[Senate Report 107-84]
[From the U.S. Government Publishing Office]
Calendar No. 193
107th Congress Report
SENATE
1st Session 107-84
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATION BILL, 2002
_______
October 11, 2001.--Ordered to be printed
_______
Mr. Harkin, from the Committee on Appropriations,
submitted the following
R E P O R T
[To accompany S. 1536]
The Committee on Appropriations reports the bill (S. 1536)
making appropriations for Departments of Labor, Health and
Human Services, and Education and related agencies for the
fiscal year ending September 30, 2002, and for other purposes,
reports favorably thereon and recommends that the bill do pass.
Amount of budget authority
Total bill as reported to Senate........................$407,267,401,000
Amount of adjusted appropriations, 2001................. 364,816,166,000
Budget estimates, 2002.................................. 399,626,042,000
The bill as reported to the Senate:
Over the adjusted appropriations for 2001........... 42,451,235,000
Over the budget estimates for 2002.................. 7,641,359,000
C O N T E N T S
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Page
Summary of Budget Estimates and Committee Recommendations........ 4
Overview and Bill Highlights..................................... 4
Highlights of the Bill........................................... 4
Bioterrorism Initiative.......................................... 6
Rural Health Initiative.......................................... 7
Aging Initiative................................................. 11
Stem Cell Research............................................... 18
Youth Violence Prevention Initiative............................. 19
Reprogramming and Initiation of New Programs..................... 19
Transfer Authority............................................... 20
Title I--Department of Labor:
Employment and Training Administration....................... 21
Pension and Welfare Benefits Administration.................. 38
Pension Benefit Guaranty Corporation......................... 38
Employment Standards Administration.......................... 38
Occupational Safety and Health Administration................ 41
Mine Safety and Health Administration........................ 42
Bureau of Labor Statistics................................... 43
Departmental management...................................... 43
Office of Disability Policy.................................. 46
Veterans Employment and Training............................. 46
Title II--Department of Health and Human Services:
Health Resources and Services Administration................. 49
Centers for Disease Control and Prevention................... 82
National Institutes of Health................................ 119
Substance Abuse and Mental Health Services Administration.... 188
Agency for Healthcare Research and Quality................... 201
Centers for Medicare and Medicaid Services................... 205
Administration for Children and Families..................... 217
Administration on Aging...................................... 235
Office of the Secretary...................................... 242
Title III--Department of Education:
Education for the disadvantaged.............................. 254
Impact aid................................................... 258
School improvement programs.................................. 259
Indian education............................................. 295
Bilingual and immigrant education............................ 296
Special education............................................ 297
Rehabilitation services and disability research.............. 301
Special institutions for persons with disabilities:
American Printing House for the Blind.................... 308
National Technical Institute for the Deaf................ 308
Gallaudet University..................................... 309
Vocational and adult education............................... 309
Vocational education......................................... 310
Adult education.............................................. 311
State grants for incarcerated youth offenders................ 312
Student financial assistance................................. 313
Federal family education loan program........................ 315
Higher education............................................. 316
Howard University............................................ 333
College housing and academic facilities loans................ 333
Historically black college and university capital Financing
program.................................................... 334
Education research, statistics, and improvement.............. 334
Departmental management:
Program administration................................... 336
Office for Civil Rights.................................. 337
Office of the Inspector General.......................... 337
General provisions........................................... 337
Title IV--Related agencies:
Armed Forces Retirement Home................................. 338
Corporation for National and Community Service............... 338
Corporation for Public Broadcasting.......................... 340
Federal Mediation and Conciliation Service................... 341
Federal Mine Safety and Health Review Commission............. 341
National Foundation of the Arts and the Humanities: Office of
Library Services: Grants and Administration................ 341
Medicare Payment Advisory Commission......................... 345
National Commission on Libraries and Information Science..... 345
National Council on Disability............................... 346
National Education Goals Panel............................... 346
National Labor Relations Board............................... 346
National Mediation Board..................................... 347
Occupational Safety and Health Review Commission............. 347
Railroad Retirement Board.................................... 347
Social Security Administration............................... 348
U.S. Institute of Peace...................................... 353
Title V--General provisions...................................... 354
Title VI--Mark-to-Market Extension Act of 2001................... 355
Budgetary impact of bill......................................... 356
Compliance with paragraph 7, rule XVI of the standing rules of
the Senate..................................................... 356
Compliance with paragraph 7(C), rule XXVI of the standing rules
of the Senate.................................................. 357
Compliance with paragraph 12, rule XXVI of the standing rules of
the Sen-
ate............................................................ 358
Comparative statement of new budget authority.................... 376
Summary of Budget Estimates and Committee Recommendations
For fiscal year 2002, the Committee recommends total budget
authority of $407,267,401,000 for the Departments of Labor,
Health and Human Services, and Education, and Related Agencies.
Of this amount, $123,071,000,000 is current year discretionary
funding.
ALLOCATION CEILING
Consistent with Congressional Budget Office scorekeeping,
the recommendations result in full use of the $123,071,000,000
in discretionary budget authority pursuant to section 302(b) of
the Congressional Budget Act of 1974, as amended.
Overview and Bill Highlights
The Labor, HHS and Education and Related Agencies bill
constitutes the largest of the 13 federal appropriations bills
being considered by Congress this year. It is the product of
extensive deliberations, driven by the realization that no task
before Congress is more important than safeguarding and
improving the health and well-being of all Americans. This bill
is made up of over 300 programs, spanning three federal
Departments and numerous related agencies. But the bill is more
than its component parts. Virtually every element of this bill
reflects the traditional ideal of democracy: That every citizen
deserves protection from illness and want; the right to a basic
education and job skills training; and an equal opportunity to
reach one's highest potential.
This bill at the same time provides a safety net of social
protections for the needy while stimulating advances in human
achievement and the life sciences. At its core, this bill
embodies those defining principles by which any free society
must be guided: compassion for the less fortunate; respect for
family and loved ones; acceptance of personal responsibility
for one's actions; character development; and the avoidance of
destructive behavior.
Highlights of the Bill
Youth violence prevention initiative.--Building on last
year's efforts, the Committee bill includes $1,542,800,000 for
currently authorized programs within the Departments of Labor,
HHS and Education. The initiative will focus resources on
activities that identify, prevent and help cope with violence
among youth.
Job Training.--The Committee recommendation includes
$5,533,281,000 for job training programs, an increase of
$404,760,000 over the budget request.
Worker protection.--The Committee bill includes
$1,422,356,000 to ensure the health and safety of workers,
including $450,262,000 for the Occupational Safety and Health
Administration and $256,093,000 for the Mine Safety and Health
Administration. The recommendation is an increase of
$63,877,000 over the 2001 level.
Persons With Disabilities.--In addition to programs
highlighted individually and to promote independent living in
home and community based settings, the Committee has included
$1,275,976,000 for services to persons with disabilities. This
includes $60,884,000 for programs authorized under the
Assistive Technology Act, an increase of $19,772,000 over 2001.
In addition, the recommendation includes $43,263,000 for the
Office of Disability Policy at the Department of Labor, and
$70,000,000 for Real Choice Systems Change Grants and Nursing
Home Transition Grants through the Center for Medicaid and
Medicare Services.
National Institutes of Health.--A total of $23,695,260,000
is recommended to fund biomedical research at the 25 Institutes
and centers that comprise the NIH. This represents an increase
of $3,400,000,000 over the fiscal year 2001 level.
Embryo Adoption.--The Committee has included $1,000,000 for
a public awareness Campaign to educate Americans about the
existence of spare embryos and adoption options.
AIDS.--The Committee bill includes $5,165,565,000 for AIDS
research, prevention, and services. This includes
$1,883,000,000 for Ryan White programs, an increase of
$75,391,000 and $781,213,000 for AIDS prevention programs at
the Centers for Disease Control and Prevention.
Bioterrorism initiative.--The Committee bill includes
$338,000,000 to fund efforts to address bioterrorism threats.
Medical Error Reduction.--The Committee recommendation
includes $60,000,000 for activities of the Agency for
Healthcare Research and Quality to reduce medical errors, an
increase of $10,000,000 over the administration's request.
Health Centers.--The recommendation includes $1,343,723,000
for health centers, an increase of $51,000,000 over the budget
request, and $175,111,000 over the fiscal 2001 enacted level.
Centers for Disease Control.--The Committee bill provides
$331,518,000 within the Centers for Disease Control and
Prevention to combat the growing threat of infectious disease.
The amount recommended is an increase of $13,844,000 over the
fiscal year 2001 amount.
Community services block grant.--The Committee bill
includes $675,000,000, an increase of $75,009,000 over the 2001
enacted level. This program provides a wide range of services
and activities to alleviate causes of poverty in communities
and to assist low-income individuals in becoming self-
sufficient.
Head Start.--The Committee recommendation includes
$6,600,000,000 for the Head Start Program. This represents an
increase of $400,188,000 over the 2001 enacted level.
Low-income home energy assistance.--The Committee
recommends $2,000,000,000 for heating and cooling assistance
for low-income individuals and families. Of this amount,
$300,000,000 supports additional energy assistance during
emergencies.
Education for the Disadvantaged.--The Committee has
provided $11,879,900,000 in grants to enhance educational
opportunities for disadvantaged children. This includes an
increase of $1,437,279,000 over the fiscal year 2001 amount for
grants to local education agencies, bringing the total to
$10,200,000,000.
Teacher Quality.--The Committee recommends $3,039,834,000
for grants to improve teacher quality. This is an increase of
$931,834,000 above the appropriation for fiscal year 2001 and
$439,834,000 over the budget request.
Educational Technology.--The Committee recommends
$1,000,000,000 for educational technology, an increase of
$182,904,000 over the budget request.
After-School Programs.--The Committee recommends
$1,000,000,000 for 21st Century Community Learning Centers, an
increase of $154,385,000 over the fiscal year 2001
appropriation and the budget request.
Student financial aid.--The Committee recommends
$12,284,100,000 for student financial assistance, an increase
of $1,610,100,000 over last year. This recommendation includes
$713,100,000 for the Federal Supplemental Educational
Opportunity Grant Program, a $22,100,000 increase over last
year. The amount provided for the Pell Grant Program will allow
the maximum grant to be raised to $4,000, an increase of $250
over the 2001 amount.
Higher education initiatives.--The Committee bill provides
$1,764,223,000 for initiatives to provide greater opportunities
for higher education, including $805,000,000 for Federal TRIO
programs.
Education for individuals with disabilities.--The Committee
bill provides $7,339,685,000 to ensure that all children have
access to a free and appropriate education, and that all
infants and toddlers with disabilities have access to early
intervention services. This represents an increase of
$1,000,000,000 over the 2001 level. Included in this
appropriation is an increase of $8,048,000 over last year's
level for Personnel Preparation Services under Part D of IDEA.
Rehabilitation services.--The bill recommends
$2,481,383,000 for rehabilitation services, an increase of
$81,593,000 above the amount provided in 2001. These funds are
essential for families with disabilities seeking employment.
Services for older Americans.--For programs serving older
Americans, the Committee recommendation totals $2,786,477,000
including $202,547,000 for senior volunteer programs,
$450,000,000 for community service employment for older
Americans, $366,500,000 for supportive services and centers,
and $561,000,000 for senior nutrition programs. For the medical
research activities of the National Institute on Aging, the
Committee recommends $909,174,000. The Committee recommendation
includes $15,000,000 for the Medicare insurance counseling
program.
Public broadcasting.--The Committee bill provides
$375,000,000 to support public radio and television, an
increase of $15,000,000 over the previous year's appropriation.
BIOTERRORISM INITIATIVE
The terrorist attacks of September 11, 2001 proved the
willingness of America's enemies to use new types of weapons of
mass destruction to murder large numbers of civilians. Among
these new weapons, the use of biological agents in acts of
terrorism is considered a potential threat with extraordinarily
grave consequences. An act of bioterrorism could be perpetrated
directly against the health of Americans, or indirectly via an
attack on the Nation's food supply. The Appropriations
Subcommittee on Labor, Health and Human Services, Education and
Related Agencies recognized the seriousness of this threat and
held a series of hearings, beginning in 1998 and culminating on
October 3, 2001, to assess the needs of the civilian agencies
responsible for responding to acts of bioterrorism. In these
hearings, the subcommittee heard testimony from Federal, State,
and local officials that identified potential deficiencies in
their response to an act of bioterrorism.
This year's appropriation to the Department of Health and
Human Services for responding to bioterrorism totals over
$338,000,000, an increase of over $48,000,000 over last year
which represents almost a doubling of that budget since 1999.
The Committee recognizes that the urgency of the threat
requires more funding, and will work with the administration to
develop a supplemental appropriation bill that addresses the
needs of Federal, State, and local agencies and health
departments to coordinate a response, stockpile appropriate
pharmaceuticals, and build our public health infrastructure so
that it may more quickly detect and more effectively respond to
an act of bioterrorism or any other event that threatens the
health of our citizens.
RURAL HEALTH INITIATIVE
There are more than 54 million Americans living in rural
areas, roughly 20 percent of the country's population. Rural
areas, however, face unique and longstanding problems in
accessing and maintaining adequate health care services.
According to HHS' Agency for Healthcare Research and Quality,
almost one-third of the adults living in rural America is in
poor to fair health--in fact, it is estimated that over 20
million rural Americans have inadequate access to health care
services.
While there is great variability across rural areas, there
are some common threads. Typically, rural communities have
small populations spread out over large geographic areas. This
causes many rural residents to have to travel great distances
to receive care and in many communities the challenges are made
even more difficult by bad weather, poor roads and/or
mountainous terrain.
Rural communities often face an aging infrastructure of
older hospitals and clinics, problems accessing capital
improvement funding and a limited and often depressed economic
base.
The serious lack of mental health and substance abuse
professionals, community-based services, and infrastructure
means that, in rural areas, individuals with a mental or
substance abuse disorder go untreated at disproportionately
greater rates than Americans with similar health problems
living in urban communities.
Rural Americans also are more likely to be poor, old, and
experiencing poor health and disabilities than their urban
counterparts. They are less likely than their urban
counterparts to have access to an automobile or public
transportation or to have a telephone.
Thus, while there are significant barriers to primary
health care for Americans living in all parts of the country,
access to basic, yet essential, health care services is most
problematic in rural communities.
Lack of health care clinicians
Although 20 percent of the population lives in rural areas,
only 9 percent of physicians practice there. In 2000, rural
areas contained 67 percent of the country's primary care health
professional shortage areas.
While primary care providers are scarce in rural areas,
specialized care is even more difficult to access. Internists,
general surgeons, obstetrician-gynecologists and pediatricians
and other medical specialists tend to be concentrated in bigger
towns and cities.
Studies show that physicians trained in rural areas are
more likely to practice in those areas. Unfortunately, few
rural training opportunities exist. There are currently only 21
rural training tracks in which the residents spend the majority
of their time training in rural areas under the 1+2 model (1
year in a teaching hospital with 2 years in a rural practice
site).
Historically, the National Health Service Corps has been a
key provider of rural health professionals. In fiscal year
2000, 61.5 percent of the NHSC placements were in rural areas.
Unfortunately, due to limited funding, only 12.5 percent of the
communities eligible for a primary care provider placement
receive assistance.
Limited local health care services
Rural hospitals are the lifeblood of the rural health care
delivery system. The bulk of the 2,187 rural hospitals are
primary care hospitals. Specialized hospital care, however, is
limited.
--Of the 245 long-term care hospitals in the country, only 12
of them are in rural areas.
--Of the 601 psychiatric hospitals in the country, only 81 of
them are in rural areas.
--Of the 208 rehabilitation hospitals in the country, only 21
of them are in rural areas.
--All of the country's 73 children's hospitals are in urban
areas.
Aging health care infrastructure
Rural areas are reliant on an aging infrastructure. Twelve
percent of rural hospitals located in counties adjacent to
urban areas are using buildings and fixed equipment that is
more than 20 years old, compared to just 7 percent for
hospitals in urban areas. For those rural counties that are not
adjacent to urban areas, the figure is even higher--15 percent
are using aging building and equipment.
There are few sources of capital for rural hospitals. The
existing capital programs available through the U.S. Department
of Housing and Urban Development are geared toward large urban
facilities with substantial administrative requirements that
are beyond the reach of most small rural providers. The USDA's
Capital Facilities Loan program offers another opportunity for
loans and grants but it has limited resources and is open to
all rural providers and not targeted specifically to health
care facilities.
Access
Access problems for rural residents are most severe in the
more isolated areas, due primarily to lack of providers and
greater distances needed to travel to receive care.
Forty-three percent of rural residents go without coverage
of prescription drugs for the entire year compared to 27
percent of urban residents. Fifty-two percent of rural elderly
residents 85 and over have no prescription drug coverage
compared to 33 percent of their urban counterparts.
Limited economic base
Rural areas are often adversely affected by poor economic
conditions. Many of these communities may have a weak economic
base, which creates limited capacity to support modern health
care delivery. The limited economic base also makes common
capital improvements, such as air conditioning repairs, major
obstacles or sometimes completely unaffordable.
Reliance on Medicare
Medicare financing plays a critical role in supporting the
rural health care delivery system and continues to be the
dominant source of health care reimbursement in rural areas.
Medicare patient expenses in 1998 accounted for 47 percent of
total patient care expenses for rural hospitals, compared to 36
percent of urban hospitals. That makes rural hospitals
particularly vulnerable to Medicare payment policy changes.
Also, rural Medicare beneficiaries are typically treated in
a fee-for-service format and their provider base is heavily
weighted toward primary care. Fifty-seven percent of the
physicians in these areas are generalists compared to 27
percent in urban areas. Therefore, rural populations are
significantly less likely to receive specialized care,
including timely EKGs for congestive heart failure and
transient ischemic attack, follow-up care after
hospitalizations for diabetes and gastrointestinal bleeding,
timely gallbladder removal for symptomatic gallstones and
screening mammography.
To address these inequities and barriers to access in rural
communities, the Committee has provided increased funding for
programs for this rural health initiative.
Access to Providers
National Health Service Corps.--To help train and retain
primary care providers in rural areas, the Committee has
provided $154,400,000, an increase of over $25,000,000 over
fiscal year 2001 for both recruitment and placement under the
National Health Service Corps. The Committee expects that a
significant portion of the additional funding will be used to
minimize the disparity in the supply of health care providers
between rural and urban communities.
Quentin N. Burdick Program for Rural Interdisciplinary
Training.--The Committee has increased funding for the Quentin
N. Burdick Program to ensure an appropriate increase in the
distribution of health care professionals to rural areas by
recruiting, training, and retaining teams of interdisciplinary
professionals to work in rural underserved areas.
Access to health care facilities
Community Health Centers.--The Committee has provided the
largest single increase--over $175,000,000, for Community
Health Centers. These centers play an integral role in
providing critical health care services to underserved and
uninsured people throughout America. The Committee expects that
a portion of the additional funding provided in this bill will
be used to expand access to health care services to rural
communities.
Support for rural hospitals
Rural Hospital Flexibility Grants.--The Committee has
provided full funding for this program to assist States to
stabilize and improve access to health care services in rural
communities.
Regulatory Relief for Rural Hospitals.--The Committee has
provided $15,000,000 for the Rural Hospital Improvement Program
to provide grants to small rural hospitals (those with fewer
than 50 beds) and rural hospital networks to assist struggling
rural facilities with the administrative burdens created by the
Balanced Budget Restoration Act and the Health Insurance
Portability and Accountability Act. While the Committee
believes these regulatory changes will ultimately improve the
health care system by improving quality and reducing medical
errors, it believes rural facilities, because of their unique
economic barriers, face unique hurdles and deserve some relief.
Reducing health disparities
Rural Health Research.--The Committee has provided an
increase for Rural Health Policy Development to improve and
expand the capacity of Rural Health Research Centers to develop
and identity appropriate recommendations for improving the
delivery of health care services in rural communities.
State Offices of Rural Health.--The Committee has doubled
funding for the State Offices of Rural Health from $4,000,000
to $8,000,000. The additional funding will enable States to
improve rural health outreach and coordination and to better
meet the specific rural health needs in each State. A portion
of the new funding will be used to fund rural health quality
improvement grants throughout America.
Improving Medicare Reimbursement Levels for Rural
Providers.--The per-beneficiary reimbursement rate for
providers is typically much lower in rural States than in more
heavily populated States. The Committee has directed the
Secretary to develop a proposal that would increase the payment
rates to Medicare providers who are currently reimbursed at a
rate below 95 percent of the national average.
Rural Health Outreach.--The Committee has provided
$5,000,000 to improve access to automatic external
defibrillators in rural communities.
Medical errors initiative
Last year, the Committee provided funds to begin to address
the problem of injuries and deaths resulting from preventable
medical errors. The Institute of Medicine (IOM) estimates that
medical errors are the fifth leading cause of death in the
United States. With the $50,000,000 the Committee provided in
fiscal year 2001, the Agency for Healthcare Research and
Quality (AHRQ) was able to fund grants for 16 States to allow
those States to begin collecting comparable data on medical
errors so that national trends can be determined and analyzed.
Also, AHRQ used a portion of the funds appropriated to support
a number of projects to determine innovative ways of reducing
medical errors.
This year, the Committee is providing a total of
$60,000,000 to continue and expand efforts to reduce medical
errors. The Committee expects that AHRQ will use these funds to
ensure that lessons learned and best practices will be shared
among hospitals and healthcare providers. The Committee directs
AHRQ to work with the Center for Medicare and Medicaid Services
(CMS) to provide such information to participating hospitals
and healthcare facilities so that they can begin implementing
successful strategies. In an effort to reduce medical errors,
the Committee also directs CMS to prepare a comprehensive
report on how current State requirements are enforced. This
report should include information detailing how well the State
licensing boards are meeting their target patient safety goals.
The Committee further directs AHRQ to provide a report
detailing the results of its efforts to reduce medical errors.
Among other things, the report should include how hospitals and
other healthcare facilities are reducing medical errors; how
these strategies are being shared among healthcare
professionals; how many hospitals and other healthcare
facilities record and track medical errors; how medical error
information is used to improve patient safety; what types of
incentives and/or disincentives have helped healthcare
professionals to reduce medical errors; a list of the most
common root causes of medical errors. The report should also
provide data showing the effectiveness of State requirements in
reducing medical errors. The report should also describe how
AHRQ is responding to some of the findings in the IOM's report
``To Err is Human: Building a Safer Health System.''
The Committee reiterates its position that there should be
zero tolerance for preventable medical mistakes and that the
Congress, the Administration, State licensing boards, and
private healthcare institutions and providers should work
together to prevent further unnecessary deaths and injuries.
AGING INITIATIVE
The decennial Census provides us with a snapshot of what
our society looks like today, reminds us how we have changed
over the years and offers a preview of the future composition
of the United States population. Last year, almost 46,000,000
Americans, or one of every six, were 60 years of age or older.
While the total population for the United States increased by
13 percent since 1990, those in the age category 75-84
increased by twice that rate. Our Nation's most senior group--
the population 85 years and older--increased by three times the
rate of the overall population, making it the second fastest
growing age group. The largest increase occurred in the number
of individuals age 45-54--members of the baby boom generation--
whose ranks increased by 50 percent since 1990. With
improvements in health care supporting increasing life
expectancy, it is this group that will add significant shades
of grey to the picture of the population of the United States.
These facts illustrate the trend of more people, living
longer, but that alone does not tell the entire story. Many
Americans know first hand that increases in age are accompanied
often by the onset of a disabling condition. Census data show
that more than half of the population 65 years of age and older
report at least one disabling condition. Almost 25 percent of
the Nation's elders will experience multiple, chronic,
disabling conditions that make it necessary for them to rely on
others for their care and help with meeting basic needs. And
for those age 80 and older, approximately 3 out of 4 are likely
to experience at least one disabling condition, and more than
one in three will require some assistance with activities of
daily living.
In recognition of these facts and the many, significant
contributions that our Nation's elderly have made and continue
to make in our society, the Committee has developed an aging
initiative designed to increase the capacity of home- and
community-based services to support a high quality life for
older Americans. The initiative is comprised of two components:
guidance for the departments funded through the Labor, Health
and Human Services, and Education and Related Agencies
appropriations bill to follow in order to improve the
administration of programs that serve seniors, and additional
resources to increase the capacity of programs to meet their
goals and objectives.
The Committee recognizes that the national aging network,
comprised of State units on aging, area agencies on aging, and
service providers, is the foundation of supports and services
for frail older people, their families and caregivers. Programs
and services administered by the aging network make it possible
for frail older people to live in their homes and receive care
in the home or a community-based setting.
The Committee notes that many of the aging services
programs are administered at the Federal level by many
different departments or agencies, which creates a number of
barriers that make State and local administration more
cumbersome. Removing some of these barriers and allowing more
State and local flexibility will improve the ability of the
aging network to be responsive to the needs of older people and
their families and caregivers. The Committee believes that
interagency cooperation and coordination across different
programs will help leverage the resources available at the
Federal level and establish a coordinated infrastructure of
home- and community-based services for older adults, thereby
improving the availability and accessibility of these services
at the local level.
Therefore, The Committee directs the Secretary of the
Department of Health and Human Services to set up an
Interagency Task Force on Aging Programs, comprised of the
Departments of Health and Human Services, Housing and Urban
Development, Agriculture, Labor and Transportation. The Task
Force's efforts should focus on coordinating activities to
maximize the impact of existing services, reducing and
eliminating duplication in both service provision and the
process for accessing such services, and minimizing regulatory
burdens and costs at the local level. The Committee also
strongly urges that HHS increase the visibility and prominence
of elder issues within the Department and encourages the
Department to provide the Administration on Aging with a more
visible and stronger leadership role within HHS. The Committee
expects to be briefed on a quarterly basis about the activities
and accomplishments of the Task Force.
Strengthening the Aging Network
The Older Americans Act is the only piece of Federal
legislation that promotes comprehensive, coordinated systems of
community care, but it falls short of its promise due to the
challenges of limited resources. The Committee recognizes that
insufficient resources available to the aging network makes it
difficult to serve effectively the millions of Americans
eligible for services. Therefore, the Committee has increased
funding for Older Americans Act programs by 10 percent over the
fiscal year 2001 level. These additional resources will provide
critical investments in nutrition, caregiver support,
transportation and other supportive services. The Committee
believes that these investments in the aging network are
essential to maintaining a high quality of life for our
Nation's elderly--in their homes and communities--and a key to
preparing for the needs associated with the aging of the baby
boom generation.
Supportive Services and Senior Centers
The Committee has provided $366,500,000 for the supportive
services and senior centers program, an increase of $41,425,000
over last year and the most significant investment in more than
two decades. The Committee recognizes the critical role that
this program plays in providing services to seniors that enable
them to continue living independently at home or in their
community. For example, transportation assistance provided to
older Americans residing in rural areas allows them to make
their doctor's appointment, get vital prescriptions filled or
shop for groceries. The Committee also is aware that funding
for elderly case management is essential to provide relief to
community service providers and partners in the process who
have historically provided support on a voluntary basis, but
who now feel they are jeopardizing their ability to provide
services to all clients by stretching their resources and
organizations to the breaking point. Without adequate
transportation assistance, adult day care, case management and
in-home services that this program provides millions of older
Americans could face avoidable hospital stays and unnecessary
institutionalization.
Protection of Vulnerable Older Americans
The Committee recommendation includes $18,181,000 to defend
the basic rights of vulnerable older Americans and to help them
protect themselves from abuse, neglect and exploitation, an
increase of $4,000,000 over last year. The Committee is aware
of the findings from the 1998 National Elder Abuse Incidence
Study that almost 450,000 individuals 60 years of age and older
in domestic settings experienced abuse, neglect, exploitation
and/or self-neglect during 1996. Less than 1 in 5 individuals
actually reported these incidents to the appropriate agencies.
In addition, approximately 3 million elderly and disabled
individuals receiving care in nursing homes, assistive living
facilities and similar arrangements throughout the United
States filed more than 200,000 complaints about their care. The
Committee notes that the Institute of Medicine report on
Improving the Quality of Long-Term Care identified the long-
term care ombudsman program as ``probably the best-known
advocacy effort in long-term care'' and stated that ombudsmen
and long-term care professionals argue that ``routine on-site
presence of ombudsmen establishes resident confidence, allows
resident problems to be detected before they become serious and
promotes positive working relationships with facility
administration and staff.'' The additional resources
recommended by the Committee will support the hiring of
additional ombudsmen and the publication and dissemination of
educational materials.
Family Caregiver Support Program
The Committee continues its investment in the critical
long-term care assistance delivered by the family and informal
caregiving support network by providing a $20,000,000 increase
in the National Family Caregiver Support Program and an
increase of $1,000,000 for the Native American Caregiver
Support Program. The Committee recommends a total of
$146,000,000 for caregiver support programs. As the population
of the United States continues to age and average life spans
continue to lengthen, more and more Americans face the
challenges of providing care to those who need help because of
chronic illness or disability. More than 12 million adults have
a disability that may require assistance from others to carry
out activities of daily living, such as bathing and feeding.
The Committee notes that if the work of the more than 7 million
unpaid caregivers had to be replaced by paid home care staff,
the estimated cost would be $94,000,000,000 per year. The
significant increase the Committee recommends is not based on
cost savings to the Nation's health care system alone, but
instead reflective of the important assistance and relief that
caregiver support programs offer for those providing unpaid
services to loved ones, friends and neighbors--our Nation's
elderly--to help them continue to live independently in their
community.
The Committee strongly urges the Assistant Secretary of the
Administration on Aging and the Chief Executive Officer of the
Corporation for National Service to coordinate activities under
the National Family Caregiver Support program of the Older
Americans Act in a way that maximizes the ability of local
communities to meet the burgeoning need for home- and
community-based care for seniors and respite care for
caregivers. The Committee notes that the Senior Companion
Program authorized under the Domestic Volunteer Service Act has
been providing in-home services to homebound seniors, respite
services to their families, and more for three decades.
Volunteers under the Retired and Senior Volunteer Program
provide hundreds of thousands of hours annually to homebound
seniors and their families. The Committee understands that
coordination between area agencies on aging and these grantees,
particularly those sponsored by groups other than senior
organizations, can serve to strengthen the infrastructure of
support available in communities throughout the country and in
doing so, provide seniors and their families greater access to
much-needed services.
Nutrition Programs
The Committee has provided $561,000,000 for elderly
nutrition programs, an increase of $30,588,000 over last year.
This increase includes an additional $25,000,000 for the home
delivered meals program. The Committee notes that nutrition
programs are a critical component of the overall package of
home- and community-based services for elderly people. For
seniors, nutrition can be especially important, because of
their vulnerability to health problems and physical and
cognitive impairments. The last evaluation of the elderly
nutrition programs indicated program participants are twice as
likely to live alone and have physical impairments, but because
of the services provided by the nutrition programs, experience
higher daily intakes of key nutrients and more social contacts
per month than similar nonparticipants. Expenditures under the
nutrition program are highly leveraged by State, tribal, local,
and other Federal monies and services and are also augmented by
donations from participants--making the nutrition programs a
great investment of Federal resources. Unfortunately, the
evaluation noted that 41 percent of service providers have
waiting lists for home-delivered meals. The increase provided
by the Committee will help address the critical need for
additional nutrition services.
Alzheimer's Disease Demonstrations
The Committee recommendation includes $13,000,000 for this
demonstration grant program, an increase of $4,038,000 over
last year. The Committee notes that an estimated 70 percent of
individuals with Alzheimer's disease live at home, where
families provide the preponderance of care. For these families,
care giving comes at enormous physical, emotional and financial
sacrifice. The Alzheimer's disease demonstration grant program
currently provides matching grants to 24 States to stimulate
and better coordinate services for families coping with
Alzheimer's. With a relatively small amount of Federal support
to provide the stimulus, States have found innovative ways to
adapt existing health, long-term care, and community services
to reach previously underserved populations, particularly
minorities and those living in rural communities. Given the
programs proven record of success, the Committee has provided a
significant investment in order to expand the program to
additional States.
Enhancing Employment and Training Services for Mature and Older Workers
Recent Census data show that among individuals age 65 years
and older, 14 percent were in the civilian labor force. The
Committee is aware that, prior to enactment of the Workforce
Investment Act (WIA), the Federal job-training program targeted
funds specifically to older workers. Currently, WIA funds are
not targeted for training older workers, at a time when the
number of older workers is increasing significantly. To remain
competitive in the labor market, older workers must acquire or
update their job skills. While WIA is designed to meet the
needs of all workers, the Committee is concerned that the One-
Stop Career Centers, funded under WIA, may not be adequately
meeting the training and educational needs of older workers.
The Committee therefore requests that the Department of Labor
(DOL) report within 180 days the measures it can undertake to
ensure training and related services, appropriated under WIA,
are available to older workers.
The Committee is pleased that both Senior Community Service
Employment Program (SCSEP) grantees and the DOL are interested
in increasing unsubsidized placements of low-income older
workers participating in the SCSEP program. However, given the
decline in the national economy, the Committee is concerned
that any significant increase in the SCSEP unsubsidized
placement goal, absent the availability of national or local
WIA occupational skills training resources for SCSEP
participants, will not be achievable. The Committee, therefore,
could support a modest increase in the SCSEP minimum
unsubsidized placement goal only if it is implemented after the
DOL has assured the Committee that the necessary WIA
occupational skills training resources are available to all
SCSEP participants.
Health Care Support Structure
The Committee has provided $15,000,000 within the Centers
for Medicare and Medicaid budget to support grants for State
Health Insurance Counseling and Assistance programs (SHIPs), an
increase of $5,000,000 over last year. SHIPs provide
information, counseling and decision support to people with
Medicare. The 53 State and territorial programs are
administered either by the State unit on aging or the State
department of insurance. The Committee is aware that these
programs provide a valuable service to people with Medicare and
require a stable source of funding. The CMS shall use these
resources to provide grants to States for SHIPs to enable them
to increase their capacity to serve Medicare beneficiaries, to
operate a resource center and to administer special projects
that will help SHIPs continuously improve the quality of
service they provide. The Committee expects CMS to include,
within its fiscal year 2003 congressional justification, a
specific dollar request for SHIPs, or to indicate that no
resources are being requested for this activity.
The Committee is aware that many elderly individuals may be
eligible for payment of the cost of medicare cost-sharing under
the Medicaid program. The Committee notes that studies have
estimated that 35 to 40 percent of the noninstitutionalized
population eligible for the Qualified Medicare Beneficiary
program and Specified Low-Income Medicare programs are not
receiving the financial assistance available from these
programs. Research has shown that individuals likely to be
eligible for this assistance tend to be relatively old, have
lower income and resources than other Medicare beneficiaries
and are more likely to be in poor health and have functional
limitations. In order to increase awareness of and
participation in these programs, the Committee has provided
$7,000,000 to the Social Security Administration (SSA) to
enable SSA to conduct outreach efforts to identify individuals
who may be eligible for payment of the cost of medicare cost-
sharing under the medicaid program.
Supporting Networks of Home and Community Based Care
The Committee strongly supports efforts to reduce barriers
to community living for all Americans. The Committee believes
the Department of Health and Human Services (HHS) should
continue to develop initiatives designed to reduce barriers to
community living and ensure that the elderly disabled
population is considered in all initiatives designed to address
barriers to community living. The Committee notes that
materials released by HHS since the Olmstead decision and in
response to the New Freedom initiative have said little or
nothing about the needs of the elderly disabled. The Committee
believes that greater attention needs to be paid to the needs
of older persons, to the role played by State Units on Aging
(SUAs) both as administrators of Medicaid waiver and other home
and community based services for the elderly and the unique
issues involved in the delivery of HCBS to older people. The
Committee also encourages the Centers for Medicare and Medicaid
Services to focus increased attention on the issue of
institutionalization, including the unique needs of the
elderly.
The Committee has included $50,000,000 within the Centers
for Medicare and Medicaid Services budget for Real Choice
Systems Change Grants to States to fund initiatives that
establish specific actions steps and timetables to achieve
enduring system improvements and to provide long-term services
and supports, including community-based attendant care, to
eligible individuals in the most integrated setting
appropriate. Grant applications should be developed jointly by
the State and Consumer Task Force. The Task Force should be
composed of individuals with disabilities, including the
elderly, consumers of long-term care services and supports, and
those who advocate on behalf of such individuals. Grant funded
activities should focus on areas of need as determined by the
States and the Task Force such as needs assessment and data
gathering, strategies to modify policies that unnecessarily
bias the provision of long-term care to institutional settings
or health care professionals, strategies to ensure the
availability of a sufficient number of qualified personal
attendants and training and technical assistance.
The Committee notes that the purpose of the Assistive
Technology Act is to enhance access to assistive technology to
empower individuals with disabilities to have greater control
over their lives and more fully participate in their home,
school, and work environments, and their communities. The
Committee recognizes the high priority of supporting
individuals in their home or community-based settings. To that
end, the Committee encourages the Secretary of Education to
give priority in providing technical assistance and planning
for assistive technology to support community living; provide
States greater flexibility to set priorities under the
assistive technology program; and facilitate States' ability to
work directly with lending institutions to make available to
consumers low cost loans to be used to purchase assistive
technology that supports independent living. The Committee also
has included bill language and sufficient resources within the
Department of Education's Assistive technology program to
continue all State projects funded under title I of the
Assistive Technology Act and maintain the current program
structure of the Alternative Loan Financing program authorized
under title III of the Act.
Investments in Biomedical Research
The Committee recommends a record $3,400,000,000 increase
for the National Institutes of Health over the fiscal year 2001
appropriation, for a total budget of $23,695,260,000. This
investment in medical research can foster improved health,
longer life expectancy, a better quality of life and lower
health care costs. While the Committee does not earmark
specific funding levels for individual diseases and conditions,
a significant portion of this record increase will go toward
research on aging-related matters. For example, funding for the
National Institute of Aging will rise 15.7 percent, from
$786,056,000 in fiscal year 2001 to $909,174,000 in fiscal year
2002. Funding for the National Institute of Arthritis and
Musculoskeletal and Skin Diseases will rise 16.5 percent, from
$394,968,000 to $460,202,000, and funding for the National
Institute of Neurological Disorders and Stroke will rise 15.4
percent, from $1,172,132,000 to $1,352,055,000.
STEM CELL RESEARCH
In November 1998, the world first learned that scientists
had successfully cultured human embryonic stem cells. Those
researchers found that these cells, in their earliest stages,
have the ability to transform into any type of cell in the
human body. In theory, a stem cell implanted into a diseased
heart, for example, would become a healthy heart cell; the same
procedure could restore new life to a damaged spinal cord, an
insulin-deficient pancreas, or a liver riddled by hepatitis.
That theory gained more credence when another team of
researchers saw promising signs of movement after injecting
human embryonic stem cells into the spinal cords of monkeys
stricken with Lou Gehrig's disease.
Since 1998, the Subcommittee on Labor, Health and Human
Services, and Education has held nine hearings on stem cell
research. The subcommittee has heard more than 20 hours of
testimony from preeminent scientists who have described the
potential of stem cells to cure the most common diseases
afflicting Americans today. It has heard from ethicists who
have discussed the moral and social implications of pursuing
this line of research. It has listened to company executives
recount their hopes for delivering therapies to patients and
patent attorneys discuss intellectual property rights. But the
most striking and most compelling testimony has come from
patients who suffer from diseases and disabilities that could
one day be treated or cured with the help of embryonic stem
cells.
The Committee urges the NIH to move quickly to support all
types of stem cell research, including embryonic, adult, and
cord blood, and to keep the Committee informed of the research
progress.
The Committee understands that it may take several years to
translate research on these cells into therapies. Therefore, it
directs the National Institutes of Health [NIH] to award grants
for human embryonic stem cell research as quickly as possible,
in strict compliance with ethical guidelines.
YOUTH VIOLENCE PREVENTION INITIATIVE
An estimated 3 million crimes a year are committed in or
near the Nation's 85,000 public schools. Homicide is now the
third leading cause of death for children age 10 to 14. For
more than a decade it has been the leading cause of death among
minority youth between the ages of 15 and 24. The trauma and
anxiety that violence begets in our children most certainly
interferes with their ability to learn and their teachers'
ability to teach: an increasing number of school-aged children
say they often fear for their own safety in and around their
classroom.
The Gun-Free Schools Act of 1994 requires states to pass
laws mandating school districts to expel any student who brings
a firearm to school. A recent study indicates that the number
of students carrying weapons to school dropped from 26.1
percent in 1991 to 18.3 percent in 1997. While this trend is
encouraging, the prevalence of youth violence is still
unacceptably high.
Fault does not rest with one single factor. In another
time, society might have turned to government for the answer.
However, there is no easy solution, and total reliance on
government would be a mistake. Youth violence has become a
public health problem that requires a national effort.
The Committee is aware of the controversy regarding the
media's role in influencing youth violence. Despite
disagreement over the media's role, the Committee is encouraged
by historic efforts of various sectors of the entertainment
industry to monitor and discipline themselves and to regulate
content. The industry's self-imposed, voluntary ratings system
is a step in the right direction.
The Committee continues its commitment to provide adequate
resources to address youth violence. Since fiscal year 1999,
the Committee has devoted $2,900,000,000 for this prevention
initiative. This year, the Committee recommends $1,542,800,000
for this purpose. By reallocating funds from existing programs
and coordinating efforts throughout the Departments of Health
and Human Services, Labor, Education and the Department of
Justice, the agencies have been able to target resources and
address youth violence in a comprehensive fashion. This
coordinated approach will improve research, prevention efforts,
education and treatment strategies.
REPROGRAMMING AND INITIATION OF NEW PROGRAMS
Reprogramming is the utilization of funds for purposes
other than those contemplated at the time of appropriation
enactment. Reprogramming actions do not represent requests for
additional funds from the Congress, rather, the reapplication
of resources already available.
The Committee has a particular interest in approving
reprogrammings which, although they may not change either the
total amount available in an account or any of the purposes for
which the appropriation is legally available, represent a
significant departure from budget plans presented to the
Committee in an agency's budget justification.
Consequently, the Committee directs that the Departments
and agencies funded through this bill make a written request to
the chairman of the Committee prior to reprogramming of funds
in excess of 10 percent, or $500,000, whichever is less,
between programs, activities, or elements unless an alternate
amount for the agency in question is specified elsewhere in
this report. The Committee desires to have the requests for
reprogramming actions which involve less than the above-
mentioned amounts if such actions would have the effect of
changing an agency's funding requirements in future years, if
programs or projects specifically cited in the Committee's
reports are affected or if the action can be considered to be
the initiation of a new program.
The Committee directs that it be notified regarding
reorganization of offices, programs, or activities prior to the
planned implementation of such reorganizations.
The Committee further directs that each agency under its
jurisdiction submit to the Committee statements on the effect
of this appropriation act within 60 days of final enactment of
this act.
TRANSFER AUTHORITY
The Committee has included bill language permitting
transfers up to 1 percent between discretionary appropriations
accounts, as long as no such appropriation is increased by more
than 3 percent by such transfer; however, the Appropriations
Committees of both Houses of Congress must be notified at least
15 days in advance of any transfer. Similar bill language was
carried in last year's bill for all three Departments.
Prior Committee notification is also required for actions
requiring the use of general transfer authority unless
otherwise provided for in this act. Such transfers specifically
include taps, or other assessments made between agencies, or
between offices within agencies. Funds have been appropriated
for each office funded by this Committee; it is not the
intention of this Committee to augment those funding levels
through the use of special assessments. This directive does not
apply to working capital funds or other fee-for-service
activities.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
training and employment services
Appropriations, 2001.................................... $5,452,453,000
Budget estimate, 2002................................... 5,128,521,000
Committee recommendation................................ 5,533,281,000
The Committee recommends $5,533,281,000 for this account in
2002 which provides funding authorized primarily by the
Workforce Investment Act [WIA]. This is $80,828,000 more than
the 2001 level. This is $404,706,000 above the Administration
request.
Training and employment services is comprised of programs
designed to enhance the employment and earnings of economically
disadvantaged and dislocated workers, operated through a
decentralized system of skill training and related services.
This appropriation is generally forward-funded on a July-to-
June cycle. Funds provided for fiscal year 2002 will support
the program from July 1, 2002, through June 30, 2003.
Beginning with the fiscal year 2000 appropriation, budget
constraints required that a portion of this account's funding
be advance appropriated, with obligations for a portion of
Adult and Dislocated Worker Employment and Training Activities
and Job Corps delayed until the following fiscal year. This
practice will continue in this year's appropriation.
Fiscal year 2000 was the first full year of operations
under the new Workforce Investment Act, beginning July 1, 2000
through June 30, 2001. The new legislation is significantly
enhancing employment and training services, consolidating,
coordinating, and improving programs utilizing a local level
one-stop delivery system. However, transition to the new
legislative requirements has resulted in higher levels of
unexpended funds than historical averages, allowing for
continued expansion of job training services in the budget year
while maintaining formula grant funding at least at current
levels. The Committee recommendation rejects the cutbacks
proposed in the President's budget, recognizing the vital role
of the workforce system at a time of economic slowdown.
Adult employment and training activities.--For Adult
Employment and Training Activities, the Committee recommends
$950,000,000. This is the same as the 2001 comparable level and
$50,000,000 more than the budget request. This program is
authorized by the Workforce Investment Act and is formula-
funded to States and further distributed to local workforce
investment boards. Services for adults will be provided through
the One-Stop system and most customers receiving training will
use their individual training accounts to determine which
programs and providers fit their needs. The Act authorizes core
services, which will be available to all adults with no
eligibility requirements, and intensive services, for
unemployed individuals who are not able to find jobs through
core services alone.
Dislocated worker employment and training activities.--For
Dislocated Worker Employment and Training Activities, the
Committee recommends $1,549,000,000. This is an increase of
$136,460,000 over the 2001 comparable level. Of this amount,
$1,272,000,000 is designated for State formula grants, an
increase of $109,968,000 over the 2001 enacted level. This
program, authorized by WIA, is a State-operated effort which
provides core services, intensive services, training, and
supportive services to help permanently separated workers
return to productive, unsubsidized employment. In addition,
States use these funds for rapid response assistance to help
workers affected by mass layoffs and plant closures. The
recommendation includes $277,000,000 available to the Secretary
for activities specified in WIA, primarily to respond to mass
layoffs, plant and/or military base closings, and natural
disasters across the country, which cannot be otherwise
anticipated, as well as technical assistance and training and
demonstration projects.
The Committee commends the administration for moving
expeditiously to release emergency dislocated worker funding in
response to the recent terrorist attacks.
The Committee bill continues language authorizing the use
of funds under the dislocated workers program for projects that
provide assistance to new entrants in the workforce and
incumbent workers. It also continues language modified to waive
a 10 percent limitation in the Workforce Investment Act with
respect to the use of discretionary funds to carry out
demonstration and pilot projects, multi-service projects and
multi-State projects with regard to dislocated workers, and to
waive certain other provisions in that Act.
The Committee recommends continuation of the following
fiscal year 2001 projects and activities in the fiscal year
2001 conference agreement under the dislocated worker program:
--Hawaii Department of Labor/Kauai Cooperative Extension
--Maui Women in High Tech Training
--JobLinks Program
--Pennyslvania Training Consortium
--Clayton College & State University GA-Virtual Ed & Training
Project
--Bethel Native Corp.--Alaska
These continuation grants are subject to project
performance, demand for activities and services, and
utilization of prior year funding.
The Committee is aware of the following projects that it
encourages the Department to consider supporting:
--Good Faith Fund of the Arkansas Enterprise Group in
Arkadelphia, Arkansas
--Opportunities Industrialization Centers, International,
services to those who had transitioned from welfare to
work but are now out of work
--Cheiron Foundation, dislocated worker activities in rural,
underserved areas
--Bloomington, Indiana job training program for dislocated
workers, using resources of Indiana University
--Worker retraining for former tobacco workers, Idealliance
group in Winston-Salem, North Carolina
--River Valley Growth Council, worker retraining for metal
products industry
--Chicago Youth and Adult Training Center, careers in the
automobile industry
--United Mineworkers of America career centers for retraining
of dislocated miners
--Dexter Training Center to train and provide career
counseling to rural, dislocated workers
--Training of dislocated and incumbent workers in plastics
and metals industries--Buncombe County Mountain Area
Workforce Development Board
--Workforce and related service requirements of migrant and
seasonal agricultural workers facing employment
dislocation--La Cooperativa Compesina de California
--Training services to both incumbent and dislocated
workers--the Labor Institute of Training in
Indianapolis, Indiana, and the Indiana Department of
Workforce Development
--Workforce Training and Retraining for dislocated and
incumbent workers in real manufacturing environment--
University of Albany, New York
--Workforce Development project to retrain older incumbent
workers for Montana workforce--Montana State
University, Billings
--Multi-State (Alabama, California, Connecticut, New
Hampshire, Michigan, Ohio, and Vermont) Pilot of
National Institute for Metal Working Skills to retrain
and certify dislocated workers and low wage workers as
metalworkers
--State of New Mexico--telecommunications job training for
dislocated workers
--Clemson University, retraining of tobacco farmers
--Oregon technology training program for incumbent and
underemployed workers
--Central Oregon Community College, manufacturing and applied
technology center
--South Central Wisconsin Workforce Development Board
--Recruiting for the Information Technology Age (RITA), to
increase the capacity of Women Work!
--Opportunity Medical, Highland Park, Illinois, job training
for disabled persons
The Committee recommendation includes, as it has in past
years, funding for dislocated worker projects aimed at
assisting the long-term unemployed.
The Committee encourages efforts to make certain that
dislocated workers in low pay, entry-level jobs can qualify for
help under the Dislocated Worker Program and get a fair share
of the funding.
The Committee has been advised that in some remote areas of
the country local personnel have received inadequate
firefighting training and in some cases lack even basic skills
such as operation of fire trucks and firefighting equipment.
The Committee urges the agency to work with local communities
to develop basic firefighting job training programs utilizing
existing training facilities.
The Committee is aware of the substantial worker
dislocation brought on by the closure of all but two sugarcane
plantations in Hawaii and the rapidly increasing demand for
food safety training at all levels of food production. To meet
these needs, the Committee urges funding for the Hawaii
Department of Labor and Industrial Relations and the Hawaii
Farm Bureau Federation to provide on-farm and off-farm food
safety training for dislocated sugarcane workers employed in
the agricultural and food sector.
The Committee is aware of a collaborative effort between
Kenosha County, Wisconsin, and Daimler Chrysler to retrain
employees and create a regional technology center through the
dislocated worker skills shortage demonstration program.
The Committee is aware of the severe worker dislocation
brought on by the closure of open-pit mines and the trend
toward underground mining. Three decades of decline in
underground operations have caused the industry to lose much of
the work force and skills of underground mining. Few, if any,
underground mechanics are available that have adequate training
in the technologies required by the industry. The Committee
encourages the Department to support funding proposals in this
area.
Youth activities.--For Youth Activities, the Committee
recommends $1,127,965,000, the same as the 2001 comparable
level and $127,000,000 more than the budget request. Youth
Activities, authorized by WIA, consolidates the Summer Youth
Employment and Training Program under JTPA Title IIB, and Youth
Training Grants under JTPA Title IIC. In addition to
consolidating programs, WIA also requires Youth Activities to
be connected to the One-Stop system as one way to link youth to
all available community resources. The purpose of Youth
Activities is to provide eligible youth with assistance in
achieving academic and employment success through improving
educational and skill competencies and providing connections to
employers. Other activities include providing mentoring
opportunities, opportunities for training, supportive services,
summer employment opportunities that are directly linked to
academic and occupational learning, incentives for recognition
and achievement, and activities related to leadership
development, citizenship, and community service.
Youth opportunity grants.--For Youth Opportunity Grants,
the Committee recommends $250,000,000, the same as the 2001
comparable level and the budget request. Youth Opportunity
Grants are authorized in the Workforce Investment Act. These
grants are aimed at increasing the long-term employment of
youth who live in empowerment zones, enterprise communities,
and other high-poverty areas. Surveys conducted by the
Department of Labor have found employment rates for out-of-
school youth as low as 24 percent in selected high-poverty
neighborhoods. Youth Opportunity Grants will attempt to
dramatically increase these employment rates, and thus improve
all aspects of life for persons living in these communities.
Job Corps.--For Job Corps, the Committee recommends
$1,399,148,000. This is the same as the budget request and the
2001 comparable level. The Committee applauds Job Corps for
establishing partnerships with national employers, and
encourages Job Corps to continue to work with both large
employers and small businesses to ensure that student training
meets current labor market needs. Job Corps should continue its
efforts to upgrade its vocational offerings and curricula to
reflect industry standards and skill shortages. Job Corps,
authorized by WIA, is a nationwide network of residential
facilities chartered by Federal law to provide a comprehensive
and intensive array of training, job placement and support
services to at-risk young adults. The mission of Job Corps is
to attract eligible young adults, teach them the skills they
need to become employable and independent, and place them in
meaningful jobs or further education. Participation in the
program is voluntary and is open to economically disadvantaged
young people in the 16-24 age range who are unemployed and out
of school. Most Job Corps students come from disruptive or
debilitating environments, and it is important that they be
relocated to residential facilities where they can benefit from
the highly structured and carefully integrated services
provided by the Job Corps program. A limited number of
opportunities are also available for non-residential
participation.
The Committee encourages Job Corps to strengthen working
relationships with work force development entities, including
employers, that will enhance services to students and increase
students' career opportunities. The Department is encouraged to
continue its efforts to meet industry standards in its
occupational offerings through a multi-year process to review,
upgrade, and modernize its vocational curricula, equipment, and
programs in order to create career opportunities for students
in appropriate growth industries. The Committee also encourages
the Department of Labor's Employment and Training
Administration to encourage Job Corps centers to coordinate
with community-based organizations, such as substance abuse
treatment centers, in innovative ways.
The Committee supports the goal of the Workforce Investment
Act of 1998 to integrate our Nation's many diverse job training
programs, and its approach of retraining the national character
of the Job Corps program within the new framework. The
Committee encourages the Department to continue its work to
develop national partnerships with major regional and national
employers to increase employment opportunities for Job Corps
graduates. The Department should also continue to establish
connections between Job Corps and State workforce development
programs, and between Job Corps and other national and
community partners, to provide the most efficient, cost-
effective services possible.
Responsible Reintegration for Young Offenders.--The
Committee recommends $55,000,000 for Responsible Reintegration
for Young Offenders, the same as the fiscal year 2001 level, to
address youth offender issues. This large scale WIA Pilot and
Demonstration initiative will link offenders under age 35 with
essential services that can help make the difference in their
choices in the future, such as education, training, job
placement, drug counseling, drug demand reduction activities,
and mentoring, in order to reintegrate them into the mainstream
economy. Through local competitive grants, this program would
establish partnerships between the criminal justice system and
local workforce investment systems, complementing a similar
program in the Department of Justice (DOJ). To maximize the
impact of these initiatives, the DOL and DOJ funds will be
targeted to the same communities and populations. An estimated
13,750 youth will be served, and it is expected that 65 percent
of program graduates will get jobs, re-enroll in high school,
or be enrolled in post-secondary education or training.
The Committee recognizes the Home Builders Institute's
Project CRAFT (Community Restitution and Apprenticeship Focused
Training) program as a model intervention technique in the
rehabilitation and reduced recidivism of accused and
adjudicated juvenile offenders. The Committee also acknowledges
the home building industry's shortage of skilled workers and
the role that Project CRAFT plays in helping to address this
need. As such, the Committee encourages the Department of Labor
to work with the Justice Department to replicate such a project
in order to offer at-risk and juvenile offenders pre-
apprenticeship training and job placement in the building
industry.
Native Americans.--For Native Americans, the Committee
recommends $57,800,000. This is $2,800,000 more than the 2001
comparable level. This program, authorized by WIA, is designed
to improve the economic well-being of Native Americans
(Indians, Eskimos, Aleuts, and Native Hawaiians) through the
provision of training, work experience, and other employment-
related services and opportunities that are intended to aid the
participants to secure permanent, unsubsidized jobs. The
recommendation includes $1,711,000 for use under section
166(j)(1) of the Act, relating to assistance to American
Samoans. The Department of Labor allocates formula grants to
Indian tribes and other Native American groups whose
eligibility for such grants is established in accordance with
Department's regulations.
Migrant and seasonal farmworkers.--For Migrant and Seasonal
Farmworkers, the Committee recommends $80,770,000. This is
$4,000,000 more than the 2001 comparable level. This program,
authorized by WIA, is designed to serve members of economically
disadvantaged families whose principal livelihood is derived
from migratory and other forms of seasonal farmwork, or
fishing, or logging activities. Enrollees and their families
are provided with employment training and related services
intended to prepare them for stable, year-round employment
within and outside of the agriculture industry.
The Committee recommendation includes bill language
providing $74,751,000 for State service area formula grants,
$5,000,000 for migrant and seasonal farmworker housing grants,
and $1,019,000 for other discretionary purposes.
In its fiscal year 2001 appropriations report the Committee
provided an additional $4,253,000 to the Department because of
the change in the formula used to allocate migrant and seasonal
farmworker funds to grantees. These funds were used to restore
grantees serving States with reduced allocations due to the
formula change to the 1998 funding level for those States. For
fiscal year 2002, in addition to the $73,643,000 recommended
for State service area formula grants, the Committee is adding
$1,108,000 to the $4,253,000 provided in fiscal year 2001 to
fund grantees in those States impacted by the formula change at
their comparable 1998 level.
The Committee believes that the Association of Farmworkers
Opportunity Programs provide valuable technical assistance and
training to grantees and has distinguished itself as a
tremendous resource. Its Children in the Fields Campaign
provides information, education, and technical assistance
related to child labor in agriculture. The Association also
provides other assistance related to employment and training
(including pesticide and other worker safety training for
children and adults). The Department is encouraged to continue
the services that the Association provides these areas.
For migrant and seasonal farmworker housing, the Committee
recommendation of $5,000,000 represents an increase of
$1,000,000 over the fiscal year 2001 level. The Committee
expects that these funds will be made available to housing
grantees receiving grants in fiscal year 2000 to develop
housing and related facilities.
National programs.--This activity includes WIA-authorized
programs in support of the workforce system including technical
assistance and incentive grants, evaluations, pilots,
demonstrations and research, the Women in Apprenticeship
Program, as well as the National Skills Standards Advisory
Board.
Technical Assistance/Incentive Grants.--The Committee
recommends $15,000,000 for the provision of technical
assistance, staff development, and replication of programs of
demonstrated effectiveness; as well as incentive grants to each
State that exceeds State adjusted levels of performance for WIA
State programs.
Pilots, Demonstrations, and Research.--The Committee
recommends $35,000,000 for grants or contracts to conduct
research, pilots or demonstrations that improve techniques or
demonstrate the effectiveness of programs.
The Committee acknowledges changes under the Workforce
Investment Act to develop and implement techniques and
approaches, and demonstrate the effectiveness of specialized
methods, of addressing the employment and training needs of
individuals. The Committee encourages the Department to ensure
that these projects are coordinated with local boards.
Appropriate time limits are established for projects. Grant
applications for over $500,000 are subject to peer review. The
Committee encourages the Department of Labor to ensure that
project performance is adequately documented and evaluated.
The Committee recommends continuation of the following
fiscal year 2001 projects and activities under the pilot and
demonstration program:
--Job Corps Fellowship Training Program at Minot State
University
--Training and Education Opportunities-University of Hawaii
at Maui
--Remote Rural Hawaii Job Training project for low-income
youth and adults
--Hawaii American Samoan Job Training
--Training and Education Opportunities--University of Hawaii
at Maui
--Ilasagvik College-Barrow, Alaska
--Kawerak, Inc. Vocational Training for Alaska Natives--Nome,
Alaska
--Alaska Federation of Natives Foundation
--Alaska Works, Construction Job Training--Fairbanks, Alaska
--Alaska Native Heritage Center, and Bishop Museum in Hawaii
--Peabody-Essex Museum in Salem, Massachusetts
--University of Missouri-St. Louis Regional Center for Ed and
Work
--Vermont Tech College-Tech Training Initiative
--Des Moines Community College-SMART Partners, Iowa
--American Indian Science & Eng. Society-Rural Computer
Utilization Training
--Maui Economic Development Board-Rural Computer Training
--South Dakota Intertribal Skill Training Cooperative
--University of Colorado Health Sciences Center-Telehealth
Distance Learning
These continuation grants are subject to project
performance, demand for activities and services, and
utilization of prior year funding.
The Committee is aware of the following projects that it
encourages the Department to consider supporting:
--Expansion of Focus Hope Information Technology Center,
Detroit
--Las Vegas Culinary Training Center
--Intertribal Bison Cooperative expansion
--Nevada Works demonstration projects
--Alexandria/Arlington Workforce Investment Board
--United Technologies Center--photonics curriculum for the
purpose of training students
--Kennebec Valley Technical College--Precision Machining
Technology Program
--New Hampshire Motor Transit Association Driver Training
School--public-private effort to recruit, train and
retain truck drivers
--City of Indianapolis--trades training initiative
--American Printing House for the Blind & Rehabilitation and
Research Training Center on Blindness at Mississippi
State University--national needs assessment of the
Workforce Investment Act's One-Stop Career Centers
--Honest Day Labor, Nashville, Tennessee--provides homeless
and poor individuals with the transportation and tools
--Total Action Against Poverty--Center for Employment
Training skill training program model
--New Iowans Career Entry--address workforce needs
--Salt Lake City--Youth City Empowerment program
--Indiana Department of Workforce Development--Technology
Enhancement Certification for Hoosiers
--Ivy Tech State College of Indiana--Machine Tool Technology
Training Initiative
--Northeast Alabama Adult Education Program--adult education
program
--Chemeketa Community College--educational and support
services to Woodburn
--Koahnic Broadcasting
--Yukon Kuskokwim Health Corporation
--Northwest Regional Miner-Training and Research Facility
vocational training for miners, laborers, and
mechanics, research facilities for underground mining
and related safety and environmental problems
--Altoona Blair County Development Corporation--highly
training workforce
--Manufacturers Research Center & 3 Lehigh Valley community
colleges--workforce development system to train
dislocated disadvantaged, incumbent and emerging
workers
--Ogontz Avenue Revitalization Corporation--community-
targeted workforce development
--Jobs for America's Graduates--school-to-work projects for
at-risk young people
--National Court Reporters Association--recruit and train
individuals to perform real-time captioning services
--Court Reporting Institute of Dallas and Alvin Community
College--train reporters and captioners
--AIB College of Business--train reporters and captioners
--Chattanooga State Community College--develop curriculum,
distance learning programs, job placements for training
closed captioners
--Real Time Captioning at the University of Mississippi
School of Court Reporting
--Lakeshore Technical College and Madison Area Technical
College, Wisconsin--train reporters and captioners
--Green River Community College--train reporters and
captioners
--Community College of Allegheny County--train reporters and
captioners
--Cuyahoga Community College--train reporters and captioners
--Clark State Community College--train reporters and
captioners
--Alfred State College--train reporters and captioners
--St. Louis Community College--train reporters and captioners
--Southern Illinois University at Carbondale--train reporters
and captioners
--Midstate College--train reporters and captioners
--Sarasota County Technical Institute--train reporters and
captioners
--Gadsen State Community College--train reporters and
captioners
--Orleans Technical Institute in Pennsylvania--train
reporters and captioners
--Chicago Area Workers' Rights Task Force, Center for Import
Research
--Region of Manufacturing Excellence (ROME)--a project to
address the manufacturing workforce needs of northeast
Ohio
--Northern Great Plains, Community eBusiness Service Center
--State of Alaska Rural Veterans Job Search and Job
Preparation program
--State of Alaska rural summer youth employment and academic
enrichment program
--International Longevity Center, New York
--Center for Employment Training in San Jose, California
--Hood River Integrated Community/Community College
Technology Training and Education program
--Vermont Telecommunications Application Center
--Cyber Skills Vermont Workforce Development Initiative
--Bay Area Workforce Development Board, Wisconsin
--Great Cities' Universities Skills Enhancement Partnership,
Wisconsin
--Wisconsin Indianhead Technical College
--Douglas County Senior Center, Wisconsin
--Northern Wisconsin Concentrated Employment Program, Inc.
--Community Learning Center at Union County College,
Elizabeth, New Jersey
--Nurse retention demonstration project, Washington Health
Foundation
--Model data plan for Washington State health workforce
analysis and planning
--San Diego State University, high-tech training program
--Good Faith Fund, Arkansas Enterprise Group
--University of Arkansas Medical Sciences BioVentures
--University of Arkansas GENESIS Technology Incubator
--Working Partners, demonstration programs to help reduce
substance abuse in the workplace
--Tanana Chiefs Conference and the Alaska Laborers Union, on-
the-job skills training and employment opportunities
for Alaska Natives
--Alaska Department of Labor and Workforce Development to
develop a training program for firefighters in remote
villages in Alaska
--Permian Basin Energy Education Project--petroleum
technology training
--Lehigh University--developing innovative educational
methods
--Collegiate Consortium--workforce training
--Cox Family Enterprise Center--helping individuals meet
dramatic challenges of owning, operating, developing
family businesses
--Good Shepherd Home in Lehigh County, the Re Place
--Compton Youth Succeed Initiative, Los Angeles County
--Federation of Southern Cooperatives
--Ready, Willing and Able
--Southern Arizona Institute of Advanced Technology, high-
tech training
--Mayville State University/Traill County Technology Center,
North Dakota
--Bishop Museum
--Pacific Basin Immigrant Job Training
--Maui Women Future Employment Opportunities
--School of the Building Arts to train students in the proper
restoration of historic sites, Charleston, SC
--Retail Employee Link to Education, New Mexico Retailers
Association
--Odyssey Maritime, school to work initiative in Washington
State
--Training for at-risk young people in occupations related to
the use of biometric technology in the security
industry at Mississippi Valley State University
--Alcorn Biotechnology Center, distance learning and business
training activities
--Mississippi State University Nursery Assistance
--University of Mississippi Engineering Coalition
--Mississippi Delta Community College Business Services
Center
--Harrisburg One-Stop project in Tupelo, Mississippi
--Creation of Southern NJ Regional Hospitality Workforce
Development Consortium to coordinate training and
develop career ladder structure in hospitality and
gaming industry
--Gloucester County College, New Jersey
--Dream Center to provide job and training skills for new
labor market entrants or re-entrants--Los Angeles,
California
--North Country Career Center model education and training
program--Newport, Vermont
--Vermont Department of Employment and Training employer-led
education and training partnerships initiative
--Vermont Information Technology Center model information
technology training initiative--Champlain College,
Burlington, Vermont
--Institute for Health Care Workforce Development, South
Carolina
--Lehigh University Job Training for hard to serve
disadvantaged youth in manufacturing sector--
Pennsylvania
--Workplace Acclimation Program for Ex-Offenders to provide
pre-employment training and job placement assistance to
former offenders--Safer Foundation, Chicago, Ill
--Remote 21st Century Rural Hawaii Job Training Project
--Remote Rural Alaska Job Training Project
--Model Community Jobs Initiative to train homeless persons,
San Francisco, CA
--Collegiate Consortium for Workforce & Economic Development,
Philadelphia Naval Business Center
--Kirkwood Community College and ACT, Inc. for workforce
skills development in Iowa
--Community Self-Empowerment & Employment Program (CSEEP)
(PA)--comprehensive employment readiness, job
development, job place, and case management for area
low-income residents
--Western Alaska workforce training initiative
--Nevada Works
--UNLV Center for Workforce Development and Occupational
Research
--University of South Carolina College of Social Work,
computer training for low-income unemployed workers
--South Sumter Resource Center, South Carolina--comprehensive
system of academic and skill training, leadership
development, support services, case management, on-the-
job training, and cultural enrichment for at-risk youth
--Green Thumb, Inc.--conduct program for rural, low-income
elders to develop entrepreneurial skills that utilize
e-commerce and IT
--California State Polytechnic University, technology
workforce training
--San Diego State University, high-tech workforce development
--Tlingit-Haida project--job training to unemployed natives
in southeast Alaska
--Mott Community College Workforce Development Institute for
Manufacturing Simulation
--Jefferson State Community College, Information Technology
workforce development
--Greater Columbus Ohio Chamber of Commerce Career Academies
program--project to design and test programs in
partnership with workforce development system
--Public/Private Ventures workplace mentoring program
--Urban League of Hudson County, New Jersey, Workforce
Development Center
--Allegheny County, Pennsylvania, training of information
technology workers
--Waukesha, Wisconsin, workforce training for economically
disadvantaged youth and adults at La Casa de Esperanza
--Skill training for low-income and disadvantaged workers at
the Center for Employment Training in San Jose
--Covington Work Initiative Network, St Tammany Parish,
Louisiana
--Job Challenge Pilot Program, Louisiana
--Southeastern Louisiana Economic and Workforce Development
Initiative
--Oregon Institute of Technology
--Minority-Owned Business Development and Training Initiative
of the Minority Business Roundtable
--Three Rivers Workforce Investment Board to train
individuals in information technology occupations to
take them from entry-level to mid-level skill positions
in Allegheny County
--University Technology Park/Westchester University for the
establishment of a Computer and Internet Training
Center
--Opportunities Industrialization Center of Philadelphia,
Inc. for the OIC Hospitality Training Institute of
Philadelphia to replicate the Philadelphia
Opportunities Inn: Hospitality Training Institute in
five cities
--Southeastern Pennsylvania Chapter of the American Red Cross
to provide job counseling, training, and services for
disaster victims receiving extended care at the SEPA
Chapter Red Cross House
--National Student Partnerships for the opening of National
Student Partnerships at Temple University, establishing
staffed offices at the University of Pennsylvania and
the University of Pittsburgh, and the continuation of
NSP's 18 current sites
--Nueva Esperanza for the administration of the Nueva
Esperanza Telework Center in Philadelphia, to provide
technological jobs in a low-income area, provide
technical job training and aid in further career
development
--Olde Kensington Redevelopment Corporation for the
establishment of the North Philadelphia Senior
Development Project by the Olde Kensington
Redevelopment Corporation
--Community Loan Fund Southwestern Pennsylvanian to expand
CLF's ``Family-Wage Job Initiative,'' which will
provide resources and create family wage jobs in nine
Southwestern Pennsylvania Counties
--The University of Louisville Center for Supply Chain
Workforce Development
The Committee is aware that even the best employment and
training programs cannot serve those who lack the basic skills
to enter such programs. The Committee understands that programs
that help unskilled workers achieve the level of literacy
necessary to participate in Employment and Training Programs
improves their chances of successfully transitioning into full-
time employment. The Committee encourages the Department to
fund demonstration grants under Workforce Investment Act Title
I National Programs to increase the capacity of national
networks of volunteer adult literacy programs, library literacy
programs and urban literacy coalitions to prepare the hardest-
to-reach/hardest-to-teach adults and out of school youth for
the workforce.
Evaluation.--The Committee recommends $9,098,000 to provide
for the continuing evaluation of programs conducted under WIA,
as well as of federally-funded employment-related activities
under other provisions of law.
Women in Apprenticeship.--The Committee recommends
$1,000,000 to continue the current level of the Women in
Apprenticeship and Nontraditional Occupations program. This
activity provides technical assistance to employers and unions
to assist them in training, placing, and retraining women in
nontraditional jobs and occupations.
National Skills Standards Advisory Board.--The Committee
recommends the budget request of $3,500,000 for the Board, the
same amount provided in fiscal year 2001.
The Committee understands that the Board helped the
Manufacturing Skill Standards Council (MSSC) develop the
comprehensive national manufacturing skill standards which were
unveiled earlier this year and believes that it should now help
the MSSC develop assessments and certifications to accompany
these standards.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriations, 2001.................................... $440,200,000
Budget estimate, 2002................................... 440,200,000
Committee recommendation................................ 450,000,000
The Committee recommends $450,000,000, an increase of
$9,800,000 over the budget request and the fiscal year 2001
appropriation for community service employment for older
Americans. This program, authorized by title V of the Older
Americans Act, provides part-time employment in community
service activities for unemployed, low-income persons aged 55
and over. It is forward-funded from July to June, and the 2002
appropriation will support the program from July 1, 2002,
through June 30, 2003. The Committee believes that within the
title V community service employment for older Americans,
special attention should be paid to providing community service
jobs for older Americans with poor employment prospects,
including individuals with a long-term detachment from the
labor force, older displaced homemakers, aged minorities,
limited English-speaking persons, and legal immigrants.
The Committee is aware that, prior to enactment of the
Workforce Investment Act (WIA), the Federal job-training
program targeted funds specifically to older workers.
Currently, WIA funds are not targeted for training older
workers, at a time when the number of older workers is
increasing significantly. To remain competitive in the labor
market, older workers must acquire or update their job skills.
While WIA is designed to meet the needs of all workers, the
Committee is concerned that the One-Stop Career Centers, funded
under WIA, may not be adequately meeting the training and
education needs of older workers. The Committee therefore
requests that the Department report within 180 days the
measures it can undertake to ensure training and related
services, appropriated under WIA, are available to older
workers.
The Committee is pleased that both senior Community Service
Employment Program grantees and the Department are interested
in increasing unsubsidized placements of low-income older
workers participating in the SCSEP program. However, given the
decline in the national economy, the Committee is concerned
that any significant increase in the SCSEP unsubsidized
placement goal, absent the availability of national or local
WIA occupational skills training resources for SCSEP
participants, will not be achievable. The Committee, therefore,
could support a modest increase in the SCSEP minimum
unsubsidized placement goal only if it is implemented after the
Department has assured the Committee that the necessary WIA
occupational skills training resources are available to SCEP
participants.
Federal unemployment benefits and allowances
Appropriations, 2001.................................... $406,550,000
Budget estimate, 2002................................... 415,650,000
Committee recommendation................................ 415,650,000
The Committee recommends $415,650,000, the same as the
budget request and an increase of $9,100,000 above the 2001
enacted level for Federal unemployment benefits and allowances.
These are entitlement funds.
The trade adjustment line item has two activities totaling
$349,500,000 in fiscal year 2002.
The first activity, trade adjustment assistance benefits,
provides for special unemployment benefit payments to workers
as authorized by the Trade Act of 1974, as amended. For this
activity the Committee recommends $255,000,000. This is the
same as the budget request and an increase of $7,000,000 above
the 2001 comparable level. These funds will permit payment of
benefits, averaging $239 per week, to 33,400 workers for 2002.
The second activity, trade adjustment assistance training,
provides training, job search, and job relocation allowances to
workers adversely affected by imports. The funding for this
activity is also authorized under the Trade Act of 1974, as
amended. The Committee recommends $94,500,000 for this
activity, the same as the budget request and an increase of
$100,000 above the 2001 comparable level. These funds will
provide services for an estimated 22,400 workers.
For NAFTA activities, $66,150,000 is provided in two
components.
The first component, NAFTA transitional adjustment
assistance benefits, provides for weekly benefit payments to
workers affected by imports from Mexico and Canada. These
payments are also authorized by the Trade Act of 1974, as
amended as a result of the signing of the North American Free
Trade Agreement [NAFTA]. The Committee recommends $29,000,000
for this activity. This is the same as the budget request and
an increase of $2,000,000 over the 2001 comparable level and
represents the current services funding level.
The second component, NAFTA transitional adjustment
assistance training, provides funds for training, job search
and job relocation to workers affected by imports from Mexico
and Canada. The fiscal year 2002 current services
recommendation is $37,150,000, the same as the fiscal year 2001
enacted level and the budget request.
Resources related to the Administration's legislative
proposals will be considered upon enactment of the requested
legislation.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriations, 2001.................................... $3,380,210,000
Budget estimate, 2002................................... 3,414,338,000
Committee recommendation................................ 3,430,338,000
The Committee recommends $3,430,338,000 for this account.
This is $16,000,000 above the budget request and $50,128,000
above the 2001 comparable level. Included in the total
availability is $3,238,886,000 authorized to be drawn from the
``Employment Security Administration'' account of the
unemployment trust fund, and $191,452,000 to be provided from
the general fund of the Treasury.
The funds in this account are used to provide
administrative grants and assistance to State agencies which
administer Federal and State unemployment compensation laws and
operate the public employment service.
For unemployment insurance (UI) services, the bill provides
$2,413,923,000. This includes $2,403,923,000 for State
Operations, which is the same as the President's request and
$50,128,000 above the fiscal year 2001 level. The Committee
expects the Department to manage these resources to ensure
equitable funding to States to handle total workload, which is
estimated to be 2,622,000 average weekly insured unemployment
(AWIU) claims. The Committee recommendation includes
$10,000,000 for UI national activities, the same as the fiscal
year 2001 level and the President's request, which is directed
to activities that benefit the State/Federal unemployment
insurance program. The bill continues to provide for a
contingency reserve amount should the unemployment workload
exceed an average weekly insured claims volume of 2,622,000.
This contingency amount would fund the administrative costs of
unemployment insurance workload over the level of 2,622,000
insured unemployed per week at a rate of $28,600,000 per
100,000 insured unemployed, with a pro rata amount granted for
amounts of less than 100,000 insured unemployed.
The Committee recommendation includes bill language which
addresses the settlement of litigation relating to the
acquisition of an automated system for benefit payments under
the unemployment compensation program.
For the employment service, the Committee recommends
$848,415,000 which includes $23,452,000 in general funds
together with an authorization to spend $824,963,000 from the
``Employment security administration'' account of the
unemployment trust fund.
Included in the recommendation for the employment service
[ES] is $796,735,000 for Grants to States, available for the
program year of July 1, 2002, through June 30, 2003. This is
the same as the budget request and the 2001 comparable level.
The recommendation includes $51,680,000 for national
activities, an increase of $2,000,000 over the budget request.
The recommendation also includes $148,000,000 for one-stop
career centers. This Committee recommendation includes funding
for America's Labor Market Information System, including core
employment statistics, universal access for customers,
improving efficiency in labor market transactions, and
measuring and displaying WIA performance information.
The recommendation includes $20,000,000 for the Work
Incentives Grants program, the same as last year's level and
the President's request, to help persons with disabilities find
and retain jobs through the One-Stop Career Center system
mandated by the Workforce Investment Act. Funding will support
systems building grants intended to ensure that one-stop
systems integrate and coordinate mainstream employment and
training programs with essential employment-related services
for persons with disabilities.
The Committee agrees that the work opportunity tax credit
[WOTC], and the welfare-to-work tax credit provide important
resources to create new jobs, particularly for those Americans
who would otherwise be dependent on welfare. Therefore, the
Committee recommendation includes $22,000,000 for the
administration of these initiatives, an increase of $2,000,000
over the 2001 level.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
Appropriations, 2001.................................... $435,000,000
Budget estimate, 2002................................... 464,000,000
Committee recommendation................................ 464,000,000
The Committee recommends $464,000,000, an increase of
$29,000,000 above the 2001 comparable level, for this account.
The appropriation is available to provide advances to several
accounts for purposes authorized under various Federal and
State unemployment compensation laws and the black lung
disability trust fund, whenever balances in such accounts prove
insufficient. The bill anticipates that fiscal year 2002
advances will be made to the black lung disability trust fund.
The requested amount is required to provide for loan interest
payments on Black Lung Trust Fund borrowed amounts.
The separate appropriations provided by the Committee for
all other accounts eligible to borrow from this account in
fiscal year 2002 are expected to be sufficient. Should the need
arise, due to unanticipated changes in the economic situation,
laws, or for other legitimate reasons, advances will be made to
the needy accounts to the extent funds are available. Funds
advanced to the black lung disability trust fund are now
repayable with interest to the general fund of the Treasury.
PROGRAM ADMINISTRATION
Appropriations, 2001.................................... $158,863,000
Budget estimate, 2002................................... 161,078,000
Committee recommendation................................ 161,078,000
The Committee recommendation includes $112,571,000 in
general funds for this account, as well as authority to expend
$48,507,000 from the ``Employment Security Administration''
account of the unemployment trust fund, for a total of
$161,078,000. This is $2,215,000 greater than the 2001
comparable level.
The Committee recommendation includes $1,300,000 for the
management and oversight of the various pilot and demonstration
projects funded as part of this year's appropriation and to
support those projects that continue to be implemented from
previous year's appropriations. These funds will be used
exclusively for financial, technical, program and general
administration provided by staff responsible for grant
management, oversight, monitoring, guidance/operation and
reporting and evaluation for the earmark activities.
General funds in this account provide the Federal staff to
administer employment and training programs under the Workforce
Investment Act, the Older Americans Act, the Trade Act of 1974,
and the National Apprenticeship Act. Trust funds provide for
the Federal administration of employment security functions
under title III of the Social Security Act and the Immigration
and Nationality Act, as amended. Federal staff costs related to
the Wagner-Peyser Act in this account are split 97 percent to 3
percent between unemployment trust funds and general revenue,
respectively.
The Committee is aware that citizens of Alaska suffer from
high unemployment rates due to a lack of available career and
vocational job training, and that Alaska employers are often
forced to import labor, while leaving many untrained Alaskans
unemployed. The Committee encourages the Department to work
with Alaska Department of Labor and Workforce Development on a
project to conduct a comprehensive analysis of the State's
labor requirements and the training facilities which would be
required to meet those needs, and to provide technical
assistance, professional development and capacity building for
existing vocational and technical training, and to establish a
statewide database of such programs.
The Committee continues to be concerned over the economic
plight of western Alaska, one of the poorest, most desolate
areas in the United States with unemployment rates ranging
upwards of 80 percent in many villages, due in large part to
the collapse of the fishing industry there. The Committee urges
the Department to continue its contribution to the University
of Alaska and the State of Alaska's major economic development
initiative in western Alaska, including establishment of talent
banks for employers, needs assessments for employers, and
training of unemployed workers for available jobs.
The Committee supports the Vermont Department of
Education's current efforts to assess the State's vocational/
technical education infrastructure.
Pension and Welfare Benefits Administration
SALARIES AND EXPENSES
Appropriations, 2001.................................... $107,633,000
Budget estimate, 2002................................... 107,988,000
Committee recommendation................................ 112,418,000
The Committee recommendation provides $112,418,000 for this
account, which is $4,785,000 above the 2001 comparable level.
This recommendation provides sufficient funding to offset
the impact of inflation, preventing the reduction in full-time
equivalent staffing assumed in the budget request.
The Pension and Welfare Benefits Administration [PWBA] is
responsible for the enforcement of title I of the Employee
Retirement Income Security Act of 1974 [ERISA] in both civil
and criminal areas. PWBA is also responsible for enforcement of
sections 8477 and 8478 of the Federal Employees' Retirement
Security Act of 1986 [FERSA]. PWBA provides funding for the
enforcement and compliance; policy, regulation, and public
services; and program oversight activities.
Pension Benefit Guaranty Corporation
The Corporation's estimate for fiscal year 2002 includes
benefit payments of $1,079,000,000, multiemployer financial
assistance of $6,270,000, administrative expenses limitation of
$11,690,000, and services related to terminations expenses of
$178,924,000.
The Pension Benefit Guaranty Corporation is a wholly owned
Government corporation established by the Employee Retirement
Income Security Act of 1974. The law places it within the
Department of Labor and makes the Secretary of Labor the Chair
of its Board of Directors. The Corporation receives its income
primarily from insurance premiums collected from covered
pension plans, collections of employer liabilities imposed by
the act, and investment earnings. It is also authorized to
borrow up to $100,000,000 from the Treasury. The primary
purpose of the Corporation is to guarantee the payment of
pension plan benefits to participants if covered plans fail or
go out of existence.
Employment Standards Administration
SALARIES AND EXPENSES
Appropriations, 2001.................................... $362,716,000
Budget estimate, 2002................................... 284,434,000
Committee recommendation................................ 377,145,000
The Committee recommendation includes $377,145,000 for this
account. This is $14,429,000 above the 2001 comparable level
and $92,711,000 above the ubdget request. The bill contains
authority to expend $1,981,000 from the special fund
established by the Longshore and Harbor Workers' Compensation
Act; the remainder are general funds. In addition, an amount of
$31,443,000 is available by transfer from the black lung
disability trust fund. This is the same as the request and
$1,150,000 above the 2001 comparable level.
This recommendation provides sufficient funding to offset
the impact of inflation, preventing the reduction in full-time
equivalent staffing assumed in the budget request. It rejects
the administration's proposed legislation that would have
established a surcharge on the amount billed to Federal
agencies for workers' compensation benefits to finance Labor
Department administrative expenses of $80,281,000.
The Employment Standards Administration is involved in the
administration of numerous laws, including the Fair Labor
Standards Act, the Immigration and Nationality Act, the Migrant
and Seasonal Agricultural Workers' Protection Act, the Davis-
Bacon Act, the Family and Medical Leave Act, the Federal
Employees' Compensation Act [FECA], the Longshore and Harbor
Workers' Compensation Act, and the Federal Mine Safety and
Health Act (black lung).
The Committee supports expansion of the equal pay
initiative, which helps business improve the way they pay their
employees, and assists in education about the importance of
equal pay.
SPECIAL BENEFITS
Appropriations, 2001.................................... $56,000,000
Budget estimate, 2002................................... 121,000,000
Committee recommendation................................ 121,000,000
The Committee recommends continuation of appropriation
language to provide authority to require disclosure of Social
Security account numbers by individuals filing claims under the
Federal Employees' Compensation Act or the Longshore and Harbor
Workers' Compensation Act and its extensions.
The recommendation includes $121,000,000, the same as the
budget request and an increase of $65,000,000 above the 2001
comparable level. This appropriation primarily provides
benefits under the Federal Employees' Compensation Act [FECA].
The payments are prescribed by law.
The total amount to be available in fiscal year 2002 is
$3,267,514,000, an increase of $25,044,000 above the 2001
comparable level.
The Committee recommends continuation of appropriation
language that provides authority to use the FECA fund to
reimburse a new employer for a portion of the salary of a newly
reemployed injured Federal worker. The FECA funds will be used
to reimburse new employers during the first 3 years of
employment not to exceed 75 percent of salary in the worker's
first year, declining thereafter. Costs will be charged to the
FECA fund.
The Committee again includes appropriation language that
retains the drawdown date of August 15. The drawdown authority
enables the agency to meet any immediate shortage of funds
without requesting supplemental appropriations. The August 15
drawdown date allows maximum flexibility for continuation of
benefit payments without interruption.
The Committee recommends continuation of appropriation
language to provide authority to deposit into the special
benefits account of the employees' compensation fund those
funds that the Postal Service, the Tennessee Valley Authority,
and other entities are required to pay to cover their fair
share of the costs of administering the claims filed by their
employees under FECA. The Committee concurs with requested bill
language to allow use fair share collections to fund capital
investment projects and specific initiatives to strengthen
compensation fund control and oversight.
Energy Employees Occupational Illness Compensation Program
Appropriations, 2001.................................... $60,328,000
Budget estimate, 2002................................... 136,000,000
Committee recommendation................................ 136,000,000
The Committee recommends $136,000,000 for this account in
2002. This is the same as the President's request and
$75,672,000 above 2001.
The mission of the Energy Employees Occupational Illness
Compensation Program is to deliver benefits to eligible
employees and former employees of the Department of Energy, its
contractors and subcontractors or to certain survivors of such
individuals, as provided in the Energy Employees Occupational
Illness Compensation Program Act. The mission also includes
delivering benefits to certain beneficiaries of the Radiation
Exposure Compensation Act.
The Energy Employees Occupational Illness Compensation
Program provides benefits authorized by the Energy Employees
Occupational Illness Compensation Program Act. The Program went
into effect on July 31, 2001. The Department of Labor's Office
of Workers' Compensation Programs within the Employment
Standards Administration is responsible for adjudicating and
administering claims filed by employees or former employees (or
their survivors) under the Act.
The Committee is concerned that the Secretary's planned
implementation of the Energy Employees Occupational Illness
Compensation Program will not result in sufficient services
being provided to residents of West Texas who may qualify for
benefits under the law. As the number of potential
beneficiaries residing near the Pantex facility in Amarillo
exceeds 12,000, a full-time resource center in that area is
necessary to fully meet their needs. The Committee therefore
expects the Secretary to establish a full-time resource center
in West Texas and to provide the Committee with a report within
90 days of enactment of the Act on the Department's progress in
this regard.
BLACK LUNG DISABILITY TRUST FUND
Appropriations, 2001 (Definite)......................... $1,027,900,000
Budget Estimate, 2002 (Definite)........................ 54,717,000
Budget Estimate, 2002 (Indefinite)...................... 981,283,000
Committee recommendation (Definite)..................... 54,717,000
Committee recommendation (Indefinite)................... 981,283,000
The Committee recommends $1,036,115,000 for this account in
2002, of which $54,832,000 is definite budget authority and
$981,283,000 is indefinite budget authority. In total, this is
an increase of $8,215,000 over the 2001 comparable level and
$115,000 more than the administration request. This represents
a change in the appropriation language beginning in fiscal year
2002 for the Black Lung Disability Trust Fund. This change will
eliminate the need for drawdowns from the subsequent year
appropriation in order to meet current year compensation,
interest, and other benefit payments. The appropriation
language will continue to provide definite budget authority for
the payment of administrative expenses for the operation and
administration of the Trust Fund.
The total amount available for fiscal year 2002 will
provide $388,283 000 for benefit payments, and $54,832,000 for
administrative expenses for the Department of Labor. Also
included is $407,343,000 for interest payments on advances. In
fiscal year 2001, comparable obligations for benefit payments
are estimated to be $407,393,000 while administrative expenses
for the Departments of Labor and Treasury, respectively, are
$52,201,000 and $356,000. In fiscal year 2001, the interest
payments on advances is estimated to be $568,000,000.
The trust fund pays all black lung compensation/medical and
survivor benefit expenses when no responsible mine operation
can be assigned liability for such benefits, or when coal mine
employment ceased prior to 1970, as well as all administrative
costs which are incurred in administering the benefits program
and operating the trust fund.
It is estimated that 53,250 people will be receiving black
lung benefits financed from the trust fund by the end of the
fiscal year 2002. This compares with an estimated 57,000
receiving benefits in fiscal year 2001.
The basic financing for the trust fund comes from a coal
excise tax for underground and surface-mined coal. Additional
funds come from reimbursement payments from mine operators for
benefit payments made by the trust fund before the mine
operator is found liable, and advances. The advances to the
fund assure availability of necessary funds when liabilities
may exceed other income. The Omnibus Budget Reconciliation Act
of 1987 continues the current tax structure until 2014.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2001.................................... $425,886,000
Budget estimate, 2002................................... 425,835,000
Committee recommendation................................ 450,262,000
The Committee recommendation includes $450,262,000 for this
account. This is an increase of $24,427,000 over the budget
request and an increase of $24,376,000 above the 2001
comparable level. This agency is responsible for enforcing the
Occupational Safety and Health Act of 1970 in the Nation's
workplaces.
This recommendation provides sufficient funding to offset
the impact of inflation, preventing the reduction in full-time
equivalent staffing assumed in the budget request.
In addition, the Committee has included language to allow
OSHA to retain up to $750,000 per fiscal year of training
institute course tuition fees to be utilized for occupational
safety and health training and education grants in the private
sector.
The Committee retains language carried in last year's bill
effectively exempting farms employing 10 or fewer people from
the provisions of the act except those farms having a temporary
labor camp. The Committee also retains language exempting small
firms in industry classifications having a lost workday injury
rate less than the national average from general schedule
safety inspections. These provisions have been in the bill for
many years.
The Committee believes that OSHA's worker safety and health
training and education programs, including the grant program
that supports such training, are a critical part of a
comprehensive approach to worker protection. The Committee is
concerned that OSHA cut funding to help establish ongoing
worker safety and health training programs and has indicated
that due to funding cutbacks, such programs would be eliminated
in fiscal year 2002. The committee has provided $3,000,000 in
additional funds to restore the institutional competency
building training grants.
The Committee is concerned about the significant increase
in workplace fatalities among Hispanic and immigrant workers
that were reported in the 2000 BLS Census of Fatal Occupational
Injuries. OSHA is urged to conduct an in-depth review of, and
within 6 months, report to the Committee on the nature and
causes of workplace fatalities and injuries among Hispanic and
immigrant workers, the adequacy of existing standards,
enforcement, compliance assistance, outreach and training
programs that are directed towards these high risk workers, and
specific initiatives OSHA plans to undertake to provide
enhanced protection to these workers.
The Committee has provided funding to maintain the State
consultation grant program and expects that this program will
continue to be targeted to provide compliance assistance to
small businesses. The Committee understands that OSHA has
conducted a study on the effectiveness of the State
consultation program--the first such evaluation of the program
since it was initiated in 1977--and that a draft report has
been prepared. The agency is urged to finalize this report
within the next 60 days and to provide a copy to the Committee
upon its completion.
The Committee is very pleased with OSHA's efforts in
placing high priority on the voluntary protection programs
(VPP) and other voluntary cooperative programs. The agency's
work in expanding participation in the programs, and promoting
prompt review and processing of applications is particularly
noteworthy. In fiscal year 2002 the Committee expects OSHA to
continue to place high priority on the VPP. Cooperative
voluntary programs, especially the VPP, are an important part
of OSHA's ability to assure worker safety and health and should
be administered in conjunction with an effective strong
enforcement program.
The Committee also intends that the Office of Regulatory
Analysis continued to be funded as close as possible to its
present level.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriations, 2001.................................... $246,306,000
Budget estimate, 2002................................... 246,306,000
Committee recommendation................................ 256,093,000
The Committee recommendation includes $256,093,000 for this
account. This is $9,787,000 more than the 2001 comparable
level.
This recommendation provides sufficient funding to offset
the impact of inflation, preventing the reduction in full-time
equivalent staffing assumed in the budget request.
This agency insures the safety and health of the Nation's
miners by conducting inspections and special investigations of
mine operations, promulgating mandatory safety and health
standards, cooperating with the States in developing effective
State programs, and improving training in conjunction with
States and the mining industry.
The Committee is concerned that miners working in
vermiculite, talc, and taconite mines throughout the country
are not being adequately protected from deposits of asbestos.
The Committee is informed that in March of this year, the
Inspector General of the Department of Labor issued an
Evaluation of MSHA's Handling of Inspections at The W.R. Grace
& Company Mine in Libby, Montana. The Committee urges MSHA to
consider initiating rulemaking to implement recommendations
contained within the Inspector General's evaluation as quickly
as possible, and to provide an update on this progress to the
Committee within 6 months.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriations, 2001.................................... $450,887,000
Budget estimate, 2002................................... 476,000,000
Committee recommendation................................ 476,000,000
The Committee includes $476,000,000 for this account, the
same as the budget request and $25,113,000 more than the 2001
comparable level. This includes $69,132,000 from the
``Employment Security Administration'' account of the
unemployment trust fund, and $406,868,000 in Federal funds.
This funding level will cover the agency's built in increases.
The Bureau of Labor Statistics is the principal fact
finding agency in the Federal Government in the broad field of
labor economics.
The Committee has included bill language making $10,280,000
of the BLS allowance for Occupational Employment Statistics
available on a program year basis. This action is taken in
order to maintain the funding stream established in the ETA
State Unemployment Insurance and Employment Service Operations
account, through which the program was previously funded,
thereby avoiding a programmatic disruption at the State level.
Departmental Management
SALARIES AND EXPENSES
Appropriations, 2001.................................... $357,387,000
Budget estimate, 2002................................... 329,765,000
Committee recommendation................................ 361,834,000
The Committee recommendation includes $361,834,000 for this
account, which is $32,069,000 more than the budget request and
$4,447,000 above the 2001 comparable level. In addition, an
amount of $22,590,000 is available by transfer from the black
lung disability trust fund, which is the same as the budget
request.
The primary goal of the Department of Labor is to protect
and promote the interests of American workers. The departmental
management appropriation finances staff responsible for
formulating and overseeing the implementation of departmental
policy and management activities in support of that goal. In
addition, this appropriation includes a variety of operating
programs and activities that are not involved in departmental
management functions, but for which other salaries and expenses
appropriations are not suitable.
The Committee recommendation reflects major Committee
priorities, including international labor affairs.
The Committee recommendation includes $25,177,000 for
Executive Direction, a 5 percent reduction from the request.
The Committee recommends $10,186,000 for the Women's
Bureau, the same as the budget request and fiscal year 2001
level. The Committee urges the Women's Bureau to provide
increased support for effective programs such as ``Women
Work!'', to provide technical assistance and training on
programming for women in transition.
The Committee recommends $147,982,000 for the Bureau of
International Labor Affairs, the same level of funding as
provided in fiscal year 2001.
Of this amount, the Committee's recommendation includes
$82,000,000 in recognition of the U.S. commitment, pursuant to
adoption and ratification of ILO Convention #182, to provide
additional resources on a sustained basis to assist developing
countries in removing the worst forms of child labor. Of that
sub-total, $45,000,000 constitutes the U.S. contribution to
sustain and replicate the successful efforts of the ILO's
International Program for the Elimination of Child Labor
(IPEC). The remaining $37,000,000 is for assistance to expand
the program initiated in fiscal year 2001 to afford access to
basic education for children removed from the worst forms of
child labor in impoverished nations where abusive and
exploitative child labor is most acute. While the Committee is
concerned by the slowness of the Department in obligating all
of the funds previously appropriated for this purpose,
affording access to basic education is the single most
effective means to curb the worst forms of child labor.
Therefore, the Committee reaffirms its support for this
complementary work to international efforts and expects the
Department to collaborate more effectively with our country's
labor attaches and labor reporting officers abroad, as well as
USAID and IPEC officials, in order to program these funds more
promptly where they can do the most good.
The Committee further recommends $20,000,000 for
multilateral technical assistance and $17,000,000 for bilateral
technical assistance. These funds help developing countries
implement core labor standards, strengthen the capacities of
Ministries of Labor to enforce national labor laws and protect
internationally-recognized worker rights. The Committee expects
ILAB to use these bilateral funds to further develop, improve,
and expand its internal capacity and to post staff in the field
to provide top quality, professional expertise on a continuing
basis. The Committee further expects ILAB to provide a report
to the Committee to explain the nature and scope of the
technical assistance already provided with the increased
funding appropriated to the Department in recent years. In this
regard, the report should include efforts to improve the depth,
quality, and regularity of reporting, as part of a strategic
plan for ILAB activities, to be submitted to the Committee no
later than September 1, 2002.
The Committee recommendation includes $10,000,000 for
global workplace-based HIV-AIDS education and prevention
programs. The Committee expects the Department to work through
the ILO to most effectively program the appropriated funds.
The Committee recommendations further include $5,000,000
for ILAB to build its own permanent capacity to monitor and
report regularly and in-depth to the Congress on the extent to
which foreign countries with trade and investment agreements
with the United States respect internationally-recognized
worker rights as currently required under various U.S. laws and
effectively promote core labor standards as embodied in the ILO
Declaration on Fundamental Principles and Rights at Work. In
this regard, the Committee recognizes that it may be necessary,
from time to time, for the Department to tap private sector
expertise from knowledgeable employer, trade union, and non-
governmental organizations with their own presence or in-
country partners on the ground in foreign countries.
For other ILAB programs, including 125 FTE for Federal
Administration, the Committee recommends $13,982,000.
Finally, the Committee requests that ILAB undertake and
complete a study by October 1, 2002 to firmly establish, if
feasible, amounts spent on military expenditures each year from
1990-2001 compared to expenditures on basic education in each
of the foreign countries with serious child labor problems as
identified in the prior seven ILAB studies on child labor. This
study should also determine the underlying trends and specific
amounts that the World Bank and other international financial
institutions have committed to specifically combat abusive
child labor and to improve access to basic education in these
problem countries every year since 1989.
The Committee requested a study by the Department in fiscal
year 1998 on the development of a methodology for the regular
reporting of working conditions in the production of apparel
imported into the United States. The Committee expects this
report to be provided by December 31, 2001 along with
corresponding recommendations for overcoming whatever
deficiencies were identified.
Acknowledging the need to upgrade the information
technology capability in the Department of Labor, the Committee
provides $37,000,000 for the information technology fund. The
total provided includes support for cross-cutting investments
such as common office automation suite implementation, and
architecture requirements and web services.
The Committee is aware of the important work the U.S.
Department of Labor's Office of Policy is doing to encourage
small businesses to develop alcohol-and drug-free workplace
programs. The Labor Department established the Working Partners
Program, an educational outreach initiative that has worked
with numerous businesses in creating prevention programs to
promote a safe, healthy and productive workforce. The Committee
encourages the Department to continue the Working Partners
Program.
The Committee retains bill language intended to ensure that
decisions on appeals of Longshore and Harborworker Compensation
Act claims are reached in a timely manner.
Office of Disability Policy
Appropriations, 2001.................................... $22,969,000
Budget estimate, 2002................................... 43,263,000
Committee recommendation................................ 43,263,000
The Committee recommends $43,263,000 for this account in
2002. This is the same as the President's request and
$20,294,000 above 2001.
Congress created the Office of Disability Employment Policy
(ODEP) in the Department of Labor's fiscal year 2001
appropriation. Programs and staff of the former President's
Committee on Employment of People with Disabilities (PCEPD)
have been integrated into this new office.
The ODEP mission, under the leadership of an Assistant
Secretary, is to bring a heightened and permanent long-term
focus to the goal of increasing employment of persons with
disabilities. This will be achieved through policy analysis,
technical assistance, and development of best practices, as
well as outreach, education, constituent services, and
promoting ODEP's mission among employers.
The increase includes: an expansion of one-stop
accessability grants, to support the process of implementing
the ``ticket to work'' through One-Stop Career Centers;
expanding the provision of grants aimed at developing and
implementing innovative programs for moving youth with
disabilities from school to work; and funding an Olmstead grant
program to assist persons with significant disabilities in
making the transition from institutional settings to the
community and employment.
The Committee recommendation includes $1,000,000 to fund a
minimum of three pilot programs to promote the employment of
individuals with significant disabilities in Federal employment
positions that can be performed from home-based work stations.
Telecommunications technology makes it possible for properly
equipped individuals employed in customer service/call contact
centers, claims, loan or financial transaction processing
operations to work from home-based work stations. Each pilot
program should identify appropriate positions in a Federal
agency, equip and train qualified individuals with significant
disabilities for such positions and, at the end of 1 year,
report to the Office of Disability Policy on the results of the
telecommuting project, including number of individuals with
disabilities employed in telecommuting jobs, attrition rates
and performance of such individuals in comparison to the
general workforce, and the feasibility of employing more
individuals with disabilities in other agency positions.
Veterans Employment and Training
Appropriations, 2001.................................... $211,656,000
Budget estimate, 2002................................... 211,703,000
Committee recommendation................................ 213,703,000
The Committee recommendation includes $213,703,000 for this
account, including $26,800,000 in general revenue funding and
$186,903,000 to be expended from the ``Employment Security
Administration'' account of the unemployment trust fund. This
is $2,000,000 more than the budget request and $2,047,000 above
the 2001 comparable level.
For State grants the bill provides $81,615,000 for the
Disabled Veterans Outreach Program and $77,253,000 for the
Local Veterans Employment Representative Program. These amounts
are the same as the budget request and the fiscal year 2001
enacted level.
For Federal administration, the Committee recommends
$28,035,000, an increase of $47,000 over the fiscal year 2001
level. The Committee supports the concept of the Transition
Assistance Program administered jointly with the Department of
Defense which assists soon-to-be-discharged service members in
transitioning into the civilian work force and includes funding
to maintain an effective program. The Committee notes the
budget request includes $2,000,000, the same as the fiscal 2001
level, for the National Veterans Training Institute [NVTI].
This Institute provides training to the Federal and State staff
involved in the direct delivery of employment and training
related services to veterans. The Committee urges funding for
the Institute be maintained, to the extent possible, at the
2001 level.
The Committee recommendation includes $19,000,000 for the
Homeless veterans program, an increase of $1,500,000 over the
budget request and fiscal year 2001 level. Also included is
$7,800,000 for the Veterans Workforce Investment Program, an
increase of $500,000 above the budget request and fiscal year
2001 level.
The recommendation also authorizes the Department of Labor
to permit the Veterans' Employment and Training Service [VETS]
to also fund activities in support of the VETS' Federal
Contractor Program [FTP] from funds currently made available to
States for veterans' employment activities.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2001.................................... $54,683,000
Budget estimate, 2002................................... 57,133,000
Committee recommendation................................ 57,133,000
The bill includes $57,133,000 for this account, the same as
the budget request and $2,450,000 above the 2001 comparable
level. This funding will cover the agency's built in increases.
The bill includes $52,182,000 in general funds and authority to
transfer $4,951,000 from the ``Employment Security
Administration'' account of the unemployment trust fund. In
addition, an amount of $328,000 is available by transfer from
the black lung disability trust fund.
The Office of the Inspector General [OIG] was created by
law to protect the integrity of departmental programs as well
as the welfare of beneficiaries served by those programs.
Through a comprehensive program of audits, investigations,
inspections, and program evaluations, the OIG attempts to
reduce the incidence of fraud, waste, abuse, and mismanagement,
and to promote economy, efficiency, and effectiveness.
General Provisions
General provision bill language is included to:
Prohibit the use of Job Corps funding for compensation of
an individual at a rate in excess of Executive Level II (sec.
101).
Permit transfers of up to 1 percent between appropriations
(sec. 102).
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
HEALTH RESOURCES AND SERVICES
Appropriations, 2001.................................... $5,570,177,000
Budget estimate, 2002................................... 4,972,687,000
Committee recommendation................................ 5,518,843,000
The Committee recommends an appropriation of $5,518,843,000
for health resources and services. This is $546,156,000 more
than the administration request and $51,334,000 less than
fiscal year 2001.
Health Resources and Services Administration [HRSA]
activities support programs to provide health care services for
mothers and infants; the underserved, elderly, homeless;
migrant farm workers; and disadvantaged minorities. This
appropriation supports cooperative programs in community
health, AIDS care, health provider training, and health care
delivery systems and facilities.
HEALTH CENTERS
The Committee provides $1,343,723,000 for the health
centers, which is $175,111,000 above the fiscal year 2001 level
and $51,000,000 above the administration request for this group
of programs, which include community health centers, migrant
health centers, health care for the homeless, and public
housing health service grants.
Community, migrant, public housing and homeless health
centers will provide primary health care services to nearly 12
million people this year. While the number of uninsured
Americans decreased last year for the first time in a decade,
the number of uninsured seeking care at health centers has
increased dramatically. In addition, millions of people who
have health insurance coverage encounter serious difficulties
in getting access to health care. For many of these Americans,
health centers are the only source of primary and preventive
health care. Located in over 3,000 rural and urban medically-
underserved communities in all 50 States, health centers have
proven to be a cost-effective and efficient source of care for
the underserved. By providing access to basic health services,
health centers annually save the health care system billions of
dollars in reduced use of costly emergency room, specialty, and
hospital inpatient care.
The Committee does not set aside any additional
appropriations for loan guarantee authority under Section
330(d) of the Public Health Services Act. The Committee intends
that unused loan guarantee authority made available in fiscal
year 1997 and fiscal year 1998 continue to be available for
guarantees of both loan principal and interest.
As in previous years, the Committee limits the amount
available for payment of claims under the Federal Tort Claims
Act to $5,000,000.
Community health centers
The community health centers provide comprehensive, case-
managed primary health care services to medically indigent and
underserved populations in rural and urban areas. Of the
clients served by community health centers, about 44 percent
are children and 67 percent have incomes below the poverty
line.
The Committee supports the administration request to
eventually expand the program to double its service capacity.
In addition, the Committee notes that HRSA should distribute
additional resources provided in this bill to increase the
number of new and expanded sites by 1,200 over the next 5
years.
As part of its rural health initiative the Committee
expects HRSA to give priority consideration to creating new
health centers in underserved communities, especially rural
communities. In addition, the Committee supports providing
assistance to struggling health centers to ensure their
stability and quality of care and to existing health centers to
expand the scope of medical services available to the
community.
The Committee remains concerned about the affordability of
prescription drugs for all Americans. To help address this
concern, the Committee encourages community health centers to
utilize innovative approaches under their statutory Federal
drug discount authority to reduce costs for those in greatest
need, particularly the elderly and lower income Americans.
The Committee continues to be concerned about how the
Department distributes health center funds to States with large
uninsured and underserved populations. The Committee requests
the Secretary to review the program to ensure that funds are
distributed in an equitable and appropriate manner, and provide
a report to the Committee by June 30, 2002. The Department
should explain how it intends to rectify any inequities in
funds distribution or if there is some rationale for these
inequities.
Within the consolidated health center line, sufficient
funds have been provided to support the activities intended to
reduce health disparities among ethnic/racial groups with high
rates of adverse health outcomes.
The Committee applauds the agency for its initiative in
Alaska, the ``Alaska Frontier Health Plan,'' and encourages the
agency to continue and expand its efforts with this program.
School-based health centers
This program provides grants for comprehensive primary and
preventive health care services and health education to at-risk
and medically underserved children and youth. Grants are
awarded to public or private, nonprofit, community-based health
care providers. Through agreements with a local school or
school system, the health care entity provides the services in
the school building or on school grounds.
The Committee is pleased with the achievements of the
healthy schools, healthy communities initiative which has been
particularly effective in providing comprehensive school-based,
school-linked, family centered, community based primary care to
approximately 24,000 children.
Migrant health program
The program helps provide culturally sensitive
comprehensive primary care services to migrant and seasonal
farm workers and their families. Over 80 percent of the centers
also receive funds from the community health centers program.
Health care for the homeless
The program provides project grants for the delivery of
primary health care services, substance abuse services, and
mental health services to homeless adults and children. About
one-half of the projects are administered by community health
centers. The other one-half are administered by nonprofit
coalitions, inner-city hospitals, and local public health
departments.
Recognizing the adverse impact of residential instability
and poverty on access to health care, the Committee urges the
Department to consider designating homeless persons, migrant
and seasonal farm workers, as medically underserved
populations. The Committee further urges the Department to take
steps to make health services provided by the Department as
fully accessible as possible to persons experiencing
homelessness.
Public housing health service grants
The program awards grants to community-based organizations
to provide case-managed ambulatory primary health and social
services in clinics at or in proximity to public housing. More
than 60 percent of the programs are operated by community
health centers.
Native Hawaiian health care
The Committee again includes the legal citation in the bill
for the Native Hawaiian Health Care Program. The Committee has
included sufficient funding so that health care activities
funded under the Native Hawaiian Health Care Program can be
supported under the broader community health centers line. The
Committee expects that not less than $7,000,000 be provided for
these activities in fiscal year 2002.
The purpose of this activity is to improve the health
status of native Hawaiians by making primary care, health
promotion, and disease prevention services available through
the support of Native Hawaiian health systems. Services
provided include health screening, nutrition programs, and
contracting for basic primary care services. This activity also
supports a health professions scholarship program for native
Hawaiians.
