[House Report 115-862]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-862
======================================================================
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES
APPROPRIATIONS BILL, 2019
_______
July 23, 2018.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Cole, from the Committee on Appropriations,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 6470]
The Committee on Appropriations submits the following
report in explanation of the accompanying bill making
appropriations for the Departments of Labor, Health and Human
Services (except the Food and Drug Administration, the Agency
for Toxic Substances and Disease Registry and the Indian Health
Service), and Education, and the Committee for Purchase from
People Who Are Blind or Severely Disabled, Corporation for
National and Community Service, Corporation for Public
Broadcasting, Federal Mediation and Conciliation Service,
Federal Mine Safety and Health Review Commission, Institute of
Museum and Library Services, Medicaid and CHIP Payment and
Access Commission, Medicare Payment Advisory Commission,
National Council on Disability, National Labor Relations Board,
National Mediation Board, Occupational Safety and Health Review
Commission, Railroad Retirement Board, and Social Security
Administration for the fiscal year ending September 30, 2019,
and for other purposes.
INDEX TO BILL AND REPORT
_______________________________________________________________________
Page number
Bill Report
Summary of Estimates and Appropriation.....................
3
General Summary of the Bill................................
3
Title I--Department of Labor: 2
5
Employment and Training Administration............. 2
5
Employee Benefits Security Administration.......... 17
10
Pension Benefit Guaranty Corporation............... 17
11
Wage and Hour Division............................. 18
11
Office of Labor-Management Standards............... 18
12
Office of Federal Contract Compliance Programs..... 19
12
Office of Workers' Compensation Programs........... 19
12
Occupational Safety and Health Administration...... 23
14
Mine Safety and Health Administration.............. 26
15
Bureau of Labor Statistics......................... 28
15
Office of Disability Employment Policy............. 28
16
Departmental Management............................ 28
16
General Provisions................................. 34
19
Title II--Department of Health and Human Services: 48
20
Health Resources and Services Administration....... 48
20
Centers for Disease Control and Prevention......... 55
35
National Institutes of Health...................... 60
52
Substance Abuse and Mental Health Services
Administration................................. 68
77
Agency for Healthcare Research and Quality......... 73
86
Centers for Medicare & Medicaid Services........... 74
87
Administration for Children and Families........... 77
102
Administration for Community Living................ 86
109
Office of the Secretary............................ 89
116
Public Health and Social Services Emergency
Fund................................... 92
123
General Provisions................................. 94
126
Title III--Department of Education: 111
129
Education for the Disadvantaged.................... 111
129
Impact Aid......................................... 112
131
School Improvement Programs........................ 113
132
Indian Education................................... 114
135
Innovation and Improvement......................... 115
136
Safe Schools and Citizenship Education............. 115
140
English Language Acquisition....................... 115
141
Special Education.................................. 116
141
Rehabilitation Services............................ 119
143
Special Institutions for Persons with Disabilities. 120
145
Career, Technical and Adult Education.............. 120
146
Student Financial Assistance....................... 121
148
Student Aid Administration......................... 121
149
Higher Education................................... 121
150
Howard University.................................. 122
154
College Housing and Academic Facilities Loans...... 123
155
Historically Black College and University Capital
Financing
Program Account................................ 123
155
Institute of Education Sciences.................... 124
155
Departmental Management............................ 124
157
General Provisions................................. 125
159
Title IV--Related Agencies: 127
160
Committee for the Purchase from People Who Are
Blind or
Severely Disabled.............................. 127
160
Corporation for National and Community Service..... 128
161
Corporation for Public Broadcasting................ 133
163
Federal Mediation and Conciliation Service......... 134
163
Federal Mine Safety and Health Review Commission... 135
163
Institute of Museum and Library Services........... 135
163
Medicare Payment Advisory Commission............... 136
164
Medicaid and CHIP Payment and Access Commission.... 135
165
National Council on Disability..................... 135
166
National Labor Relations Board..................... 136
166
National Mediation Board........................... 139
167
Occupational Safety and Health Review Commission... 139
167
Railroad Retirement Board.......................... 139
167
Social Security Administration..................... 141
168
Title V--General Provisions: 146
173
House of Representatives Report Requirements.......
175
Summary of Estimates and Appropriations
The following table compares on a summary basis the
appropriations, including trust funds for fiscal year 2019, the
budget request for fiscal year 2019, and the Committee
recommendation for fiscal year 2019 in the accompanying bill.
2019 LABOR, HHS, EDUCATION BILL
[Discretionary funding in thousands of dollars]
----------------------------------------------------------------------------------------------------------------
Fiscal Year-- 2019 Committee compared to--
Budget Activity -------------------------------------------------------------------------------
2018 Enacted 2019 Budget 2019 Committee 2018 Enacted 2019 Budget
----------------------------------------------------------------------------------------------------------------
Department of Labor............. $12,217,573 $10,936,310 $12,128,762 -88,811 +1,192,452
Department of Health and Human 88,157,139 86,726,260 89,290,026 +1,132,887 +2,563,766
Services.......................
Department of Education......... 70,867,406 63,201,057 70,784,022 -83,384 +7,582,965
Related Agencies................ 15,296,511 13,596,913 14,965,762 -330,749 +1,368,849
----------------------------------------------------------------------------------------------------------------
General Summary of the Bill
For fiscal year 2019, the Committee recommends a total of
$179,002,000,000 in current year discretionary funding,
including offsets and adjustments. The fiscal year 2019
recommendation is an increase of $6,000,000 above the fiscal
year 2018 enacted level.
Within the funds provided, the Committee has again focused
increases on priority areas that will improve the health,
safety and job opportunities for Americans of all walks of
life.
First and foremost, the Committee continues to build on the
investments made over the past several years in biomedical
research by increasing funding for the National Institutes of
Health (NIH) by $1,250,000,000. Within the total increase, the
Committee provides an increase of $401,000,000 for Alzheimer's
disease research, an increase of $100,000,000 for the Cancer
Moonshot, and an increase of $30,000,000 for research to
develop a universal influenza vaccine. The Committee also
expands upon the Down syndrome research initiative established
in fiscal year 2018.
The Committee also continues efforts to support States and
local communities combat the national scourge of opioid
addiction by including an additional $500,000,000 for grants to
States. The Committee maintains funding levels for opioid abuse
prevention, treatment, and recovery and continues to support
robust funding for mental and behavioral health.
To protect public health and the Nation in the event of a
bioterrorism attack or other public health emergency, the
Committee recommendation includes increases for the Biomedical
Research and Advanced Development Authority (BARDA), Project
BioShield, the Strategic National Stockpile, the National
Disaster Management System, and grants to States and regional
coalitions to support public health preparedness. Finally, to
allow the Secretary of Health and Human Services greater
flexibility to respond to an imminent public health threat
without waiting for Congress to act on a supplemental spending
bill, the Committee establishes $325,000,000 for a new
Infectious Disease Rapid Response Reserve Fund. These funds
will be held until needed in the event of an imminent
infectious disease outbreak that threatens the health of
Americans.
To invest in workforce training, the Committee provides
$6,988,602,000 in worker training programs of which
$2,789,832,000 is for States' training grants, $150,000,000 is
to support the Administration's apprenticeship initiatives, and
$299,662,000 is for Veterans' Employment and Training,
including $50,000,000 for the Homeless Veterans' Reintegration
program, and a new initiative in the Transition Assistance
Program to connect transitioning service members to
apprenticeship opportunities.
In the area of education, the Committee has included an
increase of $100,000,000 for Student Support and Academic
Enrichment grants, bringing this program total to
$1,200,000,000. These funds can be used flexibly by school
districts across the country to meet local challenges, whether
those be in the area of counseling and preventing school based
violence or teacher training. The Committee also provides
funding for services to assist persons with disabilities live
with dignity and support in their local communities.
In the area of continuing education beyond high school, the
Committee includes robust increases for the TRIO, $50,000,000,
and GEAR UP, $10,000,000, programs to ensure that students from
disadvantaged backgrounds have access to a college program. The
Committee also includes an increase of $115,000,000 for career
and technical education programs, to ensure that all students
have the opportunity to continue to develop their skills after
high school and enter into good paying jobs. Finally, the bill
also provides sufficient funding to maintain the maximum Pell
grant award at $6,095 in the 2019-2020 academic year.
Finally, the Committee bill continues to invest in early
childhood education by increasing the Head Start program by
$50,000,000 and including $250,000,000 within the Department of
Health and Human Services for the Preschool Development Grants
program.
The Committee believes that public service is a public
trust that requires Federal employees to place ethical
principles above private gain. Federal employees are reminded
that they shall not advance a personal agenda or give
preferential treatment to any outside organization or
individual within the government programs that they administer.
Information that is received by the employee, including
information from other employees, offices, or Congress should
be handled in a professional and confidential manner in
accordance with Code of Federal Regulations regarding the basic
obligation of public service (5 CFR 2635.101).
The Committee directs each of the agencies funded by this
Act to continue to report any funds derived by the agency from
non-Federal sources, including user charges and fines, that are
authorized by law, to be retained and used by the agency or
credited as an offset in annual budget submissions.
TITLE I--DEPARTMENT OF LABOR
Employment and Training Administration
Appropriation, fiscal year 2018....................... $10,018,202,000
Budget request, fiscal year 2019...................... 8,787,050,000
Committee Recommendation.............................. 9,801,934,000
Change from enacted level......................... -216,268,000
Change from budget request........................ +1,014,884,000
The Employment and Training Administration (ETA)
administers Federal job training grant programs and Trade
Adjustment Assistance, and provides funding and oversight for
the State Unemployment Insurance and Employment Service system.
TRAINING AND EMPLOYMENT SERVICES
Appropriation, fiscal year 2018....................... $3,486,200,000
Budget request, fiscal year 2019...................... 3,220,549,000
Committee Recommendation.............................. 3,474,341,000
Change from enacted level......................... -11,859,000
Change from budget request........................ +253,792,000
Training and Employment Services provides funding for
Federal job training programs authorized primarily by the
Workforce Innovation and Opportunity Act of 2014 (WIOA).
Workforce Training.--The Committee reiterates its support
for efforts by the Department of Labor to improve workforce
training programs by building partnerships that will better
serve participants by connecting them with in-demand jobs and
helping to reduce the skills gap.
Apprenticeship.--The Committee supports the funding and
development of industry or sector partnerships as a means of
closing the skills gap and expanding work-based learning
programs and apprenticeships in in-demand industries.
Licensing.--The Committee continues to support the
Department's efforts to address ways in which harmonizing
licensing requirements across States can reduce barriers to
labor market entry and mobility, including for dislocated
workers, transitioning service members, and veterans.
Work Opportunity Tax Credit.--The Committee supports
efforts by the Department to assist States with the
implementation of the Qualified Long-Time Unemployment
Recipients category and to reduce backlogs of Supplemental
Security Income eligibility determinations.
Information Technology (IT) Consortia.--The Committee
continues to be concerned with the challenges faced by
Unemployment Insurance IT modernization projects being carried
out by State consortia. The Committee directs the Department to
continue to provide annual reports to the Committees on
Appropriations of the House of Representatives and the Senate
on the status of all consortia projects and to implement
appropriate policies and procedures for assessing and funding
projects by State consortia.
Adult Employment and Training Activities.--For Adult
Employment and Training Activities, the Committee recommends
$845,556,000, which is the same as the fiscal year 2018 enacted
level and $30,000,000 more than the fiscal year 2019 budget
request.
Youth Employment and Training Activities.--For Youth
Employment and Training Activities, the Committee recommends
$903,416,000, which is the same as the fiscal year 2018 enacted
level and $30,000,000 more than the fiscal year 2019 budget
request.
Dislocated Worker Employment and Training Activities.--For
Dislocated Worker Employment and Training Activities, the
Committee recommends $1,240,860,000 which is $20,859,000 less
than the fiscal year 2018 enacted level and $74,141,000 more
than the fiscal year 2019 budget request.
Of the total provided for Dislocated Worker Employment and
Training Activities, $1,040,860,000 is designated for State
grants that provide core and intensive services, training, and
supportive services for dislocated workers. In addition, States
use these funds for rapid response assistance to help workers
affected by mass layoffs and plant closures.
The remaining $200,000,000 is available for the Dislocated
Workers National Reserve (DWNR). The DWNR supports national
emergency grants, technical assistance and demonstration
projects as authorized by WIOA. The Committee recommendation
eliminates advance appropriations for the DWNR by providing
$200,000,000 in current year funds and rescinding the advance
provided in fiscal year 2018. No advance is provided for fiscal
year 2020. The Committee recommendation includes $30,000,000 to
assist dislocated workers in areas of the country with the
highest rates of poverty.
Native Americans.--For the Indian and Native American
programs, the Committee recommends $55,000,000, which is
$1,000,000 more than the fiscal year 2018 enacted level. The
fiscal year 2019 budget request proposed no funding for this
program.
Migrant and Seasonal Farmworkers.--For the National
Farmworker Jobs program, the Committee recommends $87,896,000,
which is the same as the fiscal year 2018 enacted level. The
fiscal year 2019 budget request proposed no funding for this
program.
YouthBuild.--For the YouthBuild program, the Committee
recommends $92,534,000, which is $3,000,000 more than the
fiscal year 2018 enacted level and $8,000,000 more than the
fiscal year 2019 budget request.
The Committee is aware of challenges rural and Tribal
communities have in applying for YouthBuild grants. The
Committee encourages the Department to consider ways more rural
and Tribal areas can participate in the YouthBuild program.
Technical Assistance.--The Committee recommends no direct
funding for technical assistance, which is the same as the
fiscal year 2018 enacted level and $2,000,000 less than the
fiscal year 2019 budget request. WIOA provides the authority to
use DWNR funds for technical assistance.
Reintegration of Ex-Offenders.--The Committee recommends
$93,079,000 for ex-offender retraining and reintegration
activities, which is the same as the fiscal year 2018 enacted
level and $14,755,000 more than the fiscal year 2019 budget
request.
Workforce Data Quality Initiative.--The Committee
recommends $6,000,000 for the Workforce Data Quality
Initiative, which is the same as the fiscal year 2018 enacted
level. The fiscal year 2019 budget request proposed no funding
for this program.
JOB CORPS
Appropriation, fiscal year 2018....................... $1,718,655,000
Budget request, fiscal year 2019...................... 1,296,938,000
Committee Recommendation.............................. 1,718,655,000
Change from enacted level......................... - - -
Change from budget request........................ +421,717,000
Operations.--For Job Corps Operations, the Committee
recommends $1,603,325,000, which is the same as the fiscal year
2018 enacted level and $413,513,000 more than the fiscal year
2019 budget request.
Construction, Rehabilitation, and Acquisition.--The
Committee recommends $83,000,000 for construction,
rehabilitation, and acquisition activities of Job Corps
centers, which is the same as the fiscal year 2018 enacted
level and $7,984,000 more than the fiscal year 2019 budget
request.
Administration.--The Committee recommends $32,330,000 for
the administrative expenses of the Job Corps program, which is
the same as the fiscal year 2018 enacted level and $220,000
more than the fiscal year 2019 budget request.
Job Corps is a residential education and vocational
training program that helps young people ages 16 through 24
improve the quality of their lives through vocational and
academic training.
The Committee continues to be concerned about the safety
and security of students in the Job Corps program. With amounts
provided in the fiscal years 2017 and 2018 Appropriations Acts,
a total of $25,500,000 has been provided for Job Corps
construction to address physical security at Job Corps
campuses. The Committee directs the Department to submit a
report within 90 days of enactment of this Act, the report
should include the amounts and uses of funds provided to
address physical security needs, planned uses of remaining
funds, including funds provided in this Act, and an estimate of
the costs of any remaining needs not addressed within current
funding levels.
On December 29, 2017, the Department of Labor Office of
Inspector General (DOL-OIG) issued a report entitled ``Job
Corps Took Action To Mitigate Violence, Drugs, and Other
Student Misconduct At Centers, But More Needs To Be Done''
(Report Number: 26-18-001-03-370). The Committee directs the
Department to work with the DOL-OIG to implement all remaining
recommendations detailed in the report.
The Committee is concerned that the Job Corps procurement
process continues to experience delays or corrective actions
that have resulted in a number of unnecessary and costly bridge
contracts. The Committee directs the Department to review the
Job Corps contract award process to reduce procurement
disruptions, bid protests, corrective actions, and the use of
bridge contracts. The Committee directs the Department to
submit a report within 30 days of the end of the fiscal year to
the Committees on Appropriations of the House of
Representatives and the Senate, and to the authorizing
Committees of jurisdiction, with detail on each Job Corps
contract awarded during the fiscal year, any corrective actions
taken, whether the award was protested, the outcome of the
protest, if a bridge contact was awarded, and whether the
bridge contract was awarded as a result of an award protest or
procurement backlog.
On March 30, 2018, DOL-OIG issued a report entitled ``Job
Corps Could Not Demonstrate Beneficial Job Training Outcomes''
(Report Number: 04-18-001-03-370). The Committee is concerned
with the DOL-OIG finding that Job Corps contractors could not
demonstrate they had assisted participants in finding jobs for
94 percent of the placements sampled. The Committee directs ETA
to work with DOL-OIG to implement the recommendations provided
in the report, to implement policies necessary to ensure that
contractors report accurate and timely data to the Department
as required, and to implement program policies that will
improve job placement outcomes in the Job Corps program.
The Committee remains concerned with the financial
management of the Job Corps program and directs the Department
to continue to work with ETA and DOL-OIG to improve financial
and administrative oversight of the Job Corps program.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Appropriation, fiscal year 2018....................... $400,000,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 400,000,000
Change from enacted level......................... - - -
Change from budget request........................ +400,000,000
The Community Service Employment for Older Americans
program provides grants to public and private non-profit
organizations that subsidize part-time work in community
service activities for unemployed persons aged 55 and older
whose family income is below 125 percent of the poverty level.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
Appropriation, fiscal year 2018....................... $790,000,000
Budget request, fiscal year 2019...................... 790,000,000
Committee Recommendation.............................. 790,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Trade Adjustment Assistance program (TAA) provides
assistance to workers adversely affected by international
trade. TAA provides training, income support, wage subsidies
for older workers, job search and relocation allowances to
groups of workers who file a petition and are certified as
eligible to apply for such benefits due to job losses resulting
from increases in imports or foreign trade.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
Appropriation, fiscal year 2018....................... $3,464,691,000
Budget request, fiscal year 2019...................... 3,325,298,000
Committee Recommendation.............................. 3,260,282,000
Change from enacted level......................... -204,409,000
Change from budget request........................ -65,016,000
The total includes $3,176,216,000 from the Employment
Security Administration Account from the Unemployment Trust
Fund and $84,066,000 from the General Fund of the Treasury.
These funds are used to support the administration of Federal
and State unemployment compensation laws.
Unemployment Insurance Compensation.--For Unemployment
Insurance (UI) Compensation, the Committee recommends
$2,529,713,000, which is $123,784,000 less than the fiscal year
2018 enacted level and $24,897,000 more than the fiscal year
2019 budget request. The total includes $2,515,816,000 for
State Unemployment Compensation and $13,897,000 for National
Activities.
The recommendation provides contingency funding for
increased workloads that States may face in the administration
of UI. During fiscal year 2019, for every 100,000 increase in
the total average weekly insured unemployment above 2,030,000,
an additional $28,600,000 shall be made available from the
Unemployment Trust Fund.
On September 26, 2017, DOL-OIG issued a report entitled
``Program Specific Performance Measures are Needed to Better
Evaluate the Effectiveness of the Reemployment Services and
Eligibility Assessment Program'' (Report Number: 04-17-002-03-
315). The Committee supports efforts detailed in the report by
ETA to provide technical assistance, improve data quality, and
assess performance of the Reemployment Services and Eligibility
Assessment (RESEA) program. The Committee urges ETA to
establish appropriate performance measures in order to
effectively assess the impact and outcomes of the program. The
Committee believes it is critical to obtain program data that
will allow program administrators and policy-makers to assess
the impact of the RESEA program on its participants and
effectively compare RESEA program outcomes with those of other
UI claimants.
The Committee includes $117,000,000 for the RESEA program,
and an additional $33,000,000 is made available pursuant to the
Bipartisan Budget Act of 2018 (PL 115-123). The Committee
continues to support the RESEA program and urges the Department
to focus its efforts on reducing the rate of improper payments
in the UI system.
On June 13, 2017, DOL-OIG issued a report entitled DOL
Needs to Do More to Reduce Improper Payments and Improve
Reporting (Report Number 03-17-002-13-001). The Committee notes
that the rate of improper payments in the UI program exceeds
program goals and remains among the highest of any Federal
program. The Committee directs ETA to work with DOL-OIG to
implement the policies and controls necessary to make
significant progress on reducing the rate of improper payments
in the UI program. As part of this effort, the Committee
encourages ETA to use the Unemployment Insurance Integrity
Center of Excellence and the Reemployment Services and
Eligibility Assessments programs to establish better monitoring
and control over UI payments. The Committee also encourages the
Department to promote access to data at entities funded through
the UI system, including the Unemployment Insurance Integrity
Center of Excellence, and the National Directory of New Hires,
in order for ETA and DOL-OIG to better conduct their oversight
responsibilities.
The Committee is aware that trade-impacted dislocations are
geographically sensitive, and that when there is a large worker
dislocation, a particular local area or American Job Center
(AJC) in a local area will experience a surge in the demand for
services. The Committee urges the Department to continue
assisting State agencies and AJCs, as appropriate, with Rapid
Response activities to provide a surge response to these
situations. The Committee also expects the Department to work
closely with States and local AJCs to understand if any
difficulties in providing TAA services are related to service
capacity issues.
Employment Service.--The Committee recommends $605,606,000
for the Employment Service, which is $80,625,000 less than
fiscal year 2018 enacted level and $85,490,000 less than the
fiscal year 2019 budget request. The Committee directs the
Department to limit the amount used for State administrative
purposes to 20 percent and to ensure funding for client
services is maintained at fiscal year 2018 enacted levels.
Foreign Labor Certification.--The Committee recommends
$62,310,000 for the Foreign Labor Certification (FLC) program,
which is the same as the fiscal year 2018 enacted level and
$118,000 more than the fiscal year 2019 budget request. The
recommendation includes $48,028,000 for Federal administration
and $14,282,000 for grants to States.
The FLC program administers temporary foreign worker
programs including the H-2A and the H-2B temporary visa
programs. These programs are essential to employers in
industries that have cyclical peaks or that are seasonal in
nature, including agriculture, tourism, and hospitality.
One-Stop Career Centers/Labor Market Information.--The
Committee recommends $62,653,000 for One-Stop Career Centers
and Labor Market Information, which is the same as the fiscal
year 2018 enacted level and $4,541,000 less than the fiscal
year 2019 budget request.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee recommends such sums as necessary for
Advances to the Unemployment Trust Fund and Other Funds. The
funds are made available to accounts authorized under Federal
and State unemployment insurance laws and the Black Lung
Disability Trust Fund when the balances in such accounts are
insufficient.
PROGRAM ADMINISTRATION
Appropriation, fiscal year 2018....................... $158,656,000
Budget request, fiscal year 2019...................... 154,265,000
Committee Recommendation.............................. 158,656,000
Change from enacted level......................... - - -
Change from budget request........................ +4,391,000
The recommendation includes $108,674,000 from the General
Fund of the Treasury and $49,982,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
Employee Benefits Security Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $181,000,000
Budget request, fiscal year 2019...................... 189,500,000
Committee Recommendation.............................. 180,600,000
Change from enacted level......................... -400,000
Change from budget request........................ -8,900,000
The Employee Benefits Security Administration (EBSA)
assures the security of retirement, health, and other
workplace-related benefits of working Americans.
The Committee is concerned that several large, private
sector pension plans are increasingly at risk of becoming
insolvent. The Committee directs EBSA, in coordination with the
Pension Benefit Guaranty Corporation (PBGC), to submit a report
within 180 days of enactment of this Act to the Committee on
Appropriations of the House of Representatives and the Senate,
and to the authorizing Committees of jurisdiction, describing
EBSA's efforts to mitigate risks to the PBGC system through
audits and enforcement activity.
The Committee directs EBSA to provide information in the
fiscal year 2020 Congressional Justification on current efforts
at the Federal Retirement Thrift Investment Board to increase
the participation of women, and minority-owned asset management
firms in the management of Thrift Savings Plan funds.
Pension Benefit Guaranty Corporation
Appropriation, fiscal year 2018....................... $424,417,000
Budget request, fiscal year 2019...................... 445,363,000
Committee Recommendation.............................. 445,363,000
Change from enacted level......................... +20,946,000
Change from budget request........................ - - -
The Pension Benefit Guaranty Corporation (PBGC) protects
the retirement incomes of nearly 40 million American workers in
nearly 24,000 private-sector defined benefit pension plans.
PBGC was created by the Employee Retirement Income Security Act
of 1974 to encourage the continuation and maintenance of
private-sector defined benefit pension plans, provide timely
and uninterrupted payment of pension benefits, and keep pension
insurance premiums at a minimum.
The recommendation includes bill language that defines
Pension Benefit Guaranty Corporation's discretionary authority
to incur additional unforeseen and emergency administrative
expenses related to its multiemployer plan insurance program.
The Committee directs PBGC to submit reports required by
the Employee Retirement Income Security Act of 1974 and the
Pension Protection Act of 2006.
Wage and Hour Division
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $227,500,000
Budget request, fiscal year 2019...................... 230,068,000
Committee Recommendation.............................. 225,500,000
Change from enacted level......................... -2,000,000
Change from budget request........................ -4,568,000
The Wage and Hour Division (WHD) enforces Federal minimum
wage, overtime pay, recordkeeping, and child labor requirements
of the Fair Labor Standards Act. WHD also has enforcement and
other administrative responsibilities related to the Migrant
and Seasonal Agricultural Worker Protection Act, the Employee
Polygraph Protection Act, the Family and Medical Leave Act, the
Davis Bacon Act, and the Service Contract Act.
The Committee urges the WHD to consider updating relevant
guidance, training, handbooks, or field manuals, as necessary,
to the extent that it will help ensure that enforcement is
current and consistent with applicable laws and regulations.
The Committee supports the Executive Order on Exemption
from Executive Order 13658 for Recreational Services on Federal
Lands, issued on May 25, 2018, and the exemption prescribed in
Section 2 of the order. Pursuant to Section 3, the Committee
expects the Department to implement this exemption as soon as
possible.
