United States of America in Congress assembled, That the following 

sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the Departments of Labor, and Health, 

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

ending June 30, 1970, and for other purposes, namely: 

TITLE I—DEPARTMENT OF LABOR 

* * * * * * * 

OFFICE OF THE SECRETARY

* * * * * * * 

181 

øWORKING CAPITAL FUND¿ 

øThe Working Capital Fund of the Department of Labor shall 

hereafter be available for expenses necessary for personnel functions in regional administrative offices.¿ 

* * * * * * * 

DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 19994 

Be it enacted by the Senate and House of Representatives of the 

United States of America in Congress assembled, That the following 

sums are appropriated, out of any money in the Treasury not otherwise appropriated, for the Departments of Labor, Health and 

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

year ending September 30, 1994, and for other purposes, namely: 

TITLE I—DEPARTMENT OF LABOR 

* * * * * * * 

DEPARTMENTAL MANAGEMENT

* * * * * * * 

øWORKING CAPITAL FUND¿ 

øFor expenses necessary during the fiscal year ending September 

30, 1994, and each fiscal year thereafter, for the maintenance and 

operation of a comprehensive program of centralized services which 

the Secretary of Labor may prescribe and deem appropriate and 

advantageous to provide on a reimbursable basis under the provisions of the Economy Act (subject to prior notice to OMB) in the 

national office and field: Provided, That such fund shall be reimbursed in advance from funds available to agencies, bureaus, and 

offices for which such centralized services are performed at rates 

which will return in full cost of operations including services obtained through cooperative administrative services units under the 

Economy Act, including reserves for accrued annual leave, worker’s 

compensation, depreciation of capitalized equipment, and amortization of ADP software and systems (either acquired or donated): 

Provided further, That funds received for services rendered to any 

entity or person for use of Departmental facilities, including associated utilities and security services, shall be credited to and merged 

with this fund.¿ 

* * * * * * * 

HIGHER EDUCATION ACT OF 1965 

* * * * * * * 

TITLE I—GENERAL PROVISIONS 

* * * * * * * 

182 

PART B—ADDITIONAL GENERAL PROVISIONS 

* * * * * * * 

SEC. 114. NATIONAL ADVISORY COMMITTEE ON INSTITUTIONAL QUALITY AND INTEGRITY. 

(a) ESTABLISHMENT.—There is established in the Department a 

National Advisory Committee on Institutional Quality and Integrity (in this section referred to as the ‘‘Committee’’) to assess the 

process of accreditation and the institutional eligibility and certification of institutions of higher education (as defined in section 102) 

under title IV. 

(b) MEMBERSHIP.— 

(1) IN GENERAL.—The Committee shall have 18 members, of 

which— 

(A) six members shall be appointed by the Secretary; 

(B) six members shall be appointed by the Speaker of 

the House of Representatives, three of whom shall be appointed on the recommendation of the majority leader of 

the House of Representatives, and three of whom shall be 

appointed on the recommendation of the minority leader of 

the House of Representatives; and 

(C) six members shall be appointed by the President pro 

tempore of the Senate, three of whom shall be appointed 

on the recommendation of the majority leader of the Senate, and three of whom shall be appointed on the recommendation of the minority leader of the Senate. 

(2) QUALIFICATIONS.—Individuals shall be appointed as 

members of the Committee— 

(A) on the basis of the individuals’ experience, integrity, 

impartiality, and good judgment; 

(B) from among individuals who are representatives of, 

or knowledgeable concerning, education and training beyond secondary education, representing all sectors and 

types of institutions of higher education (as defined in section 102); and 

(C) on the basis of the individuals’ technical qualifications, professional standing, and demonstrated knowledge 

in the fields of accreditation and administration in higher 

education. 

(3) TERMS OF MEMBERS.—Except as provided in paragraph 

(5), the term of office of each member of the Committee shall 

be for six years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which 

the member’s predecessor was appointed shall be appointed for 

the remainder of such term. 

(4) VACANCY.—A vacancy on the Committee shall be filled in 

the same manner as the original appointment was made not 

later than 90 days after the vacancy occurs. If a vacancy occurs 

in a position to be filled by the Secretary, the Secretary shall 

publish a Federal Register notice soliciting nominations for the 

position not later than 30 days after being notified of the vacancy. 

(5) INITIAL TERMS.—The terms of office for the initial members of the Committee shall be— 

183 

(A) three years for members appointed under paragraph 

(1)(A); 

(B) four years for members appointed under paragraph 

(1)(B); and 

(C) six years for members appointed under paragraph 

(1)(C). 

(6) CHAIRPERSON.—The members of the Committee shall select a chairperson from among the members. 

(c) FUNCTIONS.—The Committee shall— 

(1) advise the Secretary with respect to establishment and 

enforcement of the standards of accrediting agencies or associations under subpart 2 of part H of title IV; 

(2) advise the Secretary with respect to the recognition of a 

specific accrediting agency or association; 

(3) advise the Secretary with respect to the preparation and 

publication of the list of nationally recognized accrediting agencies and associations; 

(4) advise the Secretary with respect to the eligibility and 

certification process for institutions of higher education under 

title IV, together with recommendations for improvements in 

such process; 

(5) advise the Secretary with respect to the relationship between— 

(A) accreditation of institutions of higher education and 

the certification and eligibility of such institutions; and 

(B) State licensing responsibilities with respect to such 

institutions; and 

(6) carry out such other advisory functions relating to accreditation and institutional eligibility as the Secretary may prescribe by regulation. 

(d) MEETING PROCEDURES.— (1) SCHEDULE.— 

(A) BIANNUAL MEETINGS.—The Committee shall meet not 

less often than twice each year, at the call of the Chairperson. 

(B) PUBLICATION OF DATE.—The Committee shall submit 

the date and location of each meeting in advance to the 

Secretary, and the Secretary shall publish such information in the Federal Register not later than 30 days before 

the meeting. 

(2) AGENDA.— 

(A) ESTABLISHMENT.—The agenda for a meeting of the 

Committee shall be established by the Chairperson and 

shall be submitted to the members of the Committee upon 

notification of the meeting. 

(B) OPPORTUNITY FOR PUBLIC COMMENT.—The agenda 

shall include, at a minimum, opportunity for public comment during the Committee’s deliberations. 

(3) SECRETARY’S DESIGNEE.—The Secretary shall designate 

an employee of the Department to serve as the Secretary’s designee to the Committee, and the Chairperson shall invite the 

Secretary’s designee to attend all meetings of the Committee. 

(4) FEDERAL ADVISORY COMMITTEE ACT.—The Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee, except that section 14 of such Act shall not apply. 

184 

(e) REPORT AND NOTICE.— (1) NOTICE.—The Secretary shall annually publish in the 

Federal Register— 

(A) a list containing, for each member of the Committee— 

(i) the member’s name; 

(ii) the date of the expiration of the member’s term 

of office; and 

(iii) the name of the individual described in subsection (b)(1) who appointed the member; and 

(B) a solicitation of nominations for each expiring term 

of office on the Committee of a member appointed by the 

Secretary. 

(2) REPORT.—Not later than the last day of each fiscal year, 

the Committee shall make available an annual report to the 

Secretary, the authorizing committees, and the public. The annual report shall contain— 

(A) a detailed summary of the agenda and activities of, 

and the findings and recommendations made by, the Committee during the fiscal year preceding the fiscal year in 

which the report is made; 

(B) a list of the date and location of each meeting during 

the fiscal year preceding the fiscal year in which the report 

is made; 

(C) a list of the members of the Committee; and 

(D) a list of the functions of the Committee, including 

any additional functions established by the Secretary 

through regulation. 

(f) TERMINATION.—The Committee shall terminate on September 

30, ø2018¿ 2019. 

* * * * * * * 

TITLE IV—STUDENT ASSISTANCE 

* * * * * * * 

PART B—FEDERAL FAMILY EDUCATION LOAN PROGRAM

* * * * * * * 

SEC. 427. ELIGIBILITY OF STUDENT BORROWERS AND TERMS OF FEDERALLY INSURED STUDENT LOANS. 

(a) LIST OF REQUIREMENTS.—Except as provided in section 428C, 

a loan by an eligible lender shall be insurable by the Secretary 

under the provisions of this part only if— 

(1) made to a student who (A) is an eligible student under 

section 484, (B) has agreed to notify promptly the holder of the 

loan concerning any change of address, and (C) is carrying at 

least one-half the normal full-time academic workload for the 

course of study the student is pursuing (as determined by the 

institution); and 

(2) evidenced by a note or other written agreement which— 

(A) is made without security and without endorsement; 

(B) provides for repayment (except as provided in subsection (c)) of the principal amount of the loan in installments over a period of not less than 5 years (unless sooner 

repaid or unless the student, during the 6 months preVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00184 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
185 

ceding the start of the repayment period, specifically requests that repayment be made over a shorter period) nor 

more than 10 years beginning 6 months after the month 

in which the student ceases to carry at an eligible institution at least one-half the normal full-time academic workload as determined by the institution, except— 

(i) as provided in subparagraph (C); 

(ii) that the note or other written instrument may 

contain such reasonable provisions relating to repayment in the event of default in the payment of interest 

or in the payment of the cost of insurance premiums, 

or other default by the borrower, as may be authorized 

by regulations of the Secretary in effect at the time 

the loan is made; and 

(iii) that the lender and the student, after the student ceases to carry at an eligible institution at least 

one-half the normal full-time academic workload as 

determined by the institution, may agree to a repayment schedule which begins earlier, or is of shorter 

duration, than required by this subparagraph, but in 

the event a borrower has requested and obtained a repayment period of less than 5 years, the borrower may 

at any time prior to the total repayment of the loan, 

have the repayment period extended so that the total 

repayment period is not less than 5 years; 

(C) provides that periodic installments of principal need 

not be paid, but interest shall accrue and be paid, during 

any period— 

(i) during which the borrower— 

(I) is pursuing at least a half-time course of 

study as determined by an eligible institution; or 

(II) is pursuing a course of study pursuant to a 

graduate fellowship program approved by the Secretary, or pursuant to a rehabilitation training 

program for individuals with disabilities approved 

by the Secretary, 

except that no borrower shall be eligible for a 

deferment under this clause, or a loan made under 

this part (other than a loan made under section 428B 

or 428C), while serving in a medical internship or residency program; 

(ii) not in excess of 3 years during which the borrower is seeking and unable to find full-time 

employmentø; or¿; 

(iii) not in excess of 3 years for any reason which the 

lender determines, in accordance with regulations prescribed by the Secretary under section 435(o), has 

caused or will cause the borrower to have an economic 

hardship; or 

(iv) in which the borrower is receiving treatment for 

cancer and the 6 months after such period. 

and provides that any such period shall not be included in 

determining the 10-year period described in subparagraph 

(B); 

186 

(D) provides for interest on the unpaid principal balance 

of the loan at a yearly rate, not exceeding the applicable 

maximum rate prescribed in section 427A, which interest 

shall be payable in installments over the period of the loan 

except that, if provided in the note or other written agreement, any interest payable by the student may be deferred 

until not later than the date upon which repayment of the 

first installment of principal falls due, in which case interest accrued during that period may be added on that date 

to the principal; 

(E) provides that the lender will not collect or attempt 

to collect from the borrower any portion of the interest on 

the note which is payable by the Secretary under this part, 

and that the lender will enter into such agreements with 

the Secretary as may be necessary for the purpose of section 437; 

(F) entitles the student borrower to accelerate without 

penalty repayment of the whole or any part of the loan; 

(G)(i) contains a notice of the system, of disclosure of information concerning such loan to consumer reporting 

agencies under section 430A, and (ii) provides that the 

lender on request of the borrower will provide information 

on the repayment status of the note to such consumer reporting agencies; 

(H) provides that, no more than 6 months prior to the 

date on which the borrower’s first payment on a loan is 

due, the lender shall offer the borrower the option of repaying the loan in accordance with a graduated or incomesensitive repayment schedule established by the lender 

and in accordance with the regulations of the Secretary; 

and 

(I) contains such other terms and conditions, consistent 

with the provisions of this part and with the regulations 

issued by the Secretary pursuant to this part, as may be 

agreed upon by the parties to such loan, including, if 

agreed upon, a provision requiring the borrower to pay the 

lender, in addition to principal and interest, amounts 

equal to the insurance premiums payable by the lender to 

the Secretary with respect to such loan; 

(3) the funds borrowed by a student are disbursed to the institution by check or other means that is payable to and requires the endorsement or other certification by such student, 

except— 

(A) that nothing in this title shall be interpreted— 

(i) to allow the Secretary to require checks to be 

made copayable to the institution and the borrower; or 

(ii) to prohibit the disbursement of loan proceeds by 

means other than by check; and 

(B) in the case of any student who is studying outside 

the United States in a program of study abroad that is approved for credit by the home institution at which such 

student is enrolled, the funds shall, at the request of the 

borrower, be delivered directly to the student and the 

checks may be endorsed, and fund transfers authorized, 

pursuant to an authorized power-of-attorney; and 

187 

(4) the funds borrowed by a student are disbursed in accordance with section 428G. 

(b) SPECIAL RULES FOR MULTIPLE DISBURSEMENT.—For the purpose of subsection (a)(4)— 

(1) all loans issued for the same period of enrollment shall 

be considered as a single loan; and 

(2) the requirements of such subsection shall not apply in the 

case of a loan made under section 428B or 428C, or made to 

a student to cover the cost of attendance at an eligible institution outside the United States. 

(c) SPECIAL REPAYMENT RULES.—Except as provided in subsection (a)(2)(H), the total of the payments by a borrower during 

any year of any repayment period with respect to the aggregate 

amount of all loans to that borrower which are insured under this 

part shall not, unless the borrower and the lender otherwise agree, 

be less than $600 or the balance of all such loans (together with 

interest thereon), whichever amount is less (but in no instance less 

than the amount of interest due and payable). 

* * * * * * * 

SEC. 428. FEDERAL PAYMENTS TO REDUCE STUDENT INTEREST 

COSTS. 

(a) FEDERAL INTEREST SUBSIDIES.— (1) TYPES OF LOANS THAT QUALIFY.—Each student who has 

received a loan for study at an eligible institution for which the 

first disbursement is made before July 1, 2010, and— 

(A) which is insured by the Secretary under this part; or 

(B) which is insured under a program of a State or of a 

nonprofit private institution or organization which was 

contracted for, and paid to the student, within the period 

specified in paragraph (5), and which— 

(i) in the case of a loan insured prior to July 1, 1967, 

was made by an eligible lender and is insured under 

a program which meets the requirements of subparagraph (E) of subsection (b)(1) and provides that repayment of such loan shall be in installments beginning 

not earlier than 60 days after the student ceases to 

pursue a course of study (as described in subparagraph (D) of subsection (b)(1)) at an eligible institution, or 

(ii) in the case of a loan insured after June 30, 1967, 

was made by an eligible lender and is insured under 

a program covered by an agreement made pursuant to 

subsection (b), 

shall be entitled to have paid on his or her behalf and for his 

or her account to the holder of the loan a portion of the interest on such loan under circumstances described in paragraph 

(2). 

(2) ADDITIONAL REQUIREMENTS TO RECEIVE SUBSIDY.—(A) 

Each student qualifying for a portion of an interest payment 

under paragraph (1) shall— 

(i) have provided to the lender a statement from the eligible institution, at which the student has been accepted 

for enrollment, or at which the student is in attendance, 

which— 

188 

(I) sets forth the loan amount for which the student 

shows financial need; and 

(II) sets forth a schedule for disbursement of the 

proceeds of the loan in installments, consistent with 

the requirements of section 428G; 

(ii) meet the requirements of subparagraph (B); and 

(iii) have provided to the lender at the time of application for a loan made, insured, or guaranteed under 

this part, the student’s driver’s number, if any. 

(B) For the purpose of clause (ii) of subparagraph (A), a student shall qualify for a portion of an interest payment under 

paragraph (1) if the eligible institution has determined and 

documented the student’s amount of need for a loan based on 

the student’s estimated cost of attendance, estimated financial 

assistance, and, for the purpose of an interest payment pursuant to this section, expected family contribution (as determined 

under part F), subject to the provisions of subparagraph (D). 

(C) For the purpose of this paragraph— 

(i) a student’s cost of attendance shall be determined 

under section 472; 

(ii) a student’s estimated financial assistance means, for 

the period for which the loan is sought— 

(I) the amount of assistance such student will receive under subpart 1 of part A (as determined in accordance with section 484(b)), subpart 3 of part A, and 

parts C and E; plus 

(II) other scholarship, grant, or loan assistance, but 

excluding— 

(aa) any national service education award or 

post-service benefit under title I of the National 

and Community Service Act of 1990; and 

(bb) any veterans’ education benefits as defined 

in section 480(c); and 

(iii) the determination of need and of the amount of a 

loan by an eligible institution under subparagraph (B) 

with respect to a student shall be calculated in accordance 

with part F. 

(D) An eligible institution may not, in carrying out the provisions of subparagraphs (A) and (B) of this paragraph, provide 

a statement which certifies the eligibility of any student to receive any loan under this part in excess of the maximum 

amount applicable to such loan. 

(E) For the purpose of subparagraphs (B) and (C) of this 

paragraph, any loan obtained by a student under section 428A 

or 428H or a parent under section 428B of this Act or under 

any State-sponsored or private loan program for an academic 

year for which the determination is made may be used to offset 

the expected family contribution of the student for that year. 

(3) AMOUNT OF INTEREST SUBSIDY.—(A)(i) Subject to section 

438(c), the portion of the interest on a loan which a student is 

entitled to have paid, on behalf of and for the account of the 

student, to the holder of the loan pursuant to paragraph (1) of 

this subsection shall be equal to the total amount of the interest on the unpaid principal amount of the loan— 

189 

(I) which accrues prior to the date the student 

ceases to carry at least one-half the normal fulltime academic workload (as determined by the institution), or 

(II) which accrues during a period in which principal 

need not be paid (whether or not such principal is in fact 

paid) by reason of a provision described in subsection 

(b)(1)(M) of this section or in section 427(a)(2)(C). 

(ii) Such portion of the interest on a loan shall not exceed, 

for any period, the amount of the interest on that loan which 

is payable by the student after taking into consideration the 

amount of any interest on that loan which the student is entitled to have paid on his or her behalf for that period under any 

State or private loan insurance program. 

(iii) The holder of a loan with respect to which payments are 

required to be made under this section shall be deemed to have 

a contractual right, as against the United States, to receive 

from the Secretary the portion of interest which has been so 

determined without administrative delay after the receipt by 

the Secretary of an accurate and complete request for payment 

pursuant to paragraph (4). 

(iv) The Secretary shall pay this portion of the interest to the 

holder of the loan on behalf of and for the account of the borrower at such times as may be specified in regulations in force 

when the applicable agreement entered into pursuant to subsection (b) was made, or, if the loan was made by a State or 

is insured under a program which is not covered by such an 

agreement, at such times as may be specified in regulations in 

force at the time the loan was paid to the student. 

(v) A lender may not receive interest on a loan for any period 

that precedes the date that is— 

(I) in the case of a loan disbursed by check, 10 days before the first disbursement of the loan; 

(II) in the case of a loan disbursed by electronic funds 

transfer, 3 days before the first disbursement of the loan; 

or 

(III) in the case of a loan disbursed through an escrow 

agent, 3 days before the first disbursement of the loan. 

(B) If— 

(i) a State student loan insurance program is covered by 

an agreement under subsection (b), 

(ii) a statute of such State limits the interest rate on 

loans insured by such program to a rate which is less than 

the applicable interest rate under this part, and 

(iii) the Secretary determines that subsection (d) does 

not make such statutory limitation inapplicable and that 

such statutory limitation threatens to impede the carrying 

out of the purpose of this part, 

then the Secretary may pay an administrative cost allowance 

to the holder of each loan which is insured under such program 

and which is made during the period beginning on the 60th 

day after the date of enactment of the Higher Education 

Amendments of 1968 and ending 120 days after the adjournment of such State’s first regular legislative session which adjourns after January 1, 1969. Such administrative cost allowVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00189 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
190 

ance shall be paid over the term of the loan in an amount per 

year (determined by the Secretary) which shall not exceed 1 

percent of the unpaid principal balance of the loan. 

(4) SUBMISSION OF STATEMENTS BY HOLDERS ON AMOUNT OF

PAYMENT.—Each holder of a loan with respect to which payments of interest are required to be made by the Secretary 

shall submit to the Secretary, at such time or times and in 

such manner as the Secretary may prescribe, statements containing such information as may be required by or pursuant to 

regulation for the purpose of enabling the Secretary to determine the amount of the payment which he must make with respect to that loan. 

(5) DURATION OF AUTHORITY TO MAKE INTEREST SUBSIDIZED

LOANS.—The period referred to in subparagraph (B) of paragraph (1) of this subsection shall begin on the date of enactment of this Act and end at the close of June 30, 2010. 

(6) ASSESSMENT OF BORROWER’S FINANCIAL CONDITION NOT

PROHIBITED OR REQUIRED.—Nothing in this or any other Act 

shall be construed to prohibit or require, unless otherwise specifically provided by law, a lender to evaluate the total financial situation of a student making application for a loan under 

this part, or to counsel a student with respect to any such loan, 

or to make a decision based on such evaluation and counseling 

with respect to the dollar amount of any such loan. 

(7) LOANS THAT HAVE NOT BEEN CONSUMMATED.—Lenders 

may not charge interest or receive interest subsidies or special 

allowance payments for loans for which the disbursement 

checks have not been cashed or for which electronic funds 

transfers have not been completed. 

(b) INSURANCE PROGRAM AGREEMENTS TO QUALIFY LOANS FOR

INTEREST SUBSIDIES.— (1) REQUIREMENTS OF INSURANCE PROGRAM.—Any State or 

any nonprofit private institution or organization may enter 

into an agreement with the Secretary for the purpose of entitling students who receive loans which are insured under a 

student loan insurance program of that State, institution, or 

organization to have made on their behalf the payments provided for in subsection (a) if the Secretary determines that the 

student loan insurance program— 

(A) authorizes the insurance in any academic year, as 

defined in section 481(a)(2), or its equivalent (as determined under regulations of the Secretary) for any student 

who is carrying at an eligible institution or in a program 

of study abroad approved for credit by the eligible home institution at which such student is enrolled at least one-half 

the normal full-time academic workload (as determined by 

the institution) in any amount up to a maximum of— 

(i) in the case of a student at an eligible institution 

who has not successfully completed the first year of a 

program of undergraduate education— 

(I) $3,500, if such student is enrolled in a program whose length is at least one academic year 

in length; and 

(II) if such student is enrolled in a program of 

undergraduate education which is less than 1 acaVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00190 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
191 

demic year, the maximum annual loan amount 

that such student may receive may not exceed the 

amount that bears the same ratio to the amount 

specified in subclause (I) as the length of such program measured in semester, trimester, quarter, or 

clock hours bears to 1 academic year; 

(ii) in the case of a student at an eligible institution 

who has successfully completed such first year but has 

not successfully completed the remainder of a program 

of undergraduate education— 

(I) $4,500; or 

(II) if such student is enrolled in a program of 

undergraduate education, the remainder of which 

is less than one academic year, the maximum annual loan amount that such student may receive 

may not exceed the amount that bears the same 

ratio to the amount specified in subclause (I) as 

such remainder measured in semester, trimester, 

quarter, or clock hours bears to one academic 

year; 

(iii) in the case of a student at an eligible institution 

who has successfully completed the first and second 

years of a program of undergraduate education but 

has not successfully completed the remainder of such 

program— 

(I) $5,500; or 

(II) if such student is enrolled in a program of 

undergraduate education, the remainder of which 

is less than one academic year, the maximum annual loan amount that such student may receive 

may not exceed the amount that bears the same 

ratio to the amount specified in subclause (I) as 

such remainder measured in semester, trimester, 

quarter, or clock hours bears to one academic 

year; 

(iv) in the case of a student who has received an associate or baccalaureate degree and is enrolled in an 

eligible program for which the institution requires 

such degree for admission, the number of years that a 

student has completed in a program of undergraduate 

education shall, for the purposes of clauses (ii) and 

(iii), include any prior enrollment in the eligible program of undergraduate education for which the student was awarded such degree; 

(v) in the case of a graduate or professional student 

(as defined in regulations of the Secretary) at an eligible institution, $8,500; and 

(vi) in the case of a student enrolled in coursework 

specified in sections 484(b)(3)(B) and 484(b)(4)(B)— 

(I) $2,625 for coursework necessary for enrollment in an undergraduate degree or certificate 

program, and, in the case of a student who has obtained a baccalaureate degree, $5,500 for 

coursework necessary for enrollment in a graduate 

192 

or professional degree or certification program; 

and 

(II) in the case of a student who has obtained a 

baccalaureate degree, $5,500 for coursework necessary for a professional credential or certification 

from a State required for employment as a teacher 

in an elementary school or secondary school; 

except in cases where the Secretary determines, pursuant 

to regulations, that a higher amount is warranted in order 

to carry out the purpose of this part with respect to students engaged in specialized training requiring exceptionally high costs of education, but the annual insurable limit 

per student shall not be deemed to be exceeded by a line 

of credit under which actual payments by the lender to the 

borrower will not be made in any years in excess of the annual limit; 

(B) provides that the aggregate insured unpaid principal 

amount for all such insured loans made to any student 

shall be any amount up to a maximum of— (i) $23,000, in the case of any student who has not 

successfully completed a program of undergraduate 

education, excluding loans made under section 428A or 

428B; and 

(ii) $65,500, in the case of any graduate or professional student (as defined by regulations of the Secretary), and (I) including any loans which are insured 

by the Secretary under this section, or by a guaranty 

agency, made to such student before the student became a graduate or professional student, but (II) excluding loans made under section 428A or 428B, 

except that the Secretary may increase the limit applicable 

to students who are pursuing programs which the Secretary determines are exceptionally expensive; 

(C) authorizes the insurance of loans to any individual 

student for at least 6 academic years of study or their 

equivalent (as determined under regulations of the Secretary); 

(D) provides that (i) the student borrower shall be entitled to accelerate without penalty the whole or any part of 

an insured loan, (ii) the student borrower may annually 

change the selection of a repayment plan under this part, 

and (iii) the note, or other written evidence of any loan, 

may contain such reasonable provisions relating to repayment in the event of default by the borrower as may be authorized by regulations of the Secretary in effect at the 

time such note or written evidence was executed, and shall 

contain a notice that repayment may, following a default 

by the borrower, be subject to income contingent repayment in accordance with subsection (m); 

(E) subject to subparagraphs (D) and (L), and except as 

provided by subparagraph (M), provides that— 

(i) not more than 6 months prior to the date on 

which the borrower’s first payment is due, the lender 

shall offer the borrower of a loan made, insured, or 

guaranteed under this section or section 428H, the opVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00192 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
193 

tion of repaying the loan in accordance with a standard, graduated, income-sensitive, or extended repayment schedule (as described in paragraph (9)) established by the lender in accordance with regulations of 

the Secretary; and 

(ii) repayment of loans shall be in installments in 

accordance with the repayment plan selected under 

paragraph (9) and commencing at the beginning of the 

repayment period determined under paragraph (7); 

(F) authorizes interest on the unpaid balance of the loan 

at a yearly rate not in excess (exclusive of any premium 

for insurance which may be passed on to the borrower) of 

the rate required by section 427A; 

(G) insures 98 percent of the unpaid principal of loans 

insured under the program, except that— 

(i) such program shall insure 100 percent of the unpaid principal of loans made with funds advanced pursuant to section 428(j); 

(ii) for any loan for which the first disbursement of 

principal is made on or after July 1, 2006, and before 

July 1, 2010, the preceding provisions of this subparagraph shall be applied by substituting ‘‘97 percent’’ for 

‘‘98 percent’’; and 

(iii) notwithstanding the preceding provisions of this 

subparagraph, such program shall insure 100 percent 

of the unpaid principal amount of exempt claims as 

defined in subsection (c)(1)(G); 

(H) provides— 

(i) for loans for which the date of guarantee of principal is before July 1, 2006, for the collection of a single insurance premium equal to not more than 1.0 percent of the principal amount of the loan, by deduction 

proportionately from each installment payment of the 

proceeds of the loan to the borrower, and ensures that 

the proceeds of the premium will not be used for incentive payments to lenders; or 

(ii) for loans for which the date of guarantee of principal is on or after July 1, 2006, and that are first disbursed before July 1, 2010, for the collection, and the 

deposit into the Federal Student Loan Reserve Fund 

under section 422A of a Federal default fee of an 

amount equal to 1.0 percent of the principal amount 

of the loan, which fee shall be collected either by deduction from the proceeds of the loan or by payment 

from other non-Federal sources, and ensures that the 

proceeds of the Federal default fee will not be used for 

incentive payments to lenders; 

(I) provides that the benefits of the loan insurance program will not be denied any student who is eligible for interest benefits under subsection (a) (1) and (2); 

(J) provides that a student may obtain insurance under 

the program for a loan for any year of study at an eligible 

institution; 

(K) in the case of a State program, provides that such 

State program is administered by a single State agency, or 

194 

by one or more nonprofit private institutions or organizations under supervision of a single State agency; 

(L) provides that the total of the payments by a borrower— 

(i) except as otherwise provided by a repayment 

plan selected by the borrower under clause (ii), (iii), or 

(v) of paragraph (9)(A), during any year of any repayment period with respect to the aggregate amount of 

all loans to that borrower which are insured under 

this part shall not, unless the borrower and the lender 

otherwise agree, be less than $600 or the balance of all 

such loans (together with interest thereon), whichever 

amount is less (but in no instance less than the 

amount of interest due and payable, notwithstanding 

any payment plan under paragraph (9)(A)); and 

(ii) for a monthly or other similar payment period 

with respect to the aggregate of all loans held by the 

lender may, when the amount of a monthly or other 

similar payment is not a multiple of $5, be rounded to 

the next highest whole dollar amount that is a multiple of $5; 

(M) provides that periodic installments of principal need 

not be paid, but interest shall accrue and be paid by the 

Secretary, during any period— 

(i) during which the borrower— 

(I) is pursuing at least a half-time course of 

study as determined by an eligible institution, except that no borrower, notwithstanding the provisions of the promissory note, shall be required to 

borrow an additional loan under this title in order 

to be eligible to receive a deferment under this 

clause; or 

(II) is pursuing a course of study pursuant to a 

graduate fellowship program approved by the Secretary, or pursuant to a rehabilitation training 

program for disabled individuals approved by the 

Secretary, 

except that no borrower shall be eligible for a 

deferment under this clause, or loan made under this 

part (other than a loan made under section 428B or 

428C), while serving in a medical internship or residency program; 

(ii) not in excess of 3 years during which the borrower is seeking and unable to find full-time employment, except that no borrower who provides evidence 

of eligibility for unemployment benefits shall be required to provide additional paperwork for a 

deferment under this clause; 

(iii) during which the borrower— 

(I) is serving on active duty during a war or 

other military operation or national emergency; or 

(II) is performing qualifying National Guard 

duty during a war or other military operation or 

national emergency, 

195 

and for the 180-day period following the demobilization date for the service described in subclause (I) øor 

(II); or¿ or (II); 

(iv) not in excess of 3 years for any reason which the 

lender determines, in accordance with regulations prescribed by the Secretary under section 435(o), has 

caused or will cause the borrower to have an economic 

hardship; or 

(v) during which the borrower is receiving treatment 

for cancer and the 6 months after such period; 

(N) provides that funds borrowed by a student— 

(i) are disbursed to the institution by check or other 

means that is payable to, and requires the endorsement or other certification by, such student; 

(ii) in the case of a student who is studying outside 

the United States in a program of study abroad that 

is approved for credit by the home institution at which 

such student is enrolled, and only after verification of 

the student’s enrollment by the lender or guaranty 

agency, are, at the request of the student, disbursed 

directly to the student by the means described in 

clause (i), unless such student requests that the check 

be endorsed, or the funds transfer be authorized, pursuant to an authorized power-of-attorney; or 

(iii) in the case of a student who is studying outside 

the United States in a program of study at an eligible 

foreign institution, are, at the request of the foreign 

institution, disbursed directly to the student, only 

after verification of the student’s enrollment by the 

lender or guaranty agency by the means described in 

clause (i). 

(O) provides that the proceeds of the loans will be disbursed in accordance with the requirements of section 

428G; 

(P) requires the borrower to notify the institution concerning any change in local address during enrollment and 

requires the borrower and the institution at which the borrower is in attendance promptly to notify the holder of the 

loan, directly or through the guaranty agency, concerning 

(i) any change of permanent address, (ii) when the student 

ceases to be enrolled on at least a half-time basis, and (iii) 

any other change in status, when such change in status affects the student’s eligibility for the loan; 

(Q) provides for the guarantee of loans made to students 

and parents under sections 428A and 428B; 

(R) with respect to lenders which are eligible institutions, provides for the insurance of loans by only such institutions as are located within the geographic area served 

by such guaranty agency; 

(S) provides no restrictions with respect to the insurance 

of loans for students who are otherwise eligible for loans 

under such program if such a student is accepted for enrollment in or is attending an eligible institution within 

the State, or if such a student is a legal resident of the 

196 

State and is accepted for enrollment in or is attending an 

eligible institution outside that State; 

(T) authorizes (i) the limitation of the total number of 

loans or volume of loans, made under this part to students 

attending a particular eligible institution during any academic year; and (ii) the emergency action, limitation, suspension, or termination of the eligibility of an eligible institution if— 

(I) such institution is ineligible for the emergency 

action, limitation, suspension, or termination of eligible institutions under regulations issued by the Secretary or is ineligible pursuant to criteria, rules, or 

regulations issued under the student loan insurance 

program which are substantially the same as regulations with respect to emergency action, limitation, suspension, or termination of such eligibility issued by 

the Secretary; 

(II) there is a State constitutional prohibition affecting the eligibility of such an institution; 

(III) such institution fails to make timely refunds to 

students as required by regulations issued by the Secretary or has not satisfied within 30 days of issuance 

a final judgment obtained by a student seeking such 

a refund; 

(IV) such institution or an owner, director, or officer 

of such institution is found guilty in any criminal, 

civil, or administrative proceeding, or such institution 

or an owner, director, or officer of such institution is 

found liable in any civil or administrative proceeding, 

regarding the obtaining, maintenance, or disbursement of State or Federal grant, loan, or work assistance funds; or 

(V) such institution or an owner, director, or officer 

of such institution has unpaid financial liabilities involving the improper acquisition, expenditure, or refund of State or Federal financial assistance funds; 

except that, if a guaranty agency limits, suspends, or terminates the participation of an eligible institution, the Secretary shall apply that limitation, suspension, or termination to all locations of such institution, unless the Secretary finds, within 30 days of notification of the action by 

the guaranty agency, that the guaranty agency’s action did 

not comply with the requirements of this section; 

(U) provides (i) for the eligibility of all lenders described 

in section 435(d)(1) under reasonable criteria, unless (I) 

that lender is eliminated as a lender under regulations for 

the emergency action, limitation, suspension, or termination of a lender under the Federal student loan insurance program or is eliminated as a lender pursuant to criteria issued under the student loan insurance program 

which are substantially the same as regulations with respect to such eligibility as a lender issued under the Federal student loan insurance program, or (II) there is a 

State constitutional prohibition affecting the eligibility of a 

197 

lender, (ii) assurances that the guaranty agency will report 

to the Secretary concerning changes in such criteria, including any procedures in effect under such program to 

take emergency action, limit, suspend, or terminate lenders, and (iii) for (I) a compliance audit of each lender that 

originates or holds more than $5,000,000 in loans made 

under this title for any lender fiscal year (except that each 

lender described in section 435(d)(1)(A)(ii)(III) shall annually submit the results of an audit required by this clause), 

at least once a year and covering the period since the most 

recent audit, conducted by a qualified, independent organization or person in accordance with standards established 

by the Comptroller General for the audit of governmental 

organizations, programs, and functions, and as prescribed 

in regulations of the Secretary, the results of which shall 

be submitted to the Secretary, or (II) with regard to a 

lender that is audited under chapter 75 of title 31, United 

States Code, such audit shall be deemed to satisfy the requirements of subclause (I) for the period covered by such 

audit, except that the Secretary may waive the requirements of this clause (iii) if the lender submits to the Secretary the results of an audit conducted for other purposes 

that the Secretary determines provides the same information as the audits required by this clause; 

(V) provides authority for the guaranty agency to require 

a participation agreement between the guaranty agency 

and each eligible institution within the State in which it 

is designated, as a condition for guaranteeing loans made 

on behalf of students attending the institution; 

(W) provides assurances that the agency will implement 

all requirements of the Secretary for uniform claims and 

procedures pursuant to section 432(l); 

(X) provides information to the Secretary in accordance 

with section 428(c)(9) and maintains reserve funds determined by the Secretary to be sufficient in relation to such 

agency’s guarantee obligations; and 

(Y) provides that— 

(i) the lender shall determine the eligibility of a borrower for a deferment described in subparagraph 

(M)(i) based on— 

(I) receipt of a request for deferment from the 

borrower and documentation of the borrower’s eligibility for the deferment; 

(II) receipt of a newly completed loan application that documents the borrower’s eligibility for a 

deferment; 

(III) receipt of student status information documenting that the borrower is enrolled on at least 

a half-time basis; or 

(IV) the lender’s confirmation of the borrower’s 

half-time enrollment status through use of the 

National Student Loan Data System, if the confirmation is requested by the institution of higher 

education; 

198 

(ii) the lender will notify the borrower of the granting of any deferment under clause (i)(II) or (III) of this 

subparagraph and of the option to continue paying on 

the loan; and 

(iii) the lender shall, at the time the lender grants 

a deferment to a borrower who received a loan under 

section 428H and is eligible for a deferment under 

subparagraph (M) of this paragraph, provide information to the borrower to assist the borrower in understanding the impact of the capitalization of interest on 

the borrower’s loan principal and on the total amount 

of interest to be paid during the life of the loan. 

(2) CONTENTS OF INSURANCE PROGRAM AGREEMENT.—Such an 

agreement shall— 

(A) provide that the holder of any such loan will be required to submit to the Secretary, at such time or times 

and in such manner as the Secretary may prescribe, statements containing such information as may be required by 

or pursuant to regulation for the purpose of enabling the 

Secretary to determine the amount of the payment which 

must be made with respect to that loan; 

(B) include such other provisions as may be necessary to 

protect the United States from the risk of unreasonable 

loss and promote the purpose of this part, including such 

provisions as may be necessary for the purpose of section 

437, and as are agreed to by the Secretary and the guaranty agency, as the case may be; 

(C) provide for making such reports, in such form and 

containing such information, including financial information, as the Secretary may reasonably require to carry out 

the Secretary’s functions under this part and protect the financial interest of the United States, and for keeping such 

records and for affording such access thereto as the Secretary may find necessary to assure the correctness and 

verification of such reports; 

(D) provide for— 

(i) conducting, except as provided in clause (ii), financial and compliance audits of the guaranty agency 

on at least an annual basis and covering the period 

since the most recent audit, conducted by a qualified, 

independent organization or person in accordance with 

standards established by the Comptroller General for 

the audit of governmental organizations, programs, 

and functions, and as prescribed in regulations of the 

Secretary, the results of which shall be submitted to 

the Secretary; or 

(ii) with regard to a guaranty program of a State 

which is audited under chapter 75 of title 31, United 

States Code, deeming such audit to satisfy the requirements of clause (i) for the period of time covered by 

such audit; 

(E)(i) provide that any guaranty agency may transfer 

loans which are insured under this part to any other guaranty agency with the approval of the holder of the loan 

and such other guaranty agency; and 

199 

(ii) provide that the lender (or the holder of the loan) 

shall, not later than 120 days after the borrower has left 

the eligible institution, notify the borrower of the date on 

which the repayment period begins; and 

(F) provide that, if the sale, other transfer, or assignment of a loan made under this part to another holder will 

result in a change in the identity of the party to whom the 

borrower must send subsequent payments or direct any 

communications concerning the loans, then— 

(i) the transferor and the transferee will be required, 

not later than 45 days from the date the transferee acquires a legally enforceable right to receive payment 

from the borrower on such loan, either jointly or separately to provide a notice to the borrower of— 

(I) the sale or other transfer; 

(II) the identity of the transferee; 

(III) the name and address of the party to whom 

subsequent payments or communications must be 

sent; 

(IV) the telephone numbers of both the transferor and the transferee; 

(V) the effective date of the transfer; 

(VI) the date on which the current servicer (as 

of the date of the notice) will stop accepting payments; and 

(VII) the date on which the new servicer will 

begin accepting payments; and 

(ii) the transferee will be required to notify the guaranty agency, and, upon the request of an institution of 

higher education, the guaranty agency shall notify the 

last such institution the student attended prior to the 

beginning of the repayment period of any loan made 

under this part, of— 

(I) any sale or other transfer of the loan; and 

(II) the address and telephone number by which 

contact may be made with the new holder concerning repayment of the loan, 

except that this subparagraph (F) shall only apply if the 

borrower is in the grace period described in section 

427(a)(2)(B) or 428(b)(7) or is in repayment status. 

(3) RESTRICTIONS ON INDUCEMENTS, PAYMENTS, MAILINGS, 

AND ADVERTISING.—A guaranty agency shall not— 

(A) offer, directly or indirectly, premiums, payments, 

stock or other securities, prizes, travel, entertainment expenses, tuition payment or reimbursement, or other inducements to— 

(i) any institution of higher education, any employee 

of an institution of higher education, or any individual 

or entity in order to secure applicants for loans made 

under this part; or 

(ii) any lender, or any agent, employee, or independent contractor of any lender or guaranty agency, 

in order to administer or market loans made under 

this part (other than a loan made as part of the guaranty agency’s lender-of-last-resort program pursuant 

200 

to section 428(j)), for the purpose of securing the designation of the guaranty agency as the insurer of such 

loans; 

(B) conduct unsolicited mailings, by postal or electronic 

means, of student loan application forms to students enrolled in secondary schools or postsecondary educational 

institutions, or to the families of such students, except that 

applications may be mailed, by postal or electronic means, 

to students or borrowers who have previously received 

loans guaranteed under this part by the guaranty agency; 

(C) perform, for an institution of higher education participating in a program under this title, any function that 

such institution is required to perform under this title, except that the guaranty agency may perform functions on 

behalf of such institution in accordance with section 485(b) 

or 485(l); 

(D) pay, on behalf of an institution of higher education, 

another person to perform any function that such institution is required to perform under this title, except that the 

guaranty agency may perform functions on behalf of such 

institution in accordance with section 485(b) or 485(l); or 

(E) conduct fraudulent or misleading advertising concerning loan availability, terms, or conditions. 

It shall not be a violation of this paragraph for a guaranty 

agency to provide technical assistance to institutions of higher 

education comparable to the technical assistance provided to 

institutions of higher education by the Department. 

(4) SPECIAL RULE.—With respect to the graduate fellowship 

program referred to in paragraph (1)(M)(i)(II), the Secretary 

shall approve any course of study at a foreign university that 

is accepted for the completion of a recognized international fellowship program by the administrator of such a program. Requests for deferment of repayment of loans under this part by 

students engaged in graduate or postgraduate fellowship-supported study (such as pursuant to a Fulbright grant) outside 

the United States shall be approved until completion of the period of the fellowship. 

(5) GUARANTY AGENCY INFORMATION TRANSFERS.—(A) Until 

such time as the Secretary has implemented section 485B and 

is able to provide to guaranty agencies the information required by such section, any guaranty agency may request information regarding loans made after January 1, 1987, to students who are residents of the State for which the agency is 

the designated guarantor, from any other guaranty agency insuring loans to such students. 

(B) Upon a request pursuant to subparagraph (A), a guaranty agency shall provide— 

(i) the name and the social security number of the borrower; and 

(ii) the amount borrowed and the cumulative amount 

borrowed. 

(C) Any costs associated with fulfilling the request of a guaranty agency for information on students shall be paid by the 

guaranty agency requesting the information. 

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(6) STATE GUARANTY AGENCY INFORMATION REQUEST OF

STATE LICENSING BOARDS.—Each guaranty agency is authorized 

to enter into agreements with each appropriate State licensing 

board under which the State licensing board, upon request, 

will furnish the guaranty agency with the address of a student 

borrower in any case in which the location of the student borrower is unknown or unavailable to the guaranty agency. 

(7) REPAYMENT PERIOD.—(A) In the case of a loan made 

under section 427 or 428, the repayment period shall exclude 

any period of authorized deferment or forbearance and shall 

begin the day after 6 months after the date the student ceases 

to carry at least one-half the normal full-time academic workload (as determined by the institution). 

(B) In the case of a loan made under section 428H, the repayment period shall exclude any period of authorized 

deferment or forbearance, and shall begin as described in subparagraph (A), but interest shall begin to accrue or be paid by 

the borrower on the day the loan is disbursed. 

(C) In the case of a loan made under section 428B or 428C, 

the repayment period shall begin on the day the loan is disbursed, or, if the loan is disbursed in multiple installments, on 

the day of the last such disbursement, and shall exclude any 

period of authorized deferment or forbearance. 

(D) There shall be excluded from the 6-month period that begins on the date on which a student ceases to carry at least 

one-half the normal full-time academic workload as described 

in subparagraph (A) any period not to exceed 3 years during 

which a borrower who is a member of a reserve component of 

the Armed Forces named in section 10101 of title 10, United 

States Code, is called or ordered to active duty for a period of 

more than 30 days (as defined in section 101(d)(2) of such 

title). Such period of exclusion shall include the period necessary to resume enrollment at the borrower’s next available 

regular enrollment period. 

(8) MEANS OF DISBURSEMENT OF LOAN PROCEEDS.—Nothing 

in this title shall be interpreted to prohibit the disbursement 

of loan proceeds by means other than by check or to allow the 

Secretary to require checks to be made co-payable to the institution and the borrower. 

(9) REPAYMENT PLANS.— 

(A) DESIGN AND SELECTION.—In accordance with regulations promulgated by the Secretary, the lender shall offer 

a borrower of a loan made under this part the plans described in this subparagraph for repayment of such loan, 

including principal and interest thereon. No plan may require a borrower to repay a loan in less than 5 years unless the borrower, during the 6 months immediately preceding the start of the repayment period, specifically requests that repayment be made over of a shorter period. 

The borrower may choose from— 

(i) a standard repayment plan, with a fixed annual 

repayment amount paid over a fixed period of time, 

not to exceed 10 years; 

(ii) a graduated repayment plan paid over a fixed 

period of time, not to exceed 10 years; 

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(iii) an income-sensitive repayment plan, with income-sensitive repayment amounts paid over a fixed 

period of time, not to exceed 10 years, except that the 

borrower’s scheduled payments shall not be less than 

the amount of interest due; 

(iv) for new borrowers on or after the date of enactment of the Higher Education Amendments of 1998 

who accumulate (after such date) outstanding loans 

under this part totaling more than $30,000, an extended repayment plan, with a fixed annual or graduated repayment amount paid over an extended period 

of time, not to exceed 25 years, except that the borrower shall repay annually a minimum amount determined in accordance with paragraph (1)(L)(i); and 

(v) beginning July 1, 2009, an income-based repayment plan that enables a borrower who has a partial 

financial hardship to make a lower monthly payment 

in accordance with section 493C, except that the plan 

described in this clause shall not be available to a borrower for a loan under section 428B made on behalf of 

a dependent student or for a consolidation loan under 

section 428C, if the proceeds of such loan were used to 

discharge the liability of a loan under section 428B 

made on behalf of a dependent student. 

(B) LENDER SELECTION OF OPTION IF BORROWER DOES

NOT SELECT.—If a borrower of a loan made under this part 

does not select a repayment plan described in subparagraph (A), the lender shall provide the borrower with a repayment plan described in subparagraph (A)(i). 

(c) GUARANTY AGREEMENTS FOR REIMBURSING LOSSES.— 

(1) AUTHORITY TO ENTER INTO AGREEMENTS.—(A) The Secretary may enter into a guaranty agreement with any guaranty agency, whereby the Secretary shall undertake to reimburse it, under such terms and conditions as the Secretary 

may establish, with respect to losses (resulting from the default of the student borrower) on the unpaid balance of the 

principal and accrued interest of any insured loan. The guaranty agency shall, be deemed to have a contractual right 

against the United States, during the life of such loan, to receive reimbursement according to the provisions of this subsection. Upon receipt of an accurate and complete request by 

a guaranty agency for reimbursement with respect to such 

losses, the Secretary shall pay promptly and without administrative delay. Except as provided in subparagraph (B) of this 

paragraph and in paragraph (7), the amount to be paid a guaranty agency as reimbursement under this subsection shall be 

equal to 100 percent of the amount expended by it in discharge 

of its insurance obligation incurred under its loan insurance 

program. A guaranty agency shall file a claim for reimbursement with respect to losses under this subsection within 30 

days after the guaranty agency discharges its insurance obligation on the loan. 

(B) Notwithstanding subparagraph (A)— 

(i) if, for any fiscal year, the amount of such reimbursement payments by the Secretary under this subsection exVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00202 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
203 

ceeds 5 percent of the loans which are insured by such 

guaranty agency under such program and which were in 

repayment at the end of the preceding fiscal year, the 

amount to be paid as reimbursement under this subsection 

for such excess shall be equal to 85 percent of the amount 

of such excess; and 

(ii) if, for any fiscal year, the amount of such reimbursement payments exceeds 9 percent of such loans, the 

amount to be paid as reimbursement under this subsection 

for such excess shall be equal to 75 percent of the amount 

of such excess. 

(C) For the purpose of this subsection, the amount of loans 

of a guaranty agency which are in repayment shall be the 

original principal amount of loans made by a lender which are 

insured by such a guaranty agency reduced by— 

(i) the amount the insurer has been required to pay to 

discharge its insurance obligations under this part; 

(ii) the original principal amount of loans insured by it 

which have been fully repaid; and 

(iii) the original principal amount insured on those loans 

for which payment of the first installment of principal has 

not become due pursuant to subsection (b)(1)(E) of this section or such first installment need not be paid pursuant to 

subsection (b)(1)(M) of this section. 

(D) Notwithstanding any other provisions of this section, in 

the case of a loan made pursuant to a lender-of-last-resort program, the Secretary shall apply the provisions of— 

(i) the fourth sentence of subparagraph (A) by substituting ‘‘100 percent’’ for ‘‘95 percent’’; 

(ii) subparagraph (B)(i) by substituting ‘‘100 percent’’ for 

‘‘85 percent’’; and 

(iii) subparagraph (B)(ii) by substituting ‘‘100 percent’’ 

for ‘‘75 percent’’. 

(E) Notwithstanding any other provisions of this section, in 

the case of an outstanding loan transferred to a guaranty agency from another guaranty agency pursuant to a plan approved 

by the Secretary in response to the insolvency of the latter 

such guarantee agency, the Secretary shall apply the provision 

of— 

(i) the fourth sentence of subparagraph (A) by substituting ‘‘100 percent’’ for ‘‘95 percent’’; 

(ii) subparagraph (B)(i) by substituting ‘‘90 percent’’ for 

‘‘85 percent’’; and 

(iii) subparagraph (B)(ii) by substituting ‘‘80 percent’’ for 

‘‘75 percent’’. 

(F)(i) Notwithstanding any other provisions of this section, in 

the case of exempt claims, the Secretary shall apply the provisions of— 

(I) the fourth sentence of subparagraph (A) by substituting ‘‘100 percent’’ for ‘‘95 percent’’; 

(II) subparagraph (B)(i) by substituting ‘‘100 percent’’ for 

‘‘85 percent’’; and 

(III) subparagraph (B)(ii) by substituting ‘‘100 percent’’ 

for ‘‘75 percent’’. 

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(ii) For purposes of clause (i) of this subparagraph, the term 

‘‘exempt claims’’ means claims with respect to loans for which 

it is determined that the borrower (or the student on whose behalf a parent has borrowed), without the lender’s or the institution’s knowledge at the time the loan was made, provided 

false or erroneous information or took actions that caused the 

borrower or the student to be ineligible for all or a portion of 

the loan or for interest benefits thereon. 

(G) Notwithstanding any other provision of this section, the 

Secretary shall exclude a loan made pursuant to a lender-oflast-resort program when making reimbursement payment calculations under subparagraphs (B) and (C). 

(2) CONTENTS OF GUARANTY AGREEMENTS.—The guaranty 

agreement— 

(A) shall set forth such administrative and fiscal procedures as may be necessary to protect the United States 

from the risk of unreasonable loss thereunder, to ensure 

proper and efficient administration of the loan insurance 

program, and to assure that due diligence will be exercised 

in the collection of loans insured under the program, including (i) a requirement that each beneficiary of insurance on the loan submit proof that the institution was contacted and other reasonable attempts were made to locate 

the borrower (when the location of the borrower is unknown) and proof that contact was made with the borrower (when the location is known) and (ii) requirements 

establishing procedures to preclude consolidation lending 

from being an excessive proportion of guaranty agency recoveries on defaulted loans under this part; 

(B) shall provide for making such reports, in such form 

and containing such information, as the Secretary may 

reasonably require to carry out the Secretary’s functions 

under this subsection, and for keeping such records and for 

affording such access thereto as the Secretary may find 

necessary to assure the correctness and verification of such 

reports; 

(C) shall set forth adequate assurances that, with respect to so much of any loan insured under the loan insurance program as may be guaranteed by the Secretary pursuant to this subsection, the undertaking of the Secretary 

under the guaranty agreement is acceptable in full satisfaction of State law or regulation requiring the maintenance of a reserve; 

(D) shall provide that if, after the Secretary has made 

payment under the guaranty agreement pursuant to paragraph (1) of this subsection with respect to any loan, any 

payments are made in discharge of the obligation incurred 

by the borrower with respect to such loan (including any 

payments of interest accruing on such loan after such payment by the Secretary), there shall be paid over to the Secretary (for deposit in the fund established by section 431) 

such proportion of the amounts of such payments as is determined (in accordance with paragraph (6)(A)) to represent his equitable share thereof, but (i) shall provide for 

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205 

ance beneficiary only to the extent required for the purpose of paragraph (8); and (ii) except as the Secretary may 

otherwise by or pursuant to regulation provide, amounts 

so paid by a borrower on such a loan shall be first applied 

in reduction of principal owing on such loan; 

(E) shall set forth adequate assurance that an amount 

equal to each payment made under paragraph (1) will be 

promptly deposited in or credited to the accounts maintained for the purpose of section 422(c); 

(F) set forth adequate assurances that the guaranty 

agency will not engage in any pattern or practice which results in a denial of a borrower’s access to loans under this 

part because of the borrower’s race, sex, color, religion, national origin, age, handicapped status, income, attendance 

at a particular eligible institution within the area served 

by the guaranty agency, length of the borrower’s educational program, or the borrower’s academic year in 

school; 

(G) shall prohibit the Secretary from making any reimbursement under this subsection to a guaranty agency 

when a default claim is based on an inability to locate the 

borrower, unless the guaranty agency, at the time of filing 

for reimbursement, certifies to the Secretary that diligent 

attempts, including contact with the institution, have been 

made to locate the borrower through the use of reasonable 

skip-tracing techniques in accordance with regulations prescribed by the Secretary; and 

(H) set forth assurances that— 

(i) upon the request of an eligible institution, the 

guaranty agency shall, subject to clauses (ii) and (iii), 

furnish to the institution information with respect to 

students (including the names and addresses of such 

students) who received loans made, insured, or guaranteed under this part for attendance at the eligible 

institution and for whom default aversion assistance 

activities have been requested under subsection (l); 

(ii) the guaranty agency shall not require the payment from the institution of any fee for such information; and 

(iii) the guaranty agency will require the institution 

to use such information only to assist the institution 

in reminding students of their obligation to repay student loans and shall prohibit the institution from disseminating the information for any other purpose. 

(I) may include such other provisions as may be necessary to promote the purpose of this part. 