Other Native Hawaiian and Pacific Islander health issues
The Committee believes the Agency could establish a
demonstration project in Hawaii to develop an integrated health
and social services model, to include traditional healing,
prevention, and disease management, that addresses the
disparities in health status and barriers to accessing health
and social services among native Hawaiians and other minority
populations at the Waimanalo Health Center. The Committee
requests inclusion of the Samoan and other Pacific Island
populations to partake in the traditional healing, prevention
and disease management opportunities in the Waimanalo Health
Center.
The Committee continues to support the concept of malama.
This innovative, culturally sensitive community partnership
program addresses the prenatal needs of minorities in rural
Hawaii. The Committee encourages the HRSA to support the
replication of this project to include teen pregnancies. The
ever increasing epidemic of teen pregnancy makes the maximum
utilization of effective strategies a necessity.
The Committee encourages the development of a Center of
Excellence for Indigenous Health and Healing at the University
of Hawaii and in other schools serving a large population of
native peoples including American Indians, Alaska Natives,
native Hawaiians and Pacific Islanders to incorporate
traditional medicine and healing practices into their training
for medical, nursing, social work, psychology, and public
health students and pharmacy. The Committee encourages HRSA,
CDC, and SAMSHA to support this effort in their grants by
including traditional practitioners as providers of care where
there are native and indigenous people residing in the service
area of the grantee. The Committee also supports the creation
of a Native Hawaiian Center of Nursing Excellence at the
University of Hawaii at Hilo.
The Committee understands that the Agency has funded the
Hui and encourages continued and increased support to address
the unique health care needs of Hawaii's underserved
population. Native Hawaiian indigenous populations continue to
experience significant health problems, including asthma and
diabetes. The Committee urges HRSA to implement a program under
which the systematic utilization of native Hawaiian health
expertise may effectively impact the health status in these
populations. The Committee recommends that community health
centers serve as a safety net for this program, utilizing nurse
practitioners and psychologists as care providers for these
underserved populations.
The Committee is also concerned that regulations and
application procedures currently governing distribution of
community health center funds are preventing remote rural areas
in States like Alaska and Hawaii from applying for and
receiving funding for health centers despite severe shortages
of health professionals and great need. The Committee urges the
agency to give appropriate priority to locating new health
centers in such remote communities and to developing a flexible
approach to working with Native health providers and other
similar groups to help meet the health needs of low income
persons living in extremely remote locations.
Currently the State of Hawaii and Pacific Basin Region are
experiencing an acute shortage of Doctorally prepared
Pharmacists and there is no school of pharmacy in the State.
Unique to Hawaii is the fact much its population comes from the
pacific basin region and use health interventions that are
unique to this part of the world. Therefore the Committee urges
HRSA to develop a pharmacy program at the University of Hawaii/
Hilo that includes as part of the curriculum, strong clinical
focus on pacific basin region culture and traditional
interventions. The University of Hawaii/Hilo has a relationship
with the National Tropical Botanical Gardens that would allow
students in the school of pharmacy a rich study in ethnobiology
helping them to provide a broader background and cultural
understanding of the Hawaiian population.
The Committee recognizes that providing health care in
rural areas is difficult, and the difficulties increase
exponentially when the location is a small island in the
Pacific. However, Molokai General Hospital has been providing
health care on this rural island and has found that its
environment provides opportunities to research outcomes of new
interventions, evaluate culturally-relevant health education,
train health providers on care of ethnic populations, and
facilitate the integration of non-Western health treatments.
Molokai's rural setting also encourages the collaboration among
diverse health professionals and necessitates the use of
technology advances, including telehealth, telemedicine,
electronic communication, and video consultation. Given
Molokai's General Hospital's ability to thrive in its isolated
location, the Committee believes that the Hospital could be
designated a Center of Excellence that will focus on the
provisions of health care in rural areas.
National Health Service Corps: Field placements
The Committee provides $49,511,000 for field placement
activities, which is $8,047,000 above the fiscal year 2001
level and $7,000,000 more than the administration request. The
funds provided for this program are used to support the
activities of National Health Service Corps obligors and
volunteers in the field, including travel and transportation
costs of assignees, training and education, recruitment of
volunteers, and retention activities. Salary costs of most new
assignees are paid by the employing entity.
National Health Service Corps: Recruitment
The Committee provides $104,916,000 for recruitment
activities, which is $17,000,000 more than the fiscal year 2001
level and the administration request. This program provides
major benefits to students (full-cost scholarships or sizable
loan repayment) in exchange for an agreement to serve as a
primary care provider in a high priority federally designated
health professional shortage area. The Committee reiterates its
intention that funds support multi-year, rather than single-
year, commitments.
As part of its rural health initiative, the Committee is
increasing funding for field placements and recruitment to
address growing concerns about primary care provider shortages
in rural and underserved areas. The Committee strongly supports
these programs because of their success in recruiting,
training, and retaining well trained providers in these areas.
The Committee is aware that providers who train in rural and
underserved areas are more likely to elect to practice in those
areas.
The Committee is concerned by the declining percentage of
placements of NHSC assignees at Community, Migrant, Homeless,
and Public Housing Health Centers. The program is intended to
supplement efforts of other Federal programs, such as health
centers, that are targeted to underserved communities and
vulnerable populations, and the Committee remains supportive of
efforts to place practitioners in close coordination with this
program.
The Committee applauds the efforts of the National Health
Service Corps (NHSC) to place psychologists and other mental
and behavioral health professionals in designated underserved
areas including community and migrant health centers.
Nevertheless, the Committee believes greater emphasis should be
placed on this priority to increase the number of these
providers placed in Mental (and Behavioral) Health Professional
Shortage Areas. In addition, the Committee is concerned that no
psychologists are participating in the Scholarship Program. The
Committee, therefore, directs the NHSC to take all necessary
steps to increase the number of positions assigned to Mental
Health Professional Shortage Areas (including for
psychologists) and to begin including psychologists in the
Scholarship Program.
The Committee intends that $8,000,000 of the funds
appropriated for this activity be used for State offices of
rural health. As part of its rural health initiative, the
Committee is significantly increasing funding for the offices
of rural health to allow States to better coordinate care and
improve support and outreach in rural areas.
HEALTH PROFESSIONS
For all HRSA health professions programs, the bill includes
$352,927,000, which is the same as fiscal year 2001 and
$213,174,000 more than the administration request for these
programs.
The health professions and nursing education programs under
Title VII and VIII of the Public Health Service Act provide
support to students, programs, departments, and institutions to
improve the accessibility, quality, and racial and ethnic
diversity of the health care workforce. In addition to
providing unique and essential training and education
opportunities, these programs help meet the health care
delivery needs of the over 2,800 Health Professions Shortage
Areas in this country, at times serving as the only source of
health care in many rural and disadvantaged communities.
Providers who were trained under Title VII and VIII-funded
programs are 3-5 times more likely to provide health care in
rural and underserved areas. The organizations representing
schools, programs, and institutions that benefit from this
funding have determined that these programs needs strong
funding to educate and train a health care workforce that meets
the public's health care needs.
The following clusters and their associated programs are
included in this consolidated account:
A. Workforce information and analysis
Health professions data and analysis
This program supports the collection and analysis of data
on the labor supply in various health professions and on future
work force configurations.
Research on certain health professions issues
This program supports research on the extent to which debt
has a detrimental effect on students entering primary care
specialties; the effects of federally funded education programs
for minorities attending and completing health professions
schools; and the effectiveness of State investigations in
protecting the health of the public. The Committee reiterates
its support for the three centers for health professions
research that are current grantees.
B. Training for diversity
Centers of excellence
This program was established to fund institutions that
train a significant portion of the Nation's minority health
professionals. Funds are used for the recruitment and retention
of students, faculty training, and the development of plans to
achieve institutional improvements. The institutions that are
designated as centers of excellence are private institutions
whose mission is to train disadvantaged minority students for
service in underserved areas. Located in poor communities and
usually with little State funding, they serve the health care
needs of their patients often without remuneration. The
Committee is pleased that the agency has refocused the minority
centers of excellence program on providing support to
historically minority health professions institutions.
The Committee is pleased that HRSA has re-focused the
Minority Centers of Excellence program on providing support to
historically minority health professions institutions. The
Committee encourages the Centers of Excellence program to
consider applications that are responsive to allied health
professions which are experiencing shortages and high vacancy
rates, such as laboratory personnel.
The Committee urges the agency to consider establishing at
least one center for excellence focused on training Alaska
Natives as community health aides to serve as sole community
health providers in remote Alaska Native villages across
Alaska.
The Committee continues to be supportive of the work of the
American Foundation for Negro Affairs in providing early
intervention training.
Health careers opportunity program
This program provides funds to medical and other health
professions schools for recruitment of disadvantaged students
and pre-professional school preparations. The Committee is
pleased that HRSA has given priority consideration for grants
to minority health professions institutions, and recommends
that grant review committees have proportionate representation
from these institutions.
The Committee has been supportive of this program's
critical role in improving the health status of minority and
disadvantaged citizens by increasing available opportunities
for those individuals seeking a health professions career. The
Committee understands that minority providers are more likely
to serve in underserved areas. The program has recognized the
contribution of historically minority health professions
schools, and have supported those institutions which have made
the greatest contribution to increasing the number of
minorities in health professions careers.
The Committee is pleased that HRSA has given priority
consideration for H-COP grants to minority health professions
institutions, and recommends that grant review committees have
proportionate representation from these institutions. The
Committee encourages the H-COP program to consider applications
that are responsive to allied health professions which are
experiencing shortages and high vacancy rates, such as
laboratory personnel.
Faculty loan repayment
This program provides for the repayment of education loans
for individuals from disadvantaged backgrounds who are health
professions students or graduates, and who have agreed to serve
for not less than 2 years as a faculty member of a health
professions school.
Scholarships for disadvantaged students
This program provides grants to health professions schools
for student scholarships to individuals who are from
disadvantaged backgrounds and are enrolled as full-time
students in such schools. The Committee continues to intend
that all health professions disciplines made eligible by
statute be able to participate in the scholarships program.
The Committee continues to intend that all health
professions disciplines made eligible by statute be able to
participate in the scholarship program.
The Committee continues to recognize the importance of
training greater numbers of psychologists and other health
professionals from disadvantaged backgrounds to participate on
interdisciplinary primary care teams addressing a range of
behavioral and mental health needs.
C. Training in primary care medicine and dentistry
The Committee recognizes that these programs play a
critical role in meeting the oral health care needs of
Americans; especially those who require specialized or complex
care and represent vulnerable populations in underserved areas.
Additionally, the Committee realizes that several States have
fewer than 10 pediatric dentists. The Committee notes that
there is clearly a shortage of dentists needed to address the
oral health requirements of America's children.
Family medicine training
Family medicine activities support grants for graduate
training in family medicine, grants for pre-doctoral training
in family medicine, grants for faculty development in family
medicine, and grants for the establishment of departments of
family medicine. The Committee reiterates its support for this
program and recognizes its importance in increasing the number
of primary care physicians in underserved areas.
General internal medicine and pediatrics training
This program provides funds to public and private nonprofit
hospitals and schools of medicine and osteopathic medicine to
support residencies in internal medicine and pediatrics. Grants
may also include support for faculty.
Physician assistants
This program supports planning, development, and operation
of physician assistant training programs.
General dentistry and pediatric dental residencies
This program assists dental schools and postgraduate dental
training institutions to meet the costs of planning,
developing, and operating residency training and advanced
education programs in general practice of dentistry and funds
innovative models for postdoctoral general dentistry and
pediatric dentistry.
The Committee recognizes the need to increase the number of
dentists in rural and underserved areas, and particularly
increase the number of pediatric dentists in those areas. Rural
States are disproportionately underserved by pediatric
dentists.
D. Public health workforce development
With the continued need for public health training
throughout the country, the Committee believes these programs
serve an important role in maintaining the country's public
health infrastructure.
Public health, preventive medicine and dental public health
This program supports awards to schools of medicine,
osteopathic medicine, public health, and dentistry for support
of residency training programs in preventive medicine and
dental public health; and for financial assistance to trainees
enrolled in such programs.
The Committee encourages the increase of residency training
opportunities in dental public health so that Federal, State,
and community-based programs have the leadership capabilities
to prevent dental disease, promote oral health, and improve
treatment outcomes.
Health administration traineeships and special projects
This program provides grants to public or nonprofit private
educational entities, including schools of social work but not
schools of public health, to expand and improve graduate
programs in health administration, hospital administration, and
health policy analysis and planning; and assists educational
institutions to prepare students for employment with public or
nonprofit private agencies.
E. Interdisciplinary, community-based linkages
The Committee recognizes the nationwide shortage of
psychologists and other mental and behavioral health
professionals, particularly among minorities and in underserved
areas. Therefore, the Committee urges the Bureau of Health
Professions to increase its efforts to meet the behavioral and
mental health needs of underserved populations.
Area health education centers
This program links university health science centers with
community health service delivery systems to provide training
sites for students, faculty, and practitioners. The program
supports three types of projects: Core grants to plan and
implement programs; special initiative funding for schools that
have previously received Area Health Education Centers (AHEC)
grants; and model programs to extend AHEC programs with 50
percent Federal funding. The Committee intends that adequate
funding be provided to the area health education centers grant
program since AHEC's are an important component of the Federal/
State partnership in addressing rural health issues.
It has been brought to the attention of the Committee that
the program has been emphasizing physical health needs, while
more could be done in addressing behavioral and mental health
needs. The Committee encourages the Bureau to train more
behavioral and mental health professionals in the AHEC program.
Health education and training centers
These centers provide training to improve the supply,
distribution, and quality of personnel providing health
services in the State of Florida or along the border between
the United States and Mexico and in other urban and rural areas
with populations with serious unmet health care needs.
Allied health and other disciplines
These programs seek to improve access, diversity, and
distribution of allied health practitioners to areas of need.
The program improves access to comprehensive and culturally
competent health care services for underserved populations.
The Committee expects this program to continue to support
schools or programs with projects designed to plan, develop, or
expand postbaccalaureate programs for the advanced training of
allied health professionals; and provide traineeships or
fellowships to postbaccalaureate students who are participating
in the program and who commit to teaching in the allied health
profession involved. This program also provides funds to expand
existing training programs or develop new ones, recruit
individuals into allied professions with the most severe
shortages or whose services are most needed by the elderly, and
increase faculty recruitment and education, and research.
The Committee continues to encourage HRSA to give priority
consideration to those projects for schools training allied
health professionals experiencing shortages, such as medical
technologists and cytotechnologists. The Committee is concerned
about high vacancy rates for these critical laboratory
personnel and encourages HRSA to redouble efforts to address
these shortages.
Geriatric education centers and training
The Committee expects this program to continue to support
grants to health professions schools to establish geriatric
education centers and to support geriatric training projects.
These centers and geriatric training programs play a vital role
in enhancing the skill-base of health care professionals to
care for our Nation's growing elderly population. The Committee
is concerned about the shortage of trained geriatricians and
urges the agency to give priority to building the work force
necessary to care for the Nation's elderly.
The Committee recognizes the Des Moines University
Osteopathic Medical Center for its development of a model
program for training and education in the field of geriatrics.
Quentin N. Burdick program for rural health
interdisciplinary training
This program addresses shortages of health professionals in
rural areas through interdisciplinary training projects that
prepare students from various disciplines to practice together,
and offers clinical training experiences in rural health and
mental health care settings to expose students to rural
practice. As part of its rural health initiative, the Committee
expects to significantly increase funding for this program to
help increase the number of health care providers in rural
areas. The Committee continues to be concerned about the lack
of providers in rural areas and expects the increased funding
for this program will help alleviate this problem.
The Committee expects that this program will continue its
current levels of support for addressing the issue of how the
delivery of chiropractic health care can be enhanced in rural
areas, and how more women and minorities can be recruited as
chiropractic health care practitioners in rural areas.
The Committee also expects the Bureau to expand its support
for telecommunications and telehealth initiatives for providing
distance education and training for nurses and allied health
professionals serving rural areas.
Podiatric primary care training
This program provides grants to hospitals and schools of
podiatric medicine for residency training in primary care. In
addition to providing grants to hospitals and schools of
podiatric medicine for residency training in primary care, the
program also permits HRSA to study and explore ways to more
effectively administer postdoctoral training in an ever
changing health care environment.
Chiropractic demonstration grants
The program provides grants to colleges and universities of
chiropractic to carry out demonstration projects in which
chiropractors and physicians collaborate to identify and
provide effective treatment of spinal and lower back
conditions. The Committee continues to strongly support the
chiropractic research and demonstration grant program,
originally authorized under Section 782 of Public Law 102-408,
and funded by the Committee in previous years. The Committee
recommends that the chiropractic-medical school demonstration
grant program be continued and funded at no less than current
levels.
F. Nursing workforce development
The Committee recognizes the current nursing shortage is
creating a health care crisis in hospitals and skilled nursing
facilities. The lack of young people in nursing has resulted in
a steady and dramatic increase in the average age of U.S.
nurses. Today, the average age of a working RN is 43 years old.
According to recent surveys, one in five nurses plans to retire
by 2006, exacerbating the shortage. Another factor contributing
to the nursing shortage is the availability of nursing faculty.
They, like nurses in healthcare delivery, are aging. Thus, for
some schools, even if they could recruit more students, they
may not have faculty to teach them. The Committee believes that
this is an area that requires critical attention.
Another reason for this shortage is the inability of
nursing schools to educate more nursing students, which is in
turn largely the result of a lack of qualified nursing faculty.
Since the average age of nurse educators today is 55, this
shortage of educators will continue to accelerate. The
Committee is further aware of the success of the Troops-to-
Teachers program at the Departments of Defense and Education in
placing qualified military veterans into teaching positions in
America's public schools through an expedited certification
process. The Committee therefore encourages HRSA to establish a
pilot program similar to the Troops-to-Teachers program to
encourage qualified, active duty military nurses to become
nurse educators in certified nursing school programs. The
program should include career and placement assistance,
transitional stipends for those who commit to teach in nursing
schools, and cooperation with nursing schools to expedite the
transition from the military to civilian teaching.
To address the well documented nursing shortage, the
Committee expects funding for advanced education nursing, basic
nurse education and practice, and nursing workforce diversity
to be increased over the fiscal year 2001 funding level.
The Committee directs the Secretaries of the Departments of
Health and Human Services and Labor, in collaboration with the
American Nurses Association and American Colleges of Nursing,
to convene a national panel by March 1, 2002, to examine
education and training requirements for all nursing
occupations. The panel is encouraged to provide specific
recommendations on education, training, continuing education,
retention, and professional development for all levels of
nursing care providers. The Committee directs the Department to
fund this initiative and provide a report to the Committee with
specific recommendations within 1 year of the panel's creation.
Advanced education nursing
This program funds nursing schools to prepare nurses at the
master's degree or higher level for teaching, administration,
or service in other professional nursing specialties.
Nurse practitioner/nurse midwife education
This program supports programs preparing nurse
practitioners and nurse midwives to effectively provide primary
health care in settings such as the home, ambulatory, and long-
term care facilities, and other health institutions. These
professionals are in especially short supply in rural and
underserved urban areas.
Professional nurse traineeships
Traineeships fund registered nurses in programs of advanced
nursing education, including preparation for teaching,
administration, supervision, clinical specialization, research,
and nurse practitioner and nurse midwife training.
Nurse anesthetist traineeships
Grants are awarded to eligible institutions to provide
traineeships for licensed registered nurses to become certified
registered nurse anesthetists [CRNA]. The program also supports
fellowships to enable CRNA faculty members to obtain advanced
education.
Basic nurse education and practice
Authorized by Public Law 105-392, the goal of this program
is to improve the quality of nursing practice. Activities under
this program will initiate new projects that will change the
educational mix of the basic nursing workforce and empower the
workforce to meet the demands of the current health care
system.
The Committee is aware of a recent meeting of the Council
on Graduate Medical Education (COGME) and the National Advisory
Council on Nursing Education Program (NACNEP) where they
determined to work together to develop educational programs to
address concerns raised in the Institute of Medicine Report,
``To Err is Human.'' Specifically, they have agreed to focus
jointly on a new initiative, ``Training Physicians and Nurses
Together to Improve Patient Safety.'' This promises to be a
constructive and productive effort and the Committee encourages
HRSA to fund this initiative.
The Committee is aware of the University of Alaska
Anchorage's program to recruit and retain Alaska Natives for
basic and advanced training as nurses to serve in Native
communities in Alaska, and notes that only 2 percent of the RN
workforce in Alaska is composed of Alaska Natives. There is
also a severe shortage of trained nursing professionals in
rural Alaska. The Committee encourages the agency to consider
continuing and expanding the University's current program,
including supportive services, stipends for needy students, and
distance delivery of educational components.
The Committee is aware of a need for more public health
nurses, public health aides and child health consultants in
remote areas of rural Alaska and encourages the agency to work
with the Alaska Department of Health and Social Services to
help meet these needs, particularly in early childhood
education programs.
Nursing workforce diversity
The goal of this program is to improve the diversity of the
nursing workforce through increased educational opportunities
for individuals from disadvantaged backgrounds. The Committee
urges the Division of Nursing to develop and increase cultural
competence in nursing and to increase the number of
underrepresented racial and ethnic minorities in all areas of
nursing education and practice to enhance nursing's ability to
provide quality health care services to the increasingly
diverse community it serves.
Children's hospital graduate medical education program
The Committee recommends $243,442,000 for the Children's
Hospital Graduate Medical Education (GME) program. This is
$8,450,000 above the fiscal year 2001 level and $43,348,000
more than the administration request.
The program provides support for health professions
training in children's teaching hospitals that have a separate
Medicare provider number (``free-standing'' children's
hospitals). Children's hospitals are statutorily defined under
Medicare as those whose inpatients are predominantly under the
age of 18. The funds in this program are intended to make the
level of Federal Graduate Medical Education support more
consistent with other teaching hospitals, including children's
hospitals which share provider numbers with other teaching
hospitals. Payments are determined by formula, based on a
national per-resident amount. Payments support training of
resident physicians as defined by Medicare in both ambulatory
and inpatient settings.
The Committee believes Federal support for GME for
children's hospitals is a sound investment in children's
health. Congress has enacted expansions in children's health
coverage and increased support for health programs devoted to
children and biomedical research. Equitable funding for
children's hospitals GME is needed to sustain the pediatric
workforce, including an adequate supply of future pediatric
researchers, and our pediatric research enterprise.
The Committee further recognizes that an inequity exists
for GME funding for children's teaching hospitals because
Medicare is the largest single payer of GME, and free-standing
children's hospitals treat few Medicare patients. These funds
provide essential, equitable support for the teaching
contributions of these institutions.
OTHER HRSA PROGRAMS
Hansen's disease services
The Committee has included $18,391,000 for the Hansen's
Disease Program which is $501,000 more than fiscal year 2001
and the same as the administration request. This program offers
Hansen's Disease treatment in Baton Rouge at the Center, at
other contract supported locations in Baton Rouge, and in grant
supported outpatient regional clinics. These programs provide
treatment to about 3,000 of the 6,000 Hansen's disease
sufferers in the United States.
With the exception of about 40 long term residents who
continue to reside at Carville, the program has completed the
move to leased space in Baton Rouge. Other former long term
residents have been offered and elected to receive a living
allowance from the program and now live independently. The
former Federal property at Carville has been transferred to the
State of Louisiana.
Over the next few years a long term facility will be
developed in the Baton Rouge area and offered to the current
long term residents remaining at the Carville location as an
alternative to remaining at the historic facility.
The program also conducts research focusing on the global
elimination of Hansen's Disease in laboratory facilities at
Louisiana State University in Baton Rouge. Research activities
are directed toward the development of new anti-leprosy drugs
and short-term more effective regimens; manufacture and
distribution of lepromin skin tests reagents through the World
Health Organization; identification of host resistant
mechanisms for potential use in vaccines development; and
application of state-of-the-art biotechnology to develop simple
lab techniques for case detection and diagnosis of preclinical
disease.
Maternal and child health block grant
The Committee recommends $719,087,000 for the maternal and
child health [MCH] block grant. This is $9,900,000 more than
fiscal year 2001 and $15,000,000 more than the administration
request.
The Maternal and Child Health Block Grant program provides
a flexible source of funding that allows States to target their
most urgent maternal and child health needs through development
of community-based networks of preventive and primary care that
coordinate and integrate public and private sector resources
and programs for pregnant women, mothers, infants, children,
and adolescents. The program supports a broad range of
activities including prenatal care, well child services and
immunizations, reducing infant mortality, preventing injury and
violence, expanding access to oral health care, addressing
racial and ethnic disparities and providing comprehensive care
for children, adolescents, and families through clinics, home
visits and school-based health programs.
The Committee is aware that each State MCH program has just
completed a needs assessment that is conducted once every 5
years. The assessment identified the need to expand programs in
a variety of areas with the aim to assure access to quality
health care; prevent disease, disability and death; provide
family-centered, community-based services for women, children,
adolescents and their families; and other priorities. The
Committee has provided an increase in the MCH Block Grant to
allow States to move forward to address the unmet needs that
they have identified.
The MCH block grant funds are provided to States to support
health care for mothers and children. According to statute,
12.75 percent of funds over $600,000,000 are used for
community-integrated service systems [CISS] programs. Of the
remaining funds, 15 percent is used for special projects of
regional or national significance [SPRANS] while 85 percent is
distributed on the same percentage split as the basic block
grant formula.
The Committee has expressed concerns in the past about MCH
plans to eliminate SPRANS funding for three thalassemia centers
that provide comprehensive services to patients and families.
These centers, located in Boston, New York and Oakland and
serving a broad geographical area, are the only source of
support for many patients. For this reason, the Committee is
pleased to learn that the Bureau has now agreed to continue
funding all three centers well into 2003. The Committee urges
MCH to continue to work closely with these centers and the
Cooley's Anemia Foundation to assure that future changes in
SPRANS funding will not have a negative impact on the centers'
operations.
The Committee commends HRSA's Maternal and Child Health
Bureau for its support of the Sudden Infant Death Syndrome
Program Support Center, and encourages the Maternal and Child
Health Bureau to continue its efforts in this important area of
service, and is pleased that the SIDS and Other Infant Death
Support Center is collaborating with the National Institutes of
Health to address the disproportionately high incidence of SIDS
among African Americans.
Partners in Program Planning for Adolescent Health (PIPPAH)
is a public-private initiative that promotes an adolescent
health care agenda among professional disciplines through
funding from the Office of Adolescent Health within the MCHB.
The program aims to improve access to health services for
adolescents, including access to mental health services. The
Committee encourages the bureau to continue using SPRANS funds
for the PIPPAH program. With sufficient funding, this programs
could be expanded to involve additional disciplines, including
health care organizations such as the American College of
Obstetricians and Gynecologists.
The Committee recognizes that access to care through the
hemophilia treatment center network is critical to the
prevention and treatment of the complications of hemophilia and
other bleeding disorders. The Committee believes that HRSA
could strengthen support for these centers and requests a
report by March 31, 2002 on the steps it has taken to improve
its services to persons with hemophilia and other blood
disorders, especially in underserved areas.
Healthy start initiative
The Committee recommends $89,996,000 for the healthy start
infant mortality initiative. This amount is the same as fiscal
year 2001 and the administration request.
The healthy start initiative was developed to respond to
persistently high rates of infant mortality in this Nation. The
initiative was expanded in fiscal year 1994 by a special
projects program, which supported an additional seven urban and
rural communities to implement infant mortality reduction
strategies and interventions.
Since 1990, the Maternal and Child Health Bureau has worked
in collaboration with the American College of Obstetricians and
Gynecologists (ACOG) to run the National Fetal and Infant
Mortality Program. NFIMR is a national activity where
professionals review community fetal and infant mortality rates
and work to address identified problems leading to mortality
and establish systems of support for women and children. The
public-private initiative also works to address problems with
health disparities in minority health, as related to fetal and
infant mortality rates. The Committee believes NFIMR should
continue to be supported through MCH and notes that additional
funds would allow more communities to be served. Adequate
funding has been provided for NFIMR through the Healthy Start
initiative. The Committee is aware that in order to meet the
demand of serving an expanded number of communities, NFIMR must
be able to continue its activities at an adequate funding
level.
The Committee is aware of the excellent services provided
by the Northern Plains Healthy Start program to provide pre-
natal care to Native American women throughout South Dakota,
Iowa, North Dakota, and Nebraska.
The Committee is also aware of the high quality services
provided to mothers and infants by Pee Dee Healthy Start in the
Pee Dee region of South Carolina.
Universal newborn hearing screening and early intervention
The Committee provides $10,000,000 for universal newborn
hearing screening and early intervention activities, which is
$2,001,000 above the fiscal year 2001 level and $3,419,000 more
than the administration request. The Committee understands that
screening technology has enabled health providers to conduct
accurate, cost-efficient newborn hearing screening prior to
hospital discharge. By detecting newborn hearing deficiencies,
health providers can implement necessary treatment to the
infant and advice to affected family members. This new program
was begun last year and the response from States has been
substantial. The Committee is aware that HRSA received many
more high quality applications for this program than it was
able to fund. Numerous studies have demonstrated that newborn
hearing screening followed by early intervention services can
greatly improve health and educational outcomes for children.
Funds provided will support grants to states to: develop
and expand statewide screening programs; link screening
programs with community-based intervention efforts; monitor the
impact of early detection and intervention activities; and
provide technical assistance.
Organ procurement and transplantation
The Committee provides $19,992,000 for organ transplant
activities. This is the same as the administration request and
$5,000,000 more than the fiscal year 2001 appropriation.
These funds support a scientific registry of organ
transplant recipients and the National Organ Procurement and
Transplantation Network to match donors and potential
recipients of organs. A portion of the appropriated funds may
be used for education of the public and health professionals
about organ donations and transplants, and to support agency
staff providing clearinghouse and technical assistance
functions. The Committee encourages the agency to establish
linkages with state and Federal transportation officials to
improve coordination of donation following vehicular accidents,
through the establishment of donor registries.
To increase the rate of organ donation, the Committee urges
increased behavioral research to better target and increase the
effectiveness of public awareness campaigns.
The Committee considers increasing the supply of organs,
particularly livers, available from voluntary donations to be a
top public health priority and expects that funds be committed
to those activities having the greatest demonstrable impact on
donation rates.
The Committee notes that in the last year while there were
approximately 4,700 liver transplants performed, there were
over 17,000 individuals on the list waiting for liver
transplantations and about 1,700 people died due to the lack of
a donor liver. In view of this continuing shortage of organ
donors, the Committee is encouraged by the growing number of
transplants using living donors who contribute a portion of
their liver to a recipient. In order to increase the living
donor liver transplantation, additional research is needed to
study the outcome of both donors and recipients, define the
optimal surgical procedure and identify eligibility criteria.
National bone marrow donor program
The Committee has included $22,000,000 for the national
bone marrow donor program. This is the same as the
administration request and $42,000 more than the fiscal year
2001 level. The National Bone Marrow Donor Registry is a
network, operated under contract, that helps patients suffering
from leukemia or other blood diseases find matching volunteer
unrelated bone marrow donors for transplants. The program also
conducts research on the effectiveness of unrelated marrow
transplants and related treatments.
Rural health outreach grants
The Committee recommends $57,921,000 for health outreach
grants. This amount is $293,000 less than the fiscal year 2001
level and $20,058,000 more than the administration request.
This program supports projects that demonstrate new and
innovative models of outreach in rural areas such as
integration and coordination of health services. The Health
Care Consolidation Act of 1996 authorized a new rural network
development program intended to develop integrated
organizational capabilities among three or more rural health
provider entities.
The Committee is aware of the importance of having trained
staff who have access to Automated External Defibrillators
(AEDs), and that the survival rate for someone experiencing
sudden cardiac arrest drops 7 percent to 10 percent as each
minute passes. The Committee therefore includes $5,000,000 to
implement the Rural AED Act of 2000 to provide grants to
community partnerships to purchase equipment and provide
training.
The Committee is aware of the difficulties small rural
hospitals have in complying with the new implementation
requirements created by the Balanced Budget Act Refinement Act,
the Health Insurance Portability and Accountability Act, and
the Medicare, Medicaid, and S-CHIP Benefits Improvement and
Protection Act. Therefore, as part of the its rural health
initiative, the Committee includes $15,000,000 to assist rural
hospitals through the Rural Hospital Performance Improvement
Program. Under this program, grants would be provided to small
rural hospitals (those with 50 beds or less), and networks of
small rural hospitals (e.g., through State Hospital
Associations), that are essential access points for Medicare
and Medicaid beneficiaries. The program would target those key
service areas in greatest need. The grants would be used to
address the following critical areas of need:
--Improved Financial Performance: Many small rural hospitals
face financial struggles in an increasingly complex
billing environment. These grants would assist these
providers in upgrading and improving their billing
practices, including technological upgrades (hardware
and software, as well as staff training), reducing
their accounts receivable, and ensuring a more
consistent financial foundation.
--Reduced Medical Errors/Quality Improvement: Improving
health quality and reducing medical errors in a rural
environment requires an approach that recognizes the
special circumstances faced by small rural hospitals
that deal with low patient volumes within a clinical
focus that is dominated by primary care. Rural
communities are often heavily dependent on retaining
local health care dollars in order to remain
financially viable. A loss of confidence in locally
delivered care can quickly escalate into a self-
fulfilling prophecy of reduced quality, as patients are
lost to distant urban providers. These grants would
allow small rural hospitals to develop locally based
and individualized quality improvement projects that
help retain local health care dollars in the community.
--Increased Organizational Capacity: The health care system
is undergoing rapid change and small rural hospitals
are not immune to these changes. These grants would
assist small rural hospitals in their efforts to
improve their local health care delivery system by
improving clinical practices, re-organizing their
clinical pathways to better meet community needs and
modernizing their health technology infrastructure.
The Committee continues to be concerned about the enormous
chronic disease and public health burden faced by the
Mississippi Delta region and expects that HRSA continue to
provide support to the Delta Regional Authority (DRA) and that
HRSA and DRA jointly administer this program. The Committee
expects these resources to be used to provide targeted,
innovative health education, access and research grants to
existing Delta health-related educational institutions that
have created comprehensive programs to improve health outcomes
in the Delta.
The Committee is aware of a number of rural health outreach
programs that, if funded by the Department, would improve
access to needed health care services in underserved rural
areas. They include:
--The Community Health Aide program, which is the only
provider of critical first-line health care in more
than 200 remote rural Alaska Native villages;
--The Center for Sustainable Health Outreach in developing
model health access programs, health-related jobs and
the sustainability of community-based providers of
health services in rural and urban communities;
--The Maui Community College and Hana Community Health Center
to facilitate the training of nurses for adequate
staffing at the Hana Community Health Center, which is
is one of the most remote areas in the State of Hawaii;
--The Rural Family Diabetes and Mental Health Outreach
program in New Mexico;
--Hispanic Community and Family Health programs in New
Mexico;
--The University of South Alabama initiative to establish a
model diabetes foot treatment center;
--LSU Health Science Center's Minority and Rural Health
Research and Outreach for the planning and development
of improved rural health outreach;
--The Clakamas County, Oregon initiative to provide primary
health care to its chronically underserved population
of rural residents;
--The Oregon Health Sciences University Institute for
Excellence in Nursing to enhance nurse training and
staff development for practicing nurses throughout
Oregon;
--The Northwest Health Center in Pascoag, Rhode Island to
support health care services for 3,500 low income
individuals in rural Rhode Island;
--The Oregon Community Health Information Network program to
allow health centers throughout Oregon to better
determine patient eligibility for Medicaid and other
health care programs;
--The diabetes lower extremity amputation preventive program
at the University of South Alabama, the Louisiana State
University Medical School, the Roosevelt Institute for
Rehabilitation, and the Jackson Medical Mall;
--The Littleton Regional Hospital in New Hampshire program to
allow the hospital to continue the paramedic services
program that is vital to that region's residents;
--The Charles Cole Memorial Hospital proposal for Porter-
Tioga Mckear Pain Clinic to be a model pain management
clinic for rural areas;
--The Louisiana Public Health Institute Center for Community
Capacity Enhancement to promote community partnerships
to address health improvement priorities;
--A demonstration project in the rural Mississippi Delta area
applying the Mississippi Medicaid disease State
management program to reduce the high prevalence and
improve management of chronic diseases such as
diabetes, asthma, hyperlipidemia, and cardiovascular
disease in rural areas;
--The Children's Health Fund in Mississippi to provide mobile
comprehensive medical care to uninsured and medically
underserved children in the Mississippi Delta,
particularly in Mississippi and Arkansas, along with
the inner-city areas of New York City;
--The comprehensive health initiative in the Mississippi
Delta and an initiative to promote basic and clinical
research on the prevention of the toxic effects of
agricultural chemicals and the prevention of
agricultural related injuries. The collaboration
between Delta State University, the University of
Mississippi Medical Center, and the Mississippi State
Department of Health could promote coordinated
consolidation of health and human services that will
positively impact the education, health, and economics
of this region;
--The North Idaho Rural Health Consortium, to extend and
improve services to high-priority participants and
rural areas;
--The Commun-I-Care program in South Carolina to provide
medications to the low-income, uninsured patients;
--The University of Montana Drug Information Service to
provide health care professionals with access to
specialized health information in rural areas of
Montana;
--The Bi-State Primary Care Association initiative to improve
the delivery of rural health care in Vermont;
--The University of Maine program to build a statewide
database and access system that will allow more
efficient tracking and referral for intervention for
infants and children at risk in rural Maine settings;
--The Hunstman Cancer Institute in South Dakota pilot project
to develop a medical outreach program utilizing mobile
clinics equipped with Positron Emission Tomography (PET
scan) to educate Native Americans in rural areas on
cancer risk, early detection, prevention and treatment.
Rural health research
The Committee recommends $15,000,000 for the Office of
Rural Health Policy. This is $1,563,000 above the fiscal year
2001 level and $8,901,000 more than the administration request.
The funds provide support for the Office as the focal point for
the Department's efforts to improve the delivery of health
services to rural communities and populations. Funds are used
for rural health research centers, the National Advisory
Committee on Rural Health, and a reference and information
service. As part of its rural health initiative, the Committee
is increasing funding for this program to improve the delivery
of health care services to rural communities.
The Committee is supportive of efforts to expand and
integrate the services of behavioral and mental health
professionals, including psychologists, in underserved rural
areas, particularly in areas affected by the current farm
crisis.
The Committee is supportive of continuing funds to the
Children's Health Fund to implement a rural health initiative
that would expand availability and accessibility of pediatric
care to underserved rural communities.
The Committee is supportive of efforts by the Iowa
Department of Public Health to demonstrate the use of portable
technology to improve the delivery of health care in rural
areas by public health nurses.
The Committee is aware of rural health research programs
that, if supported by the Department, could have a positive
impact on the delivery of health care services to rural
communities. They include:
--The Educational Mall in Beckley, West Virginia, to serve as
a coordinating and research location for rural
initiative, especially in preventative medicine;
--The Center for Rural Health and Medicine at the University
of North Dakota to study nation's the unique health
care needs of the rural elderly and special needs
populations;
--The Secure Rural Imaging Network at Avera McKennan Hospital
in Sioux Falls, South Dakota;
--The Center for Health Delivery at the University of Alaska
program to evaluate health care delivery and training
needs for health care workers to use this information
to improve the health status of Alaskans.
--The Rural Primary Care and Health Service Research Center
at the University of South Dakota School of Medicine to
help define the status of health and health care
delivery in South Dakota;
--The University of Texas Health Science Center at San
Antonio's Regional Academic Health Center program to
research and improve the diets of U.S. Hispanics,
particularly those living along the United States/
Mexico Border.
Telehealth
The Committee recommends $5,609,000 for telehealth
activities. This amount is $30,369,000 less than fiscal year
2001 and the same as the administration request.
The telehealth program promotes the use of technologies to
improve access to health services and distance education for
health professionals. The Committee recognizes the tremendous
potential that telehealth has for improving the delivery of
quality health care to rural underserved areas and for
providing distance education to health care professionals. The
Committee supports HRSA's numerous rural telehealth initiatives
and encourages the agency to work in partnership with medical
librarians and other health information specialists in the
development and implementation of its telehealth projects.
The Committee believes that HRSA could establish a number
of regional centers for the advancement of telehealth. Such
centers could advance the cost-effective deployment of
telehealth technologies and provide technical assistance to
health care providers. The centers could conduct research,
evaluations, and assessments to determine the appropriate
application of telehealth technologies that span healthcare
disciplines, applications, and settings.
The Committee is supportive of HRSA's efforts to include
EMS issues in its Telemedicine/Telehealth initiative and
encourages the Office of Rural Health Policy, the Office for
the Advancement of Telehealth and EMSC program to collaborate
on projects to improve emergency medical service for children.
The Committee strongly supports HRSA's numerous rural
telehealth initiatives and encourages the agency to work in
partnership with medical librarians, the National Library of
Medicine, and other health information specialists in the
development and implementation of its telehealth projects.
The Committee is aware of HRSA's increased commitment to
telehealth demonstration projects to serve as models for the
efficient delivery of health care services to rural,
underserved, and hard to reach populations. For example, the
Committee continues to be concerned about the extraordinary
adverse health status and the limited access to health services
of Alaska Natives and others living in Southwestern Alaska, the
region of Alaska with the highest poverty and unemployment
rates, and encourages the agency to continue and expand a
project to develop infrastructure to support a comprehensive
health care delivery system in that region. The Committee
supports this purpose, but also urges an increased focus on
demonstration grants for providing behavioral and mental health
services and advanced training for providers in prisons and
other public institutions.
The Committee is aware of a number of Telehealth programs
that, with the support of the Department, could have positive
health impacts on people living throughout America. They
include:
--The Mountaineer Doctor Television Program at West Virginia
University to allow health care providers at West
Virginia University to provide medical care through
telemedicine to rural West Virginia communities;
--The Clarion University and the Primary Care Council of
Pennsylvania's State System of Higher Education
telecommunications network to help improve the health
status of Pennsylvanians through increased community
access and comprehensive care;
--The Alaska Federal Health Care Access Network, which is
bringing telehealth services to remote villages and
communities throughout Alaska, providing linkages
between remote and inaccessible locations with tertiary
care facilities in Anchorage and Fairbanks. Continued
funding will allow expanded installation of telehealth
stations and will support bringing non-Federal partners
into the project and will fund operations of the Alaska
Telemedicine Advisory Council;
--The University of Pittsburgh Medical Center is developing
and deploying its state-of-the-art health care
information technology system;
--The Magee Womens Hospital in Pittsburgh is developing a
model to support coordinated and integrated care for
women with breast cancers by using new technologies for
mammography imaging, ultrasound imaging, and pathology
slides;
--The Pennsylvania School of Optometry in Philadelphia is
establishing a network of urban community-based
satellite centers which give inner-city, underserved
persons access to eye care;
--The Telehealth Education and Learning Center in Montana;
--The Four County Library System program to provide
programming development and delivery to communities in
need of primary health care and reference resources;
--The Pennsylvania Association of Home Health Agencies plan
to conduct a multi-facility examination of telehomecare
as a solution to the nursing shortage;
--The Midwest Center for Rural Health telehealth project in
Indiana;
--The Union Hospital in Terre Haute, Indiana, telehealth
demonstration project to improve accessibility to
quality health care for rural areas;
--The South Alabama Telemedicine Project to allow this
project to continue to serve the health needs of rural,
poor, and medically underserved communities;
--Continued support to implement Phase II of the Telehealth
Research Deployment Testbed (TRDT) program to increase
healthcare accessibility and quality in underserved
areas;
--The Geisinger Stroke Care Partnership in rural Pennsylvania
to serve as an educational link for rural patients and
their providers by establishing informational resources
and outreach efforts;
--The West Tennessee/North Mississippi Telemedicine Project
to bridge the gap between the resource-rich
metropolitan center of Shelby County, Tennessee, with
the medically underserved counties in Tennessee and
Mississippi;
--The Telehealth Project at the University of Tennessee to
build upon its infrastructure, expand the scope of
clinical services provided, and incorporate the upper
region;
--The New Mexico/Hawaii telehealth out reach for Unified
Community Health (TOUCH), which provided much needed
health services to rural patients;
--Valley Children's Hospital E-Health and telehealth program
in California;
--The Regional Telehealth Consortium's Network in Lake
Charles, Louisiana;
--North Dakota State University, College of Pharmacy
Telepharmacy project;
--The Healthy Mothers and Babies Technology Demonstration in
Minnesota to connect rural patients and their
communities to the specialty care available in
Minneapolis/St. Paul;
--The Samuel Merritt College nurse anesthesia education
improvements through telehealth in California;
--The University of Nevada Las Vegas ``e-Health'' initiative
to improve access to specialized and high quality
health care in rural Nevada;
--Saint Vincent Hospital in Billings to establish a regional
video telecommunications network for healthcare
providers;
--The Deaconess Billings Clinic (DBC) Northwest Area Center
for Studies on Aging in Billings, Montana to address
healthcare problems associated with rural aging, and
expand access to specialty healthcare via telemedicine
and video conferencing technology to a region where
specialty healthcare services are not currently
available;
--The Central Michigan University Telehealth Project to
improve health care access and quality to migrant and
underserved rural populations;
--The La Crosse Medical Health Science Consortium to support
the development of a telecommunications-based,
integrated network of Virtual Population Health Centers
in western Wisconsin;
--Continued support for Phase II of a telemedicine system to
link the research capabilities of the American Health
Foundation with patients served by the Beaufort-Jasper-
Hampton Comprehensive Health Services;
--The Vermont Telemedicine Network to reduce disparities in
the clinical care and medical education of trauma in
Vermont;
--The Susquehanna Health System plan to develop an electronic
medical information and physician access system for
rural areas;
--Expansion of the Children's Hospital in Seattle, Washington
and University of Washington telemedicine program to
improve access to health care services;
--Technology enhancements for federally Qualified Health
Centers in the state of Oregon;
--Expansion of the Mississippi telemedicine network, which
includes Mississippi Blood Services, Mississippi
community colleges and universities, and local, State,
and Federal agencies in rural areas to eliminate health
care disparities in access for the underserved in rural
areas including the Mississippi Delta;
--The Alcorn State University initiative to provide needed
medical care and health education to residents of the
lower Mississippi Delta;
--The Idaho Telehealth Integrated Care Center at Idaho State
University;
--The Rocky Mountain Technology Foundation (RMTF) in
Billings, Montana, telehealth program, which has
developed an approach to solving problems of rural and
frontier health providers; fragmentation of the health
care delivery system; slow diffusion of knowledge to
rural providers of standardized advancements in
diagnostic and therapeutic medical protocols; and lack
of strategic alliances and linkages between rural and
urban providers.
Native and rural Alaskan health care
The Committee has provided $20,000,000 for the Denali
Commission, which is $10,000,000 more than the fiscal year 2001
level and $20,000,000 more than the administration request, to
fund construction and renovation of health clinics, hospitals
and social service facilities in rural Alaska as authorized by
Public Law 106-113. Provision of this funding will help remote
communities in Alaska develop critically needed health and
social service infrastructure for which no other funding
sources are available so that health and social services may be
provided to Alaskans in remote rural communities as they are in
other communities throughout the country.
Critical care programs
The Committee has grouped the following ongoing and
proposed activities: emergency medical services for children,
the traumatic brain injury program, trauma care/emergency
medical services, and poison control centers.
The Committee provides $18,986,000 for emergency medical
services for children. This is the same as the 2001 level and
$3,412,000 more than the administration request. The program
supports demonstration grants for the delivery of emergency
medical services to acutely ill and seriously injured children.
The Committee urges HRSA to consider EMSC a high priority,
and supports the efforts and purpose of the EMSC program to
continue to work with States to improve the training and
availability of emergency medical services personnel who
effectively treat children. The Committee also urges the
Department to focus on the development of prevention and
treatment programs and education of emergency personnel in
remote and rural areas throughout the country, including Alaska
and Hawaii, using telemedicine technology.
The Committee commends the Emergency Medical Services for
Children Program for the delivery of emergency medical services
to acutely ill and seriously injured children. The Committee
also commends the Partnership for Children initiative which has
provided useful training and information to pediatric emergency
care personnel.
The Committee supports the effective collaboration between
NHTSA and HRSA in the administration of the EMSC program. The
Committee urges the EMSC program to develop practice guidelines
and other quality of care assessment and enhancement
initiatives. The Committee encourages the EMSC program to
continue a research focus and to develop a means of collecting
data to ensure accountability and to better track
accomplishments and needs.
The Committee is supportive of HRSA's efforts to include
EMS issues in its Telemedicine/Telehealth initiative and
encourages the Office of Rural Health Policy, the Office for
the Advancement of Telehealth and EMSC program to collaborate
on projects to improve emergency medical service for children.
The Committee provides $10,000,000 for the traumatic brain
injury program, which is $5,000,000 more than the fiscal year
2001 level and the administration request. The program supports
implementation and planning grants to States for coordination
and improvement of services to individuals and families with
traumatic brain injuries as well as protection and advocacy.
Such services can include: pre-hospital care, emergency
department care, hospital care, rehabilitation, transitional
services, education, employment, and long-term support. The
Committee includes $3,000,000 for protection and advocacy
services, as authorized under section 1305 of Public Law 106-
310.
The Committee is extremely interested in the risk of head
injury in youth soccer participants associated with their lack
of protective head gear use. Therefore the Committee directs a
study to determine the benefits of the use of protective head
gear in decreasing the incidence of head injury among youth
soccer participants. The Committee expects to receive the
results of this survey by June 2002.
The Committee is aware that Mississippi leads the Nation in
both mortality and rates of incidences of traumatic brain
injury. The Committee encourages HRSA to implement programs to
reduce the mortality and rate of incidences of traumatic brain
injury in Mississippi.
The Committee provides $4,000,000 for trauma/emergency
medical services. This is $1,000,000 more than fiscal year 2001
and $1,533,000 more than the administration request. This
program is intended to improve the Nation's overall emergency
medical system, including the joint efforts between HRSA and
the National Highway Traffic Safety Administration to assess
state systems and recommend improvements to the current system.
The Committee provides $24,000,000 for poison control
center activities, which is $4,004,000 more than fiscal year
2001 and $7,579,000 above the administration request. The funds
provided will support the development and assessment of uniform
patient management guidelines and will support HRSA's
participation with CDC and the joint CDC/HRSA advisory
committee on planning efforts.
Black lung clinics
The Committee includes $7,000,000 for black lung clinics.
This is $1,000,000 above both the fiscal year 2001 amount and
the administration request. This program funds clinics which
treat respiratory and pulmonary diseases of active and retired
coal miners. These clinics reduce the incidence of high-cost
inpatient treatment for these conditions.
Nurse loan repayment for shortage area service
The Committee includes $15,000,000 for nurse loan payment
for shortage area services. This is $12,721,000 more than
fiscal year 2001 and the administration request.
This program offers student loan repayment to nurses in
exchange for an agreement to serve not less than 2 years in an
Indian health service health center, native Hawaiian health
center, public hospital, community or migrant health center, or
rural health clinic. The Committee views this program as a
critical component of the rural health initiative outlined in
this report, and intends that the majority of the increased
funding be provided to increase the supply of qualified health
care professionals in rural areas.
Payment to Hawaii, Hansen's disease treatment
The Committee includes $2,045,000 for Hansen's disease
services. This is the same as fiscal year 2001 and the
administration request.
Within the amount provided for Hansen's disease services,
the Committee urges funding for the fiscal year 2002 payment to
the State of Hawaii for the medical care and treatment in its
hospital and clinic facilities of persons with Hansen's disease
at a per diem rate not greater than the comparable per diem
operating cost per patient at Gillis W. Long National Hansen's
Disease Center. This amount is the same as the administration
request and the 2001 level.
The Committee appreciates the Institute of Medicine study
of the Pacific Basin health care delivery system, conducted in
1998. It is the Committee's understanding that the IOM cited
findings for all health indicators for the people residing in
the freely associated states, as being significantly worse than
those for mainland Americans. The Committee, therefore, expects
the Department to review the IOM findings and initiate
implementation of its recommendations which include:
jurisdictional coordination by the Pacific Islanders Health
Officers Association; use of Tripler Army Medical Center and
Guam Naval Hospital for care coordination, with emphasis on
telehealth assessment and management; development of and
participation in a regional health information system for
information tracking and storage; continuing education for all
health providers; and increased involvement in health care,
particularly womens' health issues.
ACQUIRED IMMUNE DEFICIENCY SYNDROME
Ryan White AIDS programs
The Committee provides $1,883,000,000 for Ryan White AIDS
programs. This is $75,391,000 more than fiscal year 2001 and
$75,236,000 more than the administration request.
Recent advances in diagnosis, treatment, and medical
management of HIV disease has resulted in dramatic improvements
in individual health, lower death rates and transmission of HIV
from mother to infant. The Committee recognizes, however, that
not all HIV infected persons have benefitted from these medical
advances and expects that the Ryan White CARE Act programs
provide social and other support services with the specific
intent of obtaining and maintaining HIV-infected individuals in
comprehensive clinical care.
The Department is encouraged to identify obstacles
confronting people with HIV/AIDS in receiving medical care
funded through the Ryan White programs and to develop
strategies to address these problems in light of the changing
medical needs of a patient population that is living longer
with current therapies.
The Committee recognizes the recent advances in the
treatment and medical care of persons with HIV disease and the
need for early access to these interventions and services.
Furthermore, the Committee understands that disparities exist
in accessing and maintaining the benefits of these recent
advances among communities highly impacted by HIV and AIDS.
The Committee encourages HRSA to assume a leadership role
in ensuring that the prevention, treatment, and management of
HIV/ AIDS in correctional facilities is a high priority and
that the care rendered meets current medical standards for AIDS
care. The Committee encourages HRSA to collaborate with the
Federal Bureau of Prisons, CDC, the White House Office on AIDS
Policy, and other entities of jurisdiction.
Emergency assistance--title I
The Committee recommends $620,000,000 for emergency
assistance grants to eligible metropolitan areas
disproportionately affected by the HIV/AIDS epidemic. This
amount is $15,831,000 above the fiscal year 2001 and the
administration request. These funds are provided to
metropolitan areas meeting certain criteria. One-half of the
funds are awarded by formula and one-half are awarded through
supplemental competitive grants.
The Committee encourages the Secretary, when awarding
supplemental title I funds, to give priority as appropriate to
EMA's whose applications increase services to women,
adolescents, and children with AIDS/HIV infection.
Comprehensive care programs--title II
The Committee has provided $950,000,000 for HIV health care
and support services. This amount is $39,031,000 above the
administration request and the 2001 level. These funds are
awarded to States to support HIV service delivery consortia,
the provision of home and community-based care services for
individuals with HIV disease, continuation of health insurance
coverage for low-income persons with HIV disease and support
for State AIDS drug assistance programs [ADAP].
The Committee continues to be encouraged by the progress of
anti-retroviral therapy in reducing the mortality rates
associated with HIV infection and in enhancing the quality of
life of patients on medication. The Committee has approved bill
language for $610,000,000 for AIDS medications, compared to
$589,000,000 provided for this purpose in fiscal year 2001. The
Committee further urges HRSA to encourage States to utilize
Federal ADAP funding in the most cost-effective manner to
maximize access to HIV drug therapies and to eliminate cost-
shifting from Medicaid to the State ADAP programs. States with
ADAP funding should be allowed the flexibility to purchase and
maintain insurance policies for eligible clients including
covering any costs associated with these policies, or continue
to pay premiums on existing insurance policies that provide a
full range of HIV treatments and access to comprehensive
primary care services, as determined by a State. Funds should
not be committed to purchase insurance deemed inadequate by a
State in its provision of primary care or in its ability to
secure adequate access to HIV treatments.
It has been brought to the Committee's attention that many
State HIV/AIDS programs seek increased flexibility to use some
ADAP resources to fund medical care, laboratory tests, and
services to enhance patient adherence to pharmaceuticals. The
agency should consider allowing States to redirect a reasonable
portion of ADAP funds, as determined in collaboration with the
States, to such services that enhance the ability of eligible
people with HIV/AIDS to gain access to, adhere to, and monitor
their progress in taking HIV-related medications. The agency
should submit a report to the Committee with details on the
implications of such a change prior to implementation.
The Committee is concerned about restrictions being placed
on the type and scope of targeted outreach, as authorized under
the Ryan White CARE Act, to identify underserved populations
and provide them needed medical care. The Committee urges the
Secretary to provide States flexibility, where appropriate, in
conducting comprehensive, targeted outreach to underserved and
minority populations to improve access to CARE Act programs for
underserved communities.
The Committee is concerned about the increasing prevalence
of hepatitis C-HIV co-infection. Co-infection of the hepatitis
C virus (HCV) in HIV infected patients has become the leading
cause of AIDS mortality in some parts of the country. The death
rate is higher and life expectancy shorter for co-infection
patients than for patients who have only HIV.
To address this growing problem, the Committee urges HRSA
to encourage State ADAPs to offer co-infected patients access
to approved hepatitis C treatments as their resources allow, to
ensure that the Ryan White critical care funded programs
(including Title III & IV clinics) provide opportunities for
training care givers and clinicians to treat co-infected
patients, and to ensure that AETCs address the need for
physician education on HCV/HIV co-infection.
The Committee is concerned that American Indians and Alaska
Natives are not participating in ADAP to the extent that these
services are needed. The burden of covering costs for AIDS-
related drugs is often falling on local Indian Health Service,
tribal or urban program providers, or on the families of
American Indians or Alaska Natives with AIDS. The Committee
requests that HRSA and IHS work together to ensure American
Indians and Alaska Natives are participating proportionately in
each State, and there are not barriers to American Indians
accessing the ADAP drugs due solely to their status as American
Indians.
Early intervention program--title III-B
The Committee recommends $195,000,000 for early
intervention grants. This is $9,121,000 above the 2001 level
and the administration request. These funds are awarded
competitively to primary health care providers to enhance
health care services available to people at risk of HIV and
AIDS. Funds are used for comprehensive primary care, including
counseling, testing, diagnostic, and therapeutic services.
The Committee encourages HRSA to fairly allocate the
increase for title III-B between existing grantees and new
providers. By providing additional funds to current grantees,
the Committee intends to strengthen the HIV care infrastructure
already established in title III-B clinics. The Committee also
supports expansion of the number of communities receiving
assistance from this title.
Priority should be placed on funding new projects in rural,
medically underserved areas, and secondary cities outside of
major metropolitan areas in order to build clinical capacity
for the delivery of HIV care among clinicians serving high-risk
populations, minorities, and those who are unable to access
clinical HIV care for economic reasons. In building capacity,
the goal is to develop knowledgeable clinicians to improve
access to quality HIV treatment based upon the evolving HIV
treatment guidelines of DHHS.
Women, infants, children, and youth--title IV
The Committee recommends $72,000,000 for title IV pediatric
AIDS, which is $7,005,000 above the administration request and
the 2001 amount. Funds are awarded to community health centers,
family planning agencies, comprehensive hemophilia diagnostic
and treatment centers, federally qualified health centers under
section 1905(1)(2)(B) of the Social Security Act, county and
municipal health departments and other nonprofit community-
based programs that provide comprehensive primary health care
services to populations with or at risk for HIV disease.
The Committee intends that at least 90 percent of total
title IV funding be provided to grantees. The Committee expects
the agency to provide at least 75 percent of the funding
increase to existing grantees to reflect the increases in the
costs of providing comprehensive care, including the
implementation of quality management programs. HRSA should use
a significant portion of the remaining funds to expand
comprehensive services for youth, both through existing and new
grantees. The Committee expects the agency to expand efforts to
facilitate ongoing communication with grantees on the
administration of the Title IV program. These expanded efforts
should include collaboration with grantees on the forthcoming
determinations by the Secretary mandated in the Ryan White CARE
Act Amendments of 2000 on administrative expenses and HIV-
related research access. The Committee also expects HRSA to
collaborate with CDC to identify and eliminate barriers between
HIV prevention and care.
Some 5 percent of the funds appropriated under this section
may be used to provide peer-based technical assistance. Within
this amount, sufficient funds are available to maintain and
expand work being done to create a national consumer and
provider education center on the use of various strategies and
planning in the care of children, youth, women and families
infected with or affected by HIV and AIDS.
AIDS dental services
The Committee provides $12,000,000 for AIDS dental
services, which is $2,001,000 above the administration request
and the 2001 level. This program provides grants to dental
schools, dental hygiene schools, and postdoctoral dental
education programs to assist with the cost of providing
unreimbursed oral health care to patients with HIV disease.
The Committee recognizes the importance of oral health care
providers in the diagnosis of HIV and in treating the painful
and debilitating oral manifestations of this disease. The
Committee supports this program as it improves access to oral
health services for low-income and uninsured people living with
HIV and AIDS by providing partial reimbursement to dental
education institutions for delivering care. The Committee
recognizes that these dental services are vital because they
are often the only services available to AIDS patients since
many State Medicaid programs do not cover adult dental
services.
The Committee recognizes the effectiveness of this program
in training dentists and in assisting with the cost of
providing unreimbursed oral healthcare to HIV patients. The
Committee noted last year the importance of providing adequate
time and technical assistance for grantees to comply with the
new uniform reporting requirements to better access outcomes
and performance measures. With that in mind, the Committee
recommends that HRSA provide a 1-year extension to its current
deadline so that grantees can put into place reporting
mechanisms that meet the new requirements in a manner
consistent with State and institutional confidentiality
protections.
AIDS education and training centers
The Committee recommends $34,000,000 for the AIDS education
and training centers [AETC's]. This amount is $2,402,000 more
than the 2001 level and the administration request. AIDS
education and training centers train health care practitioners,
faculty, and students who care for AIDS patients outside of the
traditional health professions education venues, and support
curriculum development on diagnosis and treatment of HIV
infection for health professions schools and training
organizations. The targeted education efforts by AETC's are
needed to ensure the cost-effective use of the significant
expenditures in Ryan White programs and the AIDS drugs
assistance program. The agency is urged to fully utilize the
AETC's to ensure the quality of medical care and to ensure, as
much as possible, that no individual with HIV receives
suboptimal therapy due to the lack of health care provider
information.
Emphasis should be placed on building clinical treatment
capacity by reaching health professionals providing care to
persons within medically underserved areas, minorities, the
economically underprivileged, and rural populations. The goal
is to provide clinical education and consultation to increase
knowledge and skills of the targeted clinician group providing
care to low or medium volume of HIV patients thereby improving
the early and ongoing access to quality HIV treatment by
clinicians within urban and rural medically underserved areas
and secondary cities outside of major metropolitan areas.
Family planning
The Committee recommends $266,000,000 for the title X
family planning program. This is $12,090,000 above the fiscal
year 2001 level and $11,830,000 more than the administration
request. Title X grants support primary health care services at
more than 4,000 clinics nationwide. About 85 percent of family
planning clients are women at or below 150 percent of poverty
level.
Title X of the Public Health Service Act, which established
the family planning program, authorizes the provision of a
broad range of acceptable and effective family planning methods
and preventative health services. This includes FDA-approved
methods of contraception.
The Committee has increased funding for clinics receiving
Title X funds to address increasing financial pressures in
their effort to provide high-quality, subsidized family
planning services to 4,400,000 each year, many of whom are
uninsured. These pressures include rising costs of newer and
longer lasting contraceptive methods, pharmaceuticals, and
screening and diagnostic technologies, as well as a rising
uninsured population.
The Committee remains concerned that programs receiving
title X funds ought to have access to these resources as
quickly as possible. The Committee, therefore, again instructs
the Department to distribute to the regional offices all of the
funds available for family planning services no later than 60
days following enactment of this bill.
The Committee intends that at least 90 percent of funds
appropriated for Title X activities be for clinical services
authorized under section 1001 of the Act. All such funds for
section 1001 activities are to be provided to the regional
offices to be awarded to grantees to provide family planning
methods and services as specified by the Title X statute. The
Committee further expects the Office of Family Planning to
spend any remaining year-end funds in section 1001 activities.
Health care facilities
The Committee provides $10,000,000 for health care
facilities, which is $241,561,000 below the 2001 level and
$10,000,000 above the administration request. Funds are made
available to public and private entities for construction and
renovation of health care and other facilities.
The Committee includes funding, as authorized in section 3
of Public Law 107-21, for the Paul D. Coverdell Building at the
Institute of the Biomedical and Health Sciences at the
University of Georgia.
National Hansen's Disease Program buildings and facilities
The Committee recommends $250,000 for buildings and
facilities, which is the same as fiscal year 2001 level and the
administration request.
Rural hospital flexibility grants
The Committee includes $25,000,000 for rural hospital
flexibility grants, which is $3,000 more than the
administration request and last year's appropriation.
This program administers the Rural Health Flexibility
Program previously administered by the Health Care Finance
Administration. Under this program, eligible rural hospitals
may convert themselves into limited service facilities termed
Critical Care Hospitals. Such entities are then eligible to
receive cost-based payments from Medicare. The grant component
of the program assists States with the development and
implementation of State rural health plans, conversion
assistance, and associated activities.
National practitioner data bank
The Committee recommends $17,200,000 for the national
practitioner data bank, which is the same as last year and the
administration request. The Committee and the administration
assume that full funding will be provided entirely through the
collection of user fees and will cover the full cost of
operating the data bank. Traditional bill language is included
to ensure that user fees are collected to cover all costs of
processing requests and providing such information to data bank
users.
Health care integrity and protection data bank
The Committee recommends $8,000,000 for the health care
integrity and protection data bank, which is $3,683,000 more
than last year and the same as the administration request. The
Committee and the administration assume that full funding will
be provided entirely through the collection of user fees and
will cover the full cost of operating the data bank. The data
bank is intended to collect, maintain, and report on certain
actions taken against health care providers, suppliers, and
practitioners.
Healthcare access for the uninsured
The Committee provides $15,041,000 for this activity, which
is $124,950,000 less than fiscal year 2001 and the same as the
administration's request. This program is designed to increase
the capacity and effectiveness of community health care
institutions and providers who serve patients, regardless of
their ability to pay. These funds will enable public, private,
and non-profit health entities to assist safety-net providers
in developing and expanding integrated systems of care and
address service gaps within such integrated systems.
Program management
The Committee recommends $135,991,000 for program
management activities for fiscal year 2002. This is $3,000,000
less than fiscal year 2001 and $11,058,000 less than the
administration request.
The Committee continues to recognize the important work of
the American Foundation for Negro Affairs of Philadelphia.
The Committee strongly urges, given its unique needs,
filling of the Public Health Services Senior Programmatic
position in Hawaii.
Medical facilities guarantee and loan fund
The Committee has not included funding for the Medical
Facilities and Guarantee and Loan Fund. This fund was
established in 1972 under the Medical Facilities Construction
Program in order to make funds available for construction of
medical facilities. The fund is established in the Treasury
without fiscal year limitation to pay interest subsidies, make
payments of principal and interest in the event of default on a
guaranteed loan, and repurchase, if necessary loans sold and
guaranteed. There are sufficient carryover funds from prior
years' appropriations to pay defaults and interest subsidy
payments; therefore, no appropriation is required to cover
these payments.
Health education assistance loans
The Committee recommends no additional guarantee authority
for new HEAL loans in fiscal year 2002, which is the same as
the President's request.
The Committee recommends $10,000,000 to liquidate 1999
obligations from loans guaranteed before 1992, which is the
same as the administration request and the 2001 appropriation.
For administration of the HEAL Program including the Office
of Default Reduction, the Committee recommends $3,792,000,
which is $120,000 above the 2001 appropriation and the same as
the administration request.
The HEAL Program insures loans to students in the health
professions and helps to ensure graduate student access to
health professions education, especially among minority,
disadvantaged students, and those from behavioral and mental
health fields. The Budget Enforcement Act of 1990, changed the
accounting of the HEAL Program. One account is used to pay
obligations arising from loans guaranteed prior to 1992. A
second account was created to pay obligations and collect
premiums on loans guaranteed in 1992 and after. Administration
of the HEAL Program is separate from administration of other
HRSA programs.
Vaccine injury compensation trust fund
Appropriations, 2001.................................... $117,347,000
Budget estimate, 2002................................... 117,847,000
Committee recommendation................................ 117,847,000
The Committee recommends that $117,847,000 be released from
the vaccine injury compensation trust fund in fiscal year 2002,
of which $2,992,000 is for administrative costs. The total
amount is $500,000 more than fiscal year 2001 and the same as
the administration request budget request.
The National Vaccine Injury Compensation Program provides
compensation for individuals with vaccine-associated injuries
or deaths. Funds are awarded to reimburse medical expenses,
lost earnings, pain and suffering, legal expenses, and a death
benefit. The vaccine injury compensation trust fund is funded
by excise taxes on certain childhood vaccines.
Centers for Disease Control and Prevention
Disease Control, Research, and Training
Appropriations, 2001.................................... $4,118,319,000
Budget estimate, 2002................................... 4,005,508,000
Committee recommendation................................ 4,418,910,000
For the Centers for Disease Control and Prevention [CDC],
the Committee provides $4,418,910,000 which is $300,591,000
above the fiscal year 2001 level and $413,402,000 above the
budget request.
The activities of the CDC focus on several major
priorities: provide core public health functions; respond to
urgent health threats; monitor the Nation's health using sound
scientific methods; build the Nation's health infrastructure to
insure our national security against bioterrorist threats;
promote women's health; and provide leadership in the
implementation of nationwide prevention strategies to encourage
responsible behavior and adoption of lifestyles that are
conducive to good health.
The Committee commends CDC for the agency's immediate
response to the recent New York City and Washington, DC,
tragedies. CDC sent a total of 71 staff, including 49
epidemiologists, occupational health specialists, and other
public health professionals to supplement local efforts and
provide expertise and assistance to New York City hospitals as
directed by State and local health officials. CDC's Health
Alert Network distributed information to health officials in
New York City and around the country regarding incident
response and technical issues.
It is also the Committee's understanding that CDC used the
National Pharmaceutical Stockpile by deploying a ``push
package'' of emergency materials that arrived in New York City
within 7 hours of being requested. These materials included
pharmaceuticals, intravenous supplies, airway supplies,
emergency medication, bandages and dressings, which included
84,000 bags of intravenous fluid and other intravenous
supplies, as well as 350 portable ventilators and 250
stationary ventilators and other materials to cover a spectrum
of medical needs.
Birth Defects, Developmental Disabilities, Disability and Health
The Committee recommends $88,748,000 for birth defects,
developmental disabilities, disability and health which is
$18,015,000 above the fiscal year 2001 level and $12,468,000
above the administration request.
Birth defects are the leading cause of infant death in the
United States. More than 150,000 infants are born with birth
defects each year in the United States. The Child Health Act of
2000 created CDC's National Center on Birth Defects and
Developmental Disabilities. This new center will expand
existing surveillance, epidemiological research, prevention
programs, and require support for a broad range of functions.
The Committee recognizes CDC as the Nation's leader in
assisting States in monitoring for birth defects and
developmental disabilities and improving the health and
wellness of people living with a disability. The birth defects
and developmental disabilities monitoring programs collect,
analyze, and make available data on the incidence and causes of
birth defects and developmental disabilities.
The Committee has included funding for further
epidemiological research into Duchenne and Becker muscular
dystrophy in the United States. More extensive data on this
disease will inform research decisions, standards of care
formation, prenatal and infant screening and medical education.
The Committee is aware of the University of Louisville
Health Science Center's work to improve the diagnosis,
treatment, and prevention of birth defects. The Committee
believes CDC could consider this center to be designated as a
CDC National Center on Birth Defects Research.
The Committee continues to be supportive of funding for the
Alabama Birth Defects Monitoring and Prevention Center to be
located at the University of South Alabama to implement the
objectives outlined by the United States Birth Defects Act of
1998.
Attention Deficit/Hyperactivity Disorder.--The Committee is
aware of the importance of early identification and proper
treatment of Attention Deficit/Hyperactivity Disorder (AD/HD)
in the prevention of serious consequences, including school and
work failure, depression, conduct disorder, and substance
abuse. The Committee supports the recommendations by CDC to
establish a resource center for accurate and valid information
about AD/HD for the public and professionals, including
resource dissemination on evidence-based interventions for the
disorder and has included sufficient funding to establish such
a center.
Autism.--The Committee is concerned about the lack of
information available on the prevalence, cause or effective
treatment of autism. Basic data collection and verification is
integral to better understanding the incidence of autism, the
factors that may be associated with a higher rate of incidence,
and effective treatment. The Committee commends CDC's initial
efforts to conduct epidemiological research on autism in select
States and has included sufficient funds to expand those
activities.
Disabilities Prevention Programs.--The Committee continues
to strongly support the CDC disabilities prevention program
which provides support to States and academic centers to reduce
the incidence and severity of disabilities, especially
developmental and secondary disabilities.
The Committee commends CDC for its work with the
Christopher Reeve Paralysis Foundation to establish an
information and support center and to reduce secondary
disabilities among people with paralysis. Sufficient funds are
provided to continue this important project which will do much
to prevent secondary complications associated with paralysis,
resulting in improved outcomes and quality of life for people
living with paralysis.
Fetal Alcohol Syndrome.--Fetal Alcohol Syndrome (FAS), the
country's leading known cause of mental retardation and birth
defects, devastates the lives of as many as 12,000 newborn
children and their families each year. The Committee has
included sufficient funds for CDC to: (1) develop guidelines
for the diagnosis of FAS and other negative birth outcomes
resulting from prenatal exposure to alcohol; (2) incorporate
these guidelines into curricula for medical and allied health
students and practitioners, and seek to have them fully
recognized by professional organizations and accrediting
boards; and (3) disseminate curricula to and provide training
for medical and allied health students and practitioners
regarding these guidelines. The Committee recommends that CDC
coordinate its efforts with the National Task Force on Fetal
Alcohol Syndrome, existing federally-funded FAS prevention
programs, and appropriate non-governmental organizations.
The Committee continues to encourage the agency to work
with the State of Alaska to develop a comprehensive statewide
strategy to prevent, detect and treat fetal alcohol syndrome
and notes that Alaska has the highest rate of fetal alcohol
syndrome in the Nation.
Newborn Screening.--Recent advances in genetic screening
for newborns allow identification at birth of underlying
conditions which can cause or contribute to disease,
disabilities, and death. The Committee supports further
research and demonstration projects to facilitate the
translation of new scientific knowledge into applied newborn
public health screening programs, particularly in the areas of
Fragile X Syndrome and Cystic Fibrosis. The Committee urges CDC
to coordinate with HRSA in translating the results of these
efforts into guidance for public health programs, including
State newborn screening programs.
Special Olympics Healthy Athletes Initiative.--The
Committee is concerned regarding the unmet health needs among
persons with mental retardation. On March 5, 2001, a field
hearing was held in Anchorage Alaska, during the World Winter
Special Olympics Games. At that hearing, numerous witnesses,
including persons with mental retardation, expressed their
frustration in securing needed health services and the severe
consequences of not being able to obtain such services in a
timely and appropriate way. Persons with mental retardation
have more health challenges and poorer access to health care
than the rest of the population. As a result, their lives are
unnecessarily shortened and the quality of their lives is
severely compromised.
To address the unmet health needs among its athletes,
Special Olympics has created the Healthy Athletes Program,
which provides Special Olympics athletes access to an array of
health assessment, education, preventive health services and
supplies, and referral for follow-up care where needed. These
services are provided to athletes without cost in conjunction
with Games competitions at local, State, national, and
international levels.
The Committee strongly urges the CDC to establish a Special
Olympics Healthy Athletes Initiative. The Committee further
urges the CDC to have lead responsibility for this initiative,
in collaboration with the Health Resources and Services
Administration, National Institutes of Health, Agency for
Healthcare Research and Quality, Center for Medicare and
Medicaid Services. The agencies could examine existing programs
and resources to determine appropriate actions that they may
take, including studies and demonstration projects, to address
the health challenges to persons with mental retardation. The
initiative should help train health professionals and sensitize
health care systems and institutions, as to the health needs of
persons with mental retardation; establish clinical and program
standards of care that meet the needs of individuals with
mental retardation; expand systems to make them accessible to
persons with mental retardation; help identify the nature and
scope of health challenges and health access barriers to
persons with mental retardation; and create and test models for
athlete health promotion at the local level.
Chronic Disease Prevention and Health Promotion
The Committee recommends $701,654,000 for chronic disease
prevention and health promotion, which is $48,119,000 below the
fiscal year 2001 level and $127,094,000 above the
administration's request.
The leading causes of death and disability (e.g., heart
disease and stroke, cancer, diabetes, and arthritis) are among
the most prevalent, costly, and preventable of all health
problems. Seven of every 10 Americans who die each year, or
more than 1.7 million people, die of these chronic diseases.
Heart disease and stroke and cancer account for two-thirds of
all deaths. The prolonged course of illness and disability from
such chronic diseases as diabetes and arthritis results in
extended pain and suffering as well as in decreased quality of
life for millions of Americans. A relative few modifiable risk
factors bring suffering and early death to millions of
Americans. Three such factors--tobacco use, poor nutrition, and
lack of physical activity are major contributors to our
Nation's leading causes of death.
The Committee recognizes that a greater effort is needed to
control the leading causes of death and disability through the
prevention of risk factors. Further, this Committee which
consistently strives to insure that adequate resources are
available for biomedical research is committed to insuring that
applied research is adequately funded.
Anemia.--The Committee notes that iron deficiency in
children can result in delayed or stunted intellectual and
physical development, and is disturbed to learn that Alaska
Native children in rural areas have a high prevalence of iron
deficiency anemia. Recent evidence suggests that treatment of
H.pylori infection with antibiotics might lead to resolution of
the anemia in some children. The Committee encourages the
agency to give consideration to a proposal by the State of
Alaska to reduce unacceptably high anemia rates among the
Alaska Native children of southwestern Alaska, which includes a
clinical trial to evaluate the ability of triple therapy with
antibiotics to treat iron deficiency anemia among children 2 to
5 years of age in western Alaska.
Arthritis.--The Committee notes that Congress established
the CDC arthritis program in 1999 following the development of
the National Arthritis Action Plan (NAAP). The CDC activities
form the backbone of a multi-pronged response to the Nation's
leading cause of disability. Prior to this initiative, there
was no coordinated public health strategy to prevent and
appropriately treat the over 100 forms of this painful,
debilitating disease. Grants to States are a core component of
the CDC arthritis program. These partnerships promote the
development of a State-based network of local activities to
confront the burden of arthritis. This approach also encourages
the formation of broadly-based coalitions with health care
providers, community-based organizations, and other
stakeholders to coordinate and leverage their resources. The
Arthritis Foundation chapters across the country have led this
external effort. The Committee has been supportive of increased
funding for the arthritis program. The Committee recognizes
that there is a rising demand among States for these programs
and that CDC's desire to provide a minimum level of funding to
each participating State has produced a shortfall of funds.
Cancer Prevention and Control.--Cancer is the second
leading cause of death in the United States. Since 1990, 13
million new cancer cases have been diagnosed--including over
1.2 million new cases in 2000 alone. Cancer costs the Nation
$107,000,000,000 annually in direct and indirect costs.
Screening tests for breast, cervical and colorectal cancer
reduce the number of deaths from these diseases, and screening
tests for cervical and colorectal cancer can actually prevent
the development of cancer through the early detection and
treatment of pre-cancerous conditions.
The Committee commends CDC for its efforts to begin to
build a coordinated focus for cancer efforts at the State
level, CDC funds five States and an Indian health board to
develop comprehensive cancer control programs. These States are
building the foundation for a nationwide, comprehensive cancer
control program. Comprehensive cancer programs integrate the
full range of cancer prevention activities including research,
evaluation, health education and communication, program
development, public policy development, surveillance, and
clinical services.
The Committee has included increased funding for
comprehensive cancer control programs. Particular attention
should be paid to raising public awareness and enhancing
professional education on cancers not currently addressed by a
CDC program. For example, CDC is encouraged to develop an
awareness campaign to educate patients and practitioners about
the symptoms associated with lymphoma and the challenges of
correctly diagnosing this complicated cancer.
The Committee also urges CDC to plan and implement
awareness programs for orphan cancers for patients and
community oncologists. Patients diagnosed with these cancers,
such as esophageal, kidney, liver, multiple myeloma,
pancreatic, and stomach, currently have the lowest life
expectancy rates of all diagnosed cancers, yet community
oncologists generally lack specific knowledge about these
malignancies. The Committee also encourages CDC to establish,
with the States, high-risk registries for the digestive cancers
and other cancers with significantly low survival rates
following diagnosis.
The Committee is aware of a CDC project at Swope Parkway
Health Center in Kansas City that is successfully targeting
African American women who are at high risk for breast and
cervical cancer. The project is a collaborative effort between
the Health Center and community groups in reaching out to this
at-risk population through the dissemination, access to free
testing, and the implementation of a screening follow-up
program. The Committee urges the CDC to continue its support
for this program.
Chronic Fatigue Syndrome (CFS).--The Committee is pleased
that CDC has restored funding for CFS research, and that these
funds are being used in substantive areas of research and
education. In particular, the Committee would like to commend
CDC on its collaborations with prominent CFS clinicians, Emory
University researchers, and CFS advocates. The Committee
supports efforts to develop and test an empirically derived
case definition and initiate a national CFS survey to estimate
sex-, age-, race/eth-
nic-, and socioeconomic-specific prevalence of CFS.
The Committee strongly encourages CDC to provide the funds
and the infrastructure to support other aspects of its
``reinvigorated'' CFS research plan, which includes
surveillance projects on children, adolescents, and minorities
with CFS; a national CFS patient registry; studies of etiologic
agents, diagnostic markers, natural history, and risk factors
using specialized molecular epidemiology techniques and
advanced surveillance methodologies; and CFS public education
programs with special emphasis on general public service
announcements and expanded efforts to educate primary care
providers about the detection, diagnosis, and treatment of CFS.
The Committee recognizes CDC's support of the DHHS CFS
Coordinating Committee (CFSCC) and expect that CDC will
continue its support as the CFSCC transitions from a
coordinating committee to an advisory committee.
Community Health Centers.--The Committee strongly urges the
utilization of Community Health Centers as an integral part for
the provision of primary care in medically underserved
populations. The Committee urges CDC to contract directly with
the Hawaiian Community Health Centers to provide primary health
care for its underserved populations, this includes an approval
for expansion of the Community Health Centers to Kaui.
Cooley's Anemia.--Patients with Cooley's anemia, or
thalassemia, are the most frequently transfused of all patients
receiving blood, often every 2 weeks. This makes them an
effective ``early warning system'' for problems in the blood
supply. The Committee is aware that CDC has created a program
outline for establishing a blood safety surveillance program,
modeled on the universal data collection program used in
hemophilia. The Committee encourages CDC to provide sufficient
funds to establish this program, which will make a major
contribution to the safety of the blood supply for all
Americans.
Diabetes.--The Committee remains acutely concerned about
the high incidence of diabetes within the Native American,
Native Alaskan and Native Hawaiian populations. The Committee
urges the CDC to continue to develop a targeted prevention and
treatment program for these culturally unique yet similar
groups. The Committee encourages the CDC to continue to work
with Native Americans and Native Hawaiians to incorporate
traditional healing and develop partnerships with community
centers as a safety net during program development. The
Committee is pleased with CDC's efforts to work with the
leadership of Native Hawaiian and Pacific Basin Islander
communities in these efforts.
The Committee is also aware of a proposal from the Standing
Rock Sioux Tribe and Cheyenne River Sioux Tribe to establish
the Dakota Plains Diabetes Center.
The Committee acknowledges that the The Texas Tech
Institute for Diabetes Prevention and Control has been very
successful in addressing high incidence of diabetes in the
Southwest, and supports its continued activities.
The Committee continues to be supportive of the National
Diabetes Prevention Center in Gallup, New Mexico.
Dental decay.--The Committee urges CDC to further enhance
its oral health activities to reduce the disparity in treatment
of oral health diseases including dental decay, tooth loss,
oral cancers, gum disease, and oral conditions associated with
chronic diseases such as diabetes and heart disease. The
Committee urges the CDC to work with eligible entities to
implement the oral health prevention programs of the children's
Health Act of 2000. The Committee has included sufficient
funding to allow States to assist communities that are
initiating water fluoridation projects to apply for appropriate
assistance.
Epilepsy.--Although the CDC has developed public health
strategies to address epilepsy, additional investment is
required to effectively implement these initiatives. The
Committee has provided increased funding for CDC to enhance its
epilepsy efforts, with a focus on expanding disease
surveillance; increasing public awareness activities; public
and provider education; prevention research; and, importantly,
to more aggressively address the stigma often associated with
the disorder. Further, the Committee recognizes the recent
commitment by CDC to partner with a national voluntary health
organization dedicated to improving the lives of persons with
epilepsy and expects CDC to work with this organization and
other consumer groups in implementing this public health
initiative.
Glaucoma.--The Committee has included funds for CDC to
develop a model project to test the efficacy of glaucoma
screening using mobile units. The Committee further suggests
the program establish protocols to conduct outreach, identify
staffing needs, implement glaucoma screenings, as well as
address other eye conditions, provide patient education
regarding the management of glaucoma, and make appropriate
referrals to eye care professionals. The program should also
include a rigorous evaluation of the strategy to conduct
glaucoma screening using mobile units including measuring the
number of screenings conducted and outcome measures of the
projects effectiveness. Alternate strategies to achieve similar
goals should be explored to determine the most effective
methods to deliver glaucoma screenings in various communities.
Moreover, the evaluation component should address the
effectiveness of mobile units as a method to address
populations most in need of glaucoma screenings.
Health Promotion.--The Committee has included sufficient
funds to continue the pilot program, begun in fiscal year 2000,
for an interdisciplinary approach to mind-body medicine and to
assess the preventive health impact.
Heart Disease and Stroke.--Heart disease and stroke are the
leading causes of death in the United States among men and
women and of all racial and ethnic groups. Challenges to
combating these diseases include persistent geographic, racial
and ethnic disparities; the increasing prevalence of sedentary
lifestyles and obesity among all sectors of the American
population, the growing number of people with these diseases as
the population ages, and the under use of established effective
treatments for those already afflicted by heart disease and
stroke.
The Committee commends CDC for publishing and distributing
``Women and Heart Disease: An Atlas of Racial and Ethnic
Disparities in Mortality'', the first publication to show heart
disease death rates among women aged 35 years or older, county-
by-county, throughout the United States.
The Committee has increased funding for the WISEWOMAN
program to allow the program to expand to up to 20 States. The
WISEWOMAN program builds on the CDC's National Breast and
Cervical Cancer Early Detection Program to also screen women
for heart disease, stroke and cardiovascular disease risk
factors such as high blood pressure, elevated cholesterol, lack
of physical activity and obesity. CDC also delivers dietary and
physical activity counseling to these women to improve their
health and to prevent cardiovascular diseases, the leading
cause of death of American women. Currently in nine States, the
program has screened more than 10,000 low-income and uninsured
women ages 40-64 for heart disease and stroke risk factors.
From 50 percent to 75 percent of these women were found to have
either high blood pressure or elevated cholesterol.
Stroke remains America's No. 3 killer, a major cause of
permanent disability and a key contributor to late-life
dementia. This year, nearly 600,000 Americans will suffer a
stroke, costing Americans an estimated $45,000,000,000 in
medical expenses and lost productivity. Nearly 4.5 million
Americans live with the consequences of stroke; many are
permanently disabled. Currently, the drug tPA, is the only
approved emergency treatment for clot-based stroke, yet less
than 5 percent of those eligible for tPA receive it.
As a result, the Committee has included funding for the
Paul Coverdell National Acute Stroke Registry, established by
Congress last year and designed to track and improve the
delivery of care to patients with acute stroke. The Committee
encourages CDC to continue to work with the National Institute
of Neurological Disorders and Stroke, and the National Heart,
Lung, and Blood Institute at the National Institutes of Health,
the Brain Attack Coalition, and other professional
organizations, including hospitals, universities, State and
local health departments, and other appropriate partners
experienced in the treatment of stroke to further implement
this registry.
The Committee is impressed with the continued success of
the Michael E. DeBakey Institute for the Integrated Study of
Cardiovascular Disease and Biomedical Devices. This Institute
has supported the development of life-saving heart pumps and
other devices and combines the world-class expertise of Baylor
College of Medicine with the engineering and veterinary
medicine expertise of Texas A&M University.
Hemophilia.--The Committee is appreciative of CDC's efforts
last year to restore funding to meet the disease management,
prevention, and outreach needs of persons with hemophilia and
bleeding disorders, and in particular, women with bleeding
disorders. The Committee expects CDC to continue working with
the national hemophilia foundation to strengthen these programs
and its blood safety surveillance. The Committee also
understands that geno-typing of the hemophilia population is
needed to speed identification of inhibitors and facilitate the
rapid translation of gene therapy technologies into treatment
and prevention efforts.
Immunodeficiency Diseases.--The Committee has included
sufficient funds to continue and expand the CDC's national
education awareness campaign with regard to primary
immunodeficiency diseases, in collaboration with NICHD, NIAID,
NCI, and private entities, to serve as a model for other
genetic diseases. At a minimum, the campaign should include
development and distribution of educational materials to health
care professionals and others likely to inter-act with
undiagnosed patients, development and distribution of
culturally competent materials for patients and their families,
as well as physician and public education efforts. The Director
of CDC should submit a report to the Committee prior to next
year's appropriation hearings outlining the progress that has
been made to date. The Committee is pleased that CDC is working
to establish a competitively awarded primary immune deficiency
diseases national surveillance program.
Micronutrients.--Deficiencies of micronutrients such as
iron, iodine, and vitamin A, affect nearly one-third of the
world's population, and result in reduced mental and physical
development of children, poor pregnancy outcomes, diminished
work capacity of adults, and increased morbidity and premature
mortality among populations. Effective and inexpensive
interventions such as dietary diversification, food
fortification and supplementation have eliminated most
micronutrient deficiencies in developed countries.
The Committee has provided sufficient funding for CDC to
increase its efforts to eliminate micronutrient malnutrition.
The focus of these efforts is to support a number of national
and international efforts to assess mirconutrient status of
populations and to monitor and strengthen implementation of
interventions as well as to assess the impact of the
interventions over time. CDC has extensive expertise in
epidemiology, monitoring and assessment, and laboratory
science; and these efforts reflect the unique contribution that
CDC can make to eliminate micronutrient deficiencies.
Multiple Sclerosis.--The Committee commends the University
of Texas-Southwestern Medical Center for its preeminent
Comprehensive Multiple Sclerosis Center of Excellence and its
new National Multiple Sclerosis Training Center. This center is
providing neurologists across the United States with intensive
training on the management of MS.
Nutrition, Physical Activity and Obesity.--Physical
inactivity and unhealthy diet patterns account for at least
300,000 preventable deaths each year among Americans and
increase the risk for many chronic diseases. Most Americans do
not engage in recommended behaviors for healthy eating and
physical activity. More than 60 percent of adults do not engage
in levels of physical activity necessary to provide health
benefits, and daily participation in high school physical
education has dropped from 42 percent to 27 percent in the last
6 years. Obesity has reached epidemic proportions. In the past
15 years, the prevalence of obesity has increased by over 50
percent among adults and 100 percent in children and
adolescents. The cost of diseases associated with obesity is
almost $100,000,000,000 per year.
The Committee is concerned about the alarming increase in
childhood obesity and has provided $950,000 to CDC to fund a
study by the Institute of Medicine to assess the nature of
childhood obesity in the United States and develop an action
plan to decrease its prevalence that focuses on prevention. The
study should assess the primary factors responsible for the
increasing prevalence of childhood obesity and identify the
most promising methods for prevention.
The Committee is aware of the report of the Evaluation
Group on the national 5-A-Day for Better Health Program and the
findings that eating fruits and vegetables reduces the risk of
cancer, cardiovascular, and other diseases. Given these
findings, the Committee urges the Centers for Disease Control
and Prevention (CDC) and the National Cancer Institute (NCI) to
jointly develop a comprehensive plan to strengthen and expand
the 5-A-Day program. The plan should address the policy,
environmental changes, communications, State and community
programs, research and evaluation, and surveillance and program
channels such as mass media, restaurants, supermarkets,
schools, and faith organizations. The plan should also address
how best to use already-developed technologies to promote
healthy eating.
The Committee is aware that Alaska ranks in the top five in
the Nation in its proportion of people who are obese. The
agency is encouraged to give consideration to a pilot program
proposed by the State of Alaska to prevent and control obesity
through the promotion of increased physical activity and
improved nutrition.
The Committee is aware of the Children's Health Life Skills
Initiative at the University of North Carolina at Greensboro,
which is a multi-university effort to address obesity and
chronic disease among children.
Pancreatic Cancer.--The Committee encourages the CDC to
work with the National Cancer Institute to determine possible
areas of collaboration in epidemiology, translational research,
and awareness and registry programs for pancreatic cancer. A
report to the Committee on initiatives in these areas should be
submitted prior to next year's appropriations hearing.
Prevention Centers.--The prevention centers form a
nationwide network of academic institutions that conducts
applied research designed to develop and test innovative
strategies for health promotion and disease prevention. The
primary goals of the program are to identify risk factors, and
to identify barriers and facilitators to behavior change to
demonstrate the effectiveness of prevention interventions, to
increase collaboration among agencies and community partners,
and to train public health professionals in creative ways for
preventing chronic diseases and other health problems. The
Committee has included sufficient funds to expand the number of
prevention centers funded by CDC.
The Committee encourages the continued support of center
activities aimed at improving knowledge about the usefulness
and effectiveness of health promotion programs for persons with
disabilities.
The Committee continues to support within the prevention
center program a Tobacco Prevention Research Network to
increase the knowledge base on the most effective strategies
for preventing and reducing youth tobacco use, as well as on
the social, physiological and cultural reasons for tobacco use
among children.
For example, the West Virginia University Prevention
Research Center (PRC) worked with the American Lung
Association, schools, and communities in West Virginia and
across the United States to develop and evaluate a smoking
cessation program for teenagers. Controlled studies showed that
20 to 30 percent of participants were smoke-free by the end of
the year and young people who did not completely quit
significantly reduced their cigarette smoking. This program is
currently being used in many States, and the U.S. Army plans to
use the program in military high schools across Europe.
Compared to the Nation, Mississippi Delta residents
disproportionately suffer from heart disease, cancer, diabetes,
and other chronic illnesses. The Committee is aware that the
University of Mississippi Medical Center and Delta State
University have formed a partnership concentrating on improving
the health, education, and economic opportunities of
Mississippi Delta residents.
Prostate Cancer.--The Committee is aware that prostate
cancer is the second leading cause of cancer death among men in
the United States, and that the CDC's prostate cancer awareness
campaign plays a key role in screening, outreach, education,
and treatment of men with this disease, especially those at
high risk. The Committee is pleased with these efforts and
encourages CDC to expand this program to include the broader
at-risk male population.
The Committee recognizes that early detection of prostate
cancer by the prostate specific antigen (PSA) test is likely to
reduce disease mortality and therefore believes it is important
to accelerate programs that can benefit Americans at special
risk of this disease. In particular, the Committee encourages
CDC to improve outreach for early detection to populations at
special risk. The Committee requests that CDC prepare a report
describing how it plans to accelerate opportunities for early
detection of prostate cancer as well as linkages to appropriate
and accessible treatment for the medically underserved. It is
further expected that CDC will consult closely with the
research community, public health community, clinicians,
patient advocacy groups, and the Congress in preparation of
this report.
Pulmonary Hypertension.--The Committee continues to be
interested in pulmonary hypertension, a rare, progressive and
fatal disease that predominantly affects women, regardless of
age or race. Pulmonary hypertension causes deadly deterioration
of the heart and lungs and is a secondary condition in many
other serious disorders such as scleroderma and lupus. The
Committee provided funding for public and professional
awareness of pulmonary hypertension in the fiscal year 2001
Conference Agreement, and expects CDC to report on the progress
made to initiate this program by December 31, 2001.
Safe Motherhood.--The Committee urges the National Center
for Chronic Disease Prevention and Health Promotion and the
National Center for Health Statistics to work together to
review the Pregnancy Risk Assessment Monitoring Survey with the
intent of expanding this survey, and to explore the possibility
of a mandatory reporting requirement to track the medical care
and interventions that women receive during pregnancy and
delivery.
School Health.--The Committee supports CDC's efforts to
expand coordinated school health programs that reduce chronic
disease risk factors including poor eating habits, physical
inactivity, and tobacco use. The Committee recognizes that
children are our most valuable resource and schools represent
an opportunity to provide our children with valuable health
skills. The Committee further recognizes that significant
research has demonstrated that tobacco prevention programs in
schools can lower smoking rates among teenagers.
Sudden Infant Death Syndrome.--The Committee notes the work
of CDC, the National Institute of Child Health and Human
Development and HRSA in developing model guidelines for death
scene protocol for Sudden Infant Death Syndrome. The Committee
encourages CDC to implement projects to demonstrate the
effectiveness of the death scene protocol in a variety of
locales (urban, suburban, and rural) throughout the Nation. The
Committee expects CDC to be prepared to report on progress on
this initiative during the fiscal year 2003 budget hearings.
Tobacco Use.--Tobacco use is the single most preventable
cause of death and disease in the United States; it is
responsible for more than 430,000 deaths each year at an annual
cost of nearly $100,000,000,000. Every day 3,000 young people
become regular smokers, and it is anticipated that of today's
children, 5 million will die prematurely if current smoking
trends continue. In addition, the Committee recognizes the
consequences of tobacco use have become an issue of global
concern far beyond the confines of national boundaries. The
global tobacco epidemic will become the leading cause of
preventable and premature death worldwide.
It has been brought to the Committee's attention that
Alaska Native teens use tobacco at rates much higher than the
national average and begin using tobacco as early as age 5. The
Committee encourages the agency to consider the ``Challenge to
Quit'' program operated by the Alaska Native Health Board which
offers incentives for Alaska Native teenagers to quit using
tobacco. The Committee is also disturbed to learn that tobacco
use in the Yukon-Kuskokwim delta region of Alaska is among the
highest in the Nation, including more than 40 percent of
pregnant women, and also encourages the agency to work with the
Alaska Native Health Board in partnership with the Yukon-
Kuskokwim Health Corporation, on a tobacco cessation program in
the Yukon-Kuskokwim delta region of Alaska.
Tourette Syndrome.--The Committee recognizes that Tourette
Syndrome is a commonly misdiagnosed disease, and has learned of
the Tourette Syndrome Association's efforts to educate health
care professionals about this condition. The Committee supports
these efforts, and urges CDC to support these activities with a
focus on medically under served communities.
Youth Media Campaign.--The Committee has not included any
funding for the youth media campaign. The Committee is aware
that CDC is implementing the first year of a youth media
campaign that uses principles of marketing and communications
strategies to influence America's children to develop habits
that foster good health over a lifetime--including physical
activity, good nutrition, and the avoidance of illicit drugs,
tobacco, and alcohol. CDC is working with marketing and media
experts to design and implement a media campaign for cable or
broadcast television programs as well as on an interactive Web
site.
Environmental Health
The Committee recommends $171,683,000 for environmental
health activities which is $34,584,000 above the fiscal year
2001 level and $35,180,000 above the administration request.
Many of the public health successes that were achieved in
the 20th century can be traced to innovations in environmental
health practices. However, emerging pathogens and environmental
toxins continue to pose risks to our health and significant
challenges to public health. Pfiesteria piscicida, an organism
implicated in major fish kills at sites in the eastern United
States, may cause a variety of health problems as well as
impact local economies. Outbreaks of water-borne diseases such
as cryptosporidium show the vulnerability of our water
purification systems. The task of protecting people's health
from hazards in their environment requires a broad set of
tools. First among these tools are surveillance and data
collection to determine which substances in the environment are
getting into people and to what degree. It also must be
determined whether or not these substances are harmful to
humans, and at what level of exposure. Many scientists estimate
that about two-thirds of all cancers result from environmental
exposure, but much better data are needed to improve this
estimate and determine which exposures cause cancer and other
diseases.
Asthma.--CDC's asthma activities focus on three areas:
tracking the disease to improve the Nation's ability to
determine asthma prevalence, severity, and management; assuring
that interventions are based on science; and working to address
this problem through partnerships including providing technical
assistance to non-governmental organizations to carry out
diverse community-based childhood asthma control programs.
The Committee is pleased with the work that the CDC has
done to address the increasing prevalence of asthma. However,
the increase in asthma among children, particularly inner city
minorities, remains alarming. The Committee urges CDC to expand
its outreach aimed at increasing public awareness of asthma
control and prevention strategies, particularly among at risk
minorities populations in under served communities. The
Committee also encourages CDC to work with other Public Health
Service agencies at NIH, HRSA, and the Office of the Surgeon
General to develop a PHS-wide plan to control asthma. The
Committee has provided sufficient funds to allow CDC to
increase the numbers of States covered by this program and to
fund additional community-based interventions that apply
effective approaches demonstrated in research projects within
the public health community.
As with the rest of the United States, there is an increase
in the prevalence, incidence, and severity of asthma throughout
Hawaii, especially in its medically underserved population.
Because of this the Committee urges the CDC to contract with
Hawaiian Community Health Centers in order to provide proper
health care in the treatment of asthma throughout Hawaii.
Childhood Lead Poisoning Prevention.--Since its inception
in fiscal year 1990, the CDC program has expanded to
approximately 40 project areas that encompass States, local
areas, and numerous communities and screens an estimated 1.75
million children annually. The program has developed its first
Geographic Information System (GIS) website using U.S. Census
data on income, race, and old housing to help State and local
health departments identify high-risk geographic areas. The
availability of such information will result in more efficient,
targeted screening.
The Committee is aware of the portable, easy to use lead
screening device developed with the support and participation
of the CDC. The Committee continues to believe that this device
holds great promise for increasing childhood screening rates in
under served communities and encourages CDC to support its
further development for widespread application in community
public health settings.
The Committee notes the success that CLEARCorps/USA has had
in helping communities and families protect their children from
lead poisoning.
Childhood Leukemia.--The Committee is aware of the integral
role that CDC and ATSDR have played in helping the Nevada State
Health Division's efforts to understand and address the
outbreak of childhood acute lymphocytic leukemia (ALL) in
Fallon, Nevada. CDC officials assisted the Health Division to
develop a tool to survey the families of Fallon children with
ALL for any information suggestive of features, experiences, or
exposures in common among them. Officials from the centers also
served on the Health Division's Expert Panel, a body that has
provided the State with guidance on advancing the investigation
into the ALL outbreak. More recently, CDC and ATSDR have been
developing protocols for the study of contaminants in human
tissue, soil, air, and dust in the Fallon community. It is
anticipated that the study will be implemented later this
summer. Given the limited resources available to Nevada State
health officials to continue the investigation into the
cause(s) of the Fallon childhood ALL outbreak, the Committee
strongly urges the CDC and ATSDR to continue to support Nevada
State health officials in their investigation.
Environmental Health Activities.--CDC's environmental
epidemiology activities include conducting national and
international epidemiological studies on the association
between health effects and groundwater contamination;
collecting and analyzing data on the off-site migration of
chemical contamination and resistant microbes from concentrated
animal feeding operations; providing consultation on pesticide
use in vector-control programs; conducting human pesticide
exposure studies; developing sensitive biomarkers of pesticide
exposure; and collaborating with EPA, academia, and State and
local health departments in several pesticide-related
activities.
The genetics and disease prevention program is creating
centers for genomics and public health within schools of public
health to evaluate and disseminate information on gene-disease
associations, gene-environment interaction, and genetic tests
and to provide technical assistance and training for State and
local public health programs. CDC will incorporate genetic
discoveries about human disease into effective public health
actions that identify ways to use this new knowledge in chronic
and environmental disease prevention.
The Committee recognizes the need for scientific
investigation of the link between environmental contaminants
and diseases in both humans and ecosystems. The Committee is
aware the University of Mississippi Medical Center, in
collaboration with University of Mississippi at Oxford, has a
program focusing on the association between chemicals in the
environment and the onset of disease among residents living in
the Mississippi River basin.
The Committee is supportive of the efforts of the
University of Montana, Missoula's Center for Environmental
Health Sciences. The University is studying the impact of
environmental factors causing or exacerbating human health
conditions in an effort to (1) discover new or better
treatments, (2) better assess the actual risks caused by
environmental agents, and (3) improve methods to reduce the
adverse health impacts of these environmental agents.
Environmental Health Laboratory.--The CDC environmental
health laboratory performs assessments for State investigations
of diseases (such as cancer and birth defects) and
investigations of chemical exposures, such as dioxin,
pesticides, mercury and cadmium. CDC is also working with
States to improve public health laboratories that assess State
level biomonitoring needs. CDC works closely with academic
institutions, other Federal agencies, and other partners to
measure human exposure to toxic substances and the adverse
effects of that exposure.
The Committee recognizes CDC for its commendable work in
analyzing toxic exposures throughout the United States. The
Committee further recognizes that CDC's environmental
laboratory is unprecedented in the world for measuring toxic
exposures to humans and further commends CDC for publishing the
National Report on Human Exposure to Environmental Chemicals,
which provides information about the U.S. population's exposure
to 27 toxic substances, including heavy metals and certain
pesticides.
The Committee supports the CDC biomonitoring program and
study of environmental toxins and their relationship to chronic
diseases, such as asthma, many birth defects, and cancer to
increase our understanding of the cause of many chronic
diseases and conditions and to facilitate the development of
effective prevention strategies. CDC should continue to pursue
the development of a coordinated system among all the States to
identify and track disease and conditions caused by exposure to
environmental toxins.
Health Tracking Network.--In fiscal year 2001, the
Committee requested that the Centers for Disease Control and
Prevention (CDC) develop a plan for a coordinated Nationwide
Health Tracking Network among all States to identify and track
chronic diseases and their related environmental factors.
Across the Nation there is a serious lack of trained personnel
and modern technology dedicated to responding to the very real
health emergencies that face our communities. State and local
health departments need epidemiologists, environmental health
specialists, chronic disease investigators, technical resources
and regional laboratories to track chronic disease and evaluate
community exposures.
The Committee has included funding to develop pilot
programs in States as a first step in the development of a
Nationwide Health Tracking Network. The pilot projects would
include support for State health departments to develop and
operate a comprehensive and coordinated State health tracking
network, increased capacity at regional environmental
laboratories and State environmental health investigators to
lead rapid response teams when a disease cluster or other
health emergency is detected. Finally, these funds would allow
CDC, working in close coordination with State and local public
health officers, environmental specialists and other relevant
parties, to begin to develop national standards and protocols
for tracking priority chronic disease as part of the Nationwide
Health Tracking Network.
Rural Health.--The Committee is greatly concerned about the
health status of the residents of rural communities. The
Committee encourages CDC to conduct an assessment of rural
health problems, in particular, those that may be related to
concentrated animal feeding operations. Potential health
indicators should be identified and collected for selected
areas that reflect the general health status or well-being of
the community. Analyses of the data should be undertaken to
identify potential causes of illnesses that may require further
investigation. The Committee encourages the agency to conduct
the assessment in Iowa where rural communities reflect many of
the health problems suffered by rural residents nationwide.
World Trade Center and Pentagon Emergency Workers.--The
Committee has included funding for monitoring the health of
workers directly involved in rescue and response efforts
associated with the terrorist attacks of September 11, 2001, at
the World Trade Center in New York City and the Pentagon, in
Arlington, Virginia. CDC should coordinate its efforts with the
Federal Emergency Management Agency, the Environmental
Protection Agency, the Department of Labor, the State of New
York, the City of New York, Arlington County and affected labor
organizations. Such efforts shall include baseline and long-
term health monitoring of individuals directly involved in
rescue and response efforts. The purpose of this demonstration
is to study the long-term health impacts associated with rescue
and response efforts at the World Trade Center and the
Pentagon.
Thyroid Cancer.--The Committee has included sufficient
funds to continue the next phase of a study on radioactive
Iodine-131 and thyroid cancer. This study will look at
individuals exposed to fallout from the Nevada Nuclear Weapons
Test Site.
Epidemic Services and Response
The Committee recommends $85,303,000 for epidemic services
and response which is $7,506,000 above the fiscal year 2001
level and $5,000,000 over the administration's request.
CDC's epidemic services and response program provides
resources and scientific expertise for operating and evaluating
surveillance systems; developing and refining research methods
and strategies to the benefit of public health practice;
training public health professionals who are prepared to
respond to public health emergencies, outbreaks and other
assistance requests; and communicating with multi-faceted
audiences accurate public health information and effective
messages. The scientific basis of this program is applied
epidemiology, in concert with other components of sound public
health practice. Findings from these disciplines enable States,
health organizations, foreign ministries of health, and others
in the health field to make sound decisions and create
effective policy. Information derived from epidemiologic data
and scientific reasoning provide public health programs with an
objective rationale to set priorities, apply interventions and
policies, and evaluate public health programs. Within the
epidemic services and response program, CDC carries out a
variety of applied research and development activities. Areas
of research include: social determinants of health; aberration
detection; burden of disease; injury, and death; prevention
effectiveness; and health care quality. The Committee
recognizes that CDC maintains a keen appreciation for the fact
that local outbreaks of illness can develop rapidly into
epidemics, that previously unidentified health problems can
appear at any time, that contaminated food or defective
products may appear in the community without warning, and that
the threat of bioterrorism is present in many areas of the
world. When CDC participates in an investigation, all of the
resources of the agency are at the disposal of the affected
area, including its state-of-the-art laboratories.
Health Statistics
The Committee recommends $126,978,000 which is $5,012,000
above fiscal year 2001 and the same as the administration
request.
CDC's statistics give us context and perspective on which
we can base important public health decisions. By aggregating
the experience of individuals, we gain a collective
understanding of our health, our collective experience with the
health care system, and our problems and public health
challenges. NCHS data are used to create a basis for
comparisons between population groups or geographic areas, as
well as an understanding of how trends in health change and
develop over time.
The Committee urges CDC to continue to prioritize current
health information which is needed in all sectors of society as
a prerequisite for planning, action, and evaluation, and can
lead to improvements in health and quality of life. In this
time of rapid change in health and welfare policy, medical
practice, and biomedical knowledge, it is important to make the
investments necessary to monitor trends so that we can assess
the impact of these changes and guide policy.
The Committee is pleased that NCHS continues working with
the National Center for Infectious Diseases to implement a
primary immune deficiency national surveillance program.
HIV, STD, and TB Prevention
The Committee recommends $1,121,612,000 which is
$77,463,000 above the fiscal year 2001 level and $53,160,000
above the administration request.