The Committee notes that many Americans are on waiting
lists for organ transplants and that waiting lists for kidney
transplants in particular are very long. Removing barriers to
live organ donation can help to significantly increase the
number of transplants and reduce the amount of time recipients
wait for transplants. The Committee supports efforts that seek
to remove impediments to live organ donation for those willing
to give the gift of life to others. The Committee requests that
WHD give notice on its website, or in other public
communications as appropriate, that living donors who are
otherwise qualified under the Family Medical Leave Act are
eligible for family medical leave when they donate solid
organs, or portions thereof, to another person.
Office of Labor-Management Standards
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $40,187,000
Budget request, fiscal year 2019...................... 46,634,000
Committee Recommendation.............................. 42,187,000
Change from enacted level......................... +2,000,000
Change from budget request........................ -4,447,000
The Office of Labor Management Standards (OLMS) administers
the Labor-Management Reporting and Disclosure Act, which
establishes safeguards for union democracy and union financial
integrity, and requires public disclosure reporting by unions,
union officers, employees of unions, labor relations
consultants, employers, and surety companies.
The Committee urges OLMS to make more information
publically available regarding its enforcement actions,
including findings and remedies, as appropriate, in order to
improve oversight and accountability under the Labor-Management
Reporting and Disclosure Act.
Office of Federal Contract Compliance Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $103,476,000
Budget request, fiscal year 2019...................... 91,100,000
Committee Recommendation.............................. 99,476,000
Change from enacted level......................... -4,000,000
Change from budget request........................ +8,376,000
The OFCCP ensures equal employment opportunity in the
Federal contracting community through enforcement, regulatory
work, outreach and education to workers and their advocates.
Office of Workers' Compensation Programs
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $117,601,000
Budget request, fiscal year 2019...................... 115,282,000
Committee Recommendation.............................. 117,601,000
Change from enacted level......................... - - -
Change from budget request........................ +2,319,000
The recommendation includes $115,424,000 in General Funds
from the Treasury and $2,177,000 from the Special Fund
established by the Longshore and Harbor Workers' Compensation
Act.
The Office of Workers' Compensation Programs (OWCP)
administers the Federal Employees' Compensation Act, the
Longshore and Harbor Workers' Compensation Act, the Energy
Employees Occupational Illness Compensation Program Act, and
the Black Lung Benefits Act. These programs provide eligible
injured and disabled workers and their survivors with
compensation, medical benefits, and services including
rehabilitation, supervision of medical care, and technical and
advisory counseling.
The Committee continues to support the efforts of OWCP to
reduce fraud and abuse related to the prescription of compound
pharmaceuticals and opioids.
SPECIAL BENEFITS
Appropriation, fiscal year 2018....................... $220,000,000
Budget request, fiscal year 2019...................... 230,000,000
Committee Recommendation.............................. 230,000,000
Change from enacted level......................... +10,000,000
Change from budget request........................ - - -
These funds provide mandatory benefits under the Federal
Employees' Compensation Act.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
Appropriation, fiscal year 2018....................... $70,319,000
Budget request, fiscal year 2019...................... 25,319,000
Committee Recommendation.............................. 25,319,000
Change from enacted level......................... -45,000,000
Change from budget request........................ - - -
The Committee recommends $25,319,000 for Special Benefits
for Disabled Coal Miners. This amount is in addition to the
$15,000,000 appropriated in fiscal year 2018 as an advance for
the first quarter of fiscal year 2019. The total program level
recommendation is $45,000,000 less than the fiscal year 2018
enacted level and the same as the fiscal year 2019 budget
request.
These funds provide mandatory benefits to coal miners
disabled by black lung disease, to their survivors and eligible
dependents, and for necessary administrative costs. The
Committee recommendation also provides $14,000,000 as an
advance appropriation for the first quarter of fiscal year
2020. These funds ensure uninterrupted payments to
beneficiaries.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS
COMPENSATION FUND
Appropriation, fiscal year 2018....................... $59,846,000
Budget request, fiscal year 2019...................... 59,098,000
Committee Recommendation.............................. 59,098,000
Change from enacted level......................... -748,000
Change from budget request........................ - - -
These funds provide mandatory benefits to eligible
employees or survivors of employees of the Department of Energy
(DOE); its contractors and subcontractors; companies that
provided beryllium to DOE; atomic weapons employees who suffer
from a radiation-related cancer, beryllium-related disease, or
chronic silicosis as a result of their work in producing or
testing nuclear weapons; and uranium workers covered under the
Radiation Exposure Compensation Act.
BLACK LUNG DISABILITY TRUST FUND
Appropriation, fiscal year 2018....................... $416,561,000
Budget request, fiscal year 2019...................... 328,182,000
Committee Recommendation.............................. 328,182,000
Change from enacted level......................... -88,379,000
Change from budget request........................ - - -
The Black Lung Disability Trust Fund pays black lung
compensation, medical and survivor benefits, and administrative
expenses when no mine operator can be assigned liability for
such benefits, or when mine employment ceased prior to 1970.
The Black Lung Disability Trust Fund is financed by an excise
tax on coal, reimbursements from responsible mine operators,
and short-term advances from the Treasury. The Emergency
Economic Stabilization Act of 2008 authorized a restructuring
of the Black Lung Disability Trust Fund debt and required that
annual operating surpluses be used to pay down the debt until
all remaining obligations are retired.
Occupational Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $552,787,000
Budget request, fiscal year 2019...................... 549,033,000
Committee Recommendation.............................. 545,250,000
Change from enacted level......................... -7,537,000
Change from budget request........................ -3,783,000
The Occupational Safety and Health Act of 1970 established
the Occupational Safety and Health Administration (OSHA) to
assure safe and healthy working conditions by setting and
enforcing standards and by providing training, outreach,
education and assistance.
Within the total for OHSA, the Committee provides the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Safety and Health Standards.......................... $18,000,000
Federal Enforcement.................................. 208,000,000
Whistleblower Programs............................... 17,500,000
State Programs....................................... 100,850,000
Technical Support.................................... 24,469,000
Federal Compliance Assistance........................ 73,981,000
State Consultation Grants............................ 59,500,000
Training Grants...................................... 0
Safety and Health Statistics......................... 32,900,000
Executive Direction and Administration............... 10,050,000
------------------------------------------------------------------------
The Committee urges OSHA to carefully consider public
comments submitted in response to OSHA's proposed regulation on
Cranes and Derricks in Construction: Operator Certification
Extension published by the Department of Labor in the Federal
Register on August 30, 2017 (82 Fed. Reg. 41184 et seq.). In
addition, the Committee encourages OSHA to prioritize comments
on changes to the rule that would relieve regulatory burdens
without compromising safety.
The explanatory statement accompanying the fiscal year 2016
Consolidated Appropriations Act directed OSHA to notify the
Committee on Appropriations of the House of Representatives and
the Senate 10 days prior to the announcement of any new
National, Regional, or Local Emphasis Program including the
circumstances and data used to determine the need for the
launch of the new program. The Committee directs OSHA to
continue to provide such notices in fiscal year 2019.
Mine Safety and Health Administration
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $373,816,000
Budget request, fiscal year 2019...................... 375,906,000
Committee Recommendation.............................. 367,589,000
Change from enacted level......................... -6,227,000
Change from budget request........................ -8,317,000
The Mine Safety and Health Administration (MSHA) enforces
the Federal Mine Safety and Health Act in underground and
surface coalmines and metal/non-metal mines.
The Committee continues bill language designating up to
$2,000,000 for mine rescue recovery activities, and provides
for the retention of fees up to $2,499,000 for the testing and
certification of equipment.
The Committee includes $10,537,000 for State assistance
training grants and provides the authority to use such funds
for the purchase and maintenance of equipment required by the
``Lowering Miners' Exposure to Respirable Coal Mine Dust,
Including Continuous Personal Dust Monitors'' regulation.
The Committee supports the efforts of MSHA to reemphasize
compliance assistance programs that help mine operators to
improve safety and comply with regulations without the threat
of punitive enforcement.
The Committee appreciates the significant reductions in
mining injury and illness rates that have been achieved in
recent years and remains a strong proponent for vigilant mine
safety oversight. The Committee notes significant worker
dislocations and mine closures as a result of economic
conditions throughout the mining industry, and in coal mining
in particular. The Committee reiterates its support for the
ongoing effort to bring MSHA enforcement into proportion by
redistributing resources and activities to the areas where mine
production is currently occurring.
The Committee continues to support advances MSHA has made
in mine rescue technology and communications. The Committee
directs MSHA to assess its current mine rescue deployment
capability and strategy and discuss ongoing operational and
resource needs in the fiscal year 2020 Congressional
Justification.
Bureau of Labor Statistics
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $612,000,000
Budget request, fiscal year 2019...................... 609,386,000
Committee Recommendation.............................. 612,000,000
Change from enacted level......................... - - -
Change from budget request........................ +2,614,000
The recommendation includes $547,000,000 from the General
Fund of the Treasury and $65,000,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
The Bureau of Labor Statistics (BLS) is an independent
national statistical agency that collects, processes, analyzes,
and disseminates essential economic data to the Congress,
Federal agencies, State and local governments, businesses, and
the public. Its principal surveys include the Consumer Price
Index and the monthly unemployment series.
Within the total for BLS, the Committee provides the
following amounts:
------------------------------------------------------------------------
Budget Activity FY 2019 Committee
------------------------------------------------------------------------
Employment and Unemployment Statistics............... $208,000,000
Labor Market Information............................. 65,000,000
Prices and Cost of Living............................ 210,000,000
Compensation and Working Conditions.................. 83,000,000
Productivity and Technology.......................... 10,800,000
Executive Direction and Staff Services............... 35,200,000
------------------------------------------------------------------------
Office of Disability Employment Policy
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $38,203,000
Budget request, fiscal year 2019...................... 27,000,000
Committee Recommendation.............................. 38,203,000
Change from enacted level......................... - - -
Change from budget request........................ +11,203,000
Office of Disability Employment Policy provides policy
guidance and leadership to eliminate employment barriers to
people with disabilities.
Departmental Management
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $337,844,000
Budget request, fiscal year 2019...................... 261,035,000
Committee Recommendation.............................. 270,444,000
Change from enacted level......................... -67,400,000
Change from budget request........................ +9,409,000
The recommendation includes $270,136,000 from the General
Fund of the Treasury and $308,000 from the Employment Security
Administration Account in the Unemployment Trust Fund. The
Departmental Management appropriation provides funds for the
staff responsible for Departmental operations, management, and
policy development.
Within the total for Departmental Management, the Committee
provides the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Program Direction and Support........................ $29,750,000
Departmental Evaluation.............................. 8,040,000
Legal Services....................................... 124,558,000
International Labor Affairs.......................... 18,500,000
Administration and Management........................ 28,450,000
Adjudication......................................... 35,000,000
Women's Bureau....................................... 13,750,000
Civil Rights Activities.............................. 6,880,000
Chief Financial Officer.............................. 5,516,000
------------------------------------------------------------------------
On June 13, 2017, DOL-OIG issued a report entitled ``DOL
Needs to Do More to Reduce Improper Payments and Improve
Reporting'' (Report Number 03-17-002-13-001). The Committee
believes that accurate data is an important aspect of reducing
improper payments. The Committee appreciates that the Office of
the Chief Financial Officer agreed with the information
presented in the report and supports the reevaluation of its
Federal Employees' Compensation Act Improper Payments
Methodology.
The Committee directs the Chief Evaluation Officer to focus
evaluation efforts on the delivery and efficiency of the
Department of Labor programs with the goal of providing
administrators with the information necessary to improve
program performance and more effectively achieve agency goals.
The Committee directs the Department to submit its annual
Operating Plan to the Committees on Appropriations of the House
of Representatives and the Senate within the 45-day statutory
deadline.
VETERANS EMPLOYMENT AND TRAINING
Appropriation, fiscal year 2018....................... $295,041,000
Budget request, fiscal year 2019...................... 281,595,000
Committee Recommendation.............................. 299,662,000
Change from enacted level......................... +4,621,000
Change from budget request........................ +18,067,000
The recommendation includes $50,000,000 from the General
Fund of the Treasury and $249,662,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
The Veterans Employment and Training (VETS) program serves
America's veterans and separating service members by preparing
them for meaningful careers, providing employment resources and
expertise, and protecting their employment rights.
Within the total for VETS, the Committee provides the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
State Administration Grants......................... $180,000,000
Transition Assistance Program........................ 23,000,000
Federal Administration............................... 43,248,000
Veterans Employment and Training Institute........... 3,414,000
Homeless Veterans Reintegration Program.............. 50,000,000
------------------------------------------------------------------------
The Committee continues to support the VETS program and
encourages the Department to pursue opportunities to cooperate
with other Federal, State, and private enterprises to help the
country better serve its veterans.
The Committee includes $3,500,000 for a pilot program
within the authority of the Transition Assistance Program (TAP)
to be used by the Secretary, in consultation with the
Departments of Defense and Veterans Affairs, to prepare
transitioning service members to qualify for apprenticeship
programs and to assist them with placement services as
appropriate. The Committee believes apprenticeships can offer a
pathway to a successful career by providing broad opportunities
for paid, work-based learning, mentorship, classroom education
or related instruction, and the ability to earn industry-
recognized credentials in a safe, supervised work environment.
The pilot is intended to identify effective approaches to
obtaining qualifications and helping to place transitioning
service members in apprenticeship programs as an additional
training opportunity under TAP. The Committee expects the pilot
program to include a robust evaluation component that will
allow program administrators to assess the training strategy
and determine, on a comparative basis, whether it is an
effective approach to help transitioning service members enter
the civilian workforce.
The Committee includes $500,000 for the initiation of the
HIRE Vets Medallion Program authorized by the Honoring
Investments in Recruiting and Employing American Military
Veterans Act of 2017.
INFORMATION TECHNOLOGY MODERNIZATION
Appropriation, fiscal year 2018....................... $20,769,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 29,169,000
Change from enacted level......................... +8,400,000
Change from budget request........................ +29,169,000
Information Technology (IT) Modernization provides a
dedicated source of funding for Department-wide IT
modernization projects together with funding through the
Department's Working Capital Fund.
The Committee expects the Department to prioritize projects
that will result in cost savings by decommissioning legacy
systems.
The Committee directs the Department to assign a qualified
project manager that is an employee of the Department to each
modernization project to ensure that IT modernization projects
are executed effectively, according to Departmental
requirements, on schedule, and within budget.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $89,147,000
Budget request, fiscal year 2019...................... 87,721,000
Committee Recommendation.............................. 89,147,000
Change from enacted level......................... - - -
Change from budget request........................ +1,426,000
The recommendation includes $83,487,000 from the General
Fund of the Treasury and $5,660,000 from the Employment
Security Administration Account in the Unemployment Trust Fund.
The DOL-OIG conducts audits of Department programs and
operations in order to determine that they comply with the
applicable laws and regulations, that they use resources
effectively, and that they are achieving their intended
results.
The Committee supports the DOL-OIG efforts to reduce
improper payments in the UI program, and to reduce fraud and
abuse in the Workers' Compensation programs related to the
prescription of compound pharmaceuticals and opioids.
General Provisions
Sec. 101. The Committee continues a provision to prohibit
the use of Job Corps funds for the salary of an individual at a
rate in excess of Executive Level II.
(TRANSFER OF FUNDS)
Sec. 102. The Committee continues a provision providing the
Secretary of Labor with the authority to transfer up to one
percent of discretionary funds between appropriations, provided
that no appropriation is increased by more than three percent
by any such transfer.
Sec. 103. The Committee continues a prohibition on use of
funds to purchase goods that are in any part produced by
indentured children.
Sec. 104. The Committee continues a provision related to
grants made from funds available to the Department under the
American Competitiveness and Workforce Improvement Act.
Sec. 105. The Committee continues a provision to prohibit
recipients of funds provided to the Employment and Training
Administration from using such funds for the compensation of
any individual at a rate in excess of Executive Level II.
(TRANSFER OF FUNDS)
Sec. 106. The Committee continues a provision providing the
Secretary of Labor with the authority to transfer funds made
available to the Employment and Training Administration to
Program Administration for technical assistance and program
integrity activities.
(TRANSFER OF FUNDS)
Sec. 107. The Committee continues a provision allowing up
to 0.75 percent of discretionary appropriations provided in
this Act for specific Department of Labor agencies to be used
by the Office of the Chief Evaluation Officer for evaluation
purposes.
Sec. 108. The Committee continues a provision relating to
the Fair Labor Standards Act and certain insurance personnel
conducting post-disaster activity.
(RESCISSION)
Sec. 109. The Committee continues a provision rescinding
advance appropriations in the Dislocated Workers' National
Reserve account.
Sec. 110. The Committee continues a provision relating to
flexibility of H-2B nonimmigrant crossings.
Sec. 111. The Committee continues a provision relating to
the Secretary's security detail.
Sec. 112. The Committee includes a new provision relating
to the Working Capital Fund.
TITLE II--DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services Administration
Appropriation, fiscal year 2018....................... $6,736,753,000
Budget request, fiscal year 2019...................... 9,559,591,000
Committee Recommendation.............................. 6,540,385,000
Change from enacted level......................... -196,368,000
Change from budget request........................ -3,019,206,000
The Health Resources and Services Administration (HRSA)
supports programs that provide health services to
disadvantaged, medically underserved, and special populations;
decrease infant mortality rates; assist in the education of
health professionals; and provide technical assistance
regarding the utilization of health resources and facilities.
PRIMARY HEALTH CARE
Appropriation, fiscal year 2018....................... $1,626,522,000
Budget request, fiscal year 2019...................... 5,091,522,000
Committee Recommendation.............................. 1,526,522,000
Change from enacted level......................... -100,000,000
Change from budget request........................ -3,565,000,000
Health Centers
The Committee recommends $1,525,522,000 for the Health
Centers program, which is $100,000,000 less than the fiscal
year 2018 enacted level and $3,565,000,000 less than the fiscal
year 2019 budget request.
The Committee includes bill language providing up to
$114,893,000 for the Federal Tort Claims Act program, which is
the same as the fiscal year 2018 enacted level and $15,000,000
above the fiscal year 2019 budget request. This program
provides medical malpractice liability protection to Federally
supported health centers.
The Committee provides not less than $20,000,000 for HRSA
to perform audits and compliance reviews of all health center
access points, with a goal of conducting a compliance or audit
review that includes every access point location at least every
five years for Federally Qualified Health Center Look-Alikes
and Health Centers receiving a grant under section 330 of the
Public Health Service Act. HRSA should provide uniform guidance
to health center project officers, monitor project officer
adherence to program guidance, and periodically assess whether
program guidance is meeting program objectives. HRSA will
conduct independent compliance reviews, ensuring all health
center access points have policies, procedures, and training to
comply with all applicable Federal laws. HRSA shall submit
quarterly reports to the Committees on Appropriations of the
House of Representatives and the Senate containing the results
of all audits and compliance reviews of health center access
points and oversight of health center project officers.
Home Visiting.--Enhanced integration between health care
providers and community programs helps transform the lives of
vulnerable babies born to at-risk, first-time mothers. Research
has shown that partnering first-time mothers with registered
nurses or other professional that provide ongoing home visits
dramatically improves the health and well-bring of these
families. The Committee encourages HRSA to expand partnerships
between Health Centers and evidence-based home visiting
programs in high need areas in order to improve pregnancy,
child health and developments, and other health outcomes, all
while reducing costs.
Perinatal Transmission of Hepatitis B.--The Committee is
aware that the 2017 National Academies of Sciences Engineering
and Medicine (NASEM) report entitled ``A National Strategy for
the Elimination of Hepatitis B and C'' reported that only half
of the hepatitis B infected women who give birth each year are
identified for case management, a proportion unchanged since
2000. The NASEM report also noted that without intervention
about 90 percent of the infants born to HepatitisB infected
women contract the virus at birth and are therefore at greater
risk of premature death from liver cancer or cirrhosis later in
life. The Committee is therefore pleased that HRSA has
implemented a strategy to increase the capacity of HRSA funded
clinics to address perinatal hepatitis B transmission,
including the use of telehealth to link experts with clinic
providers around the US. The Committee requests an update on
this effort in the fiscal year 2020 Congressional
Justification. HRSA should include in its update information on
the findings and recommendations on the effectiveness of this
intervention.
Tuberculosis.--The National Action Plan for Combating Drug
Resistant Tuberculosis recommended the creation of health-care
liaisons between State and local health departments and
institutions, including health centers that serve hard-to-reach
groups at risk for Tuberculosis (TB). The Committee has
previously directed the Administrator to report on coordination
between health centers and State and local TB control programs
to help ensure appropriate identification, treatment, and
prevention of TB among vulnerable populations. The Committee
requests an update in the fiscal year 2020 Congressional
Justification on this topic.
Free Clinics Medical Malpractice
The Committee recommends $1,000,000 for carrying out
responsibilities under the Federal Tort Claims Act. This amount
is the same as fiscal year 2018 enacted level and the fiscal
year 2019 budget request. The program provides medical
malpractice coverage to individuals involved in the operation
of free clinics in order to expand access to health care
services to low-income individuals in medically underserved
areas. A free clinic must apply, consistent with the provisions
applicable to community health centers, to have those
individuals ``deemed'' an employee of the Public Health
Service, and therefore eligible for coverage.
HEALTH WORKFORCE
Appropriation, fiscal year 2018....................... $1,060,695,000
Budget request, fiscal year 2019...................... 457,798,000
Committee Recommendation.............................. 1,244,006,000
Change from enacted level......................... +183,311,000
Change from budget request........................ +786,208,000
Health Professions
The Committee recommends $719,006,000 for the health
professions programs, which is $26,689,000 below the fiscal
year 2018 enacted level and $321,208,000 above the fiscal year
2019 budget request. The Health Professions programs support
grants for the development of the health workforce in fields
challenged by a high need and insufficient supply of health
professionals. Given that colleges and universities serve the
dual role of training students and carrying out a majority of
Federally-funded biomedical research, the Committee believes
that they serve as an ideal setting to expose future clinicians
to the evidence base that underlies their intended profession.
Within the total for Health Professions, the Committee
recommends the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
National Health Service Corps........................ $105,000,000
Tribal Set-aside................................. 20,000,000
Rural Set-aside.................................. 15,000,000
Health Professions Training for Diversity:
Centers of Excellence............................ 23,711,000
Faculty Loan Repayment........................... 1,190,000
Scholarships for Disadvantaged Students.......... 48,970,000
Workforce Information and Analysis................... 5,663,000
Primary Care Training and Enhancement................ 48,924,000
Oral Health Training Programs........................ 38,673,000
Dental Faculty Loan Repayment........................ 2,000,000
Interdisciplinary Community-based Linkages:
Area Health Education Centers.................... 38,250,000
Geriatric Programs............................... 40,737,000
Graduate Psychology Education.................... 24,916,000
Behavioral Health Workforce Education and 82,500,000
Training........................................
Public Health and Preventive Medicine................ 17,000,000
Advanced Education Nursing........................... 66,581,000
Nurse Education, Practice, and Retention............. 41,913,000
Nursing Workforce Diversity.......................... 17,343,000
NURSE Corps Scholarship and Loan Repayment........... 87,135,000
Nursing Faculty Loan Program......................... 28,500,000
------------------------------------------------------------------------
Primary Care Training and Enhancement
The Committee encourages HRSA to prioritize funds for the
training of physician assistants.
Eating Disorders.--The Committee encourages integration of
evidence-based training for health professionals to screen,
access, intervene, and refer patients to specialized treatment
for the severe mental illness of eating disorders as authorized
under the 21st Century Cures Act (PL 114-255).
Oral Health Training
The Committee recommends $38,673,000 for Oral Health
Training programs, which is the same as the fiscal year 2018
enacted level and $38,673,000 above the fiscal year 2019 budget
request. These programs serve to increase the number of medical
graduates from minority and disadvantaged backgrounds and to
encourage students and residents to choose primary care fields
and practice in underserved urban and rural areas.
Within the funds provided, the Committee includes not less
than $12,000,000 for General Dentistry Programs and not less
than $12,000,000 for Pediatric Dentistry programs. HRSA is
directed to provide continuation funding for pre-doctoral and
postdoctoral training grants initially awarded in fiscal year
2015.
Dental Faculty Loan Repayment
The Committee recommends $2,000,000 for the Dental Faculty
Loan Repayment program, which is the same as the fiscal year
2018 enacted level and $2,000,000 above the fiscal year 2019
budget request. This program seeks to increase the number of
dental and dental hygiene faculty in the workforce by assisting
dental and dental hygiene training programs to attract and
retain dental and dental hygiene faculty through loan
repayment.
The Committee directs HRSA to provide continuation funding
for grants initially awarded in fiscal years 2016, 2017, and
2018. The Committee strongly supports the work of pediatric
dentistry faculty supervising residents at dental training
institutions providing clinical services in dental clinics
located in dental schools, hospitals, and community-based
affiliated sites.
Area Health Education Centers
The Committee has included funding for Area Health
Education Centers (AHEC) oral health projects that establish
primary points of service and address the need to help patients
find treatment outside of hospital emergency rooms. The
Committee is aware that some state dental associations have
already initiated programs to refer emergency room patients to
dental networks. HRSA is urged to work with those programs.
The AHEC program facilitates the diversity of the
healthcare workforce; increases access to healthcare; delivers
vital patient care; reduces health disparities; improves health
outcomes; and increases revenue through creating new jobs and
services. AHEC centers are improving the distribution of the
health professions workforce, particularly in rural and
underserved areas and preparing health professionals to expand
collaborative practice and team models of care. The AHEC
programs and centers play a critical national role in
addressing health care workforce shortages, particularly those
in primary care through an established infrastructure. The AHEC
Program grantees support the recruitment and retention of
physicians, students, faculty and other primary care providers
in rural and medically underserved areas by providing local,
community-based, interdisciplinary primary care training.
Graduate Psychology Education
The Committee recommendation includes $24,916,000 for the
inter-professional Graduate Psychology Education Program to
increase the number of health service psychologists trained to
provide integrated services to high-need, underserved
populations in rural and urban communities. In addressing the
opioid epidemic, the Committee recognizes the growing need for
highly trained mental and behavioral health professionals to
deliver evidence-based behavioral interventions for pain
management. The Committee encourages HRSA to invest in programs
that expand access to treatment for substance use disorders in
Federally Qualified Health Centers. The Committee also
encourages HRSA to invest in geropsychology training programs
and to help integrate health service psychology trainees at
Federally Qualified Health Centers.