(3) FORBEARANCE.—A guaranty agreement under this subsection— 

(A) shall contain provisions providing that— 

(i) upon request, a lender shall grant a borrower forbearance, renewable at 12-month intervals, on terms 

agreed to by the parties to the loan with the approval 

of the insurer and documented in accordance with 

paragraph (10), and otherwise consistent with the regulations of the Secretary, if the borrower— 

206 

(I) is serving in a medical or dental internship 

or residency program, the successful completion of 

which is required to begin professional practice or 

service, or is serving in a medical or dental internship or residency program leading to a degree or 

certificate awarded by an institution of higher 

education, a hospital, or a health care facility that 

offers postgraduate training, provided that if the 

borrower qualifies for a deferment under section 

427(a)(2)(C)(vii) or subsection (b)(1)(M)(vii) of this 

section as in effect prior to the enactment of the 

Higher Education Amendments of 1992, or section 

427(a)(2)(C) or subsection (b)(1)(M) of this section 

as amended by such amendments, the borrower 

has exhausted his or her eligibility for such 

deferment; 

(II) has a debt burden under this title that 

equals or exceeds 20 percent of income; 

(III) is serving in a national service position for 

which the borrower receives a national service 

educational award under the National and Community Service Trust Act of 1993; or 

(IV) is eligible for interest payments to be made 

on such loan for service in the Armed Forces 

under section 2174 of title 10, United States Code, 

and, pursuant to that eligibility, the interest is 

being paid on such loan under subsection (o); 

(ii) the length of the forbearance granted by the 

lender— 

(I) under clause (i)(I) shall equal the length of 

time remaining in the borrower’s medical or dental internship or residency program, if the borrower is not eligible to receive a deferment described in such clause, or such length of time remaining in the program after the borrower has exhausted the borrower’s eligibility for such 

deferment; 

(II) under clause (i)(II) or (IV) shall not exceed 

3 years; or 

(III) under clause (i)(III) shall not exceed the period for which the borrower is serving in a position described in such clause; and 

(iii) no administrative or other fee may be charged 

in connection with the granting of a forbearance under 

clause (i), and no adverse information regarding a borrower may be reported to a consumer reporting agency 

solely because of the granting of such forbearance; 

(B) may, to the extent provided in regulations of the Secretary, contain provisions that permit such forbearance for 

the benefit of the student borrower as may be agreed upon 

by the parties to an insured loan and approved by the insurer; 

(C) shall contain provisions that specify that— 

(i) the form of forbearance granted by the lender 

pursuant to this paragraph, other than subparagraph 

207 

(A)(i)(IV), shall be temporary cessation of payments, 

unless the borrower selects forbearance in the form of 

an extension of time for making payments, or smaller 

payments than were previously scheduled; 

(ii) the form of forbearance granted by the lender 

pursuant to subparagraph (A)(i)(IV) shall be the temporary cessation of all payments on the loan other 

than payments of interest on the loan that are made 

under subsection (o); 

(iii) the lender shall, at the time of granting a borrower forbearance, provide information to the borrower to assist the borrower in understanding the impact of capitalization of interest on the borrower’s loan 

principal and total amount of interest to be paid during the life of the loan; and 

(iv) the lender shall contact the borrower not less 

often than once every 180 days during the period of 

forbearance to inform the borrower of— 

(I) the amount of unpaid principal and the 

amount of interest that has accrued since the last 

statement of such amounts provided to the borrower by the lender; 

(II) the fact that interest will accrue on the loan 

for the period of forbearance; 

(III) the amount of interest that will be capitalized, and the date on which capitalization will 

occur; 

(IV) the option of the borrower to pay the interest that has accrued before the interest is capitalized; and 

(V) the borrower’s option to discontinue the forbearance at any time; and 

(D) shall contain provisions that specify that— 

(i) forbearance for a period not to exceed 60 days 

may be granted if the lender reasonably determines 

that such a suspension of collection activity is warranted following a borrower’s request for deferment, 

forbearance, a change in repayment plan, or a request 

to consolidate loans, in order to collect or process appropriate supporting documentation related to the request, and 

(ii) during such period interest shall accrue but not 

be capitalized. 

Guaranty agencies shall not be precluded from permitting the 

parties to such a loan from entering into a forbearance agreement solely because the loan is in default. The Secretary shall 

permit lenders to exercise administrative forbearances that do 

not require the agreement of the borrower, under conditions 

authorized by the Secretary. Such forbearances shall include (i) 

forbearances for borrowers who are delinquent at the time of 

the granting of an authorized period of deferment under section 428(b)(1)(M) or 427(a)(2)(C), and (ii) if the borrower is less 

than 60 days delinquent on such loans at the time of sale or 

transfer, forbearances for borrowers on loans which are sold or 

transferred. 

208 

(4) DEFINITIONS.—For the purpose of this subsection, the 

terms ‘‘insurance beneficiary’’ and ‘‘default’’ have the meanings 

assigned to them by section 435. 

(5) APPLICABILITY TO EXISTING LOANS.—In the case of any 

guaranty agreement with a guaranty agency, the Secretary 

may, in accordance with the terms of this subsection, undertake to guarantee loans described in paragraph (1) which are 

insured by such guaranty agency and are outstanding on the 

date of execution of the guaranty agreement, but only with respect to defaults occurring after the execution of such guaranty 

agreement or, if later, after its effective date. 

(6) SECRETARY’S EQUITABLE SHARE.—(A) For the purpose of 

paragraph (2)(D), the Secretary’s equitable share of payments 

made by the borrower shall be that portion of the payments remaining after the guaranty agency with which the Secretary 

has an agreement under this subsection has deducted from 

such payments— 

(i) a percentage amount equal to the complement of the 

reinsurance percentage in effect when payment under the 

guaranty agreement was made with respect to the loan; 

and 

(ii) an amount equal to 24 percent of such payments 

for use in accordance with section 422B, except that— 

(I) beginning October 1, 2003 and ending September 30, 2007, this clause shall be applied by 

substituting ‘‘23 percent’’ for ‘‘24 percent’’; and 

(II) beginning October 1, 2007, this clause shall 

be applied by substituting ‘‘16 percent’’ for ‘‘24 

percent’’. 

(B) A guaranty agency shall— 

(i) on or after October 1, 2006— 

(I) not charge the borrower collection costs in an 

amount in excess of 18.5 percent of the outstanding 

principal and interest of a defaulted loan that is paid 

off through consolidation by the borrower under this 

title; and 

(II) remit to the Secretary a portion of the collection 

charge under subclause (I) equal to 8.5 percent of the 

outstanding principal and interest of such defaulted 

loan; and 

(ii) on and after October 1, 2009, remit to the Secretary 

the entire amount charged under clause (i)(I) with respect 

to each defaulted loan that is paid off with excess consolidation proceeds. 

(C) For purposes of subparagraph (B), the term ‘‘excess consolidation proceeds’’ means, with respect to any guaranty agency for any Federal fiscal year beginning on or after October 1, 

2009, the proceeds of consolidation of defaulted loans under 

this title that exceed 45 percent of the agency’s total collections 

on defaulted loans in such Federal fiscal year. 

(7) NEW PROGRAMS ELIGIBLE FOR 100 PERCENT REINSUR- ANCE.—(A) Notwithstanding paragraph (1)(C), the amount to 

be paid a guaranty agency for any fiscal year— 

(i) which begins on or after October 1, 1977 and ends before October 1, 1991; and 

209 

(ii) which is either the fiscal year in which such guaranty agency begins to actively carry on a student loan insurance program which is subject to a guaranty agreement 

under subsection (b) of this section, or is one of the 4 succeeding fiscal years, 

shall be 100 percent of the amount expended by such guaranty 

agency in discharge of its insurance obligation insured under 

such program. 

(B) Notwithstanding the provisions of paragraph (1)(C), the 

Secretary may pay a guaranty agency 100 percent of the 

amount expended by such agency in discharge of such agency’s 

insurance obligation for any fiscal year which— 

(i) begins on or after October 1, 1991; and 

(ii) is the fiscal year in which such guaranty agency begins to actively carry on a student loan insurance program 

which is subject to a guaranty agreement under subsection 

(b) or is one of the 4 succeeding fiscal years. 

(C) The Secretary shall continuously monitor the operations 

of those guaranty agencies to which the provisions of subparagraph (A) or (B) are applicable and revoke the application of 

such subparagraph to any such guaranty agency which the 

Secretary determines has not exercised reasonable prudence in 

the administration of such program. 

(8) ASSIGNMENT TO PROTECT FEDERAL FISCAL INTEREST.—If 

the Secretary determines that the protection of the Federal fiscal interest so requires, a guaranty agency shall assign to the 

Secretary any loan of which it is the holder and for which the 

Secretary has made a payment pursuant to paragraph (1) of 

this subsection. 

(9) GUARANTY AGENCY RESERVE LEVEL.—(A) Each guaranty 

agency which has entered into an agreement with the Secretary pursuant to this subsection shall maintain in the agency’s Federal Student Loan Reserve Fund established under section 422A a current minimum reserve level of at least 0.25 percent of the total attributable amount of all outstanding loans 

guaranteed by such agency. For purposes of this paragraph, 

such total attributable amount does not include amounts of 

outstanding loans transferred to the guaranty agency from another guaranty agency pursuant to a plan of the Secretary in 

response to the insolvency of the latter such guaranty agency. 

(B) The Secretary shall collect, on an annual basis, information from each guaranty agency having an agreement under 

this subsection to enable the Secretary to evaluate the financial solvency of each such agency. The information collected 

shall include the level of such agency’s current reserves, cash 

disbursements and accounts receivable. 

(C) If (i) any guaranty agency falls below the required minimum reserve level in any 2 consecutive years, (ii) any guaranty agency’s Federal reimbursement payments are reduced to 

85 percent pursuant to paragraph (1)(B)(i), or (iii) the Secretary determines that the administrative or financial condition of a guaranty agency jeopardizes such agency’s continued 

ability to perform its responsibilities under its guaranty agreement, then the Secretary shall require the guaranty agency to 

210 

submit and implement a management plan acceptable to the 

Secretary within 45 working days of any such event. 

(D)(i) If the Secretary is not seeking to terminate the guaranty agency’s agreement under subparagraph (E), or assuming 

the guaranty agency’s functions under subparagraph (F), a 

management plan described in subparagraph (C) shall include 

the means by which the guaranty agency will improve its financial and administrative condition to the required level 

within 18 months. 

(ii) If the Secretary is seeking to terminate the guaranty 

agency’s agreement under subparagraph (E), or assuming the 

guaranty agency’s functions under subparagraph (F), a management plan described in subparagraph (C) shall include the 

means by which the Secretary and the guaranty agency shall 

work together to ensure the orderly termination of the operations, and liquidation of the assets, of the guaranty agency. 

(E) The Secretary may terminate a guaranty agency’s agreement in accordance with subparagraph (F) if— 

(i) a guaranty agency required to submit a management 

plan under this paragraph fails to submit a plan that is 

acceptable to the Secretary; 

(ii) the Secretary determines that a guaranty agency has 

failed to improve substantially its administrative and financial condition; 

(iii) the Secretary determines that the guaranty agency 

is in danger of financial collapse; 

(iv) the Secretary determines that such action is necessary to protect the Federal fiscal interest; or 

(v) the Secretary determines that such action is necessary to ensure the continued availability of loans to student or parent borrowers. 

(F) If a guaranty agency’s agreement under this subsection 

is terminated pursuant to subparagraph (E), then the Secretary shall assume responsibility for all functions of the guaranty agency under the loan insurance program of such agency. 

In performing such functions the Secretary is authorized to— 

(i) permit the transfer of guarantees to another guaranty 

agency; 

(ii) revoke the reinsurance agreement of the guaranty 

agency at a specified date, so as to require the merger, 

consolidation, or termination of the guaranty agency; 

(iii) transfer guarantees to the Department of Education 

for the purpose of payment of such claims and process 

such claims using the claims standards of the guaranty 

agency, if such standards are determined by the Secretary 

to be in compliance with this Act; 

(iv) design and implement a plan to restore the guaranty 

agency’s viability; 

(v) provide the guaranty agency with additional advance 

funds in accordance with section 422(c)(7), with such restrictions on the use of such funds as is determined appropriate by the Secretary, in order to— 

(I) meet the immediate cash needs of the guaranty 

agency; 

(II) ensure the uninterrupted payment of claims; or 

211 

(III) ensure that the guaranty agency will make 

loans as the lender-of-last-resort, in accordance with 

subsection (j); 

(vi) use all funds and assets of the guaranty agency to 

assist in the activities undertaken in accordance with this 

subparagraph and take appropriate action to require the 

return, to the guaranty agency or the Secretary, of any 

funds or assets provided by the guaranty agency, under 

contract or otherwise, to any person or organization; or 

(vii) take any other action the Secretary determines necessary to ensure the continued availability of loans made 

under this part to residents of the State or States in which 

the guaranty agency did business, the full honoring of all 

guarantees issued by the guaranty agency prior to the Secretary’s assumption of the functions of such agency, and 

the proper servicing of loans guaranteed by the guaranty 

agency prior to the Secretary’s assumption of the functions 

of such agency, and to avoid disruption of the student loan 

program. 

(G) Notwithstanding any other provision of Federal or State 

law, if the Secretary has terminated or is seeking to terminate 

a guaranty agency’s agreement under subparagraph (E), or has 

assumed a guaranty agency’s functions under subparagraph 

(F)— 

(i) no State court may issue any order affecting the Secretary’s actions with respect to such guaranty agency; 

(ii) any contract with respect to the administration of a 

guaranty agency’s reserve funds, or the administration of 

any assets purchased or acquired with the reserve funds of 

the guaranty agency, that is entered into or extended by 

the guaranty agency, or any other party on behalf of or 

with the concurrence of the guaranty agency, after the 

date of enactment of this subparagraph shall provide that 

the contract is terminable by the Secretary upon 30 days 

notice to the contracting parties if the Secretary determines that such contract includes an impermissible transfer of the reserve funds or assets, or is otherwise inconsistent with the terms or purposes of this section; and 

(iii) no provision of State law shall apply to the actions 

of the Secretary in terminating the operations of a guaranty agency. 

(H) Notwithstanding any other provision of law, the Secretary’s liability for any outstanding liabilities of a guaranty 

agency (other than outstanding student loan guarantees under 

this part), the functions of which the Secretary has assumed, 

shall not exceed the fair market value of the reserves of the 

guaranty agency, minus any necessary liquidation or other administrative costs. 

(I) The Secretary shall not take any action under subparagraph (E) or (F) without giving the guaranty agency notice and 

the opportunity for a hearing that, if commenced after September 24, 1998, shall be on the record. 

(J) Notwithstanding any other provision of law, the information transmitted to the Secretary pursuant to this paragraph 

shall be confidential and exempt from disclosure under section 

212 

552 of title 5, United States Code, relating to freedom of information, or any other Federal law. 

(K) The Secretary, within 6 months after the end of each fiscal year, shall submit to the authorizing committees a report 

specifying the Secretary’s assessment of the fiscal soundness of 

the guaranty agency system. 

(10) DOCUMENTATION OF FORBEARANCE AGREEMENTS.—For 

the purposes of paragraph (3), the terms of forbearance agreed 

to by the parties shall be documented by confirming the agreement of the borrower by notice to the borrower from the lender, and by recording the terms in the borrower’s file. 

(d) USURY LAWS INAPPLICABLE.—No provision of any law of the 

United States (other than this Act and section 207 of the 

Servicemembers Civil Relief Act (50 U.S.C. App. 527)) or of any 

State (other than a statute applicable principally to such State’s 

student loan insurance program) which limits the rate or amount 

of interest payable on loans shall apply to a loan— 

(1) which bears interest (exclusive of any premium for insurance) on the unpaid principal balance at a rate not in excess 

of the rate specified in this part; and 

(2) which is insured (i) by the United States under this part, 

or (ii) by a guaranty agency under a program covered by an 

agreement made pursuant to subsection (b) of this section. 

(f) PAYMENTS OF CERTAIN COSTS.— (1) PAYMENT FOR CERTAIN ACTIVITIES.— (A) IN GENERAL.—The Secretary— 

(i) for loans originated during fiscal years beginning 

on or after October 1, 1998, and before October 1, 

2003, and in accordance with the provisions of this 

paragraph, shall, except as provided in subparagraph 

(C), pay to each guaranty agency, a loan processing 

and issuance fee equal to 0.65 percent of the total 

principal amount of the loans on which insurance was 

issued under this part during such fiscal year by such 

agency; and 

(ii) for loans originated on or after October 1, 2003, 

and first disbursed before July 1, 2010, and in accordance with the provisions of this paragraph, shall, except as provided in subparagraph (C), pay to each 

guaranty agency, a loan processing and issuance fee 

equal to 0.40 percent of the total principal amount of 

the loans on which insurance was issued under this 

part during such fiscal year by such agency. 

(B) PAYMENT.—The payment required by subparagraph 

(A) shall be paid on a quarterly basis. The guaranty agency shall be deemed to have a contractual right against the 

United States to receive payments according to the provisions of this paragraph. Payments shall be made promptly 

and without administrative delay to any guaranty agency 

submitting an accurate and complete application under 

this subparagraph. 

(C) REQUIREMENT FOR PAYMENT.—No payment may be 

made under this paragraph for loans for which the disbursement checks have not been cashed or for which electronic funds transfers have not been completed. 

213 

(g) ACTION ON INSURANCE PROGRAM AND GUARANTY AGREE- MENTS.—If a nonprofit private institution or organization— 

(1) applies to enter into an agreement with the Secretary 

under subsections (b) and (c) with respect to a student loan insurance program to be carried on in a State with which the 

Secretary does not have an agreement under subsection (b), 

and 

(2) as provided in the application, undertakes to meet the requirements of section 422(c)(6)(B) (i), (ii), and (iii), 

the Secretary shall consider and act upon such application within 

180 days, and shall forthwith notify the authorizing committees of 

his actions. 

(i) MULTIPLE DISBURSEMENT OF LOANS.— 

(1) ESCROW ACCOUNTS ADMINISTERED BY ESCROW AGENT.— 

Any guaranty agency or eligible lender (hereafter in this subsection referred to as the ‘‘escrow agent’’) may enter into an 

agreement with any other eligible lender that is not an eligible 

institution or an agency or instrumentality of the State (hereafter in this subsection referred to as the ‘‘lender’’) for the purpose of authorizing disbursements of the proceeds of a loan to 

a student. Such agreement shall provide that the lender will 

pay the proceeds of such loans into an escrow account to be administered by the escrow agent in accordance with the provisions of paragraph (2) of this subsection. Such agreement may 

allow the lender to make payments into the escrow account in 

amounts that do not exceed the sum of the amounts required 

for disbursement of initial or subsequent installments to borrowers and to make such payments not more than 10 days 

prior to the date of the disbursement of such installment to 

such borrowers. Such agreement shall require the lender to notify promptly the eligible institution when funds are escrowed 

under this subsection for a student at such institution. 

(2) AUTHORITY OF ESCROW AGENT.—Each escrow agent entering into an agreement under paragraph (1) of this subsection 

is authorized to— 

(A) make the disbursements in accordance with the note 

evidencing the loan; 

(B) commingle the proceeds of all loans paid to the escrow agent pursuant to the escrow agreement entered into 

under such paragraph (1); 

(C) invest the proceeds of such loans in obligations of the 

Federal Government or obligations which are insured or 

guaranteed by the Federal Government; 

(D) retain interest or other earnings on such investment; 

and 

(E) return to the lender undisbursed funds when the student ceases to carry at an eligible institution at least onehalf of the normal full-time academic workload as determined by the institution. 

(j) LENDERS-OF-LAST-RESORT.— (1) GENERAL REQUIREMENT.—In each State, the guaranty 

agency or an eligible lender in the State described in section 

435(d)(1)(D) of this Act shall, before July 1, 2010, make loans 

directly, or through an agreement with an eligible lender or 

lenders, to eligible students and parents who are otherwise unVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00213 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
214 

able to obtain loans under this part (except for consolidation 

loans under section 428C) or who attend an institution of higher education in the State that is designated under paragraph 

(4). Loans made under this subsection shall not exceed the 

amount of the need of the borrower, as determined under subsection (a)(2)(B), nor be less than $200. No loan under section 

428, 428B, or 428H that is made pursuant to this subsection 

shall be made with interest rates, origination or default fees, 

or other terms and conditions that are more favorable to the 

borrower than the maximum interest rates, origination or default fees, or other terms and conditions applicable to that type 

of loan under this part. The guaranty agency shall consider the 

request of any eligible lender, as defined under section 

435(d)(1)(A) of this Act, to serve as the lender-of-last-resort 

pursuant to this subsection. 

(2) RULES AND OPERATING PROCEDURES.—The guaranty agency shall develop rules and operating procedures for the lenderof-last-resort program designed to ensure that— 

(A) the program establishes operating hours and methods of application designed to facilitate application by students and ensure a response within 60 days after the student’s original complete application is filed under this subsection; 

(B) consistent with standards established by the Secretary, students applying for loans under this subsection 

shall not be subject to additional eligibility requirements 

or requests for additional information beyond what is required under this title in order to receive a loan under this 

part from an eligible lender, nor, in the case of students 

and parents applying for loans under this subsection because of an inability to otherwise obtain loans under this 

part (except for consolidation loans under section 428C), be 

required to receive more than two rejections from eligible 

lenders in order to obtain a loan under this subsection; 

(C) information about the availability of loans under the 

program is made available to institutions of higher education in the State; and 

(D) appropriate steps are taken to ensure that borrowers 

receiving loans under the program are appropriately counseled on their loan obligation. 

(3) ADVANCES TO GUARANTY AGENCIES FOR LENDER-OF-LASTRESORT SERVICES.—(A) In order to ensure the availability of 

loan capital, the Secretary is authorized to provide a guaranty 

agency designated for a State with additional advance funds in 

accordance with subparagraph (C) and section 422(c)(7), with 

such restrictions on the use of such funds as are determined 

appropriate by the Secretary, in order to ensure that the guaranty agency will make loans as the lender-of-last-resort. Such 

agency shall make such loans in accordance with this subsection and the requirements of the Secretary. 

(B) Notwithstanding any other provision in this part, a guaranty agency serving as a lender-of-last-resort under this paragraph shall be paid a fee, established by the Secretary, for 

making such loans in lieu of interest and special allowance 

subsidies, and shall be required to assign such loans to the 

215 

Secretary on demand. Upon such assignment, the portion of 

the advance represented by the loans assigned shall be considered repaid by such guaranty agency. 

(C) The Secretary shall exercise the authority described in 

subparagraph (A) only if the Secretary determines that eligible 

borrowers are seeking and are unable to obtain loans under 

this part or designates an institution of higher education for 

participation in the program under this subsection under paragraph (4), and that the guaranty agency designated for that 

State has the capability to provide lender-of-last-resort loans in 

a timely manner, in accordance with the guaranty agency’s obligations under paragraph (1), but cannot do so without advances provided by the Secretary under this paragraph. If the 

Secretary makes the determinations described in the preceding 

sentence and determines that it would be cost-effective to do 

so, the Secretary may provide advances under this paragraph 

to such guaranty agency. If the Secretary determines that such 

guaranty agency does not have such capability, or will not provide such loans in a timely fashion, the Secretary may provide 

such advances to enable another guaranty agency, that the 

Secretary determines to have such capability, to make lenderof-last-resort loans to eligible borrowers in that State who are 

experiencing loan access problems or to eligible borrowers who 

attend an institution in the State that is designated under 

paragraph (4). 

(4) INSTITUTION-WIDE STUDENT QUALIFICATION.—Upon the request of an institution of higher education and pursuant to 

standards developed by the Secretary, the Secretary shall designate such institution for participation in the lender-of-last-resort program under this paragraph. If the Secretary designates 

an institution under this paragraph, the guaranty agency designated for the State in which the institution is located shall 

make loans, in the same manner as such loans are made under 

paragraph (1), to students and parent borrowers of the designated institution, regardless of whether the students or parent borrowers are otherwise unable to obtain loans under this 

part (other than a consolidation loan under section 428C). 

(5) STANDARDS DEVELOPED BY THE SECRETARY.—In developing standards with respect to paragraph (4), the Secretary 

may require— 

(A) an institution of higher education to demonstrate 

that, despite due diligence on the part of the institution, 

the institution has been unable to secure the commitment 

of eligible lenders willing to make loans under this part to 

a significant number of students attending the institution; 

(B) that, prior to making a request under such paragraph for designation for participation in the lender-oflast-resort program, an institution of higher education 

shall demonstrate that the institution has met a minimum 

threshold, as determined by the Secretary, for the number 

or percentage of students at such institution who have received rejections from eligible lenders for loans under this 

part; and 

(C) any other standards and guidelines the Secretary determines to be appropriate. 

216 

(6) EXPIRATION OF AUTHORITY.—The Secretary’s authority 

under paragraph (4) to designate institutions of higher education for participation in the program under this subsection 

shall expire on June 30, 2010. 

(7) EXPIRATION OF DESIGNATION.—The eligibility of an institution of higher education, or borrowers from such institution, 

to participate in the program under this subsection pursuant 

to a designation of the institution by the Secretary under paragraph (4) shall expire on June 30, 2010. After such date, borrowers from an institution designated under paragraph (4) 

shall be eligible to participate in the program under this subsection as such program existed on the day before the date of 

enactment of the Ensuring Continued Access to Student Loans 

Act of 2008. 

(8) PROHIBITION ON INDUCEMENTS AND MARKETING.—Each 

guaranty agency or eligible lender that serves as a lender-oflast-resort under this subsection— 

(A) shall be subject to the prohibitions on inducements 

contained in subsection (b)(3) and the requirements of section 435(d)(5); and 

(B) shall not advertise, market, or otherwise promote 

loans under this subsection, except that nothing in this 

paragraph shall prohibit a guaranty agency from fulfilling 

its responsibilities under paragraph (2)(C). 

(9) DISSEMINATION AND REPORTING.— 

(A) IN GENERAL.—The Secretary shall— 

(i) broadly disseminate information regarding the 

availability of loans made under this subsection; 

(ii) during the period beginning July 1, 2008 and 

ending June 30, 2011, provide to the authorizing committees and make available to the public— 

(I) copies of any new or revised plans or agreements made by guaranty agencies or the Department related to the authorities under this subsection; 

(II) quarterly reports on— 

(aa) the number and amounts of loans originated or approved pursuant to this subsection 

by each guaranty agency and eligible lender; 

and 

(bb) any related payments by the Department, a guaranty agency, or an eligible lender; and 

(III) a budget estimate of the costs to the Federal Government (including subsidy and administrative costs) for each 100 dollars loaned, of loans 

made pursuant to this subsection between the 

date of enactment of the Ensuring Continued Access to Student Loans Act of 2008 and June 30, 

2010, disaggregated by type of loan, compared to 

such costs to the Federal Government during such 

time period of comparable loans under this part 

and part D, disaggregated by part and by type of 

loan; and 

217 

(iii) beginning July 1, 2011, provide to the authorizing committees and make available to the public— 

(I) copies of any new or revised plans or agreements made by guaranty agencies or the Department related to the authorities under this subsection; and 

(II) annual reports on— 

(aa) the number and amounts of loans originated or approved pursuant to this subsection 

by each guaranty agency and eligible lender; 

and 

(bb) any related payments by the Department, a guaranty agency, or an eligible lender. 

(B) SEPARATE REPORTING.—The information required to 

be reported under subparagraph (A)(ii)(II) shall be reported separately for loans originated or approved pursuant to paragraph (4), or payments related to such loans, 

for the time period in which the Secretary is authorized to 

make designations under paragraph (4). 

(k) INFORMATION ON DEFAULTS.— (1) PROVISION OF INFORMATION TO ELIGIBLE INSTITUTIONS.— Notwithstanding any other provision of law, in order to notify 

eligible institutions of former students who are in default of 

their continuing obligation to repay student loans, each guaranty agency shall, upon the request of an eligible institution, 

furnish information with respect to students who were enrolled 

at the eligible institution and who are in default on the repayment of any loan made, insured, or guaranteed under this part. 

The information authorized to be furnished under this subsection shall include the names and addresses of such students. 

(2) PUBLIC DISSEMINATION NOT AUTHORIZED.—Nothing in 

paragraph (1) of this subsection shall be construed to authorize 

public dissemination of the information described in paragraph 

(1). 

(3) BORROWER LOCATION INFORMATION.—Any information 

provided by the institution relating to borrower location shall 

be used by the guaranty agency in conducting required skiptracing activities. 

(4) PROVISION OF INFORMATION TO BORROWERS IN DEFAULT.— 

Each guaranty agency that has received a default claim from 

a lender regarding a borrower, shall provide the borrower in 

default, on not less than two separate occasions, with a notice, 

in simple and understandable terms, of not less than the following information: 

(A) The options available to the borrower to remove the 

borrower’s loan from default. 

(B) The relevant fees and conditions associated with 

each option. 

(l) DEFAULT AVERSION ASSISTANCE.— (1) ASSISTANCE REQUIRED.—Upon receipt of a complete request from a lender received not earlier than the 60th day of 

delinquency, a guaranty agency having an agreement with the 

Secretary under subsection (c) shall engage in default aversion 

218 

activities designed to prevent the default by a borrower on a 

loan covered by such agreement. 

(2) REIMBURSEMENT.— 

(A) IN GENERAL.—A guaranty agency, in accordance with 

the provisions of this paragraph, may transfer from the 

Federal Student Loan Reserve Fund under section 422A to 

the Agency Operating Fund under section 422B a default 

aversion fee. Such fee shall be paid for any loan on which 

a claim for default has not been paid as a result of the 

loan being brought into current repayment status by the 

guaranty agency on or before the 300th day after the loan 

becomes 60 days delinquent. 

(B) AMOUNT.—The default aversion fee shall be equal to 

1 percent of the total unpaid principal and accrued interest 

on the loan at the time the request is submitted by the 

lender. A guaranty agency may transfer such fees earned 

under this subsection not more frequently than monthly. 

Such a fee shall not be paid more than once on any loan 

for which the guaranty agency averts the default unless— 

(i) at least 18 months has elapsed between the date 

the borrower entered current repayment status and 

the date the lender filed a subsequent default aversion 

assistance request; and 

(ii) during the period between such dates, the borrower was not more than 30 days past due on any 

payment of principal and interest on the loan. 

(C) DEFINITION.—For the purpose of earning the default 

aversion fee, the term ‘‘current repayment status’’ means 

that the borrower is not delinquent in the payment of any 

principal or interest on the loan. 

(m) INCOME CONTINGENT AND INCOME-BASED REPAYMENT.— 

(1) AUTHORITY OF SECRETARY TO REQUIRE.—The Secretary 

may require borrowers who have defaulted on loans made 

under this part that are assigned to the Secretary under subsection (c)(8) to repay those loans under an income contingent 

repayment plan or income-based repayment plan, the terms 

and conditions of which shall be established by the Secretary 

and the same as, or similar to, an income contingent repayment plan established for purposes of part D of this title or an 

income-based repayment plan under section 493C, as the case 

may be. 

(2) LOANS FOR WHICH INCOME CONTINGENT OR INCOME-BASED

REPAYMENT MAY BE REQUIRED.—A loan made under this part 

may be required to be repaid under this subsection if the note 

or other evidence of the loan has been assigned to the Secretary pursuant to subsection (c)(8). 

(n) BLANKET CERTIFICATE OF LOAN GUARANTY.— 

(1) IN GENERAL.—Subject to paragraph (3), any guaranty 

agency that has entered into or enters into any insurance program agreement with the Secretary under this part may— 

(A) offer eligible lenders participating in the agency’s 

guaranty program a blanket certificate of loan guaranty 

that permits the lender to make loans without receiving 

prior approval from the guaranty agency of individual 

219 

loans for eligible borrowers enrolled in eligible programs at 

eligible institutions; and 

(B) provide eligible lenders with the ability to transmit 

electronically data to the agency concerning loans the lender has elected to make under the agency’s insurance program via standard reporting formats, with such reporting 

to occur at reasonable and standard intervals. 

(2) LIMITATIONS ON BLANKET CERTIFICATE OF GUARANTY.—(A) 

An eligible lender may not make a loan to a borrower under 

this section after such lender receives a notification from the 

guaranty agency that the borrower is not an eligible borrower. 

(B) A guaranty agency may establish limitations or restrictions on the number or volume of loans issued by a lender 

under the blanket certificate of guaranty. 

(3) PARTICIPATION LEVEL.—During fiscal years 1999 and 

2000, the Secretary may permit, on a pilot basis, a limited 

number of guaranty agencies to offer blanket certificates of 

guaranty under this subsection. Beginning in fiscal year 2001, 

any guaranty agency that has an insurance program agreement with the Secretary may offer blanket certificates of guaranty under this subsection. 

(4) REPORT REQUIRED.—The Secretary shall, at the conclusion of the pilot program under paragraph (3), provide a report 

to the authorizing committees on the impact of the blanket certificates of guaranty on program efficiency and integrity. 

(o) ARMED FORCES STUDENT LOAN INTEREST PAYMENT PRO- GRAM.— 

(1) AUTHORITY.—Using funds received by transfer to the Secretary under section 2174 of title 10, United States Code, for 

the payment of interest and any special allowance on a loan to 

a member of the Armed Forces that is made, insured, or guaranteed under this part, the Secretary shall pay the interest 

and special allowance on such loan as due for a period not in 

excess of 36 consecutive months. The Secretary may not pay 

interest or any special allowance on such a loan out of any 

funds other than funds that have been so transferred. 

(2) FORBEARANCE.—During the period in which the Secretary 

is making payments on a loan under paragraph (1), the lender 

shall grant the borrower forbearance in accordance with the 

guaranty agreement under subsection (c)(3)(A)(i)(IV). 

(3) SPECIAL ALLOWANCE DEFINED.—For the purposes of this 

subsection, the term ‘‘special allowance’’, means a special allowance that is payable with respect to a loan under section 

438. 

* * * * * * * 

SEC. 428H. UNSUBSIDIZED STAFFORD LOANS FOR MIDDLE-INCOME 

BORROWERS. 

(a) IN GENERAL.—It is the purpose of this section to authorize insured loans under this part that are first disbursed before July 1, 

2010, for borrowers who do not qualify for Federal interest subsidy 

payments under section 428 of this Act. Except as provided in this 

section, all terms and conditions for Federal Stafford loans established under section 428 shall apply to loans made pursuant to this 

section. 

220 

(b) ELIGIBLE BORROWERS.—Prior to July 1, 2010, any student 

meeting the requirements for student eligibility under section 484 

(including graduate and professional students as defined in regulations promulgated by the Secretary) shall be entitled to borrow an 

unsubsidized Federal Stafford Loan for which the first disbursement is made before such date if the eligible institution at which 

the student has been accepted for enrollment, or at which the student is in attendance, has— 

(1) determined and documented the student’s need for the 

loan based on the student’s estimated cost of attendance (as 

determined under section 472) and the student’s estimated financial assistance, including a loan which qualifies for interest 

subsidy payments under section 428; and 

(2) provided the lender a statement— 

(A) certifying the eligibility of the student to receive a 

loan under this section and the amount of the loan for 

which such student is eligible, in accordance with subsection (c); and 

(B) setting forth a schedule for disbursement of the proceeds of the loan in installments, consistent with the requirements of section 428G. 

(c) DETERMINATION OF AMOUNT OF LOAN.—The determination of 

the amount of a loan by an eligible institution under subsection (b) 

shall be calculated by subtracting from the estimated cost of attendance at the eligible institution any estimated financial assistance reasonably available to such student. An eligible institution 

may not, in carrying out the provisions of subsection (b) of this section, provide a statement which certifies the eligibility of any student to receive any loan under this section in excess of the amount 

calculated under the preceding sentence. 

(d) LOAN LIMITS.— 

(1) IN GENERAL.—Except as provided in paragraphs (2), (3), 

and (4), the annual and aggregate limits for loans under this 

section shall be the same as those established under section 

428(b)(1), less any amount received by such student pursuant 

to the subsidized loan program established under section 428. 

(2) LIMITS FOR GRADUATE, PROFESSIONAL, AND INDEPENDENT

POSTBACCALAUREATE STUDENTS.— 

(A) ANNUAL LIMITS.—The maximum annual amount of 

loans under this section a graduate or professional student, or a student described in clause (ii), may borrow in 

any academic year (as defined in section 481(a)(2)) or its 

equivalent shall be the amount determined under paragraph (1), plus— 

(i) in the case of such a student who is a graduate 

or professional student attending an eligible institution, $12,000; and 

(ii) notwithstanding paragraph (4), in the case of an 

independent student, or a dependent student whose 

parents are unable to borrow under section 428B or 

the Federal Direct PLUS Loan Program, who has obtained a baccalaureate degree and who is enrolled in 

coursework specified in paragraph (3)(B) or (4)(B) of 

section 484(b)— 

221 

(I) $7,000 for coursework necessary for enrollment in a graduate or professional program; and (II) $7,000 for coursework necessary for a professional credential or certification from a State 

required for employment as a teacher in an elementary or secondary school, 

except in cases where the Secretary determines that a 

higher amount is warranted in order to carry out the purpose of this part with respect to students engaged in specialized training requiring exceptionally high costs of education, but the annual insurable limit per student shall not 

be deemed to be exceeded by a line of credit under which 

actual payments by the lender to the borrower will not be 

made in any years in excess of the annual limit. 

(B) AGGREGATE LIMIT.—The maximum aggregate amount 

of loans under this section a student described in subparagraph (A) may borrow shall be the amount described in 

paragraph (1), adjusted to reflect the increased annual limits described in subparagraph (A), as prescribed by the 

Secretary by regulation. 

(3) LIMITS FOR UNDERGRADUATE DEPENDENT STUDENTS.— (A) ANNUAL LIMITS.—The maximum annual amount of 

loans under this section an undergraduate dependent student (except an undergraduate dependent student whose 

parents are unable to borrow under section 428B or the 

Federal Direct PLUS Loan Program) may borrow in any 

academic year (as defined in section 481(a)(2)) or its equivalent shall be the sum of the amount determined under 

paragraph (1), plus $2,000. 

(B) AGGREGATE LIMITS.—The maximum aggregate 

amount of loans under this section a student described in 

subparagraph (A) may borrow shall be $31,000. 

(4) LIMITS FOR UNDERGRADUATE INDEPENDENT STUDENTS.— (A) ANNUAL LIMITS.—The maximum annual amount of 

loans under this section an undergraduate independent 

student, or an undergraduate dependent student whose 

parents are unable to borrow under section 428B or the 

Federal Direct PLUS Loan Program, may borrow in any 

academic year (as defined in section 481(a)(2)) or its equivalent shall be the sum of the amount determined under 

paragraph (1), plus— 

(i) in the case of such a student attending an eligible 

institution who has not completed such student’s first 

2 years of undergraduate study— 

(I) $6,000, if such student is enrolled in a program whose length is at least one academic year 

in length; or 

(II) if such student is enrolled in a program of 

undergraduate education which is less than one 

academic year, the maximum annual loan amount 

that such student may receive may not exceed the 

amount that bears the same ratio to the amount 

specified in subclause (I) as the length of such program measured in semester, trimester, quarter, or 

clock hours bears to one academic year; 

222 

(ii) in the case of such a student at an eligible institution who has successfully completed such first and 

second years but has not successfully completed the 

remainder of a program of undergraduate education— 

(I) $7,000; or 

(II) if such student is enrolled in a program of 

undergraduate education, the remainder of which 

is less than one academic year, the maximum annual loan amount that such student may receive 

may not exceed the amount that bears the same 

ratio to the amount specified in subclause (I) as 

such remainder measured in semester, trimester, 

quarter, or clock hours bears to one academic 

year; and 

(iii) in the case of such a student enrolled in 

coursework specified in— 

(I) section 484(b)(3)(B), $6,000; or 

(II) section 484(b)(4)(B), $7,000. 

(B) AGGREGATE LIMITS.—The maximum aggregate 

amount of loans under this section a student described in 

subparagraph (A) may borrow shall be $57,500. 

(5) CAPITALIZED INTEREST.—Interest capitalized shall not be 

deemed to exceed a maximum aggregate amount determined 

under subparagraph (B) of paragraph (2), (3), or (4). 

(e) PAYMENT OF PRINCIPAL AND INTEREST.— 

(1) COMMENCEMENT OF REPAYMENT.—Repayment of principal 

on loans made under this section shall begin at the beginning 

of the repayment period described in section 428(b)(7). Not less 

than 30 days prior to the anticipated commencement of such 

repayment period, the holder of such loan shall provide notice 

to the borrower that interest will accrue before repayment begins and of the borrower’s option to begin loan repayment at 

an earlier date. 

(2) CAPITALIZATION OF INTEREST.—(A) øInterest¿ Except as 

provided in subparagraph (C), interest on loans made under 

this section for which payments of principal are not required 

during the in-school and grace periods or for which payments 

are deferred under sections 427(a)(2)(C) and 428(b)(1)(M) shall, 

if agreed upon by the borrower and the lender— 

(i) be paid monthly or quarterly; or 

(ii) be added to the principal amount of the loan by the 

lender only— 

(I) when the loan enters repayment; 

(II) at the expiration of a grace period, in the case 

of a loan that qualifies for a grace period; 

(III) at the expiration of a period of deferment or forbearance; or 

(IV) when the borrower defaults. 

(B) The capitalization of interest described in subparagraph 

(A) shall not be deemed to exceed the annual insurable limit 

on account of the student. 

(C) Interest shall not accrue on a loan deferred under section 

428(b)(1)(M)(v) or 427(a)(2)(C)(iv). 

223 

(3) SUBSIDIES PROHIBITED.—No payments to reduce interest 

costs shall be paid pursuant to section 428(a) of this part on 

loans made pursuant to this section. 

(4) APPLICABLE RATES OF INTEREST.—Interest on loans made 

pursuant to this section shall be at the applicable rate of interest provided in section 427A. 

(5) AMORTIZATION.—The amount of the periodic payment and 

the repayment schedule for any loan made pursuant to this 

section shall be established by assuming an interest rate equal 

to the applicable rate of interest at the time the repayment of 

the principal amount of the loan commences. At the option of 

the lender, the note or other written evidence of the loan may 

require that— 

(A) the amount of the periodic payment will be adjusted 

annually; or 

(B) the period of repayment of principal will be lengthened or shortened, 

in order to reflect adjustments in interest rates occurring as a 

consequence of section 427A(c)(4). 

(6) REPAYMENT PERIOD.—For purposes of calculating the repayment period under section 428(b)(9), such period shall commence at the time the first payment of principal is due from 

the borrower. 

(7) QUALIFICATION FOR FORBEARANCE.—A lender may grant 

the borrower of a loan under this section a forbearance for a 

period not to exceed 60 days if the lender reasonably determines that such a forbearance from collection activity is warranted following a borrower’s request for forbearance, 

deferment, or a change in repayment plan, or a request to consolidate loans in order to collect or process appropriate supporting documentation related to the request. During any such 

period, interest on the loan shall accrue but not be capitalized. 

ø(f) Repealed¿ 

(g) SINGLE APPLICATION FORM AND LOAN REPAYMENT SCHEDULE.—A guaranty agency shall use a single application form and 

a single repayment schedule for subsidized Federal Stafford loans 

made pursuant to section 428 and for unsubsidized Federal Stafford loans made pursuant to this section. 

(h) INSURANCE PREMIUM.—Each State or nonprofit private institution or organization having an agreement with the Secretary 

under section 428(b)(1) may charge a borrower under this section 

an insurance premium equal to not more than 1.0 percent of the 

principal amount of the loan, if such premium will not be used for 

incentive payments to lenders. Effective for loans for which the 

date of guarantee of principal is on or after July 1, 2006, and that 

are first disbursed before July 1, 2010, in lieu of the insurance premium authorized under the preceding sentence, each State or nonprofit private institution or organization having an agreement with 

the Secretary under section 428(b)(1) shall collect and deposit into 

the Federal Student Loan Reserve Fund under section 422A, a Federal default fee of an amount equal to 1.0 percent of the principal 

amount of the loan, which fee shall be collected either by deduction 

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224 

eral sources. The Federal default fee shall not be used for incentive 

payments to lenders. 

* * * * * * * 

PART D—WILLIAM D. FORD FEDERAL DIRECT 

LOAN PROGRAM 

* * * * * * * 

SEC. 455. TERMS AND CONDITIONS OF LOANS. 

(a) IN GENERAL.— (1) PARALLEL TERMS, CONDITIONS, BENEFITS, AND AMOUNTS.— Unless otherwise specified in this part, loans made to borrowers under this part shall have the same terms, conditions, 

and benefits, and be available in the same amounts, as loans 

made to borrowers, and first disbursed on June 30, 2010, 

under sections 428, 428B, 428C, and 428H of this title. 

(2) DESIGNATION OF LOANS.—Loans made to borrowers under 

this part that, except as otherwise specified in this part, have 

the same terms, conditions, and benefits as loans made to borrowers under— 

(A) section 428 shall be known as ‘‘Federal Direct Stafford Loans’’; 

(B) section 428B shall be known as ‘‘Federal Direct 

PLUS Loans’’; 

(C) section 428C shall be known as ‘‘Federal Direct Consolidation Loans’’; and 

(D) section 428H shall be known as ‘‘Federal Direct Unsubsidized Stafford Loans’’. 

(3) TERMINATION OF AUTHORITY TO MAKE INTEREST SUB- SIDIZED LOANS TO GRADUATE AND PROFESSIONAL STUDENTS.— (A) IN GENERAL.—Subject to subparagraph (B) and notwithstanding any provision of this part or part B, for any 

period of instruction beginning on or after July 1, 2012— 

(i) a graduate or professional student shall not be eligible to receive a Federal Direct Stafford loan under 

this part; and 

(ii) the maximum annual amount of Federal Direct 

Unsubsidized Stafford loans such a student may borrow in any academic year (as defined in section 

481(a)(2)) or its equivalent shall be the maximum annual amount for such student determined under section 428H, plus an amount equal to the amount of 

Federal Direct Stafford loans the student would have 

received in the absence of this subparagraph. 

(B) EXCEPTION.—Subparagraph (A) shall not apply to an 

individual enrolled in course work specified in paragraph 

(3)(B) or (4)(B) of section 484(b). 

(b) INTEREST RATE.— 

(1) RATES FOR FDSL AND FDUSL.—For Federal Direct Stafford 

Loans and Federal Direct Unsubsidized Stafford Loans for 

which the first disbursement is made on or after July 1, 1994, 

the applicable rate of interest shall, during any 12-month period beginning on July 1 and ending on June 30, be determined 

on the preceding June 1 and be equal to— 

225 

(A) the bond equivalent rate of 91-day Treasury bills 

auctioned at the final auction held prior to such June 1; 

plus 

(B) 3.1 percent, 

except that such rate shall not exceed 8.25 percent. 

(2) IN SCHOOL AND GRACE PERIOD RULES.—(A) Notwithstanding the provisions of paragraph (1), but subject to paragraph (3), with respect to any Federal Direct Stafford Loan or 

Federal Direct Unsubsidized Stafford Loan for which the first 

disbursement is made on or after July 1, 1995, the applicable 

rate of interest for interest which accrues— 

(i) prior to the beginning of the repayment period of the 

loan; or 

(ii) during the period in which principal need not be paid 

(whether or not such principal is in fact paid) by reason of 

a provision described in section 428(b)(1)(M) or 

427(a)(2)(C), 

shall not exceed the rate determined under subparagraph (B). 

(B) For the purpose of subparagraph (A), the rate determined 

under this subparagraph shall, during any 12-month period beginning on July 1 and ending on June 30, be determined on 

the preceding June 1 and be equal to— 

(i) the bond equivalent rate of 91-day Treasury bills auctioned at the final auction prior to such June 1; plus 

(ii) 2.5 percent, 

except that such rate shall not exceed 8.25 percent. 

(3) OUT-YEAR RULE.—Notwithstanding paragraphs (1) and 

(2), for Federal Direct Stafford Loans and Federal Direct Unsubsidized Stafford Loans made on or after July 1, 1998, the 

applicable rate of interest shall, during any 12-month period 

beginning on July 1 and ending on June 30, be determined on 

the preceding June 1 and be equal to— 

(A) the bond equivalent rate of the security with a comparable maturity as established by the Secretary; plus 

(B) 1.0 percent, 

except that such rate shall not exceed 8.25 percent. 

(4) RATES FOR FDPLUS.— (A)(i) For Federal Direct PLUS Loans for which the first 

disbursement is made on or after July 1, 1994, the applicable rate of interest shall, during any 12-month period beginning on July 1 and ending on or before June 30, 2001, 

be determined on the preceding June 1 and be equal to— 

(I) the bond equivalent rate of 52-week Treasury 

bills auctioned at final auction held prior to such June 

1; plus 

(II) 3.1 percent, 

except that such rate shall not exceed 9 percent. 

(ii) For any 12-month period beginning on July 1 of 2001 

or any succeeding year, the applicable rate of interest determined under this subparagraph shall be determined on 

the preceding June 26 and be equal to— 

(I) the weekly average 1-year constant maturity 

Treasury yield, as published by the Board of Governors of the Federal Reserve System, for the last calendar week ending on or before such June 26; plus 

226 

(II) 3.1 percent, 

except that such rate shall not exceed 9 percent. 

(B) For Federal Direct PLUS loans made on or after July 1, 

1998, the applicable rate of interest shall, during any 12-month 

period beginning on July 1 and ending on June 30, be determined on the preceding June 1 and be equal to— 

(i) the bond equivalent rate of the security with a comparable maturity as established by the Secretary; plus 

(ii) 2.1 percent, 

except that such rate shall not exceed 9 percent. 

(5) TEMPORARY INTEREST RATE PROVISION.— (A) RATES FOR FDSL AND FDUSL.—Notwithstanding the 

preceding paragraphs of this subsection, for Federal Direct 

Stafford Loans and Federal Direct Unsubsidized Stafford 

Loans for which the first disbursement is made on or after 

July 1, 1998, and before October 1, 1998, the applicable 

rate of interest shall, during any 12-month period beginning on July 1 and ending on June 30, be determined on 

the preceding June 1 and be equal to— 

(i) the bond equivalent rate of 91-day Treasury bills 

auctioned at the final auction held prior to such June 

1; plus 

(ii) 2.3 percent, 

except that such rate shall not exceed 8.25 percent. 

(B) IN SCHOOL AND GRACE PERIOD RULES.—Notwithstanding the preceding paragraphs of this subsection, with 

respect to any Federal Direct Stafford Loan or Federal Direct Unsubsidized Stafford Loan for which the first disbursement is made on or after July 1, 1998, and before October 1, 1998, the applicable rate of interest for interest 

which accrues— 

(i) prior to the beginning of the repayment period of 

the loan; or 

(ii) during the period in which principal need not be 

paid (whether or not such principal is in fact paid) by 

reason of a provision described in section 428(b)(1)(M) 

or 427(a)(2)(C), 

shall be determined under subparagraph (A) by substituting ‘‘1.7 percent’’ for ‘‘2.3 percent’’. 

(C) PLUS LOANS.—Notwithstanding the preceding paragraphs of this subsection, with respect to Federal Direct 

PLUS Loan for which the first disbursement is made on or 

after July 1, 1998, and before October 1, 1998, the applicable rate of interest shall be determined under subparagraph (A)— 

(i) by substituting ‘‘3.1 percent’’ for ‘‘2.3 percent’’; 

and 

(ii) by substituting ‘‘9.0 percent’’ for ‘‘8.25 percent’’. 

(6) INTEREST RATE PROVISION FOR NEW LOANS ON OR AFTER

OCTOBER 1, 1998, AND BEFORE JULY 1, 2006.— (A) RATES FOR FDSL AND FDUSL.—Notwithstanding the 

preceding paragraphs of this subsection, for Federal Direct 

Stafford Loans and Federal Direct Unsubsidized Stafford 

Loans for which the first disbursement is made on or after 

October 1, 1998, and before July 1, 2006, the applicable 

227 

rate of interest shall, during any 12-month period beginning on July 1 and ending on June 30, be determined on 

the preceding June 1 and be equal to— 

(i) the bond equivalent rate of 91-day Treasury bills 

auctioned at the final auction held prior to such June 

1; plus 

(ii) 2.3 percent, 

except that such rate shall not exceed 8.25 percent. 

(B) IN SCHOOL AND GRACE PERIOD RULES.—Notwithstanding the preceding paragraphs of this subsection, with 

respect to any Federal Direct Stafford Loan or Federal Direct Unsubsidized Stafford Loan for which the first disbursement is made on or after October 1, 1998, and before 

July 1, 2006, the applicable rate of interest for interest 

which accrues— 

(i) prior to the beginning of the repayment period of 

the loan; or 

(ii) during the period in which principal need not be 

paid (whether or not such principal is in fact paid) by 

reason of a provision described in section 428(b)(1)(M) 

or 427(a)(2)(C), 

shall be determined under subparagraph (A) by substituting ‘‘1.7 percent’’ for ‘‘2.3 percent’’. 

(C) PLUS LOANS.—Notwithstanding the preceding paragraphs of this subsection, with respect to Federal Direct 

PLUS Loan for which the first disbursement is made on or 

after October 1, 1998, and before July 1, 2006, the applicable rate of interest shall be determined under subparagraph (A)— 

(i) by substituting ‘‘3.1 percent’’ for ‘‘2.3 percent’’; 

and 

(ii) by substituting ‘‘9.0 percent’’ for ‘‘8.25 percent’’. 

(D) CONSOLIDATION LOANS.—Notwithstanding the preceding paragraphs of this subsection, any Federal Direct 

Consolidation loan for which the application is received on 

or after February 1, 1999, and before July 1, 2006, shall 

bear interest at an annual rate on the unpaid principal 

balance of the loan that is equal to the lesser of— 

(i) the weighted average of the interest rates on the 

loans consolidated, rounded to the nearest higher oneeighth of one percent; or 

(ii) 8.25 percent. 

(E) TEMPORARY RULES FOR CONSOLIDATION LOANS.—Notwithstanding the preceding paragraphs of this subsection, 

any Federal Direct Consolidation loan for which the application is received on or after October 1, 1998, and before 

February 1, 1999, shall bear interest at an annual rate on 

the unpaid principal balance of the loan that is equal to— 

(i) the bond equivalent rate of 91-day Treasury bills 

auctioned at the final auction held prior to such June 

1; plus 

(ii) 2.3 percent, 

except that such rate shall not exceed 8.25 percent. 

(7) INTEREST RATE PROVISION FOR NEW LOANS ON OR AFTER

JULY 1, 2006 AND BEFORE JULY 1, 2013.— 

228 

(A) RATES FOR FDSL AND FDUSL.—Notwithstanding the 

preceding paragraphs of this subsection, for Federal Direct 

Stafford Loans and Federal Direct Unsubsidized Stafford 

Loans for which the first disbursement is made on or after 

July 1, 2006, and before July 1, 2013, the applicable rate 

of interest shall be 6.8 percent on the unpaid principal balance of the loan. 

(B) PLUS LOANS.—Notwithstanding the preceding paragraphs of this subsection, with respect to any Federal Direct PLUS loan for which the first disbursement is made 

on or after July 1, 2006, and before July 1, 2013, the applicable rate of interest shall be 7.9 percent on the unpaid 

principal balance of the loan. 

(C) CONSOLIDATION LOANS.—Notwithstanding the preceding paragraphs of this subsection, any Federal Direct 

Consolidation loan for which the application is received on 

or after July 1, 2006, and before July 1, 2013, shall bear 

interest at an annual rate on the unpaid principal balance 

of the loan that is equal to the lesser of— 

(i) the weighted average of the interest rates on the 

loans consolidated, rounded to the nearest higher oneeighth of one percent; or 

(ii) 8.25 percent. 

(D) REDUCED RATES FOR UNDERGRADUATE FDSL.—Notwithstanding the preceding paragraphs of this subsection 

and subparagraph (A) of this paragraph, for Federal Direct 

Stafford Loans made to undergraduate students for which 

the first disbursement is made on or after July 1, 2006, 

and before July 1, 2013, the applicable rate of interest 

shall be as follows: 

(i) For a loan for which the first disbursement is 

made on or after July 1, 2006, and before July 1, 2008, 

6.8 percent on the unpaid principal balance of the 

loan. 

(ii) For a loan for which the first disbursement is 

made on or after July 1, 2008, and before July 1, 2009, 

6.0 percent on the unpaid principal balance of the 

loan. 

(iii) For a loan for which the first disbursement is 

made on or after July 1, 2009, and before July 1, 2010, 

5.6 percent on the unpaid principal balance of the 

loan. 

(iv) For a loan for which the first disbursement is 

made on or after July 1, 2010, and before July 1, 2011, 

4.5 percent on the unpaid principal balance of the 

loan. 

(v) For a loan for which the first disbursement is 

made on or after July 1, 2011, and before July 1, 2013, 

3.4 percent on the unpaid principal balance of the 

loan. 

(8) INTEREST RATE PROVISIONS FOR NEW LOANS ON OR AFTER

JULY 1, 2013.— (A) RATES FOR UNDERGRADUATE FDSL AND FDUSL.—Notwithstanding the preceding paragraphs of this subsection, 

for Federal Direct Stafford Loans and Federal Direct UnVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00228 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
229 

subsidized Stafford Loans issued to undergraduate students, for which the first disbursement is made on or after 

July 1, 2013, the applicable rate of interest shall, for loans 

disbursed during any 12-month period beginning on July 

1 and ending on June 30, be determined on the preceding 

June 1 and be equal to the lesser of— 

(i) a rate equal to the high yield of the 10-year 

Treasury note auctioned at the final auction held prior 

to such June 1 plus 2.05 percent; or 

(ii) 8.25 percent. 

(B) RATES FOR GRADUATE AND PROFESSIONAL FDUSL.— Notwithstanding the preceding paragraphs of this subsection, for Federal Direct Unsubsidized Stafford Loans 

issued to graduate or professional students, for which the 

first disbursement is made on or after July 1, 2013, the applicable rate of interest shall, for loans disbursed during 

any 12-month period beginning on July 1 and ending on 

June 30, be determined on the preceding June 1 and be 

equal to the lesser of— 

(i) a rate equal to the high yield of the 10-year 

Treasury note auctioned at the final auction held prior 

to such June 1 plus 3.6 percent; or 

(ii) 9.5 percent. 

(C) PLUS LOANS.—Notwithstanding the preceding paragraphs of this subsection, for Federal Direct PLUS Loans, 

for which the first disbursement is made on or after July 

1, 2013, the applicable rate of interest shall, for loans disbursed during any 12-month period beginning on July 1 

and ending on June 30, be determined on the preceding 

June 1 and be equal to the lesser of— 

(i) a rate equal to the high yield of the 10-year 

Treasury note auctioned at the final auction held prior 

to such June 1 plus 4.6 percent; or 

(ii) 10.5 percent. 

(D) CONSOLIDATION LOANS.—Notwithstanding the preceding paragraphs of this subsection, any Federal Direct 

Consolidation Loan for which the application is received on 

or after July 1, 2013, shall bear interest at an annual rate 

on the unpaid principal balance of the loan that is equal 

to the weighted average of the interest rates on the loans 

consolidated, rounded to the nearest higher one-eighth of 

one percent. 

(E) CONSULTATION.—The Secretary shall determine the 

applicable rate of interest under this paragraph after consultation with the Secretary of the Treasury and shall publish such rate in the Federal Register as soon as practicable after the date of determination. 

(F) RATE.—The applicable rate of interest determined 

under this paragraph for a Federal Direct Stafford Loan, 

a Federal Direct Unsubsidized Stafford Loan, or a Federal 

Direct PLUS Loan shall be fixed for the period of the loan. 