Recognizing the intersection among these diseases, and the
need for a focal point for leadership and accountability, CDC
combines HIV, STD, and TB activities to provide leadership in
preventing and controlling human immunodeficiency virus
infection, other sexually transmitted diseases (STDs), and
tuberculosis. CDC works in collaboration with partners at
community, State, national, and international levels, applying
well-integrated, multi-disciplinary programs of research,
surveillance, technical assistance and evaluation. These
diseases are not vaccine preventable and must be controlled and
prevented through identifying, diagnosing, and treating
infected persons; through provision of confidential, culturally
competent counseling to identify and reach those who have been
exposed to infection and who may not know it; and through
individual and population level health promotion to reduce high
risk behaviors.
HIV/AIDS Prevention.--CDC's HIV/AIDS prevention programs
are working in every State and territory to prevent new
infections, link people who are already infected to medical
care and translate scientific research findings into practical
prevention programs available to every person at risk. CDC will
continue to adapt these prevention programs to meet new and
different needs.
The Committee urges that racial minorities be more fully
targeted and included in HIV prevention efforts. The Committee
urges CDC to consider allocating increased resources to address
the HIV-related health disparities in ethnic and racial
minority populations. In particular, CDC should continue to
target support for minority community-based organizations and
minority regional and national organizations including
education, technical assistance, infrastructure, capacity
building, community development, and public health initiatives.
According to the CDC, between 4 million and 5 million
people in the United States are at continued behavioral risk
for HIV infection. The Committee recognizes that this is a low
estimate due to under-reporting by participants and the lack of
inclusion of schools, prisons, and the military. Communities
must be better equipped with local data to identify and direct
resources to those most at risk. They must have an array of
effective interventions available and the capacity to implement
and evaluate them at the local level. They must also be able
not only to address barriers and deter risky behavior but also
to encourage health promotion behavior through a variety of
individual and group interventions, community-level supports,
and structural level changes. Because those at risk for or
living with HIV infection are often also at risk for other
health problems, HIV prevention must be integrated with other
services such as STD and TB screening and treatment,
reproductive health services, mental health services, and drug
use prevention and treatment. Therefore, the Committee urges
CDC to give its HIV Strategic Plan high priority, especially
with regard to behavioral research, development,
implementation, and evaluation of prevention and intervention
programs for at-risk subpopulations, such as racial and ethnic
minorities, adolescents, women, sex workers, substance abusers,
and incarcerated individuals.
The Committee is concerned regarding the level funding
received by the HIV school health program during the last
decade compared to the increased funding for HIV activities.
Significant increases in the HIV epidemic in the United States
during the same period disproportionately affect adolescents
and young adults who can benefit from school and university
based HIV prevention programs. Of the increase provided for
HIV/AIDS programs, the Committee directs CDC to increase school
health HIV funding to a level that is consistent with the
increased cost of living since 1991.
Oral fluid testing is one of the newest and most
revolutionary advances in diagnostic testing. Recent
technological advances have resulted in a rapid oral fluid
test, currently in FDA clinical trials, that will indicate HIV/
AIDS status within 20 minutes. The Committee is aware that,
with some level of attention by the Centers of Disease Control,
this test could be adapted to a variety of infectious diseases,
including those resulting from biological warfare or
bioterrorism.
The Committee is aware of the growing incidence of HIV/AIDS
along the United States-Mexico border and the greater
difficulty health providers have in identifying and treating
individuals in this region. The Committee understands that
University of Texas Health Sciences Center-Houston could
establish a Center for HIV Research and Education to better
understand and respond to the unique demographic
characteristics and needs of this population to help prevent
the further spread of AIDS
Global HIV/AIDS.--CDC's international work is conducted in
collaboration with USAID and other Federal agencies. In fiscal
year 2000 CDC began to implement prevention activities and
programs in 15 countries, including India and 14 countries in
Africa. In fiscal year 2002, CDC will expand activities to
Latin America and other countries in Africa and Asia. The
Committee has included bill language that will allow CDC to
carry out international health activities, including HIV/AIDS.
HIV/AIDS and other diseases such as hepatitis are spread in
sub-Saharan Africa by blood transfusion. Testing sub-Saharan
African blood using FDA approved blood transfusion testing
technologies is important. Since testing will deteriorate the
available blood supply in sub-Saharan Africa, funding for the
development of donor and transfusion facilities with trained
staff would ensure an adequate safe blood supply and safe
transfusion practices. Funding initiatives vis-a-vis blood
testing must include the comprehensive training of African
nationals to staff testing laboratories and donor facilities.
The Committee urges CDC to fund microbicide research and
development within funds provided for global AIDS. These funds
could support clinical trials of microbicides as set forth in
CDC's HIV Prevention Strategic Plan and its topical
microbicides 5-year research agenda.
Sexually transmitted diseases.--CDC's strategy for STD
prevention is to provide national and international leadership
through research, surveillance, policy development, and
assistance to States, territories and local health departments
in the delivery of services to prevent and control the
transmission of STDs and their complications. The Committee
recognizes that this year, more than 15 million Americans will
contract a STD. This epidemic will disproportionately affect
adolescents, women, and people of color. The epidemic will
tally $8,400,000,000 in direct costs, along with immeasurable
human costs in pain and suffering. National surveillance of
syphilis, chlamydia, and gonorrhea is supported, and sentinel
surveillance strategies are being developed for new viral STDs,
specifically, human papillomavirus. Prevention research is
conducted to improve methods and delivery of prevention
services and to develop and refine interventions.
The Committee commends CDC in its work in this area and
recognizes that STD prevention programs are highly effective.
Two major foci of national STD prevention efforts are syphilis
elimination and prevention of STD-related infertility. CDC has
undertaken an initiative to eliminate syphilis in the United
States by 2005 which builds upon existing STD programs and
takes advantage of the opportunity afforded by historic lows in
syphilis rates.
Given the continuing high prevalence of chlamydia in the
United States and the need to expand screening and treatment
efforts, the Committee has included increased funding for this
program and directs that this increase be used to provide
services to all regions of the country, with each region
receiving the same percentage increase.
The Committee is concerned regarding the lack of adequate
surveillance of HIV-STD among American Indian, Alaska Native,
and native Hawaiian populations, and encourages CDC to work in
consultation with tribes, urban programs, and the Indian Health
Service to develop a more effective surveillance strategy.
Tuberculosis Elimination.--CDC works with local, State,
national, and international partners towards the goal of
eliminating TB. In addition to promoting the more effective use
of existing tools for combating TB, CDC is working with NIH and
FDA to develop new diagnostic and treatment tools as well as
better vaccines.
The Committee commends CDC for its continued efforts to
control tuberculosis (TB) in the United States, as demonstrated
by the eighth year of declining TB trends reported for 2000.
However, with the recent release of the Institute of Medicine's
report ``Ending Neglect: the Elimination of Tuberculosis in the
United States,'' the Committee remains concerned about the
threat of TB and multi-drug resistant tuberculosis. The
Committee is also concerned that, until global control efforts
are more effective and new treatments and effective vaccines
are developed, the global crisis on TB will continue to
directly impact the United States. Therefore, the Committee
encourages CDC to continue to work with domestic partners to
maintain strong prevention and control programs. In addition,
the Committee encourages CDC to work with international
partners to assure the success of international control
programs, and to encourage and support, when possible, the
development of new TB treatments and the development of a new
effective TB vaccine.
The Committee is pleased with CDC's program to control TB
along the United States-Mexico border. CDC is collaborating
with the Mexican National Public Health Laboratory Program and
the Association of State and Territorial Public Health
Laboratory Directors to coordinate laboratory training between
United States and Mexican laboratorians. CDC also provides
funding to State and local health departments which supports
several border health activities. The Texas-Mexico bi-national
border projects are designed to reduce TB by co-managing TB
cases and their contacts.
The Committee is aware of the County of San Diego's program
that provides treatment to multi-drug resistant TB patients
along the northern Mexico border with California and encourages
CDC to give full and fair consideration to this program.
Immunization
The Committee recommends $637,145,000 for the program
authorized under section 317 of the Public Health Service Act
which is $84,540,000 above the fiscal year 2001 level and
$62,500,000 above the administration request.
The Omnibus Reconciliation Act [OBRA] of 1993 established a
new vaccine purchase and distribution system that provides,
free of charge, all pediatric vaccines recommended for routine
use by the Advisory Committee on Immunization Practices to all
Medicaid-eligible children, uninsured children, underinsured,
and native Americans through program-registered providers.
Included in the Medicaid estimate for fiscal year 2002 is
$796,193,000 for the purchase and distribution of vaccines,
which when combined with the section 317 discretionary funding
totals $1,370,838,000.
Despite great success in lowering disease levels and
raising immunization coverage rates, much remains to be done to
ensure the protection of children and adults worldwide.
Approximately 1 million 2-year-old children in the United
States have not received one or more of the more established,
recommended vaccines. New vaccines, although greatly beneficial
to public health, complicate an already complex immunization
schedule and make it increasingly difficult to ensure complete
immunization. One of our Nation's greatest challenges is
extending our success in childhood immunization to the adult
population. The burden due to the occurrence of vaccine-
preventable diseases in adults in the United States is
staggering. As many as 50,000 U.S. adults die of influenza,
pneumococcal infections and hepatitis B. CDC is addressing
these obstacles to the greatest extent possible and continues
to provide leadership to reduce disability and death resulting
from diseases that can be prevented through vaccination.
The Committee encourages CDC to increase section 317 grant
support for infrastructure development and purchase of vaccines
for the State of Alaska's universal immunization program. It
has been brought to the Committee's attention that
infrastructure costs of delivering vaccines to children in
Alaska are substantially higher than in other areas of the
country because of the many small, remote communities which
must be served, primarily by air. The Committee encourages the
agency to give careful consideration to Alaska's request for
sufficient funding for the purchase of vaccines needed for 90
percent of Alaskan children and to provide infrastructure
support needed to deliver these vaccines at the community
level, including development of a statewide immunization
registry to ensure that all children in Alaska are immunized.
The Committee notes that the Maine Immunization Registry
Demonstration Project proposes a comprehensive, secure and
detailed technological infrastructure to maintain databases
that enroll children at birth and store information on each
immunization; consolidate scattered immunization records; and
transfer immunization records confidentially to patients' new
providers to prevent the costly and clinically inappropriate
duplication of vaccine administration.
Global Immunization Activities.--Included in the amount for
immunization are funds to continue CDC's global immunization
activities, which include additional funds for polio vaccine
and surveillance to augment support for the highly successful,
yet unfinished polio eradication efforts; support for the
purchase of measles vaccine for measles mortality reduction and
regional measles elimination initiatives and to expand
epidemiologic, laboratory, and programmatic/operational support
to WHO and its member countries; and establishing CDC's program
activities as a partner in the Global Alliance for Vaccines and
Immunization (GAVI). Measles and GAVIactivities should build on
the global disease control and surveillance infrastructure
developed for polio eradication.
Infectious Disease Control
The Committee recommends $331,518,000 for infectious
disease control which is $13,844,000 above the fiscal year 2001
level and the same as the administration request.
These activities focus on: national surveillance of
infectious disease; applied research to develop new or improved
diagnoses; prevention and control strategies; working with
State and local departments and private health care providers
to transfer application of infectious disease prevention
technologies; and strengthening the capability to respond to
outbreaks of new or reemerging disease.
Infectious diseases are a leading cause of death worldwide,
accounting for 1/4 to 1/3 of the estimated 54 million deaths in
1998. Disease outbreaks endanger U.S. citizens at home and
abroad, threaten U.S. Armed Forces overseas, and exacerbate
social and political instability. Outbreaks can interfere with
the global marketplace, affecting tourism, trade, and foreign
investment. CDC's strategies to combat infectious diseases
invest in and build upon both the public health system that was
established over a century ago to increase the preparedness to
address the emergence of dangerous new threats.
The Committee is aware that in 1995, in partnership with
Federal, State, and local agencies, universities, private
industry, foreign governments, the World Health Organization
(WHO), and many non-governmental organizations, CDC launched
the first phase of a nationwide program to revitalize national
capacity to protect the public from infectious disease threats.
The second phase of CDC's effort, ``Preventing Emerging
Infectious Diseases: A Strategy for the 21st Century'',
published in 1998, continues these partnerships to build
domestic and global capacity for recognizing and responding to
infectious diseases.
Approximately 11 million people live along the 2,000-mile
Southwest border between the United States and Mexico in the
States of New Mexico, Texas, Arizona, and California. With
rapid population growth, cross-border interchange, and low
socio-economic status in many border areas, public health and
safety is an ongoing concern. The Committee encourages CDC to
expand its investment in the Border Infectious Diseases
Surveillance (BIDS) program to provide increased personnel,
equipment, training, and technical support to better monitor
public health conditions and safety along the Southwest border.
The Committee recognizes the excellent work being done at
the University of Texas Medical Branch-Galveston and at the
University of Texas Health Center-Tyler in the treatment and
control of infectious disease, particularly along the United
States/Mexico border.
The Committee is aware of the Center for Emerging
Infectious Diseases at the University of New Mexico and its
work in biological detection and intervention against emerging
infectious diseases.
Antimicrobial Resistance Initiative.--The Committee is
concerned about the development of resistance in microbes to
current antimicrobial therapies. Bacterial resistance to common
antimicrobial agents has become one of the most serious
emerging infectious disease threats facing communities and the
health care system in the United States. To combat this
national health threat, the Committee recognizes the need to
discover and develop new pharmaceutical products to combat
these drug resistant microbes. The Committee notes that the
University of Mississippi, a leader in antimicrobial research
and new compound discovery, has been working with CDC on this
issue and urges CDC to give consideration to continuing this
partnership.
The Committee also recognizes the excellent work of
Southern Methodist University in modifying antibiotics to make
them more effective at combating human bacterial infection
without causing antibiotic resistance.
Bacterial Infections.--According to CDC, 65 percent of the
bacterial infections treated by physicians in the developed
world are caused by biofilms. The Committee understands that
the Center for Biofilm Engineering at Montana State University
is prepared to undertake research in the etiology and control
of middle ear infections and encourages CDC to give full and
fair consideration to this proposal.
Food Safety.--CDC established PulseNet in 45 State health
departments. PulseNet is a national network of public health
laboratories that performs DNA ``fingerprinting'' on bacteria
that may be foodborne. The PulseNet network has revolutionized
foodborne disease surveillance by allowing near real-time
comparison of these ``fingerprint'' patterns through an
electronic database at CDC. Matching patterns can indicate
possible nationwide outbreaks and provide an early warning for
public health investigation and intervention. The Committee is
pleased that CDC has developed and implemented a state-of the
art diagnostic and communications system to improve parasitic
disease diagnoses in the United States. This system, known as
DPDx, uses Internet communication to rapidly exchange
diagnostic images of parasites digitally captured from
microscopic slides. Using DPDx, public health laboratories can
obtain diagnostic assistance in real time, allowing for rapid
identification of possible outbreaks.
The Committee is aware of concerns raised within and
outside Alaska about the safety of Alaskan wild foods. The
Committee encourages the agency to give careful consideration
to a State of Alaska program to monitor the safety of Alaskan
wild foods, including field studies of the effects of
environmental chemical contaminants and naturally occurring
metals in Alaskan wild foods, measurement of PCB levels in
remote arctic communities, documentation of mercury levels in
ancient humans, documentation of incidence of childhood asthma,
and development of public health recommendations on Alaskan
wild food consumption by subsistence users and others.
Global Malaria Initiative.--The Committee continues to
recognize the tremendous impact of malaria in the developing
world, and notes malaria's increasing resistance to
antimalarial drugs designed to counter its pervasive effects.
New drugs must be developed, and the Committee urges the CDC to
continue its efforts to lead in new compound discovery. The
Committee notes that the University of Mississippi has been
working collaboratively with the CDC to address research in the
area of malaria, along with TB and HIV/AIDS. The Committee
encourages CDC to give full consideration of these projects and
to continue its important research in this area.
Hawaiian Patients with End Stage Renal Disease.--The
Committee is aware that many Native Hawaiian in rural Hawaii
afflicted with End Stage Renal Disease (ESRD) and on dialysis
have a history of repeated infections that put them at greater
risk for frequent hospitalization. The Committee encourages CDC
to consider a demonstration project in Hawaii to reduce the
incidence of infection in this patient population.
Hepatitis C.--The Committee encourages funding for the
National Hepatitis C Prevention Strategy, a public health
initiative to control and reduce the incidence of Hepatitis C.
This funding will begin to develop State-based programs by
funding public health Hepatitis C coordinators in all 50
States, plus 15 large metropolitan areas and demonstrations in
15 States to learn the most feasible approach to integrating
Hepatitis C and B screening, counseling and referral programs
into the existing HIV-STD State programs. The Committee is
pleased that the demonstrations include funding for screening,
counseling, and referral services, but is concerned that no
such services are funded in the remaining States and that even
the demonstrations only provide the more comprehensive services
in selected areas of the 15 demonstration States. The Committee
therefore requests that the CDC submit by January 15, 2002 an
implementation plan for a full response to the need for
Hepatitis C prevention.
The Committee continues to be highly interested in
supporting the Secretary's ``lookback'' initiatives regarding
screening and counseling for people who may have been infected
with Hepatitis C through blood transfusions before 1992. The
Committee is aware that CDC is supporting an evaluation of the
adequacy of ongoing efforts to screen and counsel these
individuals and believes it is critical that such an assessment
be made at least quarterly and made public. The Committee again
calls on CDC to assure that those potentially infected receive
appropriate counseling and screening and encourages CDC to
develop a centralized national screening program supported by a
toll-free telephone number-based operation, involving risk
assessment, convenient screening and counseling. Under this
program, persons receiving lookback notification letters would
be advised of the hotline service that provides education and
telephone counseling and coordinates convenient testing.
Lyme Disease.--The Committee is deeply concerned about the
safety of the Lyme disease vaccine (LymeRix). Over 1,000
adverse event reports were filed with the Food and Drug
Administration from December 1998 to October 2000. The
Committee encourages CDC to work closely with the FDA to ensure
that all adverse event reports are thoroughly and expeditiously
investigated to ensure public safety as the vaccine is being
distributed. Investigators should pay particular attention to
patients' reports of arthritis when evaluating these reports.
The Committee recognizes that the current state of
laboratory testing for Lyme disease is very poor. The situation
has led many people to be misdiagnosed and delayed proper
treatment. The vaccine clinical trial has documented that more
that one third (36 percent) of the people with Lyme disease did
not test positive on the most sophisticated tests available.
The ramifications of this deficit in terms of unnecessary pain,
suffering and cost is staggering. The Committee directs CDC to
work closely with the Food and Drug Administration to develop
an unequivocal test for Lyme disease.
The Committee is distressed in hearing of the widespread
misuse of the current Lyme disease surveillance case
definition. While the CDC does state that ``this surveillance
case definition was developed for national reporting of Lyme
disease: it is NOT appropriate for clinical diagnosis,'' the
definition is reportedly misused as a standard of care for
healthcare reimbursement, product (test) development, medical
licensing hearings, and other legal cases. The CDC is
encouraged to aggressively pursue and correct the misuse of
this definition. This includes issuing an alert to the public
and physicians, as well as actively issuing letters to places
misusing this definition.
The Committee recommends that the CDC strongly support the
re-examination and broadening of the Lyme disease surveillance
case definition by the Council of State and Territorial
Epidemiologists. Voluntary and patient groups should have input
into this process. Currently there is just one definition
(``confirmed case'') of seven possible categories. By
developing other categories while leaving the current category
intact, the true number of cases being diagnosed and treated
will be more accurately counted, lending to improved public
health planning for finding solutions to the infection.
The CDC is encouraged to include a broad range of
scientific viewpoints in the process of planning and executing
their efforts. This means including community-based clinicians
with extensive experience in treating these patients, voluntary
agencies who have advocacy in their mission, and patient
advocates in planning committees, meetings, and outreach
efforts.
Mosquito surveillance and research.--The Committee urges
the CDC and related State and local mosquito control agencies
participating in CDC research into mosquito borne illnesses to
utilize emerging technologies, including counterflow
technology, in the collection, trapping or surveillance of
mosquitos used in connection with such research. Emerging
technologies developed for trapping mosquitos offer
environmentally sound alternatives that have the potential to
increase the productivity of personnel and enhance the quality
of specimens collected for this research.
Prevention Epicenter Program.--The Committee applauds CDC's
support for the Prevention Epicenter Program and encourages CDC
to continue and expand this program to address patient safety
issues.
Research and Development of Improved Vaccine Delivery
Mechanisms.--Particularly in light of the recent terrorist
attack, there is a pressing need to improve the availability of
vaccines. The Committee is aware of exciting new work by the
Oral Vaccine Institute to develop delivery mechanisms that
allow vaccines currently only administered by injection to be
given orally. These and other potential improvements would
significantly reduce costs, and improve transportability and
ease of storage. The Committee expects CDC to expand its
efforts in this area.
West Nile Virus.--The Committee is aware of CDC's effort to
complete a national plan for West Nile virus response in the
United States. That includes developing a computerized national
surveillance system for West Nile virus and provides funds to
53 health departments to build national capacity to develop and
implement effective surveillance, prevention, and control of
West Nile virus in the United States.
Injury Prevention and Control
The Committee recommends $146,655,000 for injury prevention
and control which is $3,805,000 above the 2001 level and
$3,000,000 above the administration request.
CDC is the lead Federal agency for injury prevention and
control. Programs are designed to prevent premature death and
disability and reduce human suffering and medical costs caused
by: fires and burns; poisoning; drowning; violence; lack of
bicycle helmet use; lack of seatbelt and proper baby seat use;
and other injuries. The national injury control program at CDC
encompasses nonoccupational injury and applied research in
acute care and rehabilitation of the injured. Funds are
utilized for both intramural and extramural research as well as
assisting State and local health agencies in implementing
injury prevention programs. The Committee recognizes the vital
role CDC serves as a focal point for all Federal injury control
activities.
The Committee is aware that accidental injury is the
leading cause of death for Alaska children and teens. The
injury fatality rate for Alaskan children exceeds the national
average by 60 percent. The Committee encourages the agency to
give careful consideration to a proposal by the State of Alaska
to collect and analyze data on injury occurrence,
scientifically examine childhood death, and, working with the
Alaska Injury Prevention Center, provide targeted community-
based interventions to reduce the incidence of childhood injury
and death.
Injuries Among the Elderly.--By 2020, one in six Americans
will be age 65 or older and every day, more than 100 older
persons die from an injury. The three leading causes of injury
deaths among older adults are falls (9,000 per year), motor
vehicle collisions (7,000 per year), and suicide (6,000 per
year). In addition, hundreds of thousands of older adults
suffer non-fatal injuries every year (350,000 from falls;
170,000 from motor vehicle crashes). Many if not most of these
are preventable. The Committee is pleased that CDC and its
public and private partners are making tremendous progress in
injury prevention and control. CDC's strategy includes
implementing successful safety programs into more States,
communities, and businesses; communicating what works to safety
organizations, health care providers, and the public; and
conducting research to find out why people get injured, what
works to prevent injuries, and how to get people to use
interventions that are successful.
Injury Control Research Centers.--The Committee recognizes
the need for an additional Injury Control Research Center in
Federal Region 7, and has included sufficient funds for an
additional injury control center in Iowa. Preference should be
given to applicants with proven injury center experience. The
Committee is aware that injury ranks as one of the Nation's
most pressing health problems accounting for 150,000 deaths and
38 million emergency room visits per year. The Committee
believes that rural populations have special and underserved
needs in injury control. These funds would address the pressing
needs to control morbidity, disability, death, and costs
associated with injury in rural populations.
National Violent Death Reporting System.--In fiscal year
2001, Congress called for CDC to develop a system for more
timely, complete, objective and accurate information about
violent deaths and injuries to inform and evaluate policy and
program efforts. The Committee is pleased that, during the past
year, CDC has worked with the Department of Justice and a
variety of interested groups to develop a model plan to
implement a national violent death reporting system (NVDRS)
that will enable State governments to understand more about the
violence problem in their States. The Committee urges CDC to
begin initial implementation of the Plan and has provided funds
for that purpose.
The Committee is aware of the progress made by the
University of Pennsylvania, which sponsors injury reporting in
Iowa and Ohio, and efforts being made by the University of
Maryland in establishing reporting systems. The Medical College
of Wisconsin and the Harvard School of Public Health are also
developing injury reporting systems. The Committee urges the
CDC to work with private health and education agencies as well
as State agencies, when developing an injury reporting system.
The Committee is pleased with the progress of the
University of Northern Iowa (UNI) in implementing the action
steps described in the National Action Plan for the Prevention
of Playground Injuries and encourages continued support of this
project.
Residential Fire Deaths and Injuries.--Every 10 seconds in
the United States, a residential fire occurs, and every 23
minutes a residential fire injures a human being. In addition,
445,000 burn victims miss more than half a day of work or
school and residential fires cause $5,000,000,000 in direct
property damage each year. Yet, deaths from fires are
preventable and CDC's research indicates that installing smoke
alarms and educating residents about fire safety can reduce
deaths by as much as 50-80 percent. The Committee urges CDC to
continue its efforts to increase the use of smoke alarms
especially among under served and minority populations.
Trauma Care.--The Trauma Information and Exchange Program
(TIEP) stands to serve as the first-ever national clearinghouse
on trauma statistics, enabling trauma physicians, emergency
care coordinators and public health officials to determine and
respond to trauma trends such as geographical variations among
injuries, age-related injuries, and variations among rural
versus urban/suburban environments. A fully operational TIEP
will enhance prevention, amelioration, and treatment of injury
and the reduction of injury-related disability and death across
the Nation. The Committee continues to be supportive of the
work of the American Trauma Society.
The Committee recognizes that the scope of the ``National
Study on Costs and Outcomes of Trauma Care'' has expanded since
it was initially designed, and encourages CDC to expand and
complete this effort. The expanded study would include greater
analysis of trauma care, critical examination of patient care
outcomes, and a broader range of patients analyzed, paying
particular attention to elderly populations.
The Committee is aware of the importance of the ongoing
National Study on Costs and Outcomes of Trauma Care currently
being conducted by Harborview Medical Center in Seattle,
Washington and John Hopkins University.
Youth Violence.--The Committee is acutely concerned about
school shootings and similar violent acts among our youth. The
Committee is also aware of the progress made by the agencies in
coordinating youth violence efforts and requests that the CDC
coordinate their efforts with the Domestic Policy Council and
continue to work with the National Institute of Child Health
and Human Development and the Substance Abuse and Mental Health
Services Administration to develop a collaborative program in
this regard. The Committee is pleased that the CDC focused a
portion of their research efforts to discover approaches to
intervene and prevent the complex behavior problems in children
and youth which utilize molecular neuroscience, brain mapping,
and behavioral analysis.
Occupational Safety and Health
The Committee recommends $276,135,000 for occupational
safety and health programs which is $16,001,000 above the 2001
level and $10,000,000 above the administration budget.
The CDC's National Institute for Occupational Safety and
Health (NIOSH), is the only Federal agency responsible for
conducting research and making recommendations for the
prevention of work-related illness and injury. The NIOSH
mission spans the spectrum of activities necessary for the
prevention of work-related illness, injury, disability, and
death by gathering information, conducting scientific
biomedical research (both applied and basic), and translating
the knowledge gained into products and services that impact
workers in settings from corporate offices to constructions
sites to coal mines.
The Committee encourages NIOSH to give full consideration
to establishing a center on environmental toxins at the
University of Hawaii at Hilo.
National Occupational Research Agenda.--The continuing need
for occupational safety and health research, both public and
private, led NIOSH to work with the occupational safety and
health community to create the National Occupational Research
Agenda (NORA) in 1996. Now in its 5th year, NORA has become the
largest stakeholder-based research agenda in the United States,
targeting 21 research priorities considered by the Nation's
occupational safety and health community as most essential for
improving the safety and health of the U.S. work force.
Approximately 500 organizations and individuals outside of
NIOSH provided input into the development of the agenda. These
efforts have led to the evolution of more efficient and
effective ways to conduct research within NIOSH, the growth of
NIOSH's extramural programs, and the expansion of occupational
safety and health research in other government agencies.
The Committee is pleased that research conducted by NIOSH
scientists is producing information of practical importance to
millions of workers and their employers. For example, recent
laboratory findings have confirmed the ability of common
solvents to cause hearing damage, revealed the mechanisms by
which inhaled metal dusts may be causing lung cancer, and
determined the physical characteristics of inhaled fibers that
cause occupational lung diseases. Engineering research
identified effective technology for protecting workers from
chemical emissions in automobile repair, lifting injuries in
nursing homes and beverage delivery, and hazardous dusts in
construction and mining.
Aviation Safety.--The Committee continues to be pleased
that the National Transportation Safety Board has taken an
aggressive approach to address the recent rash of injuries and
deaths from aircraft accidents in Alaska. It supports
continuation of the joint interagency initiative which involves
the Federal Aviation Administration, the NTSB, and the National
Institute of Occupational Safety and Health. The Committee
encourages NIOSH to continue to implement the Board's
recommendations to improve aviation safety in Alaska.
Construction Safety and Health.--The Committee once again
is very pleased with the progress that NIOSH has made in its
program directed at occupational illnesses and injuries in the
building and construction industry. According to the Bureau of
Labor Statistics, the rate of serious illnesses and injuries in
construction has dropped 32 percent from 1992 to 1997. The
Committee is also pleased by NIOSH's new focus on active
intervention to prevent occupational injury and illness in the
construction industry, and the National Occupational Research
Agenda (NORA) for establishing research priorities. However,
the Committee is concerned with the continued high fatality
rate in the industry, and has included funds to continue the
program at no less than current levels.
The Committee is aware that the Construction Safety
Alliance (CSA), a consortium of universities that include the
University of Texas at Austin, the University of Florida at
Gainesville, the University of Cincinnati in Ohio, and Purdue
University in Indiana is conducting research to develop and
implement a national program in construction safety and health.
The Alliance will develop epidemiologic methods of studying
injuries and illnesses and evaluating methods of prevention.
Education and Research Centers.--The Committee commends the
work of the 15 university-based Education and Research Centers
(ERC's) and the smaller single discipline Training Project
Grants (TPG's). These regional centers are integral to the
Nation's efforts to improve the health and safety of working
men and women, and important to the future efforts of NIOSH to
implement the National Occupational Research Agenda (NORA). The
Committee has provided sufficient funding for the ERCs to
expand research activities in support of implementation of the
National Occupational Research Agenda (NORA).
Emergency Workers.--The Committee believes that significant
work must continue to protect emergency responders from
biological and chemical terrorism exposures. Fire fighters,
emergency medical personnel, and other on-site workers need
reliable personal protective equipment, principally
respirators, but also protective clothing and detection devices
to be able to effectively help victims in case of exposure to
biological and chemical terrorist agents. The Committee urges
the NIOSH to carry out research and related activities aimed at
protecting workers, who respond to public health needs in the
event of a terrorist incident. The Committee further urges
NIOSH to move forward quickly with a chemical and biological
respirator certification standard. The Committee requests CDC
to report to the Committee on its progress before next year's
budget hearings.
Farm Health and Safety.--The Committee has included funding
to continue the farm health and safety initiative. This
important initiative, begun in fiscal year 1990, has a primary
focus of reducing the incidence of fatal and nonfatal injuries
and occupational diseases among the millions of agricultural
workers and their families in the United States. The Committee
is particularly pleased with the research being undertaken by
the Agricultural Research Centers.
Maine Fishing Industry.--The Committee is aware of the loss
of life in Maine's fishing industry in the last 18 months and
urges NIOSH to work with the State of Maine to address
occupational safety and health in the commercial fishing
industry.
Mine Safety Research.--The fatality rate for the mining
industry continues to be excessive and is more than five times
greater than the national average for all industry segments.
The primary causes of mining fatalities are associated with
ground falls, equipment operation and powered-haulage systems.
The Committee recognizes that the mine safety and health
research programs address these and other issues in the mining
industry and continue as a high priority for NIOSH. The
Committee is pleased with CDC's recent accomplishment to
develop a load rate warning system for mobile roof supports.
Retreat mining in underground coal mines is one of the more
hazardous operations and the adoption of this mining strategy
has increased significantly following the development of mobile
roof supports. These supports replaced wooden timbers for roof
support and have dramatically increased the productivity of the
mining operation. The mobile roof supports may become
overloaded depending upon the specific mining conditions and
failure of the systems is often dramatic and catastrophic. The
development of a warning system has been adopted by the
industry and is now commercially available by the major
manufacturer of the systems.
Sleep Disorders.--The Committee is aware that sleepiness,
as a result of either untreated sleep disorders or simple sleep
deprivation, has been identified as a causal factor in many
chronic diseases as well as a growing number of vehicular and
on-the-job injuries. Sleep deprivation is also a growing
problem for high school students, the largest at-risk group for
fall-asleep car crashes, as well as police officers and medical
residents.
The Committee encourages CDC to develop and begin
implementation of a 5-year sleep awareness action plan designed
to develop public health programs regarding sleepiness and
sleep disorders nationwide.
Workplace Violence.--The Committee recognizes that
workplace violence is a major national occupational priority
and that it is the second leading cause of workplace deaths
among women workers. The Committee further recognizes that
several hundred workers die each year as victims of workplace
violence, that at least 2 million workers suffer from injuries
that result from workplace violence, and that the health care
costs, lost productivity and countermeasure costs run into the
billions of dollars. The Committee has included increased
funding for NIOSH to develop an intramural and extramural
prevention research program that will target all aspects of
workplace violence and to coordinate its efforts with the
Departments of Justice and Labor.
Preventive Health and Health Services Block Grant
The Committee recommends $135,030,000 for the preventive
health and health services block grant which is the same as the
2001 level and the administration's request.
The Preventive Health and Health Services Block Grant
provides States with funds for services to reduce preventable
morbidity and mortality to improve the quality of life. The
Block Grant is the primary source of funding to States for
health education and risk reduction activities; cholesterol,
hypertension, and cancer screening; and programs to prevent sex
offenses. The strategy of the Block Grant is to provide States
with flexibility to tailor prevention and health promotion
programs to their health priority needs. Block Grant funding
enables States to provide money for developing new programs;
fund essential services that would otherwise go unfunded; and
address urgent, rapidly developing health hazards such as
disease outbreaks or environmental disasters.
Public Health Improvement
The Committee recommends $114,910,000 for public health
improvement which is $4,021,000 above the fiscal year 2001
level and $5,000,000 above the administration request.
Our national public health system is the first line of
defense against preventable disease and disability. Virtually
every health problem in our communities--infectious disease
outbreaks, chemical hazards, chronic diseases, and injuries--is
first recognized by local public health professionals, who must
work in concert with State and national officials to control
these threats, prevent spread, and save lives. Despite steady
increases and shifts in the U.S. population there has been a
decline in the number of public health workers per capita in
the past decade. Schools of Public Health and Preventive
Medicine report that the majority of graduates do not seek
employment in public health agencies. Only an estimated 44
percent of the Nation's current 448,000 public health
practitioners have had formal training in public health. One-
half of all public health nurses--the largest profession in
public health--lack a baccalaureate nursing degree. The
majority of public and private laboratory scientists lack
access to continuing education and training essential to using
the cascade of new, high-technology laboratory tests accurately
and safely.
Minority Health Disparities.--This program is intended to
help racial and ethnic minority communities mobilize and
organize their resources to support effective and sustainable
programs that will contribute to the elimination of health
disparities in the following six target health areas: infant
mortality, breast and cervical cancer screening and management,
cardiovascular disease, diabetes, HIV infection and AIDS, and
child and adult immunizations. REACH 2010 is a 2-phased, 5-year
demonstration project. Phase I is a 12-month planning phase to
support planning and development of demonstration programs.
Phase II is a 4-year implementation and evaluation phase. The
Committee is pleased with CDC's commitment to the REACH 2010
Program. The planning (Phase I) communities currently are
establishing infrastructure to support community-level data
collection, establishing collaborative partnerships,
establishing linkages with other state and local agencies, and
working with Federal agencies and other partners to identify
promising prevention strategies that have the greatest
potential for reducing the health disparities in the target
populations.
National Electronic Disease Surveillance System.--Accurate,
timely health information is a critical component of all
effective prevention and control efforts. Yet, only 55 percent
of local health departments have high-speed, continuous
Internet access for finding the most recent health guidelines
and recommendations. Only 56 percent can successfully receive
broadcast health alerts. Only 50 percent have access to
community health information critical for setting priorities,
taking effective actions, and tracking improvements in health
status. The Committee is pleased with CDC's work to integrate
disease detection and monitoring to ensure rapid reporting and
follow-up.
Phytomedicines.--Millions of U.S. citizens consume dietary
supplements regularly. But there is no formal mechanism for
reporting adverse events that may be associated with the use of
such products, including events that may be linked to
inappropriate use or interactions with drugs or foods. The
Committee recognizes that development, implementation, and
oversight of such a system must necessarily involve expertise
in pharmaceutical care, disease management, monitoring and
surveillance, and the chemistry and biology of natural
products.
Prevention Research.--The CDC Office of Extramural
Prevention Research sponsors peer-reviewed research conducted
by academic researchers who are linked with State and local
health agencies to develop improved interventions and services.
Extramural investigators are located in leading schools of
public health, medical schools, State health departments, and
other academic and practice-based organizations. Translation of
research findings into information, guidelines, and tools for
front-line public health practitioners are an integral part of
the program and will be facilitated through existing and new
partnerships between CDC's Public Health Practice Program
Office and public health practice organizations. In addition to
supporting high-priority prevention research projects, the
Office of Extramural Prevention Research is a focal point for
CDC's extramural research partners, aids development of
practice-oriented CDC prevention research agendas, promotes use
of rigorous peer-review processes for extramural research, and
facilitates dissemination of research findings and translation
of findings into action.
The Committee supports CDC's efforts to expand prevention
research. There are many areas of research that can pay
dividends in both improved health and reduced health care
costs. The Committee expects more of these funds to be used to
support research on ways to prevent disease and disability in
rural areas and to better utilize nurses and allied health
professionals in prevention and health promotion efforts.
As more and more Americans use alternative and
complementary therapies to maintain and improve their health,
there is a growing need for better consumer information about
these therapies. The Committee is encouraged with CDC's plans
to initiate an expansion of their effort in this area.
Practice-based assessments and the identification and study of
promising and heavily used complementary and alternative
therapies and practices should be undertaken and results
published. The Committee expects CDC to collaborate with the
National Center for Complementary and Alternative Medicine to
assure that its efforts complement efforts by this Center.
The Committee has also included funds to research the
antioxidant and anti-adhesion effects of Vaccinium
proanthocyanidins from native North American fruit for possible
prevention or treatment of cardiovascular disease and diseases
or conditions caused by microbial pathogens such as ulcers,
urinary tract infections and various diseases of the ear, nose
and throat.
Recognizing the importance of pediatric sleep disorders,
last year the Committee included language encouraging CDC to
allocate increased funding for research on these problems. The
Committee is aware of Kosair Children's Hospital's Sleep
Medicine Center and the University of Louisville's Multi-
Disciplinary Early Childhood Research Center's research to
improve the prevention, diagnosis, and treatment of sleep
disorders in children.
The Committee is aware of the social, economic, and health
disparities in Mississippi and that health-related
interventions and programs should reflect the findings of
individualized community assessments, and that measurements of
resulting outcomes must evolve from a research design framed
around the problem, the intervention, and the appropriate
evaluation methodologies. The Committee recognizes that it is
through research-based outcomes that health care planners and
policy makers can best respond to the real needs of citizens.
The Committee is aware of the development of the Research
Center of Excellence located in Mississippi and recommends the
utilization of the Mississippi Research Center of Excellence to
offer its assessment and evaluation expertise to identify
community health care needs and wants.
The Committee is aware of the Tulane and Xavier
Universities request for funding for research on environmental
signals and work on biosensors and biomarkers which will
identify hazards in the environment that may cause damage to
humans.
The Committee is aware of the Vermont Oxford Network,
located in Burlington, Vermont, and it efforts to improve the
quality of health care available to children born prematurely
through the reduction of medical errors.
The Committee urges CDC to give full and fair consideration
to these proposals.
Buildings and Facilities
The Committee recommendation includes $250,000,000 for the
planning, design, and construction of new facilities as well as
the repair and renovation of existing CDC facilities. This is
$75,000,000 above the fiscal year 2001 level and $100,000,000
above the administration request.
While making progress on addressing the many problems
caused by its buildings and facilities, CDC continues to carry
out its mission with clearly inadequate laboratories, support
facilities, and security infrastructure. As the Committee noted
last year, CDC's buildings and facilities create serious
problems regarding employee safety and interfere with the
ability of the agency to carry out its mission in an efficient
and effective manner. Some facilities are more than 40 years
past their original life expectancy and should be replaced,
while others are in great need of complete renovation.
The Committee directs CDC to continue full implementation
of the agency's 10 year buildings and facilities Master Plan.
As provided by the Committee last year, CDC should use the
enhanced contracting language provided in the bill to
accelerate the start of new projects. This authority has
acquired greater urgency in light of recent events impacting
the security of Federal facilities. It is also the same
authority that has allowed the National Institutes of Health to
move forward quickly on the Clinical Center. The Committee is
particularly interested in ensuring that the agency improves
communications and distance training of local public health
professionals in State and local health departments throughout
the country. These institutions are the first line of defense
in the event of bioterrorism and naturally occurring adverse
health events, whether caused by infectious disease agents,
chemical exposures, or changes in the population. CDC should
focus efforts on constructing a Communications Center as soon
as possible during fiscal year 2002 to address these
challenges.
Additionally, the Committee directs CDC to either start or
continue the planning, design or construction of the following
projects in the Master Plan: the Emerging Infectious Disease
Laboratory and its required Central Utility Plant/
infrastructure; the Environmental Toxicology Laboratory and its
required Central Utility Plant/infrastructure; the Scientific
Communications Center; Phase I infrastructure, design, and
construction of the East Campus Consolidated Laboratory
Project; the Worker Safety and Injury Prevention facility at
the Roybal Campus; the Environmental Health facility at the
Chamblee Campus; the Transshipment facility and related
infrastructure at the Roybal Campus; and repairs and
improvements of CDC's nationwide inventory of facilities.
Office of the Director
The Committee recommends $49,440,000 for the Office of the
Director which is $7,919,000 above the fiscal year 2001 level
and the same as the administration request.
The Office of the Director (OD) manages and directs
programs of the CDC. OD provides leadership, advises on policy
matters, and develops and evaluates progress of goals and
objectives related to disease prevention and control. OD
provides direction and coordination to the epidemiologic
activities of CDC and coordinates CDC's response to health
emergencies. In addition, OD coordinates and manages programs
on global health activities, minority health, and women's
health relating to disease prevention and control.
The Committee is pleased to learn that CDC has embarked on
an aggressive Financial Management Excellence Initiative to
improve fiscal management practices in four key areas that
include: simplifying and streamlining the current fiscal
structure, identifying new systems to share fiscal information
throughout the agency, appointing senior level finance and
accounting staff to provide leadership, and investing in
education and training for financial management staff. The
Committee recognizes that CDC's commitment to improving their
financial management practices is consistent with the findings
and recommendations of independent auditors who collaborated
closely with the GAO in conducting a management review. The
Committee recognizes that continuing improvement in CDC's
financial management practices requires replacement of the
agency's financial system with an enterprise-wide business
solution. It is expected the new financial system will increase
productivity and improve performance of the CDC's financial
management practices. The Committee also recognizes and
commends CDC for simplifying its budget structure at the
recommendation of both an outside financial auditor and the
Appropriations Subcommittee. The simplification includes
changes in the presentation of the All Purpose Table and
associated sub-budget activities. The change also adds
transparency to CDC's very complex operating structure.
The Committee notes that the Mississippi's Delta is a
community with residents who disproportionately experience
disease risk factors and have children who are significantly
behind national averages for mental and physical development.
The best hope for breaking the cycle of poor health in the
Mississippi Delta is through a community health education
program directed at individuals, families, and communities. The
Committee believes that collaboration between Delta State
University, the University of Mississippi Medical Center,
University of Mississippi School of Nursing, and the
Mississippi State Department of Health with CDC will promote
coordinated consolidation of health and human services that
will positively impact the education, health, and economics of
this region.
The Committee encourages the CDC to support the
Environmental and Public Health Alliance to perform necessary
public health service during the 2002 Winter Olympics.
Bioterrorism
The Committee recommends $181,919,000 for preparation,
infrastructure and public health response to the threat of
bioterrorism which is $1,000,000 above the fiscal year 2001
level and the same as the administration request.
The events of September 11, 2001 have made it clear that we
must begin to look at our public health system as part of our
national defense system against biological attacks. The
Committee plans to work with the administration to craft a
supplemental appropriation bill that will address the needs of
our State and local health departments as our first line of
defense against bioterrorism and to provide CDC with the needed
resources to coordinate a national plan. The Committee has
included the President's request for bioterrorism but realizes
that more funds are necessary and will address those needs in
the supplemental appropriation.
As scientific and technological advances increase the ease
with which individuals are able to access and weaponize
biological and chemical agents, the potential for bioterrorism
continues to threaten the health of the U.S. public.
Furthermore, factors such as genetic engineering, ambiguous
relationships among certain foreign states, and decreasing
biologic resistance to smallpox in the U.S. population
contribute to this national concern. A strong public health
infrastructure will result in a rapid, effective response,
thereby, minimizing morbidity and mortality associated with
such a bioterrorism event. An attack could result in a huge
volume of patients and a corresponding need for large
quantities of medical supplies and therapeutics, diagnostic
tests, and hospital beds that could overwhelm public health
capacity. Emergency responders, health care workers, and public
health officials could be at special risk, and public fear of
contagion could be high. U.S. capacity to respond quickly and
effectively to biological or chemical terrorist threats depends
on strong local capacity for public health surveillance, rapid
laboratory diagnosis, and outbreak response.
The Committee is aware of a proposal by the University of
Louisville to develop a plan for the comprehensive integration
of all essential activities in preparation for an attack that
could serve as a template for medium-sized cities throughout
the Nation. The Committee is encouraged that the surveillance
and control capabilities generated under this proposal and
other proposals would also produce helpful applications in the
detection of other emerging pathogens, such as West Nile Virus,
or the response to an outbreak of pandemic influenza.
The Committee is pleased with the progress of the CDC and
other public health agencies to prepare for the potential for a
domestic biochemical terrorist attack, but remains concerned
about the ability of many public health entities to accurately
identify biochemical agents in human victims. The Committee is
aware of a training and first responder training program
utilizing human patient simulators being conducted by the
National Emergency Response and Rescue Training Center.
The Committee continues to support the work of the
University of Texas, Medical Branch--Galveston National Rapid
Response Bioterrorism Defense Center, which has been at the
forefront of developing drugs to counter hazardous viruses that
could be used by terrorists.
National Pharmaceutical Stockpile.--The National
Pharmaceutical Stockpile has been established to assure rapid
availability of pharmaceuticals, supplies and medical equipment
in the event of a bioterrorism or chemical incident. The
Committee was pleased by the rapid deployment of materials from
the stockpile to New York following the September 11, 2001
terrorist attacks, and strongly supports the continued
maintenance and expansion of the stockpile so that it will
continue to be available and effective when requested.
National Institutes of Health
The fruits of medical research have proved to be among this
Nation's greatest achievements. Countless saved lives, new
cures and treatments, and a thriving biomedical research
industry are all the result of a long-standing Federal
investment in improving people's health. Americans today are
living longer than ever. Life expectancy at birth was less than
50 years in 1900; it is 77 years today. Life expectancy at age
65 was about 11 years in the first half of the 20th century;
today, it is 17. Medical research has also improved the quality
of those added years of life, as reflected by the steady
decline of disabilities and other impairments among the elderly
population. By another measure, basic research has stimulated
immeasurable economic dividends in the form of new products,
skilled jobs, and increased productivity. In sum, the Nation's
investments in this area have directly benefited the lives of
millions of Americans while reaffirming the central tenet of
our democratic society: to protect the value and the sanctity
of every individual.
The unparalleled scientific advances of the past, however,
are not self-sustaining--nor is the promise of future
breakthroughs self-fulfilling. Despite remarkable progress,
there are new and growing challenges to confront. Infectious
diseases are now the second-leading cause of death worldwide.
At least 20 well-known diseases--including tuberculosis,
malaria, and cholera--have reemerged as major threats to
health, while 30 previously unknown disease agents have been
identified. On another front, while society's overall health
status has improved, troubling disparities persist among
African Americans, Hispanics, Native Americans, Alaskan
natives, Asians, and Pacific Islanders. The graying of America
is another area of concern. Ten years from now, 75 million baby
boomers will begin to turn 65. By 2050, the number of Americans
over 65 will more than double, and the number of individuals
over 85 will grow five-fold. With that demographic explosion
comes greater risk of disease and disability, as well as
enormous strain on Medicare, Medicaid, and the Nation's health
care infrastructure.
But there is also good cause to hope for the future. The
Human Genome Project has revolutionized our understanding of
the fundamental mechanisms of life. As scientists learn more
about how to decipher our DNA code, 95 percent of which has now
been sequenced, we can look forward to a day when genetic tests
will routinely predict a person's susceptibility to disease;
diagnoses will be far more precise; treatments will attack
diseases at the molecular level; and drugs will be matched to a
patient's likely response.
The Committee has a long tradition of support for the NIH,
the single largest source for medical research funding. In
1998, the Committee played a lead role in launching an effort
to double funding for the NIH by fiscal year 2003. That
decision was rooted in the firm belief that sustained and
sufficient funding is essential to accelerate the pace of
research advances, ensure the timely application of new
discoveries into clinical practice, and maintain the Nation's
research infrastructure. At the same time, the Committee notes
that an investment of this magnitude demands accountability.
The NIH must preserve a rigorous system for determining
research priorities and for selecting those most qualified to
pursue those priorities. And it must monitor research conducted
with taxpayer dollars to ensure it is carried out ethically,
responsibly and consistent with the research funding award.
The Committee recommends $23,695,260,000 for the NIH, an
increase of $3,400,000,000 over the fiscal year 2001
appropriation and $748,358,000 more than the budget request.
This amount maintains the goal of doubling funding for the NIH
by fiscal year 2003.
NATIONAL CANCER INSTITUTE
Appropriations, 2001.................................... $3,716,064,000
Budget estimate, 2002................................... 4,153,398,000
Committee recommendation................................ 4,258,516,000
The Committee recommends an appropriation of $4,258,516,000
for the National Cancer Institute [NCI]. This is $105,118,000
more than the budget request and $542,452,000 more than the
fiscal year 2001 appropriation. The comparable amounts for the
budget estimate include funds to be transferred from the Office
of AIDS Research.
Mission.--The NCI conducts and supports basic and applied
cancer research in prevention, early detection, diagnosis,
treatment, and rehabilitation. The Institute provides training
support for research scientists, clinicians, and educators, and
maintains a national network of cancer centers, clinical
cooperative groups, community clinical oncology programs,
cancer prevention and control initiatives, and outreach
programs to rapidly translate basic research findings into
clinical practice.
The Committee continues to regard scientific investigation
into the cause, cure, prevention, and treatment of cancer as
one of the Nation's top priorities. Research offers the only
hope for putting a stop to a disease that wastes precious human
resources and contributes to spiraling health care costs.
Behavioral science research.--The Committee commends NCI
for expanding its infrastructure to fund behavioral and
population research in cancer prevention, treatment, and
control. NCI is encouraged to expand its investigation of the
effective provision of mental health services to improve the
course of cancer treatment and to aid in the adjustment to
cancer survivorship. NCI is also encouraged to build upon its
collaborations with the National Institute on Drug Abuse to
more thoroughly investigate issues of youth tobacco use. In
particular, the Committee is interested in expanding health
promotion research focused on children and youth, and
interdisciplinary research on tobacco addiction and cessation.
The Committee also encourages NCI to expand its research on
adherence to treatment regimens and to health-promoting
behaviors such as physical activity and healthy diet.
Blood cancers.--The Committee is interested in NCI's
upcoming Progress Review Group report on leukemia, lymphoma,
and multiple myeloma, and it is eager to know what research
strategies NCI is pursuing to improve treatments for these
blood cancers. In particular, the Committee urges NCI to expand
its research on myelodysplasia, a serious blood disorder
affecting primarily older adults and individuals who have
previously undergone radiation or chemotherapy treatment for
cancer.
The Committee has listened to testimony about the
devastating effects that multiple myeloma has on its victims
and recognizes that, despite recent advances, median survival
for patients responding to treatment is only 3 to 5 years. The
Committee urges continued research and effort to seek new and
better treatment for this disease. The Committee also requests
that the NCI and NIEHS develop a joint report by April 1, 2002,
on the progress of lymphoma and hematological cancer research.
The report should address how the PRG has determined funds will
be expended to expand the current base of lymphoma and
hematological cancer research.
Bone metastasis.--The Committee encourages NCI to conduct
research to develop a better understanding of the unique role
the bone microenvironment plays in metastatis of cancer to
bone, in particular, breast cancer, prostate cancer and
myeloma. The Committee also encourages NCI to support research
on the development of animal models of bone metastasis and the
identification of novel therapeutic targets and modalities to
prevent and treat bone metastases.
Brain tumors.--The Committee is concerned that insufficient
attention is being given by NCI and the National Institute for
Neurological Diseases and Stroke (NINDS) to brain tumor
research. The recently issued report of the NCI/NINDS-sponsored
Brain Tumor Progress Review Group has called for substantially
greater effort into this little-understood area of tumor
research and treatment. The Committee encourages NCI to fund at
least three Specialized Program of Research Excellence in Brain
Tumors (SPORE) grants in the upcoming fiscal year, with
particular emphasis on those proposals which include both basic
research and clinical treatment applications.
Breast cancer.--The Committee continues to be concerned
over the disparity in breast cancer mortality and morbidity
among African-American women. The Committee therefore
encourages the NCI to report to Congress by April 1, 2002,
about existing efforts, as well as planned future efforts, to
better understand and respond to this disturbing phenomenon.
The Committee is aware of the importance of restoring
sensitivity of tumor cells to standard chemotherapy drugs by
reversing the effects of low oxygen stress on the cells. Cancer
researchers have developed methods of achieving this important
scientific tool, and the Committee encourages the NCI to
consider this important research.
Breast implants.--The Committee encourages the NCI to
continue to collect and analyze data from the women in its
three recent studies of the health risks of breast implants, to
determine whether there is a link between breast implants and
breast cancer, other cancers, or mortality from all causes.
Cancer and minorities.--The Committee remains concerned
over recent statistics citing higher incidences of cancer among
the native Hawaiian population. In comparison to other ethnic
and racial groups, native Hawaiians have the highest incidence
of the most common forms of cancer such as breast, colon, and
lung cancer. The Committee encourages continued research in the
areas of prevention and detection, utilizing nurse
practitioners in community-based centers for screening and
education for the underserved populations.
Cancer centers.--The Committee recognizes the high quality
of care provided by NCI-designated Cancer Centers, but notes
that many cancer patients must travel great distances to
receive care from these centers. In addition, many other
smaller institutions provide excellent patient care, perform
high-caliber basic research, address unique cancer prevention
and treatment issues, and lend great expertise to cancer
treatment and control. The Committee encourages the NCI to
further expand their Cancer Centers Program and give full
consideration to applicants that care for a large number of
underserved patients from rural and economically distressed
areas.
Cancer gene therapy.--With the sequencing of the human
genome nearly complete, the challenge is no longer to identify
genes but to understand the functions of these genes in order
to find cures and treatments for cancer--especially prostate,
breast and pancreatic cancer. As a result, the Committee and
the NCI have previously supported cancer genomics projects that
investigate the role of oncogenes in the CaSm, Ets 2 and ESF
genes. The Committee expects the NCI to continue these projects
with the goal of identifying potential cancer therapies.
Chronic lymphocytic leukemia (CLL).--The Committee, during
its fiscal year 2002 hearings, heard compelling testimony from
patients regarding the devastating effects of chronic
lymphocytic leukemia (CLL). This disease has evaded a
satisfying cure, as only 50 percent of patients with CLL
survive 6 years and only 25 percent survive 10 years. The
Committee urges the NCI to increase research on CLL, its
underlying cause, and improved therapies. The Committee is
pleased to learn that the NCI awarded a program project grant
last year to establish and lead a multidisciplinary national
research consortium to study CLL at both the cellular and
clinical levels. The Committee strongly encourages the NCI to
give full and fair consideration to expanding the scope of
research activities funded through the CLL Research Consortium
and the participating partners involved.
Complementary and alternative cancer therapies.--The
Committee expects NCI to expand its work and its collaborative
efforts with the National Center for Complementary and
Alternative Medicine to support research on promising
complementary and alternative cancer therapies as well as on
their integration with traditional therapies. Thousands of
Americans are turning to these therapies, and consumers will
benefit from a rigorous scientific review of them.
DES.--The Committee continues to strongly support increased
efforts to study and educate the public and health
professionals about the impact of exposure to the synthetic
hormone diethylstilbestrol (DES). The Committee expects NCI to
continue its support of research in this area. In addition, the
Committee urges NCI to continue its agreement with CDC to
implement a national education program for consumers and health
professionals. The Committee expects NCI and these other
agencies to continue to consult with organizations representing
individuals impacted by DES as they carry out DES research and
education efforts.
Gynecologic cancer.--Ovarian cancer remains one of the
deadliest cancers for women, in part due to the lack of
effective early screening methods. The Committee strongly urges
NCI to expedite current research on screening methods to
detect, diagnose, and identify staging of ovarian cancer. The
Committee is pleased that NCI has fully funded four ovarian
cancer SPOREs, and it encourages the Institute to consider
issuing a new request for applications for additional ovarian
cancer SPOREs. The Committee also believes that identification
of a cost-effective screening strategy could result in earlier
diagnosis for women and higher cure rates. NCI is strongly
urged to accelerate research in this area.
Healthy eating.--The Committee commends the NCI's national
5-A-Day program. The Committee recognizes that a diet including
a minimum of five servings of fruits and vegetables is a
critical factor in reducing cancer risk. The Committee
encourages NCI to fund behavioral research on how best to
promote healthy eating, especially fruit and vegetable
consumption. New research projects could include, but not be
limited to (a) children and adolescents, the general adult
population, policymakers, and low-income and disparate groups,
especially African Americans and Latinos; (b) program channels
such as the mass media, restaurants, supermarkets, schools, and
faith organizations; and (c) transfer of already-developed
technologies to other units and levels of government and to
non-profit, civic, and other organizations.
Hepatocellular carcinoma.--The Committee is aware that the
incidence of hepatocellular carcinoma in the United States has
increased by more than 70 percent in the last two decades.
Given the limited treatment options available, most cases are
fatal. Viral hepatitis is the leading predisposing factor
contributing to this affliction. With 4 million Americans
infected with hepatitis C virus, it is predicted that the
incidence of hepatocellular carcinoma will continue to
increase. The Committee is aware that too little is known about
the mechanisms and natural history of this disease. The
Committee, therefore, strongly encourages the NCI to work
closely with the NIDDK to develop a comprehensive liver cancer
research initiative to investigate prevention, diagnosis, and
therapy.
Imaging systems technologies.--The Committee is encouraged
by progress made by NCI following its August 1999 conference on
biomedical imaging, and it urges NCI to continue to take a
leadership role with the Health Care Financing Administration
and the Food and Drug Administration to avoid duplicative
reviews of new imaging technologies that may prevent their
benefits from reaching patients on a timely basis. The
Committee is aware of the great potential for improved patient
care and disease management represented by molecular imaging
technologies, especially positron emission tomography (PET).
The Committee continues to support NCI's increased emphasis on
examining the molecular basis of disease through imaging
technologies such as PET and MicroPET. The Committee continues
to encourage the large-scale testing of women for breast cancer
and of men for prostate cancer to demonstrate and quantify the
increased diagnostic and staging capabilities of PET relative
to conventional diagnostic and staging technologies, including
mammography.
Melanoma.--The Committee is aware of numerous epidemiologic
accounts and personal stories of melanoma. The Committee
believes that public knowledge of overexposure to sunlight and
its connection with melanoma may be lacking. The Committee
urges the NCI to continue seeking new therapies for melanoma as
well as educate the public through campaigns that encourage
appropriate protection from sunlight.
National cancer registries.--The Committee encourages the
Registries program to establish, with the States, high-risk
registries for the digestive cancers (liver, pancreatic) and
other cancers with significantly low survival rates following
diagnosis.
Neurofibromatosis (NF).--Neurofibromatosis research has
significant potential for cancer patients since NF genes have
been implicated in the signaling process that determines cell
growth and cell differentiation. The Committee encourages NCI
to strengthen its NF research portfolio in such areas as
further development of animal models, natural history studies,
therapeutic experimentation and clinical trials.
Neurological cancer.--The Committee is pleased to learn of
innovative research on the uniformly fatal brain cancer
glioblastoma multiorme. Investigators have developed a
transgenic mouse model in which tumor growth can be reduced by
replacing a new gene that helps transport the brain chemical
glutamate. The Committee is also aware of the importance of
this research in the study of epilepsy. The Committee
encourages the NCI to take note of these exciting developments.
Pancreatic cancer.--The Committee commends NCI for its
report on the Pancreatic Cancer Progress Review Group. The
Committee urges the NCI to develop a professional judgment
budget in line with the Progress Review Group for the period
from fiscal year 2003 to fiscal year 2008. This budget should
be presented to the Committee by April 1, 2002. In addition,
the Committee encourages NCI to develop an initiative to raise
the awareness of pancreatic cancer in the general public and
the research community.
Population health.--The Committee congratulates the NCI for
building and nurturing an infrastructure to support rigorous
community-based research. Community-based research makes it
possible for interventions developed at taxpayer expense to
reach the greatest number of people. The National Research
Council has called attention to the need for additional
research at multiple levels of analysis (individual, family,
community) that integrates population health dynamics with
behavioral, psychosocial, and environmental factors. One
challenge is the development of methodologies that can enable
such multilevel analyses. The Committee encourages NCI to
continue its leadership in this area.
Primary immunodeficiencies (PI).--The Committee notes that
NCI held a symposium in March 2000 concerning the relationship
between primary immunodeficiencies and cancer. The symposium
showed, among other things, that PI patients have a 200 times
greater risk of developing cancer (including lymphomas) than
someone without PI. The Committee strongly encourages the
Institute to develop a comprehensive research portfolio on the
basis of the data generated at that conference and to supply
the Committee with a report concerning its research plans not
later than April 1, 2002. In addition, NCI is urged to greatly
expand its role in the national education and awareness
campaign sponsored by the Jeffrey Modell Foundation.
Prostate cancer.--The Committee believes that prostate
cancer research has not kept pace with the scientific
opportunities and the proportion of the male population who are
afflicted with the disease. This has resulted in significant
gaps in scientific and clinical knowledge that contribute to
the ongoing impact of prostate cancer on patients and their
families. NIH has begun to address this shortcoming in the 5-
year prostate cancer research strategy presented to Congress in
June 1999. The Committee strongly urges the NIH to renew its
commitment to prostate cancer research with special emphasis on
accelerating new avenues for basic research, drug development
and clinical research. The Committee further requests that NIH
submit a prostate research plan for fiscal year 2003 to fiscal
year 2008 by April 1, 2002. In developing this plan, the
Committee urges the NIH to consult and work closely with the
research community, clinicians, patient advocacy groups and the
Congress.
The Committee is aware of a novel DNA-based tumor vaccine
that has proven effective in pre-clinical, phase I and phase II
studies for the treatment of advanced prostate cancer. The
Committee is also aware of complementary research in prostate
cancer treatment using Cox-2 inhibitors. The Committee
encourages NCI to explore the use of these important research
initiatives.
Transdisciplinary tobacco use research centers.--The
Committee commends the Institute for its collaboration with the
National Institute on Drug Abuse and private foundations in
establishing seven new Transdisciplinary Tobacco Use Research
Centers. These Centers establish critical links across diverse
scientific disciplines in order to evaluate new models of
nicotine addiction; heredity factors in vulnerability,
treatment success, and deleterious consequences of tobacco use;
cultural determinants of successful prevention efforts;
treatment-resistant populations; and determinants of relapse.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
Appropriations, 2001.................................... $2,287,015,000
Budget estimate, 2002................................... 2,554,319,000
Committee recommendation................................ 2,618,966,000
The Committee recommendation includes $2,618,966,000 for
the National Heart, Lung, and Blood Institute [NHLBI]. This is
$64,647,000 more than the budget request and $331,951,000 more
than the fiscal year 2001 appropriation. The comparable amounts
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--The National Heart, Lung, and Blood Institute
provides leadership for a national research program in diseases
of the heart, blood vessels, lungs and blood, in transfusion
medicine, and in sleep disorders through support of innovative
basic, clinical, population-based, and health education
research.
Advanced imaging technology for heart disease and stroke.--
The Committee is aware that heart perfusion PET scans using
Rubidium-82 are considered the ``gold standard'' for
determining the extent of muscle damage to the heart following
a heart attack. The ability of the heart to survive an event is
a biochemical question that can be determined through PET,
which is biological imaging. The Committee encourages NHLBI to
expand its research efforts into the role of biological imaging
and PET in delivering more accurate information to determine
appropriate treatment for heart disease patients.
Alpha-1.--The Committee is aware that Alpha-1 Antitrypsin
Deficiency is a genetic disorder that can result in devastating
and fatal lung and or liver disease that is often misdiagnosed
as asthma or Chronic Obstructive Pulmonary Disease (COPD).
Alpha-1 is a major cause of lung transplantation in adults. The
Committee encourages the NHLBI to expand its resources
dedicated to researching and raising awareness of this
devastating disorder.
Bone formation and cardiovascular disease.--The Committee
is aware that calcium is an early marker of atherosclerosis
involving the arterial wall. Evidence suggests an association
between bone formation, repair and breakdown (e.g.
osteoporosis) and development of heart disease and other
cardiovascular diseases. The Committee encourages the NHLBI to
explore basic research in this area that may result in
strategies to prevent osteoporosis and cardiovascular diseases.
Cardiovascular diseases.--The Committee continues to regard
research into the causes, cure, prevention and treatment of
heart disease, stroke and other cardiovascular diseases as one
of the Nation's top priorities. The Committee is alarmed that
an expert panel, convened in 1999 at the request of this
Committee, reports that progress in reducing the death rate
from cardiovascular diseases has slowed and that there are
striking differences in these death rates by race/ethnicity,
socioeconomic status and geography, suggesting that new
strategies are needed to control these diseases. The Committee
continues to believe that an intensive research program on
heart disease, stroke and other cardiovascular diseases should
be a priority of the NHLBI and of the NIH.
Children's heart defects.--Congenital heart defects are the
most prevalent birth defect in the United States today. More
than 32,000 babies--1 out of every 115 births--are born each
year with congenital heart defects. The Committee encourages
the NHLBI to research the issue of newborn screening for such
defects in order to develop improved and cost-effective
methodologies for heart screening and for the proper training
of physicians.
Cholesterol.--It has been brought to the Committee's
attention that immunizing rabbits and mice against their own
LDL (``bad'') cholesterol can significantly reduce arterial
plaque build-up despite very high cholesterol levels in the
blood. Further work is needed to bring this concept to human
testing and application, and identify which part of the LDL-
cholesterol molecule provokes a protective immune response will
be necessary. The Committee urges the Institute to facilitate
research in this area.
Cooley's anemia.--The Committee continues to be pleased
with the outstanding progress being made by the Thalassemia
Clinical Research Network, which is comprised of the leading
research centers in North America on thalassemia, the medical
term for Cooley's anemia, as well as with the leadership of
NHLBI. The Committee understands that the Network is currently
prioritizing the wide variety of potential research areas that
are ripe for investigation. NHLBI and NIDDK should submit a
joint report to the Committee on the work of the Network and,
in general, the work they are doing that is of direct benefit
to thalassemia patients by April 1, 2002.
Cord blood.--The Committee recognizes the advances that are
being made in the use of life-saving hematopoietic stem cells
and the growing use of umbilical cord blood and placental blood
as rich sources of these cells. The Committee is aware of the
success of cord blood stem cell transplants in treating
diseases such as leukemia, lymphoma, severe aplastic anemia and
sickle cell disease. The Committee urges the NHLBI to support
research on umbilical cord blood and cord blood stem cells to
determine the nature of their capabilities, to identify their
similarities and differences to stem cells from other sources,
and to understand the mechanisms of differentiation.
Heart disease, stroke and other cardiovascular diseases in
women.--Cardiovascular diseases remain a major cause of
disability and the leading cause of death of American females.
The clinical course of cardiovascular disease is different in
women than in men, and current diagnostic capabilities are less
accurate in women than in men. Despite the seriousness of these
diseases in women, they are largely unrecognized both by women
and their doctors. The Committee urges the NHLBI to expand
cardiovascular disease research in women, including studies to
develop safe, efficient and cost-effective diagnostic
approaches for women, and to create more informational and
educational programs for women patients and health care
providers on heart disease and stroke risk factors.
Hemophilia.--The Committee commends NHLBI for the
significant support it has provided for hemophilia gene therapy
research, and it urges the Institute to continue this and other
efforts to address the needs of persons with hemophilia and
bleeding disorders, including blood and blood product safety,
treatment of hepatitis C and other complications, and women's
bleeding disorders. The Committee is concerned about the
increasing shortage of trained hematology specialists to
translate research discoveries into the treatment of hemophilia
and prevention of its complications. The Committee urges NHLBI
to work with the National Hemophilia Foundation to pursue
strategies for addressing this critical issue.
Juvenile diabetes.--Vascular complications including
cardiovascular, peripheral vascular, and cerebrovascular are a
major cause of mortality and morbidity in persons with
diabetes--particular in those with juvenile diabetes. NHLBI is
encouraged to launch major initiatives in diabetic-specific
vascular complications, with emphasis on the accelerate
pathways seen in juvenile diabetes, in order to develop
effective treatments and prevention. NHLBI should consider
newer therapeutic modalities, including gene therapy, and build
upon the growing understanding of angiogenesis. The Institute
should also consider collaborating with NIDDK to assess the
genetics of complications of juvenile diabetes, understand gene
function in individuals with diabetes who have serious and
life-threatening complications, and help develop more effective
therapeutic interventions.
National Asthma Education and Prevention Program (NAEPP).--
The Committee commends the National Asthma Education and
Prevention Program (NAEPP) for its leadership in helping to
educate physicians, asthma patients, their families and the
general public regarding asthma and asthma management. The
Children's Health Act of 2000 authorized NAEPP to develop, in
conjunction with other Federal agencies and voluntary and
professional health organizations, a Federal plan to respond to
asthma. The Committee urges NHLBI to move forward as
expeditiously as possible.
Pediatric Asthma Network.--The Committee recognizes that
little is known about the optimal treatment for asthma in
infants and young children. For example, it is still unknown
what the most effective dose and type of medicine would be for
different types of asthma and whether early therapy can prevent
asthma. The Committee urges the NHLBI to consider the research
amassed through the Pediatric Asthma Clinical Research Network
to provide clearer choices for childhood asthma therapy, to
encourage the development of new therapies, and to identify
optimum asthma-management strategies for children.
Primary pulmonary hypertension.--Primary pulmonary
hypertension (PPH) is a rare, progressive, and fatal disease
that predominantly affects women. PPH causes deadly
deterioration of the heart and lungs and is a secondary
condition in many other serious disorders, such as scleroderma
and lupus. The Committee supports continued, high-quality
research in this area and urges the Institute to increase
funding for basic research, gene therapy, and clinical trials
or promising pharmaceuticals.
Sickle cell anemia.--Sickle cell anemia is an inherited
condition that is particularly prevalent among African
Americans. While there is no cure for sickle cell anemia,
several promising developments have occurred to improve the
quality of life of sickle cell patients, and the Committee
encourages the Institute to carry out further research.
Transfusion medicine.--The Committee supports the
establishment of a clinical research network in transfusion
medicine and hemostasis, which would attract and train much-
needed clinicians to hematology, while at the same time
enabling patients with non-malignant blood disorders to
participate in high-quality clinical protocols.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Appropriations, 2001.................................... $304,606,000
Budget estimate, 2002................................... 340,158,000
Committee recommendation................................ 348,767,000
The Committee recommendation includes $348,767,000 for the
National Institute of Dental and Craniofacial Research [NIDCR].
This is $8,609,000 more than the budget request and $44,161,000
more than the fiscal year 2001 appropriation. The comparable
amounts for the budget estimate include funds to be transferred
from the Office of AIDS Research.
Mission.--The NIDCR supports research and research training
to improve the oral health of the American people. The
Institute emphasizes ways to prevent disease in high-risk
groups, including the elderly, minority populations, and
individuals with medical conditions and medications that
compromise oral health. The research agenda includes studies of
craniofacial genes and birth defects; bone and joint diseases;
AIDS, other infections, and immunity; oral cancer; chronic
pain; epidemiology; biomaterials; and diagnostic systems.
Dental caries.--The Committee is concerned about the
exceptionally high rate of severe dental caries suffered by
American Indian children. Within the funds provided, the
Committee encourages the NIDCR to support long-term research of
the etiology and pathogenesis of dental caries in these
populations. The Committee also encourages NIDCR to conduct
clinical research trials on effective ways to control severe
caries in American Indian children.
Fibrous dysplasia.--The Committee is aware that the NIDCR
is playing a critical role in studies of fibrous dysplasia. In
particular, the Committee is aware of NIDCR support for studies
on drugs and surgical procedures to treat fibrous dysplasia.
The Committee understands that one of the key problems faced by
people with fibrous dysplasia is the lack of medical
professionals who know and understand the disease. Therefore,
the Committee encourages the NIDCR to work with other
institutes to highlight and expand these activities in fibrous
dysplasia and other bone research.
Head and neck cancer.--Head and neck cancer has serious and
debilitating effects on quality of life. Surgical treatment
often leaves patients with impaired speech, eating
difficulties, and severe disfigurement. The Institute is
encouraged to support basic, clinical, and translational
research to advance techniques for replacing bony structures of
the head and face, and restoring sensory and motor functions of
the reconstructed structures.
Osteoporosis.--Given that osteoporosis and related bone
diseases affect millions of Americans, the Committee encourages
NIDCR to enhance its research efforts to compare bone loss in
the oral cavity with bone loss elsewhere in the body. The
Committee also encourages NIDCR to enhance research on
dentinogenesis imperfecta and orthodontic manipulation in
individuals with osteogenesis imperfecta.
Temporomandibular joint disorders (TMJ).--The Committee is
aware that the research portfolio on temporomandibular diseases
and disorders includes extensive studies on the psychological
and behavioral factors in the etiology or chronicity of TMJ
diseases and disorders. The Committee urges the Institute to
broaden its scientific base for TMJ research by putting greater
emphasis on basic and clinical research on normal and abnormal
structural and functional features of the joint and related
structures, using the tools of cell and molecular biology as
well as advanced imaging techniques. The Committee expects
NIDCR to collaborate on this research with the National
Institute of Arthritis and Musculoskeletal and Skin Diseases,
the National Institute of Allergy and Infectious Diseases, and
the National Institute of Biomedical Imaging and
Bioengineering.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
Appropriations, 2001.................................... $1,302,798,000
Budget estimate, 2002................................... 1,456,996,000
Committee recommendation................................ 1,501,476,000
The Committee recommends an appropriation of $1,501,476,000
for the National Institute of Diabetes and Digestive and Kidney
Diseases [NIDDK]. This is $44,480,000 more than the
administration's request and $198,678,000 more than the fiscal
year 2001 appropriation. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The NIDDK provides leadership for a national
program in three major disease categories: diabetes,
endocrinology, and metabolic diseases; digestive diseases and
nutrition; and kidney, urologic, and hematologic diseases. The
NIDDK plans, conducts, fosters, and supports a coordinated
program of fundamental and clinical research and demonstration
projects relating to the causes, prevention, diagnosis, and
treatment of diseases within these categories. The Institute
also supports efforts to transfer the knowledge gained from its
research program to health professionals, patients, and the
general public.
Adult stem cell research.--The Committee is aware of the
rapidly developing field of research in adult stem cell
plasticity, and it encourages NIDDK to work with the American
Society of Hematology in determining the next steps for
realizing the full potential of adult stem cell biology in
curing disease.
The Committee encourages the National Institutes of Health
to continue working with the Office of Naval Research to
support research to develop curative therapies for patients
with breast cancer, leukemia, lymphoma, and sickle cell
disease, and for victims of radiation, chemical, and biological
exposure.
Benign prostatic hypertrophy.--The Committee is aware that
benign prostatic hypertrophy affects more than 12 million men
over age 50. Although new treatments have become available,
there is still a poor understanding of the factors that affect
prostate growth. The Committee encourages NIDDK to stimulate
additional work and to capitalize on developments in other
fields of science through additional funding. The Committee
further encourages NIDDK to focus more attention on the bladder
and urethral changes in response to the enlarged prostate.
Bladder disease.--More than 1 of every 10 Americans suffers
from bladder disease, 1 in 9 women will require bladder-related
surgery, and patients continue to be added as the population
ages. The Committee believes that these needs must be met with
a strong commitment to fund research concerning bladder
disease. The Committee is also pleased by NIDDK's issuance of
an RFA related to urinary incontinence. While these steps are
important, the Committee remains concerned about the funding
level for research in bladder disease. The Committee urges the
Institute to finalize a long-term research strategy based upon
the recommendations of the Bladder Research Progress Review
Group convened in 2001. The Committee supports increased
bladder disease research by any available means, and encourages
the Institute to consider initiating and maintaining a National
Cell/Tissue Archive for Bladder Disease.
Crohn's disease.--The Committee is concerned about the
increasing frequency of regional enteritis (Crohn's disease) in
the United States. The Committee is aware of the complicated
etiology of this disease, which involves immunologic,
infectious, and dietary factors. The Committee supports further
research into Crohn's disease that may lead to better treatment
of this chronic illness.
Complementary and alternative medicine treatments.--
Complementary and alternative medicine treatments for liver
diseases are becoming more common despite limited evidence of
safety and efficacy. The Committee is aware that the NIDDK,
working with the NCCAM, has begun funding studies of some of
these treatments. The Committee urges the NIDDK to continue
supporting this research and ensure that the public is aware of
the results.
Congenital urological disorders.--The Committee is aware
that urology problems that are present at birth result in
significant physical and psychological stress for both the
parents and the child. The Committee urges NIDDK to collaborate
with other interested institutes in developing a strategic
research plan to address congenital urological disorders in the
pediatric age group, and to initiate new, innovative research
projects in areas such as ureteral reflux, fetal
hydronephrosis, and bladder dysfunction of spina bifida.
Cooley's anemia.--The Committee continues to support
strongly the work being done in NIDDK to advance treatments for
Cooley's anemia in the fields of iron measurement, fetal
hemoglobin, iron chelation, and more. The April 2001 iron
measurement workshop helped to set a direction for future
research. In addition, the development of HBED, a more
efficient iron chelator, under an NIDDK contract holds great
promise to improve treatment and compliance. NIDDK and NHLBI
should submit a joint report on the work they are conducting
that is of direct benefit to thalassemia patients by April 1,
2002. In addition, the Committee would like NIDDK to encourage
greater investigator-initiated research in this area.
Diabetes in native Hawaiians.--The Committee recognizes the
Institute's interest in studying the incidence of diabetes in
native American, Hawaiian, and Alaskan populations, and
encourages NIDDK to include native Hawaiian and Alaskan
populations, the Mississippi Band of the Choctaw Indians, and
the Eastern Band of the Cherokee Indians in diabetes studies.
Diabetic macular edema.--The Committee urges the Director
of NIDDK to consider the National Eye Institute's new
multicenter clinical trial initiative on diabetic macular
edema, a major cause of visual loss in patients with diabetes,
when allocating the special funds targeted for diabetes made
available to the Department.
Digestive cancers.--The Committee is pleased with the NCI
Progress Review Group on Pancreatic Cancer and urges the NIDDK
to collaborate with NCI on mutual research areas and awareness
programs for the scientific and lay communities. The Committee
urges NIDDK to establish translational research activities to
understand the inter-relationships of pancreatitis, diabetes,
and pancreatac cancer.
Digestive diseases.--Diseases of the digestive system, such
as colorectal cancer, inflammatory bowel disease, irritable
bowel syndrome, and hepatitis, continue to affect more than
one-half of all Americans at some time in their lives. The
Committee continues to encourage NIDDK to strike an appropriate
balance between conducting basic studies on digestive diseases
and bringing those research findings to the bedside in the form
of improved patient care. The Committee recognizes the success
of NIDDK's Digestive Disease Centers program in addressing a
wide range of disorders that result in tremendous human
suffering and economic cost. The Committee continues to
encourage NIDDK to expand this important program with an
increased emphasis on inflammatory bowel disease.
Drug-induced liver disease.--The Committee is aware of the
findings of a recent NIDDK-sponsored workshop that discussed
the most appropriate response to the growing problem of drug-
induced liver injury. Liver injury due to over-the-counter and
prescription drugs is an increasingly frequent cause of acute
and chronic liver disease and is the single most common cause
of acute liver failure in the United States. The Committee
urges the NIDDK, in cooperation with other appropriate
Institutes and the pharmaceutical industry, to establish a
national surveillance system to further document hepatotoxicity
of medications and to fund research to prevent and treat this
serious cause of liver injury.
Glomerular injury research.--The Committee urges NIDDK to
expand its research efforts on glomerular injury, a group of
diseases which affect the filtering mechanisms of the kidney.
The Committee is pleased that in addition to basic research
being conducted, NIDDK is working to initiate several clinical
trials related to glomerular injury. Further, the Committee
encourages NIDDK to consider initiating a consensus development
conference on glomerular injury research, and to explore
support for gathering prevalence data on glomerular injury.
Hepatitis C.--The Committee is encouraged that the HALT-
Hepatitis C Clinical Trial should yield important information
about the relatively low response rates to current hepatitis C
treatments. The Committee is concerned, however, with the
slower than expected progress to enroll patients in the
clinical trial. The Committee has also learned that 10
promising ancillary research projects have been developed,
which is more than anticipated. The Committee therefore
requests a report by April 1, 2002, on the timetable, new
findings and additional resources that may be necessary to
complete the HALT-Hepatitis C clinical trial.
The Committee is also aware that the prevalence of
hepatitis C in African Americans is more than two times greater
than in Caucasians and that African Americans have a poor
response rate to treatments. The Committee encourages the
Institute to establish the appropriate number of clinical trial
centers and a data-coordinating center to study the impact of
the hepatitis C virus infection and the variable response to
treatment in different human hosts. The Committee also urges
the Institute to collaborate with the National Center on
Minority Health and Health Disparities on this issue.
Hereditary hemochromatosis.--Hereditary hemochromatosis,
the most common genetic disease in human beings, is associated
with identified genetic mutations in 70 to 90 percent of cases.
The Committee urges the Institute, working with NHLBI, to
expand research funding on this common disease with particular
emphasis on screening, early diagnosis, and the still-unknown
genetic mutations that cause 10 to 30 percent of cases.
Inflammatory bowel disease.--The Committee has been
encouraged in recent years by discoveries related to Crohn's
disease and ulcerative colitis, collectively known as
inflammatory bowel disease (IBD). The Committee commends NIDDK
for its leadership in this area and encourages the Institute to
give priority consideration to the following areas of IBD
research; (1) investigation into the cellular, molecular and
genetic structure of IBD, (2) identification of the genes that
determine susceptibility or resistance to IBD in various
patient subgroups, and (3) coordination and integration of
basic investigations designed to clarify mechanisms of action
and disease pathogenesis into clinical trials, as described in
the research agenda developed by the scientific community
titled ``Challenges in Inflammatory Bowel Disease.'' The
Committee believes that NIDDK should review the current
intestinal transplantation procedures and make future
recommendations on how they could be improved. It also
encourages the Institute to implement a long-range research
agenda to adequately fund research into the cause of and a cure
for IBD and short bowel syndrome.
Interstitial cystitis.--The Committee is aware that there
is unprecedented momentum in interstitial cystitis research,
particularly in the area of urinary markers. The Committee
urges the NIDDK to aggressively support research that will
enhance these recent advances. The Committee is pleased that
the NIDDK convened a Bladder Research Review Group in 2001 to
create a strategic plan and set research priorities for all
aspects of bladder disease, including IC. The Committee urges
that the strategic plan's recommendations regarding IC be
implemented and fully funded as soon as possible. The Committee
is pleased with the progress of the IC Clinical Trials group
and it urges the NIDDK to re-compete the trials at the end of
the current grant period. Since patients with IC frequently get
multiple disorders, the Committee also encourages the NIDDK to
support collaborative research on IC that includes urologists,
neurologists, geneticists, and specialists in visceral pain,
vulvodynia, irritable bowel syndrome, and irritable bowel
disease
Irritable bowel syndrome.--The Committee remains concerned
about the increasing frequency of irritable bowel syndrome
(IBS), a chronic complex of disorders that malign the digestive
system. The Committee encourages NIDDK to provide adequate
funding for irritable bowel syndrome/functional bowel disorders
research and to give priority consideration to funding IBS
education/scientific symposiums. Moreover, the Committee urges
NIDDK to work with CDC and the private sector to initiate an
IBS public awareness campaign.
Juvenile diabetes.--The Committee wishes to commend NIDDK
for its leadership in implementing the juvenile diabetes
research funding approved by Congress last year. The Committee
hopes that NIDDK's juvenile diabetes research portfolio will
include such areas as vaccine development, the creation of
genomics/bioinformatic capability, initiatives to enhance
research training for juvenile diabetes, and the vigorous
pursuit of the most promising scientific opportunities to
develop alternative sources of insulin-producing beta cells for
therapeutic replacement.
Kidney disease clinical research.--It has been brought to
the Committee's attention that the lack of a permanent
infrastructure for clinical trials to study kidney disease is
hampering the translation of basic research discoveries to the
bedside. In order to provide an organizational framework, the
Committee urges the NIDDK to make resources available to plan
the development of a Cooperative Clinical Trials Group Program
for Kidney Disease Research.
Liver transplantation.--The Committee is aware of the
significant and continuing shortage of livers available for
transplantation, and therefore urges additional research that
would facilitate the success of liver transplantation and the
number of livers available for transplantation. Many believe
that the use of living liver donors may be one of the most
important surgical and scientific breakthroughs that can assist
people in the need of liver transplants.
Mucopolysaccharidosis (MPS).--The Committee encourages the
NIDDK to expand research efforts in the development of
effective treatments for MPS disorders. The Committee
encourages the Institute to pursue research addressing
genotype-phenotype studies, the blood brain barrier, cell
biology, pathophysiology of brain damage and substrate
deprivation as they relate to MPS disorders. The Committee
urges the NIDDK, NINDS, and NICHD to engage in collaborative
research efforts and enhance grant support for current studies
as well as new efforts to develop effective therapies for these
deadly disorders.
Neurological disorder-associated bladder dysfunction.--The
Committee encourages NIDDK to increase funding into the
effective treatment of bladder dysfunction associated with
spinal cord injury and neurological diseases. The Committee
urges NIDDK to investigate the most effective methods of
treatment and new and innovative approaches to treatment.
Non-alcoholic steatohepatitis.--Non-alcoholic
steatohepatitis liver disease (NASH) is the second-most common
cause of liver disease after hepatitis C. The disease is often
unrecognized and undiagnosed, and it leads to cirrhosis and
liver failure. The Committee urges the Institute to initiate a
long-term epidemiological study including research focused on
treatment options and outcomes for NASH.
Obesity.--Obesity is a major health threat in the United
States, with more than 49 million American adults considered
clinically obese. The Committee urges the NIDDK to expand
research in this area, particularly into the effects of obesity
on gene expression, as well as excessive risk of
gastrointestinal cancers, including colon cancer and liver
disease. The Committee also encourages NIDDK to support
research in the role of GI hormones, motility, and mucosal
absorption in the complex balances of satiety, nutrient uptake
and calorie and energy balance. Finally, the Committee urges
NIDDK to support research into the effect of diet and nutrient
intake on metabolism and gene function to provide further
insight into how nutrients conversely affect gut function.
Osteoporosis and related bone disorders.--The Committee
urges NIDDK to enhance research on osteoporosis, primary
hyperparathyroidism and other disorders of calcium metabolism,
including renal osteodystrophy, a disorder affecting
individuals suffering from chronic kidney disease. NIDDK is
also encouraged to enhance its efforts in the areas of
nutritional and hormonal influences on calcium and skeletal
status and functional genomics in bone. The Committee urges
NIDDK to work with NCI to focus on cancer that spreads to bone.
Parity for kidney research.--The Committee is concerned
that the resources available to conduct kidney research are not
keeping pace with inflation. The Committee urges the NIDDK to
review the current funding policy and provide increased funding
for kidney disease research.
Pediatric kidney disease.--The Committee remains concerned
over the alarming number of children and adolescents suffering
from kidney disease, a disproportionate number of whom are
minorities. In calling for greater research emphasis on this
vulnerable segment of our population, the Committee notes that
chronic kidney failure among young people results in
particularly severe consequences. Normal growth and development
are impaired, and many scientists believe that chronic kidney
failure has a profound effect on the developing brain, often
resulting in learning disabilities and mental retardation. The
Committee urges NIDDK to sharpen its research focus on both
congenital and acquired chronic renal failure, including: the
molecular mechanisms underlying growth failure in children with
kidney failure; hypertension as a risk factor for
cardiovascular and renal disease; and the development of a
database of genetic renal diseases. Additionally, NIDDK is
encouraged to launch new training initiatives to help ease the
workforce shortage in this field.
Pediatric liver disease.--The Committee is aware of the
``Pediatric Liver Research Agenda 2000: A Blueprint for the
Future'' developed by the Children's Liver Council of the
American Liver Foundation, which defines research priorities
for biliary atresia. Although rare, biliary atresia is the most
common cause of liver transplantation in children. Since too
few patients are seen annually at individual centers, a
collaborative network of centers is needed to gather sufficient
data and study specific hypotheses of the cause and treatment
of biliary atresia. The Committee encourages the Institute to
establish clinical centers and a data-coordinating center to
address the scourge of biliary atresia.
Phytotherapy.--The Committee is aware of the increasing use
of patient self-administered phytotherapy (saw palmetto) to
treat benign prostatic hypertrophy. However, there is little
information available to clinicians or patients regarding the
relative safety and effectiveness of this therapy. The
Committee encourages NIDDK to move forward on clinical trials
aimed at aiding the public and urologists better understanding
whether or not there is a role for phytotherapy in treating
benign prostatic hypertrophy.
Polycystic kidney disease (PKD).--The Committee is
encouraged that the number and significance of research
discoveries leading to a treatment and cure for PKD are growing
at a rapid pace and that notable breakthroughs are coming from
the four P-50 PKD research centers established last year by
NIDDK. The Committee is also pleased that the NIDDK is planning
an International Scientific Workshop focusing on clinical
aspects of PKD and an RFA for a PKD Interventional Trials
Network, both in early fiscal year 2002. The Committee
recommends that the NIDDK fund and execute the PKD Strategic
Plan without delay.
Training programs for physicians.--The Committee is aware
of the need to encourage physicians who wish to pursue careers
in the epidemiology of urologic disease and in the development
and conduct of urological clinical trials. The Committee
encourages NIDDK to initiate a training program to meet these
needs.
Urinary incontinence.--The Committee urges the NIDDK to
significantly enhance its support of urinary incontinence
research following the recommendations from the Bladder
Progress Review Group. The Committee encourages the NIDDK to
elevate its focus on urinary incontinence research by expanding
its support to the Urinary Incontinence Treatment Network
Initiative by increasing the number of clinical sites.
Urinary tract obstruction.--The Committee is encouraged
that the NIDDK will hold a workshop on obstructive uropathy and
reflux in infancy and early childhood. Urinary tract
obstruction, if left untreated, can result in progressive,
irreversible loss of kidney function and end-stage renal
disease.
Urologic disorders and diabetes.--The Committee is aware of
urological complications such as impotence and urinary
retention associated with diabetes. The Committee encourages
NIDDK to examine these aspects of diabetes and asks that NIDDK
provide the Committee with its plan to address this problem.
Urological disorders affecting women.--The Committee is
aware that urological disorders affect millions of women of all
ages. Urinary incontinence is a major cause of nursing home
admissions for women. The Committee encourages NIDDK to support
research targeted to these problems that may substantially
prolong the ability of many elderly women to remain in their
homes.
Urology research.--The Committee is concerned that the
urology research effort is not addressing the large public
health impact of urological diseases and conditions. The
Committee encourages NIDDK to increase funding for existing
programs in urology research at a growth rate similar to that
for the overall agency budget. The Committee is also aware of
the significant progress made at the George M. O'Brien Kidney
and Urology Research Centers of the NIDDK. The Committee urges
continued and increased funding for their activities. In
addition, the Committee encourages the creation of two new
urologic centers, both of which should have a clinical
component and a research training component.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Appropriations, 2001.................................... $1,172,132,000
Budget estimate, 2002................................... 1,311,179,000
Committee recommendation................................ 1,352,055,000
The Committee recommends an appropriation of $1,352,055,000
for the National Institute of Neurological Disorders and Stroke
[NINDS]. This is $40,876,000 more than the budget request and
$179,923,000 more than the fiscal year 2001 appropriation. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--The NINDS conducts and supports a broad range of
research and research training on the normal function of the
brain, spinal cord, and peripheral nerves, and on neurological
and neuromuscular disorders. Neurological research includes
epidemiology studies to identify risk factors for disease;
laboratory studies to examine the structure and function of
nerve cells; and brain imaging studies to understand how the
brain is affected by disease and how it operates to carry out
tasks such as learning and memory. New approaches for the
diagnosis, treatment, and prevention of brain disorders are
evaluated in studies with patients and those at risk for brain
disorders.
Alzheimer's disease.--NINDS continues to play an integral
role in advancing science's understanding of Alzheimer's, a
progressive brain disorder that results in memory loss,
behavior and personality changes, and a decline in thinking
abilities. Working collaboratively with NIA, NINDS-supported
researchers found that cortical degeneration, or brain atrophy,
was 20 to 25 percent greater in patients with Alzheimer's,
confirming this as the major basis for cognitive decline in
Alzheimer's patients. The Committee encourages NINDS to treat
Alzheimer's research as a high priority, and to continue to
work closely with NIA and other research Institutes.
The Committee is aware that positron emission tomography
(PET) has been shown to identify Alzheimer's disease at a
significantly earlier stage than other diagnostic methods.
Earlier diagnosis of Alzheimer's allows for added treatment
options which may delay the onset of the more debilitating
aspects of this disease. The Committee urges NINDS, in
collaboration with the National Institute on Aging and the
National Institute of Mental Health, to expand its research
into early diagnosis of Alzheimer's using PET imaging of the
brain.
Amyotropic Lateral Sclerosis (ALS).--Also known as Lou
Gehrig's Disease, ALS is a progressive, fatal, neurological
disease that attacks specialized nerve cells that control the
movement of voluntary muscles. Findings with respect to ALS can
lead to methods for prevention and treatment of many other
neurodegenerative disorders, including Parkinson's,
Alzheimer's, Huntington's, and multiple sclerosis. The
Committee encourages the Institute to continue to expand and
intensify its research efforts into ALS.
Batten disease.--The Committee is disappointed with the
pace of research in Batten disease. The Committee believes that
the Institute should actively solicit grant applications for
Batten disease and also take aggressive steps to assure that a
vigorous research program is established. In recent years,
funding for this disease has decreased. The Committee strongly
urges that increased funding be provided to combat this
devastating disease.
Brachial plexus injuries.--The Committee understands that
injury to the nerves of the brachial plexus, which control the
muscles of the shoulder, arm, elbow, wrist, hand, and fingers,
can result in full to partial paralysis. While these injuries
most often occur during the birthing process at a rate of 2-3
of every 1,000 births, traumatic injury is another cause.
Although many affected individuals recover without
intervention, and others can be helped with surgery, some
experience permanent nerve damage. The Committee encourages
NINDS to continue an aggressive program of nerve regeneration
research, which should have benefits that can be applied to
these injuries as well as to other forms of damage to the
peripheral and central nervous systems.
Brain tumors.--The Committee is concerned that not enough
attention is being given by NINDS to identifying causes of and
treatments for brain tumors, and it encourages NINDS to
continue working with NCI to carry out the recommendations of
the recently issued Report of the Brain Tumor Progress Review
Group.
Congenital muscular dystrophy (CMD).--The Committee urges
the Institute to collaborate with the NIAMS to intensify
research into CMD. The Committee is extremely concerned that,
unlike nearly all other forms of muscular dystrophy, no
specific gene defect or protein deficiency has even been
identified to date for several types of CMD. The Committee
requests that the NIH report to the Committee by April 1, 2002,
on steps it will take to create a comprehensive research
portfolio in CMD.
Duchenne muscular dystrophy.--The Committee is aware that
NIH has been directed to intensify and enhance muscle disease
research, and it urges NINDS to aggressively support
translational research where possible. To accomplish this, the
Committee strongly urges NINDS to establish no fewer than three
centers of excellence for basic and applied research in the
muscular dystrophies and encourages the Institute to provide
sufficient funds for this purpose. The Committee expects NINDS
to coordinate with NIAMS and the Centers for Disease Control
and Prevention on the planning and activities for the centers
of excellence.
Dystonia.--The Committee is concerned that NIH has
traditionally underfunded research to develop treatments for
the neurological movement disorder dystonia. In light of the
fact that it ranks as the third most common movement disorder
behind Parkinson's and tremor, the Committee encourages NIH to
afford substantial increased funding for additional research on
both focal and genetic dystonia as its sets its priorities for
fiscal year 2002. The Committee also continues to be interested
in the expansion of NINDS's extramural research portfolio with
respect to dystonia, and it encourages NINDS to continue to
expand the study of the DYT1 gene. In addition, the Committee
encourages the Institute to increase its collaboration with the
dystonia research community in supporting epidemiological
studies on dystonia and in increasing public and professional
awareness of this disorder.
Epilepsy.--The Committee believes that NIH should make
finding a cure and effective treatments for epilepsy a
priority. The Committee is encouraged by the establishment of
13 epilepsy research benchmarks resulting from the NINDS March
2000 conference ``Curing Epilepsy: Focus on the Future.'' The
Committee encourages NIH to develop a plan to implement the
research benchmarks, as the Director deems appropriate,
including the funding projections needed to carry out the plan.
The Committee directs that the plan be submitted to Congress by
April 1, 2002. Further, the Committee encourages the
establishment of an Interagency Epilepsy Coordinating Committee
comprised of agency scientists, industry, and patient
representatives.
Multiple sclerosis (MS).--Multiple sclerosis is a chronic,
progressive disease of the central nervous system which is
estimated to affect between 250,000 and 350,000 persons in the
United States. While there is no known cure for MS, a number of
therapies have been found helpful in slowing the disabling
progression of the disease. The cause of MS remains equally
elusive, although investigators are examining such factors as
the role of viruses, genetics, and the environment. The
Committee is aware that several scientific studies have not
supported the role of trauma in causing MS or in triggering MS
exacerbations. Nevertheless, the Committee is concerned over
increasing reports of MS incidence caused by environmental
triggers, be they allergic reactions, or more commonly, traumas
such as automobile accidents. The Committee urges the Institute
to devote additional resources toward study of the role of such
traumas in causing multiple sclerosis.
Neurofibromatosis.--Neurofibromatosis (NF) is a genetic
disorder of the nervous system that causes tumors to grow along
nerves anywhere on or in the body. The Committee is aware that
recent advances in research have linked NF to cancer, brain
tumors, learning disabilities and heart disease. It urges NINDS
to expand its NF basic and clinical research portfolio through
mechanisms such as requests for applications and program
announcements.
Prion disease.--Britain and several other countries in
Europe have documented transmissible forms of spongiform
encephalopathies (TSEs) and variant Creutzfeldt-Jakob Disease
(vCJD), a type of TSE, caused by small infectious proteins
called prions. It appears that the prions causing vCJD come
from eating infected beef cattle. To date, NIH funding of
prion-mediated diseases has been mainly for Creutzfeldt-Jakob
disease (CJD--a separate but related disease to vCJD) but also
has included funding for bovine (cow) spongiform
encephalopathy, scrapie (sheep spongiform encephalopathy) and
chronic wasting (human). The Committee urges NINDS to
specifically fund research into prion disease and to work with
other agencies to develop a diagnostic test to detect the
presence of the disease.
Stroke.--The Committee continues to regard research into
the causes, cure, prevention, treatment and rehabilitation of
stroke as a top priority of the NINDS and of the NIH. Stroke
remains the third-leading cause of death in the United States,
a leading cause of permanent disability and a major contributor
to late-life dementia. The Committee commends the NINDS for its
efforts in beginning to develop a 5-year strategic stroke
research plan. Expected to be released in fall 2001, this plan
will strongly stimulate novel ideas in stroke research. The
Committee also encourages NINDS to expand its research efforts
into the utility of PET scans of the brains of stroke victims
to determine whether brain tissue damage from stroke may be
reversible.
Stroke in women.--Stroke in women is a major health
problem, with women representing 61 percent of all deaths from
stroke. Stroke kills twice as many women as breast cancer and
AIDS combined. The Committee is concerned that very little
research has been directed toward understanding gender
differences in stroke and cerebrovascular disease. Since the
physiology of women's bodies is different from men's, stroke
prevention and treatments may affect women in dissimilar ways.
The Committee is pleased to learn that NINDS is funding a trial
looking at whether postmenopausal hormone replacement therapy
alters stroke risk. The Committee urges the Institute to
increase research specifically in the area of stroke-related
care, risk factors, preventive strategies, acute stroke
management, aspects of post-stroke recovery and long-term
outcomes among women. The Committee further urges the Institute
to take steps to increase research into new therapies for
stroke in women as well as ways of enhancing the vascular
health of all Americans.
Stroke research.--The Committee supports continued research
and development efforts in the area of Polynitroxylated Albumin
(PNA) as a neuroprotectant for ischemic stroke, hemorrhagic
stroke and transient ischemic attack.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Appropriations, 2001.................................... $2,062,089,000
Budget estimate, 2002................................... 2,329,643,000
Committee recommendation................................ 2,375,836,000
The Committee recommends an appropriation of $2,375,836,000
for the National Institute of Allergy and Infectious Diseases
[NIAID]. This is $46,193,000 more than the budget request and
$313,747,000 more than the fiscal year 2001 appropriation.
Included in these funds is $25,000,000 to be transferred to the
Global Fund to fight HIV/AIDS, Malaria, and Tuberculosis. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--The NIAID supports and conducts basic and
clinical research and research training programs in infectious
diseases, including AIDS, and diseases caused by, or associated
with, disorders of the immune system. The NIAID is the lead NIH
Institute charged with developing new and improved vaccines and
supporting research on acquired immunodeficiency syndrome,
tuberculosis, sexually transmitted diseases, and tropical
diseases. The NIAID's research goal is to improve the health
and quality of life of people by improving diagnosis,
treatment, and prevention of diseases.
Asthma research and management.--The Committee is pleased
with NIAID's leadership regarding asthma research and
management. The Committee recognizes the role that NIAID has
played with the Inner City Asthma Study and the importance of
this effort concerning morbidity and mortality among
underserved populations, particularly children. The Committee
urges NIAID to continue to improve its focus and efforts on
asthma management, particularly as it relates to children.
Chronic fatigue syndrome (CFS).--The Committee supports the
development of a multidisciplinary, multidimensional Chronic
Fatigue Syndrome Assessment and Treatment Center where people
can be assessed and treated.
Crohn's disease.--The Committee notes with interest and
concern NIAID's report titled ``Crohn's Disease--Is There a
Microbial Etiology?'' The report findings show that Crohn's
disease may have an infectious etiology. The Committee shares
NIAID's concern that if it is proven that Mycobacterium avium,
subspecies paratuberculosis is the cause of Crohn's disease,
the impact upon the public health could be enormous because of
the prevalence of this mycobacteria on farms and in standing
water. The Committee urges the NIH to consider designating
Crohn's as an ``emerging infectious disease'' and encourages
the NIAID to establish a formal Crohn's disease program
specifically for research into an infectious cause of Crohn's
disease.
Hemophilia.--The Committee encourages NIAID to continue its
efforts with the National Hemophilia Foundation leadership to
ensure that persons with hemophilia have access to and
opportunities to participate in research for improving
treatment of HIV and complications of hemophilia, including
hepatitis C.
Gender-based research.--The Committee understands that the
NIAID has partnered with the National Multiple Sclerosis
Society and other groups to support research related to gender-
based differences in immune function and immunologic disease.
The Committee commends the Institute for undertaking this
important initiative.
Hepatitis C vaccine development.--The Committee encourages
increased priority on research that will accelerate the
development of a hepatitis C vaccine. The development of an
effective vaccine would be greatly assisted by research that
studies the mechanisms that lead to recovery from initial
infection, the mechanism that leads to the transition from
asymptomatic infection to chronic infection and recovery in
response to therapy. The Committee is aware that the NIAID has
conceptually approved research in this field encompassed by a
project titled Hepatitis C: Recovery Research Network. The
Committee urges that adequate funding be made available to
initiate this project. As part of that effort, the Committee
urges the Institute to evaluate early treatment or treatment
within the first year of infection.
Inflammatory bowel disease (IBD).--The Committee is aware
of NIAID's research partnerships with the IBD community, and it
encourages the Institute to expand its support of research
focused on the immunology of IBD as well as the interaction of
genetics and environmental factors in the development of the
disease.
Pediatric kidney disease.--Studies have shown that
improvements seen in transplant survival among adults with
kidney disease have not been completely realized in children,
who have not fully benefited from improvements in
immunosuppressive medications tested largely in the adult
population. NIAID is encouraged to step up its efforts to
maintain transplants over a longer period, thereby improving
kidney transplant outcomes in children and adolescents.
Population mixing.--The Committee urges the NIAID, in
cooperation with the Department of Defense, to develop a plan
for studying population mixing, which is an unusual mixing of
people in relatively isolated rural areas. In such situations,
a variety of infectious viruses and bacteria may trigger an
unusual and rare reaction that affects children in susceptible
populations. The Committee hopes that this study will
contribute to a greater understanding of this important
possible cause of childhood cancers. This will benefit
communities around the Nation such as Fallon, Nevada, which has
experienced an outbreak of childhood acute lymphocytic leukemia
(ALL).
Primary immunodeficiencies (PI).--The Committee continues
to be pleased with NIAID's strong commitment to addressing the
medical and other problems caused by primary
immunodeficiencies. In particular, the Committee looks forward
to learning the results of the NIAID-sponsored research
concerning the impact of PI among urban minority populations
and seeing the research replicated on a larger scale throughout
the country. Building on past collaborations with nonprofit
groups, the Committee encourages NIAID to move aggressively in
all research areas, including cutting-edge research related to
gene therapy, bone marrow transplantation, and cord blood
transplantation. The Committee also continues to be pleased
with NIAID's PI clinical registries program, and urges the
NIAID to continue to support this important initiative. The
Committee also encourages the Institute to work with the PI
community and the Centers for Disease Control and Prevention on
a national surveillance program. Finally, the Committee urges
NIAID to continue to remain actively and meaningfully involved
in the national education and awareness campaign for PI
sponsored by the Jeffrey Modell Foundation and to expand its
role in fiscal year 2002.
Prostatitis research.--The Committee strongly urges the
formation of prostatitis research centers under the direction
of infectious disease specialists as separate and distinct
entities from the urological centers.
Rhinosinusitis.--Chronic rhinosinusitis affects
approximately 33,000,000 Americans, yet its cause remains
unclear. Recent studies have suggested that the trigger is
fungus or fungi that circulate in the environment. Many
healthy, normal people may be exposed to the same fungi, yet do
not develop rhinosinusitis or sinus polyps. The Institute is
urged to support studies to determine the factors that
sensitize an individual to fungus or which generate a fungus-
specific immune response.
Temporomandibular joint disorders (TMJ).--The Committee
urges NIAID to put a greater focus in its research portfolio on
TMJ patients and autoimmune and inflammatory processes. The
collection of tissue samples from TMJ patients and people
without TMJ disease has been suggested (as part of a patient
registry) to determine whether inflammatory mediators, growth
factors, cytokines and other cell and molecular factors
affecting immunity may differ between people with and without
TMJ disease.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
Appropriations, 2001.................................... $1,530,988,000
Budget estimate, 2002................................... 1,710,182,000
Committee recommendation................................ 1,753,465,000
The Committee recommendation includes $1,753,465,000 for
the National Institute of General Medical Sciences [NIGMS].
This is $43,283,000 more than the budget request and
$222,477,000 more than the fiscal year 2001 appropriation. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--NIGMS supports research and research training in
the basic biomedical sciences. Institute grantees, working in
such fields as cell biology, biophysics, genetics,
developmental biology, pharmacology, physiology, and biological
chemistry, study normal biological processes to better
understand what goes wrong when disease occurs. In this way,
NIGMS supplies the new knowledge, theories, and technologies
that can then be applied to the disease-targeted studies
supported by other NIH components. NIGMS-supported basic
research advances also regularly find applications in the
biotechnology and pharmaceutical industries. The Institute's
training programs help provide the scientists needed by
industry and academia to maintain United States leadership in
biomedical science.
Behavioral science research and training.--The Committee is
concerned that NIGMS does not support behavioral science
research training. As the only Institute mandated to support
research not targeted to specific diseases or disorders, there
is a range of basic behavioral research and training that NIGMS
could be supporting. The Committee urges NIGMS, in consultation
with the Office of Behavioral and Social Sciences, to develop a
plan for pursuing the most promising research topics in this
area.
Promoting adherence to medical and behavioral therapies.--
The Committee notes that failure to follow medical
recommendations causes tens of thousands of deaths a year,
increased hospitalizations and delayed recovery. The Committee
encourages the Institute to expand research on innovative
theories about behavioral, cultural, social, psychological and
environmental methods to increase adherence to lifestyle and
medical regimen. The Committee further encourages the Institute
to take steps to inform medical personnel of effective
indicators to measure the standard of delivery of care of
health systems and to change physician behavior and practices.
Training.--The Committee continues to be pleased with the
quality of NIGMS's training programs, particularly those that
have a special focus on increasing the number of minority
scientists, such as the Minority Access to Research Careers
(MARC) and Minority Biomedical Research Support (MBRS)
programs. The Committee expects NIGMS to continue to support
these important initiatives, and is particularly pleased that
NIGMS has supported biomedical research career opportunity
programs for high school and undergraduate college students in
conjunction with minority institutions. The Committee urges
continued, long-term support of this program.
NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
Appropriations, 2001.................................... $978,136,000
Budget estimate, 2002................................... 1,095,954,000
Committee recommendation................................ 1,123,692,000
The Committee recommends an appropriation of $1,123,692,000
for the National Institute of Child Health and Human
Development [NICHD]. This is $27,738,000 more than the budget
request and $145,556,000 more than the fiscal year 2001
appropriation. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--NICHD is that component of the National
Institutes of Health which is responsible for conducting and
supporting research on maternal and child health, the
population sciences, and medical rehabilitation. Research
encompassed by these areas targets infant mortality; genetic
diseases, including birth defects; mental retardation;
gynecological health and contraceptive development and
evaluation; pediatric, maternal, and adolescent AIDS;
developmental biology; vaccine development; demographic and
behavioral research; and restoration or enhancement of function
in individuals experiencing physical disability due to injury,
disease, or birth defect.
Adolescent health and disparities.--The Committee strongly
encourages the collaboration of NICHD, the National Cancer
Institute, the NIH Office of Behavioral and Social Science
Research, and the Centers for Disease Control and Prevention
(CDC) in efforts to support CDC's Healthy Passages Program,
which studies the developmental paths of health risk behaviors
and adverse health outcomes in white, African-American, and
Hispanic youth. The Committee commends the involvement of NIH
Institutes in supporting this CDC study on adolescent health
and health disparities.
Autism.--The Committee is aware that NIH, under the
auspices of its Autism Coordinating Committee, has established
a plan to implement the autism provisions of recent legislation
dealing with children's health. The Committee notes that
current plans include an expedited implementation of the full-
scale program of Centers for Research in Autism. Despite the
expedited nature of this plan for centers, the Committee
expects that peer review will be a primary factor in funding
decisions regarding these grants. The Committee also commends
NIH efforts in a program under which samples of tissues and
genetic materials are donated, collected, preserved, and made
available for autism research.
The Committee also urges the NICHD to continue its support
of the Collaborative Programs of Excellence in Autism (CPEA), a
program that has encouraged collaboration in research efforts
among leading institutions in the field of autism research.
Behavioral and social sciences research.--The Committee is
pleased to learn that NICHD is undertaking a strategic planning
process strongly emphasizing a collaborative process between
the biomedical and behavioral sciences to successfully
accomplish the goals of the Institute.
Bone disease in adolescents.--Given the high incidence of
teen pregnancies, more research is needed to understand the
relationship between pregnancy, lactation, and bone mass in
adolescents. In particular, NICHD is urged to support research
on the impact of chronic anticoagulation on bone mass in
pregnancy, the effect of oral contraceptives on acquisition of
peak bone mass and bone loss in early adolescence, and the
impact on bone status of chronic under-nutrition of young
women. The Committee supports the continuing efforts of the
Institute to provide a database of bone density across a decade
for white and minority children and adolescents. Furthermore,
the Committee encourages NICHD to expand research on
osteogenesis imperfecta, with special emphasis on further
research into genetic therapies, animal models, drug treatment
and rehabilitation techniques.
Child development and behavioral research.--The Committee
is pleased that NICHD is undertaking a number of initiatives to
increase understanding of the behavioral and cognitive aspects
of child development. The Committee encourages these efforts.
Child development and literacy.--The Committee recognizes
NICHD's leading role in identifying factors affecting how
children learn generally, both with and without formal
instruction, and for normal children as well as children for
whom learning is a challenge. NICHD research on early child
development, reading development and disorders has contributed
to converging evidence about how children must be taught in
order to read and how children who are likely to have
difficulty learning may be identified early in their education.
The Committee strongly supports NICHD's efforts to translate
this research to improve literacy and academic performance.
Chromosome 18.--The Committee is aware of efforts to
encourage new scientific work into the molecular genetic,
clinical and therapeutic aspects for chromosome abnormalities.
NIH has supported little research into the abnormalities of
Chromosome 18, despite repeated urging by this Committee. The
Committee believes that the NIH must ensure that this research
be performed. It requests that a strategic plan and report
addressing initiatives to fund Chromosome 18 research be
provided to the Committee by no later than April 1, 2002.
Demographic research.--The Committee strongly endorses
demographic and behavioral research supported by NICHD, which
includes studies of poor families and neighborhoods, adolescent
health, fertility patterns and their relationship to education
and labor, risky sexual behavior and HIV, infant mortality, and
particularly health disparities. The Committee is pleased that
NICHD plans to expand its examination of health disparities
through research on the social and behavioral factors leading
to pre-term births and low birth weight, as well as research to
develop more effective means of preventing and treating HIV
among minority youth. The Committee strongly supports planned
research linking social and cultural understandings of gender
dynamics to account for how these factors may influence HIV
risk among different racial, ethnic and socioeconomic groups.
The Committee also supports research identifying the barriers
to school readiness and academic success for minority and low-
income children.
Duchenne muscular dystrophy.--The Committee is aware that
NICHD has done little in the field of muscular dystrophy
research, even though Duchenne muscular dystrophy is the single
most common lethal genetic disorder of children in America. The
Committee urges NICHD to develop collaborative partnerships
with NINDS and NIAMS to advance basic, clinical, and
translational research into treatment for Duchenne muscular
dystrophy.
Environmental effects on child health and development.--The
Committee applauds NICHD for its efforts to work with the
Environmental Protection Agency and the Centers for Disease
Control and Prevention on developing a major national
longitudinal study quantifying the effects of environmental
exposures and biological and social factors on child health and
development. The Committee places a high priority on
investigating the relationship between behavior and exposure to
harmful environmental influences, such as the extent to which
behavior drives exposure to low-level contaminants during key
developmental phases of a child's life.
Fatherhood and family stability.--The Committee applauds
NICHD's demographic, behavioral and social science-based
surveys on fatherhood, marriage and other issues affecting the
stability of families. NICHD's leading efforts to understand
the impact of fatherhood and other factors affecting the
integrity of families will provide critical information to
enhance our understanding of family formation, family structure
and parent roles, and the impact of these factors on the
development and well-being of children.
Fragile X.--Fragile X, the most common inherited cause of
mental retardation, results from the failure of a single gene
to produce a specific protein. Researchers at the NICHD have
made great strides in understanding the mechanism by which this
genetic defect causes mental retardation, seizures, aggressive
outbursts and severe anxiety. Fragile X has the potential to be
a powerful research model for other forms of X-linked mental
retardation, as well as neuropsychiatric disorders, including
autism, schizophrenia, mood disorders, and pervasive
developmental disorder. The Committee is gratified that the
NICHD has enhanced its research efforts on fragile X both
internally and by partnering with the FRAXA Research Foundation
in the issuance and funding of a Request for Applications to
research scientists.
The Committee notes that Title II of the Children's Health
Act of 2000 calls for the establishment of at least three
fragile X research centers. The Committee strongly urges the
NICHD to allocate sufficient funds for that purpose, to
expedite that objective, and to ensure the discrete
accountability of the Centers.
Health behaviors of youth.--The Committee is increasingly
concerned about youth and health behaviors and their impact on
society as a whole. The Committee is pleased that the NICHD
will be collaborating with the Centers for Disease Control and
Prevention, the Substance Abuse and Mental Health Services
Administration, and the Health Resources and Services
Administration, and it requests that the agencies involved
focus a portion of their efforts on discovering approaches to
intervene and prevent complex behavior problems in children and
youth which utilize molecular neuroscience, brain mapping, and
behavioral analysis.
Infertility and contraceptive research.--The Committee
continues to place a high priority on research to combat
infertility and speed the development of improved
contraceptives. NICHD is urged to continue aggressive
activities in this area, including individual research grants
and those of the infertility and contraceptive research
centers.
Juvenile diabetes.--The Committee is concerned about
reports of a severe shortage of pediatric endocrinologists, and
it urges NICHD to develop a strategy to ameliorate this
problem. The Committee also wishes to reiterate its interest in
NICHD collaborating with NIAID and NIDDK in leading a project
that will develop a vaccine for juvenile diabetes. The
Committee understands that CDC is funding a pediatric diabetes
registry project and urges NICHD to collaborate in this
project.
Maternal-fetal medicine.--The Committee urges the NICHD to
sponsor a planning workshop for the purpose of defining
research questions regarding the causes of pre-term delivery,
building on previous research surrounding the role of infection
and the immune response, and the role of genetics. The outcome
should provide the basis for the development of appropriate
funding mechanisms and increased collaboration with academic
centers not currently participating in cooperative agreements
with the NICHD. The Director is urged to report to the
Committee on activities in this area by June 30, 2002.
Medical rehabilitation.--The Committee is pleased with the
Center's progress in addressing rehabilitation and disability
research issues. The Committee encourages the Center to focus
on a number of priority areas including: advanced orthotics and
prosthetics; increased research into engineered biomaterials
and tissue reengineering as strategies for rehabilitation with
a focus on incorporating nanotechnology and robotics into
orthotics and prosthetics; and additional research in traumatic
brain injury through the clinical trials network. The Committee
is also pleased with the progress on clinical trials in the
areas of hip fracture and stroke, and it requests progress
reports on the results of these trials.
National longitudinal cohort study.--The Committee
understands that the NICHD is leading a consortium of
representatives from appropriate Federal agencies, including
other NIH Institutes, CDC and EPA, in planning and developing a
national longitudinal cohort study of environmental influences
on children's health. The Committee is pleased that an
interagency workgroup has begun preliminary work in developing
an innovative structure for the study and initiating necessary
pilot studies. The Committee urges the Institute to provide
sufficient funds to support increased planning and piloting
activities over the next 2 fiscal years, so that the full study
is underway by the end of 2003.
Pediatric emergency medicine.--The Committee encourages
NICHD to develop a research initiative on pediatric emergency
medicine, including both prehospital and emergency care. To
date, only minimal attention has been paid to addressing this
costly and important aspect of children's health care. We also
encourage NICHD to work closely with HRSA in the development of
national educational programs and conferences to encourage and
support research in emergency medical services for children.
Pediatric kidney disease.--Despite scientific advances,
kidney disease continues to be a major cause of illness and
death among children and adolescents. NICHD is encouraged to
strengthen support for research on the understanding and
treatment of congenital diseases and kidney malformations which
lead to chronic renal failure and end-stage renal disease in
children and adolescents, as well as the prevention and
treatment of the adverse effects of chronic renal failure on
cognitive and physical development in children.
Pelvic floor dysfunction.--The Committee is encouraged by
the NICHD's accomplishments to date on establishing a research
portfolio into pelvic floor disorders. The Committee urges
NICHD make resources available to fund additional grant
applications for epidemiological research and for the newly
created clinical trials network. The Committee also encourages
NICHD to foster research interest by sponsoring a
grantsmanship's technical assistance workshop for gynecologic
and obstetrics researchers.
Policy-relevant demographic research.--The Committee urges
the NICHD to continue its strong support for objective, policy-
relevant demographic research on vital issues such as marriage,
family structure, teen childbearing, fatherhood, immigration,
child and adolescent health, and the impact of changing age
structures on children and adults. It endorses the expansion of
interdisciplinary research which bridges biomedical,
demographic, social and spatial sciences. The Committee
continues to strongly support NICHD's partnerships with Federal
statistical agencies that help to produce the data so critical
to demographic research.
Primary immunodeficiencies (PI).--The Committee continues
to be impressed by the comprehensive commitment that NICHD has
shown in addressing PI, particularly with regard to the
national education and awareness campaign sponsored by the
Jeffrey Modell Foundation in partnership with the Institute, as
well as NIAID, NCI, CDC, and other private entities. The
Committee encourages NICHD to expand its commitment in fiscal
year 2002 through such steps as additional Clinical Center
Grand Rounds, distribution of appropriate materials to
pediatricians and others, trans-institute cooperation on
research issues, and replication of successful programs to
determine the nature of under-diagnosis in minority
communities.
Reproductive health.--The Committee commends NICHD on its
strategic plan to translate research on reproductive health to
reduce the incidence of unwanted pregnancy and to identify
usable strategies to increase knowledge about healthy adult
sexuality and improved reproductive health. The Committee is
pleased that such translation will draw from the research
advances of the last 10 years including improved identification
of behavioral factors affecting both fertility and infertility.
The Committee supports NICHD's perspective that research
relating to reproductive health should integrate economic,
political, sociocultural and psychological factors while
considering other factors that affect reproductive function.
The Committee additionally encourages efforts to understand and
better address the barriers to appropriate contraceptive
services in minority communities.
Small grants.--The Committee is pleased to learn that NICHD
recently began promoting small grants as a way to attract new
investigators to child development research. The Committee
encourages the Institute to examine whether B/START small grant
awards as used by other Institutes would encourage interest
among your investigators.
Sudden Infant Death Syndrome (SIDS).--The Committee is
pleased with NICHD's continued efforts to extend the reach of
its extremely successful ``Back to Sleep'' campaign to
underserved populations and daycare providers. The Committee
also commends NICHD's attempts to further its progress in SIDS
research by initiating a third SIDS 5-year research plan. This
third 5-year plan will continue the efforts of the past two 5-
year plans, which have been responsible for many of the
research breakthroughs in the effort to reduce SIDS cases in
the Nation. The Committee is particularly pleased that NICHD is
collaborating with HRSA's Maternal and Child Health Bureau and
the NIH Director's Office to improve public awareness about
SIDS to the African-American community.
Uterine fibroids.--Uterine fibroids (leiomyomata) are one
of the most prevalent diseases impacting women today, with over
70 percent of all women having fibroids present in/on their
uterus. African-American women have the highest prevalence
rates and are two to three times more likely to acquire
symptoms related to uterine fibroids. The majority of all women
with symptomatic uterine fibroids undergo a hysterectomy. The
Committee urges NICHD to aggressively increase efforts that
will lead to an understanding of the physiological endocrine
mechanisms that allow uterine fibroids to grow and become
symptomatic. The Conferees also encourage research leading to
new treatments, new preventives, and new interventions (beyond
the hysterectomy) in the care and treatment of women with
uterine fibroids.
Vulvodynia.--Preliminary new research indicates that
millions of American women suffer from vulvodynia, a painful
and often debilitating disorder of the female reproductive
system. Despite its prevalence, very little attention has been
paid to the disorder by health professionals or researchers.
Since fiscal year 1998, the Committee has called on the NICHD
to support research on the prevalence, causes and treatment of
vulvodynia. While some initial steps have been taken, the
Committee continues to be very concerned about the lack of
research progress made in this important area and the low
priority placed on it by NICHD. The Committee urges NICHD to
significantly expand research on vulvodynia.
NATIONAL EYE INSTITUTE
Appropriations, 2001.................................... $507,842,000
Budget estimate, 2002................................... 568,103,000
Committee recommendation................................ 614,000,000
The Committee recommends an appropriation of $614,000,000
for the National Eye Institute [NEI]. This is $45,897,000 more
than the budget request and $106,158,000 more than the fiscal
year 2001 appropriation. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The NEI is the Nation's Federal resource for the
conduct and support of laboratory and clinical research,
research training, and other programs with respect to blinding
eye diseases, visual disorders, mechanisms of visual function,
preservation of sight, and the special health problems and
needs of individuals who are visually impaired or blind. In
addition, the NEI is responsible for the dissemination of
information, specifically public and professional education
programs aimed at the prevention of blindness.
The Committee is pleased that vision impairment is a
priority area in the national Healthy People 2010 initiative.
The Institute is urged to develop the data on the extent of the
problem of eye disease, especially among the aging population,
and the economic consequences of eye disease so progress in
these areas can be measured.
Diabetic retinopathy.--Diabetic retinopathy is the leading
cause of new cases of blindness in working-age adults. The
Committee recognizes the collaborative efforts of the NEI with
other Institutes and Centers to study ways to control the
proliferation of abnormal vessels that give rise to diabetic
complications within the eye and in other organs and systems of
the body. The Committee encourages the NEI to continue this
important research that may lead to the development of methods
to inhibit this proliferation before sight-threatening damage
has occurred.
Genomic research.--The Committee recognizes the outstanding
success of the NEI's Functional Genomics Workshop and the
implementation of its recommendations to create a national eye
genome resource. Not only has the NEI significantly increased
its support of research to identify and sequence genes that are
expressed in the visual system, work is now underway to make
this information publicly available through a NEI-supported Web
site. This will assist researchers in gaining a better
understanding of genetic diseases that affect the eye and
visual system and will speed development and testing of new
gene-based therapies. The Committee encourages the Institute to
emphasize the development of these gene-based therapies
especially for retinal degenerative diseases.
Glaucoma.--Glaucoma is a significant cause of blindness in
older Americans and is the number one cause of blindness in
African Americans, who are disproportionally at greater risk
for developing the disease and being blinded by it. NEI-
supported clinical trials have demonstrated the effectiveness
of a variety of treatments, as well as the importance of early
detection and appropriate treatment in preventing or delaying
vision loss. The Committee looks forward to the results of the
Ocular Hypertension Treatment Study, which will determine the
benefit of treating people with ocular hypertension with
pressure-lowering drugs to prevent or delay sight-threatening
eye damage. The Committee also encourages the NEI to continue
its research on the genetics of the development of glaucoma and
on the discovery of ways to protect against nerve damage from
glaucoma.
Health education.--The Committee is pleased with the NEI's
efforts to communicate the results of its research efforts into
meaningful health education messages to the public and to
professionals through its National Eye Health Education
Program. The Committee is particularly pleased with the NEI's
efforts to increase awareness of low vision and its impact on
quality of life. Through a mobile exhibit that travels to
shopping malls and centers around the country, information on
low-vision services and resources are made directly available
to those with low vision and their families. The Institute
should continue its emphasis on this important outreach
program.
Macular degeneration.--The Committee commends the NEI for
the prioritization of its research on macular degenerative
diseases, which account for nearly 30 percent of the bilateral
blindness in this country and are particularly devastating to
the independence and quality of life of our older citizens.
NEI-supported research has demonstrated that two potentially
modifiable risk factors, smoking and hypertension, are
associated with the most severe form of the disease. The
Committee eagerly awaits the results of a clinical trial that
will determine whether low-intensity laser treatment can
prevent the development of advanced complications in the age-
related form of the disease.
Retinitis pigmentosa.--Retinitis pigmentosa is a chronic,
progressive, degenerative disease that causes the deterioration
of the photoreceptor cells in adolescence and leads to
substantial visual loss in adulthood. Retinitis pigmentosa,
Usher's Syndrome, and other related degenerative disorders can
have a dramatic effect on the quality of life of those affected
and their families. The Committee recognizes the technical
difficulties associated with rescue and regeneration of
deteriorating neurons but is encouraged by the Institute's
exploration of the use of growth factors, transplantation, and
gene-based techniques to combat this destructive disease.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
Appropriations, 2001.................................... $502,987,000
Budget estimate, 2002................................... 561,729,000
Committee recommendation................................ 585,946,000
The Committee recommends an appropriation of $585,946,000
for the National Institute of Environmental Health Sciences
[NIEHS]. This is $24,217,000 more than the budget request and
$82,959,000 more than the fiscal year 2001 appropriation. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--The mission of the NIEHS is to define how
environmental exposures affect health; how individuals differ
in their susceptibility to these effects; and how these
susceptibilities change with time. This knowledge, coupled with
prevention and communication programs, can lead to a reduction
in environmentally associated diseases and dysfunctions.
Agent Orange.--The Committee urges the NIEHS to continue
its work with scientists in the United States and Southeast
Asia on the health and environmental effects of the use of
Agent Orange and dioxin. Scientists representing the United
States and Vietnamese Governments have recently negotiated a
landmark commitment to proceed with this program, and this
Committee recognizes the importance of demonstrating sustained,
timely interest and engagement on the part of the U.S.
Government. NIEHS is encouraged to continue these efforts and
expand them when feasible into a broader-based effort,
including a grants program that funds both independent and
collaborative research. NIEHS should provide a report on these
activities to the Congress by April 1, 2002.
Animal manure management.--The Committee urges NIEHS to
study the issue of animal manure management and storage by
agricultural producers, and to explore the public health
implications of this issue.
Breast cancer.--The Committee recognizes the serious lack
of research on the relationship between the environment and
breast cancer, and believes that it is essential for the
Institute to support such research. The Committee understands
that the Institute will establish a Breast Cancer and
Environmental Research Advisory Board to make recommendations
to the Director with regard to the development of Breast Cancer
and Environmental Research Centers. The Committee is aware of
the tremendous success of the DOD Breast Cancer Research
Program and its grant process. The Committee expects the
Advisory Board to integrate a peer review and planning process
along the lines of the DOD integration panel. The Committee is
pleased that the Advisory Board will include representatives
from the breast cancer community who have had breast cancer.
The Committee further strongly urges the NIEHS to establish
centers to conduct multi-disciplinary and multi-institution
research on environmental factors that may be related to breast
cancer.
Environmental factors and liver disease.--The impact of
environmental factors on liver disease is an important area
that needs additional attention. The Committee urges the
Institute to collaborate with NIDDK in an effort to better
understand environmental factors that may contribute to the
development of liver disease.
Environmental health sciences centers.--The Committee
continues to strongly support the Environmental Health Sciences
Centers program and believes that a fully funded Centers
program is critical to carrying out the mission of NIEHS. The
Committee expects these Centers to be funded at peer-reviewed
levels.
Lymphoma.--The Committee encourages NIEHS to expand its
research on investigating the potential of environmental,
bacterial, and viral factors that are associated with the
development of lymphoma and other hematological cancers. The
Committee also encourages NIEHS to collaborate with NCI and CDC
to conduct research that will lead to a better understanding on
how environmental factors contribute to the development of
lymphoid malignancies. The Committee requests that NIEHS and
NCI submit a joint report to the Committee by April 1, 2002, on
their current research portfolios on lymphoma and the direction
of future research.
Test methods.--The Committee supports the assessment of
scientific validation of new, revised and alternative
toxicological test methods by ICCVAM. The Committee encourages
NIEHS to use the expertise and credibility of ICCVAM for these
assessments to streamline their individual consideration of
new, revised and alternative toxicological test methods.
Waste treatment management.--The Committee urges NIEHS to
study the issue of waste treatment management by indigenous
native Hawaiians, and to explore the public health implications
of this issue and the ``living machines'' approach to waste
management.
NATIONAL INSTITUTE ON AGING
Appropriations, 2001.................................... $786,056,000
Budget estimate, 2002................................... 879,651,000
Committee recommendation................................ 909,174,000
The Committee recommendation includes $909,174,000 for the
National Institute on Aging [NIA]. This is $29,523,000 more
than the budget request and $123,118,000 more than the fiscal
year 2001 appropriation. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The NIA conducts biomedical, behavioral, and
social research related to the aging process to prevent disease
and other problems of the aged, and to maintain the health and
independence of older Americans. Research in aging over the
last two decades demonstrates that aging should not be equated
with inevitable decline and disease.
Advanced imaging technology for Alzheimer's.--The Committee
continues to urge NIA to focus on early detection of
Alzheimer's disease so clinical interventions to slow or stop
the progression of the disease may be undertaken. The Committee
notes that positron emission tomography (PET) has now been
shown to identify Alzheimer's disease definitively and at a
much earlier stage than other diagnostic methods, and it
encourages NIA, in collaboration with NINDS and NIMH, to expand
its research efforts into early diagnosis of Alzheimer's using
PET imaging of the brain.
Alzheimer's disease.--Few diseases affect more Americans,
require more prolonged treatment, cause more suffering for the
families of the afflicted, and waste more precious human and
financial resources than Alzheimer's disease. An estimated 4
million persons suffer from Alzheimer's, or about one in 10
Americans over age 65 and nearly half of those over age 85. As
the baby boom generation shoulders its way into old age, few
diseases represent a greater threat to the health and financial
well being of society as a whole. Within the next few decades,
14 million individuals will be stricken with Alzheimer's,
raising the annual cost of caring for its victims to
$375,000,000. Because of its critical size and tragic impact,
Alzheimer's disease represents one of the nation's most
critical health problems. After two decades of intensive
research, scientists have begun to understand the basic
mechanisms of Alzheimer's as well as the complex interplay of
genetic and environmental risk factors. Past investments have
opened the doors to exciting new opportunities, including
clinical trials of a vaccine that may prevent amyloid deposits
in the brain, a hallmark of Alzheimer's; evidence that
cholesterol-lowering drugs may delay or prevent the onset of
the disease; and FDA approval of a fourth drug for the
treatment of the disease's cognitive symptoms. But if society
hopes to avert widespread suffering and enormous strain on its
health care system, science must act now because researchers
believe that Azheimer's actually begins 10 to 20 years before
its first symptoms appear. While investigator-initiated
research continues, concurrent large-scale clinical trials
offer the best hope for finding ways to treat, delay or prevent
Alzheimer's disease. The Committee urges NIA to expand its
investment in Alzheimer's disease research, particularly for
clinical trials, and has provided additional funds for that
purpose. It is the Committee's goal to increase the NIH
commitment to Alzheimer's research to $1,000,000,000 as soon as
possible, a goal made even more compelling by the growing
number of Americans who will soon be at greatest risk.
Alzheimer's research.--NIA is commended for its innovative
research on effective management of Alzheimer's disease
patients (special care units) and the needs of Alzheimer's
caregivers. The Committee commends NIA for its efforts to plan
and map promising topics in cognitive research. The Committee
also commends NIA for its excellent public information
materials on encouraging older adults to exercise and stay
physically active. NIA is encouraged to expand its research on
health promotion interventions in aging populations.
Behavioral and Social Research.--The Committee commends
NIA's Behavioral and Social Research (BSR) program for its
demographic and economic research portfolio on health dynamics
in older populations and the early life determinants of the
late life health disparities. The Health and Retirement Study
and the National Long Term Care Survey, the Office of
Demography and the 11 demographic research centers are
important national resources for advancing research on the
Medicare and Social Security systems. The Committee is very
pleased with the BSR's efforts to link demography and biology,
and to develop a more integrated social and behavioral science.
Bone disease and aging.--The Committee encourages NIA to
coordinate its research on osteoporosis and Paget's disease
with NIAMS. NIA is also encouraged to study the effects of
aging on individuals with osteogenesis imperfecta. The
Committee urges the Institute to renew its commitment to
funding studies related to the aging skeleton.
Cardiovascular aging research.--Heart attack, congestive
heart failure, stroke, and other cardiovascular diseases remain
America's leading cause of death of older men and women and a
main cause of disability. The Committee encourages the
Institute to make cardiovascular research a priority, and urges
it to expand into innovative extramural and intramural
cardiovascular research programs.
Claude D. Pepper Older Americans Independence Centers.--The
Committee continues to strongly support these successful
centers, which focus on developing innovative and cost-
effective ways to enhance the independence of older Americans.
The centers also play a critical role in developing top-level
experts in geriatrics. The Committee again urges NIA to expand
these centers to include a school of nursing.
Cognitive changes during aging.--The Committee understands
that research on cognitive changes during aging is an important
focus of the Institute, and that maintaining mental acuity is
an important concern of aging adults. It is generally
recognized that research on higher-order mental processing is
underdeveloped in the field of aging. NIA is working to expand
is portfolio in this area, and the Committee encourages those
efforts. The Committee is pleased to learn that a study now
underway at the Institute of Medicine is examining the current
knowledge base in the area of cognition and aging. The
Committee urges NIA to use the IOM recommendations as a guide
for expanding its portfolio in this critical area of research.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
Appropriations, 2001.................................... $394,968,000
Budget estimate, 2002................................... 441,803,000
Committee recommendation................................ 460,202,000
The Committee recommends an appropriation of $460,202,000
for the National Institute of Arthritis and Musculoskeletal and
Skin Diseases [NIAMS]. This is $18,399,000 more than the budget
request and $65,234,000 more than the fiscal year 2001
appropriation. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--The NIAMS conducts and supports basic and
clinical research and research training, and the dissemination
of health information on the more than 100 forms of arthritis;
osteoporosis and other bone diseases; muscle biology and muscle
diseases; orthopedic disorders, such as back pain and sports
injuries; and numerous skin diseases. The research agenda of
the NIAMS addresses many devastating and debilitating diseases
that afflict millions of Americans. These diseases of the
joints, muscles, bones, connective tissues, and skin, in the
aggregate, will affect nearly every American at some point in
their lives, causing tremendous human suffering and costing the
Nation billions of dollars in both health care and lost
productivity. The research activities of this Institute serve
the concerns of many different special populations, including
women, minorities, children, and the elderly.
Behavioral and social science research.--The Committee
notes that the portion of the NIAMS research portfolio devoted
to behavioral and social sciences research is significantly
lower than the NIH average. Therefore, the Committee urges the
NIAMS to fund promising behavioral social sciences research.
Additionally, the Committee urges favorable consideration of
research in the area of behavioral and social science factors
relating to the adherence to medical recovery regimes, exercise
and weight-reduction programs.
Drug research.--The Committee supports research in the area
of TOPS-ester therapeutics, a type of drug being developed that
is compartmentalized inside skin cells and expresses
antioxidant actions that limit oxidant mediated pathologies
including psoriasis, sunburn, skin aging and cancer.
Duchenne muscular dystrophy.--The Committee is aware of
past collaboration between NIAMS and NINDS to intensify and
enhance muscle disease research. The Committee urges NIAMS to
continue working closely with NINDS to identify collaborative
opportunities to advance basic, clinical, and translational
research into treatment for Duchenne muscular dystrophy. The
Committee has urged NINDS to establish centers of excellence
for basic and applied research in the muscular dystrophies. The
Committee urges NIAMS to coordinate with NINDS and the Centers
for Disease Control and Prevention on the planning and
activities for these centers.
Economic burden of skin diseases.--The Committee is aware
of the lack of information regarding the overall economic
burden of skin diseases for the nation, as well as the lack of
reliable data on how many individuals in the United States are
affected by these diseases. The Committee, therefore,
encourages the NIAMS, in conjunction with other PHS components,
including NCHA, CDC, AHRQ, and HRSA, to sponsor a workshop to
identify existing information sources on the costs and scope of
skin diseases, and to recommend strategies for developing new
information sources. The Institute is encouraged to work with
skin diseases researchers and voluntary health organizations to
plan the workshop.
Ehlers-Danlos syndrome.--Ehlers-Danlos syndrome (EDS) is a
family of genetic disorders whose manifestations include, but
are not limited to, the skin, joints and other components of
the connective tissue. EDS is potentially a model for a number
of more common medical and biological problems stemming from
genetic acquired connective tissue defect. The Institute is
encouraged to provide greater funding for continued research of
this disease.
Fibrous dysplasia.--Fibrous dysplasia is a chronic disorder
of the skeleton that predominantly afflicts young children and
adolescents, resulting in uneven growth, severe pain, and
deformed extremities. Given the long-term implications of this
disorder on both children and adults, the Committee sees the
need for a targeted research effort to evaluate promising drug
therapies. NIAMS is encouraged to support such research at an
institution with a large population of both pediatric and
adolescent fibrous dysplasia patients, as well as a staff of
orthopedic and endocrinology specialists qualified to conduct
this research.
Osteogenesis imperfecta.--Osteogenesis imperfecta (OI) is a
genetic disorder characterized by frequent fractures from
little or no trauma. The Committee commends the effort NIAMS
has made to encourage and fund osteogenesis imperfecta research
and recommends that osteogenesis imperfecta continue to be an
area of special emphasis in the Institute. NIAMS and NHLBI are
urged to investigate respiratory and cardiovascular problems
associated with OI. The Committee also encourages NIAMS to
continue its strong support of research into gene therapies and
drug treatment for OI, and to continue its active follow-up of
new research opportunities arising out of the 2001 NIH workshop
on OI.
Osteoporosis and related bone diseases.--The Committee
recognizes that osteoporosis and related bone diseases are a
major public health problem that exacts an enormous human and
economic toll. The Committee commends the National Resource
Center for its role in providing patients, health professionals
and the public with access to resources, and encourages the
Center to increase prevention and treatment efforts. The
Committee encourages NIAMS to devote additional resources to
studying osteoporosis in non-white women, as well as
understanding the genetic predisposition of osteoporosis in
certain populations. Moreover, given the large number of
individuals affected by this disease, NIAMS is urged to focus
on therapies to improve quality of life and to reduce the
subsequent risk of fractures. The Committee encourages NIAMS to
continue to work with NHLBI to investigate the basic and
clinical relationship between cardiovascular diseases and
osteoporosis.
Paget's disease.--The Committee is aware of the importance
of research on the viral and genetic factors that may cause
Paget's disease, and it encourages NIAMS to enhance efforts in
this area as well as research to develop animal models for
Paget's disease.
Pediatric rheumatoid arthritis.--The Committee commends the
NIAMS for its growing support of research and training
activities to better understand childhood rheumatic diseases,
including pediatric rheumatoid arthritis. The Committee is
especially pleased with the continued operation of the
Pediatric Rheumatology Clinic, which opened on the NIH campus
in the fall of 2000. The Committee is also pleased to learn
that, through research at an NIAMS-supported Multipurpose
Arthritis and Musculoskeletal Diseases Center, the drug
Etanercept has recently been shown to be a safe and effective
drug in the treatment of children and teenagers with pediatric
rheumatoid arthritis. The Committee appreciates the Institute's
emphasis on pediatric rheumatic diseases in recent research
solicitations. The Committee understands that the Institute's
pediatric rheumatoid arthritis registry has been expanded to
include a major emphasis on a genome-wide search for
susceptibility genes and strongly urges the Institute to
continue its research into the genetic factors as well as
infectious triggers of the disease.
Psoriasis.--Psoriasis is a genetically acquired immune-
mediated disease of the skin and joints that affects over 7
million Americans. The Committee encourages NIAMS to conduct a
scientific workshop to assess basic and clinical research in
psoriasis, especially prospects for innovative therapeutic
approaches for moderate to severe forms of the disease. The
Committee urges the Institute to collaborate with patient
organizations, medical specialty societies, and other
interested parties in the development of this workshop. NIAMS
is further urged to work with these partners through all
available mechanisms to support a public awareness and
education program on the best available treatments for moderate
and severe psoriasis.
Sjogren's syndrome.--The Committee is pleased that the
NIAMS has published a booklet on Sjogren's syndrome, providing
an important means of educating people about this common
autoimmune disease. The Committee encourages the Institute to
do more for this disease, including holding scientific
workshops, providing grant monies, and including Sjogren's in
autoimmune databases.
Temporomandibular joint disorders (TMJ).--The Institute is
urged to increase research on unique features of the
temporomandibular joint as well as exploring to what extent TM
disorders share common pathogenic mechanisms with fibromyalgia
and osteoarthritis.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
Appropriations, 2001.................................... $301,069,000
Budget estimate, 2002................................... 336,744,000
Committee recommendation................................ 349,983,000
The Committee recommends an appropriation of $349,983,000
for the National Institute on Deafness and Other Communication
Disorders [NIDCD]. This is $13,239,000 more than the budget
request and $48,914,000 more than the fiscal year 2001
appropriation. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--The NIDCD funds and conducts research and
research training in the normal and disordered processes of
human communication, specifically in the areas of hearing,
balance, smell, taste, voice, speech, and language. The
Institute addresses the special biomedical and behavioral
problems of people who have communication impairments or
disorders; contributes to health promotion and disease
prevention; and supports efforts to create devices that
substitute for lost and impaired sensory and communication
functions.
Dysphonia.--The Committee continues to be pleased with
NIDCD's expanding intramural research program with respect to
dysphonia. The Committee encourages NIDCD to explore
possibilities for a more active extramural research effort on
dysphonia, and for collaboration with other NIH Institutes on
this important disorder.
Health survey.--The Committee encourages the Institute to
create and administer a national deaf and hard of hearing
health survey, conducted annually, to assess the health status
of this population and monitor changes as a result of
intervention efforts.
Noise-induced hearing loss.--The Committee continues to be
concerned by the number of Americans who suffer from noise-
induced hearing loss. Thirty million Americans are exposed to
dangerous levels of noise that can permanently impair their
hearing. Ten million Americans have suffered irreversible
noise-induced hearing loss. The Committee has been pleased by
the Institute's efforts to tackle this preventable health
problem. The Wise Ears campaign has the potential to make
significant inroads towards educating Americans of all ages.
The Committee urges the Institute to provide sufficient funds
to expand this promising new initiative.
NATIONAL INSTITUTE OF NURSING RESEARCH
Appropriations, 2001.................................... $105,158,000
Budget estimate, 2002................................... 117,681,000
Committee recommendation................................ 125,659,000
The Committee recommends an appropriation of $125,659,000
for the National Institute of Nursing Research [NINR]. This is
$7,978,000 more than the budget request and $20,501,000 more
than the fiscal year 2001 appropriation. The comparable amounts
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--The National Institute of Nursing Research [NINR]
supports clinical and basic research on biological and
behavioral aspects of critical national health problems. The
Institute's programs have established a scientific basis for
research that seeks to reduce the burden of acute and chronic
illness and disability for individuals of all ages; improve the
quality of life by preventing and delaying the onset of disease
or slowing its progression; and establishing better approaches
to promoting health and preventing disease. The NINR supports
programs essential to improving clinical environments by
testing interventions which influence patient health outcomes
and reduce costs and demands for care.
Cancer screenings.--The Committee continues to be concerned
about disparities in the incidence and prevalence of cancer
among minorities. The Committee believes that the NINR is
positioned well to address prevention strategies, particularly
screening for minority populations. Therefore, the Committee
urges increased promotion of regular cancer screenings and
positive behavioral modifications that will help prevent
cancers.
Caregivers.--Informal caregivers in the home need help as
they administer to the needs of patients with chronic
illnesses. One in four U.S. families is involved in caregiving.
The Committee is troubled that caregivers themselves are at
risk for poor physical and emotional health as they devote
themselves to tending to others. The NINR is urged to devote
greater attention to caregiver needs regarding improved
strategies, skills, and support.
Chronic conditions.--The NINR is to be commended for its
increased focus on chronic illnesses, which affect growing
numbers of people in this country as patients live longer with
severe but enduring diseases. The Committee urges the Institute
to continue its emphasis on pain management and other
conditions such as cachexia, which involves muscle wasting and
weight loss.
End-of-life care.--The Committee is pleased with the NINR's
efforts to stimulate research on palliative care. Research
supported by the NINR and collaborative organizations is
critical to addressing key issues such as how to manage pain
and help patients and their families make difficult choices
about treatment and care.
Mentorship program.--The Committee is greatly encouraged by
the progress made by the NINR and the NIMH in implementing a
technical assistance workshop on grant writing and navigating a
research career trajectory in the area of behavioral change
related to psychiatric populations--a program that will build
the research capacity of our Nation's psychiatric mental health
nurse researchers. The Committee urges the NINR and NIMH to
implement a a mentorship program that will enable participants
to develop formal grant proposals for ultimate submission to
the Institutes.
New research opportunities.--The Committee encourages the
Institute to take advantage of increased funding by supporting
new research opportunities in several areas, including:
research on health disparities in diseases such as diabetes and
cardiovascular disease, self-management of chronic pain, end-
of-life research to address weight loss, muscle wasting,
fatigue, and caregiver issues. Most critical to enhancing
research within the nursing profession is infrastructure
development that increases the pool of nurse investigators,
expands programs to develop partnerships between research-
intensive environments and small colleges and universities, and
promotes career development for minority researchers.
Nurse researchers.--The Committee is concerned about the
effects of the nursing shortage on evidence-based practice. The
NINR has the Committee's strong support for its emphasis on
protecting and expanding the infrastructure of nursing
research. Recruiting minority researchers and enhancing career
development for all nurses interested in research is essential
to addressing the Nation's pressing health issues. Expanding
technological skills for the nursing discipline, through
efforts such as the NINR's training program in genetics, is
another laudable goal for the Institute.
Nursing interventions for psychiatric populations.--The
Committee is concerned over the lack of resources for outcomes
research focused on nursing interventions for psychiatric
populations. The Committee urges the NINR and the NIMH to
jointly sponsor a workshop with the psychiatric nursing
community to identify areas of research and specific questions
directed at interventions in psychiatric populations that
directly correlate to enhanced patient care. This workshop
would lead to a joint request for applications by the NINR and
the NIMH.
Volcanic emissions.--The Committee continues to be very
concerned about the public health aspects of volcanic emissions
in Hawaii, and it urges the Institute to collaborate with the
National Institute of Environmental Health Sciences to develop
a multidisciplinary approach to this problem.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
Appropriations, 2001.................................... $340,537,000
Budget estimate, 2002................................... 381,951,000
Committee recommendation................................ 390,761,000
The Committee recommends an appropriation of $390,761,000
for the National Institute on Alcohol Abuse and Alcoholism
[NIAAA]. This is $8,810,000 more than the budget request and
$50,224,000 more than the fiscal year 2001 appropriation. The
comparable amounts for the budget estimate include funds to be
transferred from the Office of AIDS Research.
Mission.--The NIAAA conducts biomedical and behavioral
research for improving prevention and treatment and reducing or
eliminating the associated health, economic, and social
consequences of alcohol abuse and alcoholism. NIAAA provides
leadership in the country's effort to combat these problems by
developing new knowledge that will decrease the incidence and
prevalence of alcohol abuse and alcoholism and associated
morbidity and mortality. NIAAA addresses these questions
through an integrated program of biomedical, behavioral, and
epidemiologic research on alcoholism, alcohol abuse, and
related problems. This broad-based program includes various
areas of special emphasis such as medications development,
fetal alcohol syndrome, genetics, and moderate drinking.
Alaska native substance abuse.--The Committee is aware of
serious problems with alcohol and substance abuse in Alaska,
especially among its Alaska native population, and of the need
for translating research into clinical applications for this
population. The Committee urges NIAAA to sponsor a Research to
Practice Forum with the Substance Abuse and Mental Health
Services Administration and the State of Alaska to focus on
bridging the gap between researchers and practitioners and
translating scientific research into clinical applications, and
encourages NIAAA to support the implementation of any
recommendations developed at the forum.
Alcohol consumption and hepatitis C.--It is well
established that alcohol consumption in patients with hepatitis
C increases the damage caused by the disease. Less well known
is the mechanism by which this happens, as well as why alcohol
inhibits the success of standard treatments for the disease.
Both of these areas are important for dealing with this
disease, and the Committee strongly encourages the Institute to
pursue them both individually and collectively with other
interested Institutes.
Alcoholic liver disease.--The Committee recognizes that
alcoholic liver disease (ALD) is a major cause of morbidity and
mortality in the United States today. Developing effective
interventions for this disease is of paramount importance. The
Committee is pleased that the Institute has begun to focus
greater attention on this problem, and it encourages NIAAA to
consider sponsoring additional research on treatment.
Alcohol treatment services.--Given the rapid growth of
managed behavioral health care, the Committee is concerned that
more needs to be known about how alcohol treatment services are
delivered under managed care arrangements and the specific
characteristics of behavioral health components of health
insurance plans and managed care organizations. The Committee
is supportive of the NIAAA Advisory Council's comprehensive
plan for health services, particularly its recommendation to
prioritize research to understand the effects of managed care
on treatment services. The Committee acknowledges NIAAA's
progress in implementing this recommendation and encourages the
Institute to consider supporting additional research in this
area.
Behavioral research to identify high-risk youth.--Studies
show that people who begin drinking early in life have a
dramatically higher risk of later becoming alcoholic than do
those who begin later. Other studies show that personality
characteristics that are evident as early as age 3 predict
alcoholism in adulthood. Given these data, developing effective
methods for identifying high-risk youth, as well as appropriate
prevention strategies, is particularly important. The Committee
urges NIAAA to expand efforts on this promising line of
research.
College drinking.--The Committee continues its strong
support of the NIAAA Advisory Council's Subcommittee on College
Drinking and its efforts to create a unique dialogue among
college presidents, administrators and alcohol researchers. The
Committee appreciates the progress made by NIAAA in building
community partnerships to help expand the research on college
drinking and in developing research-based interventions for
preventing the harm caused by misuse of alcohol. Further, the
Committee understands that NIAAA will soon begin the first
national, longitudinal survey to assess alcohol consumption and
contributing characteristics of adolescents and college-age
youth. The Committee encourages NIAAA to continue and expand
these activities.
Health disparities.--The Committee encourages the NIAAA to
place a priority on studying the disparities in risk of
alcoholism and treatment availability and accessibility among
various ethnic and racial groups. Additionally, the Committee
urges the Institute to consider establishing a mentoring
program with the specific objective of providing quality
research training for all racial groups.
Multidisciplinary approaches.--The examination of alcohol
misuse and alcohol use disorders must include the effective
integration of multiple disciplines and strong
interdisciplinary coordination. Thus, the Committee urges that
sufficient funding be directed toward those endeavors which
seek to apply multidisciplinary approaches to relevant
questions of etiology, consequences and recovery. Specifically,
the Committee urges support for efforts directed toward
integrating animal and human data as well as the multiple
sources of human data.
Prevention and treatment of violence.--The Committee is
supportive of NIAAA's efforts to understand the relationships
between alcohol use and violence. The Committee encourages
NIAAA to consider supporting more research in this area,
particularly to understand individual characteristics and
environmental conditions, situations, and circumstances under
which alcohol use and violent behavior are connected. The
Committee also encourages the NIAAA to consider supporting
additional research on the prevention and treatment of violence
by persons with alcohol problems.
Risk and resiliency.--The Committee sees a critical need to
identify adequate resources regarding risk and resiliency,
including both genetic and psychosocial factors, and age-
appropriate education and prevention materials which can be
empirically evaluated.
Technology advances.--Advances in a range of technologies,
such as genetic applications and brain imaging, may benefit the
study of alcoholism. The Committee encourages the NIAAA to
allocate adequate funding not only for the application of these
technologies, but also for providing training to current and
new investigators in these technologies.
NATIONAL INSTITUTE ON DRUG ABUSE
Appropriations, 2001.................................... $779,510,000
Budget estimate, 2002................................... 905,810,000
Committee recommendation................................ 902,000,000
The Committee recommends an appropriation of $902,000,000
for the National Institute on Drug Abuse [NIDA]. This is
$3,810,000 less than the budget request and $122,490,000 more
than the fiscal year 2001 appropriation. The comparable numbers
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--Created in 1974, NIDA supports about 85 percent
of the world's biomedical research in the area of drug abuse
and addiction. The Committee commends NIDA for demonstrating
through research that drug use is a preventable behavior and
that addiction is a treatable disease. NIDA's basic research
plays a fundamental role in furthering knowledge about the ways
in which drugs act on the brain to produce dependence, and
contributes to understanding how the brain works. In addition,
NIDA research identifies the most effective pharmacological and
behavioral drug abuse treatments. NIDA conducts research on the
nature and extent of drug abuse in the United States and
monitors drug abuse trends nationwide to provide information
for planning both prevention and treatment services. An
important component of NIDA's mission is also to study the
outcomes, effectiveness, and cost benefits of drug abuse
services delivered in a variety of settings.
Behavioral sciences.--The Committee understands that
behavioral intervention is a critical, and sometimes only,
component of drug addiction. The Committee continues to support
NIDA's expansion of its behavioral science portfolio and views
NIDA as a model of how to approach its behavioral science and
public health responsibilities.
Children and adolescents.--Recognizing the devastating
impact of drug addiction on children and youth, the Committee
commends NIDA's children and adolescent research initiative.
The Committee urges NIDA to continue to support its research
portfolio in areas of co-occurring mental disorders,
developmental consequences, prenatal exposure, genetic
vulnerability, and environmental risk factors. The Committee is
especially pleased that NIDA is planning to launch a drug abuse
prevention model to more systematically test prevention
programs in a wide variety of diverse settings and populations.
Clinical trials network.--The Committee applauds NIDA's
success in launching and expanding the new National Drug Abuse
Treatment Clinical Trials Network, a much-needed infrastructure
to test science-based drug addiction treatments in real-life
community-based treatment settings. The Committee believes this
is an extraordinary step forward in improving the quality of
drug addiction treatment in this country, especially for
minority populations and disadvantaged groups in both rural and
urban settings. The Committee commends NIDA's leadership in
forging strong partnerships with treatment researchers and
community-based treatment providers to ensure that new
treatments are tested and incorporated into ongoing drug
treatment programs. The Committee encourages NIDA to continue
to make this network, and research of new behavioral and
pharmacological treatments, a top priority.
Emerging drug problems.--The Committee is pleased that NIDA
has launched a new Club Drug Research and Dissemination
Initiative. Given the emergence of club drugs, such as ecstasy,
methamphetamine, GHB, and ketamine, the Committee is encouraged
by NIDA's proactive efforts to curtail these emerging drug
problems, and it urges NIDA to continue its efforts to develop
an even broader array of effective new prevention and treatment
approaches to focus on these emerging drug challenges.
Genes and drug abuse.--The Committee recognizes that
treating drug abuse effectively requires understanding what
makes individuals more or less vulnerable to addiction. The
Committee urges further research in the Human Genome Project,
which will provide the information and technology to identify
genes that may play a role in addiction.
International efforts.--The Committee commends NIDA for
expanding its international efforts to more globally address
drug addiction and the health consequences such as HIV/AIDS
that it brings in its wake. These international efforts will
better equip the United States to effectively prevent and treat
addiction and infectious diseases.
Medications development.--The Committee encourages NIDA to
study the development of anti-addiction medications, clarify
the neurological and behavioral benefits of the use of
pharmacological agents, and develop an understanding of how
best to use these medications.
Methamphetamine.--The Committee continues to be concerned
about methamphetamine abuse across the nation. The problem is
essentially acute in Iowa and other Midwestern states. The
Committee again urges NIDA to expand its research on improved
methods of prevention and treatment of methamphetamine abuse.
National Drug Abuse Clinical Trials Network.--The Committee
commends NIDA's leadership in continuing to recognize the
importance of behavioral and social science research, and it is
especially pleased that this is reflected in the recent NIDA
reorganization, which elevates behavioral research in both the
Division of Neuroscience and Behavioral Research and the
Division of Treatment Research and Development. The Committee
believes NIDA could consider evaluating these promising
behavioral treatments in clinical trials through its new
National Drug Abuse Clinical Trials Network.
Neuroscience.--The Committee recognizes that basic
neuroscience and behavioral research provides a foundation for
NIDA's research portfolio. The Committee urges NIDA to continue
its efforts to develop new areas of neuroscience research,
including the role that genetics plays in vulnerability to
addiction.
Nicotine research.--The Committee recognizes that the
consequences of nicotine addiction are substantial to adults,
children, and adolescents, and it commends NIDA's support of
research yielding effective replacement therapies and
behavioral interventions. The Committee encourages NIDA to
continue to support research on the prevention and behavioral
and pharmacological treatment of nicotine addiction. The
Committee supports NIDA's ongoing research in the basic
sciences, behavioral and medical treatments, genetic
vulnerability, and epidemiology of nicotine use and abuse.
Prescription drug abuse.--Certain segments of the
population, including adolescents, women, and the elderly,
appear to be particularly vulnerable to the problem of
prescription drug abuse. The Committee is particularly pleased
that NIDA has taken a proactive leadership role in informing
the public, health care professionals and others about the
misuse and abuse of certain medications, particularly opiates.
The Committee recognizes the importance of both behavioral and
pharmacological interventions in treating prescription drug
abuse and the critical role that primary care providers and
mental health specialists play in identifying abuse and
addiction.
Prevention.--As our Nation continues to look for effective
and cost-effective ways to reduce drug abuse, the Committee is
pleased to hear that NIDA will launch a new initiative to
develop a National Drug Abuse Prevention Trials System. The
system will test proven research-based efforts in a wide
variety of populations and settings. The Committee recognizes
that different racial and ethnic groups have different patterns
of drug use and abuse. NIDA is encouraged to expand research
aimed at developing effective, culturally specific drug abuse
prevention strategies for minority populations who are at
increased risk for drug abuse.
The Committee also applauds NIDA's efforts to launch a
major new National Prevention Research Initiative. This
initiative will establish the Prevention Research System, which
is intended to ensure that communities across the country have
effective ways to prevent drug abuse, particularly among
adolescents.
Stress.--NIDA is to be commended for its work on
determining the role that stress plays in drug abuse and
relapse to addiction and for developing science-based
approaches to help individuals cope with stress and drug
craving. The recent terrorist attacks and the fact that Post-
Traumatic Stress Disorder is a known risk factor for substance
abuse and addiction warrants that NIDA expand its research in
this important area.
Transdisciplinary tobacco research centers.--The use of
tobacco products remains one of the Nation's deadliest
addictions. The Committee strongly supports NIDA's continuing
efforts to address this major public health problem through its
comprehensive research portfolio. The Committee is pleased that
NIDA has teamed with the National Cancer Institute and an
outside foundation to establish the Transdisciplinary Tobacco
Use Research Center (TTURC). This multifaceted approach should
lead to an increased understanding of how nicotine acts in the
brain and body, and to new strategies for treating nicotine
addiction and preventing tobacco use, particularly by teens and
younger children.
NATIONAL INSTITUTE OF MENTAL HEALTH
Appropriations, 2001.................................... $1,103,062,000
Budget estimate, 2002................................... 1,234,389,000
Committee recommendation................................ 1,279,383,000
The Committee recommends an appropriation of $1,279,383,000
for the National Institute of Mental Health [NIMH]. This is
$44,994,000 more than the budget request and $176,321,000 more
than the fiscal year 2001 appropriation. The comparable amounts
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--The research programs of the Institute lead the
Federal effort to identify the causes of--and the most
effective treatments for--mental illnesses, which, according to
a report recently issued by the Surgeon General of the United
States, afflict more than one in five American adults. One
result of the Federal research investment has been a growing
awareness that undiagnosed and untreated mental illness, in all
its forms and with all of its consequences, is as damaging as
physical illness to the Nation's well-being.
Aging.--Studies show that elderly people are at greater
risk of mental disorders and their complications than younger
people; major life changes, such as the loss of friends and
loved ones, and physical illnesses, which often co-occur with
depression, are often contributing factors. The Committee is
pleased that NIMH has renewed and strengthened its emphasis on
mental disorders among the elderly, and it commends the
increased resources being directed to this critical area. The
Committee also notes the launch of an intra-NIMH consortium of
scientists concerned with mental disorders in the aging
population, with a goal of increasing coordinated research
efforts, expanding recognition of disorders in the elderly,
developing new treatments, and reducing stigma.
Alzheimer's disease.--NIMH continues to play an important
role in research on the causes of Alzheimer's disease, its
clinical course, and treatment and services for patients. For
example, the Institute is providing extensive support to
scientists to investigate aspects of depression, an important
problem that affects both Alzheimer's patients and family
caregivers. A clinical study already underway has documented a
strong link between depression and physical aggression in
Alzheimer's patients, suggesting that depression treatment may
reduce aggression in patients. The Committee encourages NIMH to
assign a high priority to Alzheimer's research and to continue
to collaborate with NIA and other institutes.
Children's mental health.--The Committee is aware that
NIMH's National Advisory Mental Health Council established a
Workgroup on Child and Adolescent Mental Health that is charged
with charting a new, more rational course for the future of
child and adolescent mental health research. The Committee
supports this effort in light of the continuing evidence of
high prevalence of mental illnesses in children and
adolescents, and the difficulty many children encounter in
accessing effective treatments, preventive strategies, and
services. The Committee endorses the further direction of
targeted research programs specifically for children and
adolescents.
Clinical trials.--The Committee commends NIMH on its launch
of four large clinical trials to investigate real-world
effectiveness of mental health research. The Committee
recognizes the efforts of NIMH to study treatments in everyday
settings by enrolling a representative sample of typical clinic
patients who may have co-occurring diseases and come from
diverse backgrounds. The Committee urges a balanced approach in
this endeavor, integrating clinical approaches to disease and
intervention efforts that address social and behavioral
determinants of disease.
Emergency medical services.--The Committee commends the
work supported by NIMH on mental health issues related to
emergency medical services for children through the University
of Tennessee, and also the collaboration of NIMH with HRSA in
funding the National Congress on EMSC in 1998. The Committee
encourages NIMH to enhance its support of EMSC-related projects
and to continue to work with HRSA in educational programs on
EMSC such as national conferences.
Extramural aging research.--The Committee is concerned
that, despite substantial funding increases for NIMH in recent
years, the Institute's sponsorship of extramural research on
the mental health of the elderly has not kept pace with its
funding of research for other populations. The Committee
strongly encourages NIMH to devote additional resources to
extramural aging research and urges the Director of NIMH to
designate an individual within the Office of the Director to
oversee the Institute's aging research agenda and initiatives.
The Committee also encourages the Director to ensure that
reviewers of research proposals include members with
specialized expertise in geriatrics.
Families and School Together Track program.--The Committee
commends NIMH for building science-based programs, such as the
Families and School Together (FAST) Track program, designed to
improve school-based mental health delivery systems. The
Committee encourages NIMH to continue to support research on
multi-year, multi-component interventions at the family,
school, and community levels. The Committee also urges NIMH to
further develop research on early interventions in children,
with a particular emphasis on problems of mood, anxiety and
conduct, taking into account informational deficits,
attitudinal factors, and cultural barriers that inhibit use of
these services.
Fragile X.--Fragile X is the most common single-gene
neuropsychiatric disease known, affecting 1 in 2,000 males and
1 in 4,000 females with cognitive impairment and mental
disorders such as obsessive-compulsive disorder and extreme
anxiety. The Committee urges NIMH to conduct research on the
neurobiological basis of fragile X, including studies on
specific neural circuits and molecules. The Committee encourage
NIMH to use its unique expertise to characterize the mental
health symptoms of fragile X and to investigate effective
treatments and promising new psychopharmacologic interventions
that target those symptoms. The Committee also urges NIMH to
include fragile X in its studies of related neuropsychiatric
disorders and to work with other Institutes such as NICHD and
NINDS to develop cooperative research support mechanisms in
this area.
Frontier mental health needs.--The Committee is pleased
that NIMH continued its series of conferences on the mental
health needs of remote rural and frontier communities with a
``Mental Health at the Frontier'' conference in Alaska in
August 1999 and commends NIMH on its outreach efforts to
determine the differences in mental health needs which may
exist in remote frontier communities. The Committee encourages
NIMH to expand its research efforts into these communities,
which are often ignored in research projects, but which
continue to suffer from high incidences of mental health
problems including depression, suicide and co-occurring
disorders with substance abuse.
Health disparities.--The Committee commends NIMH's efforts
to investigate the causes for the disproportionate impact of
mental disorders on racial and ethnic minority groups, as well
as methods of addressing and alleviating these health
disparities. The Committee is concerned that within and among
minority populations of Hawaii, access to health services and
treatment is uneven and at times nonexistent, and that
prevention of illness, recovery and treatment have often been
poorer in minority populations. The Committee strongly supports
NIMH's strategic plan to address problems and develop solutions
in the area of health disparities, and particularly supports
the following strategic goals: to achieve a more ethnic and
racially diverse pool of mental health investigators; to ensure
inclusion of minority groups in clinical trials funded by NIMH;
to obtain an accurate measurement of the extent of mental
health disparities; and to use basic behavioral science to
determine cultural differences in stress, coping and
resilience. The Committee also notes that NIMH has established
a Workgroup on Initiatives on Racial/Ethnic Diversity in
Training and Health Disparities Research. The Committee
endorses such efforts to increase racial/ethnic diversity among
research scientists as a means to reduce the severe disparities
that exist in the burden that mental illnesses place on
minority groups.
HIV/AIDS prevention for individuals at high risk.--The
Committee commends NIMH for developing research knowledge
essential for understanding and preventing HIV transmission,
particularly among people at high risk for infection (such as
the mentally ill, women of color, youth, and rural populations)
where the epidemic is spreading most rapidly. NIMH should
continue to support studies seeking to develop more effective
ways to prevent infections and strategies to deliver cost-
effective services.
Joint workshop between NINR and NIMH.--The Committee is
concerned regarding the lack of resources for outcomes research
focused on nursing interventions for psychiatric populations.
The Committee urges the NINR and the NIMH to jointly sponsor a
workshop with the psychiatric nursing community to identify
areas of research and specific questions directed at
interventions in psychiatric populations that directly
correlate to enhanced patient care.
Learning disabilities in infants and children.--The
Committee commends NIMH for the work conducted to explore the
neurological and behavioral aspects of learning disabilities.
The Committee encourages the Institute to continue to
coordinate with other Institutes to work on related activities.
Native Hawaiian center of excellence.--The Committee
remains very supportive of NIMH's efforts to develop a cadre of
native Hawaiian mental health researchers. Native Hawaiians
have historically experienced a disproportionate incidence of
various mental health problems, including depression. In order
to effectively address these issues in the long run, NIMH
should consider establishing a native Hawaiian center of
excellence in mental health.
New neuroscience center.--The NIMH, the NINDS, and other
Institutes have begun to design the John Edward Porter National
Neuroscience Research Center (NNRC), which will house
outstanding trans-NIH research programs. Intramural
neuroscience researchers from nine Institutes will perform
cutting-edge projects and form better collaborations due to
proximity in the same facility. This is critically important to
increasing the effectiveness, efficiency and pace of progress
in overall neuroscience being conducted at the NIH. The
Committee hopes that by fostering interaction among scientists
in different organizational settings, and among diverse
disciplines, the NNRC will serve to break down artificial
barriers that can keep scientists who are studying
complementary areas of science from communicating and
collaborating. Additionally, this will hasten the translation
of new knowledge into clinical applications.
Review of mood disorders research.--NIMH recently conducted
a major review of its research portfolio on mood disorders,
such as major depression and bipolar disorder. To do this, NIMH
brought together almost 100 of the country's leading
researchers in this area to evaluate the state of the field of
research and to make recommendations for future directions for
research. Participants were also asked to offer their views and
ideas for shaping the Institute's research agenda, as well as
informing educational and communication efforts for improving
health care. The Committee looks forward to hearing more from
NIMH about how this process is succeeding, and how it has
influenced the conduct of research in this area.
Social work research.--The Committee commends NIMH for its
continued recognition of the importance of social work research
in the delivery of disease prevention and treatment services.
The Committee urges NIH to explore ways to further involve
social workers in research efforts and to report back to
Congress on the involvement of social work in promoting
effective prevention and treatment outcomes throughout all NIH
Institutes and programs. The Committee continues to support the
NIMH's efforts to expand the number of social work research
development centers in light of the important work the centers
do to inform the delivery of mental health services by social
workers and other providers.
Suicide risk and protective factors.--The Committee urges
that NIMH and the CDC continue their collaboration to develop
and implement a consensus agenda of key questions on suicide
risk and protective factors. The NIMH should consider
supporting additional research on protective factors to better
understand phenomena such as why African-American women have
among the lowest suicide rates but have mental disorders at
rates comparable to those experienced by white women. The
Committee requests that the NIMH and the CDC submit an updated
consensus agenda on key research questions on suicide to the
Committee along with the administration's fiscal year 2003
budget proposal.
Tourette syndrome.--The Committee recognizes that public
misunderstanding of the neurobiological disorder Tourette
syndrome frequently results in ridicule, denied learning
accommodations and lost employment opportunities for children
and adults who have this disorder. The Committee is concerned
that lack of knowledge about and treatment for this disorder
may be particularly onerous in traditionally under-served
communities. The Committee is pleased that NIH has initiated
research into the genetic basis of this little-known disorder.
Consistent with the Children's health Act of 2000, the NIMH is
urged to develop a public education program that would reach
parents, educators, pediatricians, family physicians, and other
health care workers.
Translational behavioral research.--The Committee strongly
supports NIMH's efforts to investigate methods of building on
the Institute's portfolio of basic behavioral science in order
to address major public health issues including mental health
disorders. The Committee strongly supports translational
research in the behavioral and social sciences in order to
inform the diagnosis, treatment and delivery of services for
mental illness, particularly for young people. The Committee
commends NIMH for convening conferences bringing together
experts in basic behavioral research, clinical research and
services research, and others, to share information and
identify specific areas of promise for translational research
in addressing public health problems. The Committee also
promotes the establishment of translational behavioral research
as a priority funding area for NIMH.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Appropriations, 2001.................................... $381,101,000
Budget estimate, 2002................................... 425,674,000
Committee recommendation................................ 440,448,000
The Committee recommendation includes $440,448,000 for the
National Human Genome Research Institute [NHGRI]. This is
$14,774,000 more than the budget request and $59,347,000 more
than the fiscal year 2001 appropriation. The comparable amounts
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--The NHGRI has the responsibility at the National
Institutes of Health for providing leadership and support for
the Human Genome Project and for conducting a vigorous research
program aimed at understanding and treating both simple and
complex genetic disorders.
The Human Genome Project (HGP) is an international
collaboration to characterize the complete set of genetic
instructions encoded in the estimated 3.1 billion base pairs of
DNA. Begun in October 1990, the HGP is funded in the United
States by the NHGRI and the Department of Energy (DOE).
International partners include the United Kingdom, France,
Germany, Japan, and China. A major goal of the Human Genome
Project is to read each of the 3.1 billion bases, or letters,
in the human genetic instruction book. The rapid availability
of sequence, deposited every 24 hours into a publicly available
database, is providing valuable information to the research
community.
Human DNA sequencing is not the only goal of the Project.
The new 5-year Human Genome Project Research Plan, published in
Science magazine in October 1998, includes another seven
ambitious goals. These goals are guiding the development of a
new and more diverse set of genomic research tools for
researchers in both the public and private sectors in order to
advance our understanding and treatment of human disease. These
tools include: (1) optimization of current sequencing
technologies and development of novel strategies; (2) a catalog
of common variations, or single-nucleotide polymorphisms
(SNPs), in the human DNA sequence; (3) new technologies and
strategies for studying the function of genes and genomes; (4)
completion of the DNA mapping and sequence of additional model
organisms, including the fruit fly and mouse; (5) new
approaches to addressing the ethical, legal, and social
implications (ELSI) of research; (6) development of improved
databases and analytical tools in bioinformatics and
computational biology; and (7) training programs in scientific
and ELSI aspects of genomic and genetic sciences.
Using the information and tools produced by the Human
Genome Project, scientists in the Institute's intramural
research program are developing techniques to study the
fundamental mechanisms of genetic disorders and genetic factors
involved in disease risks. These cutting-edge approaches are
yielding new knowledge about human genetic diseases and their
diagnosis, prevention and treatment.
Clearinghouse for rare and genetic disorders.--
Approximately 6,000 of the 7,000 genetic disorders are rare
disorders. Unfortunately, there is no centralized clearinghouse
that can provide information to health professionals and the
public about such disorders. In previous years, the Committee
has encouraged the NHGRI, in collaboration with the Office of
Rare Diseases (ORD), to create an information center to
disseminate information, knowledge, and understanding of rare
and genetic disorders. The Committee is pleased to learn that
the NHGRI and the ORD plan to establish such a center this
fiscal year.
Epilepsy.--The Committee encourages the Institute to
intensify its efforts to identify epilepsy genes for the more
than 40 different types of epilepsy, and to assist the NINDS in
the search for a genetic fingerprint diagnostic test aimed at
improving drug therapy for epilepsy. The Committee suggests
that the Institute coordinate efforts with the NINDS to create
a national consortium to identify new epilepsy susceptibility
genes through a large-scale genotype:phenotype screen. The
Committee urges the Institute to make research in epilepsy a
priority and to coordinate research efforts with other
Institutes through the Interagency Epilepsy Coordinating
Committee comprised of agency scientists and industry and
patient representatives.
Human Genome Project.--The Committee commends the
international Human Genome Project, led by the NHGRI, for
sequencing 95 percent of the 3.1 billion bases of the human
genome years ahead of schedule. This was a remarkable
achievement that could not have occurred without Federal
support. At the same time, the Committee recognizes that
substantial effort will be required to produce the final,
highly accurate sequence by 2003. The Committee encourages
NHGRI to pursue the development of the next generation of
genomic tools and technologies needed to study the human genome
and understand its role in human health and disease.
The Committee is pleased that the NHGRI has made it a
policy to provide the sequence information immediately and
freely to the world via the World Wide Web, with no
restrictions on its use or redistribution. The information is
scanned daily by scientists in academia and industry, as well
as by commercial database companies, providing key information
services to biotechnologists. Already, tens of thousands of
genes have been identified from the genome sequence, including
more than 30 in just the last 2 years that play a direct role
in human disease. The Committee encourages the NIH to continue
this policy of free and unfettered access to genomic data.
The Committee also commends the NHGRI for its leadership in
research and policy development related to the ethical, legal
and social implications of the Human Genome Project. The early
commitment to devote 5 percent of the Institute's research
budget to study the ethical, legal, and social implications of
genome research has generated important information and
recommendations regarding research and public policy. The
Committee is particularly pleased with the Institute's
attention to protecting the genetic information of individuals
from misuse in health insurance and employment and its
development of policy recommendations in both areas. The
Committee supports and encourages the NHGRI's ongoing efforts
to examine the privacy and fair use of genetic information in
these settings and the many other important issues related to
human genetics research and its consequences, including: the
appropriate use of genetic tests; the protection of human
subjects who participate in genetic research; the development
of policies to guide research into genetic variation; and the
attention to complex social issues, such as how genetics
informs concepts of race and ethnicity.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
Appropriations, 2001.................................... $68,823,000
Budget estimate, 2002................................... 115,425,000
Committee recommendation................................ 140,000,000
The Committee recommends an appropriation of $140,000,000
for the National Institute of Biomedical Imaging and
Bioengineering [NIBIB]. This is $24,575,000 more than the
budget request and $71,177,000 more than the fiscal year 2001
appropriation. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--The NIBIB improves health by promoting
fundamental discoveries, design and development, and
translation and assessment of technological capabilities in
biomedical imaging and bioengineering, enabled by relevant
areas of information science, physics, chemistry, mathematics,
materials science, and computer sciences. The Institute plans,
conducts, fosters, and supports an integrated and coordinated
program of research and research training that can be applied
to a broad spectrum of biological processes, disorders and
diseases and across organ systems. The Institute coordinates
with the biomedical imaging and bioengineering programs of
other agencies and NIH Institutes to support imaging and
engineering research with potential medical applications and
facilitates the transfer of such technologies to medical
applications.
The Committee recognizes the contribution bioengineering
brings to medicine. Bioengineering improves the quality of life
through its contribution to advances in science and technology
related to health. The Committee understands that this newly
created Institute must have adequate resources to begin its
important task of high-quality research.
Imaging technologies.--The Committee encourages this new
Institute to devote significant resources to molecular imaging
technologies such as positron emission tomography (PET) and
microPET to take advantage of the capacities of molecular
imaging to detect disease process at the molecular level and to
monitor the effectiveness of targeted gene therapies now under
development. The Committee also encourages the new Institute to
develop its research agenda in close collaboration with other,
disease-specific Institutes at NIH, so that new imaging
technologies are closely tied to the research projects being
undertaken by the various other Institutes of NIH.
Joint replacement wear.--Average life expectancy has at
least doubled over the past century, presenting new challenges
in our efforts to reduce disability. For example, an estimated
500,000 joint replacements are performed in the United States
each year, many of which fail and require additional surgery.
Because the patients are typically elderly and frail, the
failed implant is often difficult to remove. The required
surgery is much more complex, dangerous, and expensive than the
original procedure, and the failure rate is several times
greater. It is widely recognized that the majority of failures
of artificial joints are caused by wear of the weight-bearing
surfaces. In light of demographic projections of a rapid
increase in the elderly population, the Committee expects the
Institute to assign a high priority to research identifying the
causes of wear in prosthetic joints as well as to finding
solutions to the problem, such as new materials.
Non-destructive evaluation.--The Committee is encouraged by
the possible use of non-destructive evaluation research for the
improvement of diagnostic capabilities in medicine. It also
recognizes that the initial parts of many clinical studies will
proceed more quickly on living animals. Research on developing
quantitative measurement techniques in the areas of
radiography, CT, ultrasound and magnetic resonance, and others
should be investigated, with experiments on animals being a
vehicle for early clinical studies.
Temporomandibular joint disorders (TMJ).--The Committee is
aware that the research portfolio on temporomandibular diseases
and disorders has extensively studied psychological and
behavioral factors in the etiology or chronicity of TMJ
diseases and disorders. The Committee urges the Institute to
broaden its scientific base for TMJ research by putting greater
emphasis on basic and clinical research on normal and abnormal
structural and functional features of the joint and related
structures, using the tools of cell and molecular biology as
well as advanced imaging techniques.
NATIONAL CENTER FOR RESEARCH RESOURCES
Appropriations, 2001.................................... $811,237,000
Budget estimate, 2002................................... 967,025,000
Committee recommendation................................ 1,014,044,000
The Committee recommends an appropriation of $1,014,044,000
for the National Center for Research Resources [NCRR]. This is
$47,019,000 more than the budget request and $202,807,000 more
than the fiscal year 2001 appropriation. The comparable amounts
for the budget estimate include funds to be transferred from
the Office of AIDS Research.
Mission.--The NCRR develops and supports critical research
technologies and shared resources that underpin research to
maintain and improve the health of our Nation. The NCRR
programs develop a variety of research resources; provide
biomaterial and resources for complex biotechnologies, clinical
research, and specialized primate research; develop research
capacity in minority institutions; and enhance the science
education of precollege students and the general public.
Crystallography.--The Committee is aware of the important
role that X-ray diffractometers and crystallography
laboratories play in allowing researchers to study the
interaction between possible drugs and receptor proteins. The
Committee encourages NCRR to consider supporting these systems,
which could benefit the development of new cancer treatments.
Extramural construction.--The Committee has included bill
language identifying $125,000,000 for extramural biomedical
facility renovation and construction. This is an increase of
$50,000,000 over the fiscal year 2001 appropriation. These
funds are to be awarded competitively, consistent with the
requirements of section 481A of the Public Health Service Act,
which allocates 25 percent of the total funding to institutions
of emerging excellence. The Committee commends NCRR for taking
a more proactive role in fulfilling this requirement.
General Clinical Research Centers.--Over three decades ago,
NIH established the General Clinical Research Centers (GCRCs)
program to support regional patient-oriented research centers.
Today, the NCRR supports about 80 GCRCs, which provide citizens
across the country with local access to clinical research
programs focused on a wide range of diseases and disorders. In
recent years, the Committee has expressed concern regarding the
inadequate funding provided to the GCRCs. Last year, the
Congress recognized the need to expand the GCRCs by authorizing
them in law as part of the Clinical Research Enhancement Act.
To achieve this goal and ensure that the GCRCs are equipped to
support clinical research aimed at preventing and curing
disease, the Committee has provided $275,000,000 for the GCRC
program as authorized by Section 481C of the Public Health Act.
This increase should be used to address the funding shortfall
of recent years; upgrade GCRC facilities with the sophisticated
technologies needed to apply information from the mapping of
the human genome to the pursuit of cures for diseases with a
genetic component; expand staffing as recently mandated by NCRR
to ensure patient safety and maximum compliance with new
regulatory requirements; and support local GCRC pilot projects
as approved by the NCRR Advisory Council in May of last year.
Human tissue supply.--The Committee continues to be very
interested in matching the increased needs of researchers,
particularly NIH grantees, as well as intramural and
university-based researchers, who rely upon human tissues and
organs to study human diseases and to search for cures. The
Committee is aware that the leader in this competitive field,
the National Disease Research Interchange [NDRI], is uniquely
positioned to serve NIH grantees, as well as the intramural and
university-based researchers who are finding it increasingly
difficult to obtain this valuable and effective alternative
research resource. More than 400 peer-reviewed research
advances made by NDRI-dependent researchers have been published
during the past 3 years contributing to the research
community's fund of knowledge. The Committee is greatly
encouraged by NDRI's role in these research advances and
applauds the Director's initial efforts to expand support for
NDRI by bringing NEI, NIDDK, NIAID, and the Office of Rare
Diseases into the multi-institute initiative. While this is
promising, more needs to be done to match the expanding and
unmet demand for the use of human tissue in research. The
Committee, therefore, expects the Director to advise the
Director of NCRR to substantially increase its core support for
NDRI, and to continue to encourage the Institute Directors NIH-
wide to identify and implement program-specific initiatives to
expand support for NDRI. The NIH should submit a written
progress report to the Committee no later than April 1, 2002,
outlining its plan and action steps to accomplish these goals
in fiscal year 2002.
IDeA grants.--The Committee has provided $200,000,000 for
the Institutional Development Award [IDeA] Program authorized
by section 402(g) of the Public Health Service Act. This is a
$100,000,000 increase over fiscal year 2001.
The Committee urges the NCRR to continue the successful
Centers of Biomedical Research Excellence program, as well as
the Biomedical Research Infrastructure Network program. The
focus of IDeA should continue to be on improving the necessary
infrastructure and strengthening the biomedical research
capacity and capability of research institutions within the
IDeA States.
Imaging technology.--The Committee continues to urge NCRR
to support research resource centers for the development and
refinement of positron emission tomography (PET) as a unique
imaging technology to diagnose and stage diseases of the brain,
including Alzheimer's disease.
Science Education Partnership Awards.--The Committee
applauds NCRR's demonstrated commitment to the Science
Education Partnership Awards (SEPA) program and the full
participation of the Nation's science centers and museums in
enhancing public awareness of health related research. The
Committee expects that a portion of NCRR's overall increase
will be used for a new competition of SEPA grants.
NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE [CCAM]
Appropriations, 2001.................................... $89,121,000
Budget estimate, 2002................................... 100,059,000
Committee recommendation................................ 110,000,000
The Committee has included $110,000,000 for the National
Center for Complementary and Alternative Medicine, an increase
of $9,941,000 above the budget request and $20,879,000 over the
fiscal year 2001 appropriation. The comparable amounts for the
budget estimate include funds to be transferred from the Office
of AIDS Research.
The Committee strongly supports the work of the National
Center for Complementary and Alternative Medicine. The Center
is charged with ensuring that complementary and alternative
therapies be rigorously reviewed to provide consumers with
reliable information.
The Committee expects that funding for existing and new
Centers supported by NCCAM will be maintained and directs the
Center to undertake field investigations and a program for the
collection and evaluation of outcome data on promising
alternative therapies. The Committee expects NCCAM to expand
its support of CDC's field investigations program and of AHRQ
literature reviews and data-analysis efforts. The Committee
also expects the Center to allocate sufficient funds to develop
and disseminate a comprehensive set of fact sheets on CAM
therapies to inform the public and health professionals of the
state of scientific knowledge about these therapies.
The Committee also expects the Center to transfer
sufficient funds to the White House for the operations of the
White House Commission on Complementary and Alternative
Medicine Policy if funds provided in previous years prove
insufficient.
Plant-based medicinal products.--The Committee supports the
need to accelerate the development and commercialization of
plant-based medicinal products, and encourages the NCCAM to
consider collaborating with plant scientists and companies in
Hawaii to responsibly use that State's unprecedented
biodiversity in developing new, health-enhancing products.
Traditional and indigenous medicine.--The Committee is
aware that knowledge of traditional and folk medicine is
rapidly disappearing from areas such as the Appalachian region
of the eastern United States, and it encourages NCCAM to fund
studies that preserve indigenous knowledge of the uses of
medicinal plants and investigate possible scientific bases for
their efficacy. The Committee further recognizes that the
moderated harvest of wild medicinal plants is important to
their availability for future use and recommends that funding
preference be afforded to those studies that incorporate a
holistic approach of scientific investigation and resource
management.
NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
Appropriations, 2001.................................... $132,044,000
Budget estimate, 2002................................... 158,421,000
Committee recommendation................................ 158,421,000
The Committee has included $158,421,000 for the National
Center on Minority Health and Health Disparities, the same as
the budget request and $26,377,000 over the fiscal year 2001
appropriation. The comparable amounts for the budget estimate
include funds to be transferred from the Office of AIDS
Research.
Mission.--The NCMHD advises the NIH Director and Institute
and Center (IC) directors on the development of NIH-wide policy
issues related to minority health disparities research,
research on other health disparities, and related research
training. Among other activities, the NCMHD develops, in
consultation with the NIH Director, IC directors, and the
advisory council, a comprehensive strategic plan that
identifies and establishes objectives, priorities, budgets, and
policy statements governing the conduct and support of all NIH
minority health disparities research, research on other health
disparities, and related research training activities. It also
administers funds for the support of minority health
disparities research and other health disparities research, by
awarding grants and leveraging the programs of the ICs.
Glomerular injury.--The Committee understands that
glomerular injury, a group of diseases that affect the
filtering mechanisms of the kidney, are more prevalent among
African Americans than the general population. The Committee
urges NCMHD to explore collaborations with NIDDK to conduct and
support research activities related to glomerular injury.
Osteoporosis.--The Committee urges the Center to support
research that furthers the understanding of the risk factors,
causes and consequences of osteoporosis among African-American,
Hispanic, Asian-American and Native American women and men.
Furthermore, the Center is encouraged to undertake
epidemiological studies to establish the prevalence of
osteoporosis among these populations and to determine whether
FDA-approved drug therapies are as efficacious among these
populations as in white postmenopausal women and men.
JOHN E. FOGARTY INTERNATIONAL CENTER FOR ADVANCED STUDY IN THE HEALTH
SCIENCES
Appropriations, 2001.................................... $50,472,000
Budget estimate, 2002................................... 56,446,000
Committee recommendation................................ 57,874,000
The Committee recommends an appropriation of $57,874,000
for the Fogarty International Center [FIC]. This is $1,428,000
more than the budget request and $7,402,000 more than the
fiscal year 2001 appropriation. The comparable amounts for the
budget estimate include funds to be transferred from the Office
of AIDS Research.
Mission.--Adapting research advances in biomedicine to
populations at home and abroad requires a continuing commitment
to basic science as well as rigorous clinical and applied
(epidemiological) studies. Examples are vaccines, anti-
infective agents, drugs, and more efficient diagnostic tools,
combinations of interventions, and health policies to reduce
the risk of disease and its associated human, social and
economic consequences. These challenges will benefit from a
more coordinated and multi-disciplinary approach to global
health needs. It is the mission of the FIC to address these
challenges by forging collaborations with a range of domestic
and global partners in international research and training to
pursue three core objectives: first, to accelerate the pace of
discovery and its application by special projects enabling
scientists worldwide to share conceptual insights, analytic
methods, data sets, patient cohorts, or special environments;
second, to engage and assist young as well as more established
U.S. investigators to address scientific challenges related to
global health; and third, to help develop a cadre of highly
capable young foreign investigators positioned to cooperate
with U.S. scientists in areas of the world that, due to
geography, genetics, or disease burdens, provide unique
opportunities to understand disease pathogenesis, anticipate
disease trends, or develop interventions of relevance and
priority for both the U.S. and the collaborating country.
Global tuberculosis threat.--The Committee recognizes the
growing importance of international research and surveillance
programs with respect to infectious diseases such as
tuberculosis (TB). The Committee is pleased by the Center's
research collaboration with international organizations and
governments on multi-drug-resistant TB, and it encourages the
Center to continue these important studies. The Committee is
aware that FIC offers TB supplemental training grants to
recipients of the AIDS International Training and Research
Program (AITRP) or the International Training and Research
Program in Emerging Infectious Diseases (ERID). The Committee
encourages FIC to develop a specific free-standing TB training
program.
NATIONAL LIBRARY OF MEDICINE
Appropriations, 2001.................................... $245,338,000
Budget estimate, 2002................................... 274,633,000
Committee recommendation................................ 281,584,000
The Committee recommends an appropriation of $281,584,000
for the National Library of Medicine [NLM]. This is $6,951,000
more than the budget request and $36,246,000 more than the
fiscal year 2001 appropriation. The comparable amounts for the
budget estimate include funds to be transferred from the Office
of AIDS Research.
Mission.--The National Library of Medicine is the Federal
institution that for more than 150 years has collected,
organized, preserved, and disseminated the world's output of
biomedical literature in all forms. As a result of this
activity NLM is the world's largest library of the health
sciences, its holdings numbering more than 5 million items. The
NLM has pioneered innovative methods to disseminate
bibliographic information. Basic to the mission of the NLM is a
wide-ranging research program to improve how medical
information is communicated. This responsibility is aided by a
grants program and by specialized services in toxicology,
environmental health, and biotechnology.
Bioethical issues.--Since 1985, the NLM has undertaken
important work in support of information retrieval in bioethics
and has established an effective and cooperative relationship
with the National Reference Center for Bioethics Literature at
the Georgetown University-based Kennedy Institute of Ethics. As
public policy debates today increasingly include in-depth
discussion of the bioethical aspects of topics such as the
oversight of human experimentation, stem cell research, cloning
and privacy issues surrounding health and genetic records, the
Committee is particulary aware of the importance of the work
begun through this partnership. The Committee encourages the
NLM and the Kennedy Institute of Ethics to maintain and build
upon this important work.
Facility expansion.--The Committee is pleased to actively
support the allocation of the needed funds to complete the full
design of the NLM facilities expansion. It hopes the design
will be completed expeditiously so that the burgeoning programs
of the National Center for Biotechnology Information and the
growing limits of available space for the world's greatest
medical collection can be satisfied through new facility
construction.
Home medical consultations.--The Committee expects NLM to
provide sufficient funds for a demonstration to test the use of
state-of-the-art telemedicine technology for home medical
consultations. This innovative approach holds great promise for
improving the care and lowering health care costs for home-
bound individuals who require frequent monitoring.
Outreach.--The Committee continues to note the success of
NLM's MEDLINE and MEDLINEplus databases. The Committee
encourages NLM to continue its outreach activities aimed at
educating health care professionals and the general public
about the Library's products and services, in coordination with
medical librarians and other health information specialists.
The Committee continues to be concerned about challenges
related to access to health information in the rural and other
medically underserved areas, and it particularly supports NLM's
efforts to address this through its Internet Connection Grant
program.
PubMed Central.--The Committee commends NLM for its
leadership in developing PubMed Central, an electronic online
repository for life sciences articles. PubMed Central holds
great promise for increasing access to health care literature
by health professionals, students, educators, researchers and
the general public. The Committee encourages NLM to work with
the medical library community regarding issues related to
copyright, fair use, peer-review and classification of
information on PubMed Central.
Senior citizen outreach.--The Committee again notes that
senior citizens would benefit greatly from expanded access to
NLM's databases, and it therefore expects NIH to provide
sufficient funds for a demonstration of a different means to
that end, such as including Internet access at senior centers
and congregate meal sites. The Committee expects to be briefed
on NLM's progress in this area.
OFFICE OF THE DIRECTOR
Appropriations, 2001.................................... $188,346,000
Budget estimate, 2002................................... 232,929,000
Committee recommendation................................ 236,408,000
The Committee recommends an appropriation of $236,408,000
for the Office of the Director [OD]. This is $3,479,000 more
than the budget request and $48,062,000 more than the fiscal
year 2001 appropriation. The comparable amounts for the budget
estimate include funds to be transferred from the Office of
AIDS Research.
Mission.--The Office of the Director provides leadership
and direction to the NIH research community, and coordinates
and directs initiatives which crosscut the NIH. The Office of
the Director 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
operation of the NIH.
The Committee directs the Director of NIH to make a written
request to the chairman of the Committee prior to any
reprogramming of $1,000,000 or more, between programs,
projects, activities, institutes, divisions and centers. The
Committee desires to have the requests for reprogramming
actions which involve less than the above-mentioned amounts if
such actions would have the effect of changing funding
requirements in future years, if programs or projects
specifically cited in the Committee's reports are affected, or
if the action can be considered to be the initiation of a new
program.
Aphasia.--It has come to the Committee's attention that the
scientific knowledge of this common and devastating acquired
speech and language disorder has gone virtually unchanged for
decades. The Committee, therefore, urges the appropriate
Institutes and Centers to expand and better coordinate their
support of research into the cause, incidence, treatment and
prevention of aphasia. Furthermore, the Committee urges the
Director to initiate a trans-NIH aphasia research planning and
coordinating function, charged initially with developing an
aggressive Aphasia Research Agenda that involves a
comprehensive state-of-the-science review and a delineation of
those areas with the most potential for yielding significant
advances in near-term treatments and rehabilitation
methodology.
Asian Indians.--The Committee recognizes that Asian Indians
worldwide have one of the highest rates of coronary artery
disease (CAD) and diabetes mellitus (DM) of any community
around the world, ranging from 2 to 10 times higher in any
given age range. The Committee understands that while there are
data in other countries regarding the prevalence of and risk
factors for CAD and DM of Asian Indians, there is a lack of
such data in the U.S. The Committee recommends that the
Director gather and analyze data from Indian-American
communities to study the prevalence of DM and CAD within this
population, and to create a registry for a longitudinal study
to gain insight into effective intervention strategies.
Asthma and allergic diseases.--Given the widespread
incidence of asthma and allergies and their high economic toll
on society, the Committee urges the NIH to consider a
cooperative effort by the appropriate Institutes and Centers,
including the NHLBI and NIAID, to encourage and promote
increased research in these areas.
Autism.--The Committee urges the Director, in coordination
with NIAID, NIDCD, NIEHS, NIMH, and NINDS, to continue to fund
and aggressively encourage researchers to engage in research
related to the potential causes, treatments, prevention, and
cure of autism spectrum disorders. In particular, the Committee
wishes to see the meaningful implementation of the new Centers
of Excellence in Autism Research, mandated in the Children's
Health Act of 2000. To that end, the Committee urges the
Director to allocate sufficient resources to advance the
scientific and research agenda related to autism spectrum
disorders.
Autoimmune diseases.--Autoimmunity is at the root of a
family of over 80 genetically and clinically interrelated major
diseases affecting some 50 million Americans. The Committee
encourages NIH and its Autoimmune Disease Coordinating
Committee to expand research aimed at improving awareness,
diagnosis and treatment for the entire family of autoimmune
diseases. Interrelated disease research will accelerate the
application of important findings among the many medical
specialties dealing with autoimmune diseases. The Committee
encourages NIH to study the overlapping genetics of autoimmune
diseases in order to improve diagnostic procedures and
effective treatments.
Behavioral science.--There is growing public awareness of
the behavioral underpinnings of disease. Heart disease, lung
cancer, liver disease, AIDS, suicide, developmental
disabilities, and many neurological and cognitive disorders in
some cases can be attributed directly or indirectly to
unhealthy behavior. The Committee urges NIH to incorporate
behavioral research as part of its core public health mission.
The Committee also urges the NIH to provide a detailed
description of its ongoing work in the behavioral sciences,
including a breakdown by Institute, and funds within each
Institute of research and training activities included in NIH's
behavioral and social science portfolio.
Biotechnology.--Over the last decade, there has been an
enormous growth in development of products from biotechnology.
With the nearing completion of the Human Genome Project and the
development of many new biological techniques, there are still
a large number of untapped areas of research that may produce
cures for many debilitating diseases. The Committee encourages
the Director to explore new projects that link government,
academia and industry, and involve public-private partnerships
across traditionally separated disciplines including genetics,
nano-technology, material sciences, physics, biology and
chemistry.
Child abuse and neglect.--The Committee recognizes the
significance of child abuse and neglect as a serious public
health problem claiming an estimated 826,000 victims in 1999,
according to the most recent data reported by the Department of
Health and Human Services. In 1996, the Committee called upon
NIH to develop a research agenda designed to address the
problems and gaps that currently exist in the State of research
in child abuse and neglect. The Committee encourages NIH to
proceed at a high level of attention with addressing the
research agenda with which it began in examining the National
Research Council report entitled Understanding Child Abuse and
Neglect, and requests that the working group be prepared to
report on current NIH research efforts in this area, the
accomplishments of that research, and on plans for future
coordination efforts at NIH at the fiscal year 2003 hearings.
Childhood birth defects and developmental disorders.--The
Committee recognizes the importance of helping children
suffering from birth defects and developmental disorders.
Thousands of children each year suffer from birth defects and
developmental disorders including cleft lip, cleft palate,
missing limbs and other facial deformities from hemangiomas,
hemifacial microsomia, microtia, aural atresia, and
craniosynostosis. The Committee, therefore, urges the
appropriate Institutes and Centers to expand and better
coordinate their support of research into the causes,
incidence, treatment and prevention of these and other
children's congenital or developmental conditions and to
develop a comprehensive action plan targeting these conditions.
Chronic fatigue syndrome (CFS).--Despite the Committee's
supportive report language for CFS research and generous
funding increases to NIH overall, CFS funding has not
increased. The Committee is pleased by NIH's efforts toward
elevating the prominence of CFS, such as moving the CFS program
to the Office of the Director, revitalizing the internal NIH
CFS Working Group, and holding two ``State of the Science''
conferences on CFS. In fiscal year 2001, the NIH developed a
program announcement to solicit applications in the priority
areas identified by the 2000 CFS State of the Science meetings,
and its next priority task will be to work on building a
multifaceted intramural research project.
Clinical research loan repayment.--The Committee is
concerned about the declining numbers of physician-scientists
pursuing careers in clinical research. In 1994, the Institute
of Medicine recommended the creation of an NIH extramural loan
repayment program. Last year, the Congress authorized the
program in the Clinical Research Enhancement Act. The Committee
believes that this program is critically important and that
tuition loan repayment should be made available to the largest
possible number of health professionals who are pursuing
structured training experience in clinical research; actively
engaged in clinical research career development activities with
the guidance of a mentor; or conducting clinical research with
independent support from NIH.
Collaboration with the CDC.--The Committee urges the Office
of Behavioral and Social Sciences Research (OBSSR) to develop a
working group or groups in collaboration with the Centers for
Disease Control in order to speed translation of behavioral
research to practice. The Committee recognizes that without
dedicated resources it is difficult for staff in different
agencies to collaborate as closely as may be needed. NIH is
urged to use its increased funding to intensify collaboration,
as well as facilitate communication and the transfer of
information.
Epilepsy.--The Committee recognizes that while the NINDS is
the primary Institute for addressing epilepsy, several other
Institutes are also involved in related research. As 75 percent
of epilepsy cases begin in childhood, the NICHD has an
important role to play in studying this disease. So, too, does
the NHGRI, which is urged to assist the NINDS in the search for
a genetic fingerprint diagnostic test aimed at improving drug
therapy for epilepsy, and the NIMH, which is urged to explore
the link between epilepsy and mood disorders, both of which are
often treated with anticonvulsant medications. Finally, the NIA
is encouraged to examine epilepsy in patients over age 65. The
Committee urges the Director to coordinate research efforts
among all these Institutes through an Interagency Epilepsy
Coordinating Committee that includes agency scientists and
industry and patient representatives.
Graduate Training in Clinical Investigation Awards.--The
Committee is pleased that the NIH has initiated the Clinical
Research Curriculum Awards to improve the quality of training
in clinical research. However, it is clear that a shortcoming
of this program is the absence of support for tuition and
stipends for the individual students. Last year, the Congress
addressed this by authorizing the Graduate Training in Clinical
Investigation Awards in the Clinical Research Enhancement Act.
The Committee believes that these grants are necessary if the
Curriculum Awards are to fulfill their enormous potential to
replenish the supply of well-trained clinical investigators.
Information technology.--Advances in information technology
make it possible to build powerful software-based simulations
that integrate the information emanating from medical and
biological science in ways that greatly enhance research,
education and training and medical practice. The Committee
urges the Director to facilitate the development and use of
these new tools by leading a national effort to ensure that
software components for simulations developed by NIH
contractors and by other Federal agencies can interoperate and
easily be improved and reused. The Director should also
encourage researchers to form an open-source community that
would facilitate sharing of software components and ensure
thorough peer review and testing of simulations against
empirical data. The Committee also urges the Director to
coordinate NIH's activities with other Federal agencies
including the National Science Foundation, the Department of
Defense and DARPA, and NASA.
Juvenile arthritis.--The Committee urges the Director, in
collaboration with the NIAMS, NICHD, and NIAID, to strengthen
its investment in and commit additional resources to basic,
clinical, and translational research efforts and related
activities specific to juvenile arthritis as authorized by the
Children's Health Act.
Lyme disease.--The Committee recommends that the NIH
improve its communication across Institutes in order to better
coordinate Lyme disease research and outreach to public and
private scientists with the goal of stimulating research
interest in this field. The Committee encourages the Office of
the Director to involve NIAID, NHLBI, NINDS, NEI, NIMH, and
NCCAM in promising areas of research. The Committee urges NIH
officials to identify appropriate NIH advisory committees for
Lyme disease representation and ensure the appointment of
qualified persons. The NIH is encouraged to include a broad
range of scientific viewpoints in the process of planning and
executing these efforts, including community-based clinicians
with extensive experience in treating these patients, voluntary
agencies who have advocacy in their mission, and patient
advocates.
Microbicides research.--The Committee is supportive of
increased funding for microbicide research and product
development through the OAR, NIAID, NICHD, NIMH, NIDA, and
ORWH. The Committee urges NIH to begin implementation of the 5-
year strategic plan for microbicide research, development and
evaluation in coordination with other Federal agencies. To
accelerate that implementation, the Committee encourages NIH to
increase the number of full-time employees dedicated to work
encompassed by the plan. The Committee requests a report by
March 31, 2002, on the status of its new microbicides program,
including research efforts, funding and staffing levels, and
implementation of the strategic plan.
Mississippi Delta.--The Committee urges the NIH to pursue a
comprehensive medical research agenda with academic
institutions in the Mississippi Delta that have partnered
together to develop initiatives and research projects focusing
on the disproportionate disease-risk factors and high rates of
morbidity in this health-challenged region. Though this area
leads the Nation in several chronic disease categories, the NIH
has not conducted any systematic study of the region. The
Committee requests that the Director report to the Committee by
March 1, 2002, on what comprehensive study should be
undertaken, when the research will begin, and with what
institutions the NIH will partner.
Neurofibromatosis.--The Committee recognizes that
neurofibromatosis (NF) research involves many Institutes and
Centers, including NCI, NINDS, NHLBI, NEI, NIDCD, and NIAMS.
The Committee urges the Director to develop a plan to identify
new research opportunities regarding NF that cuts across
Institutes and Centers. The Committee encourages the Director
to intensify and expand its NF research portfolio, and to work
with NF advocacy groups when identifying and pursuing new
scientific opportunities that will ultimately allow for the
development of effective treatments of NF.
NIH/DOE Medical Technology Partnership.--The Committee
urges the NIH to continue to collaborate with the Department of
Energy (DOE) to evaluate the technologies developed within the
nuclear weapons program and other DOE programs in terms of
their potential to enhance health sciences, with the goal of
achieving clinical applications and improved national health
care.
Office of Dietary Supplements.--The use of dietary
supplements has increased significantly among Americans who
want to improve their health and prevent disease, and there is
a great need for additional research to better inform consumers
of the benefits of these supplements. The Committee expects the
Office to allocate sufficient funds to expand the number of
botanical research centers, and it urges that hypericum and
echinacea be studied at one of these new centers.
The Committee has included sufficient funds to speed up
ongoing collaborative efforts to develop, validate, and
disseminate analytical methods, and reference materials for the
most commonly used botanicals and other dietary supplements.
The Committee is pleased that the ODS has followed through
on its recommendation to begin a major research initiative on
the safety and efficacy of products containing ephedra, and it
urges the Office to continue and expand this important effort.
The results of this expanded research should be evaluated by
the FDA to ensure that any final action on the proposed rule on
products containing ephedrine alkaloids is based on sound
science. The Committee believes the Department should
immediately take necessary interim action that addresses
scientifically supportable safety activities (such as adopting
appropriate warning labels that include contraindications and
warn against sales to minors) while this research is being
completed.
Office of Research on Women's Health.--The Office of
Research on Women's Health (ORWH) works in collaboration with
the Institutes and Centers (ICs) of the NIH to promote and
foster efforts to address gaps in knowledge related to women's
health through the enhancement and expansion of funded research
and the initiation of new investigative studies. The ORWH is
responsible for ensuring the inclusion of women in clinical
research funded by the NIH, including the development and
implementation of a computerized tracking system and the
implementation of guidelines on such inclusion. The Office is
also involved in promoting programs to increase the number of
women in biomedical science careers, and in developing women's
health and sex and gender factors in biology as a focus of
medical/scientific research. The Committee urges the Director
to use the increased funds provided to ORWH for new research
activities in a variety of health issues and new and expanded
career development programs for women scientists, such as
Building Indisciplinary Research Careers in Women's Health. In
addition, the Committee strongly supports the creation of new
interdisciplinary research centers to focus on multi-systemic
diseases in women, and urges ORWH, in conjunction with the NIH
ICs, to move forward with this proposal without delay. The
Director is asked to present a progress report to the Committee
by April 1, 2002.
Omega-3 fatty acids.--The Committee is aware of promising
research showing significant positive heart health effects
related to the consumption of omega-3 fatty acids through foods
or supplements. Given the significant human and financial costs
associated with coronary heart disease, the Committee urges the
Office to begin preliminary work on a major assessment of the
health benefits of omega-3 fatty acid consumption.
Parkinson's disease.--In consultation with the extramural
research community, the NIH has developed a Parkinson's Disease
Research Agenda that would require an estimated $1,000,000,000
increase in funding over 5 years to carry out. It is the clear
intent of the Committee that the NIH seek to implement this
research agenda, and that the Office of the Director assume an
aggressive leadership role in this effort.
Last year, the Congress strongly urged the NIH to work
toward implementing Year 1 of the research agenda, which cited
the need for a $71,400,000 increase in Parkinson's research
funding. The Committee is concerned that the NIH did not meet
that goal. As a consequence, much of the agenda remains to be
undertaken, and this highly promising field of research is not
moving ahead as speedily as the Congress intended.
An estimated $143,500,000 increase over the baseline year
would be needed to implement Year 2 of the research agenda, and
the Committee has provided additional funds for that purpose.
In order to ensure full implementation and funding, the
Committee directs the NIH to host a series of consortia in
collaboration with the Parkinson's research-related Institutes
and the extramural research community by February 15, 2002. The
consortia shall identify, to the full extent of available
scientific opportunity, the research needed to implement the
Research Agenda and the funding mechanism and dollars necessary
for each area. The Committee requests the Director to report by
March 15, 2002, that the consortia have been held, and on the
specific steps the NIH will take to implement the Research
Agenda.
The Committee commends the NIH for encouraging and
supporting workshops and other collaboration between sectors of
the Parkinson's research community, including the NIEHS-
supported consortia and the NINDS-supported workshop on gene
therapy, and encourages similar collaborative models. The
Committee also urges the NIH to continue support of the Udall
Centers program and to continue expansion thereof.
Pediatric research initiative.--The Committee is aware that
the Children's Health Act of 2000 authorized the establishment
of the Pediatric Research Initiative within the Office of the
NIH Director, for the purpose of encouraging an increased
emphasis on research addressing children's illnesses and
conditions across the various Institutes and Centers. The
Committee urges the Office of the NIH Director to carry out the
Initiative, including supporting training for pediatric
researchers, as authorized by Title X of the Children's Health
Act. The Committee requests NIH to provide a report to the
Committee by April 1, 2002, on the pediatric research
activities supported with these Initiative funds.
Pediatric Research Loan Repayment.--The Children's Health
Act of 2000 established the Pediatric Research Loan Repayment
Program to ensure the future supply of researchers dedicated to
the care and research needs of children. The Committee urges
NIH to use this program to encourage promising investigators to
enter various areas of pediatric research, particularly in the
areas of Duchenne muscular dystrophy and fragile X. The
Committee requests that the Director prepare a report, by April
1, 2002, detailing the progress of this program.
Population-based prevention research.--The Committee urges
NIH to significantly expand its support for studies that
examine the biological, behavioral and environmental risks for
disease. The Committee is especially interested in the
assessment of prevention-focused interventions designed to
enhance health status, the exploration of heath disparities
across population subgroups, the examination of strategies
designed to move the findings of laboratory-based research from
individuals to population-wide applications, and the
exploration of the potential uses of communication technologies
to enhance human health. The Committee urges NIH to submit a
report to the Committee by April 1, 2002, that indicates total
dollars spent on population-based prevention research by
Institute and relevant disease areas where possible.
Resuscitation research.--Some 600 Americans die each day
from cardiac arrest. The Committee understands that
cardiopulmonary and trauma resuscitation techniques have only
about a 10 to 15 percent success rate, and the average survival
rate has not improved significantly over the last four decades.
The Committee is pleased that the NHLBI, the NINDS, the NICHD,
the NIGMS, the Department of Defense, and the Food and Drug
Administration supported a forum to set a broad research agenda
on novel life-saving therapies and to identify promising new
directions in CPR and trauma resuscitation research. The
Committee encourages these agencies to pursue these new areas
of investigation.
Sjogren's syndrome.--Sjogren's syndrome is an autoimmune
disease with significant impact, and the Committee recommends
that the NIH Autoimmune Diseases Coordinating Committee include
Sjogren's syndrome as a priority in its strategic plan.
Sjogren's crosses many specialties and falls under the auspices
of many NIH institutes, including the National Institute of
Arthritis and Musculoskeletal and Skin Diseases, the National
Institute of Allergy and Infectious Diseases, the National
Institute of Dental and Craniofacial Research, and the National
Eye Institute. The Committee recognizes the need for NIH to
develop an integrated plan to cover Sjogren's syndrome that
cuts across the Institutes and meets the diverse needs of
Sjogren's patients.
Summer Student Research Program.--The Committee is aware of
the highly successful ``Summer Student Research Program,''
administered through Children's Research Institute at
Children's Hospital in Columbus, Ohio, that addresses the
critical shortage of physician-scientists in pediatrics--a
shortage that is far more acute in pediatrics than in adult
medicine. This program should be made permanent due to its
success in placing highly-qualified medical students in summer
research experiences in pediatrics and due to its outstanding
track record of including under-represented minorities and
women. Since 1991 there have been 1,183 applications to the
program, and 370 students from more than 80 different medical
schools have been successfully placed in nearly 140
laboratories throughout the United States and Canada. One-
fourth of awardees have been from under-represented minorities,
and women awardees have outnumbered men by more than 1.5 to 1.
Systems and integrated biology.--The Committee recommends
increased support for research and training in whole-systems
pharmacology, physiology, toxicology, and other integrative
biological disciplines that help to define the effects of
therapy on disease and the overall function of the human body.
Over the past two decades, there has been an emphasis on
supporting research and training at the cellular and molecular
levels, but diminished support for training and research in
systems and integrated biology. The erosion of support in the
area of integrated systems threatens to slow the rate at which
fundamental discoveries made at the cellular and subcellular
levels are translated into useful therapies. The Committee
understands that the Center for Scientific Review (CSR) is
currently reorganizing its peer review panels. It hopes that
the CSR will ensure that scientists with whole-systems
expertise will be represented on those panels.
Tobacco products.--The Committee urges that the NIH,
including NCI, NIDA, NHLBI, and NIMH, increase its commitment
to tobacco-related research, especially regarding cigarette
design, including ingredients and constituents. There is a
growing concensus in the scientific community that cigarettes
could be made less toxic and that changes in tobacco products
could reduce the risk of the disease and death in people who
continue to use them. However, there are major gaps in the
science base necessary for guiding such efforts. For example,
research is needed to understand the impact of tobacco product
variations on the development of cancer, heart disease, brain
diseases, fetal growth and nicotine addition itself. A specific
request for research applications, along with support for
intramural researchers to conduct such research, would
accelerate the process of discovery and cultivation of
expertise on this critical subject.
Temporomandibular joint disorders (TMJ).--The Committee
recognizes that the problems associated with temporomandibular
diseases and disorders involve many Institutes and Centers,
including the National Institute of Dental and Craniofacial
Research, the National Institute of Arthritis and
Muscoloskeletal and Skin Diseases, the National Institute of
Allergy and Infectious Diseases, and the National Institute of
Biomedical Imaging and Bioengineering. The Committee calls on
the Office of the Director to coordinate cross-cutting research
by the various Institutes and Centers and provide a report
directly to the Committee by April 1, 2002, on TMJ initiatives
begun in fiscal year 2001 or scheduled to begin in fiscal year
2002. In addition, a Special Emphasis Panel should be
established to review applications in the multiple disciplines
applied to studies of the causes, manifestations and treatments
of temporomandibular diseases and disorders.
Veterans affairs cooperation.--The VA system of 173
hospitals and 771 clinics provides medical care for the full
array of diseases and medical conditions to 4.1 million
veterans. The Committee, therefore, believes that the VA system
is an ideal setting for large multi-center studies and clinical
trials and that NIH should more aggressively utilize this
resource to facilitate and accelerate research. The Committee
requests that NIH explore with the VA ways to increase
cooperative research efforts and develop an interagency
Memorandum of Understanding to accomplish this purpose and
report to the Committee by April 1, 2002, on the projects
initiated under this move.
BUILDINGS AND FACILITIES
Appropriations, 2001.................................... $153,761,000
Budget estimate, 2002................................... 236,600,000
Committee recommendation................................ 306,600,000
The Committee recommends an appropriation of $306,600,000
for buildings and facilities [B&F]. The amount recommended is
$70,000,000 more than the budget request and $152,839,000 more
than the fiscal year 2001 appropriation. Included in these
funds is $70,000,000 to be transferred to the Global Fund to
fight HIV/AIDS, Malaria, and Tuberculosis.
Mission.--The buildings and facilities appropriation
provides for the NIH construction programs including design,
construction, and repair and improvement of the clinical and
laboratory buildings and supporting facilities necessary to the
mission of the NIH. This program maintains physical plants at
Bethesda, Poolesville, Baltimore, and Frederick, MD; Research
Triangle Park, NC; Hamilton, MT; Perrine, FL; New Iberia, LA;
and Sabana Seca, PR.
OFFICE OF AIDS RESEARCH
Appropriations, 2001....................................................
Budget estimate, 2002...................................................
Committee recommendation................................................
The Committee recommendation does not include a direct
appropriation for the Office of AIDS Research [OAR]. Instead,
funding for AIDS research is included within the appropriation
for each Institute, Center, and Division of the NIH. The
recommendation also includes a general provision which directs
that the funding for AIDS research, as determined by the
Director of the National Institutes of Health and the OAR, be
allocated directly to the OAR for distribution to the
Institutes consistent with the AIDS research plan. The
recommendation also includes a general provision permitting the
Director of the NIH and the OAR to shift up to 3 percent of
AIDS research funding among Institutes and Centers throughout
the year if needs change or unanticipated opportunities arise.
These modifications to the budget recommendation are consistent
with the manner in which funding for AIDS research was provided
in fiscal year 2001. The Committee requests that the Director
report on the fiscal year 2001 allocation plans for AIDS
research within 60 days of enactment and provide notification
to the Committee in the event the Directors exercise the 3
percent transfer authority.
The NIH Office of AIDS Research [OAR] coordinates the
scientific, budgetary, legislative, and policy elements of the
NIH AIDS research program. Congress provided new authorities to
the OAR to fulfill these responsibilities in the NIH
Revitalization Act Amendments of 1993. The law mandates the OAR
to develop an annual comprehensive plan and budget for all NIH
AIDS research and to prepare a Presidential bypass budget.
Substance Abuse and Mental Health Services Administration
Appropriations, 2001.................................... $2,963,856,000
Budget estimate, 2002................................... 3,029,456,000
Committee recommendation................................ 3,073,456,000
The Committee recommends $3,073,456,000 for the Substance
Abuse and Mental Health Services Administration [SAMHSA] for
fiscal year 2002, an increase of $109,600,000 over the fiscal
year 2001 level and $44,000,000 more than the administration
request. SAMHSA is responsible for supporting mental health
programs and alcohol and other drug abuse prevention and
treatment services throughout the country, primarily through
categorical grants and block grants to States.