Behavioral Health Workforce Education and Training
The Committee recommends $82,500,000 for the Behavioral
Health Workforce Education and Training Grant Program. This
program establishes or expands internships or field placement
programs in behavioral health serving populations in rural and
medically underserved areas.
Nursing Education, Practice, and Retention
Veteran's Bachelor of Science Degree in Nursing.--The Nurse
Education, Practice, Quality and Retention Program's Veteran's
Bachelor of Science Degree in Nursing has been important in
helping our nation's veterans progress and graduate with a
Bachelor of Science in Nursing degree. The Committee supports
the enacted level for these efforts and urges HRSA to continue
this vital program, aimed at helping veterans transition to
civilian life, removing barriers, and building our nursing
workforce. HRSA should either continue to support current
grantees or re-compete this program in fiscal year 2019,
placing emphasis on institutions that already have a program in
place to support these veterans moving to nursing careers.
Children's Hospitals Graduate Medical Education
The Committee recommends $325,000,000 for the Children's
Hospitals Graduate Medical Education Payment program, which is
$10,000,000 more than the fiscal year 2018 enacted level and
$325,000,000 more than the fiscal year 2019 budget request. The
Children's Hospitals Graduate Medical Education Payment program
helps eligible hospitals maintain graduate medical education
programs, which support the training of residents to care for
the pediatric population and enhance the supply of primary care
and pediatric medical and surgical subspecialties.
Graduate Medical Education
Numerous studies have found evidence of a future shortage
of physicians, particularly for primary care. To ensure access
to care for impacted areas, the Committee includes $200,000,000
for grants to four year public universities to support expanded
and existing graduate education programs for health care
professions. The Committee includes bill language directing
HRSA to prioritize applications from Colleges of Medicine
located in States with a projected primary care provider
shortage. Within the States in the top quartile of primary care
provider shortage, HRSA is directed to give additional priority
to applications from universities who serve a large percentage
of Medicaid beneficiaries or are located in States with a
significant proportion of Federally recognized Tribes.
National Practitioner Data Bank
The Committee assumes $18,814,000 for the National
Practitioner Data Bank, which is the same as the fiscal year
2018 enacted level and the fiscal year 2019 budget request. The
Committee recommendation and the fiscal year 2019 budget
request assume that the data bank will be self-supporting. The
Committee continues to include bill language to ensure that
user fee collections cover the full costs of data bank
operations.
MATERNAL AND CHILD HEALTH
Appropriation, fiscal year 2018....................... $886,789,000
Budget request, fiscal year 2019...................... 1,136,200,000
Committee Recommendation.............................. 893,089,000
Change from enacted level......................... +6,300,000
Change from budget request........................ -243,111,000
Maternal and Child Health Block Grant
The Committee recommends $655,000,000 for the Maternal and
Child Health Block Grant, which is $3,300,000 more than the
fiscal year 2018 enacted level and $27,300,000 more than the
fiscal year 2019 budget request. States use the block grant to
improve access to care for mothers, children, and their
families; reduce infant mortality; provide pre- and post-natal
care; support screening and health assessments for children;
and provide systems of care for children with special health
care needs.
Neonatal Abstinence Syndrome.--The Committee is alarmed by
reports that the leading cause of maternal mortality in a
growing number of States is overdose and suicide, with a direct
connection to the opioid epidemic. The Committee also
recognizes the work done to implement the Protecting Our
Infants Act of 2015 (PL 114-91), which culminated in a strategy
to address gaps in research; overlaps, duplication, or gaps in
the relevant Federal programs; and coordination of Federal
efforts to address neonatal abstinence syndrome with
recommendations regarding maternal and child prevention,
treatment, and services. An October 2017 GAO report entitled
``Newborn Health: Federal Action Needed to Address Neonatal
Abstinence Syndrome'' recommended that HHS expeditiously
develop a plan for implementing the recommendations included in
the strategy. The Committee requests an update in the fiscal
year 2020 Congressional Justification on implementation of
recommendations outlined in the strategy and identification of
barriers to implementation, including specifics on any areas
where Congressional action is needed.
Special Projects of Regional and National Significance
The Committee continues bill language identifying specific
amounts for Special Projects of Regional and National
Significance (SPRANS). The Committee provides the following
within SPRANS:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Set-aside for Oral Health............................ $5,250,000
Set-aside for Epilepsy............................... 3,642,000
Set-aside for Sickle Cell Disease.................... 3,000,000
Set-aside for Fetal Alcohol Syndrome................. 477,000
Set-aside for Neonatal Abstinence Syndrome........... 1,300,000
------------------------------------------------------------------------
Alliance for Innovation on Maternal Health.--The Committee
is aware that more women in the US die from pregnancy
complications than in any other developed country, and that the
maternal mortality rate rose by 26 percent from 2000 to 2014,
and continues to rise. The Committee recognizes the vital role
of the Alliance for Innovation on Maternal Health (AIM) in
reducing maternal mortality and morbidity in the US by engaging
provider organizations, State-based health and public health
systems, consumer groups, and other stakeholders within a
national partnership to assist State-based teams in
implementing evidence-based maternal safety bundles. Maternal
safety bundles are a set of targeted, straightforward, and
evidence-based practices, that, when reliably implemented,
improve patient outcomes and reduce maternal mortality and
severe maternal morbidity. HRSA is encouraged to continue to
support AIM with adequate funding to meet the growing desire of
States and hospital systems to participate in the program.
Cell-free DNA Prenatal Screening.--The Committee recognizes
the importance the medical genetics workforce plays in
delivering on the promise of precision medicine, particularly
given the unprecedented advances in genetic testing and the
rapid and widespread application of these tests across all of
medicine. Appropriate pre- and posttest education and
counseling are critical for optimal implementation and the
avoidance of harm. The Committee requests that the GAO conduct
a nationwide analysis of the medical genetics workforce, to
include all medical genetics professionals. GAO's analysis
should include a determination as to whether there are
sufficient qualified professionals for this important and
growing health need, as well as whether there are particular
geographic areas of the country that lack access to genetics
counseling.
Childhood Cancer.--The Committee requests that GAO conduct
a review and submit recommendations to Congress on existing
barriers to obtaining and paying for adequate medical care for
survivors of childhood cancer. This report would include
identifying existing barriers to the availability of complete
and coordinated survivorship care for survivors of childhood
cancer and make recommendations to provide improved access and
payment plans for childhood cancer survivorship programs and
palliative care, including psychosocial services.
Hemophilia Treatment Centers.--The Committee provides level
funding for Hemophilia Treatment Centers. The Regional
Hemophilia Network Program uses a regional infrastructure of
hemophilia treatment centers to promote and improve the
comprehensive care of individuals with hemophilia and related
bleeding disorders or clotting disorders.
Improving Child Health.--The Committee provides level
funding for the third year of an ongoing study focused on
improving child health through a statewide system of early
childhood developmental screenings and interventions.
Infant-Toddler Court Teams.--The Committee includes
$3,000,000, within SPRANS, for the second year of a contract or
cooperative agreement to support research-based Infant-Toddler
Court Teams to change child welfare practices to improve well-
being for infants, toddlers, and their families. This funding
should help to build on and continue the work of sites
established through the Quality Improvement Center for
Research-based Infant-Toddler Court Teams, including by
providing training and technical assistance in support of such
court teams' efforts across the country.
Oral Health Literacy.--The Committee includes $1,000,000
within SPRANS for HRSA to develop and implement an oral health
awareness and education campaign across all of the relevant
HRSA divisions, including the Health Centers Program, Oral
Health Workforce, Maternal and Child Health, Ryan White HIV/
AIDS Program, and Rural Health. The Committee expects HRSA to
ensure these divisions collaborate in developing and
implementing the campaign. As part of this campaign, the
Committee directs HRSA to identify oral health literacy
strategies that are evidence-based and focused on oral
healthcare prevention and education, including prevention of
oral disease such as early childhood and other caries,
periodontal disease, and oral cancer. The Committee expects the
Chief Dental Officer to play a key role in the design,
monitoring, oversight, and implementation of this project.
Set-aside for Neonatal Abstinence Syndrome.--The Committee
is alarmed by the prevalence of Neonatal Abstinence Syndrome
(NAS), or babies born exposed to opioids and other drugs during
pregnancy, and the health issues these newborns face. The
Committee provides $1,300,000 to address NAS in areas where the
reported NAS incidence rate exceeds the national average.
Set-aside for Oral Health.--The Committee includes 250,000
to continue demonstration projects to increase the
implementation of integrating oral health and primary care
practice. The projects should model the core clinical oral
health competencies for non-dental providers that HRSA
published and initially tested in its 2014 report,
``Integration of Oral Health and Primary Care Practice.'' The
Committee expects the Chief Dental Officer to continue to
direct the design, monitoring, oversight, and implementation of
these projects.
Thalassemia.--HRSA has a long history of supporting
thalassemia services. The thalassemia program has been
instrumental in aiding patients with this inherited blood
disorder, especially as treatments and best practices have
evolved over time. The Committee strongly encourages HRSA to
reconstitute this program in order to ensure the continued
improvement of care and treatment options for patients with
this complex and debilitating blood disorder.
Maternal and Child Health Programs
In addition to the Maternal and Child Health Block Grant,
the Maternal and Child Health Bureau at HRSA supports several
programs to improve the health of all mothers, children, and
their families. These programs support activities that develop
systemic mechanisms for the prevention and treatment of sickle
cell disease; provide information and research on and promote
screening of autism and other developmental disorders; provide
newborn and child screening of heritable disorders; provide
grants to reduce infant mortality and improve perinatal
outcomes; fund States to conduct newborn hearing screening; and
provide grants to improve existing emergency medical services.
Within the total for Maternal and Child Health Programs,
the Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Sickle Cell Anemia Program........................... $4,455,000
Autism and Other Developmental Disorders............. 52,099,000
Heritable Disorders.................................. 16,883,000
Healthy Start........................................ 110,500,000
Universal Newborn Hearing............................ 17,818,000
Emergency Medical Services for Children.............. 22,334,000
Screening and Treatment for Maternal Depression...... 5,000,000
Pediatric Mental Health Access....................... 9,000,000
------------------------------------------------------------------------
Autism and Other Developmental Disorders
The Committee recommends $52,099,000 for Autism and Other
Developmental Disorders; this funding level is $3,000,000 more
than the fiscal year 2018 enacted level and $52,099,000 above
the fiscal year 2019 budget request. These programs seek to
improve the health and well-being of children and adolescents
with autism spectrum disorder and other developmental
disabilities and to advance best practices for the early
identification and treatment of autism and related
developmental disabilities.
Leadership Education in Neurodevelopmental and Related
Disabilities.--The Committee provides not less than $36,000,000
for the Leadership Education in Neurodevelopmental and Related
Disabilities (LEND) program to maintain the program's capacity
to train professionals to screen, diagnose, and provide
evidence-based interventions to individuals with autism
spectrum disorder and other developmental disabilities as
authorized by the Autism CARES Act (PL113-157). This program
provides advanced training to students and fellows from at
least 12 disciplines in the identification, assessment, and
treatment of children and youth with a wide range of
developmental disabilities, including autism. The 52 LEND
network programs in 44 states are making significant strides
toward improved screening and diagnosis of autism among younger
children and helping to train healthcare professionals who
treat a number of different developmental and intellectual
disabilities.
Pediatric Neurodevelopmental Delivery of Care.--The
Committee encourages the Secretary of HHS to collaborate with
public and private non-profit organizations with expertise in
pediatric neurodevelopmental disabilities, including autism, to
develop a pilot project designed to improve the delivery and
coordination of care and to lower costs through integrated
subspecialty outpatient service delivery models that
incorporate comprehensive diagnostic services and therapeutic
care for pediatric neurodevelopmental disability patients,
including those with autism. The Committee requests an update
on this activity in fiscal year 2020 Congressional
Justification.
Heritable Disorders
The Committee provides $16,883,000 for the Heritable
Disorders program, which is $1,000,000 more than the fiscal
year 2018 enacted level and $16,883,000 more than the fiscal
year 2019 budget request. Newborn Screening is a complex public
health system that relies on coordinated actions by
stakeholders, including clinicians, hospitals, parents, labs,
and public health professionals. HRSA's Heritable Disorders
Program supports a number of activities that strengthen this
system to ensure infants born in every State receive rapid
identification, early intervention, and potentially life-saving
treatment.
Newborn Screening.--Newborn Screening (NBS) is a complex
public health system that relies on coordinated actions by
stakeholders, including clinicians, hospitals, parents, labs,
and public health professionals. HRSA's Heritable Disorders
Program supports a number of activities that strengthen this
system to ensure infants born in every State receive rapid
identification, early intervention, and potentially life-saving
treatment. With new funding provided in fiscal year 2019, the
Heritable Disorders program will support expansion of efforts
to add new conditions to state newborn screening panels.
Beginning in fiscal year 2015, Congress provided an additional
$2,000,000 to support the wider implementation, education, and
awareness of NBS for a single disorder, Severe Combined Immune
Deficiency. Forty-five States now universally screen infants
for that disorder. HRSA will build on that successful program
by providing grants to support States with the implementation,
education, and awareness of newborn screening for new
conditions recently added to the Recommended Uniform Screening
Panel, including Pompe, Mucopolysaccharidosis I, and X-linked
adrenoleukodystrophy. The program will also disseminate
national, regional, and State education and training resources
for parents, families and providers.
Pediatric Hospice Care.--The Committee recognizes the
importance of pediatric hospice care. The Committee understands
the unique conditions surrounding pediatric hospice care and
grief support for families including the need to support family
members, the recognition that child death can have more intense
and longer grieving periods, and the need for development of
best practices for counseling, support, medication, and other
factors impacting the end of life experience for children. The
Committee encourages HRSA through the Heritable Disorders
Program to work with experienced hospice providers which are
not conflicted by decisions of whether to provide hospice or
curative treatments in the hospital to children nearing the end
of life to establish a pilot program aimed at developing best
practices.
Severe Combined Immune Deficiency.--Within the amount for
Heritable Disorders, the Committee provides $2,000,000 for the
second year of a grant to continue supporting wider
implementation, education, and awareness of newborn screening
for Severe Combined Immune Deficiency.
Healthy Start
The Committee recommends $110,500,000 for the Healthy Start
program, which is the same as the fiscal year 2018 enacted
level and $7,000,000 more than the fiscal year 2019 budget
request. The program provides discretionary grants to
communities with high rates of infant mortality to support
primary and preventive health care services for mothers and
their infants.
RYAN WHITE HIV/AIDS PROGRAM
Appropriation, fiscal year 2018....................... $2,318,781,000
Budget request, fiscal year 2019...................... 2,260,170,000
Committee Recommendation.............................. 2,318,781,000
Change from enacted level......................... - - -
Change from budget request........................ +58,611,000
The Ryan White Human Immunodeficiency Virus/Acquired
Immunodeficiency Syndrome (HIV/AIDS) program funds activities
to address the care and treatment of persons living with HIV/
AIDS who are either uninsured or underinsured and need
assistance to obtain treatment. The program provides grants to
States and eligible metropolitan areas to improve the quality,
availability, and coordination of health care and support
services to include access to HIV-related medications; grants
to service providers for early intervention outpatient
services; grants to organizations to provide care to HIV
infected women, infants, children, and youth; and grants to
organizations to support the education and training of health
care providers.
Within the total for the Ryan White HIV/AIDS program, the
Committee provides the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Emergency Assistance................................. $655,876,000
Comprehensive Care Programs.......................... 1,315,005,000
AIDS Drug Assistance Program..................... 900,313,000
Early Intervention Program........................... 201,079,000
Children, Youth, Women, and Families................. 75,088,000
AIDS Dental Services................................. 13,122,000
Education and Training Centers....................... 33,611,000
Special Projects of National Significance............ 25,000,000
------------------------------------------------------------------------
HEALTH CARE SYSTEMS
Appropriation, fiscal year 2018....................... $111,693,000
Budget request, fiscal year 2019...................... 116,518,000
Committee Recommendation.............................. 121,693,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +5,175,000
These programs support national activities that enhance
health care delivery in the US. Activities include maintaining
a national system to allocate and distribute donor organs to
individuals awaiting transplant; building an inventory of cord
blood units; maintaining a national system for the recruitment
of bone marrow donors; operating the 340B drug discount
program; and operating a national toll-free poison control
hotline.
Within the total for Health Care Systems, the Committee
provides the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Organ Transplantation................................ $25,549,000
National Cord Blood Inventory........................ 17,266,000
C.W. Bill Young Cell Transplantation Program......... 25,109,000
Office of Pharmacy Affairs........................... 15,238,000
Poison Control Centers............................... 22,846,000
Hansen's Disease Program............................. 13,706,000
Hansen's Disease Buildings and Facilities............ 122,000
Hansen's Payment to Hawaii........................... 1,857,000
------------------------------------------------------------------------
National Cord Blood Inventory
The Committee recommends $17,266,000 for the National Cord
Blood Inventory, which is $2,000,000 more than the fiscal year
2018 enacted level and $5,000,000 more than the fiscal year
2019 budget request. The National Cord Blood Inventory program
builds a genetically and ethnically diverse inventory of high-
quality umbilical cord blood for transplantation.
The Committee strongly supports the collection of umbilical
cord blood, which may be used to treat many blood and bone
marrow disorders such as leukemia, lymphoma, and sickle cell
disease. In order to expand access to life-saving transplants,
the Committee urges HRSA to fund public cord blood bank pilot
demonstrations that are focused on increasing recruitment of
donors and banking of cord blood units from diverse
populations. In addition, the Committee encourages HRSA to
support proposals for novel pilot programs using cord blood and
tissue-derived cellular therapies in regenerative therapies.
C.W. Bill Young Cell Transplantation Program
The Committee recommends $25,109,000 for the C.W. Bill
Young Cell Transplantation program, which is $1,000,000 more
than the fiscal year 2018 enacted level and $3,000,000 more
than the fiscal year 2019 budget request. The C.W. Bill Young
Cell Transplantation Program provides support to patients who
need a bone marrow transplant or umbilical cord blood
transplant. A bone marrow or cord blood transplant may be
needed for some patients who have leukemia, lymphoma, sickle
cell anemia, or other inherited metabolic or immune system
disorders.
Office of Pharmacy Affairs
The Committee provides $15,238,000 for the Office of
Pharmacy Affairs (OPA), which is $5,000,000 more than the
fiscal year 2018 enacted level and $11,000,000 less than the
fiscal year 2019 budget request. The Office of Pharmacy Affairs
oversees the 340B Drug Pricing Program, which requires drug
manufacturers to provide discounts on outpatient prescription
drugs to certain safety net health care providers.
The Committee includes an increase of $5,000,000 for
additional oversight of the 340B program. An in-depth
examination of the 340B program by the House Energy and
Commerce Committee resulted in a report entitled ``Review of
the 340B Drug Pricing Program.'' The Committee directs HRSA to
use additional funds to implement recommendations contained in
such report. Specifically, the Committee directs HRSA to
conduct additional audits of covered entities, finalize
guidance to clarify parameters of the 340B program, and
complete the rulemaking process for areas where HRSA has
regulatory authority.
The Committee does not include bill language requesting
authority to charge a user fee. The Committee does not include
appropriations language seeking additional regulatory
authority. The Committee believes such reform of the 340B
program is best addressed by the authorizing committee of
jurisdiction.
The 340B drug pricing program was designed to help safety
net providers maintain, improve, and expand patient access to
healthcare services. Since its enactment in 1992, the 340B
program has lowered the cost of outpatient drugs to government
funded health clinics, as well as nonprofit and public
hospitals that serve a disproportionate share of low-income
patients or rural communities whereby these entities are able
to provide additional services and benefits to the communities
they serve with the savings realized. The Committee recognizes
the 340B drug pricing program remains important, allowing
covered entities to stretch their resources to provide
comprehensive services to patients.
Since the 1990s, the health care landscape and the scope of
the 340B program has evolved significantly. A 2011 GAO report
on the 340B program found HRSA's guidance on program
requirements lacked the necessary level of specificity to
provide clear direction making it difficult for covered
entities to self-police or monitor compliance. GAO recommended
that HRSA release more specific guidance on the definition of
an eligible patient and issue guidance to further specify the
criteria for participating hospitals. The Committee supports
HRSA's continued engagement to provide program guidance to
covered entities in the 340B program.
The Committee is aware that the 340B statute requires HRSA
to make 340B ceiling prices available to covered entities
through a secure website and continues to be concerned that OPA
has failed to meet deadlines to complete work on the secure
website. The Committee urges OPA to complete the development of
a secure website. The Committee directs OPA to issue a report
to Congress on its progress implementing these security
measures.
Poison Control Centers
The Committee recommends $22,846,000 for Poison Control
Centers, which is $2,000,000 more than the fiscal year 2018
enacted level and $4,000,000 more than the fiscal year 2019
budget request. This program funds poison centers, a national
toll-free number (800-222-1222), and implements a nationwide
media campaign to educate the public and health care providers
about poison prevention, poison center services, and the 800
number.
The Committee recognizes the critical role of this proven
national public health program and the value of its highly
effective public-private/local-State-Federal partnership
services to all citizens. In 2015, 2.8 million calls were
managed by poison control centers, which is an average of
approximately 8,000 calls per day. Of these calls, 47 percent
were related to exposures to children five and under, and 22
percent came from health care facilities. Of the approximate
2.2 million poisonings reported in 2015, 67 percent were
managed at the site of exposure, avoiding unnecessary visits to
emergency departments.
Hansen's Disease Program
The Committee recommends $15,685,000 for the Hansen's
Disease Program, Hansen's Disease buildings and facilities, and
payment to Hawaii for treatment, which is the same as the
fiscal year 2018 enacted level and $2,175,000 more than the
fiscal year 2019 budget request. The Hansen's Disease Program
provides medical care, education, and research for Hansen's
disease (leprosy) and related conditions.
The Committee understands that the incidence of leprosy in
some areas has been increasing. With level funding provided for
this year, the Committee strongly encourages HRSA to sustain
its contracts with satellite clinics to ensure that essential
services are provided for these vulnerable patients and to
allow treatment for patients' ongoing problems and the timely
interventions for new complications and for newly diagnosed
patients.
RURAL HEALTH
Appropriation, fiscal year 2018....................... $290,794,000
Budget request, fiscal year 2019...................... 74,911,000
Committee Recommendation.............................. 281,294,000
Change from enacted level......................... -9,500,000
Change from budget request........................ +206,383,000
Rural Health programs provide funding to improve access,
quality, and coordination of care in rural communities; for
research on rural health issues; for technical assistance and
recruitment of health care providers; for screening activities
for individuals affected by the mining, transport, and
processing of uranium; for the outreach and treatment of coal
miners and others with occupation-related respiratory and
pulmonary impairments; and for the expansion of telehealth
services.
Within the total for Rural Health activities, the Committee
provides the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Rural Health Outreach Programs....................... $71,500,000
Rural Health Research................................ 9,351,000
Rural Hospital Flexibility Grants.................... 33,667,000
Small Hospital Improvement Grants.................... 25,942,000
State Offices of Rural Health........................ 11,000,000
Black Lung Clinics................................... 12,000,000
Radiation Exposure Screening and Education........... 1,834,000
Telehealth........................................... 23,500,000
Rural Communities Opioid Response.................... 82,500,000
Rural Residency Program.............................. 10,000,000
------------------------------------------------------------------------
Rural Health Outreach Programs
Rural Health Outreach programs funds activities that
improve access to and coordination of care in rural
communities, with a focus on building sustainable health
programs that continue beyond Federal funding. Outreach
programs focus on supporting rural community needs related to
issues such as such as behavioral health, oral health, care
coordination, quality improvement, workforce training, chronic
disease management and enhancing the rural health care delivery
system of rural hospitals, clinics and other safety net
providers. Programs under this heading include:
Outreach Service Grants, which focus on improving access
care in rural communities through the work of community
coalitions and partnerships.
Rural Network Development Grants, which support building
regional or local partnerships among local hospitals,
physicians groups, long-term care facilities, and public
agencies to improve management of scare health care resources.
Delta States Network Grant Program, which provides network
development grants to the eight states in Mississippi Delta for
network and rural health infrastructure development.
Network Planning Grants, which bring together key parts of
the rural healthcare delivery system to target emerging public
health issues.
Small Healthcare Provider Quality Improvement Grants, which
help improve patient care and chronic disease outcomes by
assisting rural primary care providers with the implementation
of quality improvement activities.
Rural Hospital Flexibility Grants
The Committee provides $33,667,000 for the Medicare Rural
Hospital Flexibility grant program, which provides funding to
State governments to support critical access hospitals through
quality, performance, and financial improvements.
Under the Rural Hospital Flexibility Grants, of the funds
provided for section 1820(g)(6) of the Social Security Act, the
Committee recommends a transition from supporting telehealth
activities to other efforts to improve care for rural veterans,
such as helping rural hospitals and clinics that seek to serve
as access points under the Veterans Affairs (VA) Community Care
Program or other VA-contracted care.
Small Hospital Improvement Grants
The Committee provides $25,942,000 for the Small Rural
Hospital Improvement Program, this program provides awards
through States to assist eligible small rural hospitals with
software and equipment related to quality, reporting, and
billing, with a particular focus on transitioning from
prospective payment system hospitals.
Telehealth
Within the funds provided for Telehealth, the agreement
continues support for the Telehealth Centers for Excellence,
which identify best practices, serve as national training
resources, and test the efficacy of different telehealth
clinical applications.
Given the rising rates of maternal mortality and severe
maternal morbidity, as well as barriers to access to care in
rural areas, the Committee encourages HRSA to explore the use
of telemedicine for high-risk pregnant women to include, but
not limited to pregnant women with chronic conditions,
preeclampsia, or a need to see a maternal-fetal medicine
specialist.
FAMILY PLANNING
Appropriation, fiscal year 2018....................... $286,479,000
Budget request, fiscal year 2019...................... 286,479,000
Committee Recommendation.............................. - - -
Change from enacted level......................... -286,479,000
Change from budget request........................ -286,479,000
The Committee does not recommend funding for the Family
Planning program. The Family Planning program administers Title
X of the Public Health Service Act.
PROGRAM MANAGEMENT
Appropriation, fiscal year 2018....................... $155,000,000
Budget request, fiscal year 2019...................... 151,993,000
Committee Recommendation.............................. 155,000,000
Change from enacted level......................... - - -
Change from budget request........................ +3,007,000
Program management supports the cost of Federal staff and
related activities to coordinate, direct, and manage the
programs of HRSA.