(9) REPAYMENT INCENTIVES.— (A)(A) INCENTIVES FOR LOANS DISBURSED BEFORE JULY 1, 

2012.—Notwithstanding any other provision of this part 

with respect to loans for which the first disbursement of 

230 

principal is made before July 1, 2012,, the Secretary is authorized to prescribe by regulation such reductions in the 

interest or origination fee rate paid by a borrower of a loan 

made under this part as the Secretary determines appropriate to encourage on-time repayment of the loan. Such 

reductions may be offered only if the Secretary determines 

the reductions are cost neutral and in the best financial interest of the Federal Government. Any increase in subsidy 

costs resulting from such reductions shall be completely 

offset by corresponding savings in funds available for the 

William D. Ford Federal Direct Loan Program in that fiscal year from section 458 and other administrative accounts. 

(B) ACCOUNTABILITY.—Prior to publishing regulations 

proposing repayment incentives with respect to loans for 

which the first disbursement of principal is made before 

July 1, 2012, the Secretary shall ensure the cost neutrality 

of such reductions. The Secretary shall not prescribe such 

regulations in final form unless an official report from the 

Director of the Office of Management and Budget to the 

Secretary and a comparable report from the Director of the 

Congressional Budget Office to the Congress each certify 

that any such reductions will be completely cost neutral. 

Such reports shall be transmitted to the authorizing committees not less than 60 days prior to the publication of 

regulations proposing such reductions. 

(C) NO REPAYMENT INCENTIVES FOR NEW LOANS DIS- BURSED ON OR AFTER JULY 1, 2012.—Notwithstanding any 

other provision of this part, the Secretary is prohibited 

from authorizing or providing any repayment incentive not 

otherwise authorized under this part to encourage on-time 

repayment of a loan under this part for which the first disbursement of principal is made on or after July 1, 2012, 

including any reduction in the interest or origination fee 

rate paid by a borrower of such a loan, except that the Secretary may provide for an interest rate reduction for a borrower who agrees to have payments on such a loan automatically electronically debited from a bank account. 

(10) PUBLICATION.—The Secretary shall determine the applicable rates of interest under this subsection after consultation 

with the Secretary of the Treasury and shall publish such rate 

in the Federal Register as soon as practicable after the date of 

determination. 

(c) LOAN FEE.— 

(1) IN GENERAL.—The Secretary shall charge the borrower of 

a loan made under this part an origination fee of 4.0 percent 

of the principal amount of loan. 

(2) SUBSEQUENT REDUCTION.—Paragraph (1) shall be applied 

to loans made under this part, other than Federal Direct Consolidation loans and Federal Direct PLUS loans— 

(A) by substituting ‘‘3.0 percent’’ for ‘‘4.0 percent’’ with 

respect to loans for which the first disbursement of principal is made on or after the date of enactment of the 

Higher Education Reconciliation Act of 2005, and before 

July 1, 2007; 

231 

(B) by substituting ‘‘2.5 percent’’ for ‘‘4.0 percent’’ with 

respect to loans for which the first disbursement of principal is made on or after July 1, 2007, and before July 1, 

2008; 

(C) by substituting ‘‘2.0 percent’’ for ‘‘4.0 percent’’ with 

respect to loans for which the first disbursement of principal is made on or after July 1, 2008, and before July 1, 

2009; 

(D) by substituting ‘‘1.5 percent’’ for ‘‘4.0 percent’’ with 

respect to loans for which the first disbursement of principal is made on or after July 1, 2009, and before July 1, 

2010; and 

(E) by substituting ‘‘1.0 percent’’ for ‘‘4.0 percent’’ with 

respect to loans for which the first disbursement of principal is made on or after July 1, 2010. 

(d) REPAYMENT PLANS.— 

(1) DESIGN AND SELECTION.—Consistent with criteria established by the Secretary, the Secretary shall offer a borrower of 

a loan made under this part a variety of plans for repayment 

of such loan, including principal and interest on the loan. The 

borrower shall be entitled to accelerate, without penalty, repayment on the borrower’s loans under this part. The borrower 

may choose— 

(A) a standard repayment plan, consistent with subsection (a)(1) of this section and with section 

428(b)(9)(A)(i); 

(B) a graduated repayment plan, consistent with section 

428(b)(9)(A)(ii); 

(C) an extended repayment plan, consistent with section 

428(b)(9)(A)(iv), except that the borrower shall annually 

repay a minimum amount determined by the Secretary in 

accordance with section 428(b)(1)(L); 

(D) an income contingent repayment plan, with varying 

annual repayment amounts based on the income of the 

borrower, paid over an extended period of time prescribed 

by the Secretary, not to exceed 25 years, except that the 

plan described in this subparagraph shall not be available 

to the borrower of a Federal Direct PLUS loan made on behalf of a dependent student; and 

(E) beginning on July 1, 2009, an income-based repayment plan that enables borrowers who have a partial financial hardship to make a lower monthly payment in accordance with section 493C, except that the plan described 

in this subparagraph shall not be available to the borrower 

of a Federal Direct PLUS Loan made on behalf of a dependent student or a Federal Direct Consolidation Loan, if 

the proceeds of such loan were used to discharge the liability on such Federal Direct PLUS Loan or a loan under section 428B made on behalf of a dependent student. 

(2) SELECTION BY SECRETARY.—If a borrower of a loan made 

under this part does not select a repayment plan described in 

paragraph (1), the Secretary may provide the borrower with a 

repayment plan described in subparagraph (A), (B), or (C) of 

paragraph (1). 

232 

(3) CHANGES IN SELECTIONS.—The borrower of a loan made 

under this part may change the borrower’s selection of a repayment plan under paragraph (1), or the Secretary’s selection of 

a plan for the borrower under paragraph (2), as the case may 

be, under such terms and conditions as may be established by 

the Secretary. 

(4) ALTERNATIVE REPAYMENT PLANS.—The Secretary may 

provide, on a case by case basis, an alternative repayment plan 

to a borrower of a loan made under this part who demonstrates 

to the satisfaction of the Secretary that the terms and conditions of the repayment plans available under paragraph (1) are 

not adequate to accommodate the borrower’s exceptional circumstances. In designing such alternative repayment plans, 

the Secretary shall ensure that such plans do not exceed the 

cost to the Federal Government, as determined on the basis of 

the present value of future payments by such borrowers, of 

loans made using the plans available under paragraph (1). 

(5) REPAYMENT AFTER DEFAULT.—The Secretary may require 

any borrower who has defaulted on a loan made under this 

part to— 

(A) pay all reasonable collection costs associated with 

such loan; and 

(B) repay the loan pursuant to an income contingent repayment plan. 

(e) INCOME CONTINGENT REPAYMENT.— 

(1) INFORMATION AND PROCEDURES.—The Secretary may obtain such information as is reasonably necessary regarding the 

income of a borrower (and the borrower’s spouse, if applicable) 

of a loan made under this part that is, or may be, repaid pursuant to income contingent repayment, for the purpose of determining the annual repayment obligation of the borrower. 

Returns and return information (as defined in section 6103 of 

the Internal Revenue Code of 1986) may be obtained under the 

preceding sentence only to the extent authorized by section 

6103(l)(13) of such Code. The Secretary shall establish procedures for determining the borrower’s repayment obligation on 

that loan for such year, and such other procedures as are necessary to implement effectively income contingent repayment. 

(2) REPAYMENT BASED ON ADJUSTED GROSS INCOME.—A repayment schedule for a loan made under this part and repaid 

pursuant to income contingent repayment shall be based on 

the adjusted gross income (as defined in section 62 of the Internal Revenue Code of 1986) of the borrower or, if the borrower 

is married and files a Federal income tax return jointly with 

the borrower’s spouse, on the adjusted gross income of the borrower and the borrower’s spouse. 

(3) ADDITIONAL DOCUMENTS.—A borrower who chooses, or is 

required, to repay a loan made under this part pursuant to income contingent repayment, and for whom adjusted gross income is unavailable or does not reasonably reflect the borrower’s current income, shall provide to the Secretary other 

documentation of income satisfactory to the Secretary, which 

documentation the Secretary may use to determine an appropriate repayment schedule. 

233 

(4) REPAYMENT SCHEDULES.—Income contingent repayment 

schedules shall be established by regulations promulgated by 

the Secretary and shall require payments that vary in relation 

to the appropriate portion of the annual income of the borrower 

(and the borrower’s spouse, if applicable) as determined by the 

Secretary. 

(5) CALCULATION OF BALANCE DUE.—The balance due on a 

loan made under this part that is repaid pursuant to income 

contingent repayment shall equal the unpaid principal amount 

of the loan, any accrued interest, and any fees, such as late 

charges, assessed on such loan. The Secretary may promulgate 

regulations limiting the amount of interest that may be capitalized on such loan, and the timing of any such capitalization. 

(6) NOTIFICATION TO BORROWERS.—The Secretary shall establish procedures under which a borrower of a loan made under 

this part who chooses or is required to repay such loan pursuant to income contingent repayment is notified of the terms 

and conditions of such plan, including notification of such borrower— 

(A) that the Internal Revenue Service will disclose to the 

Secretary tax return information as authorized under section 6103(l)(13) of the Internal Revenue Code of 1986; and 

(B) that if a borrower considers that special circumstances, such as a loss of employment by the borrower 

or the borrower’s spouse, warrant an adjustment in the 

borrower’s loan repayment as determined using the information described in subparagraph (A), or the alternative 

documentation described in paragraph (3), the borrower 

may contact the Secretary, who shall determine whether 

such adjustment is appropriate, in accordance with criteria 

established by the Secretary. 

(7) MAXIMUM REPAYMENT PERIOD.—In calculating the extended period of time for which an income contingent repayment plan under this subsection may be in effect for a borrower, the Secretary shall include all time periods during 

which a borrower of loans under part B, part D, or part E— 

(A) is not in default on any loan that is included in the 

income contingent repayment plan; and 

(B)(i) is in deferment due to an economic hardship described in section 435(o); 

(ii) makes monthly payments under paragraph (1) or (6) 

of section 493C(b); 

(iii) makes monthly payments of not less than the 

monthly amount calculated under section 428(b)(9)(A)(i) or 

subsection (d)(1)(A), based on a 10-year repayment period, 

when the borrower first made the election described in section 493C(b)(1); 

(iv) makes payments of not less than the payments required under a standard repayment plan under section 

428(b)(9)(A)(i) or subsection (d)(1)(A) with a repayment period of 10 years; or 

(v) makes payments under an income contingent repayment plan under subsection (d)(1)(D). 

(f) DEFERMENT.— 

234 

(1) EFFECT ON PRINCIPAL AND INTEREST.—A borrower of a 

loan made under this part who meets the requirements described in paragraph (2) shall be eligible for a deferment, during which periodic installments of principal need not be paid, 

and interest— 

(A) shall not accrue, in the case of a— 

(i) Federal Direct Stafford Loan; or 

(ii) a Federal Direct Consolidation Loan that consolidated only Federal Direct Stafford Loans, or a combination of such loans and Federal Stafford Loans for 

which the student borrower received an interest subsidy under section 428; or 

(B) shall accrue and be capitalized or paid by the borrower, in the case of a Federal Direct PLUS Loan, a Federal Direct Unsubsidized Stafford Loan, or a Federal Direct Consolidation Loan not described in subparagraph 

(A)(ii). 

(2) ELIGIBILITY.—A borrower of a loan made under this part 

shall be eligible for a deferment during any period— 

(A) during which the borrower— 

(i) is carrying at least one-half the normal full-time 

work load for the course of study that the borrower is 

pursuing, as determined by the eligible institution (as 

such term is defined in section 435(a)) the borrower is 

attending; or 

(ii) is pursuing a course of study pursuant to a graduate fellowship program approved by the Secretary, or 

pursuant to a rehabilitation training program for individuals with disabilities approved by the Secretary, 

except that no borrower shall be eligible for a deferment 

under this subparagraph, or a loan made under this part 

(other than a Federal Direct PLUS Loan or a Federal Direct Consolidation Loan), while serving in a medical internship or residency program; 

(B) not in excess of 3 years during which the borrower 

is seeking and unable to find full-time employment; 

(C) during which the borrower— 

(i) is serving on active duty during a war or other 

military operation or national emergency; or 

(ii) is performing qualifying National Guard duty 

during a war or other military operation or national 

emergency, 

and for the 180-day period following the demobilization 

date for the service described in clause (i) or (ii); or 

(D) not in excess of 3 years during which the Secretary 

determines, in accordance with regulations prescribed 

under section 435(o), that the borrower has experienced or 

will experience an economic hardship. 

(3) DEFERMENT FOR BORROWERS RECEIVING CANCER TREAT- MENT.— 

(A) EFFECT ON PRINCIPAL AND INTEREST.—A borrower of 

a loan made under this part who meets the requirements 

of subparagraph (B) shall be eligible for a deferment, during which periodic installments of principal need not be 

paid, and interest shall not accrue. 

235 

(B) ELIGIBILITY.—A borrower of a loan made under this 

part shall be eligible for a deferment during— 

(i) any period in which such borrower is receiving 

treatment for cancer; and 

(ii) the 6 months after such period. 

(C) APPLICABILITY.—This paragraph shall apply with respect to loans— 

(i) made on or after the date of the enactment of this 

paragraph; or 

(ii) in repayment on the date of the enactment of this 

paragraph. 

ø(3)¿ (4) DEFINITION OF BORROWER.—For the purpose of this 

subsection, the term ‘‘borrower’’ means an individual who is a 

new borrower on the date such individual applies for a loan 

under this part for which the first disbursement is made on or 

after July 1, 1993. 

ø(4)¿ (5) DEFERMENTS FOR PREVIOUS PART B LOAN BORROWERS.—A borrower of a loan made under this part, who at 

the time such individual applies for such loan, has an outstanding balance of principal or interest owing on any loan 

made, insured, or guaranteed under part B of title IV prior to 

July 1, 1993, shall be eligible for a deferment under section 

427(a)(2)(C) or section 428(b)(1)(M) as such sections were in effect on July 22, 1992. 

(g) FEDERAL DIRECT CONSOLIDATION LOANS.—A borrower of a 

loan made under this part may consolidate such loan with the 

loans described in section 428C(a)(4), including any loan made 

under part B and first disbursed before July 1, 2010. To be eligible 

for a consolidation loan under this part, a borrower shall meet the 

eligibility criteria set forth in section 428C(a)(3). 

(h) BORROWER DEFENSES.—Notwithstanding any other provision 

of State or Federal law, the Secretary shall specify in regulations 

which acts or omissions of an institution of higher education a borrower may assert as a defense to repayment of a loan made under 

this part, except that in no event may a borrower recover from the 

Secretary, in any action arising from or relating to a loan made 

under this part, an amount in excess of the amount such borrower 

has repaid on such loan. 

(i) LOAN APPLICATION AND PROMISSORY NOTE.—The common financial reporting form required in section 483(a)(1) shall constitute 

the application for loans made under this part (other than a Federal Direct PLUS loan). The Secretary shall develop, print, and distribute to participating institutions a standard promissory note and 

loan disclosure form. 

(j) LOAN DISBURSEMENT.— 

(1) IN GENERAL.—Proceeds of loans to students under this 

part shall be applied to the student’s account for tuition and 

fees, and, in the case of institutionally owned housing, to room 

and board. Loan proceeds that remain after the application of 

the previous sentence shall be delivered to the borrower by 

check or other means that is payable to and requires the endorsement or other certification by such borrower. 

(2) PAYMENT PERIODS.—The Secretary shall establish periods 

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236 

sistent with payment of Federal Pell Grants under subpart 1 

of part A of this title. 

(k) FISCAL CONTROL AND FUND ACCOUNTABILITY.— (1) IN GENERAL.—(A) An institution shall maintain financial 

records in a manner consistent with records maintained for 

other programs under this title. 

(B) Except as otherwise required by regulations of the Secretary an institution may maintain loan funds under this part 

in the same account as other Federal student financial assistance. 

(2) PAYMENTS AND REFUNDS.—Payments and refunds shall 

be reconciled in a manner consistent with the manner set forth 

for the submission of a payment summary report required of 

institutions participating in the program under subpart 1 of 

part A, except that nothing in this paragraph shall prevent 

such reconciliations on a monthly basis. 

(3) TRANSACTION HISTORIES.—All transaction histories under 

this part shall be maintained using the same system designated by the Secretary for the provision of Federal Pell 

Grants under subpart 1 of part A of this title. 

(l) ARMED FORCES STUDENT LOAN INTEREST PAYMENT PRO- GRAM.— 

(1) AUTHORITY.—Using funds received by transfer to the Secretary under section 2174 of title 10, United States Code, for 

the payment of interest on a loan made under this part to a 

member of the Armed Forces, the Secretary shall pay the interest on the loan as due for a period not in excess of 36 consecutive months. The Secretary may not pay interest on such a 

loan out of any funds other than funds that have been so 

transferred. 

(2) FORBEARANCE.—During the period in which the Secretary 

is making payments on a loan under paragraph (1), the Secretary shall grant the borrower forbearance, in the form of a 

temporary cessation of all payments on the loan other than the 

payments of interest on the loan that are made under that 

paragraph. 

(m) REPAYMENT PLAN FOR PUBLIC SERVICE EMPLOYEES.— (1) IN GENERAL.—The Secretary shall cancel the balance of 

interest and principal due, in accordance with paragraph (2), 

on any eligible Federal Direct Loan not in default for a borrower who— 

(A) has made 120 monthly payments on the eligible Federal Direct Loan after October 1, 2007, pursuant to any 

one or a combination of the following— 

(i) payments under an income-based repayment plan 

under section 493C; 

(ii) payments under a standard repayment plan 

under subsection (d)(1)(A), based on a 10-year repayment period; 

(iii) monthly payments under a repayment plan 

under subsection (d)(1) or (g) of not less than the 

monthly amount calculated under subsection (d)(1)(A), 

based on a 10-year repayment period; or 

(iv) payments under an income contingent repayment plan under subsection (d)(1)(D); and 

237 

(B)(i) is employed in a public service job at the time of 

such forgiveness; and 

(ii) has been employed in a public service job during the 

period in which the borrower makes each of the 120 payments described in subparagraph (A). 

(2) LOAN CANCELLATION AMOUNT.—After the conclusion of 

the employment period described in paragraph (1), the Secretary shall cancel the obligation to repay the balance of principal and interest due as of the time of such cancellation, on 

the eligible Federal Direct Loans made to the borrower under 

this part. 

(3) DEFINITIONS.—In this subsection: 

(A) ELIGIBLE FEDERAL DIRECT LOAN.—The term ‘‘eligible 

Federal Direct Loan’’ means a Federal Direct Stafford 

Loan, Federal Direct PLUS Loan, or Federal Direct Unsubsidized Stafford Loan, or a Federal Direct Consolidation Loan. 

(B) PUBLIC SERVICE JOB.—The term ‘‘public service job’’ 

means— 

(i) a full-time job in emergency management, government (excluding time served as a member of Congress), military service, public safety, law enforcement, 

public health (including nurses, nurse practitioners, 

nurses in a clinical setting, and full-time professionals 

engaged in health care practitioner occupations and 

health care support occupations, as such terms are defined by the Bureau of Labor Statistics), public education, social work in a public child or family service 

agency, public interest law services (including prosecution or public defense or legal advocacy on behalf of 

low-income communities at a nonprofit organization), 

early childhood education (including licensed or regulated childcare, Head Start, and State funded prekindergarten), public service for individuals with disabilities, public service for the elderly, public library 

sciences, school-based library sciences and other 

school-based services, or at an organization that is described in section 501(c)(3) of the Internal Revenue 

Code of 1986 and exempt from taxation under section 

501(a) of such Code; or 

(ii) teaching as a full-time faculty member at a Tribal College or University as defined in section 316(b) 

and other faculty teaching in high-needs subject areas 

or areas of shortage (including nurse faculty, foreign 

language faculty, and part-time faculty at community 

colleges), as determined by the Secretary. 

(4) INELIGIBILITY FOR DOUBLE BENEFITS.—No borrower may, 

for the same service, receive a reduction of loan obligations 

under both this subsection and section 428J, 428K, 428L, or 

460. 

(n) IDENTITY FRAUD PROTECTION.—The Secretary shall take such 

steps as may be necessary to ensure that monthly Federal Direct 

Loan statements and other publications of the Department do not 

contain more than four digits of the Social Security number of any 

individual. 

238 

(o) NO ACCRUAL OF INTEREST FOR ACTIVE DUTY SERVICE MEM- BERS.— 

(1) IN GENERAL.—Notwithstanding any other provision of 

this part and in accordance with paragraphs (2) and (4), interest shall not accrue for an eligible military borrower on a loan 

made under this part for which the first disbursement is made 

on or after October 1, 2008. 

(2) CONSOLIDATION LOANS.—In the case of any consolidation 

loan made under this part that is disbursed on or after October 

1, 2008, interest shall not accrue pursuant to this subsection 

only on such portion of such loan as was used to repay a loan 

made under this part for which the first disbursement is made 

on or after October 1, 2008. 

(3) ELIGIBLE MILITARY BORROWER.—In this subsection, the 

term ‘‘eligible military borrower’’ means an individual who— 

(A)(i) is serving on active duty during a war or other 

military operation or national emergency; or 

(ii) is performing qualifying National Guard duty during 

a war or other military operation or national emergency; 

and 

(B) is serving in an area of hostilities in which service 

qualifies for special pay under section 310, or paragraph 

(1) or (3) of section 351(a), of title 37, United States Code. 

(4) LIMITATION.—An individual who qualifies as an eligible 

military borrower under this subsection may receive the benefit of this subsection for not more than 60 months. 

(p) DISCLOSURES.—Each institution of higher education with 

which the Secretary has an agreement under section 453, and each 

contractor with which the Secretary has a contract under section 

456, shall, with respect to loans under this part and in accordance 

with such regulations as the Secretary shall prescribe, comply with 

each of the requirements under section 433 that apply to a lender 

with respect to a loan under part B. 

(q) ELIGIBILITY FOR, AND INTEREST CHARGES ON, FEDERAL DIRECT STAFFORD LOANS FOR NEW BORROWERS ON OR AFTER JULY 1, 

2013.— 

(1) IN GENERAL.—Notwithstanding subsection (a) or any 

other provision of this title, any borrower who was a new borrower on or after July 1, 2013, shall not be eligible for a Federal Direct Stafford Loan if the period of time for which the 

borrower has received Federal Direct Stafford Loans, in the aggregate, exceeds the period of enrollment described in paragraph (3). Such borrower may still receive any Federal Direct 

Unsubsidized Stafford Loan for which such borrower is otherwise eligible. 

(2) ACCRUAL OF INTEREST ON FEDERAL DIRECT STAFFORD

LOANS.—Notwithstanding subsection (f)(1)(A) or any other provision of this title and beginning on the date upon which a borrower who is enrolled in a program of education or training (including a course of study or program described in paragraph 

(3)(B) or (4)(B) of section 484(b)) for which borrowers are otherwise eligible to receive Federal Direct Stafford Loans, becomes 

ineligible for such loan as a result of paragraph (1), interest on 

all Federal Direct Stafford Loans that were disbursed to such 

borrower on or after July 1, 2013, shall accrue. Such interest 

239 

shall be paid or capitalized in the same manner as interest on 

a Federal Direct Unsubsidized Stafford Loan is paid or capitalized under section 428H(e)(2). 

(3) PERIOD OF ENROLLMENT.— 

(A) IN GENERAL.—The aggregate period of enrollment referred to in paragraph (1) shall not exceed the lesser of— 

(i) a period equal to 150 percent of the published 

length of the educational program in which the student is enrolled; or 

(ii) in the case of a borrower who was previously enrolled in one or more other educational programs that 

began on or after July 1, 2013, and subject to subparagraph (B), a period of time equal to the difference between— 

(I) 150 percent of the published length of the 

longest educational program in which the borrower was, or is, enrolled; and 

(II) any periods of enrollment in which the borrower received a Federal Direct Stafford Loan. 

(B) REGULATIONS.—The Secretary shall specify in regulation— 

(i) how the aggregate period described in subparagraph (A) shall be calculated with respect to a borrower who was or is enrolled on less than a full-time 

basis; and 

(ii) how such aggregate period shall be calculated to 

include a course of study or program described in 

paragraph (3)(B) or (4)(B) of section 484(b), respectively. 

* * * * * * * 

SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES. 

(a) ADMINISTRATIVE EXPENSES.— 

(1) MANDATORY FUNDS FOR FISCAL YEAR 2006.—For fiscal year 

2006, there shall be available to the Secretary, from funds not 

otherwise appropriated, funds to be obligated for— 

(A) administrative costs under this part and part B, including the costs of the direct student loan programs under 

this part; and 

(B) account maintenance fees payable to guaranty agencies under part B and calculated in accordance with subsections (b) and (c), 

not to exceed (from such funds not otherwise appropriated) 

$820,000,000 in fiscal year 2006. 

(3) AUTHORIZATION FOR ADMINISTRATIVE COSTS BEGINNING IN

FISCAL YEARS 2007 THROUGH 2014.—For each of the fiscal years 

2007 through 2014, there are authorized to be appropriated 

such sums as may be necessary for administrative costs under 

this part and part B, including the costs of the direct student 

loan programs under this part. 

(4) CONTINUING MANDATORY FUNDS FOR ACCOUNT MAINTENANCE FEES.—For each of the fiscal years 2007 through ø2018¿ 

2019, there shall be available to the Secretary, from funds not 

otherwise appropriated, funds to be obligated for account mainVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00239 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
240 

tenance fees payable to guaranty agencies under part B and 

calculated in accordance with subsection (b). 

(5) ACCOUNT MAINTENANCE FEES.—Account maintenance fees 

under paragraph (3) shall be paid quarterly and deposited in 

the Agency Operating Fund established under section 422B. 

(6) TECHNICAL ASSISTANCE TO INSTITUTIONS OF HIGHER EDU- CATION.— 

(A) PROVISION OF ASSISTANCE.—The Secretary shall provide institutions of higher education participating, or seeking to participate, in the loan programs under this part 

with technical assistance in establishing and administering such programs. 

(B) FUNDS.—There are authorized to be appropriated, 

and there are appropriated, to carry out this paragraph (in 

addition to any other amounts appropriated to carry out 

this paragraph and out of any money in the Treasury not 

otherwise appropriated), $50,000,000 for fiscal year 2010. 

(C) DEFINITION.—In this paragraph, the term ‘‘assistance’’ means the provision of technical support, training, 

materials, technical assistance, and financial assistance. 

(7) ADDITIONAL PAYMENTS.— (A) PROVISION OF ASSISTANCE.—The Secretary shall provide payments to loan servicers for retaining jobs at locations in the United States where such servicers were operating under part B on January 1, 2010. 

(B) FUNDS.—There are authorized to be appropriated, 

and there are appropriated, to carry out this paragraph (in 

addition to any other amounts appropriated to carry out 

this paragraph and out of any money in the Treasury not 

otherwise appropriated), $25,000,000 for each of the fiscal 

years 2010 and 2011. 

(8) CARRYOVER.—The Secretary may carry over funds made 

available under this section to a subsequent fiscal year. 

(b) CALCULATION BASIS.—Account maintenance fees payable to 

guaranty agencies under subsection (a)(4) shall be calculated on 

the basis of 0.06 percent of the original principal amount of outstanding loans on which insurance was issued under part B. 

(c) BUDGET JUSTIFICATION.—No funds may be expended under 

this section unless the Secretary includes in the Department of 

Education’s annual budget justification to Congress a detailed description of the specific activities for which the funds made available by this section have been used in the prior and current years 

(if applicable), the activities and costs planned for the budget year, 

and the projection of activities and costs for each remaining year 

for which administrative expenses under this section are made 

available. 

* * * * * * * 

PART E—FEDERAL PERKINS LOANS

* * * * * * * 

SEC. 464. TERMS OF LOANS. 

(a) TERMS AND CONDITIONS.—(1) Loans from any student loan 

fund established pursuant to an agreement under section 463 to 

any student by any institution shall, subject to such conditions, 

241 

limitations, and requirements as the Secretary shall prescribe by 

regulation, be made on such terms and conditions as the institution 

may determine. 

(2)(A) Except as provided in paragraph (4), the total of loans 

made to a student in any academic year or its equivalent by an institution of higher education from a loan fund established pursuant 

to an agreement under this part shall not exceed— 

(i) $5,500, in the case of a student who has not successfully 

completed a program of undergraduate education; or 

(ii) $8,000, in the case of a graduate or professional student 

(as defined in regulations issued by the Secretary). 

(B) Except as provided in paragraph (4), the aggregate unpaid 

principal amount for all loans made to a student by institutions of 

higher education from loan funds established pursuant to agreements under this part may not exceed— 

(i) $60,000, in the case of any graduate or professional student (as defined by regulations issued by the Secretary, and including any loans from such funds made to such person before 

such person became a graduate or professional student); 

(ii) $27,500, in the case of a student who has successfully 

completed 2 years of a program of education leading to a bachelor’s degree but who has not completed the work necessary for 

such a degree (determined under regulations issued by the Secretary), and including any loans from such funds made to such 

person before such person became such a student; and 

(iii) $11,000, in the case of any other student. 

(3) Regulations of the Secretary under paragraph (1) shall be designed to prevent the impairment of the capital student loan funds 

to the maximum extent practicable and with a view toward the objective of enabling the student to complete his course of study. 

(4) In the case of a program of study abroad that is approved for 

credit by the home institution at which a student is enrolled and 

that has reasonable costs in excess of the home institution’s budget, the annual and aggregate loan limits for the student may exceed the amounts described in paragraphs (2)(A) and (2)(B) by 20 

percent. 

(b) DEMONSTRATION OF NEED AND ELIGIBILITY REQUIRED.—(1) A 

loan from a student loan fund assisted under this part may be 

made only to a student who demonstrates financial need in accordance with part F of this title, who meets the requirements of section 484, and who provides the institution with the student’s drivers license number, if any, at the time of application for the loan. 

A student who is in default on a loan under this part shall not be 

eligible for an additional loan under this part unless such loan 

meets one of the conditions for exclusion under section 462(g)(1)(E). 

(2) If the institution’s capital contribution under section 462 is directly or indirectly based in part on the financial need demonstrated by students who are (A) attending the institution less 

than full time, or (B) independent students, then a reasonable portion of the loans made from the institution’s student loan fund containing the contribution shall be made available to such students. 

(c) CONTENTS OF LOAN AGREEMENT.—(1) Any agreement between 

an institution and a student for a loan from a student loan fund 

assisted under this part— 

242 

(A) shall be evidenced by note or other written instrument 

which, except as provided in paragraph (2), provides for repayment of the principal amount of the loan, together with interest thereon, in equal installments (or, if the borrower so requests, in graduated periodic installments determined in accordance with such schedules as may be approved by the Secretary) payable quarterly, bimonthly, or monthly, at the option 

of the institution, over a period beginning nine months after 

the date on which the student ceases to carry, at an institution 

of higher education or a comparable institution outside the 

United States approved for this purpose by the Secretary, at 

least one-half the normal full-time academic workload, and 

ending 10 years and 9 months after such date except that such 

period may begin earlier than 9 months after such date upon 

the request of the borrower; 

(B) shall include provision for acceleration of repayment of 

the whole, or any part, of such loan, at the option of the borrower; 

(C)(i) may provide, at the option of the institution, in accordance with regulations of the Secretary, that during the repayment period of the loan, payments of principal and interest by 

the borrower with respect to all outstanding loans made to the 

student from a student loan fund assisted under this part shall 

be at a rate equal to not less than $40 per month, except that 

the institution may, subject to such regulations, permit a borrower to pay less than $40 per month for a period of not more 

than one year where necessary to avoid hardship to the borrower, but without extending the 10-year maximum repayment 

period provided for in subparagraph (A) of this paragraph; and 

(ii) may provide that the total payments by a borrower for 

a monthly or similar payment period with respect to the aggregate of all loans held by the institution may, when the amount 

of a monthly or other similar payment is not a multiple of $5, 

be rounded to the next highest whole dollar amount that is a 

multiple of $5; 

(D) shall provide that the loan shall bear interest, on the unpaid balance of the loan, at the rate of 5 percent per year in 

the case of any loan made on or after October 1, 1981, except 

that no interest shall accrue (i) prior to the beginning date of 

repayment determined under paragraph (2)(A)(i), or (ii) during 

any period in which repayment is suspended by reason of paragraph (2); 

(E) shall provide that the loan shall be made without security and without endorsement; 

(F) shall provide that the liability to repay the loan shall be 

cancelled— 

(i) upon the death of the borrower; 

(ii) if the borrower becomes permanently and totally disabled as determined in accordance with regulations of the 

Secretary; 

(iii) if the borrower is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment that can be expected to result in death, has lasted for a continuous peVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00242 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
243 

riod of not less than 60 months, or can be expected to last 

for a continuous period of not less than 60 months; or 

(iv) if the borrower is determined by the Secretary of 

Veterans Affairs to be unemployable due to a service-connected disability; 

(G) shall provide that no note or evidence of obligation may 

be assigned by the lender, except upon the transfer of the borrower to another institution participating under this part (or, 

if not so participating, is eligible to do so and is approved by 

the Secretary for such purpose), to such institution, and except 

as necessary to carry out section 463(a)(6); 

(H) pursuant to regulations of the Secretary, shall provide 

for an assessment of a charge with respect to the loan for failure of the borrower to pay all or part of an installment when 

due, which shall include the expenses reasonably incurred in 

attempting collection of the loan, to the extent permitted by 

the Secretary, except that no charge imposed under this subparagraph shall exceed 20 percent of the amount of the monthly payment of the borrower; and 

(I) shall contain a notice of the system of disclosure of information concerning default on such loan to consumer reporting 

agencies under section 463(c). 

(2)(A) No repayment of principal of, or interest on, any loan from 

a student loan fund assisted under this part shall be required during any period— 

(i) during which the borrower— 

(I) is pursuing at least a half-time course of study as determined by an eligible institution; or 

(II) is pursuing a course of study pursuant to a graduate 

fellowship program approved by the Secretary, or pursuant 

to a rehabilitation training program for disabled individuals approved by the Secretary, 

except that no borrower shall be eligible for a deferment under 

this clause, or loan made under this part while serving in a 

medical internship or residency program; 

(ii) not in excess of 3 years during which the borrower is 

seeking and unable to find full-time employment; 

(iii) during which the borrower— 

(I) is serving on active duty during a war or other military operation or national emergency; or 

(II) is performing qualifying National Guard duty during 

a war or other military operation or national emergency, 

and for the 180-day period following the demobilization date 

for the service described in subclause (I) or (II); 

(iv) not in excess of 3 years for any reason which the lender 

determines, in accordance with regulations prescribed by the 

Secretary under section 435(o), has caused or will cause the 

borrower to have an economic hardshipø; or¿; 

(v) during which the borrower is engaged in service described 

in section 465(a)(2); or 

(vi) during which the borrower is receiving treatment for 

cancer and the 6 months after such period; 

and provides that any such period shall not be included in determining the 10-year period described in subparagraph (A) of paragraph (1). 

244 

(B) No repayment of principal of, or interest on, any loan for any 

period described in subparagraph (A) shall begin until 6 months 

after the completion of such period. 

(C) An individual with an outstanding loan balance who meets 

the eligibility criteria for a deferment described in subparagraph 

(A) as in effect on the date of enactment of this subparagraph shall 

be eligible for deferment under this paragraph notwithstanding any 

contrary provision of the promissory note under which the loan or 

loans were made, and notwithstanding any amendment (or effective date provision relating to any amendment) to this section 

made prior to the date of such deferment. 

(3)(A) The Secretary is authorized, when good cause is shown, to 

extend, in accordance with regulations, the 10-year maximum repayment period provided for in subparagraph (A) of paragraph (1) 

with respect to individual loans. 

(B) Pursuant to uniform criteria established by the Secretary, the 

repayment period for any student borrower who during the repayment period is a low-income individual may be extended for a period not to exceed 10 years and the repayment schedule may be adjusted to reflect the income of that individual. 

(4) The repayment period for a loan made under this part shall 

begin on the day immediately following the expiration of the period, specified in paragraph (1)(A), after the student ceases to carry 

the required academic workload, unless the borrower requests and 

is granted a repayment schedule that provides for repayment to 

commence at an earlier point in time, and shall exclude any period 

of authorized deferment, forbearance, or cancellation. 

(5) The institution may elect— 

(A) to add the amount of any charge imposed under paragraph (1)(H) to the principal amount of the loan as of the first 

day after the day on which the installment was due and to notify the borrower of the assessment of the charge; or 

(B) to make the amount of the charge payable to the institution not later than the due date of the next installment. 

(6) Requests for deferment of repayment of loans under this part 

by students engaged in graduate or post-graduate fellowship-supported study (such as pursuant to a Fulbright grant) outside the 

United States shall be approved until completion of the period of 

the fellowship. 

(7) There shall be excluded from the 9-month period that begins 

on the date on which a student ceases to carry at least one-half the 

normal full-time academic workload (as described in paragraph 

(1)(A)) any period not to exceed 3 years during which a borrower 

who is a member of a reserve component of the Armed Forces 

named in section 10101 of title 10, United States Code, is called 

or ordered to active duty for a period of more than 30 days (as defined in section 101(d)(2) of such title). Such period of exclusion 

shall include the period necessary to resume enrollment at the borrower’s next available regular enrollment period. 

(d) AVAILABILITY OF LOAN FUND TO ALL ELIGIBLE STUDENTS.— An agreement under this part for payment of Federal capital contributions shall include provisions designed to make loans from the 

student loan fund established pursuant to such agreement reasonably available (to the extent of the available funds in such fund) 

to all eligible students in such institutions in need thereof. 

245 

(e) FORBEARANCE.—(1) The Secretary shall ensure that, as documented in accordance with paragraph (2), an institution of higher 

education shall grant a borrower forbearance of principal and interest or principal only, renewable at 12-month intervals for a period 

not to exceed 3 years, on such terms as are otherwise consistent 

with the regulations issued by the Secretary and agreed upon in 

writing by the parties to the loan, if— 

(A) the borrower’s debt burden equals or exceeds 20 percent 

of such borrower’s gross income; 

(B) the institution determines that the borrower should qualify for forbearance for other reasons; or 

(C) the borrower is eligible for interest payments to be made 

on such loan for service in the Armed Forces under section 

2174 of title 10, United States Code, and, pursuant to that eligibility, the interest on such loan is being paid under subsection (j), except that the form of a forbearance under this 

paragraph shall be a temporary cessation of all payments on 

the loan other than payments of interest on the loan that are 

made under subsection (j). 

(2) For the purpose of paragraph (1), the terms of forbearance 

agreed to by the parties shall be documented by— 

(A) confirming the agreement of the borrower by notice to 

the borrower from the institution of higher education; and 

(B) recording the terms in the borrower’s file. 

(f) SPECIAL REPAYMENT RULE AUTHORITY.—(1) Subject to such restrictions as the Secretary may prescribe to protect the interest of 

the United States, in order to encourage repayment of loans made 

under this part which are in default, the Secretary may, in the 

agreement entered into under this part, authorize an institution of 

higher education to compromise on the repayment of such defaulted loans in accordance with paragraph (2). The Federal share 

of the compromise repayment shall bear the same relation to the 

institution’s share of such compromise repayment as the Federal 

capital contribution to the institution’s loan fund under this part 

bears to the institution’s capital contribution to such fund. 

(2) No compromise repayment of a defaulted loan as authorized 

by paragraph (1) may be made unless the student borrower pays— 

(A) 90 percent of the loan under this part; 

(B) the interest due on such loan; and 

(C) any collection fees due on such loan; 

in a lump sum payment. 

(g) DISCHARGE.— 

(1) IN GENERAL.—If a student borrower who received a loan 

made under this part on or after January 1, 1986, is unable 

to complete the program in which such student is enrolled due 

to the closure of the institution, then the Secretary shall discharge the borrower’s liability on the loan (including the interest and collection fees) and shall subsequently pursue any 

claim available to such borrower against the institution and 

the institution’s affiliates and principals, or settle the loan obligation pursuant to the financial responsibility standards described in section 498(c). 

(2) ASSIGNMENT.—A borrower whose loan has been discharged pursuant to this subsection shall be deemed to have 

assigned to the United States the right to a loan refund in an 

246 

amount that does not exceed the amount discharged against 

the institution and the institution’s affiliates and principals. 

(3) ELIGIBILITY FOR ADDITIONAL ASSISTANCE.—The period 

during which a student was unable to complete a course of 

study due to the closing of the institution shall not be considered for purposes of calculating the student’s period of eligibility for additional assistance under this title. 

(4) SPECIAL RULE.—A borrower whose loan has been discharged pursuant to this subsection shall not be precluded, because of that discharge, from receiving additional grant, loan, 

or work assistance under this title for which the borrower 

would be otherwise eligible (but for the default on the discharged loan). The amount discharged under this subsection 

shall be treated as an amount canceled under section 465(a). 

(5) REPORTING.—The Secretary or institution, as the case 

may be, shall report to consumer reporting agencies with respect to loans that have been discharged pursuant to this subsection. 

(h) REHABILITATION OF LOANS.— 

(1) REHABILITATION.— 

(A) IN GENERAL.—If the borrower of a loan made under 

this part who has defaulted on the loan makes 9 on-time, 

consecutive, monthly payments of amounts owed on the 

loan, as determined by the institution, or by the Secretary 

in the case of a loan held by the Secretary, the loan shall 

be considered rehabilitated, and the institution that made 

that loan (or the Secretary, in the case of a loan held by 

the Secretary) shall request that any consumer reporting 

agency to which the default was reported remove the default from the borrower’s credit history. 

(B) COMPARABLE CONDITIONS.—As long as the borrower 

continues to make scheduled repayments on a loan rehabilitated under this paragraph, the rehabilitated loan shall 

be subject to the same terms and conditions, and qualify 

for the same benefits and privileges, as other loans made 

under this part. 

(C) ADDITIONAL ASSISTANCE.—The borrower of a rehabilitated loan shall not be precluded by section 484 from receiving additional grant, loan, or work assistance under 

this title (for which the borrower is otherwise eligible) on 

the basis of defaulting on the loan prior to such rehabilitation. 

(D) LIMITATIONS.—A borrower only once may obtain the 

benefit of this paragraph with respect to rehabilitating a 

loan under this part. 

(2) RESTORATION OF ELIGIBILITY.—If the borrower of a loan 

made under this part who has defaulted on that loan makes 

6 ontime, consecutive, monthly payments of amounts owed on 

such loan, the borrower’s eligibility for grant, loan, or work assistance under this title shall be restored to the extent that the 

borrower is otherwise eligible. A borrower only once may obtain the benefit of this paragraph with respect to restored eligibility. 

(i) INCENTIVE REPAYMENT PROGRAM.— 

247 

(1) IN GENERAL.—Each institution of higher education may 

establish, with the approval of the Secretary, an incentive repayment program designed to reduce default and to replenish 

student loan funds established under this part. Each such incentive repayment program may— 

(A) offer a reduction of the interest rate on a loan on 

which the borrower has made 48 consecutive, monthly repayments, but in no event may the rate be reduced by 

more than 1 percent; 

(B) provide for a discount on the balance owed on a loan 

on which the borrower pays the principal and interest in 

full prior to the end of the applicable repayment period, 

but in no event may the discount exceed 5 percent of the 

unpaid principal balance due on the loan at the time the 

early repayment is made; and 

(C) include such other incentive repayment options as 

the institution determines will carry out the objectives of 

this subsection. 

(2) LIMITATION.—No incentive repayment option under an incentive repayment program authorized by this subsection may 

be paid for with Federal funds, including any Federal funds 

from the student loan fund, or with institutional funds from 

the student loan fund. 

(j) ARMED FORCES STUDENT LOAN INTEREST PAYMENT PRO- GRAM.— 

(1) AUTHORITY.—Using funds received by transfer to the Secretary under section 2174 of title 10, United States Code, for 

the payment of interest on a loan made under this part to a 

member of the Armed Forces, the Secretary shall pay the interest on the loan as due for a period not in excess of 36 consecutive months. The Secretary may not pay interest on such a 

loan out of any funds other than funds that have been so 

transferred. 

(2) FORBEARANCE.—During the period in which the Secretary 

is making payments on a loan under paragraph (1), the institution of higher education shall grant the borrower forbearance 

in accordance with subsection (e)(1)(C). 

(k) The Secretary may develop such additional safeguards as the 

Secretary determines necessary to prevent fraud and abuse in the 

cancellation of liability under subsection (c)(1)(F). Notwithstanding 

subsection (c)(1)(F), the Secretary may promulgate regulations to 

resume collection on loans cancelled under subsection (c)(1)(F) in 

any case in which— 

(1) a borrower received a cancellation of liability under subsection (c)(1)(F) and after the cancellation the borrower— 

(A) receives a loan made, insured, or guaranteed under 

this title; or 

(B) has earned income in excess of the poverty line; or 

(2) the Secretary determines necessary. 

* * * * * * * 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

248 

TITLE II—ADMINISTRATION AND MISCELLANEOUS 

PROVISIONS 

* * * * * * * 

PART B—MISCELLANEOUS PROVISIONS

* * * * * * * 

SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINATION AGAINST 

PROVIDERS OF HEALTH SERVICES THAT ARE NOT INVOLVED IN ABORTION. 

(a) IN GENERAL.—Notwithstanding any other law, the Federal 

Government, and any State or local government that receives Federal financial assistance, may not penalize, retaliate against, or otherwise discriminate against a health care provider on the basis that 

the provider does not— 

(1) perform, refer for, pay for, or otherwise participate in 

abortion; 

(2) provide or sponsor abortion coverage; or 

(3) facilitate or make arrangements for any of the activities 

specified in this subsection. 

(b) RULE OF CONSTRUCTION.—Nothing in this section shall be 

construed— 

(1) to prevent any health care provider from voluntarily electing to participate in abortions or abortion referrals; 

(2) to prevent any health care provider from voluntarily electing to provide or sponsor abortion coverage or health benefits 

coverage that includes abortion; 

(3) to prevent an accrediting agency, the Federal Government, 

or a State or local government from establishing standards of 

medical competency applicable only to those who have knowingly, voluntarily, and specifically elected to perform abortions, 

or from enforcing contractual obligations applicable only to 

those who, as part of such contract, knowingly, voluntarily, and 

specifically elect to provide abortions; 

(4) to affect, or be affected by, section 1867 of the Social Security Act (42 U.S.C. 1395dd, commonly referred to as the ‘‘Emergency Medical Treatment and Active Labor Act’’); or 

(5) to supersede any law enacted by any State for the purpose 

of regulating insurance, except as specified in subsection (a). 

(c) ADMINISTRATION.—The Secretary shall designate the Director 

of the Office for Civil Rights of the Department of Health and 

Human Services— 

(1) to receive complaints alleging a violation of this section, 

section 245 of this Act, or any of subsections (b) through (e) of 

section 401 of the Health Programs Extension Act of 1973; and 

(2) to pursue the investigation of such complaints in coordination with the Attorney General. 

(d) DEFINITIONS.—For purposes of this section: 

(1) FEDERAL FINANCIAL ASSISTANCE.—The term ‘‘Federal financial assistance’’ means Federal payments to cover the cost of 

health care services or benefits, or other Federal payments, 

grants, or loans to promote or otherwise facilitate health-related 

activities. 

(2) HEALTH CARE PROVIDER.—The term ‘‘health care provider’’ 

means— 

249 

(A) an individual physician, nurse, or other health care 

professional; 

(B) a hospital, health system, or other health care facility 

or organization (including a party to a proposed merger or 

other collaborative arrangement relating to health services, 

and an entity resulting therefrom); 

(C) a provider-sponsored organization, an accountable 

care organization, or a health maintenance organization; 

(D) a social services provider that provides or authorizes 

referrals for health care services; 

(E) a program of training in the health professions or an 

applicant to or participant in such a program; 

(F) an issuer of health insurance coverage; or 

(G) a group health plan or student health plan, or a 

sponsor or administrator thereof. 

(3) STATE OR LOCAL GOVERNMENT THAT RECEIVES FEDERAL

FINANCIAL ASSISTANCE.—The term ‘‘State or local government 

that receives Federal financial assistance’’ includes every agency 

and other governmental unit and subdivision of a State or local 

government, if such State or local government, or any agency or 

governmental unit or subdivision thereof, receives Federal financial assistance. 

SEC. 245B. CIVIL ACTION FOR CERTAIN VIOLATIONS. 

(a) IN GENERAL.—A qualified party may, in a civil action, obtain 

appropriate relief with regard to a designated violation. 

(b) DEFINITIONS.—For purposes of this section: 

(1) QUALIFIED PARTY.—The term ‘‘qualified party’’ means— 

(A) the Attorney General of the United States; or 

(B) any person or entity adversely affected by the designated violation. 

(2) DESIGNATED VIOLATION.—The term ‘‘designated violation’’ 

means an actual or threatened violation of— 

(A) section 245 or 245A of this Act; or 

(B) any of subsections (b) through (e) of section 401 of the 

Health Programs Extension Act of 1973 regarding an objection to abortion. 

(c) ADMINISTRATIVE REMEDIES NOT REQUIRED.—An action under 

this section may be commenced, and relief may be granted, without 

regard to whether the party commencing the action has sought or 

exhausted available administrative remedies. 

(d) DEFENDANTS IN ACTIONS UNDER THIS SECTION MAY INCLUDE

GOVERNMENTAL ENTITIES AS WELL AS OTHERS.— 

(1) IN GENERAL.—An action under this section may be maintained against, among others, a party that is a Federal or State 

governmental entity. Relief in an action under this section may 

include money damages even if the defendant is such a governmental entity. 

(2) DEFINITION.—For the purposes of this subsection, the term 

‘‘State governmental entity’’ means a State, a local government 

within a State, and any agency or other governmental unit or 

subdivision of a State or of such a local government. 

(e) NATURE OF RELIEF.—In an action under this section, the court 

shall grant— 

(1) all necessary equitable and legal relief, including, where 

appropriate, declaratory relief and compensatory damages, to 

250 

prevent the occurrence, continuance, or repetition of the designated violation and to compensate for losses resulting from 

the designated violation; and 

(2) to a prevailing plaintiff, reasonable attorneys’ fees and 

litigation expenses as part of the costs. 

* * * * * * * 

SECTION 235 OF THE WILLIAM WILBERFORCE TRAFFICKING VICTIMS PROTECTION REAUTHORIZATION 

ACT OF 2008 

SEC. 235. ENHANCING EFFORTS TO COMBAT THE TRAFFICKING OF 

CHILDREN. 

(a) COMBATING CHILD TRAFFICKING AT THE BORDER AND PORTS

OF ENTRY OF THE UNITED STATES.— 

(1) POLICIES AND PROCEDURES.—In order to enhance the efforts of the United States to prevent trafficking in persons, the 

Secretary of Homeland Security, in conjunction with the Secretary of State, the Attorney General, and the Secretary of 

Health and Human Services, shall develop policies and procedures to ensure that unaccompanied alien children in the 

United States are safely repatriated to their country of nationality or of last habitual residence. 

(2) SPECIAL RULES FOR CHILDREN FROM CONTIGUOUS COUN- TRIES.— 

(A) DETERMINATIONS.—Any unaccompanied alien child 

who is a national or habitual resident of a country that is 

contiguous with the United States shall be treated in accordance with subparagraph (B), if the Secretary of Homeland Security determines, on a case-by-case basis, that— 

(i) such child has not been a victim of a severe form 

of trafficking in persons, and there is no credible evidence that such child is at risk of being trafficked 

upon return to the child’s country of nationality or of 

last habitual residence; 

(ii) such child does not have a fear of returning to 

the child’s country of nationality or of last habitual 

residence owing to a credible fear of persecution; and 

(iii) the child is able to make an independent decision to withdraw the child’s application for admission 

to the United States. 

(B) RETURN.—An immigration officer who finds an unaccompanied alien child described in subparagraph (A) at a 

land border or port of entry of the United States and determines that such child is inadmissible under the Immigration and Nationality Act (8 U.S.C. 1101 et seq.) may— 

(i) permit such child to withdraw the child’s application for admission pursuant to section 235(a)(4) of the 

Immigration and Nationality Act (8 U.S.C. 1225(a)(4)); 

and 

(ii) return such child to the child’s country of nationality or country of last habitual residence. 

(C) CONTIGUOUS COUNTRY AGREEMENTS.—The Secretary 

of State shall negotiate agreements between the United 

251 

States and countries contiguous to the United States with 

respect to the repatriation of children. Such agreements 

shall be designed to protect children from severe forms of 

trafficking in persons, and shall, at a minimum, provide 

that— 

(i) no child shall be returned to the child’s country 

of nationality or of last habitual residence unless returned to appropriate employees or officials, including 

child welfare officials where available, of the accepting 

country’s government; 

(ii) no child shall be returned to the child’s country 

of nationality or of last habitual residence outside of 

reasonable business hours; and 

(iii) border personnel of the countries that are parties to such agreements are trained in the terms of 

such agreements. 

(3) RULE FOR OTHER CHILDREN.—The custody of unaccompanied alien children not described in paragraph (2)(A) who 

are apprehended at the border of the United States or at a 

United States port of entry shall be treated in accordance with 

subsection (b). 

(4) SCREENING.—Within 48 hours of the apprehension of a 

child who is believed to be described in paragraph (2)(A), but 

in any event prior to returning such child to the child’s country 

of nationality or of last habitual residence, the child shall be 

screened to determine whether the child meets the criteria listed in paragraph (2)(A). If the child does not meet such criteria, 

or if no determination can be made within 48 hours of apprehension, the child shall immediately be transferred to the Secretary of Health and Human Services and treated in accordance with subsection (b). Nothing in this paragraph may be 

construed to preclude an earlier transfer of the child. 

(5) ENSURING THE SAFE REPATRIATION OF CHILDREN.— (A) REPATRIATION PILOT PROGRAM.—To protect children 

from trafficking and exploitation, the Secretary of State 

shall create a pilot program, in conjunction with the Secretary of Health and Human Services and the Secretary of 

Homeland Security, nongovernmental organizations, and 

other national and international agencies and experts, to 

develop and implement best practices to ensure the safe 

and sustainable repatriation and reintegration of unaccompanied alien children into their country of nationality or of 

last habitual residence, including placement with their 

families, legal guardians, or other sponsoring agencies. 

(B) ASSESSMENT OF COUNTRY CONDITIONS.—The Secretary of Homeland Security shall consult the Department 

of State’s Country Reports on Human Rights Practices and 

the Trafficking in Persons Report in assessing whether to 

repatriate an unaccompanied alien child to a particular 

country. 

(C) REPORT ON REPATRIATION OF UNACCOMPANIED ALIEN

CHILDREN.—Not later than 18 months after the date of the 

enactment of this Act, and annually thereafter, the Secretary of State and the Secretary of Health and Human 

Services, with assistance from the Secretary of Homeland 

252 

Security, shall submit a report to the Committee on the 

Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives on efforts to improve 

repatriation programs for unaccompanied alien children. 

Such report shall include— 

(i) the number of unaccompanied alien children ordered removed and the number of such children actually removed from the United States; 

(ii) a statement of the nationalities, ages, and gender of such children; 

(iii) a description of the policies and procedures used 

to effect the removal of such children from the United 

States and the steps taken to ensure that such children were safely and humanely repatriated to their 

country of nationality or of last habitual residence, including a description of the repatriation pilot program 

created pursuant to subparagraph (A); 

(iv) a description of the type of immigration relief 

sought and denied to such children; 

(v) any information gathered in assessments of 

country and local conditions pursuant to paragraph 

(2); and 

(vi) statistical information and other data on unaccompanied alien children as provided for in section 

462(b)(1)(J) of the Homeland Security Act of 2002 (6 

U.S.C. 279(b)(1)(J)). 

(D) PLACEMENT IN REMOVAL PROCEEDINGS.—Any unaccompanied alien child sought to be removed by the Department of Homeland Security, except for an unaccompanied 

alien child from a contiguous country subject to exceptions 

under subsection (a)(2), shall be— 

(i) placed in removal proceedings under section 240 

of the Immigration and Nationality Act (8 U.S.C. 

1229a); 

(ii) eligible for relief under section 240B of such Act 

(8 U.S.C. 1229c) at no cost to the child; and 

(iii) provided access to counsel in accordance with 

subsection (c)(5). 

(b) COMBATING CHILD TRAFFICKING AND EXPLOITATION IN THE

UNITED STATES.— 

(1) CARE AND CUSTODY OF UNACCOMPANIED ALIEN CHILDREN.—Consistent with section 462 of the Homeland Security 

Act of 2002 (6 U.S.C. 279), and except as otherwise provided 

under subsection (a), the care and custody of all unaccompanied alien children, including responsibility for their detention, where appropriate, shall be the responsibility of the Secretary of Health and Human Services. 

(2) NOTIFICATION.—Each department or agency of the Federal Government shall notify the Department of Health and 

Human services within 48 hours upon— 

(A) the apprehension or discovery of an unaccompanied 

alien child; or 

(B) any claim or suspicion that an alien in the custody 

of such department or agency is under 18 years of age. 

253 

(3) TRANSFERS OF UNACCOMPANIED ALIEN CHILDREN.—Except 

in the case of exceptional circumstances, any department or 

agency of the Federal Government that has an unaccompanied 

alien child in custody shall transfer the custody of such child 

to the Secretary of Health and Human Services not later than 

72 hours after determining that such child is an unaccompanied alien child. 

(4) AGE DETERMINATIONS.—The Secretary of Health and 

Human Services, in consultation with the Secretary of Homeland Security, shall develop procedures to make a prompt determination of the age of an alien, which shall be used by the 

Secretary of Homeland Security and the Secretary of Health 

and Human Services for children in their respective custody. 