The Committee remains concerned by the disproportionate
presence of substance abuse in rural and native communities,
particularly for American Indian, Alaska Native and Native
Hawaiian communities. The Committee reiterates its belief that
funds for prevention and treatment programs should be targeted
to those persons and communities most in need of service.
Therefore, the Committee has provided sufficient funds within
CSAP and CSAT to continue supporting projects that increase
knowledge about effective ways to deliver services to rural and
native communities. The Committee believes that Community
Health Centers should be utilized in this effort.
The Children's Health Act of 2000 reauthorized programs
administered by the SAMHSA and created new program authorities
designed to address emerging mental health, alcohol and other
drug abuse issues. The Committee has provided funding for
programs of regional and national significance under each of
the three SAMHSA centers: mental health services, substance
abuse treatment and substance abuse prevention. Separate
funding is available for the children's mental health services
program, projects for assistance in transition from
homelessness, the protection and advocacy program, data
collection activities undertaken by the Office of Applied
Studies and the two block grant programs: the community mental
health services block grant and the substance abuse prevention
and treatment block grant.
CENTER FOR MENTAL HEALTH SERVICES
Appropriations, 2001.................................... $782,048,000
Budget estimate, 2002................................... 766,148,000
Committee recommendation................................ 787,148,000
The Committee recommends $787,148,000 for mental health
services, $5,100,000 more than last year's level and
$21,000,000 more than the budget request. Included in this
amount is funding for programs of regional and national
significance, the mental health performance partnership block
grant to the States, children's mental health services,
projects for assistance in transition from homelessness, and
protection and advocacy services for individuals with mental
illnesses. The Committee continues to support funding for
mental health counselors for school-age children, as part of an
effort to reduce the incidence of youth violence. The Committee
intends that $90,000,000 be used for counseling services for
school-age youth.
Programs of regional and national significance
The Committee recommends $203,599,000 for programs of
regional and national significance, $5,100,000 more than the
fiscal year 2001 amount and $21,000,000 more than the
administration's request. Programs of regional and national
significance address priority mental health needs through
developing and applying best practices, offering training and
technical assistance, providing targeted capacity expansion
grants, and changing the delivery system through family,
client-oriented and consumer run activities.
The Committee has again included resources to continue and
expand mental health services for schoolchildren that are at
risk of exhibiting violent behavior. Among other things, the
Committee believes that mental health counseling for troubled
youth can help prevent violent acts, and therefore is providing
additional resources to help schools in that effort. It is
again expected that SAMHSA will collaborate with the
Departments of Education and Justice to continue a coordinated
approach.
The Committee is concerned that the Agency's funding of
health services knowledge development for the mental health of
the elderly has not kept pace with its funding for other
populations. For example, CMHS does not have any projects
planned to assess how health care systems impact access to
quality mental health for the elderly population. The Committee
strongly encourages CMHS to devote additional resources in
fiscal year 2002 and subsequent fiscal years to this issue, and
urges the Director of CMHS to designate an individual within
the Office of the Director to oversee the Center's aging
knowledge development agenda and initiatives. Special priority
should be given to funding dissemination and implementation of
evidence based practices in real world health care settings.
The Committee is aware of the need for additional suicide
prevention activities and is impressed with the Surgeon
General's report, ``A National Strategy for Suicide Prevention:
Goals and Objectives for Action'', which was released in May
2001. The passage of S. Res. 84 and H. Res. 212 in the 105th
Congress recognized suicide as a national problem and declared
suicide prevention to be a national priority. Since then, the
Committee is encouraged by the progress being made through the
collaborative efforts of both the public and private sectors to
raise national awareness on suicide prevention, to develop a
national suicide prevention strategy, and to involve States in
the development of State plans for grassroots implementation to
continue reducing the rate of suicide in America. Preliminary
data from the National Center for Health Statistics for 1999
suggest that these collective efforts have had a positive
impact. The number of suicides in the United States decreased
more than 5 percent from 30,575 in 1998 to 29,041 in 1999.
Nevertheless, suicide remains a serious public health challenge
and more needs to be done.
The Committee commends the joint efforts of the SAMHSA/
CMHS, NIH/NIMH, CDC, and HRSA to launch a website resource
which provides a wide array of suicide prevention related
information and resources for mental and public health
professionals, health care providers, community coalitions,
policymakers, survivors, and advocates. Significant activity is
now ongoing at the State, community, and non-profit levels in
developing and implementing plans, programs and services. This
follows the guidance outlined in the National Strategy for
Suicide Prevention: Goals and Objectives for Action (NSSP).
Further, the NSSP recommends the development of one or more
training and technical resource centers to build capacity for
States and communities to implement and evaluate suicide
prevention programs. The Committee has included $3,000,000 to
build upon the work of the Agencies identified above by
establishing a National Suicide Prevention Resource Center to
provide technical assistance in developing, implementing and
evaluating effective suicide prevention programs. The Resource
Center will provide training and field support and serve as a
clearinghouse for all pertinent best practices information
regarding suicide prevention. The Center should promote
evaluation of suicide prevention programs to ensure that
effective techniques, strategies, and recommended best
practices are made available to users.
Hawaii has a large refugee immigrant population that has
been found to be suffering from a disproportionately high
amount of post-traumatic stress disorder. Because of the
multiple diverse cultures that these future citizens come from
and the fact many speak no English, it is very difficult to
meet their mental health needs. The Committee urges attention
be given to effectively resolving the mental health problems of
these future citizens.
The Committee recommendation includes funding for the Safe
Schools/Healthy Students Program, which supports the
Departments of Health and Human Services, Justice, and
Education, working together to develop empirically supported
programs to prevent youth violence and to intervene with
families, schools, and communities where violence has already
occurred. The Committee urges the use of community health
centers as part of this effort.
The Committee commends CMHS for its efforts to reduce
stigma and other barriers that discourage Americans from
seeking mental health services. The Committee is aware that
fewer than one-third of Americans with a diagnosable mental
disorder seek out services and notes the recent Surgeon General
finding that stigma is a barrier that both discourages people
from obtaining treatment and promotes discrimination against
the mentally ill. The Committee understands that the National
Mental Health Awareness Campaign has launched a very successful
youth initiative designed to reduce the fear and shame
associated with childhood mental disorders. The Committee
believes that a nationwide public service advertising campaign
combating stigma among adults and senior citizens could have a
positive effect on public attitudes and behaviors.
The Committee is aware of the significant steps CMHS has
taken to improve services to those living with and suffering
from HIV/AIDS and has included sufficient funding to continue
these efforts. The Committee recognizes the need for more
trained health providers, including allied health professionals
and social workers, to work with people suffering from HIV/AIDS
and commends the collaborative effort of CMHS, HRSA, NIMH,
NIAAA and NIDA to address this issue. The Committee also notes
the support CMHS has provided to community-based initiatives to
deliver direct mental health services for people living with
HIV/AIDS. These HIV/AIDS activities should continue to develop
and apply new knowledge that improves the quality of services
available.
The Committee recommendation includes resources for
Targeted Capacity Expansion (TCE) activities to develop and
implement empirically based models for prevention and early
intervention for children's mental health problems. The
Committee recognizes that the increased number of young
children diagnosed with mental disorders, the rising teen
suicide rate, and the recent incidents of school violence are
all indicators that our Nation's children and youth have
serious unmet mental health needs.
The Committee appreciates CMHS's commitment to improving
the quality, effectiveness and availability of therapeutic
services delivered to traumatized children and adolescents;
furthering the understanding of the individual, familial, and
community impact of child and adolescent traumatic stress and
the methods used to prevent its consequences; and reducing the
frequency and consequences of traumatic events on children and
adolescents. The Committee recommendation includes sufficient
funding to expand activities of the Child Traumatic Stress
Program.
The Committee notes that the Minority Fellowship Program
(MFP) plays a crucial role in reducing the racial and ethnic
disparities in mental health status in Native Hawaiian and
Samoan communities. The MFP plays a significant role in
training minority mental health professionals to provide
services, through community health centers and other clinics,
to individuals who would otherwise go untreated.
The Committee is pleased that the Center for Mental Health
Services funds state-of-the-art, peer-run programs that help
people with mental illnesses live successfully in the
community. These low-cost services have an impressive record of
assisting people with mental disorders to decrease their
dependence on expensive social services and avoid
hospitalization. The Committee is supportive of CMHS's funding
of five national technical assistance centers that provide
training and information to help these programs serve their
clients.
The Committee is aware of the following projects and
programs, and encourages SAMHSA to give each full and fair
consideration for awards available in new grant competitions.
Expansion of Phase II of the HIV/AIDS High Risk Behavior
Prevention Program will help reduce the behavioral transmission
of the virus and support mental health services to those
persons already infected with the disease.
The Comprehensive Community Mental Health Services for
Children and their Families program will continue the
development and evaluation of mental health services for
children and youth in States and localities using community
health centers.
Life Quest Community Mental Health Center, which serves the
second largest population center in Alaska, is seeking to fill
the previously unmet need for treatment of co-occurring
disorders for severely and persistently mentally ill, severely
emotionally disturbed adults and children in the Mat-Su Valley
region of Alaska.
Ventura County, California has developed its capacity to
effectively transition mentally ill prisoners out of detention
facilities and into a community treatment environment.
The Pennington County Detention Center in Rapid City, South
Dakota has experienced significant growth in the number of
detainees in need of mental health and substance abuse
treatment services.
The Weingart Center in Los Angeles, California will develop
and expand mental health support and long-term case management
within transitional housing and clinical programs to help end
poverty and break the cycle of homelessness.
Washoe County, Nevada will develop a suicide prevention
program designed to investigate the effect of an Intensive
Depression Recognition and Treatment Training Program for
primary care physicians and their nurses, psychiatrists, and
corporate and student health personnel on the recognition of
mood disorder, suicide mortality and morbidity.
The Texas Medication Algorithm Project (T-MAP) has
developed a disease management program that synthesizes
scientific and practitioner consensus into a practical
guideline for physicians, and also has demonstrated
improvements in the quality of care for individuals receiving
psychotropic medications.
The Mental Health Connection of Tarrant County, Texas, is
planning a collaborative initiative to provide families and
individuals with a seamless, accessible ``wraparound'' system
of community mental health services.
The Fairbanks Native Association, Tanana Chiefs Conference,
and the University of Alaska Fairbanks' ``Ch'eghutsen''
comprehensive mental health services program for children in
interior Alaska is addressing the critical shortage of
culturally relevant mental health services for children,
especially those who are seriously emotionally disturbed, in
the vast area which comprises interior Alaska. Ch'eghutsen is
guided by Alaska Native principles which view the child as
inseparable from family and community, and is addressing
suicide attempts, substance abuse, fetal alcohol syndrome and
fetal alcohol effect, sexual abuse, violence, and individual
and collective trauma for the more than 600 Alaska Native
children who are estimated to suffer from serious emotional
disturbances in this region.
The Alaska Psychiatric Institute and the State of Alaska
will continue designing programs to treat co-occurring
disorders and focus efforts on developing treatments for
victims and witnesses of domestic violence and child abuse, a
considerable problem in Alaska, which has the highest rates of
child abuse and domestic violence in the Nation.
The Alaska Federation of Natives, in consultation with the
State of Alaska, continues to develop integrated systems of
community care for Alaska Native children who commit suicide at
the highest rate in the Nation and suffer disproportionately
from behavioral and mental disorders, some caused by fetal
alcohol syndrome.
The Alaska Federation of Natives, in consultation with the
State of Alaska, will develop a plan for outreach, screening
and diagnostic treatment services, rehabilitation, mental
health services, alcohol and drug treatment, training, and case
management to help reduce the large numbers of individuals,
particularly Alaska Natives, suffering from severe mental
illness and substance abuse disorders who are also homeless.
This problem is especially acute in Anchorage, Alaska.
Family Communications and its pilot project, ``What Do You
Do with the Mad that You Feel?'' has provided encouraging
evidence of success in preventing youth violence. Family
Communications proposes to expand this initiative beyond the
original pilot States and plans to introduce a follow-up
program, ``The Challenging Child.''
The 2nd Trauma project, an initiative designed to help over
7 million families each year who receive the news of the
sudden, unexpected violent death or critical injury of their
child, spouse, parent or other loved one, has developed a
program to train trauma center and emergency room personnel to
develop the skills needed to tell a family member that a loved
one has suffered a traumatic injury or death, prepare personnel
to provide immediate and sensitive counseling on critical
decisions, and engage long-term community support networks when
appropriate.
Safe Havens, an award-winning training program for care
givers and teachers, aims to help adults counsel children who
have witnessed violence and plans to expand its training beyond
the pilot States of Pennsylvania, Iowa, Massachusetts,
Maryland, and New York.
The Alaska Federation of Natives, in consultation with the
State of Alaska, will identify the most effective service
delivery practices and develop model programs for
implementation in the Alaska Native community that help reduce
the rates of suicide, child abuse, and alcohol dependency,
especially in Native communities. Alaska has the highest rates
of alcohol dependency in the Nation, the highest rate of
suicide, and the highest rate of child abuse, especially in
Native communities in Alaska.
Mental health performance partnership block grant
The Committee recommends $420,000,000 for the mental health
performance partnership block grant, the same amount as the
fiscal year 2001 appropriation and the budget request. States
use these funds to support the development and implementation
of innovative community-based services and maintain continuity
of community programs. Funds are allocated to States and
territories by formula.
Children's mental health services
The Committee recommends $91,694,000 for the children's
mental health services program, the same amount as the fiscal
year 2001 level and the administration's request. This program
provides grants and technical assistance to support community-
based services for children and adolescents with serious
emotional, behavioral or mental disorders. Grantees must
provide matching funds, and services must involve the
educational, juvenile justice, and health systems.
The Committee has provided sufficient resources to expand
the child mental health services program over the past several
years. However, staff resources dedicated to administering this
program have not grown. The Committee recognizes the benefit of
providing sufficient staff support to ensure that local
grantees have the technical capacity to operate this program
effectively.
Projects for assistance in transition from homelessness [PATH]
The Committee recommends $39,855,000 for the PATH Program,
an increase of $3,000,000 over the fiscal year 2001 amount and
the administration's request.
PATH is a critical program which provides outreach, mental
health, and case management services and other assistance to
persons who are homeless and have serious mental illnesses. The
PATH Program makes a significant difference in the lives of
homeless persons with mental illnesses. PATH services eliminate
the revolving door of episodic inpatient and outpatient
hospital care. Multidisciplinary teams address client needs
within a continuum of services, providing needed stabilization
so that mental illnesses and co-occurring substance abuse and
medical issues can be addressed. Assistance is provided to
enhance access to housing, rehabilitation and training, and
other needed supports, assisting homeless people in returning
to secure and stable lives.
Protection and advocacy
The Committee recommends $32,000,000 for the protection and
advocacy program, an increase of $2,000,000 over the fiscal
year 2001 amount and the administration's request. This program
helps ensure that the rights of mentally ill individuals are
protected while they are patients in treatment facilities, or
while they are living in the community, including their own
homes. Funds are allocated to States according to a formula
based on population and relative per capita income.
The Committee notes the Children's Health Act of 2000
provided additional authorities to State P&A systems in their
efforts to protect the rights of individuals with mental
illness and severe emotional impairment. This includes the
specific authority to monitor all public and private
residential care and treatment facilities and non-medical
community-based facilities for children and youth to ensure
that they are not at risk for inappropriate use of seclusion
and restraint and to investigate all incidents involving
serious injuries and deaths related to incidents of seclusion
and restraint used by staff at these facilities. State P&A
systems also have a significant role in addressing the
community integration needs of individuals identified in the
Olmstead decision. The Committee recommendation includes
$2,000,000 more than last year's appropriation to support State
P&A systems in their effort to address these critical issues.
CENTER FOR SUBSTANCE ABUSE TREATMENT
Appropriations, 2001.................................... $1,921,122,000
Budget estimate, 2002................................... 2,021,122,000
Committee recommendation................................ 2,001,122,000
The Committee recommends $2,001,122,000 for substance abuse
treatment programs, an increase of $80,000,000 over last year's
funding and $20,000,000 less than the budget request. This
amount funds substance abuse treatment programs of regional and
national significance and the substance abuse prevention and
treatment block grant to the States.
The Committee is concerned about the treatment gap that
continues to exist for those Americans in need of substance
abuse treatment services, for whom treatment is not available.
The latest estimates indicate that millions of Americans with
serious substance abuse treatment go untreated each year,
adding billions in monetary costs to our society each year and
immeasurable emotional pain and suffering for millions of
families. Studies have shown that substance abuse treatment is
effective at reducing primary drug use by nearly 50 percent,
criminal activity by 80 percent and alcohol- and drug-related
medical visits by 50 percent while increasing individual
financial self-sufficiency. The Committee commends CSAT for
initiating its National Treatment Plan Initiative (NTP), and
believes that additional resources need to be devoted to the
NTP and to reducing, and eventually eliminating, the treatment
gap.
Programs of regional and national significance
The Committee recommends $276,122,000 for programs of
regional and national significance [PRNS]. This amount is
$20,000,000 above the fiscal year 2001 amount and $20,000,000
less than the budget request.
Programs of regional and national significance, as
reauthorized by the Children's Health Act of 2000, include
three primary activities: knowledge development and application
projects are used to develop more information on how best to
serve those most in need; training and technical assistance
supports dissemination of information through knowledge
development; and targeted capacity expansion programs enable
the agency to respond to service needs in local communities.
The Committee recommendation includes $10,000,000 to expand
CSAT's support of clinically based treatment and related
services for adult, juvenile and family drug courts and
individuals returning from the community who are on probation,
parole, or unsupervised release. The Committee is aware of the
rapid increases in the use of drug courts throughout the
country as an alternative to the traditional court system.
These courts make substance abuse treatment available, when
appropriate, as an alternative to incarceration, and are
considered a cost-effective approach to helping drug users
regain control of their lives. While the fiscal year 2002
appropriation for CSAT includes additional resources for
treatment, the Committee notes that support for treatment
services has not kept pace with the increase in the use of drug
courts, thereby limiting the cost-effectiveness of this
approach. The Committee also believes SAMHSA should work with
the Department of Justice (DOJ) to ensure that administrative
and drug testing costs associated with sanctions-based
treatment for individuals under DOJ supervision are distributed
fairly.
Programs of regional and national significance include
critical support for substance abuse treatment services for the
Nation's homeless population. The homeless have unique needs
and life circumstances that have received inadequate attention
in terms of substance abuse treatment. Therefore, the Committee
continues to advocate coordinated and seamless service delivery
for the homeless that includes mental health, primary care, and
other social services that will support positive treatment
outcomes. The Committee recommendation includes additional
resources to continue to make progress in this area.
The Committee understands that methamphetamine abuse
continues to be a major problem in many areas of the country,
in particular, the South and the Midwest. The State of Iowa is
experiencing a particularly high incidence of methamphetamine
abuse, as well as other emerging drug issues. The Committee
recommendation includes sufficient funding to support
prevention and treatment demonstration projects in Iowa and
other parts of the Midwest and South. School-based prevention
demonstration projects would teach the dangers of
methamphetamine abuse and addiction as well as other emerging
drug issues, using methods that are effective and evidence-
based and include initiatives that give students the
responsibility to create their own anti-drug abuse education
programs for their schools. Treatment demonstrations would
carry out planning, establishing, or administering evidence-
based treatment programs that are designed to assist
individuals to quit their use of methamphetamine or other
emerging drugs and remain drug-free.
The Committee recognizes the importance of the residential
treatment program for pregnant and postpartum women, which was
authorized as part of the Children's Health Act of 2000 (Public
Law 106-310). This program has helped significantly increase
the percentage of children born free of illicit substances.
Continued funding of this program will contribute to the health
and well being of pregnant women with addictions and their
children.
The Committee is aware of the following projects and
programs, and encourages SAMHSA to give each full and fair
consideration for awards available in new grant competitions.
The Cook Inlet Council on Alcohol and Drug Abuse is
providing coordinated treatment services to meet the needs of
an underserved group of women and their children who are in the
custody of the State of Alaska and women affected by domestic
violence in the Kenai Peninsula area of Alaska.
Center Point, Inc. will demonstrate and evaluate the
effectiveness of its Adolescent Residential and Aftercare
Treatment Program, which is widely recognized throughout
Northern California as an effective option for troubled youth
because it provides a continuum of care, involves the family
and provides critical aftercare support.
The City of New Orleans Seamless Accountability System for
Substance Involved Offenders is a pre-sentencing program that
focuses on anti-violence behaviors and treatment therapies. The
program targets offenders 17 to 24 years of age.
The City of San Francisco's Treatment on Demand program
provides services that advance individuals' recovery through
abstinence and harm reduction, including the reduction of
delays in gaining access to substance abuse.
Haymarket West in Schaumburg, Illinois will expand its
comprehensive substance abuse treatment and related services in
the northwest suburbs.
The city of Baltimore is employing innovative techniques to
enhance drug treatment services for area residents,
particularly for those in need of intermediate residential
treatment.
Spectrum Youth and Family Services proposes to expand
services provided through its Youth Health Clinic located in
Burlington, Vermont.
Recovery House, Inc., in Wallingford, Vermont is developing
a day treatment program for women with dependent children and
pregnant women.
The Vermont Division of Alcohol and Drug Abuse Program and
the Vermont Department of Social and Rehabilitative Services
will improve access to residential treatment for adolescents in
custody in Rutland County.
The Navajo-Farmington Alcohol Crisis Response Program is
addressing the substance abuse problems in the City of
Farmington, San Juan County, and also working with affiliated
partners by establishing and operating an alcohol crisis
response network of services to address serious alcohol
problems.
The United Community Center/Centro de la Comunidad Unida's
demonstration project to address domestic violence in
Milwaukee's Hispanic community represents an innovative
integration of domestic violence intervention with the Center's
Latinas Unidas treatment program for substance-abusing women
and their families.
Lutheran Social Services of Wisconsin and Upper Michigan,
Inc. is developing a unique alcohol and other drug abuse
treatment program to address the specific needs of the older
adult population by locating certified alcohol treatment in the
community-based settings of three senior centers in northeast
Wisconsin.
The Corporation for Supportive Housing will help combat
chronic homelessness in communities by supporting the provision
of health-related assistance to this vulnerable population.
The National Center on Addiction and Substance Abuse at
Columbia University is partnering with the New Jersey
Department of HHS and the Department of Health and Senior
Services to evaluate strategies to assist women who have
substance abuse problems and are approaching Federal welfare
time limits.
The Southcentral Foundation in Anchorage has developed an
innovative program designed to provide substance abuse
treatment for Alaska Native adolescents.
The inpatient treatment program for adult Alaska Native
substance abusers at the Ernie Turner Center operated by the
Cook Inlet Tribal Council continues to provide inpatient and
outpatient services.
The Allegheny County Department of Human Services continues
to provide for both inpatient and outpatient drug and alcohol
services for its citizens as it faces increasing costs for
inpatient services that severely strain its ability to meet the
demand for treatment.
Substance abuse prevention and treatment block grant
The Committee recommends $1,725,000,000 for the substance
abuse prevention and treatment block grant, $60,000,000 more
than the fiscal year 2001 level and the same as the
administration's request.
The block grant provides funds to States to support alcohol
and drug abuse prevention, treatment, and rehabilitation
services. Funds are allocated to the States according to
formula. State plans must be submitted and approved annually.
The Children's Health Act of 2000 made several changes to
the authority for the substance abuse prevention and treatment
block grant, including the development of a performance
partnership framework in which States are granted program
flexibility for achieving a common set of performance measures;
extending the period of time States have to obligate block
grant funds; and prohibiting discrimination against religious
organizations in receiving Federal assistance for providing
substance abuse services. The Committee expects SAMHSA to be
prepared to provide detailed information about implementation
of these and other modified and new program authorities during
the fiscal year 2003 budget process.
The Committee supports efforts currently underway in SAMHSA
to create a strategic plan around homelessness. The Committee
commends SAMSHA on this initiative, and encourages the Agency
to tie this plan in with planning requirements in the recent
SAMSHA reauthorization bill. Specifically, the Committee
encourages SAMSHA to build housing status into the common set
of performance measures required from States reporting on block
grant programs. The Committee is concerned about the lack of
data from the mental health and substance abuse block grant
programs on the housing status of persons entering and exiting
programs. A set of consistent performance measures is needed
across programs serving homeless and precariously housed people
in SAMHSA and other Operating Divisions, including HRSA, ACF
and CMS, to understand the impact HHS programs are having.
Further, the Committee requests reports on the status of plans
for performance partnerships, including the outcomes to be
measured, from the Substance Abuse Prevention and Treatment
Block Grants and Mental Health Block Grants within 6 months of
the enactment of this Act.
CENTER FOR SUBSTANCE ABUSE PREVENTION
Appropriations, 2001.................................... $175,013,000
Budget estimate, 2002................................... 175,013,000
Committee recommendation................................ 189,013,000
The Committee recommends $189,013,000 for programs to
prevent substance abuse, an increase of $14,000,000 above last
year's level and $14,000,000 more than the budget request. This
amount funds substance abuse prevention programs of regional
and national significance.
Programs of regional and national significance
The Committee has provided $189,013,000 for programs of
regional and national significance [PRNS], $14,000,000 more
than the fiscal year 2001 amount and $14,000,000 more than the
administration's request. The Center for Substance Abuse
Prevention is the sole Federal organization with responsibility
for improving accessability and quality of substance abuse
prevention services. Through the programs of regional and
national significance activity, CSAP supports: development of
new practice knowledge on substance abuse prevention;
identification of proven effective models; dissemination of
science-based intervention information; State and community
capacity-building for implementation of proven effective
substance abuse prevention programs; and programs addressing
new needs in the prevention system.
The Committee notes the alarming increase in use and
availability of ecstasy and other club drugs among our Nation's
youth. For 2 consecutive years, ecstasy use reported by 10th
and 12th grade students has increased. According to SAMHSA's
Drug Abuse Warning Network, ecstasy-related emergency room
admissions in the United States increased significantly from
253 in 1994 to 4,511 in 2000. The Committee urges SAMHSA to pay
close attention to this and other emerging drug use issues.
The Committee is aware of the need to strengthen fetal
alcohol syndrome (FAS) prevention efforts and improve service
delivery by ensuring that professionals in key fields are
knowledgeable about FAS and related birth defects, particularly
in high-prevalence regions. The Committee has therefore
included sufficient funding to allow the Four-State FAS
Consortium in Minnesota, Montana, North Dakota, and South
Dakota to develop programs to provide training on FAS and
related birth defects for professionals and students in health
care, education, social work, foster care, criminal justice,
and other relevant fields.
The Committee notes the insufficient number of effective
fetal alcohol syndrome and fetal alcohol effects (FAS/FAE)
programs in communities affected by this problem. The Committee
has provided an additional $1,300,000 to expand efforts to
identify, disseminate and implement effective FAS/FAE
prevention and treatment programs.
The Committee is aware of the following projects and
programs, and encourages SAMHSA to give each full and fair
consideration for awards available in new grant competitions.
The Fairbanks Native Association's LifeGivers residential
treatment program continues to achieve successes in helping
pregnant women with substance abuse problems and their
children.
The Vermont Department of Health, Division of Alcohol and
Drug Abuse Programs proposes a pilot project of support for
community-based programs in Rutland, Burlington, and Barre to
explore best practices for combating the growing drug abuse
problem.
The Ai Ki Ruti Center is developing outreach initiatives to
underserved Native American populations in Northeast Nebraska
to increase their access to needed prevention and treatment
services.
The Start SMART Foundation in Bethlehem, Pennsylvania is
developing a pilot project to reduce underage drinking
utilizing QED, a new saliva alcohol test which returns an
accurate measurement of blood alcohol levels in 2 to 5 minutes.
The National Center on Addiction and Substance Abuse at
Columbia University has developed CASEWORKS for Families, an
innovative program to help women at risk of substance abuse.
The Institute for Research, Education, and Training in
Addictions in Pittsburgh will facilitate the coordination of
approaches to research, treatment and health policy
development.
The Municipality of Anchorage, home to almost 50 percent of
Alaska's population, plans to initiate a prevention program
based on research into best practices and culturally relevant
programs to reduce the incidence of drug and alcohol abuse
among Anchorage residents.
The City of Providence's Southeast Asian Youth and Family
Development (SEAYFD) project has helped address the increase in
drug and alcohol abuse, and the alarming gang activity among
the Southeast Asian community.
The Bridgebuilders program in Ohio will create and evaluate
the effectiveness of a multi-tiered blueprint for reducing
youth alcohol and drug use that uses a systematic, statewide
approach to bridge the divide between youth, parents, community
systems, and related State systems.
The Alaska Department of Health and Social Services will
assess and screen Alaska youth for alcohol abuse and dependency
and develop a statewide plan to address youth alcohol abuse and
dependency in Alaska. The plan is a response to concerns that
50.8 percent of Alaska high school youth report current alcohol
use and 33.4 percent report binge drinking at least once a
month.
PROGRAM MANAGEMENT
The Committee recommends $96,173,000 for program management
activities of the agency, $10,500,000 more than the fiscal year
2001 level and $29,000,000 more than the President's request.
The additional $29,000,000 provided by the Committee
support national data collection activities, including the
Household Survey on Drug Abuse. The increase will be used to
add to the survey two new components: The Longitudial Survey of
Youth and Survey of the Elderly, as well as augment the Drug
Abuse Warning System. The budget requested the $29,000,000 for
these activities under the Department's evaluation authority.
The program management activity includes resources for
coordinating, directing, and managing the agency's programs.
Program management funds support salaries, benefits, space,
supplies, equipment, travel, and departmental overhead required
to plan, supervise, and administer SAMHSA's programs.
The Committee commends SAMHSA for its prompt, effective
response to the terrorist attacks that occurred on September
11, 2001. The Committee is aware that the agency promptly
mobilized personnel, resources and other supportive services to
help address the needs of individuals in affected areas. Mental
health experts were provided promptly to help address immediate
needs as well as to assist with longer-term planning for future
mental health and substance abuse services in affected States
and communities. The Committee is supportive of additional
resources being made available to SAMHSA to ensure that
individuals affected by the events of that day have access to
appropriate mental health and substance abuse prevention and
treatment services.
Agency For Healthcare Research and Quality
Appropriations, 2001.................................... $269,796,000
Budget estimate, 2002................................... 306,245,000
Committee recommendation................................ 291,245,000
The Committee recommends $291,245,000 for the Agency for
Healthcare Research and Quality [AHRQ]. This is $15,000,000
less than the administration request and $21,449,000 more than
the fiscal year 2001 level. The administration proposed to fund
AHRQ through transfers available under section 241 of the
Public Health Service Act. The Committee did not approve this
request.
The Agency for Healthcare Research and Quality was
established in 1990 to promote improvements in clinical
practice and patient outcomes, promote improvements in the
financing, organization, and delivery of health care services,
and increase access to quality care. AHRQ is the Federal agency
charged to produce and disseminate scientific and policy-
relevant information about the cost, quality, access, and
medical effectiveness of health care. AHRQ provides
policymakers, health care professionals, and the public with
the information necessary to improve cost effectiveness and
appropriateness of health care and to reduce the costs of
health care.
HEALTH COSTS, QUALITY, AND OUTCOMES
The Committee provides $240,145,000 for research on health
costs, quality and outcomes [HCQO], which is $15,000,000 less
than the administration request and $13,699,000 above the
fiscal year 2001 level. HCQO research activity is focused upon
improving clinical practice, improving the health care system's
capacity to deliver quality care, and tracking progress toward
health goals through monitoring and evaluation.
Medical Errors
The Committee continues to be very concerned about the
enormous personal and economic cost of medical errors.
According to the Institute of Medicine (IOM), an estimated
44,000 to 98,000 people each year die from medical errors. Even
using the lower estimate, this would make medical errors the
eighth leading cause of death in this country--higher than car
accidents, breast cancer or AIDS. The IOM also suggests that
medical errors may cost up to $29,000,000,000 in excess health
care expenditures and lost productivity each year.
Last year the Committee provided $50,000,000 for initiating
research into the causes of medical errors in the hope of
dramatically improving the safety of health care services in
this country. The Committee commends the Agency for planning
and instituting an impressive patient safety initiative, which
includes demonstrations to test best practices for reducing
errors, development and testing the use of appropriate
technologies to reduce medical errors, such as hand-held
electronic medication systems, and research in geographically
diverse locations to determine the causes of medical errors.
Of the total amount provided for HCQO, the Committee
directs AHRQ to devote $60,000,000 to determining ways to
reduce medical errors, an increase of $10,000,000 over the
amount provided in fiscal year 2001. The Committee expects that
AHRQ will use these funds to share lessons learned and best
practices among hospitals and healthcare providers. The
Committee directs AHRQ to work with the Center for Medicare and
Medicaid Services (CMS) to provide this information to
participating hospitals and healthcare facilities so that they
can begin implementing successful strategies.
The Committee further directs AHRQ to provide a report
detailing the results of its efforts to reduce medical errors.
The report should include how hospitals and other healthcare
facilities are reducing medical errors; how these strategies
are being shared among healthcare professionals; how many
hospitals and other healthcare facilities record and track
medical errors; how medical error information is used to
improve patient safety; what types of incentives and/or
disincentives have helped healthcare professionals reduce
medical errors and; a list of the most common root causes of
medical errors. The report should provide data showing the
effectiveness of State requirements in reducing medical errors.
The report should also describe how AHRQ is responding to some
of the findings in the IOM's report ``To Err is Human: Building
a Safer Health System.''
The Committee reiterates its position that there should be
zero tolerance for preventable medical mistakes and that the
Congress, the Administration, State licensing boards, and
private healthcare institutions and providers should work
together to prevent further unnecessary deaths and injuries.
The Committee encourages the Agency to fund research on
health costs, quality, and outcomes, especially in the chronic
illness and disability population.
The Committee notes that the University of Louisville, in
conjunction with experts in computers, medical informatics,
nosology, and related fields, is developing and implementing a
new system of electronic medical record transfer that would
facilitate the selected transfer of medical information. The
University is also working with health care facilities to
capture data from all available electronic sources and provide
access to the data from multiple perspectives and groupings,
which will enable uses from the research, community health and
consumer health communities. The University would be eligible
to receive funding under AHRQ's patient safety initiative for
both these efforts.
The Committee supports the Vermont Oxford Network in
Burlington, Vermont and its efforts to improve the quality of
health care available to children born prematurely through the
reduction of medical errors.
The Committee is aware of the Medical Error Reduction
project at Valley Hospital in Ridgewood, New Jersey. Valley
Hospital has found that the complete standardization of
processes and use of hand-held technology help guarantee the
correct dispensation of medications and collection of
specimens.
The Committee is aware that Cedars-Sinai Hospital will
design and implement a computer-based integrated health
information system to track patient care resulting in a
reduction of preventable medical errors.
Cerebral Autosomal Dominant Arteriopathy with Subcortical
Infarcts and Leukoencephalopathy (CADASIL).--The Committee
encourages AHRQ to consider an evidence-based review for the
care of CADASIL carriers, including Native Hawaiians. AHRQ is
encouraged to work closely with the Native Hawaiian Health Care
System to translate the evidence on the care of CADISIL into
clinical practice strategies.
Chronic fatigue syndrome.--The Committee understands that
AHRQ is nearing completion of its evidence report on chronic
fatigue syndrome and encourages the Agency to make databases
used in the writing of this report readily available to
researchers and the public on the Internet.
End of life care.--In order to address the lack of adequate
information to tailor programs and match needs in end of life
care, the Committee encourages the Agency to develop methods of
measurement, translation of findings into usual practice and
guidelines to improve the reliability of care of the seriously,
chronically ill individual.
Geographical distribution.--In order to broaden the
geographic distribution of health services research funding by
enhancing the competitiveness for research funding among
institutions, the Committee encourages the Agency for
Healthcare Research and Quality to continue the peer reviewed
and merit-based program, ``Building Research Infrastructure and
Capacity (BRIC).''
Pharmaceutical pricing.--The Committee recognizes the high
prevalence of chronic disease in rural areas. The management
and control of these chronic diseases through medication and
lifestyle alteration is essential to controlling overall health
expenditures. However, the lack of documented outcome measures
of health improvement and cost savings has hindered the
progression of Disease State Management programs in both
treatment and reimbursement. The Mississippi Medicaid model
produces significant outcome improvements and cost savings in
theory, and in the limited practice settings allowed in small
demonstration projects. The Committee also recognizes the
expertise in Marketing and Management of the University of
Mississippi. The Committee believes that AHRQ could undertake a
research project to examine the cost savings and improved
clinical outcomes associated with the Mississippi Medicaid
Disease State Management Program that would result from the
application of this disease management program to a
demonstration project in the Medicare population of the
Mississippi Delta region.
Practice guidelines.--The Committee is concerned that a
study published in the Journal of the American Medical
Association found that three-quarters of the practice
guidelines developed by AHRQ for treating illnesses were
outdated. While AHRQ has removed these out-of-date guidelines
from its web site and no longer produces guidelines, the
Committee encourages AHRQ to devote more resources to ensuring
that the National Guideline Clearinghouse contains updated and
timely information.
MEDICAL EXPENDITURES PANEL SURVEYS
The Committee provides $48,500,000 for health insurance and
medical expenditures panel surveys [MEPS], which is the same as
the administration request and $7,650,000 above the fiscal year
2001 level. MEPS is intended to obtain timely national
estimates of health care use and expenditures, private and
public health insurance coverage, and the availability, costs
and scope of private health insurance benefits. It also
develops cost and savings estimates of proposed changes in
policy and identifies impact of policy changes on payers,
providers, and patients.
Program support
The Committee recommends $2,600,000 for program support.
This amount is the same as the administration request and is
$100,000 more than the fiscal year 2001 level. This activity
supports the overall management of the Agency.
Centers for Medicare and Medicaid Services
Grants to States for Medicaid
Appropriations, 2001.................................... $99,613,130,000
Budget estimate, 2002................................... 106,821,882,000
Committee recommendation................................ 106,821,882,000
The Committee recommends $106,821,882,000 for Grants to
States for Medicaid. This amount is $7,208,752,000 more than
the fiscal year 2001 appropriation and the same as the
administration's request. This amount excludes $36,207,551,000
in fiscal year 2001 advance appropriations for fiscal year
2002. In addition, $46,601,937,000 is provided for the first
quarter of fiscal year 2003, as requested by the
administration.
The Medicaid program provides medical care for eligible
low-income individuals and families. It is administered by each
of the 50 States, the District of Columbia, Puerto Rico, and
the territories. Federal funds for medical assistance are made
available to the States according to a formula which determines
the appropriate Federal matching rate for State program costs.
This matching rate, which may range from 50 to 90 percent, is
based upon the State's average per capita income relative to
the national average.
The Committee understands that a General Accounting Office
report estimated that two-thirds of children on Medicaid have
never been screened for lead, despite Federal laws requiring
such screening. The Committee urges CMS to more closely monitor
screening rates and take every appropriate step to ensure that
screening rates among children enrolled in Medicaid are
substantially increased, reporting the national results to
Congress within 18 months, including lead screening rates for
children age 2 and under.
Payments to Health Care Trust Funds
Appropriations, 2001.................................... $70,381,600,000
Budget estimate, 2002................................... 81,924,200,000
Committee recommendation................................ 81,994,200,000
The Committee recommends $81,994,200,000 for Federal
payments to health care trust funds. This amount is $70,000,000
more than the administration's request and is an increase of
$11,612,600,000 from the fiscal year 2001 appropriation. The
committee recommendation includes $70,000,000 to reimburse the
Hospital Insurance Trust Fund for funds advanced on behalf of
the general fund for Real Choice Systems Change Grants to
States and Medicaid community-based attendant care
demonstrations in the research and demonstration activity of
program management.
This entitlement account includes the general fund subsidy
to the Supplementary Medical Insurance Trust Fund (Medicare
Part B), plus other reimbursements to the Hospital Insurance
Trust Fund (Medicare Part A), for benefits and related
administrative costs which have not been financed by payroll
taxes or premium contributions.
A shortfall of $832,000,000 is anticipated in fiscal year
2001 for the Federal contribution of the Supplementary Medical
Insurance Trust Fund. This shortfall is a result of the current
estimate being slightly higher than when Congress enacted the
appropriation. The fiscal year 2002 request includes an
estimated payback of $844,000,000 including the fiscal year
2001 shortfall plus interest. The Committee has provided
$81,332,000,000 for Federal payment to the Supplementary
Medical Insurance Trust Fund. This payment provides matching
funds for premiums paid by Medicare Part B enrollees. This
amount is the same as the administration's request, and is
$11,555,000,000 more than the fiscal year 2001 amount.
The recommendation also includes $292,000,000 for hospital
insurance for the uninsured. This amount is the same as the
administration's request and is $29,000,000 less than the 2001
amount. The Committee also recommends $150,000,000 for Federal
uninsured benefit payment. This payment reimburses the Hospital
Insurance Trust Fund for the cost of benefits provided to
Federal annuitants who are eligible for Medicare. This amount
is the same as the administration's request and is $18,000,000
more than the fiscal year 2001 appropriation. The Committee
recommendation includes $220,200,000 to be transferred to the
Hospital Insurance Trust Fund as the general fund share of
CMS's program management administrative expenses. This amount
is $70,000,000 more than the administration's request and is
$68,600,000 more than the fiscal year 2001 level.
Program Management
Appropriations, 2001.................................... $2,242,162,000
Budget estimate, 2002................................... 2,351,158,000
Committee recommendation................................ 2,464,658,000
The Committee recommends $2,464,658,000 for CMS program
management. This is $113,500,000 more than the administration
request and $222,496,000 more than the fiscal year 2001 enacted
level.
Research, demonstrations, and evaluations
The Committee recommends $125,311,000 for research,
demonstration, and evaluation activities. This amount is
$70,000,000 more than the budget request and $13,000,000 less
than the amount provided in fiscal year 2001.
CMS research and demonstration activities facilitate
informed, rational Medicare and Medicaid policy choices and
decisionmaking. These studies and evaluations include projects
to measure the impact of Medicare and Medicaid policy analysis
and decisionmaking, to measure the impact of Medicare and
Medicaid on health care costs, to measure patient outcomes in a
variety of treatment settings, and to develop alternative
strategies for reimbursement, coverage, and program management.
The recommended funding level for the research and
demonstration program will provide for continuation of current
activities. Priority areas for CMS research include access to
high-quality health care, health service delivery systems, and
provider payment systems.
The Committee has included funds to continue at $20,000,000
the Nursing Home Transition Initiative, to help States carry
out demonstration projects of developing community-based
attendant care services that ensure maximum control by
consumers to select and control their attendant care services,
including the provision of support and technical assistance
from CMS to assure effective implementation of these
demonstrations.
The Committee has included $50,000,000 for Real Choice
Systems Change Grants to States to fund initiatives that
establish specific actions steps and timetables to achieve
enduring system improvements and to provide long term services
and supports, including community-based attendant care, to
eligible individuals in the most integrated setting
appropriate. Grant applications should be developed jointly by
the State and Consumer Task Force. The Task Force should be
composed of individuals with disabilities, consumers of long-
term care services and supports, and those who advocate on
behalf of such individuals. Grant funded activities should
focus on areas of need as determined by the States and the Task
Force such as needs assessment and data gathering, strategies
to modify policies that unnecessarily bias the provision of
long-term care to institutional settings or health care
professionals, strategies to ensure the availability of a
sufficient number of qualified personal attendants and training
and technical assistance.
The Committee encourages CMS to consider creating a
statewide network of community-based early learning and
professional development hubs located in high needs
neighborhoods to improve access to early childhood physical and
mental health services and professional development
opportunities for childcare professionals.
The Committee is supportive of the continuation of CMS's
demonstration program to develop a comprehensive and reliable
paramedic services program.
The Committee reiterates its continued support for a
lifestyle modification demonstration, begun in fiscal year
2000, at the Mind-Body Institute of Boston, Massachusetts. The
Committee encourages CMS to expand the eligibility criteria by
increasing the number of enrollees and including in the
demonstration ischemia-free patients with recent acute
myocardial infarctions, coronary artery bypass graft surgery,
angioplasty and stents.
The Committee is pleased with the progress of the Western
Governors' Association Health Passport project and commends HHS
in the awarding of discretionary funding in 2001 allowing
continuation of this pilot project that demonstrates an
important new public-private, multi-agency, integrated model of
health care and benefit delivery using smart cards, magnetic
stripe, and public key infrastructure secure certificate
technologies. The Committee reiterates its support for this
demonstration project which serves as a model for complying
with the Health Insurance Portability and Accountability Act.
The Committee recognizes that persons with uncontrolled
diabetes account for about 50 percent of all leg amputations,
25 percent of all kidney failure, and are the leading source of
preventable blindness and a major cost to the Medicare program.
Diabetes mullitus is clearly a major health problem in the
country and is particularly acute among Hispanics and Native
Americans. Funds for this project would be used to establish
six rural regional programs to improve the access to care for
some of our elderly citizens. The programs would provide
monitoring and diet assistance for rural elderly with diabetes,
as well as assessment and referral related to depression of
rural elderly. This demonstration will provide much needed
nutrition and social services to our most vulnerable elderly
populations and potentially decrease the effects of diabetes
and depression. Funding would be targeted to low-income elderly
in geographic regions with high incidence of diabetes mullitus.
The Committee is aware of the need for a mobile asthma care
program at Valley Children's Hospital in California. The poor
air quality in California makes those children who suffer from
asthma particularly vulnerable to asthma attacks. These mobile
asthma care teams would work with patients and families
throughout the Central Valley to reduce the cost of asthma
care.
The Committee is aware of the California State University
Hayward's Health and Wellness Program. This program produces
graduates that are well prepared to be health care
professionals in the region. With additional funding, the
Institute would create a model program for students to enter a
mental health career.
The Committee is aware of the University of Kentucky's
Cooperative Extension Service and School of Public Health's
partnership to identify and target the most frequent and
expensive medication use issues in the State. This center would
improve medication use in Kentucky's highest need counties with
additional Federal funds.
The Committee is concerned about the confidentiality of
patient medical records. The University of Louisville is
currently constructing an electronic medical record that could
serve as a prototype for proper transmission of medical
records. Additional Federal funding would further this effort
significantly.
Providing health care professionals access to patient data
both in the community and the university setting is a complex
task but necessary to provide uniform quality. A demonstration
project between the University of Louisville and the
surrounding community hospitals would be important to further
this goal.
With additional Federal funding, the Center for Healthcare
Systems Standards in South Carolina would conduct a
demonstration project to examine reducing medical errors
through standards-based Quality Management Systems.
The Committee encourages CMS to consider a 2-year
demonstration project conducted by the Regional Nursing Center
Consortium to determine the potential of nurse-managed health
clinics as a safety net model in underserved communities.
As a follow-up to the Committee's recommendation in fiscal
year 2001, and in order to determine the effectiveness of the
nurse-managed clinic model, the Committee encourages CMS to
conduct a 5-year demonstration project that provides financial
support for existing nurse-managed clinics and their
utilization of advance practice registered nurses as primary
care providers, minimally in Hawaii, Pennsylvania, Delaware,
and New Jersey. These clinics operate with limited and short
term funding, limited Medicaid and Medicare reimbursement, and
yet provide up to 60 percent uncompensated care. Despite
limited funding, preliminary data from the Regional Nursing
Center Consortium indicates that nurse-managed health clinics
have better patient outcomes than conventional primary health
care models. To determine the potential of nurse managed health
clinics as a safety net model in underserved communities, the
Committee encourages CMS to consider both operating support and
funding for clinical and information management systems to
existing nurse-managed clinics to determine client outcomes and
the effectiveness of the model.
The Committee encourages CMS to consider the concept of
nurse-run clinics and the utilization of advanced practice
nurses as primary care providers in its research and
demonstration activities. As Medicare and Medicaid move into
the managed care arena, it is important that the most effective
health care delivery systems be identified and utilized. Health
promotion and prevention initiatives which are integral
functions of nursing will play a significant role in the future
of health care of our aging population.
The Committee is aware of the proposed modification by CMS
in determining the eligibility status for Medicaid of
individuals who migrate to Hawaii under the provisions of the
Compact of Free Association. The State of Hawaii has no control
over its borders. Thus, there remains a clear Federal
responsibility for the health of these individuals.
Accordingly, CMS should continue its negotiations with the
appropriate State authorities and inform the Committee of its
deliberations, prior to making any modifications.
The Committee remains concerned about the extraordinary
adverse health status of Native Hawaiians and encourages CMS to
continue its demonstration project at the Waimanalo health
center exploring the use of preventive and indigenous health
care expertise. The Committee further recommends that Papa Ola
Lokahi, the Native Hawaiian health care organization recognized
in the Native Hawaiian Health Care Act, participate in this
demonstration project.
The Committee encourages the Department to consider a
demonstration project on the island of Molokai that would
integrate health education and prevention with the delivery of
primary health care services. The Committee recommends that the
Native Hawaiian Health Care Systems, recognized in the Native
Hawaiian Health Care Act, be considered to participate in this
demonstration project, along with community health centers
whose clientele is primarily Native Hawaiian.
The Committee is aware that Daniel Freeman Hospital is
seeking a Federal partnership to pursue necessary program
expansion directed to improving the health status of multi-
cultural and medically disenfranchised populations, and
insuring their access to insurance enrollment, primary care,
and education.
The Committee is supportive of efforts by the University of
Pittsburgh Medical Center Health System (UPMC-HS) to implement
a state-of-the-art Health System-wide project to electronically
store and provide all clinical and administrative information
in a secure and automated manner. The UPMC-HS automation
project will serve as a national model for reducing medical
errors; improving medical efficiency; reducing health care
costs; and improving access to high quality, cost-effective
care for the elderly and the medically underserved.
The Committee understands that the State University System
of Florida is creating a statewide network of community-based
professional development hubs in high needs neighborhoods to
improve access to healthcare services for children.
The Committee is aware that the Kettering Medical Center
has a Healthy Hearts 2000 demonstration project that, with
additional Federal funding, will focus on the effectiveness of
three levels of prevention: primary (education), secondary
(screening, detection and education) and tertiary (treatment,
health maintenance and education).
The Committee is aware of an innovative program begun by
the non-profit organization We Are Family/The Family Van in
Boston, MA, to maintain a periodic presence in low-income urban
neighborhoods and provide education on how uninsured low-income
families may access medical insurance and medical care.
The Committee is aware that Children's Hospital of Boston
seeks to construct a state-of-the-art research facility that
will enable it to continue its exemplary record of advancing
scientific knowledge through biomedical research and improving
outcomes for children stricken with serious illness or injury.
Existing research space is used to maximum density and
productivity. Additional facilities are needed to translate new
biomedical insights learned daily through basic research into
new treatments for cancer, neurological diseases, spinal cord
injuries, and organ failure in the youngest patients, as well
as for adults.
The Committee is supportive of a study to estimate the
total unreimbursed costs that hospitals, localities, and States
incur to treat undocumented aliens for medical emergencies.
Hospitals, States, and localities are increasingly financially
burdened by the costs associated with providing undocumented
aliens emergency medical care.
The Committee also understands that Carondolet Health
Network plans to initiate a project which targets the need for
health access and continuity of care for the uninsured in urban
and rural communities.
The Committee is aware of research being conducted by the
Appalachian Center for Low Vision Rehabilitation which is aimed
at testing interventions and improving the quality of life for
individuals with low vision, with a particular focus on the
elderly and children.
The Committee is aware that the Kansas University Human
Imaging Institute is planning to utilize innovative technology
to detect abnormal electrical activity in deep brain regions
invisible to electroencephalography.
The Committee remains strongly supportive of CMS's
telemedicine demonstration projects. The Committee has provided
funds for the administrative and evaluation costs at these
sites in order to ensure that they would be able to continue
operating through the full period associated with the pilot
waiver program.
With additional Federal funding, the Children's Hospital
Los Angeles would purchase and develop programming for a
Magnetic Resonance Microscope.
The Committee is supportive of the continuation of CMS's
demonstration program to develop a comprehensive and reliable
paramedic services program.
The Committee is pleased with the progress of the
Mississippi Medicaid Disease State Management plan approved in
1998 that allows reimbursement of pharmacists working under
protocol of physicians to manage patients with certain chronic
diseases. The Committee urges CMS to consider extension of a
demonstration project for the Mississippi Medicare population.
The Committee expects CMS to continue to provide demonstration
grants to States for the extension of Disease State Management
Programs to Medicare demonstration projects, giving priority to
States with established Medicaid models.
The Committee is aware of efforts by the Center for
Pharmaceutical Marketing and Management to conduct analysis and
provide research on the effective and efficient pricing and
marketing of pharmaceutical products through a Medicare drug
benefit, and encourages CMS to utilize the expertise of the
center in policy making.
The Committee understands that terminally ill patients
desire to receive outpatient end-of-life care in their homes.
Hospice care is an effort to meet these needs. Currently, no
reimbursement is allowed for inpatient hospice, but there are
individuals in rural areas in every State who are denied
hospice care because they lack homes or have no able care
giver. The Committee recognizes the need for freestanding
inpatient hospice residence homes in rural areas. The Committee
is aware that the Sanctuary Hospice House, located in Tupelo,
Mississippi, has developed a demonstration model to care for
the short-term needs of terminally ill patients requiring pain
management and palliative care.
The Committee is supportive of Health Link of Idaho, to
establish private-public partnerships with employers, State
governments, and health insurance providers, to provide health
coverage for very small businesses (employing fewer than 10
people) with low-wage employees. The project will test the
efficacy of the model in both urban and rural areas for its
ability to increase access, foster appropriate use of health
care services and reduce public expenditures.
The Committee is aware of a proposal that would enable a
multilingual, mulitmedia screening tool for citizens to better
determine their potential eligibility for Medicare Medicaid,
and QMB, and urges CMS to fully assess the concept.
The Committee encourages CMS to consider a proposal to
provide a pilot project for Arizona to provide reimbursement to
Arizona hospitals and localities for cost associated with
providing federally-defined emergency medical care to
undocumented immigrants.
The Committee encourages CMS to consider expansion of the
California State University expansion of the Health and
Wellness program. The program is designed to meet increasing
demand for well prepared health care professionals in the
region.
The Committee encourages CMS to consider a 2-year
demonstration model for establishing private-public
partnerships with employers, State governments, and health
insurance providers, to provide health coverage for very small
businesses (employing fewer than 10 people) with low-wage
employees (average of less than $10 per hour). The project
would test the efficacy of the model in both urban and rural
areas for its ability to increase access, foster appropriate
use of health care services and reduce public expenditures.
Results would be evaluated and disseminated nationally.
The Committee is pleased with CMS's proposal to provide
demonstration grants to States to test innovative asthma
disease management techniques for children enrolled in
Medicaid. The Committee encourages CMS to provide this program
with the necessary funding to carry out this initiative.
The Committee encourages CMS to consider a demonstration
project in Cook County, Illinois to reduce morbidity and
mortality from asthma in the community areas in Cook County
with the highest prevalence and inadequate service.
The Committee encourages CMS to consider a project for the
Illinois Primary Health Care Association to implement the
Shared Integrated Management Information System and provide
centralized case management, reimbursement, and administrative
support services to a number of Consolidated Health Centers in
Illinois.
The Committee encourages CMS to continue an outreach
program designed to provide Chicago public school students with
vision care.
The Committee encourages CMS to consider a proposal from
the Madonna Rehabilitation Center Institute for Rehabilitation
Science and Engineering in Lincoln, Nebraska.
The Committee encourages CMS to conduct a Medicare Medical
Nutrition Therapy Education Campaign, to inform both Medicare
beneficiaries and physicians about the new Medicare benefit of
Medicare Nutrition Therapy for patients with diabetes and renal
disease, available January 2002.
The Balanced Budget Refinement Act of 1999 required the
Medicare Payment Advisory Commission (MEDPAC) study to
determine whether skilled nursing facilities in Alaska and
Hawaii should receive additional payment to accommodate their
unique circumstances. The Committee recommends CMS conduct a
detailed study to determine if there are enough differences in
these States non-labor costs to justify a payment adjustment
for the skilled nursing facilities in Alaska and Hawaii, the
Committee further suggests consideration of a temporary
adjustment to the non-labor share of the per diem payment for
skilled nursing facilities in Alaska and Hawaii at this time.
The Committee understands that the Montana Comprehensive
Health Care Association in Helena, Montana has expressed a need
for a demonstration project to subsidize coverage to
individuals under 150 percent of the Federal poverty level who
have significant health conditions and are therefore
uninsurable.
Medicare contractors
The Committee recommends $1,547,000,000 for Medicare
contractors, which is $25,000,000 more than the budget request
and $190,000,000 more than the comparable fiscal year 2001
appropriation. In addition, $700,000,000 is available for the
Medicare Integrity Program within the mandatory budget as part
of the health insurance reform legislation.
Medicare contractors, which are usually insurance
companies, are responsible for reimbursing Medicare
beneficiaries and providers in a timely fashion and a fiscally
responsible manner. These contractors also provide information,
guidance, and technical support to both providers and
beneficiaries.
The Committee recommendation includes $15,000,000 to
support grants for State Health Insurance Counseling and
Assistance programs (SHIPs), an increase of $5,000,000 over
last year and $15,000,000 more than the budget request. SHIPs
provide information, counseling and decision support to people
with Medicare. The 53 State and territorial programs are
administered either by the State unit on aging or the State
department of insurance. The Committee is aware that these
programs provide a valuable service to people with Medicare and
require a stable source of funding. The Centers for Medicare
and Medicaid Services (CMS) shall use these resources to
provide grants to States for SHIPs to enable them to increase
their capacity, to operate a resource center and to administer
special projects that will help SHIPs continuously improve the
quality of service they provide. The Committee expects CMS to
include, within its fiscal year 2003 congressional
justification, a specific dollar request for SHIPs, or to
indicate that no resources are being requested for this
activity.
State survey and certification
Survey and certification activities ensure that
institutions and agencies providing care to Medicare and
Medicaid beneficiaries meet Federal health, safety, and program
standards. On-site surveys are conducted by State survey
agencies, with a pool of Federal surveyors performing random
monitoring surveys.
The Committee recommends $260,647,000 for Medicare State
survey and certification activities, which is an increase of
$18,500,000 over the fiscal year 2001 level.
Federal administration
The Committee recommends $531,700,000 for Federal
administration costs. This recommendation is $26,996,000 more
than the fiscal year 2001 level, and the same as the budget
request. This will support 4,632 full-time equivalent
positions, an increase of 22 over fiscal year 2001. Most of the
increase is for fixed expenses of personnel compensation and
benefits.
The Committee understands that HIV drug resistance testing
is a critical component of the Nation's fight against AIDS. HIV
drug resistance testing lengthens life expectancy, enhances
life functions and retards emergence of a more resistant virus.
Because of the life-saving aspect of these tests and because
their reliability has historically been so variable, the FDA
has determined that HIV drug resistance tests should be subject
to FDA approval to insure a high degree of reliability. One
such test has already been approved and others are in progress.
The Committee understands that the differential in cost between
FDA approved and non-approved tests may be significant,
therefore urges CMS to review its reimbursement policies to
assure that Medicare beneficiaries have access to the highest
quality most medically beneficial HIV drug resistance tests.
Medicaid and the SCHIP program are the sole source of most
dental care provided to the Nation's poor children. However,
according to the U.S. Surgeon General's report, ``Oral Health
in America'', fewer than one in five Medicaid-covered children
received a single preventive dental visit in a year. Left
untreated, dental disease is inevitable and will not abate.
Therefore, the Committee believes that it is important that CMS
maintain a distinct focus on oral health by retaining a
position of Chief Dental Officer.
The Committee remains extremely concerned over CMS's
continuing failure to articulate clear guidelines and to set
expeditious timetables for consideration of new technologies,
procedures and products for Medicare coverage. A particularly
troubling example is CMS's lengthy delays and failure to
articulate clear standards regarding Medicare coverage of
positron emission tomography (PET). The effect of these delays
in instituting Medicare coverage is to continue to deny the
benefits to these technologies and procedures to Medicare
patients. The Committee also remains concerned that CMS appears
to be requiring some new technologies to repeat clinical trials
and testing already successfully completed by the new
technologies in the process of gaining FDA approval or in NIH
clinical trials and which serve as signals to private insurers
to cover new technologies. The Committee is also concerned that
CMS appears to be requiring substantially different levels of
evidence to approve various new products for Medicare coverage,
requiring, for example, very little documentation for approval
of MRA (magnetic resonance angiography), while at the same time
continuing to demand voluminous amounts of data to make a
coverage decision on PET. The Committee remains concerned that
the recently created 120-person technical advisory committee to
review new technologies may be further delaying coverage
decisions and creating unnecessary costs for the Medicare
program. Because of the possible duplication of efforts among
HHS agencies and related unnecessary costs to the Medicare
program and the Department, the Committee again asks that the
Secretary take a leadership role in resolving this matter
expeditiously. The Committee also urges the Secretary to
investigate the recent proposal by CMS to reduce hospital
outpatient payment for PET scans from $2,200 to $841 in light
of the fact that each PET scan uses a unit of the radioisotope
FDG which generally costs from $500 to $600 per dose.
In the Balanced Budget Act of 1997, Congress urged the
Secretary to provide GME reimbursement for clinical
psychological programs. To date CMMS has not issued the
necessary rule. The Committee expects the agency to release the
rule immediately.
A provision was included in the Health Insurance
Portability and Accountability Act (HIPAA) to redesign the
specialty provider code system to an alphanumeric system;
however, implementation of this new system seems to be in
doubt. In the interim, to ensure that pregnant women receive
risk-appropriate care, the Committee urges CMS to create an
interim two-digit specialty code under the current system,
recognizing maternal-fetal medicine.
The Committee is concerned that many severely disabled
Medicare recipients are being denied access to specialized
equipment that can improve their health and quality of life.
Through administrative ruling 96-1 Medicare changed its
coverage policy and classified certain highly specialized sets
of braces individually fit for the patient as non-covered
wheelchairs. Congress has since mandated that the GAO review
this change in policy. While the Congress awaits GAO's report,
the Committee calls on CMS to withhold enforcement of 96-1 and
to develop a proper ``L'' code and carrier instructions that
would provide permanent and clear parameters for this type of
reimbursement while safeguarding program integrity.
The Omnibus Consolidated & Emergency Supplemental
Appropriations Act for Fiscal Year 2001, which included ``the
Medicare, Medicaid & S-CHIP Benefits Improvement & Protection
Act of 2000,'' incorporated provisions relating to States'
Medicaid upper payment limit programs. These provisions, which
included reasonable transition periods for States to adopt a
revised standard for treatment of their programs, were adopted
after intense bipartisan negotiations among the House, Senate,
and administration.
The Committee is pleased that the administration, in
January and September 2001, supported this Medicaid upper
payment limit agreement in the promulgation of Medicaid upper
payment limit regulations. Further, the Committee reiterates
its commitment to both the letter and spirit of this agreement,
and directs the administration to maintain its course in
complying with congressional intent. Any subsequent
modifications should be done only after the administration has
had an opportunity to assess the implementation of the new
regulations and only in consultation with the States and their
Medicaid programs, as well as the other stakeholders. The
Committee is extremely concerned that eliminating the higher
payment limit category compromise struck last year would be
disastrous for all safety net hospitals, both public and
private, that participate in the Medicaid program.
The Committee is aware of the progress made in translating
selected CMS material into Chinese and disseminating to
selected communities, and encourages the agency expand these
efforts by broadening dissemination to a national basis and
including additional Asian and Pacific languages. The Committee
further encourages the agency to continue its collaboration
with national aging organizations with proven experience in
serving minority elders.
The Committee is aware of efforts by the Center for
Healthcare Systems Standards to help hospitals implement the
``Guidelines for Process Improvements in Healthcare
Organizations,'' developed as international standards under ISO
9001:2000 and ISO 9004:2000. These new standards focus
attention on reducing medical errors through process
improvement including identifying systemic root causes of
medical errors, improving the documentation process, and
changing organizations towards a culture of systemic review,
continuous error reduction, and overall quality improvement.
The Committee encourages CMS to pursue efforts like this to
help hospitals reduce errors.
The Committee is pleased with improvements in the rate of
mispayments by the Medicare program. Additional resources and
efforts have begun to make a difference. However, the Committee
remains very concerned with the amount of money that continues
to be lost to fraud, waste and abuse in the Medicare program.
The Committee has held many hearings and taken other corrective
actions over a 10-year period to expose and reduce these
losses. The Balanced Budget Act contains a number of important
reforms derived from Committee hearings.
The Committee continues to urge CMS to utilize new
authorities for competitive bidding and improved beneficiary
information so that savings to Medicare will accrue as quickly
as possible.
There is strong evidence, through reports by the General
Accounting Office, the Department and others that Medicare is
significantly overpaying for many medical supplies. Therefore,
the Committee continues to strongly urge use of the Secretary's
enhanced inherent reasonableness authority on a national basis.
The Committee is aware that CMS completed tests of
commercial off-the-shelf computer software designed to reduce
Medicare mispayments and found that significant savings could
be achieved by employing edits from the tested software. The
Committee urges CMS to undertake testing of other similar
commercial software and to incorporate edits found to achieve
savings within current Medicare regulations and without harming
quality of care.
The Committee is pleased that CMS has moved ahead to
establish program integrity contracts. These contractors have
significant potential to reduce losses to the Medicare program.
The Committee encourages CMS to fully utilize these contractors
and to explore the use of companies to recover mispayments that
have significant experience providing this service to major
commercial insurers and major employers.
The Committee believes that compliance with Medicare
reimbursement policies would be enhanced by an expansion of
provider education. Such an expansion would also aid health
professionals who often feel overwhelmed by the volume and
complexity of Medicare requirements. Therefore, the Committee
urges that a portion of the increase in MIP funds be used to
expand provider education and assistance.
The Committee is pleased with the progress that the CMS has
made in meeting the Congressional mandates for a Medicare
prospective payment system for long-term care hospitals. It
remains important that this payment system be based on data
from long-term care hospital patients and be designed expressly
for patients treated in long-term care hospitals. It is also
important that this improved payment system be based on patient
medical diagnoses, reflect the level of acuity for long-term
care hospital patients, recognize that these patients often
have multiple medical problems, and include appropriate
adjustments for outlier patients and other typical payment
factors. CMS should maintain these efforts and continue to
coordinate with Congress and all affected parties.
The Committee has held hearings documenting the need to
reform Medicare's payments for ambulance services. It is this
Committee's understanding that CMS will implement this year a
comprehensive regulation establishing a new fee schedule for
ambulance payments as required by the Balanced Budget Act of
1997. The Committee is concerned that CMS is considering
implementing the new fee schedule without fully implementing
the required condition codes and believes such a decision would
be adverse to beneficiaries, quality health care and program
integrity. Therefore, the Committee directs CMS to implement
the full set of condition codes simultaneously with the
implementation of the fee schedule.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriations, 2001.................................... $2,441,800,000
Budget estimate, 2002................................... 2,447,800,000
Committee recommendation................................ 2,447,800,000
The Committee recommends that $2,447,800,000 be made
available in fiscal year 2002 for payments to States for child
support enforcement and family support programs, the same as
the administration request. These payments support the States'
efforts to promote the self-sufficiency and economic security
of low-income families. The appropriation, when combined with
the $1,000,000,000 in advance funding provided in last year's
bill and an estimated $460,000,000 from offsetting collections,
makes $3,907,800,000 available for this program.
The Committee also has provided $1,100,000,000 in advance
funding for the first quarter of fiscal year 2003 for the child
support enforcement program, the same as the budget request.
These funds support efforts to locate noncustodial parents,
determine paternity when necessary, and establish and enforce
orders of support.
low-income home energy assistance program
Appropriations, 2001.................................... $2,000,000,000
Budget estimate, 2002................................... 1,700,000,000
Committee recommendation................................ 2,000,000,000
The Committee recommendation for LIHEAP is $2,000,000,000.
This amount, when combined with the $300,000,000 available from
the Supplemental Appropriations Act, 2001, provides a total of
$2,300,000,000 for the LIHEAP program. This level of funding is
$300,000,000 more than last year and $600,000,000 more than the
budget request.
LIHEAP grants are awarded to States, territories, Indian
tribes and tribal organizations to assist low-income households
in meeting the costs of home energy. States receive great
flexibility in how they provide assistance, including direct
payments to individuals and vendors and direct provision of
fuel.
The Committee recommendation includes $1,700,000,000 for
the State grant program, $300,000,000 more than last year's
funding level and the amount requested by the administration.
These resources are distributed by formula to States,
territories, Indian tribes and tribal organizations defined by
statute, based in part on each State's share of home energy
expenditures by low-income households nationwide.
The Committee recommendation includes $300,000,000 for the
contingency fund, the same as the amount requested by the
Administration and $300,000,000 less than the fiscal year 2001
appropriation. These resources are available until expended and
can be released only upon submission of a formal request
designating the need for the funds as an emergency, as defined
by the Balanced Budget and Emergency Deficit Control Act. The
Administration did not request resources for the contingency
fund subject to this emergency requirement. The contingency
fund may be used to provide assistance to one or more States
adversely affected by extreme heat or cold, significant price
increases or other causes of energy-related emergencies.
The Committee intends that up to $27,500,000 of the amounts
appropriated for LIHEAP for fiscal year 2002 be used for the
leveraging incentive fund. The fund will provide a percentage
match to States for private or non-Federal public resources
allocated to low-income home energy benefits.
refugee and entrant assistance
Appropriations, 2001.................................... $433,103,000
Budget estimate, 2002................................... 445,224,000
Committee recommendation................................ 445,224,000
The Committee recommends $445,224,000 for refugee and
entrant assistance, $12,121,000 more than the fiscal year 2001
level and the same amount as the budget request.
Based on an estimated refugee admission ceiling of 121,000,
this appropriation, together with prior-year funds available
for fiscal year 2002 expenses, will enable States to continue
to provide at least 8 months of cash and medical assistance to
eligible refugees and entrants, a variety of social and
educational services, as well as foster care for refugee and
entrant unaccompanied minors.
The Refugee and Entrant Assistance Program is designed to
assist States in their efforts to assimilate refugees, asylees,
Cuban and Haitian entrants, and adults and minors who are
trafficking victims, into American society as quickly and
effectively as possible. The program funds State-administered
transitional and medical assistance, the voluntary agency
matching grant program, programs for victims of trafficking and
torture, employment and social services, targeted assistance,
and preventive health.
In order to carry out the refugee and entrant assistance
program, the Committee recommends $227,291,000 for transitional
and medical assistance, including State administration and the
voluntary agency program; $10,000,000 for victims of
trafficking; $143,621,000 for social services; $4,835,000 for
preventive health; and $49,477,000 for targeted assistance.
Section 412(a)(7) of title IV of the Immigration and
Nationality Act authorizes the use of funds appropriated under
this account to be used to carry out monitoring, evaluation,
and data collection activities to determine the effectiveness
of funded programs and to monitor the performance of States and
other grantees.
The Committee recommends $10,000,000 to treat and assist
victims of torture. These funds may also be used to provide
training to healthcare providers to enable them to treat the
physical and psychological effects of torture. The Committee
acknowledges that well-established treatment centers, such as
the Center for Victims of Torture, have developed the knowledge
base that has fostered growth of treatment facilities around
the country and strengthened treatment services generally. This
positive trend may continue if leading centers are able to
expand their staffs to create more trainers and improve
evaluation and research needed to guide and develop new
programs.
CHILD CARE AND DEVELOPMENT BLOCK GRANT
Appropriations, 2001.................................... $1,999,987,000
Budget estimate, 2002................................... 2,199,987,000
Committee recommendation................................ 2,000,000,000
The Committee recommendation provides $2,000,000,000 for
the child care and development block grant, $199,987,000 less
than the budget request and $13,000 more than fiscal year 2001.
The child care and development block grant supports grants
to States to provide low-income families with financial
assistance for child care; for improving the quality and
availability of child care; and for establishing or expanding
child development programs. The funds are used to both expand
the services provided to individuals who need child care in
order to work or attend job training or education and allow
States to continue funding the activities previously provided
under the consolidated programs.
The Committee rejects the administration proposal to set
aside $400,000,000 within the block grant for States to provide
certificates for low-income parents to help defray the costs of
after-school programs with an education focus. The Committee
notes that the 21st century community learning centers program
administered by the Department of Education currently operates
an education-based extended learning program for school-aged
students. Fiscal year funding for this program was sufficient
to fund just one in five high quality applications and
approximately $800,000,000 was needed to provide grants to all
applicants considered worthy of funding. Any fundamental change
in the way the program operates is an issue that should be
considered during the reauthorization of the child care and
development block grant program.
The Committee recommendation provides $19,120,000 for the
purposes of supporting resource and referral programs and
before and afterschool services. This represents the Federal
commitment to the activities previously funded under the
dependent care block grant. The Committee further expects that
these funds will not supplant current funding dedicated to
resource and referral and school age activities provided by the
child care and development block grant. The Committee strongly
encourages States to address the matters of before and
afterschool care and the establishment of resource and referral
programs with the funds provided in this program.
The Committee recommendation includes $272,672,000 for
child care quality activities, and sets aside $100,000,000
specifically for an infant care quality initiative. The
Committee recommendation also provides $10,000,000 for child
care research, demonstration and evaluation activities.
The Committee understands that the National Association of
Child Care Resource and Referral Agencies is currently
operating Child Care Aware, the national toll-free information
hotline, which links families to local child care services and
programs. The Committee recognizes that funding from the
resource and referral programs would allow the Association to
continue to provide this critical assistance to parents
returning to the workforce.
SOCIAL SERVICES BLOCK GRANT
Appropriations, 2001.................................... $1,725,000,000
Budget estimate, 2002................................... 1,700,000,000
Committee recommendation................................ 1,700,000,000
The Committee recommends an appropriation of $1,700,000,000
for the social services block grant. The recommendation is the
same amount as the budget request and $25,000,000 below the
2001 enacted level.
The Committee has included bill language that will allow
States to transfer up to 5.9 percent from their fiscal year
2002 allocations under the Temporary Assistance for Needy
Families program to the Social Services Block Grant program.
Under the budget request, States would be limited to transfers
of up to 4.25 percent for fiscal year 2002. The Committee
recognizes that the block grant is a vital source of support
for many vulnerable children and families, the elderly and
single adults.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriations, 2001.................................... $7,965,739,000
Budget estimate, 2002................................... 8,191,398,000
Committee recommendation................................ 8,592,496,000
The Committee recommends an appropriation of $8,592,496,000
for children and families services programs. This is
$626,757,000 more than the fiscal year 2001 appropriation and
$401,098,000 more than the budget request.
This appropriation provides funding for programs for
children, youth, and families, the developmentally disabled,
and Native Americans, as well as Federal administrative costs.
Head Start
Head Start provides comprehensive development services for
low-income children and families, emphasizing cognitive and
language development, socioemotional development, physical and
mental health, and parent involvement to enable each child to
develop and function at his or her highest potential. At least
10 percent of enrollment opportunities in each State are made
available to children with disabilities.
The Committee recommends $6,600,000,000 for the Head Start
Program, an increase of $400,188,000 above the 2001 level and
$275,188,000 more than the budget request. The Committee
recommendations includes $1,400,000,000 in advance funding that
will become available on October 1, 2002.
The Committee is aware of the unique circumstances rural
areas face in designing Early Head Start programs to meet the
needs of families. Rural areas experience higher costs per
child, either due to the higher cost of transporting infants
and children to Early Head Start Centers, or because of higher
rents due to the lack of adequate and licensable facilities in
rural areas. In selecting new grantees under this program, the
Committee believes the Department should give consideration to
applicants serving rural areas that meet or exceed all
performance criteria but propose a higher cost per child due to
these factors.
The Committee is aware that, in fiscal year 2001,
approximately $180,000,000 was included in Head Start funding
to improve staff salaries and professional development. This
has increased both teacher compensation and retention rates
among Head Start staff. The Committee expects the Department to
continue to focus quality improvement efforts on improving Head
Start teacher compensation such that teacher salaries more
equitably reflect educational level and experience.
The Committee is aware of the need to strengthen the
qualifications of Head Start teachers. At least 50 percent of
teachers in center-based Head Start programs must have an
associate, baccalaureate, or advanced degree in early childhood
education or a degree in a related field, with experience in
teaching preschool children, by September 30, 2003. The
Committee expects the Department to focus staff development
efforts on increasing the educational level of Head Start
teachers in order to meet this goal.
The Head Start Act contemplates services to low-income
children and their families. The law does not, however,
prescribe age requirements for Head Start participation, short
of limiting enrollment to children ``who have not yet reached
the age of compulsory school attendance.'' Despite this fact,
Head Start has traditionally served children in their years
immediately prior to their entering into kindergarten. With
States and localities increasing their investments in preschool
services, local Head Start programs have been presented with
not only an opportunity, but a need to serve infants and
toddlers--in their years proven to be the most formative in
recently publicized brain research developmental studies.
Accordingly, the Committee encourages the Department of
Health and Human Services to support efforts by local Head
Start programs to use grant funds to deliver quality services
to the infant and toddler population where a community
assessment evidences a need for such services and the local
program has the capacity to meet that need. The Committee
supports this expansion in response to changing local community
needs, separate and apart from the new grant process under the
Early Head Start program created as part of the 1994 Head Start
reauthorization. When combined with the new grant authority for
Early Head Start which flows from increased appropriations
annually, expansion of existing preschool programs to serve
infants and toddlers is particularly responsive to research
emphasizing the developmental needs of our youngest children--
needs which can be ably addressed through the Head Start model
of comprehensive services.
During the 107th Congress, the House and Senate will
consider reauthorization of the Personal Responsibility and
Work Opportunities Act, in order to assist individuals to
secure gainful employment and help families to gain self-
sufficiency in the new economy. As a result of the 1996
enactment of welfare reform, families previously eligible for
Head Start services based on their low-income status have found
themselves marginally exceeding those income limitations and,
therefore, losing access to Head Start services for their
children.
The Committee recognizes that Head Start does not serve all
income-eligible children and their families in the country.
Nonetheless, while eligibility for other programs is sensitive
to regional disparities in income, Head Start eligibility is
not. It is clear that an inner-city family's expenses with
respect to food, housing and medical needs are different from
those of a rural family, while a rural family's transportation
needs, for one, may well outpace similar needs for their urban
neighbors. Eligibility requirements should reflect this
difference. Current law gives the Secretary of Health and Human
Services authority to permit the enrollment of a ``reasonable
number'' of over-income families in Head Start. In a welfare-
reformed era, families may find their income marginally
exceeding national poverty guidelines, while their need for
quality early childhood programming is even more pronounced.
The Committee encourages the Secretary to permit local programs
to best address local community needs in these changing times,
but encourages flexibility which does not deny services to the
neediest of the needy.
Accordingly, the Committee encourages the Secretary to
exercise his authority to permit the enrollment of over-income
children and their families in up to 25 percent of program
placements, so long as services are not denied to income-
eligible children and families as a result of this flexibility.
The Committee is aware that the goal of the Head Start
program is to ensure the school readiness of children upon
completion of the program. The Committee expects the Department
of Health and Human Services to continue to promote learning
and brain development to accelerate and improve the cognitive
development of Head Start children. The Committee expects the
Department to monitor Head Start programs to ensure that a
majority of children participating in Head Start programs meet
the minimum educational performance measures and standards upon
completion of the program as outlined in the Head Start Act, as
amended in 1998.
The Committee believes that Head Start funds should be
spent to maximize the number of children served. Therefore,
Head Start should limit its own operation of vehicles for the
transportation of Head Start children, working to increase
coordination with publicly-funded transit agencies or other
public entities when such agencies can provide for the safe
transportation of Head Start children at a reasonable cost. The
Committee is aware of cases where Head Start has purchased
buses when local transit authorities have been able to provide
that service at a lower cost. In some cases, buses have been
sold after being significantly underutilized. The Committee
directs Head Start programs to purchase their own vehicles to
transport children only when it can be demonstrated that such
an approach is safer, more cost effective and more responsive
to family needs than alternative approaches, including vehicle
leasing and contracting with local transportation providers.
The Committee expects the Department to provide adequate
direction and decisional support to regional offices
responsible for assessing the need for bus purchases and
requests that the Department provide the Committee with a
report of steps taken to ensure that vehicles are purchased
only when the local program demonstrates that this approach is
safest and most cost effective. The Committee believes that the
level of bus purchases in fiscal year 2002 should not exceed
the fiscal year 2001 level. Further, the Committee directs the
Head Start Bureau to provide the Committee with a list of all
bus purchases made by local programs, the number of vehicle
lease agreements entered into and the number of contracts for
services with local transportation providers for fiscal year
2002.
The Committee understands that there are serious concerns
that the bus safety rule promulgated at the beginning of 2001
contains elements that make it difficult to use the same buses
for children and adults throughout the day in ways that have
little or no effective safety benefits to Head Start
participants, significantly increasing the program's
transportation costs. The Department is urged to carefully
examine that issue.
The Committee understands the serious need for additional
and expanded Head Start facilities among native American
populations and in rural areas. The Committee believes that the
Department could help serve these needy communities by
providing minor construction funding for facilities in the
Alaskan communities served by the Tanana Chiefs Conference and
the Central Council of Tlingit-Haida of Alaska.
The Committee encourages the agency to continue and expand
its support of the Alaska SEED initiative to expand early
childhood services for at risk children in Alaska ages 0-6 and
to train Early Head Start teachers with AAS degrees through
distance delivery for positions in rural Alaskan communities.
Consolidated runaway and homeless youth program
The Committee recommends $105,133,000 for this program, an
increase of $36,000,000 above the fiscal year 2001 level and
$3,000,000 more than the Administration request.
This program addresses the crisis needs of runaway and
homeless youth and their families through support to local and
State governments and private agencies. The Runaway and
Homeless Youth Act requires that not less than 90 percent of
the funds be allocated to States for the purpose of
establishing and operating community-based runaway and homeless
youth centers, as authorized under Parts A and B of the Act.
Funds are distributed on the basis of the State youth
population under 18 years of age in proportion to the national
total. The remaining 10 percent funds networking and research
and demonstration activities including the National Toll-Free
Communications Center.
Grants are used to develop or strengthen community-based
programs which assist homeless youth in making a smooth
transition to productive adulthood and social self-sufficiency;
and to provide technical assistance to transitional living
programs for the acquisition and maintenance of resources and
services.
The basic centers program, authorized under Part A of the
Act, supports grants to community-based public and private
agencies for the provision of outreach, crisis intervention,
temporary shelter, counseling, family unification and aftercare
services to runaway and homeless youth and their families.
The transitional living grant program provides grants to
local public and private organizations to address shelter and
service needs of homeless youth, ages 16-21. The program's
goals are to have youth safe at home or in appropriate
alternative settings and to help them develop into independent,
contributing members of society.
A homeless youth accepted into the program is eligible to
receive shelter and services continuously for up to 540 days.
The services include counseling; life skills training, such as
money management and housekeeping; interpersonal skill
building, such as decision-making and priority setting;
educational advancement; job preparation attainment; and mental
and physical health care.
Maternity group homes.--Within the Committee recommendation
for the consolidated runaway and homeless youth program,
$33,000,000 is available for the maternity group home program,
the same as the budget request. This is a new program proposed
by the administration as part of its Faith Based Initiative.
Under this program, the ACF will provide targeted funding for
community-based, adult-supervised group homes for young mothers
and their children. These homes will provide safe, stable,
nurturing environments for mothers who cannot live safely with
their own families and assist them in moving forward with their
lives by providing support so they can finish school, acquire
job skills, and learn to be good parents.
Child abuse prevention programs
The Committee has included $54,743,000 for child abuse and
neglect prevention and treatment activities, including
$21,026,000 for State grants and $33,717,000 for discretionary
activities. This is the same as the fiscal year 2001 level and
$15,739,000 more than the administration request. These
programs seek to improve and increase activities at all levels
of government which identify, prevent, and treat child abuse
and neglect through State grants, technical assistance,
research, demonstration, and service improvement. The Committee
believes that the agency should fund activities aimed at
developing and disseminating research-based models for child
abuse prevention.
The Committee is aware of the following projects and
programs, and encourages ACF to give each full and fair
consideration for awards available in new grant competitions.
Parents Anonymous, Inc. will establish and maintain a
national network of mutual support and parent leadership
programs as a means of strengthening families in partnership
with their communities.
A significant number of abused or neglected children in
foster care programs have serious emotional, psychological and
developmental problems which cannot be adequately addressed in
regular foster care. Ohel Family Services in Brooklyn, New York
plans to provide specialized services to aid these children,
including intensive psychiatric and psychological treatment and
crisis intervention, in-home support for foster parents, and
rehabilitation activities for biological families.
Babyland Family Services, Inc. will integrate its family
violence and child abuse prevention and crisis intervention
services in order to develop a comprehensive program for
children and families.
The University of Notre Dame has proposed a collaborative
intervention and research project to prevent child neglect and
delinquency among teenage mothers and their children.
Casa Myrna Vazquez is the largest provider of comprehensive
services to battered women and children in New England.
Klamath Tribes Children's Protective Services and Family
Preservation program will provide child abuse and prevention
services.
The Alaska Native Health Board and Alaska Department of
Health and Social Services will support the development and
implementation of a statewide child abuse prevention and
treatment plan to identify, prevent, and treat child abuse and
neglect through technical assistance, research, demonstration
and service improvement.
The innovative Connecticut Healthy Families Initiative will
expand to additional sites and help prevent child abuse and
neglect in families at risk for such behavior.
``STOP IT NOW!'', a national non-profit organization
dedicated to preventing the sexual abuse of children, will
continue to increase public awareness about child sexual abuse,
educate adults about the ways to stop it, and call on abusers
and potential abusers to stop and seek help.
Healthy Families Home Visiting program in Alaska continues
to achieve success especially in the area of preventing child
abuse, in part due to the one-on-one interaction represented by
this program. The State of Alaska will work with Alaska Native
regional nonprofit corporations to continue and expand the
Healthy Families Home Visiting Program in Alaska.
The Alaska Department of Health and Social Services
proposes to develop a training program for social service and
health providers in Alaska designed to help these providers
identify cases of child abuse and document them appropriately.
Abandoned infants assistance
The Committee concurs with the budget request in
recommending an appropriation of $12,205,000 for abandoned
infants assistance, the same as the 2001 level and the
administration request. This program provides financial support
to public and private entities to develop, implement, and
operate demonstration projects that will prevent the
abandonment of infants and young children. Grants provide
additional services such as identifying and addressing the
needs of abandoned infants, especially those who are drug
exposed or HIV positive; providing respite care for families
and care givers; and assisting abandoned infants and children
to reside with their natural families or in foster care.
Child welfare services
The Committee recommends an appropriation of $291,986,000
for child welfare services, the same as the fiscal year 2001
level and the administration request. This program helps State
public welfare agencies improve their child welfare services
with the goal of keeping families together. State services
include: preventive intervention, so that, if possible,
children will not have to be removed from their homes;
reunification so that children can return home and development
of alternative placements like foster care or adoption if
children cannot remain at home.
Child welfare training
The Committee recommends $7,998,000, an increase of
$1,000,000 over the fiscal year 2001 level and the
administration request. Under section 426, title IV-B
discretionary grants are awarded to public and private
nonprofit institutions of higher learning to develop and
improve education/training programs and resources for child
welfare service providers. These grants upgrade the skills and
qualifications of child welfare workers.
Adoption opportunities
The Committee recommends $27,405,000 for adoption
opportunities, the same as the fiscal year 2001 level and the
administration request. This program eliminates barriers to
adoption and helps find permanent homes for children who would
benefit by adoption, particularly children with special needs.
Since the Committee recommendation exceeds $5,000,000, grants
for placement of minority children and postlegal adoption
services, as well as grants for improving State efforts to
increase placement of foster children legally free for
adoption, should be made, as required by law.
Adoption incentives
The Committee recommends $43,000,000 for adoption
incentives, the same amount as the fiscal year 2001
appropriation and the budget request. The purpose of this
program is to provide incentive funds to States to encourage an
increase in the number of adoptions of children from the public
foster care system. These funds are used to pay States bonuses
for increasing their number of adoptions. The appropriation
allows incentive payments to be made for adoptions completed in
fiscal years 2000 and 2001.
Adoption awareness
The Committee recommendation includes $12,906,000 for the
adoption awareness program, an increase of $3,006,000 over the
fiscal year 2001 level and $3,000,000 more than the
administration request. This program was authorized in the
Children's Health Act of 2000. The program consists of two
activities: the Infant Adoption Awareness Training Program and
the Special Needs Awareness Campaign. The Committee has
provided resources above the request to implement the Special
Needs Awareness Campaign in fiscal year 2002.
Compassion capital fund
The Committee recommendation includes $89,000,000 for the
compassion capital fund, the same as the budget request. This
new program is part of the Administration's Faith Based
Initiative. Funds available for this program will be used for
grants to public/private partnerships that help small faith-and
community-based organizations replicate or expand model social
services programs. Partnerships will provide technical
assistance to these entities to increase their capacity to
deliver high quality social services and provide financial
assistance to support start up and operational costs of their
social service programs.
The Committee expects funds made available through this
program to supplement and not supplant private resources and
encourages the Secretary to require private resources to match
grant funding provided to public/private partnerships.
Responsible fatherhood initiative
The Committee recommendation does not include resources for
this proposed program. As part of its Faith Based Initiative,
the administration proposed creating a new program to make
responsible fatherhood a national priority and requested
$64,000,000 for this new effort. The Committee has deferred
action on this program pending the enactment of authorizing
language. The proposed program would support competitive grants
to faith- and community-based organizations to support
initiatives that promote responsible fatherhood.
Social services research
The Committee recommends $27,426,000 for social services
and income maintenance research, $10,175,000 less than the
fiscal year 2001 level and $21,000,000 above the administration
request. These funds support cutting-edge research and
evaluation projects in areas of critical national interest.
Research includes determining services that are more cost-
effective and alternative ways to increase the economic
independence of American families.
The Committee is concerned about the current status and
future prospects for hard-to-employ welfare recipients who are
close to meeting the 60-month time limit on benefits
established by the Personal Responsibility and Work Opportunity
Reconciliation Act (PRWORA). A March, 2001 report by the
General Accounting Office entitled ``Moving Hard-to-Employ
Recipients Into the Workforce'', found that many current
welfare recipients have two or more characteristics that make
it difficult for them to find and hold a job. The report also
observed that some States are unclear about the kinds of
activities they are allowed to provide to welfare recipients,
and as a result, are hesitant to allow recipients to
participate in the full range of activities that might help
them find and keep jobs. The Committee strongly urges the
Department to undertake research to identify the types of
barriers hard-to-employ welfare recipients face, the
pervasiveness of these barriers among the current population of
recipients and to estimate the number of such recipients who
will reach their 60-month limit on benefits. The Committee also
encourages the Department to expand its efforts to help States
better understand how to use the flexibility they have under
the PRWORA to provide appropriate services to hard-to-employ
welfare recipients.
At the Committee's request, ACF 3 years ago launched a
concerted effort to assist States in meeting the complex
information and systems reporting requirements of TANF. ACF
turned to the State information technology consortium, out of
which emerged a knowledge base that is enabling each State to
tailor the best practices developed by others to meet their own
unique needs. In order to further streamline service delivery
and reduce overall costs, an effort is now underway to apply
web-based technology to help each State integrate their loosely
connected stand-alone systems under a single information
technology network. The Committee supports this common-sense
approach to systems coordination and encourages ACF to continue
this effort at the current level of support.
The Committee continues to be supportive of the National
Center for Appropriate Technology's information technology
clearinghouse in Butte, Montana.
The Committee is aware of the following projects and
programs, and encourages the Department to give each full and
fair consideration when making awards in new grant
competitions.
The Toni Jennings Exceptional Education Institute located
within the University of Central Florida's Academy for
Teaching, Learning and Leadership has developed programs to
enhance parenting skills; develop new approaches for
interaction between fathers and their special needs children;
and facilitate the development of knowledge and skills
necessary to provide educational and clinical services for
children and adults.
The Montana Child Care Financing Demonstration Project
proposes to establish an ongoing child care financing fund to
create meaningful support for the many low income working
families who earn just above the eligibility guidelines for
child care financial assistance.
The City of Newark will develop and evaluate a coordinated
approach for the delivery of a full spectrum of social services
to underinsured and uninsured women and youth ages 0-5 to
improve the health status of this target population.
CONTACT project provides health and human services
information and referrals, as well as Elder Reassurance and
volunteer referrals in support of the needs of community
residents.
The family resiliency initiative of the University of
Hawaii Center on the Family will include the development of a
comprehensive data system for a wide range of end users.
Community-based resource centers
The Committee recommends $32,834,000 for community-based
resource centers, the same level as provided in fiscal year
2001. This amount, the same as the administration request,
funds a consolidation of the community-based family resource
program and the temporary child care and crisis nurseries
program. This program is intended to assist States in
implementing and enhancing a statewide system of community-
based, family-centered, family resource programs, and child
abuse and neglect prevention through innovative funding
mechanisms and broad collaboration with educational,
vocational, rehabilitation, health, mental health, employment
and training, child welfare, and other social services within
the State. The temporary child care and crisis nurseries serve
thousands of families with children who have a disability or
serious illness, and families that are under stress, including
families affected by HIV/AIDS, homelessness, violence, family
crisis, and drugs and alcohol.
Developmental disabilities
The Committee recommends $140,534,000 for developmental
disabilities programs, an increase of $7,000,000 over last year
and $7,200,000 more than the request. The Administration on
Developmental Disabilities supports community-based delivery of
services which promote the rights of persons of all ages with
developmental disabilities. Developmental disability is defined
as severe, chronic disability attributed to mental or physical
impairments manifested before age 22, which causes substantial
limitations in major life activities.
State councils
For State councils, the Committee recommends $69,800,000.
In 1987, the Developmental Disabilities Act changed the focus
of State councils from services provision and demonstration to
planning and services coordination directed to effecting
systems change. Since that time, the States have been shifting
away from their original role of services provision to their
current mission to effect system change on behalf of persons
with developmental disabilities.
Protection and advocacy grants
For protection and advocacy grants, the Committee
recommends $35,000,000. This formula grant program provides
funds to States to establish protection and advocacy systems to
protect the legal and human rights of persons with
developmental disabilities who are receiving treatment,
services, or rehabilitation within the State.
The Committee supports the continuation of an interagency
approach to providing training and technical assistance to the
Protection and Advocacy System. This collaboration has worked
well in coordinating the provision of critical information to
the system. The Committee intends that training and technical
assistance should be delivered through a multiyear cooperative
agreement with an agency that has demonstrated the capacity to
provide this service and is supported by the P&A agencies in
the States. The Committee recommends that ADD involve other
agencies which administer P&A programs such as Social Security
Administration and HRSA in determining the entity to receive
the interagency grant.
Projects of national significance
The Committee recommends $11,734,000 for projects of
national significance to assist persons with developmental
disabilities. This program funds grants and contracts providing
nationwide impact by developing new technologies and applying
and demonstrating innovative methods to support the
independence, productivity, and integration into the community
of persons with developmental disabilities.
The Committee recognizes the work of the Family Friends
program in training senior volunteers to provide respite to
families whose members have disabilities. The Committee
believes that additional funds from the Department will assist
in the development of a Family Friends pilot project to provide
technical assistance and training in the application of the
successful Family Friends volunteer respite care model to the
needs of aging parents of adult individuals with developmental
disabilities.
University-affiliated programs
For university-affiliated programs, the Committee
recommends $24,000,000. This program provides operational and
administrative support for a national network of university-
affiliated programs and satellite centers. Grants are made
annually to university-affiliated programs and satellite
centers for interdisciplinary training, exemplary services,
technical assistance, and information dissemination activities.
Native American programs
The Committee recommends $45,996,000 for Native American
programs, the same amount as the 2001 level and $1,600,000 more
than the budget request. The Administration for Native
Americans [ANA] assists Indian tribes and native American
organizations in planning and implementing long-term strategies
for social and economic development through the funding of
direct grants for individual projects, training and technical
assistance, and research and demonstration programs.
The Committee continues to be concerned that Native
American children may be placed in homes without foster care
maintenance payments to support the cost of food, shelter,
clothing, daily supervision, school supplies, or liability
insurance for the child. For children adopted through tribal
placements, there may be no administrative payments for
expenses associated with adoption and training of professional
staff or parents involved in the adoption. In the past, the
Committee has supported a demonstration project to provide
funding to two Alaska Native regional non-profit organizations,
Cook Inlet Tribal Council, Inc. in Anchorage, and Kawerak, Inc.
in Nome. Also, the Tanana Chiefs Conference in Interior Alaska
is developing a State/Alaska Native information system so that
Alaska Native children have the same support as other American
children.
The Committee is aware that in Alaska Native villages,
disparate programs exist to deal with problems of infants,
children, the disabled, the elderly and others, as well as for
alcohol and drug use, physical and sexual abuse, and mental
health, and that the Alaska Federation of Natives has initiated
a program to bring together the resources of all such programs
to help Native communities in Alaska heal themselves and their
members on a holistic basis, without social stigma attached to
any individual or family.
The Committee is aware that the Tate Ota (Many Winds)
Corporation on the Rosebud Indian Reservation in Mission, South
Dakota, will research historical efforts to educate Native
American youth and apply what is learned to improve the
educational process in tribal schools.
The Committee is concerned about the allocation of
resources for Native Hawaiian groups, and urges equal
consideration for future government-funded programs that affect
Native Hawaiians. The Committee recommends equitable funding
from the Administration for Native Americans for the provision
of assistance to support educational activities associated with
the exercise of self-determination by Native Hawaiian people
and the identification of self-government.
Community services
The Committee recommends an appropriation of $765,304,000
for the community services programs. This is $82,654,000 more
than the fiscal year 2001 level and $110,289,000 higher than
the administration request.
Within the funds provided, the Committee recommends
$675,000,000 for the community services block grant [CSBG].
These funds are used to make formula grants to States and
Indian tribes to provide a wide range of services and
activities to alleviate causes of poverty in communities and to
assist low-income individuals in becoming self-sufficient. The
Committee recommendation recognizes the increased demand by the
low-income population for services provided by CSBG-funded
community action agencies.
The Committee continues to recognize the importance of the
Community Services Block Grant and the Community Action
Agencies it funds. An appropriation of $675,000,000 has been
provided for CSBG for fiscal year 2002, a sizable increase of
$75,009,000 over the fiscal year 2001 level.
It is the intent of the Committee that all eligible
entities in good standing receive a proportionate share of the
increase provided for fiscal year 2002. Congress has provided
significant investment in the Community Services Block Grant in
recent years, and expects all eligible entities, particularly
Community Action Agencies, to benefit. The Committee is aware
that report language in the statement of the managers
accompanying the fiscal year 2001 conference report to this
effect (H. Rept. 106-1033) was not universally implemented in
all States; therefore the Committee has adopted legislative
language to make its intentions unambiguously clear. The
Committee expects that the Office of Community Services will
enforce this bill language.
The Committee expects the Office of Community Services to
release funding to the States in the most timely manner. The
Committee also expects the States to makes funds available
promptly. The Committee is aware that the Office of Community
Services and some States have been extraordinarily delinquent
in providing funds to local eligible entities.
The Committee is aware that Community Action Agencies have
well-established partnerships with the private sector, the
public sector, other community-based organizations, and faith-
based organizations. The Committee expects fiscal year 2002
funding to help provide stronger partnerships of eligible
entities of the Community Services Block Grant, which are
predominantly Community Action Agencies.
The Committee is also aware that Community Action Agencies
are developing model programs in the areas of fatherhood
initiatives, mentoring, literacy, and family development. For
example, CAP of Lancaster County, of Lancaster, Pennsylvania,
and Metropolitan Development Council of Tacoma, Washington,
have excellent fatherhood programs. CHANGE, Inc. of Weirton,
West Virginia and the Rural Alaska Community Action Program,
Inc., which serves the entire State of Alaska, have developed
exemplary mentoring programs. CAP Services, Inc. of Stevens
Point, Wisconsin and the Community Action Council of Lexington,
Kentucky, have implemented nationally recognized literacy
programs. Community Action Agencies across Iowa and Wisconsin
have developed exemplary family development programs. The
Committee expects that the money going to Community Action
Agencies through the Community Services Block Grant will
continue to provide services that innovate and create model
programs such as these.
In addition, the Committee again expects the Office of
Community Services to inform the State CSBG grantees of any
policy changes affecting carryover CSBG funds within a
reasonable time after the beginning of the Federal fiscal year.
Several discretionary programs are funded from this
account. Funding for these programs is recommended at the
following levels for fiscal year 2002: community economic
development, $35,000,000; individual development accounts,
$24,990,000; rural community facilities, $7,000,000; national
youth sports, $16,000,000; and community food and nutrition,
$7,314,000.
Community economic development grants are made to private,
nonprofit community development corporations, which in turn
provide technical and financial assistance to business and
economic development projects that target job and business
opportunities for low income citizens. The Committee has
included bill language clarifying that Federal funds made
available through this program may be used for financing for
construction and rehabilitation and loans or investments in
private business enterprises owned by Community Development
Corporations. Of the total provided, the Committee has included
$5,000,000 for the Job Creation Demonstration authorized under
the Family Support Act to target community development
activities to create jobs for people on public assistance. As
in the past, the Committee expects that a priority for grants
under this program go to experienced community development
corporations. The Committee reiterates its expectation that
national youth sports funds be awarded competitively.
The Committee has provided funding for Rural Community
Facilities Technical Assistance. Most of the drinking water and
waste water systems in the country that are not in compliance
with Federal standards are in communities of 3,000 or fewer.
Rural Community Assistance Programs [RCAPs] use these funds to
assist a number of communities in gaining access to adequate
community facilities, gaining financing for new or improved
water and waste water systems and in complying with Federal
standards.
The Committee continues to support the Job Creation
Demonstration program, authorized by the Family Support Act.
Approximately 46 nonprofit organizations have been funded under
this program since 1990, providing welfare recipients and low
income individuals an estimated 4,000 new jobs and allowing
them to start 2,000 new micro-businesses. The Committee
recognizes that continued and additional funding of the Job
Creation Demonstration program would provide opportunities for
more low-income individuals.
The Committee is aware that Yellowstone County, Montana is
home to a growing number of low income, high-risk, preschool
children and families with escalating needs. The County is
developing innovative solutions that coordinate employment
training, health services and school readiness programs for
these disadvantaged families. The Committee encourages ACF to
give consideration to such a proposal.
Family violence prevention and services
The Committee recommends $139,156,000 for family violence
prevention and services programs, an increase of $5,082,000
over the fiscal year 2001 appropriation and the budget request.
For the runaway youth prevention program, the Committee
recommends $14,999,000, which is the same as the fiscal year
2001 appropriation and the administration request. This is a
discretionary grant program open to private nonprofit agencies
for the provision of services to runaway, homeless, and street
youth. Funds may be used for street-based outreach and
education, including treatment, counseling, provision of
information, and referrals for these youths, many of whom have
been subjected to or are at risk of being subjected to sexual
abuse.
For the national domestic violence hotline, the Committee
recommends $2,157,000, which is the same amount as the fiscal
year 2001 appropriation and the administration request. This is
a cooperative agreement which funds the operation of a
national, toll-free, 24-hours-a-day telephone hotline to
provide information and assistance to victims of domestic
violence.
The Committee recommends $122,000,000 for the grants for
battered women's shelters program, $5,082,000 above the fiscal
year 2001 program level and the administration request. This is
a formula grant program to support community-based projects
which operate shelters for victims of domestic violence.
Emphasis is given to projects which provide counseling,
advocacy, and self-help services to victims and their children.
Early learning opportunities program
The Committee recommendation includes $25,000,000 for the
early learning opportunities program, $5,002,000 more than the
fiscal year 2001 funding level. The administration proposed
eliminating this program. This program supports grants to local
community councils comprised of representatives from agencies
involved in early learning programs, parent organizations and
key community leaders. Funds are used to increase the capacity
of local organizations to facilitate development of cognitive
skills, language comprehension and learning readiness; enhance
childhood literacy; improve the quality of early learning
programs through professional development and training; and
remove barriers to early learning programs.
Faith-based center
The Committee recommendation does not include $3,000,000
requested for staff to support operation of a Center for Faith-
Based and Community Initiatives. The staff resources required
for the Center can be absorbed within the general departmental
management account.
Program administration
The Committee recommends $171,870,000 for program
administration, $8,000,000 above the fiscal year 2001
appropriation and the same as the administration request.
The Committee appreciates the contributions made by ACF in
responding to the tragedy that occurred on September 11, 2001.
The Committee notes that ACF promptly released resources to
support the social service needs of individuals in affected
communities and provide for child care and related services
required to sustain the heroic efforts of relief workers. These
resources, as well as the additional support provided to ACF's
programs that serve children in affected communities, will help
individuals and families access the services and information
they need to cope with and heal from the tragic events of that
day.
The Committee is aware of the Department's new rule
regarding outcome-based reviews. These reviews are an effective
method for monitoring the progress States are making in
assuring the safety, health and permanency for children in
child welfare and foster care as required in the Adoption and
Safe Families Act. The Committee encourages the Department to
make available sufficient resources to ensure full
implementation of the new collaborative monitoring system.
PROMOTING SAFE AND STABLE FAMILIES
Appropriations, 2001.................................... $305,000,000
Budget estimate, 2002................................... 572,000,000
Committee recommendation................................ 305,000,000
The Committee recommends $305,000,000 for fiscal year 2002,
$267,000,000 less than the amount requested by the
administration and the same amount as the fiscal year 2001
level. These funds will support: (1) community-based family
support services to assist families before a crisis arises; and
(2) innovative child welfare services such as family
preservation, family reunification, and other services for
families in crisis. These funds include resources to help with
the operation of shelters for abused and neglected children,
giving them a safe haven, and providing a centralized location
for counseling.
The promoting safe and stable families program is under
consideration for reauthorization this year. The administration
proposed increasing the authorization level of this
appropriated entitlement program by $200,000,000 and also
requested $67,000,000 for a new mentoring children of prisoners
program. The Committee defers action on these requests pending
enactment of authorizing legislation.
Mentoring children of prisoners
The Committee defers action on this request pending
enactment of authorizing legislation. As part of its Faith
Based Initiative, the administration proposed a new program
designed to mentor children of prisoners and requested
$67,000,000 for this purpose. Funds would be used to award
competitive grants to local governments for the establishment
or operation of programs providing mentoring for children of
prisoners and probationers through networks of community
organizations, including faith based organizations.
payments to states for foster care and adoption assistance
Appropriations, 2001.................................... $4,863,100,000
Budget estimate, 2002................................... 4,945,200,000
Committee recommendation................................ 4,885,200,000
The Committee recommends $4,885,200,000 for this account,
which is $22,100,000 more than the 2001 comparable level and
$60,000,000 less than the budget request. In addition, the
Committee recommendation concurs with the administration's
request of $1,754,000,000 for an advance appropriation for the
first quarter of fiscal year 2003. The Foster Care Program
provides Federal reimbursement to States for: maintenance
payments to families and institutions caring for eligible
foster children, matched at the Federal medical assistance
percentage [FMAP] rate for each State; and administration and
training costs to pay for the efficient administration of the
Foster Care Program, and for training of foster care workers
and parents.
The Adoption Assistance Program provides funds to States
for maintenance costs and the nonrecurring costs of adoption
for children with special needs. The goal of this program is to
facilitate the placement of hard-to-place children in permanent
adoptive homes, and thus prevent long, inappropriate stays in
foster care. As in the Foster Care Program, State
administrative and training costs are reimbursed under this
program.
The Independent Living Program provides services to foster
children under 18 and foster youth ages 18-21 to help them make
the transition to independent living by engaging in a variety
of services including educational assistance, life skills
training, health services and room and board. States are
awarded grants from the annual appropriation proportionate to
their share of the number of children in foster care, subject
to a matching requirement.
The administration proposed amending the Independent Living
program by increasing the cap on entitlement spending to
$200,000,000. The additional $60,000,000 made available through
this proposal would support vouchers for children who age out
of the foster care system so they can pursue vocational
training or college and be better prepared to live
independently and contribute productively to society. The
Committee defers action on this proposal pending enactment of
authorizing legislation.
Administration on Aging
Appropriations, 2001.................................... $1,103,093,000
Budget estimate, 2002................................... 1,097,718,000
Committee recommendation................................ 1,209,756,000
The Committee recommends an appropriation of $1,209,756,000
for aging programs, $106,663,000 above the 2001 appropriation
and $112,038,000 more than the budget request.
Supportive services and senior centers
The Committee recommends an appropriation of $366,000,000
for supportive services and senior centers, $41,425,000 more
than the amount appropriated in fiscal year 2001 and
$39,425,000 more than the administration request. The increased
funding will provide additional transportation, in-house
services, chore services, case management and other support for
frail older individuals. This State formula grant program funds
a wide range of social services for the elderly, including
multipurpose senior centers, adult day care and ombudsman
activities. State agencies on aging award funds to designated
area agencies on aging who in turn make awards to local
services providers. All individuals age 60 and over are
eligible for services, although, by law, priority is given to
serving those who are in the greatest economic and social need,
with particular attention to low-income minority older
individuals and those residing in rural areas. Under the basic
law, States have the option to transfer up to 30 percent of
funds appropriated between the senior centers program and the
nutrition programs which allows the State to determine where
the resources are most needed.
Preventive health services
The Committee recommends $22,000,000 for preventive health
services, an increase of $877,000 more than the amount
appropriated in fiscal year 2001 and the budget request. Funds
appropriated for this activity are part of the comprehensive
and coordinated service systems targeted to those elderly most
in need. Preventive health services include nutritional
counseling and education, exercise programs, health screening
and assessments, and prevention of depression. Within the
appropriation for this program, $5,000,000 is provided to
continue medication management, screening and education
activities to prevent incorrect medication and adverse drug
reactions. These activities will help older adults learn more
about managing medications safely and help reduce unnecessary
hospitalizations and illnesses.
Protection of vulnerable older Americans
The Committee recommends $18,181,000 for grants to States
for protection of vulnerable older Americans. Within the
Committee recommendation, $12,949,000 is for the ombudsman
services program and $5,232,000 is for the prevention of elder
abuse program. The amount recommended for the ombudsman
services program is $3,500,000 more than the fiscal year 2001
level and the administration request. The amount recommended
for the elder abuse prevention program is $500,000 more than
the fiscal year 2001 level and budget request. Both programs
provide formula grants to States to prevent the abuse, neglect,
and exploitation of older individuals. The ombudsman program
focuses on the needs of residents of nursing homes and board
and care facilities, while elder abuse prevention targets its
message to the elderly community at large.