Chief Dental Officer.--The Committee is pleased that HRSA
has restored the position of Chief Dental Officer (CDO) and
looks forward to learning how the agency has ensured that the
CDO is functioning at an executive level authority with
resources to oversee and lead HRSA oral health programs an
initiatives. The Committee requests an update in the fiscal
year 2020 Congressional Justification on how the CDO is serving
as the agency representative on oral health issues to
international, national, State and/or local government
agencies, universities, and oral health stakeholder
organizations.
VACCINE INJURY COMPENSATION PROGRAM TRUST FUND
Appropriation, fiscal year 2018....................... $277,200,000
Budget request, fiscal year 2019...................... 317,200,000
Committee Recommendation.............................. 317,200,000
Change from enacted level......................... +40,000,000
Change from budget request........................ - - -
The National Vaccine Injury Compensation Program provides a
system of compensation for individuals with vaccine-associated
injuries or deaths. Funds for claims from vaccines administered
on or after October 1, 1988 are generated by a per-dose excise
tax on the sale of selected prescribed vaccines. The Vaccine
Injury Compensation Trust Fund receives revenues raised by this
tax. Trust funds made available will support the liability
costs of vaccines administered after September 30, 1988.
The Committee recommends $9,200,000 for administration of
the program, which is the same as the fiscal year 2018 enacted
level and the fiscal year 2019 budget request.
Centers for Disease Control and Prevention
Appropriation, fiscal year 2018....................... $8,301,166,000
Budget request, fiscal year 2019...................... 5,660,755,000
Committee Recommendation.............................. 7,685,266,000
Change from enacted level......................... -615,900,000
Change from budget request........................ +2,024,511,000
The Committee recommendation for the Centers for Disease
Control and Prevention (CDC) program level includes
$6,781,908,000 in discretionary budget authority, $55,358,000
in mandatory funds under the terms of the Energy Employees
Occupational Illness Compensation Program Act, and $848,000,000
in transfers from the Prevention and Public Health (PPH) Fund.
CDC's mission is to protect Americans from health, safety, and
security threats, which it accomplishes by supporting core
public health functions at State, local, and Tribal health
departments, detecting and responding to new and emerging
health threats, promoting health and safety, and providing
leadership in the public health workforce.
IMMUNIZATION AND RESPIRATORY DISEASES
Appropriation, fiscal year 2018....................... $798,405,000
Budget request, fiscal year 2019...................... 700,828,000
Committee Recommendation.............................. 808,405,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +107,577,000
The Committee recommendation includes $484,055,000 in
discretionary budget authority and $324,350,000 in transfers
from the PPH Fund.
Immunization grants are awarded to State and local public
health departments for planning, developing, and conducting
childhood, adolescent, and adult immunization programs,
including enhancement of the vaccine delivery infrastructure.
CDC directly maintains a stockpile of vaccines, supports
consolidated purchase of vaccines for State and local health
agencies, and conducts surveillance, investigations, and
research into the safety and efficacy of new and presently-used
vaccines.
Within the total for Immunization and Respiratory Diseases,
the Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Section 317 Immunization Program..................... $620,847,000
National Immunization Survey..................... 12,864,000
Influenza Planning and Response...................... 187,558,000
------------------------------------------------------------------------
Influenza Vaccine Procurement.--The Committee encourages
CDC to consider including vaccines produced through recombinant
DNA technology in addition to traditionally-produced vaccines
in future solicitations to facilitate the competitive process
for all vaccine manufacturers.
Section 317 Immunization Program.--The Committee believes
that a strong public health immunization infrastructure is
critical for ensuring high vaccination coverage levels,
preventing the spread of vaccine-preventable diseases, and
responding to outbreaks. During the 2015 measles outbreak,
section 317 funds supported State and local health departments
in rapid response, public health communication, data gathering,
and diagnostics.
HIV/AIDS, VIRAL HEPATITIS, SEXUALLY TRANSMITTED DISEASES, AND
TUBERCULOSIS PREVENTION
Appropriation, fiscal year 2018....................... $1,127,278,000
Budget request, fiscal year 2019...................... 1,117,278,000
Committee Recommendation.............................. 1,147,278,000
Change from enacted level......................... +20,000,000
Change from budget request........................ +30,000,000
CDC provides national leadership and support for prevention
research and the development, implementation, and evaluation of
evidence-based HIV, viral hepatitis, sexually transmitted
diseases (STD), and tuberculosis (TB) prevention programs
serving persons affected by, or at risk for, these infections.
Activities include surveillance, epidemiologic and laboratory
studies, and prevention activities. CDC provides funds to
State, local, and Tribal health departments and community-based
organizations to develop and implement integrated community
prevention plans.
Within the total for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention, the Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Domestic HIV/AIDS Prevention and Research............ $788,712,000
HIV Prevention by Health Departments............. 397,161,000
HIV Surveillance................................. 119,861,000
Activities to Improve Program Effectiveness...... 103,208,000
National, Regional, Local, Community, and Other 135,401,000
Organizations...................................
School Health-HIV................................ 33,081,000
Viral Hepatitis...................................... 39,000,000
Sexually Transmitted Diseases........................ 157,310,000
Tuberculosis......................................... 142,256,000
Elimination Initiative............................... 20,000,000
------------------------------------------------------------------------
Elimination Initiative.--The Committee includes $20,000,000
for the Infectious Disease Elimination Initiative proposed in
the fiscal year 2019 budget request. This new initiative will
support efforts to eliminate new infections such as HIV,
hepatitis B virus (HBV), hepatitis C virus (HCV), STDs, and TB
in high-risk States and jurisdictions, including those with
high rates of opioid-related transmission. The Committee
requests an update on this new initiative within 60 days of
enactment of this Act.
Latent Tuberculosis Infection.--CDC estimates that there
are up to 13 million individuals in the US with latent TB
infection. The identification and preventive treatment of
individuals with TB infection would prevent future active TB
cases, reducing future healthcare costs. The Committee again
urges the Director to support State and local TB programs to
effectively identify and treat latent TB infection cases.
Viral Hepatitis.--The Committee is concerned that as a
result of the opioid epidemic, infections of viral hepatitis
have spiked in many parts of the nation, including a 233
percent increase in infections nationwide since 2010. Even
though the HBV vaccine is more than 90 percent effective, there
were over 41,000 new HBV infections in 2016. The Committee
notes that the link between viral hepatitis infection and
primary liver cancer is well-established, with up to 60 percent
of global liver cancer cases caused by HBV. The Committee notes
that in 2017 the National Academies of Sciences, Engineering,
and Medicine (NASEM) report entitled ``A National Strategy for
the Elimination of Hepatitis B and C'' made a series of
recommendations for vaccination, higher rates of diagnosis,
care, and treatment. The Committee urges CDC, in cooperation
with the leading national viral hepatitis organizations, to
develop a plan to implement the NASEM recommendations to
achieve the goal of the elimination of hepatitis B and C. The
Committee also requests a report on CDC's plan for
implementation of the NASEM recommendations within 90 days of
enactment of this Act.
Viral Hepatitis and Injection Drug Use.--The Committee
notes that there has been a nationwide increase in new viral
hepatitis diagnoses and regional increases in HIV diagnoses
attributed to injection drug use associated with the opioid
epidemic. Research shows that awareness of one's HIV infection
status can increase motivation to begin substance use disorder
treatment, especially when medication-assisted treatment is
integrated with antiretroviral treatment for HIV patients. The
Committee looks forward to working with HHS to ensure opioid
resources address the overlapping public health testing
activities for affected communities.
EMERGING AND ZOONOTIC INFECTIOUS DISEASES
Appropriation, fiscal year 2018....................... $614,572,000
Budget request, fiscal year 2019...................... 508,328,000
Committee Recommendation.............................. 614,572,000
Change from enacted level......................... - - -
Change from budget request........................ +106,244,000
The Committee recommendation includes $562,572,000 in
discretionary appropriations and $52,000,000 in transfers from
the PPH Fund. Programs funded under Emerging and Zoonotic
Infectious Diseases (EZID) support the prevention and control
of infectious diseases through surveillance, outbreak
investigation and response, research, and prevention.
Within the total for EZID, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Core Infectious Diseases............................. $422,000,000
Emerging Infectious Diseases..................... 155,457,000
Lab Safety and Quality........................... 8,000,000
Antibiotic Resistance Initiative................. 168,000,000
All Other Infectious Diseases.................... 29,840,000
Vector-borne Diseases............................ 38,603,000
Lyme Disease..................................... 10,700,000
Prion Disease.................................... 6,000,000
Chronic Fatigue Syndrome......................... 5,400,000
Food Safety.......................................... 58,000,000
National Health Care Safety Network.................. 21,000,000
Quarantine........................................... 31,572,000
Advanced Molecular Detection......................... 30,000,000
Epidemiology and Laboratory Capacity................. 40,000,000
Healthcare-Associated Infections..................... 12,000,000
------------------------------------------------------------------------
Antibiotic Resistance Solutions Initiative.--The Committee
recognizes the importance of addressing antibiotic-resistant
bacteria through a ``One Health'' approach, simultaneously
combating antibiotic resistance in human, animal, and
environmental settings. The Committee encourages CDC to
competitively award research activities that address aspects of
antibiotic resistance related to ``OneHealth'' among entities,
including public academic medical centers, veterinary schools
with agricultural extension services, and State public health
departments whose proposals are in line with CDC's strategy for
addressing antibiotic resistant bacteria. The Committee
requests that CDC provide an updated spend plan to the
Committee within 30 days of enactment of this Act and include
an update on these efforts in the fiscal year 2020
Congressional Justification. The Committee encourages CDC to
prevent spread by enhancing State, local, and regional public
health capacity to prevent, detect, and respond to new and
existing antibiotic resistance faster and to develop a national
capacity to identify and catalog microbial genome sequences,
paying attention to antibiotic-resistant microbes. Finally, the
Committee encourages CDC to continue to pursue research
opportunities in the area of antimicrobial stewardship in
diverse healthcare settings and encourage regional
collaborations to study the most effective strategies to
improve antibiotic prescribing and stewardship.
Eye Health and Safety.--The Committee is aware of CDC's
long history in research related to keratitis outbreaks and
contact lens-related infections and applauds the development of
the healthy contact lens program. The Committee is also aware
of concerns raised in the medical community regarding rules
regulating the sale of contact lenses, which are Food and Drug
Administration (FDA) Class II and III medical devices. Given
these developments, the Committee directs CDC to update both
its 2010 report, Estimated Burden of Keratitis, to include the
most recent data available and its 2016 survey and reporting
related to risk behaviors for contact lens-related eye
infections. In addition, the Committee encourages CDC to work
with relevant professional societies to leverage data from
qualified clinical data registries on contact lens adverse
events, including those that do not result in permanent loss of
vision, to better inform the understanding of the risks
associated with contact lens wear.
Nutritional Alternatives to Antibiotic Use.--Each year,
approximately 97 million outpatient visits in the US are
associated with antibiotic prescriptions, with over half of all
women acquiring a urinary tract infection (UTI) at least once
in their lifetime. As E.coli, which is responsible for over 80
percent of UTIs, is becoming resistant to many antibiotics, the
Committee encourages support for stewardship efforts that
further examine the role that bioactive compounds found in
certain nutrient dense foods play in reducing antibiotic use.
The Committee further encourages CDC to continue to pursue
nutritional alternative opportunities in diverse healthcare
settings to study the most effective strategies to improve
antibiotic prescribing and stewardship.
Tick-Borne Disease Resources and Guidelines.--The Committee
encourages CDC to ensure transparency on its website of its
physician education programs regarding Lyme disease, including
scientific resources and schedules, to solicit input from the
treating physician community at large regarding such education
programs, and to include the broad spectrum of scientific
viewpoints; to provide written rationale for selection of Lyme
and tick-borne diseases treatment guidelines it displays on its
website; and to intensify surveillance of Borrelia infections
in non-endemic/non-high-incidence areas.
Vector-Borne Diseases.--The Committee recognizes the
critical role that EZID and its Vector-Borne Disease Program
play in ongoing efforts to prepare for and fight tropical
diseases emerging on US soil, such as Dengue, Chikungunya, and
Zika. EZID is critical to crafting sustainable long-term
abilities of States to prepare for vector-borne disease such as
Zika and West Nile and is the Federal government's only central
focus on vector control.
Vector-Borne Disease Centers of Excellence.--The Committee
is concerned about the Pacific Northwest being an underserved
region for funding and representation in the Regional Centers
of Excellence in Vector-Borne Diseases network recently
established by CDC. The ecology, disease transmission dynamics,
and resources for vector-borne disease training, surveillance,
and control in the Northwest differ significantly from those in
the five regional centers currently funded. The Committee
encourages CDC to examine options to provide greater coverage
the Northwest region for vector-borne disease resources.
CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION
Appropriation, fiscal year 2018....................... $1,162,896,000
Budget request, fiscal year 2019...................... 939,250,000
Committee Recommendation.............................. 1,205,396,000
Change from enacted level......................... +42,500,000
Change from budget request........................ +266,146,000
The Committee recommendation includes $910,746,000 in
discretionary appropriations and $294,650,000 in transfers from
the PPH Fund. Programs supported within Chronic Disease
Prevention and Health Promotion (CDPHP) provide national
leadership and support for State, Tribal, and community efforts
to promote health and well-being through the prevention and
control of chronic diseases.
The recommendation for CDPHP maintains the existing program
line items as they were funded in fiscal year 2018 and does not
provide funding for the America's Health Block Grant proposed
in the fiscal year 2019 budget request. Chronic diseases, such
as Alzheimer's disease, diabetes, heart disease, and stroke,
are the leading causes of death and disability in the US and
account for 86 cents of every dollar spent on health care. Many
of these conditions are largely preventable through improved
nutrition and physical activity. The Committee supports
evidence-based strategies to address public health priorities
through proven State-based grant programs, utilizing related
national organizations for technical assistance, and encourages
CDC to continue and expand these successful approaches.
Within the total provided, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Tobacco.............................................. $210,000,000
Nutrition, Physical Activity, and Obesity............ 54,920,000
High Obesity Rate Counties....................... 15,000,000
School Health........................................ 15,400,000
Health Promotion..................................... 18,000,000
Glaucoma......................................... 4,000,000
Visual Screening Education....................... 1,000,000
Alzheimer's Disease.............................. 4,500,000
Inflammatory Bowel Disease....................... 1,000,000
Interstitial Cystitis............................ 1,000,000
Excessive Alcohol Use............................ 4,000,000
Chronic Kidney Disease........................... 2,500,000
Prevention Research Centers.......................... 25,461,000
Heart Disease and Stroke............................. 147,062,000
Diabetes............................................. 155,129,000
National Diabetes Prevention Program................. 26,800,000
Cancer Prevention and Control........................ 367,674,000
Breast and Cervical Cancer....................... 218,000,000
WISEWOMAN.................................... 21,120,000
Breast Cancer Awareness for Young Women.......... 4,960,000
Cancer Registries................................ 49,440,000
Colorectal Cancer................................ 43,294,000
Comprehensive Cancer............................. 19,675,000
Johanna's Law.................................... 7,000,000
Ovarian Cancer................................... 9,500,000
Prostate Cancer.................................. 13,205,000
Skin Cancer...................................... 2,125,000
Cancer Survivorship Resource Center.............. 475,000
Oral Health.......................................... 22,000,000
Safe Motherhood/Infant Health........................ 50,000,000
Preterm Birth.................................... 4,000,000
Other Chronic Diseases............................... 26,000,000
Arthritis........................................ 13,000,000
Epilepsy......................................... 8,500,000
National Lupus Patient Registry.................. 6,500,000
Racial and Ethnic Approaches to Community Health..... 66,950,000
Good Health and Wellness in Indian Country....... 32,000,000
Million Hearts....................................... 4,000,000
National Early Child Care Collaboratives............. 4,000,000
Hospitals Promoting Breastfeeding.................... 10,000,000
------------------------------------------------------------------------
Alzheimer's Disease Healthy Brain Initiative.--The
Committee continues to support the Healthy Brain Initiative,
and encourages CDC to assist States in collecting cognitive
decline and caregiving data through the Behavioral Risk Factor
Surveillance System and implementing the Healthy Brain
Initiative's Public Health Roadmap for State and National
Partnerships.
Chronic Fatigue Syndrome.--The Committee applauds CDC's
efforts to collaborate with disease experts in its multi-site
study to resolve case definition issues around Myalgic
Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and urges
CDC to complete that effort. The Committee also commends CDC's
recent update of its website informing the public about ME/CFS
and encourages CDC to work with disease experts and patients to
continue to better educate healthcare providers about the
disease and its appropriate management. However, the Committee
is concerned that neither the website updates nor CDC's current
plans will address the continued medical stigma and
misinformation about ME/CFS and the critical lack of medical
providers. The Committee is also concerned that there are fewer
than twelve experts in the country. The Committee urges CDC to
partner with other HHS agencies, disease experts, and key
medical societies to implement a proactive plan to address
these issues and find creative ways to bring additional
clinicians into the field.
Chronic Obstructive Pulmonary Disease.--The Committee
commends the release of the Chronic Obstructive Pulmonary
Disease (COPD) National Action Plan and its comprehensive
approach to confronting the burden of COPD. The Committee
encourages CDC to begin implementation of the National Action
Plan by integrating COPD surveillance, research, prevention,
and management strategies into its chronic disease efforts.
Eating Disorders.--The Committee encourages CDC to assist
States in collecting data by reincluding standard questions on
unhealthy weight control practices for eating disorders,
including binge-eating, through the Youth Risk Behavioral
Surveillance System.
Inflammatory Bowel Disease.--The Committee commends CDC for
supporting epidemiological studies on Irritable Bowel Disease
(IBD), including a focus on minority and underserved
communities. The Committee encourages CDC to continue to
identify innovative approaches, including mixed methods
research, for determining the incidence and prevalence of IBD.
Maternal Health Pilot Project.--The Committee is aware that
the U.S. ranks 30th among 33 nations in infant mortality rates,
that these statistics disproportionately impact communities of
color, and that preventing infant mortality is challenging
because data is several years old and not consistently captured
or analyzed during pregnancy. Using real-time data from
maternity wards can enable public health officials, providers,
and communities to provide care and address needs during
pregnancy that can reduce and prevent high infant mortality and
morbidity rates. The Committee includes $2,000,000 within the
total available for Safe Motherhood/Infant Health, Preterm
Birth Perinatal Collaboratives to develop a maternal health
pilot project. This pilot should make use of existing State
biosurveillance tools to create a real-time database of
prenatal and newborn health data, including opioid related
concerns, such as neonatal abstinence syndrome, during
pregnancy and early motherhood, to forecast individual risk of
infant mortality and morbidity and to establish plans to
optimize care and referrals to promising or proven
interventions. CDC should focus this pilot on States with the
highest infant mortality rate.
Maternal Mortality Review Committees.--The Committee
includes $2,000,000 within the total available for Safe
Motherhood/Infant Health to support States to implement
maternal mortality review committees, including promoting best
practices and providing technical assistance, training, tools,
and resources.
National Lupus Patient Registry.--The Committee continues
to support research efforts under the National Lupus Patient
Registry program and acknowledges that there has been
significant progress to understand better the epidemiology of
lupus. However, the Committee recognizes that challenges and
disparities still remain. The Committee encourages CDC to focus
on studies related to the natural history and pathogenesis of
pediatric lupus to understand better the lifetime burden of
disease in children and young adults. The Committee also
encourages CDC and the Lupus Federal Working Group to
prioritize research into the racial and ethnic disparities in
lupus. Finally, the Committee encourages the continuing
development of lupus self-management programs by current lupus
registry cohorts and national voluntary health organizations
for adults with lupus to improve quality of life and health
outcomes.
Ovarian Cancer.--The Committee is pleased by CDC's launch
of Know: BRCA to help increase the public's awareness of
hereditary breast and ovarian cancers and improve understanding
the individual risk of having a BRCA mutation. The Committee
strongly encourages CDC to take steps to integrate components
of the Inside Knowledge Campaign, which works to increase
awareness of the signs and symptoms of ovarian and other
gynecologic cancers, and Know: BRCA to the extent possible, to
ensure coordination of public health messages related to
ovarian cancer, leveraging of resources, and maximizing
economies of scale.
Psoriatic Disease Initiative.--The Committee recognizes the
growing body of evidence linking psoriatic disease, which
impacts more than eight million Americans, to other
comorbidities such as cardiovascular disease, mental health,
substance abuse challenges, kidney disease, and other
conditions. The Committee commends CDC for identifying
opportunities for expanded research on psoriatic disease in its
Public Health Agenda for Psoriasis and Psoriatic Arthritis and
encourages CDC to support intramural and grant-based research
on the comorbidities of psoriatic disease, including research
that can be done in collaboration with or funded by other
disease programs such as Arthritis, Cardiovascular Health, or
Mental Illness.
Pulmonary Hypertension.--The Committee is concerned that
most pulmonary hypertension (PH) patients are not diagnosed for
many years until the condition has reached a catastrophic
stage, which leads to significant disability, greatly increased
mortality, and the need for costly and dramatic medical
interventions, such as heart-lung transplantation. Considering
the availability of effective therapies for early-stage PH, the
Committee encourages CDC to support education, awareness, and
epidemiology activities that promote early and accurate
diagnosis of PH.
Racial and Ethnic Approaches to Community Health.--The
Committee includes $32,000,000 within Racial and Ethnic
Approaches to Community Health to significantly expand the Good
Health and Wellness in Indian Country program. The Good Health
initiative supports efforts by American Indian and Alaska
Native communities to implement holistic and culturally-adapted
approaches to reduce tobacco use, improve physical activity and
nutrition, and increase health literacy. The Committee requests
an update on CDC's plans for this expansion within 60 days of
enactment of this Act.
Safe Motherhood and Infant Health.--The Committee continues
to support activities within this line related to maternal and
infant health, such as State-Based Perinatal Collaboratives and
the Pregnancy Risk Assessment Monitoring System, at the fiscal
year 2018 enacted level. The Committee recommendation does not
include funding for the teen pregnancy prevention cooperative
agreement.
Sepsis.--The Committee encourages CDC to increase its
public awareness, outreach, and education efforts on sepsis,
including health provider outreach and other related activities
to prevent sepsis and improve early recognition and management
of sepsis. The Committee requests CDC provide a report on its
activities to improve public awareness of sepsis in the fiscal
year 2020 Congressional Justification.
Type 1 Diabetes and Diabetic Ketoacidosis.--The Committee
is concerned about the increase in type 1 diabetes and the risk
of diabetic ketoacidosis. The Committee encourages CDC to
conduct national monitoring and epidemiologic analysis of
recent trends and determinants in type 1 diabetes and related
acute complications, including diabetic ketoacidosis, and to
educate key stakeholders, such as providers and others, on
effective diabetes management and prevention of acute
complications such as diabetic ketoacidosis.
BIRTH DEFECTS, DEVELOPMENTAL DISABILITIES, DISABILITIES, AND HEALTH
Appropriation, fiscal year 2018....................... $140,560,000
Budget request, fiscal year 2019...................... 110,000,000
Committee Recommendation.............................. 150,560,000
Change from enacted level......................... +10,000,000
Change from budget request........................ +40,560,000
This account supports efforts to conduct research on and
address the causes of birth defects and developmental
disabilities, as well as reduce the complications of blood
disorders and improve the health of people with disabilities.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Child Health and Development......................... $65,800,000
Birth Defects.................................... 19,000,000
Fetal Death...................................... 900,000
Fetal Alcohol Syndrome........................... 11,000,000
Folic Acid....................................... 3,150,000
Infant Health.................................... 8,650,000
Autism........................................... 23,100,000
Health and Development for People with Disabilities.. 59,660,000
Disability & Health incl. Child Development...... 27,000,000
Tourette Syndrome................................ 2,000,000
Early Hearing Detection and Intervention......... 10,760,000
Muscular Dystrophy............................... 6,000,000
Attention Deficit Hyperactivity Disorder......... 1,900,000
Fragile X........................................ 2,000,000
Spina Bifida..................................... 6,000,000
Congenital Heart Defects......................... 4,000,000
Blood Disorders...................................... 15,100,000
Public Health Approach to Blood Disorders........ 4,400,000
Hemophilia Activities............................ 3,500,000
Hemophilia Treatment Centers..................... 5,100,000
Thalassemia...................................... 2,100,000
Surveillance for Emerging Threats to Mothers and 10,000,000
Babies..............................................
------------------------------------------------------------------------
Duchenne Muscular Dystrophy and Newborn Screening.--The
Committee continues to be encouraged by efforts to develop a
newborn screening test for Duchenne Muscular Dystrophy. The
Committee is aware of the successful pilot project in Ohio and
supports CDC's plans to consider an additional State pilot.
Duchenne Muscular Dystrophy Surveillance.--The Committee is
pleased by the publication of updates of the care standards for
Duchenne Muscular Dystrophy and encourages CDC to continue
supporting widespread dissemination of these standards to all
appropriate provider audiences. The Committee is also aware of
CDC's efforts to support refinement of an ICD 10 code for
Duchenne and Becker Muscular Dystrophy (DBMD) and requests that
CDC use MD STARnet to monitor the implementation of the code
and measure how accurately and effectively the code is being
applied to known cases of DBMD.
Fragile X and Fragile X-Associated Disorders.--The
Committee commends CDC's efforts to identify and define the
population impacted by Fragile X (FX) and all conditions
associated with the gene mutation with the goal of
understanding the public health impact of these conditions. To
help this effort, the Committee urges the National Center on
Birth Defects and Developmental Disabilities (NCBDDD) to
support additional strategies to promote earlier identification
of children with FX, such as newborn screening. The Committee
acknowledges the significant progress made by NCBDDD in growing
its FORWARD Database and Patient Registry and extending FORWARD
participation to adults with FX. This project will have a
highly significant impact on understanding the natural history
of FX throughout the lifespan, and defining how to best measure
patient outcomes. Given the potential connections among FX, the
FX protein, and autism, the prospect of targeted treatments for
overlapping characteristics of both conditions, the Committee
urges the NCBDDD to explore cross-divisional funding
opportunities to accelerate data-driven public health research
to reduce the public health burdens of both FX and autism.