At a minimum, these procedures shall take into account multiple forms of evidence, including the non-exclusive use of 

radiographs, to determine the age of the unaccompanied alien. 

(c) PROVIDING SAFE AND SECURE PLACEMENTS FOR CHILDREN.— 

(1) POLICIES AND PROGRAMS.—The Secretary of Health and 

Human Services, Secretary of Homeland Security, Attorney 

General, and Secretary of State shall establish policies and 

programs to ensure that unaccompanied alien children in the 

United States are protected from traffickers and other persons 

seeking to victimize or otherwise engage such children in 

criminal, harmful, or exploitative activity, including policies 

and programs reflecting best practices in witness security programs. 

(2) SAFE AND SECURE PLACEMENTS.— (A) MINORS IN DEPARTMENT OF HEALTH AND HUMAN

SERVICES CUSTODY.—Subject to section 462(b)(2) of the 

Homeland Security Act of 2002 (6 U.S.C. 279(b)(2)), an unaccompanied alien child in the custody of the Secretary of 

Health and Human Services shall be promptly placed in 

the least restrictive setting that is in the best interest of 

the child. In making such placements, the Secretary may 

consider danger to self, danger to the community, and risk 

of flight. Placement of child trafficking victims may include 

placement in an Unaccompanied Refugee Minor program, 

pursuant to section 412(d) of the Immigration and Nationality Act (8 U.S.C. 1522(d)), if a suitable family member is 

not available to provide care. A child shall not be placed 

in a secure facility absent a determination that the child 

poses a danger to self or others or has been charged with 

having committed a criminal offense. The placement of a 

child in a secure facility shall be reviewed, at a minimum, 

on a monthly basis, in accordance with procedures prescribed by the Secretary, to determine if such placement 

remains warranted. 

(B) ALIENS TRANSFERRED FROM DEPARTMENT OF HEALTH

AND HUMAN SERVICES TO DEPARTMENT OF HOMELAND SECU- RITY CUSTODY.—If a minor described in subparagraph (A) 

reaches 18 years of age and is transferred to the custody 

of the Secretary of Homeland Security, the Secretary shall 

consider placement in the least restrictive setting available 

after taking into account the alien’s danger to self, danger 

to the community, and risk of flight. Such aliens shall be 

254 

eligible to participate in alternative to detention programs, 

utilizing a continuum of alternatives based on the alien’s 

need for supervision, which may include placement of the 

alien with an individual or an organizational sponsor, or 

in a supervised group home. 

(3) SAFETY AND SUITABILITY ASSESSMENTS.— (A) IN GENERAL.—Subject to the requirements of subparagraph (B), an unaccompanied alien child may not be 

placed with a person or entity unless the Secretary of 

Health and Human Services makes a determination that 

the proposed custodian is capable of providing for the 

child’s physical and mental well-being. Such determination 

shall, at a minimum, include verification of the custodian’s 

identity and relationship to the child, if any, as well as an 

independent finding that the individual has not engaged in 

any activity that would indicate a potential risk to the 

child. 

(B) HOME STUDIES.—Before placing the child with an individual, the Secretary of Health and Human Services 

shall determine whether a home study is first necessary. 

A home study shall be conducted for a child who is a victim of a severe form of trafficking in persons, a special 

needs child with a disability (as defined in section 3 of the 

Americans with Disabilities Act of 1990 (42 U.S.C. 

12102(2))), a child who has been a victim of physical or 

sexual abuse under circumstances that indicate that the 

child’s health or welfare has been significantly harmed or 

threatened, or a child whose proposed sponsor clearly presents a risk of abuse, maltreatment, exploitation, or trafficking to the child based on all available objective evidence. The Secretary of Health and Human Services shall 

conduct follow-up services, during the pendency of removal 

proceedings, on children for whom a home study was conducted and is authorized to conduct follow-up services in 

cases involving children with mental health or other needs 

who could benefit from ongoing assistance from a social 

welfare agency. 

(C) ACCESS TO INFORMATION.—Not later than 2 weeks 

after receiving a request from the Secretary of Health and 

Human Services, the Secretary of Homeland Security shall 

provide information necessary to conduct suitability assessments from appropriate Federal, State, and local law 

enforcement and immigration databases. 

(4) LEGAL ORIENTATION PRESENTATIONS.—The Secretary of 

Health and Human Services shall cooperate with the Executive 

Office for Immigration Review to ensure that custodians receive legal orientation presentations provided through the 

Legal Orientation Program administered by the Executive Office for Immigration Review. At a minimum, such presentations shall address the custodian’s responsibility to attempt 

to ensure the child’s appearance at all immigration proceedings 

and to protect the child from mistreatment, exploitation, and 

trafficking. 

(5) ACCESS TO COUNSEL.—The Secretary of Health and 

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255 

ticable and consistent with section 292 of the Immigration and 

Nationality Act (8 U.S.C. 1362), that all unaccompanied alien 

children who are or have been in the custody of the Secretary 

or the Secretary of Homeland Security, and who are not described in subsection (a)(2)(A), have counsel to represent them 

in legal proceedings or matters and protect them from mistreatment, exploitation, and trafficking. To the greatest extent 

practicable, the Secretary of Health and Human Services shall 

make every effort to utilize the services of pro bono counsel 

who agree to provide representation to such children without 

charge. 

(6) CHILD ADVOCATES.— 

(A) IN GENERAL.—The Secretary of Health and Human 

Services is authorized to appoint independent child advocates for child trafficking victims and other vulnerable unaccompanied alien children. A child advocate shall be provided access to materials necessary to effectively advocate 

for the best interest of the child. The child advocate shall 

not be compelled to testify or provide evidence in any proceeding concerning any information or opinion received 

from the child in the course of serving as a child advocate. 

The child advocate shall be presumed to be acting in good 

faith and be immune from civil liability for lawful conduct 

of duties as described in this provision. 

(B) APPOINTMENT OF CHILD ADVOCATES.— (i) INITIAL SITES.—Not later than 2 years after the 

date of the enactment of the Violence Against Women 

Reauthorization Act of 2013, the Secretary of Health 

and Human Services shall appoint child advocates at 

3 new immigration detention sites to provide independent child advocates for trafficking victims and 

vulnerable unaccompanied alien children. 

(ii) ADDITIONAL SITES.—Not later than 3 years after 

the date of the enactment of the Violence Against 

Women Reauthorization Act of 2013, the Secretary 

shall appoint child advocates at not more than 3 additional immigration detention sites. 

(iii) SELECTION OF SITES.—Sites at which child advocate programs will be established under this subparagraph shall be located at immigration detention sites 

at which more than 50 children are held in immigration custody, and shall be selected sequentially, with 

priority given to locations with— 

(I) the largest number of unaccompanied alien 

children; and 

(II) the most vulnerable populations of unaccompanied children. 

(C) RESTRICTIONS.— 

(i) ADMINISTRATIVE EXPENSES.—A child advocate 

program may not use more that 10 percent of the Federal funds received under this section for administrative expenses. 

(ii) NONEXCLUSIVITY.—Nothing in this section may 

be construed to restrict the ability of a child advocate 

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256 

ing from any other source to carry out the programs 

described in this section. 

(iii) CONTRIBUTION OF FUNDS.—A child advocate program selected under this section shall contribute nonFederal funds, either directly or through in-kind contributions, to the costs of the child advocate program 

in an amount that is not less than 25 percent of the 

total amount of Federal funds received by the child advocate program under this section. In-kind contributions may not exceed 40 percent of the matching requirement under this clause. 

(D) ANNUAL REPORT TO CONGRESS.—Not later than 1 

year after the date of the enactment of the Violence 

Against Women Reauthorization Act of 2013, and annually 

thereafter, the Secretary of Health and Human Services 

shall submit a report describing the activities undertaken 

by the Secretary to authorize the appointment of independent Child Advocates for trafficking victims and vulnerable unaccompanied alien children to the Committee on 

the Judiciary of the Senate and the Committee on the Judiciary of the House of Representatives. 

(E) ASSESSMENT OF CHILD ADVOCATE PROGRAM.— 

(i) IN GENERAL.—As soon as practicable after the 

date of the enactment of the Violence Against Women 

Reauthorization Act of 2013, the Comptroller General 

of the United States shall conduct a study regarding 

the effectiveness of the Child Advocate Program operated by the Secretary of Health and Human Services. 

(ii) MATTERS TO BE STUDIED.—In the study required 

under clause (i), the Comptroller General shall— collect information and analyze the following: 

(I) analyze the effectiveness of existing child advocate programs in improving outcomes for trafficking victims and other vulnerable unaccompanied alien children; 

(II) evaluate the implementation of child advocate programs in new sites pursuant to subparagraph (B); 

(III) evaluate the extent to which eligible trafficking victims and other vulnerable unaccompanied children are receiving child advocate services and assess the possible budgetary implications of increased participation in the program; 

(IV) evaluate the barriers to improving outcomes for trafficking victims and other vulnerable 

unaccompanied children; and 

(V) make recommendations on statutory 

changes to improve the Child Advocate Program 

in relation to the matters analyzed under subclauses (I) through (IV). 

(iii) GAO REPORT.—Not later than 3 years after the 

date of the enactment of this Act, the Comptroller 

General of the United States shall submit the results 

of the study required under this subparagraph to— 

257 

(I) the Committee on the Judiciary of the Senate; 

(II) the Committee on Health, Education, Labor, 

and Pensions of the Senate; 

(III) the Committee on the Judiciary of the 

House of Representatives; and 

(IV) the Committee on Education and the Workforce of the House of Representatives. 

(F) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to the Secretary and Human 

Services to carry out this subsection— (i) $1,000,000 for each of the fiscal years 2014 and 

2015; and 

(ii) $2,000,000 for each of the fiscal years 2016 and 

2017. 

(d) PERMANENT PROTECTION FOR CERTAIN AT-RISK CHILDREN.— 

(1) IN GENERAL.—Section 101(a)(27)(J) of the Immigration 

and Nationality Act (8 U.S.C. 1101(a)(27)(J)) is amended— 

(A) in clause (i), by striking ‘‘State and who has been 

deemed eligible by that court for long-term foster care due 

to abuse, neglect, or abandonment;’’ and inserting ‘‘State, 

or an individual or entity appointed by a State or juvenile 

court located in the United States, and whose reunification 

with 1 or both of the immigrant’s parents is not viable due 

to abuse, neglect, abandonment, or a similar basis found 

under State law;’’; and 

(B) in clause (iii)— 

(i) in the matter preceding subclause (I), by striking 

‘‘the Attorney General expressly consents to the dependency order serving as a precondition to the grant 

of special immigrant juvenile status;’’ and inserting 

‘‘the Secretary of Homeland Security consents to the 

grant of special immigrant juvenile status,’’; and 

(ii) in subclause (I), by striking ‘‘in the actual or constructive custody of the Attorney General unless the 

Attorney General specifically consents to such jurisdiction;’’ and inserting ‘‘in the custody of the Secretary of 

Health and Human Services unless the Secretary of 

Health and Human Services specifically consents to 

such jurisdiction;’’. 

(2) EXPEDITIOUS ADJUDICATION.—All applications for special 

immigrant status under section 101(a)(27)(J) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(27)(J)) shall be adjudicated by the Secretary of Homeland Security not later than 

180 days after the date on which the application is filed. 

(3) ADJUSTMENT OF STATUS.—Section 245(h)(2)(A) of the Immigration and Nationality Act (8 U.S.C. 1255(h)(2)(A)) is 

amended to read as follows: 

‘‘(A) paragraphs (4), (5)(A), (6)(A), (6)(C), (6)(D), (7)(A), 

and (9)(B) of section 212(a) shall not apply; and’’. 

(4) ELIGIBILITY FOR ASSISTANCE.— (A) IN GENERAL.—A child who has been granted special 

immigrant status under section 101(a)(27)(J) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(27)(J)) and 

who was in the custody of the Secretary of Health and 

258 

Human Services at the time a dependency order was 

granted for such child, was receiving services pursuant to 

section 501(a) of the Refugee Education Assistance Act of 

1980 (8 U.S.C. 1522 note) at the time such dependency 

order was granted, or has been granted status under section 101(a)(15)(U) of the Immigration and Nationality Act 

(8 U.S.C. 1101(a)(15)(U)),, shall be eligible for placement 

and services under section 412(d) of the Immigration and 

Nationality Act (8 U.S.C. 1522(d)) until the earlier of— 

(i) the date on which the child reaches the age designated in section 412(d)(2)(B) of the Immigration and 

Nationality Act (8 U.S.C. 1522(d)(2)(B)); or 

(ii) the date on which the child is placed in a permanent adoptive home. 

(B) STATE REIMBURSEMENT.—Subject to the availability 

of appropriations, if State foster care funds are expended 

on behalf of a child who is not described in subparagraph 

(A) and has been granted special immigrant status under 

section 101(a)(27)(J) of the Immigration and Nationality 

Act (8 U.S.C. 1101(a)(27)(J)), or status under section 

101(a)(15)(U) of the Immigration and Nationality Act (8 

U.S.C. 1101(a)(15)(U)),, 1 the Federal Government shall reimburse the State in which the child resides for such expenditures by the State. 

(5) STATE COURTS ACTING IN LOCO PARENTIS.—A department 

or agency of a State, or an individual or entity appointed by 

a State court or juvenile court located in the United States, 

acting in loco parentis, shall not be considered a legal guardian 

for purposes of this section or section 462 of the Homeland Security Act of 2002 (6 U.S.C. 279). 

(6) TRANSITION RULE.—Notwithstanding any other provision 

of law, an alien described in section 101(a)(27)(J) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(27)(J)), as 

amended by paragraph (1), may not be denied special immigrant status under such section after the date of the enactment 

of this Act based on age if the alien was a child on the date 

on which the alien applied for such status. 

(7) ACCESS TO ASYLUM PROTECTIONS.—Section 208 of the Immigration and Nationality Act (8 U.S.C. 1158) is amended— 

(A) in subsection (a)(2), by adding at the end the following: 

‘‘(E) APPLICABILITY.—Subparagraphs (A) and (B) shall 

not apply to an unaccompanied alien child (as defined in 

section 462(g) of the Homeland Security Act of 2002 (6 

U.S.C. 279(g))).’’; and 

(B) in subsection (b)(3), by adding at the end the following: 

‘‘(C) INITIAL JURISDICTION.—An asylum officer (as defined in section 235(b)(1)(E)) shall have initial jurisdiction 

over any asylum application filed by an unaccompanied 

alien child (as defined in section 462(g) of the Homeland 

Security Act of 2002 (6 U.S.C. 279(g))), regardless of 

whether filed in accordance with this section or section 

235(b).’’. 

259 

(8) SPECIALIZED NEEDS OF UNACCOMPANIED ALIEN CHIL- DREN.—Applications for asylum and other forms of relief from 

removal in which an unaccompanied alien child is the principal 

applicant shall be governed by regulations which take into account the specialized needs of unaccompanied alien children 

and which address both procedural and substantive aspects of 

handling unaccompanied alien children’s cases. 

(e) TRAINING.—The Secretary of State, the Secretary of Homeland Security, the Secretary of Health and Human Services, and 

the Attorney General shall provide specialized training to all Federal personnel, and upon request, state and local personnel, who 

have substantive contact with unaccompanied alien children. Such 

personnel shall be trained to work with unaccompanied alien children, including identifying children who are victims of severe forms 

of trafficking in persons, and children for whom asylum or special 

immigrant relief may be appropriate, including children described 

in subsection (a)(2). 

(f) AMENDMENTS TO THE HOMELAND SECURITY ACT OF 2002.— 

(1) ADDITIONAL RESPONSIBILITIES.—Section 462(b)(1)(L) of 

the Homeland Security Act of 2002 (6 U.S.C. 279(b)(1)(L)) is 

amended by striking the period at the end and inserting ‘‘, including regular follow-up visits to such facilities, placements, 

and other entities, to assess the continued suitability of such 

placements.’’. 

(2) TECHNICAL CORRECTIONS.—Section 462(b) of such Act (6 

U.S.C. 279(b)) is further amended— 

(A) in paragraph (3), by striking ‘‘paragraph (1)(G),’’ and 

inserting ‘‘paragraph (1),’’; and 

(B) by adding at the end the following: 

‘‘(4) RULE OF CONSTRUCTION.—Nothing in paragraph (2)(B) 

may be construed to require that a bond be posted for an unaccompanied alien child who is released to a qualified sponsor.’’. 

(g) DEFINITION OF UNACCOMPANIED ALIEN CHILD.—For purposes 

of this section, the term ‘‘unaccompanied alien child’’ has the meaning given such term in section 462(g) of the Homeland Security Act 

of 2002 (6 U.S.C. 279(g)). 

(h) EFFECTIVE DATE.—This section— 

(1) shall take effect on the date that is 90 days after the date 

of the enactment of this Act; and 

(2) shall also apply to all aliens in the United States in pending proceedings before the Department of Homeland Security 

or the Executive Office for Immigration Review, or related administrative or Federal appeals, on the date of the enactment 

of this Act. 

(i) GRANTS AND CONTRACTS.—The Secretary of Health and 

Human Services may award grants to, and enter into contracts 

with, voluntary agencies to carry out this section and section 462 

of the Homeland Security Act of 2002 (6 U.S.C. 279). 

(j) CONSTRUCTION.— (1) IN GENERAL.—Notwithstanding any other provision of 

law, judicial determination, consent decree, or settlement agreement, the detention of any alien child who is not an unaccompanied alien child shall be governed by sections 217, 235, 236, 

and 241 of the Immigration and Nationality Act (8 U.S.C. 

1187, 1225, 1226, and 1231). There exists no presumption that 

260 

an alien child who is not an unaccompanied alien child should 

not be detained, and all such determinations shall be in the 

discretion of the Secretary of Homeland Security. 

(2) RELEASE OF MINORS OTHER THAN UNACCOMPANIED

ALIENS.—In no circumstances shall an alien minor who is not 

an unaccompanied alien child be released by the Secretary of 

Homeland Security other than to a parent or legal guardian. 

(3) FAMILY DETENTION.—The Secretary of Homeland Security 

shall— 

(A) maintain the care and custody of an alien, during the 

period during which the charges described in clause (i) are 

pending, who— 

(i) is charged only with a misdemeanor offense under 

section 275(a) of the Immigration and Nationality Act 

(8 U.S.C. 1325(a)); and 

(ii) entered the United States with the alien’s child 

who has not attained 18 years of age; and 

(B) detain the alien with the alien’s child. 

SECTION 9 OF THE SMALL BUSINESS ACT 

SEC. 9. (a) Research and development are major factors in the 

growth and progress of industry and the national economy. The expense of carrying on research and development programs is beyond 

the means of many small-business concerns, and such concerns are 

handicapped in obtaining the benefits of research and development 

programs conducted at Government expense. These small-business 

concerns are thereby placed at a competitive disadvantage. This 

weakens the competitive free enterprise system and prevents the 

orderly development of the national economy. It is the policy of the 

Congress that assistance be given to small-business concerns to enable them to undertake and to obtain the benefits of research and 

development in order to maintain and strengthen the competitive 

free enterprise system and the national economy. 

(b) It shall be the duty of the Administration, and it is hereby 

empowered— 

(1) to assist small-business concerns to obtain Government 

contracts for research and development; 

(2) to assist small-business concerns to obtain the benefits of 

research and development performed under Government contracts or at Government expense; 

(3) to provide technical assistance to small-business concerns 

to accomplish the purposes of this section; and 

(4) to develop and maintain a source file and an information 

program to assure each qualified and interested small business 

concern the opportunity to participate in Federal agency small 

business innovation research programs and small business 

technology transfer programs; 

(5) to coordinate with participating agencies a schedule for 

release of SBIR and STTR solicitations, and to prepare a master release schedule so as to maximize small business’ opportunities to respond to solicitations; 

(6) to independently survey and monitor the operation of 

SBIR and STTR programs within participating Federal agencies; 

261 

(7) to report not less than annually to the Committee on 

Small Business of the Senate, and to the Committee on Science 

and the Committee on Small Business of the House of Representatives, on the SBIR and STTR programs of the Federal 

agencies and the Administration’s information and monitoring 

efforts related to the SBIR and STTR programs, including— 

(A) the data on output and outcomes collected pursuant 

to subsections (g)(8) and (o)(9); 

(B) the number of proposals received from, and the number and total amount of awards to, HUBZone small business concerns and firms with venture capital, hedge fund, 

or private equity firm investment (including those majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms) under each of 

the SBIR and STTR programs; 

(C) a description of the extent to which each Federal 

agency is increasing outreach and awards to firms owned 

and controlled by women or by socially or economically disadvantaged individuals under each of the SBIR and STTR 

programs; 

(D) general information about the implementation of, 

and compliance with the allocation of funds required 

under, subsection (dd) for firms owned in majority part by 

venture capital operating companies, hedge funds, or private equity firms and participating in the SBIR program; 

(E) a detailed description of appeals of Phase III awards 

and notices of noncompliance with the SBIR Policy Directive and the STTR Policy Directive filed by the Administrator with Federal agencies; 

(F) an accounting of funds, initiatives, and outcomes 

under the Commercialization Readiness Program; and 

(G) a description of the extent to which Federal agencies 

are providing in a timely manner information needed to 

maintain the database described in subsection (k); 

(8) to provide for and fully implement the tenets of Executive 

Order No. 13329 (Encouraging Innovation in Manufacturing); 

and 

(9) to coordinate the implementation of electronic databases 

at each of the Federal agencies participating in the SBIR program or the STTR program, including the technical ability of 

the participating agencies to electronically share data. 

(c) The Administration is authorized to consult and cooperate 

with all Government agencies and to make studies and recommendations to such agencies, and such agencies are authorized 

and directed to cooperate with the Administration in order to carry 

out and to accomplish the purposes of this section. 

(d)(1) The Administrator is authorized to consult with representatives of small-business concerns with a view to assisting and encouraging such firms to undertake joint programs for research and 

development carried out through such corporate or other mechanism as may be most appropriate for the purpose. Such joint programs may, among other things, include the following purposes: 

(A) to construct, acquire, or establish laboratories and other 

facilities for the conduct of research; 

(B) to undertake and utilize applied research; 

262 

(C) to collect research information related to a particular industry and disseminate it to participating members; 

(D) to conduct applied research on a protected, proprietary, 

and contractual basis with member or nonmember firms, Government agencies, and others; 

(E) to prosecute applications for patents and render patent 

services for participating members; and 

(F) to negotiate and grant licenses under patents held under 

the point program, and to establish corporations designed to 

exploit particular patents obtained by it. 

(2) The Administrator may, after consultation with the Attorney 

General and the Chairman of the Federal Trade Commission, and 

with the prior written approval of the Attorney General, approve 

any agreement between small-business firms providing for a joint 

program of research and development, if the Administrator finds 

that the joint program proposed will maintain and strengthen the 

free enterprise system and the economy of the Nation. The Administrator or the Attorney General may at any time withdraw his approval of the agreement and the joint program of research and development covered thereby, if he finds that the agreement or the 

joint program carried on under it is no longer in the best interests 

of the competitive free enterprise system and the economy of the 

Nation. A copy of the statement of any such finding and approval 

intended to be within the coverage of this subsection, and a copy 

of any modification or withdrawal of approval, shall be published 

in the Federal Register. The authority conferred by this subsection 

on the Administrator shall not be delegated by him. 

(3) No act or omission to act pursuant to and within the scope 

of any joint program for research and development, under an 

agreement approved by the Administrator under this subsection, 

shall be construed to be within the prohibitions of the antitrust 

laws or the Federal Trade Commission Act. Upon publication in the 

Federal Register of the notice of withdrawal of his approval of the 

agreement granted under this subsection, either by the Administrator or by the Attorney General, the provisions of this subsection 

shall not apply to any subsequent act or omission to act by reason 

of such agreement or approval. 

(e) For the purpose of this section— 

(1) the term ‘‘extramural budget’’ means the sum of the total 

obligations minus amounts obligated for such activities by employees of the agency in or through Government-owned, Government-operated facilities, except that for the Agency for 

International Development it shall not include amounts obligated solely for general institutional support of international 

research centers or for grants to foreign countries, and except 

that for the Department of Energy it shall not include amounts 

obligated for atomic energy defense programs for weapons and 

weapons-related activities or for naval reactor programs; 

(2) the term ‘‘Federal agency’’ means an executive agency as 

defined in section 105 of title 5, United States Code, or a military department as defined in section 102 of such title, except 

that it does not include any agency within the Intelligence 

Community (as the term is defined in section 3.4(f) of Executive Order 12333 or its successor orders); 

263 

(3) the term ‘‘funding agreement’’ means any contract, grant, 

or cooperative agreement entered into between any Federal 

agency and any small business for the performance of experimental, developmental, or research work funded in whole or in 

part by the Federal Government; 

(4) the term ‘‘Small Business Innovation Research Program’’ 

or ‘‘SBIR’’ means a program under which a portion of a Federal 

agency’s research or research and development effort is reserved for award to small business concerns through a uniform 

process having— 

(A) a first phase for determining, insofar as possible, the 

scientific and technical merit and feasibility of ideas that 

appear to have commercial potential, as described in subparagraph (B), submitted pursuant to SBIR program solicitations; 

(B) a second phase, which shall not include any invitation, pre-screening, or pre-selection process for eligibility 

for Phase II, that will further develop proposals which 

meet particular program needs, in which awards shall be 

made based on the scientific and technical merit and feasibility of the proposals, as evidenced by the first phase, considering, among other things, the proposal’s commercial 

potential, as evidenced by— 

(i) the small business concern’s record of successfully 

commercializing SBIR or other research; 

(ii) the existence of second phase funding commitments from private sector or non-SBIR funding 

sources; 

(iii) the existence of third phase, follow-on commitments for the subject of the research; and 

(iv) the presence of other indicators of the commercial potential of the idea; and 

(C) where appropriate, a third phase for work that derives from, extends, or completes efforts made under prior 

funding agreements under the SBIR program— 

(i) in which commercial applications of SBIR-funded 

research or research and development are funded by 

non-Federal sources of capital or, for products or services intended for use by the Federal Government, by 

follow-on non-SBIR Federal funding awards; or 

(ii) for which awards from non-SBIR Federal funding sources are used for the continuation of research 

or research and development that has been competitively selected using peer review or merit-based selection procedures; 

(5) the term ‘‘research’’ or ‘‘research and development’’ means 

any activity which is (A) a systematic, intensive study directed 

toward greater knowledge or understanding of the subject 

studied; (B) a systematic study directed specifically toward applying new knowledge to meet a recognized need; or (C) a systematic application of knowledge toward the production of useful materials, devices, and systems or methods, including design, development, and improvement of prototypes and new 

processes to meet specific requirements; 

264 

(6) the term ‘‘Small Business Technology Transfer Program’’ 

or ‘‘STTR’’ means a program under which a portion of a Federal agency’s extramural research or research and development 

effort is reserved for award to small business concerns for cooperative research and development through a uniform process 

having— 

(A) a first phase, to determine, to the extent possible, 

the scientific, technical, and commercial merit and feasibility of ideas submitted pursuant to STTR program solicitations; 

(B) a second phase, which shall not include any invitation, pre-screening, or pre-selection process for eligibility 

for Phase II, that will further develop proposals that meet 

particular program needs, in which awards shall be made 

based on the scientific, technical, and commercial merit 

and feasibility of the idea, as evidenced by the first phase 

and by other relevant information; and 

(C) where appropriate, a third phase for work that derives from, extends, or completes efforts made under prior 

funding agreements under the STTR program— 

(i) in which commercial applications of STTR-funded 

research or research and development are funded by 

non-Federal sources of capital or, for products or services intended for use by the Federal Government, by 

follow-on non-STTR Federal funding awards; and 

(ii) for which awards from non-STTR Federal funding sources are used for the continuation of research 

or research and development that has been competitively selected using peer review or scientific review 

criteria; 

(7) the term ‘‘cooperative research and development’’ means 

research or research and development conducted jointly by a 

small business concern and a research institution in which not 

less than 40 percent of the work is performed by the small 

business concern, and not less than 30 percent of the work is 

performed by the research institution; 

(8) the term ‘‘research institution’’ means a nonprofit institution, as defined in section 4(5) of the Stevenson-Wydler Technology Innovation Act of 1980, and includes federally funded 

research and development centers, as identified by the National Scientific Foundation in accordance with the governmentwide Federal Acquisition Regulation issued in accordance 

with section 35(c)(1) of the Office of Federal Procurement Policy Act (or any successor regulation thereto); 

(9) the term ‘‘commercial applications’’ shall not be construed 

to exclude testing and evaluation of products, services, or technologies for use in technical or weapons systems, and further, 

awards for testing and evaluation of products, services, or technologies for use in technical or weapons systems may be made 

in either Phase II or Phase III of the Small Business Innovation Research Program and of the Small Business Technology 

Transfer Program, as defined in this subsection; 

(10) the term ‘‘commercialization’’ means— 

(A) the process of developing products, processes, technologies, or services; and 

265 

(B) the production and delivery (whether by the originating party or by others) of products, processes, technologies, or services for sale to or use by the Federal Government or commercial markets; 

(11) the term ‘‘Phase I’’ means— 

(A) with respect to the SBIR program, the first phase described in paragraph (4)(A); and 

(B) with respect to the STTR program, the first phase 

described in paragraph (6)(A); 

(12) the term ‘‘Phase II’’ means— 

(A) with respect to the SBIR program, the second phase 

described in paragraph (4)(B); and 

(B) with respect to the STTR program, the second phase 

described in paragraph (6)(B); and 

(13) the term ‘‘Phase III’’ means— 

(A) with respect to the SBIR program, the third phase 

described in paragraph (4)(C); and 

(B) with respect to the STTR program, the third phase 

described in paragraph (6)(C). 

(f) FEDERAL AGENCY EXPENDITURES FOR THE SBIR PROGRAM.— 

(1) REQUIRED EXPENDITURE AMOUNTS.—Except as provided in 

paragraph (2)(B), each Federal agency which has an extramural budget for research or research and development in excess of $100,000,000 for fiscal year 1992, or any fiscal year 

thereafter, shall expend with small business concerns— 

(A) not less than 1.5 percent of such budget in each of 

fiscal years 1993 and 1994; 

(B) not less than 2.0 percent of such budget in each of 

fiscal years 1995 and 1996; 

(C) not less than 2.5 percent of such budget in each of 

fiscal years 1997 through 2011; 

(D) not less than 2.6 percent of such budget in fiscal 

year 2012; 

(E) not less than 2.7 percent of such budget in fiscal year 

2013; 

(F) not less than 2.8 percent of such budget in fiscal year 

2014; 

(G) not less than 2.9 percent of such budget in fiscal 

year 2015; 

(H) not less than 3.0 percent of such budget in fiscal 

year 2016; and 

(I) not less than 3.2 percent of such budget in fiscal year 

2017 and each fiscal year thereafter, 

specifically in connection with SBIR programs which meet the 

requirements of this section, policy directives, and regulations 

issued under this section. 

(2) LIMITATIONS.—A Federal agency shall not— 

(A) use any of its SBIR budget established pursuant to 

paragraph (1) for the purpose of funding administrative 

costs of the program, including costs associated with salaries and expenses; or 

(B) make available for the purpose of meeting the requirements of paragraph (1) an amount of its extramural 

budget for basic research which exceeds the percentages 

specified in paragraph (1). 

266 

(3) EXCLUSION OF CERTAIN FUNDING AGREEMENTS.—Funding 

agreements with small business concerns for research or research and development which result from competitive or single source selections other than an SBIR program shall not be 

considered to meet any portion of the percentage requirements 

of paragraph (1). 

(4) RULE OF CONSTRUCTION.—Nothing in this subsection may 

be construed to prohibit a Federal agency from expending with 

small business concerns an amount of the extramural budget 

for research or research and development of the agency that 

exceeds the amount required under paragraph (1). 

(g) Each Federal agency required by subsection (f) to establish a 

small business innovation research program shall, in accordance 

with this Act and regulations issued hereunder— 

(1) unilaterally determine categories of projects to be in its 

SBIR program; 

(2) issue small business innovation research solicitations in 

accordance with a schedule determined cooperatively with the 

Small Business Administration; 

(3) unilaterally determine research topics within the agency’s 

SBIR solicitations, giving special consideration to broad research topics and to topics that further 1 or more critical technologies, as identified by— 

(A) the National Critical Technologies Panel (or its successor) in the 1991 report required under section 603 of 

the National Science and Technology Policy, Organization, 

and Priorities Act of 1976, and in subsequent reports 

issued under that authority; or 

(B) the Secretary of Defense, in the 1992 report issued 

in accordance with section 2522 of title 10, United States 

Code, and in subsequent reports issued under that authority; 

(4)(A) unilaterally receive and evaluate proposals resulting 

from SBIR proposals; and 

(B) make a final decision on each proposal submitted under 

the SBIR program— 

(i) not later than 1 year after the date on which the applicable solicitation closes, if with respect to the National 

Institutes of Health or the National Science Foundation, or 

90 days after the date on which the applicable solicitation 

closes, if with respect to any other participating agency; or 

(ii) if the Administrator authorizes an extension with respect to a solicitation, not later than 90 days after the date 

that would otherwise be applicable to the agency under 

clause (i); 

(5) subject to subsection (l), unilaterally select awardees for 

the SBIR funding agreements and inform each awardee under 

such an agreement, to the extent possible, of the expenses of 

the awardee that will be allowable under the funding agreement; 

(6) administer its own SBIR funding agreements (or delegate 

such administration to another agency); 

(7) make payments to recipients of SBIR funding agreements 

on the basis of progress toward or completion of the funding 

agreement requirements and, in all cases, make payment to reVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00266 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
267 

cipients under such agreements in full, subject to audit, on or 

before the last day of the 12-month period beginning on the 

date of completion of such requirements; 

(8) collect annually, and maintain in a common format in accordance with the simplified reporting requirements under 

subsection (v), such information from awardees as is necessary 

to assess the SBIR program, including information necessary 

to maintain the database described in subsection (k), including— 

(A) whether an awardee— 

(i) has venture capital, hedge fund, or private equity 

firm investment or is majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms and, if so— 

(I) the amount of venture capital, hedge fund, or 

private equity firm investment that the awardee 

has received as of the date of the award; and 

(II) the amount of additional capital that the 

awardee has invested in the SBIR technology; 

(ii) has an investor that— 

(I) is an individual who is not a citizen of the 

United States or a lawful permanent resident of 

the United States and, if so, the name of any such 

individual; or 

(II) is a person that is not an individual and is 

not organized under the laws of a State or the 

United States and, if so, the name of any such 

person; 

(iii) is owned by a woman or has a woman as a principal investigator; 

(iv) is owned by a socially or economically disadvantaged individual or has a socially or economically disadvantaged individual as a principal investigator; 

(v) is a faculty member or a student of an institution 

of higher education, as that term is defined in section 

101 of the Higher Education Act of 1965 (20 U.S.C. 

1001); or 

(vi) is located in a State described in subsection 

(u)(3); 

(B) a justification statement from the agency, if an 

awardee receives an award in an amount that is more 

than the award guidelines under this section; and 

(C) data with respect to the Federal and State Technology Partnership Program (FAST Program); 

(9) make an annual report on the SBIR program to the Small 

Business Administration and the Office of Science and Technology Policy; 

(10) include, as part of its annual performance plan as required by subsections (a) and (b) of section 1115 of title 31, 

United States Code, a section on its SBIR program, and shall 

submit such section to the Committee on Small Business of the 

Senate, and the Committee on Science and the Committee on 

Small Business of the House of Representatives; 

268 

(11) provide for and fully implement the tenets of Executive 

Order No. 13329 (Encouraging Innovation in Manufacturing); 

and 

(12) provide timely notice to the Administrator of any case 

or controversy before any Federal judicial or administrative tribunal concerning the SBIR program of the Federal agency. 

(h) In addition to the requirements of subsection (f), each Federal 

agency which has a budget for research or research and development in excess of $20,000,000 for any fiscal year beginning with 

fiscal year 1983 or subsequent fiscal year shall establish goals specifically for funding agreements for research or research and development to small business concerns, and no goal established under 

this subsection shall be less than the percentage of the agency’s research or research and development budget expended under funding agreements with small business concerns in the immediately 

preceding fiscal year. 

(i) ANNUAL REPORTING.— 

(1) IN GENERAL.—Each Federal agency required by this section to have an SBIR program or to establish goals shall report 

annually to the Small Business Administration the number of 

awards (including awards under subsection (y)) pursuant to 

grants, contracts, or cooperative agreements over $10,000 in 

amount and the dollar value of all such awards, identifying 

SBIR awards and comparing the number and amount of such 

awards with awards to other than small business concerns. 

(2) CALCULATION OF EXTRAMURAL BUDGET.— (A) METHODOLOGY.—Not later than 4 months after the 

date of the enactment of each appropriations Act for a Federal agency required by this section to have an SBIR program, the Federal agency shall submit to the Administrator a report, which shall include a description of the 

methodology used for calculating the amount of the extramural budget of that Federal agency. 

(B) ADMINISTRATOR’S ANALYSIS.—The Administrator 

shall include an analysis of the methodology received from 

each Federal agency referred to in subparagraph (A) in the 

report required by subsection (b)(7). 

(j)(1) POLICY DIRECTIVES.—The Small Business Administration, 

after consultation with the Administrator of the Office of Federal 

Procurement Policy, the Director of the Office of Science and Technology Policy, and the Intergovernmental Affairs Division of the Office of Management and Budget, shall, within one hundred and 

twenty days of the enactment of the Small Business Innovation Development Act of 1982, issue policy directives for the general conduct of the SBIR programs within the Federal Government, including providing for— 

(A) simplified, standardized, and timely SBIR solicitations; 

(B) a simplified, standardized funding process which provides for (i) the timely receipt and review of proposals; (ii) outside peer review for at least Phase II proposals, if appropriate; 

(iii) protection of proprietary information provided in proposals; 

(iv) selection of awardees; (v) retention of rights in data generated in the performance of the contract by the small business 

concern; (vi) transfer of title to property provided by the agency 

to the small business concern if such a transfer would be more 

269 

cost effective than recovery of the property by the agency; (vii) 

cost sharing; and (viii) cost principles and payment schedules; 

(C) exemptions from the regulations under paragraph (2) if 

national security or intelligence functions clearly would be 

jeopardized; 

(D) minimizing regulatory burden associated with participation in the SBIR program for the small business concern which 

will stimulate the cost-effective conduct of Federal research 

and development and the likelihood of commercialization of the 

results of research and development conducted under the SBIR 

program; 

(E) simplified, standardized, and timely annual report on the 

SBIR program to the Small Business Administration and the 

Office of Science and Technology Policy; 

(F) standardized and orderly withdrawal from program participation by an agency having a SBIR program; at the discretion of the Administration, such directives may require a 

phased withdrawal over a period of time sufficient in duration 

to minimize any adverse impact on small business concerns; 

and 

(G) the voluntary participation in a SBIR program by a Federal agency not required to establish such a program pursuant 

to subsection (f). 

(2) MODIFICATIONS.—Not later than 90 days after the date of 

enactment of the Small Business Research and Development 

Enhancement Act of 1992, the Administrator shall modify the 

policy directives issued pursuant to this subsection to provide 

for— 

(A) retention by a small business concern of the rights 

to data generated by the concern in the performance of an 

SBIR award for a period of not less than 4 years; 

(B) continued use by a small business concern participating in Phase III of the SBIR program, as a directed 

bailment, of any property transferred by a Federal agency 

to the small business concern in Phase II of an SBIR program for a period of not less than 2 years, beginning on 

the initial date of the concern’s participation in Phase III 

of such program; 

(C) procedures to ensure, to the extent practicable, that 

an agency which intends to pursue research, development, 

or production of a technology developed by a small business concern under an SBIR program enters into follow-on, 

non-SBIR funding agreements with the small business 

concern for such research, development, or production; 

(D) an increase to $150,000 in the amount of funds 

which an agency may award in Phase I of an SBIR program, and to $1,000,000 in Phase II of an SBIR program, 

and an adjustment of such amounts every year for inflation; 

(E) a process for notifying the participating SBIR agencies and potential SBIR participants of the 1991, 1992, and 

the current critical technologies, as identified— 

(i) by the National Critical Technologies Panel (or 

its successor), in accordance with section 603 of the 

270 

National Science and Technology Policy, Organization, 

and Priorities Act of 1976; or 

(ii) by the Secretary of Defense, in accordance with 

section 2522 of title 10, United States Code; 

(F) enhanced outreach efforts to increase the participation of socially and economically disadvantaged small business concerns, as defined in section 8(a)(4), and the participation of small businesses that are 51 percent owned and 

controlled by women in technological innovation and in 

SBIR programs, including Phase III of such programs, and 

the collection of data to document such participation; 

(G) technical and programmatic guidance to encourage 

agencies to develop gap-funding programs to address the 

delay between an award for Phase I of an SBIR program 

and the application for and extension of an award for 

Phase II of such program; 

(H) procedures to ensure that a small business concern 

that submits a proposal for a funding agreement for Phase 

I of an SBIR program and that has received more than 15 

Phase II SBIR awards during the preceding 5 fiscal years 

is able to demonstrate the extent to which it was able to 

secure Phase III funding to develop concepts resulting 

from previous Phase II SBIR awards; and 

(I) procedures to ensure that agencies participating in 

the SBIR program retain the information submitted under 

subparagraph (H) at least until the General Accounting 

Office submits the report required under section 105 of the 

Small Business Research and Development Enhancement 

Act of 1992. 

(3) ADDITIONAL MODIFICATIONS.—Not later than 120 days 

after the date of the enactment of the Small Business Innovation Research Program Reauthorization Act of 2000, the Administrator shall modify the policy directives issued pursuant 

to this subsection— 

(A) to clarify that the rights provided for under paragraph (2)(A) apply to all Federal funding awards under 

this section, including Phase I, Phase II, and Phase III; 

(B) to provide for the requirement of a succinct commercialization plan with each application for a Phase II award 

that is moving toward commercialization; 

(C) to require agencies to report to the Administration, 

not less frequently than annually, all instances in which 

an agency pursued research, development, or production of 

a technology developed by a small business concern using 

an award made under the SBIR program of that agency, 

and determined that it was not practicable to enter into a 

follow-on non-SBIR program funding agreement with the 

small business concern, which report shall include, at a 

minimum— 

(i) the reasons why the follow-on funding agreement 

with the small business concern was not practicable; 

(ii) the identity of the entity with which the agency 

contracted to perform the research, development, or 

production; and 

271 

(iii) a description of the type of funding agreement 

under which the research, development, or production 

was obtained; and 

(D) to implement subsection (v), including establishing 

standardized procedures for the provision of information 

pursuant to subsection (k)(3). 

(k) DATABASE.— 

(1) PUBLIC DATABASE.—Not later than 180 days after the 

date of the enactment of the Small Business Innovation Research Program Reauthorization Act of 2000, the Administrator shall develop, maintain, and make available to the public a searchable, up-to-date, electronic database that includes— 

(A) the name, size, location, and an identifying number 

assigned by the Administrator, of each small business concern that has received a Phase I or Phase II SBIR or STTR 

award from a Federal agency; 

(B) a description of each Phase I or Phase II SBIR or 

STTR award received by that small business concern, including— 

(i) an abstract of the project funded by the award, 

excluding any proprietary information so identified by 

the small business concern; 

(ii) the Federal agency making the award; and 

(iii) the date and amount of the award; 

(C) an identification of any business concern or subsidiary established for the commercial application of a 

product or service for which an SBIR or STTR award is 

made; 

(D) information regarding mentors and Mentoring Networks, as required by section 35(d); 

(E) with respect to assistance under the STTR program 

only— 

(i) whether the small business concern or the research institution initiated their collaboration on each 

assisted STTR project; 

(ii) whether the small business concern or the research institution originated any technology relating 

to the assisted STTR project; 

(iii) the length of time it took to negotiate any licensing agreement between the small business concern 

and the research institution under each assisted STTR 

project; and 

(iv) how the proceeds from commercialization, marketing, or sale of technology resulting from each assisted STTR project were allocated (by percentage) between the small business concern and the research institution; and 

(F) for each small business concern that has received a 

Phase I or Phase II SBIR or STTR award from a Federal 

agency, whether the small business concern— 

(i) has venture capital, hedge fund, or private equity 

firm investment and, if so, whether the small business 

concern is registered as majority-owned by multiple 

venture capital operating companies, hedge funds, or 

272 

private equity firms as required under subsection 

(dd)(3); 

(ii) is owned by a woman or has a woman as a principal investigator; 

(iii) is owned by a socially or economically disadvantaged individual or has a socially or economically disadvantaged individual as a principal investigator; 

(iv) is owned by a faculty member or a student of an 

institution of higher education, as that term is defined 

in section 101 of the Higher Education Act of 1965 (20 

U.S.C. 1001); or 

(v) received assistance under the Federal and State 

Technology Partnership Program (FAST Program). 

(2) GOVERNMENT DATABASE.—Not later than 90 days after 

the date of enactment of the SBIR/STTR Reauthorization Act 

of 2011, the Administrator, in consultation with Federal agencies required to have an SBIR program pursuant to subsection 

(f)(1) or an STTR program pursuant to subsection (n)(1), shall 

develop and maintain a database to be used exclusively for 

SBIR and STTR program evaluation that— 

(A) contains for each small business concern that applies 

for, submits a proposal for, or receives an award under 

Phase I or Phase II of the SBIR program or the STTR program— 

(i) the name, size, and location of, and the identifying number assigned by the Administration to, the 

small business concern; 

(ii) an abstract of the applicable project; 

(iii) the specific aims of the project; 

(iv) the number of employees of the small business 

concern; 

(v) the names and titles of the key individuals that 

will carry out the project, the position each key individual holds in the small business concern, and contact information for each key individual; 

(vi) the percentage of effort each individual described in clause (v) will contribute to the project; 

(vii) whether the small business concern is majorityowned by multiple venture capital operating companies, hedge funds, or private equity firms; and 

(viii) the Federal agency to which the application is 

made and contact information for the person or office 

within the Federal agency that is responsible for reviewing applications and making awards under the 

SBIR program or the STTR program; 

(B) contains for each Phase II award made by a Federal 

agency— 

(i) information collected in accordance with paragraph (3) on revenue from the sale of new products or 

services resulting from the research conducted under 

the award; 

(ii) information collected in accordance with paragraph (3) on additional investment from any source, 

other than Phase I or Phase II SBIR or STTR awards, 

273 

to further the research and development conducted 

under the award; and 

(iii) any other information received in connection 

with the award that the Administrator, in conjunction 

with the SBIR and STTR program managers of Federal agencies, considers relevant and appropriate; 

(C) includes any narrative information that a small business concern receiving a Phase II award voluntarily submits to further describe the outputs and outcomes of its 

awards; 

(D) includes, for each awardee— 

(i) the name, size, and location of, and any identifying number assigned by the Administrator to, the 

awardee; 

(ii) whether the awardee has venture capital, hedge 

fund, or private equity firm investment and, if so— 

(I) the amount of venture capital, hedge fund, or 

private equity firm investment as of the date of 

the award; 

(II) the percentage of ownership of the awardee 

held by a venture capital operating company, 

hedge fund, or private equity firm, including 

whether the awardee is majority-owned by multiple venture capital operating companies, hedge 

funds, or private equity firms; and 

(III) the amount of additional capital that the 

awardee has invested in the SBIR or STTR technology, which information shall be collected on an 

annual basis; 

(iii) the names and locations of any affiliates of the 

awardee; 

(iv) the number of employees of the awardee; 

(v) the number of employees of the affiliates of the 

awardee; and 

(vi) the names of, and the percentage of ownership 

of the awardee held by— 

(I) any individual who is not a citizen of the 

United States or a lawful permanent resident of 

the United States; or 

(II) any person that is not an individual and is 

not organized under the laws of a State or the 

United States; 

(E) includes any other data collected by or available to 

any Federal agency that such agency considers may be 

useful for SBIR or STTR program evaluation; 

(F) is available for use solely for program evaluation 

purposes by the Federal Government or, in accordance 

with policy directives issued by the Administration, by 

other authorized persons who are subject to a use and nondisclosure agreement with the Federal Government covering the use of the database; and 

(G) includes a timely and accurate list of any individual 

or small business concern that has participated in the 

SBIR program or STTR program that has been— 

274 

(i) convicted of a fraud-related crime involving funding received under the SBIR program or STTR program; or 

(ii) found civilly liable for a fraud-related violation 

involving funding received under the SBIR program or 

STTR program. 

(3) UPDATING INFORMATION FOR DATABASE.— 

(A) IN GENERAL.—A small business concern applying for 

a Phase II award under this section shall be required to 

update information in the database established under this 

subsection for any prior Phase II award received by that 

small business concern. In complying with this paragraph, 

a small business concern may apportion sales or additional 

investment information relating to more than one Phase II 

award among those awards, if it notes the apportionment 

for each award. 

(B) ANNUAL UPDATES UPON TERMINATION.—A small business concern receiving a Phase II award under this section 

shall— 

(i) update information in the database concerning 

that award at the termination of the award period; 

and 

(ii) be requested to voluntarily update such information annually thereafter for a period of 5 years. 

(C) GOVERNMENT DATABASE.—Not later than 60 days 

after the date established by a Federal agency for submitting applications or proposals for a Phase I or Phase II 

award under the SBIR program or STTR program, the 

head of the Federal agency shall submit to the Administrator the data required under paragraph (2) with respect 

to each small business concern that applies or submits a 

proposal for the Phase I or Phase II award. 

(4) PROTECTION OF INFORMATION.—Information provided 

under paragraph (2) shall be considered privileged and confidential and not subject to disclosure pursuant to section 552 

of title 5, United States Code. 

(5) RULE OF CONSTRUCTION.—Inclusion of information in the 

database under this subsection shall not be considered to be 

publication for purposes of subsection (a) or (b) of section 102 

of title 35, United States Code. 

(l) REPORTING OF AWARDS MADE FROM SINGLE PROPOSAL, TO

MULTIPLE AWARD WINNERS, OR TO CRITICAL TECHNOLOGY TOPICS.— 

(1) SINGLE PROPOSAL.—If a Federal agency required to establish an SBIR program under subsection (f) makes an award 

with respect to an SBIR solicitation topic or subtopic for which 

the agency received only 1 proposal, the agency shall provide 

written justification for making the award in its next quarterly 

report to the Administration and in the agency’s next annual 

report required under subsection (g)(8). 

(2) MULTIPLE AWARDS.—An agency referred to in paragraph 

(1) shall include in its next annual report required under subsection (g)(8) an accounting of the awards the agency has made 

for Phase I of an SBIR program during the reporting period to 

275 

entities that have received more than 15 awards for the Phase 

II of an SBIR program during the preceding 5 fiscal years. 

(3) CRITICAL TECHNOLOGY AWARDS.—An agency referred to in 

paragraph (1) shall include in its next annual report required 

under subsection (g)(8), an accounting of the number of awards 

it has made to critical technology topics, as defined in subsection (g)(3), including an identification of the specific critical 

technologies topics, and the percentage by number and dollar 

amount of the agency’s total SBIR awards to such critical technology topics. 

(m) TERMINATION.—The authorization to carry out the Small 

Business Innovation Research Program established under this section shall terminate on September 30, 2022. 

(n) REQUIRED EXPENDITURES FOR STTR BY FEDERAL AGENCIES.— 

(1) REQUIRED EXPENDITURE AMOUNTS.— 

(A) IN GENERAL.—With respect to each fiscal year 

through fiscal year 2022, each Federal agency that has an 

extramural budget for research, or research and development, in excess of $1,000,000,000 for that fiscal year, shall 

expend with small business concerns not less than the percentage of that extramural budget specified in subparagraph (B), specifically in connection with STTR programs 

that meet the requirements of this section and any policy 

directives and regulations issued under this section. 

(B) EXPENDITURE AMOUNTS.—The percentage of the extramural budget required to be expended by an agency in 

accordance with subparagraph (A) shall be— 

(i) 0.15 percent for each fiscal year through fiscal 

year 2003; 

(ii) 0.3 percent for each of fiscal years 2004 through 

2011; 

(iii) 0.35 percent for each of fiscal years 2012 and 

2013; 

(iv) 0.40 percent for each of fiscal years 2014 and 

2015; and 

(v) 0.45 percent for fiscal year 2016 and each fiscal 

year thereafter. 

(2) LIMITATIONS.—A Federal agency shall not— 

(A) use any of its STTR budget established pursuant to 

paragraph (1) for the purpose of funding administrative 

costs of the program, including costs associated with salaries and expenses, or, in the case of a small business concern or a research institution, costs associated with salaries, expenses, and administrative overhead (other than 

those direct or indirect costs allowable under guidelines of 

the Office of Management and Budget and the governmentwide Federal Acquisition Regulation issued in accordance with section 25(c)(1) of the Office of Federal Procurement Policy Act); or 

(B) make available for the purpose of meeting the requirements of paragraph (1) an amount of its extramural 

budget for basic research which exceeds the percentage 

specified in paragraph (1). 

(3) EXCLUSION OF CERTAIN FUNDING AGREEMENTS.—Funding 

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276 

search and development which result from competitive or single source selections other than an STTR program shall not be 

considered to meet any portion of the percentage requirements 

of paragraph (1). 

(o) FEDERAL AGENCY STTR AUTHORITY.—Each Federal agency 

required to establish an STTR program in accordance with subsection (n) and regulations issued under this Act, shall— 

(1) unilaterally determine categories of projects to be included in its STTR program; 

(2) issue STTR solicitations in accordance with a schedule 

determined cooperatively with the Administration; 

(3) unilaterally determine research topics within the agency’s 

STTR solicitations, giving special consideration to broad research topics and to topics that further 1 or more critical technologies, as identified— 

(A) by the National Critical Technologies Panel (or its 

successor) in reports required under section 603 of the National Science and Technology Policy, Organization, and 

Priorities Act of 1976; or 

(B) by the Secretary of Defense, in accordance with section 2522 of title 10, United States Code; 

(4)(A) unilaterally receive and evaluate proposals resulting 

from STTR solicitations; and 

(B) make a final decision on each proposal submitted under 

the STTR program— 

(i) not later than 1 year after the date on which the applicable solicitation closes, if with respect to the National 

Institutes of Health or the National Science Foundation, or 

90 days after the date on which the applicable solicitation 

closes, if with respect to any other participating agency; or 

(ii) if the Administrator authorizes an extension for a solicitation, not later than 90 days after the date that would 

be applicable to the agency under clause (i); 

(5) unilaterally select awardees for its STTR funding agreements and inform each awardee under such an agreement, to 

the extent possible, of the expenses of the awardee that will be 

allowable under the funding agreement; 

(6) administer its own STTR funding agreements (or delegate 

such administration to another agency); 

(7) make payments to recipients of STTR funding agreements on the basis of progress toward or completion of the 

funding agreement requirements and, in all cases, make payment to recipients under such agreements in full, subject to 

audit, on or before the last day of the 12-month period beginning on the date of the completion of such requirements; 

(8) include, as part of its annual performance plan as required by subsections (a) and (b) of section 1115 of title 31, 

United States Code, a section on its STTR program, and shall 

submit such section to the Committee on Small Business of the 

Senate, and the Committee on Science and the Committee on 

Small Business of the House of Representatives; 

(9) collect annually, and maintain in a common format in accordance with the simplified reporting requirements under 

subsection (v), such information from applicants and awardees 

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comes, including information necessary to maintain the database described in subsection (k), including— 

(A) whether an applicant or awardee— 

(i) has venture capital, hedge fund, or private equity 

firm investment or is majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms and, if so— 

(I) the amount of venture capital, hedge fund, or 

private equity firm investment that the applicant 

or awardee has received as of the date of the application or award, as applicable; and 

(II) the amount of additional capital that the applicant or awardee has invested in the STTR technology; 

(ii) has an investor that— 

(I) is an individual who is not a citizen of the 

United States or a lawful permanent resident of 

the United States and, if so, the name of any such 

individual; or 

(II) is a person that is not an individual and is 

not organized under the laws of a State or the 

United States and, if so, the name of any such 

person; 

(iii) is owned by a woman or has a woman as a principal investigator; 

(iv) is owned by a socially or economically disadvantaged individual or has a socially or economically disadvantaged individual as a principal investigator; 

(v) is a faculty member or a student of an institution 

of higher education, as that term is defined in section 

101 of the Higher Education Act of 1965 (20 U.S.C. 

1001); or 

(vi) is located in a State in which the total value of 

contracts awarded to small business concerns under 

all STTR programs is less than the total value of contracts awarded to small business concerns in a majority of other States, as determined by the Administrator in biennial fiscal years, beginning with fiscal 

year 2008, based on the most recent statistics compiled by the Administrator; 

(B) if an awardee receives an award in an amount that 

is more than the award guidelines under this section, a 

statement from the agency that justifies the award 

amount; and 

(C) data with respect to the Federal and State Technology Partnership Program (FAST Program); 

(10) submit an annual report on the STTR program to the 

Administration and the Office of Science and Technology Policy; 

(11) adopt the agreement developed by the Administrator 

under subsection (w) as the agency’s model agreement for allocating between small business concerns and research institutions intellectual property rights and rights, if any, to carry out 

follow-on research, development, or commercialization; 

278 

(12) develop, in consultation with the Office of Federal Procurement Policy and the Office of Government Ethics, procedures to ensure that federally funded research and development centers (as defined in subsection (e)(8)) that participate 

in STTR agreements— 

(A) are free from organizational conflicts of interests relative to the STTR program; 

(B) do not use privileged information gained through 

work performed for an STTR agency or private access to 

STTR agency personnel in the development of an STTR 

proposal; and 

(C) use outside peer review, as appropriate; 

(13) not later than July 31, 1993, develop procedures for assessing the commercial merit and feasibility of STTR proposals, as evidenced by— 

(A) the small business concern’s record of successfully 

commercializing STTR or other research; 

(B) the existence of Phase II funding commitments from 

private sector or non-STTR funding sources; 

(C) the existence of Phase III follow-on commitments for 

the subject of the research; and 

(D) the presence of other indicators of the commercial 

potential of the idea; 

(14) implement an outreach program to research institutions 

and small business concerns for the purpose of enhancing its 

STTR program, in conjunction with any such outreach done for 

purposes of the SBIR program; 

(15) provide for and fully implement the tenets of Executive 

Order No. 13329 (Encouraging Innovation in Manufacturing); 

and 

(16) provide timely notice to the Administrator of any case 

or controversy before any Federal judicial or administrative tribunal concerning the STTR program of the Federal agency. 