The Committee recognizes the importance of the Long-Term
Care Ombudsman Program in assisting residents of nursing homes
and board and care facilities resolve abuse and neglect
complaints. The Committee is aware of the Institute of
Medicine's 1995 study which recommended a ratio of 1 Ombudsman
for every 2,000 nursing home beds to meet the needs of long-
term care residents, as well as DHHS Office of Inspector
General's 1999 report recommending additional funding for the
program. Therefore, the Committee has provided an increase of
$3,500,000 for the Long-Term Ombudsman Program, which will
allow the program to hire additional Ombudsman staff, expand
public information and education campaigns, and upgrade
technology.
The Committee supports continued and additional funding for
the long-term care ombudsman resource center and its training
and clearinghouse functions, which provide information,
technical assistance, programmatic, and other support for State
and regional long-term care ombudsmen.
National family caregiver support program
The Committee recommends $140,000,000 for the national
family caregiver support program, an increase of $20,000,000
over the amount appropriated in fiscal year 2001 and
$18,000,000 more than the budget request. Funds appropriated
for this activity established a multifaceted support system in
each State for family caregivers. All States are expected to
implement the following five components into their program:
individualized referral information services; assistance to
caregivers in locating services from a variety of private and
voluntary agencies; caregiver counseling, training and peer
support; respite care provided in the home, an adult day care
center or other residential setting located in an assisted
living facility; and limited supplemental services that fill
remaining service gaps.
Native American Caregiver Support Program
The Committee recommendation includes $6,000,000 to carry
out the Native American Caregiver Support Program, an increase
of $1,000,000 over last year. The program will assist Tribes in
providing multifaceted systems of support services for family
caregivers and for grandparents or older individuals who are
relative caregivers. In fiscal year 2001, funds were used to
provide both discretionary and formula grants to support the
purpose of this program.
Congregate and home-delivered nutrition services
For congregate nutrition services, the Committee recommends
an appropriation of $384,000,000, an increase of $5,588,000
over the amount appropriated in fiscal year 2001 and the budget
request. For home-delivered meals, the Committee recommends
$177,000,000, an increase of $25,000,000 over the amount
appropriated in fiscal year 2001 and $19,000,000 more than the
administration request. These programs address the nutritional
need of older individuals. Projects funded must make home-
delivered and congregate meals available at least once a day, 5
days a week, and each meal must meet one-third of the minimum
daily dietary requirements. While States receive separate
allotments of funds for congregate and home-delivered nutrition
services and support services, they are permitted to transfer
up to 40 percent of funds between these programs.
Aging grants to Indian tribes and native Hawaiian organizations
The Committee recommends $26,000,000 for grants to native
Americans, $2,543,000 more than the amount appropriated in
fiscal year 2001 and $543,000 more than the administration
request. Under this program awards are made to tribal and
Alaskan Native organizations and to public or nonprofit private
organizations serving native Hawaiians which represent at least
50 percent Indians or Alaskan Natives 60 years of age or older
to provide a broad range of supportive services and assure that
nutrition services and information and assistance are
available.
Training, research and discretionary projects
The Committee recommends $36,574,000 for training,
research, and discretionary projects, $722,000 more than the
fiscal year 2001 enacted level and $19,000,000 more than the
budget request. These funds support activities designed to
expand public understanding of aging and the aging process,
apply social research and analysis to improve access to and
delivery of services for older individuals, test innovative
ideas and programs to serve older individuals, and provide
technical assistance to agencies who administer the Older
Americans Act.
The Committee has provided support at last year's level to
continue the pilot project to test the best ways of using the
skills of retired nurses, doctors, accountants and other
professionals to train other seniors and to serve as expert
resources to detect and stop Medicare fraud, waste and abuse.
The Committee expects that these funds will be used to make
grants and that administrative costs will be minimized. In
addition, the Committee expects that an improved system will be
developed and implemented in coordination with CMS and the OIG
to track cases referred by this initiative.
The following programs and projects have been brought to
the Committee's attention. The Committee expects the
Administration on Aging to give each full and fair
consideration for awards available under new grant
competitions.
The National Indian Council on Aging continues to initiate
programs designed to improve access to social services at the
Federal, State, and tribal levels for elders in Indian Country
through the nation's 235 Title VI programs.
Recent studies have forecasted significant changes in the
size and economic well being of the elderly population in
Missoula, Montana. The Missoula Aging Services will continue to
develop new and innovative programs such as a resource center
and other support systems to serve the needs of community
residents.
The SPRY Foundation will continue its efforts to improve
the quality of life for seniors throughout the United States by
developing web-based resources and related training programs to
help seniors and their families access high-quality information
and caregiver support services.
The West Virginia University National Rural Aging Project
proposes to support State efforts to implement and evaluate
best practices in improving service delivery to the elderly in
rural areas.
The National Council on the Aging proposes to establish the
National Center on Senior Benefit Outreach to provide seniors
and caregivers with timely information and assistance about
State and Federal programs that address important health,
financial and social needs.
The Motion Picture and Television Fund, in partnership with
the University of Southern California's Andrus School of
Gerontology has developed the Eden Alternative demonstration
project, which seeks to improve quality of care and life for
seniors residing in nursing homes and assisted living
facilities.
Sonoma State University has developed the Lifelong Learning
Institute which encompasses a university-community partnership
designed to promote a wide range of intellectually stimulating
learning opportunities in support of the creative growth of
retired individuals.
Naturally Occurring Retirement Communities (NORCs) provide
seniors with the supportive services that they need to continue
living independently and avoid early and unnecessary
institutionalization. A multi-state demonstration project
targeting NORC communities in Baltimore, Cleveland, Detroit,
St. Louis, and Pittsburgh could promote the testing and
development of improved integrated systems providing supportive
services to large concentration of seniors, the results of
which could be used to formulate national models.
Access Community Health Network in Chicago has developed a
Senior Outreach Program to provide direct links to primary
health care for the isolated elderly.
The Florida State University System has developed a major
research initiative consisting of an integrated set of
research, policy analysis and development projects designed to
address long-term care in Florida and the nation, in particular
focusing on community-based long-term care services with the
integration of housing, assistive technology, transportation,
caregiver, mental health and acute-care services.
The Gerontological Studies Center at Northern Michigan
University will combine research and educational programming
with community services to benefit the elderly population of
Michigan's upper peninsula.
Oregon Health Sciences University will expand its Healthy
Aging project by helping the elderly and their family maintain
self-determination, dignity and optimal quality of life as they
deal with inevitable declines in physical independence.
Texas Tech University's Center for Healthy Aging, a state-
of-the art geriatric care, training, and research center, will
serve as a national model for the treatment and understanding
of long-term health care for older Americans.
The Coalition of Wisconsin Aging Groups proposes to expand
the Elder Law Center to provide legal backup to benefit
specialists and to educate members of the legal community and
the public on growing concerns about financial elder abuse and
possible remedies to that problem.
The La Crosse Hmong Mutual Assistance Association is
developing programs to provide employment, social, economic and
educational assistance to elderly Hmong refugees.
Champlain Senior Center in Burlington, Vermont proposes to
utilize technology in its efforts to help more low income
senior remain independent and active for as long as possible.
The University of Indianapolis, through its new Center for
Aging and Community Health, is developing an integrated
complement of clinical, educational, and research programs in
order to improve services to the community.
The Center to Enhance Quality of Life in Chronic Illness at
Indiana University proposes to undertake research on preventing
falls among the elderly, home support of patients with
congestive heart failure and interventions to family care
givers of Alzheimer patients.
The National Asian Pacific Center for Aging's efforts have
helped increase access for American Asian and Pacific Islander
seniors to social services and other support programs.
The Franciscan Health System's program ``Improving Care
through the End of Life'' has demonstrated cost savings
achieved by programs that integrate palliative care into a
comprehensive, interdisciplinary service geared toward patients
with terminal illnesses.
The Hana Community Health Center provides traditional
nutrition services to the area's elderly population, and also
provides additional wellness programs, home health care and
transportation assistance, enabling the elderly to remain in
the Hana Community.
The Allegheny County Homestead Apartments LIFE Center will
provide quality primary health care, physical and occupational
therapy, and limited social services to the senior citizens at
the Homestead Apartments and in the surrounding area, allowing
seniors to remain at home.
The International Longevity Center proposes to establish a
Visiting Scholars Program, expand research focused on the daily
life experiences of older persons and disseminate research
findings widely.
The Family Friends Project continues to pursue new
replication approaches and support technical assistance and
training for local sites through the Family Friends national
office.
Aging network support activities
The Committee recommends $2,379,000 for aging network
support activities, $567,000 more than the fiscal year 2001
level and the budget request. The Committee recommendation
includes $1,198,607 for Eldercare Locator, $337,557 more than
the fiscal year 2001 appropriation. The Committee
recommendation provides $1,180,393 for the pension information
and counseling projects, $229,000 more than last year. These
program were funded as demonstration activities through the
fiscal year 2001 appropriation. Last year's reauthorization of
the Older Americans Act authorized both of these activities
under section 201 of the Act.
The Eldercare Locator, a toll-free, nationwide directory
assistance service for older Americans and their caregivers, is
operated by the National Association of Area Agencies on Aging.
Since 1991, the service has linked nearly 500,000 callers to an
extensive network of resources for aging Americans and their
caregivers. Pension counseling projects provide information,
advice, and assistance to workers and retirees about pension
plans, benefits, and pursuing claims when pension problems
arise.
Alzheimer's Disease Demonstration Grants to States
As a result of the aging of the Baby Boom generation, the
number of individuals affected by Alzheimer's Disease will
double in the next twenty years. The Committee recommends a
funding level of $13,000,000, an increase of $4,038,000 over
the fiscal year 2001 level and the Administration's request.
Currently, an estimated 70 percent of individuals with
Alzheimer's disease live at home, where families provide the
preponderance of care. For these families, care giving comes at
enormous physical, emotional and financial sacrifice. The
Alzheimer's disease demonstration grant program currently
provides matching grants to 24 States to stimulate and better
coordinate services for families coping with Alzheimer's. With
a relatively small amount of Federal support to provide the
stimulus, States have found innovative ways to adapt existing
health, long-term care, and community services to reach
previously underserved populations, particularly minorities and
those living in rural communities. Given the programs proven
record of success, the Committee recommends an increase of
$4,038,000 over the comparable 2001 appropriation to expand the
program to additional States.
Program administration
The Committee recommends $18,122,000 to support Federal
staff that administer the programs in the Administration on
Aging, $903,000 above the 2001 level and the same amount as the
budget request. These funds provide administrative and
management support for programs administered by the agency.
The Committee applauds the efforts of the AoA and the
national aging network in helping address the needs of the
elderly and their caregivers arising from the tragedy that
occurred on September 11, 2001. The Committee recognizes that
AoA and many State and local organizations serving the elderly
and caregivers focused resources and increased attention on
helping support the local aging network in responding to the
needs of elderly individuals residing in communities affected
by that day's tragedy. These events underscore both the
vulnerability of the elderly, and especially homebound elderly,
in times of both natural and man-made disasters. However, these
events also underscore the fact that the national aging
network, comprising 56 State units on aging, 655 area agencies
on aging, 235 Tribes and Tribal organizations, and 29,000 local
services providers, represents a tremendous resource for
assisting the community at large during emergency situations.
The Committee commends and supports the continued efforts of
AOA and the aging network in providing for the needs of the
elderly and their caregivers, including mental health needs, in
affected communities. The Committee also urges the Secretary to
continue efforts to plan for emergencies, to ensure that the
elderly and their caregivers receive the help they need and to
facilitate making the resources of the national aging network
available to the community at large in emergency situations.
Office of the Secretary
GENERAL DEPARTMENTAL MANAGEMENT
Appropriations, 2001.................................... $378,019,000
Budget estimate, 2002................................... 442,751,000
Committee recommendation................................ 422,212,000
The Committee recommends $422,212,000 for general
departmental management [GDM]. This is $20,539,000 less than
the administration request and $44,193,000 above the fiscal
year 2001 level. Within this amount, the Committee includes the
transfer of $5,851,000 from Medicare trust funds, which is the
same as the administration request and the fiscal year 2001
level. Included in these funds is $5,000,000 to be transferred
to the Global Fund to Fight HIV/AIDS, Malaria, and
Tuberculosis.
This appropriation supports those activities that are
associated with the Secretary's role as policy officer and
general manager of the Department. It supports certain health
activities performed by the Office of Public Health and
Science, including the Office of the Surgeon General. GDM funds
also support the Department's centralized services carried out
by several Office of the Secretary staff divisions, including
personnel management, administrative and management services,
information resources management, intergovernmental relations,
legal services, planning and evaluation, finance and
accounting, and external affairs.
The Office of the Surgeon General, in addition to its other
responsibilities, provides leadership and management oversight
for the PHS Commissioned Corps, including the involvement of
the Corps in departmental emergency preparedness and response
activities.
The Committee is aware that, in response to the September
11th terrorist attacks, the Department activated the National
Disaster Medical System (NDMS) to provide emergency medical
assistance to local officials in New York City and at the
Pentagon. The Office of Emergency Preparedness deployed 328
medical personnel as part of Disaster Medical Assistance Teams
(DMATS), which consisted of physicians, nurses and emergency
medical technicians trained to deal with traumatic injuries. In
addition, four Disaster Mortuary Operation Response Teams
(DMORTS) were dispatched to New York City, and three to the
Washington area. The Committee commends the Department for its
quick response and for providing needed resources to local
emergency personnel.
The Committee has provided $4,000,000 to support the
activities of the United States-Mexico Border Health Commission
as authorized by Public Law 103-400. The Commission is
authorized to assess and resolve current and potential health
problems that affect the general population of the United
States-Mexico border area.
The Committee directs that specific information requests
from the Chairman and Ranking Members of the Subcommittee on
Labor, Health and Human Services, and Education, and Related
Agencies, on scientific research or any other matter, shall be
transmitted to the Committee on Appropriations in a prompt
professional manner and within the time frame specified in the
request. The Committee further directs that scientific
information requested by the Committees on Appropriations and
prepared by government researchers and scientists be
transmitted to the Committee on Appropriations, uncensored and
without delay.
The Committee is aware that the Department is undertaking
an overhaul of its internal computer systems, specifically a
Unified Financial Management System. The Committee is further
aware that there are concerns about the process by which the
Department has solicited bids for fulfilling its software
needs. Therefore, the Committee urges the Department to ensure
that the procurement process for any and all service and
software purchases is conducted in the most open, fair, and
appropriate manner in compliance with current Federal
guidelines.
The Committee has included funding for the Human Services
Transportation Technical Assistance Program. These funds shall
be used to provide assistance to human service transportation
providers on management, coordination and meeting the
requirements of the Americans with Disabilities Act. Funding is
also included for a Medicare Transportation Demonstration
Program in Iowa. Under this demonstration, residents of an
urban and rural community shall receive non-emergency
transportation assistance for visits to hospitals, clinics, and
physicians and for related services. The purpose of this
demonstration is to ascertain the obstacles, including costs,
that senior citizens encounter in securing non-emergency
transportation to health care providers. The Committee notes
that the technical assistance provided by the Community
Transportation Association of America is vital to the success
of these demonstrations.
The Committee understands that Mercy Housing, Inc., a
national non-profit faith-based organization focused on
improving the health care and housing opportunities available
to low-income families, elderly households and individuals,
would benefit from technical assistance to develop linkages
between health care services and affordable housing
developments.
Children's eye exams.--As 80 percent of what children learn
is acquired through vision processing information, the
Committee recognizes that ensuring that all children start
school ready to learn is essential to their academic
achievement and our Nation's economic success and urges that
all children have access to comprehensive eye examinations
prior to school matriculation. The Committee believes that
comprehensive eye exams in children prior to entering school
are an important step to assure they start their academic
careers ready to learn and that the full range of visual
impairments are identified and diagnosed. The Committee
therefore urges the Secretary to explore and develop ways in
which to assure that more children receive comprehensive eye
examinations.
Chronic fatigue.--The Committee is pleased that the
Department has announced that it will establish a chronic
fatigue syndrome advisory committee to build upon progress made
by the DHHS CFS Coordinating Committee within the limits of its
charter. It is this Committee's expectation that this
transition to an advisory committee will not diminish the full
partnership of involved agencies or the collaborative
relationships among Federal agencies, scientists, and CFS
advocates that have developed over recent years through the CFS
Coordinating Committee. The Committee is disappointed that,
despite 2 years of report language, the Department has not yet
undertaken a prominent educational campaign to inform health
care professionals and the general public about CFS. The
Committee urges the Secretary and the Surgeon General to take a
leadership role in this effort and to report back to the
Committee within 90 days on plans to inform the public that CFS
is a serious, prevalent, and disabling illness.
Coordination of child support enforcement activities.--The
flow of information between Federal and State agencies and the
court system continues to be a critical factor in the success
of the Child Support Enforcement program. While some States
have succeeded in implementing seamless, cost-effective
processes for information-sharing among their human service
agencies and the courts, others have not. The Committee has
been impressed with the results of ACF's efforts using the
State information technology consortium to improve the
information and systems reporting requirements of TANF. That
success underscores the notion that States are in the best
position to solve their own problems. The Committee therefore
encourages the Secretary to utilize this consortium of States
to identify and widely disseminate methods for improving the
flow of information between agencies and the court system.
Dietary supplements.--The Committee recognizes the
substantial role that dietary supplements can play in improving
the health status of Americans. Indeed, improved nutrition and
healthful diets may mitigate the need for expensive medical
procedures and reduce health care expenditures. In 1994, the
Congress passed the Dietary Supplement Health and Education Act
(DSHEA), which provides the regulatory framework necessary to
ensure that consumers have access to safe, accurately labeled
dietary supplements and information about those products.
However, while the Food and Drug Administration (FDA) has spent
resources to take action against a number of important
healthful products, the Committee believes it has failed to
take action against a number of clearly violative claims and
inaccurate ingredient labels. The Committee is aware that
funding for the Food and Drug Administration is in the
Department of Agriculture appropriations bill. However, the
Committee directs the Secretary to work with the FDA to
undertake appropriate enforcement of DSHEA in areas relating to
the accuracy of claims about dietary supplement ingredients,
and prohibiting any dietary supplement claim that is false or
misleading.
Embryo adoption awareness.--During hearings devoted to Stem
Cell research, the Committee became aware of approximately
100,000 spare frozen embryos stored in in vitro fertilization
(IVF) clinics throughout the United States. The Committee is
also aware of many infertile couples who, if educated about the
possibility, may choose to implant such embryos into the woman
and, potentially, bear children. The Committee therefore
directs the Department to launch a public awareness campaign to
educate Americans about the existence of these spare embryos
and adoption options. The Committee has provided $1,000,000 for
this purpose.
Homelessness.--The Committee supports the ongoing efforts
of the Department in its initiative to end chronic
homelessness. The Committee encourages the collaboration
between HHS and the Department of Housing and Urban Development
(HUD) and supports the goal of ending homelessness for the
estimated 150,000 chronically homeless. The Department should
continue to identify funds for supportive services to
supplement permanent supportive housing projects being funded
by HUD.
Long-term care.--The Committee notes that long-term care
settings (nursing homes, assisted living, home health care,
etc.) nationwide are facing a shortage of frontline caregivers
including registered and licensed practical nurses, certified
nurse aids (CNAs) and other direct care workers. The Committee
notes that the General Accounting Office estimates that the
U.S. health care system will need an additional 800,000 nurse
aides by the year 2008. The Committee expects the Secretary to
coordinate a study with the Administrators of HRSA and CMS to
identify the causes of the shortage of frontline caregivers in
long-term care settings and make comprehensive recommendations
to the Committee to address the increasing demand of an aging
baby-boomer generation, and report findings and recommendations
to the Committee by June 1, 2002.
Medical devices.--The Secretary is urged to submit a report
to the Committee on medical devices developed or improved by
the Federal Government or in conjunction with Federal funds.
The report should specifically address medical devices used in
the treatment of chronic illness, including diabetes. To the
extent possible, the report should address how medical devices
developed or used by the Federal Government are introduced into
the mainstream health care delivery system; how the use of a
medical device by a chronically ill person is evaluated for
efficacy; how the Federal Government can improve efforts to
introduce medical device technology developed by its agencies
and programs into the mainstream health care delivery system;
and how the Department can improve its consideration of the
needs of chronically ill patients when evaluating the efficacy
of medical devices. The Secretary is urged to report to the
Committee no later than May 30, 2002.
Nurse anesthetists.--The Committee understands that
concerns have been raised about the administration's proposed
rules to address the issue of physician supervision of
certified registered nurse anesthetists. The Committee urges
the Secretary to take the differing views of the interested
parties, including the nurse anesthetists and
anesthesiologists, into consideration before issuing a final
rule.
Report on osteoporosis and related bone diseases.--More
than 30 million Americans suffer from some form of bone
disease, including osteoporosis, Paget's disease and
osteogenesis imperfecta. The Committee therefore recommends
that the Department commission a Surgeon General's report on
osteoporosis and related bone diseases, detailing the burden
bone diseases places on society, and highlighting preventive
measures to improve and maintain bone health throughout life.
The report should also identify best practices for collecting
data about the prevalence, morbidity and disability associated
with bone diseases among minority populations.
Runaway youth.--The Committee is concerned with reports
that runaway, throwaway, homeless, and street experiences among
youth are increasing. The Committee is also troubled that the
exact nature of these problems is not well defined because
national statistics on the number, characteristics, and
circumstances of this population are not tabulated. The
Committee instructs the Secretary, acting through the Assistant
Secretary of Planning and Evaluation, to prepare and submit by
September 30, 2002 a plan for developing estimates of the
incidences of runaway, throwaway, homeless, and street
experiences among youth, as well as a plan for regularly
monitoring incidence trends.
Underage drinking prevention.--The Committee recommendation
includes $1,000,000 for the National Academy of Sciences
Institute of Medicine to conduct a comprehensive review of all
existing Federal, State and non-governmental programs designed
specifically to reduce the illegal purchase and consumption of
alcohol, as well as media-based programs with the purpose of
changing the attitudes and behaviors of youth. The Committee
directs the NAS to review, evaluate and report on the
effectiveness of all such programs, the results of which shall
identify those programs which have been the most successful at
accomplishing the goals of reducing underage drinking or
successfully altering the attitudes and behaviors of youth. The
NAS shall, based on its review, make recommendations on a
comprehensive strategy for reducing and preventing underage
drinking in the United States. The review and recommendations
of the NAS shall be reported to the United States Senate
Committee on Appropriations, the United States Secretary of
Health and Human Services, the United States Secretary of
Education and the United States Attorney General no later than
12 months after the date of enactment of this Act.
Adolescent family life
The Committee has provided $30,000,000 for the Adolescent
Family Life Program [AFL]. This is $5,673,000 more than the
fiscal year 2001 appropriation and $2,138,000 over the
administration request.
AFL is the only Federal program focused directly on the
issue of adolescent sexuality, pregnancy, and parenting.
Through demonstration grants and contracts, AFL focuses on a
comprehensive range of health, educational, and social services
needed to improve the health of adolescents, including the
complex issues of early adolescent sexuality, pregnancy, and
parenting.
Within the total provided, the Committee continues the
prevention projects begun in fiscal year 1998, as well as new
prevention projects. The Committee again expects the Department
to fund new prevention projects which enable smaller
communities to begin the organization and implementation of
coalitions to implement abstinence-based education programs.
The Committee again expects the Department, when announcing
grant competitions, to provide a reasonable length of time for
applicants to complete application packages, provide extensive
technical assistance to applicants, with special assistance
given to new applicants, and revise the terminology and
instructions in grant applications to assure that the
information being requested is as clear as possible.
Physical fitness and sports
The Committee recommends $1,139,000 for the Federal staff
which supports the President's Council on Physical Fitness and
Sports. This is the same as the budget request and $48,000 more
than the fiscal year 2001 appropriation.
The President's Council on Physical Fitness and Sports
serves as a catalyst for promoting increased physical activity/
fitness and sports participation for Americans of all ages and
abilities, in accordance with Executive Order 12345, as
amended. The programs sponsored by PCPFS are supported largely
through private sector partnerships.
Minority health
The Committee recommends $43,084,000 for the Office of
Minority Health. This is the same as the budget request and
$5,935,000 less than the fiscal year 2001 appropriation.
The Office of Minority Health [OMH] focuses on strategies
designed to decrease the disparities and to improve the health
status of racial and ethnic minority populations in the United
States. OMH establishes goals, and coordinates all departmental
activity related to improving health outcomes for disadvantaged
and minority individuals. OMH supports several demonstration
projects, including the Minority Community Health Coalition,
the Bilingual/Bicultural Service, the Center for Linguistic and
Cultural Competency in Health Care, and the Family and
Community Violence Prevention Program.
The Committee has provided $1,000,000, the same as the
budget request, to support a national program to assess and
reduce health disparities affecting minority males. The
Committee urges the Department, when launching the new National
Minority Male Health Project, to do so through a consortium of
historically black colleges and universities with a
demonstrated relationship that will contribute to educating
minority males about their health. The Committee further urges
the Department to directly involve historically black colleges
and universities in the community-based health strategies
affecting minority males.
The Committee encourages the Office of Minority Health to
provide support to historically black serving institutions and
other minority-serving institutions to enhance their efforts in
HIV/AIDS and other disease prevention.
The Committee recommends continuation of the following
fiscal year 2001 projects and activities referenced in the
fiscal year 2001 conference agreement:
--Trinity Health in Detroit, Michigan for its primary care
clinic that serves underserved, low-income and minority
individuals
--the Community Lead Education and Reduction Corps
(CLEARCorps) at the University of Maryland Baltimore
County to prevent lead poisoning among low-income and
minority children.
The Committee is aware of the following projects and urges
the Department to give them full and fair consideration:
--the American Association of Physicians of Indian Origin
(AAPI) efforts to study bone mineral density (BMD) in
the Indian American community
--the AIDS Foundation of Chicago's efforts to expand current
prevention programs
--the Center for Hispanic Community and Family Health at the
University of North Carolina at Greensboro
--Padres Contra El Cancer, a non-profit organization that
serves Latino children with cancer in Los Angeles, CA
--the Institute for the Elimination of Health Disparities at
the University of Medicine and Dentistry of New Jersey
(UMDNJ) for focusing on minority health issues
--the California Teratogen Information Service in San Diego,
CA for its outreach and education program directed at
Hispanic women of reproductive age
--the Chronic Disease Prevention for Hispanic Children
Project being sponsored through the Texas Agricultural
Extension Service, Baylor Children's Hospital and the
Texas A&M Health Sciences Center
--the Baltimore City Health Department for HIV/AIDS testing
for high-risk individuals.
--the Thomas Jefferson University Hospital for providing
linguistically competent and culturally sensitive
health care services to the Chinese community.
Office on Women's Health
The Committee recommends $27,396,000 for the Office on
Women's Health. This is the same as the administration request
and $10,126,000 more than the fiscal year 2001 appropriation.
The PHS Office on Women's Health [OWH] develops,
stimulates, and coordinates women's health research, health
care services, and public and health professional education and
training across HHS agencies. It advances important
crosscutting initiatives and develops public-private
partnerships, providing leadership and policy direction, and
initiating and synthesizing program activities to redress the
disparities in women's health.
The Committee remains strongly supportive of the various
women's health-related offices in NIH, CDC, HRSA, FDA, SAMHSA,
AHRQ, and HCFA. These offices are essential to the mission of
the Department and must be adequately supported to accomplish
their goals in line with the expanded role planned for OWH. The
Secretary should notify the Committee in advance of any
significant changes in the status of any of these offices.
The Committee is supportive of the efforts of Wishard
Health Services in Indianapolis, Indiana to establish a
National Center of Excellence in Women's Health. The Center of
Excellence would offer a comprehensive array of programs
designed to help women take important steps toward leading
positive, productive lives.
National Bone Health Campaign.--The Committee commends the
Office on Women's Health for their commitment to the National
Bone Health Campaign aimed at girls aged 9 to 18. The Committee
encourages the Office on Women's Health to increase their
support of the Campaign.
Office of Emergency Preparedness
The Committee has provided $14,200,000, which is the same
as the budget request and $2,532,000 more than last year, for
activities to counter the adverse health and medical
consequences from major terrorist events. Within this amount,
sufficient funds are provided for the Office of Emergency
Preparedness to staff and administer this program, as well as
the other OEP activities specified in the administration's
request. The amount provided by the Committee is intended to
continue the formation of new metropolitan medical strike teams
in key uncovered urban areas of the country.
The Department has lead responsibility for health, medical,
and health-related support under the Federal response plan to
catastrophic disasters. On behalf of the Department, the Office
of Emergency Preparedness assesses the potential health and
medical consequences of a terrorist incident and to formulate
necessary responses. The funds provided would support
activities to build local, State, and Federal capacity to
respond to terrorist acts with public health implications. Such
activities would include assisting local emergency managers
through the MMST system to build an enhanced capability to
detect and identify biologic and chemical agents.
Bioterrorism
The Committee recommendation includes $68,700,000 for
bioterrorism activities, which is the same as the
administration request and $8,670,000 above the fiscal year
2001 level. In fiscal year 2001 funds for bioterrorism were
appropriated in the Public Health and Social Services Emergency
Fund. The fiscal year 2002 budget request funds bioterrorism
programs in the OEP and the Office of the Secretary. Additional
funds for bioterrorism have been provided by the Committee
within the CDC and NIH.
The Committee expects that, within the amount provided to
the Secretary for biosecurity, the rebuilding of the nation's
public health infrastructure be given the highest priority.
Communications, information technology, laboratories and
associated technologies, hospital capacity, and trained
professionals are essential elements of a national public
health infrastructure which protects the civilian population
against both bioterrorist threats and the rapid onset of
naturally occurring diseases.
The Committee is aware that the administration is
submitting a supplemental budget request for additional fiscal
year 2002 bioterrorism funding. The Committee looks forward to
working with the administration on this request to insure that
substantially increased investments are made in our public
health infrastructure, and that our first-responders at the
State and local level are sufficiently prepared in the event of
a bioterrorist attack.
The Committee recommends continuation of the following
fiscal year 2001 projects and activities in the fiscal year
2001 conference agreement:
--the West Virginia University Virtual Medical Campus to
address medical community needs for weapons of mass
destruction readiness and preparedness.
--University of Findlay's National Center for Terrorism
Preparedness for an ALERT (Actual Learning Environment
Response Training) Center.
--the Center for the Study of Bioterrorism and Emerging
Infections at the St. Louis University School of Public
Health.
The Committee is aware of the following projects that it
encourages the Department to consider supporting:
--The Center for BioDefense at the University of Medicine and
Dentistry in New Brunswick, New Jersey
--The Detroit Medical Center for an urban disaster and
emergency medical response initiative
--The Center for Civilian Biodefense Studies at Johns Hopkins
University
--St. Michael's Medical Center in Newark, New Jersey, for its
work on bioterrorism as part of the practice and study
of high risk infectious disease
--The Centers for Biopreparedness and Infectious Disease at
the University of North Carolina.
HIV/AIDS in minority communities
To address high-priority HIV prevention and treatment needs
of minority communities heavily impacted by HIV/AIDS, the
Committee recommends $50,000,000. These funds are available to
key operating divisions of the department with capability and
expertise in HIV/AIDS services to assist minority communities
with education, community linkages, and technical assistance.
OFFICE OF INSPECTOR GENERAL
Appropriations, 2001.................................... $33,786,000
Budget estimate, 2002................................... 35,786,000
Committee recommendation................................ 35,786,000
The Committee recommends an appropriation of $35,786,000
for the Office of Inspector General. This is the same as the
administration request and $2,000,000 higher than the fiscal
year 2001 level. In addition to discretionary funds, the Health
Insurance Portability and Accountability Act of 1996 provides
$150,000,000 in mandatory funds for the Office of the Inspector
General in fiscal year 2002; the total funds provided to the
Office by this bill and the authorizing bill would be
$185,786,000 in fiscal year 2002.
The Office of Inspector General conducts audits,
investigations, inspections, and evaluations of the operating
divisions within the Department of Health and Human Services.
The OIG functions with the goal of reducing the incidence of
waste, abuse, and fraud. It also pursues examples of
mismanagement toward the goal of promoting economy and
efficiency throughout the Department.
The Committee commends the Office of Inspector General for
their continued good work to reduce waste, fraud and abuse in
Department programs. The Committee expects efforts to reduce
Medicare mispayments will be continued and expanded. The
Committee also wants to assure that seniors calling into the
toll-free telephone line to report Medicare mispayments get a
prompt and complete response.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2001.................................... $28,005,000
Budget estimate, 2002................................... 32,005,000
Committee recommendation................................ 32,005,000
The Committee recommends $32,005,000 for the Office for
Civil Rights. This is the same as the administration request
and $4,000,000 more than the fiscal year 2001 level.
This recommendation includes the transfer of $3,314,000
from the Medicare trust funds, which is the same as the
administration request and the fiscal year 2001 level.
The Office for Civil Rights is responsible for enforcing
civil rights-related statutes in health care and human services
programs. To enforce these statutes, OCR investigates
complaints of discrimination, conducts program reviews to
correct discriminatory practices, and implements programs to
generate voluntary compliance among providers and constituency
groups of health and human services.
The Committee supports the efforts of OCR to properly
enforce the final medical privacy regulation that went into
effect earlier this year. The Committee urges OCR to ensure
that the necessary resources are not taken away from the
Office's other enforcement areas of responsibilities.
POLICY RESEARCH
Appropriations, 2001.................................... $16,715,000
Budget estimate, 2002................................... 20,500,000
Committee recommendation................................ 20,500,000
The Committee recommends $20,500,000 for policy research,
which is the same as the administration request and $3,785,000
more than the fiscal year 2001 amount.
Funds appropriated under this title provide resources for
research programs that examine broad issues which cut across
agency and subject lines, as well as new policy approaches
outside the context of existing programs. This research can be
categorized into three major areas: health policy, human
services policy, and disability, aging and long-term care
policy.
RETIREMENT PAY AND MEDICAL BENEFITS FOR COMMISSIONED OFFICERS
Appropriations, 2001.................................... $219,772,000
Budget estimate, 2002................................... 242,577,000
Committee recommendation................................ 242,577,000
The Committee provides an estimated $242,577,000 for
retirement pay and medical benefits for commissioned officers
of the U.S. Public Health Service. This is the same as the
administration request and is $22,805,000 over the estimated
payments for fiscal year 2001.
This account provides for: retirement payments to U.S.
Public Health Service officers who are retired for age,
disability, or length of service; payments to survivors of
deceased officers; medical care to active duty and retired
members and dependents and beneficiaries; and for payments to
the Social Security Administration for military service
credits.
General Provisions, Department of Health and Human Services
The Committee recommendation includes language placing a
$37,000 ceiling on official representation expenses (sec. 201),
the same as existing law.
The Committee recommendation includes language included in
fiscal year 2001 which limits assignment of certain public
health personnel (sec. 202).
The Committee recommendation retains language carried in
fiscal year 2001 regarding set-asides in the authorizing
statute of the National Institutes of Health (sec. 203).
The Committee recommendation retains a provision carried in
fiscal year 2001 to limit use of grant funds to pay individuals
more than an annual rate of Executive level I (sec. 204).
The Committee recommendation retains language from fiscal
year 2001 restricting the use of taps (sec. 205) for program
evaluation activities by the Secretary prior to submitting a
report on the proposed use of the funds to the Appropriations
Committee.
The Committee recommendation (sec. 206) authorized transfer
of up to 2 percent of Public Health Service funds for
evaluation activities.
The Committee recommendation retains language included in
fiscal year 2001 restricting transfers of appropriated funds
among accounts and requiring a 15-day notification of both
Appropriations Committees prior to any transfer (sec. 207).
The Committee recommendation includes language included in
fiscal year 2001 permitting the transfer of up to 3 percent of
AIDS funds among Institutes and Centers (sec. 208) by the
Director of NIH and the Director of the Office of AIDS Research
of NIH.
The recommendation also includes language included in
fiscal year 2001 which directs that the funding for AIDS
research as determined by the Directors of the National
Institutes of Health and the Office of AIDS Research be
allocated directly to the OAR for distribution to the
Institutes and Centers consistent with the AIDS research plan
(sec. 209).
The Committee recommendation includes a provision (sec.
210) regarding family planning applicants to certify to the
Secretary to encourage family participation in the decision of
a minor who seeks family planning services.
The Committee recommendation includes a provision included
in fiscal year 2001 which restricts the use of funds to carry
out the MedicareChoice Program if the Secretary denies
participation to an otherwise eligible entity (sec. 211).
The Committee includes a provision (sec. 212) which states
that no provider of services under Title X of the PHS Act
except from State laws regarding child abuse.
The Committee includes a provision (sec. 213) extending the
refugee status for persecuted religious groups.
The Committee continues to include a provision prohibiting
the Secretary from withholding substance abuse treatment funds
(sec. 214).
The Committee recommendation includes a provision (sec.
215) that facilities expenditure of funds for international
AIDS activities.
The Committee recommendation includes a provision allowing
the Acting Director of NIH to remain in that position until a
new Director is confirmed (sec. 216).
The Committee has included a provision (sec. 217)
transferring $100,000,000 to International Assistance Programs
for the Global Fund to Fight HIV/AIDS, Malaria and
Tuberculosis.
TITLE III--DEPARTMENT OF EDUCATION
The Committee understands that programs authorized by the
Elementary and Secondary Education Act (ESEA) of 1965, as
amended, currently are under consideration for reauthorization.
Therefore, the Committee has allocated funds for these programs
in accordance with H.R. 1, the ESEA reauthorization bill, as
passed by the Senate on June 14, 2001.
education for the disadvantaged
Appropriations, 2001.................................... $10,014,621,000
Budget estimate, 2002................................... 11,045,621,000
Committee recommendation................................ 11,879,900,000
The Committee recommends an appropriation of
$11,879,900,000 for education for the disadvantaged. This is
$1,865,279,000 more than the fiscal year 2001 appropriation and
$834,279,000 more than the budget request. In fiscal year 2001,
$6,953,300,000 was made available for this account in fiscal
year 2002 funds. The Committee recommends the same amount in
fiscal year 2003 funds for fiscal year 2002.
Programs financed under this account are authorized under
Title I of the ESEA as amended by H.R. 1 as passed by the
Senate and section 418A of the Higher Education Act. ESEA Title
I programs provide financial assistance to State and local
educational agencies (LEAs) to meet the special educational
needs of educationally disadvantaged children, migrant
children, neglected and delinquent children in State
institutions, homeless children, and juveniles in adult
correctional institutions. In addition, the Even Start Program
supports projects that integrate early childhood education with
parenting and adult literacy training. Funds for most of these
programs are allocated through formulas that include the number
of eligible children and each State's average per-pupil
expenditure. Even Start funds are allocated according to each
State's proportion of Title I grants to LEAs.
Grants to local educational agencies
Title I grants to local educational agencies provide
supplemental education funding to LEAs and schools, especially
in high-poverty areas, to help low-income, low-achieving
students learn to the same high standards as other children.
The formula for basic grants is based on the number of children
from low-income families in each LEA, weighted by per-pupil
expenditures for education in the State. The Department makes
Federal allocations to the LEA level. States have the option to
reallocate funds to LEAs serving areas with fewer than 20,000
residents using the best data available on the number of poor
children. States are also required to reserve funds generated
by counts of children in correctional institutions to make
awards to LEAs for dropout-prevention and high-quality
educational programs involving youth from correctional
facilities and other at-risk children. By law, 1 percent of the
total LEA grant appropriation is set aside for the Bureau of
Indian Affairs and the outlying areas.
The Committee is aware that the distribution formula for
Title I grants to LEAs is the subject of ongoing negotiations
by House and Senate conferees on the ESEA reauthorization bill.
Given the uncertain outcome of that process, the Committee
recommends distributing the funds under the formula used in
fiscal year 2001 and will revisit this issue at conference for
this bill.
For Title I basic grants, including the amount transferred
to the Census Bureau for poverty updates, the Committee
recommends an appropriation of $8,568,000,000, which is
$1,169,279,000 more than appropriated in fiscal year 2001 and
$1,330,279,000 more than the budget request.
The Committee recommends $1,632,000,000 for concentration
grants. This amount is $268,000,000 more than the amount
appropriated in fiscal year 2001 and the budget request. Funds
under this program are distributed according to the basic
grants formula, except that they go only to LEAs where the
number of poor children equals at least 6,500, or 15 percent,
of the total school-aged population.
The Committee recommends that each State and LEA should
receive the greater of either the amount it would receive at
specified levels under a 100 percent hold-harmless provision or
what it would receive using the statutory formulas. This
applies for both basic and concentration grants. Also, the
Department should make 100 percent hold-harmless awards to LEAs
that were eligible for concentration grants in fiscal year
2001, but are not eligible to receive grants in fiscal year
2002.
William F. Goodling Even Start Family Literacy Program
For the Even Start program, the Committee recommends
$200,000,000, which is $50,000,000 less than the budget request
and the fiscal year 2001 appropriation.
The Even Start program provides grants for family literacy
programs that serve disadvantaged families with children under
8 years of age and adults eligible for services under the Adult
Education and Family Literacy Act. Programs combine early
childhood education, adult literacy, and parenting education.
States receive funds on the basis of their proportion of
Title I LEA grant allocations and make competitive 4-year
grants to partnerships of local educational agencies and
community-based organizations. Grant funds must be equitably
distributed among urban and rural areas. The local share of
program costs must increase from 10 percent in the first year
to 40 percent in the 4th year, 50 percent in years 5 through 8,
and 65 percent after 8 years.
The Committee is aware that the National Even Start
Association, in conjunction with the National Center for Family
Literacy, the National Institute for Child Health and Human
Development, the National Institute for Literacy and the
William F. Goodling Institute for Research in Family Literacy,
will provide training and technical assistance to local Even
Start programs in need of such support (as identified by the
States). Activities shall include, but are not limited to,
assistance to personnel to help them meet the qualifications
for instructional personnel set forth in the Even Start law,
and training and materials to ensure instructional programs are
based on scientifically based reading research.
Reading First State Grants
The Committee recommends $900,000,000, the same as the
budget request, for the Reading First State Grants program.
This program will build on and replace the Reading and Literacy
Grants program, which was authorized under the Reading
Excellence Act program and funded at $286,000,000 in fiscal
year 2001.
Reading First is a comprehensive effort, authorized by the
Senate-passed version of H.R. 1, to provide States and LEAs
with funds to implement comprehensive reading instruction for
children in grades K-3. The purpose of the program is to help
ensure that every child can read by third grade. LEAs and
schools that receive funds under this program should use the
money to provide professional development in reading
instruction for teachers and administrators, adopt and use
reading diagnostics for students in grades K-3 to determine
where they need help, implement reading curricula that are
based on scientific research, and provide reading interventions
for children who are not reading at grade level.
Early Reading First
The Committee recommends $75,000,000, the same as the
budget request, for Early Reading First, a new program
authorized by the Senate-passed version of H.R. 1. Early
Reading First will complement Reading First State Grants by
providing competitive grants to school districts and nonprofit
groups to support activities in existing preschool programs
that are designed to enhance the verbal skills, phonological
awareness, letter knowledge, pre-reading skills, and early
language development of children ages 3 through 5. Funds will
be targeted to communities with high numbers of low-income
families.
Migrant
For the State agency migrant program, the Committee
recommends $380,000,000, the same as the budget request and the
fiscal year 2001 appropriation.
The Title I migrant program authorizes grants to State
educational agencies for programs to meet the special
educational needs of the children of migrant agricultural
workers and fishermen. Funds are allocated to the States
through a statutory formula based on each State's average per-
pupil expenditure for education and counts of migratory
children ages 3 through 21 residing within the States. Only
migratory children who have moved within the last 3 years are
generally eligible to be counted and served by the program.
This appropriation also supports activities to improve
interstate and intrastate coordination of migrant education
programs.
Neglected and delinquent
The Committee recommends $50,000,000 for the Title I
neglected and delinquent program. This amount is $4,000,000
more than the budget request and the fiscal year 2001
appropriation.
This program provides financial assistance to State
educational agencies for education services to neglected and
delinquent children and youth in State-run institutions and for
juveniles in adult correctional institutions.
Funds are allocated to individual States through a formula
based on the number of children in State-operated institutions
and per-pupil education expenditures for the State.
States are authorized to set aside up to 10 percent of
their neglected and delinquent funds to help students in State-
operated institutions make the transition into locally operated
programs. Transition activities are designed to address the
high failure and dropout rate of institutionalized students and
may include alternative classes, counseling and supervisory
services, or educational activities in State-supported group
homes.
Evaluation
The Committee bill includes $8,900,000, the same as the
budget request and the fiscal year 2001 appropriation, for
Title I evaluation activities. Evaluation funds are used to
support large-scale national surveys that examine how the Title
I program is contributing to student performance.
High school equivalency program
The Committee bill includes $20,000,000 for the high school
equivalency program (HEP). This amount is the same as the
budget request and the fiscal year 2001 appropriation.
This program provides 5-year grants to institutions of
higher education and other nonprofit organizations to recruit
migrant students ages 16 and over and provide the academic and
support services needed to help them obtain a high school
equivalency certificate and subsequently gain employment, win
admission to a postsecondary institution or a job-training
program, or join the military. Projects provide counseling,
health services, stipends, and placement assistance. HEP serves
about 6,000 migrants.
College Assistance Migrant Program
For the College Assistance Migrant Program (CAMP), the
Committee recommends $10,000,000, the same as the budget
request and the fiscal year 2001 appropriation.
Funds provide 5-year grants to institutions of higher
education and nonprofit organizations for projects that provide
tutoring, counseling, and financial assistance to migrant
students during their first year of postsecondary education.
Projects also may use up to 10 percent of their grants for
follow-up services after students have completed their first
year of college, including assistance in obtaining student
financial aid.
Education for homeless children and youth
For carrying out education activities authorized by part B,
subtitle B of the Stewart B. McKinney Homeless Assistance Act,
the Committee recommends $36,000,000, which is $1,000,000 more
than the budget request and the fiscal year 2001 appropriation.
This program provides assistance to each State to support
an office of the coordinator of education for homeless children
and youth, to develop and implement State plans for educating
homeless children, and to carry out other activities to ensure
that all homeless children and youth in the State have access
to the same free, appropriate public education, including a
public preschool education, as provided to other children and
youth. Grants are made to States based on the total that each
State receives under the Title I program.
IMPACT AID
Appropriations, 2001.................................... $993,302,000
Budget estimate, 2002................................... 1,130,500,000
Committee recommendation................................ 1,130,500,000
The Committee recommends an appropriation of $1,130,500,000
for impact aid for the Department of Education. This amount is
the same as the budget request and $137,198,000 more than the
fiscal year 2001 appropriation.
Impact aid provides financial assistance to school
districts for the costs of educating children when enrollments
and the availability of revenues from local sources have been
adversely affected by the presence of Federal activities.
Children who reside on Federal or Indian lands generally
constitute a financial burden on local school systems because
these lands do not generate property taxes--a major revenue
source for elementary and secondary education in most
communities. In addition, realignments of U.S. military forces
at bases across the country often lead to influxes of children
into school districts without producing the new revenues
required to maintain an appropriate level of education.
Basic support payments.--The Committee recommends
$954,000,000 for basic support payments, $72,000,000 more than
the budget request and the fiscal year 2001 appropriation.
Under statutory formula, payments are made on behalf of all
categories of federally connected children.
The Committee is aware that the Frazer School District in
Montana must repay over $350,000 in impact aid funding because
of errors made by former school district administrators, and
that the district does not qualify for the forgiveness criteria
as currently encoded. The Committee urges the Department to
work with the district to identify possible solutions to this
problem.
Payments for children with disabilities.--Under this
program additional payments are made for certain federally
connected children eligible for services under the Individuals
with Disabilities Education Act. The Committee bill includes
$50,000,000 for this purpose, the same as the fiscal year 2001
level and the budget request.
Facilities maintenance.--This activity provides funding for
maintaining certain school facilities owned by the Department
of Education. The Committee recommends $8,000,000 for this
purpose, the same as the budget request and the fiscal year
2001 level.
Construction.--Payments are made to eligible LEAs to be
used for construction and renovation of school facilities, or
for debt service related to the construction of school
facilities. The Committee recommends $68,000,000 for this
program. This amount is $82,000,000 less than the budget
request and $55,198,000 more than the fiscal year 2001
appropriation.
The Committee is aware that Blair Elementary School, which
operates on Fairfield Air Force Base in Washington State, has
inadequate electrical, heating, ventilation, and air
conditioning systems. The Committee urges the Department to
work with the Medical Lake School District to identify possible
solutions to this situation.
The Committee is aware that the Ronan School District in
Montana was forced to close its middle school because of sewer
contamination and poor indoor air quality, and that the
students are now attending the already crowded elementary and
high schools. The Committee encourages the Department to work
with the school district to remedy this situation.
The Committee understands that Harlem Elementary School, at
the edge of the Fort Belknap Indian Reservation in Montana,
requires major reconstruction because of damage caused by an
underground stream. The Committee urges the Department to work
with the Harlem School District to rectify this situation.
The Committee understands that San Juan School District in
Utah serves children in extremely rural areas, including many
residing on Indian reservations. The Committee is aware of the
need for a new elementary school in Monument Valley, and it
urges the Department to work with the District to rectify this
situation.
The Committee is aware of the critical construction needs
for a new regional vocational school in the Yukon-Kuskokwim
delta area of Alaska, the poorest region in the State. The
Committee requests that the Department work with the Lower
Kuskokwim School District in Alaska and its partners to address
this issue and ensure that all possible solutions are explored.
The Committee is aware that Brockton School in Montana is
experiencing significant problems with the K-8 facility,
including a leaky roof, faulty boilers, deteriorating pipes and
plumbing, and asbestos removal. The Committee urges the
Department to provide assistance to the Brockton School in
identifying appropriate measures to improve the learning
environment.
The Committee recognizes the need for further construction
monies for Hays/Lodgepole Elementary School in Montana and
encourages the Department of Education to give every
consideration to its construction needs.
Payments for Federal property.--These payments compensate
local educational agencies in part for revenue lost due to the
removal of Federal property from local tax rolls. Payments are
made to LEAs that have a loss of tax base of at least 10
percent of assessed value due to the acquisition since 1938 of
real property by the U.S. Government. The Committee recommends
$50,500,000 for this activity, $10,000,000 more than the budget
request and the fiscal year 2001 appropriation.
SCHOOL IMPROVEMENT PROGRAMS
Appropriations, 2001.................................... $7,053,575,000
Budget estimate, 2002................................... 6,353,794,000
Committee recommendation................................ 8,717,014,000
The Committee recommends an appropriation of $8,717,014,000
for school improvement programs. This is $2,363,220,000 more
than the budget request and $1,663,439,000 more than comparable
programs in the fiscal year 2001 appropriation. Unless
otherwise noted, programs under this account are authorized by
the Senate-passed version of H.R. 1.
State grants for improving teacher quality
The Committee recommends an appropriation of $3,039,834,000
for State grants for improving teacher quality, a new program.
This amount is $439,834,000 more than the budget request and
$931,834,000 more than comparable programs in the fiscal year
2001 appropriation.
This program replaces the Eisenhower professional
development State grants program, Eisenhower professional
development Federal activities, Eisenhower regional math and
science education consortia, and the class size reduction
program. Reducing class sizes will remain an allowable use of
teacher quality State grants.
States and LEAs that receive grants for improving teacher
quality will be required to ensure that program funds are used
for professional development that is based on the best
available research on training and learning, tied to State or
local standards, of sufficient intensity and duration to affect
teaching performance, and designed to improve teachers'
knowledge concerning the subjects they teach. In addition,
States will be held accountable for ensuring that all children
are taught by highly qualified teachers and for improving
student achievement.
States and LEAs may use funds for a range of activities
related to the certification, recruitment, professional
development and support of teachers. Activities may include
reforming teacher certification and licensure requirements,
addressing alternative routes to State certification of
teachers, recruiting teachers and principals, and implementing
teacher mentoring systems, teacher testing, merit pay and
merit-based performance systems.
The Committee recognizes that smaller classes in the early
grades can have a positive impact on students for years to come
by improving classroom discipline, providing students with more
individualized attention, and allowing parents and teachers to
work more closely together. Some research has shown that
reducing class sizes in kindergarten through third grade to no
more than 18 students improves student achievement, especially
among our most disadvantaged students. Congress has
appropriated funds specifically for reducing class sizes for
the past 3 years, with the goal of enabling schools to hire an
additional 100,000 fully qualified teachers. Although the
fiscal year 2002 bill does not include a guaranteed funding
stream for class-size reduction, funds within the teacher
quality State grants program may be used to continue this
commitment to our Nation's students, parents and teachers,
without taking away from other efforts to invest in
professional development.
The first year of Federal class-size-reduction funds
enabled schools to hire 29,000 teachers who are already
teaching in smaller classes across the country. As a result,
approximately 1.7 million students are learning in smaller
classrooms. Another 8,000 teachers will be hired with the funds
provided by the fiscal year 2001 appropriations bill, creating
smaller learning environments for hundreds of thousands of
additional students. The Committee encourages districts to
continue that progress.
The Committee directs the Department to submit a report as
soon as possible at the end of the program year on how much
money was spent to reduce class sizes and how many new teachers
were hired through the program.
Mathematics and science partnerships
In January 2001, the U.S. Commission on National Security/
21st Century issued a report titled ``Road Map for National
Security: Imperative for Change.'' This Commission, co-chaired
by former Senators Warren Rudman and Gary Hart, concluded that
``America faces distinctly new dangers, particularly to the
homeland and to our scientific and educational base.'' One of
the many recommendations outlined in the report was the need to
produce more science and engineering professionals as well as
qualified teachers in science and math.
In responding to this need, the Committee recommends
$25,000,000 for mathematics and science partnerships, a new
program authorized by the Senate-passed version of the ESEA
reauthorization bill. The administration requested no funds for
this purpose. These funds will be used to improve the
performance of students in the areas of math and science by
bringing math and science teachers in elementary and secondary
schools together with scientists, mathematicians, and engineers
to increase the teachers' subject-matter knowledge and improve
their teaching skills. The Secretary is authorized to award
grants, on a competitive basis, to eligible partnerships to
enable the entities to pay the Federal share of the costs of
developing or redesigning more rigorous mathematics and science
curricula that are aligned with State and local standards;
creating opportunities for enhanced professional development
that improves the subject-matter knowledge of math and science
teachers; recruiting math and science majors; and improving and
expanding training of math and science teachers, including the
effective integration of technology into curricula and
instruction.
National activities/Transition to Teaching
The Committee recommends $95,000,000 for professional
development national activities. This amount is $54,000,000
more than the fiscal year 2001 appropriation and $65,000,000
more than the budget request. Within those funds, $15,000,000
is included for professional development activities for early
childhood educators and caregivers in high-poverty communities.
This amount is $5,000,000 more than the fiscal year 2001
appropriation and $15,000,000 more than the budget request. In
addition, $5,000,000 is included for the Eisenhower National
Clearinghouse for Mathematics and Science Education, and
$10,000,000 for the National Board for Professional Teaching
Standards.
Funds are also included for the Transition to Teaching
program requested by the administration. The purpose of
Transition to Teaching is to support the Defense Department's
Troops to Teachers program, which helps prepare retiring
military personnel to teach in high-poverty school districts,
as well as other recruitment efforts involving non-military
teacher candidates. The budget request for Transition to
Teaching is $30,000,000. The remaining funds may be used for
other efforts to recruit teachers and principals, subject to
ongoing conference negotiations over the Elementary and
Secondary Education Act.
Innovative education program strategies State grants
The Committee recommends $410,000,000 for innovative
education program strategies State grants. This amount is
$25,000,000 more than the fiscal year 2001 appropriation and
$61,500,000 less than the amount requested by the
administration for the proposed Choice and Innovation State
Grants program, which has a similar purpose.
The innovative education program provides support to States
and LEAs in developing education reform initiatives that will
improve the performance of students, schools and teachers.
School renovation
The Committee recommends $925,000,000 for grants to local
educational agencies for emergency school renovation and repair
activities, as authorized in section 321 of this Act. This
amount is $250,000,000 less than the fiscal year 2001
appropriation. The administration requested no funds for this
program.
The funds should be distributed to State educational
agencies based on the Title I, part A allocations under the
Elementary and Secondary Education Act. The State educational
agency or other entity with jurisdiction over school facilities
financing, as the case may be, would distribute the State funds
to local educational agencies through competitive grants for
emergency school repair and renovation activities.
These funds may be used by local educational agencies to
meet the requirements of Federal mandates such as the Americans
with Disabilities Act, Section 504 of the Rehabilitation Act,
asbestos-abatement requirements and security upgrades. Funds
may also be used for emergency health and safety of students
and staff (repairing, replacing, or installing roofs,
electrical wiring, plumbing systems, or sewage systems;
repairing, replacing, or installing heating, ventilation, or
air conditioning systems, including insulation; and bringing
schools into compliance with fire and safety codes.)
If a State holds a grant competition among LEAs that
attracts school renovation applications that are of
insufficient quality and quantity, it must use 100 percent of
its excess allocation to provide all LEAs in the State an award
under section 5312 of H.R. 1 as passed by the Senate on June
14, 2001. This reallocation can take place only after the State
has held a period of public notice and comment about the
availability of funds for emergency repairs and the
insufficient response, consistent with State and local laws
governing how the comments may be received and reviewed by the
public. Funds received by LEAs under this reallocation may be
used for any purpose under section 5331 of H.R. 1, including
professional development, acquisition of instructional
materials, and school improvement activities.
Educational technology state grants
The Committee recommends $712,146,000 for educational
technology State grants, as authorized under the Senate-passed
version of H.R. 1. This is $40,000,000 less than the budget
request.
This program consolidates four current educational
technology programs, five fewer than the budget request. Funds
will flow by formula to States and may be used for the purchase
of hardware and software, and teacher training on integrating
technology into the curriculum.
Community technology centers
The Committee recommends $64,950,000, the same amount as
the fiscal year 2001 appropriation, for community technology
centers. The administration proposed eliminating this program
by consolidating it into the educational technology State
grants program. This community technology centers program
supports grants, contracts, or cooperative agreements to local
and State educational agencies, institutions of higher
education, libraries, museums, foundations, or other public,
private, non-profit and for-profit entities or consortia of
such organizations to create or expand community technology
centers. Although the number of Americans connected to the
Internet is soaring, there remains a digital divide between
those who have access to technology and use it effectively, and
those who don't. In many cases, the divide is actually
widening. Minorities, low-income persons, the less-educated,
and children of single-parent households, particularly when
they reside in rural areas or central cities, are among the
groups that lack access to information resources. Community
technology centers provide disadvantaged residents of
economically distressed urban and rural communities with access
to information technology and related training. They can
provide, among other things, preschool and after-school
programs, adult education and literacy, and workforce
development and training.
Preparing Tomorrow's Teachers to Use Technology
The Committee recommends $125,000,000, the same amount as
the fiscal year 2001 appropriation, for the Preparing
Tomorrow's Teachers to Use Technology program. The
administration proposed consolidating this program into the
educational technology States grants program. Funds will be
used to assist consortia of private and public entities to
prepare prospective teachers to use advanced technology in the
classroom.
Ready to Learn Television
The Committee recommends an appropriation of $24,000,000
for the Ready to Learn Television program. This is $8,000,000
more than the fiscal year 2001 level. The administration
proposed consolidating this program into the educational
technology State grants program.
Ready to Learn Television supports the development and
distribution of educational television programming designed to
improve the readiness of preschool children to enter
kindergarten and elementary school, consistent with the first
national education goal that all children should start school
ready to learn. The program supports the development,
production, and dissemination of educational materials designed
to help parents, children, and caregivers obtain the maximum
advantage from educational programming. Funding will support
the growth in demand for related local educational activities,
improve training for professional caregivers, provide new
foreign language translations of children's programs, enhance
the online components of the program, reach additional
underserved populations, and demonstrate the use of digital
broadcasting to provide programming and training to underserved
populations.
Ready to Teach/Teacherline
The Committee recommends $15,000,000 for the continuation
of the Public Broadcasting Service initiative called
Teacherline, formerly known as Mathline. This amount is
$6,500,000 more than the fiscal year 2001 appropriation. The
administration proposed consolidating this program into the
educational technology State grants program.
Within this amount, the Committee provides $6,000,000 for
digital educational content (DEC) development grants, a
demonstration project authorized by the Senate-passed version
of the ESEA reauthorization bill. DEC grants will allow
community partnerships among local public television stations,
State and local educational agencies, institutions of higher
education, and businesses to develop, produce, and distribute
innovative educational instructional video programming that is
designed for use by K-12 schools based on State and local
standards and capable of distribution through digital
broadcasting and school digital networks. The Committee
strongly encourages the Secretary to award DEC grants that
assure the delivery of integrated data to schools serving high
concentrations of disadvantaged children.
The remaining funds should be used to provide high-quality,
accessible and continuous professional development to school
teachers. The increase from the fiscal year 2001 level will
allow the Teacherline Program to link the digitized public
broadcasting infrastructure beyond its current partnership with
29 local public television stations and LEAs to provide
training services to institutions of higher education for pre-
service teacher training as well as in-service professional
development for K-12 teachers.
Safe and drug-free schools and communities
The Committee remains extremely concerned about the
frequent and horrific occurrence of violence in our Nation's
schools. The Committee recommends a total of $644,250,000 for
activities to promote safe and drug-free schools and
communities. This amount is the same as the budget request and
the fiscal year 2001 appropriation.
State grant program.--The Committee bill provides
$444,250,000 for the safe and drug-free schools and communities
State grant program. This amount is $5,000,000 more than the
fiscal year 2001 appropriation and $103,362,000 less than the
budget request.
National programs.--The Committee has included $150,000,000
for the national programs portion of the safe and drug-free
schools program. This amount is $5,000,000 less than the fiscal
year 2001 appropriation and $53,362,000 more than the budget
request. The Committee intends that $117,000,000 of these
funds, the same amount as last year, be used for the Safe
Schools/Healthy Students program, which the Department funds in
conjunction with the Departments of Justice and Health and
Human Services. Safe Schools/Healthy Students supports LEAs and
communities in developing and implementing comprehensive
programs that create safe, disciplined, and drug-free learning
environments and promote healthy childhood development. Funds
for national programs are also used for a variety of other
activities designed to improve the field of drug and violence
prevention.
The Committee is aware of the increasing problem of alcohol
and drug abuse on college campuses. Therefore, it has included
$850,000 to continue the National Recognition Awards program
under the same guidelines outlined by Section 120(f) of Public
Law 105-244. This amount is the same as the fiscal year 2001
level. This program identifies and provides models of alcohol
and drug abuse prevention and education programs in higher
education. The Committee encourages the Secretary to make
fiscal year 2002 awards to institutions of higher education
that did not receive an award in the fiscal year 2001
competition.
Coordinator initiative
The Committee has included $50,000,000 for the coordinator
initiative, the same amount as the fiscal year 2001
appropriation. The administration requested no funds for this
program. The Committee has provided resources for this program
as part of its youth violence prevention initiative. The
Committee recommendation will enable the Department to provide
assistance to LEAs to recruit, hire, and train drug prevention
and school safety program coordinators in middle schools with
significant drug and school safety problems. These coordinators
will be responsible for developing, conducting and analyzing
assessments of their school's drug and crime problems, and
identifying promising research-based drug and violence
prevention strategies and programs to address these problems.
21st Century Community Learning Centers
The Committee recommends an appropriation of $1,000,000,000
for the 21st Century Community Learning Centers program. This
amount is $154,386,000 more than the budget request and the
fiscal year 2001 appropriation.
The purpose of the program is to support public elementary
and secondary schools, especially low-performing schools, or
consortia of such schools, to implement or expand projects that
benefit the educational, health, social service, cultural, and
recreational needs of the community.
The Committee has been alerted to the increasing demands
made by parents and school administrators for after-school
programming and encourages local innovation to remedy the
multitude of social problems that arise after school hours. The
Committee encourages the States to target funds to areas of
high need that have low-achieving students and lack resources
to establish after-school centers. The Committee notes that
successful after-school programs often combine academic
enrichment, through the use of supplementary educational
materials and instruction, with other extracurricular
activities.
The Committee has listed relevant projects of interest
under the Local Innovations for Education program in this
year's Committee report.
State assessments
A key accountability measure in the Senate-passed version
of the ESEA reauthorization calls for annual State assessments
in reading and mathematics for all students in grades 3-8.
States will be permitted to select and design their own new
assessments, as long as they are aligned with State standards
and student achievement results are comparable from year to
year. Funds under this new program would pay the Federal share
of developing and implementing these new assessments. The
Committee recommends $320,000,000 for this purpose, the same
amount as the budget request.
Inexpensive book distribution
For the inexpensive book distribution program, the
Committee provides $25,000,000, which is $2,000,000 more than
the fiscal year 2001 appropriation. The administration proposed
consolidating this program into the Choice and Innovation State
Grants program.
The inexpensive book distribution program is operated by
Reading Is Fundamental (RIF), a private nonprofit organization
associated with the Smithsonian Institution. This program has
been successful in motivating children to read, increasing the
use of libraries, increasing parental involvement in schools,
and contributing to improved reading achievement.
Enhanced assessment instruments
The Committee recommends $32,000,000 for enhanced
assessment instruments, a new program authorized by the Senate-
passed version of the ESEA reauthorization bill. The
administration did not request funds for this program.
Grants under this program will be awarded to States and
LEAs to help them collaborate with institutions of higher
education, other research institutions, and other organizations
on ways to improve the quality and fairness of State assessment
systems required under Title I of the ESEA. Grant recipients
should strive to design enhanced assessments that better
measure higher-order thinking skills, analytical abilities, and
learning over time.
Magnet schools assistance
For the magnet schools assistance program, the Committee
bill provides $110,000,000, the same as the budget request and
the fiscal year 2001 appropriation.
This program supports grants to local educational agencies
to establish and operate magnet schools that are part of an
approved desegregation plan and are designed to attract
substantial numbers of students of different social, economic,
ethnic, and racial backgrounds. Grantees may use funds for
teacher salaries, purchase of computers, and other educational
materials and equipment.
Within the amount provided, the Committee has included
$5,000,000 for innovative programs, the same as the fiscal year
2001 appropriation.
Training and advisory services
For training and advisory services authorized by Title IV
of the Civil Rights Act, the Committee recommends $7,334,000,
the same as the budget request and the fiscal year 2001
appropriation.
The funds provided will continue the 10 regional equity
assistance centers (EACs) formerly known as regional
desegregation assistance centers. Each EAC provides services to
school districts upon request. Activities include disseminating
information on successful practices and legal requirements
related to nondiscrimination on the basis of race, color, sex,
or national origin in education programs. No funds are included
for civil rights units in State education agencies.
Ellender fellowships
For Ellender fellowships, the Committee bill includes
$1,500,000, the same as the fiscal year 2001 appropriation. The
administration proposed consolidating this program into the
Choice and Innovation State Grants program. The Ellender
fellowship program makes an award to the Close Up Foundation of
Washington, D.C., to provide fellowships to students from low-
income families and their teachers to enable them to
participate with other students and teachers for 1 week of
seminars on Government and meetings with representatives of the
three branches of the Federal Government.
Education for Native Hawaiians
For programs for the education of Native Hawaiians, the
Committee bill includes $33,000,000, which is $5,000,000 more
than the budget request and the fiscal year 2001 appropriation.
When allocating these funds, the Committee urges the Department
to provide $7,500,000 for curricula development, teacher
training, and recruitment programs, including native language
revitalization. Priority should be given to the University of
Hawaii at Hilo Native Language College, aquaculture, prisoner
education initiatives, waste management, computer literacy, big
island astronomy, and indigenous health programs. The Committee
also recommends $2,600,000 for the community-based learning
centers; $3,700,000 for the Hawaii higher education program;
$1,500,000 for the gifted and talented programs; $2,200,000 for
construction of schools with high enrollments of Native
Hawaiian children, pursuant to ESEA reauthorization language;
$3,100,000 for the special education programs; $500,000 for the
Native Hawaiian education councils; and $11,900,000 for family-
based education centers, including early childhood education
for Native Hawaiian children.
Child literacy initiative.--The Committee is concerned that
Hawaiian students are significantly behind in quantitative
literacy, and it encourages teachers to promote teacher
training in this area. The Committee is aware that the Hawaii
State Department of Education, the American Statistical
Association, and the Kamehameha school district have
collaborated to design and implement workshops for teachers in
quantitative literacy.
Education for Native Hawaiians in agriculture and
business.--The Committee supports the expansion of the
partnerships between community-based agricultural businesses
and cooperating Hawaii high schools where agricultural and
business practices are integrated into the curriculum,
resulting in hands-on agribusiness training, exposure to
entrepreneurship, and marketable products. The Committee
recommends full funding be made available by grant or otherwise
to the Hawaii Farm Bureau to carry out this program.
Education for Native Hawaiians in community education.--The
Committee is aware of the Malama Hawaii initiative and the
effort to provide for community education programs that address
issues of education, health, justice, environment, culture, and
the economy through experiential and outdoor education programs
that involve children, youth, and families. These community-led
outreach projects foster community stewardship of geographic
areas and natural resources employing cultural practices and
protocols in programs that train formal and informal teachers
to educate others about critical issues facing the Hawaii
community, and through interpretive programs that educate the
public and increase appreciation and support for significant
cultural and natural heritage sites. The Committee recommends
that full funding be made available in fiscal year 2002 under
the authority of the Native Hawaiian Education Act for the
Malama Hawaii Community Education Initiative.
Native Hawaiian Agriculture Partnership.--The Committee is
aware of the dismal economic and social conditions in the rural
areas of Hawaii resulting from the closure of several sugar
cane plantations that formerly provided infrastructure for
these communities. The Committee favors and continues to
support the expansion of the partnerships between community-
based agricultural businesses and cooperating high schools,
where agricultural and business practices are integrated into
the curriculum and products that are ultimately purchased by
the cooperating businesses.
Computer literacy and access for Hawaiian and part-Hawaiian
children.--The importance of literacy for success in school has
been clearly demonstrated. Disadvantaged Native Hawaiian and
part-Hawaiian children struggle for opportunities. The
Committee urges that students interested in becoming elementary
and high school teachers be strongly encouraged to pursue these
fields of study.
Indigenous health and traditional medicine education.--The
Native Hawaiian Health Care Improvement Act provides authority
for inclusion of Native Hawaiian traditional healers in the
comprehensive health care delivery system. There is similar
recognition of traditional healing within the Indian Health
Service health care delivery system. Because of a lack of
available instruction in traditional medicine, this knowledge
is being lost for younger generations of Native Americans and
Native Hawaiians. The Committee is aware of the benefits of
educating health care practitioners in traditional medicines
and techniques in Native Indian and Native Hawaiian
communities.
Hawaii marine resource management.--The Committee notes
that the Hui Malama o Mo'omomi has been working to document the
traditional fishery management techniques used in the Hawaiian
culture. These techniques have both scientific and cultural
relevance to the efficient management of Hawaii's marine
resources. The Committee understands the value of a community-
based outreach program to teach Hawaiian children these
traditional marine management practices and recognizes the
expertise that Hui Malama o Mo'omomi and their consortium
partners have in this area.
Hawaiian development of culturally appropriate curricula.--
Because Hawaiian and part-Hawaiian children have fallen behind
in this area during the past decade, the Committee strongly
recommends that the Department fund an initiative to develop
culturally appropriate curricula and programs that would meet
the National Council of Teachers of Mathematics' 2000
standards. Such a curricula must successfully equip students
with tools to present, organize and interpret numerical
information while reflecting the traditional culture's reliance
on observation and practical use of statistical processes. The
Committee urges the Department to develop these materials with
nonprofit, community organizations such as the Pacific American
Foundation and/or the foundation Partners in Development.
Curricula workshops for teachers in Hawaii.--Hawaiian and
part-Hawaiian families suffer from elevated levels of health
problems, alcoholism, drug use, and domestic violence. These
form significant barriers to the successful education of
Hawaiian and part-Hawaiian children. Public and private schools
and their staffs are not sufficiently prepared to identify,
treat, or refer students and their families to appropriate
public or private agencies providing help in these areas of
need. The Committee urges the Department to fund the
development and implementation of curricula and workshops for
teachers and staff in culturally appropriate ways to identify
and refer students and their families in need of counseling and
assistance and to provide teachers and staff with information
and resources on the most current and effective referral
agencies available. The Committee urges the Department to use
nonprofit, community development agencies and organizations
such as the Pacific American Foundation and/or Partners in
Development to develop and implement such needed programs.
Curricula teaching environmental stewardship.--A strong
understanding of environmental stewardship and the responsible
use of the environment are anchor values in the traditional
Hawaiian culture. Environmental stewardship needs to be taught
to all students, particularly Hawaiian and part-Hawaiian
students. The Committee urges the Department to fund the
development and implementation of curricula teaching
environmental stewardship based on the traditional ecological
knowledge (TEK) of the Hawaiian culture. Given the oral
tradition of the Hawaiian culture, this development program
should include the identification, translation, and analysis of
appropriate traditional chants and stories related to the
management and responsible use of Hawaii's resources and the
integration of these perspectives into an effective curriculum
that addresses Hawaii State Educational Standards in social and
natural sciences. The Committee recommends that nonprofit
organizations with experience in these areas, such as the
Pacific American Foundation and/or Partners in Development, be
used to develop these curricula units.
Native Hawaiian Mid-level Practitioners Training Program.--
The Committee urges the Department of Education to develop a
focused program to recruit, train, and place nurse
practitioners, physician assistants, clinical psychologists,
and clinical pharmacists to work in Hawaiian communities. The
Committee also recommends that nongovernmental agencies, such
as health care providers, insurers, and nonprofit foundations
like Partners in Development, be integrated into the effort.
Adjudicated and High-Risk Native Hawaiian Youth Education
Program.--The Committee is concerned about the high proportion
of Native Hawaiian Youth on legal status with Family Court
statewide and in Hawaii youth correctional facilities.
Therefore, the Committee recommends that the Adjudicated and
High-Risk Native Hawaiian Youth Education Program, which is
intended to prevent recidivism and strengthen Hawaiian
families, should be considered a priority to receive funding.
Postsecondary computer and technology training for Native
Hawaiians.--The Committee recognizes the lack of computer and
technology skills possessed by the Native Hawaiian community
and its resultant impact on their employability. The Committee
requests culturally sensitive educational centers be
established to provide training in career skills, technology
readiness, technology management, and advanced technology
certification. The Committee recommends this program should be
considered a priority to receive funding.
Native Hawaiian Financial Literacy Program.--The Committee
is concerned of the inability of many Native Hawaiians to
understand money management and financial planning. The
Committee recommends the development of culturally sensitive
training on money management, financial literacy, family
budgeting, and debt avoidance. The Committee recommends this
program should be considered a priority to receive funding.
Alaska Native educational equity
The Committee recommends $33,000,000 for the Alaska Native
educational equity assistance program. This amount is
$18,000,000 more than the budget request and the fiscal year
2001 appropriation. The Committee recommends expanding this
program to include cultural education programs operated by the
Alaska Native Heritage Center and continuing operation of the
Rose program operated by the Alaska Humanities Forum to expose
urban students to Native culture in rural Alaska.
Funds from this program address the severe educational
handicaps of Alaska Native schoolchildren. It has been brought
to the Committee's attention that in urban areas, 60 percent of
Alaska Natives entering high school do not graduate, and that
Alaska Natives' test scores are on average 40 percent lower
than those of other students. In some districts, none of the
Alaska Native elementary students and 40 percent of Native high
school students are performing at their grade level. The funds
provided under the Alaska Native education equity assistance
program will help to address some of the barriers faced by
Native Alaskan schoolchildren and develop programs tailored to
the unique needs of these children to improve performance
levels.
Charter Schools Homestead Fund
The Committee recommends $50,000,000 for the Charter
Schools Homestead Fund, a new program authorized in the Senate-
passed version of H.R. 1. This amount is $125,000,000 less than
the budget request.
A major obstacle to the creation of charter schools in many
communities is the limited availability of suitable academic
facilities. The Charter Schools Homestead Fund would build on
and replace the Charter School Facility Demonstration Grants
program by providing grants to public and nonpublic entities to
leverage funds to help charter schools purchase, construct,
renovate, or lease academic buildings or obtain donated
buildings. The demonstration grants program, currently funded
through the school renovation program, received $25,000,000 in
fiscal year 2001.
Charter schools
The Committee recommends $200,000,000 for the support of
charter schools. This amount is the same as the budget request
and $10,000,000 more than the fiscal year 2001 appropriation.
This program provides funds to the Secretary to make awards
to State educational agencies, which, in turn, make subgrants
to partnerships of developers and local education agencies or
other public entities that can authorize or approve a charter
school. Grants are limited to 3 years in duration, of which not
more than 18 months may be used for planning and program
design, not more than 2 years for the initial implementation of
a charter school, and not more than 2 years to carry out
dissemination activities.
Comprehensive regional assistance centers
The Committee has included bill language to provide
$28,000,000 to continue the operation of the current
comprehensive regional technical assistance centers. This
recommendation is the same as the budget request and the fiscal
year 2001 level. This program supports 15 regional centers that
provide support, training, and technical assistance to
Department of Education grantees.
Advanced Placement test fees
The Committee recommends $22,000,000 for the Advanced
Placement test fees program. This amount is the same as the
budget request and the fiscal year 2001 appropriation. This
program awards grants to States to enable them to cover part or
all of the cost of Advanced Placement test fees of low-income
individuals who are enrolled in an Advanced Placement class and
plan to take an Advanced Placement test. The Committee is aware
of the benefits of Internet-based AP pilot programs in rural
parts of the country or other underserved districts where
students would otherwise not have access to AP instruction, and
it encourages the Department to consider proposals that meet
the needs of students in these areas of the country.
Parental assistance
The Committee recommends $45,000,000 for parental
assistance services. This amount is $7,000,000 more than the
fiscal year 2001 appropriation. The administration proposed
eliminating this program by consolidating it into the teacher
quality State grants program. This title authorizes a variety
of activities designed to improve parenting skills and
strengthen the partnership between parents and professionals in
meeting the education needs of their children ages 5 and under.
Sociological and scientific studies show that the first 3
years of a child's cognitive development set the foundation for
life-long learning and can determine an individual's emotional
capabilities. Parents, having the primary and strongest
influence on their child, play a pivotal role at this stage of
development. Scientists have found that parental relationships
affect their child's brain in many ways. Research further
indicates that a secure connection with the parent will better
equip a child to handle stressful events throughout life.
The Committee strongly urges the Department of Education to
stipulate that at least 50 percent of each grant award shall be
used for Parents as Teachers Programs.
Small, Safe and Successful High Schools
The Committee recommends an appropriation of $100,000,000
for the Small, Safe and Successful High Schools program. This
amount is $25,000,000 less than the fiscal year 2001
appropriation. The administration recommended eliminating this
program by consolidating it into its proposed Choice and
Innovation State Grants program.
These funds shall be used for activities related to the
redesign of large high schools enrolling 1,000 or more
students.
Local Innovations for Education
The Committee recommends an appropriation of $300,000,000
for the Local Innovations for Education (LIFE) program, a new
program authorized by the Senate-passed version of H.R. 1 that
consolidates eight existing activities or programs, including
five in the Fund for the Improvement of Education. This amount
is $124,099,000 less than comparable activities and programs in
the fiscal year 2001 appropriation. The administration proposed
eliminating most of these programs through consolidations.
LIFE provides the Secretary with broad authority to support
nationally significant programs and projects to improve the
quality of education, help all students meet high academic
standards, and contribute to the achievement of the national
education goals.
Within the amount recommended, the Committee includes
$35,000,000 for the Elementary School Counseling Demonstration
Program to establish or expand counseling programs in
elementary schools, and $10,000,000 to make awards under part H
of Title I of the Senate-passed version of H.R. 1 for a dropout
prevention demonstration project. These levels are each
$5,000,000 higher than the fiscal year 2001 appropriations.
The Committee also includes $100,000,000 for a
demonstration program focusing on the instruction of American
history in elementary and secondary education. This amount is
$50,000,000 more than the fiscal year 2001 level. Under this
program, the Secretary of Education will award grants to local
educational agencies, and, in turn, the LEAs will make awards
to schools that are teaching American history as a separate
subject within a school curriculum, not as a part of a social
studies course. Grant awards are designed to augment the
quality of American history instruction and to provide
professional development activities and teacher education in
the area of American history.
The LIFE appropriation also includes $59,318,000 for the
Star Schools program. This amount is the same as the fiscal
year 2001 appropriation. The Star Schools program is designed
to improve instruction in math, science, foreign languages, and
other subjects such as vocational education, to underserved
populations by means of telecommunications technologies. The
program supports eligible telecommunications partnerships to
develop and acquire telecommunications facilities and
equipment, instructional programming, teacher training programs
and technical assistance. The Committee recognizes the efforts
of the Star Schools program to provide educational resources
for traditionally underserved populations, including
disadvantaged, illiterate, and limited-English-proficient
persons, and individuals with disabilities through the use of
distance learning technologies.
The Committee recommends $10,000,000 for a new program to
provide educational, cultural, apprenticeship, and exchange
programs for Alaska Natives, Native Hawaiians and their
historical whaling and trading partners in Massachusetts. This
is a new program authorized by the Senate-passed version of the
ESEA reauthorization bill; it was not requested by the
administration.
Funds will be used to develop and implement innovative
culturally-based educational programs and cultural exchanges to
assist Alaska Natives, Native Hawaiians and children and
families of Massachusetts linked by history and tradition to
Alaska and Hawaii to learn about shared culture and traditions,
and to develop internship and apprenticeship programs to assist
these groups prepare for professional careers in cultural
institutions and related fields. The Committee expects that
funds will be equally divided by the Department among the
Alaska Native Heritage Center, the Inupiat Heritage Center in
Barrow, AK, the Bishop Museum in Hawaii, the Peabody-Essex
Museum in Salem, MA, and the New Bedford Whaling Museum/New
Bedford Historical Site in MA.
The Committee also includes $30,000,000 for the arts in
education program. This amount is the same as the fiscal year
2001 appropriation. It includes $6,650,000 for a grant to VSA
arts, which supports the development of programs to integrate
the arts into the lives of children and adults with
disabilities, and $5,600,000 for a grant to the John F. Kennedy
Center for the Performing Arts, which supports a variety of
activities throughout the Nation. Funds provided in this
account also support youth violence prevention activities and
model professional development activities to support the
increasing demand for arts and music teachers.
The Committee is supportive of the upcoming Very Special
Arts International Festival. Held every 5 years in locations
throughout the world, the June 2004 festival will take place in
Washington, D.C. Approximately 2,000 children and adults with
disabilities will participate in this 5-day exploration and
celebration of the role of the arts in learning at home, in the
workplace and in the community. The Committee recommends
$1,650,000 for this purpose.
The Committee is aware that recent data and empirical
evidence indicate that specific instruction in music, art, and
dance improves the success of K-12 students. The Committee
supports grants, authorized under this program, to eligible
recipients for: the development and implementation of
curriculum frameworks for arts education; the development of
model pre-service and in-service professional development
programs for arts educators and other instructional staff;
specific instruction in music, art, theater, and dance; the
development of model arts education assessments based on high
standards; and supporting model projects and programs to
integrate arts education into the regular elementary and
secondary school curriculum.
The LIFE appropriation also includes $3,000,000 for the
women's educational equity program. This amount is the same as
the fiscal year 2001 appropriation. The program supports
projects that assist in the local implementation of gender
equity policies and practices.
The Committee also recommends $25,000,000 for character
education grants to States and LEAs. The administration
requested the same amount as part of its proposed Reform and
Innovation Fund. The money may be used for developing character
education curricula, implementing model character education
programs that involve parents and community members, and
training teachers to incorporate character-building lessons and
activities into the classroom.
The LIFE appropriation includes sufficient funds for the
Reach Out and Read program, which promotes literacy by
providing children's books to pediatricians and arranging for
trained volunteers to read to children while they wait for
their appointments in doctors' waiting rooms.
The appropriation also includes sufficient funds for
Project GRAD, a school-community program designed to improve
the instructional quality and school environment of at-risk
children. The core program focuses on improving student
achievement in math, reading and language arts. Another
component of the program addresses student behavior and
discipline problems. Students participating in Project GRAD
have a 24 percent increase in graduation rates, an 18 percent
increase in their reading skills, a 34 percent increase in
their math scores and a 25 percent increase in college
enrollment. Project GRAD is currently operating in Houston; Los
Angeles; Atlanta; Columbus, Ohio; Nashville; Newark, N.J.;
Cincinnati; Knoxville, Tenn.; and Laredo and Brownsville,
Texas. Projects will soon be operating in Philadelphia and
three other Ohio communities.
The Committee notes that there is considerable evidence
that lack of appropriate nutrition, and in particular
deficiencies in basic vitamins and minerals, can reduce
students' academic performance. The Committee is aware of a
pilot project by the Healthy Foundation to distribute a daily
multi-vitamin to impoverished school children. The Committee
commends this program and urges the Department to fund an
expansion of this promising initiative and to rigorously
evaluate its impact on school performance.
The Committee is aware of the following projects and
encourages the Department to give them full and fair
consideration:
The University of Montana, working with law enforcement,
education, and community organizations, will develop a
statewide community-based curriculum that promotes responsible
behavior and prevents violence in schools and communities.
Montana State University-Bozeman will coordinate an
Educational Technology Leadership Institute that will train
school administrators in rural areas how to encourage their
teachers and students to use technology effectively.
The Montana TREK Center at Flathead Valley Community
College will provide rural educators with professional and
educational growth opportunities through access to technology
and training.
The Indiana Academy for Science, Mathematics and Humanities
develops distance education programs to bring enhanced science
education into classrooms across the Nation.
The ProEquity Advancement Placement teacher training
project will increase the availability of AP coursework, expand
the number of schools participating in the AP program, and
train teachers at urban and rural schools serving disadvantaged
students in five States.
The Riverside School for the Arts in California trains
students for performing and technical careers in the
entertainment industry while providing a strong liberal arts
and sciences education.
Columbia Teachers College plans to expand its successful
teacher training pilot program to Mississippi, Pennsylvania,
New York, and Dallas, Texas. This program has been proven
effective at increasing teacher retention.
The Wheeling Jesuit University NASA Center for Educational
Technologies will provide technology training to all elementary
and secondary West Virginia mathematics and science teachers.
Steps to Success, an ongoing initiative which plans on
attracting significant non-Federal funding, plans to expand its
efforts to provide parents of children from birth to 3 years of
age with the information and support necessary for their
development.
The Missoula Family YMCA in Missoula, Montana is developing
the ``Give Me Five'' after school program.
The After School Recreation Program works in cooperation
with Pasadena Unified School District in California to provide
a recreation program for elementary-school-age children.
The San Francisco Unified School District Child
Development/Pre-School Program provides early childcare and
educational services for young children. It promotes cognitive
development and ensures that children are ready and eager to
learn.
The Fresno Unified School District in California will
expand the Keep Kids in School program, which the district runs
in collaboration with the Fresno County District Attorney's
Office, the Fresno County Superior Court and the Fresno County
Interagency.
California State University, San Bernardino will create a
Math/Science Demonstration Center that will house a wide
variety of university and collaborative school district
programs revolving around an advanced math/science lab school.
The County of San Bernardino, Calif., will expand a program
that provides family-centered case management and special
school-based, grade-appropriate education for the children of
homeless families.
Fresno Pacific University in California will expand its
math and science program to more effectively deliver quality
math and science education to teachers, and to encourage more
underrepresented students to teach those subjects.
California State University San Marcos runs the Barahona
Center for the Study of Books in Spanish for Children and
Adolescents, which collects, catalogues and reviews the world's
only complete collection of Spanish-language books published
since 1989 for children and adolescents.
The Los Angeles Center Theatre Group will develop a
national model K-12 curriculum for the integration of the
dramatic arts into general reading and language arts skills.
The American Film Institute will establish a Screen
Education Center within the Los Angeles Unified School District
that will develop curricular modules for teachers and students.
THINK Together provides after-school tutoring and homework
assistance for low-income and low-achieving students in Orange
County, Calif.
The city of Twentynine Palms in California will expand its
education and after-school care program, which serves many low-
income families and helps ensure that students are academically
ready to enter kindergarten.
The California Department of Education's Technology
Information Center for Administrative Leadership (TICAL)
Project, administered through the Santa Cruz County Office of
Education, is a Web site where school administrators can access
resources on using technology to improve teaching, learning,
and school management.
Audubon After School plans to expand its two existing
after-school programs, and add a third program, for at-risk
students in kindergarten through 8th grade in New Orleans.
The University of New Orleans' Millennium School Project
will establish a charter school district and redesign teacher
education to support school restructuring.
Nicholls State University's Center for the Study of
Dyslexia will train faculty, reading specialists and families
to identify the reading disabilities of children and adults in
the Southern Gulf Coast region of Louisiana.
Southeastern Louisiana University's Alternate Teacher
Certification Program offers all its professional education
courses via the Internet.
Prevent Child Abuse Louisiana and the Task Force on Child
Sexual Abuse plan to train 10,500 teachers in the greater New
Orleans area on how to recognize and report child abuse cases
among their students.
Southern University plans to study the use and
effectiveness of an interactive Web-based learning program.
Prime Time Family Reading Time, a family literacy program,
plans to expand into 20 States.
The city of Shreveport's Sci-Port Discovery Center plans to
develop space science educational programs.
Louisiana Tech University's CATALYST program will be a
regional center for math and science education serving rural
populations in Louisiana, Arkansas, Texas, and Mississippi.
Southern University will conduct research on the influence
of nutrition and access to health care on elementary school
student performance.
Virtual school classroom demonstration programs have been
proposed for the Washington State Office of Public Instruction,
New Mexico, the Iowa Department of Education, and the U.S.
Secretary of Education.
The Olympic National Institute Hands-on Environmental
Education Access Project in Washington State seeks to improve
student competencies in science and math through hands-on
educational training.
The Pacific Science Center in Seattle is developing a
hands-on genetic exhibit to explain basic concepts of genetics
and the Human Genome Project to children.
The Washington Department of Public Instruction is
designing a project to use the Web to link together schools,
districts, and the Office of Public Instruction to provide an
accessible central database for student information.
The Pacific Northwest Aquarium in Seattle will develop
exhibits designed to educate students about marine ecosystems.
The NASA Educator Resource Center at Southeast Missouri
State University will make available to K-12 schools, teachers,
and students throughout Missouri a wide array of educational
materials related to science and math.
Finance CIRCLE is a new demonstration initiative that will
set up financial-aid systems to help families send their
children to early learning and after-school programs in five
sites: greater Kansas City, Mo.; Seattle/King County; greater
Minneapolis; the lakes region of New Hampshire; and Fairfax
County, Va.
The Georgia Project, a nonprofit consortium of business and
community leaders in Dalton, continues to support the academic
and social needs of Hispanic children and their families in
northern Georgia.
The Great Cities' Universities coalition plans to expand
its Urban Educator Corps Partnership Initiative, which seeks to
meet the urgent demand for classroom teachers in the Nation's
urban schools.
The Ellijay Wildlife Rehabilitation Sanctuary seeks to
expand its ecological science education programs to make them
available to more students in Georgia.
The city of Macon, Ga., plans to develop and implement a
character-building education program.
Spelman College's Teacher as Leader Educational Initiative
seeks to provide early intervention and academic support for
at-risk, disadvantaged children and their families.
The Challenger Learning Center at SciTrek in Atlanta will
use a simulated mission control station and space laboratory to
create a dynamic learning environment for students in the areas
of science and technology.
The Institute for Student Achievement in New York plans to
expand its programs, which are designed to support school
districts' strategies for helping students overcome academic
and social challenges adversely affecting performance.
The Long Island Works Coalition is consolidating and
building upon school-to-career partnerships educating students
in Long Island.
Life and Industry for Education (LIFE) provides vocational
and computer training, family workshops, after-school and
weekend initiatives for at-risk youth, and English language
instruction in New York. LIFE's proposed Recreational,
Educational, and Counseling Center would centralize the group's
efforts in Hewlett, N.Y.
The ExplorNet Technology Learning Project provides
technology education and workforce development programs to K-12
students and helps schools and communities implement their
technology plans.
The Center for Math, Science, and Teaching Excellence at
New Jersey Institute of Technology will develop and deploy
technology to provide interactive learning experiences for
teachers who want to improve their math, science, and
technology skills.
RUNet 2000 at Rutgers University will continue to expand
its innovative voice-video-data communications system to bring
the resources of the university to more K-12 teachers and
students throughout the State.
Babyland Family Services, Inc. will launch the Newark
Project, a technology initiative that will provide minority
inner-city children and families with access to educational
institutions and other community resources.
The New York University Child Study Center will expand the
ParentCorps project into urban New Jersey areas and evaluate
its impact. ParentCorps trains parents to improve parenting
skills and promote the academic, social, and emotional
readiness of their children.
Project REACH will provide before-school, after-school, and
summer programming for K-12 students at six schools in
Mitchell, S.D.
Marty Indian School in South Dakota will provide students
with after-school and summer educational opportunities.
The East Dakota Educational Cooperative in Sioux Falls,
S.D., will provide before-and after-school programs, as well as
summer activities, in eleven communities.
The HOPE Consortium, which consists of seven schools in
South Dakota, will address educational, health, social
services, cultural, and recreational needs of students and
their communities through school-based learning centers.
Crazy Horse School in Wanblee, S.D., plans to provide
after-school and summer programs on the Pine Ridge Indian
Reservation.
The Brookings School District in South Dakota will provide
students with after-school and summer educational opportunities
in a wide variety of subjects and interest areas.
The Huron School District in South Dakota, in conjunction
with the local YWCA and Career Learning Center, will expand its
after-school programming.
The Howard and Carthage School Districts in Miner County,
S.D., will expand an after-school program to make it available
to more students and begin a summer program.
The Consortium Community Education Project will provide
out-of-school activities to students in the Redfield, Lower
Brule, and Beresford School Districts in South Dakota.
The Foundation for School Safety runs a Safe and Disaster-
Resistant Schools Initiative to help school facilities address
disaster risks through the help of disaster-mitigation
professionals.
The Digital Dakota Network wires South Dakota classrooms to
the Internet, trains teachers and administrators on how to use
technology in schools, and facilitates distance education.
The Dial Corporation will develop, implement, and evaluate
three K-12 courses in biology, health sciences, and earth
sciences, to be delivered over South Dakota's distance learning
network.
Kids Voting USA is a nonprofit, nonpartisan, grassroots
organization that works with schools and communities to enhance
civics education and encourage voter participation.
The Bushnell Center for the Performing Arts in Hartford,
Conn., will expand its Partners in Arts and Education
Revitalizing Schools Program, which strengthens language arts
instruction and multicultural understanding for students.
Amistad America, Inc., a foundation that built and operates
a full-size, working replica of the slave ship Amistad, will
coordinate with local schools to provide students free
admission, tours, and history lessons on the schooner when it
visits various ports in the United States.
Minot State University in North Dakota is developing an
Institute for Rural Human Services to study and develop systems
designed to meet the unique needs of persons with disabilities
living in rural communities, with a special emphasis on working
with hearing-impaired children.
Millikin University in Decatur, Ill., runs an initiative to
assist inner-city and rural high school students in preparing
for college.
The Chicago Public Schools plan to expand tutoring and
mentoring programs.
Columbia College--Chicago will establish a mentoring
program designed to improve minority student educational
success and retention.
The Virginia Frank Child Development Center in Chicago will
provide youth scholarships to support inner-city children.
Southern Illinois University will undertake a teacher
preparation and placement initiative.
The Northwest Community Center in Rockford, Ill., will
develop technology-based educational outreach programs.
The Illinois Institute of Technology's Digital Media Center
will use digital technology to help elementary and high school
students and their teachers improve learning in math and
science.
Chicago State University's Urban Campus/Community
Technology Initiative is designed to support teacher training
and expand teachers' technology skills.
College Summit is a national program that assists low-
income students prepare for and enroll in college. College
Summit Chicago is the hub of the program.
The Teen Reach Community Youth Program in Illinois is a
comprehensive initiative to teach Temporary Assistance for
Needy Families populations and at-risk youth practical skills
while encouraging tutoring and mentoring.
The North Carolina Electronics and Information Technologies
Association will help bridge the digital divide in the State's
rural and under-served school districts through a school
technology demonstration program.
Fresno At-Risk Youth Services in California will attack the
problem of at-risk youths by coordinating the city's efforts
through an education program coordinator, working with targeted
groups, and making peer counselors available to students.
The Foundation for the Improvement of Mathematics and
Education seeks to improve math and science testing scores
through the advancement of curriculum and improvement in
teacher/administrator education.
Yosemite National Institutes will develop more outreach
programs targeted on Native American and minority communities,
support training programs for educators from disadvantaged
areas, and purchase advanced technology.
The Los Angeles Unified School District will provide a
pilot pre-kindergarten program to 1,000 students.
The California Institute for the Arts teaches college-level
arts programs for high school-age students with the goal of
providing young people with job skills needed for the arts and
entertainment industry.
The Florida Department of Education is continuing its
Comprehensive Plan for Teacher Recruitment and Retention
(formerly known as ``SchoolNet'').
The YMCAs of Sarasota, St. Petersburg, and Clearwater,
Fla., will launch additional YMCA Character Development
Schools, also known as ``Second Chance Schools.'' The schools,
conducted in cooperation with local school districts, are
designed to address behavior problems.
The Technology Research and Development Authority of
Florida will continue implementation of a program for math,
science and technology teacher education for grades 9 through
12.
One-to-one ``e-learning'' pilot programs are planned at one
school in each of these four States: South Carolina, Montana,
Massachusetts, and Washington. The programs will provide
students with their own wireless laptop computer, teacher and
administrator training, and progress reports on student
achievement.
The South Carolina Association of School Administrators
continues to develop a clearinghouse to facilitate the
distribution and implementation of the methodology and pedagogy
used by Blue Ribbon Schools.
Clemson University has developed the Call Me Mister
collaborative effort with Morris College, Benedict College, and
Claflin College to recruit, train, certify, and secure
employment for 200 minority male teachers in public schools.
The University of South Carolina continues to develop the
Partners for Literacy model to promote the literacy growth of
children from birth through age 8.
Everybody Wins! is a mentoring program that promotes
children's literacy and love of learning through shared reading
experiences with caring adults.
YMCA centers in Texas will continue and expand their youth
assistance and teen intervention programs, in conjunction with
the YMCA of the USA.
The Houston Independent School District will expand and
improve the computer and telecommunications technology of its
schools through its Technology Infrastructure Plan.
The Early Childhood Development Center at Texas A&M, Corpus
Christi, serves as a childhood development center for at-risk
children, a professional development center for area public
school teachers, and a clinical research facility in the study
of childhood development.
The Novice and Student Teacher Support Project of West
Texas A&M University and Texas A&M University, College Station,
will continue its efforts to recruit and retain more qualified
teachers to America's public schools.
The National Association of Partners in Education
establishes mentoring programs for students across the country
and encourages business-education partnerships.
Building Trust in Representative Democracy, a joint effort
of the National Conference of State Legislatures, the Center
for Civic Education, and the Center on Congress at Indiana
University, will work to improve public understanding and trust
in our Nation's democratic institutions through multimedia
classroom materials.
The Reading Evaluation and Assessment Demonstration (READ)
project, supported by the Today Foundation of Dallas, Texas,
uses educational software to help students learn to read.
Help One Student to Succeed (HOSTS) programs encourage
volunteers to provide effective one-on-one academic mentoring
to students in districts across the Nation, including Texas.
The Institute for Engineering at Southern Methodist
University brings together engineering and science professors
with high school educators, in conjunction with private
industry, to increase the interest and quality of math and
science programs in Dallas-area high schools.
The National Center for School Improvement, formed by a
consortium of universities and led by Southwest Texas State
University, sends teams of educators into struggling schools to
help turn them around.
Sam Houston State University will continue its efforts to
establish a technical assistance learning center to facilitate
the development of after-school programs for at-risk youth.
The California School of Professional Psychology, in
cooperation with school districts in the San Diego, Los
Angeles, San Francisco and Fresno metropolitan areas, plans to
develop and implement model teacher training programs regarding
using technology in the classroom, violence prevention, and
brain functioning.
The Pacific Islands Center for Educational Development
develops and implements training and educational programs aimed
at assisting Samoan and other Pacific Islander students who
aspire college education.
The Vermont Higher Education Consortium will support
universal, early learning programs through the development,
coordination and delivery of academic and experiential training
programs for early childhood educators.
Watertown Public Schools in South Dakota will integrate
technology in the classroom by expanding Macintosh iBook
Wireless Labs and computers to five elementary schools.
Jobs for Youth uses technology to provide basic literacy
and job-skill training to youths and adults.
WGBH, the Nation's largest producer of public television
programming, will develop the earth sciences portion of a Web
site called TeachersDomain.org, an Internet portal that will
benefit teachers and children nationwide.
The Milwaukee Teacher Education Center will expand programs
to recruit, prepare and retain a diverse, effective, innovative
teaching force for the Milwaukee Public Schools.
The University of Wisconsin--Extension's School Readiness
Project will provide training and technical assistance to its
partners in preparing children for learning in school.
St. Norbert College in DePere, Wis., runs a field-based
teacher training program that partners with K-12 area schools
to better prepare teachers to address obstacles in the
classroom.
The Green Bay Area Public Schools will establish a project-
oriented model for technology integration by introducing
teachers and students to effective and appropriate use of
untethered (wireless, battery-powered) network-connected
computers.
The YMCA of Metropolitan Milwaukee is expanding its Teen
Agenda to serve at-risk teenage youth.
The Grand Valley State University Teacher Academy in
Michigan will train a cadre of master teachers who will develop
a curriculum and mentor pre-service and novice science and math
teachers.
The University of Arkansas Little Rock will offer high
school students a Web-based math course with the goal of
reducing the number of entering freshmen who need math
remediation.
The Early Childhood Compact between Arkansas, Louisiana,
Mississippi, and Alabama is a plan to develop and implement a
high-quality, early childhood educational pilot program for at-
risk 4-year-olds that will form the basis of a comprehensive,
cohesive, universally accessible preschool education program.
The Yell County schools in Arkansas will expand their
bilingual programs to address the needs of a growing Hispanic
population.
The Maryland Institute for Minority Achievement and Urban
Education, which is run by the University of Maryland's College
of Education in partnership with the Maryland Department of
Education, will serve State school districts by enhancing urban
education and closing the minority achievement gap.
The Boys & Girls Clubs of Greater Washington is one of the
region's largest service organizations helping at-risk youths
develop the skills necessary for their growth into adulthood.
The Northeast and Islands Regional Educational Laboratory
at Brown University has created a Web site called Knowledge
Loom that provides enrichment resources for educators.
The Professional Partnership Laboratory School at Roger
Williams University in Bristol, R.I., will provide an
innovative learning environment for approximately 500 K-12
students in the Bristol Warren Regional School District.
The Institute for International Sport, a nonprofit group
located on the campus of the University of Rhode Island, plans
to expand the reach of its Center for Sports Parenting. The
center addresses the difficult questions related to
sportsmanship between young athletes and their parents,
coaches, and teachers.
The Charter School Development Foundation will operate a
charter school that is intended to improve the dropout rate in
Las Vegas schools by offering academic programs designed to
enhance students' character, self-esteem, and career
possibilities.
The Humboldt County School District in Winnemuca, Nev.,
will operate an English as a Second Language program for each
of its schools.
Project STARS will provide literacy interventions for
Nevada students in grades 3 to 5.
Pahranagat Valley Elementary School, Hawthorne Elementary
and Junior High School, and Schurz Elementary School in Nevada
will provide each of their students with a laptop computer.
The Baltimore City Public School system is continuing its
efforts to provide each of its classrooms with the technology
needed to bridge the digital divide.
The Kennedy Krieger Institute's Career and Technology High
School in Baltimore provides a school-to-work transition for
youths with serious learning, emotional, neurological, and
development disabilities and adolescents who have suffered
traumatic brain injury.
The University of Maryland College Park and Morgan State
University will create a Center for Minority Achievement and
Urban Education Research.
The Baltimore Symphony Orchestra's Distance Learning at
Home and Abroad initiative will extend the reach of BSO's
programming to students in Maryland public schools and to
students across the Nation via the Internet.
New York City's Museum of Modern Art will use a distance
learning program to maintain education-outreach opportunities
while the museum embarks on a major expansion and renovation
project.
The 24 Challenge/Jumping Levels Math Program supplements
basic math curriculum in grades 1-8.
Bloomsburg University in Pennsylvania is providing
computers, computer wiring, and training for teachers in 25
surrounding school districts.
The Boys and Girls Clubs of Philadelphia are developing a
school-based mentoring program.
Cabrini College in Pennsylvania is developing a new Center
for Science, Education, and Technology that will provide a
model elementary education classroom to facilitate and enhance
the educational experience of Cabrini undergraduate students
majoring in education.
CAPE/PETE Net is continuing to develop its national
demonstration program for distance learning with 105
Pennsylvania universities and colleges.
Cheyney University in Pennsylvania is creating a pilot
Collaborative Center for Teacher Preparation program by
partnering with area school districts.
The city of Philadelphia is continuing to modernize its
community recreational centers with new computer terminals and
other technological improvements. The City is also developing
an anti-truancy initiative and establishing after-school
programs for its students.
The College of Physicians of Philadelphia is expanding its
educational outreach to all students in the Philadelphia School
District through a medical science museum-based experimental
learning program.
Communities in Schools of Lehigh Valley is developing in-
school and after-school programs for at-risk middle school and
high school students.
Drug-Free Pennsylvania is implementing a demonstration
project in which it would partner with local school districts
and media outlets in an effort to provide at-risk students with
an opportunity to develop and produce public service
announcements targeting drug use prevention.
The Eisenhower Foundation is replicating a full community
school program that emphasizes the school as the central point
of the community.
Freedom Theatre, the Nation's largest African-American
theater and performing arts training program, trains over 900
youth annually by promoting artistic and personal development.
It plans to provide greater access to its training programs for
talented youth.
HUBS is providing tools for teacher training tools and
classroom management, including school-to-home communication.
Indiana University of Pennsylvania is establishing a K-12
computer services center for area school districts.
Jazz in the Schools is continuing to expand its program to
engage inner city high school students in a hands-on program
that uses jazz as a means to maintain student interest in
academic subjects in the core curriculum.
MICROSOCIETY has developed and will continue to disseminate
a comprehensive school reform model.
The National Foundation for Teaching Entrepreneurship plans
to expand to Philadelphia. The program partners with high
schools and community-based organizations to teach topics such
as sales, marketing, venture capital, and business ethics
classes.
The Opera Company of Philadelphia is developing the Sounds
of Learning, which uses opera as the base for integrating all
aspects of a child's formal education. The program targets low-
income households living in urban school districts.
The Pennsylvania Ballet is developing the Accent on Dance
program for elementary and secondary school students for in-
school and after-school programs.
The Philadelphia Orchestra is expanding its five
educational programs to reach a broader and more diverse
audience.
The Philadelphia Zoo is seeking to develop and create
programs and interpretive media for the Avian Conservation
Center.
Pittsburgh Technology Council is providing computer
training to teachers in school districts in a 13-county area.
Project 2000 is planning to expand its existing academic
support and mentoring programs for inner-city African-American
youth to an adjoining housing project.
SEPCHE is developing a ``global curriculum'' to challenge
students to develop their knowledge of foreign languages and
cultures, and recognize relationships between history and
current issues.
Tesoro High School in California is developing a Knowledge
Center which will be a customized facility consisting of a
technology lab, seminar lab, communications center, and
library.
Washington and Jefferson College is conducting quality
education initiatives and professional development in the
southwest region of Pennsylvania. A key focus of the program is
to integrate technology into teacher preparation and
performance.
Walnut Street Theatre's Educational Outreach Program for K-
12 schools in the Philadelphia area includes an apprenticeship
program, an adopt-a-school program, and a summer camp.
Widener University in Pennsylvania is seeking to provide
computer networking management services to 12 area school
districts and other educational entities.
The Pittsburgh YWCA is continuing to expand its after-
school activities.
Big Brothers/Big Sisters is hoping to double the number of
children served in school-based mentoring.
The Detroit Science Center will develop and implement an
educational series of new Urban Intervention Science Programs
that will correlate with Michigan Educational Assessment
Program measures. Students will be introduced to careers in
science, technology, and engineering.
The Detroit Public Schools will provide professional
development for its site-based management teams.
The Principals Academy in Detroit will serve as the primary
entity for ensuring that the school system's principals are
trained to run high-quality schools.
The Detroit Public Schools will create an alternative
teacher certification program to attract working professionals
who want to teach but are not currently certified.
The Michigan Association of School Administrators (Region
I) will expand its telecommunications infrastructure in the
upper peninsula to allow schools to communicate with
individuals more effectively.
The Eastern Upper Peninsula Intermediate School District in
Michigan will offer services and activities for youths and
adults during after-school hours and, during the summer, all
day.
The Eastern Upper Peninsula Intermediate School District in
Michigan will provide cost-effective curriculum and student
enrichment programs to 12 communities through distance
learning.
The Flint Area Chamber of Commerce in Michigan will
establish an ``e-mentoring'' program designed to create a
partnership between employers and students, with the goal of
improving academic performance and workforce readiness.
The YWCA of Anchorage offers after-school and enrichment
programs to at-risk schoolchildren and their mothers that
stress building self-esteem and strong value systems.
The United Way of Anchorage supports a number of high-
quality after-school programs designed to help students stay
out of trouble and do well in school.
Alaska's Right Start program provides extended-day programs
for kindergarten-age schoolchildren who are behind expected
developmental levels and makes use of academic program
coordinators.
The Alaska Initiative for Community Engagement (Alaska ICE)
program uses community resources to help schoolchildren
increase academic performance and involve them in their own
communities.
Alyeska Central School in Alaska plans to use online
distance education to help students in small, rural schools
prepare for the State's high school graduation qualifying
examination.
The Qualified Teachers for Alaska program recruits and
prepares teachers to work in the State.
The Alaska Department of Education runs an intense remedial
summer reading program for high school students that is
designed to help them graduate on time and with their
classmates.
Big Brothers Big Sisters agencies in Alaska plan to extend
their after-school mentoring programs across the State to
include rural and remote villages and communities.