Health Promotion for People with Disabilities.--The
Committee supports the activities of the National Center on
Health, Physical Activity, and Disability (NCHPAD) and its
primary goal of promoting better health, wellness, and quality
of life for people with disabilities. The Committee encourages
NCHPAD to implement a demonstration project to develop and
implement strategies to reduce diabetes and obesity among
people with mobility limitations in coordination with CDC State
Disability and Health Programs.
Neonatal Abstinence Syndrome Surveillance.--The Committee
urges CDC to expand its surveillance of adverse infant outcomes
and long-term developmental outcomes of children who were
diagnosed with neonatal abstinence syndrome at birth, as very
little is currently known about the full impact of prenatal
opioid exposure or the educational and social challenges that
these children face as they grow and enter school. The
Committee urges CDC to recognize the complex nature of this
epidemic by studying the impact of poly-substance use as well
as opioid use by pregnant women, in addition to other factors
in the home setting that may affect the development of these
children.
Pre-Term Birth.--Preterm birth affects more than 380,000
babies each year in the US and is the leading cause of neonatal
mortality. The Committee commends CDC for funding six State-
based Perinatal Collaboratives that focus on improving birth
outcomes and maternal health and safety using known prevention
strategies such as reducing early elective deliveries.
Spina Bifida.--The Committee recognizes that spina bifida
is the most common permanently disabling birth defect in the
US. Each year in the US, about 1,500 babies are born with spina
bifida, and there are an estimated 166,000 individuals living
with all forms of this complex birth defect. Spina bifida and
related neural tube defects are largely but not entirely
preventable through education and adequate daily folic acid
consumption, so it is important to identify other risk factors
in order to allow more complete prevention of this devastating
birth defect. The Committee encourages CDC to use funding
provided for the National Spina Bifida Program (NSBP) to
support the continuation of the National Spina Bifida Patient
Registry and the Spina Bifida Clinical Care Monitoring and
Tracking program. Further, the Committee commends the NSBP for
serving as a model for programs assisting other individuals
living with similar complex conditions and encourages CDC to
continue to support the dissemination of information to
clinicians, parents, and families living with spina bifida.
Surveillance for Emerging Threats to Mothers and Babies.--
The Committee includes $10,000,000 for Surveillance for
Emerging Threats to Mothers and Babies, as proposed in the
fiscal year 2019 budget request. This new initiative will build
upon surveillance through the Zika pregnancy and infant
registry to monitor the long-term impact of Zika and can be
leveraged for other emerging infectious diseases and emerging
threats. The Committee requests an update on this new
initiative within 60 days of enactment of this Act.
Thalassemia.--The Committee is aware of the critical work
done by CDC's thalassemia program in connecting patients with
this rare genetic blood disorder to life-saving resources and
treatment centers. Thalassemia patients experience serious
comorbidities which can impact almost every aspect of their
lives. The Committee requests that the CDC continue
collaborating with thalassemia treatment centers, non-profits,
and patient advocates through this program.
PUBLIC HEALTH SCIENTIFIC SERVICES
Appropriation, fiscal year 2018....................... $490,397,000
Budget request, fiscal year 2019...................... 468,000,000
Committee Recommendation.............................. 495,397,000
Change from enacted level......................... +5,000,000
Change from budget request........................ +27,397,000
This account supports programs that provide leadership and
training for the public health workforce, support
infrastructure to modernize public health surveillance, promote
and facilitate science standards and policies, and improve
access to information on disease outbreaks and other threats.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Health Statistics.................................... $160,397,000
Surveillance, Epidemiology, and Informatics.......... 284,000,000
Laboratory Training and Oversight................ 5,000,000
Public Health Workforce.............................. 51,000,000
------------------------------------------------------------------------
National Neurological Conditions Surveillance System.--The
Committee provides $5,000,000 within the total for
Surveillance, Epidemiology, and Informatics for the
establishment of the National Neurological Conditions
Surveillance System (NNCSS), which was authorized in the 21st
Century Cures Act (PS 114-255). This funding will support CDC
to enhance and expand existing infrastructure and activities to
conduct surveillance of neurological conditions. The NNCSS will
provide for the collection and storage of key information on
incidence and prevalence of subset of neurological diseases in
the U.S.
Surveillance Data Platform.--The Committee encourages CDC
to continue the efforts started with the development of the
Surveillance Data Platform by using this program to modernize
the surveillance infrastructure of the over 100 surveillance
applications at CDC, leveraging and supporting initiatives in
CDC's 2014 Surveillance Strategy. This would be an important
step forward for CDC in modernizing their critical data
collection systems that will allow for better data sharing and
analysis on a common platform that will help reduce redundancy
and maintenance.
ENVIRONMENTAL HEALTH
Appropriation, fiscal year 2018....................... $205,750,000
Budget request, fiscal year 2019...................... 157,000,000
Committee Recommendation.............................. 201,350,000
Change from enacted level......................... -4,400,000
Change from budget request........................ +44,350,000
The Committee recommendation includes $184,350,000 in
discretionary appropriations and $17,000,000 in transfers from
the PPH Fund.
Programs supported within Environmental Health conduct
surveillance and data collection to detect and address emerging
pathogens and environmental toxins that pose significant
challenges to public health, as well as determine whether and
at what level of exposure these substances are harmful to
humans.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Environmental Health Laboratory...................... $68,750,000
Newborn Screening Quality Assurance Program...... 19,000,000
Newborn Screening/Severe Combined 1,250,000
Immunodeficiency Diseases.......................
Environmental Health Activities...................... 34,600,000
Environmental Health Activities.................. 16,000,000
Safe Water....................................... 8,600,000
Amyotrophic Lateral Sclerosis (ALS) Registry..... 10,000,000
Climate Change................................... 0
Environmental and Health Outcome Tracking Network.... 34,000,000
Asthma............................................... 29,000,000
Childhood Lead Poisoning............................. 35,000,000
------------------------------------------------------------------------
Harmful Algal Blooms.--The Committee supports the work that
CDC is doing to conduct surveillance for and report health
concerns related to harmful algal blooms and urges CDC to
continue this work and (1) to provide more outreach to State
and local public health officials to use these surveillance and
reporting systems, and (2) to work with other agencies,
including the Environmental Protection Agency, National Oceanic
and Atmospheric Administration, and United States Geological
Survey, to integrate disparate sets of data to allow for a
broader understanding of the spatial and temporal dynamics of
the environmental and health impacts of harmful algal blooms.
Intermountain West Wildfire Smoke Health Monitoring.--The
Committee is concerned with the public health impact of the
ever-increasing number and severity of wildfires in the
Intermountain West, noting increased long-term hospital
admissions due to respiratory symptoms and chronic obstructive
pulmonary disease. Through CDC's Environmental Public Health
Tracking Network, grantees are using data on wildfires to
educate residents in affected areas about ways to protect their
health during wildfires. The Committee continues to encourage
the use of the tracking network to better understand the impact
of wildfires in the Intermountain West and inform health
policymakers and resource managers.
Lyme Disease.--The Committee encourages CDC to consider
expanding activities related to developing sensitive and more
accurate diagnostic tools and tests for Lyme disease and
evaluating the development of a national reporting system.
National Asthma Control Program.--The Committee encourages
CDC to continue its 6|18 Initiative efforts which promote
evidence-based asthma medical management and strategies aimed
at improving access and adherence to the 2007 National Asthma
Education and Prevention Program.
Newborn Screening Quality Assurance Program.--The Committee
is aware that State laboratories need specialized support to
begin screening for additional newborn conditions and
recognizes CDC's expertise in working with laboratories to
implement accurate newborn screening tests. The Committee
supports the Newborn Screening Quality Assurance Program to
support State laboratories as they implement screening for new
disorders. The Committee encourage CDC to support evaluation of
testing methods for new conditions, expansion of CDC's quality
assurance materials, and funding to States for critical
335,200,000 and development of tests for rare conditions.
INJURY PREVENTION AND CONTROL
Appropriation, fiscal year 2018....................... $648,559,000
Budget request, fiscal year 2019...................... 266,309,000
Committee Recommendation.............................. 690,559,000
Change from enacted level......................... +42,000,000
Change from budget request........................ +424,250,000
Programs supported within Injury Prevention and Control
provide national leadership on violence and injury prevention,
conduct research and surveillance, and promote evidence-based
strategies to inform real-world solutions to prevent premature
death and disability and to reduce human suffering and medical
costs caused by injury and violence.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Intentional Injury................................... $102,730,000
Domestic Violence and Sexual Violence............ 32,700,000
Child Maltreatment........................... 7,250,000
Youth Violence Prevention........................ 15,100,000
Domestic Violence Community Projects............. 5,500,000
Rape Prevention.................................. 49,430,000
National Violent Death Reporting System.............. 23,500,000
Unintentional Injury................................. 8,800,000
Traumatic Brain Injury........................... 6,750,000
Elderly Falls.................................... 2,050,000
Injury Prevention Activities......................... 28,950,000
Opioid Overdose Prevention and Surveillance.......... 515,579,000
Injury Control Research Centers...................... 11,000,000
------------------------------------------------------------------------
Child Sexual Abuse Prevention.--It is estimated that 15 to
25 percent of girls and five to 10 percent of boys will
experience child sexual abuse. While the Federal government has
invested in treatment for victims and punishment for offenders,
the Committee believes that more emphasis should be placed on
prevention. The Committee requests that the Center report on
its current activities related to the development and
evaluation of primary public health interventions targeting
child sexual abuse. Additionally, the Committee requests that
the Center identify gaps in research that can be filled to
promote child sexual abuse primary prevention. The Committee
requests this report within 180 days of enactment of this Act.
Core State Violence and Injury Prevention Program.--The
Core State Violence and Injury Prevention Program (Core SVIPP)
is the only program of its kind in the US that uses research-
based evidence to identify the most effective strategies to
prevent injuries caused by accidents or violence. To further
strengthen State decision-making and support allocation of
funds to high burden areas, the Committee encourages CDC to
explore ways in which States can utilize Core SVIPP funds to
implement, evaluate, and disseminate effective violence and
injury prevention programs and policies beyond the four core
focus areas selected by CDC.
Gun Research.--The Committee continues a general provision
to prevent funds from being used to advocate for or promote gun
control.
Opioid Overdose Surveillance.--The Committee continues to
support the use of data to support forecasting of opioid-
related overdose risk, including by geographic region. The
Committee encourages CDC to initiate a demonstration project in
States experiencing the highest rates of opioid-related
overdose to use data to develop forecasts that public health
officials can use to intervene and prevent overdoses.
Prescription Drug Overdose.--The Committee commends CDC for
its leadership on combatting prescription and opioid drug
overdoses. The Committee encourages CDC to implement these
activities based on population-adjusted burden of disease
criteria, including mortality data (age-adjusted rate), as
significant criteria when distributing funds for the State PDO
Prevention activities. The Committee assumes these funds will
be distributed via a competitive mechanism and not merely a
mathematical formula or standard allocation to each State.
Further, the Committee strongly encourages CDC to support local
prevention activity to determine the effectiveness of
medication-approved treatment modalities in treating heroin and
prescription drug abuse and reducing diversion of buprenorphine
for illicit purposes.
NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH
Appropriation, fiscal year 2018....................... $335,200,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 339,200,000
Change from enacted level......................... +4,000,000
Change from budget request........................ +339,200,000
The National Institute for Occupational Safety and Health
(NIOSH) conducts applied research, develops criteria for
occupational safety and health standards, and provides
technical services to government, labor, and industry,
including training for the prevention of work-related diseases
and injuries. This appropriation supports surveillance, health
hazard evaluations, intramural and extramural research,
instrument and methods development, dissemination, and training
grants.
The Committee does not move NIOSH into NIH, as proposed in
the budget request. The Committee believes NIOSH's mission does
not align with NIH's focus on biomedical research and is better
achieved within CDC.
Within the total for NIOSH, the Committee recommends the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
National Occupational Research Agenda................ $118,000,000
Agricultural, Forestry, and Fishing.............. 27,500,000
Education and Research Centers....................... 31,000,000
Personal Protective Technology....................... 20,000,000
Mining Research...................................... 59,500,000
National Mesothelioma Registry and Tissue Bank....... 1,100,000
Other Occupational Safety and Health Research........ 109,600,000
------------------------------------------------------------------------
ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM
Appropriation, fiscal year 2018....................... $55,358,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 55,358,000
Change from enacted level......................... - - -
Change from budget request........................ +55,358,000
The Energy Employees Occupational Illness Compensation
Program (EEOICPA) provides compensation to employees and
survivors of employees of Department of Energy facilities and
private contractors who have been diagnosed with a radiation-
related cancer, beryllium-related disease, or chronic silicosis
as a result of their work. NIOSH estimates occupational
radiation exposure for cancer cases, considers and issues
determinations for adding classes of workers to the Special
Exposure Cohort, and provides administrative support to the
Advisory Board on Radiation and Worker Health.
The Committee does not move EEOICPA into NIH, as proposed
in the budget request. The Committee believes EEOICPA's mission
does not align with NIH's focus on biomedical research and is
better achieved within CDC.
GLOBAL HEALTH
Appropriation, fiscal year 2018....................... $488,621,000
Budget request, fiscal year 2019...................... 408,762,000
Committee Recommendation.............................. 488,621,000
Change from enacted level......................... - - -
Change from budget request........................ +79,859,000
Through its Global Health activities, CDC coordinates,
cooperates with, participates with, and provides consultation
to other nations, Federal agencies, and international
organizations to prevent and contain diseases and environmental
health problems and to develop and apply health promotion
activities. In cooperation with ministries of health and other
appropriate organizations, CDC tracks and assesses evolving
global health issues and identifies and develops activities to
apply CDC's technical expertise.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Global AIDS Program.................................. $128,421,000
Global Immunization Program.......................... $226,000,000
Polio Eradication................................ $176,000,000
Other Global/Measles............................. $50,000,000
Parasitic Diseases and Malaria....................... $26,000,000
Global Disease Detection and Emergency Response...... $108,200,000
Global Public Health Capacity Development............ $9,800,000
------------------------------------------------------------------------
Global Health Security and Global Health Research.--The
Committee supports CDC's work to protect American and global
health security through programs that detect, prevent, and
respond to infectious disease and other health threats. As
emerging infectious diseases like Ebola and Zika represent
perpetual challenges for the US health system, the Committee
supports continued and enhanced work in health research,
innovation, capacity-building for disease research, detection,
and surveillance, and robust monitoring and evaluation systems
at home and abroad.
Soil Transmitted Helminth and Related ``Diseases of
Poverty''.--The Committee provides $1,500.00, the same as
fiscal year 2018, for surveillance, source remediation, and
clinical care aimed at reducing Soil Transmitted Helminth
infection in areas not being addressed by the current outreach.
PUBLIC HEALTH PREPAREDNESS AND RESPONSE
Appropriation, fiscal year 2018....................... $1,450,000,000
Budget request, fiscal year 2019...................... 800,000,000
Committee Recommendation.............................. 860,000,000
Change from enacted level......................... -590,000,000
Change from budget request........................ +60,000,000
The Public Health Preparedness and Response (PHPR) account
supports programs that build and strengthen national
preparedness for public health emergencies, both naturally-
occurring and intentional. PHPR supports needs assessments,
response planning, training, epidemiology and surveillance, and
upgrades for laboratory capacity and communications systems.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
State and Local Preparedness and Response Capability. $698,200,000
Public Health Emergency Preparedness Cooperative 690,000,000
Agreement.......................................
Academic Centers for Public Health Preparedness.. 8,200,000
CDC Preparedness and Response........................ 161,800,000
BioSense......................................... 23,000,000
All Other CDC Preparedness and Response.......... 138,800,000
Strategic National Stockpile (SNS)................... 0
------------------------------------------------------------------------
Strategic National Stockpile.--The Committee includes
funding for the Strategic National Stockpile (SNS) in the
Office of the Assistant Secretary for Preparedness and
Response, as requested in the fiscal year 2019 budget request.
The Committee expects that this organizational change will
continue to include a significant role for CDC in providing
scientific expertise in decision-making related to procurement
of countermeasures as well as maintaining strong relationships
with State and local public health departments to facilitate
efficient deployment of countermeasures in public health
emergencies.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2018....................... $510,000,000
Budget request, fiscal year 2019...................... 30,000,000
Committee Recommendation.............................. 30,000,000
Change from enacted level......................... -480,000,000
Change from budget request........................ - - -
This account supports capital projects as well as repairs
and improvements to restore, maintain, and improve CDC's assets
at facilities in seven States and San Juan, Puerto Rico.
The Committee continues language from fiscal year 2018 to
allow CDC to retain unobligated funds in the Individual
Learning Accounts from departed employees to support the
replacement of the underground and surface coal mine safety and
health research facility.
CDC-WIDE ACTIVITIES AND PROGRAM SUPPORT
Appropriation, fiscal year 2018....................... $273,570,000
Budget request, fiscal year 2019...................... 155,000,000
Committee Recommendation.............................. 598,570,000
Change from enacted level......................... +325,000,000
Change from budget request........................ +443,570,000
The Committee recommendation includes $438,570,000 in
discretionary funds and $160,000,000 in transfers from the PPH
Fund.
This account supports public health leadership and support
activities at CDC.
Within the total, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
nPreventive Health and Health Services Block Grant... $160,000,000
Public Health Leadership and Support................. 113,570,000
Infectious Disease Rapid Response Reserve Fund....... 300,000,000
------------------------------------------------------------------------
Biomonitoring.--The Committee directs CDC to examine how to
utilize Biomonitoring Equivalents, or similar methods, to
interpret and communicate human biomonitoring results from the
National Biomonitoring Program in a health risk assessment
context, including an estimate of the resources needed, and
report their findings to the Committee within 90 days of
enactment of this Act.
Foundation for the CDC.--The Committee directs the
Foundation for the Centers for Disease Control and Prevention
(``Foundation'') to abide by section 399G(h)(7) of the Public
Health Service Act by including in the Foundation's annual
report the source and amount of all monetary gifts to the
Foundation, as well as the source and description of all gifts
of real or personal property. Each annual report shall disclose
a specification of any restrictions on the purposes for which
gifts to the Foundation may be used. The annual report shall
not list ``anonymous'' as a source for any gift that includes a
specification of any restrictions on the purpose for which the
gift may be used.
Infectious Disease Rapid Response Reserve Fund.--The
Committee recommendation includes $325,000,000 within this
account for a new Infectious Diseases Rapid Response Reserve
Fund. The Reserve Fund, in which funds will be available until
expended, will provide an immediate source of funding to
quickly respond to a future, imminent infectious disease crisis
that endangers American lives without waiting for Congress to
act on a supplemental funding bill. Bill language establishing
the Reserve Fund is included in section 228 of the General
Provisions for this Title.
Public Health Information.--The Committee notes limited
information is available which compares controlled substances
transactions reported to the Drug Enforcement Administration
(DEA) with available public health information collected by the
CDC. The Committee encourages CDC to incorporate on its website
addressing opioid overdose, DEA data from the Automated Reports
and Consolidated Ordering System Retail Drug Summary Report.
The Committee further encourages CDC to include an interactive
map to view current data provided by the DEA displaying the
amount of grams of fentanyl, hydrocodone, oxycodone and other
controlled substances that have been shipped to each State. The
website should also include accessible and frequently updated
CDC data on overdose death rates and the incidence rates of
HIV, Hepatitis A, B, and C for each State in an interactive
manner that allows users to compare on the same page, the
amounts of drugs distributed with public health morbidities.
The Committee requests an update on this effort in the fiscal
year 2020 Congressional Justification.
National Institutes of Health
Appropriation, fiscal year 2018....................... $37,084,000,000
Budget request, fiscal year 2019...................... 34,588,391,000
Committee Recommendation.............................. 38,334,000,000
Change from enacted level......................... +1,250,000,000
Change from budget request........................ +3,745,609,000
The Committee recommendation for the National Institutes of
Health (NIH) program level includes $37,661,129,000 in
discretionary appropriations and $922,871,000 in Public Health
Service Act section 241 evaluation set-aside transfers. Within
the total discretionary appropriation, the Committee
recommendation includes $711,000,000 in budget authority
authorized in the 21st Century Cures Act (PL 114-255).
The mission of NIH is to seek fundamental knowledge about
the nature and behavior of living systems and the application
of that knowledge to enhance health, lengthen life, and reduce
illness and disability. NIH conducts and supports research to
understand the basic biology of human health and disease;
applies this understanding towards designing new approaches for
preventing, diagnosing, and treating disease and disability;
and ensures that these approaches are widely available.
The recommendation provides the following funding
increases: $401,000,000 for Alzheimer's disease research;
$100,000,000 for the Cancer Moonshot Initiative; $147,000,000
for the ``All of Us'' precision medicine initiative;
$29,000,000 for the Brain Research through Application of
Innovative Neurotechnologies (BRAIN) Initiative; $15,000,000
for combating antibiotic-resistant bacteria; $30,000,000 for
the development of a universal influenza vaccine; and
$15,000,000 for Institutional Development Awards. The Committee
also continues and expands upon the trans-NIH Down syndrome
research initiative that was established in fiscal year 2018.
The Committee recommendation also provides an increase for
every Institute and Center (IC) to support innovative research
to advance fundamental knowledge and speed the development of
new therapies and diagnostics to improve the health of all
Americans.
The Committee expects the 3.4 percent increase of funds
over the fiscal year 2018 enacted level to support an increase
in the number of new and competing Research Project Grants,
with a focus on early-stage investigators and investigators
seeking first-time renewals. The Committee expects NIH to
provide a stipend level increase to training grantees that is
consistent with any fiscal year 2019 Federal employee pay
raise. The Committee continues to provide in bill language
funding levels for Clinical and Translational Science Awards,
Institutional Development Awards (IDeA), the Cures Acceleration
Network, the Common Fund, and the Environmental Influences on
Child Health Outcomes study.
The Committee recommendation does not include the general
provision proposed in the fiscal year 2019 budget request to
limit the percentage of a researcher's salary that may be paid
for using NIH grant funds, as the impact of this policy change
is unclear. The Committee requests an analysis of the projected
impact of such a policy change on the number and average cost
of NIH grants, as well as on academic institutions, in the
fiscal year 2020 Congressional Justification.
NATIONAL CANCER INSTITUTE (NCI)
Appropriation, fiscal year 2018....................... $5,964,800,000
Budget request, fiscal year 2019...................... 5,626,312,000
Committee Recommendation.............................. 6,136,037,000
Change from enacted level......................... +471,237,000
Change from budget request........................ +509,725,000
Mission.--NCI leads, conducts, and supports cancer research
across the nation to advance scientific knowledge and help all
people live longer, healthier lives.
Access to Clinical Trials.--The Committee supports NCI's
efforts to improve equitable patient access to and
participation in cancer clinical trials at NCI and NCI-
designated Cancer Centers across the country, including an
emphasis on patient enrollment, retention, and minority
participation in those trials. The Committee believes that an
underappreciated cause of low enrollment into cancer clinical
trials is the barrier that ancillary cost of participation
creates, especially for underserved and minority communities.
This creates an access issue for many patients who could
participate in clinical trials in order to take advantage of
the medical advances trials offer as an alternative to hospice.
The Committee directs NCI to implement a new pilot initiative
to investigate the impact of providing navigation and direct
patient expense reimbursement associated with participation in
cancer clinical trials on cancer clinical trial enrollment,
retention, patient outcomes, and research outcomes, including
among underrepresented and minority communities. NCI is
encouraged to develop the pilot research program in
consultation with NCI-designated Cancer Centers, the National
Clinical Trials Network, the NCI Community Research Program,
and non-profit foundations currently working in this area. The
Committee requests a description of NCI's plans for this pilot
program within 90 days of enactment of this Act.
Cancer Immunotherapy.--The Committee continues to be
encouraged by new breakthroughs in cancer immunotherapy, which
are revolutionizing treatments for a growing number of cancers.
This includes remarkable improvement in outcomes for an
increasing number of cancer patients. In some cases, however,
the side effects of such treatments are far different than
those associated with chemotherapy. Early recognition and
management of cancer immunotherapy-related side effects can
result in resolution of these side effects before permanent
damage is done, and allows for continued cancer treatment. As
more patients benefit from cancer immunotherapy, recognizing
and treating possible side effects will take on greater
urgency. Therefore, the Committee urges NCI to prioritize
research and education on the underlying mechanisms of cancer
immunotherapy toxicities.
Cancer Moonshot.--The Committee recommendation directs NIH
to transfer $400,000,000 from the NIH Innovation Account to NCI
to support the Cancer Moonshot initiative. These funds were
authorized in the 21st Century Cures Act (PL 114-255).
Children's Oncology Group.--The Committee continues to
support the important work of the Children's Oncology Group and
other pediatric research efforts to advance drug development.
Pediatric cancer patients and their families rely heavily on
the trials run by the Children's Oncology Group. The vast
majority of childhood cancer patients are enrolled in trials
conducted by the Children's Oncology Group and advances in
treatment are dependent on the cancer research community's
ability to conduct trials quickly and enroll as many pediatric
patients as possible.
Collaboration Between Agencies Regarding Pediatric
Investigation of Appropriate New Drugs.--The Committee
recognizes that Title V of the Food and Drug Administration
Reauthorization Act (FDARA) amended the Pediatric Research
Equity Act to support the early evaluation of potentially
effective drugs by requiring pediatric investigation of
appropriate new drugs intended for adults with cancer. The law
directs the FDA, in collaboration with the NCI, to establish,
publish, and regularly update a list of molecular targets
considered on the basis of data the Agency determines to be
adequate, to be substantially relevant to the growth or
progression of pediatric cancers, and that may trigger the
requirement for pediatric investigations. The Committee
encourages NCI to collaborate with FDA as well as the patient
community, providers, and manufacturers, and conduct a
transparent and inclusive process to implement FDARA in a
timely manner.
Deadliest Cancers.--The Committee remains concerned that
while more effective screening methods and treatments have
lowered overall cancer incidence and death rates, there are
still very few early detection and treatment tools for
``recalcitrant cancers'', defined in statute as those whose
five-year survival rate is below 50 percent. These cancers
account for nearly half of all cancer deaths in the US and
include cancers of the brain, esophagus, liver, lung, ovary,
pancreas, and stomach. Given the toll these types of cancer
exact on society and the lack of tools currently available to
help patients, the Committee urges NCI to continue to support
research with an emphasis on developing improved screening and
early detection tools and more effective treatments. The
Committee requests an update in the fiscal year 2020
Congressional Justification on the Requests for Applications
NCI issued in fiscal years 2017 and 2018 and funding awarded to
specifically advance these goals.