(p) STTR POLICY DIRECTIVE.— 

(1) ISSUANCE.—The Administrator shall issue a policy directive for the general conduct of the STTR programs within the 

Federal Government. Such policy directive shall be issued after 

consultation with— 

(A) the heads of each of the Federal agencies required by 

subsection (n) to establish an STTR program; 

(B) the Under Secretary of Commerce for Intellectual 

Property and Director of the United States Patent and 

Trademark Office; and 

(C) the Director of the Office of Federal Procurement 

Policy. 

(2) CONTENTS.—The policy directive required by paragraph 

(1) shall provide for— 

(A) simplified, standardized, and timely STTR solicitations; 

(B) a simplified, standardized funding process that provides for— 

(i) the timely receipt and review of proposals; 

(ii) outside peer review, if appropriate; 

(iii) protection of proprietary information provided in 

proposals; 

279 

(iv) selection of awardees; 

(v) retention by a small business concern of the 

rights to data generated by the concern in the performance of an STTR award for a period of not less 

than 4 years; 

(vi) continued use by a small business concern, as a 

directed bailment, of any property transferred by a 

Federal agency to the small business concern in Phase 

II of the STTR program for a period of not less than 

2 years, beginning on the initial date of the concern’s 

participation in Phase III of such program; 

(vii) cost sharing; 

(viii) cost principles and payment schedules; and 

(ix) 1-year awards for Phase I of an STTR program, generally not to exceed $150,000, and 2-year awards 

for Phase II of an STTR program, generally not to exceed $1,000,000, (each of which the Administrator 

shall adjust for inflation annually) greater or lesser 

amounts to be awarded at the discretion of the awarding agency, and shorter or longer periods of time to be 

approved at the discretion of the awarding agency 

where appropriate for a particular project; 

(C) minimizing regulatory burdens associated with participation in STTR programs; 

(D) guidelines for a model agreement, to be used by all 

agencies, for allocating between small business concerns 

and research institutions intellectual property rights and 

rights, if any, to carry out follow-on research, development, 

or commercialization; 

(E) procedures to ensure that— 

(i) a recipient of an STTR award is a small business 

concern, as defined in section 3 and the regulations 

promulgated thereunder; and 

(ii) such small business concern exercises management and control of the performance of the STTR 

funding agreement pursuant to a business plan providing for the commercialization of the technology that 

is the subject matter of the award; and 

(F) procedures to ensure, to the extent practicable, that 

an agency which intends to pursue research, development, 

or production of a technology developed by a small business concern under an STTR program enters into followon, non-STTR funding agreements with the small business 

concern for such research, development, or production. 

(3) MODIFICATIONS.—Not later than 120 days after the date 

of enactment of this paragraph, the Administrator shall modify 

the policy directive issued pursuant to this subsection to clarify 

that the rights provided for under paragraph (2)(B)(v) apply to 

all Federal funding awards under this section, including Phase 

I, Phase II, and Phase III. 

(q) DISCRETIONARY TECHNICAL ASSISTANCE.— (1) IN GENERAL.—Each Federal agency required by this section to conduct an SBIR program or STTR program may enter 

into an agreement with a vendor selected under paragraph (2) 

to provide small business concerns engaged in SBIR or STTR 

280 

projects with technical assistance services, such as access to a 

network of scientists and engineers engaged in a wide range of 

technologies, or access to technical and business literature 

available through on-line data bases, for the purpose of assisting such concerns in— 

(A) making better technical decisions concerning such 

projects; 

(B) solving technical problems which arise during the 

conduct of such projects; 

(C) minimizing technical risks associated with such 

projects; and 

(D) developing and commercializing new commercial 

products and processes resulting from such projects. 

(2) VENDOR SELECTION.—Each agency may select a vendor to 

assist small business concerns to meet the goals listed in paragraph (1) for a term not to exceed 5 years. Such selection shall 

be competitive and shall utilize merit-based criteria. 

(3) ADDITIONAL TECHNICAL ASSISTANCE.— 

(A) PHASE I.—A Federal agency described in paragraph 

(1) may— 

(i) provide to the recipient of a Phase I SBIR or 

STTR award, through a vendor selected under paragraph (2), the services described in paragraph (1), in 

an amount equal to not more than $5,000 per year; or 

(ii) authorize the recipient of a Phase I SBIR or 

STTR award to purchase the services described in 

paragraph (1), in an amount equal to not more than 

$5,000 per year, which shall be in addition to the 

amount of the recipient’s award. 

(B) PHASE II.—A Federal agency described in paragraph 

(1) may— 

(i) provide to the recipient of a Phase II SBIR or 

STTR award, through a vendor selected under paragraph (2), the services described in paragraph (1), in 

an amount equal to not more than $5,000 per year; or 

(ii) authorize the recipient of a Phase II SBIR or 

STTR award to purchase the services described in 

paragraph (1), in an amount equal to not more than 

$5,000 per year, which shall be in addition to the 

amount of the recipient’s award. 

(C) FLEXIBILITY.—In carrying out subparagraphs (A) and 

(B), each Federal agency shall provide the allowable 

amounts to a recipient that meets the eligibility requirements under the applicable subparagraph, if the recipient 

requests to seek technical assistance from an individual or 

entity other than the vendor selected under paragraph (2) 

by the Federal agency. 

(D) LIMITATION.—A Federal agency may not— 

(i) use the amounts authorized under subparagraph 

(A) or (B) unless the vendor selected under paragraph 

(2) provides the technical assistance to the recipient; 

or 

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sistance is based on total number of Phase I or Phase 

II awards. 

(r) PHASE III AGREEMENTS, COMPETITIVE PROCEDURES, AND JUSTIFICATION FOR AWARDS.— 

(1) IN GENERAL.—In the case of a small business concern 

that is awarded a funding agreement for Phase II of an SBIR 

or STTR program, a Federal agency may enter into a Phase III 

agreement with that business concern for additional work to be 

performed during or after the Phase II period. The Phase II 

funding agreement with the small business concern may, at 

the discretion of the agency awarding the agreement, set out 

the procedures applicable to Phase III agreements with that 

agency or any other agency. 

(2) DEFINITION.—In this subsection, the term ‘‘Phase III 

agreement’’ means a follow-on, non-SBIR or non-STTR funded 

contract as described in paragraph (4)(C) or paragraph (6)(C) 

of subsection (e). 

(3) INTELLECTUAL PROPERTY RIGHTS.—Each funding agreement under an SBIR or STTR program shall include provisions 

setting forth the respective rights of the United States and the 

small business concern with respect to intellectual property 

rights and with respect to any right to carry out follow-on research. 

(4) COMPETITIVE PROCEDURES AND JUSTIFICATION FOR

AWARDS.—To the greatest extent practicable, Federal agencies 

and Federal prime contractors shall— 

(A) consider an award under the SBIR program or the 

STTR program to satisfy the requirements under section 

2304 of title 10, United States Code, and any other applicable competition requirements; and 

(B) issue, without further justification, Phase III awards 

relating to technology, including sole source awards, to the 

SBIR and STTR award recipients that developed the technology. 

(s) COMPETITIVE SELECTION PROCEDURES FOR SBIR AND STTR 

PROGRAMS.—All funds awarded, appropriated, or otherwise made 

available in accordance with subsection (f) or (n) must be awarded 

pursuant to competitive and merit-based selection procedures. 

(t) INCLUSION IN STRATEGIC PLANS.—Program information relating to the SBIR and STTR programs shall be included by each Federal agency in any update or revision required of the Federal agency under section 306(b) of title 5, United States Code. 

(u) COORDINATION OF TECHNOLOGY DEVELOPMENT PROGRAMS.— 

(1) DEFINITION OF TECHNOLOGY DEVELOPMENT PROGRAM.—In 

this subsection, the term ‘‘technology development program’’ 

means— 

(A) the Experimental Program to Stimulate Competitive 

Research of the National Science Foundation, as established under section 113 of the National Science Foundation Authorization Act of 1988 (42 U.S.C. 1862g); 

(B) the Defense Experimental Program to Stimulate 

Competitive Research of the Department of Defense; 

(C) the Experimental Program to Stimulate Competitive 

Research of the Department of Energy; 

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(D) the Experimental Program to Stimulate Competitive 

Research of the Environmental Protection Agency; 

(E) the Experimental Program to Stimulate Competitive 

Research of the National Aeronautics and Space Administration; 

(F) the Institutional Development Award Program of the 

National Institutes of Health; and 

(G) the National Research Initiative Competitive Grants 

Program of the Department of Agriculture. 

(2) COORDINATION REQUIREMENTS.—Each Federal agency 

that is subject to subsection (f) and that has established a technology development program may, in each fiscal year, review 

for funding under that technology development program— 

(A) any proposal to provide outreach and assistance to 

one or more small business concerns interested in participating in the SBIR program, including any proposal to 

make a grant or loan to a company to pay a portion or all 

of the cost of developing an SBIR proposal, from an entity, 

organization, or individual located in— 

(i) a State that is eligible to participate in that program; or 

(ii) a State described in paragraph (3); or 

(B) any proposal for Phase I of the SBIR program, if the 

proposal, though meritorious, is not funded through the 

SBIR program for that fiscal year due to funding restraints, from a small business concern located in— 

(i) a State that is eligible to participate in a technology development program; or 

(ii) a State described in paragraph (3). 

(3) ADDITIONALLY ELIGIBLE STATE.—A State referred to in 

subparagraph (A)(ii) or (B)(ii) of paragraph (2) is a State in 

which the total value of contracts awarded to small business 

concerns under all SBIR programs is less than the total value 

of contracts awarded to small business concerns in a majority 

of other States, as determined by the Administrator in biennial 

fiscal years, beginning with fiscal year 2000, based on the most 

recent statistics compiled by the Administrator. 

(v) REDUCING PAPERWORK AND COMPLIANCE BURDEN.— (1) STANDARDIZATION OF REPORTING REQUIREMENTS.—The 

Administrator shall work with the Federal agencies required 

by this section to have an SBIR or STTR program to standardize reporting requirements for the collection of data from 

SBIR or STTR applicants and awardees, including data for inclusion in the database under subsection (k), taking into consideration the unique needs of each agency, and to the extent 

possible, permitting the updating of previously reported information by electronic means. Such requirements shall be designed to minimize the burden on small businesses. 

(2) SIMPLIFICATION OF APPLICATION AND AWARD PROCESS.— Not later than 1 year after the date of enactment of this paragraph, and after a period of public comment, the Administrator 

shall issue regulations or guidelines, taking into consideration 

the unique needs of each Federal agency, to ensure that each 

Federal agency required to carry out an SBIR program or 

STTR program simplifies and standardizes the program proVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00282 Fmt 6659 Sfmt 6601 E:\HR\OC\HR862.XXX HR862
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posal, selection, contracting, compliance, and audit procedures 

for the SBIR program or STTR program of the Federal agency 

(including procedures relating to overhead rates for applicants 

and documentation requirements) to reduce the paperwork and 

regulatory compliance burden on small business concerns applying to and participating in the SBIR program or STTR program. 

(w) STTR MODEL AGREEMENT FOR INTELLECTUAL PROPERTY

RIGHTS.— 

(1) IN GENERAL.—The Administrator shall promulgate regulations establishing a single model agreement for use in the 

STTR program that allocates between small business concerns 

and research institutions intellectual property rights and 

rights, if any, to carry out follow-on research, development, or 

commercialization. 

(2) OPPORTUNITY FOR COMMENT.—In promulgating regulations under paragraph (1), the Administrator shall provide to 

affected agencies, small business concerns, research institutions, and other interested parties the opportunity to submit 

written comments. 

(x) RESEARCH AND DEVELOPMENT FOCUS.— (1) REVISION AND UPDATE OF CRITERIA AND PROCEDURES OF

IDENTIFICATION.—In carrying out subsection (g), the Secretary 

of Defense shall, not less often than once every 4 years, revise 

and update the criteria and procedures utilized to identify 

areas of the research and development efforts of the Department of Defense which are suitable for the provision of funds 

under the Small Business Innovation Research Program and 

the Small Business Technology Transfer Program. 

(2) UTILIZATION OF PLANS.—The criteria and procedures described in paragraph (1) shall be developed through the use of 

the most current versions of the following plans: 

(A) The Joint Warfighting Science and Technology Plan 

required under section 270 of the National Defense Authorization Act for Fiscal Year 1997 (Public Law 104–201; 

10 U.S.C. 2501 note). 

(B) The Defense Technology Area Plan of the Department of Defense. 

(C) The Basic Research Plan of the Department of Defense. 

(3) INPUT IN IDENTIFICATION OF AREAS OF EFFORT.—The criteria and procedures described in paragraph (1) shall include 

input in the identification of areas of research and development efforts described in that paragraph from Department of 

Defense program managers (PMs) and program executive officers (PEOs). 

(y) COMMERCIALIZATION READINESS PROGRAM.— 

(1) IN GENERAL.—The Secretary of Defense and the Secretary 

of each military department is authorized to create and administer a ‘‘Commercialization Readiness Program’’ to accelerate 

the transition of technologies, products, and services developed 

under the Small Business Innovation Research Program or 

Small Business Technology Transfer Program to Phase III, including the acquisition process. The authority to create and administer a Commercialization Readiness Program under this 

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subsection may not be construed to eliminate or replace any 

other SBIR program or STTR program that enhances the insertion or transition of SBIR or STTR technologies, including 

any such program in effect on the date of enactment of the National Defense Authorization Act for Fiscal Year 2006 (Public 

Law 109–163; 119 Stat. 3136). 

(2) IDENTIFICATION OF RESEARCH PROGRAMS FOR ACCELER- ATED TRANSITION TO ACQUISITION PROCESS.—In carrying out 

the Commercialization Readiness Program, the Secretary of 

Defense and the Secretary of each military department shall 

identify research programs of the Small Business Innovation 

Research Program or Small Business Technology Transfer Program that have the potential for rapid transitioning to Phase 

III and into the acquisition process. 

(3) LIMITATION.—No research program may be identified 

under paragraph (2) unless the Secretary of the military department concerned certifies in writing that the successful 

transition of the program to Phase III and into the acquisition 

process is expected to meet high priority military requirements 

of such military department. 

(4) FUNDING.— (A) IN GENERAL.—The Secretary of Defense and each 

Secretary of a military department may use not more than 

an amount equal to 1 percent of the funds available to the 

Department of Defense or the military department pursuant to the Small Business Innovation Research Program 

for payment of expenses incurred to administer the Commercialization Readiness Program under this subsection. 

(B) LIMITATIONS.—The funds described in subparagraph 

(A)— 

(i) shall not be subject to the limitations on the use 

of funds in subsection (f)(2); and 

(ii) shall not be used to make Phase III awards. 

(5) INSERTION INCENTIVES.—For any contract with a value of 

not less than $100,000,000, the Secretary of Defense is authorized to— 

(A) establish goals for the transition of Phase III technologies in subcontracting plans; and 

(B) require a prime contractor on such a contract to report the number and dollar amount of contracts entered 

into by that prime contractor for Phase III SBIR or STTR 

projects. 

(6) GOAL FOR SBIR AND STTR TECHNOLOGY INSERTION.—The 

Secretary of Defense shall— 

(A) set a goal to increase the number of Phase II SBIR 

contracts and the number of Phase II STTR contracts 

awarded by the Secretary that lead to technology transition into programs of record or fielded systems; 

(B) use incentives in effect on the date of enactment of 

the SBIR/STTR Reauthorization Act of 2011, or create new 

incentives, to encourage agency program managers and 

prime contractors to meet the goal under subparagraph 

(A); and 

(C) submit to the Administrator for inclusion in the annual report under subsection (b)(7)— 

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(i) the number and percentage of Phase II SBIR and 

STTR contracts awarded by the Secretary that led to 

technology transition into programs of record or fielded systems; 

(ii) information on the status of each project that received funding through the Commercialization Readiness Program and efforts to transition those projects 

into programs of record or fielded systems; and 

(iii) a description of each incentive that has been 

used by the Secretary under subparagraph (B) and the 

effectiveness of that incentive with respect to meeting 

the goal under subparagraph (A). 

(z) ENCOURAGING INNOVATION IN ENERGY EFFICIENCY.— 

(1) FEDERAL AGENCY ENERGY-RELATED PRIORITY.—In carrying 

out its duties under this section relating to SBIR and STTR solicitations by Federal departments and agencies, the Administrator shall— 

(A) ensure that such departments and agencies give high 

priority to small business concerns that participate in or 

conduct energy efficiency or renewable energy system research and development projects; and 

(B) include in the annual report to Congress under subsection (b)(7) a determination of whether the priority described in subparagraph (A) is being carried out. 

(2) CONSULTATION REQUIRED.—The Administrator shall consult with the heads of other Federal departments and agencies 

in determining whether priority has been given to small business concerns that participate in or conduct energy efficiency 

or renewable energy system research and development 

projects, as required by this subsection. 

(3) GUIDELINES.—The Administrator shall, as soon as is 

practicable after the date of enactment of this subsection, issue 

guidelines and directives to assist Federal agencies in meeting 

the requirements of this subsection. 

(4) DEFINITIONS.—In this subsection— 

(A) the term ‘‘biomass’’— 

(i) means any organic material that is available on 

a renewable or recurring basis, including— 

(I) agricultural crops; 

(II) trees grown for energy production; 

(III) wood waste and wood residues; 

(IV) plants (including aquatic plants and 

grasses); 

(V) residues; 

(VI) fibers; 

(VII) animal wastes and other waste materials; 

and 

(VIII) fats, oils, and greases (including recycled 

fats, oils, and greases); and 

(ii) does not include— 

(I) paper that is commonly recycled; or 

(II) unsegregated solid waste; 

(B) the term ‘‘energy efficiency project’’ means the installation or upgrading of equipment that results in a significant reduction in energy usage; and 

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(C) the term ‘‘renewable energy system’’ means a system 

of energy derived from— 

(i) a wind, solar, biomass (including biodiesel), or 

geothermal source; or 

(ii) hydrogen derived from biomass or water using 

an energy source described in clause (i). 

(aa) LIMITATION ON SIZE OF AWARDS.— 

(1) LIMITATION.—No Federal agency may issue an award 

under the SBIR program or the STTR program if the size of 

the award exceeds the award guidelines established under this 

section by more than 50 percent. 

(2) MAINTENANCE OF INFORMATION.—Participating agencies 

shall maintain information on awards exceeding the guidelines 

established under this section, including— 

(A) the amount of each award; 

(B) a justification for exceeding the guidelines for each 

award; 

(C) the identity and location of each award recipient; 

and 

(D) whether an award recipient has received any venture capital, hedge fund, or private equity firm investment 

and, if so, whether the recipient is majority-owned by multiple venture capital operating companies, hedge funds, or 

private equity firms. 

(3) REPORTS.—The Administrator shall include the information described in paragraph (2) in the annual report of the Administrator to Congress. 

(4) WAIVER FOR SPECIFIC TOPIC.—Upon the receipt of an application from a Federal agency, the Administrator may grant 

a waiver from the requirement under paragraph (1) with respect to a specific topic (but not for the agency as a whole) for 

a fiscal year if the Administrator determines, based on the information contained in the application from the agency, that— 

(A) the requirement under paragraph (1) will interfere 

with the ability of the agency to fulfill its research mission 

through the SBIR program or the STTR program; and 

(B) the agency will minimize, to the maximum extent 

possible, the number of awards that do not satisfy the requirement under paragraph (1) to preserve the nature and 

intent of the SBIR program and the STTR program. 

(5) RULE OF CONSTRUCTION.—Nothing in this subsection 

shall be construed to prevent a Federal agency from 

supplementing an award under the SBIR program or the STTR 

program using funds of the Federal agency that are not part 

of the SBIR program or the STTR program of the Federal 

agency. 

(bb) SUBSEQUENT PHASE II AWARDS.— 

(1) AGENCY FLEXIBILITY.—A small business concern that received a Phase I award from a Federal agency under this section shall be eligible to receive a subsequent Phase II award 

from another Federal agency, if the head of each relevant Federal agency or the relevant component of the Federal agency 

makes a written determination that the topics of the relevant 

awards are the same and both agencies report the awards to 

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the Administrator for inclusion in the public database under 

subsection (k). 

(2) SBIR AND STTR PROGRAM FLEXIBILITY.—A small business 

concern that received a Phase I award under this section under 

the SBIR program or the STTR program may receive a subsequent Phase II award in either the SBIR program or the STTR 

program and the participating agency or agencies shall report 

the awards to the Administrator for inclusion in the public 

database under subsection (k). 

(3) PREVENTING DUPLICATIVE AWARDS.—The head of a Federal agency shall verify that any activity to be performed with 

respect to a project with a Phase I or Phase II SBIR or STTR 

award has not been funded under the SBIR program or STTR 

program of another Federal agency. 

(cc) PHASE FLEXIBILITY.—During fiscal years 2012 through 2017, 

the National Institutes of Health, the Department of Defense, and 

the Department of Education may each provide to a small business 

concern an award under Phase II of the SBIR program with respect 

to a project, without regard to whether the small business concern 

was provided an award under Phase I of an SBIR program with respect to such project, if the head of the applicable agency determines that the small business concern has completed the determinations described in subsection (e)(4)(A) with respect to such 

project despite not having been provided a Phase I award. 

(dd) PARTICIPATION OF SMALL BUSINESS CONCERNS MAJORITYOWNED BY VENTURE CAPITAL OPERATING COMPANIES, HEDGE

FUNDS, OR PRIVATE EQUITY FIRMS IN THE SBIR PROGRAM.— 

(1) AUTHORITY.—Upon providing a written determination described in paragraph (2) to the Administrator, the Committee 

on Small Business and Entrepreneurship of the Senate, and 

the Committee on Small Business and the Committee on 

Science, Space, and Technology of the House of Representatives, not later than 30 days before the date on which any such 

award is made— 

(A) the Director of the National Institutes of Health, the 

Secretary of Energy, and the Director of the National 

Science Foundation may award not more than 25 percent 

of the funds allocated for the SBIR program of the applicable Federal agency to small business concerns that are 

owned in majority part by multiple venture capital operating companies, hedge funds, or private equity firms 

through competitive, merit-based procedures that are open 

to all eligible small business concerns; and 

(B) the head of a Federal agency other than a Federal 

agency described in subparagraph (A) that participates in 

the SBIR program may award not more than 15 percent 

of the funds allocated for the SBIR program of the Federal 

agency to small business concerns that are owned in majority part by multiple venture capital operating companies, hedge funds, or private equity firms through competitive, merit-based procedures that are open to all eligible 

small business concerns. 

(2) DETERMINATION.—A written determination described in 

this paragraph is a written determination by the head of a 

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Federal agency that explains how the use of the authority 

under paragraph (1) will— 

(A) induce additional venture capital, hedge fund, or private equity firm funding of small business innovations; 

(B) substantially contribute to the mission of the Federal 

agency; 

(C) demonstrate a need for public research; and 

(D) otherwise fulfill the capital needs of small business 

concerns for additional financing for SBIR projects. 

(3) REGISTRATION.—A small business concern that is majority-owned by multiple venture capital operating companies, 

hedge funds, or private equity firms and qualified for participation in the program authorized under paragraph (1) shall— 

(A) register with the Administrator on the date that the 

small business concern submits an application for an 

award under the SBIR program; and 

(B) indicate in any SBIR proposal that the small business concern is registered under subparagraph (A) as majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms. 

(4) COMPLIANCE.— (A) IN GENERAL.—The head of a Federal agency that 

makes an award under this subsection during a fiscal year 

shall collect and submit to the Administrator data relating 

to the number and dollar amount of Phase I awards, Phase 

II awards, and any other category of awards by the Federal agency under the SBIR program during that fiscal 

year. 

(B) ANNUAL REPORTING.—The Administrator shall include as part of each annual report by the Administration 

under subsection (b)(7) any data submitted under subparagraph (A) and a discussion of the compliance of each Federal agency that makes an award under this subsection 

during the fiscal year with the maximum percentages 

under paragraph (1). 

(5) ENFORCEMENT.—If a Federal agency awards more than 

the percent of the funds allocated for the SBIR program of the 

Federal agency authorized under paragraph (1) for a purpose 

described in paragraph (1), the head of the Federal agency 

shall transfer an amount equal to the amount awarded in excess of the amount authorized under paragraph (1) to the 

funds for general SBIR programs from the non-SBIR and nonSTTR research and development funds of the Federal agency 

not later than 180 days after the date on which the Federal 

agency made the award that caused the total awarded under 

paragraph (1) to be more than the amount authorized under 

paragraph (1) for a purpose described in paragraph (1). 

(6) FINAL DECISIONS ON APPLICATIONS UNDER THE SBIR PROGRAM.— 

(A) DEFINITION.—In this paragraph, the term ‘‘covered 

small business concern’’ means a small business concern 

that— 

(i) was not majority-owned by multiple venture capital operating companies, hedge funds, or private equity firms on the date on which the small business 

289 

concern submitted an application in response to a solicitation under the SBIR programs; and 

(ii) on the date of the award under the SBIR program is majority-owned by multiple venture capital 

operating companies, hedge funds, or private equity 

firms. 

(B) IN GENERAL.—If a Federal agency does not make an 

award under a solicitation under the SBIR program before 

the date that is 9 months after the date on which the period for submitting applications under the solicitation 

ends— 

(i) a covered small business concern is eligible to receive the award, without regard to whether the covered small business concern meets the requirements 

for receiving an award under the SBIR program for a 

small business concern that is majority-owned by multiple venture capital operating companies, hedge 

funds, or private equity firms, if the covered small 

business concern meets all other requirements for 

such an award; and 

(ii) the head of the Federal agency shall transfer an 

amount equal to any amount awarded to a covered 

small business concern under the solicitation to the 

funds for general SBIR programs from the non-SBIR 

and non-STTR research and development funds of the 

Federal agency, not later than 90 days after the date 

on which the Federal agency makes the award. 

(7) EVALUATION CRITERIA.—A Federal agency may not use investment of venture capital or investment from hedge funds or 

private equity firms as a criterion for the award of contracts 

under the SBIR program or STTR program. 

(ee) COLLABORATING WITH FEDERAL LABORATORIES AND RESEARCH AND DEVELOPMENT CENTERS.— (1) AUTHORIZATION.—Subject to the limitations under this 

section, the head of each participating Federal agency may 

make SBIR and STTR awards to any eligible small business 

concern that— 

(A) intends to enter into an agreement with a Federal 

laboratory or federally funded research and development 

center for portions of the activities to be performed under 

that award; or 

(B) has entered into a cooperative research and development agreement (as defined in section 12(d) of the Stevenson-Wydler Technology Innovation Act of 1980 (15 U.S.C. 

3710a(d))) with a Federal laboratory. 

(2) PROHIBITION.—No Federal agency shall— 

(A) condition an SBIR or STTR award upon entering 

into agreement with any Federal laboratory or any federally funded laboratory or research and development center 

for any portion of the activities to be performed under that 

award; 

(B) approve an agreement between a small business concern receiving an SBIR or STTR award and a Federal laboratory or federally funded laboratory or research and development center, if the small business concern performs 

290 

a lesser portion of the activities to be performed under 

that award than required by this section and by the SBIR 

Policy Directive and the STTR Policy Directive of the Administrator; or 

(C) approve an agreement that violates any provision, 

including any data rights protections provision, of this section or the SBIR and the STTR Policy Directives. 

(3) IMPLEMENTATION.—Not later than 180 days after the date 

of enactment of this subsection, the Administrator shall modify 

the SBIR Policy Directive and the STTR Policy Directive 

issued under this section to ensure that small business concerns— 

(A) have the flexibility to use the resources of the Federal laboratories or federally funded research and development centers; and 

(B) are not mandated to enter into agreement with any 

Federal laboratory or any federally funded laboratory or 

research and development center as a condition of an 

award. 

(4) ADVANCE PAYMENT.—If a small business concern receiving an award under this section enters into an agreement with 

a Federal laboratory or federally funded research and development center for portions of the activities to be performed under 

that award, the Federal laboratory or federally funded research and development center may not require advance payment from the small business concern in an amount greater 

than the amount necessary to pay for 30 days of such activities. 

(ff) ADDITIONAL SBIR AND STTR AWARDS.— 

(1) EXPRESS AUTHORITY FOR AWARDING A SEQUENTIAL PHASE

II AWARD.—A small business concern that receives a Phase II 

SBIR award or a Phase II STTR award for a project remains 

eligible to receive 1 additional Phase II SBIR award or Phase 

II STTR award for continued work on that project. 

(2) PREVENTING DUPLICATIVE AWARDS.—The head of a Federal agency shall verify that any activity to be performed with 

respect to a project with a Phase I or Phase II SBIR or STTR 

award has not been funded under the SBIR program or STTR 

program of another Federal agency. 

(gg) PILOT PROGRAM.— 

(1) AUTHORIZATION.—The head of each covered Federal agency may allocate not more than 10 percent of the funds allocated to the SBIR program and the STTR program of the covered Federal agency— 

(A) for awards for technology development, testing, evaluation, and commercialization assistance for SBIR and 

STTR Phase II technologies; or 

(B) to support the progress of research, research and development, and commercialization conducted under the 

SBIR or STTR programs to Phase III. 

(2) APPLICATION BY FEDERAL AGENCY.— (A) IN GENERAL.—A covered Federal agency may not establish a pilot program unless the covered Federal agency 

makes a written application to the Administrator, not later 

than 90 days before the first day of the fiscal year in which 

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the pilot program is to be established, that describes a 

compelling reason that additional investment in SBIR or 

STTR technologies is necessary, including unusually high 

regulatory, systems integration, or other costs relating to 

development or manufacturing of identifiable, highly promising small business technologies or a class of such technologies expected to substantially advance the mission of 

the agency. 

(B) DETERMINATION.—The Administrator shall— 

(i) make a determination regarding an application 

submitted under subparagraph (A) not later than 30 

days before the first day of the fiscal year for which 

the application is submitted; 

(ii) publish the determination in the Federal Register; and 

(iii) make a copy of the determination and any related materials available to the Committee on Small 

Business and Entrepreneurship of the Senate and the 

Committee on Small Business and the Committee on 

Science, Space, and Technology of the House of Representatives. 

(3) MAXIMUM AMOUNT OF AWARD.—The head of a covered 

Federal agency may not make an award under a pilot program 

in excess of 3 times the dollar amounts generally established 

for Phase II awards under subsection (j)(2)(D) or (p)(2)(B)(ix). 

(4) REGISTRATION.—Any applicant that receives an award 

under a pilot program shall register with the Administrator in 

a registry that is available to the public. 

(5) AWARD CRITERIA OR CONSIDERATION.—When making an 

award under this section, the head of a covered Federal agency 

shall give consideration to whether the technology to be supported by the award is likely to be manufactured in the United 

States. 

(6) REPORT.—The head of each covered Federal agency shall 

include in the annual report of the covered Federal agency to 

the Administrator an analysis of the various activities considered for inclusion in the pilot program of the covered Federal 

agency and a statement of the reasons why each activity considered was included or not included, as the case may be. 

(7) TERMINATION.—The authority to establish a pilot program under this section expires at the end of fiscal year 2017. 

(8) DEFINITIONS.—In this subsection— 

(A) the term ‘‘covered Federal agency’’— 

(i) means a Federal agency participating in the 

SBIR program or the STTR program; and 

(ii) does not include the Department of Defense; and 

(B) the term ‘‘pilot program’’ means each program established under paragraph (1). 

(hh) TIMING OF RELEASE OF FUNDING.—Federal agencies participating in the SBIR program or STTR program shall, to the extent 

possible, attempt to shorten the amount of time between the provision of notice of an award under the SBIR program or STTR program and the subsequent release of funding with respect to the 

award. 

292 

(ii) REPORTING ON TIMING.—Federal agencies participating in the 

SBIR program or STTR program shall provide to the Administrator, for the annual report on the SBIR and STTR program under 

subsection (b)(7), the average amount of time the agency takes to 

make a final decision on proposals submitted under such programs, 

the average amount of time the agency takes to release funding 

with respect to an award under such programs, and the goals established to reduce such amounts. 

(jj) PHASE 0 PROOF OF CONCEPT PARTNERSHIP PILOT PROGRAM.— 

(1) IN GENERAL.—The Director of the National Institutes of 

Health may use $5,000,000 of the funds allocated under subsection (n)(1) for a Proof of Concept Partnership pilot program 

to accelerate the creation of small businesses and the commercialization of research innovations from qualifying institutions. 

To implement this program, the Director shall award, through 

a competitive, merit-based process, grants to qualifying institutions. These grants shall only be used to administer Proof of 

Concept Partnership awards in conformity with this subsection. 

(2) DEFINITIONS.—In this subsection— 

(A) the term ‘‘Director’’ means the Director of the National Institutes of Health; 

(B) the term ‘‘pilot program’’ refers to the Proof of Concept Partnership pilot program; and 

(C) the terms ‘‘qualifying institution’’ and ‘‘institution’’ 

mean a university or other research institution that participates in the National Institutes of Health’s STTR program. 

(3) PROOF OF CONCEPT PARTNERSHIPS.— 

(A) IN GENERAL.—A Proof of Concept Partnership shall 

be set up by a qualifying institution to award grants to individual researchers. These grants should provide researchers with the initial investment and the resources to 

support the proof of concept work and commercialization 

mentoring needed to translate promising research projects 

and technologies into a viable company. This work may include technical validations, market research, clarifying intellectual property rights position and strategy, and investigating commercial or business opportunities. 

(B) AWARD GUIDELINES.—The administrator of a Proof of 

Concept Partnership program shall award grants in accordance with the following guidelines: 

(i) The Proof of Concept Partnership shall use a 

market-focused project management oversight process, 

including— 

(I) a rigorous, diverse review board comprised of 

local experts in translational and proof of concept 

research, including industry, start-up, venture 

capital, technical, financial, and business experts 

and university technology transfer officials; 

(II) technology validation milestones focused on 

market feasibility; 

(III) simple reporting effective at redirecting 

projects; and 

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(IV) the willingness to reallocate funding from 

failing projects to those with more potential. 

(ii) Not more than $100,000 shall be awarded towards an individual proposal. 

(C) EDUCATIONAL RESOURCES AND GUIDANCE.—The administrator of a Proof of Concept Partnership program 

shall make educational resources and guidance available 

to researchers attempting to commercialize their innovations. 

(4) AWARDS.— 

(A) SIZE OF AWARD.—The Director may make awards to 

a qualifying institution for up to $1,000,000 per year for 

up to 3 years. 

(B) AWARD CRITERIA.—In determining which qualifying 

institutions receive pilot program grants, the Director 

shall consider, in addition to any other criteria the Director determines necessary, the extent to which qualifying 

institutions— 

(i) have an established and proven technology transfer or commercialization office and have a plan for engaging that office in the program’s implementation; 

(ii) have demonstrated a commitment to local and 

regional economic development; 

(iii) are located in diverse geographies and are of diverse sizes; 

(iv) can assemble project management boards comprised of industry, start-up, venture capital, technical, 

financial, and business experts; 

(v) have an intellectual property rights strategy or 

office; and 

(vi) demonstrate a plan for sustainability beyond the 

duration of the funding award. 

(5) LIMITATIONS.—The funds for the pilot program shall not 

be used— 

(A) for basic research, but to evaluate the commercial 

potential of existing discoveries, including— 

(i) proof of concept research or prototype development; and 

(ii) activities that contribute to determining a 

project’s commercialization path, to include technical 

validations, market research, clarifying intellectual 

property rights, and investigating commercial and 

business opportunities; or 

(B) to fund the acquisition of research equipment or supplies unrelated to commercialization activities. 

(6) EVALUATIVE REPORT.—The Director shall submit to the 

Committee on Science, Space, and Technology and the Committee on Small Business of the House of Representatives and 

the Committee on Small Business and Entrepreneurship of the 

Senate an evaluative report regarding the activities of the pilot 

program. The report shall include— 

(A) a detailed description of the institutional and proposal selection process; 

(B) an accounting of the funds used in the pilot program; 

294 

(C) a detailed description of the pilot program, including 

incentives and activities undertaken by review board experts; 

(D) a detailed compilation of results achieved by the 

pilot program, including the number of small business concerns included and the number of business packages developed, and the number of projects that progressed into subsequent STTR phases; and 

(E) an analysis of the program’s effectiveness with supporting data. 

(7) SUNSET.—The pilot program under this subsection shall 

terminate at the end of fiscal year ø2017¿ 2019. (kk) PHASE III REPORTING.—The annual SBIR or STTR report to 

Congress by the Administration under subsection (b)(7) shall include, for each Phase III award— 

(1) the name of the agency or component of the agency or the 

non-Federal source of capital making the Phase III award; 

(2) the name of the small business concern or individual receiving the Phase III award; and 

(3) the dollar amount of the Phase III award. 

(ll) CONSENT TO RELEASE CONTACT INFORMATION TO ORGANIZA- TIONS.— 

(1) ENABLING CONCERN TO GIVE CONSENT.—Each Federal 

agency required by this section to conduct an SBIR program or 

an STTR program shall enable a small business concern that 

is an SBIR applicant or an STTR applicant to indicate to the 

Federal agency whether the Federal agency has the consent of 

the concern to— 

(A) identify the concern to appropriate local and Statelevel economic development organizations as an SBIR applicant or an STTR applicant; and 

(B) release the contact information of the concern to 

such organizations. 

(2) RULES.—The Administrator shall establish rules to implement this subsection. The rules shall include a requirement 

that a Federal agency include in the SBIR and STTR application a provision through which the applicant can indicate consent for purposes of paragraph (1). 

(mm) ASSISTANCE FOR ADMINISTRATIVE, OVERSIGHT, AND CON- TRACT PROCESSING COSTS.— 

(1) IN GENERAL.—Subject to paragraph (3) and until September 30, 2017, the Administrator shall allow each Federal 

agency required to conduct an SBIR program to use not more 

than 3 percent of the funds allocated to the SBIR program of 

the Federal agency for— 

(A) the administration of the SBIR program or the STTR 

program of the Federal agency; 

(B) the provision of outreach and technical assistance relating to the SBIR program or STTR program of the Federal agency, including technical assistance site visits, personnel interviews, and national conferences; 

(C) the implementation of commercialization and outreach initiatives that were not in effect on the date of enactment of this subsection; 

(D) carrying out the program under subsection (y); 

295 

(E) activities relating to oversight and congressional reporting, including waste, fraud, and abuse prevention activities; 

(F) targeted reviews of recipients of awards under the 

SBIR program or STTR program of the Federal agency 

that the head of the Federal agency determines are at high 

risk for fraud, waste, or abuse to ensure compliance with 

requirements of the SBIR program or STTR program, respectively; 

(G) the implementation of oversight and quality control 

measures, including verification of reports and invoices 

and cost reviews; 

(H) carrying out subsection (dd); 

(I) contract processing costs relating to the SBIR program or STTR program of the Federal agency; and 

(J) funding for additional personnel and assistance with 

application reviews. 

(2) OUTREACH AND TECHNICAL ASSISTANCE.— (A) IN GENERAL.—Except as provided in subparagraph 

(B), a Federal agency participating in the program under 

this subsection shall use a portion of the funds authorized 

for uses under paragraph (1) to carry out the policy directive required under subsection (j)(2)(F) and to increase the 

participation of States with respect to which a low level of 

SBIR awards have historically been awarded. 

(B) WAIVER.—A Federal agency may request the Administrator to waive the requirement contained in subparagraph (A). Such request shall include an explanation of 

why the waiver is necessary. The Administrator may grant 

the waiver based on a determination that the agency has 

demonstrated a sufficient need for the waiver, that the 

outreach objectives of the agency are being met, and that 

there is increased participation by States with respect to 

which a low level of SBIR awards have historically been 

awarded. 

(3) PERFORMANCE CRITERIA.—A Federal agency may not use 

funds as authorized under paragraph (1) until after the effective date of performance criteria, which the Administrator 

shall establish, to measure any benefits of using funds as authorized under paragraph (1) and to assess continuation of the 

authority under paragraph (1). 

(4) RULES.—Not later than 180 days after the date of enactment of this subsection, the Administrator shall issue rules to 

carry out this subsection. 

(5) COORDINATION WITH IG.—Each Federal agency shall coordinate the activities funded under subparagraph (E), (F), or 

(G) of paragraph (1) with their respective Inspectors General, 

when appropriate, and each Federal agency that allocates more 

than $50,000,000 to the SBIR program of the Federal agency 

for a fiscal year may share such funding with its Inspector 

General when the Inspector General performs such activities. 

(6) REPORTING.—The Administrator shall collect data and 

provide to the Committee on Small Business and Entrepreneurship of the Senate and the Committee on Small Business, 

the Committee on Science, Space, and Technology, and the 

296 

Committee on Appropriations of the House of Representatives 

a report on the use of funds under this subsection, including 

funds used to achieve the objectives of paragraph (2)(A) and 

any use of the waiver authority under paragraph (2)(B). 

(nn) ANNUAL REPORT ON SBIR AND STTR PROGRAM GOALS.— 

(1) DEVELOPMENT OF METRICS.—The head of each Federal 

agency required to participate in the SBIR program or the 

STTR program shall develop metrics to evaluate the effectiveness and the benefit to the people of the United States of the 

SBIR program and the STTR program of the Federal agency 

that— 

(A) are science-based and statistically driven; 

(B) reflect the mission of the Federal agency; and 

(C) include factors relating to the economic impact of the 

programs. 

(2) EVALUATION.—The head of each Federal agency described 

in paragraph (1) shall conduct an annual evaluation using the 

metrics developed under paragraph (1) of— 

(A) the SBIR program and the STTR program of the 

Federal agency; and 

(B) the benefits to the people of the United States of the 

SBIR program and the STTR program of the Federal agency. 

(3) REPORT.— 

(A) IN GENERAL.—The head of each Federal agency described in paragraph (1) shall submit to the appropriate 

committees of Congress and the Administrator an annual 

report describing in detail the results of an evaluation conducted under paragraph (2). 

(B) PUBLIC AVAILABILITY OF REPORT.—The head of each 

Federal agency described in paragraph (1) shall make each 

report submitted under subparagraph (A) available to the 

public online. 

(C) DEFINITION.—In this paragraph, the term ‘‘appropriate committees of Congress’’ means— 

(i) the Committee on Small Business and Entrepreneurship of the Senate; and 

(ii) the Committee on Small Business and the Committee on Science, Space, and Technology of the House 

of Representatives. 

(oo) COMPETITIVE SELECTION PROCEDURES FOR SBIR AND STTR 

PROGRAMS.—All funds awarded, appropriated, or otherwise made 

available in accordance with subsection (f) or (n) must be awarded 

pursuant to competitive and merit-based selection procedures. 

(pp) LIMITATION ON PILOT PROGRAMS.— 

(1) EXISTING PILOT PROGRAMS.—The Administrator may only 

carry out a covered pilot program that is in operation on the 

date of enactment of this subsection during the 3-year period 

beginning on such date of enactment. 

(2) NEW PILOT PROGRAMS.—The Administrator may only 

carry out a covered pilot program established after the date of 

enactment of this subsection— 

(A) during the 3-year period beginning on the date on 

which such program is established; and 

297 

(B) if such program does not continue and is not based 

on, in any manner, a previously established covered pilot 

program. 

(3) COVERED PILOT PROGRAM DEFINED.—In this subsection, 

the term ‘‘covered pilot program’’ means any initiative, project, 

innovation, or other activity— 

(A) established by the Administrator; 

(B) relating to an SBIR or STTR program; and 

(C) not specifically authorized by law. 

(qq) MINIMUM STANDARDS FOR PARTICIPATION.— 

(1) PROGRESS TO PHASE II SUCCESS.— 

(A) ESTABLISHMENT OF SYSTEM AND MINIMUM COMMERCIALIZATION RATE.—Not later than 1 year after the date of 

enactment of this subsection, the head of each Federal 

agency participating in the SBIR or STTR program shall— 

(i) establish a system to measure, where appropriate, the success of small business concerns with respect to the receipt of Phase II SBIR or STTR awards 

for projects that have received Phase I SBIR or STTR 

awards; 

(ii) establish a minimum performance standard for 

small business concerns with respect to the receipt of 

Phase II SBIR or STTR awards for projects that have 

received Phase I SBIR or STTR awards; and 

(iii) begin evaluating, each fiscal year, whether each 

small business concern that received a Phase I SBIR 

or STTR award from the agency meets the minimum 

performance standard established under clause (ii). 

(B) CONSEQUENCE OF FAILURE TO MEET MINIMUM COMMERCIALIZATION RATE.—If the head of a Federal agency determines that a small business concern that received a 

Phase I SBIR or STTR award from the agency is not meeting the minimum performance standard established under 

subparagraph (A)(ii), such concern may not participate in 

Phase I (or Phase II if under the authority of subsection 

(cc)) of the SBIR or STTR program of that agency during 

the 1-year period beginning on the date on which such determination is made. 

(2) PROGRESS TO PHASE III SUCCESS.— 

(A) ESTABLISHMENT OF SYSTEM AND MINIMUM COMMERCIALIZATION RATE.—Not later than 2 years after the date 

of enactment of this subsection, the head of each Federal 

agency participating in the SBIR or STTR program shall— 

(i) establish a system to measure, where appropriate, the success of small business concerns with respect to the receipt of Phase III SBIR or STTR awards 

for projects that have received Phase I SBIR or STTR 

awards; 

(ii) establish a minimum performance standard for 

small business concerns with respect to the receipt of 

Phase III SBIR or STTR awards for projects that have 

received Phase I SBIR or STTR awards; and 

(iii) begin evaluating, each fiscal year, whether each 

small business concern that received a Phase I SBIR 

298 

or STTR award from the agency meets the minimum 

performance standard established under clause (ii). 

(B) CONSEQUENCE OF FAILURE TO MEET MINIMUM COM- MERCIALIZATION RATE.—If the head of a Federal agency determines that a small business concern that received a 

Phase I SBIR or STTR award from the agency is not meeting the minimum performance standard established under 

subparagraph (A)(ii), such concern may not participate in 

Phase I (or Phase II if under the authority of subsection 

(cc)) of the SBIR or STTR program of that agency during 

the 1-year period beginning on the date on which such determination is made. 

(3) ADMINISTRATION OVERSIGHT.— 

(A) APPROVAL AND PUBLICATION OF SYSTEMS AND MINIMUM PERFORMANCE STANDARDS.—Each system and minimum performance standard established under paragraph 

(1) or paragraph (2) shall be submitted by the head of the 

applicable Federal agency to the Administrator and shall 

be subject to the approval of the Administrator. In making 

a determination with respect to approval, the Administrator shall ensure that the minimum performance standard exceeds a de minimis level. The Administrator shall 

publish on the Internet Web site of the Administration the 

systems and minimum performance standards approved. 

(B) SUBMISSION OF EVALUATION RESULTS BY AGENCY.— The head of each covered Federal agency shall submit to 

the Administrator the results of each evaluation conducted 

under paragraph (1) or paragraph (2). 

(4) REQUIREMENT OF NOTICE AND COMMENT.—Each system 

and minimum performance standard established under paragraph (1) or paragraph (2) and each approval provided by the 

Administrator under paragraph (3)(A), at least 60 days before 

becoming effective, shall be preceded by the provision of notice 

of and an opportunity for public comment on such system, 

standard, or approval. 

(rr) PUBLICATION OF CERTAIN INFORMATION.—In order to increase 

the number of small businesses receiving awards under the SBIR 

or STTR programs of participating agencies, and to simplify the application process for such awards, the Administrator shall establish 

and maintain a public Internet Web site on which the Administrator shall publish such information relating to notice of and application for awards under the SBIR program and STTR program 

of each participating Federal agency as the Administrator determines appropriate. 

(ss) REPORT ON ENHANCEMENT OF MANUFACTURING ACTIVITIES.— 

Not later than October 1, 2013, and annually thereafter, the head 

of each Federal agency that makes more than $50,000,000 in 

awards under the SBIR and STTR programs of the agency combined shall submit to the Administrator, for inclusion in the annual 

report required under subsection (b)(7), information that includes— 

(1) a description of efforts undertaken by the head of the 

Federal agency to enhance United States manufacturing activities; 

(2) a comprehensive description of the actions undertaken 

each year by the head of the Federal agency in carrying out 

299 

the SBIR or STTR program of the agency in support of Executive Order 13329 (69 Fed. Reg. 9181; relating to encouraging 

innovation in manufacturing); 

(3) an assessment of the effectiveness of the actions described in paragraph (2) at enhancing the research and development of United States manufacturing technologies and processes; 

(4) a description of efforts by vendors selected to provide discretionary technical assistance under subsection (q)(1) to help 

SBIR and STTR concerns manufacture in the United States; 

and 

(5) recommendations that the program managers of the 

SBIR or STTR program of the agency consider appropriate for 

additional actions to increase the effectiveness of enhancing 

manufacturing activities. 

CHANGES IN THE APPLICATION OF EXISTING LAW

Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of the 

House of Representatives, the following statements are submitted 

describing the effect of provisions in the accompanying bill that directly or indirectly change the application of existing law. 

TITLE I—DEPARTMENT OF LABOR 

Language is included under ‘‘Employment and Training Administration’’ providing that allotments to outlying areas are not required to be made through the Pacific Region Educational Laboratory as provided by section 127 of the Workforce Innovation and 

Opportunity Act (WIOA). 

Language is included under ‘‘Employment and Training Administration’’ providing additional waiver authority to the Secretary for 

Wagner-Peyser Act requirements pursuant to requests from States. 

Language is included under ‘‘Employment and Training Administration’’ providing amounts made available for dislocated workers 

may be used for State activities or across multiple local areas 

where workers remain dislocated. 

Language is included under ‘‘Employment and Training Administration’’ providing that technical assistance and demonstration 

projects may provide assistance to new entrants in the workforce 

and incumbent workers. 

Language is included under ‘‘Employment and Training Administration’’ providing that the Department of Labor may take no action to limit the number or proportion of eligible applicants receiving related assistance services in the migrant and seasonal farmworkers programs. 

Language is included under ‘‘Job Corps’’ providing that amounts 

made available for construction and rehabilitation may include acquisition and maintenance of major items of equipment. 

Language is included under ‘‘Job Corps’’ providing authority to 

transfer up to 15 percent of construction and rehabilitation funds 

for operational needs with prior written notice to the Committee 

and that any such transfers are available for obligation through 

June 30, 2019. 

300 

Language is included under ‘‘Job Corps’’ providing that no funds 

from any other appropriation may be used for meal services at Job 

Corps. 

Language is included under ‘‘Job Corps’’ providing that the Secretary may prioritize enrollment of applicants who are at least 20 

years of age. 

Language in included under ‘‘Federal Unemployment Benefits 

and Allowances’’ providing that funding may be available beyond 

the current year in accordance with section 245(c) of the Trade Act 

of 1974. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for reemployment services and referrals to training for claimants of unemployment insurance for ex-service members, for improper payment reviews, and 

for unemployment claimants most likely to exhaust their benefits. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing additional funds for reemployment services, eligibility assessments, and unemployment 

insurance improper payment reviews pursuant to the Balanced 

Budget and Emergency Deficit Control Act of 1985. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that States may use up 

to 100 percent of allotted under Section 6 to carry out activities described in Section 7(a) of the Wagner-Peyser Act Act. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing for additional administrative funds from the Unemployment Trust Fund if unemployment 

claims exceed certain levels. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing authority for States to 

use funds to assist other States to carry out authorized activities 

in cases of a major disaster declared by the President under the 

Robert T. Stafford Disaster Relief and Emergency Assistance Act. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments on behalf of States for the use of the 

National Directory of New Hires. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments from funds appropriated for States’ 

grants on behalf of States to the entity operating the State Information Data Exchange System. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may make payments from funds appropriated for States’ 

grants on behalf of States to the entity operating the Unemployment Insurance Integrity Center of Excellence. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that appropriations for 

establishing a national one-stop career system may be obligated in 

contracts, grants or agreements with States or non-State entities. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that States awarded 

grants to support national activities of the Federal-State unemployment insurance system may award subgrants to other States. 

301 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that funds available for 

integrated Unemployment Insurance and Employment Service automation may be used by States notwithstanding cost allocation 

principles prescribed under the Office of Management and Budget 

‘‘Uniform Administrative Requirements, Cost Principles, and Audit 

Requirements for Federal Awards.’’ 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ providing that the Department of 

Labor may reallot funds among States participating in a consortium. 

Language is included under ‘‘State Unemployment Insurance and 

Employment Service Operations’’ allowing the Secretary to collect 

fees for the costs associated with additional data collection, analyses, and reporting services related to the National Agricultural 

Workers Survey. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing for additional administrative funds if participants with plans terminated during the period exceed a certain 

level. 

Language is included under ‘‘Pension Benefit Guarantee Corporation’’ providing that obligations may exceed amounts provided 

for unforeseen and extraordinary pretermination expenses or unforeseen and extraordinary multiemployer program expenses if approved by the Office of Management and Budget. 

Language is included under ‘‘Special Benefits’’ providing that the 

Department of Labor may use authority to reimburse an employer 

who is not the employer at the time of injury for portions of the 

salary of a re-employed, disabled beneficiary. 

Language is included under ‘‘Special Benefits’’ providing that unobligated balances of reimbursements shall remain available until 

expended for the payment of compensation, benefits, and expenses. 

Language is included under ‘‘Special Benefits’’ providing that 

funds shall be transferred to the appropriation from entities required under 5 U.S.C. 8147(c) as determined by the Department of 

Labor. 

Language is included under ‘‘Special Benefits’’ providing that 

funds transferred from entities under 5 U.S.C 8147(c), specified 

amounts may be used by the Department of Labor for maintenance 

and data and communications systems, workload processing, roll 

disability management and medical review, and program integrity 

with remaining amounts paid into the Treasury. 

Language is included under ‘‘Special Benefits’’ providing that the 

Secretary may prescribe regulations requiring identification for the 

filing of benefit claims. 

Language is included under ‘‘Administrative Expenses, Energy 

Employees Occupational Illness Compensation Fund’’ providing 

that the Secretary may prescribe regulations for requiring identification for the filing of benefit claims. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that up to a certain amount of fees collected from the training institute may be retained and used for related training and education. 

Language is included under ‘‘Occupational Safety and Health Administration’’ providing that fees collected from Nationally RecogVerDate Sep 11 2014 12:17 Jul 24, 2018 Jkt 030839 PO 00000 Frm 00301 Fmt 6659 Sfmt 6602 E:\HR\OC\HR862.XXX HR862
302 

nized Testing Laboratories may be used to administer laboratory 

recognition programs that insure safety of equipment used in the 

workplace. 

Language is included under ‘‘Occupational Safety and Health Administration’’ that prohibits enforcement on farming operations of 

10 or fewer employees or of an employer with 10 or fewer employees that is below the national average in specific injury categories 

except under specific exclusions. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that funds made available for State assistance 

grants may be used for the purchase and maintenance of equipment required by the Lowering Miners’ Exposure to Respirable 

Coal Mine Dust rule. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected by the 

National Mine Health and Safety Academy and made available for 

mine safety and health education and training. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that a specific amount may be collected from the 

approval and certification of equipment and materials and made 

available for other such activities. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may accept lands, 

buildings, equipment, and other contributions from public and private sources for cooperative projects. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may promote 

health and safety education and training through cooperative 

agreements with States, industry and safety associations. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may recognize the 

Joseph A. Holmes Safety Association as the principal safety association and may provide funds or personnel as officers in local 

chapters or the national organization. 

Language is included under ‘‘Mine Safety and Health Administration’’ providing that the Department of Labor may use appropriated funds to provide for costs associated with mine rescue and 

survival operations in the event of a major disaster. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that the Bureau of International 

Labor Affairs may administer international labor activities through 

grants, subgrants or other arrangements. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available for program 

evaluation may be used to administer grants for evaluation purposes subject to certain conditions. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that funds available to the Women’s 

Bureau may be used for grants to service and promote the interests 

of women in the workplace. 

Language is included under ‘‘Departmental Management—Salaries and Expenses’’ providing that certain amounts made available 

to the Women’s Bureau shall be used for grants authorized by the 

Women in Apprenticeship and Nontraditional Occupations Act. 

303 

Language is included under ‘‘Veterans Employment and Training’’ providing that up to three percent of States’ grants may be 

used for federal expenditures for data systems and contract support. 

Language is included under ‘‘Veterans Employment and Training’’ providing that funds may be used for support specialists providing intensive services to wounded service members. 

Language is included under ‘‘Veterans Employment and Training’’ providing for a pilot project to train and place transitioning 

service members in apprenticeships. 

Language is included under ‘‘Veterans Employment and Training’’ providing that Department of Labor may reallocate up to three 

percent of funds provided among appropriated accounts. 

Language is included under ‘‘Veterans Employment and Training’’ providing that the Department may award grants under section 2023 of Title 38, United States Code. 

Language is included under ‘‘Veterans Employment and Training’’ providing that services may be provided to certain homeless or 

recently incarcerated veterans under section 2021 of Title 38, 

United States Code. 