The Anchorage School District will develop a Summer Reading
Lab to increase reading comprehension skills for Anchorage area
high school students.
The Sheldon Jackson College Center for Life Long Learning
trains teachers, especially Alaska Natives, to teach in remote
Alaskan villages.
Alaska Geographic Alliance plans to work with Library of
Congress to incorporate its Meeting of the Frontiers project
into the Alaska school history and geography curriculum.
The Galena School District and several partners are
assisting Alaska Native students who attend boarding schools
and colleges make the transition from rural village life to
educational residence facilities.
The University of Alaska Anchorage's LitSite project will
help bridge the rural/urban literacy gap in Alaska, especially
for schoolchildren in grades K-12.
The Anchorage Community Theater School is initiating an
after-school performing arts program for Anchorage-area
schoolchildren in grades K-12.
The Rowan Center for the Advancement of Learning at Rowan
University in New Jersey has developed a process called Let Me
Learn that enables students to understand what types of
learners they are so they can learn more effectively. The
center plans to implement its programs in eight sites
throughout the State.
Schools Plus is a safe, neighborhood-based, after-school
program designed to provide academic assistance and one-on-one
mentoring for students.
The Northwest Regional Education Laboratory in Portland,
Ore., is training senior citizens to serve as reading tutors in
K-12 school settings in Oregon, Alaska and Washington.
Oregon State University's Lifelong Learning Alliance will
use distance learning to create a new statewide system for
providing a variety of education-related services, including
professional development for teachers and school counselors.
The Schools Uniting Neighborhoods (SUN) program in
Portland, Ore., is creating and supporting school/neighborhood
partnerships in an effort to increase student achievement and
family involvement with children.
Portland State University in Oregon is establishing the
Portland Metropolitan Partnership for School Leadership, a
program that will recruit, prepare, and offer professional
development for school leaders in the region's secondary
schools.
Self-Enhancement, Inc. in Portland, Ore., provides after-
school services for at-risk students.
The Native American Performing Arts Project will add a 3-
day performing arts workshop to the Konaway Nika Tillicum,
Southern Oregon University's summer youth academic camp for
middle school students. It will also create a Native American
Theater production that would travel the State.
The Multnomah Outdoor School project in Oregon is a
residential program that allows students to experience hands-on
science learning over an extended weekend.
Friends of the Children, a national nonprofit group based
in Portland, Ore., provides adult mentors to children who are
most in danger of school failure, abuse, gang and drug
involvement, and other serious problems.
The Integrated Performance Benchmarking System, tested by
Oregon and Nebraska the past 2 years, is a proposed initiative
to eliminate cumbersome paperwork currently required by the
Department by allowing States to electronically store, share,
and even compare State education data.
Several school districts in Utah plan to conduct a
demonstration project in which they would administer their
annual assessments using computers.
Under the Utah Reading Excellence Act, school districts in
the State are working to improve literacy among their students,
especially those in grades K-3.
The University of Montana's Safe Schools Project is
facilitating a statewide community-based curriculum development
initiative that promotes responsible youth behavior.
Fisher's Peak YMCA in Trinidad, Colo., has established a
teen center and is sustaining a conflict resolution center.
The YMCA of Metropolitan Denver is developing a teen
initiative program targeting at-risk African-American and
Hispanic teens at the East Denver Family YMCA.
The Pikes Peak YMCA is expanding the Youth Connection
Program in Colorado Springs, which connects at-risk teens with
business leaders to learn job skills and model other healthy
behavior.
The Pueblo YMCA in Colorado is developing teen programs and
a new teen center that will focus on leadership development,
outdoor adventure skills and intramural sports programs.
Longmont YMCA is trying to double the number of teens
served in Longmont and the St. Vrain Valley in Colorado.
Additional funds will allow the programs to mentor youths,
provide employment and training skills, and offer community
service activities, reading skills, fitness activities, and
summer camping.
The Boulder Valley YMCA in LaFayette, Colo., is expanding
its After School and Active Peer (ASAP) program, which works in
conjunction with local universities to provide mentoring and
tutoring to high school students.
The Pathway Partners rural education program, developed in
the mountains of Maine, plans to expand to more rural
communities.
The Lewiston-Auburn College/University of Southern Maine
TEAMS Program is preparing future and current teachers to meet
the demands of Maine's 21st century elementary and middle
schools.
The University of Maine Foreign Language Education
Initiative aims to increase the competitiveness of the U.S.
workforce in the global economy by enhancing foreign language
education.
I-SAFE America, an Internet-safety education foundation,
plans to expand a current pilot project in Utah to encompass
school districts and police departments nationwide.
The University of Nebraska at Omaha's P-12 Urban Education
Program plans to implement an innovative program to improve
mathematics and science education in urban public schools. This
project will be a collaborative effort between the College of
Education at UNO, Omaha Public Schools, and other partners.
The University of Nebraska at Kearney is working with pre-
service and in-service teachers to assist them in dealing with
an increasingly diverse student population.
Stillman College, in conjunction with Zelpha Wells Cultural
Education Center, is providing music education and music
instruction to minority and disadvantaged youth.
The Pendleton, Pilot Rock, and Athena-Weston school
districts in Oregon have partnered with the Confederated Tribes
of the Umatilla Indian Reservation (CTUIR) to establish a
formal cooperative dropout-prevention program.
Fayette County High School in Tennessee is continuing its
efforts to support technology enhancements and improve after-
school programs.
Classika Theatre of Arlington, Va., plans to expand its
successful ARTsmarts and SS VETA (Social Studies: Virginia
Education Through Arts) programs, which are intended to improve
students' overall academic performance, enhance reading and
comprehension skills, and strengthen concentration and
memorization ability.
Junior Achievement of Delaware Valley educates students
about free enterprise, business, and economics through its
Exchange City program.
The Regional Performing Arts Center in Philadelphia will
include a state-of-the-art concert hall, a recital theater, and
an arts education center that will offer distance learning
programs, with instant access for schools in the region.
The Tupelo Public School District plans to expand its
C*R*E*A*T*E* for Mississippi project, which joins teachers in
several districts into a network to model successful,
replicable technology application and use in classrooms.
The Electronic Learning Marketplace uses technology in
support of educators' efforts to improve the learning of all
Maine students toward the rigorous standards defined by the
Maine Learning Results.
The Maine Center for Educational Services' Discover ME Web
site will create an on-line resource center that will allow
students and teachers to access curriculum materials,
participate in panel discussions with experts, share resources,
and build an online community.
The Schools and Technology for Assessment and Reflection
(STAR) project in Maine uses telecommunications technology with
the goal of significantly increasing the number of students who
demonstrate proficiency on State mathematics, science, reading
and writing educational standards.
The University of Alabama plans to upgrade its science
lecture halls to incorporate state-of-the-art, multimedia
rooms, instant response devices, and distance learning
technology to provide instruction to K-12 classes.
Spring Hill College in Mobile, Ala., is developing
technology enhancements and technology training of their
teachers for distance learning.
Three Rivers Connect of Allegheny County, Pennsylvania,
plans to acquire and upgrade nearly 3,000 Federal surplus
computers to be used by Pittsburgh Public Schools to provide an
Internet-based learning curriculum.
Educational Service District 117 in Wenatchee, Wash., will
equip a community technology center to expand technology-based
training.
KCTS, a PBS affiliate in Seattle, will develop a database
of primary-source research materials.
The Washington Association of Career and Technical
Education will update its training technology to ensure that it
meets industry standards.
The Community Education and Lifelong Learning Center at
Satsop Development Park in Washington State will equip its
classrooms and conference facilities.
The Temple University Center for Research in Human
Development and Education is developing innovative models to
address teacher recruitment, training, and mentoring that will
enhance student achievement and raise the capabilities of low-
performing schools.
Lock Haven University and the Keystone Central School
District in Pennsylvania will collaborate to form a model
alternative school that will provide educational opportunities
for students who are not able to succeed in the conventional
classroom.
The First Freedom Center in Richmond, Va., will prepare and
design educational exhibits to show the history of religious
freedom and its role in U.S. democracy.
Great Films Project Co., Inc. of New York produces
documentary films to provide objective assessments of the
impact of Federal education programs on the education of our
Nation's youth.
The Pennsylvania Department of Education's Division of
Migrant Education, in a consortium with the Migrant Education
Division of Arkansas, Colorado, Texas, Florida, Illinois,
Montana and Kansas, will create an educational technology
system geared toward improving K-8 migrant student achievement
in reading, language proficiency and mathematics.
The New Mexico Department of Education will continue to
expand use of the Individual Services Model to help reduce the
dropout rate for high school students in the State.
The New Mexico Department of Education is developing a
``virtual school'' technology plan that would ensure that all
students, regardless of circumstance or geographic location,
have equal opportunity to develop a strong academic foundation,
by creating dynamic, student-centered learning environment
delivered via the World Wide Web, two-way interactive video
conferencing, and satellite downlink technologies in
collaboration with the State's major education partners.
The Children and Family Development Education Center in
Albuquerque, N.M., will expand access to comprehensive,
community-based continuum of services to preschoolers and their
families, including comprehensive child and family development
services.
The Mid-Rio Grande Collaborative for Educational in
Albuquerque is developing innovative strategies for working
with at-risk students, aligning curriculum and standards, and
improving literacy, math and science studies.
Albuquerque Public Schools will continue to develop an
innovative schoolwide program at one of its high schools. The
program will focus on the teaching and learning of mathematics,
science and technologies, and serve as a resource for all of
New Mexico's school districts through research, teacher
training, and distance learning.
The Integrated TechCenter program in Roswell, N.M., is an
innovative program designed to provide secondary students with
technology skills that will prepare them for employment.
St. Joseph's Indian School in South Dakota plans to expand
and improve education outcomes of at-risk Native American youth
by providing services that help reduce the high school drop-out
rate, improve academic standing, and provide rehabilitative
counseling.
The Alameda County Social Services Agency in California
will support an education and training program for high school
students.
The California School of Professional Psychology runs an
initiative to help ensure that elementary and secondary school
students have adequate access to counseling and mental health
services in their schools.
The Enterprise Center, in West Philadelphia, will expand
its revitalization program in distressed urban neighborhoods to
educate its residents with entrepreneurial skills, resources,
and opportunities.
The Louisiana State University Health Science Center will
establish the National Center for Special Education
Accountability and Monitoring, which will be devoted to
improving education for children with disabilities.
School boards in Orleans Parish and Jefferson Parish, La.,
will implement a universal literacy system at competitively
selected schools.
The District Attorney's Office in Orleans Parish, La., will
run a school-based, drug-awareness education and prevention
program.
The North Carolina Electronics and Information Technologies
Association will improve workforce development in underserved
areas to increase technology tools, including teacher training,
hardware, software, connectivity.
The Holy Redeemer Health System in Philadelphia will expand
and enhance afterschool programs for at-risk youth.
The Department of Education of the Commonwealth of
Pennsylvania will provide assistance to low-performing school
districts that are deemed distressed and slated for potential
takeover by the Commonwealth as prescribed by Pennsylvania law.
The initiative is intended to improve the management and
operations of the school districts; assist with curriculum
development; provide after-school, summer and weekend programs;
offer teacher and principal professional development; and
promote the acquisition and effective use of instructional
technology and equipment.
Do Something America instills self-confidence and
leadership skills in K-12 students by encouraging them to
participate in community projects.
American Theater Arts for Youth, Inc. is developing an Arts
in Education Program.
The Children's Literacy Initiative is planning to
supplement Head Start's distance learning programs and provide
a teacher education program.
Friends of the Children is providing full-time, paid adult
mentors to at-risk children in Chester, Pennsylvania.
Music Education and Technology Advancement (MENC) is
planning to establish a standard music education and creativity
instructional technology and professional development program
for approximately 4,000 K-12 public schools.
Lincoln University plans to purchase laboratory and
computer equipment to provide a 6-week summer workshop for
Philadelphia teachers, and also to conduct a 1-day annual
workshop for approximately 200 high school students to expose
them to scientific disciplines.
Champions of Caring programs encourage young people to take
an active role in their communities.
A consortium of nine school districts in Washington State
will establish interconnectivity in rural schools to expand
learning opportunities.
The YMCA of Greater Seattle will expand teen activities
offering academic support and leadership development.
First Book will expand to serve an additional 80
communities nationwide.
The Odyssey Maritime Discovery Center in Seattle will
develop educational programs.
The I Can Learn program assists teachers in algebra
instruction.
The Correction Education Association, in partnership with
the Pennsylvania Department of Education, Juvenile Corrections
Education, and Lock Haven University, will design and develop
curricula and student assessments.
Delta State University will run an initiative to address to
address teacher recruitment and retention, technology
development, and administrator training in the Mississippi
Delta.
The Madison County, Mississippi, school district will
conduct an impact study of the sudden influx of new students in
the district.
Protecting You, Protecting Me is an educational curriculum
for grades 1-5 developed by Mother's Against Drunk Driving.
Futures for Children of Albuquerque will expands its
educational services to American Indian children to prepare
them for high school.
New Mexico public broadcasters are implementing a digital
translator project to deliver educational programming to two
demonstration sites in rural New Mexico.
The Spring Arbor University-based consortium of higher
education institutions is using high voluntary standards in
technology integration to improve teacher preparation and
classroom practice.
Reading Together USA is a demonstration program working to
improve reading comprehension and fluency among second grade
children.
The Clark County (Nevada) School-to-Work Program provides
students who do not plan to attend college with instruction in
nursing and home health aid.
The Lynn Meadows Discovery Center for Arts Education in
Gulfport, Mississippi will continue and enhance its Shooting
Stars program for students ages 12-17.
The University of Southern Mississippi Frances Karnes
Gifted Center will continue its summer programs and make
participation available to an increased number of students.
The Mississippi Humanities Council will provide programs in
local libraries to support Prime Time Family Reading Time.
The Fort Lewis College Child Development Center is designed
to serve young children, their families, students, faculty and
community members in Southwest Colorado and the Four Corners
Region.
A Rural Distance Learning Coalition comprising three
States--Montana, Alaska, and Hawaii--will address the issues
and challenges surrounding distance learning opportunities for
rural and remote populations.
The Committee is aware of the need for an up-to-date
comprehensive management information system for the Alaska
Department of Education and Early Development's early childhood
activities, including all of the programs it administers and
central eligibility and payment components to reduce
duplication and provide better access to needed services.
The Committee is concerned that Alaska Native students in
high schools and middle schools in Anchorage have achievement
scores well below those of their non-Native counterparts and
that the dropout rate for Alaska Native students is more than
twice that of non-Native students. The Committee encourages the
Department to consider the ``Partners for Success'' program of
the Cook Inlet Tribal Council, Inc. and the Anchorage School
District to provide additional resources to increase graduation
rates and achievement scores of Alaska Native schoolchildren in
the Anchorage area.
The Committee encourages the Department to continue its
support of the Galena School District's innovative distance
education program, which benefits thousands of children across
Alaska, especially in remote areas, by allowing students access
to more courses and subject-qualified teachers.
The Committee encourages the Department to continue its
support of the Partnerships 2000 project of the National
Association of Partners in Education, and to consider a study
by the organization of the effectiveness of business/community/
school partnerships on student performance and to explore
additional strategies to expand these partnerships at the State
and local levels.
The Committee encourages the Department to consider a
proposal from Alaska Digital Video to document important
segments of Alaska's history from 18,000 B.C. to the present to
help Alaskan schoolchildren learn the history of an important
part of their State.
The Committee is concerned that students and teachers in
rural, remote communities of Alaska do not have access to
coursework, teaching materials and teacher training in science
and mathematics, and it encourages the Department to consider a
proposal from the Imaginarium in Anchorage to develop new
courses in math and science for students and teachers in rural
communities in Alaska using distance delivery.
The Committee is concerned that in the first round of
Alaska's High School Qualifying Exam, more than two-thirds of
students failed the math portion and over half of students
failed the writing portion. The Committee urges the Department
to work with the University of Alaska and the Alaska Department
of Education and Early Development to establish the Alaska
Center for Excellence in Schools at the University of Alaska to
assist Alaska's low-performing schools meet requirements of new
State educational standards.
The Committee is aware of the Tanana School District's need
for technology to help its students bridge the digital divide
in this remote rural Alaskan community.
Mentoring
The Committee recommends $5,000,000 for mentoring programs.
This is a new program authorized by the Senate-passed version
of the ESEA reauthorization bill; it was not requested by the
administration.
Funds will be used to promote mentoring programs for
children who lack strong, positive adult role models or who are
at risk of educational failure or involvement in criminal or
delinquent activities. Such programs must seek to help these
children receive support and guidance from a caring adult,
improve their academic performance, and avoid involvement with
gangs. The Department may award grants through this program to
LEAs; nonprofit, community-based groups; or partnerships
between the two.
Community service for expelled or suspended students
The Committee recommends $50,000,000 for a new program to
encourage community service by students who have been expelled
or suspended from school. This program was authorized by the
Senate-passed version of H.R. 1; it was not requested by the
administration.
The program will provide grants to States to help make it
possible for students who have been expelled or suspended from
school to participate in a community service activity during
the period of expulsion or suspension. While the Committee
recognizes that most LEAs require expelled or suspended
students to attend an alternative school during the period of
expulsion or suspension, the hours for such schools often
differ from those of regular schools. The Committee also
recognizes that primary caretakers in many households work
outside of their homes, giving students the opportunity to
engage in inappropriate behavior during non-school hours.
This program is intended to demonstrate to students who are
apathetic about their expulsion or suspension that there are
repercussions to their bad behavior, as well as give them the
opportunity to give back to their community in a positive way.
Public school choice
The Committee recommends $50,000,000 for public school
choice, a new program authorized by the Senate-passed version
of the ESEA reauthorization bill. This program was not
requested by the administration.
Funds will be used to assist school districts implement
public school choice programs that permit disadvantaged
students to transfer from a failing public school to a high-
performing public school. School districts may use funds for a
variety of purposes associated with implementing a public
school choice program including: informing parents and students
about the choice program, covering the costs of transportation,
and capacity-enhancing activities that enable high-demand
schools to accommodate transfer requests. Grants will be made
on a competitive basis to local educational agencies to plan
and implement programs of intradistrict-wide or interdistrict-
wide public school choice. In awarding the grants, the
Secretary is directed to give the highest priority to school
districts with low-performing schools.
Youth Alcohol Abuse Prevention Initiative
The Committee recommends $25,000,000 for the Youth Alcohol
Abuse Prevention Initiative, a new program authorized by the
Senate-passed version of H.R. 1; it was not requested by the
administration.
This program authorizes competitive grants to LEAs to
implement proven strategies for reducing underage drinking in
secondary schools. The Committee directs the Department and the
Substance Abuse and Mental Health Services Administration
(SAMHSA) to work together on this effort. According to SAMHSA,
by the time students are high school seniors, more than 80
percent have used alcohol and 64 percent have gotten drunk.
When adolescents move on to college, they bring their drinking
habits with them. Members of the Committee are deeply concerned
about the prevalence of underage drinking, and this program
addresses the need for this issue to be an educational
priority.
The Committee directs that $20,000,000 should be used to
provide the grants and $5,000,000 should be used by SAMHSA to
provide alcohol abuse resources to assist in implementing the
anti-alcohol programs.
Rural education
The Committee recommends $125,000,000 for rural education
programs. The funding should be equally divided between the
Small Rural Schools Achievement Program and the Low-Income and
Rural Schools Program. The administration did not request
funding for these new programs, which were authorized by the
Senate-passed version of H.R. 1.
The Small Rural School Achievement Program permits rural
school districts to combine certain Federal education funds and
apply them toward local initiatives, such as professional
development to improve student achievement. The Low-Income and
Rural Schools Program is designed to meet the needs of school
districts serving large numbers of economically disadvantaged
students. Participating local education agencies are eligible
to receive supplemental grant funds that will enable the rural
schools to offer activities of sufficient size, scope, and
quality to have a significant impact on student achievement.
Physical Education for Progress
The Committee recommends $50,000,000 for the Physical
Education for Progress program, which received $5,000,000 in
fiscal year 2001 as part of the Fund for the Improvement of
Education. The administration did not request any funding for
this program.
Under this program, the Secretary is authorized to award
grants to, and enter into contracts with, LEAs to pay the
Federal share of the costs of initiating, expanding and
improving physical education programs in grades K-12 by: (1)
providing equipment and support to enable students to actively
participate in physical education activities; and (2) providing
funds for staff and teacher training and education. Each LEA
desiring a grant or contract shall submit to the Secretary an
application outlining its plan to initiate, expand or improve
its physical education program. The Secretary shall ensure that
grants and contracts that are awarded shall be equitably
distributed between LEAs serving urban and rural areas, and
areas with both large and small student enrollments. Not more
than 5 percent of any grant or contract may be used for
administrative costs.
Improving Literacy Through School Libraries
Recognizing the strong, research-based connection between
well-equipped and well-staffed school libraries and the
literacy skills of students, the Committee recommends
$25,000,000 for the Improving Literacy Through School Libraries
program, which was authorized in the Senate-passed version of
H.R. 1. This is a new program that was not requested by the
administration.
Improving Literacy Through School Libraries will provide
funds for urgently needed, up-to-date school library books and
training for school library media specialists in order to
support the scientifically based reading programs authorized by
the new Reading First initiative. States and local educational
agencies will receive funds on the basis of their proportion of
Title I allocations. Funds should be targeted by LEAs to high-
poverty schools and schools with the greatest need for school
library improvement. Funds may be used to acquire up-to-date
school library media resources, including books and advanced
technology; facilitate resource-sharing networks among schools
and school libraries; provide professional development for
school library media specialists; and provide students with
access to school libraries during non-school hours.
INDIAN EDUCATION
Appropriations, 2001.................................... $115,500,000
Budget estimate, 2002................................... 116,000,000
Committee recommendation................................ 117,000,000
The Committee recommends $117,000,000 for Indian education
programs. This amount is $1,500,000 more than the fiscal year
2001 appropriation and $1,000,000 more than the budget request.
Grants to local education agencies
For grants to local education agencies, the Committee
recommends $94,265,000, which is $1,500,000 more than the
budget request and the fiscal year 2001 appropriation. These
funds provide financial support to reform elementary and
secondary school programs that serve Indian students, including
preschool children. Funds are awarded on a formula basis to
local educational agencies and schools supported and operated
by the Bureau of Indian Affairs.
Special programs for Indian children
The Committee recommends $20,000,000 for special programs
for Indian children, the same as the budget request and the
fiscal year 2001 appropriation. Funds will be used for
demonstration grants to improve Indian student achievement
through early childhood and preschool education programs, and
professional development grants for training Indians who are
preparing to begin careers in teaching and school
administration.
National activities
The Committee recommends $2,735,000 for national
activities, the same as the fiscal year 2001 appropriation and
$500,000 less than the budget request. Funds are used for
research, evaluation, and data collection to provide
information on the educational status for the Indian population
and on the effectiveness of Indian education programs.
BILINGUAL AND IMMIGRANT EDUCATION
Appropriations, 2001.................................... $460,000,000
Budget estimate, 2002................................... 460,000,000
Committee recommendation................................ 516,000,000
The Committee recommends an appropriation of $516,000,000
for bilingual and immigrant education, $56,000,000 more than
the budget request and the fiscal year 2001 appropriation. The
bilingual programs authorized by the Senate-passed version of
H.R. 1 are designed to increase the capacity of States and
school districts to provide special instruction to limited-
English-proficient students.
Bilingual and immigrant education State grants
The Committee recommends $500,000,000 for bilingual and
immigrant education State grants, a new program that
consolidates the three bilingual activities with the immigrant
education program. This amount is $40,000,000 more than the
budget request. The program is intended to help States address
the needs of limited-English-proficient and immigrant students
statewide, instead of dealing with these problems on a
piecemeal basis.
Foreign language assistance
The Committee recommends $16,000,000, which is $2,000,000
more than the fiscal year 2001 appropriation, for competitive
foreign language assistance grants. The administration proposed
consolidating this program into the State block grant program.
The Committee notes the lack of Federal incentives to
provide adequate instruction in second language acquisition to
elementary and secondary students. Recent research shows that
the optimum human learning time for all languages is between
birth and age 10. The Committee is especially concerned that
the nation's educational system is not meeting a critical need
for speakers of foreign languages to fill sensitive Federal
agency jobs, and is not preparing enough students to face an
internationally competitive business environment. Further, the
Committee is distressed that the only Federal program designed
to help schools meet this need is unavailable to the poorest
schools. The Committee encourages the Secretary to use his
ability to waive the matching requirement for qualifying
schools and to increase awareness of this accommodation among
the affected school population.
SPECIAL EDUCATION
Appropriations, 2001.................................... $7,439,948,000
Budget estimate, 2002................................... 8,425,595,000
Committee recommendation................................ 8,439,643,000
The Committee is aware that the Senate-passed version of
the ESEA reauthorization bill would fully fund the Federal
Government's share of special education costs within 7 years.
If Senate and House conferees agree to that measure, special
education grants to States will become a mandatory spending
program.
In the meantime, the Committee recommends a program level
of $8,439,643,000 for special education. This amount is
$999,695,000 more than the fiscal year 2001 appropriation and
$14,048,000 more than the budget request. It includes
$5,072,000,000 in fiscal year 2003 advanced funding.
These programs, which are authorized by the Individuals
with Disabilities Education Act (IDEA), provide assistance to
ensure that all children with disabilities have access to a
free, appropriate public education, and that all infants and
toddlers with disabilities have access to early intervention
services. This assistance is provided through State grants that
offset a portion of the costs incurred by States and local
educational agencies in educating children with disabilities
and in developing and implementing statewide systems of early
intervention services, and through six programs that provide a
streamlined structure to help States improve educational and
early intervention results for children with disabilities.
The Committee is aware of the greater difficulties faced by
special needs students and their parents in remote rural
communities in Alaska, and it urges the Department to continue
and expand its work with Alaska's PARENTS, Inc., which trains
teachers, specialists and parents in the use of technology to
assist students with disabilities. PARENTS, Inc. also plans to
create a matching, mentoring and home-visit system to support
rural Alaskan parents of children with disabilities, and to
partner with community faith-based organizations to develop a
mentoring program for youth with disabilities at risk for
entering the juvenile justice system in Alaska.
The Committee recognizes the unique and progressive work of
the University of Southern Mississippi's Center for Literacy
and Assessment. For over 30 years, this center has served as
the South's only comprehensive resource for reading disabled
students. Reading difficulty is the most prevalent disability
and recent research by the National Institute of Health
suggests that it is treatable, and most important, preventable
in a large portion of the population. The Committee is
impressed with the Center's progress and responsiveness in
meeting the expectations set out in fiscal year 2000 and fiscal
year 2001. It is especially encouraged that the Center is using
the recommendations of the National Reading Panel in its
research dissemination, teacher and parent training,
development of replicable models for reading assessment and
intervention.
The Committee also urges the Department to provide funds
required to support operations for the 2002 Paralympic Games in
Salt Lake City.
Grants to States
The Committee bill provides $7,339,685,000, including
$5,072,000,000 in fiscal year 2003 advanced funding, for
special education grants to States. The amount recommended is
$1,000,000,000 more than the fiscal year 2001 appropriation and
the same as the budget request. This program supports formula
grants to States to finance a portion of the cost of providing
special education and related services for children with
disabilities.
The Committee's recommended funding level represents
approximately 17 percent of the estimated average per-pupil
expenditure and 14 percent of excess costs, and would provide
an estimated Federal share of $1,133 per child for the 6.5
million children expected to receive special education
services.
Preschool grants
The Committee recommends $390,000,000 for preschool grants,
the same as the fiscal year 2001 appropriation and the budget
request. The preschool grants program provides formula grants
to States based on the amount of funding received in fiscal
year 1997, the number of preschool children aged 3 through 5,
and the number of preschool children aged 3 through 5 living in
poverty.
The amount provided by the Committee is approximately $637
per child for the 612,700 preschoolers expected to receive
special education and related services in the next school year.
States may retain an amount equal to 25 percent of their
1997 allocation, cumulatively adjusted upward by the lesser of
inflation or the percentage increase in the State's allocation,
of which 20 percent may be used for administration. These funds
may be used for direct and support services for 3- through 5-
year-olds; at a State's discretion, to serve 2-year-olds with
disabilities who will turn age 3 during the school year; and
for other purposes. The remaining funds must be distributed to
local educational agencies.
Grants for infants and families
The Committee bill provides $383,567,000 for grants for the
infants and families program under part C of the IDEA. This is
the same amount as the fiscal year 2001 appropriation and the
budget request. This program provides formula grants to States
to implement statewide systems of coordinated, comprehensive,
multidisciplinary interagency programs to make available early
intervention services to all children with disabilities, ages 2
and under, and their families.
State improvement
For State improvement grants, the bill provides
$49,200,000, the same as the fiscal year 2001 appropriation and
the budget request. This program provides competitive grants to
State educational agencies to assist them, in partnership with
parents, teachers, institutions of higher education, interest
groups, and others, to improve results for children with
disabilities by reforming and improving their educational
systems.
Research and innovation
The Committee has included $70,000,000, the same as the
budget request, for research and innovation. This amount is
$7,353,000 less than the fiscal year 2001 appropriation. This
program supports competitive awards to produce and advance the
use of knowledge to improve services and results for children
with disabilities.
The Committee urges the Secretary to emphasize research
that contributes to the development and evaluation of
empirically based practices designed to address the needs of
children in special education, and enhance our knowledge of
best practices, as well as research on programs that provide
early intervention for children and youth with behavioral
disorders at risk of requiring more intensive special education
services.
The Committee is aware of the following project and
encourages the Department to give it full and fair
consideration:
Oregon State University will research and pilot a program
to expand the scope of special education training to include
cultural influences on special needs, and to address the
shortage of special education teachers with a bilingual
background.
Technical assistance and dissemination
The Committee bill provides $53,481,000, the same as the
fiscal year 2001 level and the budget request. These funds
provide technical assistance and information through
competitive awards that support institutes, regional resource
centers, clearinghouses, and efforts to build State and local
capacity to make systemic changes and improve results for
children with disabilities.
Personnel preparation
The Committee recommends $90,000,000 for the personnel
preparation program. This amount is $8,048,000 more than the
fiscal year 2001 appropriation and the budget request. Funds
support competitive awards to help address State-identified
needs for qualified personnel to work with children with
disabilities, and to ensure that these personnel have the
skills and knowledge they need to serve these children.
The appropriation includes funds to provide preparation for
personnel to serve children with high-incidence disabilities,
including grants for graduate support, to ensure a proper
balance among all authorized grant categories.
The Committee has increased funds for personnel preparation
in response to the alarming shortage of special education
personnel, including special education teachers and faculty.
The increase should help institutions of higher learning
address this shortage so that students with disabilities will
be appropriately served.
Parent information centers
The Committee bill provides $26,000,000 for parent
information centers, the same as the fiscal year 2001
appropriation and the budget request. This program makes awards
to parent organizations to support parent training and
information centers, including community parent resource
centers. These centers provide training and information to meet
the needs of parents of children with disabilities living in
the areas served by the centers, particularly underserved
parents, and parents of children who may be inappropriately
identified.
Technology and media services
The Committee recommends $36,210,000 for technology and
media services, $1,000,000 less than the fiscal year 2001
appropriation and $4,500,000 more than the budget request. This
program makes competitive awards to support the development,
demonstration, and use of technology, and educational media
activities of value to children with disabilities.
The Committee recommendation includes $9,500,000 for
Recording for the Blind and Dyslexic, Inc. This is the same
amount as the fiscal year 2001 level and $3,500,000 more than
the budget request. These funds support the continued
production and circulation of recorded textbooks, increased
outreach activities to print-disabled students and their
teachers, and accelerated use of digital technology.
The Committee notes that video description is important for
the full inclusion of blind and visually impaired children in
the education process, and it directs the Department to fund
this service at a level of $2,500,000, an increase of
$1,000,000 over the budget request and the fiscal year 2001
appropriation.
Readline
The Committee recommends $1,500,000 for the Readline
Program. The amount recommended is the same as the fiscal year
2001 appropriation for this activity. The administration
proposed eliminating this program.
This activity is authorized by section 687(b)(2)(G) of the
Individuals with Disabilities Education Act, as amended. The
Committee recognizes the progress of the Readline Program,
which is developing a wide range of media resources to
disseminate research conducted by the National Institutes of
Health, as well as other research concerning effective teaching
strategies, early diagnosis of, and intervention for, young
children with reading disabilities. These resources include an
extensive Web site, videos, and programming for television and
radio broadcast. The Committee includes funding for the
continued development and distribution of media resources to
reach the parents and teachers of children with reading
disabilities.
REHABILITATION SERVICES AND DISABILITY RESEARCH
Appropriations, 2001.................................... $2,805,339,000
Budget estimate, 2002................................... 2,930,117,000
Committee recommendation................................ 2,932,617,000
The Committee recommends $2,932,617,000 for rehabilitation
services and disability research, $127,278,000 more than the
2001 appropriation and $2,500,000 more than the administration
request.
Vocational rehabilitation State grants
The Committee provides $2,481,383,000 for vocational
rehabilitation grants to States, which is $81,593,000 more than
the fiscal year 2001 appropriation and the same as the budget
request.
Basic State grant funds assist States in providing a range
of services to help persons with physical and mental
disabilities prepare for and engage in meaningful employment.
Authorizing legislation requires States to give priority to
persons with significant disabilities. Funds are allotted to
States based on a formula that takes into account population
and per capita income. States must provide a 21.3 percent match
of Federal funds, except the State's share is 50 percent for
the cost of construction of a facility for community
rehabilitation program purposes.
The Rehabilitation Act requires that no less than 1 percent
and not more than 1.5 percent of the appropriation in fiscal
year 2002 for vocational rehabilitation State grants be set
aside for grants for Indians. Service grants are awarded to
Indian tribes on a competitive basis to help tribes develop the
capacity to provide vocational rehabilitation services to
American Indians with disabilities living on or near
reservations.
The Committee strongly supports individual States' efforts
to provide vocational services to the disabled and recognizes
that the Vocational Rehabilitation program has helped put
millions of people back to work. The Committee is aware that
the cost of critical care and counseling services is rising,
while per capita income and population in most States is
increasing at a slower rate. The Committee notes that the
authorizing statute determines the annual increase in this
mandatory appropriation, and also specifies the allotment for
each State. The Committee recognizes that if formula
allocations for each State increased by the annual cost of
living, States would be better prepared to ensure that services
continue to be successfully rendered.
Client assistance
The Committee bill recommends $12,147,000 for the client
assistance program, $500,000 more than the fiscal year 2001
appropriation and the administration request.
The client assistance program funds State formula grants to
assist vocational rehabilitation clients or client applicants
in understanding the benefits available to them and in their
relationships with service providers. Funds are distributed to
States according to a population-based formula, except that
minimum grants of $100,000 are guaranteed to each of the 50
States, the District of Columbia, and Puerto Rico, and $45,000
is guaranteed to each of the outlying areas, if the
appropriation exceeds $7,500,000. States must operate client
assistance programs in order to receive vocational
rehabilitation State grant funds.
Training
The Committee provides $39,629,000 for training
rehabilitation personnel, the same as the 2001 appropriation
and the administration request.
The purpose of this program is to ensure that skilled
personnel are available to serve the rehabilitation needs of
individuals with disabilities. It supports training,
traineeships, and related activities designed to increase the
numbers of qualified personnel providing rehabilitation
services. The program awards grants and contracts to States and
public or nonprofit agencies and organizations, including
institutions of higher education, to pay all or part of the
cost of conducting training programs. Long-term, in-service,
short-term, experimental and innovative, and continuing
education programs are funded, as well as special training
programs and programs to train interpreters for persons who are
deaf, hard of hearing and deaf-blind.
Demonstration and training programs
The Committee bill includes $16,492,000 for demonstration
and training programs for persons with disabilities, $4,600,000
less than the fiscal year 2001 appropriation and the same as
the administration request. This program awards grants to
States and nonprofit agencies and organizations to develop
innovative methods and comprehensive services to help
individuals with disabilities achieve satisfactory vocational
outcomes. Demonstration programs support projects for
individuals with a wide array of disabilities.
The Committee is aware of the following projects and
encourages the Department to give them full and fair
consideration:
The University of New Orleans will provide support services
to meet the needs of entrepreneurs with disabilities through
its Training Research and Assistive Technology Center.
Minot State University has initiated a program designed to
meet the unique needs of persons with disabilities living in
remote rural communities through the use of telecommunications
technology and ongoing training for families and professionals.
The Virtual Reality-Based Education and Training for Deaf
and Hearing Impaired Children and Adults Project at Orange
County (FL) Public Schools allows hearing-impaired children and
adults to gain life experience skills through the use of
virtual reality and military simulation technology. The project
will also provide a medium for adults to acquire job skills and
support teacher training and professional development.
The member institutions of the Consortium for Orthotic and
Prosthetic Education and Research will develop programs
designed to improve the quality of applied orthotic and
prosthetic research and help meet the increasing demand for
provider services.
The National Literacy Center for the Visually Impaired in
Atlanta, Georgia is well suited to address the growing need to
upgrade and keep current the skills of the cadre of teachers
across the country that teach blind or visually impaired
children and adults.
The Hot Springs Rehabilitation Center continues to help
individuals with disabilities gain the vocational skills they
need to lead productive and independent lives.
The Seattle Lighthouse for the Blind will offer support-
service providers to deaf-blind citizens, improve outreach and
enhance support programs for eligible individuals.
Migrant and seasonal farmworkers
The Committee recommends $2,350,000 for migrant and
seasonal farmworkers, the same as the fiscal year 2001
appropriation and the budget request.
This program provide grants limited to 90 percent of the
costs of the projects providing comprehensive rehabilitation
services to migrant and seasonal farm workers with disabilities
and their families. Projects also develop innovative methods
for reaching and serving this population. The program
emphasizes outreach, specialized bilingual rehabilitation
counseling, and coordination of vocational rehabilitation
services with services from other sources.
Recreational programs
The Committee provides $2,596,000 for recreational
programs, the same amount as the fiscal year 2001 appropriation
and the administration request.
Recreational programs help finance activities such as
sports, music, dancing, handicrafts, and art to aid in the
employment, mobility, and socialization of individuals with
disabilities. Grants are awarded to States, public agencies,
and nonprofit private organizations, including institutions of
higher education. Grants are awarded for a 3-year period with
the Federal share at 100 percent for the first year, 75 percent
for the second year, and 50 percent for the third year.
Programs must maintain the same level of services over the 3-
year period.
Protection and advocacy of individual rights
The Committee recommends $14,000,000 for protection and
advocacy of individual rights, the same as the 2001
appropriation and the budget request.
This program provides grants to agencies to protect and
advocate for the legal and human rights of persons with
disabilities.
The Committee understands that the issue of program income
is treated differently among protection and advocacy systems
established under various Federal laws. The Committee
recommends that RSA review its policies on program income and
develop a policy that is consistent with the other Federal
agencies that administer P&A programs.
Projects with industry
The Committee bill includes $22,071,000 for projects with
industry, the same as the 2001 appropriation and the
administration request.
The projects with industry [PWI] program promotes greater
participation of business and industry in the rehabilitation
process. PWI provides training and experience in realistic work
settings to prepare individuals with disabilities for
employment in the competitive job market. Postemployment
support services are also provided. The program makes grants to
a variety of agencies and organizations, including
corporations, community rehabilitation programs, labor and
trade associations, and foundations.
Supported employment State grants
The Committee's bill includes $38,152,000 for the supported
employment State grant program, the same as the 2001
appropriation and the budget request.
This program assists persons who may have been considered
too severely disabled to benefit from vocational rehabilitation
services by providing the ongoing support needed to obtain
competitive employment. Short-term vocational rehabilitation
services are augmented with extended services provided by State
and local organizations. Federal funds are distributed on the
basis of population.
Independent living State grants
The Committee recommends $22,296,000 for independent living
State grants, which is the same as the amount appropriated in
2001 and the budget request.
The independent living State formula grants program
provides funding to improve independent living services,
support the operation of centers for independent living,
conduct studies and analysis, and provide training and
outreach.
Independent living centers
For independent living centers, the Committee bill includes
$60,000,000, an increase of $2,000,000 over the 2001
appropriation and the budget request.
These funds support consumer-controlled, cross-disability,
nonresidential, community-based centers that are designed and
operated within local communities by individuals with
disabilities. These centers provide an array of independent
living services.
Independent living services for older blind individuals
The Committee provides $20,000,000 for independent living
services to older blind individuals, the same as the 2001
appropriation and the administration request.
States participating in the program must match every $9 of
Federal funds with not less than $1 in non-Federal resources.
Assistance is provided to persons aged 55 or older to adjust to
their blindness, continue living independently and avoid
societal costs associated with dependent care. Services may
include the provision of eyeglasses and other visual aids,
mobility training, braille instruction and other communication
services, community integration, and information and referral.
These services help older individuals age with dignity,
continue to live independently and avoid significant societal
costs associated with dependent care. The services most
commonly provided by this program are daily living skills
training, counseling, the provision of low-vision devices
community integration, information and referral, communication
devices, and low-vision screening. The Committee notes that
there are 5 million Americans in this country age 55 and older
who are experiencing vision loss and that the number of
Americans in this category is expected to double in the next 30
years. The Committee recognizes the very important and cost-
effective work carried out through this program. By allowing
older individuals to remain in their homes and communities,
substantial savings are achieved. The Committee is informed
that the yearly savings to society for just 10 percent of the
clients now receiving independent living services is
$56,000,000. The Committee believes this program is deserving
of future increases.
Program improvement activities
For program improvement activities, the Committee provides
$900,000, a decrease of $1,000,000 from the 2001 appropriation
and the same as the budget request. In fiscal year 2002, funds
for these activities will continue to support technical
assistance efforts to improve the efficiency and effectiveness
of the vocational rehabilitation program and improve
accountability efforts. The funds provided are sufficient to
support ongoing program improvement activities and to support
ongoing dissemination and performance measurement activities.
Evaluation
The Committee recommends $1,000,000 for evaluation
activities, $587,000 less than the 2001 appropriation and the
same amount as the administration request.
These funds support evaluations of the impact and
effectiveness of programs authorized by the Rehabilitation Act.
The Department awards competitive contracts for studies to be
conducted by persons not directly involved with the
administration of Rehabilitation Act programs.
Helen Keller National Center
The Committee bill includes $8,717,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults, the same as
the 2001 appropriation and the budget request.
The Helen Keller National Center consists of a national
headquarters in Sands Point, NY, with a residential training
and rehabilitation facility where deaf-blind persons receive
intensive specialized services; a network of 10 regional field
offices which provide referral and counseling assistance to
deaf-blind persons; and an affiliate network of 47 agencies. At
the recommended level, the center would serve approximately 102
persons with deaf-blindness at its headquarters facility and
provide field services to approximately 1,950 individuals and
families.
National Institute on Disability and Rehabilitation Research
The Committee recommends $110,000,000 for the National
Institute on Disability and Rehabilitation Research [NIDRR],
$9,600,000 more than the amount appropriated in 2001 and the
same as the budget request.
NIDRR develops and implements a comprehensive and
coordinated approach to the conduct of research, demonstration
projects, and related activities that enable persons with
disabilities to better function at work and in the community,
including the training of persons who provide rehabilitation
services or who conduct rehabilitation research. The Institute
awards competitive grants to support research in federally
designated priority areas, including rehabilitation research
and training centers, rehabilitation engineering research
centers, research and demonstration projects, and dissemination
and utilization projects. NIDRR also supports field-initiated
research projects, research training, and fellowships.
The Committee urges the NIDRR to focus on activities to
enhance access to assistive technology for people with
disabilities, including technology-based activities, such as
technology transfer.
The Committee strongly encourages NIDDR to give priority in
awarding grants for the establishment of new rehabilitation and
research engineering centers which will aid in the
implementation of the Executive Order to implement the Supreme
Court Decision in L.C. vs. Olmstead.
The Committee recommendation supports increased funding for
the Interagency Committee on Disability Research (ICDR) and
notes that the primary purpose of the ICDR is to promote
cooperation across various government agencies in the
development and execution of disability and rehabilitation and
research activities. The Committee strongly encourages the ICDR
to enter into cooperative agreements with other ICDR members to
identify federally funded technological and scientific research
that could be applied to promote the independence of people
with disabilities and the elderly. The same Federal agencies
shall work in partnership with the private sector to develop a
plan to bring the applied technologies to the private
marketplace. The Committee also encourages ICDR to expand its
website/database for the coordination of research by various
agencies.
The Committee strongly urges NIDRR to use resource
appropriated for the Assistive Technology Development Fund to
develop new assistive technology, bring technology that has
already been developed to market and expand the availability of
existing assistive technology to people with disabilities. The
Committee believes that priority for grants should be given to
the development of technology that has a limited number of
users, or orphan technology. In addition, a portion of these
funds should be used to further the development of assistive
technology for children and students and reach the goals of
projects that were previously funded through the small business
innovation research activity of OSER's technology and media
services program.
Assistive technology
The Committee bill provides $60,884,000 for assistive
technology, an increase of $19,772,000 over the fiscal year
2001 appropriation and the same as the budget request.
The Assistive Technology Program is designed to improve
occupational and educational opportunities and the quality of
life for people of all ages with disabilities through increased
access to assistive technology services and devices. It
provides grants to States to develop comprehensive, consumer-
responsive statewide programs that increase access to, and the
availability of, assistive technology devices and services. The
National Institute on Disability and Rehabilitation Research
administers the program.
The Committee recommendation includes $34,000,000 for
activities authorized under title I of the Assistive Technology
Act (AT Act). The Committee has included bill language which
allows all State projects funded currently under title I of the
AT Act to receive minimum grants of $500,000. The bill language
also provides outlying areas minimum grants of $150,000 and
State protection and advocacy systems minimum grants of
$100,000. In fiscal year 2002, the AT Act would require 9
States to lose Federal financial support provided by title I,
at a time when States are operating in a new policy landscape
that includes the Olmstead decision, final section 508
guidelines and the Ticket to Work and Work Incentives
Improvement Act. The Committee notes that all of the grants
awarded in fiscal year 2000 for the alternative financing
program were provided to State entities receiving Federal
support under title I of the AT Act.
The Committee recommendation includes $26,884,000 to
support grants to States and technical assistance activities,
authorized under title III of the AT Act, to establish or
maintain alternative loan financing programs, an increase of
$11,884,000 over the fiscal year 2001 level. Currently, major
service programs such as Medicaid, Medicare, special education,
and vocational rehabilitation cannot meet the growing demand
for assistive technology. Loan programs offer individuals with
disabilities attractive options that significantly enhance
their ability to purchase assistive technology devices and
services.
The Committee recommendation concurs with the
administration request to make technical changes to the
alternative financing program authorized under title III of the
AT Act. The changes will eliminate the minimum grant amount and
formula allocation requirements, allow States to receive more
than 1 year of funding and enable States to be awarded more
than one grant. These changes will ensure that States are able
to take full advantage of the opportunities presented by this
program and are the same as enacted in the Department of
Education Appropriations Act, 2001. The Committee believes that
States should be allowed to utilize non-Federal resources from
any source in order to meet the match required to receive an
award to operate alternative loan programs.
Access to telework fund
The Committee bill provides $20,000,000 for the access to
telework fund, the same as the budget request. This fund is a
new program requested by the administration.
The access to telework fund is designed to increase
employment opportunities for individuals with disabilities by
providing greater access to computers and other equipment
individuals need if they decide to work from home. The fund
would provide matching funds to States to enable them to
provide loans for individuals with disabilities to purchase
computers and other equipment so that they can telework from
home. Funds appropriated are available until September 30,
2003.
The Committee encourages the Department of Education to
design the access to telework loan program in a manner which
creates the maximum incentives for people with disabilities to
participate. The Committee recognizes that the decision to
attempt to work involves a high level of risk for a person with
a disability, including the potential loss of health care
coverage and income subsidies, and that the design of the
program should take this fact into account (including the
possibility of loan forgiveness should the person's attempt to
work fail). Finally, the Committee encourages the Department to
allow States flexibility in implementation of the program to
encourage participation, including the use of any non-Federal
resources to meet the match requirement.
Special Institutions for Persons With Disabilities
American printing house for the blind
Appropriations, 2001.................................... $12,000,000
Budget estimate, 2002................................... 12,000,000
Committee recommendation................................ 14,000,000
The Committee recommends $14,000,000 for the American
Printing House for the Blind [APH], $2,000,000 above the 2001
appropriation and the budget request.
This appropriation helps support the American Printing
House for the Blind, which provides educational materials to
students who are legally blind and enrolled in programs below
the college level. The Federal subsidy provides about 49
percent of APH's total sales income. Materials are distributed
free of charge to schools and States through per capita
allotments based on the total number of students who are blind.
Materials provided include textbooks and other educational aids
in braille, large type, and recorded form and microcomputer
applications. The Committee recommendation includes sufficient
funds to continue the Accessible Textbook Initiative and
Collaborative Project.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriations, 2001.................................... $53,376,000
Budget estimate, 2002................................... 52,570,000
Committee recommendation................................ 54,976,000
The Committee recommends an appropriation of $54,976,000
for the National Technical Institute for the Deaf [NTID], an
increase of $1,600,000 over the 2001 appropriation and
$2,406,000 above the budget request.
The Institute, located on the campus of the Rochester
Institute of Technology, was created by Congress in 1965 to
provide a residential facility for postsecondary technical
training and education for persons who are deaf. NTID also
provides support services for students who are deaf, trains
professionals in the field of deafness, and conducts applied
research. Within the amount provided, $5,376,000 is for
construction.
It has come to the Committee's attention that the
administration request for the third installment towards NTID's
$14,900,000 dormitory renovations project has been reduced by a
total of $806,000 to $4,570,000. This reduction reflects the
Department's expectation that NTID raise 15 percent of the
funds required to complete the project from private sources. It
is NTID's professional judgment, based on extensive discussions
with potential donors, that they are far better served using
their very limited fundraising resources on raising funds for
scholarships, classroom technology and new academic programs.
The Committee notes that NTID has been very successful in
raising funds for these purposes over the past 5 years.
Given NTID's efforts in reducing its appropriation needs in
these other areas through fundraising, the fact that it has
already contributed $1,000,000 from its operating funds to
supplement the dormitory project and the hardship placed upon
the institution to raise private funds for this purpose, the
Committee directs the Department of Education not to impose a
matching requirement on this construction project.
GALLAUDET UNIVERSITY
Appropriations, 2001.................................... $89,400,000
Budget estimate, 2002................................... 89,400,000
Committee recommendation................................ 97,000,000
The Committee recommends $97,000,000 for Gallaudet
University, an increase of $7,600,000 above the amount
appropriated in 2001 and the budget request.
Gallaudet University is a private, nonprofit institution
offering undergraduate, and continuing education programs for
students who are deaf, as well as graduate programs in fields
related to deafness for students who are hearing-impaired. The
university conducts basic and applied research related to
hearing impairments and provides public service programs for
the deaf community.
The Model Secondary School for the Deaf serves as a
laboratory for educational experimentation and development,
disseminates models of instruction for students who are deaf,
and prepares adolescents who are deaf for postsecondary
academic or vocational education. The Kendall Demonstration
Elementary School develops and provides instruction for
children from infancy through age 15.
The Committee recommendation includes funding to enable
Gallaudet University to maintain and enhance its technological
base, continue investments in faculty and staff, and support
improvements in physical facilities, including campus security.
VOCATIONAL AND ADULT EDUCATION
Appropriations, 2001.................................... $1,825,600,000
Budget estimate, 2002................................... 1,801,660,000
Committee recommendation................................ 1,818,060,000
The Committee recommendation includes a total of
$1,818,060,000 for vocational and adult education, consisting
of $1,240,000,000 for vocational education and $556,060,000 for
adult education, and $22,000,000 for State grants for
incarcerated youth offenders. Of the total, $791,000,000 is
advanced funded for fiscal year 2003.
Vocational education
The Committee recommendation of $1,240,000,000 for
vocational education is $3,100,000 less than the fiscal year
2001 amount and $16,400,000 more than the administration's
request.
Basic grants.--The Committee has included $1,100,000,000
for basic grants, the same as the fiscal year 2001
appropriation and the administration request. Of the
recommended amount, $791,000,000 will become available on
October 1, 2002.
Funds provided under the State grant program assist States,
localities, and outlying areas to expand and improve their
programs of vocational education and provide equal access to
vocational education for populations with special needs.
Persons assisted range from secondary students in prevocational
courses through adults who need retraining to adapt to changing
technological and labor market conditions. Funds are
distributed according to a formula based on State population
and State per capita income.
Under the Indian and Hawaiian natives programs, competitive
grants are awarded to federally recognized Indian tribes or
tribal organizations and to organizations primarily serving and
representing Hawaiian natives for services that are in addition
to services such groups are eligible to receive under other
provisions of the Perkins Act.
The Committee has included bill language allowing the
Secretary to establish the set aside available for incentive
grants. Incentive grants are provided to States that exceed
their adjusted level of performance required in title I of WIA,
the Adult Education and Family Literacy Act and the Perkins
Act. The Committee requests that the Department provide a
report detailing how the incentive grant set aside is
determined for fiscal year 2002 incentive grant awards.
Tech-prep education.--The Committee recommends $106,000,000
for tech-prep programs. This is the same as the 2001
appropriation and the administration request. This program is
designed to link academic and vocational learning and to
provide a structured link between secondary schools and
postsecondary education institutions. Funds are distributed to
the States through the same formula as the basic State grant
program. States then make planning and demonstration grants to
consortia of local educational agencies and postsecondary
institutions to develop and operate model 4-year programs that
begin in high school and provide students with the
mathematical, science, communication, and technological skills
needed to earn a 2-year associate degree or 2-year certificate
in a given occupational field.
Tribally controlled postsecondary vocational
institutions.--The Committee has provided $7,000,000 on a
current-funded basis for tribally controlled postsecondary
vocational institutions, an increase of $1,400,000 over the
fiscal year 2001 level and the budget request. This program
provides grants for the operation and improvement of two
tribally controlled postsecondary vocational institutions to
ensure continued and expanded opportunities for Indian
students: United Tribes Technical College in Bismarck, North
Dakota, and Crownpoint Institute of Technology in Crownpoint,
New Mexico. Grantee institutions may use the funds for costs
connected with training teachers, providing instructional
services, purchasing equipment, administering programs, and
operating and maintaining the institution.
National programs, research.--The Committee recommends
$12,000,000 for national research programs and other national
activities, $5,500,000 less than the 2001 appropriation and the
same amount as the administration request. The National
Research Center for Career and Technical Education and the
National Dissemination Center for Career and Technical
Education are the only federally funded centers charged with
the responsibility to conduct research and provide technical
assistance to vocational educators. The results of the applied
research done by the Center inform technical assistance to
reform and improve vocational education instruction in schools
and colleges. Resources made available through this program
also are used to support a variety of activities to identify
and promote effective research-based programs and practice in
vocational education.
Tech-prep education demonstration program.--The Committee
recommendation includes $5,000,000 for this program, the same
amount as provided in fiscal year 2001. The administration did
not request funding for this program. Under this demonstration
authority, the Secretary awards grants competitively to
consortia that involve a business as a member, locate a
secondary school on the site of a community college, and seek
voluntary participation of secondary school students enrolled
such a high school. The purpose of the demonstration program is
to support development of the ``middle college'' model of high
school, which promotes higher student achievement and
postsecondary enrollment. Funds may be used for curriculum,
professional development, equipment, and other start-up and
operational costs.
Occupational and employment information program.--The
amount of $10,000,000 has been provided to continue activities
authorized by Section 118 of the Carl Perkins Act, $1,000,000
more than last year. The administration proposed to eliminate
this program. The Act requires that at least 85 percent of the
amount be provided directly to State entities to develop and
deliver occupational and career information to students, job
seekers, employers, education, employment and training
programs; make available and improve access to career
information and planning resources; equip teachers,
administrators and counselors with the skills and knowledge to
assist students and parents; and improve coordination and
communication among workforce development administrators and
planners. The remaining funds may be used for national
activities to support the efforts of the State entities,
including technical assistance, dissemination of information
promoting replication of high-quality practices, and the
development and distribution of products and related services.
Adult Education
The Committee has included $556,060,000 for adult
education, $4,440,000 less than the 2001 appropriation and the
same as the administration request.
Adult education State programs.--For adult education State
programs, the Committee recommends $540,000,000, the same
amount as the fiscal year 2001 appropriation and the
administration request. These funds are used by States for
programs to enable economically disadvantaged adults to acquire
basic literacy skills, to enable those who so desire to
complete a secondary education, and to make available to adults
the means to become more employable, productive, and
responsible citizens.
The Committee recommendation continues the English literacy
and civics education State grants set aside within the Adult
Education State grant appropriation. Within the total,
$70,000,000 is available to help States or localities affected
significantly by immigration and large limited-English
populations to implement programs that help immigrants acquire
English literacy skills, gain knowledge about the rights and
responsibilities of citizenship and develop skills that will
enable them to navigate key institutions of American life. The
amount recommended is the same as the fiscal year 2001 level
and the budget request.
The Committee has included bill language allowing the
Secretary to establish the set aside available for incentive
grants. Incentive grants are provided to States that exceed
their adjusted level of performance required in title I of WIA,
the Adult Education and Family Literacy Act and the Perkins
Act. The Committee requests that the Department provide a
report detailing how the incentive grant set aside is
determined for fiscal year 2002 incentive grant awards.
National activities.--The Committee has included
$9,500,000, a decrease of $4,500,000 from the 2001
appropriation and the same as the administration request.
National Institute for Literacy.--The Committee recommends
$6,560,000 for the National Institute for Literacy, authorized
under section 242 of the Adult Education and Family Literacy
Act, $60,000 more than the amount appropriated in 2001 and the
same as the budget request. The Institute provides leadership
and coordination for national literacy efforts by conducting
research and demonstrations on literacy, providing technical
assistance through a State capacity building grant program,
establishing and maintaining a national center for adult
literacy and learning disabilities, and awarding fellowships to
outstanding individuals in the field to conduct research
activities under the auspices of the Institute.
State grants for incarcerated youth offenders
The Committee has included $22,000,000 for a program
authorized by part D of title VIII of the Higher Education Act,
the same as the amount appropriated in fiscal year 2001 and the
administration request. This program provides grants to State
correctional education agencies to assist and encourage
incarcerated youth to acquire functional literacy, life and job
skills, through the pursuit of a postsecondary education
certificate or an associate of arts or bachelor's degree.
Grants also assist correction agencies in providing employment
counseling and other related services that start during
incarceration and continue through prerelease and while on
parole. Each student is eligible for a grant of not more than
$1,500 annually for tuition, books, and essential materials,
and not more than $300 annually for related services such as
career development, substance abuse counseling, parenting
skills training, and health education. In order to participate
in a program, a student must be no more than 25 years of age
and be eligible to be released from prison within 5 years.
Youth offender grants are for a period not to exceed 5 years, 1
year of which may be devoted to study in remedial or graduate
education.
Within the appropriation for State grants for incarcerated
youth offenders, the Committee includes $5,000,000 to continue
the prisoner literacy initiative. The Committee notes that the
extremely high rates of illiteracy or marginal reading skills
among inmates is a national problem and therefore encourages
the development of a uniform model to evaluate literacy
programs across the country.
STUDENT FINANCIAL ASSISTANCE
Appropriations, 2001.................................... $10,674,000,000
Budget estimate, 2002................................... 11,674,000,000
Committee recommendation................................ 12,284,100,000
The Committee recommends an appropriation of
$12,284,100,000 for student financial assistance, an increase
of $1,610,100,000 over the fiscal year 2001 appropriation and
$610,100,000 over the administration request.
Federal Pell Grant Program
For Pell grant awards in the 2002-2003 academic year, the
Committee recommends $10,314,000,000.
Pell grants provide need-based financial assistance that
helps low- and middle-income undergraduate students and their
families pay the costs of postsecondary education and
vocational training. Awards are determined according to a
statutory need analysis formula that takes into account a
student's family income and assets, household size, and the
number of family members, excluding parents, attending
postsecondary institutions. Pell grants are considered the
foundation of Federal postsecondary student aid.
The amount recommended is sufficient to raise the maximum
Pell grant to $4,000, the highest level in the program's
history and an increase of $250 over the maximum grant for the
2001-2002 academic year.
Federal supplemental educational opportunity grants
The Committee recommends $713,100,000 for Federal
supplemental educational opportunity grants [SEOG], an increase
of $22,100,000 above the 2001 appropriation level and the
budget request.
This program provides funds to postsecondary institutions
for need-based grants to undergraduate students. Institutions
must contribute 25 percent of SEOG awards, which are subject to
a maximum grant level of $4,000. School financial aid officers
have flexibility to determine student awards, though they must
give priority to Pell grant recipients.
Federal work-study programs
The Committee bill provides $1,011,000,000 for the Federal
Work-Study Program, the same as the 2001 level and the
administration request. This program provides grants to more
than 3,300 institutions to help an estimated 1 million
undergraduate, graduate, and professional students meet the
costs of postsecondary education through part-time employment.
Work-study jobs must pay at least the Federal minimum wage and
institutions must provide at least 25 percent of student
earnings. Institutions also must use at least 7 percent of
their grants for community-service jobs.
The Committee strongly supports continued funding for the
work colleges program authorized in section 448 of the Higher
Education Act of 1965. These funds help support comprehensive
work-service learning programs at seven work colleges, and
cooperative efforts among the work colleges to expose other
institutions of higher education to the work college concept.
Federal Perkins loans
The Committee bill includes $100,000,000 for Federal
Perkins loans capital contributions, which is the same as the
2001 appropriation and the budget request. The amount
recommended, when combined with institutional revolving funds,
would maintain the 2002 loan volume at the current estimated
level of $1,112,692,000. At this funding level nearly 700,000
loans would be made.
The Federal Perkins Loan Program supports student loan
revolving funds built up with capital contributions to about
2,000 participating institutions. Institutions use these
revolving funds, which also include Federal capital
contributions (FCC), institutional contributions equal to one-
third of the FCC, and student repayments, to provide low-
interest (5 percent) loans that help financially needy students
pay the costs of postsecondary education. The Committee has
included the amount necessary to maintain the current loan
volume level.
The Committee bill also includes $70,000,000 for loan
cancellations, an increase of $15,000,000 over the 2001 level
and amount requested by the administration. These funds
reimburse institutional revolving funds on behalf of borrowers
whose loans are cancelled in exchange for statutorily specified
types of public or military service, such as teaching in a
qualified low-income school, working in a Head Start Program,
serving in the Peace Corps or VISTA, or nurses and medical
technicians providing health care services.
Leveraging educational assistance partnership program
For the Leveraging educational assistance partnership
[LEAP] program, the Committee includes $70,000,000, an increase
of $15,000,000 over the 2001 appropriation and the
administration request. This program provides a Federal match
to States as an incentive for providing need-based grant and
work-study assistance to eligible postsecondary students.
Federally supported grants and job earnings are limited to
$5,000 per award year for full-time students.
Loan forgiveness for child care providers
The Committee recommends $1,000,000 for this demonstration
program, the same as the fiscal year 2001 appropriation and the
budget request. Under this demonstration program, Stafford and
Unsubsidized Stafford Loan borrowers under the Federal Family
Education Loan Program and the William D. Ford Direct Loan
program who have earned a degree in early childhood education
and work for 2 full years as a child care provider in a low-
income community may have a portion of their loan obligation
forgiven.
FEDERAL FAMILY EDUCATION LOAN PROGRAM
Appropriations, 2001.................................... $48,000,000
Budget estimate, 2002................................... 49,636,000
Committee recommendation................................ 49,636,000
The Committee recommends $49,636,000 for discretionary
Federal administrative expenses related to the Federal Family
Education Loan [FFEL] Program, formerly known as the Guaranteed
Student Loan Program. The amount recommended is $1,636,000 more
than the amount appropriated in fiscal year 2001 and the same
as the budget request.
Funds appropriated for Federal administrative expenses will
partially cover the fiscal year 2002 salaries and benefits,
travel, printing, contracts, and other expenses associated with
the program, including payment and claims processing, reducing
loan default costs, and program monitoring. This discretionary
administrative funding is included in the ``Federal family
education loans'' appropriation account rather than under the
Department's ``Salaries and expenses'' account pursuant to a
requirement of the Federal Credit Reform Act of 1990.
The FFEL Program is administered through State and private
nonprofit guaranty agencies that insure loans directly, collect
defaulted loans, and provide various services to lenders. The
Federal Government supports the guaranty agencies by providing
loan advances and reinsurance payments for borrower default,
death, disability, and bankruptcy. The Federal Government also
pays guaranty agencies loan processing and issuance fees out of
the FFEL subsidy and account maintenance fees in the
administrative funds under section 458 of the Higher Education
Act.
The Federal Government also pays an interest subsidy to
lenders, based on the borrower's interest rate, on behalf of
Stafford loan student borrowers while they are in school and
during certain grace and deferment periods. To be eligible for
this subsidy, students must demonstrate financial need, be
enrolled at least half time, and not be incarcerated. Federal
Stafford loans may be borrowed by eligible students, regardless
of their school year or dependency status. Borrowing limits are
tied to the extent of need, for the cost of attendance minus an
expected family contribution, and other aid as determined by a
statutory need analysis system.
An unsubsidized Stafford Loan Program for middle-income
borrowers provides federally reinsured loans to borrowers who
do not qualify for Federal interest subsidy payments under the
need-based Stafford Loan Program. Except for the interest
benefit and certain loan limits, all other terms and conditions
of the Federal Stafford Loan Program apply to the unsubsidized
Stafford loans.
Federal PLUS loans are made to parents of dependent
undergraduate students. Interest rates for PLUS loans are
usually higher than those for Federal Stafford loans, and the
Federal Government does not pay the interest during in-school,
grace, and deferment periods. No need analysis is required, but
borrowing cannot exceed cost of attendance minus other aid.
HIGHER EDUCATION
Appropriations, 2001.................................... $1,911,710,000
Budget estimate, 2002................................... 1,723,223,000
Committee recommendation................................ 1,764,223,000
The Committee recommends an appropriation of $1,764,223,000
for higher education programs, $147,487,000 less than the
fiscal year 2001 amount and $41,000,000 more than the budget
request.
Aid for institutional development
The Committee recommends $418,000,000 for aid for
institutional development authorized by titles III and V of the
Higher Education Act, $25,500,000 above the 2001 appropriation
and $6,500,000 more than the budget request.
The Committee encourages the Department to provide
technical assistance and conduct research on issues germane to
predominately and Historically Black Colleges and Universities
(HBCUs) and other institutions of higher education that have
large minority student populations, including disseminating
best practices information on the most efficient and cost-
effective uses of title III funding, reducing student loan
default rates, increasing graduation rates, and grant writing
training.
Strengthening institutions.--The Committee bill includes
$74,250,000 for the part A strengthening institutions program,
an increase of $1,250,000 over the fiscal year 2001 level and
the budget request. The part A program supports competitive, 1-
year planning and 5-year development grants for institutions
with a significant percentage of financially needy students and
low educational and general expenditures per student in
comparison with similar institutions. Applicants may use part A
funds to develop faculty, strengthen academic programs, improve
institutional management, and expand student services.
Institutions awarded funding under this program are not
eligible to receive grants under other sections of part A or
part B.
Hispanic-serving institutions [HSI].--The Committee
recommends $73,750,000 for institutions at which Hispanic
students make up at least 25 percent of enrollment, $5,250,000
more than the fiscal year 2001 level and $1,250,000 more than
the administration request. Institutions applying for title V
funds must meet the regular part A requirements and show that
at least one-half of their Hispanic students are low-income
college students. Funds may be used for acquisition, rental or
lease of scientific or laboratory equipment, renovation of
instructional facilities, development of faculty, support for
academic programs, institutional management, and purchase of
educational materials. Title V recipients are not eligible for
other awards provided under title III, parts A and B.
Strengthening historically black colleges and
universities.--The Committee provides $197,000,000 for part B
grants, $12,000,000 more than the fiscal year 2001 level and
the same as the administration request. The part B
strengthening historically black colleges and universities
[HBCU] program makes formula grants to HBCUs that may be used
to purchase equipment, construct and renovate facilities,
develop faculty, support academic programs, strengthen
institutional management, enhance fundraising activities,
provide tutoring and counseling services to students, and
conduct outreach to elementary and secondary school students.
The minimum allotment is $500,000 for each eligible
institution. Part B recipients are not eligible for awards
under part A.
The Committee encourages Historically Black Colleges and
Universities to use funds, as suggested by the Hart-Rudman
Report of 2001, to train students in the fields of math,
science, and engineering as well as to be teachers in those
fields.
Strengthening historically black graduate institutions.--
The Committee bill includes $48,000,000 for the part B, section
326 program, $3,000,000 more than the fiscal year 2001 level
and the same amount as the administration request. The section
326 program provides 5-year grants to strengthen historically
black graduate institutions [HBGIs]. The Higher Education
Amendments of 1998 increased the number of recipients to 18
named institutions, but reserved the first $26,600,000
appropriated each year to the 16 institutions included in the
previous authorization. Grants may be used for any part B
purpose and to establish an endowment.
Strengthening Alaska Native and Native Hawaiian-serving institutions
The Committee recommends $7,000,000 for this program, an
increase of $1,000,000 over the fiscal year 2001 appropriation
and the budget request. The purpose of this program is to
improve and expand the capacity of institutions serving Alaska
Native and Native Hawaiian students. Funds may be used to plan,
develop, and implement activities that encourage: faculty and
curriculum development, better fund and administrative
management, renovation and improvement of instructional
facilities, student services, and the purchase of library books
and other educational materials.
Strengthening tribally controlled colleges and universities
The Committee recommends $18,000,000 to support the Title
III program for strengthening the Nation's tribal colleges and
universities (TCUs), an increase of $3,000,000 over the fiscal
year 2001 level and the budget request. While sufficient funds
are not available to adequately address all of the needs of
these important institutions, the Committee believes that the
funds provided represent an important step in that direction.
The recommendation includes $6,000,000 for grants for
renovation and construction of facilities. The additional funds
provided for facilities grants, a program launched by the
Committee last year, will enable TCUs to begin remedying
serious structural and safety issues at these institutions.
Over the past three decades, tribally controlled colleges and
universities (TCCUs) have emerged to play a pivotal role in
meeting the educational needs of American Indian students.
Driven by the premise that education is the key to social
renewal, TCCUs have demonstrated their ability to educate
students who might not otherwise be served by mainstream
postsecondary institutions. However, TCCUs are among the most
poorly funded institutions in America. Unlike non-Indian
institutions, TCCUs cannot rely on endowments, State
appropriations or wealthy alumni to defray costs.
Fund for the improvement of postsecondary education
The Committee recommends $51,200,000 for the fund for the
improvement of postsecondary education [FIPSE], which is
$95,487,000 less than the 2001 appropriation and the same
amount as the administration request. FIPSE stimulates
improvements in education beyond high school by supporting
exemplary, locally developed projects that have potential for
addressing problems and recommending improvements in
postsecondary education. The fund is administered by an
independent board that provides small, competitive grants and
contracts to a variety of postsecondary institutions and
agencies, including 2- and 4-year colleges and universities,
State education agencies, community-based organizations, and
other non-profit institutions and organizations concerned with
education beyond high school.
The Committee recommendation includes sufficient funding
for the Shriver Peace Worker Program, Inc. to support the
establishment of the Sargent Shriver Peace Center and graduate
research fellowships, professorships, and grants and
scholarships for students related to peace studies and social
change.
The Committee recommendation for FIPSE is consistent with
the Administration request to consolidate the Learning Anytime
Anywhere program (LAAP) within the FIPSE program. The Committee
recommendation includes $22,680,000 to continue support for 63
current LAAP grantees. The Committee notes that the
administration's rationale for this action is that new projects
focused on the development and improvement of distance learning
technologies can be funded under FIPSE.
The Committee is aware of the following projects and
encourages the Department to give them full and fair
consideration:
The National Center for Health Care Informatics at Montana
Tech University will link the disciplines of information
technology and health care administration through internships
and specialized degree programs to support the job skill needs
of workers in the health care industry.
The University of Great Falls will utilize state-of-the-art
computer, video and audio equipment to provide distance
students the opportunity to access and fully participate in
university courses.
The University of New Mexico, through its nonprofit Science
and Technology Corporation, is developing an innovative core
cluster of courses at their Anderson Business School for a High
Technology Executive Training Program.
A 3-year service learning program at Eastern New Mexico
University will be designed to integrate volunteer community
service and pre-professional experiential learning with active
guided reflection into the curriculum to enhance and enrich
student learning of course material.
The California School of Professional Psychology has
developed an initiative to train doctorate level counseling
personnel and masters level school psychologists to help
participating school districts in California meet the
recommended 250 to 1 student to counselor ratio.
The Ruby Gerontology Center at California State University,
Fullerton proposes to utilize technology in delivering high-
quality training and education programs.
CADERA connects rural Americans to the new distance
education and on-line career training mainstream by
incorporating best educational methods and technologies in a
model program.
Occidental College will improve access to higher education
for non-native English speakers through the Northeast Los
Angeles College Resource Center.
California State University-Northridge will develop
specialized applications for a new entertainment engineering
curriculum.
California State University-Chico continues to develop its
polymer engineering program.
The Lifelong Learning and Technology Complex at Grambling
State University will improve academic programs offered at the
University.
Dillard University's Center for Technology, Learning and
Culture will improve preparation of minority students entering
graduate business programs.
Louisiana State University and Southern University will
establish the Center for Analytical Chemistry to focus on
developing solutions to environmental and medical research
problems.
City University plans to expand its distance learning
program in Slovakia by enhancing its technology infrastructure
and course offerings, which will enable the University to
increase student exchange programs in Eastern Europe.
The University of Washington-Tacoma is developing the
Washington Institute for Technology to address the gap between
the number of technology jobs being created within the region
and the number of college graduates with sufficient education
and training to meet this increasing employment.
Westminster College will support programs to improve
leadership among high school and college students and faculty
through innovative services provided by its Center for
Leadership Service and Churchill Summer Leadership Academy.
Logan College of Chiropractic will alter significantly the
college's instructional framework, through the use of
technology, to make college education more accessible.
Southeast Missouri State University will utilize advanced
communication and computer technology to improve curricula and
programs offered by its integrated School of Visual and
Performing Arts.
The Advanced Distributed Learning project at Middle Georgia
College has been developed to provide technology-based training
and access to educational programs to America's servicemen and
women throughout the world.
Albany Technical College in Georgia has developed an
Interactive Distance Learning Project to provide high-quality
educational opportunities in rural communities.
The Coles College of Business at Kennesaw State University
in Georgia will utilize technology to link universities across
the country to facilitate the sharing of programs, information
and materials to enhance the ongoing educational training and
development opportunities for family businesses.
The C.W. Post Campus of Long Island University has proposed
to augment its efforts in education in the arts and sciences
programs, and improve outreach to students.
The North Dakota State University will continue to address
the need for technically trained personnel through its Tech
Based Industry Traineeship program by expanding and enhancing a
program which provides post-secondary students with carefully
constructed and monitored traineeship operations in companies
in North Dakota, South Dakota and Minnesota.
Minnesota State Colleges and Universities' Emerging
Curriculum project supports the development and design of
emerging curriculum, professional development, development of
an e-monitoring environment to support e-learning needs and
formulating and implementing pilot policies for the new era of
e-learning.
Fairfield University will develop instructional technology
to improve access to and enhance the quality of its graduate
and undergraduate programs.
Darton College will establish and operate an information
and technology network that will provide underserved and
disadvantaged populations access to education opportunities and
career services in the health care and information technology
fields.
The Federation of Independent Illinois Colleges and
Universities will utilize a high bandwidth network, distance
learning technologies and innovative training programs to link
Illinois institutions and improve access to and quality of
postsecondary education.
California State University at Dominquez Hill plans to
improve academic support services for students by utilizing
digital media and advanced technologies.
The University of San Francisco has launched programs to
train adult learners for positions in the new economy and will
incorporate advanced technologies and related training in
expanded programs throughout northern California.
St. Mary's College of Maryland has developed an initiative
to enhance the technology skills of K-16 students and adult
learners through its proposed Center for Teaching and Learning
Systems.
The University of Maryland Baltimore County and Georgetown
University have proposed the shared development of advanced
degree programs to accelerated the training period of students
entering the field of biotechnology.
The Grand Valley State University Teacher Academy will
provide training and support for math and science teachers.
Lake Superior State University will develop and implement a
new degree program and utilize distance learning to increase
the number of skilled trade workers trained in new
technologies.
The Gerald R. Ford School of Public Policy at the
University of Michigan will continue to increase understanding
of public policy problems and contribute to the development of
solutions.
Finlandia University plans to improve educational programs
for nursing and teaching and other specialties that meet the
needs of rural areas.
Michigan Technological University will increase student
exposure to high-tech instructional practices and advanced
learning technologies through its Center for Microsystems
Technology.
The Lifelong Learning Center at Northwestern Michigan
College will support innovative educational partnerships
between the public and private sectors.
The Center for Teacher Preparation and Learning
Technologies at Montclair State University will provide
teachers with the most recent skills, techniques and training
for use of technology in the classroom.
Brookdale Community College has developed an innovative
approach for establishing higher education and business
training solutions in Central New Jersey.
The Plangere Center for Communication and Instructional
Technology at Monmouth University will utilize state-of-the-art
instructional technology to improve the technical skills of
communication students.
The Oregon Graduate Institute at Oregon Health Sciences
University seeks to increase student participation and
retention, particularly for those from diverse and disadvantage
backgrounds, in certificate and degree programs in
Environmental Information Technology.
New Mexico State University Cooperative Extension Service
in Las Cruces is developing a training program utilizing a
national E-commerce model to assist experienced business and
community leaders with making strategic electronic business and
community planning decisions, and establishing a network of
youth with advanced computer training to provide rural
community and rural business leaders with fundamental computer
and Internet access skills.
Salve Regina University will expand and update its distance
education efforts to serve a larger potential student market
via web links and interactive communication to courses,
services, and information.
The African Technology for Education and Workforce
Development Initiative will employ new information technologies
to deliver education and training from American universities to
Africa.
The University of Alaska and the State of Alaska propose to
establish the Alaska Digital Archives and Digital Library to
help students and others in rural and remote parts of Alaska
access historical materials and research tools relating to
Alaska's history.
The partnership of the Galena School District and the
University of Alaska-Southeast continues to develop and
implement occupation-based curriculum for students in Alaska.
The Alaska Distance Education Corsortium will serve
students throughout the entire State, regardless of how remote
the area.
The collaborative technology transfer program of the
College of Rural Alaska-Interior Aleutians and the Galena
School District continues to improve access and quality of
education.
The Barahona Center for the Study of Books in Spanish at
California State University, San Marcos' will continue its
effort to improve access to Spanish-language literature.
California State University, Northridge will implement a
new entertainment engineering curriculum.
The Oregon Institute of Technology has established a
Technology Training Program designed to integrate technology
into the lives of disadvantaged students and improve student
success.
The Early Childhood Leadership initiative of Oregon State
University will pioneer new strategies to develop
collaboration, administration and evaluation skills among early
childhood personnel.
Oregon State University will design and implement a model
program for placement of graduate students and interns within
positions of government and nonprofit agencies.
The Center for Distance Learning and Accessibility Research
at Oregon State University will develop programs that support
an integrated strategy of linking accessibility research and
distance learning technologies.
The Tides Foundation plans to support an existing
charitable program of the McKelvey Foundation which provide
entrepreneurial college scholarships to rural, low-income
Pennsylvania high school graduates who demonstrate spirit and
excellence.
Western Governors University, an online university created
by the governors of 19 western States, continues the
development of innovative distance learning programs.
The University of Idaho continues to test, evaluate, and
develop Internet-based interactive learning environments for
physically handicapped, at-risk, isolated, rural, and other
populations.
The Burns Telecommunications Center (BTC) at Montana State
University-Bozeman plans to launch a Coalition for Establishing
a National Teacher Enhancement Network, which will improve
professional development opportunities for science teachers.
The University of Idaho will continue to develop its
Advanced Computing and Modelling Laboratory in Boise, to
educate students in using new tools for research and practical
applications.
The Maine Technical College System ``Careers for ME''
project will develop a multimedia, Internet-based career
information site for careers in Maine related to programs of
the Technical Colleges.
Southern New Hampshire University in Manchester plans to
expand its high tech infrastructure and professional
development, as part of its distance learning program.
Colorado State University proposes to use an existing
network of universities to assess the software and the
technical health of solutions to common technical problems and
a research laboratory based on collaborative projects in
response to business needs disseminate the concept throughout
Colorado.
The University of Nebraska Medical Center is developing
distance education programs in Medical Technology, Radiation
Science Technology, Physical Therapy and Nursing.
Utah State University (USU) will advance science education
for all USU students through innovative applications of
distance learning.
The University of Colorado, Boulder Alliance for
Technology, Learning, and Society (ATLAS) program is developing
new curricula and teaching methods that employ leading
technologies in classrooms and through distance learning.
Montana State University in Billings is developing a pilot
project to initiate a 2-year computer science program within
the College of Technology.
University of Southern Colorado, the only comprehensive
regional university in Southern Colorado, has developed a plan
to make significant improvements to its information technology
infrastructure.
Oklahoma State University (OSU), through its School of
International Studies, is organizing OSU's intellectual capital
around international regional bureaus, a world-region focused
structure similar to that utilized by the U.S. State
Department.
``Peirce Online'', an Internet Mediated Delivered Learning
(IMDL) degree program at Peirce College in Philadelphia, helps
students reach their educational goals and earn a degree via
the flexibility of online learning.
The University of Maine offers associate and baccalaureate
programs at its three campus locations in Augusta, Bangor, and
Lewiston, Maine. UMA has developed plans for a technological
extension of existing academic courses and programs from one or
more UMA campus locations to its other locations, focusing
specifically on UMA, Lewiston-Auburn.
Lehigh University, through its Integrated Product, Project
and Process (IP3) Program involve students in all phases of the
industrial design discipline.
The Coalition for Ultrasound Education and Training is
developing a comprehensive multi-institution model distance
training network for the training of ultrasound technologists
and medical sonographers.
The Mark Hatfield School of Government at Portland State
University will enhance academic programs that support
professional development of elected officials and other
individuals associated with public and nonprofit management.
The Native American Tribal Government Center at Portland
State University will improve recruitment and retention of
Native American students and provide professional development
opportunities for Tribal governments.
The collaborative efforts of the University of Charleston
and the Clay Center for Arts and Sciences will promote access
to and effective use of technology for arts and science
education and outreach.
The Concord College Technology Center will better equip new
teachers with the technical skills essential for the
utilization of informational technologies in the classroom.
Maryland Community College Information Technology
Initiative will support collaborative efforts designed to
improve the quality and quantity of programs that train
information technology workers.
The Consortium on the Advancement of Women, Minorities and
Persons with Disabilities in Science, Engineering and
Technology will develop programs to encourage and support
women, minorities and persons with disabilities to enter and
complete programs in science, engineering and technology.
The Single Parents Support System Program at Texas College
in Tyler, Texas will provide assistance that addresses the
support needs of single parent students.
College Summit will expand programs designed to help
promising, low-income students access, persist in and complete
postsecondary education.
The University of Hawaii's efforts continue to support
development of a Globalization Research Consortium.
The Flandrau Santee Sioux Tribe will improve postsecondary
education opportunities through expansion of the higher
education assistance program.
The Standing Rock Sioux Tribe will help improve access to
opportunities in higher education for tribal members.
Lake Area Technical College proposes to integrate
interactive learning in its technical education programs.
South Dakota State University, Brookings will enhance the
programs offered by the Polytechnic Center of Excellence in the
College of Engineering.
Waukesha County Technical College and Marquette University
are developing joint curricula to train minority students in
the fields of engineering and nursing.
The Community-Based Services Training Partnership for
Adults proposes to develop curriculum to support professional
development opportunities for those social workers whose client
populations are primarily rural, impoverished, and vulnerable
adults.
Norwalk Community College will develop new information
technology courses and service learning opportunities through
its new center for excellence in information technology.
California State University at Stanislaus has developed a
proposal to address the acute regional and statewide nursing
shortage.
The University of South Dakota and Good Samaritan Society
Nursing Education/Service Partnership will support remote
learning for those interested in entering the nursing
profession.
The Connecticut State University System continues to
develop innovative initiatives for its nursing program.
The University of San Diego Institute for Advancement of
Health Policy is expanding its programs to develop more
professionally trained nurses.
Wayne State University and the University of Detroit-Mercy
Nurse will expand programs designed to prepare nurse
anesthetists.
The Nursing Center of Excellence at the University of
Vermont proposes programs designed to address rural nursing
workforce issues.
The Washington Health Foundation initiative will improve
nurse retention in the State of Washington.
The Creighton University Accelerated Nursing Program will
increase the number of well-qualified nurses in Nebraska and
Iowa.
The Ryan-Matura Library and Jandrisevits Learning Center at
Sacred Heart University will utilize new technology to improve
access to University resources for students and faculty.
Project Access, an initiative of the University of
Indianapolis, will employ advanced technologies to enable
Indiana's first generation higher education students to pursue
a degree.
The Indiana Higher Education Commission, in collaboration
with Intelenet, Indiana's telecommunication commission, will
support small Indiana colleges and universities as they develop
applications for higher-performance computer networks.
Ivy Tech State College of Indiana, through its campuses in
East Chicago and South Bend, is developing an education and
training program in machine tool technology.
The East Chicago campus of Ivy Tech State College is
developing a mortuary science degree program.
Indiana University proposes to expand the successful
Project TEAM initiative to additional campuses in the Indiana
University system.
Indiana State University, in collaboration with Bowling
Green State University, East Carolina University, University of
Wisconsin-Stout, North Carolina A&T State University and
Central Missouri State University, will create a shared
doctoral program for technology management.
The Columbia River Estuary Research Program will establish
certificate and degree programs.
The Native American Law Center at the University of
Washington School of Law provides a tremendous opportunity for
students interested in Native American issues to gain academic
and practical experience in the field.
Green River Community College is developing a program in
Communications Access Realtime Translation Services Training.
The Center for Families at Edmonds Community College is
developing curriculum for training and certificate programs in
early childhood education.
The Technology Training Center at Seminole State College
will provide a high-quality environment for dynamic and
interactive training.
Emmanuel College will continue to improve access to higher
education programs for all students.
The University of Massachusetts School of Marine Science
and Technology proposes to enhance research programs in
fisheries management, aquaculture and ocean communications and
control.
Emerson College will develop educational programs through
its Performance and Production Center.
The Assumption College Lt. Joseph P. Kennedy Jr. Science
and Technology Center will improve research and instructional
opportunities for students and faculty.
The University of Arkansas Little Rock will utilize
advanced and simulation technology to improve teaching and
learning in medical, engineering and other sciences.
The University of Arkansas Mountain Home will utilize
distance learning technology to develop and offer a new degree
program for hearing healthcare practitioners.
The Environmental Biotechnology Initiative at the
University of Rhode Island will enhance teaching, research and
outreach through programs in genomics, transgenics, imaging and
bioinformatics.
Cabrini College is developing a new Center for Science,
Education, and Technology which will provide a model elementary
education classroom to facilitate and enhance the educational
experience of Cabrini undergraduate students majoring in
education.
The Army War College is developing a major educational
center to provide research and educational programs in military
and social history.
East Stroudsburg University is planning to purchase
laboratory equipment for its degree programs in biotechnology
and chemical biotechnology at its Science and Technology
Center.
Eastern College plans to hire additional faculty and
purchase computers, printers, telecommunications equipment, and
laboratory equipment for the Center for Information, Science
and Learning Resources.
Keystone Virtual University is establishing an ``online''
Pennsylvania University.
Lehigh University is developing a Center for Promoting
Healthy Development for Individuals with Disabilities.
Temple University's Center for Research in Human
Development and Education is developing innovative models to
address teacher recruitment, training, and mentoring which will
enhance student achievement.
The George Mitchell Scholarships program is providing
scholarships to allow Americans to pursue a year of post-
graduate study at universities in Ireland.
The Benjamin L. Hooks Institute for Social Change at the
University of Memphis will pursue a broad agenda that
emphasizes the continued importance of the civil rights
movement and encourage academic research and community
outreach.
The Clinical Skills Training and Assessment Center at
Thomas Jefferson University will supplement the clinical
learning and evaluation skills of healthcare professionals.
``Project Promotion'' for Paraprofessional Educators, a
cooperative project of the Southern Penobscot Regional Program
for Children with Exceptionalities and Eastern Maine Technical
College, aims to improve the education and support for
currently employed educational technicians.
The University of Hartford-Hartt Performing Arts Education
Center will enhance educational opportunities for its students,
and improve theater and music instruction and educational
programs for area teachers and students.
The Center for Science and Technology at Dominican
University of California will improve access to and delivery of
nurse and teacher development programs, as well as other
educational opportunities at the university.
The United Negro College Fund will conduct a project for
curriculum development at historically black colleges and
universities and other institutions to develop the capacity of
these entities to prepare minority students for careers in
international affairs and business and the global employment
market.
Urban College will continue its efforts to provide
affordable continuing education for nontraditional students
through tutoring and other supportive services.
The University of Detroit Mercy will improve its
information technology infrastructure to provide students and
faculty with an enhanced learning environment.
The Center for International Education and Entrepreneurship
at Ramapo College would expand the offerings of international,
intercultural and global courses and related services.
The Technology Center at Mountain State University will
improve its information technology infrastructure and establish
interactive classrooms for students to improve training and
education programs for students to create their own electronic
business opportunities.
Pittsburgh Digital Greenhouse is continuing to develop a
state-of-the-art, high-tech curriculum in a collaborative
effort with three member universities--Penn State, University
of Pittsburgh and Carnegie Mellon Contact--to train university
students. This initiative will further enhance the high tech
talent pool (which is in short supply) in the Allegheny County
area.
Shippensburg University is wiring its computers for the
Performing Arts Center.
Wilson College is expanding and developing the ``Women with
Children Program,'' which assists single women with children in
earning a degree, becoming financially independent, and raising
the children's aspirations for educational accomplishment.
Westchester University plans to develop curriculum for the
University's Business and Information Technology Center.
The partnership of Jackson State University, located in
Jackson, Mississippi, with three other Historically Black
Universities, Alabama A&M, Prairie View A&M University in Texas
and Southern University and A&M College in Louisiana, will
establish four Minority Centers of Excellence for Math &
Science Teacher Preparation. This concerted effort to prepare
minority teachers of math and science will help reduce the
disproportionate representation of minorities in the math and
science teaching field, where less than 6 percent of teachers
are minorities.
Jackson State University will establish electronics-based
program to advance the Central Mississippi Communications and
Information Technology Cluster at the Mississippi e-Center.
East Central Community College, Ellisville, Mississippi
will establish a Wireless Computer Lab to enhance learning on
that campus and in that community.
The La Roche College plans to develop its Integrated
Transcultural Technology Center with information technology
features critical to 21st Century educational institutions,
including state-of-the-art ``smart'' classrooms.
Minority science and engineering improvement
The Committee recommends $8,500,000 for the minority
science and engineering improvement program [MSEIP], the same
as the fiscal year 2001 level and the administration request.
This program provides discretionary grants to institutions with
minority enrollments greater than 50 percent to purchase
equipment, develop curricula, and support advanced faculty
training. Grants are intended to improve science and
engineering education programs and increase the number of
minority students in the fields of science, mathematics, and
engineering.
International education and foreign language studies
The bill includes a total of $78,022,000 for international
education programs, the same as the fiscal year 2001 level and
the budget request.
Domestic programs.--The Committee recommends $67,000,000
for domestic program activities related to international
education and foreign language studies, including international
business education, under title VI of the HEA, the same as the
fiscal year 2001 appropriation and the administration request.
Domestic programs include national resource centers,
undergraduate international studies and foreign language
programs, international research and studies projects,
international business education projects and centers, American
overseas research centers, language resource centers, foreign
language and area studies fellowships, and technological
innovation and cooperation for foreign information access.
Overseas programs.--The bill includes $10,000,000 for
overseas programs authorized under the Mutual Educational and
Cultural Exchange Act of 1961, popularly known as the
Fulbright-Hays Act. The recommendation is the same amount as
the fiscal year 2001 level and the budget request. Under these
overseas programs, grants are provided for group and faculty
research projects abroad, doctoral dissertation research
abroad, and special bilateral projects. Unlike other programs
authorized by the Fulbright-Hays Act and administered by the
Department of State, these Department of Education programs
focus on training American instructors and students in order to
improve foreign language and area studies education in the
United States.
Institute for International Public Policy.--The Committee
bill recommends $1,022,000 for the Institute for International
Public Policy. This is the same amount as the fiscal year 2001
level and the budget request. This program is designed to
increase the number of minority individuals in foreign service
and related careers by providing a grant to a consortium of
institutions for undergraduate and graduate level foreign
language and international studies. An institutional match of
50 percent is required.
Interest subsidy grants
The Committee recommends $5,000,000 for interest subsidy
grants, $5,000,000 less than the fiscal year 2001 level and the
same as the administration request. This appropriation is
required to meet the Federal commitment to pay interest
subsidies on 124 loans made in past years for constructing,
renovating, and equipping postsecondary academic facilities. No
new interest subsidy commitments have been entered into since
1973 but subsidy payments on existing loans are expected to
continue until the year 2013.
Federal TRIO programs
The Committee bill includes $805,000,000 for Federal TRIO
programs, an increase of $75,000,000 above the fiscal year 2001
appropriation and $25,000,000 more than the administration
request.
TRIO programs provide a variety of services to improve
postsecondary education opportunities for low-income
individuals and first-generation college students: Upward Bound
offers disadvantaged high school students academic services to
develop the skills and motivation needed to continue their
education; Student Support Services provides remedial
instruction, counseling, summer programs and grant aid to
disadvantaged college students to help them complete their
postsecondary education; Talent Search identifies and counsels
individuals between ages 11 and 27 regarding opportunities for
completing high school and enrolling in postsecondary
education; Educational Opportunity Centers provide information
and counseling on available financial and academic assistance
to low-income adults who are first-generation college students;
and the Ronald E. McNair Postbaccalaureate Achievement Program
supports research internships, seminars, tutoring, and other
activities to encourage disadvantaged college students to
enroll in graduate programs.
The Committee notes that, at the budget request level,
$3,070,000 has not been allocated to any particular TRIO
program. To the extent that the Department receives highly
rated applications for funding under the Talent Search and
Educational Opportunity Centers grant competitions, the
Committee encourages the Secretary to allocate these
undistributed funds, as well as the increase provided by the
Committee, to additional or increased grants for these
programs.
Gaining early awareness and readiness for undergraduate programs [GEAR
UP]
The Committee recommends $227,000,000, a decrease of
$68,000,000 from the amount provided in fiscal year 2001 and
the same as the budget request. Under this program funds are
used by States and partnerships of colleges, middle and high
schools, and community organizations to assist middle and high
schools serving a high percentage of low-income students.
Services provided help students prepare for and pursue a
postsecondary education. The Committee notes that at the
funding level requested by the administration, all continuing
GEAR UP cohorts of low-income middle and high school students
would be fully funded.
The Committee is very concerned that the Department decided
to alter significantly its plans for awarding new grants under
the GEAR UP program. The Committee notes that the number of new
partnership grants the Department planned to award according to
the fiscal year 2001 congressional justification was 127, for
total new award funding of $58,457. The actual number of new
partnership awards made with the fiscal year 2001 appropriation
for this program was six, for total new award funding of
$42,502. The Committee's ability to respond to and act on the
budget request for a given fiscal year depends on credible and
reliable information about the rationale supporting the
request, as well as the plan for implementing the program. The
Committee strongly urges the Department to notify the Committee
not less than 3 business days prior to any grant opportunities
or notices inviting applications that include funding
priorities, competitive preferences or stated funding
availability different from what is contained in the
congressional justification.
Byrd honors scholarships
The Committee recommends $41,001,000 for the Byrd Honors
Scholarship program, the same amount as the fiscal year 2001
appropriation and the budget request.
The Byrd honors scholarship program is designed to promote
student excellence and achievement and to recognize
exceptionally able students who show promise of continued
excellence. Funds are allocated to State education agencies
based on each State's school-aged population. The State
education agencies select the recipients of the scholarships in
consultation with school administrators, teachers, counselors,
and parents. The funds provided will support a new cohort of
first-year students in 2002, and continue support for the 1999,
2000, and 2001 cohorts of students in their fourth, third and
second years of study, respectively. The amount recommended
will provide scholarships of $1,500 to 27,334 students.
Javits fellowships
The Committee recommends $10,000,000 for the Javits
Fellowships program, the same as the fiscal year 2001 amount
and the budget request.
The Javits Fellowships program provides fellowships of up
to 4 years to students of superior ability who are pursuing
doctoral degrees in the arts, humanities, and social sciences
at any institution of their choice. Each fellowship consists of
a student stipend to cover living costs, and an institutional
payment to cover each fellow's tuition and other expenses.
Funds provided in the fiscal year 2002 appropriation support
fellowships for the 2003-2004 academic year.
Graduate assistance in areas of national need [GAANN]
The Committee recommends $31,000,000 for graduate
assistance in areas of national need, the same as the fiscal
year 2001 level and the budget request. This program awards
competitive grants to graduate academic departments and
programs for fellowship support in areas of national need as
determined by the Secretary. In fiscal year 2001, the Secretary
designated the following areas of national need: biology,
chemistry, computer and information sciences, engineering,
geological and related sciences, mathematics and physics.
Recipients must demonstrate financial need and academic
excellence, and seek the highest degree in their fields.
Learning anytime anywhere partnerships
The Committee does not recommend an appropriation for the
learning anytime anywhere partnerships program (LAAP) in fiscal
year 2002. Consistent with the administration's request, the
Committee has included sufficient resources under the fund for
the improvement of postsecondary education to continue all
grants funded under this program. In fiscal year 2001,
$30,000,000 was made available for the LAAP program. Funds
support projects using technology and other innovations to
enhance the delivery of postsecondary education and lifelong
learning opportunities, especially for underserved populations
in underserved geographic areas.
The Committee notes that the administration's rationale for
not requesting funds for the LAAP program is that all of the
activities carried out under its authority can be supported
under FIPSE. The Committee expects the Department to provide
the Committee with a report documenting FIPSE grant support in
fiscal years 2001 and 2002 of projects that support the use of
technology and other innovations to enhance the delivery of
postsecondary education and lifelong learning, especially for
underserved populations in underserved geographic areas.
Teacher quality enhancement grants
The Committee recommends $54,000,000 for the teacher
quality enhancement grants program, $44,000,000 less than the
fiscal year 2001 level and the same as the budget request. The
program was established to support statewide initiatives that
best meet their specific teacher preparation and recruitment
needs. Further, the Act provides and designates funding for the
program in three focus areas: 45 percent of resources support a
State grant program, 45 percent of funds are used for a
partnership program, and 10 percent are designated for a
recruitment grant program.
The administration has requested resources sufficient to
fund only current State and partnership grantees and has not
included funding for recruitment grants nor for new awards
under this program. Further, the administration has proposed to
set aside 1.4 percent of the appropriation for two national
evaluations of the program.
The Committee recommendation is made consistent with the
budget request to fund only current State and partnership
grantees, and has therefore, included bill language overriding
the distribution requirements of section 210 of the HEA.
The Committee recommendation does not include the bill
language requested to establish a set-aside for the two
national evaluations. Instead, the Committee will provide
sufficient resources within the GPRA/HEA evaluation program for
this purpose.
Under the State grant program, funds may be used for a
variety of State-level reforms, including more rigorous teacher
certification and licensure requirements; provision of high-
quality alternative routes to certification; development of
systems to reward high-performing teachers and principals; and
development of efforts to reduce the shortage of qualified
teachers in high-poverty areas.
Teacher training partnership grants, which are awarded to
local partnerships comprised of at least one school of arts and
science, one school or program of education, a local education
agency, and a K-12 school, may be used for a variety of
activities designed to improve teacher preparation and
performance, including efforts to provide increased academic
study in a proposed teaching specialty area; to prepare
teachers to use technology effectively in the classroom; to
provide preservice clinical experiences; and to integrate
reliable research-based teaching methods into the curriculum.
Partnerships may work with other entities, with those involving
businesses receiving priority consideration. Partnerships are
eligible to receive a one-time-only grant to encourage reform
and improvement at the local level.
The recruitment grant program supports efforts to reduce
shortages of qualified teachers in high-need school districts
as well as provide assistance for high-quality teacher
preparation and induction programs to meet the specific
educational needs of the local area.
Child care means parents in schools
The Committee recommends an appropriation of $25,000,000
for the Child Care Access Means Parents in School (CAMPUS)
program, the same amount as the 2001 appropriation and the
budget request. This program was established in the Higher
Education Amendments of 1998 to support the efforts of a
growing number of non-traditional students who are struggling
to complete their college degrees at the same time that they
take care of their children. Discretionary grants of up to 4
years are made to institutions of higher education to support
or establish a campus-based childcare program primarily serving
the needs of low-income students enrolled at the institution.
Demonstration projects to ensure quality higher education for students
with disabilities
The Committee recommends $7,000,000 for this program, an
increase of $1,000,000 over the fiscal year 2001 appropriation
and $7,000,000 over the budget request. This program's purpose
is to ensure that students with disabilities receive a high-
quality postsecondary education. Grants are made to support
model demonstration projects that provide technical assistance
and professional development activities for faculty and
administrators in institutions of higher education.
Underground railroad program
The Committee recommendation includes $2,000,000 for the
Underground Railroad program, an increase of $250,000 over the
fiscal year 2001 amount. The administration did not request any
resources for this program. The program was newly authorized by
the Higher Education Amendments of 1998 and was funded for the
first time in fiscal year 1999. Grants are provided to
research, display, interpret, and collect artifacts relating to
the history of the underground railroad. Educational
organizations receiving funds must demonstrate substantial
private support through a public-private partnership, create an
endowment fund that provides for ongoing operation of the
facility, and establish a network of satellite centers
throughout the United States to share information and teach
people about the significance of the underground railroad in
American history.
Web-based Education Commission
The Committee recommendation does not include funding for
this program, the same as the budget request. The fiscal year
2001 appropriation for the Commission was $250,000. The Web-
based Education Commission was established by Congress to
conduct a thorough study to assess the educational software
available in retail markets for secondary and postsecondary
education students who choose to use such software. In December
2000, the Commission completed its work when it released its
report, ``The Power of the Internet for Learning: Moving from
Promise to Practice.''
GPRA/Higher Education Act Program Evaluation
The Committee recommends $1,500,000 for the Government
Performance and Results Act data collection and for the Higher
Education Act Program Evaluation program, $1,500,000 less than
the fiscal year 2001 appropriation and $500,000 more than the
budget request. The administration requested these funds to
comply with the Government Performance and Results Act, which
requires the collection of data and evaluation of Higher
Education programs and the performance of recipients of Higher
Education funds. Additional resources have been provided to
continue support for evaluations of the teacher quality
enhancements grants program.
Thurgood Marshall legal educational opportunity program
The Committee recommendation does not include funding for
this program, the same as the budget request. The $4,000,000
appropriated for fiscal year 2001 will be used to provide
minority, low-income or disadvantaged college students with the
information, preparation, and financial assistance needed to
gain access to and complete law school study.
B.J. Stupak Olympic scholarships
The Committee recommendation does not include funding for
this program, the same as the budget request. The $1,000,000
appropriated for fiscal year 2001 will be used to provide
financial assistance to athletes who are training at the United
States Olympic Education Center or one of the United States
Olympic Training Centers and who are pursuing a postsecondary
education at an institution of higher education.
howard university
Appropriations, 2001.................................... $232,474,000
Budget estimate, 2002................................... 232,474,000
Committee recommendation................................ 232,474,000
The Committee recommends an appropriation of $232,474,000
for Howard University, which is the same as the fiscal year
2001 appropriation and the budget request. Howard University is
located in the District of Columbia and offers undergraduate,
graduate, and professional degrees through 12 schools and
colleges. The university also administers the Howard University
Hospital, which provides both inpatient and outpatient care, as
well as training in the health professions. Federal funds from
this account support about 53 percent of the university's
projected educational and general expenditures, excluding the
hospital. The Committee agrees with the administration and
recommends, within the funds provided, $3,600,000 for the
endowment program.
Howard University Hospital.--Within the funds provided, the
Committee recommends $30,374,000 for the Howard University
Hospital, the same as the fiscal year 2001 level and the budget
request. The hospital serves as a major acute and ambulatory
care center for the District of Columbia and functions as a
major teaching facility attached to the university that trains
physicians in 25 specialty areas. The Federal appropriation
provides partial funding for the hospital's operations.
college housing and academic facilities loans
Appropriations, 2001.................................... $762,000
Budget estimate, 2002................................... 762,000
Committee recommendation................................ 762,000
Federal administration.--The Committee bill includes
$762,000 for Federal administration of the CHAFL program, the
same as the 2001 level and the same as the administration
request.
These funds will be used to reimburse the Department for
expenses incurred in managing the existing CHAFL loan portfolio
during fiscal year 2002. These expenses include salaries and
benefits, travel, printing, contracts (including contracted
loan servicing activities), and other expenses directly related
to the administration of the CHAFL Program.
historically black college and university capital financing program
Appropriations, 2001.................................... $208,000
Budget estimate, 2002................................... 208,000
Committee recommendation................................ 208,000
Federal administration.--The Committee recommends $208,000
for Federal administration of the Historically Black College
and University [HBCU] Capital Financing Program, the same as
the fiscal year 2001 level and the administration request.
The HBCU Capital Financing Program makes capital available
to HBCUs for construction, renovation, and repair of academic
facilities by providing a Federal guarantee for private sector
construction bonds. Construction loans will be made from the
proceeds of the sale of the bonds.
education research, statistics, and assessment
Appropriations, 2001.................................... $383,367,000
Budget estimate, 2002................................... 382,120,000
Committee recommendation................................ 431,567,000
The bill includes $431,567,000 for educational research,
statistics, assessment, and improvement programs. This amount
is $48,200,000 more than the fiscal year 2001 appropriation and
$49,447,000 more than the budget request. This account supports
education research, statistics, and assessment activities, as
well as a variety of other discretionary programs for
educational improvement.
Research, development, and dissemination
The Committee recommends $120,567,000 for educational
research and national dissemination activities. This amount is
the same as the fiscal year 2001 appropriation and $2,500,000
less than the budget request. The Committee has also included
$65,000,000 for regional educational laboratories, the same as
the fiscal year 2001 appropriation and the budget request.
These activities are administered by the Office of Educational
Research and Improvement (OERI).
These funds support research, development, dissemination,
and technical assistance 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 $80,000,000 for data-gathering and
statistical-analysis activities of the National Center for
Education Statistics (NCES), the same as the fiscal year 2001
appropriation and $5,000,000 less than the budget request.
NCES collects, analyzes, and reports statistics on
education in the United States. Activities are carried out
directly and through grants and contracts. The Center collects
data on educational institutions at all levels, longitudinal
data on student progress, and data relevant to public policy.
Technical assistance to State and local education agencies and
postsecondary institutions is also provided by the Center.
Assessment
The Committee recommends $109,000,000 for assessment. This
amount is $53,000 less than the budget request and $69,000,000
more than the fiscal year 2001 appropriation.
The National Center for Education Statistics uses these
funds to administer the National Assessment of Educational
Progress (NAEP), a congressionally mandated assessment created
to measure the educational achievement of American students.
The primary goal of NAEP is to determine and report the status
and trends over time in educational achievement, subject by
subject. NAEP has been expanded in recent years to include
State representative assessments as well.
The Committee encourages the Department to consider
conducting a feasibility study for a trial urban assessment of
the National Assessment of Educational Progress. This study
would involve up to five voluntarily participating large urban
school districts.
Within these funds, the Committee recommends $4,000,000 for
the National Assessment Governing Board (NAGB), the same as the
fiscal year 2001 appropriation and $53,000 less than the budget
request. The NAGB is responsible for formulating policy for
NAEP.
International education exchange
The Committee provides $12,000,000 to the Center for Civic
Education and the National Council on Economic Education for
the International Education Exchange program, which was
authorized by the Senate-passed version of H.R. 1. This amount
is $2,000,000 more than the fiscal year 2001 appropriation. The
administration requested no funds for this program. These funds
are intended, in part, to sustain current activities in Bosnia-
Herzegovina and the civic education program in Ireland and
Northern Ireland. The Committee further intends that $2,000,000
of the funds be reserved to expand and strengthen the civic
education and the economics education programs currently
underway in Russia.
Civic education
The Committee recommends $15,000,000 for the Center for
Civic Education. This amount is $3,000,000 more than the fiscal
year 2001 appropriation. The administration recommended
eliminating this program by consolidating it into its proposed
Choice and Innovation State Grants program. The civic education
program provides a course of instruction at the elementary and
secondary level on the basic principles of our constitutional
democracy and the history of the Constitution and the Bill of
Rights. Funds also may be used to provide advanced training for
teachers concerning the Constitution and the Bill of Rights.
The Committee intends that $1,500,000 of the amount
provided be used to continue the violence prevention
demonstration program and $500,000 be used to conduct a Native
American civic education initiative.
Javits gifted and talented students education
The Committee has included $15,000,000 for the Javits
Gifted and Talented Students Education Program. This amount is
$7,500,000 more than the fiscal year 2001 appropriation. The
administration recommended eliminating this program by
consolidating it into its proposed Choice and Innovation State
Grants program.
The Javits program authorizes awards to State and local
education agencies, institutions of higher education, and
public and private agencies for research, demonstration, and
training activities designed to enhance the capability of
elementary and secondary schools to meet the special
educational needs of gifted and talented students. Priority is
given to projects that identify and serve gifted and talented
students who may not be identified and served through
traditional assessment methods, including those who are
economically disadvantaged or limited-English-proficient, or
have disabilities. Some funds are set aside for a national
center for research and development in the education of gifted
and talented children and youth, which conducts research on
methods and techniques for identifying and teaching gifted and
talented students. The Committee intends that the additional
funding provided be used to award grants to State educational
agencies, regional educational service centers and local
educational agencies to expand programs for gifted and talented
students.
National Writing Project
The Committee bill provides $15,000,000 for the National
Writing Project. This amount is $5,000,000 more than the fiscal
year 2001 appropriation. The administration recommended
eliminating this program by consolidating it into its proposed
Choice and Innovation State Grants program.
These funds are awarded to the National Writing Project in
Berkeley, Calif., which in turn funds projects in 47 States,
Washington, D.C., and Puerto Rico, to train teachers of all
subjects how to teach effective writing.