Gynecologic Cancer Clinical Trials.--The Committee supports
continued investment in Federally-funded clinical trials for
gynecologic cancers. Gynecologic cancers include ovarian,
cervical, uterine, vaginal, and vulvar cancer. Given the high
mortality rates for certain gynecologic cancers, the Committee
requests NCI provide an update on access to gynecologic cancer
clinical trials its fiscal year 2020 Congressional
Justification.
IDeA States and Cancer Trials.--The Committee recognizes
that NCI supports clinical trials across the country through
its National Clinical Trials Network (NCTN) and the NCI
Community Oncology Research Program (NCORP). The Committee
believes, however, that there are more opportunities for
academic medical centers in IDeA States to become engaged in
these networks. Therefore, the Committee encourages NCI to
coordinate with the National Institute of General Medical
Sciences (NIGMS) to help IDeA states that do not currently have
NCORP or NCTN awards build capacity in these regions to conduct
cancer clinical trials. The Committee also encourages NCI to
continue to support NCORP in its mission to increase diversity
among patients participating in NCI clinical trials, especially
with regard to rural and minority populations. Finally, the
Committee urges NCI, in consultation with NIGMS, to encourage
collaboration between IDeA awardees and existing NCI designate
cancer centers, NCTN lead sites, and NCORP sites.
Metastatic Cancer Research.--The Committee recognizes that
the incidence of and mortality rates for liver cancer have
risen over the past decade and that comorbid conditions such as
hepatitis continue to be risk factors for liver cancer. The
Committee commends the Cancer Moonshot and encourages continued
support for its implementation.
Office of Cancer Survivorship.--The Committee recognizes
that the needs of childhood cancer survivors are unique. By
2020, there will be at least 500,000 childhood cancer survivors
in the US. Two-thirds of childhood cancer survivors suffer from
at least one health problem caused from their treatment. The
Committee urges NCI to continue to support childhood cancer
survivorship, including research on survivorship following
targeted and immune-therapies as well as a standard of care.
The research should focus on the specific needs for childhood
cancer survivors such as psycho-social treatments.
Pancreatic and Other Recalcitrant Cancers.--Pancreatic
cancer is currently the third leading cause of cancer-related
death in the US, claiming the lives of over 44,000 Americans
annually. Despite progress in combating other forms of cancer,
pancreatic cancer remains the only major cancer with a five-
year survival rate in the single digits, at 9 percent, in large
part because there are no reliable early detection methods or
effective treatment options. The Committee urges NCI to
continue to support research with an emphasis on developing
improved screening and early detection tools and more effective
treatments. The Committee specifically requests an update on
the pancreatic cancer scientific framework in the fiscal year
2020 Congressional Justification, including a description of
ongoing and planned future research in this area.
Pediatric Rare Cancer.--After accidents, cancer is the
second leading cause of death in children ages one to fourteen.
In 2018 alone, cancer will affect over 15,000 children and
adolescents, and most of those diagnoses will be for rare forms
which lack therapeutic options. While children face dozens of
cancers, only one pediatric-specific cancer has a targeted
therapeutic. Moreover, children with cancer can suffer more
severe side effects from aggressive treatments than adult
patients. The Committee strongly encourages NIH to expand
funding for research that may contribute to the development of
new treatments for pediatric rare cancers. TheCommittee notes
the ongoing research and development work in this field by
private industry and encourages NIH to work with the private
sector to promote a focus on rapidly developing and delivering
treatments for rare cancers.
Precision Oncology.--The Committee recognizes the potential
for significant advancements in cancer treatments from the NCI-
MATCH (Molecular Analysis for Therapy Choice) trial, which
remains the central pillar of the precision medicine research
focused on oncology for cancers that are unresponsive to
standard interventions. The Committee requests that NCI provide
an update on precision medicine activities in the fiscal year
2020 Congressional Justification.
Prostate Cancer.--The Committee is concerned that prostate
cancer lacks treatments for men with advancing disease as well
as adequate diagnostic and imaging methodologies common in
other hormone-driven cancers with similar disease burden. In
order to ensure Federal resources are leveraged to the greatest
extent possible, the Committee encourages NCI to coordinate its
response to these needs with other Federal agencies, including
the Department of Defense, as well as private research
foundations and advocacy groups.
NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)
Appropriation, fiscal year 2018....................... $3,383,201,000
Budget request, fiscal year 2019...................... 3,112,032,000
Committee Recommendation.............................. 3,423,604,000
Change from enacted level......................... +40,403,000
Change from budget request........................ +311,572,000
Mission.--NHLBI provides global leadership for a research,
training, and education program to promote the prevention and
treatment of heart, lung, and blood disorders and enhance the
health of all individuals so that they can live longer and more
fulfilling lives.
Alzheimer's Disease and Vascular Dementia.--The Committee
recognizes the value that well-characterized, longitudinal,
population-based cohort studies provide in bringing to light
more information about the risk factors related to dementia. By
studying participants and their descendants over time, much can
be learned about cognitive decline and early biomarkers that
will help us understand the role of environmental versus
genetic factors in disease development and progression. The
Committee commends the NHLBI for its work to follow its current
and future cohort study participants for the development and
progression of risk factors and to detect signs of cognitive
decline in order to provide new insights into risk
identification and accelerated prevention efforts.
Congenital Heart Disease.--The Committee commends NHLBI for
its continued work to better understand causation and
appropriate treatments for those with the most life-threatening
congenital heart defects through its biomedical research
program Bench to Bassinet and the critical multi-centered
infrastructure of the Pediatric Heart Network. The Committee
urges NHLBI to continue its work with other Federal agencies
and professional and patient organizations to expand
collaborative activities targeted toward prevention and
treatment of the diverse lifelong needs of children and adults
living with congenital heart disease. The Committee requests a
report on these efforts in the fiscal year 2020 Congressional
Justification.
General Cardiac Research.--The Committee encourages NIH to
pursue highly translational basic and clinical research that
will have a near-term impact on health care of aging
populations in States with high numbers of patients with cancer
suffering from cardiovascular complications of chemotherapy,
severe peripheral vascular disease, genetic cardiac diseases,
and clotting disorders associated with aging and cardiac
arrhythmias. Research should be conducted across the
disciplines of medicine, immunology, imaging, chemistry,
biomedical engineering, physics, statistics, mathematics, and
entrepreneurship to design new drugs and drug delivery systems
and strategies that are safer, more effective, and improve
patient compliance, while seeking to move technologies from
bench to bedside with private partners and local health care
and community organizations.
National Chronic Obstructive Pulmonary Disease Action
Plan.--The Committee notes NHLBI's role in crafting the
National Chronic Obstructive Pulmonary Disease Action Plan.
NHLBI is encouraged to continue this important work by
supporting additional research activities and collaborating
with other Public Health Service agencies to facilitate
implementation of the plan's recommendations.
Pulmonary Hypertension.--The Committee recognizes NHLBI's
work to advance research into pulmonary hypertension,
especially with regard to idiopathic pulmonary arterial
hypertension. The Committee encourages NHLBI to continue
working with stakeholders to advance these critical research
priorities.
Sickle Cell Disease Research.--The Committee encourages
NHLBI to devote more research to the study of sickle cell
disease. Academic medical centers located in States with
significant populations of sickle cell patients have made
progress in treating the disease through NIH-sponsored clinical
trials and through blood and marrow transplantation, which is
currently the only therapy that can cure the disease. However,
more focused research is needed to augment the limited
treatment options available.
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)
Appropriation, fiscal year 2018....................... $447,735,000
Budget request, fiscal year 2019...................... 413,196,000
Committee Recommendation.............................. 453,082,000
Change from enacted level......................... +5,347,000
Change from budget request........................ +39,886,000
Mission.--The mission of NIDCR is to improve dental, oral,
and craniofacial health through research, research training,
and the dissemination of health information.
Biodevices.--The Committee is pleased that NIDCR is
exploring how to leverage oral biodevices for overall health,
including developing tools to detect bone loss. The Committee
encourages NIDCR to continue focusing on novel products, such
as imaging technologies and dental restorative materials, which
can improve individuals' oral and overall health and well-
being.
NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND
KIDNEY DISEASES (NIDDK)
Appropriation, fiscal year 2018....................... $2,120,797,000
Budget request, fiscal year 2019...................... 1,965,434,000
Committee Recommendation.............................. 2,144,333,000
Change from enacted level......................... +23,536,000
Change from budget request........................ +178,899,000
Mission.--The NIDDK mission is to conduct and support
medical research and research training and disseminate science-
based information on diabetes and other endocrine and metabolic
diseases; digestive diseases, nutritional disorders, and
obesity; and kidney, urologic, and hematologic diseases, to
improve people's health and quality of life.
End-Stage Renal Disease.--The Committee recognizes NIDDK's
accomplishments in supporting critical kidney research,
including research on end-stage renal disease. The Committee
notes the recent GAO report on research funding and encourages
NIDDK to continue working with stakeholders to disseminate
critical information and discuss new opportunities for
research.
Hepatitis B.--The Committee notes that the Hepatitis B
virus (HBV) research community convened a virtual consensus
conference that resulted in articles published in 2018 in two
peer reviewed scientific journals identifying the most urgent
research questions that must be answered to find a cure for
HBV. The Committee urges NIDDK to pursue multiple critical
research opportunities towards improved treatments and a cure
for HBV and to provide an update in the fiscal year 2020
Congressional Justification.
Inflammatory Bowel Disease.--The Committee is pleased by
NIDDK's support of research into inflammatory bowel diseases
and notes recent CDC prevalence data, which suggests
inflammatory bowel disease (IBD) is twice as prevalent as
originally thought. The Committee encourages NIDDK to respond
to these findings by providing enhanced support for research on
IBD. Research should include a focus on the environmental
triggers and epigenetics of IBD as well as interventions for
the rising prevalence of IBD, and be targeted at both pediatric
and adult patients.
Pediatric Kidney Disease.--The Committee is encouraged by
the research funded by NIDDK on pediatric kidney disease.
However, the Committee continues to urge the NIDDK to plan and
work toward multicenter clinical trials and translational
studies that will focus on the unique needs of children with
kidney disease. Pediatric patients and the entire pediatric
nephrology community have benefited extensively from the
previous two large pediatric focused clinical studies, RIVUR
and CKiD. These studies not only addressed important clinical
questions but also established large biorepositories and
databases, which can be used by the research community to gain
important additional knowledge from the study populations. The
Committee also encourages NIDDK to fund research aimed at
establishing new prognostic indicators such as genomics and
personalized medicine, novel diagnostics, and therapeutics that
may help further understanding in pediatric kidney disease that
may also lead to breakthroughs and applications in adult kidney
disease. The Committee requests that NIDDK report back in the
fiscal year 2020 Congressional Justification on the progress
made towards additional pediatric focused clinical studies.
Technology and Ophthalmic Disorders.--The Committee notes
that the specific use of technology, such as web-based
telemedicine software, centralized reading centers, hand-held
fundus cameras, photography training programs, and internet-
based storage and transmission of images can efficiently detect
early signs of diabetic retinopathy and glaucoma in rural and
underserved populations.
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (NINDS)
Appropriation, fiscal year 2018....................... $2,145,149,000
Budget request, fiscal year 2019...................... 1,838,556,000
Committee Recommendation.............................. 2,228,780,000
Change from enacted level......................... +83,631,000
Change from budget request........................ +390,224,000
Mission.--The NINDS mission is to seek fundamental
knowledge about the brain and nervous system and use that
knowledge to reduce the burden of neurological disease.
BRAIN Initiative.--The Committee recommendation includes
bill language transferring $57,500,000 from the NIH Innovation
Account to NINDS to support the BRAIN Initiative. These funds
were authorized in the 21st Century Cures Act (PL 114-255). The
Committee recognizes the importance of neuroscience research
funded by NIH, which is fueling a vital scientific endeavor and
is the essential foundation for understanding and treating
diseases that impact over 100 million Americans each year. The
Committee also commends NIH for its successful implementation
of the BRAIN Initiative, and for its 5 year partnership with an
array of agencies. This collaborative effort is revolutionizing
the understanding of how neural components and their dynamic
interactions result in complex behaviors, cognition, and
disease, while accelerating the development of transformative
tools to explore the brain in unprecedented ways making
information previously beyond reach accessible. The Committee
encourages NIH to continue to build off its 5 years of success
as a leader and partner on the BRAIN Initiative bringing
together various disciplines and funding meritorious research
to advance our knowledge of the brain.
Non-Addictive Pain Treatments.--The Committee is aware that
many people who suffer from acute pain are exposed to opioids,
leading to addiction, and many others who suffer from chronic
pain turn to opioids for relief because they lack alternative
pain treatments and management. This is a particular challenge
in Appalachia. The Committee encourages NINDS to prioritize the
development of non-addictive treatments for pain, recognizing
that there are regions of the country with high per capita
rates of opioid deaths.
Opioids.--The Committee commends NIH for launching the HEAL
(Helping to End Addiction Long-Term) Initiative, a trans-NIH
effort to speed scientific solutions to stem the national
opioid public health crisis. This initiative will build on
extensive, well-established NIH research, including basic
science of the complex neurological pathways involved in pain
and addiction, implement science to develop and test treatment
models, and research to integrate behavioral interventions with
medication-assisted treatment for opioid use disorder. The
Committee continues to support opioid-related research at NINDS
and expects NINDS to expand this research in fiscal year 2019.
Stroke Research.--The Committee continues its concern that
stroke inflicts a vast burden, including topping per capita
spending for all chronic conditions in the Medicare fee-for-
service program. The Committee encourages NINDS to prioritize
and implement robust investment to spur, strengthen,
accelerate, and coordinate stroke research. This investment
should focus on expediting novel basic, clinical and
translational research by all available and appropriate
mechanisms. The Committee encourages NINDS to intensify
enactment of top stroke priorities, including prevention,
endovascular therapy, early stroke recovery, and tele-
rehabilitation.
Traumatic Brain Injury.--The Committee understands that
regenerative medicine research, including the use of adult stem
cells, tissue engineered scaffolds, and means to promote
neuroplasticity, may play an important role in the treatment of
traumatic brain injury (TBI) and stroke. The Committee strongly
encourages NINDS to work with the National Institute on Aging
and other relevant ICs to ensure a robust and coordinated
portfolio of research on how to leverage regenerative medicine
research in the treatment of TBI and stroke. The Committee
requests an update in the fiscal year 2020 Congressional
Justification on efforts in these specific areas of research.
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID)
Appropriation, fiscal year 2018....................... $5,260,210,000
Budget request, fiscal year 2019...................... 4,761,948,000
Committee Recommendation.............................. 5,368,029,000
Change from enacted level......................... +107,819,000
Change from budget request........................ +606,081,000
Mission.--The NIAID mission is to conduct and support basic
and applied research to better understand, treat, and
ultimately prevent infectious, immunologic, and allergic
diseases.
Combating Antibiotic-Resistant Bacteria.--The Committee
recommendation includes at least $538,000,000 within NIAID for
research related to combating antibiotic-resistant bacteria.
Many infectious organisms have adapted to the drugs designed to
kill them, making the products less effective. Because most
bacteria, viruses, and other microbes multiply rapidly, they
can quickly evolve and develop resistance to antimicrobial
drugs. Overusing or misusing antimicrobial drugs can make
resistance develop even faster. These funds enable NIAID to
support research on antimicrobial (drug) resistance, including
basic research on how microbes develop resistance, new and
faster diagnostics, and clinical trials designed to find new
vaccines and treatments effective against drug-resistant
microbes. The Committee requests an update on these activities
in the fiscal year 2020 Congressional Justification.
Hepatitis B.--The Committee notes that both the World
Health Organization in 2016 and the National Academies of
Science, Engineering, and Medicine in 2017 declared that the
elimination of Hepatitis B virus (HBV) is possible. In the
U.S., one in 20 Americans have been infected and more than two
million are chronically infected with acute infections. The
Committee further notes that the link between HBV infection and
primary liver cancer is well established, with up to 60 percent
of global liver cancer cases caused by HBV. The Committee
requests that NIAID develop and lead an inter-institute working
group, to include representation from NCI, NIDDK, and the
National Institute on Minority Health and Health Disparities
(NIMHD), to coordinate their research agendas and
infrastructure to find a cure for HBV. The Committee requests a
report on these efforts within 90 days of enactment of this
Act. Additionally, the Committee urges NIAID to issue targeted
calls for HBV research to fund the many critical research
opportunities identified by the scientific community in the
Roadmap for a Cure and report to the Committee on
Appropriations of the House of Representatives and the Senate
within 90 days of enactment of this Act NIAID's research plan
to pursue a cure for HBV.
Microbicides.--The Committee recognizes that with NIH and
United States Agency for International Development (USAID)
leadership, research has shown the potential for antiretroviral
(ARV) drugs to prevent HIV infection in women. The Committee
encourages NIAID to continue coordination with USAID, the
Department of State, and others to advance ARV-based
microbicide development efforts with the goal of enabling
regulatory approval of the first safe and effective microbicide
for women and supporting an active ARV-based microbicide
pipeline to produce additional solutions to prevent HIV and to
help end the epidemic.
Tick-Borne Diseases.--The Committee encourages NIAID to
intensify research on Lyme and other tick-borne diseases,
including research that will increase understanding of the full
range of processes that cause Lyme disease infection, including
any possible mechanisms of persistent infection as well as
potential treatments for Lyme disease. This should include
research on the pathophysiology of infection with Borrelia
burgdorferi and Borrelia mayonii, as well as the development of
more sensitive and accurate diagnostic tests for Lyme and other
tick-borne diseases, including next-generation polymerase chain
reaction and new testing methodologies such as proteomics and
metabolomics.
Universal Influenza Vaccine.--The Committee directs NIAID
to allocate at least $140,000,000 to support basic,
translational, and clinical research to develop a universal
influenza vaccine. This funding supports research to develop an
influenza vaccine that provides robust, long-lasting protection
against multiple subtypes of flu, rather than a select few.
Such a vaccine would eliminate the need to update and
administer the seasonal flu vaccine each year and could provide
protection against newly emerging flu strains, potentially
including those that could cause a flu pandemic. The Committee
requests an update on these efforts within 60 days of enactment
of this Act.
NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES (NIGMS)
Appropriation, fiscal year 2018....................... $2,785,400,000
Budget request, fiscal year 2019...................... 2,572,669,000
Committee Recommendation.............................. 2,818,667,000
Change from enacted level......................... +33,267,000
Change from budget request........................ +245,998,000
Mission.--NIGMS supports basic research that increases our
understanding of biological processes and lays the foundation
for advances in disease diagnosis, treatment, and prevention.
Institutional Development Awards.--The Committee provides
$365,575,000 for the Institutional Development Awards (IDeA)
program. IDeA supports high-quality research and investigators
throughout the country in States in which the success rate for
NIH grants has been historically low.
Native American Research Centers for Health.--The Committee
commends NIGMS for supporting the Native American Research
Centers for Health program, which provides opportunities for
Tribes and Tribal organizations to build the capacity to
support research, research training, and faculty development to
address health disparities in American Indian/Alaska Native
communities.
EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT (NICHD)
Appropriation, fiscal year 2018....................... $1,452,006,000
Budget request, fiscal year 2019...................... 1,339,592,000
Committee Recommendation.............................. 1,469,346,000
Change from enacted level......................... +17,340,000
Change from budget request........................ +129,754,000
Mission.--NICHD investigates human development throughout
the entire life process, with a focus on understanding
disabilities and important events that occur during pregnancy.
Endometriosis.--The Committee is aware that endometriosis
is a serious chronic condition that impacts one in ten women in
the US between the ages of 10 and 49. Women with this condition
can suffer up to ten years before being properly diagnosed,
often due to lack of awareness and limited treatment options
available. The Committee encourages NICHD to develop a report
on the current state of endometriosis. Further, the Committee
encourages NICHD, through research and in collaboration with
CDC, to continue to support education, outreach, and awareness
to promote early and accurate diagnosis of endometriosis.
Long-Term and Developmental Health Effects of Zika.--The
Committee recognizes the unique nature of NICHD research into
how the Zika virus infection affects pregnancy and the long-
term and developmental health effects on children exposed to
the Zika virus. The Committee urges NICHD to prioritize
investment in long-term and developmental health effects of the
Zika virus as the fight against the virus continues.
Neonatal Abstinence Syndrome.--The Committee recognizes the
importance of developing evidenced-based treatment protocols
for babies with neonatal abstinence syndrome (NAS). The
Committee requests that the NICHD provide a report to the
Committee on existing research regarding evidence based-
treatment protocols for both full-term and premature babies
with NAS and recommendations for future research within 90 days
of enactment of this Act.
Pre-Term Birth.--Preterm birth affects approximately
380,000 babies each year in the U.S. and is the leading cause
of infant mortality. The Committee applauds NICHD's research
portfolio spanning the range of discovery, development, and
delivery of science in order to identify the causes of
premature birth and infant mortality. The Committee encourages
NICHD to continue to provide robust support to extramural
preterm birth prevention research, the Maternal-Fetal Medicine
Units Network, the Neonatal Research Network, and the
intramural research program related to prematurity.
Rehabilitation Research.--The Committee recognizes the
significant challenges faced by patients with neurological
impairments who live in rural areas, where access to assistive
devices, medical advice, and community resources can be
limited. Proper rehabilitation, with the help of patient
``navigators'', is critical to improving patients' quality of
life and preventing further, and more costly, health problems.
The Committee encourages the National Center for Medical
Rehabilitation Research to provide greater support for research
efforts on assistive health technology, particularly in
underserved rural settings.
Task Force on Research in Pregnant Women and Lactating
Women.--The Committee looks forward to the Task Force's report
to the Secretary and Congress in September 2018, and continues
to encourage and support the important work of the Task Force
to ensure that pregnant and lactating women are included in
research, and that consumers and health care professionals have
up-to-date and accurate information on the safety and efficacy
of drugs that women are taking while pregnant or breastfeeding.
NATIONAL EYE INSTITUTE (NEI)
Appropriation, fiscal year 2018....................... $772,317,000
Budget request, fiscal year 2019...................... 711,015,000
Committee Recommendation.............................. 781,540,000
Change from enacted level......................... +9,223,000
Change from budget request........................ +70,525,000
Mission.--NEI conducts and supports basic and clinical
research, research training, and other programs with respect to
blinding eye diseases, visual disorders, and mechanisms of
visual function, preservation of sight, and the special health
problems and needs of individuals who are visually-impaired or
blind.
Blepharospasm.--The Committee is pleased that NEI is
expanding research on blepharospasm, a form of dystonia. The
Committee encourages NEI to work with NINDS and stakeholders on
cross cutting research opportunities that affect all forms of
dystonia.
Neuromyelitis Optica Spectrum Disorder.--The Committee
directs NEI to provide an update in the fiscal year 2020
Congressional Justification on research related to
Neuromyelitis Optica Spectrum Disorder (NMO/SD), a rare
autoimmune disease that causes blindness and/or paralysis. The
Committee strongly encourages NEI to work with other ICs,
including NINDS and NIAID, to support basic research into the
causes and treatment of NMO/SD.
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES (NIEHS)
Appropriation, fiscal year 2018....................... $751,143,000
Budget request, fiscal year 2019...................... 693,199,000
Committee Recommendation.............................. 760,113,000
Change from enacted level......................... +8,970,000
Change from budget request........................ +66,914,000
Mission.--NIEHS' mission is to discover how the environment
affects people in order to promote healthier lives.
NATIONAL INSTITUTE ON AGING (NIA)
Appropriation, fiscal year 2018....................... $2,574,091,000
Budget request, fiscal year 2019...................... 1,988,200,000
Committee Recommendation.............................. 3,005,831,000
Change from enacted level......................... +431,740,000
Change from budget request........................ +1,017,631,000
Mission.--NIA's mission is to understand the nature of
aging and the aging process, and diseases and conditions
associated with growing older, in order to extend the healthy,
active years of life.
Alzheimer's Disease.--In recognition that Alzheimer's
disease poses a serious threat to the nation's long-term health
and economic stability, the Committee recommends a total of at
least $2,250,000,000 for Alzheimer's disease research. NIA
should continue to address the research goals set forth in the
National Plan to Address Alzheimer's disease, as well as the
recommendations from the Alzheimer's disease Research Summit in
2015.
Alzheimer's Disease Disparities.--The Committee commends
the NIA for its leadership in supporting longitudinal,
population-based cohort studies into the causes of dementia.
Because rural, poor, and minority populations may be at
enhanced risk for dementia, the value and application of these
studies is enhanced when they include individuals from various
geographic, ethnic, socio-economic and generational
backgrounds. The Committee encourages NIA to diversify its
cohort studies, with the specific goal of better understanding
disease burden and biomarkers by race and geographic region.
Additionally, the Committee is concerned about the racial and
ethnic disparities that exist in Alzheimer's disease diagnoses
and encourages NIA to support research exploring the
disproportionate impact Alzheimer's disease has on people of
color, particularly African Americans who are two times more
likely to develop late-onset Alzheimer's disease than whites.
Azheimer's Disease Research Data.--The Committee is aware
the advances in information technology make possible the
ability to share research results broadly within the scientific
community that seeks to develop a treatment for Alzheimer's.
Therefore, the Committee encourages NIA to develop a strategy
to share Alzheimer's research data across the research
community as effectively and expeditiously as possible.
Azheimer's Disease Vaccine.-- The Committee recognizes
recent evidence suggests that the next generation of active or
passive vaccines are one of the most promising therapies for
efficacious treatment of Alzheimer's. The Committee encourages
NIH to pursue these technologies to accelerate the development
and testing of promising vaccine candidates.
Caregiver Dementia Initiative.--At any given time, more
than 15 million Americans are providing informal care to an
older relative with dementia. However, dementia caregivers
experience considerable stress and depression and impaired
subjective well-being, self-efficacy, and physical health. The
Committee encourages NIA to fund a pilot community-based peer
support program designed to develop an accessible, feasible,
and sustainable program that capitalizes on the expertise of
former caregivers. Persons who previously cared for a person
with dementia but have transitioned out of that role can
provide one-on-one problem-solving, or coaching, for current
dementia caregivers. Family care is preferred by both family
members and persons with dementia themselves, and removes a
substantial burden from the US healthcare system.
Healthy Brain Aging.--In the context of NIA's robust
Alzheimer's Disease research portfolio, the Committee
recognizes the need to understand healthy brain aging and risk
factors for Alzheimer's Disease. The Committee encourages NIA
to continue to address the research goals and recommendations
related to healthy brain aging and cognitive resilience
identified during the NIH's 2015 Alzheimer's Policy Summit.
NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND
SKIN DISEASES (NIAMS)
Appropriation, fiscal year 2018....................... $586,661,000
Budget request, fiscal year 2019...................... 545,494,000
Committee Recommendation.............................. 593,663,000
Change from enacted level......................... +7,002,000
Change from budget request........................ +48,169,000
Mission.--NIAMS' mission is to support research into the
causes, treatment, and prevention of arthritis and
musculoskeletal and skin diseases; the training of basic and
clinical scientists to carry out this research; and the
dissemination of information on research progress in these
diseases.
Alopecia Areata.--The Committee applauds NIAMS for its
leadership in autoimmune research breakthroughs that have
advanced treatment development for alopecia areata. The
Committee requests an update from NIAMS on new alopecia areata
research advances in the fiscal year 2020 Congressional
Justification.
Lupus.--The Committee recognizes NIAMS for implementing the
Action Plan for Lupus Research and for leading the Lupus
Federal Working Group. The Committee is concerned about the
substantial racial disparities in the incidence and prevalence
of lupus and notes that African American women experience the
highest lupus rate. Therefore, the Committee encourages NIAMS
to continue to support lupus research, including studies to
understand why the disease disproportionately affects women of
color.
Mucopolysaccharide Diseases.--Mucopolysaccharide (MPS)
diseases are inherited, with death occurring for many in early
childhood. This systemic disease causes progressive damage to
the bones, heart, respiratory system, and brain, causing
permanent disability and early death. The Committee continues
to urge NIH to put a high priority on better understanding and
treating MPS diseases. The Committee commends NIH for
allocating funds to discover, develop, define, and make
available for research animal models of human genetic disease.
The Committee encourages expanded research of treatments for
neurological, chronic inflammation, cardiovascular and skeletal
manifestations of MPS, with an emphasis on gene therapy. The
Committee thanks NCATS, NINDS, and NIDDK for again funding the
Lysosomal Disease Network through the Rare Disease Clinical
Network and for funding lysosomal research meetings. The
Committee encourages NIH to expand support to incentivize MPS
research. Understanding the manifestations and treatments of
both the skeletal and neurological disease continues to be an
area of great unmet need.
Scleroderma.--The Committee recognizes the work that NIAMS
is doing to support research of fibrotic disease and continues
to encourage prioritizing research including scleroderma. The
Committee also encourages NIAMS to work with other ICs on
collaborative opportunities where feasible to advance critical
research.
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
(NIDCD)
Appropriation, fiscal year 2018....................... $459,974,000
Budget request, fiscal year 2019...................... 423,992,000
Committee Recommendation.............................. 465,467,000
Change from enacted level......................... +5,493,000
Change from budget request........................ +41,475,000
Mission.--NIDCD conducts and supports biomedical and
behavioral research and research training in the normal and
disordered processes of hearing, balance, taste, smell, voice,
speech, and language. NIDCD also conducts and supports research
and research training related to disease prevention and health
promotion; addresses special biomedical and behavioral problems
associated with people who have communication impairments or
disorders; and supports efforts to create devices which
substitute for lost and impaired sensory and communication
function.
Spasmodic Dysphonia.--The Committee continues to encourage
NIDCD to expand research on spasmodic dysphonia, a form of
dystonia. The Committee also encourages NIDCD to meet with
stakeholders to link research with the needs of the community.
NATIONAL INSTITUTE OF NURSING RESEARCH (NINR)
Appropriation, fiscal year 2018....................... $158,033,000
Budget request, fiscal year 2019...................... 145,842,000
Committee Recommendation.............................. 159,920,000
Change from enacted level......................... +1,887,000
Change from budget request........................ +14,078,000
Mission.--The mission of NINR is to promote and improve the
health of individuals, families, and communities. To achieve
this mission, NINR supports and conducts clinical and basic
research and research training on health and illness, research
that spans and integrates the behavioral and biological
sciences, and develops the scientific basis for clinical
practice.
NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM (NIAAA)
Appropriation, fiscal year 2018....................... $509,573,000
Budget request, fiscal year 2019...................... 469,109,000
Committee Recommendation.............................. 515,658,000
Change from enacted level......................... +6,085,000
Change from budget request........................ +46,549,000
Mission.--NIAAA's mission is to generate and disseminate
fundamental knowledge about the effects of alcohol on health
and well-being, and apply that knowledge to improve diagnosis,
prevention, and treatment of alcohol-related problems,
including alcohol use disorder, across the lifespan.
NATIONAL INSTITUTE ON DRUG ABUSE (NIDA)
Appropriation, fiscal year 2018....................... $1,383,603,000
Budget request, fiscal year 2019...................... 1,137,403,000
Committee Recommendation.............................. 1,400,126,000
Change from enacted level......................... +16,523,000
Change from budget request........................ +262,723,000
Mission.--NIDA's mission is to advance science on the
causes and consequences of drug use and addiction and to apply
that knowledge to improve individual and public health.
Neonatal Abstinence Syndrome.--The Committee recognizes the
importance of research and prevention, identification, and
treatment of prenatal opioid exposure and neonatal abstinence
syndrome. The Committee encourages NIDA to ensure the review
process includes appropriate focus on geographic locations
where the problem is particularly acute or two or fewer
treatment programs are available. The Committee encourages NIH,
based on appropriate scientific review, to support meritorious
research opportunities for institutions offering clinical
services to women, particularly women from rural areas, who are
at risk for opioid dependence and opioid exposure during
pregnancy and for infants born with neonatal abstinence
syndrome.
Opioids.--The Committee commends NIH for launching the HEAL
(Helping to End Addiction Long-Term) Initiative, a trans-NIH
effort to speed scientific solutions to stem the national
opioid public health crisis. This Initiative will build on
extensive, well-established NIH research, including basic
science of the complex neurological pathways involved in pain
and addiction, implementation science to develop and test
treatment models, and research to integrate behavioral
interventions with medication-assisted treatment for opioid use
disorder. The Committee continues to support opioid-related
research at NIDA and expects NIDA to expand this research in
fiscal year 2019.
The Committee continues to be extremely concerned about the
epidemic of prescription opioids, heroin, and synthetic opioid
use, addiction, and overdose in the US. Approximately 144
people die each day in this country from opioid overdose,
making it one of the most common causes of non-disease-related
deaths for adolescents and young adults. This crisis has been
exacerbated by the availability of fentanyl and its analogs in
many communities. The Committee appreciates the important role
that research can and should play in the various Federal
initiatives aimed at this crisis. The Committee urges NIDA to
continue funding research on medication development to
alleviate pain, especially the development of medications with
reduced abuse liability, and to report on what we know
regarding the transition from opioid analgesics to heroin and
synthetic opioid abuse and addiction within affected
populations.
Raising Awareness and Engaging the Medical Community in
Drug Abuse and Addiction Prevention and Treatment.--The
Committee notes that education is a critical component of any
effort to curb drug use and addiction, and it must target every
segment of society, including healthcare providers (doctors,
nurses, dentists, and pharmacists), patients, and families.
Medical professionals must be in the forefront of efforts to
curb the opioid crisis. The Committee continues to be pleased
with the NIDAMED initiative, targeting physicians-in-training,
including medical students and resident physicians in primary
care specialties (e.g., internal medicine, family practice, and
pediatrics). The Committee encourages NIDA to continue its
efforts in this space, providing physicians and other medical
professionals with the tools and skills needed to incorporate
drug abuse screening and treatment into their clinical
practices. The Committee encourages NIDA and CDC to develop
strategies for increasing participation in its online
continuing medical education course on safe prescribing for
pain and managing patients who abuse prescription opioids. The
Committee also encourages NIDA and CDC to develop strategies
for increasing participation in its online continuing medical
education courses on safe prescribing for pain and managing
patients who abuse prescription opioids.
NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH)
Appropriation, fiscal year 2018....................... $1,711,775,000
Budget request, fiscal year 2019...................... 1,612,192,000
Committee Recommendation.............................. 1,790,231,000
Change from enacted level......................... +78,456,000
Change from budget request........................ +178,039,000
Mission.--NIMH's mission is to transform the understanding
and treatment of mental illnesses through basic and clinical
research, paving the way for prevention, recovery, and cure.
BRAIN Initiative.--The Committee recommendation includes
bill language transferring $57,500,000 from the NIH Innovation
Account to NIMH to support the BRAINInitiative. These funds are
authorized by the 21st Century Cures Act (PL 114-255). The
Committee recognizes the importance of NIH funded neuroscience
research, which is fueling a vital scientific endeavor and is
the essential foundation for understanding and treating
diseases that impact over 100 million Americans each year. The
Committee also commends the NIH for its successful
implementation of the BRAIN Initiative, and for its five year
partnership with an array of agencies. This collaborative
effort is revolutionizing our understanding of how neural
components and their dynamic interactions result in complex
behaviors, cognition, and disease, while accelerating the
development of transformative tools to explore the brain in
unprecedented ways making information previously beyond reach
accessible. The Committee encourages NIH to continue to build
off its five years of success as a leader and partner on the
BRAIN Initiative bringing together various disciplines and
funding meritorious research to advance knowledge of the brain.
Eating Disorder Research.--Eating disorders are a serious
mental illness that affect 30 million Americans during their
lifetime and has the highest mortality rate of any psychiatric
illness. The Committee encourages NIH to continue to support
eating disorders research, with a focus on applied research in
prevention, early identification, and innovative treatment.
NATIONAL HUMAN GENOME RESEARCH INSTITUTE (NHGRI)
Appropriation, fiscal year 2018....................... $556,881,000
Budget request, fiscal year 2019...................... 512,979,000
Committee Recommendation.............................. 563,531,000
Change from enacted level......................... +6,650,000
Change from budget request........................ +50,552,000
Mission.--NHGRI's mission is to accelerate scientific and
medical breakthroughs that improve human health by driving
cutting-edge research, developing new technologies, and
studying the impact of genomics on society.
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)
Appropriation, fiscal year 2018....................... $377,871,000
Budget request, fiscal year 2019...................... 346,550,000
Committee Recommendation.............................. 382,384,000
Change from enacted level......................... +4,513,000
Change from budget request........................ +35,834,000
Mission.--The NIBIB mission is to improve health by leading
the development and accelerating the application of biomedical
technologies.
NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES (NIMHD)
Appropriation, fiscal year 2018....................... $303,200,000
Budget request, fiscal year 2019...................... 280,545,000
Committee Recommendation.............................. 306,821,000
Change from enacted level......................... +3,621,000
Change from budget request........................ +26,276,000
Mission.--NIMHD's mission is to lead scientific research to
improve minority health and reduce health disparities.
Focal Segmental Glomerulosclerosis Research.--The Committee
recognizes the work that NIMHD and NIDDK are doing to address
the connection between the APOL1 gene and the onset of Focal
Segmental Glomerulosclerosis (FSGS). The Committee encourages
NIMHD to work with community stakeholders caring for the
affected population to identify areas of collaboration.
Hepatitis B.--The Committee notes that half of all HBV
patients in the US are immigrant Asian-Americans or Pacific
Islanders, though these groups only accounts for about six
percent of the population. Further, among African immigrants,
the prevalence of chronic HBV is about 10 percent. The
Committee urges NIMHD to fund research to test scale-up model
programs that increase HBV awareness, knowledge, testing and
linkage to care for treatment among the disproportionately HBV-
impacted communities.
NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH (NCCIH)
Appropriation, fiscal year 2018....................... $142,184,000
Budget request, fiscal year 2019...................... 130,717,000
Committee Recommendation.............................. 143,882,000
Change from enacted level......................... +1,698,000
Change from budget request........................ +13,165,000
Mission.--The mission of NCCIH is to define, through
rigorous scientific investigation, the usefulness and safety of
complementary and integrative health interventions and their
roles in improving health and health care.
NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES (NCATS)
Appropriation, fiscal year 2018....................... $742,354,000
Budget request, fiscal year 2019...................... 685,087,000
Committee Recommendation.............................. 751,219,000
Change from enacted level......................... +8,865,000
Change from budget request........................ +66,132,000
Mission.--NCATS was established to transform the
translational process so that new treatments and cures for
disease can be delivered to patients faster.
Clinical and Translational Science Awards.--The Committee
expects NIH to fund Clinical and Translational Science Awards
(CTSAs) at not less than the level provided in fiscal year
2018.
Rural Health Outcomes and Health Disparities.--The
Committee notes translational science and education is critical
to developing new treatments and healthcare approaches that can
be disseminated to underserved and special populations to
improve health outcomes across the life span. The Committee
continues and encourages NCATS, through its CTSA program, to
enhance its commitment to the value of translational science
and funding for universities to continue to innovate by
leveraging statewide resources and capabilities to improve
rural health outcomes and eliminate health disparities. The
Committee requests an update on the actions within the CTSA
program to improve rural health outcomes and health disparities
in the fiscal year 2020 Congressional Justification.
JOHN E. FOGARTY INTERNATIONAL CENTER (FIC)
Appropriation, fiscal year 2018....................... $75,733,000
Budget request, fiscal year 2019...................... 70,084,000
Committee Recommendation.............................. 76,637,000
Change from enacted level......................... +904,000
Change from budget request........................ +6,553,000
Mission.--FIC's mission is to support and facilitate global
health research conducted by US and international
investigators, building partnerships between health research
institutions in the US and abroad, and training the next
generation of scientists to address global health needs.
NATIONAL LIBRARY OF MEDICINE (NLM)
Appropriation, fiscal year 2018....................... $428,553,000
Budget request, fiscal year 2019...................... 395,493,000
Committee Recommendation.............................. 433,671,000
Change from enacted level......................... +5,118,000
Change from budget request........................ +38,178,000
Mission.--The NLM collects and organizes information
important to biomedicine; serves as a national information
resource for medical education, research, and health service
activities; enhances access to biomedical literature through
electronic services; serves the public by providing electronic
access to reliable health information for consumers; supports
and directs the national network of libraries of medicine;
provides grants for research in biomedical communications,
medical library development, and training health information
specialists; conducts and supports research in biomedical
informatics and computational biology; and creates information
resources for genomics, molecular biology, toxicology, medical
images, environmental health, emergency preparedness and
response, and health services research.
OFFICE OF THE DIRECTOR (OD)
Appropriation, fiscal year 2018....................... $1,803,293,000
Budget request, fiscal year 2019...................... 1,795,706,000
Committee Recommendation.............................. 1,902,828,000
Change from enacted level......................... +99,535,000
Change from budget request........................ +107,122,000
Mission.--The OD provides leadership to the NIH research
enterprise and coordinates and directs initiatives that
crosscut NIH. OD is responsible for the development and
management of intramural and extramural research and research
training policy, the review of program quality and
effectiveness, the coordination of selected NIH-wide program
activities, and the administration of centralized support
activities essential to the operations of NIH.
Common Fund.--The Committee recommends $601,613,000 for the
Common Fund (CF), and an additional $12,600,000 provided to
support the Gabriella Miller Kids First Research Act for the
fifth year of the ten-year Pediatric Research Initiative. NIH
is expected to continue the longstanding CF policy for projects
to be short-term, high-impact awards, with no projects
receiving funding for more than ten years.
Environmental Influences on Child Health Outcomes.--The
Committee continues to recognize the importance of
investigating the effects of environmental exposures on child
health and development. The Environmental Influences on Child
Health Outcomes (ECHO) Project has the potential to greatly
increase understanding of these critical determinants of health
across the lifespan, through its observational cohorts and the
IDeA States Pediatric Clinical Trials Network. The Committee
encourages continued communication about the program's progress
toward goals, milestones, and projected funding estimates with
both external stakeholders and Congress. Within 180 days of
enactment of this Act, the Committee directs NIH to submit and
make public a summary of progress made to date, including an
analysis of the composition of the funded cohort studies, the
capacity of the Network to conduct trials among rural and
underserved children, and the short- and long-term goals of the
program.
Undiagnosed Diseases Network.-- The Committee continues to
support the Undiagnosed Diseases Network (UDN) and urges UDN to
continue efforts to enhance access to patients, caregivers, and
other stakeholders as well as make information obtained through
the UDN available to Federal agencies.
Multi-Institute Research Issues
Adult Stem Cell Technology.--The Committee continues to
recognize adult stem cell technology (including induced
pluripotent stem cells, mesenchymal stem cells, and other types
of adult stem cells) as a critical tool in the realm of
personalized medicine. The Committee notes that adult stem
cells provide promising opportunities to develop sources of
cells with great therapeutic value and potential for curing
human diseases. The Committee also recognizes that basic
science leads to pre-clinical studies and clinical trials,
which may in turn generate new diagnostics, treatments and
cures. The Committee encourages NIH to further explore
additional basic science opportunities. The Committee requests
an update in the fiscal year 2020 Congressional Justification
on NIH efforts to foster basic research on adult stem cell
technology, including through collaborative consortiums and
other approaches to leveraging existing research capabilities
to further advance scientific knowledge.
Amyloidosis.--The Committee encourages NIH to continue to
expand its research efforts into amyloidosis, a group of rare
diseases characterized by abnormally folded protein deposits in
tissues. Amyloidosis is often fatal and there is no known cure.
Current methods of treatment are risky and unsuitable for many
patients. The Committee requests that NIH provide an update on
the steps taken to increase the understanding of the causes of
amyloidosis and the measures taken to improve the diagnosis and
treatment of this devastating group of diseases in the fiscal
year 2020 Congressional Justification.
Angelman Syndrome.--The Committee recognizes the promising
scientific gains made in the pursuit of treatments for Angelman
Syndrome. The Committee applauds the significant contributions
of the Angelman Syndrome Natural History Study, funded by NIH,
and the private partners working diligently to advance the
growing body of Angelman Syndrome research towards practical
treatments. Further research in this area holds great promise
for both Angelman Syndrome and forms of autism also linked to
misexpression of the UBE3A gene. With two innovative new
treatments poised for clinical trials, the Committee urges NIH
to support Angelman Syndrome research, and specifically to
advance research in the roles of the UBE3A gene in brain
functions.
Chronic Fatigue Syndrome.--The Committee is pleased that
NIH has begun to expedite research into Chronic Fatigue
Syndrome. The Committee urges NIH to collaborate with disease
experts and the patient community to identify additional
opportunities to expedite progress on this understudied
disease. Specifically, the Committee encourages NIH to increase
research to (1) identify underlying causes of the illness to
enable therapies that would effectively prevent or treat the
illness, (2) identify biological markers linked to the various
forms of the illness to optimize selection of specific patient
subgroups for trials, (3) increase investigator-initiated
studies and early-stage investigator awards, and (4) develop
mechanisms to incentivize researchers to enter the field.
Cystic Fibrosis.--The Committee applauds the work of NIH to
support research aimed at correcting the genetic defect that
causes cystic fibrosis (CF), including recent Requests for
Applications that will advance the fields of gene editing, lung
stem cell biology, and nucleic acid delivery. Cystic fibrosis
is a rare, life-threatening genetic disease that impacts the
lungs and digestive system. There are more than 1,700 mutations
that cause CF, some of which may only be effectively overcome
through genetic repair approaches. The Committee also
encourages the continuation of collaborative initiatives to
overcome current barriers to implementing genetic repair
approaches for treating human diseases. One such project, a
joint workshop between the NHLBI and the Cystic Fibrosis
Foundation, focused on identifying barriers and proposing
solutions to deliver gene editing technologies to the lungs of
people with CF as a means to cure the disease.
Duchenne Muscular Dystrophy.--Duchenne muscular dystrophy
is a severe type of muscular dystrophy for which there is no
cure and for which the average life expectancy is 26 years. The
Committee strongly encourages NIH to significantly expand its
support for research on Duchenne muscular dystrophy.
Epidermolysis Bullosa.--The Committee encourages NIH to
continue to support research and coordination of activities
with respect to epidermolysis bullosa and related connective
tissue disorders.
Fibrosis.--The Committee recognizes NIH for their work on
addressing the need for coordination across ICs on fibrotic
research. The Committee encourages NIH to continue working
across ICs and with stakeholders to advance critical
priorities.
Food Allergies.--Food allergies affect 15 million
Americans, can be life threatening, and have no cure.
Currently, the Consortium of Food Allergy Research network
includes seven clinical sites/centers. In addition,
approximately 10 other NIH-supported centers are conducting
basic, translational, and clinical research on food allergies.
The Committee encourages NIH to expand its clinical research
network to add new centers of excellence in food allergy
clinical care and to select such centers from those with a
proven expertise in food allergy research.
Food is Medicine.--The Committee recognizes the important
role of nutrition in health outcomes and encourages OD to work
with relevant ICs, including NIDDK, NHLBI, NIA, and NICHD, to
report on the research that has been conducted on Food is
Medicine-related topics. This may include, but is not limited
to, medically-tailored meals, medical nutrition therapy,
produce prescription programs, the role of proper nutrition in
aging, and the role of proper nutrition in reproductive health.
The Committee further encourages additional collaboration among
the ICs on these topics.
Foundation for the NIH.--The Committee directs the
Foundation for the National Institutes of Health
(``Foundation'') to abide by section 499(j)(4) of the Public
Health Service Act by including in the Foundation's annual
report the source and amount of all monetary gifts to the
Foundation, as well as the source and description of all gifts
of real or personal property. Each annual report shall disclose
a specification of any restrictions on the purposes for which
gifts to the Foundation may be used. The annual report shall
not list ``anonymous'' as a source for any gift that includes a
specification of any restrictions on the purpose for which the
gift may be used.
Fragile X.--The Committee commends NIH for supporting
research to understand the nature of fragile X (FX) and its
association with other conditions such as autism. The Committee
encourages NIH to continue to fund at least three FX research
centers, supporting interdisciplinary research in important new
areas. The Committee urges NIH to assure that the FX research
centers program includes clinical and translational research
that directly addresses the needs of affected children and
their families, and that applicants for new centers may propose
clinical trials as part of their research portfolio. Given the
inextricable connection between the FX protein and autism, the
Committee urges the Director and his counterparts at each IC
with an FX and autism portfolio to explore ways to create
greater efficiency and synergy among these two research tracks
to accelerate translational research toward a better
understanding of both conditions and to shorten the time to
bring effective treatments for both conditions to market
including the funding for clinical trials for both disorders.
Headache Disorders.--The Committee encourages NIH to
prioritize fundamental, translational, and clinical research on
headache disorders. In 2016, 36 million Americans experienced a
migraine attack, 12 million suffered from chronic daily
headaches, and millions further were affected by cluster
headaches, post-traumatic headaches, or other disabling
headache disorders.
Heavy Ion Cancer Therapy and Research.--The Committee
supports NIH's continued exploration of advanced therapeutic
cancer research, specifically heavy ion irradiation technology.
This technology will introduce a novel treatment option to
cancer patients that is currently not available in the US. The
Committee supports NIH's work with the heavy ion planning grant
recipients to further advance access to novel heavy ion
treatment within the US. The Committee encourages NIH to
explore further the establishment of a state-of-the-art heavy
ion research facility in the US. Furthermore, the Committee
encourages NIH to work with the Departments of Defense and
Energy, and other applicable Federal agencies to equip the
first US heavy ion research center. The Committee urges NIH to
capitalize on the expertise and potential of the heavy ion
facility planning grant recipients in order to foster a
multidisciplinary approach and advance heavy ion research that
would produce novel, cutting edge treatments for cancer
patients.
Lymphangioleiomyomatosis.--The Committee requests an update
on Lymphangioleiomyomatosis research in the fiscal year 2020
Congressional Justification.
Mitochondrial Disease Research.--The Committee understands
that no fewer than 17 ICs are involved in research efforts
related to mitochondrial disease and dysfunction. The Committee
appreciates the NIH's support of the trans-NIH Mitochondrial
Disorders Working Group, the North American Mitochondrial
Disease Consortium, the Mitochondrial Disease Sequence Data
Resource Consortium, and its support for investigator-initiated
intramural and extramural studies. The Committee encourages NIH
to continue its efforts to ensure that individuals with
mitochondrial disease participate in both the All of Us
research program and the ECHO study. The Committee understands
that the NIH is funding research relevant to mitochondrial
disease through the Office of Research Infrastructure Programs
(ORIP). The Committee encourages the Director to promote
mitochondrial disease research within ORIP and to provide an
update to the Committee in the fiscal year 2020 Congressional
Justification on progress made through this research. The
Committee applauds the efforts made by the agency's Office of
Dietary Supplements (ODS) on nutritional interventions for
those with mitochondrial disease and requests the agency
include mitochondrial disease as a focus of its future practice
and to reengage its trans-NIH research through the ODS on these
issues. The Committee further encourages the Director to
competitively fund mitochondrial disease centers of excellence
that combine a critical mass of clinical care and research on
mitochondrial disease.
Neurofibromatosis.--The Committee supports efforts to
increase funding and resources for Neurofibromatosis (NF)
research and treatment at multiple NIH ICs, including NCI,
NINDS, NIDCD, NHLBI, NICHD, NIMH, NCATS, and NEI. Children and
adults with NF are at significant risk for the development of
many forms of cancer. The Committee encourages NCI to increase
its NF research portfolio in fundamental basic science,
translational research and clinical trials focused on NF. The
Committee also encourages the NCI to support NF centers, NF
clinical trials consortia, NF preclinical mouse models
consortia and NF-associated tumor sequencing efforts. Because
NF causes brain and nerve tumors and is associated with
cognitive and behavioral problems, the Committee urges NINDS to
continue to aggressively fund fundamental basic science
research on NF relevant to nerve damage and repair. Based on
emerging findings from numerous researchers worldwide
demonstrating that children with NF are at significant risk for
autism, learning disabilities, motor delays, and attention
deficits, the Committee encourages NINDS, NIMH, and NICHD to
expand their investments in laboratory-based and clinical
investigations in these areas. Since NF2 accounts for
approximately five percent of genetic forms of deafness, the
Committee encourages NIDCD to expand its investment in NF2
basic and clinical research. NF1 can cause vision loss due to
optic gliomas, the Committee encourages NEI to expand its
investment in NF1 basic and clinical research.
Office of AIDS Research.-- The Committee encourages the
Offie to strategically focus resources allocated to AIDS
research towards the highest quality peer reviewed projects
aimed at finding a cure, creating a vaccine, and developing
better treatments for the disease.