Language is included under ‘‘Veterans Employment and Training’’ providing that funds made available to assist homeless veterans may be used for data systems and contract support track 

participant and performance information. 

Language is included under ‘‘Veterans Employment and Training’’ providing that the fees assessed pursuant to the HIRE Vets 

Medallion Award Fund shall be available to the Secretary for expenses of the HIRE Vets Medallion Award Program and that the 

start date prescribed in the Act shall not apply. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of Job Corps funds to pay the salaries and bonuses at a rate 

in excess of Executive Level II. 

Language is included under ‘‘General Provisions’’ authorizing the 

transfer of up to one percent of discretionary funds between programs, projects, or activities as long as the transfer does not increase any program, project, or activity by more than three percent 

and no new program, project, or activity is created by such transfer. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use funds for procurement of goods or services rendered by forced 

or indentured child labor. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for grants under section 414(c) of the 

American Competitiveness and Workforce Improvement Act of 

1998, for purposes other than competitive grants for training individuals over the age of 16 who are not currently enrolled in school 

in the occupations and industries for which employers are using H– 

1B visa to hire foreign workers. 

Language is included under ‘‘General Provisions’’ prohibiting the 

use of any funds appropriated for Employment and Training Administration programs to be used to pay the salaries and bonuses 

at a rate in excess of Executive Level II except under specific exclusions. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from the Employment 

304 

and Training Administration to Program Administration when it is 

determined that services will be more efficiently performed and 

that the Department may transfer certain amounts to Program Administration to conduct program integrity activities. 

Language is included under ‘‘General Provisions’’ providing that 

the Department of Labor may transfer funds from specified accounts to the ‘‘Office of the Chief Evaluation Officer’’ for program 

evaluations. 

Language is included under ‘‘General Provisions’’ regarding the 

application of certain Fair Labor Standards Act requirements pertaining to the evaluation of claims following a major disaster. 

Language is included under ‘‘General Provisions’’ rescinding advance appropriations for the Dislocated Workers National Reserve. 

Language is included under ‘‘General Provisions’’ providing flexibility of crossing for H-2B nonimmigrant workers in the seafood industry. 

Language is included under ‘‘General Provisions’’ providing certain authorities related to the Secretary’s security detail. 

Language is included under ‘‘General Provisions’’ providing certain authorities for the Working Capital Fund. 

TITLE II—DEPARTMENT OF HEALTH AND HUMAN 

SERVICES 

Language is included under ‘‘Health Resources and Services Administration—Health Workforce’’ overriding the proportional funding requirements in the Public Health Service Act for sections 751 

and 762. 

Language is included under ‘‘Health Resources and Services Administration—Health Workforce’’ providing that fees collected for 

the disclosure of information under the information reporting requirement program authorized by section 1921 of the Social Security Act shall be sufficient to recover the full costs of the operation 

program and shall remain available until expended to carry out 

that Act. 

Language is included under ‘‘Health Resources and Services Administration—Health Workforce’’ providing funding under the National Health Service Corps Loan Repayment Program for substance use disorder counselors and placement in Indian Health 

Service facilities. 

Language is included under ‘‘Center for Disease Control and Prevention—Public Health Preparedness and Response’’ permitting 

CDC to operate and maintain an aircraft. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing the use of funds to 

support acquisition, renovation, or replacement, of the National Institute Occupational Safety and Health’s underground and surface 

coal mining research capacity. 

Language is included under ‘‘Center for Disease Control and Prevention—Buildings and Facilities’’ providing funds from former employees with existing Individual Learning Accounts unobligated to 

be available to support acquisition, renovation, or replacement, of 

the National Institute for Occupational Safety and Health’s underground and surface coal mining research capacity. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ requiring states 

305 

to spend 10 percent of the Mental Health Block Grant for programs 

for individuals with early serious mental illness. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Mental Health’’ exempting the 

Mental Health Block Grant from the evaluation set-aside in section 

241 of the Public Health Service Act. 

Language is included under ‘‘Substance Abuse and Mental 

Health Services Administration—Substance Abuse Treatment’’ exempting the Substance Abuse Prevention and Treatment Block 

Grant from the evaluation set-aside in section 241 of the Public 

Health Service Act. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Program Management’’ prohibiting the collection of fees 

from qualified health plans offered through an Exchange established under Public Law 111–148. 

Language is included under ‘‘Centers for Medicare and Medicaid 

Services—Health Care Fraud and Abuse Control Account’’ providing funds to support the cost of the Senior Medicare Patrol program. 

Language is included under ‘‘Administration for Children and 

Families—Low Income Home Energy Assistance’’ modifying the formula distribution of funds provided. 

Language is included under ‘‘Administration for Children and 

Families—Refugee and Entrant Assistance’’ permitting a 10 percent transfer. 

Language is included under ‘‘Administration for Children and 

Families—Payments to States for the Child Care and Development 

Block Grant’’ increasing the tribal set-aside to 5 percent. 

Language is included under ‘‘Administration for Children and 

Families—Payments to States for the Child Care and Development 

Block Grant’’ establishing a demonstration grant program for families needing care on an emergency basis, located in rural areas, or 

non-traditional work hours. 

Language is included under ‘‘Administration for Children and 

Families—Children and Families Services Programs’’ providing for 

payments under the Head Start Act for a cost of living adjustment 

and the calculation of a base grant. 

Language is included under Administration for Community Living establishing an assistive technology alternative financing program. 

Language is included under Administration for Community Living prohibiting the use of the funds provided in the bill to pursue 

legal action on behalf of a protection and advocacy system described in section 103 of the Protection and Advocacy for Individuals with Mental Illness Act unless public notice has been provided 

within 90 of instituting action to the named person or their legal 

guardian. 

Language is included under Administration for Community Living waiving the public notice requirement for individuals without 

a guardian, who are not competent to consent, who are wards of 

the State or subject to public guardianship. 

Language is included under ‘‘General Departmental Management’’ for competitive grants that implement education in sexual 

risk avoidance using medically accurate information, evidencebased approaches and teach benefits of healthy relationships, goal 

306 

setting and resisting sexual coercion and other youth risk behaviors. 

Section 201 limits the amount available for official reception and 

representation expenses. 

Section 202 limits the salary of an individual through an HHS 

grant or other extramural mechanism to not more than the rate of 

Executive Level II. 

Section 203 prohibits the Secretary from using evaluation setaside funds until the Committees on Appropriations of the House 

of Representatives and the Senate receive a report detailing the 

planned use of such funds. 

Section 204 sets the PHS evaluation set-aside to 2.5 percent. 

Section 205 permits the Secretary of HHS to transfer up to one 

percent of any discretionary funds between appropriations, provided that no appropriation is increased by more than three percent by any such transfer to meet emergency needs. Notification 

must be provided to the Committees on Appropriations at the program, project, and activity level in advance of any transfer. 

Section 206 continues the 60 day flexibility for National Health 

Service Corps contract terminations. 

Section 207 prohibits the use of Title X funds unless the applicant for the award certifies to the Secretary that it encourages family participation in the decision of minors to seek family planning 

services and that it provides counseling to minors on how to resist 

attempts to coerce minors into engaging in sexual activities. 

Section 208 states that no provider of services under Title X shall 

be exempt from any state law requiring notification or the reporting of child abuse, child molestation, sexual abuse, rape, or incest. 

Section 209 provides conscience protections to participants in the 

Medicare Advantage program who chose not to provide, pay for, 

provide coverage of, or provide referrals for abortions. 

Section 210 prohibits funds from being used to advocate or promote gun control. 

Section 211 limits assignments of Public Health Service staff to 

assist in child survival activities to not more than 60 days. 

Section 212 permits funding for HHS international HIV/AIDS 

and other infectious disease, chronic and environmental disease, 

and other health activities abroad to be spent under the State Department Basic Authorities Act of 1956. 

Section 213 provides the Director of NIH, jointly with the Director of the Office of AIDS Research, the authority to transfer up to 

three percent of human immunodeficiency virus funds. 

Section 214 makes NIH funds available for human immunodeficiency virus research available to the Office of AIDS Research. 

Section 215 grants authority to the Office of the Director of the 

NIH to enter directly into transactions in order to implement the 

NIH Common Fund for medical research and permitting the Director to utilize peer review procedures, as appropriate, to obtain assessments of scientific and technical merit. 

Section 216 clarifies that funds appropriated to NIH institutes 

and centers may be used for minor repairs or improvements to 

their buildings, up to $3,500,000 per project with a total limit for 

NIH of $45,000,000. 

Section 217 transfers one percent of the funding made available 

for National Institutes of Health National Research Service Awards 

307 

to the Health Resources and Services Administration and Agency 

for Healthcare Research and Quality. 

Section 218 continues the Biomedical Advanced Research and 

Development Authority ten year contract authority. 

Section 219 requires HHS to include certain information concerning the number of full-time federal employees and contractors 

working on the ACA in the fiscal year 2020 budget request. 

Section 220 includes specific report requirements for CMS’s marketplaces activities in the fiscal year 2020 budget request. 

Section 221 prohibits CMS Program Account from being used to 

support risk corridor payments. 

Section 222 directs the spending and transfer of amount in the 

Prevention and Public Health fund. 

Section 223 modifies a provision relating to breast cancer screening. 

Section 224 requires the NIH to continue to use existing indirect 

cost negotiated rates. 

Section 225 permits transfer authority within NIH, to the Director of NIH for activities related to opioid addiction, opioid alternatives, pain management, and addiction treatment. 

Section 226 permits transfer authority for activities related to 

evaluation for programs administered by the Administration for 

Children and Families. 

Section 227 prohibits funds from being used for Title X family 

planning activities. 

Section 228 establishes the account Infectious Disease Rapid Response Reserve Fund for emergency use by the Secretary. 

Section 230 includes a new provision relating to cervical cancer 

screening. 

Section 231 extends the authorization of Small Business Innovation Research pilot programs. 

Section 232 provides authority to accept donations for the care of 

unaccompanied alien children. 

TITLE III—DEPARTMENT OF EDUCATION 

Language is included under ‘‘General Provisions’’ allowing ESEA 

funds consolidated for evaluation purposes to be available from 

July 1, 2019 through September 30, 2020. 

Language is included under ‘‘General Provisions’’ allowing certain institutions to continue to use endowment income for student 

scholarships. 

Language is included under ‘‘General Provisions’’ extending the 

authorization of the National Advisory Committee on Institutional 

Quality and Integrity. 

Language is included under ‘‘General Provisions’’ extending the 

authority to provide account maintenance fees to guaranty agencies 

for Federal student loans. 

Lanuage is included under ‘‘General Provisions’’ permitting the 

Department of Education to allow universities to service Perkins 

Loan accounts. 

TITLE IV—RELATED AGENCIES 

Language is included under ‘‘General Provisions’’ instructing the 

Department of Education in matters related to performance targets 

308 

and performance bonuses for Office of Federal Student Aid employees. 

Language is included under ‘‘Federal Mediation and Conciliation 

Service—Salaries and Expenses’’ providing that fees charged for 

special training and other services and be retained and used for authorized purposes, that fees for arbitration services may only be 

used for training agency personnel, and that the Director may accept gifts and services in aid of any projects under the Director’s 

jurisdiction. 

Language is included under ‘‘National Labor Relations Board— 

Salaries and Expenses’’ prohibiting the use of funds for organizing 

or assisting in the organization of agricultural workers or for investigations, hearings, directives, or orders related to bargaining units 

of agricultural workers including employees involved in the maintenance and operations of ditches, canals, reservoirs and waterways 

for agricultural purposes. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the use of electronic voting 

in representation elections. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the application of a new 

‘‘joint-employer’’ standard. 

Language is included under ‘‘National Labor Relations Board— 

Administrative Provisions’’ prohibiting the exertion of jurisdiction 

related to Indian Tribes. 

Language is included under ‘‘The Committee for Purchase from 

People Who are Blind or Severely Disabled’’ requiring that written 

agreements, with certain oversight provisions, be in place in order 

for authorized fees to be charged by certified nonprofit agencies. 

TITLE V—GENERAL PROVISIONS 

Section 501 permits the Secretaries of Labor, Health and Human 

Services, and Education to transfer unexpended balances of prior 

appropriations to accounts corresponding to current appropriations 

to be used for the same purpose and for the same periods of time 

for which they were originally appropriated. 

Section 502 prohibits the obligation of funds beyond the current 

fiscal year unless expressly so provided. 

Section 503 prohibits funds from being used to support or defeat 

legislation. 

Section 504 limits the amount available for official reception and 

representation expenses for the Secretaries of Labor and Education, the Director of the Federal Mediation and Conciliation Service, and the Chairman of the National Mediation Board. 

Section 505 requires grantees receiving Federal funds to clearly 

state the percentage of the total cost of the program or project that 

will be financed with Federal money. 

Section 506 prohibits the use of funds for any abortion. 

Section 507 provides exceptions to section 506 and a provision 

prohibiting funds from being made available to a Federal agency or 

program, or to a State or local government, if such agency, program 

or government discriminates against institutional or individual 

health care entities because they do not provide, pay for, provide 

coverage of, or refer for abortions. 

309 

Section 508 prohibits use of funds for certain research involving 

human embryos. 

Section 509 prohibits use of funds for any activity that promotes 

the legalization of any drug or substance included in schedule I of 

the schedules of controlled substances. 

Section 510 prohibits use of funds to promulgate or adopt any 

final standard providing for a unique health identifier until legislation is enacted specifically approving the standard. 

Section 511 prohibits funds to be obligated or expended on a contract with an entity that has not submitted a report on qualified 

veteran employees as required under 38 U.S.C. 4212(d). 

Section 512 prohibits any transfer of funds made available in 

this Act except by the authority provided in this Act or another appropriation Act. 

Section 513 limits funds in the bill for public libraries to those 

that comply with the requirements of the Children’s Internet Protection Act. 

Section 514 dictates the procedures for the reprogramming of any 

funds provided in the bill. 

Section 515 continues a provision pertaining to appointments to 

federal scientific advisory committees to prevent the disclosure of 

information like political affiliation of candidates for appointment. 

Section 516 requires each department and related agency funded 

through this Act to submit an operating plan within 45 days of enactment, detailing any funding allocations that are different than 

those specified in this Act, the accompanying detailed table, or 

budget request. 

Section 517 requires the Secretaries of Labor, Health and 

Human Services, and Education to submit a quarterly report to the 

Committees on Appropriations of the House of Representatives and 

the Senate containing certain information on noncompetitive contracts, grants, and cooperative agreements exceeding $500,000 in 

value. 

Section 518 prohibits use of funds to process claims for credit for 

quarters of coverage based on work performed under a Social Security number that was not the claimant’s number, where the performance of such work under such number has formed the basis for 

a conviction of the claimant of a violation of section 208(a)(6) or (7) 

of the Social Security Act. 

Section 519 prohibits use of funds to implement a Social Security 

totalization agreement with Mexico. 

Section 520 prohibits federal funds for the purchase of syringes 

or sterile needles, but allows communities with rapid increases in 

cases of HIV and Hepatitis to access federal funds for other activities, including substance use counseling and treatment referrals. 

Section 521 prohibits the use of funds for the downloading or exchanging of pornography. 

Section 522 prohibits funding from going to the Association of 

Community Organizations for Reform Now (ACORN), or any of its 

affiliates, subsidiaries, allied organizations, or successors. 

Section 523 directs certain reporting requirements for conference 

expenditures. 

Section 524 requires disclosure of U.S. taxpayer funding for programs used in advertising. 

Section 525 authorizes performance partnership pilots. 

310 

Section 526 requires quarterly reports on the status of balances 

of appropriations from the Departments of Labor, Health and 

Human Services and Education. 

Section 527 prohibits the use of funds to implement, administer, 

enforce or further the provisions of Public Law 111–148 and portions of Public Law 111–152 with certain exceptions. 

Section 528 prohibits the use of funds to implement, administer, 

enforce or further advance the Navigators program. 

Section 532 prohibits funds for research on fetal tissue obtained 

from an induced abortion. 

Section 533 restricts funding to certain health care entities. 

Section 536 clarifies standards related to family detention centers. 

Section 537 restricts funding to States related to certain child 

welfare service providers. 

Section 538 restricts the administration of medication to unaccompanied alien children, unless certain health assessments have 

been completed. 

APPROPRIATIONS NOT AUTHORIZED BY LAW

Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of the 

House of Representatives, the following table lists the appropriations in the accompanying bill which are not authorized by law for 

the period concerned (dollars in thousands): 

311 

Agency 

Program 

Last Year of 

Authorization 

Authorization 

Level 

Appropriations 

in Last Year of 

Authorization 

Appropriations 

in this Bill 

DEPARTMENT OF LABOR ETA: 

Reintegration of Ex-Offenders (transition activities authorized by Second Chance Act, 2007) .................................... FY 2010 ........... $20,000,000 .... $15,000,000 $82,078,000 

VETERANS’ EMPLOYMENT AND TRAINING SERVICE: 

Homeless Veterans Program ............................................................................................................................................ FY 2018 ........... 50,000,000 ...... 50,000,000 50,000,000 

DEPARTMENT OF HEALTH AND HUMAN SERVICES: 

HRSA: 

Faculty Loan Repayment ......................................................................................................................................... FY 2014 ........... 5,000,000 ........ 1,187,000 1,190,000 Scholarships for Disadvantaged Students ............................................................................................................. FY 2014 ........... Such Sums ...... 44,857,000 48,970,000 National Center for Workforce Analysis .................................................................................................................. FY 2014 ........... 7,500,000 ........ 4,651,000 5,663,000 Primary Care Training and Enhancement .............................................................................................................. FY 2014 ........... Such Sums ...... 38,831,000 48,924,000 Oral Health Training Programs ............................................................................................................................... FY 2012 ........... 25,000,000 ...... 31,928,000 40,673,000 Area Health Education Centers .............................................................................................................................. FY 2014 ........... 125,000,000 .... 30,250,000 38,250,000 

Education & Training—Geriatrics: 

(Workforce Development) ........................................................................................................................................ FY 2014 ........... 10,800,000 ...... 33,237,000 40,737,000 (Career Incentive Awards) ...................................................................................................................................... FY 2013 ........... 10,000,000 ...... ........................................ ........................................

Mental & Behavioral Health Education .................................................................................................................. FY 2013 ........... 35,000,000 ...... 7,896,000 107,416,000 Graduate Medical Education .................................................................................................................................. N/A .................. N/A .................. N/A 200,000,000 Nursing Education Loan Repayment ...................................................................................................................... FY 2007 ........... Such Sums ...... 31,055,000 87,135,000 Nurse Education, Practice, Quality and Retention Program .................................................................................. FY 2012 ........... Such Sums ...... 41,913,000 41,913,000 Nurse Education, Practice, Retention, and Quality Grants .................................................................................... FY 2014 ........... Such Sums ...... 37,913,000 41,913,000 Nurse Faculty Loan Program .................................................................................................................................. FY 2014 ........... Such Sums ...... 24,500,000 28,500,000 Nursing Workforce Diversity .................................................................................................................................... ......................... Such Sums ...... ........................................ 17,343,000 Sickle Cell ............................................................................................................................................................... FY 2009 ........... 10,000,000 ...... 4,455,000 4,455,000 

Healthy Start ........................................................................................................................................................... FY 2013 ........... Formula ........... 100,746,000 110,500,000 

Emergency Relief—Part A ...................................................................................................................................... FY 2013 ........... 789,471,000 .... 649,373,000 655,876,000 Comprehensive Care—Part B ................................................................................................................................ FY 2013 ........... 1,562,169,000 1,314,446,000 1,315,005,000 Early Intervention—Part C ..................................................................................................................................... FY 2013 ........... 285,766,000 .... 205,544,000 201,079,000 Coordinated Services and Access to Research for Women, Infants, Children and Youth—Part D ..................... FY 2013 ........... 87,273,000 ...... 75,088,000 75,088,000 Special Projects of National Significance—Part F ................................................................................................ FY 2013 ........... 25,000,000 ...... 25,000,000 25,000,000 AIDS Education and Training Centers—Part F ...................................................................................................... FY 2013 ........... 42,178,000 ...... 33,275,000 33,611,000 Dental Reimbursement—Part F ............................................................................................................................. FY 2013 ........... 15,802,000 ...... 12,991,000 13,122,000 Organ Transplantation ............................................................................................................................................ FY 1993 ........... Such Sums ...... 2,767,000 25,549,000 Rural Health Outreach Grants ................................................................................................................................ FY 2012 ........... 45,000,000 ...... 55,553,000 71,500,000 Rural Hospital Flexibility Grants ............................................................................................................................. FY 2012 ........... Such Sums ...... 41,040,000 59,609,000 State Offices of Rural Health ................................................................................................................................. FY 2002 ........... Such Sums ...... 4,000,000 11,000,000 Telehealth ................................................................................................................................................................ FY 2006 ........... Such Sums ...... 6,814,000 23,500,000 

312 

Agency 

Program 

Last Year of 

Authorization 

Authorization 

Level 

Appropriations 

in Last Year of 

Authorization 

Appropriations 

in this Bill 

CDC: 

Sexually Transmitted Diseases Grants ................................................................................................................... FY 1998 ........... Such Sums ...... 113,671,000 157,310,000 National Cancer Registries ..................................................................................................................................... FY 2003 ........... Such Sums ...... N/A 49,440,000 National Center for Health Statistics ..................................................................................................................... FY 2003 ........... Such Sums ...... 125,899,000 160,397,000 WISEWOMEN ............................................................................................................................................................ FY 2003 ........... Such Sums ...... 12,419,000 21,120,000 

Asthma (Environmental) ......................................................................................................................................... FY 2005 ........... Such Sums ...... 32,422,000 29,000,000 

Folic Acid ................................................................................................................................................................ FY 2005 ........... Such Sums ...... 2,188,000 3,150,000 Injury Prevention and Control ................................................................................................................................. FY 2005 ........... Such Sums ...... 138,237,000 690,559,000 Oral Health Promotion ............................................................................................................................................ FY 2005 ........... Such Sums ...... 11,204,000 22,000,000 Safe Motherhood/Infant Health Promotion ............................................................................................................. FY 2005 ........... Such Sums ...... 44,738,000 44,000,000 Grants to Promote Childhood Nutrition and Physical Activity ............................................................................... FY 2005 ........... Such Sums ...... 26,835,000 54,920,000 Screening, Referrals, and Education Regarding Lead Poisoning .......................................................................... FY 2005 ........... 40,000,000 ...... 36,474,000 35,000,000 Birth Defects, Developmental Disability, Disability and Health ............................................................................ FY 2007 ........... Such Sums ...... 122,242,000 150,560,000 Breast and Cervical Cancer ................................................................................................................................... FY 2012 ........... 275,000,000 .... 204,779,000 218,000,000 Johanna’s Law ........................................................................................................................................................ FY 2014 ........... 18,000,000 ...... 4,972,000 7,000,000 Epidemiology Laboratory Capacity Grants .............................................................................................................. FY 2014 ........... 190,000,000 .... 32,424,000 40,000,000 National TB Strategy/Grants ................................................................................................................................... FY 2013 ........... 243,101,000 .... 132,997,000 142,256,000 Public Health Workforce and Career Development ................................................................................................. FY 2013 ........... 39,500,000 ...... 64,000,000 51,000,000 National Diabetes Prevention Program ................................................................................................................... FY 2014 ........... Such Sums ...... 10,000,000 26,800,000 Section 317 Immunization ...................................................................................................................................... FY 2014 ........... Such Sums ...... 610,847,000 620,847,000 Congenital Heart Disease Programs ....................................................................................................................... FY 2015 ........... Such Sums ...... 4,000,000 4,000,000 

SAMHSA: 

State Opioid Response Grants ................................................................................................................................ N/A .................. N/A .................. N/A $1,000,000,000 

AHRQ: 

Research on Health Costs, Quality, and Outcomes ............................................................................................... FY 2005 ........... Such Sums ...... 324,000,000 197,156,000 

ACF: 

Low Income Home Energy Assistance Program ...................................................................................................... FY 2007 ........... 5,100,000,000 2,161,170,000 3,640,304,000 Children and Families Services Programs: Adoption and Legal Guardianship Incentive Payments ......................................................................................... FY 2016 ........... 43,000,000 ...... 37,943,000 80,000,000 Native American Programs ..................................................................................................................................... FY 2002 ........... Such Sums ...... 45,826,000 55,050,000 Community Services Block Grant ........................................................................................................................... FY 2003 ........... Such Sums ...... 645,762,000 750,000,000 Head Start ............................................................................................................................................................... FY 2012 ........... Such Sums ...... 7,968,544,000 9,963,095,000 Runaway and Homeless Youth Programs ............................................................................................................... FY 2013 ........... Such Sums ...... 107,852,000 104,280,000 CAPTA programs ..................................................................................................................................................... FY 2015 ........... Such Sums ...... 143,981,000 158,074,000 

Family Violence Programs ....................................................................................................................................... FY 2015 ........... 178,500,000 .... 139,500,000 169,250,000 

Child Welfare Services ............................................................................................................................................ FY 2016 ........... 325,000,000 .... 268,735,000 278,735,000 

313 

Refugee and Entrant Assistance: Transitional and Medical Services ......................................................................................................................... FY 2002 ........... Such Sums ...... 227,243,000 320,000,000 Social Services ........................................................................................................................................................ FY 2002 ........... Such Sums ...... 158,600,000 155,000,000 Preventive Health .................................................................................................................................................... FY 2002 ........... Such Sums ...... 4,835,000 4,600,000 Targeted Assistance ................................................................................................................................................ FY 2002 ........... Such sums ...... 49,477,000 47,601,000 Victims of Torture ................................................................................................................................................... FY 2007 ........... 25,000,000 ...... 9,817,000 10,622,000 

ACL: 

Alzheimer’s Diseases Demonstration ...................................................................................................................... FY 2002 ........... Such Sums ...... 11,483,000 23,500,000 

Lifespan Respite Care ............................................................................................................................................ FY 2011 ........... 94,810,000 ...... 2,495,000 4,110,000 State Health Insurance Assistance Program .......................................................................................................... FY 1996 ........... 10,000,000 ...... N/A 49,115,000 Developmental Disabilities ..................................................................................................................................... FY 2007 ........... Such Sums ...... 155,115,000 176,316,000 Voting Access for People with Disabilities ............................................................................................................. FY 2005 ........... $17,410,000 .... $13,879,000 6,963,000 Elder Justice/ Adult Protective Services ................................................................................................................. FY 2014 ........... 129,000,000 .... 0 15,874,000 Assistive Technology ............................................................................................................................................... FY 2010 ........... Such Sums ...... 25,000,000 36,000,000 

PHSSEF: 

National Disaster Medical System .......................................................................................................................... FY 2018 ........... 52,700,000 ...... 57,404,000 62,404,000 

Medical Reserve Corps ........................................................................................................................................... FY 2018 ........... 11,200,000 ...... 6,000,000 6,000,000 Hospital Preparedness Program ............................................................................................................................. FY 2018 ........... 374,700,000 .... 254,555,000 279,555,000 BARDA ..................................................................................................................................................................... FY 2018 ........... 415,000,000 .... 536,700,000 586,700,000 Project BioShield ..................................................................................................................................................... FY 2018 ........... 2,800,000,000 710,000,000 780,000,000 Strategic National Stockpile ................................................................................................................................... FY 2018 ........... 533,800,000 .... 610,000,000 710,000,000 

DEPARTMENT OF EDUCATION: 

National Technical Institute for the Deaf .............................................................................................................. FY 2014 ........... Such Sums ...... 66,291,000 75,000,000 Gallaudet University ................................................................................................................................................ FY 2014 ........... Such Sums ...... 119,000,000 134,361,000 Aid for Institutional Development ........................................................................................................................... FY 2014 ........... Such Sums ...... 521,299,000 316,880,000 International Education And Foreign Language ..................................................................................................... FY 2014 ........... Such Sums ...... 72,164,000 72,164,000 Teacher Quality Partnerships .................................................................................................................................. FY 2011 ........... Such Sums ...... 40,592,000 43,092,000 Federal TRIO Programs ........................................................................................................................................... FY 2014 ........... Such Sums ...... 838,252,000 1,060,000,000 GEAR UP .................................................................................................................................................................. FY 2014 ........... Such Sums ...... 301,639,000 360,000,000 Child Care Access Means Parents in School ......................................................................................................... FY2014 ............ Such Sums ...... 15,134,000 37,000,000 Federal Work-Study Programs ................................................................................................................................. FY 2014 ........... Such Sums ...... 974,728,000 1,130,000,000 Federal Supplemental Educational Opportunity Grants ......................................................................................... FY 2014 ........... Such Sums ...... 733,130,000 840,000,000 Discretionary Federal Pell Grant ............................................................................................................................. FY 2017 ........... Such Sums ...... 22,475,352,000 22,475,352,000 IDEA National Activities .......................................................................................................................................... FY 2010 ........... Such Sums ...... 260,203,000 229,803,000 

RELATED AGENCIES: 

Corporation for Public Broadcasting ...................................................................................................................... FY 1996 ........... 425,000,000 .... 275,000,000 465,000,000 Corporation for National and Community Service .................................................................................................. FY 2014 ........... Such Sums ...... 1,049,954,000 767,629,000 Institute of Museum and Library Services ............................................................................................................. FY 2016 ........... Such Sums ...... 274,840,000 240,000,000 

314 

PROGRAM DUPLICATION

Pursuant to section 3(j)(2) of H. Res. 5 (115th Congress), no provision of this bill establishes or reauthorizes a program of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the Government Accountability Office to Congress pursuant to section 21 of 

Public Law 111–139, or a program related to a program identified 

in the most recent Catalog of Federal Domestic Assistance. 

DIRECTED RULE MAKING

The bill does not direct any rule making. 

COMPARISON WITH THE BUDGET RESOLUTION

Pursuant to clause 3(c)(2) of rule XIII of the Rules of the House 

of Representatives and Section 308(a)(1)(A) of the Congressional 

Budget Act of 1974, the following table compares the levels of new 

budget authority provided in the bill with the appropriate allocations under section 302(b) of the Budget Act: 

[In millions of dollars] 

302(b) Allocation This Bill 

Budget 

Authority Outlays Budget Authority Outlays 

Discretionary .................................................................................. $177,100 $185,655 $177,105 1 $182,541 

Mandatory ...................................................................................... 783,118 782,757 783,118 1 778,222 

1 Includes outlays from prior-year budget authority 

FIVE-YEAR OUTLAY PROJECTIONS

Pursuant to section 308(a)(1)(B) of the Congressional Budget Act 

of 1974, the following table contains five-year projections prepared 

by the Congressional Budget Office of outlays associated with the 

budget authority provided in the accompanying bill: 

[In millions of dollars] 

Projection of outlays associated with the recommendation: 

2019 ....................................................................................... 1 $858,012 

2020 ....................................................................................... 101,295 

2021 ....................................................................................... 27,721 

2022 ....................................................................................... 4,507 

2023 and future years .......................................................... 1,057 1 Excludes outlays from prior-year budget authority. 

ASSISTANCE TO STATE AND LOCAL GOVERNMENTS

Pursuant to section 308(a)(1)(C) of the Congressional Budget Act 

of 1974, the amounts of financial assistance to State and local governments is as follows: 

[In millions of dollars] 

New Budget Authority ....................................................................... $481,368 

Fiscal year 2019 outlays resulting therefrom .................................. 1 434,643 1 Excludes outlays from prior-year budget authority. 

315 


Insert offset folio 0140 here HR862.001

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. I 

Date: July 1 !, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mr. Cole 

Description of Motion: Amend William Wilberforce Traflicking Victims Protection Reauthorization Act of2008 

related to alien minors and family detention. 

Results: Adopted 31 yeas to 21 nays 

Members Voting Yea 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuyscn 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 

Members Voting Nay 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 
316 


Insert offset folio 0141 here HR862.002

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X HI of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 2 

Date: July 11. 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mr. Aderholt 

Description of Motion: Prohibit discrimination against a child welfare service provider based on the provider 

declining to provide a service that conflicts with its sincerely held religious or moral beliefs. 

Results: Adopted 29 yeas to 23 nays 

Members Voting Yea 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 

Members Voting Nay 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Taylor 

Mr. Visclosky 

Ms. Wasserman Schultz 
317 


Insert offset folio 0142 here HR862.003

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 3 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mr. Price 

Description of Motion: Require monthly reports from the Department of Health and Human Services related to 

unaccompanied children separated at the border. 

Results: Defeated 21 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
318 


Insert offset folio 0143 here HR862.004

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

eaeh roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 4 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Roybal-Allard 

Description of Motion: Limit funds for sharing certain information between the Department of Health and Human 

Services and the Department of Homeland Security, if such information is used for immigration enforcement. 

Results: Defeated 20 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
319 


Insert offset folio 0144 here HR862.005

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALL NO. 5 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Lee 

Description of Motion: Provide funding for a Family Case Management program, eliminate funding for the Sexual 

Risk Avoidance program. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Yaladao 

Mr. Yoder 

Mr. Young 
320 


Insert offset folio 0145 here HR862.006

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 6 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mr. Serrano 

Description of Motion: Limits funds related to certain facilities for the housing of unaccompanied children and 

prioritize funding for residential placements. 

Results: Defeated 22 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
321 


Insert offset folio 0146 here HR862.007

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule Xlll of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 7 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Meng 

Description of Motion: Limit funds that are inconsistent with the preliminary injunction in k!s. L vs. ICE or with 

ftores v. Reno settlement agreement. 

Results: Defeated 22 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersbergcr 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
322 


Insert offset folio 0147 here HR862.008

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule Xlll of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 8 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 20 19 

Motion by: Mr. Kilmer 

Description of Motion: Require action by the Department of Health and Human Services related to payments for 

the Risk Adjustment program. 

Results: Defeated 22 yeas to 27 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
323 


Insert offset folio 0148 here HR862.009

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 9 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Roybal-Allard 

Description of Motion: Increase the maximum Pel! grant. 

Results: Defeated 22 yeas to 28 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Fre!inghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
324 


Insert offset folio 0149 here HR862.010

FlJLL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. I 0 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. McCollum 

Description of Motion: Limit funding to recognize the Accrediting Council for Independent Colleges and Schools. 

Results: Defeated 23 yeas to 26 nays 

Members Voting Yea 

Mr.Agui1ar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms. DeLaura 

Ms. Herrera Buetler 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersbcrger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Mr. Young 

Members Voting Nay 

Mr. Aderholt 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 
325 


Insert offset folio 0150 here HR862.011

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO, 11 

Date: July 11,2018 

Mea~ure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mrs. Lowey 

Description of Motion: Provide funding for firearm injury prevention research. 

Results: Defeated 20 yeas to 32 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Cartwright 

Ms. Clark 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wa~serman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Bishop 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 
326 


Insert offset folio 0151 here HR862.012

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLLCALL NO. 12 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. DeLaura 

Description of Motion: Include language related to registered apprenticeship programs under the National 

Apprenticeship Act. 

Results: Defeated 23 yeas to 28 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Mr. Joyce 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppcrsberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wassennan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
327 


Insert offset folio 0152 here HR862.013

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 13 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Lee 

Description of Motion: Amend the Fair Labor Standards Act related to increasing the Federal Minimum Wage. 

Results: Defeated 21 yeas to 30 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodci 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
328 


Insert offset folio 0153 here HR862.014

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO, 14 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mrs. Lowey 

Description of Motion: Provide funding for the Family Planning program and strike the provision prohibiting such 

funding; limit funds for modifying regulations related to title X of the Public Health Service Act. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms.Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
329 


Insert offset folio 0154 here HR862.015

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 15 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Clark 

Description of Motion: Strike section 533, a provision related to prohibited health care entities. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
330 


Insert offset folio 0155 here HR862.016

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 16 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Kaptur 

Description of Motion: Require a report from the Department of Health and Human Services related to prescription 

drug prices. 

Results: Adopted 26 yeas to 25 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Herrera Buetler 

Mr. Jenkins 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Mr. Rogers 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Yisclosky 

Ms. Wasserman Schultz 

Mr. Young 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 
331 


Insert offset folio 0156 here HR862.017

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

fhose voting against, are printed below: 

ROLL CALL l-:0. 17 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Wasserman Schultz 

Description of Motion: Increase funding for the Centers for Medicare and Medicaid Services Program 

Management, strike sections 527 and 528 related to implementation of the Affordable Care Act (P.L. 111-148). 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Yisclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
332 


Insert offset folio 0157 here HR862.018

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 18 

Date: July II, 2018 

Measure: Labor, Health and Human Services. Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. DeLaura 

Description of Motion: Increase funds for the Department of Labor Wage and Hour Division; eliminate funding for 

the Sexual Risk A voidance program. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
333 


Insert offset folio 0158 here HR862.019

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 19 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Lee 

Description of Motion: Provide funding for the Teen Pregnancy Prevention program; not offset. 

Results: Defeated 21 yeas to 29 nays 

l'Jembers Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
334 


Insert offset folio 0159 here HR862.020

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 20 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Mr. Cole 

Description of Motion: Include language related to performance targets and bonuses for Federal Student Aid 

employees. 

Results: Adopted 30 yeas to 20 nays 

Members Voting Yea 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 

Members Voting Nay 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms. DeLauro 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Serrano 

Mr. Visclosky 

Ms. W asserrnan Schultz 
335 


Insert offset folio 0160 here HR862.021

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 21 

Date: July 11,2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Lee 

Description of Motion: Increase funding for various job training and worker protection programs; not offset 

Results: Defeated 22 yeas to 29 nays 

Memhers Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
336 


Insert offset folio 0161 here HR862.022

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives. the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against. are printed below: 

ROLL CALL NO. 22 

Date: July 11,2018 

Measure: Labor, Health and Human Services. Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. DeLaura 

Description of Motion: Limit expenditure of funds from the Department of Education until the Secretary withdraws 

certain guidance related to student loan programs and servicers. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Yaladao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
337 


Insert offset folio 0162 here HR862.023

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XIII of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 23 

Date: July 1 I, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. W asserrnan Schultz 

Description of Motion: Limit funds to prepare or file legal documents related to certain judicial proceedings 

pertaining to portions of the Public Health Service Act. 

Results: Defeated 22 yeas to 29 nays 

Members Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Pocan 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rutherlln·d 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
338 


Insert offset folio 0163 here HR862.024

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule XHI of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 24 

Date: July II, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 2019 

Motion by: Ms. Wasserman Schultz 

Description of Motion: Strike section 534 related to conscience protection. 

Results: Defeated 21 yeas to 31 nays 

Afembers Voting Yea 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Members Voting Nay 

Mr. Aderholt 

Mr.Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Cuellar 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 
339 


Insert offset folio 0164 here HR862.025

FULL COMMITTEE VOTES 

Pursuant to the provisions of clause 3(b) of rule X Ill of the House of Representatives, the results of 

each roll call vote on an amendment or on the motion to report, together with the names of those voting for and 

those voting against, are printed below: 

ROLL CALL NO. 25 

Date: July I I, 2018 

Measure: Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill, FY 20 I 9 

Motion by: Mr. Rogers 

Description of Motion: Report the bill to the House. as amended. 

Results: Adopted 30 yeas to 22 nays 

Memher~ Voting Yea 

Mr. Aderholt 

Mr. Amodei 

Mr. Calvert 

Mr. Carter 

Mr. Cole 

Mr. Culberson 

Mr. Diaz-Balart 

Mr. Fleischmann 

Mr. Fortenberry 

Mr. Frelinghuysen 

Ms. Granger 

Mr. Graves 

Dr. Harris 

Ms. Herrera Beutler 

Mr. Jenkins 

Mr. Joyce 

Mr. Moolenaar 

Mr. Newhouse 

Mr. Palazzo 

Mrs. Roby 

Mr. Rogers 

Mr. Rooney 

Mr. Rutherford 

Mr. Simpson 

Mr. Stewart 

Mr. Taylor 

Mr. Valadao 

Mr. Womack 

Mr. Yoder 

Mr. Young 

Members Voting Nay 

Mr. Aguilar 

Mr. Bishop 

Mr. Cartwright 

Ms. Clark 

Mr. Cuellar 

Ms. DeLaura 

Ms. Kaptur 

Mr. Kilmer 

Ms. Lee 

Mrs. Lowey 

Ms. McCollum 

Ms. Meng 

Ms. Pingree 

Mr. Paean 

Mr. Price 

Mr. Quigley 

Ms. Roybal-Allard 

Mr. Ruppersberger 

Mr. Ryan 

Mr. Serrano 

Mr. Visclosky 

Ms. Wasserman Schultz 

Insert offset folio 165 here HR862R.001

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE I -DEPARTMENT OF LABOR 

EMPLOYMENT AND TRAINING ADMINISTRATION 

Tra1ning and Employment Services 

Grants to States: 

Adult Training, current year. 

Advance from prior year 

FY 2020. 

Subtotal. 

Youth Training. 

Dislocated Worker Assistance, current year. 

Advance from prior year. 

FY 2020 .. 

Subtotal. 

Subtotal, Grants to States. 

Current Year. 

FY 2020, 

D 

NA 

D 

D 

D 

NA 

D 

FY 2018 

Enacted 

133,556 

(712,000) 

712,000 

FY 2019 

Request 

103,556 

(712,000) 

712,000 

Bil 

133,556 

(712,000) 

712,000 

_________ .. 

----

------- ------

845,556 815,556 845,556 

903,416 873,416 903,416 

180,860 160,860 180,860 

(860,000) (860,000) (860,000) 

860,000 860,000 860,000 

---- -------- ------------

1,040,860 1,020,860 1,040,860 

-

----

-

. 

----- ------ "-- -------- --

2,789,832 2,709,832 2,789,832 

(1 ,217,832) ( 1 ' 137' 832) ( 1 .217 ,832) 

(1 ,572,000) (1,572,000) (1 ,572,000) 

Bill vs. Sill vs. 

Enacted Request 

+30,000 FF 

----------

-

- ------------

+30' 000 

--- +30,000 FF 

+20,000 FF ---~~-~~~-- ---------

--- +20,000 

-- -- -- - ---- - ---

--- +80,000 

--- ( +80' 000) 

Insert offset folio 166 here HR862R.002

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Nati anal Programs: 

Dislocated Worker Assistance National Reserve: 

Current year. 

Advance from prior year 

FY 2020. 

Subtotal , 

Subtotal, Dislocated Worker Assistance 

Native American programs., 

Migrant and Seasonal Farmworker programs. 

YouthBuild activities. 

Technical assistance 

Reintegration of Ex-Offenders. 

Workforce Data Quality Initiative 

Apprenticeship programs.,. 

Total, National Programs 

Current Year 

FY 2020., 

D 

NA 

D D 

D D D D 

D 

D 

FY 2018 

Enacted 20,859 

( 200' 000) 

200,000 

220,859 

1,261,719 

54,000 

87,896 89,534 

93,079 

6,000 

145,000 

FY 2019 

Request 

20,859 

(200,000) 

125,000 

w w w 

145,859 

1 '166, 719 

84,534 

2,000 

78,324 

200,000 

-- W 

696,368 510,717 

( 496, 368) (385,717) 

(200' 000) ( 125, 000) 

Bi 11 

200,000 

(200,000) 

200,000 

---

1,240,860 

55,000 

87,896 

92,534 93,079 

6,000 

150,000 

684,509 

(684,509) 

Bi 11 vs, 

Enacted 

+179,141 

---

-200,000 

---

-20,859 

-20,859 

+1 ,000 +3,000 +5,000 

Bill vs. 

Request 

+179' 141 

-125,000 

+54' 141 +74' 141 +55,000 +87,896 

+8,000 

-2,000 

+14,755 

+6,000 

-50' 000 

-11 ,859 +173,792 

(+188, 141) (+298,792) 

(-200,000) (-125,000) 

FF 

FF FF FF 

Insert offset folio 167 here HR862R.003

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Total, Training and Employment Services (TES) 

Current Year. 

FY 2020. ,,,,, 

Job Corps 

Operations. D Construction, Rehabilitation and Acquisition. D 

Administration. . ' . ' . . D 

Total, Job Corps .. 

Current Year .. 

Community Service Employment For Older Americans .. D 

Federal Unemployment Benefits and Allowances 

(indefinite) .. M 

FY 2018 

Enacted 

FY 2019 

Request Bi 11 

-------

--- --

. 

-- --- - -

-

-- --- -- --

3,486,200 3,220,549 3,474,341 

(1 ,714,200) (1,523,549) (1,902,341) 

(1 ,772,000) (1,697,000) (1,572,000) 

1,603,325 1 '189,812 1,603,325 

83,000 75,016 83,000 

32,330 32,110 32,330 

Bi 11 vs. 

Enacted 

----------- -

-11,859 

(+188, 141) 

(-200,000) 

--· 

------

------------ -- ------

-

-

-

-

--

---- ---------

1 ,718' 655 1,296,938 1,718,655 

(1,718,655) (1,296,938) (1 ,718,655) --

400,000 --- 400,000 ·--

790,000 790,000 790,000 

Bi 11 vs 

Request 

-----------

+253,792 

( +378 ,792) ( 125 '000) 

+413,513 

+7,984 

+220 

------------

+421 '717 

( +421 '717) 

+400,000 

FF FF 

FF 

Insert offset folio 168 here HR862R.004

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

State Unemployment Insurance and Employment 

Service Operations 

Unemployment Compensation (UI): 

State Operations .. 

Reemployment eligibility assessments--UI Permissible cap adjustment. 

UI Integrity Center of Excellence. 

Subtotal, Unemployment Compensation. 

Federal-State UI National Activities 

Employment Service (ES): 

Grants to States: 

Federal Funds. 

Trust Funds. 

Subtotal, Grants to States. 

ES National Activities. 

Subtotal, Employment Service. 

Federal Funds. 

Trust Funds. 

TF 

integrity TF 

TF 

TF 

TF 

D 

TF TF 

FY 2018 

Enacted 

2,510,600 

120' 000 

9,000 

2,639,600 

13,897 

21,413 

645,000 

---

-

-------

666,413 

19,818 

FY 2019 

Request 

2,356,816 

130,000 

6,000 

2,492,816 

12,000 

21,413 

650,000 

-----------

---

671,413 

19,683 

Bi 11 

2,356,816 

117,000 

33,000 

9,000 

2,515,816 

13,897 

21 ,413 

564,375 

Bill vs 

Enacted 

153,784 

-3,000 

+33,000 

-123,784 

-80,625 

Bill vs. 

Request 

-13' 000 

+33 '000 

+3 '000 

+23,000 

+1 ,897 

-85,625 

------- -------- - --- -------------

585,788 ·80,625 -85,625 

19,818 +135 

---------

------- ---- ----------

_________ ..,,._ 

----------

686' 231 691 '096 605,606 -80,625 -85' 490 

(21 ,413) (21 '413) (21 ,413) --· --

(664' 818) (669,683) (584,193) (-80,625) ( -85 '490) 

FF FF 

FF 

Insert offset folio 169 here HR862R.005

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Foreign Labor Certifications and Related Activities: 

Federal Administration. 

Grants to States. 

Subtotal, Foreign Labor Certification. 

One-Stop Career Centers/Labor Market Information. 

Total , State UI and ES 

Federal Funds. 

Trust Funds .. 

TF TF 

0 

FY 2018 

Enacted 

48,028 

14,282 

FY 2019 

Request 47,937 

14,255 

Bi 11 

48,028 

14,282 

Bi 11 vs. 

Enacted 

---

Bi 1l vs 

Request 

+91 

+27 

-----

--- --- --- -- -- -- - - ---- -- ------------

62,310 62,192 62,310 +118 

62,653 67,194 62,653 -4' 541 

.. 

---

.. 

-- ------- -------- - ------- --

3,464,691 3,325,298 3,260,282 ·204,409 -65,016 

(84,066) (88,607) (84,066) --· { -4,541) 

( 3 ' 380' 625) (3,236,691) (3,176,216) ( -204' 409) (-60,475) 

FF 

Insert offset folio 170 here HR862R.006

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Program Administration 

Training and Employment. 

Trust Funds 

Employment Security. 

Trust Funds. 

Apprenticeship Services. 

Executive Direction. 

Trust Funds. 

Total, Program Administration. 

Federal Funds. 

Trust Funds. 

Total, Employment and Training Administration 

Federal Funds. 

Current Year .. 

FY 2020. 

Trust Funds .. 

0 

TF 

D 

TF 

D 

D 

TF 

FY 2018 

Enacted 

62,040 

8,639 

3,440 

39,264 

36,160 

7,034 

2,079 

158,656 

(108,674) 

(49, 982) 

-·-

FY 2019 

Request 

59,744 

8,580 

2,184 

38,997 

35,914 

6,781 

2,065 

154,265 

( 104, 623) 

(49,642) 

Bi 1l 

62,040 

8,639 

3,440 

39,264 

36,160 

7,034 

2,079 

-- - -

158,656 

(108,674) 

(49,982) 

Bill vs. Bill vs. 

Enacted Request 

--- +2' 296 

--- +59 

--- +1 ,256 

--- +267 

+246 

+253 

+14 

-------- ~-- --· 

--- +4, 391 

--- (+4,051) 

--- (+340) 

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

===~~========= 

==~========== 

10,018,202 8,787,050 9,601,934 -216,268 +1 ,014,884 

6,587,595 5,500,717 6,575,736 -11 ,859 +1 ,075,019 

(4' 815, 595) (3' 803 ,717) (5,003,736) (+188, 141) (+1 ,200,019) 

( 1 ' 772' 000) (1,697,000) (1 ,572,000) (-200,000) (-125,000) 

3' 430,607 3,286,333 3,226,198 -204,409 -60,135 

Insert offset folio 171 here HR862R.007

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

EMPLOYEE BENEFITS SECURITY ADMINISTRATION (EBSA) 

Salaries and Expenses 

Enforcement and Participant Assistance .. 0 

Policy and Compliance Assistance D 

Executive Leadership, Program Oversight and D 

Administration, D 

Total, EBSA .. 

PENSION BENEFIT GUARANTY CORPORATION (PBGC) 

Pension Benefit Guaranty Corporation Fund 

Consolidated Administrative budget, ' .... NA 

WAGE AND HOUR DIVISION, Salaries and Expenses. D 

OFFICE OF LABOR-MANAGEMENT STANDARDS, Salaries and 

Expenses. , D 

FY 2018 

Enacted 

147,400 

26,901 

6,699 

FY 2019 

Request 

154,813 

28,033 

6,654 

Bi 11 

147,000 

26,901 

6,699 

Bill vs. Bill vs. 

Enacted Request 

-400 -7,813 

--- 1 '132 

--- +45 

--

-

-

- -

---- -- -

- - -

-

- -

-

-

-

---- --------

-

-- --- --

-

----

-

---

- - - - - -

-

- - - -

-

- - - -

181,000 189,500 180,600 -400 -8,900 

( 424' 417) (445,363) (445,363) (+20,946) 

227,500 230,068 225,500 -2,000 -4,568 

40,187 46,634 42,187 +2,000 -4,447 

Insert offset folio 172 here HR862R.008

STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, 

Salaries and Expenses. D 

OFFICE OF WORKERS' COMPENSATION PROGRAMS D 

Salaries and Expenses. .. ' ... D 

Trust Funds TF 

Total, Salaries and Expenses. 

Federal Funds. 

Trust Funds ... 

Special Benefits 

Federal Employees' Compensation Benefits. M 

Longshore and Harbor Workers' Benefits. M 

Total, Special Benefits. 

---- -

FY 2018 

Enacted 

103,476 

115,424 

2,177 

117,601 

( 115,424) 

(2' 177) 

217' 000 

3,000 

FY 2019 

Request 

91 '100 

113,109 

2,173 

----------- -

115,282 

(113, 109) 

(2, 173) 

227,000 

3,000 

--------- - -

220,000 230,000 

Bill 

99,476 

115,424 

2,177 

.. 

- --

---

117' 601 

(115,424) 

(2, 177) 

227,000 

3,000 

-----------

230,000 

Bi 11 vs 

Enacted 

-4,000 

---

---

-- ---

----

---

---

--

+10,000 

-------

+10,000 

Blll vs' 

Request 

+8,376 +2,315 

+4 

---

+2,319 

(+2,315) 

(+4) 

Insert offset folio 173 here HR862R.009

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Special Benefits for Disabled Coal Miners 

Benefit Payments. 

Administration 

Subtotal, FY 2019 program level. 

Less funds advanced in prior year. 

Total , Current Year 

New advances, 1st quarter, FY 2020. 

Total, Special Benefits for Disabled Coal Miners 

Administrative Expenses, Energy Employees Occupational 

Illness Compensation Fund 

Administrative Expenses. 

M M M 

M 

FY 2018 

Enacted 

65,000 

5,319 

FY 2019 

Request 

20,000 

5,319 

---- -

- - - -

- -- ---- --- ---

- -

-

- --- - -

70,319 25,319 

-16,000 15,000 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

20,000 -45,000 

5,319 

----- -------- -- ---------- -

25,319 -45,000 

-15,000 +1 ,000 

--- ----- --- ------- --- --------- ---- ------------- - ---------

54,319 10,319 10,319 -44,000 

15,000 14,000 14,000 1 ,000 

-----------·-- ----------- -------- ------ ---- --------

69,319 24,319 24,319 -45,000 

59,846 59,098 59,098 -748 

Insert offset folio 174 here HR862R.010

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Black Lung Disability Trust Fund 

Benefit Payments and Interest on Advances. M 

Workers' Compensation Programs, Salaries and Expenses M 

Departmental Management, Salaries and Expenses. M 

Departmental Management, Inspector Genera·!.. M 

Subtotal, Black Lung Disability. 

Treasury Department Administrative Costs 

Total, Black Lung Disability Trust Fund. 

Total, Workers' Compensation Programs. 

Federal Funds .. 

Current year. 

FY 2020. 

Trust Funds. 

M 

FY 2018 

Enacted 

345,635 

38,246 31,994 

330 

416,205 

356 

---- -- - -----

416,561 

FY 2019 

Request 

257.256 

38,246 31,994 

330 

327,826 

356 

-----------

328,182 

Bill 

257,256 

38,246 

31,994 

330 

327.826 

356 

-- -

... 

-

--- ---- -

328' 182 

Bi 11 vs. Bi 11 vs. 

Enacted Request 

-88,379 

-88,379 

---- ---------

-88,379 

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

883,327 756' 881 759,200 -124,127 +2,319 

881 '150 754,708 757,023 -124' 127 +2 315 

I 866, 150) 1740,708) 1743,023) ( -123, 127) (+2,315) 

(15,000) (14,000) (14 ,000) I -1 ,ooo) ---

2,177 2' 173 2' 177 --- +4 

Insert offset folio 175 here HR862R.011

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) 

Salaries and Expenses 

Safety and Health Standards 

Federal Enforcement, 

Whistleblower enforcement 

State Programs, 

Technical Support,, 

Compliance Assistance: 

Federal Assistance, 

State Consultation Grants 

Training Grants,, 

Subtotal, Compliance Assistance 

Safety and Health Statistics 

Executive Direction and Administration, 

Total, OSHA, 

0 

D 

D 

D D D D D 

0 

D D 

*¥ 

___ 

FY 2018 

Enacted 

18,000 

208,000 

17,500 

100,850 

24' 469 

70,981 

59' 500 

10,537 

FY 2019 

Request 

17,878 

212,735 

17' 381 

100,165 

23,766 

75,619 

59,096 

---

- ---- - - -- - - - - - - w -

141,018 134,715 

32,900 32,677 

10,050 9,716 

Bi 11 

18,000 

208,000 

17,500 

100,850 

24,469 

73,981 

59,500 

----------

133,481 

32,900 

10,050 

Bi 11 vs 

Enacted 

+3,000 

-10,537 

-------

-7,537 

---

---

Bill vs, 

Request 

+122 

-4,735 

+119 +685 

+703 

-1 ,638 

+404 

----------

1 ,234 

+223 +334 

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

552' 787 549,033 545,250 -7,537 -3,783 

Insert offset folio 176 here HR862R.012

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

{Amounts in Thousands) 

MINE SAFETY AND HEALTH ADMINISTRATION 

Salaries and Expenses 

Coal Enforcement. D 

Meta·l /Non-Metal Enforcement. D 

Standards Development. D 

Assessments. D 

Educational Policy and Development. D 

Technical Support. D 

Program Evaluation and Information Resources (PEIR). D 

Program Administration. D 

Total, Mine Safety and Health Administration. 

Total, Worker Protection Agencies 

Federal Funds 

Trust Funds. 

FY 2018 

Enacted 

160,000 

94,500 

4,500 

6,627 

39,320 35,041 

17,990 15,838 

FY 2019 

Request 

156,136 

96,975 

5,345 

7,394 

38,297 

33,848 

21 '953 

15,958 

Bi 11 

153,773 

94,500 

4,500 

6,627 

39,320 35,041 

17 '990 

15,838 

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

373,816 375,906 367,589 

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

,596,367 1,597,523 1 ,578,203 

(1 ,594, 190) ( 1 '595' 350) (1 ,576,026) 

(2' 177) (2, 173) (2, 177) 

Bil I vs. 

Enacted 

-6,227 

-6,227 

-18,164 

( -18, 164) 

Bi 11 vs. 

Request 

-2,363 

-2,475 

-845 

-767 

+1 ,023 

+1 '193 

-3,963 

120 

-8,317 

19,320 

( 19,324) 

(+4) 

Insert offset folio 177 here HR862R.013

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

BUREAU OF LABOR STATISTICS 

Salaries and Expenses 

Employment and Unemployment Statistics 

Labor Market Information. 

Prices and Cost of Living. 

Compensation and Working Cond1tions. 

Productivity and Technology. 

Executive Direction and Staff Services. 

Total, Bureau of Labor Statistics 

Federa·l Funds 

Trust Funds. 