The writing project is the only federally funded program
for the teaching of writing skills at all grade levels.
Departmental Management
PROGRAM ADMINISTRATION
Appropriations, 2001.................................... $412,196,000
Budget estimate, 2002................................... 424,212,000
Committee recommendation................................ 424,212,000
The Committee recommends $424,212,000 for program
administration, $12,016,000 more than the fiscal year 2001
appropriation and the same as the budget request.
Funds support personnel compensation and benefits, travel,
rent, communications, utilities, printing, equipment and
supplies, automated data processing, and other services
required to award, administer, and monitor approximately 170
Federal education programs. Support for program evaluation and
studies and advisory councils is also provided under this
activity.
OFFICE FOR CIVIL RIGHTS
Appropriations, 2001.................................... $75,822,000
Budget estimate, 2002................................... 79,934,000
Committee recommendation................................ 79,934,000
The Committee bill includes $79,934,000 for the Office for
Civil Rights [OCR], $4,112,000 more than the fiscal year 2001
appropriation and the same as the budget request.
The Office for Civil Rights is responsible for the
enforcement of laws that prohibit discrimination on the basis
of race, color, national origin, sex, disability, and age in
all programs and institutions funded by the Department of
Education. To carry out this responsibility, OCR investigates
and resolves discrimination complaints, monitors desegregation
and equal educational opportunity plans, reviews possible
discriminatory practices by recipients of Federal education
funds, and provides technical assistance to recipients of funds
to help them meet civil rights requirements.
OFFICE OF THE INSPECTOR GENERAL
Appropriations, 2001.................................... $36,411,000
Budget estimate, 2002................................... 38,720,000
Committee recommendation................................ 38,720,000
The Committee recommends $38,720,000 for the Office of the
Inspector General, $2,309,000 more than the fiscal year 2001
appropriation and the same as the budget request.
The Office of the Inspector General has the authority to
investigate all departmental programs and administrative
activities, including those under contract or grant, to prevent
and detect fraud and abuse, and to ensure the quality and
integrity of those programs. The Office investigates alleged
misuse of Federal funds, and conducts audits to determine
compliance with laws and regulations, efficiency of operations,
and effectiveness in achieving program goals.
General Provisions
The Committee bill contains language which has been
included in the bill since 1974, prohibiting the use of funds
for the transportation of students or teachers in order to
overcome racial imbalance (sec. 301).
The Committee bill contains language included in the bill
since 1977, prohibiting the transportation of students other
than to the school nearest to the student's home (sec. 302).
The Committee bill contains language which has been
included in the bill since 1980, prohibiting the use of funds
to prevent the implementation of programs of voluntary prayer
and meditation in public schools (sec. 303).
The Committee bill includes a provision giving the
Secretary of Education authority to transfer up to 1 percent of
any discretionary funds between appropriations (sec. 304).
TITLE IV--RELATED AGENCIES
Armed Forces Retirement Home Board
Appropriations, 2001.................................... $69,832,000
Budget estimate, 2002................................... 71,440,000
Committee recommendation................................ 71,440,000
The Committee recommends authority to expend $71,440,000
from the Armed Forces Home Trust Fund to operate and maintain
the United States Soldiers' and Airmen's Home and the United
States Naval Home. This amount is equal to the budget request.
Corporation for National and Community Service
Domestic Volunteer Service Programs
Appropriations, 2001.................................... $303,850,000
Budget estimate, 2002................................... 316,850,000
Committee recommendation................................ 321,276,000
The Committee recommends an appropriation of $321,276,000
for the domestic volunteer service programs of the Corporation
for National and Community Service. The Committee
recommendation is $17,426,000 above the fiscal year 2001
comparable level, and $4,426,000 more than the budget request.
The Committee applauds the Corporation and its programs--
AmeriCorps, VISTA, and the National Senior Volunteer Corps--for
their exemplary work in support of the relief efforts following
the terrorist attacks on New York City and the Pentagon.
AmeriCorps members, VISTA volunteers and National Senior
Service Corps volunteers helped coordinate blood drives,
collected food and clothing for victims' families, and provided
valuable support to the American Red Cross in this time of
need.
The Committee recognizes that coordination of National
Senior Volunteer Corps activities with other senior initiatives
is critical to avoid duplication and maximize the potential of
scarce Federal, State, local, and private resources to serve
our Nation's elderly population. The Committee directs the
Assistant Secretary of the Administration on Aging and the
Chief Executive Officer of the Corporation for National Service
to coordinate activities under the National Family Caregiver
Support program of the Older Americans Act in a way that
maximizes the ability of local communities to meet the
burgeoning need for home and community-based care for seniors
and respite care for caregivers. The Senior Companion Program
authorized under the Domestic Volunteer Service Act,
specifically, has been providing in-home services to homebound
seniors, respite services to their families, and more for three
decades. And volunteers under the Retired and Senior Volunteer
Program provide hundreds of thousands of hours annually to
homebound seniors and their families. The Committee notes that
coordination between area agencies on aging and these grantees,
particularly those sponsored by groups other than senior
organizations, can serve to strengthen the infrastructure of
support available in communities throughout the country and in
doing so, provide seniors and their families greater access to
much-needed services.
The Corporation for National Service has a network of State
offices that provide accountability, oversight, and technical
assistance for National Senior Volunteer Corps and the VISTA
programs. The Committee commends the work of the State offices
for providing the support structure for thousands of volunteers
nationwide. The Corporation also supports governor-appointed
State commissions on national and community service that
administer the AmeriCorps program. These state commissions
provide direction that allows AmeriCorps to respond efficiently
to local needs and priorities. The Committee requests a report
by March 31, 2002 on the division of responsibilities between
the CNS State offices and the State commissions and how these
two entities are functioning in the States. The report should
include an examination of the unique ways both the State
offices and State commissions can best serve communities in the
future.
VISTA
The Committee bill provides $86,500,000 for the Volunteers
in Service to America (VISTA) Program, $3,426,000 above the
fiscal year 2001 level and $4,426,000 above the budget request.
VISTA is a 36-year-old program which provides capacity
building for small community-based organizations. VISTA
volunteers raise resources for local projects, recruit and
organize volunteers, and establish and expand local community-
based programs in housing, employment, health, and economic
development activities.
National Senior Volunteer Corps
The Committee bill provides $202,547,000 for the National
Senior Volunteer Corps programs, $14,000,000 above the fiscal
year 2001 level and equal to the budget request.
The Committee has included $400,000 for senior
demonstration programs. The Committee has provided these
resources solely for the purpose of continuing grants for
existing demonstration activities and its recommendation does
not include resources for any new grants or activities.
The Committee recognizes the valuable contributions of
seniors participating in the Foster Grandparent (FGP), Retired
and Senior Volunteer (RSVP) and Senior Companion Programs
(SCP). In accordance with the Domestic Volunteer Service Act
(DVSA), the Committee intends that at least one-third of each
program's increase over the fiscal year 2001 level shall be
used to fund Program of National Significance (PNS) expansion
grants to allow existing FGP, RSVP and SCP programs to expand
the number of volunteers serving in areas of critical need as
identified by Congress in the DVSA. Within the appropriation,
sufficient funding has been included to provide adequate
resources for administrative cost increases realized by all
current grantees in each DVSA program. Remaining funds should
be used to begin new FGP, RSVP and SCP programs in geographic
areas currently underserved. The Committee expects these
projects to be awarded via a nationwide competition among
potential community-based sponsors.
Foster Grandparent Program
The Committee recommends $102,868,000 for the Foster
Grandparent Program, $4,000,000 above the fiscal year 2001
appropriations level and equal to the budget request.
This program provides volunteer opportunities to seniors
age 60 and over who serve at-risk youth. This program involves
seniors in their communities and provides a host of services to
children.
Senior Companion Program
For the Senior Companion Program, the Committee bill
includes $44,395,000, an increase of $4,000,000 over the fiscal
year 2001 appropriations level and equal to the budget request.
This program enables senior citizens to provide personal
assistance and companionship to adults with physical, mental,
or emotional difficulties. Senior companions provide vital in-
home services to elderly Americans who would otherwise have to
enter nursing homes. The volunteers also provide respite care
to relieve care givers.
The Committee recognizes the work of the Civic Venture's
Experience Corps in developing a model program that mobilizes
the time, talent, and experience of older adults in service to
the younger generation. The Committee encourages the
Corporation to give full and fair consideration to this
project, in particular its activities in Indianapolis, Indiana.
Retired and Senior Volunteer Program
The Committee bill provides $54,884,000 for the Retired and
Senior Volunteer Program (RSVP), $6,000,000 above the fiscal
year 2001 level and equal to the budget request.
This program involves persons age 55 and over in volunteer
opportunities in their communities.
The Committee recognizes the work of the Nevada Rural
Counties RSVP Home Companion Program in assisting seniors in
rural areas remain in their homes.
Program support
The Committee bill includes $32,229,000 for program
support, equal to the fiscal year 2001 appropriation and the
budget request.
Corporation for Public Broadcasting
Appropriations, 2000.................................... $350,000,000
Appropriations, 2001.................................... 365,000,000
Budget estimate, 2002...................................................
Committee recommendation................................ 395,000,000
The Committee recommends an appropriation of $395,000,000
for the Corporation for Public Broadcasting (CPB), an advance
appropriation for fiscal year 2004. This amount is $30,000,000
more than the fiscal year 2003 appropriation and $395,000,000
more than the budget request.
In addition, the Committee recommends $25,000,000 for the
conversion to digital broadcasting. The recommendation is
$5,000,000 above the administration request for fiscal year
2002 and 2001.
The Committee encourages CPB to explore new methodologies
for distribution of Federal matching dollars which take into
account measures such as per capita support and other factors
that would serve to level the playing field between urban and
rural stations in the distribution of matching funds.
Federal Mediation and Conciliation Service
Appropriations, 2001.................................... $38,200,000
Budget estimate, 2002................................... 39,482,000
Committee recommendation................................ 40,482,000
The Committee recommends an appropriation of $40,482,000
for the Federal Mediation and Conciliation Service (FMCS),
$2,282,000 above the fiscal year 2001 appropriation and
$1,000,000 more than the budget request.
The Committee commends FMCS for their work to prevent youth
violence by teaching students mediation and conflict resolution
techniques. Additional funds have been included to continue and
expand this important work.
The FMCS was established by Congress in 1947 to provide
mediation, conciliation, and arbitration services to labor and
management. FMCS is authorized to provide dispute resolution
consultation and training to all Federal agencies.
Federal Mine Safety and Health Review Commission
Appropriations, 2001.................................... $6,320,000
Budget estimate, 2002................................... 6,939,000
Committee recommendation................................ 6,939,000
The Committee recommends an appropriation of $6,939,000 for
the Federal Mine Safety and Health Review Commission, an
increase of $619,000 over the fiscal year 2001 appropriation
and the same as the budget request.
The Federal Mine Safety and Health Review Commission
provides administrative trial and appellate review of legal
disputes under the Federal Mine Safety and Health Act of 1977.
The five-member Commission provides administrative appellate
review of the Commission's administrative law judge decisions.
National Foundation on the Arts and the Humanities
Institute of Museum and Library Service
Office of Library Services: Grants and Administration
Appropriations, 2001.................................... $207,469,000
Budget estimate, 2002................................... 168,078,000
Committee recommendation................................ 168,078,000
The Committee recommends an appropriation of $168,078,000
for the Office of Library Services: Grants and Administration.
This is $39,391,000 less than the 2001 level and equal to the
administration request.
Office of Library Services State Grants
The Committee recommends $151,955,000 for State grants.
Funds are provided to States by formula to carry out 5-year
State plans. These plans must set goals and priorities for the
State consistent with the purpose of the act, describe
activities to meet the goals and priorities and describe the
methods by which progress toward the goals and priorities and
the success of activities will be evaluated. States may
apportion their funds between two activities, technology and
targeted services. For technology, States may use funds for
electronic linkages among libraries, linkages to educational,
social and information services, accessing information through
electronic networks, or link different types of libraries or
share resources among libraries. For targeted services, States
may direct library and information services to persons having
difficulty using a library, underserved urban and rural
communities, and children from low income families. Within the
total recommended, $2,941,000 has been provided for library
services to Native Americans and Native Hawaiians.
National leadership projects
The Committee recommends $11,081,000 for national
leadership projects. These funds support activities of national
significance to enhance the quality of library services
nationwide and to provide coordination between libraries and
museums. Activities are carried out through grants and
contracts awarded on a competitive basis to libraries,
agencies, institutions of higher education and museums.
Priority is given to projects that focus on education and
training of library personnel, research and development for the
improvement of libraries, preservation, digitization of library
materials, partnerships between libraries and museums and other
activities that enhance the quality of library services
nationwide.
The following programs under this account have been brought
to the Committee's attention. The Committee believes that each
will support improvements to the quality of services provided
to communities, consistent with the priorities of the
Institute. The Committee encourages the Department to give each
of the following projects full and fair consideration:
--A.E. Seaman Mineral Museum in Houghton, Michigan;
--Academy of Natural Sciences in Philadelphia to preserve
natural science specimens and provide natural science
educational programs;
--Alaska Humanities Forum for the ``Alaska 20/20'' project to
develop a long range vision and goals for Alaska's
future;
--Alaska Moving Image Preservation Association to inventory,
assess, and preserve historic Alaska audio visual
collections;
--Adler Center for Space Science Education and CyberSpace
Learning Center in Chicago for the development of
educational programs;
--American Helicopter Museum Education Center located in
Westchester, Pennsylvania;
--Audubon Aquarium of the Americas traveling wetlands
exhibit;
--Bishop Museum and the Alaska Native Heritage Center for the
``New Trade Winds'' project to establish an educational
and cultural demonstration project to help youth
strengthen their appreciation and knowledge of regional
heritage;
--Boston Museum of Science for the new National Center for
Informational Technology Education;
--Children's Museum in Brownsville, Texas, for renovations of
exhibits and facilities;
--City of Los Angeles Gene Autry Museum's Multicultural
Heritage Camp Immersion Program and Feria de California
to offer courses to high school seniors;
--City of Twentynine Palms in California to complete murals
and provide public outreach;
--Dallas Children's Theater to provide additional services to
at-risk children in the Dallas area;
--Delaware Valley Historic Aircraft Association to develop
educational programs related to the historic military
aircraft presently on display at the Naval Air Station
at Willow Grove;
--Discovery Square in Pennsylvania to develop science and
technology exhibits in its new cultural complex;
--Exploris in Raleigh, North Carolina to develop and evaluate
on-site learning environments, on-line programming,
curriculum and instruction materials, and faculty
training and development programs;
--Fine Arts Museums of San Francisco for educational
programming and technology improvements at the de Young
Memorial Museum;
--Franklin Pierce College in Rindge, New Hampshire for the
Life Center library project;
--Herreshoff Marine Museum/America's Cup Museum in Bristol,
Rhode Island to enhance educational staff, facilities
and resources;
--Heritage Harbor Museum in Providence, Rhode Island for
operations support to facilitate exhibit space
preparation;
--Houston Public Library for the ``Cybraries'' program to
improve public access to online information and
computer training;
--Independence Seaport Museum to develop educational
materials for K-12 students to learn about the OLYMPIA
ship, which is being preserved for Penn's Landing in
Philadelphia;
--Koahnic Broadcasting Corporation and the Alaska Humanities
Forum to record histories of Native elders and pioneers
in communities throughout Alaska, so that these
resources are not lost to future generations of
Alaskans and scholars;
--Lake Champlain Science Center in Burlington, Vermont for
the establishment of displays and collections;
--Long Island Children's Museum for the development of
exhibits to be placed in their newly renovated airplane
hangar;
--Mandan-on-a-Slant Museum in North Dakota to replace
exhibits and interpretive research;
--Monmouth University's Guggenheim Library in New Jersey to
provide computer equipment, updated wiring for computer
labs throughout the buildings and library-specific
software;
--Montshire Museum in Norwich, Vermont to help meet its added
responsibilities as the education center for the Silvio
Conte National Wildlife Refuge;
--Mystic Seaport Museum Onboard and Online program to provide
distance learners with improved orientation and content
pathways;
--National Accounting Library of the University of
Mississippi at Oxford to digitize the library of the
American Institute of Certified Public Accountants;
--National Aviary in Pittsburgh to develop the ``Conservation
Education Technology Integration Project,'' which will
provide increased internet access to environmental
education programs;
--National Liberty Museum of Philadelphia to expand its pilot
program of after-school workshops to reinforce themes
of responsible citizenship, reducing violence in
schools, and promoting racial and religious harmony;
--National Museum of Women in the Arts in Washington, D.C.
for exhibit, education and project expansions;
--North Carolina Museum of Art for cultural and educational
programming;
--North Dakota State Historical Society and the Confluence
Visitor Center in Williston, North Dakota for Lewis and
Clark exhibits;
--Oregon Museum of Science and Industry to upgrade and expand
its network and video conferencing to develop
interactive demonstrations;
--Paso del Norte Immigration Museum at the University of
Texas, El Paso to highlight the history and importance
of immigration, particularly in the American Southwest;
--Pittsburgh Children's Museum to develop educational
exhibits and programs for area K-12 schools;
--Please Touch Museum in Philadelphia to develop hands-on
learning exhibits to engage children in problem solving
activities that promote the development of cognitive,
communication and social skills;
--Princeton Public Library for technology enhancements;
--Rosa and Raymond Parks Institute for Self Development to
continue and expand its Pathways to Freedom program;
--Salem Daycare Center to enhance their Literacy & Bookmobile
project;
--ScienceSouth to develop a math, science and technology
center for South Carolina's Pee Dee region;
--Shakespeare Theatre in Massachusetts;
--Shasta County Library for technology enhancements;
--Towamencin Township's Kooker Mill Reserve Discover and
Learn Center to restore a reserve which provided
shelter to George Washington after the battle of
Germantown;
--University of Oregon Museum of Natural History Conservation
Project to survey environmental conditions in
exhibition and storage spaces as well as determine
conservation problems specific to particular artifacts;
--University of Idaho to continue to develop an archival
library and research program in the fine arts including
cataloguing, displaying, and digitally accessing
materials;
--Vermont Historical Society in Montpelier, Vermont to expand
displays, exhibits and programming;
--Wayne Arts Center to develop programs in partnership with
three area K-12 public schools to provide a community
resource for teachers and specialized workshops for
students;
--Webster University in St. Louis, Missouri to create a
centralized and technologically advanced Global Access
Library;
--Weis Earth Science Museum on the campus of the University
of Wisconsin-Fox Valley in Menasha, Wisconsin.
Administration
The Committee recommends $5,042,000 for program
administration, the same as the budget request. Funds support
personnel compensation and benefits, travel, rent,
communications, utilities, printing, equipment and supplies,
automated data processing, and other services.
Medicare Payment Advisory Commission
Appropriations, 2001.................................... $8,000,000
Budget estimate, 2002................................... 8,000,000
Committee recommendation................................ 8,500,000
The Committee recommends an appropriation of $8,500,000 for
the Medicare Payment Advisory Commission, $500,000 more than
the fiscal year 2001 appropriation and the budget request.
The Medicare Payment Advisory Commission (MedPAC) was
established by Congress as part of the Balanced Budget Act of
1997 (Public Law 105-33). Congress merged the Physician Payment
Review Commission with the Prospective Payment Assessment
Commission to create MedPAC.
The Committee is concerned by the great disparity in
Medicare per beneficiary reimbursement rates among States.
States receiving lower per beneficiary rates suffer a myriad of
problems, including rural providers that are unable to meet
operating margins, increased workforce shortages, and seniors
receiving less services and benefits.
For these reasons, the Committee has included additional
funding for MedPAC to prepare a report identifying programatic
changes that would, when taken together, ensure that on an
annual basis no State receives over 105 percent of the national
average of per beneficiary reimbursement, no State receives
under 95 percent of the national average of per beneficiary
reimbursement and the range for Geographical Payment
Classification Indices (GPCI) is restricted so that no GPCI is
greater than 1.05 or less than .95 of the standard index of
1.00. The report should include specific details on both the
necessary reimbursement rate and policy changes and the minimum
timeline for such changes to be implemented. The changes should
assure that beneficiaries are held harmless and that overall
reimbursement changes would be budget neutral. The Committee
expects to receive this report no later than June 30, 2002.
National Commission on Libraries and Information Science
Appropriations, 2001.................................... $1,495,000
Budget estimate, 2002...................................................
Committee recommendation................................ 1,495,000
The Committee recommends an appropriation of $1,495,000 for
the National Commission on Libraries and Information Science,
the same as the fiscal year 2001 appropriation and $1,495,000
more than the budget request.
The Commission determines the need for, and makes
recommendations on, library and information services, and
advises the President and Congress on the development and
implementation of national policy in library and information
sciences. The Committee is considerably disturbed over the
administration request to terminate this Commission at a time
when information science and management continue to spur the
economic growth of the Nation. The Committee, therefore, has
recommended an appropriation that will allow the Commission to
continue to play its important role in the library and
information science field.
National Council on Disability
Appropriations, 2001.................................... $2,615,000
Budget estimate, 2002................................... 2,830,000
Committee recommendation................................ 2,830,000
The Committee recommends an appropriation of $2,830,000 for
the National Council on Disability, $215,000 above the fiscal
year 2001 appropriation and the same as the budget request.
The Council is mandated to make recommendations to the
President, the Congress, the Rehabilitation Services
Administration, and the National Institute on Disability and
Rehabilitation Research, on the public issues of concern to
individuals with disabilities. The Council gathers information
on the implementation, effectiveness, and impact of the
Americans With Disabilities Act and looks at emerging policy
issues as they affect persons with disabilities and their
ability to enter or reenter the Nation's work force and to live
independently.
National Education Goals Panel
Appropriations, 2001.................................... $1,500,000
Budget estimate, 2002................................... 2,000,000
Committee recommendation................................ 2,000,000
The Committee recommends $2,000,000 for the national
education goals panel, $500,000 above the 2001 appropriation
and the same as the budget request.
Following the 1989 education summit in Charlottesville, the
Governors and President Bush agreed on education goals for the
Nation and created the National Education Goals Panel as an
accountability mechanism to monitor and report on the Nation's
progress toward reaching the goals.
National Labor Relations Board
Appropriations, 2001.................................... $216,438,000
Budget estimate, 2002................................... 221,438,000
Committee recommendation................................ 226,438,000
The Committee recommends an appropriation of $226,438,000
for the National Labor Relations Board (NLRB), $10,000,000 more
than the fiscal year 2001 comparable level and $5,000,000 more
than the budget request.
The Committee is pleased to note that the NLRB has made
significant progress, reducing the unfair labor practice case
backlog by approximately 800 cases in fiscal year 2000. While
the bulk of the increased appropriation is intended to cover
built in costs, such as the mandatory cost of living
adjustments, the Committee has included funds to continue the
effort to reduce backlogged cases.
The NLRB is a law enforcement agency which adjudicates
disputes under the National Labor Relations Act.
National Mediation Board
Appropriations, 2001.................................... $10,400,000
Budget estimate, 2002................................... 10,635,000
Committee recommendation................................ 10,635,000
The Committee recommends an appropriation of $10,635,000
for the National Mediation Board, $235,000 more than the fiscal
year 2001 appropriation and the same as the budget request.
The National Mediation Board protects interstate commerce
as it mediates labor-management relations in the railroad and
airline industries under the Railway Labor Act. The Board
mediates collective bargaining disputes, determines the choice
of employee bargaining representatives through elections, and
administers arbitration of employee grievances.
Occupational Safety and Health Review Commission
Appropriations, 2001.................................... $8,720,000
Budget estimate, 2002................................... 8,964,000
Committee recommendation................................ 8,964,000
The Committee recommends an appropriation of $8,964,000 for
the Occupational Safety and Health Review Commission, $244,000
above the fiscal year 2001 appropriation and the same as the
budget request.
The Commission serves as a court to justly and
expeditiously resolve disputes between the Occupational Safety
and Health Administration (OSHA) and employers charged with
violations of health and safety standards enforced by OSHA.
Railroad Retirement Board
dual benefits payments account
Appropriations, 2001.................................... $150,000,000
Budget estimate, 2002................................... 146,000,000
Committee recommendation................................ 146,000,000
The Committee has provided a total of $146,000,000 for dual
benefits, including $9,000,000 in income tax receipts on dual
benefits as authorized by law. The Committee recommendation is
$4,000,000 less than the fiscal year 2001 level and the same as
the budget request.
This appropriation provides for vested dual benefit
payments authorized by the Railroad Retirement Act of 1974, as
amended by the Omnibus Reconciliation Act of 1981. This
separate account, established for the payment of dual benefits,
is funded by general fund appropriations and income tax
receipts of vested dual benefits.
Federal Payments to the Railroad Retirement Account
Appropriations, 2001.................................... $150,000
Budget estimate, 2002................................... 150,000
Committee recommendation................................ 150,000
The Committee recommends $150,000 for interest earned on
unnegotiated checks. This is the same as the fiscal year 2001
appropriation and budget request.
Limitation on Administration
Appropriations, 2001.................................... $95,000,000
Budget estimate, 2002................................... 97,700,000
Committee recommendation................................ 97,700,000
The Committee recommends an appropriation of $97,700,000
for the administration of railroad retirement/survivor benefit
programs. This amount is $2,700,000 more than the fiscal year
2001 comparable level, and the same as the budget request.
The Board administers comprehensive retirement-survivor and
unemployment-sickness insurance benefit programs for the
Nation's railroad workers and their families. This account
limits the amount of funds in the railroad retirement and
railroad unemployment insurance trust funds which may be used
by the Board for administrative expenses.
Limitation on the Office of the Inspector General
Appropriations, 2001.................................... $5,700,000
Budget estimate, 2002................................... 6,480,000
Committee recommendation................................ 6,480,000
The Committee recommends $6,480,000 for the Office of the
Inspector General, $780,000 above the 2001 appropriation and
the same as the budget request.
The Committee has included bill language to allow the
Office of the Inspector General to use funds to conduct audits,
investigations, and reviews of the Medicare program. The
Committee finds that as long as the RRB has the authority to
negotiate and administer the separate Medicare contract, the
RRB Inspector General should not be prohibited from using funds
to review, audit, or investigate the RRB's separate Medicare
contract.
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriations, 2001.................................... $20,400,000
Budget estimate, 2002................................... 434,400,000
Committee recommendation................................ 434,400,000
The Committee recommends an appropriation of $434,400,000
for payments to Social Security trust funds, the same as the
administration request. This amount reimburses the old age and
survivors and disability insurance trust funds for special
payments to certain uninsured persons, costs incurred
administering pension reform activities, and the value of the
interest for benefit checks issued but not negotiated. This
appropriation restores the trust funds to the same financial
position they would have been in had they not borne these
costs, properly charged to the general funds.
The increase includes $414,000,000 for the quinquennial
adjustment to reimburse the OASI trust funds for the costs of
granting noncontributory wage credits for military service.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriations, 2001.................................... $365,748,000
Budget estimate, 2002................................... 332,840,000
Committee recommendation................................ 332,840,000
The Committee recommends an appropriation of $332,840,000
for special benefits for disabled coal miners. This is in
addition to the $114,000,000 appropriated last year as an
advance for the first quarter of fiscal year 2002. The
recommendation is the same as the administration request. These
funds are used to provide monthly benefits to coal miners
disabled by black lung disease and to their widows and certain
other dependents, as well as to pay related administrative
costs.
The Social Security Administration holds primary
responsibility for claims filed before July 1973, with the
Department of Labor responsible for claims filed after that. By
law, increases in black lung benefit payments are tied directly
to Federal pay increases. The year-to-year decrease in this
account reflects a declining beneficiary population.
The Committee recommends an advance appropriation of
$108,000,000 for the first quarter of fiscal year 2003, the
same as the administration request. These funds will ensure
uninterrupted benefit payments to coal miners, their widows,
and dependents.
SUPPLEMENTAL SECURITY INCOME
Appropriations, 2001.................................... $23,344,000,000
Budget estimate, 2002................................... 21,576,412,000
Committee recommendation................................ 21,577,412,000
The Committee recommends an appropriation of
$21,577,412,000 for supplemental security income. This is in
addition to the $10,470,000,000 appropriated last year as an
advance for the first quarter of fiscal year 2002 and includes
funds for continuing disability reviews. The recommendation is
$1,000,000 more than the administration's request and
$1,766,588,000 less than the fiscal year 2001 level. The
Committee also recommends an advance appropriation of
$10,790,000,000 for the first quarter of fiscal year 2003 to
ensure uninterrupted benefits payments.
These funds are used to pay benefits under the SSI Program,
which was established to ensure a Federal minimum monthly
benefit for aged, blind, and disabled individuals, enabling
them to meet basic needs. It is estimated that approximately
6.4 million persons will receive SSI benefits each month during
fiscal year 2002. In many cases, SSI benefits supplement income
from other sources, including Social Security benefits. The
funds are also used to reimburse the Social Security trust
funds for the administrative costs for the program with a final
settlement by the end of the subsequent fiscal year as required
by law, to reimburse vocational rehabilitation agencies for
costs incurred in successfully rehabilitating SSI recipients
and for research and demonstration projects.
Beneficiary services
The Committee recommendation includes $37,412,000 for
beneficiary services, which is the same as the administration
request and $33,588,000 less than the fiscal year 2001 level.
This appropriation added to carryover funding of approximately
$38,000,000 will bring the fiscal year 2002 program funding
level to approximately $75,000,000. This amount is available
for reimbursement of State vocational rehabilitation agencies
and alternate public or private providers. In 1994 SSA
published a regulation permitting direct reimbursement of
alternate public and private providers to provide vocational
rehabilitation services. Vocational rehabilitation services are
now more readily available to a larger number of people with
disabilities, since the regulation allows SSA to use an
alternate public or private sector provider, if a State
vocational rehabilitation agency has not accepted an SSA-
referred person for services or extended evaluation.
Research and demonstration projects
The Committee recommendation includes $37,000,000 for
research and demonstration projects conducted under sections
1110 and 1115 of the Social Security Act. This is $7,000,000
more than the fiscal year 2001 level and the administration
request.
This amount will support SSA's efforts to strengthen its
policy evaluation capability and focus on research of: program
solvency issues, the impact of demographic changes on future
workloads and effective return-to-work strategies for disabled
beneficiaries.
The Committee has added $7,000,000 to the Administration's
request in order to enable SSA to implement Section 1144 of the
Social Security Act. This section requires the Commissioner of
Social Security to conduct outreach efforts to identify
individuals who may be eligible for payment of the cost of
medicare cost-sharing under the medicaid program. This
outreach, including notices to individuals and States of an
individual's potential eligibility, will be evaluated by the
General Accounting Office. The Committee looks forward to the
GAO report regarding SSA's efforts in this area as well as the
report's recommendations for further action.
The Committee understands that some patients with Lyme
disease and other tick-borne disorders have encountered some
difficulty when applying for assistance through SSA offices,
due to SSA employees' unfamiliarity with these illnesses. SSA
is encouraged to work on developing educational materials for
SSA employees to facilitate a better understanding of the
potential debilitating effects of these disorders. The
Committee suggests that SSA collaborate with clinicians who
have expertise on the multi-system chronic effects of Lyme, as
well as patient and voluntary communities, to accomplish this
goal.
The Committee is pleased that SSA officials have continued
to educate adjudicators at all levels of the SSA process about
the April 1999 CFS ruling (99-2p). The Committee encourages SSA
to continue these educational efforts, to ensure SSA employees
are properly informed about CFS and the functional limitations
it imposes. Finally, the Committee encourages SSA to continue
its investigation of obstacles to benefits for persons with
CFIDS, to assess the impact of the new ruling on CFS patients'
access to benefits, and to keep medical information updated
throughout all levels of the application and review process.
Administration
The Committee recommendation includes $2,627,000,000 for
payment to the Social Security trust funds for the SSI
Program's share of SSA's base administrative expenses. This is
$278,000,000 above the fiscal year 2001 level and equal to the
administration request.
Continuing Disability Reviews
The recommendation includes $200,000,000 for payments to
the Social Security trust fund to process continuing reviews
and redeterminations of the disability and nondisability
eligibility factors of entitlement for individuals receiving
supplemental security income on the basis of their disability.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriations, 2001.................................... $7,124,000,000
Budget estimate, 2002................................... 7,574,000,000
Committee recommendation................................ 7,568,000,000
The Committee recommends a program funding level of
$7,568,000,000 for the limitation on administrative expenses,
which is equal to the administration request and $444,000,000
higher than the fiscal year 2001 level.
This account provides resources from the Social Security
trust funds to administer the Social Security retirement and
survivors and disability insurance programs, and certain Social
Security health insurance functions. As authorized by law, it
also provides resources from the trust funds for certain
nontrust fund administrative costs, which are reimbursed from
the general funds. These include administration of the
supplemental security income program for the aged, blind and
disabled; work associated with the Pension Reform Act of 1984;
and the portion of the annual wage reporting work done by the
Social Security Administration for the benefit of the Internal
Revenue Service. The dollars provided also support automated
data processing activities and fund the State disability
determination services which make initial and continuing
disability determinations on behalf of the Social Security
Administration. Additionally, the limitation provides funding
for computer support, and other administrative costs.
The limitation includes $7,035,000,000 for routine
operating expenses of the agency, which is equal to the amount
requested by the President and $452,000,000 over the 2001
comparable amount. These funds, as well as those derived from
an increase in the user fees which are discussed below, cover
the mandatory costs of maintaining equipment and facilities, as
well as staffing.
The Committee has provided $433,000,000 to process
continuing reviews and redeterminations of the disability and
nondisability eligibility factors of entitlement for
individuals receiving benefits on the basis of their
disability.
The Committee commends the efforts of the Social Security
Administration in establishing and publicizing special
emergency handling procedures for claims resulting from the
terrorist attacks at the World Trade Center, the Pentagon, and
Pennsylvania, particularly in light of the obstacles faced in
the New York region. The Committee thanks the employees of the
Social Security Administration for their extraordinary efforts
in response to this crisis.
Given the limited resources, the Committee encourages the
Agency to consider the service delivery preferences of its
customers when making resource allocation decisions regarding
customer points of contact (field offices, teleservice centers,
internet-based services). The agency, as part of the
congressional justification for its fiscal year 2003 budget
request, should include information about the service delivery
preferences of current and future customers and a plan for
allocating resources to best meet their needs.
The Committee is concerned that barriers exist preventing
eligible homeless persons from applying for and receiving SSDI
and SSI benefits. The Agency is to be commended for their past
participation in the Interagency Council on the Homeless (ICH).
The mission of the Council is vital to ending homelessness by
coordinating Federal resources, reducing duplications of
service and recommending improvements in Federal programs. The
Committee strongly encourages the Agency to continue and expand
its participation in the Council, preparing an Agency-wide plan
for providing services to the homeless. This plan should
include an overview of ways for the Agency to work with non-
profit and community based organizations to assist homeless
persons in applying for and receiving much needed benefits. The
Agency should comment in its fiscal year 2003 budget request on
the status of this plan and on any efforts undertaken to assist
homeless people.
The Committee is monitoring the implementation of the
Return to Work Program created by the TWWIIA Act. The Committee
encourages the Social Security Administration to fund the
components of the program at the authorized level in fiscal
year 2002. These components include the Protection and Advocacy
System for Beneficiaries of Social Security (PABSS) and the
Benefits Planning, Assistance and Outreach Program (BPAO).
Social Security Advisory Board
The Committee has included $1,800,000 within the limitation
on administrative expenses account for the Social Security
Advisory Board for fiscal year 2002, the same level as the
administration request and the same as the fiscal year 2001
level.
User fees
In addition to other amounts provided, the Committee
recommends $100,000,000 for administrative activities funded
from user fees that were authorized in fiscal year 1998. This
is $6,000,000 less than the administration's request and an
increase of $9,000,000 over the fiscal year 2001 level.
Office of the Inspector General
Appropriations, 2001.................................... $69,444,000
Budget estimate, 2002................................... 75,000,000
Committee recommendation................................ 75,000,000
The Committee recommends $75,000,000 for activities for the
Office of the Inspector General, $5,556,000 more than fiscal
year 2001 and equal to the administration request. This
includes a general fund appropriation of $19,000,000 together
with an obligation limitation of $56,000,000 from the Federal
old-age and survivors insurance trust fund and the Federal
disability insurance trust fund.
The Committee continues to be very concerned with the many
challenges to protecting the privacy of individuals' Social
Security Numbers (SSNs). The number of complaints of identity
theft and other abuses due to the inappropriate sale or misuse
use of SSNs has risen dramatically. The Committee commends the
Office of Inspector General for their work on the inappropriate
sale and misuse of SSNs and has included additional funds above
the fiscal year 2001 appropriation to allow an expansion of
these important consumer protection efforts and to
appropriately respond to the rapidly rising number of
complaints.
U.S. Institute of Peace
Appropriations, 2001.................................... $15,000,000
Budget estimate, 2002................................... 15,207,000
Committee recommendation................................ 15,207,000
The Committee recommends an appropriation of $15,207,000
for the U.S. Institute of Peace, $207,000 more than the fiscal
year 2001 appropriation and equal to the budget request.
The Institute was established by the U.S. Institute of
Peace Act (Public Law 98-525) in 1984. The Institute is an
independent, nonprofit, national organization whose primary
mission is to promote, through scholarship and education,
international peace, and the resolution of conflicts without
recourse to violence.
The setting of Federal budget priorities is an issue of
critical relevance to the international community, U.S. foreign
policy and the field of international conflict resolution.
Inadequate Federal funds have historically undermined efforts
to strengthen the Nation's capacity to promote the peaceful
resolution of international conflict. The Committee directs the
Institute to support research, through the Jennings Randolph
Program for International Peace on setting and implementing
Federal budget priorities.
TITLE V--GENERAL PROVISIONS
The Committee recommendation retains provisions which:
authorize transfers of unexpended balances (sec. 501); limit
funding to 1 year availability unless otherwise specified (sec.
502); limit lobbying and related activities (sec. 503); limit
official representation expenses (sec. 504); prohibit funding
of any program to carry out distribution of sterile needles for
the hypodermic injection of any illegal drug unless the
Secretary of HHS determines such programs are effective in
preventing the spread of HIV and do not encourage the use of
illegal drugs (sec. 505); state the sense of Congress about
purchase of American-made equipment and products (sec. 506);
clarify Federal funding as a component of State and local grant
funds (sec. 507); and limit use of funds for abortion (sec. 508
and sec. 509).
The Committee recommendation includes language on human
embryo research (sec. 510).
The Committee recommendation retains the limitation on use
of funds for promotion of legalization of controlled substances
included last year (sec. 511).
The Committee recommendation retains the bill language
limitation on use of funds to enter into or review contracts
with entities subject to the requirement in section 4212(d) of
title 38, United States Code, if the report required by that
section has not been submitted (sec. 512).
The Committee bill includes language regarding the
individual health identifier (sec. 513).
The Committee recommendation includes a provision relating
to grant notification procedures (sec. 514).
TITLE VI--MARK-TO-MARKET EXTENSION ACT OF 2001
This title includes the text to H.R. 2589, the ``Mark-to-
Market Extension Act of 2001'' which has been passed by the
House and reflects the agreement of the Senate Committee on
Banking, Housing, and Urban Affairs. This legislation, among
other things, would extend HUD's authority to restructure the
oversubsidized mortgages of multifamily housing with expiring
section 8 contracts to ensure that the assisted rents are
consistent with the rents of comparable private units in a
marketplace.
BUDGETARY IMPACT OF BILL
PREPARED IN CONSULTATION WITH THE CONGRESSIONAL BUDGET OFFICE PURSUANT TO SEC. 308(a), PUBLIC LAW 93-344, AS
AMENDED
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
Budget authority Outlays
---------------------------------------------------
Committee Amount of Committee Amount of
allocation bill allocation bill
----------------------------------------------------------------------------------------------------------------
Comparison of amounts in the bill with Committee allocations
to its subcommittees of amounts in the First Concurrent
Resolution for 2002: Subcommittee on Labor, Health and
Human Services, Education, and Related Agencies:
General purpose, non-defense............................ 123,071 123,071 NA NA
General purpose......................................... NA NA 107,716 \1\ 107,716
Mandatory............................................... 272,937 272,937 272,968 272,968
Projections of outlays associated with the recommendation:
2002.................................................... ........... ........... ........... \2\ 258,082
2003.................................................... ........... ........... ........... 86,032
2004.................................................... ........... ........... ........... 18,269
2005.................................................... ........... ........... ........... 5,057
2006 and future years................................... ........... ........... ........... 1,017
Financial assistance to State and local governments for 2002 NA 164,180 NA 132,426
----------------------------------------------------------------------------------------------------------------
\1\ Includes outlays from prior-year budget authority.
\2\ Excludes outlays from prior-year budget authority.
NA: Not applicable.
Note.--Consistent with the funding recommended in the bill for continuing disability reviews and adoption
assistance, and in accordance with section 314 of the Congressional Budget Act of 1974, the Committee
anticipates that the Budget Committee will file a revised section 302(a) allocation for the Committee on
Appropriations reflecting an upward adjustment of $453,000,000 in budget authority and $384,000,000 in
outlays.
COMPLIANCE WITH PARAGRAPH 7, RULE XVI, OF THE STANDING RULES OF THE
SENATE
Paragraph 7 of rule XVI requires that Committee report on
general appropriations bills identify each Committee amendment
to the House bill ``which proposes an item of appropriation
which is not made to carry out the provisions of an existing
law, a treaty stipulation, or an act or resolution previously
passed by the Senate during that session.''
The following items are identified pursuant to this
requirement:
Trade adjustment assistance, $349,500,000;
National Skills Standards Board, $3,500,000;
Work Opportunity Tax Credits, $22,000,000;
Family Planning, $260,000,000;
Preventive Health and Health Services Block Grant,
$139,030,000;
Sexually transmitted diseases, $166,200,000;
Community health centers, $1,343,723,000;
National Health Service Corps, $154,427,000;
Denali Commission, $20,000,000;
Health care facilities, $10,000,000;
Rural health and telehealth programs, $103,527,000;
School renovation grants, $925,000,000;
Adolescent Family Life, $30,000,000;
Nursing Loan Payment, $15,000,000;
Organ Transplantation, $19,992,000;
Abandoned infants assistance, $12,205,000;
Adoptions opportunities, $27,405,000;
Child Abuse Prevention and Treatment Act programs,
$88,577,000;
Promoting safe and stable families, $305,000,000;
National Education Goals Panel, $2,000,000;
National Commission on Libraries and Information
Science, $1,495,000.
COMPLIANCE WITH PARAGRAPH 7(C), RULE XXVI OF THE STANDING RULES OF THE
SENATE
Pursuant to paragraph 7(c) of rule XXVI, the Committee
ordered reported, S. 1536, an original Departments of Labor,
Health and Human Services, and Education, and related agencies
appropriations bill, 2002, subject to amendment and subject to
its budget allocations, by a recorded vote of 29-0, a quorum
being present. The vote was as follows:
Yeas Nays
Chairman Byrd
Mr. Inouye
Mr. Hollings
Mr. Leahy
Mr. Harkin
Ms. Mikulski
Mr. Reid
Mr. Kohl
Mrs. Murray
Mr. Dorgan
Mrs. Feinstein
Mr. Durbin
Mr. Johnson
Ms. Landrieu
Mr. Reed
Mr. Stevens
Mr. Cochran
Mr. Specter
Mr. Domenici
Mr. Bond
Mr. McConnell
Mr. Burns
Mr. Shelby
Mr. Gregg
Mr. Bennett
Mr. Campbell
Mr. Craig
Mrs. Hutchison
Mr. DeWine
COMPLIANCE WITH PARAGRAPH 12, RULE XXVI OF THE STANDING RULES OF THE
SENATE
Paragraph 12 of rule XXVI requires that Committee reports
on a bill or a joint resolution repealing or amending any
statute include ``(a) the text of the statute or part thereof
which is proposed to be repealed; and (b) a comparative print
of that part of the bill or joint resolution making the
amendment and of the statute or part thereof proposed to be
amended, showing by stricken through type and italics, parallel
columns, or other appropriate typographical devices the
omissions and insertions which would be made by the bill or
joint resolution if enacted in the form recommended by the
committee.''
In compliance with this rule, the following changes in
existing law proposed to be made by the bill are shown as
follows: existing law to be omitted is enclosed in black
brackets; new matter is printed in italic; and existing law in
which no change is proposed is shown in roman.
TITLE 8--ALIENS AND NATIONALITY
* * * * * * *
CHAPTER 12--IMMIGRATION AND NATIONALITY
* * * * * * *
SUBCHAPTER II--IMMIGRATION
Part I--Selection System
* * * * * * *
Sec. 1157. Annual admission of refugees and admission of emergency
situation refugees
* * * * * * *
Establishing Categories of Aliens for Purposes of Refugee
Determinations
* * * * * * *
``(a) * * *
* * * * * * *
``(b) Establishment of Categories.--
``(1) * * *
``(3) Within the number of admissions of refugees
allocated for for [sic] each of fiscal years [1997,
1998, 1999, 2000, and 2001] 1997, 1998, 1999, 2000,
2001, and 2002 for refugees who are nationals of the
Soviet Union under section 207(a)(3) of the Immigration
and Nationality Act [8 U.S.C. 1157(a)(3)] and within
the number of such admissions allocated for each of
fiscal years 1993, 1994, 1995, and 1996 for refugees
who are nationals of the independent states of the
former Soviet Union, Estonia, Latvia, and Lithuania
under such section, notwithstanding any other provision
of law, the President shall allocate one thousand of
such admissions for such fiscal year to refugees who
are within the category of aliens described in
paragraph (2)(B).
* * * * * * *
``(e) Period of Application.--
``(1) Subsections (a) and (b) shall take effect on
the date of the enactment of this Act [Nov. 21, 1989]
and shall only apply to applications for refugee status
submitted before [October 1, 2001] October 1, 2002.
``(2) Subsection (c) shall apply to decisions made
after the date of the enactment of this Act and before
[October 1, 2001] October 1, 2002.
``(3) Subsection (d) shall take effect on the date
of the enactment of this Act and shall only apply to
reapplications for refugee status submitted before
[October 1, 2001] October 1, 2002.''
* * * * * * *
Part V--Adjustment and Change of Status
* * * * * * *
Sec. 1255. Adjustment of status of nonimmigrant to that of person
admitted for permanent residence
* * * * * * *
Adjustment of Status for Certain Soviet and Indochinese Parolees
Pub. L. 101-167, title V, Sec. 599E, Nov. 21, 1989, 103
Stat. 1263, as amended by Pub. L. 101-513, title V, Sec.
598(b), Nov. 5, 1990, 104 Stat. 2063; Pub. L. 101-649, title
VI, Sec. 603(a)(22), Nov. 29, 1990, 104 Stat. 5084; Pub. L.
102-232, title III, Sec. 307(l)(9), Dec. 12, 1991, 105 Stat.
1757; Pub. L. 102-391, title V, Sec. 582(a)(2), (b)(2), Oct. 6,
1992, 106 Stat. 1686; Pub. L. 102-511, title IX, Sec.
905(b)(2), Oct. 24, 1992, 106 Stat. 3356; Pub. L. 103-236,
title V, Sec. 512(2), Apr. 30, 1994, 108 Stat. 466; Pub. L.
103-416, title II, Sec. 219(bb), Oct. 25, 1994, 108 Stat. 4319;
Pub. L. 104-208, div. A, title I, Sec. 101(c) [title V, Sec.
575(2)], Sept. 30, 1996, 110 Stat. 3009-121, 3009-168; Pub. L.
104-319, title I, Sec. 101(2), Oct. 19, 1996, 110 Stat. 3865;
Pub. L. 105-118, title V, Sec. 574(2), Nov. 26, 1997, 111 Stat.
2432; Pub. L. 105-277, div. A, Sec. 101(f) [title VII,
Sec. 705(2)], Oct. 21, 1998, 112 Stat. 2681-337, 2681-389; Pub.
L. 106-113, div. B, Sec. 1000(a)(4) [title II, Sec. 214(2)],
Nov. 29, 1999, 113 Stat. 1535, 1501A-240, provided that:
``(a) In General.--The Attorney General shall adjust the
status of an alien described in subsection (b) to that of an
alien lawfully admitted for permanent residence if the alien--
* * * * * * *
``(b) Aliens Eligible for Adjustment of Status.--The
benefits provided in subsection (a) shall only apply to an
alien who--
``(1) was a national of an independent state of the
former Soviet Union, Estonia, Latvia, Lithuania,
Vietnam, Laos, or Cambodia, and
``(2) was inspected and granted parole into the
United States during the period beginning on August 15,
1988, and ending on [September 30, 2001] September 30,
2002, after being denied refugee status.
* * * * * * *
TITLE 42--THE PUBLIC HEALTH AND WELFARE
* * * * * * *
CHAPTER 69--COMMUNITY DEVELOPMENT
* * * * * * *
Sec. 5305. Activities eligible for assistance
(a) Enumeration of eligible activities
Activities assisted under this chapter may include only--
(1) * * *
* * * * * * *
(8) provision of public services, including but not
limited to those concerned with employment, crime
prevention, child care, health, drug abuse, education,
energy conservation, welfare or recreation needs, if
such services have not been provided by the unit of
general local government (through funds raised by such
unit, or received by such unit from the State in which
it is located) during any part of the twelve-month
period immediately preceding the date of submission of
the statement with respect to which funds are to be
made available under this chapter, and which are to be
used for such services, unless the Secretary finds that
the discontinuation of such services was the result of
events not within the control of the unit of general
local government, except that not more than 15 per
centum of the amount of any assistance to a unit of
general local government (or in the case of nonentitled
communities not more than 15 per centum statewide)
under this chapter including program income may be used
for activities under this paragraph unless such unit of
general local government used more than 15 percent of
the assistance received under this chapter for fiscal
year 1982 or fiscal year 1983 for such activities
(excluding any assistance received pursuant to Public
Law 98-8), in which case such unit of general local
government may use not more than the percentage or
amount of such assistance used for such activities for
such fiscal year, whichever method of calculation
yields the higher amount, except that of any amount of
assistance under this chapter (including program
income) in each of fiscal years 1993 [through 2001]
through 2003 to the City of Los Angeles and County of
Los Angeles, each such unit of general government may
use not more than 25 percent in each such fiscal year
for activities under this paragraph, and except that of
any amount of assistance under this chapter (including
program income) in each of fiscal years 1999, 2000, and
2001, to the City of Miami, such city may use not more
than 25 percent in each fiscal year for activities
under this paragraph;
* * * * * * *
UNITED STATES HOUSING ACT OF 1937
* * * * * * *
TITLE I--GENERAL PROGRAM OF ASSISTED HOUSING
* * * * * * *
lower income housing assistance
Sec. 8. (a) * * *
* * * * * * *
(t) Enhanced Vouchers.--
(1) * * *
* * * * * * *
(2) Eligibility event.--For purposes of this
subsection, the term ``eligibility event'' means, with
respect to a multifamily housing project, the
prepayment of the mortgage on such housing project, the
voluntary termination of the insurance contract for the
mortgage for such housing project (including any such
mortgage prepayment during fiscal year 1996 or a fiscal
year thereafter or any insurance contract voluntary
termination during fiscal year 1996 or a fiscal year
thereafter), the termination or expiration of the
contract for rental assistance under section 8 of the
United States Housing Act of 1937 for such housing
project, or the transaction under which the project is
preserved as affordable housing, that, under paragraphs
(3) and (4) of section 515(c), section 524(d) of the
Multifamily Assisted Housing Reform and Affordability
Act of 1997 (42 U.S.C. 1437f note), section 223(f ) of
the Low-Income Housing Preservation and Resident
Homeownership Act of 1990 (12 U.S.C. 4113(f )), or
section 201(p) of the Housing and Community Development
Amendments of 1978 (12 U.S.C. 1715z-1a(p)), results in
tenants in such housing project being eligible for
enhanced voucher assistance under this subsection.
* * * * * * *
NATIONAL HOUSING ACT
* * * * * * *
miscellaneous housing insurance
Sec. 223. (a) * * *
(1) * * *
* * * * * * *
(7) given to refinance an existing mortgage insured
[under this Act: Provided, That the principal] under
this Act, or an existing mortgage held by the Secretary
that is subject to a mortgage restructuring and rental
assistance sufficiency plan pursuant to the Multifamily
Assisted Housing Reform and Affordability Act of 1997
(42 U.S.C. 1437f note), provided that--
(A) the principal amount of any such
refinancing mortgage shall not exceed the
original principal amount or the unexpired term
of such existing mortgage and shall bear
interest at such rate as may be agreed upon by
the mortgagor and the mortgagee, [except that
(A)] except that (i) the principal amount of
any such refinancing mortgage may equal the
outstanding balance of an existing mortgage
insured pursuant to section 245, if the amount
of the monthly payment due under the
refinancing mortgage is less than that due
under the existing mortgage for the month in
which the refinancing mortgage is executed;
[(B)] (ii) a mortgagee may not require a
minimum principal amount to be outstanding on
the loan secured by the existing mortgage;
[(C)] (iii) in any case involving the
refinancing of a loan in which the Secretary
determines that the insurance of a mortgage for
an additional term will inure to the benefits
of the applicable insurance fund, taking into
consideration the outstanding insurance
liability under the existing insured mortgage,
such refinancing mortgage may have a term not
more than twelve years in excess of the
unexpired term of such existing insured
mortgage; and [(D)] (iv) any multifamily
mortgage that is refinanced under this
paragraph shall be documented through
amendments to the existing insurance contract
and shall not be structured through the
provisions of a new insurance contract[:
Provided further, That a mortgage]; and
(B) a mortgage of the character described
in paragraphs (1) through (6) of this
subsection shall have a maturity and a
principal obligation not in excess of the
maximums prescribed under the applicable
section or title of this Act, except that in no
case may the principal obligation of a mortgage
referred to in paragraph (5) of this subsection
exceed 90 per centum of the appraised value of
the mortgage property, and shall bear interest
at such rate as may be agreed upon by the
mortgagor and the mortgagee; [or]
(C) a mortgage that is subject to a
mortgage restructuring and rental assistance
sufficiency plan pursuant to the Multifamily
Assisted Housing Reform and Affordability Act
of 1997 (42 U.S.C. 1437f note) and is
refinanced under this paragraph may have a term
of not more than 30 years; or
* * * * * * *
HOUSING AND COMMUNITY DEVELOPMENT ACT OF 1974
* * * * * * *
TITLE I--COMMUNITY DEVELOPMENT
findings and purpose
* * * * * * *
(8) provision of public services, including but not
limited to those concerned with employment, crime
prevention, child care, health, drug abuse, education,
energy conservation, welfare or recreation needs, if
such services have not been provided by the unit of
general local government (through funds raised by such
unit, or received by such unit from the State in which
it is located) during any part of the twelve-month
period immediately preceding the date of submission of
the statement with respect to which funds are to be
made available under this title, and which are to be
used for such services, unless the Secretary finds that
the discontinuation of such services was the result of
events not within the control of the unit of general
local government, except that not more that 15 per
centum of the amount of any assistance to a unit of
general local government (or in the case of nonentitled
communities not more than 15 per centum statewide)
under this title including program income may be used
for activities under this paragraph unless such unit of
general local government used more than 15 percent of
the assistance received under this title for fiscal
year 1982 or fiscal year 1983 for such activities
(excluding any assistance received pursuant to Public
Law 98-8), in which case such unit of general local
government may use not more than the percentage or
amount of such assistance used for such activities for
such fiscal year, whichever method of calculation
yields the higher amount, except that of any amount of
assistance under this title (including program income)
in each of fiscal years 1993 through 1999 to the City
of Los Angeles and County of Los Angeles, each such
unit of general government may use not more than 25
percent in each such fiscal year for activities under
this paragraph, and except that of any amount of
assistance under this title (including program income)
in each of fiscal years 1999, 2000, and 2001, to the
City of Miami, such city may use not more than 25
percent in each fiscal year for activities under this
paragraph;
* * * * * * *
MULTIFAMILY ASSISTED HOUSING REFORM AND ACCOUNTABILITY ACT OF 1997
* * * * * * *
TITLE V--HUD MULTIFAMILY HOUSING REFORM
* * * * * * *
Subtitle A--FHA-Insured Multifamily Housing Mortgage and Housing
Assistance Restructuring
* * * * * * *
SEC. 511. FINDINGS AND PURPOSES.
(a) * * *
(1) * * *
* * * * * * *
(12) the authority and duties of the Secretary, not
including the control by the Secretary of applicable
accounts in the Treasury of the United States, may be
delegated to State, local or other entities at the
discretion of the Secretary, to the extent the
Secretary determines, and for the purpose of carrying
out [this Act] this title, so that the Secretary has
the discretion to be relieved of processing and
approving any document or action required by these
reforms.
* * * * * * *
SEC. 512. DEFINITIONS.
In this subtitle:
(1) * * *
* * * * * * *
(2) * * *
(A) * * *
* * * * * * *
(C) financed by a mortgage insured or held
by the Secretary under the National Housing
Act.
Such term does not include any project with an expiring
contract described in paragraph (1) or (2) of section
524(e), but does include a project described in section
524(e)(3). Notwithstanding any other provision of this
title, the Secretary may treat a project as an eligible
multifamily housing project for purposes of this title
if (I) the project is assisted pursuant to a contract
for project-based assistance under section 8 of the
United States Housing Act of 1937 renewed under section
524 of this Act, (II) the owner consents to such
treatment, and (III) the project met the requirements
of the first sentence of this paragraph for eligibility
as an eligible multifamily housing project before the
initial renewal of the contract under section 524.
* * * * * * *
(18) * * *
(A) * * *
* * * * * * *
(C) is not in default under any Government
National Mortgage Association obligation.
``(19) Office.--The term `Office' means the Office
of Multifamily Housing Assistance Restructuring
established under section 571.''
* * * * * * *
SEC. 513. AUTHORITY OF PARTICIPATING ADMINISTRATIVE ENTITIES.
(a) * * *
(1) * * *
* * * * * * *
(2) Portfolio restructuring agreements.--Each
portfolio restructuring agreement entered into under
this subsection shall--
(A) * * *
* * * * * * *
(I) include, where appropriate, incentive
agreements with the participating
administrative entity to reward superior
performance in meeting the purposes of [this
Act] this title.
(b) * * *
(1) * * *
* * * * * * *
(3) Partnerships.--For the purposes of any
participating administrative entity applying under this
subsection, participating administrative entities are
encouraged to develop partnerships with each other and
with nonprofit organizations, if such partnerships will
further the participating administrative entity's
ability to meet the purposes of [this Act] this title.
* * * * * * *
SEC. 514. MORTGAGE RESTRUCTURING AND RENTAL ASSISTANCE SUFFICIENCY
PLAN.
(a) * * *
* * * * * * *
(f) * * *
* * * * * * *
(3) Funding.--
(A) In general.--The [Secretary may provide
not more than $10,000,000 annually in funding]
Secretary shall make available not more than
$10,000,000 annually in funding, which amount
shall be in addition to any amounts made
available under this subparagraph and carried
over from previous years, from which the
Secretary may make obligations to tenant
groups, nonprofit organizations, and public
entities for building the capacity of tenant
organizations, for technical assistance in
furthering any of the purposes of this subtitle
(including transfer of developments to new
owners), for technical assistance for
preservation of low-income housing for which
project-based rental assistance is provided at
below market rent levels and may not be renewed
(including transfer of developments to tenant
groups, nonprofit organizations, and public
[entities), and for tenant services,]
entities), for tenant services, and for tenant
groups, nonprofit organizations, and public
entities described in section 517(a)(5), from
those amounts made available under
appropriations Acts for implementing this
subtitle or previously made available for
technical assistance in connection with the
preservation of affordable rental housing for
low-income persons.
(B) Manner of providing.--Notwithstanding
any other provision of law restricting the use
of preservation technical assistance funds, the
Secretary may provide any funds made available
under subparagraph (A) through existing
technical assistance programs pursuant to any
other Federal law, including the Low-Income
Housing Preservation and Resident Homeownership
Act of 1990 and the Multifamily Housing
Property Disposition Reform Act of 1994, or
through any other means that the Secretary
considers consistent with the purposes of this
subtitle, without regard to any set-aside
requirement otherwise applicable to those
funds.
* * * * * * *
(g) Rent Levels.--
(1) * * *
* * * * * * *
(2) Exceptions.--
(A) In general.--A contract under this
section may include rent levels that exceed the
rent level described in paragraph (1) at rent
levels that do not exceed 120 percent of the
fair market rent for the market area (except
that the Secretary may waive this limit for not
more than five percent of all units subject to
[restructured mortgages in any fiscal year]
portfolio restructuring agreements, based on a
finding of special need), if the participating
administrative entity--
* * * * * * *
(h) * * *
(1) * * *
(2) the project is a project financed under section
202 of the Housing Act of 1959 or section 515 of the
Housing Act of 1949, or refinanced pursuant to section
811 of the American Homeownership and Economic
Opportunity Act of 2000 (12 U.S.C. 1701q note); or
* * * * * * *
SEC. 515. SECTION 8 RENEWALS AND LONG-TERM AFFORDABILITY COMMITMENT BY
OWNER OF PROJECT.
(a) * * *
* * * * * * *
(c) Determination of Whether To Renew With Project-Based or
Tenant-Based Assistance.--
(1) Mandatory renewal of project-based
assistance.--Section 8 assistance shall be renewed with
project-based assistance, if--
(A) the project is located in an area in
which the participating administrative entity
determines, based on housing market indicators,
such as low vacancy rates or high absorption
rates, that there is not adequate available and
affordable housing or that the tenants of the
project would not be able to locate suitable
units or use the tenant-based assistance
successfully;
(B) a predominant number of the units in
the project are occupied by elderly families,
disabled families, or elderly and disabled
families; or
* * * * * * *
SEC. 516. PROHIBITION ON RESTRUCTURING.
(a) * * *
* * * * * * *
(d) Displaced Tenants.--[Subject to]
(1) Notice to certain residents.--The Office shall
notify any tenant that is residing in a project or
receiving assistance under section 8 of the United
States Housing Act of 1937 (42 U.S.C. 1437f) at the
time of rejection under this section, of such
rejection, except that the Office may delegate the
responsibility to provide notice under this paragraph
to the participating administrative entity.
(2) Assistance and moving expenses.--Subject to the
availability of amounts provided in advance in
appropriations Acts, for any low-income tenant that is
residing in a project or receiving assistance under
section 8 of the United States Housing Act of 1937 at
the time of rejection under this section, that tenant
shall be provided with tenant-based assistance and
reasonable moving expenses, as determined by the
Secretary.
* * * * * * *
SEC. 517. RESTRUCTURING TOOLS.
(a) Mortgage Restructuring.--
(1) * * *
(A) * * *
(B) a second mortgage that is in an amount
equal to [no more than the] not more than the
greater of--
``(i) the full or partial payment
of claim made under this subtitle; or
``(ii) the difference between the
restructured or new first mortgage and
the indebtedness under the existing
insured mortgage immediately before it
is restructured or refinanced, provided
that the amount of the second mortgage
shall be in an amount that the
Secretary or participating
administrative entity determines can
reasonably be expected to be repaid.
* * * * * * *
(5) The Secretary may modify the terms of the
second mortgage, assign the second mortgage to the
acquiring organization or agency, or forgive all or
part of the second mortgage if the Secretary holds the
second mortgage and if the project is acquired by a
tenant organization or tenant-endorsed community-based
nonprofit or public agency, pursuant to guidelines
established by the Secretary.
(b) Restructuring Tools.--In addition to the requirements
of subsection (a) and to the extent these actions are
consistent with this section and with the control of the
Secretary of applicable accounts in the Treasury of the United
States, an approved mortgage restructuring and rental
assistance sufficiency plan under this subtitle may include one
or more of the following actions:
(1) Full or partial payment of claim.--[m]Making a
full payment of claim or partial payment of claim under
section 541(b) of the National Housing Act, as amended
by section 523(b) of this Act. Any payment under this
paragraph shall not require the approval of a
mortgagee[;].
(2) Refinancing of debt.--[r]Refinancing of all or
part of the debt on a project. If the refinancing
involves a mortgage that will continue to be insured
under the National Housing Act, the refinancing shall
be documented through amendment of the existing
insurance contract and not through a new insurance
contract[;].
(3) Mortgage insurance.--[p]Providing FHA
multifamily mortgage insurance, reinsurance or other
credit enhancement alternatives, including multifamily
risk-sharing mortgage programs, as provided under
section 542 of the Housing and Community Development
Act of 1992. The Secretary shall use risk-shared
financing under section 542(c) of the Housing and
Community Development Act of 1992 for any mortgage
restructuring, rehabilitation financing, or debt
refinancing included as part of a mortgage
restructuring and rental assistance sufficiency plan if
the terms and conditions are considered to be the best
available financing in terms of financial savings to
the FHA insurance funds and will result in reduced risk
of loss to the Federal Government. Any limitations on
the number of units available for mortgage insurance
under section 542 shall not apply to eligible
multifamily housing projects. Any credit subsidy costs
of providing mortgage insurance shall be paid from the
Liquidating Accounts of the General Insurance Fund or
the Special Risk Insurance Fund and shall not be
subject to any limitation on appropriations[;].
(4) Credit enhancement.--[p]Providing any
additional State or local mortgage credit enhancements
and risk-sharing arrangements that may be established
with State or local housing finance agencies, the
Federal Housing Finance Board, the Federal National
Mortgage Association, and the Federal Home Loan
Mortgage Corporation, to a modified or refinanced first
mortgage[;].
(5) Compensation of third parties.--[c]Consistent
with the portfolio restructuring agreement, entering
into agreements, incurring costs, or making payments,
including incentive agreements designed to reward
superior performance in meeting the purposes of this
Act, as may be reasonably necessary, to compensate the
participation of participating administrative entities
and other parties in undertaking actions authorized by
this subtitle. Upon request to the Secretary,
participating administrative entities that are
qualified under the United States Housing Act of 1937
to serve as contract administrators shall be the
contract administrators under section 8 of the United
States Housing Act of 1937 for purposes of any
contracts entered into as part of an approved mortgage
restructuring and rental assistance sufficiency plan.
Subject to the availability of amounts provided in
advance in appropriations Acts for administrative fees
under section 8 of the United States Housing Act of
1937, such amounts may be used to compensate
participating administrative entities for compliance
monitoring costs incurred under section 519[;].
(6) Use of project accounts.--[a]Applying any
residual receipts, replacement reserves, and any other
project accounts not required for project operations,
to maintain the long-term affordability and physical
condition of the property or of other eligible
multifamily housing projects. The participating
administrative entity may expedite the acquisition of
residual receipts, replacement reserves, or other such
accounts, by entering into agreements with owners of
housing covered by an expiring contract to provide an
owner with a share of the receipts, not to exceed 10
percent, in accordance with guidelines established by
the Secretary[; and].
* * * * * * *
(c) Rehabilitation Needs and Addition of Significant
Features.--
* * * * * * *
[(7)] (1) Rehabilitation needs.--
* * * * * * *
(B) * * *
``(2) Addition of Significant Features.--
``(A) Authority.--An approved mortgage
restructuring and rental assistance sufficiency
plan may require the improvement of the project
by the addition of significant features that
are not necessary for rehabilitation to the
standard provided under paragraph (1), such as
air conditioning, an elevator, and additional
community space. The Secretary shall establish
guidelines regarding the inclusion of
requirements regarding such additional
significant features under such plans.
``(B) Funding.--Significant features added
pursuant to an approved mortgage restructuring
and rental assistance sufficiency plan may be
paid from the funding sources specified in the
first sentence of paragraph (1)(A).
``(C) Limitation on owner contribution.--An
owner of a project may not be required to
contribute from non-project resources, toward
the cost of any additional significant features
required pursuant to this paragraph, more than
25 percent of the amount of any assistance
received for the inclusion of such features.
``(D) Applicability.--This paragraph shall
apply to all eligible multifamily housing
projects, except projects for which the
Secretary and the project owner executed a
mortgage restructuring and rental assistance
sufficiency plan on or before the date of the
enactment of the Mark-to-Market Extension Act
of 2001.''
* * * * * * *
[(c) Role of FNMA and FHLMC.--Section 1335 of the Federal
Housing Enterprises Financial Safety and Soundness Act of 1992
(12 U.S.C. 4565) is amended--
[(1) in paragraph (3), by striking ``and'' at the
end;
[(2) paragraph (4), by striking the period at the
end and inserting ``; and'';
[(3) by striking ``To meet'' and inserting the
following:
[``(a) In General.--To meet''; and
[(4) by adding at the end the following:
[``(5) assist in maintaining the affordability of
assisted units in eligible multifamily housing projects
with expiring contracts, as defined under the
Multifamily Assisted Housing Reform and Affordability
Act of 1997.
[``(b) Affordable Housing Goals.--Actions taken under
subsection (a)(5) shall constitute part of the contribution of
each entity in meeting its affordable housing goals under
sections 1332, 1333, and 1334 for any fiscal year, as
determined by the Secretary.''.]
* * * * * * *
SEC. 520. REPORTS TO CONGRESS.
(a) Annual Review.--In order to ensure compliance with this
subtitle, the Secretary shall conduct an annual review and
report to the Congress on actions taken under this subtitle and
the status of eligible multifamily housing projects.
(b) Semiannual Review.--Not less than semiannually during
the 2-year period beginning on the date of the enactment of
this Act and not less than annually thereafter, the Secretary
shall submit reports to the Committee on [Banking and]
Financial Services of the House of Representatives and the
Committee on Banking, Housing, and Urban Affairs of the Senate
stating, for such periods, the total number of projects
identified by participating administrative entities under each
of clauses (i) and (ii) of section 515(c)(2)(C).
* * * * * * *
SEC. 524. RENEWAL OF EXPIRING PROJECT-BASED SECTION 8 CONTRACTS.
(a) * * *
(1) * * *
* * * * * * *
(4) * * *
(A) * * *
* * * * * * *
(B) * * *
(C) Rents not exceeding market rents.--In
the case of a project that is not subject to
subparagraph (A) or (B), at rent levels that--
(i) are not less than the existing
rents under the terminated or expiring
contract, as adjusted by an operating
cost adjustment factor established by
the Secretary (which shall not result
in a negative adjustment), if such
adjusted rents do not exceed comparable
market rents for the market area; and
(ii) do not exceed comparable
market rents for the market area.
In determining the rent level for a contract
under this subparagraph, the Secretary shall
approve rents sufficient to cover budget-based
cost increases and shall give greater
consideration to providing rent at a level up
to comparable market rents for the market area
based on the number of the criteria under
clauses (i) through (iii) of subparagraph (D)
that the project meets. Notwithstanding any
other provision of law, the Secretary shall
include in such budget-based cost increases
costs relating to the project as a whole
(including costs incurred with respect to units
not covered by the contract for assistance),
but only (I) if inclusion of such costs is
requested by the owner or purchaser of the
project, (II) if inclusion of such costs will
permit capital repairs to the project or
acquisition of the project by a nonprofit
organization, and (III) to the extent that
inclusion of such costs (or a portion thereof)
complies with the requirement under clause
(ii).
* * * * * * *
(e) Contractual Commitments Under Preservation Laws.--
Except as provided in subsection (a)(2) and notwithstanding any
other provision of this subtitle, the following shall apply:
(1) * * *
* * * * * * *
(2) Demonstration projects.--
(A) * * *
* * * * * * *
(i) * * *
* * * * * * *
(iii) * * *
(3) Mortgage restructuring and rental assistance
sufficiency plans.--Notwithstanding paragraph (1), the
owner of the project may request, and the Secretary may
consider, mortgage restructuring and rental assistance
sufficiency plans to facilitate sales or transfers of
properties under this subtitle, subject to an approved
plan of action under the Emergency Low Income Housing
Preservation Act of 1987 (12 U.S.C. 1715l note) or the
Low-Income Housing Preservation and Resident
Homeownership Act of 1990 (12 U.S.C. 4101 et seq.),
which plans shall result in a sale or transfer of those
properties.
* * * * * * *
SEC. 525. CONSISTENCY OF RENT LEVELS UNDER ENHANCED VOUCHER ASSISTANCE
AND RENT RESTRUCTURINGS.
(a) In General.--The Secretary shall examine the standards
and procedures for determining and establishing the rent
standards described under subsection (b). Pursuant to such
examination, the Secretary shall establish procedures and
guidelines that are designed to ensure that the amounts
determined by the various rent standards for the same dwelling
units are reasonably consistent and reflect rents for
comparable unassisted units in the same area as such dwelling
units.
(b) Rent Standards.--The rent standards described in this
subsection are as follows:
(1) Enhanced vouchers.--The payment standard for
enhanced voucher assistance under section 8(t) of the
United States Housing Act of 1937 (42 U.S.C. 1437f(t)).
(2) Mark-to-market.--The rents derived from
comparable properties, for purposes of section 514(g)
of the Multifamily Assisted Housing Reform and
Affordability Act of 1997 (42 U.S.C. 1437f note).
(3) Contract renewal.--The comparable market rents
for the market area, for purposes of section 524(a)(4)
of the Multifamily Assisted Housing Reform and
Affordability Act of 1997 (42 U.S.C. 1437f note).
* * * * * * *
SEC. 572. DIRECTOR.
[(a) Appointment.--The Office shall be under the management
of a Director, who shall be appointed by the President by and
with the advice and consent of the Senate, from among
individuals who are citizens of the United States and have a
demonstrated understanding of financing and mortgage
restructuring for affordable multifamily housing. Not later
than 60 days after the date of the enactment of this Act, the
President shall submit to the Senate a nomination for initial
appointment to the position of Director.]
(a) Appointment.--The Office shall be under the management
of a Director, who shall be appointed by the President from
among individuals who are citizens of the United States and
have a demonstrated understanding of financing and mortgage
restructuring for affordable multifamily housing.
[(b) Vacancy.--A vacancy in the position of Director shall
be filled in the manner in which the original appointment was
made under subsection (a).]
(b) Vacancy.--A vacancy in the position of Director shall
be filled by appointment in the manner provided under
subsection (a). The President shall make such an appointment
not later than 60 days after such position first becomes
vacant.
* * * * * * *
SEC. 573. DUTY AND AUTHORITY OF DIRECTOR.
(a) * * *
(b) Authority.--The Director is authorized to make such
determinations, take such actions, issue such regulations, and
perform such functions assigned to the Director under law as
the Director determines necessary to carry out such functions,
subject to the review and approval of the Secretary. The
Director shall semiannually submit a report to the [Secretary]
Assistant Secretary of the Department of Housing and Urban
Development who is the Federal Housing Commissioner regarding
the activities, determinations, and actions of the Director.
* * * * * * *
(d) Independence in Providing Information to Congress.--
(1) * * *
(2) Requirement.--If the Director determines at any
time that the Secretary is taking or has taken any
action that interferes with the ability of the Director
to carry out the duties of the Director under this Act
or that affects the administration of the program under
subtitle A of this Act in a manner that is inconsistent
with the purposes of this Act, including any proposed
action by the Director, in the discretion of the
Director, that is overruled by the Secretary, the
Director shall immediately report directly to the
Committee on [Banking and] Financial Services of the
House of Representatives and the Committee on Banking,
Housing, and Urban Affairs of the Senate regarding such
action. Notwithstanding subsection (a) or (b), any
determination or report under this paragraph by the
Director shall not be subject to prior review or
approval of the Secretary.
* * * * * * *
SEC. 576. LIMITATION ON SUBSEQUENT EMPLOYMENT.
Neither the Director nor any former officer or employee of
the Office who, while employed by the Office, was compensated
at a rate in excess of the lowest rate for a position
classified higher than GS-15 of the General Schedule under
section 5107 of title 5, United States Code, may, during the
[2-year period] 1-year period beginning on the date of
separation from employment by the Office, accept compensation
from any party (other than a Federal agency) having any
financial interest in any mortgage restructuring and rental
assistance sufficiency plan under subtitle A or comparable
matter in which the Director or such officer or employee had
direct participation or supervision.
* * * * * * *
[SEC. 578. SUSPENSION OF PROGRAM BECAUSE OF FAILURE TO APPOINT
DIRECTOR.
[(a) In General.--If, upon the expiration of the 12-month
period beginning on the date of the enactment of this Act, the
initial appointment to the office of Director has not been
made, the
operation of the program under subtitle A shall immediately be
suspended and such provisions shall not have any force or
effect during the period that ends upon the making of such
appointment.
[(b) Interim applicability of demonstration program.--
Notwithstanding any other provision of law, during the period
referred to in subsection (a), the Secretary shall carry out
sections 211 and 212 of the Departments of Veterans Affairs and
Housing and Urban Development, and Independent Agencies
Appropriations Act, 1997. For purposes of applying such
sections pursuant to the authority under this section, the term
``expiring contract'' shall have the meaning given in such
sections, except that such term shall also include any contract
for project-based assistance under section 8 of the United
States Housing Act of 1937 that expires during the period that
the program is suspended under subsection (a).]
SEC. 578. OVERSIGHT BY FEDERAL HOUSING COMMISSIONER.
All authority and responsibilities assigned under this
subtitle to the Secretary shall be carried out through the
Assistant Secretary of the Department of Housing and Urban
Development who is the Federal Housing Commissioner.
* * * * * * *
SEC. 579. TERMINATION.
[(a) Repeal.--Subtitle A (except for section 524) and
subtitle D (except for this section) are repealed effective
October 1, 2001.]
(a) Repeals.--
(1) Mark-to-market program.--Subtitle A (except for
section 524) is repealed effective October 1, 2006.
(2) OMHAR.--Subtitle D (except for this section) is
repealed effective October 1, 2004.
(b) Exception.--Notwithstanding the repeal under subsection
(a), the provisions of subtitle A (as in effect immediately
before such repeal) shall apply with respect to projects and
programs for which binding commitments have been entered into
under this Act before [October 1, 2001] October 1, 2006.
(c) Termination of Director and Office.--The Office of
Multifamily Housing Assistance Restructuring and the position
of Director of such Office shall terminate [upon September 30,
2001] at the end of September 30, 2004.
[(d) Transfer of Authority.--Effective upon the termination
under subsection (c), any authority and responsibilities
assigned to the Director that remain applicable after such date
pursuant to subsection (b) are transferred to the Secretary.]
(d) Transfer of Authority.--Effective upon the repeal of
subtitle D under subsection (a)(2) of this section, all
authority and responsibilities to administer the program under
subtitle A are transferred to the Secretary.
McKINNEY-VENTO HOMELESS ASSISTANCE ACT, H.R. 5417
An Act
To rename the Stewart B. McKinney Homeless Assistance Act as the
`McKinney-Vento Homeless Assistance Act'.
* * * * * * *
SECTION 1. DESIGNATION.
[Section 1] Section 101 of the Stewart B. McKinney Homeless
Assistance Act (42 U.S.C. 11301 note; Public Law 100-77) is
amended by striking subsection (a) and inserting the following
new subsection:
* * * * * * *
DEPARTMENTS OF VETERANS AFFAIRS AND HOUSING AND URBAN DEVELOPMENT, AND
INDEPENDENT AGENCIES APPROPRIATIONS ACT, 2000, PUBLIC LAW 106-74
* * * * * * *
TITLE V--PRESERVATION OF AFFORDABLE HOUSING
* * * * * * *
Subtitle C--Renewal of Expiring Rental Assistance Contracts and
Protection of Residents
SEC. 531. RENEWAL OF EXPIRING CONTRACTS AND ENHANCED VOUCHERS FOR
PROJECT RESIDENTS.
(a) * * *
* * * * * * *
(c) Projects Exempted From Restructuring Agreements.--
[Section 514(h)] Section 514(h)(1) of the Multifamily Assisted
Housing Reform and Affordability Act of 1997 (42 U.S.C. 1437f
note) is amended by inserting before the semicolon at the end
the following: ``and the financing involves mortgage insurance
under the National Housing Act, such that the implementation of
a mortgage restructuring and rental assistance sufficiency plan
under this subtitle is in conflict with applicable law or
agreements governing such financing''.
* * * * * * *
AMERICAN HOMEOWNERSHIP AND ECONOMIC OPPORTUNITY ACT OF 2000
SEC. 811. PROGRAM REQUIREMENTS.
(a) * * *
* * * * * * *
[(e) Management and Maintenance.--As a condition to
receiving grant amounts under this title, the Director shall
develop policies governing the management and maintenance of
housing assisted with grant amounts under this title.]
* * * * * * *
COMPARATIVE STATEMENT OF NEW BUDGET (OBLIGATIONAL) AUTHORITY FOR FISCAL YEAR 2001 AND BUDGET ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL
YEAR 2002
[In thousands of dollars]
--------------------------------------------------------------------------------------------------------------------------------------------------------
Senate Committee recommendation
compared with (+ or -)
Item 2001 Budget estimate Committee -----------------------------------
appropriation recommendation 2001
appropriation Budget estimate
--------------------------------------------------------------------------------------------------------------------------------------------------------
TITLE I--DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
Grants to States:
Adult Training, current year.............................. 238,000 900,000 238,000 ................ -662,000
Advance from prior year............................... (712,000) (712,000) (712,000) ................ ................
Fiscal year 2003...................................... 712,000 ................ 712,000 ................ +712,000
-----------------------------------------------------------------------------------------
Adult Training, program level....................... 950,000 900,000 950,000 ................ +50,000
Youth Training............................................ 1,127,965 1,000,965 1,127,965 ................ +127,000
Dislocated Worker Assistance, current year................ 352,540 1,383,040 489,000 +136,460 -894,040
Advance from prior year............................... (1,060,000) (1,060,000) (1,060,000) ................ ................
Fiscal year 2003...................................... 1,060,000 ................ 1,060,000 ................ +1,060,000
-----------------------------------------------------------------------------------------
Dislocated Worker Assistance, program level......... 1,412,540 1,383,040 1,549,000 +136,460 +165,960
Federally administered programs:
Native Americans.......................................... 55,000 55,000 57,800 +2,800 +2,800
Migrant and Seasonal Farmworkers.......................... 76,770 76,770 80,770 +4,000 +4,000
Job Corps:
Operations............................................ 687,773 1,278,773 687,773 ................ -591,000
Advance from prior year........................... (591,000) (591,000) (591,000) ................ ................
Fiscal year 2003.................................. 591,000 ................ 591,000 ................ +591,000
Construction and Renovation........................... 20,375 120,375 20,375 ................ -100,000
Advance from prior year........................... (100,000) (100,000) (100,000) ................ ................
Fiscal year 2003.................................. 100,000 ................ 100,000 ................ +100,000
-----------------------------------------------------------------------------------------
Subtotal, Job Corps, program level.............. 1,399,148 1,399,148 1,399,148 ................ ................
National activities:
Pilots, Demonstrations and Research................... 97,432 35,000 35,000 -62,432 ................
Responsible Reintegration of Youthful Off............. 55,000 ................ 55,000 ................ +55,000
Evaluation............................................ 9,098 9,098 9,098 ................ ................
Youth Opportunity Grants.............................. 250,000 250,000 250,000 ................ ................
Technical Assistance/Incentive grants..................... 15,000 15,000 15,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, National activities........................... 426,530 309,098 364,098 -62,432 +55,000
=========================================================================================
Subtotal, Federal activities............................ 1,957,448 1,840,016 1,901,816 -55,632 +61,800
=========================================================================================
Total, Workforce Investment Act......................... 5,447,953 5,124,021 5,528,781 +80,828 +404,760
Women in Apprenticeship................................... 1,000 1,000 1,000 ................ ................
Skill Standards........................................... 3,500 3,500 3,500 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, National activities, TES...................... 431,030 313,598 368,598 -62,432 +55,000
=========================================================================================
Total, Training and Employment Services................. 5,452,453 5,128,521 5,533,281 +80,828 +404,760
Current Year........................................ (2,989,453) (5,128,521) (3,070,281) (+80,828) (-2,058,240)
Advance year........................................ (2,463,000) ................ (2,463,000) ................ (+2,463,000)
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS.............. 440,200 440,200 450,000 +9,800 +9,800
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Trade Adjustment.............................................. 342,400 ................ 349,500 +7,100 +349,500
NAFTA Activities.............................................. 64,150 11,000 66,150 +2,000 +55,150
Legislative Proposal (NAFTA/TAA).............................. ................ 404,650 ................ ................ -404,650
-----------------------------------------------------------------------------------------
Total................................................... 406,550 415,650 415,650 +9,100 ................
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Unemployment Compensation:
State Operations.......................................... 2,353,795 2,403,923 2,403,923 +50,128 ................
National Activities....................................... 10,000 10,000 10,000 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, Unemployment Comp (trust funds)............... 2,363,795 2,413,923 2,413,923 +50,128 ................
Employment Service:
Allotments to States:
Federal Funds......................................... 23,452 23,452 23,452 ................ ................
Trust Funds........................................... 773,283 773,283 773,283 ................ ................
-----------------------------------------------------------------------------------------
Subtotal............................................ 796,735 796,735 796,735 ................ ................
ES National Activities.................................... 49,680 49,680 51,680 +2,000 +2,000
=========================================================================================
Subtotal, Employment Service............................ 846,415 846,415 848,415 +2,000 +2,000
Federal Funds....................................... 23,452 23,452 23,452 ................ ................
Trust Funds......................................... 822,963 822,963 824,963 +2,000 +2,000
One Stop Career Centers/Labor Market Information.............. 150,000 134,000 148,000 -2,000 +14,000
Work Incentives Grants........................................ 20,000 20,000 20,000 ................ ................
=========================================================================================
Total, State Unemployment............................... 3,380,210 3,414,338 3,430,338 +50,128 +16,000
Federal Funds....................................... 193,452 177,452 191,452 -2,000 +14,000
Trust Funds......................................... 3,186,758 3,236,886 3,238,886 +52,128 +2,000
ADVANCES TO THE UI AND OTHER TRUST FUNDS \1\.................. 435,000 464,000 464,000 +29,000 ................
PROGRAM ADMINISTRATION
Adult Employment and Training................................. 32,911 34,010 34,010 +1,099 ................
Trust Funds............................................... 2,797 2,887 2,887 +90 ................
Youth Employment and Training................................. 37,011 37,557 37,557 +546 ................
Employment Security........................................... 4,974 5,789 5,789 +815 ................
Trust Funds............................................... 44,351 44,216 44,216 -135 ................
Apprenticeship Services....................................... 21,069 21,367 21,367 +298 ................
Executive Direction........................................... 7,960 7,945 7,945 -15 ................
Trust Funds............................................... 1,359 1,404 1,404 +45 ................
Welfare to Work............................................... 6,431 5,903 5,903 -528 ................
-----------------------------------------------------------------------------------------
Total, Program Administration........................... 158,863 161,078 161,078 +2,215 ................
Federal Funds......................................... 110,356 112,571 112,571 +2,215 ................
Trust Funds........................................... 48,507 48,507 48,507 ................ ................
=========================================================================================
Total, Employment and Training Administration........... 10,273,276 10,023,787 10,454,347 +181,071 +430,560
Federal Funds....................................... 7,038,011 6,738,394 7,166,954 +128,943 +428,560
Current Year.................................... (4,575,011) (6,738,394) (4,703,954) (+128,943) (-2,034,440)
Advance year.................................... (2,463,000) ................ (2,463,000) ................ (+2,463,000)
Trust Funds......................................... 3,235,265 3,285,393 3,287,393 +52,128 +2,000
PENSION AND WELFARE BENEFITS ADMINISTRATION
SALARIES AND EXPENSES
Enforcement and Compliance.................................... 83,453 84,640 87,542 +4,089 +2,902
Policy, Regulation and Public Service......................... 20,205 19,234 20,762 +557 +1,528
Program Oversight............................................. 3,975 4,114 4,114 +139 ................
-----------------------------------------------------------------------------------------
Total, PWBA............................................. 107,633 107,988 112,418 +4,785 +4,430
PENSION BENEFIT GUARANTY CORPORATION
Program Administration subject to limitation (TF)............. 11,652 11,652 11,690 +38 +38
Termination services not subject to limitation (NA)........... (178,924) (178,924) (178,924) ................ ................
-----------------------------------------------------------------------------------------
Total, PBGC (Program level)............................. (190,576) (190,576) (190,614) (+38) (+38)
EMPLOYMENT STANDARDS ADMINISTRATION
SALARIES AND EXPENSES
Enforcement of Wage and Hour Standards........................ 152,369 152,569 158,322 +5,953 +5,753
Office of Labor-Management Standards.......................... 30,492 30,632 32,869 +2,377 +2,237
Federal Contractor EEO Standards Enforcement.................. 76,148 76,308 78,849 +2,701 +2,541
Federal Programs for Workers' Compensation.................... 88,687 90,098 91,866 +3,179 +1,768
FECA Fees................................................. ................ -80,281 ................ ................ +80,281
Trust Funds............................................... 1,981 1,981 1,981 ................ ................
Program Direction and Support................................. 13,039 13,127 13,258 +219 +131
-----------------------------------------------------------------------------------------
Total, ESA salaries and expenses........................ 362,716 284,434 377,145 +14,429 +92,711
Federal Funds....................................... 360,735 282,453 375,164 +14,429 +92,711
Trust Funds......................................... 1,981 1,981 1,981 ................ ................
SPECIAL BENEFITS
Federal employees compensation benefits....................... 53,000 118,000 118,000 +65,000 ................
Longshore and harbor workers' benefits........................ 3,000 3,000 3,000 ................ ................
-----------------------------------------------------------------------------------------
Total, Special Benefits................................. 56,000 121,000 121,000 +65,000 ................
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND
Program Benefits (NA)......................................... (358,000) (597,000) (597,000) (+239,000) ................
Administrative Expenses \2\................................... 60,328 136,000 136,000 +75,672 ................
-----------------------------------------------------------------------------------------
Total, Energy Emp Occupational Illness Comp Fund........ 60,328 136,000 136,000 +75,672 ................
BLACK LUNG DISABILITY TRUST FUND
Benefit payments and interest on advances..................... 975,343 981,283 981,283 +5,940 ................
Employment Standards Adm. S&E................................. 30,293 31,443 31,558 +1,265 +115
Departmental Management S&E................................... 21,590 22,590 22,590 +1,000 ................
Departmental Management, Inspector General.................... 318 328 328 +10 ................
-----------------------------------------------------------------------------------------
Subtotal, Black Lung Disability......................... 1,027,544 1,035,644 1,035,759 +8,215 +115
Treasury Administrative Costs................................. 356 356 356 ................ ................
-----------------------------------------------------------------------------------------
Total, Black Lung Disability Trust Fund................. 1,027,900 1,036,000 1,036,115 +8,215 +115
=========================================================================================
Total, Employment Standards Administration.............. 1,506,944 1,577,434 1,670,260 +163,316 +92,826
Federal Funds....................................... 1,504,963 1,575,453 1,668,279 +163,316 +92,826
Trust Funds......................................... 1,981 1,981 1,981 ................ ................
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Safety and Health Standards................................... 15,069 13,875 16,321 +1,252 +2,446
Federal Enforcement........................................... 151,836 154,816 162,768 +10,932 +7,952
State Programs................................................ 88,369 88,119 92,119 +3,750 +4,000
Technical Support............................................. 20,189 19,562 20,251 +62 +689
Compliance Assistance:
Federal Assistance........................................ 56,255 57,180 60,173 +3,918 +2,993
State Consultation Grants................................. 48,834 48,834 51,843 +3,009 +3,009
Training Grants........................................... 11,175 8,175 11,175 ................ +3,000
-----------------------------------------------------------------------------------------
Subtotal................................................ 116,264 114,189 123,191 +6,927 +9,002
Safety and Health Statistics.................................. 25,597 26,257 26,595 +998 +338
Executive Direction and Administration........................ 8,562 9,017 9,017 +455 ................
=========================================================================================
Total, OSHA............................................. 425,886 425,835 450,262 +24,376 +24,427
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
Coal Enforcement.............................................. 114,505 110,915 119,885 +5,380 +8,970
Metal/Non-Metal Enforcement................................... 55,117 60,424 60,424 +5,307 ................
Standards Development......................................... 1,760 2,304 2,357 +597 +53
Assessments................................................... 4,265 4,701 4,807 +542 +106
Educational Policy and Development............................ 31,455 27,984 27,984 -3,471 ................
Technical Support............................................. 27,053 27,427 28,085 +1,032 +658
Program Administration........................................ 12,151 12,551 12,551 +400 ................
-----------------------------------------------------------------------------------------
Total, Mine Safety and Health Administration............ 246,306 246,306 256,093 +9,787 +9,787
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
Employment and Unemployment Statistics........................ 142,313 146,796 146,796 +4,483 ................
Labor Market Information (Trust Funds)........................ 67,257 69,132 69,132 +1,875 ................
Prices and Cost of Living..................................... 135,136 149,264 149,264 +14,128 ................
Compensation and Working Conditions........................... 71,076 74,126 74,126 +3,050 ................
Productivity and Technology................................... 9,164 9,599 9,599 +435 ................
Executive Direction and Staff Services........................ 25,941 27,083 27,083 +1,142 ................
-----------------------------------------------------------------------------------------
Total, Bureau of Labor Statistics....................... 450,887 476,000 476,000 +25,113 ................
Federal Funds....................................... 383,630 406,868 406,868 +23,238 ................
Trust Funds......................................... 67,257 69,132 69,132 +1,875 ................
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
Executive Direction........................................... 26,303 26,502 25,177 -1,126 -1,325
Departmental IT Crosscut...................................... 37,000 80,000 37,000 ................ -43,000
Legal Services................................................ 74,384 74,657 74,657 +273 ................
Trust Funds............................................... 310 310 310 ................ ................
International Labor Affairs................................... 147,982 71,588 147,982 ................ +76,394
Administration and Management................................. 24,732 29,732 29,732 +5,000 ................
Adjudication.................................................. 24,688 24,688 24,688 ................ ................
Women's Bureau................................................ 10,186 10,186 10,186 ................ ................
Civil Rights Activities....................................... 5,839 5,839 5,839 ................ ................
Chief Financial Officer....................................... 5,963 6,263 6,263 +300 ................
-----------------------------------------------------------------------------------------
Total, Salaries and expenses............................ 357,387 329,765 361,834 +4,447 +32,069
Federal Funds....................................... 357,077 329,455 361,524 +4,447 +32,069
Trust Funds......................................... 310 310 310 ................ ................
OFFICE OF DISABILITY EMPLOYMENT POLICY
Office of Disability Employment Policy........................ 20,413 40,623 40,623 +20,210 ................
Task Force on Employment of Adults with Disabilities.......... 2,556 2,640 2,640 +84 ................
-----------------------------------------------------------------------------------------
Total, Office of Disability Employment Policy........... 22,969 43,263 43,263 +20,294 ................
VETERANS EMPLOYMENT AND TRAINING
State Administration:
Disabled Veterans Outreach Program........................ 81,615 81,615 81,615 ................ ................
Local Veterans Employment Program......................... 77,253 77,253 77,253 ................ ................
-----------------------------------------------------------------------------------------
Subtotal, State Administration.......................... 158,868 158,868 158,868 ................ ................
Federal Administration........................................ 27,988 28,035 28,035 +47 ................
Homeless Veterans Program..................................... 17,500 17,500 19,000 +1,500 +1,500
Veterans Workforce Investment Programs........................ 7,300 7,300 7,800 +500 +500
-----------------------------------------------------------------------------------------
Total, Veterans Employment and Training................. 211,656 211,703 213,703 +2,047 +2,000
Federal Funds....................................... 24,800 24,800 26,800 +2,000 +2,000
Trust Funds......................................... 186,856 186,903 186,903 +47 ................
OFFICE OF THE INSPECTOR GENERAL
Program Activities............................................ 43,111 45,114 45,114 +2,003 ................
Trust Funds............................................... 4,770 4,951 4,951 +181 ................
Executive Direction and Management............................ 6,802 7,068 7,068 +266 ................
-----------------------------------------------------------------------------------------
Total, Office of the Inspector General.................. 54,683 57,133 57,133 +2,450 ................
Federal funds....................................... 49,913 52,182 52,182 +2,269 ................
Trust funds......................................... 4,770 4,951 4,951 +181 ................
=========================================================================================
Total, Departmental Management.......................... 646,695 641,864 675,933 +29,238 +34,069
Federal Funds....................................... 454,759 449,700 483,769 +29,010 +34,069
Trust Funds......................................... 191,936 192,164 192,164 +228 ................
=========================================================================================
Total, Labor Department................................. 13,669,279 13,510,866 14,107,003 +437,724 +596,137
Federal Funds....................................... 10,161,188 9,950,544 10,544,643 +383,455 +594,099
Current Year.................................... (7,698,188) (9,950,544) (8,081,643) (+383,455) (-1,868,901)
Advance year.................................. (2,463,000) ................ (2,463,000) ................ (+2,463,000)
Trust Funds......................................... 3,508,091 3,560,322 3,562,360 +54,269 +2,038
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION
HEALTH RESOURCES AND SERVICES
Community health centers...................................... 1,168,612 1,292,723 1,343,723 +175,111 +51,000
National Health Service Corps:
Field placements.......................................... 41,464 42,511 49,511 +8,047 +7,000
Recruitment............................................... 87,916 87,916 104,916 +17,000 +17,000
-----------------------------------------------------------------------------------------
Subtotal................................................ 129,380 130,427 154,427 +25,047 +24,000
Health Professions
Training for Diversity:
Centers of excellence..................................... 30,639 12,847 ................ -30,639 -12,847
Health careers opportunity program........................ 32,797 13,752 ................ -32,797 -13,752
Faculty loan repayment.................................... 1,330 557 ................ -1,330 -557
Scholarships for disadvantaged students................... 44,475 18,651 ................ -44,475 -18,651
-----------------------------------------------------------------------------------------
Subtotal................................................ 109,241 45,807 ................ -109,241 -45,807
Training in Primary Care Medicine and Dentistry............... 91,053 ................ ................ -91,053 ................
Interdisciplinary Community-Based Linkages:
Area health education centers............................. 33,364 7,556 ................ -33,364 -7,556
Health education and training centers..................... 4,403 ................ ................ -4,403 ................
Allied health and other disciplines....................... 8,422 1,907 ................ -8,422 -1,907
Geriatric programs........................................ 12,411 ................ ................ -12,411 ................
Quentin N. Burdick pgm for rural training................. 5,988 ................ ................ -5,988 ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 64,588 9,463 ................ -64,588 -9,463
Health Professions Workforce Info and Analysis................ 824 824 ................ -824 -824
Public Health Workforce Development:
Public health, preventive med. and dental pgms............ 9,478 2,147 ................ -9,478 -2,147
Health administration programs............................ 1,231 ................ ................ -1,231 ................
-----------------------------------------------------------------------------------------
Subtotal................................................ 10,709 2,147 ................ -10,709 -2,147
Children's Hospitals Graduate Medical Educ.................... 234,992 200,094 243,442 +8,450 +43,348
Advanced Education Nursing.................................... 59,048 59,048 ................ -59,048 -59,048
Basic nurse education and practice............................ 12,791 16,291 ................ -12,791 -16,291
Nursing workforce diversity................................... 4,673 6,173 ................ -4,673 -6,173
Consolidated Health professions............................... ................ ................ 352,927 +352,927 +352,927
-----------------------------------------------------------------------------------------
Subtotal, Health professions............................ 587,919 339,847 596,369 +8,450 +256,522
Other HRSA Programs:
Hansen's Disease Services................................. 17,890 18,391 18,391 +501 ................
Maternal and Child Health Block Grant..................... 709,187 704,087 719,087 +9,900 +15,000
Abstinence Education:
Advance from prior year............................... (20,000) (30,000) (30,000) (+10,000) ................
Fiscal year 2002...................................... 30,000 ................ ................ -30,000 ................
Fiscal year 2003...................................... ................ ................ 30,000 +30,000 +30,000
Current Year.......................................... ................ 15 15 +15 ................
Healthy Start............................................. 89,996 89,996 89,996 ................ ................
Universal Newborn Hearing................................. 7,999 6,581 10,000 +2,001 +3,419
Organ Transplantation..................................... 14,992 19,992 19,992 +5,000 ................
Bone Marrow Program....................................... 21,958 22,000 22,000 +42 ................
Rural outreach grants..................................... 58,214 37,863 57,921 -293 +20,058
Rural Health Research..................................... 13,437 6,099 15,000 +1,563 +8,901
Telehealth................................................ 35,978 5,609 5,609 -30,369 ................
Denali Commission......................................... 10,000 ................ 20,000 +10,000 +20,000
Critical care programs:
Emergency medical services for children............... 18,986 15,574 18,986 ................ +3,412
Poison control........................................ 19,996 16,421 24,000 +4,004 +7,579
Traumatic Brain injury................................ 5,000 5,000 10,000 +5,000 +5,000
-----------------------------------------------------------------------------------------
Subtotal, Critical care programs.................... 43,982 36,995 52,986 +9,004 +15,991
Black lung clinics........................................ 6,000 6,000 7,000 +1,000 +1,000
Trauma Care............................................... 3,000 2,467 4,000 +1,000 +1,533
Nursing loan repayment for shortage area service.......... 2,279 2,279 15,000 +12,721 +12,721
Payment to Hawaii, treatment of Hansen's.................. 2,045 2,045 2,045 ................ ................
=========================================================================================
Subtotal, Other HRSA programs:..........................
Current year........................................ 1,036,957 960,419 1,059,042 +22,085 +98,623
Other HRSA programs--Advance Years...................... 30,000 ................ 30,000 ................ +30,000
Ryan White AIDS Programs:
Emergency Assistance...................................... 604,169 604,169 620,000 +15,831 +15,831
Comprehensive Care Programs............................... 910,969 910,969 950,000 +39,031 +39,031
AIDS Drug Assistance Program (ADAP) (NA).............. (589,000) (589,000) (610,000) (+21,000) (+21,000)
Early Intervention Program................................ 185,879 186,034 195,000 +9,121 +8,966
Pediatric HIV/AIDS........................................ 64,995 64,995 72,000 +7,005 +7,005
AIDS Dental Services...................................... 9,999 9,999 12,000 +2,001 +2,001
Education and Training Centers............................ 31,598 31,598 34,000 +2,402 +2,402
-----------------------------------------------------------------------------------------
Subtotal, Ryan White AIDS programs...................... 1,807,609 1,807,764 1,883,000 +75,391 +75,236
Family Planning............................................... 253,910 254,170 266,000 +12,090 +11,830
Health Care and Other Facilities.............................. 251,561 ................ 10,000 -241,561 +10,000
Buildings and Facilities...................................... 250 250 250 ................ ................
Rural Hospital Flexibility Grants............................. 24,997 24,997 25,000 +3 +3
National Practitioner Data Bank............................... 17,200 17,200 17,200 ................ ................
User Fees................................................. -17,200 -17,200 -17,200 ................ ................
Health Care Integrity and Protection Data Bank................ 4,317 8,000 8,000 +3,683 ................
User Fees................................................. -4,317 -8,000 -8,000 -3,683 ................
Community Access Program...................................... 139,991 15,041 15,041 -124,950 ................
Program Management............................................ 138,991 147,049 135,991 -3,000 -11,058
=========================================================================================
Total, Health resources and services.................... 5,570,177 4,972,687 5,518,843 -51,334 +546,156
Current year........................................ (5,540,177) (4,972,687) (5,488,843) (-51,334) (+516,156)
Advance year.................................... (30,000) ................ (30,000) ................ (+30,000)
HEALTH EDUCATION ASSISTANCE LOANS PROGRAM:
Liquidating account....................................... (10,000) (10,000) (10,000) ................ ................
Program account........................................... (9,000) ................ ................ (-9,000) ................
Program management........................................ 3,672 3,792 3,792 +120 ................
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND:
Post-fiscal year 1988 claims.............................. 114,355 114,855 114,855 +500 ................
HRSA administration....................................... 2,992 2,992 2,992 ................ ................
-----------------------------------------------------------------------------------------
Total, Vaccine injury................................... 117,347 117,847 117,847 +500 ................
=========================================================================================
Total, Health Resources and Services Admin.............. 5,691,196 5,094,326 5,640,482 -50,714 +546,156
Current year........................................ (5,661,196) (5,094,326) (5,610,482) (-50,714) (+516,156)
Fiscal year 2003.................................... (30,000) ................ (30,000) ................ (+30,000)
CENTERS FOR DISEASE CONTROL
DISEASE CONTROL, RESEARCH AND TRAINING
Birth Defects/Developmental Disabilities/Disability and Health 70,733 76,280 88,748 +18,015 +12,468
Chronic Disease Prevention and Health Promotion............... 749,773 574,560 701,654 -48,119 +127,094
Environmental Health.......................................... 137,279 136,683 171,863 +34,584 +35,180
Epidemic Services and Response................................ 77,797 80,303 85,303 +7,506 +5,000
Health Statistics............................................. 50,276 ................ 126,978 +76,702 +126,978
Evaluation Tap funding (NA)............................... (71,690) (126,978) ................ (-71,690) (-126,978)
HIV/AIDS, STD and TB Prevention............................... 1,044,149 1,068,452 1,121,612 +77,463 +53,160
Immunization.................................................. 552,605 574,645 637,145 +84,540 +62,500
Infectious Disease Control.................................... 317,674 331,518 331,518 +13,844 ................
Injury Prevention and Control................................. 142,850 143,655 146,655 +3,805 +3,000
Occupational Safety and Health \3\............................ 260,134 266,135 276,135 +16,001 +10,000
Preventive Health and Health Services Block Grant............. 135,030 135,030 135,030 ................ ................
Public Health Improvement..................................... 110,889 109,910 114,910 +4,021 +5,000
Buildings and Facilities...................................... 175,000 150,000 250,000 +75,000 +100,000
Office of the Director........................................ 41,521 49,440 49,440 +7,919 ................
Bioterrorism.................................................. 180,919 181,919 181,919 +1,000 ................
ATSDR \4\..................................................... (74,835) (78,235) (78,235) (+3,400) ................
-----------------------------------------------------------------------------------------
Total, Disease Control.................................. 4,046,629 3,878,530 4,418,910 +372,281 +540,380
Evaluation Tap funding (NA)......................... (71,690) (126,978) ................ (-71,690) (-126,978)
Total, Disease Control program level.................... (4,118,319) (4,005,508) (4,418,910) (+300,591) (+413,402)
NATIONAL INSTITUTES OF HEALTH
National Cancer Institute..................................... 3,716,064 4,153,398 4,258,516 +542,452 +105,118
National Heart, Lung, and Blood Institute..................... 2,287,015 2,554,319 2,618,966 +331,951 +64,647
National Institute of Dental and Craniofacial Research........ 304,606 340,158 348,767 +44,161 +8,609
National Institute of Diabetes and Digestive and Kidney 1,302,798 1,456,996 1,501,476 +198,678 +44,480
Diseases.....................................................
National Institute of Neurological Disorders and Stroke....... 1,172,132 1,311,179 1,352,055 +179,923 +40,876
National Institute of Allergy and Infectious Diseases......... 2,062,089 2,329,643 2,375,836 +313,747 +46,193
National Institute of General Medical Sciences................ 1,530,988 1,710,182 1,753,465 +222,477 +43,283
National Institute of Child Health and Human Development...... 978,136 1,095,954 1,123,692 +145,556 +27,738
National Eye Institute........................................ 507,842 568,103 614,000 +106,158 +45,897
National Institute of Environmental Health Sciences........... 502,987 561,729 585,946 +82,959 +24,217
NIEHS/Superfund (NA) \5\.................................. (62,861) (70,228) (70,228) (+7,367) ................
National Institute on Aging................................... 786,056 879,651 909,174 +123,118 +29,523
National Institute of Arthritis and Musculoskeletal and Skin 394,968 441,803 460,202 +65,234 +18,399
Diseases.....................................................
National Institute on Deafness and Other Communication 301,069 336,744 349,983 +48,914 +13,239
Disorders....................................................
National Institute of Nursing Research........................ 105,158 117,681 125,659 +20,501 +7,978
National Institute on Alcohol Abuse and Alcoholism............ 340,537 381,951 390,761 +50,224 +8,810
National Institute on Drug Abuse.............................. 779,510 905,810 902,000 +122,490 -3,810
National Institute of Mental Health........................... 1,103,062 1,234,389 1,279,383 +176,321 +44,994
National Human Genome Research Institute...................... 381,101 425,674 440,448 +59,347 +14,774
National Institute of Biomedical Imaging and Bioengineering... 68,823 115,425 140,000 +71,177 +24,575
National Center for Research Resources........................ 811,237 967,025 1,014,044 +202,807 +47,019
National Center for Complementary and Alternative Medicine.... 89,121 100,059 110,000 +20,879 +9,941
National Center on Minority Health and Health Disparities..... 132,044 158,421 158,421 +26,377 ................
John E. Fogarty International Center.......................... 50,472 56,446 57,874 +7,402 +1,428
National Library of Medicine.................................. 245,338 274,633 281,584 +36,246 +6,951
Office of the Director........................................ 188,346 232,929 236,408 +48,062 +3,479
Buildings and Facilities...................................... 153,761 236,600 306,600 +152,839 +70,000
-----------------------------------------------------------------------------------------
Total, N.I.H............................................ 20,295,260 22,946,902 23,695,260 +3,400,000 +748,358
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Mental Health:
Programs of Regional and National Significance............ 203,499 187,599 203,599 +100 +16,000
Mental Health Performance Partnership..................... 420,000 420,000 420,000 ................ ................
Children's Mental Health Services......................... 91,694 91,694 91,694 ................ ................
Grants to States for the Homeless (PATH).................. 36,855 36,855 39,855 +3,000 +3,000
Protection and Advocacy................................... 30,000 30,000 32,000 +2,000 +2,000
-----------------------------------------------------------------------------------------
Subtotal, Mental Health................................. 782,048 766,148 787,148 +5,100 +21,000
Substance Abuse Treatment:
Programs of Regional and National Significance............ 256,122 296,122 276,122 +20,000 -20,000
Substance Abuse Performance Partnership................... 1,665,000 1,725,000 1,725,000 +60,000 ................
-----------------------------------------------------------------------------------------
Subtotal, Substance Abuse Treatment..................... 1,921,122 2,021,122 2,001,122 +80,000 -20,000
Substance Abuse Prevention: Programs of Regional and National 175,013 175,013 189,013 +14,000 +14,000
Significance.................................................
Program Management and Buildings and Facilities............... 85,673 67,173 96,173 +10,500 +29,000
Evaluation funds (NA)..................................... ................ (29,000) ................ ................ (-29,000)
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Total, Substance Abuse and Mental Health................ 2,963,856 3,029,456 3,073,456 +109,600 +44,000