OFFICE Of DISABILITY EMPLOYMENT POLICY 

Salaries and Expenses 

D 

TF 

D 

D D D 

D 

FY 2018 

Enacted 

209,000 

65,000 

209,000 

83,500 

10,500 

35,000 

FY 2019 

Request 

209,398 

64,559 

207,235 

80,947 

10,622 

36,625 

Bi 1 

208,000 

65,000 

210,000 

83,000 

10,800 

35,200 

Bill vs. 

Enacted 

1,000 

+1 ,000 

-500 

+300 +200 

Bi 11 vs 

Request 

-1 ,398 

+441 

+2,765 

+2' 053 

+178 

-1 ,425 

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

612,000 609,386 612,000 -- +2,614 

547,000 544,827 547,000 ·-- +2' 173 

65,000 64,559 65,000 ·-- +441 

38,203 27,000 38,203 -·- +11 ,203 

Insert offset folio 178 here HR862R.014

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

DEPARTMENTAL MANAGEMENT 

Salaries and Expenses 

Executive Direction. 

Departmental Program Evaluation .. 

Legal Serv1ces. 

Trust Funds 

International Labor Affairs 

Administration and Management. 

Adjudication 

Women's Bureau. 

Civil Rights Activities. 

Chief Financial Officer. 

Total, Departmental Management Salaries and 

expenses. 

Federal Funds. 

Trust Funds. 

D 

D 

D 

TF 

D 

D 

D 

D 

D 

D 

FY 2018 

Enacted 

30,250 

8,040 

123,745 

308 

86,125 

23,534 

35,000 

13,530 

6,880 

10,432 

337,844 

(337,536) 

(308) 

FY 2019 

Request 

30,045 

7,985 

124,644 

306 

18,500 

23,808 

35,462 

3,525 

6,833 

9,927 

Bill 

29,750 

8,040 

124,250 

308 

18,500 

28,450 

35,000 

13,750 

6,880 

5,516 

---

- - - • M A - - -

261,035 270,444 

(260 ,729) (270,136) 

(306) (308) 

Bill vs 

Enacted 

-500 

+505 

-67,625 

+4,916 

+220 

-4,916 

---- --- ----

-67,400 

(-67,400) 

Bi 11 vs. 

Request 

-295 

+55 

-394 

+2 

+4 '642 

-462 

+10,225 

+47 

-4,411 

--

-

-

- -

. 

-

+9 '409 

(+9,407) 

(+2) 

Insert offset folio 179 here HR862R.015

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Veterans Employment and Training 

State Administration, Grants. 

Transit1on Assistance Program 

Federal Administration. 

National Veterans' Employment and Training Services 

Institute. 

Homeless Veterans Programs. 

Total, Veterans Employment and Training. 

Federal Funds. 

Trust Funds. 

IT Modernization 

Departmental support systems. 

Infrastructure technology modernization .. 

Total. IT Modernization 

TF 

TF 

TF 

TF 

D 

D 

D 

FY 2018 

Enacted 

180,000 

19,500 

42,127 

3,414 

50,000 

FY 2019 

Request 

173,812 

16,950 

42,748 

3, 391 

44,694 

- --- - -- -- ---

295' 041 

50,000 

245,041 

4,889 

15,880 

20,769 

281.595 

44,694 

236,901 ~---- Bi 11 180,000 23,000 43,248 3,414 50,000 -- - --- 299,662 50,000 249,662 

4,889 

24,280 

29,169 

Bill vs 

Enacted 

---

+3,500 

+1 '121 

---

---

--

+4,621 

+4,621 

+8,400 

+8,400 

Bill vs. 

Request 

+6, 188 

+6,050 

+500 

+23 

+5,306 

--------

+18,067 

+5,306 

+12 '761 

+4,889 

+24' 280 

+29, 169 

Insert offset folio 180 here HR862R.016

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Office of Inspector General 

Program Activ1ties .. 

Trust Funds. 

Total, Office of Inspector General. Total, Departmental Management 

Federal Funds. 

Current Year. 

Trust Funds. 

Total, Workforce Investment Act Programs. 

Current Year. 

FY 2020. 

Total, Title I, Department of Labor 

Federal Funds. 

Current Year. 

FY 2020. 

Trust Funds. 

D 

TF 

FY 2018 

Enacted 

83,487 

5,660 

FY 2019 

Request 

82,061 

5,660 

-

-

-

. 

- - - -

-

-

--- - - ------

-- -

-

-

-- -

89,147 87,721 

Bi 11 vs. 

Bi 11 Enacted 

83,487 ... 

5,660 

- ---- ----------

89,147 ... 

Bill vs 

Request +1 ,426 

-------------

+1 ,426 

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

742,801 630,351 688,422 ·54,379 +58' 071 

491,792 387,484 432,792 -59,000 +45,308 

(491,792) (387,484) (432 ,792) (-59,000) (+45,308) 

251,009 242,867 255,630 +4,621 +12,763 

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

5,204,855 4,517,487 5' 192' 996 ·11 ,859 +675' 509 

(3,432,855) (2,820,487) (3,620,996) (+188, 141) ( +800 '509) 

(1 '772, 000) (1,697,000) (1,572,000) (·200,000) ( ·125,000) 

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

13,773,299 12,292' 909 13,360,361 ·412,938 +1 ,067,452 

10,024,506 8,696,977 9,811,356 -213,150 +1 ,114,379 

(8' 237' 506) (6,985,977) (6,225,356) ( ·12, 150) (+1 ,239,379) 

( 1 '787' 000) ( 1 '711 ,000) ( 1 '586' 000) ( ·201 '000) (·125,000) 

3,748,793 3, 595,932 3,549,005 199,788 ·46,927 

Insert offset folio 181 here HR862R.017

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE II --DEPARTMENT OF HEALTH AND HUMAN SERVICES 

HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) 

Primary Health Care 

Community Health Centers.. D 

Mandatory budget authority (Public Law 115·123)(NA). M 

Total, Community Health Centers 

Health CenterTort Claims. Free Clinics Medical Malpractice 

Total, Pr1mary Health Care (excluding 

mandatory funds) .. 

Health Workforce 

National Health Service Corps. 

Training for Diversity: 

Centers of Excellence. 

Health Careers Opportunity Program ... Faculty Loan Repayment. 

Scholarships for Disadvantaged Students 

Total, Training for Diversity 

0 

D 

D 

D D 

D 

D 

FY 2018 

Enacted 

1 '625' 522 

(3,800,000) 

---------·----

(5,425,522) 

1,000 

FY 2019 

Request 

4,990,629 

·-· 

---------

(4,990,629) 

99,893 

1,000 

--- - -------- -.- ·-

1 '626' 522 5,091,522 

105,000 310,000 

23,711 ---

14,189 ---

1 '190 

48,970 

··-

-

. 

- --

88,060 ··-

Bi 11 

1,525,522 

(4,000,000) 

Bi 11 vs 

Enacted 

·100 '000 

(+200,000) 

----- ---------

(5,525,522) (+100 ,000) 

1,000 

. 

-- - " -.. -- ·- --- --------

1,526,522 100,000 

105,000 

23,711 

-14,189 

1 '190 ·-· 

48,970 

------

- -

---------

73,871 -14,189 

B11l vs. 

Request 

·3,465, 107 

(+4' 000' 000) 

-----------

(+534' 893) 

-99,893 

--------

-3,565,000 

-205,000 

+23, 711 

---

+1 '190 

+48,970 

-

-

----

+73,871 

Insert offset folio 182 here HR862R.018

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Care Training and Enhancement 

lth Training. 

Dental Faculty loan Repayment. 

Interdisciplinary Community-Based Linkages 

Area Health Education Centers. 

Geriatric Programs. 

D 

D 

D D 

D 

D 

D 

Mental and Behavorial Health. 

Graduate Psychology Education. 

Behavioral Health Workforce Education and Training D 

Total, Interdisciplinary Community Linkages. 

Workforce Assessment .. 

Public Health and Preventive Medicine programs. 

Nursing Programs: 

Advanced Education Nursing. 

Nurse Education, Practice, and Retention. 

Nursing Workforce Diversity. Nursing Corps Scho'larship and Loan Repayment 

Program. 

Nursing Faculty Loan Program. 

Subtotal, Nursing programs. 

D 

0 

D 

D 

D 

D D 

FY 2018 

Enacted 

48,924 40,673 

38,250 

40,737 

36,916 

75,000 

190,903 

5,663 

17,000 

74,581 

41,913 

17 '343 

87,135 

28,500 

249' 472 

----

FY 2019 

Request Bi 11 

48,924 

38,673 

2,000 

38,250 

40,737 

---

24,916 

82,500 

Bill vs 

Enacted 

-2,000 

+2,000 

·36,916 

+24,916 

+7,500 

------- ------- -- -- -----------

4,663 

83,135 83,135 

186,403 

5,663 

17,000 

66,581 

41,913 

17,343 

87' 135 

28,500 

241 '472 

-4,500 

-8,000 

-8,000 

Bi 11 VS 

Request 

+48,924 +38,673 

+2 '000 

+38,250 +40,737 

··-

+24,916 

+82,500 

------------

+186,403 

+1 ,000 

+17,000 

+66' 581 +41,913 +17,343 

+4,000 

+28' 500 

+158,337 

Insert offset folio 183 here HR862R.019

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Children's Hospitals Graduate Medical Education. D 

Graduate Medical Education D 

Teaching Health Center, Graduate Medical Education .. 0 

National Practitioner Data Bank. D 

User Fees .. 0 

Total, Health Workforce. .. '' .. 

Maternal and Ch1ld Health 

Maternal and Child Health Block Grant D 

Sickle Cell Anemia Demonstration Program. D 

Autism and Other Developmental Disabilities. D 

Heritable Disorders in Newborns and Children. 0 

Family-to-Family Health Information Centers. D Maternal, Infant and Early Childhood Home Visiting 

Program. D 

Healthy Start. . D 

Universal Newborn Hearing Screening. 0 

Emergency Medical Services for Children. D 

Screening and treatment for maternal depression. D 

Pediatric Mental Health Care Access. D 

Total, Maternal and Child Health 

FY 2018 

Enacted 

315,000 

---

--· 

18,814 18,814 

FY 2019 

Request 

---

---

60,000 

18,814 

·18,814 

----- --- ------

1,060,695 457,798 

651,700 627,700 

4,455 ---

49,099 ---

15,883 -·-

--- 5,000 --- 400,000 

110,500 103,500 

17,818 

22,334 --

5,000 ---

10,000 

- - - - - w --

---------

886,789 1 '136' 200 

Bill 

325,000 

200,000 

--

18,814 

-18,814 

---

------ --

1 ,244,006 

655,000 

4,455 

52,099 

16,883 

110,500 

17,818 

22,334 

5,000 

9,000 

-

-

.. 

-

---- ---

893,089 

Bill vs. 

Enacted 

+10,000 

+200,000 

-----------

+183,311 

+3,300 +3,000 +1 ,000 

-·-

------

-1 ,000 

- ----- w--

+6,300 

Bi 11 vs 

Request 

+325,000 +200,000 

-60,000 

-- -----

+786' 208 

+27,300 

+4,455 

+52,099 +16,883 

-5,000 

-400,000 

+7,000 

+17,818 

+22,334 

+5 '000 

+9,000 

-243,111 

Insert offset folio 184 here HR862R.020

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Ryan White HIV/AIDS Program 

Emergency Assistance (Part A). 

Comprehensive Care Programs (Part B). 

AIDS Drug Assistance Program (ADAP) (NA). 

Early Intervention Program (Part C) .. 

Children, Youth, Women, and Families (Part D). 

AIDS Dental Services (Part F). 

Education and Training Centers (Part F). 

Special Projects of National Significance. 

Total, Ryan White HIV/AIDS program. 

Health Care Systems 

Organ Transplantation. 

National Cord Blood Inventory. 

C W. Bill Young Cell Transplantation 3408 Drug Pricing program/Office of Pharmacy Affairs 

User Fees .. 

Poison Control Centers. Hansen's Disease Program 

Hansen's Disease Program Buildings and Fac1lities. 

Payment to Kawai i , Treatment of Hansen's, . 

Total. Health Care Systems. 

0 

D 

NA 

D 

D D D 

0 

D D 

0 

D D D D 

0 

D 

FY 2018 

Enacted 

655,876 

1,315,005 

( 900' 313) 

201.079 

75,088 

13,122 

33,611 

25,000 

- k - - - " --

2,318,781 

25' 549 

15,266 

24,109 

10,238 

... 

20,846 

13,706 

122 

1,857 

FY 2019 

Request 

655,876 

1,315,005 

(900,313) 

201,079 

75,088 

13,122 

... 

--------------

2,260,170 

23,549 

12,266 

22,109 26,238 

-16,000 

18,846 11,653 

1,857 

. 

--

---- " --" ----

111,693 100,518 

Bill 

655,876 

1 ,315,005 

(900,313) 

201 '079 

75,088 

13,122 

33,611 

25,000 

---------- ---

2,318,781 

25,549 

17' 266 

25,109 

15,238 

22,846 

13,706 

122 

1 ,857 

--------- -

121,693 

Bill vs 

Enacted 

... ... 

Bill vs 

Request 

+33, 611 

+25,000 

----- -----

- -"---

... +58,611 

+2,000 

+2,000 +5,000 +1,000 +3,000 +5,000 -11 ,000 

+16,000 

+2,000 +4,000 

·-- +2,053 

--- +122 

--------·-- ----

+10,000 +21 ,175 

Insert offset folio 185 here HR862R.021

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Rural Health 

Rural Outreach Grants. 

Rural Health Research/Policy Development 

Rural Hospital Flexibility Grants. 

Small Hospital Improvement Grants. 

State Offices of Rural Health. 

Black Lung Clinics ... Radiation Exposure Screening and Education Program. 

Telehealth. 

Rural Communities Opioid Response. Rural Residency Program. 

Total. Rural Health 

Family Planning 

Program Management 

Total, Health resources and services (HRS) 

D 

D 

D 

D 

D 

D 

D 

D D D D 

D 

FY 2018 

Enacted 

71,500 

9,351 

49,609 

10,000 

10,000 

1,834 

23,500 

100,000 

15,000 

- --- --

290,794 286,479 

155,000 

FY 2019 

Request 

50,811 

5,000 

7,266 

1,834 

10,000 

... 

- - h -- - - - K -

74,911 

286,479 

151 ,993 

---- --

--

--- ---------

6,736,753 9,559,591 

Bi 11 

71,500 

9,351 

33,667 

25,942 

11 000 

12,000 

1 ,834 

23,500 

82,500 

10,000 

----------

281,294 

... 

155,000 

------------

6,540,385 

Bill vs. 

Enacted 

... 

"' 

-15,942 

+25,942 

+1 ,000 

+2' 000 

... 

-17' 500 

·5,000 

Bill vs 

Request 

+20 '689 

+4 ,351 

+33,667 +25,942 

+11 ,000 

+4,734 

+13,500 +82' 500 +10,000 

-- ---- --- ... 

·9,500 +206,383 

·286,479 ·286,479 

·-· +3,007 

----- ---- -- -----

196,368 ·3,019,206 

Insert offset folio 186 here HR862R.022

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Vaccine Injury Compensation Program Trust Fund 

Post-FY 1988 Claims. 

HRSA Administrative expenses. 

Total, Vaccine Injury Compensation Trust Fund. 

Total, Health Resources and Services 

Administration. 

CENTERS FOR DISEASE CONTROL AND PREVENTION 

Immunization and Respiratory Diseases 

Prevention and Public Health Fund 1/. 

Subtotal . 

HIV/AIDS, Viral Hepatitis, Sexually Transmitted 

Diseases, and Tuberculosis Prevention. 

Emerging and Zoonotic Infectious Diseases. 

Prevention and Public Health Fund 11. 

Subtotal. 

TF 

D 

NA 

D 

D 

NA 

FY 2018 

Enacted 

268,000 

9,200 

277' 200 

7,013,953 

474' 055 

(324,350) 

- -

. 

-

. 

-

( 798' 405) 

1 '127' 278 

562,572 

(52, 000) 

614,572 

--

FY 2019 

Request 

308,000 

9,200 

317,200 

9,876,791 

700,828 

---

--

. 

(700,828) 

1,117,278 

508,328 

---

508,328 

Bi 11 

308,000 

9,200 

317,200 

6,857,585 

484,055 

(324,350) 

(808,405) 

1 '147,278 

562,572 

(52,000) 

614,572 

Bi 11 vs. Bi 11 vs. 

Enacted Request 

+40,000 

+40,000 

-156,368 -3,019,206 

+10,000 -216,773 

--- (+324 '350) 

(+10,000) (+107,577) 

+20,000 +30,000 

--- +54,244 

(+52,000) 

. 

-

--- +106,244 

Insert offset folio 187 here HR862R.023

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2016 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts 10 Thousands) 

Chronic Disease Prevention and Health Promotion. 0 

Prevention and Public Health Fund 11 ... NA 

Subtotal 

Birth Defects, Developmental Disabilities, 

Disabilities and Health. D 

Subtotal. NA 

Public Health Scientific Services. D 

Evaluation Tap Funding. NA 

Subtotal. 

Environmental Health. D 

Prevention and Public Health Fund 11 .. NA 

Subtotal. 

Injury Prevention and Control. D 

National Institute for Occupational Safety and Health D 

Energy Employees Occupational Illness 

Compensation Program. M 

... 

FY 2016 

Enacted 

915,346 

(247,550) 

1 '162, 896 

140,560 

-------------

140,560 

490,397 

---

--- ----

( 490' 397) 

188,750 

(17,000) 

--------------

205,750 

648,559 

335,200 

55,358 

FY 2019 

Request 

939,250 

.. . 

939,250 

110,000 

Bi 11 

910,746 

(294,650) 

. 

--

... 

-- ---

1,205,396 

150,560 

Bi 11 vs. Bill vs. 

Enacted Request 

-4,600 -28,504 

(+47,100) ( +294 '650) 

---

.,. . ---

+42,500 +266,146 +10,000 +40,560 

----------- ---- -------- --- ----------

110,000 150,560 +10,000 +40,560 

332,180 495,397 +5,000 +163,217 

( 135 ,820) --- --- { -135,820) 

- " -- - - - " " -- " ------ -- -------- --- ---

(468,000) (495,397) (+5,000) ( +27' 397) 

157,000 184,350 -4,400 +27,350 

--- (17 ,000) -·· ( +17' 000) 

---------- ---

- --------

--------

-------------

157,000 201,350 -4,400 +44,350 

266,309 690,559 +42,000 +424,250 

339,200 +4,000 +339,200 

55,358 ... +55,358 

Insert offset folio 188 here HR862R.024

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Global Health D 

Public Health Preparedness and Response .. D 

Buildings and Facilities. D 

Transfers from Nonrecurring Expenses Fund. NA 

Subtotal. 

CDC-Wide Activities and Program Support 

Prevention and Public Health Fund 1/. NA 

Office of the Director. D 

Infectious Diseases Rapid Response Reserve Fund. D 

Subtotal, CDC-Wide Activit1es and Program Support. 

Total, Centers for Disease Control .. 

Discretionary. 

Evaluation Tap Funding (NA) .. 

Prevention and Public Health Fund 1/. 

Transfers from Nonrecurring Expenses Fund .. 

Total, Centers for Disease Control Program Level 

NA 

NA 

NA 

FY 2018 

Enacted 

488,621 

1 '450' 000 

270,000 

(240,000) 

FY 2019 

Request 

408,762 

800,000 

30,000 

---

Bi 11 

488,621 

860,000 

30,000 

---

Bi 11 vs 

Enacted 

-590,000 

-240,000 

( -240' 000) 

Bi 11 VS, 

Request 

+79,859 

+60,000 

-------------- ----------- -- -------------- -- -- ------- -

-

-------------

510,000 30,000 30,000 -480,000 

( 160, 000) --- (160,000) (+160,000) 

113,570 155,000 113,570 -41 ,430 

325,000 +325,000 +325,000 

--- ---------- -------------- ------------ - ------ ------- ------- -- ---

(273,570) (155,000) (598,570) (+325,000) (+443,570) 

============== =========~==== 7,260,266 5,524,935 6,837,266 -423,000 +1 ,312,331 

7,204,908 5,524,935 6,781,908 -423,000 +1 '256' 973 

--- (135,820) --- (-135,820) 

(800, 900) --- (848,000) (+47' 100) (+848,000) 

(240,000) --- --- (-240,000) 

-

----- ---- -- ---

(8,301 '166) (5,660,755) (7,685,266) ( -615' 900) (+2,024,511) 

Insert offset folio 189 here HR862R.025

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

NATIONAL INSTITUTES OF HEALTH 

National Cancer Institute (NCI). 

NIH Innovation Account, CURES Act2/, 

Subtotal , NCI 

National Heart, Lung, and Blood Institute (NHLBI) National Institute of Dental and Craniofacial Research 

(N!DCR). 

National Institute of D1abetes and Digestive and 

D 

D 

D D 

Kidney Diseases (NIDDK). D 

,Juvenile Diabetes (mandatory)., NA 

Subtotal , NIDDK program level , 

National Institute of Neurological Disorders and 

Stroke (NINDS). D 

NIH Innovation Account, CURES Act2/, D 

Subtotal, NINDS. 

National Institute of Allergy and Infectious Diseases 

(NIAID). D 

FY 2018 

Enacted 

5' 664,800 

- -- -- " 

-

5,664,800 

3,383,201 

447,735 

1 '970, 797 

(150,000) 

2' 120' 797 

2, 145,149 

--------- ----

2, 145,149 

5,260,210 

FY 2019 

Request 

5,226,312 

400,000 

5,626,312 

3,112,032 

413,196 

1,965,434 

(150,000) 

2,115,434 

1 '781 ,056 

57,500 

Bi 11 

5,736,037 

400,000 

6' 136' 037 

3,423,604 

453,082 

1 '994' 333 

(150,000) 

2' 144' 333 

2' 171 '280 

57.500 

Bill vs, 

Enacted 

+71 ,237 

+400,000 +471 ,237 

+40,403 

+5,347 

+23,536 +23,536 +26, 131 

+57,500 

------ ------- - -- -----------

1,838,556 2,228,780 +83' 631 

4,761,948 5,368,029 +107,819 

Bill vs, 

Request 

+509,725 

+509,725 +311,572 

+39,686 

+28,899 

+28' 899 

+390,224 

-----------

+390,224 +606 '081 

Insert offset folio 190 here HR862R.026

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

National Institute of General Medical Sciences (NIGMS) D 

Evaluation Tap Funding. NA 

Subtotal, NIGMS program level. 

Eunice Kennedy Shriver National Institute of Child 

Health and Human Development (NICHD). D 

National Eye Institute (NEI) .. D 

National Institute of Environmental Health Sciences 

(NIEHS). ... ' .. 0 

National Institute on Aging (NIA). 0 

National Institute of Arthritis and Musculoskeletal 

and Skin Diseases (NIAMS). D 

National Institute on Deafness and Other Communication 

Disorders (NIDCD). 0 

Nati anal Institute of Nursing Research (NINR). D 

National Institute on Alcohol Abuse and Alcoholism 

(NIAAA). D 

National Institute on Drug Abuse (NIDA). D 

National Institute of Mental Health (NIMH). D 

NIH Innovation Account, CURES Act21. D 

Subtota 1 , NIMH. 

National Human Genome Research Institute (NHGRI) D 

National Institute of Biomedical Imaging and 

Bioengineering (NIBIB). D 

FY 2018 

Enacted 

1 '862' 529 

(922,871) 

FY 2019 

Request 

1,831,669 

(741,000) 

Bi 11 

1,895,796 

(922,871) 

Bill vs. Bill vs. 

Enacted Request 

+33,267 +64' 127 

--- (+181 ,871) 

-

- -

--

-

-

-

----- -

- -

-

-

-

-

--

-

--- -

- -

-----

-

-

-

---- -- -

-

-----

-

--- -

-

-----

- -

-

-

--

-

2,785,400 2,572,669 2,818,667 +33,267 +245,998 

1 '452' 006 1,339,592 1,469,346 +17,340 +129,754 

772' 317 711,015 781,540 +9,223 +70,525 

751 '143 693,199 760,113 +8,970 +66,914 

2,574,091 1,988,200 3,005,831 +431 ,740 +1,017,631 

586,661 545,494 593,663 +7,002 +48, 169 

459,974 423,992 465,467 +5' 493 +41 ,475 

158,033 145,842 159,920 +1 ,887 +14,078 

509,573 469,109 515,658 +6,085 +46,549 

1,383,603 1 '137' 403 1 '400' 126 +16,523 +262,723 

1 '711 '775 1,554,692 1,732,731 +20,956 +178 '039 

57,500 57,500 +57' 500 ~~~-~~~-~- -~ 1 '711 '775 1 ,612,192 1 ,790' 231 +78,456 +178 '039 

556' 881 512,979 563,531 +6,650 +50,552 

377' 871 346,550 382,384 +4,513 +35,834 

Insert offset folio 191 here HR862R.027

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

National Center for Complementary and Integrative 

Health (NCCIH). D 

National Institute on Minority Health and Health 

Disparities (NIMHD).. D 

John E. Fogarty International Genter (FIC). D 

National Library of Medicine (NLM). D 

National Center for Advancing Translational Sciences 

(NCATS). D 

National Institute for Research on Safety and Quality 

(NIRSQ)31. . . . . . D 

National Institute for Occupational Safety and Health 

(NIOSH). 0 

National Institute on Disability, Independent living, 

and Rehabilitation Research (NIDILRR) D 

Energy Employees Occupational Illness 

Compensation Program.. M 

Office of the Director. D 

Common Fund (non-add). NA 

Gabriella Miller Kids First Research Act (Common 

Fund add). D 

NIH Innovation Account, CURES Act21.. D 

Buildings and Facilities.. D 

Total, National Institutes of Health (NIH). 

(Evaluation Tap Funding). 

Total . NIH Program Level . 

FY 2018 

Enacted 

142, 1B4 

303,200 

75' 733 

428,553 

742,354 

1,803,293 

(588, 116) 

12,600 

496,000 

128,863 

36,161 '129 

(922 ,871) 

(37,084,000) 

FY 2019 

Request 

130,717 

280,545 

70,084 

395,493 

685,087 

255,960 200,000 

95,127 

55,358 

1,795,706 

(586, 181) 

12,600 

196,000 

200,000 

33,847' 391 

(741,000) 

(34,588,391) 

Bi 11 

143,882 

306.821 

76,637 

433,671 

751,219 

1,902,828 

(595,139) 

12,600 

196,000 

200,000 

37,411,129 

(922,871) 

(38,334,000) 

Bill vs. 

Enacted 

+1 ,698 

+3 ,621 

+904 

+5' 118 

+8,865 

+99,535 

(+7,023) 

-300,000 

+71 '137 

+1,250,000 

Bill vs. 

Request 

+13' 165 

+26,276 

+6,553 

+38' 178 

+66' 132 

-255,960 

-200,000 

-95,127 

-55' 358 

+107,122 

(+8,958) 

+3,563,738 

(+181 ,871) 

(+1,250,000) (+3,745,609) 

Insert offset folio 192 here HR862R.028

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION (SAMHSA) 

Menta 1 Health 

Programs of Regional and National Significance .. 

Prevention and Public Health Fund 11 

Subtotal .. 

Mental Health block grant. 

Evaluation Tap Funding 

Subtotal. 

Certified Community Behavioral Health Clinics 

National Child Traumatic Stress Initiative 

Children's Mental Health. . ......... , 

Grants to States for the Homeless (PATH) .. 

Protection and Advocacy .. 

Unspecified reduction 

Subtotal, Mental Health. 

(Evaluation Tap Funding) (Prevention and Public Health Fund 1/) 

Subtotal, Mental Health program level. 

D 

NA 

D 

NA 

0 0 0 0 0 0 

FY 2018 

Enacted 

426,659 

( 12,000) 

438,659 

701,532 

(21,039) 

(722, 571) 

100,000 125,000 

64,635 

36,146 

1,453,972 

(21 ,039) 

(12,000) 

(1 ,487,011) 

FY 2019 

Request 

282,544 282,544 

541,532 

(21,039} 

(562,571) 

119,026 

64,635 

36,146 

1,043,883 

(21,039) 

(1 ,064,922) 

Bi 11 

412,271 412,271 

701 ,532 

(21,039) 

(722,571) 

63,887 

125,000 

64,635 

36 '146 

-10,000 

1,393,471 

(21 ,039) 

(1 ,414,510) 

Bill vs. 

Enacted 

-14,388 

(-12,000) 

-26,388 

-100,000 

+63,887 

-10,000 -80,501 

( -12,000) 

( -72,501) 

Bi 11 vs. 

Request 

+129,727 

+129,727 

+160,000 

(+160,000) 

+63,887 

+5,974 

-10,000 

+349,588 

(+349,588) 

Insert offset folio 193 here HR862R.029

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Programs of 

Evaluation 

Subtotal. 

Substance Abuse Treatment 

and National Significance 

Funding. 

Substance Abuse block grant 

Evaluation Tap Funding. 

Subtotal. block grant 

State Opioid Response grants. 

Subtotal, Substance Abuse Treatment. 

(Evaluation Tap Funding). 

Subtotal, Program level. 

D 

NA 

D 

NA 

0 

FY 2018 

Enacted 

403,427 

(2,000) 

FY 2019 

Request 

255,318 

---

Bi 11 

493,427 

(2,000) 

Bill vs. Bi 11 vs. 

Enacted Request 

+90,000 +238, 109 

(+2,000) 

-

. 

----

- - -

-- - --- -------- ----- -- ---------- --- -------------

(405,427) (255,318) (495' 427) (+90,000) (+240, 109) 

1 '778' 879 1 '778' 879 2,278,879 +500,000 +500,000 

(79,200) (79,200) (79,200) 

--- ----- --- ----- ----- ----------- ---- --------- --------

(1 ,858,079) (1,858,079) (2,358,079) (+500,000) (+500,000) 

1,000,000 1 ,000,000 --- +1 ,000,000 

---- - -- -- --------- --- ----------.- .. ---------- - ---

3, 182,306 2,034,197 3,772,306 +590,000 +1 '738, 109 

(81 '200) (79,200) (81 ,200) --- (+2,000) 

(3,263,506) (2,113,397) (3,853,506) (+590,000) (+1 ,740,109) 

Insert offset folio 194 here HR862R.030

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Substance Abuse Prevention 

Programs of Regional and National Significance. 

Evaluation Tap Funding (NA), 

Subtotal,, 

Health Surveillance and Program Support. 

Evaluation Tap Funding (NA). 

Subtotal, 

Total, SAMHSA. 

(Evaluation Tap Funding) (Prevention and Public Health Fund 11)., 

Total, SAMHSA Program Level, 

D 

NA 

D 

NA 

FY 2018 

Enacted 

248,219 

---

-- -

-- - -

-- --

248,219 

128,830 

(31 ,428) 

--------- ----

160,258 

FY 2019 

Request 

220,885 

---

Bi 11 

19,954 

(228,765) 

Bill VS, 

Enacted 

-228,265 

( +228 ,765) 

-------- ------- --- ----------

220,885 248.719 +500 

126,922 133,830 +5,000 

(20,426) (31 ,428) ---

------ --------- -------------

147,348 165,258 +5,000 

Bill VS, 

Request 

-200,931 

{+228,765) 

-------------

+27,834 

+6' 908 

(+11 ,002) 

---------

+17 '910 

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

5,013,327 3,425,887 5,319,561 +306,234 +1,893,674 

(133,667) (120,665} (362,432) (+228,765) {+241 '767) 

(12,000) --- (-12,000) 

------ -

-

---- ---

-

---- -------- --· 

( 5' 158' 994) (3,546,552) (5,681,993) (+522,999) ( +2' 135' 441) 

Insert offset folio 195 here HR862R.031

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)31 

Healthcare Research and Quality 

Research on Health Costs, Quality, and Outcomes 

Federal Funds. 

Medical Expenditures Panel Surveys: 

Federal Funds. 

Program Support: 

Federal Funds 

Total, AHRQ (Federal funds)3/ Total, Public Health Service (PHS) appropriation Total, Public Health Service Program Level. 

D 

0 

D 

FY 2018 

Enacted 

197,156 

66,000 

70,844 

334,000 

55,782,675 

(57' 892' 113) 

FY 2019 

Request 

52,675,004 

(53,672,489) 

Bill vs. B1ll vs. 

Bil Enacted Request 

192,709 -4,447 +192,709 

69,991 +3,991 +69 '991 

71,300 +456 +71 '300 

- -- ---- ---

-

------- -- -

334,000 --- +334,000 

============== =========;==== ============= 

56.759,541 +976,866 +4,084,537 

(58,892,844) (+1 ,000, 731) (+5,220,355) 

Insert offset folio 196 here HR862R.032

COMPARATIVE STATEMENT OF NEW BUDOET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

CENTERS FOR MEDICARE AND MEDICAID SERVICES 

Grants to States for Medicaid 

Medicaid Current Law Benefits. 

State and Local Administration 

Vaccines for Children. 

Subtotal, Medicaid Program Level 

Less funds advanced in prior year. 

Total, Grants to States for Medicaid. 

New advance, 1st quarter, FY 2020, 

Payments to Health Care Trust Funds 

Supplemental Medical Insurance .. 

Federal Uninsured Payment 

Program Management ... 

General Revenue for Part D Benef1t. General Revenue for Part D Administration. 

HCFAC Reimbursement .. 

State Low-Income Determination for Part D. 

Total, Payments to Trust Funds, Program Level .. 

M 

M 

M 

M 

M 

M 

M 

M 

M 

M M 

M 

FY 2018 

Enacted 

384,608,394 

20' 811,084 

4,598,358 

FY 2019 

Request 

384,882,625 

21 '474, 885 

4,726,461 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

384,882,625 +274,231 

21,474,885 +663,801 

4,726' 461 +128,103 

- ---

--

--

- -

. 

- -- -------- ----- - --- -------- -- -------------

410,017,836 411,083,971 411,083,971 +1,066,135 

-125' 219 '452 -134,847,759 -134,847,759 -9,628,307 

-------------- -------- --------- ---------- -------------

284,798,384 276,236,212 276,236,212 -8.562,172 

134,847,759 137,931,797 137' 931 ,797 +3,084,038 

245,396,000 284,288,300 284,288,300 +38,892,300 

132,000 127,000 127,000 -5,000 

1 '104,000 898,000 898,000 -206,000 

76' 133,000 92,070,000 92,070,000 +15,937,000 

422,000 642,000 642,000 +220,000 

307,000 315,000 315,000 +8,000 

3,300 3,500 3,500 +200 

------- ------- --- -------------- --- ------- --- -- ---

323,497,300 378,343,800 378,343,800 +54,846,500 

Insert offset folio 197 here HR862R.033

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Program Management 

Research, Demonstration, Evaluat1on. 

Program Operations. 

State Survey and Certification 

Federal Administration 

Total, Program management. 

Health Care Fraud and Abuse Control Account 

Centers for Medicare and Medicaid Services 

HHS Office of Inspector General .. 

Medicaid/CHIP. Department of Justice .. 

Total, Health Care Fraud and Abuse Control. 

Total, Centers for Medicare and Medicaid Services 

Federal funds .. 

Current year. 

New advance, FY 2020. 

Trust Funds. 

TF 

TF 

TF 

TF TF TF 

TF TF 

FY 2018 

Enacted 20,054 

2,519,823 

397,334 

732,533 

FY 2019 

Request 

18,054 

2 402,089 

421 '135 

702,601 

Bi 11 

2,402,089 

397,334 

702,601 

- + - - -- - -----

-------- ----- - ---

3,669,744 3,543,879 3,502,024 

500,368 604,389 599,389 

84,398 87,230 87,230 84,398 

75,836 78,381 78,381 

- -- - ---- -- - -- ----------

745,000 770,000 765,000 

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

747,558,187 796.825,688 796,778,833 

743,143,443 792,511,809 792,511,809 

(608,295,684) (654,580,012) (654,580,012) ( 134 ' 84 7 ' 759) (137,931,797) ( 137' 931 ,797) 

4, 414,744 4,313,879 4,267,024 

Bill vs. 

Enacted 

-20,054 

-117.734 

-29,932 

-167' 720 

+99 ,021 

+2,832 

-84,398 

+2,545 

+20,000 

+49,220,646 

+49,368,366 

(+46,284,328) 

(+3,084,038) 

-147,720 

Bill vs. 

Request 

-18,054 -23,801 

-41,855 

-5,000 

-5,000 

-46,855 -46,855 

Insert offset folio 198 here HR862R.034

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF) 

Payments to States for Child Support Enforcement and 

Family Support Programs 

0 ayments to Territories .. Repatriation 

Subtotal. 

:hild Support Enforcement: 

State and Local Adm1nistration. 

Feder a 1 Incentive Payments. 

Access and Visitation 

Subtotal, Child Support Enforcement 

Tot a 1 , Fami 1 y Support Payments Program Leve 1 . 

M 

M 

M M M 

Less funds advanced in previous years. M 

Total, Fami 1 y Support Payments, current year. 

New advance, 1st quarter, FY 2020. M 

FY 2018 

Enacted 

33,000 

1 ,000 

34,000 

763,200 

588,200 

10,000 

·---------- --

4,361,400 

------------

4,395,400 

·1 ,400,000 

FY 2019 

Request 

33,000 

1,000 

34,000 

3,689,574 

588,673 

10,000 

Bi 11 

33,000 

1,000 

34,000 

3,689,574 

588,673 

10,000 

Bi 11 vs. Bill vs. 

Enacted Request 

-73,626 

+473 

-------- ---- -- -- -

-

- -

-

------ -

- -

-

-

-- -------

---

4,288,247 4,288,247 -73,153 

------------ ------

---

-- --------- -------------

4,322,247 4,322,247 -73,153 

·1,400,000 -1,400,000 

------ ----- ---------- ------------ .. --------

2,995,400 2,922,247 2,922,247 -73,153 

1, 400,000 1,400,000 1,400,000 

Insert offset folio 199 here HR862R.035

COMPARATIVE STATEMENT OF NEW BUDGET {OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

{Amounts in Thousands) 

Low Income Home Energy Assistance {LIHEAP) 

Formula Grants. 

Refugee and Entrant Assistance 

Transitional and Medical Services 

Refugee Support Services 

Victims of Trafficking 

Unaccompanied Minors .. 

Unaccompanied Minors Contingency Fund. 

Victims of Torture. 

Total, Refugee and Entrant Assistance 

0 

0 

D D 

D D 

D 

FY 2018 

Enacted 

3, 640,304 

320,000 

207.201 

23,755 

1 '303' 245 

---

10,735 

------·----

1,864,936 

FY 2019 

Request 

354,000 

160,821 

18,755 

1,048,000 

200,000 

10,735 

-----------

1 '792, 311 

Bill vs. Bi l1 vs 

Bi 11 Enacted Request 

3,640,304 -- +3,640,304 

320,000 --- -34,000 

207,201 --- +46,380 

23,755 +5,000 

1,303,245 +255,245 

--- -200,000 

10,735 

-------- ----- - --- --------

1,864,936 --- +72,625 

Insert offset folio 200 here HR862R.036

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Payments to States for the Child Care and Development 

Block Grant.. D 

Social Services Block Grant (Title XX). M 

Discretionary Funds... D 

Children and Families Services Programs 

Programs for Children, Youth and Families: 

Head Start, current funded. 0 Preschool Development Grants. 0 

Consolidated Runaway, Homeless Youth Program. 0 

Prevention Grants to Reduce Abuse of Runaway Youth D 

Child Abuse State Grants. D Child Abuse Discretionary Activities.. 0 

Community Based Child Abuse Prevention. D Child Welfare Services. D Child Welfare Training, Research, or Demonstration 

projects. D 

Adoption Opportunities. D 

Adoption Incentive grants.. D 

FY 2018 

Enacted 

5,226,000 

1,700,000 

9,863,095 

250,000 

110,280 

17,141 

85,310 

33,000 39,764 

268,735 

17,984 

39,100 

75,000 

FY 2019 

Request 

3,006,000 

1,700,000 

85,000 

9,275,000 

101,980 

17,141 

25,310 

33,000 

39,764 

268,735 

17,984 

39,100 37,943 

Bi 11 

5,226,000 

1,700,000 

9,913,095 

250,000 

104,280 

17,141 

85,310 

33,000 39,764 

278,735 

17,984 

39,100 

80,000 

Bill vs. 

Enacted 

+50,000 

-6,000 

+10,000 

+5,000 

Bill vs. 

Request 

+2,220,000 

-85.000 

+638,095 +250,000 

+2. 300 

+60. 000 +10,000 +42,057 

Insert offset folio 201 here HR862R.037

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Social Services and Income Maintenance Research D 

Native American Programs. D 

Community Services: 

Community Services Block Grant Act programs: 

Grants to States for Community Services. D 

Economic Development D 

Rural Community Facilities, D 

Subtotal, Community Services. 

Domestic Violence Hotline. D Family Violence/Battered Women's Shelters. D 

Chafee Education and Training Vouchers, D 

Disaster Human Services Case Management. D 

Program Direction. D 

Total, Children and Families Services Programs 

FY 2018 

Enacted 

6,512 

54,050 

715,000 

19,883 

8,000 

FY 2019 

Request 

6,512 

52,050 

---------

Bi 11 

6,512 

55,050 

750,000 

19,883 10,000 

Bi 11 vs, 

Enacted 

+1 ,000 

+35,000 

+2' 000 

- ------- --- ----- -------- -- -- ----

-

------ --

742,883 779' 883 +37,000 

9,250 8,250 9,250 ---

160,000 151,000 160,000 ---

43,257 43,257 43,257 

1,864 1,864 1 ,864 

205,000 205,000 208,000 +3' 000 

-----

-" . --- - -- --------·-* -------

12,022,225 10,323,890 12' 122 '225 +100,000 

Bi 11 vs 

Request +3 '000 

+750,000 

+19,883 

+10,000 

----------

+779,883 

+1 ,000 +9,000 

+3' 000 

---

+1 '798' 335 

Insert offset folio 202 here HR862R.038

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Promoting Safe and Stable Families ... M 

Discretionary Funds .. D 

Total, Promoting Safe and Stable Families 

Payments for Foster Care and Permanency 

Foster Care M 

Adoption Assistance. ''''' M 

Guardianship. ''''' M 

Independent Living. M 

Total. Payments to States. 

Less Advances from Prior Year. M 

Total, payments, current year. 

New Advance, 1st quarter, FY 2020. M 

Total, ACF. ... ,., 

Current year. ........ 

FY 2020. 

Total , ACF Program Level 

---

---

FY 2018 

Enacted 

345,000 

99,765 

---

444,765 

5,537,000 

2,867,000 

181,000 140,000 

---

8,725,000 

-2,500,000 

-------------

6,225,000 

2,700,000 

FY 2019 

Request 

325,000 

209,765 

- --

.. 

- --

534,765 

5,329,000 

3,063,000 

203,000 

140,000 

-- --

8,735,000 

-2,700,000 

-------------

6,035,000 

2,800,000 

Bi 11 

345,000 

59,765 

----- ----

404,765 

5,329,000 

3,063,000 

203,000 

140,000 

Bi 11 VS. 

Enacted 

-40,000 

--

_, __ 

-40,000 

-208 000 

+196,000 

+22,000 

Bill vs 

Request 

+20,000 

150,000 

- --

130,000 

--------- ---- --- ----- -----

8,735,000 +10,000 

·2,700,000 -200,000 

------- ---- - ---- --------- --

6,035,000 -190,000 

2,800,000 +100,000 

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

38,218,630 30,599,213 38,115,477 -103,153 +7,516,264 

(34, 118,630) (26,399,213) (33, 915' 477) ( -203' 153) (+7,516,264) 

(4, 100,000) (4,200,000) (4,200,000) (+100,000) 

- -- ------- -- ---------- -- - ------ - ----

38,218,630 30,599,213 38' 115' 477 -103,153 +7,516,264 

Insert offset folio 203 here HR862R.039

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

ADMINISTRATION FOR COMMUNITY LIVING 

Aging and Disability Services Programs 

Grants to States: 

Home and Community-based Supportive Services. D 

Preventive Health. D 

Protection of Vulnerable Older Americans-Title VII D 

Subtota 1 . 

Family Caregivers. 

Native American Caregivers Support. 

Subtotal, Caregivers. 

Nutrition: 

Congregate Meals 

Home Delivered Meals. 

Nutrition Services Incentive Program. 

Subtotal. 

Subtotal, Grants to States. 

D 

D 

D 

D 

D 

FY 2018 

Enacted 

385,074 

24,848 

21 ,658 

--- ---

431 '580 

180,586 

9,556 

FY 2019 

Request 

350,224 

24,848 

20,628 

M M - - - - M M -

395,700 

150' 586 

7,556 

----------- -- --------------

190,142 158,142 

490,342 450,342 

246,342 227,342 

160,069 160,069 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

385,074 +34,850 

24,848 

21,658 +1 ,030 

-- -- - ---- -- -- -------- -------------

431,580 --- +35,880 

180,586 +30,000 

10,556 +1 ,000 +3,000 

----------- -------------- -----------

191 '142 +1 ,000 +33 '000 

490,342 --- +40,000 

246,342 --- +19,000 

160,069 

-------------- -------------- -------------- -------------- -------------

896,753 837,753 896,753 --- +59,000 

- - w - - -

-- --- ----

1,518,475 1,391,595 1,519,475 +1 ,000 +127,880 

Insert offset folio 204 here HR862R.040

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Grants for Native Americans. 

Aging Network Support Activities. 

Alzheimer's Disease Program. 

Prevention and Public Health Fund 1/. 

Lifespan Respite care. 

Chronic Disease Self-Management Program. 

Prevention and Public Health Fund 1/. 

Elder Falls Prevention. 

Prevention and Public Health Fund 11. 

Elder R1ghts Support Activities. 

Aging and Disability Resources. 

State Health Insurance Program 

Paralysis Resource Center. 

Limb loss. 

Traumatic Brain Injury. 

D 

0 

D 

NA 

D 

D 

NA 

D 

NA 

D 

D 

TF 

D 

D 

D 

FY 2018 

Enacted 

33,208 

12,461 

8.800 

(14,700) 

4,110 

(8,000) 

... 

(5,000) 

15,874 

8,119 

49,115 

7, 700 

3,500 

11 '321 

FY 2019 

Request 

31,208 

8,998 

19.490 

3,360 

11 '874 

6,119 

9,321 

Bi l1 vs. Bill vs. 

Bi l1 Enacted Request 

35,208 +2,000 +4,000 

17,461 +5,000 +8,463 

23,500 +14,700 +4,010 

(-14,700) ... 

4,110 ... +750 

8,000 +8,000 +8,000 

··- (·8,000) ... 

5,000 +5,000 +5,000 

( ·5,000) 

15,874 ... +4,000 

8,119 ... +2,000 

49,115 ... +49,115 

7,700 ... +7,700 

3,500 +3,500 

11 ,321 . .. +2,000 

Insert offset folio 205 here HR862R.041

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Developmental Disabilities Programs: 

State Councils. D 

Protection and Advocacy. 0 

Voting Access for Individuals with Disabilities D 

Developmental Disabilities Projects of National D 

Significance. D 

University Centers for Excellence in Developmental D 

Disabilities. D 

Subtotal, Developmental Disabilities Programs 

Workforce Innovat1on and Opportunity Act 

Independent Living. 0 

National Institute on Disability, Independent 

Living, and Rehabilitation Research. 0 

Assistive Technology. 0 

Subtotal, Workforce Innovation and Opportunity 

Act. 

FY 2018 

Enacted 

76,000 

40,734 

6,963 

12,000 

40,619 

FY 2019 

Request 

56,000 

38,734 

4,963 

1,050 

32,546 

-

-

. 

-

-

-

------ -------

- -

---- -

176,316 133,293 113,183 95,997 104,970 ---

36,000 31 '939 

------

---

..... 

--

254' 153 127,936 

Bill VS. Bi 11 vs. 

Bi 11 Enacted Request 

76,000 --- +20,000 

40,734 --- +2,000 

6,963 --- +2,000 

12,000 --- +10,950 

40,619 --- +8,073 

----------- ------- --- ----------

176,316 +43' 023 

120,000 +6,817 +24,003 104,970 --- +104,970 

36,000 --- +4, 061 

----

--

-

-- - -- - - - -- ---

260,970 +6,817 +133,034 

Insert offset folio 206 here HR862R.042

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Aging and D1sability Services Programs 

Area Agencies on Aging .. 

National Center for Benefits Outreach and 

Enrollment. 

State Health Insurance Ass1stance 

Aging and Disability Resource Centers 

Subtotal, Aging and Disability Services Programs 

Program Administration. 

Total, Administrat10n for Community Living {ACL) 

Federal funds 

Trust Funds. 

(Prevention and Public Health Fund 1/) .. 

Total, ACL program level 

D 

D 

D 

D 

D 

FY 2018 

Enacted 

41,063 

FY 2019 

Request 

7,500 

12,000 

13,000 

5,000 

37,500 

37,987 

Bil 

41 ,063 

Bill vs. 

Enacted 

---

Bill vs 

Request 

-7,500 

-12,000 

-13,000 

-5,000 

-37,500 

+3,076 

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

2,144,215 1,818,681 2' 186' 732 +42,517 +368,051 

(2,095, 100) ( 1 '781' 181) (2,137,617) (+42,517) (+356,436) 

(49 '115) (37 ,500) (49' 115) --- (+11 ,615) 

(27' 700) --- --- ( -27 '700) 

-- --- ---

-

-- -

-

------ -------------- -- -------

-

--- -------------

2,171,915 1,818,681 2, 186,732 +14,817 +368 '051 

Insert offset folio 207 here HR862R.043

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OFFICE OF THE SECRETARY 

General Departmental Management 

General Departmental Management, Federal Funds. 

Teen Pregnancy Prevention Community Grants .. 

Evaluation Tap Funding. 

Subtotal, Grants. 

Sexual Risk Avoidance. 

Office of Minority Health 

Office on Women's Health 

M1nority HIV/AIDS prevention and treatment. 

Embryo Adoption Awareness Campaign. 

Planning and Evaluation, Evaluation Tap Funding 

Total, General Departmental Management .. 

Federal Funds 

(Evaluation Tap Funding). 

Total, General Departmental Management Program. 

D 

D 

NA 

D 

D 

D 

D 

D 

NA 

FY 2018 

Enacted 

200,919 

101,000 

(6,800) 

( 107 ,800) 

25,000 

56,670 

32,140 

53,900 

1 ,000 

(58,028) 

470,629 

(470,629) 

(64,828) 

535,457 

FY 2019 

Request 

206,135 

53,956 

28,454 

1,000 

(53,445) 

289,545 

(289,545) 

(53,445) 

342.990 

Bi 11 

206,135 

30,000 

56,670 

32' 140 

53,900 

1 ,000 

(53,445) 

379,845 

(379,845) 

(53,445) 

433,290 

Bill vs. 

Enacted 

+5,216 

-101 ,000 

( -6,800) 

( -107' 800) 

+5 '000 

(-4,583) 

-90,784 

( -90,784) 

( -11 ,383) 

-102,167 

Bill vs. 

Request 

+30,000 

+2,714 

+3,686 

+53,900 

+90,300 

(+90,300) 

+90,300 

Insert offset folio 208 here HR862R.044

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Account for the State Response to the Opioid Abuse 

Crisis, CURES Act21. 

Office of Medicare Hearings and Appeals. 

Office of Medicare Hearings and Appeals and 

Departmental Appeals Board Recovery Audit Contractor 

(RAG) appeals related expenses. 

Office of the National Coordinator for Health 

Information Technology. 

Combatting Opioids Abuse and Misuse and Addressing 

Mental Illness. 

Office of Inspector General 

Inspector General Federal Funds. 

HCFAG funding (NA). 

Total, Inspector General Program Level .. 

Office for Civil Rights 

Feder a 1 Funds .. 

D 

TF 

D 

D 

D 

D 

NA 

D 

FY 2018 

Enacted 

500,000 

182,381 

60,367 

80,000 

(334' 097) 

... 

(414,097) 

38,798 

FY 2019 

Request 

112,361 

10,000 

38,381 

10' 000' 000 

80,000 

(334,097) 

(414,097) 

30,904 

Bill 

·-

172,381 

42,705 

80,000 

(334,097) 

-

. 

- -- ---

(414,097) 

38,798 

Bi 11 vs 

Enacted 

-500,000 

·10, 000 

·-· 

·17,662 

- w - -

Bi 11 vs. 

Request 

+60,000 

-10,000 

+4,324 

10,000,000 

---- -- -----

+7,894 

Insert offset folio 209 here HR862R.045

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Retirement Pay and Medical Benef1ts for 

Commissioned Officers 

Ret1rement Payments. 

Surv1vors Benefits 

Dependents' Medical Care 

Total, Benefits for Commissioned Officers 

Public Health and Social Services Emergency Fund 

(PHSSEF) 

Ass1stant Secretary for Preparedness and Response 

Operat1ons. 

Preparedness and Emergency Operations 

National Disaster Medical System. 

Hospital Preparedness Cooperative Agreement Grants: 

Formula Grants. 

B1omedical Advanced Research and Development 

Authority (BARDA) 

Pol1cy and Plann1ng. 

Project B1oShield. 

Strateg1c National Stockpile .. 

Subtotal, Preparedness and Response. 

M 

M 

M 

D 

D 

D 

D 

D 

D 

D 

D 

D 

D 

D 

FY 2018 

Enacted 

456.266 

31 583 

130,840 

FY 2019 

Request 

469,246 

31,756 

128,207 

Bill vs. 

Bi 11 Enacted 

469.246 +12.980 

31 '756 +173 

128.207 -2.633 

-

- - -

--- -

- - - -

--

- - - -

--- -

- - - - - - - -

-

--

- - - - - - - - - - - - - - --

618,689 629,209 629,209 +10,520 

30,938 30,879 30,938 ---

24,654 26,596 24,654 ---

57,404 49,809 62,404 +5,000 

264 555 254,555 279,555 +15,000 

536 700 511 JOO 586,700 +50,000 

14.877 14,849 14' 877 

710,000 510,000 780,000 +70,000 

575,000 710,000 +710,000 

--- --- - - -----

1 '639, 128 1,973,388 2,4B9, 128 +850,000 

Bill vs. 

Request 

----------

+59 

-1 ,942 

+12,595 

+25 '000 

+75,000 

+28 

+270,000 

+135,000 

--- -----

+515,740 

Insert offset folio 210 here HR862R.046

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Assistant Secretary for Admin1stration 

Assistant Secretary for Administration, Cybersecurity. D 

Office of Security and Strategic Information. D 

Public Health and Science 

Medical Reserve Corps. D 

Pandem1c Influenza Preparedness. D 

Subtotal, Non-pandemic flu/BioShield/Parklawn/Other 

construction........ . . . . . . . . . . . . D 

Total, PHSSEF .. Total, Office of the Secretary .. 

Federal Funds. 

Trust Funds 

(Evaluation Tap Funding) 

Total. Office of the Secretary Program Level 

FY 2018 

Enacted 

50,860 

7,470 

6,000 

250,000 

FY 2019 

Request 

68,093 

8,496 

3,900 

250,000 

Bill 

60,000 

8,000 

6,000 

250,000 

Bill vs. Bill vs. 

Enacted Request 

+9, 140 -8,093 

+530 -496 

--- +2' 100 

-------------- -------------- -------------- -------------- -------------

993,458 1 '543, 877 1 '783, 128 +789,670 +239' 251 

- - - - - - - - - - - w - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

1,953,458 2,303,877 2,813,128 +859,670 +509' 251 

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

3,904,322 13,494,297 4,156,066 +251,744 -9,338,231 3,721 '941 13,381,916 3,983,685 +261,744 -9' 398' 231 

182,381 112,381 172,381 10,000 +60,000 

(64, 828) (53,445) (53,445) ( -11 ,383) 

--- ---

3,969,150 13,547,742 4,209,511 +240,361 -9,338,231 

Insert offset folio 211 here HR862R.047

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Total, T1 tle II, Health and Human Services. 

Federal Funds. 

Current year. 

FY 2020. 

Trust Funds .. 

Total, CURES Act2/. 

Total, Prevention and Public Health Fund 1/ 

Total, Transfers from Nonrecurring Expenses Fund 

Title II Footnotes: 

1/ Sec.4002 of Public Law 111-148 

2/ 21St Century CURES Act (Public Law 114-255) 

3/ FY2019 budget request proposes consolidating the 

Agency for Healthcare Research and Quality within 

the National Institutes of Health as the National 

Institute for Research on Safety and Quality 

FY 2018 

Enacted 

FY 2019 

Request Bi 11 

Bill vs. Bill vs. 

Enacted Request 

~=~=========== ============== ============== ============== ============= 

847,608,029 895,412,883 897,996,649 +50,388,620 +2,583,766 

842,952,589 890,939,923 893,498,929 +50,546,340 +2,559,006 

(704' 004 ,830) (748,808, 126) (751 '367' 132) (+47,362,302) (+2,559,006) 

( 1 38 ' 94 7 '759) (142, 131 '797) ( 142' 131 '797) (+3, 184,038) 

4,655,440 4,472,960 4' 497,720 -157,720 +24' 760 

(996' 000) (711 ,000) (711 ,000) ( -285 '000) 

(840,600) --- (848,000) (+7,400) (+848,000) 

(240,000) --- --- ( -240' 000) 

Insert offset folio 212 here HR862R.048

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE II! DEPARTMENT OF EDUCATION 

EDUCATION FOR THE DISADVANTAGED 

Grants to Local Educational Agencies (LEAs) 

Basic Grants: 

Advance from prior year., 

Forward funded .. , 

Current funded .. 

Subtotal, Basic grants current year approp. Subtotal, Basic grants total funds available 

Bas1c Grants FY 2020 Advance. 

Subtotal, Basic grants, program level., 

Concentration Grants 

Advance from prior year 

FY 2020 Advance. 

Subtotal 

NA 

D 

D 

D 

NA 

D 

FY 2018 

Enacted 

(1 ,840,776) 

4,913,625 

5,000 

-- --------

4,918,625 

(6, 759,401) 

1 '540, 776 

. 

---

-

-----

6,459,401 

(1 ,362,301) 

1,362,301 

-------

1,362,301 

FY 2019 

Request 

(1,540,776) 

3,777,904 

---

------- ---

3,777,904 

(5,318,680) 

2,681,497 

Bill vs. 

Bi 11 Enacted 

(1 ,840,776) ---

4,913,625 ---

5,000 -·· 

Bill VS, 

Request 

(+300,000) 

+1 '135' 721 

+5,000 

- -------- -------- ----- -------

4,918,625 --- +1 '140, 721 

(6,759,401) (+1 ,440, 721) 

1 ,540 '776 -1 '140, 721 

----- - ----

-

--

- ---

--

... 

-

--

-

-

-

-

-

.... 

- ------------

6,459,401 6,459,401 

( 1 '362' 301 ) (1,362,301) 

1 '362' 301 1,362,301 

------------

--

-

... 

--- - ----- -- -----

1 '362' 301 1 '362' 301 

FF 

Insert offset folio 213 here HR862R.049

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Targeted Grants: 

Advance from prior year NA 

FY 2020 Advance. D 

Subtotal .. 

Education Finance Incentive Grants: 

Advance from prior year. NA 

FY 2020 Advance. D 

Subtotal, Subtotal, Grants to LEAs, program level 

Innovative Approaches to Literacy. 0 

Comprehensive literacy development grants D 

State Agency Programs: 

Migrant. D 

Neglected and Delinquent/High Risk Youth D 

Subtotal, State Agency programs. 

FY 2018 

Enacted 

(3,819,050) 

3,969,050 

FY 2019 

Request 

(3,969,050) 

3,819,050 

Si 11 

(3,819,050) 

3,969,050 

- - - * - -- - - - - - - - w k - - - -- - - - - - - - - -

3,969,050 3,819,050 3,969,050 

(3,819,050) (3,969,050) (3,819,050) 

3,969,050 3,819,050 3,969,050 

-------- -- -------------

_.,. _______ 

3,969,050 3,819,050 3,969,050 

Bill vs. 

Enacted 

------------

------

Bi 11 vs 

Request 

(-150,000) 

+150,000 

------------

+150,000 

(-150,000) 

+150,000 

---

-

-

-

-

-

-

-

-

--- +150,000 

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

15,759,802 15,459,802 15,759,802 +300,000 

27,000 --- 27,000 +27,000 

190,000 --- 190,000 --- +190,000 

374,751 374,751 374,751 --- ---

47,614 47,614 47,614 --- ---

w-w- -------------- ----------

--

- --- ----

422,365 422,365 422,365 

FF 

FF FF 

Insert offset folio 214 here HR862R.050

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Special Programs for Migrant Students 

Total, Education for the disadvantaged. 

Current Year. 

FY 2020. 

Subtotal, Forward Funded .. 

IMPACT AID 

Basic Support Payments 

Payments for Children with Disabilities. 

Facilit1es Maintenance (Sec. 8008) .. 

Construction (Sec. 8007). 

Payments for Federal Property (Sec. 8002). 

Total, Impact aid. 

D 

D D 

D D 

D 

FY 2018 

Enacted 

44,623 

FY 2019 

Request 44,623 

Bi I 

44,623 

Bi 11 vs. 

Enacted 

Bi 11 vs 

Request 

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

16,443,790 15,926,790 16,443,790 +517,000 

(5' 602' 613) (4,244,892) (5,602,613) (+1 ,357,721) 

(10,841 ,177) (11 ,681 ,898) (10,841 '177) (·840,721) 

(5' 525, 990) (4,200,269) (5,525,990) ... (+1 '325 '721) 

1,270,242 1 '189, 233 1,320,242 +50,000 +131 ,009 

48,316 48,316 48,316 

4,835 4,835 4,835 

17,406 17,406 17,406 

73,313 75,313 +2,000 +75,313 

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

1 ,414,112 1,259,790 1 ,466,112 +52,000 +206,322 

Insert offset folio 215 here HR862R.051

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 201B AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED lN THE BILL FOR 

(Amounts in Thousands) 

SCHOOL IMPROVEMENT PROGRAMS 

Supporting Effective Instruction State Grants .. D 

Advance from prior year NA 

FY 2020 .. D 

Subtotal, Supporting Effective Instruction 

State Grants, program level. 

Supplemental Education Grants. D 

21st Century Community Learning Centers. D 

State Assessments. 0 

Education for Homeless Children and Youth. 0 

Training and Advisory Services (Civil Rights). D 

Education for Native Hawaiians. D 

Alaska Native Education Equity. D 

Rural Education. D 

Comprehensive Centers .. D 

Student Support and Academic Enrichment grants .. D 

Total, School Improvement Programs .. 

Current Year .. 

FY 2020. 

Subtotal, Forward Funded. 

FY 2018 

Enacted 

374,389 

(1 ,681 ,441) 

1 ,681 ,441 

-

-----------

2,055,830 

16,699 

1 ,211,673 

378,000 

85,000 

6,575 

36,397 

35,453 

180,840 

52,000 

1 '100,000 

FY 2019 

Request 

( 1 ,681,441) 

---

-----------

---

16,699 

. 

--

369.100 

77,000 

6,575 

... ... 

175,840 

. 

--

Bi 11 

374,389 

(1 '681 '441) 

1 ,681,441 

Bill vs 

Enacted 

·--

---

Bill vs 

Request 

+374,389 

+1,681,441 

" * - - - - - - - - - - ---- ----------

2,055,830 +2,055,830 

16,699 

1 .211,673 ... +1 ,211,673 

378,000 ... +8,900 

85,000 . -- +8 '000 

6,575 --· 

36,397 --· +36,397 35,453 --- +35,453 

180,840 +5,000 

52,000 +52,000 

1,200,000 +100,000 +1,200,000 

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

5,158,467 645,214 5,258,467 +100,000 +4,613,253 

(3,477,026) (645,214) (3 '577' 026) (+100,000) (+2,931 ,812) 

(1 ,681 ,441) (1 ,681 ,441) . .. (+1 ,681,441) 

( 3 ' 329' 902) (621,940) (3,429,902) (+100,000) (+2,807,962) 

FF 

FF FF FF FF 

FF 

Insert offset folio 216 here HR862R.052

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

INDIAN EDUCATION 

Grants to Local Educational Agencies. 

Federal Programs: 

Special Programs for Indian Children ... 

National Activities. 

Subtotal, Federal Programs 

Total, Indian Education 

INNOVATION AND IMPROVEMENT 

Opportunity Grants. 

Education Innovation and Research .. 

American History and Civics Academies. 

American History and Civics National Activities. 

Charter Schools Grants 

Magnet Schools Assistance. 

Teacher and School Leader Incentive Grants. 

Ready-to-Learn Television. 

Supporting Effective Educator Development (SEED) 

Arts in Education 

D 

D 

0 

0 

D D 

D D 

D 

D D D D 

FY 2018 

Enacted 

105,381 

67,993 

6,865 

- -

-

-

- - -

----

74,858 

FY 2019 

Request 

100,381 

57,993 

6,565 

------------ --- -

64,558 

Bill 

105,381 

67,993 

6,865 

Bi 1'1 vs 

Enacted 

---

- -

---

Bi 11 vs. 

Request 

+5,000 

+10,000 

+300 

------ -------- --- ------------

74,858 +10,300 

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

180,239 164,939 180,239 --- +15,300 

1,000,000 --- --- -1,000,000 

120,000 180,000 145,000 +25,000 -35' 000 

1 ,815 --- --- -1,815 ---

1 '700 --- 4,700 +3,000 +4,700 

400,000 500,000 450,000 +50,000 -50,000 

105,000 97,647 105,000 +7,353 

200,000 --- 200,000 --- +200,000 

27,741 27,741 --- +27,741 

75' 000 75,000 --- +75 '000 

29,000 29,000 --- +29' 000 

Insert offset folio 217 here HR862R.053

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts 1n Thousands) 

Javits Gifted and Talented Students 

Statew1de Family Engagement Centers 

Total. Innovation and Improvement. 

Current Year 

SAFE SCHOOLS AND CITIZENSHIP EDUCATION 

Promise Neighborhoods 

School Safety National Activities. 

Full-Service Community Schools. 

Total, Safe Schools and Citizenship Educat1on 

ENGLISH LANGUAGE ACQUISITION 

Current funded. 

Forward funded. 

Total, English Language Acquisit1on .. 

D 

D 

D 

D 

0 

D 

D 

FY 2018 

Enacted 

12 000 

10 000 

FY 2019 

Request Bill 

12,000 

10,000 

Bi 11 vs 

Enacted 

Bill vs. 

Request 

+12,000 

+10,000 =~=;===~~===~= ======~======= ============== ==========~=== ============= 

982,256 

( 982' 256) 

78,254 

90,000 

17,500 

,777.647 

( 1 '777 .647) 

43,000 

1,058 441 

(1 ,058.441) 

78,254 

90,000 

17.500 

+76,185 

(+76,185) 

---

-719,206 

(-719,206) 

+78,254 

+47,000 

+17,500 :===========~= ============== =~============ ============== ============= 

185.754 43,000 185,754 +142' 754 

47,931 47,931 47,931 

689,469 689,469 689,469 --· 

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

737,400 737,400 737,400 

FF 

Insert offset folio 218 here HR862R.054

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

SPECIAL EDUCATION 

State Grants: 

Grants to States Part B current year. 

Part B advance from prior year 

Grants to States Part B (FY 2020). 

Subtotal, program level 

Preschool Grants. 

Grants for Infants and Families. 

Subtotal. program level 

IDEA National Activities (current funded): 

State Personnel Development. 

Technical Assistance and Dissemination (including 

Special Olympics Education). 

Personnel Preparation. Parent Information Centers. 

D 

NA 

D D D 

D 

D D D 

FY 2018 

Enacted 

2,994,465 

(9. 283, 383) 

9,283,383 

FY 2019 

Request 

1,878,745 

(9,283,383) 

10,124,103 

Bill 

2,844,465 

(9,283,383) 

9,483,383 

Bill vs. Bi 11 vs. 

Enacted Request 

+965 '720 

- -

-

+200,000 

-------------- -------------- -------------- -------------- -------------

12,277,848 12,002,848 12,327,848 +50,000 +325,000 

381 ,120 368,238 395,000 +13,880 +26,762 

470,000 458,556 470,000 --- +11 '444 

-------------- --------------

--------------

-------------

13,128,968 12,829,642 13,192.848 +63,880 +363,206 

38,630 38,630 41,000 +2,370 +2 '370 

59,428 44,345 44,345 -15,083 

83,700 83,700 89,000 +5,300 +5 '300 

27,411 27,411 27,411 

FF 

FF FF 

Insert offset folio 219 here HR862R.055

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AKOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Educat1onal Technology, Media. and Materials. 

Subtotal. IDEA National ACt1Vltles 

Adjustment to match official bill language. 

Total, Special education 

Current Year. 

FY 2020. 

Subtotal, Forward Funded 

REHABILITATION SERVICES 

D 

D 

Vocat1onal Rehabilitation State Grants. M 

Client Assistance State grants. D 

Trai01ng. D 

Demonstration and Training programs. D 

Protection and Advocacy of Individual Rights (PAIR). D 

Supported Employment State grants. 0 

Independent Living: 

Services for Older Blind Individuals. D 

Helen Keller National Center for Deaf/Blind Youth and D 

Adults. D 

Total. Rehabilitation services 

FY 2018 

Enacted 

28,047 

237.216 

13,366,184 

(4 '082,801) 

(9,283,383) 

(3,845,585) 

3,452,931 

13,000 

29,388 

5,796 

17,650 

22,548 

33 '317 

12.500 

3' 587' 130 

FY 2019 

Request 

28,047 

222,133 

13,051,776 

(2,927,673) 

(10, 124, 103) 

(2,705,539) 

3,521,990 

13,000 

29,388 

9,296 

17,650 

33' 317 

10,336 

3,634,977 

Bi 11 

28,047 

229,803 

13,422,651 

(3,939,268) 

(9,483.383) 

(3 .709' 465) 

3,521,990 

13,000 

29,388 

5,796 

17,650 

22,548 

33,317 

14,000 

3,657,689 

Bi 11 vs. 

Enacted 

-7.413 

+56,467 

143,533) 

+200,000) 

-136,120) 

+69,059 

+1 ,500 

+70,559 

Bill vs. 

Request 

+7,670 

·1 

+370,875 

(+1 ,011 ,595) 

( -640 '720) 

(+1 ,003,926) 

-3,500 

+22,548 

+3,664 

+22,712 

Insert offset folio 220 here HR862R.056

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES 

American Printing House for the Blind. 

National Technical Institute for the Deaf (NTID): 

Operations. 

Gallaudet University: 

Operations. 

Total. Special Institutions for Persons with 

Disabilities. 

CAREER, TECHNICAL, AND ADULT EDUCATION 

Career Education: 

Basic State Grants/Secondary & Technical Educat1on 

D 

D 

D 

State Grants, current funded. D 

Advance from prior year NA 

FY 2020. D 

Subtotal, Basic State Grants, program level. 

National Programs. D 

Subtotal, Career Education. 

FY 2018 

Enacted 

27,431 

73,000 

128,000 

228,431 

401 ,598 

( 791 '000) 

791 ,000 

1 '192' 598 

7,421 

1,200,019 

FY 2019 

Request 

25,431 

70,016 

121,275 

216,722 

326,598 

(791,000) 

791,000 

1 '117' 598 

20,000 

1 '137. 598 

Bi 11 

28,431 

75,000 

134,361 

237,792 

503,598 

(791 ,000) 

791,000 

1,294,598 

20,000 

1,314,598 

Bill vs 

Enacted 

+1 ,000 

+2,000 

+6,361 

+9,361 

+102,000 

+102,000 

+12,579 

+114,579 

Bill vs. 

Request 

+3 '000 

+4,984 

+13,086 

+21 '070 

+177,000 FF 

+177,000 

FF 

+177,000 

Insert offset folio 221 here HR862R.057

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Adult Education: 

State Grants/Adult Basic and Literacy Education: 

State Grants, current funded. 

National Leadership Activities. 

Subtotal, Adult education. 

Total, Career, Technical, and Adult Education 

Current Year 

FY 2020. 

Subtotal, Forward Funded. 

STUDENT FINANCIAL ASSISTANCE 

Pall Grants -- maximum grant (NA) Pe 11 Grants. Federal Supplemental Educational Opportunity Grants. 

Federal Work Study. 

Total, Student Financial Assistance (SFA). 

FEDERAL DIRECT STUDENT LOAN PROGRAM ACCOUNT. 

D D D 

NA 

0 0 

D 

CH 

FY 2018 

Enacted 

616,955 

13,712 

FY 2019 

Request 

485,849 

13,712 

Bil 

616,955 

13,712 

Bill vs. 

Enacted 

---

Bill vs 

Request 

+131 '106 

---

-

--

-

-----

. 

- -- ----

-

--------

- - -

--

-

-----

-

--- -----

-

-

-

--

-

--- ---

- - -

-

-

-

- - - -

630,667 499,561 630,667 --- +131 '106 

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

1 '830 ,686 1 '637' 159 1,945,265 +114,579 +308,106 

( 1 ' 039 '686) (846, 159) (1 '154,265) (+114,579) (+308' 106) 

( 791 '000) (791 ,000) (791 ,000) ---

(1,039,686) (846, 159) ( 1 ' 1 54 ' 265) (+114,579) (+308' 106) 

(5,035) (4,860) (5,035) --- (+175) 

22,475,352 22,475,352 22,475,352 

840,000 --- 840,000 --- +840,000 

1 '130,000 500,000 1,130,000 --- +630,000 

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

24,445,352 22,975,352 24,445,352 +1 ,470,000 

350,000 -350.000 

FF FF 

Insert offset folio 222 here HR862R.058

COMPARATIVE STATEMENT OF NEW BUDGET {OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

STUDENT AID ADMINISTRATION 

Salar1es and Expenses 

Serv1cing Activities 

Total, Student Aid Administration 

HIGHER EDUCATION 

A1d for Institutional Development: 

0 

D 

Strengthening Institut1ons. D 

Hispanic Serving Institutions D Promoting Post-Baccalaureate Opportunities for D 

Hispanic Americans D 

Strengthening Historically Black Colleges {HBCUs). 0 Strengthening Historically Black Graduate D 

Institutions.. D 

Strengthening Predominantly Black Institutions. D 

Asian American Pacific Islander. D 

Strengthening Alaska Native and D 

Native Hawaiian-Serving Institut1ons. D 

Strengthening Native American-Serving Nontribal D 

Institutions D 

Strengthening Tribal Colleges D 

Strengthening HBCU Masters programs D 

Subtotal, Aid for Institutional development 

FY 2018 

Enacted 

698,943 

980.000 

FY 2019 

Request 

762 000 

1,010000 

B1ll 

698.943 

980 000 

Bi 11 vs 

Enacted 

Bill vs. 

Request 

-63 057 

·30.000 

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

1,678.943 

98.886 

123,183 

11,052 

279,624 

72,314 

11,361 

3,826 

15.772 

3.826 

31 ,539 

8,571 

659.954 

1,772,000 

---

244 694 

63,281 

-·-

27,599 

7.500 

343.074 

1.678,943 

98,886 

123.183 

11,052 

279,624 

72,314 

11 ,361 

3,826 

15,772 

3,826 

31,539 

8,571 

659,954 

---

·--

---

·93,057 

+98,886 

+123.183 

+11 .052 

+34,930 

+9,033 

+11 ,361 

+3,826 

+15.772 

+3,826 

+3,940 

+1 ,071 

+316,880 

Insert offset folio 223 here HR862R.059

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

International Education and foreign Language: 

Domestic Programs. 

Overseas Programs. 

Subtotal, International Education & Foreign Lang 

Postsecondary Program for Students with Intellectual 

D1sabilities. 

Minority Science and Engineer1ng Improvement. 

Tribally Controlled Postsec Voc/Tech Institutions 

Federal TRIO Programs. 

GEAR UP. 

Graduate Assistance in Areas of National Need. 

Teacher Quality Partnerships. 

Child Care Access Means Parents in School. 

Fund for the Improvement of Postsecondary Ed. (FIPSE). 

Consolidated MSI Grant .. 

Total, Higher Education 

D 

D 

D 

D D 

D 

D 

D D D D 

D 

D 

FY 2018 

Enacted 

65,103 

7,061 

72,164 

11,800 11,025 

9,469 

1 '01 0' 000 

350,000 

23' 047 

43' 092 

50,000 

6,000 

2,246,551 

FY 2019 

Request 

11,800 

9,648 

8,286 

950,000 

15,134 

147,906 

1,485,848 

Bi 11 

65,103 

7,061 

72,164 

11 ,800 

11,025 

9,469 

1,060,000 

360,000 

23,047 

43,092 

50,000 

2,300,551 

Bill vs. 

Enacted 

---

+50,000 +10,000 

--

-6,000 

:::::::::::::::::::::::::::::::::::::::::::::: 

+54,000 

Bi '11 vs. 

Request 

+65' 103 

+7,061 

+72,164 

+1 '377 

+1 '183 

+110 '000 +360' 000 

+23,047 +43,092 +34,866 

-147,906 

+814 ,703 

Insert offset folio 224 here HR862R.060

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Academic Program 

Endowment Program. 

HOWARD UNIVERSITY 

Howard University Hospital. 

Total, Howard Un1versity 

D D D 

COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM. D 

HISTORICALLY BLACK COLLEGE AND UNIVERSITY (HBCU) 

CAPITAL FINANCING PROGRAM ACCOUNT 

HBCU Federal Adm1n1strat1on. HBCU Loan Subsidies. 

Total, HBCU Capital financing Program. 

D D 

FY 2018 

Enacted 

201,788 

3 405 

27.325 

232,518 

435 

334 

30,150 

30,484 

FY 2019 

Request 

191,091 

3,405 

27,325 

221,821 

448 

339 

20,150 

Bi 11 

201,788 

3,405 

27,325 

232,518 

448 

339 

30,150 

Bi 11 YS 

Enacted 

+13 

+5 

---

Bill vs. 

Request 

+10,697 +10,697 

+10,000 

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

20,489 30,489 +5 +10,000 

Insert offset folio 225 here HR862R.061

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

INSTITUTE OF EDUCATION SCIENCES (IES) 

Research, Development and Dissemination. 

Statistics. 

Regional Educational Laboratories. Research in Special Education 

Special Education Studies and Evaluations. Statewide Data Systems 

Assessment: 

National Assessment. National Assessment Governing Board 

Subtotal, Assessment. 

Total, IES. 

D D D 

D 

D 

D 

D 

D 

FY 2018 

Enacted 

192' 695 109,500 

55,423 56,000 

10,818 

32,281 

149,000 

7,745 

FY 2019 

Request 

187,500 

112,500 

---

54,000 

10,818 

---

149,000 

7,745 

Bill vs. Bi 11 vs. 

Bi 11 Enacted Request 

192,695 --- +5, 195 

109,500 --- -3,000 

55,423 +55,423 56,000 --- +2,000 

10,818 ---

32,281 --- +32 '281 

149,000 

7,745 

----

-

-

-

-

-

-----

-

-

------ ----- -----

-

-------- -- ----

-

----

-

-

-

---

-

-----

-

-

-

-

156,745 156,745 156,745 

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

613,462 521,563 613,462 --- +91 '899 

Insert offset folio 226 here HR862R.062

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

{Amounts in Thousands) 

DEPARTMENTAL MANAGEMENT 

Adm1ni strati on 

ar1es and Expenses 

Building Modernlzation 

Total, Program administration 

Office for Civil Rights 

Office of Inspector General. 

Total Departmental management 

Total, Title !II, Department of Education 

Current Year 

FY 2020 .. 

D 

0 

D 

D 

" . 

FY 2018 

Enacted 

430,000 

---

--

. 

-

430.000 

117,000 

61 '143 

FY 2019 

Request 

432,506 

26,751 

. ~.-- - -

459,257 

107,438 

63,418 

Bi 11 

432,506 

--- -~- ... ~---~··~ --~--- 432,506 

117,000 

61 '143 

Bi 11 vs 

Enacted 

+2,506 

---

+2,506 

---

Bi 11 vs 

Request 

-26,751 

----

-26,751 

+9,562 

-2,275 ~==~=~======== ======~======= ============== 

========~~~~== ~============ 608 143 630,113 610,649 +2' 506 -19,464 

============== ============== =~============ =:============ ~============ 74,320,337 66,723,048 74,506,012 +185,675 +7,782,964 

(51 ,723,336) (44,126,047) (51 ,709,011) (-14,325) (+7,582,964) 

( 22 ' 597 ' 00 1 ) (22,597,001) (22,797,001) (+200, DOO) (+200,000) 

Insert offset folio 227 here HR862R.063

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

TITLE IV--RELATED AGENCIES 

COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR 

SEVERELY DISABLED 

CORPORATION FOR NATIONAL AND COMMUNITY SERVICE 

Operating Expenses 

Domestic Volunteer Service Programs 

Volunteers in Service to America (VISTA) 

National Sen1or Volunteer Corps: 

Foster Grandparents Program 

Senior Companion Program 

Retired Senior Volunteer Program 

Subtotal, Senior Volunteers 

Subtotal, Domestic Volunteer Serv1ce 

0 

D D D D 

-·-

FY 2016 

Enacted 

8,250 

92,364 

107.702 

45,512 48,903 

202,117 

-------- -

294,481 

------

FY 2019 

Request 

8.650 

4,910 

117 117 

117 

351 

-------------

5, 261 

Bill vs. 81ll VS. 

Bi 11 Enacted Request 

8,250 ·400 

92,364 +87,454 

107,702 --- +107,585 

45,512 +45,395 48,903 --- +48,786 

--------- -- ... - -- - ------

202' 117 -·- +201 ,766 

H H H H H H H H H ------- -------

294,481 ·-· +289,220 

Insert offset folio 228 here HR862R.064

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

National and Community Service Programs: 

AmeriCorps State and National Grants. D 

Innovation, Assistance, and Other Activities. D 

Evaluation D 

National Civilian Community Corps (NCCC)(subtitle 

E). D 

State Commission Support Grants.. D 

Subtotal, National and Community Service. 

Total, Operating expenses. 

National Service Trust. 

Salaries and Expenses .. 

Office of Inspector General 

Total, Corp. for National and Community Service. 

D 

D 

D 

FY 2018 

Enacted 

412,010 

7,600 

4,000 

32,000 

17,538 

FY 2019 

Request 

2,341 

... 

... 

24,087 

... ~~~-~~-- ------- -

473,148 26,428 

-------- -- ~--------- 767,629 31,689 

206,842 

83,737 87,389 

5, 750 3,568 

Bi 11 vs. Bill vs. 

Bi 11 Enacted Request 

412,010 ·-- +409,669 

7,600 +7,600 

4.000 +4,000 

32,000 ·-· +7,913 

17' 538 +17,538 

-------- -- - ---------- . 

-

-----------

473,148 -·· +446,720 

--------- -- ---- -- ---- -

767,629 +735,940 

206,842 +206,842 

83,737 -3,652 

5,750 ... +2' 182 

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

1,063,958 122,646 1,063,958 ... +941 '312 

Insert offset folio 229 here HR862R.065

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

CORPORATION FOR PUBLIC BROADCASTING: 

FY 2021 (current) with fY 2019 comparable FY 2020 advance with FY 2018 comparable (NA} 

Resciss1on of FY 2020 funds (NA) 

Subtotal, FY 2020 program level 

FY 2019 advance with FY 2017 comparable (NA) 

Rescission of FY 2019 funds (NA), 

Subtotal, FY 2019 program level 

D 

NA 

NA 

NA NA 

Public televls1on interconnection system (current) D 

FY 2018 

Enacted 

445,000 

(445,000) 

445,000 

(445,000} 

445,000 

20 '000 

FY 2019 

Request 

(445,000) 

(·430,000) 

15,000 

(445,000) 

(·429,550) 

15.450 

Bi 11 

445,000 

(445,000) 

445,000 

(445,000) 

445,000 

20,000 

Bill vs. 

Enacted 

Bi 11 vs. 

Request 

+445,000 

(+430.000) 

+430,000 

(+429,550) 

+429,550 

+20 '000 

Insert offset folio 230 here HR862R.066

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

FEDERAL MEDIATION AND CONCILIATION SERVICE. D FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION. 0 

INSTITUTE OF MUSEUM AND LIBRARY SERVICES. D 

MEDICAID AND CHIP PAYMENT AND ACCESS COMMISSION .. 

MEDICARE PAYMENT ADVISORY COMMISSION. TF 

NATIONAL COUNCIL ON DISABILITY. D NATIONAL LABOR RELATIONS BOARD .. D NATIONAL MEDIATION BOARD. D 

OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION. D 

RAILROAD RETIREMENT BOARD 

Dual Benef1ts Payments Account. D 

Less Income Tax Receipts on Dual Benefits. D 

Subtotal, Dual Benefits. 

Federal Payments to the Railroad Retirement Accounts. M 

Limitation on Administration. TF Limitation on the Office of Inspector General. TF 

FY 2018 

Enacted 

46,650 

17' 184 

240,000 

8,480 

12,545 

3,250 

274,224 

13,800 13,225 

22,000 

1,000 

21 ,000 

150 

123,500 

11 ,000 

FY 2019 

Request 47,200 

17,053 

23,000 

8,700 

12,471 

3,211 

249,000 

13,205 12,615 19,000 

-1 ,000 

18,000 

150 

115,225 

8,437 

Bi 11 vs. Bi 11 vs. 

Bi 11 Enacted Request 

46,800 +150 -400 

17' 124 -60 +71 

240,000 --- +217,000 

8,480 --- -220 D 

13,045 +500 +574 

3,250 +39 

261,325 -12,899 +12,325 

13,510 -290 +305 12,975 -250 +360 19,000 -3,000 

1,000 

--- -

-

- -

-

--- ------ - ·-

18,000 -3,000 

150 

126,000 +2,500 +10,775 

8,500 -2,500 +63 

Insert offset folio 231 here HR862R.067

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

SOCIAL SECURITY ADMINISTRATION 

Payments to Social Security Trust Funds. 

Supplemental Security Income Program 

Federal Benefit Payments 

Beneficiary Services. 

Research and Demonstration 

Administration 

Subtotal, SSI program level .. 

Less funds advanced in prior year .. 

Subtotal, regular SSI current year. 

New advance, 1st quarter, FY 2020 .. 

Total, SSI program. 

M 

M 

M 

M 

D 

M 

M 

FY 2018 

Enacted 

11,400 

48,236,000 

1513,000 

101,000 

4 '991 '277 

••w• - -

--

53,487,277 

-15,000,000 

FY 2019 

Request 

11,000 

55,716,000 

126,000 

101,000 

4,765' 000 

-------

60,708,000 

-19,500,000 

Bi 11 vs. Bill vs. 

Bill Enacted Request 

11,000 -400 

55,716,000 +7,480,000 

126,000 -33' 000 

101 ,000 ---

4,808,000 -183,277 +43' 000 

------- - -- -------# --- ----

60,751,000 +7,263,723 +43 '000 

-19' 500 '000 -4,500,000 

... _________ 

-------- ----- --- ---- ------- -- ------------

38,487' 277 41,208,000 41,251,000 +2,763,723 +43,000 

19,500,000 19,700' 000 19,700,000 +200' 000 

--- ---- ------- -------- - ------------- ---------

57,987,277 60,908,000 60,951,000 +2,963,723 +43,000 

Insert offset folio 232 here HR862R.068

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts 1n Thousands) 

Limitation on Administrative Expenses 

OASJ/DI Trust Funds. 

Hl/SMI Trust Funds 

Social Security Advisory Board 

SSI 

Subtotal, regular LAE. 

User Fees 

SSI User Fee act1vities .. 

ceo adjustment. 

SSPA User Fee Activities. 

CBO adjustment 

Subtotal, User fees. Subtotal, Lim1tation on admin1strative expenses 

Program Integrity: 

OASDI Trust Funds. 

§!, 

Subtotal, Program 1ntegrity fund1ng. 

Total, Limitation on Administrat1ve Expenses, 

TF 

TF TF 

TF 

D 

D 

TF 

TF 

FY 2018 

Enacted 

5,101 ,321 

2.313.197 

2,300 

3 '602' 127 

FY 2019 

Request 

4,895,700 

2,220,000 

2,300 

3,457,000 

Bi 

4,936,645 

2,300,000 

2,400 

3,500,000 

... " - -

-

. 

-- ----------- -

11,018,945 10,575,000 10,739' 045 

118,000 134,000 134,000 

·3,000 ·5,000 ·5,000 

1 ,000 1,000 1,000 

·1 ,000 ·1 ,000 1,000 

--------- --- ----------- -- -- - -- --

115,000 129,000 129,000 

Bi 11 vs. 

Enacted 

·164,676 

·13, 197 

+100 

·102, 127 

--------

-279,900 

+16,000 

·2,000 

------

+14,000 

------------ - -- --- ----- ----- ------- -----

11 '133 '945 10,704,000 10,868,045 ·265,900 

345,850 375,000 375,000 +29, 150 

1 '389, 150 1,308,000 1,308,000 -81 '150 

--- -- -- --

-

--- ---------- -- ------------

1 '735,000 1,683,000 1,683,000 ·52,000 

B1ll vs 

Request 

+40,945 +80,000 

+100 

+43,000 

-- -- ---

+164,045 

-----------

+164,045 

---------

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

12,868,945 12,387,000 12,551,045 ·317,900 +164,045 

Insert offset folio 233 here HR862R.069

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts 1n Thousands) 

Federal Funds. 

Trust Funds 

Off1ce of Inspector General 

Total, Office of Inspector General. 

D 

TF 

Adjustment: Trust fund transfers from general revenues TF 

Total, Social Security Adm1nistration. 

Federal funds. 

Current year 

New advances, 1st quarter FY 2020 

Trust funds. 

Total, Title IV. Related Agencies 

Federal Funds 

Current Year. 

FY 2020 Advance 

FY 2021 Advance 

Trust Funds 

FY 2018 

Enacted 

30.000 

75.500 

105.500 

·4,991 ,277 

FY 2019 

Request 

30,000 75,500 

105,500 

-4,765' 000 

Bi 11 

31 ,000 

77,500 

108,500 

-4,808,000 

81 11 vs 

Enacted 

+1 ,000 

+2,000 

+3,000 

+183,277 

Bill vs. 

Request 

+1 .000 

+2.000 +3,000 

-43,000 

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

65' 981 '845 

58 143.677 

(38' 643, 677) 

( 19, sao. ooo I 

7' 838,168 

68' 304,061 

60,318,848 

(40. 373, 848) 

( 19,500, 000) 

( 445' 000) 

7,985,213 

68,646,500 61,078,000 

(41 ,378,000) (19, 700,000) 

7,568,500 

69,306,063 61,601,430 

(41,901,430) 

( 19' 700' 000) 

7,704,633 

68,813,545 61.122,000 

(41 ,422,000) ( 19. 700 '000) 

7.691,545 

71,119,912 

63,280,822 

(43,135,822) (19,700,000) 

(445,000) 

7,839,090 

+2,831 ,700 

+2,978,323 

(+2,778,323) 

(+200,000) 

-146,623 

+2,815,851 +2,961 ,974 

(+2,761,974) 

(+200,000) 

146,123 

+167,045 

+44,000 

(+44,000) 

+123.045 

+1 ,813,849 

+1 ,679,392 

(+1 ,234,392) 

(+445,000) 

+134.457 

Insert offset folio 234 here HR862R.070

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

OTHER APPROPRIATIONS 

FURTHER ADDITIONAL SUPPLEMENTAL APPROPRIATIONS FOR 

DISASTER RELIEF REQUIREMENTS ACT, 2018 

TITLE VIII 

DEPARTMENT OF LABOR 

Employment and Train1ng Administration 

Training and Employment Services (emergency). 

Job Corps (emergency). 

General Prov1sions -- Department of Labor 

Deferment of of interest payments for U.S. Virgin 

Islands (Sec.20801) (emergency) 

FY 2018 

Enacted 

100,000 

30,900 

1,000 

FY 2019 

Request 8111 

Bi 11 vs. 

Enacted 

100,000 

-30,900 

+1 '000 

Bi 11 vs 

Request 

Insert offset folio 235 here HR862R.071

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for D1sease Control and Prevention 

CDC-Wide Activlties and Program Support (emergency) 

National Institutes of Health 

Office of the Director (emergency). 

Administrat1on for Children and Families 

Children and Famil1es Services Programs (emergency) 

Office of the Secretary 

Public Health and Social Serv1ces Emergency Fund 

(emergency) 

FY 2018 

Enacted 

200,000 

50,000 

650,000 

162,000 

FY 2019 

Request Bi 11 

Bi 11 vs 

Enacted 

-200,000 

-50,000 

-650,000 -162,000 

8 ill vs 

Request 

Insert offset folio 236 here HR862R.072

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

DEPARTMENT OF EDUCATION 

Hurr1cane Education Recovery 

Hurricane Education Recovery (emergency) .. Hurricane Education Recovery waiver authority for HEA 

of 1965 (Federal Direct Student Loan Program 

account) (emergency). 

General Provisions -- Department of Education 

HBCU Hurricane Supplemental Loan Program (loan 

forgiveness) (Sec.20804) (emergency). 

Total, title VIII. 

Total Supplemental Appropriations for D1saster 

Relief Requirements (Public Law 115-123 (D1vB, 

Subdi vi si on1)). 

Total. Other Appropriations. 

FY 2018 

Enacted 

2,700.000 

5,000 

90,000 

3.986,900 

3,986,900 

3,986,900 

FY 2019 

Request Bi 11 

Bill vs. 

Enacted 

-2.700,000 

-5,000 

-90,000 

-3,986,900 

-3.986.900 

-3,986,900 

Bil I vs 

Request 

Insert offset folio 237 here HR862R.073

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

RECAP 

Mandatory, total in bi 11 .. 

Less advances for subsequent years. 

Plus advances provided in prior years. 

Total, mandatory, current year 

Discretionary, total in bil 

Less advances for subsequent years. 

Plus advances provided in prior years .. 

Subtotal, discretionary, current year. 

Discret1onary Scorekeeping adJustments: 

Average Weekly Insured Unemployment (AWIU) 

Contingent. TF 

Medicare Eligible Accruals 

(permanent,indefinite)11. D 

Surplus property (Department of Labor). CH 

Dislocated Worker training and employment 

activities (rescission) 0 

FY 2018 

Enacted 

817,467,097 

-158,462,759 

144' 135,452 

--------------

803' 139.790 

190,525,529 

-24,814,001 

24,814,001 

FY 2019 

Request 

869,794,362 

161,845,797 

158,462,759 

Bill 

869,814,362 

-161,845,797 

158,462,759 

Bill vs. 

Enacted 

+52,347,265 

-3,383,038 

+14,327,307 

-------- ----- ---- ------------

866,411,324 866,431,324 +63' 291 '534 

173,940,541 187,168,572 -3,356,957 

·24' 294' 001 -24,814,001 

24,814,001 24,814,001 

- ---------- --- ---- -------- ------------

190,525,529 174 '460' 541 187' 168,572 -3,356,957 

10,000 25,000 10,000 ... 

32,484 30,041 30,041 -2,443 

2,000 5,000 ·2,000 

-75.000 ... ·-· 

Bi 11 vs. 

Request 

+20,000 

-------------

+20,000 

+13,228,031 

-520,000 

----------

+12 ,708 '031 

·15, 000 

-5,000 

+75' 000 

Insert offset folio 238 here HR862R.074

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Dislocated Workers ass•stance National Reserve 

(rescission). 

Work1ng Cap•tal Fund (not to exceed $40M) 

(reappropriation) (CBO est1mate) .. 

Nonrecurring expenses fund (rescission 

Childrens Health Insurance Program 

bonus (rescission) 

Childrens Health Insurance Program one-time 

payment (rescission). 

Childrens Health Insurance Program Annual 

Allotment to States (rescission). 

Child Enrollment contingency fund (rescission) 

Limitation on el1gible health care entity 

Student loan medical deferment. 

Federal Emergency Response Fund (HHS) 

(by transfer) (CBO estimate) 

PHSSEF (HHS) (transfer out) (emergency) 

(CBO estimate). 

Centers for Disease Control (HHS) (transfer 

out)(emergency) (CBO estimate) 

D 

CH 

D 

CH 

CH CH CH 

CH CH CH CH CH 

FY 2018 

Enacted 

-12 500 -88,613 

-54 

-3,572,000 -3,110.946 

---

FY 2019 

Request 

37,000 

-54 

3,118,000 

-667,000 

25,000 

( 10, 000) 

(-15,000) 

Bill vs. Bill vs. 

Bi 11 Enacted Request 

-200,000 -187,500 -200,000 

-37,000 

-400,000 -400,000 -400,000 

+88,613 

+54 +54 

-3,345,000 +227,000 -227,000 -3,378,613 -267,667 -2.711 ,613 

-48,000 -48,000 -48' 000 

5,000 +5,000 +5 '000 

-25,000 

(+10,000) (+15,000) 

Insert offset folio 239 here HR862R.075

COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR 2018 AND BUDGET REQUESTS AND AMOUNTS RECOMMENDED IN THE BILL FOR 

(Amounts in Thousands) 

Pell: Increase maximum award 

Pall mandatory funds (rescission) 

SSI User Fee Collection. 

CBO adjustment. 

SSA SSPA User Fee Col·l ect ion. 

CBO ad)ustment 

Traditional Medicare program 

CNCS National Service Trust unobligated balances 

(rescission). 

Corporation for Public Broadcasting FY2019 advance 

(rescission) ....... . 

Cohort Default Rate Modification (Education). 

21ST Century Cures Act adjustment (PL 114-255). 

Total, discretionary. 

Grand Total, current year .. 

CH 

CH 

D D 

D 

D 

D D 

0 

CH 

D 

FY 2018 

Enacted 

48,000 

-48,000 

-118,000 

3,000 

1, ODD 

1,000 

305,000 

. 

--

. 

--

3, 000 

-996,000 

- --

-

--------

178' 996, 000 

FY 2019 

Request 

--

-134.000 

5,000 

-1,000 

1 '000 

---

-150,000 

-429,550 

-·-

-711,000 

- w - -- - - - - - - -

Bi 11 

---

---

134,000 

5,000 

-1,000 

1,000 

---

---------

-711,000 

Bi 11 vs 

Enacted 

-48,000 

+48,000 

-16,000 

+2,000 

-305,000 

-3,000 

+285,000 

- ---

--

------

169,302,978 179,002,000 +6,000 

•----------- - -- M--------- •- ---- ------- ----------

982,135,790 1,035,714,302 1,045,433,324 +63,297,534 

Bi 11 vs. 

Request 

+150,000 

+429,550 

----------

+9,S99,022 

-------------

+9, 719,022 

============== ============== ============== ============= 
(415) 

MINORITY VIEWS 

We would like to acknowledge the efforts of Chairman Frelinghuysen and Chairman Cole to hold a full committee markup of the 

Labor-HHS-Education bill for the fourth year in a row. It is important for the full committee to debate this bill in public every year. 

We are disappointed, however, that the Majority introduced and 

passed on a party-line vote a partisan bill that fails to build on last 

year’s investments. In addition to shortchanging important programs, this bill once again pushes a dangerous and harmful agenda 

to sabotage access to affordable health insurance and eliminate access to critical health care services for millions of low-income 

women. 

The Labor-HHS-Education bill supports some of the Nation’s 

most critical programs, which touch individuals and families 

throughout their lifespan, from Early Head Start to Social Security. 

The bill supports NIH research, CDC public health infrastructure, 

Community Health Centers, and Meals on Wheels. It helps students go to college with Pell Grants and Work Study. It helps unemployed workers get access to job training and ensures the American workforce is not exposed to unsafe or unhealthy working conditions. The Labor-HHS-Education bill provides every American 

with a better chance at a better life—with a good education, a good 

job, and access to affordable health care. 

That is why we were so proud of what we all accomplished in 

March, when we passed a great fiscal year 2018 Labor-HHS-Education bill. Members on both sides of the aisle were justifiably 

proud. We made many good investments—in biomedical research, 

opioid treatment, public health, child care and early education, 

postsecondary education, and more. Our colleagues on the Committee—both Democrats and Republicans—took credit for those investments. And we should. It was a great bill. 

So, we must ask: why not do that again? 

As we all know, there is an additional $18 billion of non-defense 

discretionary funding for fiscal year 2019. Labor-HHS-Education is 

nearly one-third of non-defense discretionary spending. So, proportionally, the Labor-HHS-Education bill should see an increase of 

$5.5 billion. Instead, it receives no increase at all. 

If the Labor-HHS-Education bill received a fair allocation, we 

could reach more kids through Head Start. We could help make 

college more affordable for students and families with increased financial aid. We could expand job training and worker protections. 

But sadly, this bill does none of those things. 

Moreover, this bill takes only modest steps to address the humanitarian crisis created by the Trump Administration’s Zero Tolerance policy. The Administration’s policy rendered approximately 

2,500 children (and as many as 3,000) as ‘‘unaccompanied’’—including more than 100 kids younger than five years old—and placed 

416 

them in HHS custody. But even now, they do not have a clear plan 

for reunification, or even an understanding of the path forward. 

There is no plan. There never was a plan. 

Despite sending a letter to Office of Management and Budget 

(OMB) Director Mick Mulvaney and HHS Secretary Alex Azar, requesting information about the rapidly spiraling costs of the White 

House’s disastrous policy, the Administration has chosen not to respond. We have also requested that the Committee hold oversight 

hearings. Again, no response. 

That is why House Democrats introduced nearly 20 amendments 

related to addressing the effects of the Trump Administration’s 

cruel family separation policy and ensuring proper oversight of the 

conditions in which children are being held in custody by HHS’s 

Office of Refugee Resettlement. We are very pleased the Majority 

joined us in agreeing to 12 of those amendments—it is a positive 

sign that the Committee is willing to rebuke the White House on 

a bipartisan basis and begin to exercise some of its oversight responsibilities. 

Despite these successes, however, House Republicans severely 

worsened the humanitarian situation for immigrant children. The 

Majority voted to authorize the prolonged and indefinite detention 

of families with children and override the Flores settlement agreement that governs the conditions of detention for children, including that facilities be safe, sanitary, and appropriate for children. 

We strongly oppose this radical policy. 

More broadly, the Labor-HHS-Education bill passed by the majority shortchanges American families and the problems they face. 

This bill fails to address the rising cost of health care. Instead, 

it cuts Medicare and Medicaid operations by almost half a billion 

dollars, breaking our promise to seniors. This follows the Majority’s 

corporate tax cut bill, which continues to be a dream for the 

wealthiest and a nightmare for the rest. We should not be cutting 

from Medicare or Medicaid while offering trillions in tax giveaways 

to corporations and wealthy families. 

This bill also furthers the Majority’s attempt to eviscerate the Affordable Care Act. The Majority recently endorsed a move by the 

Trump Administration to once again allow private insurance companies to discriminate against Americans with pre-existing conditions. We would note that Republicans are now breaking their 

promise to protect Americans with pre-existing conditions from 

being denied insurance or being charged exorbitant premiums. 

This bill fails to fund research into firearm injury prevention. In 

2016, the most recent year with CDC data, there were approximately 38,000 firearm-related deaths; more than 81,000 people 

went to the emergency room to be treated for firearm injuries. And 

yet, the Majority continues to block research that could save thousands of lives every year. 

The bill also fails to address stagnant wages or insufficient worker protections and training. Instead, it cuts $289 million from the 

Department of Labor, including a rescission of $200 million from 

Dislocated Worker job training. And it cuts funding for the Wage 

and Hour Division, the Office of Federal Contract Compliance, and 

the Occupational Safety and Health Administration. 

417 

Of course, there are some bright spots in this bill. We strongly 

support increases for NIH research, CDC public health programs, 

substance abuse prevention and treatment programs, emergency 

preparedness, the Community Services Block Grant, the Student 

Support and Academic Enrichment program, career and technical 

education, as well as TRIO and GEAR UP. 

But even those increases show the fundamental insufficiency of 

the subcommittee’s allocation: more than 20 of NIH’s Institutes and 

Centers would receive an increase of only 1.2 percent, which is less 

than inflation, and the increase for SAMHSA’s Substance Abuse 

Prevention and Treatment Block Grant merely offsets the loss of 

$500 million made available in prior years by the 21st Century 

Cures Act. 

We also note and appreciate the comprehensive nature of the 

committee report accompanying the bill, which reflects a substantial number of requests from both Republicans and Democrats. 

Unfortunately, the positive elements of this bill are undermined 

by the Majority’s decision to shortchange critical priorities in 

health care, education, job training, and worker protection, as well 

as sabotage access to affordable health insurance. 

We offered nearly 50 amendments to remedy these shortfalls and 

eliminate unnecessary policy riders, but most of our amendments 

were rejected. 

AFFORDABLE CARE ACT

This bill reduces access to affordable health care by cutting the 

Centers for Medicare and Medicaid Services (CMS) operating budget by nearly half a billion dollars, in a misguided attempt to sabotage the Affordable Care Act’s health insurance marketplace. It is 

irresponsible for the Majority to continue to push its plan to take 

away health insurance from more than 30 million Americans and 

to support the Administration’s efforts to eliminate protections for 

people with pre-existing conditions. 

We proposed an amendment to restore funds to CMS’s operating 

budget, which would ensure ongoing support for 12 million people 

who receive their health insurance coverage through the ACA marketplace. Unfortunately, the majority rejected the amendment. 

We also proposed amendments to protect access to affordable 

health insurance against attacks by the Trump Administration: 

first, we proposed an amendment to prevent the Administration 

from filing legal motions in federal court against the Affordable 

Care Act; and second, we proposed an amendment to direct the 

Secretary of Health and Human Services to make required payments under the Risk Adjustment program, which shift funds to insurers that cover patients with the highest medical costs and come 

at no cost to American taxpayers. Again, the majority rejected the 

amendments. 

WOMEN’S HEALTH

The bill also hurts women’s health by pushing a dangerous and 

harmful ideological agenda. It eliminates funding for Title X Family Planning and the Teen Pregnancy Prevention program—a combined elimination of about $400 million to reproductive health services for women—and includes an ideological rider that would block 

418 

all federal funding for Planned Parenthood, which is the preferred 

health care provider for 2.5 million patients annually, including 

many low-income women with few health care alternatives. At the 

same time, the bill includes additional funding for abstinence-only 

programs, which studies show do not work. 

We proposed amendments to restore funding for Title X Family 

Planning and the Teen Pregnancy Prevention program. In addition, 

we offered an amendment to strike the rider against Planned Parenthood. To our disappointment, the majority rejected our efforts to 

restore funds for reproductive health and retained their misguided 

anti-Planned Parenthood rider that does not belong in this bill. 

CHILDREN FORCIBLY SEPARATED FROM THEIR PARENTS

As we noted above, this bill takes small steps toward holding the 

Administration accountable for its unconscionable and reckless policy of separating children from their families at the border. The 

White House has implemented this policy with callous disregard for 

the truth, making up its own version of the law and history to fit 

its false narrative. 

We proposed a series of amendments to expedite reunification of 

children with their families, improve the care of children in HHS 

custody, and require significant congressional oversight of the Administration going forward. We were pleased that the Majority 

agreed to adopt Democratic amendments to: 

1. Demand the Secretary of HHS report to Congress on a plan 

to swiftly reunify separated families and rescind funds from the 

Secretary if the plan is not submitted by August 1; 

2. Ensure that siblings who have been separated from their parents are kept together; 

3. Prevent the forced medication of separated children without a 

medical assessment, including a trauma assessment; 

4. Express the sense of Congress that families should not be separated and that families should be reunited immediately; 

5. Require an HHS Inspector General report on the implementation of the family separation policy, the Executive Order ending the 

policy, and ongoing family reunification efforts; 

6. Reaffirm HHS’s statutory and court-ordered responsibilities 

about the care of unaccompanied children; 

7. Fund mental health services for children separated from their 

parents; 

8. Prohibit the Office of Refugee Resettlement (ORR) and its contractors from asking questions about religion or religious practices 

for purposes of family reunification; 

9. Require a report on the number of pre-literate children in 

ORR’s custody, a list of languages spoken by those children, the 

number of translators needed for each language, and any additional resources needed to ensure that children are able to communicate with staff; 

10. Direct ORR to ensure protection of genetic material and other 

personal data and prohibit use for criminal or immigration enforcement; 

11. Require a report on guidance from ORR to shelters about the 

mental health needs of children separated from their parents, 

419 

treatment resources available to them, and the average length of 

stay for separated children; and 

12. Require a monthly report on the number of separated children and additional details, including a plan for children and parents to remain in contact and be reunified. 

Unfortunately, the Majority rejected additional amendments to: 

1. Require the Administration to comply with court orders mandating reunification of children separated from their parents; 

2. Prohibit HHS from sharing personally identifiable information 

of a sponsor or potential sponsor of an unaccompanied child with 

the Department of Homeland Security for immigration enforcement 

purposes; 3. Provide $30 million to create a Family Case Management program as a less costly alternative to detention for asylum seekers; 

and 

4. Prohibit additional large-scale institutional shelter facilities 

for unaccompanied children or tent cities, and prioritize community-based residential placements. 

And despite improving the bill significantly by adopting 12 

Democratic amendments, we are dismayed that the Majority chose 

to countermand those improvements by adopting a partisan 

amendment to allow the Department of Homeland Security to hold 

immigrant children in unlicensed family detention facilities for prolonged periods of time. We do not believe that indefinite detention 

of children is in the spirit of our country’s values. 

WORKERS

This bill hurts workers by rescinding $200 million in advance funding for Dislocated Worker job training, as well as cutting $81 

million from the Employment Service, which helps millions of unemployed workers find jobs through the American Job Center network. It strips language included since fiscal year 2016 that supports the bipartisan and successful registered apprenticeship program to help ensure workers have an industry-recognized credential, which benefits workers and employers alike. 

We proposed an amendment to restore funding for job training 

programs and the Employment Service, and an amendment to ensure that funding for apprenticeships continues to focus on highquality registered apprenticeships instead of potentially low-quality 

programs that would not be portable or lead to higher wages. Unfortunately, while one member of the majority joined our effort to 

preserve the registered apprenticeship model, both amendments 

were defeated. 

Moreover, this bill does nothing to boost wages for current workers. Despite 75 straight months of strong job growth under President Obama, which has continued under President Trump, those 

job gains are not translating into higher wages for most workers. 

We proposed an amendment to gradually increase the federal 

minimum wage to $15 per hour by 2025, which would ensure that 

broad economic gains also accrue to the benefit of low-wage workers. And we proposed an amendment to boost funding for the Department of Labor’s Wage and Hour Division to reduce wage theft 

from the paychecks of low-wage workers. Once again, the majority 

opposed our amendments. 

420 

STUDENTS

We are deeply disappointed that the bill fails to make additional 

investments in Title I, which reaches 25 million students in more 

than 80 percent of our school districts, and the 21st Century Community Learning Centers program, which provides before- and 

after-school and summer school programs to nearly 2 million students. 

Despite the mountain of evidence that early childhood interventions work to reduce inequality and narrow achievement gaps, the 

bill provides level funding for Preschool Development Grants and 

Child Care and only a nominal increase for Head Start, meaning 

we will continue to fall behind in providing children and families 

with high-quality early education opportunities and care. 

In addition, this bill hurts professionals who committed to public 

service by eliminating the discretionary relief fund created on a bipartisan basis in 2018 to help correct a flaw in the mandatory Public Service Loan Forgiveness program that has caused teachers and 

other intended beneficiaries to be ineligible for loan forgiveness. 

And the bill once again eliminates funding for the Special Olympics 

program, which helps support activities to increase the participation of individuals with intellectual disabilities in the youth sports 

demonstration and education program. 

We proposed an amendment to increase the maximum Pell Grant by $135 to help keep up with inflation. Our Republican colleagues 

rejected our effort to help make college more affordable by voting 

against the amendment. 

To help protect students and taxpayer dollars, we proposed an 

amendment to block funding to recognize a failing for-profit college 

accreditor. While the amendment attracted some bipartisan support, the majority ultimately defeated it. We also proposed language that would have forced the Secretary of Education to withdraw her misguided interpretation that seeks to block States from 

enforcing their consumer protection laws that help borrowers repaying their loans. Unfortunately, the amendment was defeated by 

the majority. 

A bright spot in the bill, however, is the elimination of two-longstanding riders that have been carried since at least 1974 regarding the use of funds for transportation to overcome racial imbalance or to carry out a plan of racial desegregation. We proposed the 

elimination of these riders during fiscal year 2018 conference negotiations, in addition to similar language in the General Education 

Provisions Act. We hope to work together to ensure that all education funding can be used for transportation and transportationrelated activities if authorized by the Elementary and Secondary 

Education Act. 

SENIORS

This bill hurts seniors who rely on Medicare and Social Security. 

In addition to cutting nearly $500 million from CMS Program Management, which would undermine Medicare services, this bill also 

cuts the Social Security Administration’s (SSA) operating budget by 

$318 million. As millions of seniors retire every year, we should be 

investing in SSA’s services instead of cutting them. This bill would 

421 

force SSA to continue to close field offices and it would further exacerbate long waiting times and busy signals on Social Security’s 

toll-free phone line. 

PARTISAN POLICY RIDERS

In addition to riders that would limit a woman’s access to health 

care, this bill attempts to block all funding for the Affordable Care 

Act. It also blocks funding for important fetal tissue research and 

adds an entire authorizing bill that would hurt a patient’s ability 

to receive potentially life-saving health care services. 

It even includes a new rider on behalf of Monsanto, the former 

agribusiness company. The Monsanto Rider would block funding 

for the World Health Organization’s cancer agency the International Agency for Research on Cancer (IARC). The IARC released 

a report which found that the chemical glyphosate in some of 

Monsanto’s most popular products is a probable carcinogen. By 

blocking NIH from funding the IARC’s research, it appears the Majority is putting Monsanto’s interests ahead of public health. 

While the Senate is passing bipartisan bills and avoiding poison 

pill riders, the House majority continues to include provisions that 

have no chance of enactment. 

We proposed amendments to eliminate each of these ideological 

riders; unfortunately, the majority rejected each amendment. 

To make matters worse, however, the Majority adopted a new 

amendment that inserts bigotry and discrimination into our bill by 

allowing child welfare organizations, including adoption and foster 

care providers, to make child placement determinations based on 

their ‘‘religious beliefs or moral convictions,’’ regardless of the 

needs of the child. Simply put, it would allow adoption and foster 

care agencies to discriminate against and turn away qualified 

LGBTQ couples who are looking to adopt—based on the couple’s 

sexual orientation. 

CONCLUSION

This bill is filled with misplaced priorities and missed opportunities, and it stands in stark contrast to the bipartisan Labor-HHS– 

Education bill included in the fiscal year 2018 Omnibus. 

The funding in this bill fails to meet our country’s needs and 

breaks our promises to students, seniors, women, families, and 

workers. It does not reflect our values of putting the middle class 

and the vulnerable first; instead, it benefits those with the most 

money and the most lobbyists. 

We hope our colleagues on the other side of the aisle will work 

with Democrats during the conference process to fix the many inadequacies in this bill. At that point, we look forward to working with 

Chairman Frelinghuysen and Chairman Cole to move forward on 

a bill we can all support. 

NITA M. LOWEY. 

ROSA L. DELAURO. 

Æ