Pediatric Precision Medicine.--The Committee recognizes the
potential that precision medicine holds for all populations,
including children, and encourages NIH to prioritize timely and
meaningful enrollment for the pediatric population, including
healthy children and those with rare disease, in the All of Us
research program. The Committee is encouraged that NIH
impaneled a Child Enrollment Scientific Vision Working Group,
which released a report that identifies scientific
opportunities relevant to child health. The Committee requests
an update within 30 days of enactment of this Act on: (1) the
timing for the Special Populations Committee to provide
recommendations regarding the practical considerations of child
enrollment and data collection involving children, (2) plans to
ensure that the research cohort includes a sufficient number of
children to make meaningful studies possible, (3) the target
date for enrollment to commence, and (4) how enrollment
strategies will include input from pediatric stakeholders
across the country with experience in pediatric clinical trial
enrollment.
Polycystic Ovary Syndrome.--The Committee recognizes the
significant health burden of Polycystic Ovary Syndrome (PCOS),
which has reproductive, metabolic, and mental health
manifestations. The exact causes of PCOS are unknown at this
time; however, PCOS is the most common cause of female
infertility, affecting up to 10 to 15 percent of women,
depending on diagnostic criteria used. To date, 70 percent of
NIH's investment in PCOS has focused on the reproductive
implications of the syndrome, and the Committee commends NICHD
for its leadership in PCOS research. The Committee requests
that NIH also focus on comorbidities associated with PCOS, as
they contribute to increased health care costs and negative
health outcomes. The Committee requests that NICHD, in
consultation with the relevant NIH ICs, including NIDDK, NHLBI,
NCI, the Office of Research on Women's Health, NIMH, and NICHD,
report on the research that has been conducted on PCOS and its
comorbidities to date in the fiscal year 2020 Congressional
Justification. The Committee further urges these ICs to support
investigator-initiated studies and early-stage investigator
awards, and mechanisms to incentivize researchers to enter the
field.
Transformative High-Resolution Cryo-Electron Microscopy.--
The Committee commends NIH on its initial investment in the
Transformative High Resolution Cryo-Electron Microscopy (Cryo-
EM) program. The recent Nobel Prize for chemistry was awarded
for the development of Cryo-EM research funded by NIH. The
Committee urges the NIH to expand the number of national
service centers and training opportunities to further refine
and advance Cryo-EM research. The Committee directs NIH to
provide an update of these efforts in the fiscal year 2020
Congressional Justification.
Trisomy 21.--The Committee applauds the NIH for
significantly increasing its investment in Down syndrome
research and for the NIH Director's leadership in advancing the
trans-NIH initiative the Committee included in the fiscal year
2018 appropriation. The Committee directs NIH to continue to
make new investments in Down syndrom research that prioritize
funding for both new research grants that will significantly
expand the current pipeline of Down syndrom research, as well
as the implementation of the new trans-NIH intiative. In
addition, the Committee encourages NIH to prioritize funding
for research to improve the health and neurodevelopment of
individuals with Down syndrome and typical individuals at risk
for immune system dyregulation, Alzheimer's disease, cancer,
cardiovascular disease, and autism.
Valley Fever.--The Committee understands that based on the
recommendation of the independent Data and Safety Monitoring
Board (DSMB) for the Valley Fever Randomized Controlled Trial
(RCT), NIAID has halted enrollment in the RCT due to lack of
patient enrollment, primarily those with Valley Fever. In light
of this, the DSMB recommended revising the study protocol.
Accordingly, the Committee directs NIAID to expeditiously
revise the study design to address the critical need for
effective treatment of Valley Fever in order to restart
enrolling patients before the end of 2018, including increasing
the number of participating healthcare provider enrollment
sites. Furthermore, the Committee directs NIAID to work with
stakeholders to develop and implement a plan to maximize the
number of health care provider patient enrollment sites and
raise awareness of this study with the broader public with the
goal of increasing patient enrollment. The Committee requests
regular updates on the Valley Fever RCT revisions on quarterly
basis until patient enrollment is restarted, as well as a
report on maximizing health care provider enrollment sites and
public awareness plans to increase patient enrollment in the
revised RCT within 90 days of enactment of this Act.
BUILDINGS AND FACILITIES
Appropriation, fiscal year 2018....................... $128,863,000
Budget request, fiscal year 2019...................... 200,000,000
Committee Recommendation.............................. 200,000,000
Change from enacted level......................... +71,137,000
Change from budget request........................ - - -
Mission.--This account provides for the design,
construction, improvement, and major repair of clinical,
laboratory, and office buildings and supporting facilities
essential to the mission of the NIH. The funds in this
appropriation support the buildings on the main NIH campus in
Bethesda, Maryland; the Animal Center in Poolesville, Maryland;
the NIEHS facility in Research Triangle Park, North Carolina;
and other smaller facilities throughout the US.
NIH INNOVATION ACCOUNT
This account supports NIH programs authorized in the 21st
Century Cures Act (PL 114-255).
All of Us.--Within the total for this account, the
Committee includes $186,000,000 for the All of Us precision
medicine initiative. The Committee expects that NIH will also
include at least $251,000,000 in budget authority from other
NIH ICs to support this initiative.
Regenerative Medicine.--Within the total for this account,
the Committee includes $10,000,000 for Regenerative Medicine.
Substance Abuse and Mental Health Services Administration
Appropriation, fiscal year 2018....................... $5,158,994,000
Budget request, fiscal year 2019...................... 3,546,552,000
Committee Recommendation.............................. 5,681,993,000
Change from enacted level......................... +522,999,000
Change from budget request........................ +2,135,441,000
The Substance Abuse and Mental Health Services
Administration (SAMHSA) is the agency within the U.S.
Department of Health and Human Services that leads public
health efforts to advance the behavioral health of the nation.
SAMHSA's mission is to reduce the impact of substance abuse and
mental illness on America's communities.
The Committee continues to include bill language that
exempts the Mental Health Block Grant and the Substance Abuse
Prevention and Treatment Block Grant as a source for the Public
Health Service Act section 241 evaluation set-aside in fiscal
year 2019.
The Committee does not include the requested bill language
allowing the Assistant Secretary for Mental Health and
Substance Use to transfer three percent or less of funds
between any of SAMHSA's accounts.
The Committee continues to strongly encourage SAMHSA to
ensure States are engaging meaningfully with Tribal populations
in the planning and use of block grant funds. SAMHSA is also
encouraged to share best practices across States.
Where permitted in the authorizing statute, the Committee
directs SAMHSA when issuing new funding opportunity
announcements, to include as an eligible applicant: States,
political subdivisions of States (local government/
communities/ municipalities), Indian Tribes or Tribal
organizations, or other public or nonprofit entities or
organizations. The Committee encourages SAMHSA to provide
outreach and technical assistance to ensure the maximum level
of awareness and participation in new grant announcements.
MENTAL HEALTH
Appropriation, fiscal year 2018....................... $1,487,011,000
Budget request, fiscal year 2019...................... 1,064,922,000
Committee Recommendation.............................. 1,414,510,000
Change from enacted level......................... -72,501,000
Change from budget request........................ +349,588,000
Within the total provided for Mental Health Programs of
Regional and National Significance, the Committee provides the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Seclusion and Restraint.......................... $1,147,000
Project AWARE.................................... 71,000,000
Mental Health Awareness Training................. 19,963,000
Healthy Transitions.............................. 25,951,000
Infant and Early Childhood Mental Health......... 5,000,000
Children and Family Programs..................... 7,229,000
Consumer and Family Network Grants............... 4,954,000
Project LAUNCH................................... 23,605,000
Mental Health System Transformation.............. 3,779,000
Primary and Behavioral Health Care Integration... 49,877,000
National Strategy for Suicide Prevention......... 13,500,000
Zero Suicide................................. 11,500,000
American Indian and Alaska Native Set- 2,500,000
Aside...................................
Suicide Lifeline................................. 7,198,000
Garrett Lee Smith-Youth Suicide Prevention:
State Grants................................. 35,427,000
Campus Grants................................ 6,488,000
American Indian and Alaska Native Suicide 2,931,000
Prevention......................................
Tribal Behavioral Health Grants.................. 20,000,000
Homeless Prevention Programs..................... 30,696,000
Minority AIDS.................................... 9,224,000
Criminal and Juvenile Justice Programs........... 14,269,000
Assisted Outpatient Treatment.................... 15,000,000
Assertive Community Treatment for Individuals 15,000,000
with Serious Mental Illness.....................
Science and Service:
Garrett Lee Smith-Suicide Prevention Resource 5,988,000
Center..........................................
Practice Improvement and Training................ 7,828,000
Consumer and Consumer Support Technical 1,918,000
Assistance Centers..............................
Primary and Behavioral Health Care Integration 1,991,000
Technical Assistance............................
Minority Fellowship Program...................... 8,059,000
Disaster Response................................ 1,953,000
Homelessness..................................... 2,296,000
------------------------------------------------------------------------
Assertive Community Treatment.--The Committee provides
$15,000,000 for this program, which is authorized by section
9015 of the 21st Century Cures Act (PL 114-255).
Mental Health Awareness Training.--The Committee is pleased
with the progress of the Mental Health Awareness Training
program, which has trained more than one million Americans to
recognize the signs and symptoms of common mental disorders. In
continuing competitive funding opportunities, SAMHSA is
directed to include as eligible grantees local law enforcement
agencies, fire departments, and emergency medical units with a
special emphasis on training for crisis de-escalation
techniques. SAMHSA is also encouraged to allow training for
veterans, armed services personnel, and their family members.
Consistent with the authorization, funds are directed to
support grants for evidence-based programs that provide
training and education on recognizing the signs and symptoms of
mental illness, resources available in the community for
individuals with a mental illness, and safely de-escalating
crisis situations involving individuals with a mental illness.
Project AWARE.--The Committee includes $71,000,000 for
Project AWARE State grants. These grants are awarded to State
Education Agencies to promote comprehensive, coordinated, an
integrated efforts to make schools safer and increase access to
mental health services. Project AWARE supports several
strategies for addressing mental health in schools: supports
for mental wellness in education settings, building awareness
of mental health issues, and early intervention with
coordinated supports.
Suicide Prevention.--The Committee recognizes the rising
rate of suicide and notes that family and friends are often in
the best position to recognize the warning signs of suicide and
to help an at-risk individual get treatment. The Committee
urges SAMHSA to develop and disseminate programs to provide
specialized training and resources on identifying and
responding to people at risk of suicide for families and
friends of at-risk individuals.
Mental Health Block Grant
The Committee recommends a total of $722,571,000 for the
Mental Health Block Grant, which is the same as the fiscal year
2018 enacted program level and $160,000,000 above the fiscal
year 2019 budget request program level. The block grant
provides funds to States to support mental illness prevention,
treatment, and rehabilitation services. Funds are allocated
according to a statutory formula among the States that have
submitted approved annual plans.
The Committee continues the ten percent set-aside within
the Mental Health Block Grant for evidence-based programs that
address the needs of individuals with early serious mental
illness, including psychotic disorders. The Committee expects
SAMHSA to continue its collaboration with the National
Institute of Mental Health to encourage States to use this
block grant funding to support programs that demonstrate strong
evidence of effectiveness.
National Child Traumatic Stress Initiative
The Committee recommends $63,887,000 for the National Child
Traumatic Stress Initiative, which is $10,000,000 more than the
fiscal year 2018 enacted level and $15,000,000 above the fiscal
year 2019 budget request. The National Child Traumatic Stress
Initiative aims to improve behavioral health services and
interventions for children and adolescents exposed to traumatic
events. SAMHSA has provided funding for a national network of
grantees known as the National Child Traumatic Stress Network
to develop and promote effective community practices for
children and adolescents exposed to a wide array of traumatic
events.
Children's Mental Health
The Committee recommends $125,000,000 for the Children's
Mental Health program, which is the same as the fiscal year
2018 enacted level and $5,974,000 above the fiscal year 2019
budget request. Funding for this program supports grants and
technical assistance for community-based services for children
and adolescents with serious emotional, behavioral, or mental
disorders. The program assists States and local jurisdictions
in developing integrated systems of community care.
Projects for Assistance in Transition from Homelessness
The Committee recommends $64,635,000 for the Projects for
Assistance in Transition from Homelessness (PATH) program,
which is the same as the fiscal year 2018 enacted level and the
fiscal year 2019 budget request. The PATH program supports
grants to States and territories for assistance to individuals
suffering from severe mental illness and/or substance abuse
disorders and who are homeless or at imminent risk of becoming
homeless. Grants may be used for outreach, screening and
diagnostic treatment services, rehabilitation services,
community mental health services, alcohol or drug treatment
services, training, case management services, supportive and
supervisory services in residential settings, and a limited set
of housing services.
Protection and Advocacy for Individuals with Mental Illness
The Committee recommends $36,146,000 for the Protection and
Advocacy for Individuals with Mental Illness program, which is
the same as the fiscal year 2018 enacted level and the fiscal
year 2019 budget request. This program serves to ensure that
the rights of mentally ill individuals are protected while they
are patients in all public and private facilities or while they
are living in the community. Funds are allocated to States
according to a formula based on population and relative per
capita incomes.
SUBSTANCE ABUSE TREATMENT
Appropriation, fiscal year 2018................ $3,263,506,000
Budget request, fiscal year 2019............... 2,113,397,000
Committee Recommendation....................... 3,853,506,000
Change from enacted level.................. +590,000,000
Change from budget request................. +1,740,109,000
Substance Abuse Prevention and Treatment Block Grant
The Committee recommends a program level of $2,358,079,000
for the Substance Abuse Prevention and Treatment Block Grant,
which is $500,000,000 more than the fiscal year 2018 enacted
program level and the fiscal year 2019 budget request program
level. The Substance Abuse Prevention and Treatment Block Grant
provides funds to States to support alcohol and drug abuse
prevention, treatment, and rehabilitation services. The
Committee recognizes the critical role the block grant plays in
State systems across the country.
Within the total provided for Programs of Regional and
National Significance, the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Opioid Treatment Programs and Regulatory $32,724,000
Activities......................................
Medical Provider Education on Opioid 24,000,000
Treatment...................................
Reducing Underage Drinking through Screening and 2,000,000
Brief Intervention..............................
PHS Evaluation Funds......................... 2,000,000
Targeted Capacity Expansion--General............. 125,192,000
Medication-Assisted Treatment................ 114,000,000
Tribal Set-aside......................... 15,000,000
Grants to Prevent Prescription Drug/Opioid 12,000,000
Overdose........................................
First Responder Training......................... 36,000,000
Rural Focus.................................. 18,000,000
Pregnant and Postpartum Women.................... 29,931,000
Recovery Community Services Program.............. 2,434,000
Children and Families............................ 29,605,000
Treatment Systems for Homeless................... 36,386,000
Minority AIDS.................................... 65,570,000
Criminal Justice Activities...................... 99,000,000
Drug Courts.................................. 80,000,000
Improving Access to Overdose Treatment........... 1,000,000
Building Communities of Recovery................. 10,000,000
Science and Service:
Addiction Technology Transfer Centers............ 9,046,000
Minority Fellowship Program...................... 4,539,000
------------------------------------------------------------------------
Medical Provider Education on Opioid Treatment
The Committee provides $24,000,000 for carrying out medical
and other healthcare practitioner education. The Committee
directs SAMHSA to provide grants to medical schools, schools of
nursing, social work, physician assistants, and other colleges
and universities to ensure that training in the field of
substance use disorders, including opioid use disorders, is
incorporated into the standard curriculum of the university
programs. Activities should include both didactic and hands on
training for students. Funds should support Drug Addiction
Treatment Act of 2000 waiver training for designated
practitioners to be able to engage in office based treatment
for substance use disorders, including opioid use disorders.
The Committee expects training and practice requirements to be
consistent with section 303(g)(2) of the Controlled Substances
Act, including diversion control, relapse prevention, overdose
reversal, detoxification, and the clinical use of FDA-approved
medications. These grants are expected to generate a well-
equipped workforce to address the behavioral health needs of
individuals across the country and ultimately close the
substance use disorder treatment gap.
Screening, Brief Intervention and Referral to Treatment
The Committee does not provide funding for Screening, Brief
Intervention and Referral to Treatment, which is $30,000,000
below the fiscal year 2018 enacted program level, and the same
as the fiscal year 2019 budget request program level.
Reducing Underage Drinking through Screening and
Brief Intervention
The Committee provides $2,000,000 for grants to pediatric
health care providers in accordance with the specifications
outlined in section 9016 of the 21st Century Cures Act (PL 114-
255). Training grants should focus on screening for underage
drinking, opioid use, and other drug use.
Targeted Capacity Expansion
The Committee recommends $123,192,000 for Targeted Capacity
Expansion activities. Of this amount, $114,000,000 is for
services that address prescription drug abuse and heroin use in
high-risk communities. Within the $114,000,000, the Committee
provides $15,000,000 for grants to Indian Tribes, Tribal
organizations, or consortia. SAMHSA should target funds to
grantees located in States with the highest rates of admissions
and that have demonstrated a dramatic increase in admissions
for the treatment of opioid use disorders.
The Center for Substance Abuse Treatment is directed to
include as an allowable use medication-assisted treatment and
other clinically appropriate services to achieve and maintain
abstinence from all opioids and heroin and prioritize treatment
regimens that are less susceptible to diversion for illicit
purposes. Further, for the additional funds, the Committee
directs SAMHSA to prioritize grants from nonprofit
organizations and political subdivisions of States.
Grants to Prevent Prescription Drug/Opioid Overdose and
First Responder Training
The Committee notes strong concerns about the increasing
number of unintentional overdose deaths attributable to
prescription and nonprescription opioids. SAMHSA is urged to
take steps to encourage and support the use of Substance Abuse
and Prevention Block Grant funds for opioid safety education
and training, including initiatives that improve access for
licensed healthcare professionals, including paramedics, to
emergency devices used to rapidly reverse the effects of opioid
overdoses. Such initiatives should incorporate robust evidence
based intervention training, and facilitate linkage to
treatment and recovery services.
Pregnant and Postpartum Women
The Committee provides $29,931,000 for Pregnant and
Postpartum Women, which is the same as the fiscal year 2018
enacted level and $10,000,000 more than the fiscal year 2019
budget request.
The Committee recognizes the importance of treatment for
women during pregnancy who are at risk for opioid dependence
and opioid exposure during pregnancy, and infants born with
neonatal abstinence syndrome. A 2015 GAO report stated that the
most frequently cited program gap was the lack of available
treatment programs for pregnant women. There is a need for
increased available treatment options for pregnant women,
especially in States with large populations and few treatment
programs available. The Committee encourages SAMSHA to provide
grants to expand existing treatment programs for women and
infants in States with fewer than three available programs.
Substance use during pregnancy, particularly the misuse of
opioids, has increased in parallel with the national rate of
opioid misuse. While much attention has been paid to the
negative impacts of opioid use on the fetus and newborn, less
attention has been given to the pregnant woman. The Committee
encourages cross-HHS collaboration between research and public
health programs, as well as engagement with health care
providers and patients to ensure that the care and treatment of
pregnant women with substance use disorder is considered and
included in any national efforts to address the opioid
epidemic. The Committee requests an update on these efforts in
the fiscal year 2020 Congressional Justification.
Criminal Justice Activities
The Committee provides $99,000,000 for the Criminal Justice
Activities program, which is $10,000,000 above the fiscal year
2018 enacted level and $21,000,000 more than the fiscal year
2019 budget request. Of this amount, the Committee directs that
not less than $80,000,000 will be used exclusively for Drug
Court activities.
Drug Courts.--The Committee continues to direct SAMHSA to
ensure that all funding appropriated for Drug Treatment Courts
is allocated to serve people diagnosed with a substance use
disorder as their primary condition. The Committee directs
SAMHSA to ensure that all drug treatment court grant recipients
work directly with the corresponding State substance abuse
agency in the planning, implementation, and evaluation of the
grant. The Committee further directs SAMHSA to expand training
and technical assistance to drug treatment court grant
recipients to ensure evidence-based practices are fully
implemented.
Center for Substance Abuse Treatment
Addiction Medicine Awareness.--SAMHSA, in coordination with
the Office of National Drug Control Policy, should coordinate
efforts among Federal agencies to raise awareness among
qualified physicians of the opportunity to sit for the
addiction medicine subspecialty board exam. In 2016, addiction
medicine was recognized as an American Board of Medical
Specialties (ABMS) subspecialty under the American Board of
Preventive Medicine. The first ABMS addiction medicine board
exam was offered in October 2017. While the board exam will be
open to any American physician with a primary ABMS board
certification until 2022, after that time period, physicians
will need to complete a year-long fellowship program to be
qualified to sit for the exam. In five short years, the number
of accredited and funded addiction medicine fellowship programs
and slots will be the limiting factor in determining how many
addiction medicine specialists can receive board certification.
It is critical that all stakeholders work to maximize funded
addiction medicine fellowship opportunities before their number
begins to limit qualified examinees.
Continuum of Care.--Evidence demonstrates that efforts to
coordinate opioid abuse treatment that promote a continuum of
care model can produce effective results. Successful examples
include the development of ``no wrong door'' treatment models
and the use of mechanisms to scale-up training and increase the
number of peer coaches. In addition, the use of mobile app
technology to enhance access to services promotes successful
treatment outcomes and supports long-term relapse prevention.
SAMHSA is encouraged to ensure that State and local grantees
are prioritizing the implementation of coordinated continuum of
care approaches. The Committee encourages SAMHSA to support
projects of regional and national significance to further
develop and validate the effectiveness of such approaches.
Implant Delivery Opioid Deterrent Treatment.--The Committee
requests an update in the fiscal year 2020 Congressional
Justification on SAMHSA's efforts to increase patient coverage
for opioid deterrent treatments and expand access of medication
assisted treatment, including efforts to train more providers
in this method of treatment.
Infectious Disease and the Opioid Epidemic.--The Committee
notes that the prevalence of hepatitis C and human
immunodeficiency virus (HlV) have increased along with the
opioid epidemic. New research suggests that awareness of one's
infection status can help limit ongoing opioid abuse. The
Committee supports efforts to address the overlapping public
health challenges of hepatitis C and HIV, and requests an
update in the fiscal year 2020 Congressional Justification on
efforts to promote screening and rapid-testing activities for
affected communities.
Prescription Digital Therapeutics.--The Committee
recognizes that the emerging field of prescription digital
therapeutics is bringing to market clinically validated, Food
and Drug Administration-cleared software treatments that
improve clinical outcomes for patients living with substance
and opioid use disorders. Given the opportunity to increase
abstinence and reduce relapse among the over 21 million
American estimated to be struggling with these disorders, the
Committee requests that SAMHSA update the January 2015 Federal
Guidelines for Opioid Treatment Programs and consider the role
that prescription digital therapeutics can play as part of
evidence-based treatment standards, and in particular their
potential role in meeting the counseling services requirements
under 42 CFR 8.12(f). The Committee requests that SAMHSA
include an update on this effort in the fiscal year 2020
Congressional Justification.
SUBSTANCE ABUSE PREVENTION
Appropriation, fiscal year 2018....................... $248,219,000
Budget request, fiscal year 2019...................... 220,885,000
Committee Recommendation.............................. 248,719,000
Change from enacted level......................... +500,000
Change from budget request........................ +27,834,000
Within the total provided for Programs of Regional and
National Significance, the Committee provides the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Capacity:
Strategic Prevention Framework................... $137,484,000
PHS Evaluation Funds......................... 116,560,000
Strategic Prevention Framework Rx............ 18,000,000
PHS Evaluation Funds..................... 18,000,000
Opioid Prevention Grants......................... 25,000,000
PHS Evaluation Funds......................... 25,000,000
Minority AIDS.................................... 41,205,000
PHS Evaluation Funds......................... 41,205,000
Federal Drug-Free Workplace...................... 4,894,000
Sober Truth on Preventing Underage Drinking...... 8,000,000
PHS Evaluation Funds......................... 8,000,000
National Adult-Oriented Media Public 1,000,000
Service Campaign........................
Community Based Coalition Enhancement 6,000,000
Grants..................................
Interagency Coordinating Committee to 1,000,000
Prevent Underage Drinking...............
Tribal Behavioral Health Grants.................. 20,000,000
PHS Evaluation Funds......................... 20,000,000
Science and Service:
Center for the Application of Prevention 7,493,000
Technologies....................................
Science and Service Program Coordination......... 4,072,000
Minority Fellowship Program...................... 571,000
------------------------------------------------------------------------
Center for the Application of Prevention Technologies.--The
Committee directs the Secretary to expand eligibility for
grants under SAMHSA Prevention Programs of Regional and
National Significance and the corresponding services provided
by the Center for the Application of Prevention Technologies to
private, non-profit, regional organizations, including faith-
based organizations. The broad coalitions orchestrated by these
regional organizations are uniquely positioned to supplement
the work already being done by the State, Tribal and community
organizations currently authorized for such grants.
Minority Fellowship Program.--Culturally competent
behavioral health services are necessary to meet demand and
behavioral health challenges facing communities across the US,
including the opioid epidemic. In addition, significant
behavioral health disparities persist in diverse communities
across the US. There are persistent health disparities between
different racial and ethnic populations, and health equity
remains a challenge with minorities receiving less mental
health and addiction treatment and lower-quality care. To meet
this need, the Minority Fellowship Program (MFP) has been
increasing the number of culturally competent behavioral health
professionals providing mental health and substance use
disorders services to underserved populations. The MFP provides
support to behavioral health professionals in the fields of
psychiatry, psychology, social work, nursing, marriage and
family therapy, counseling and addictions. The MFP is the only
Federal program supporting culturally competent mental health
and substance use disorders professionals.
Opioid Prevention Grants.--The Committee notes that
substance use prevention, to stop misuse of opioids before it
starts, has been underutilized despite its potential to reduce
the pathway to addiction and that the most effective approach
to dealing with prevention is comprehensive planning and
implementation of multiple strategies across multiple sectors
of a community. The Committee includes $25,000,000 for opioid
prevention grants. The Committee intends for such grants to
enable multi-sector community organizations to receive grants
of up to $150,000 to partner with relevant community sectors to
implement at least one strategy, program, or activity across
the allowable uses of funds and then evaluate progress in
reducing population levels of opioid misuse in the community
using baseline data, which shall then be collected every two
years for the target population. Funds may be used for the
implementation of an array of strategies, programs, and
activities across each of the following: reduce access to and
availability of opioids; change social norms in the community
about misusing opioids; build skills with scale and scope in
parents/caregivers, youth, school personnel, the medical
community, law enforcement, youth serving organizations,
fraternal or faith based organizations, and the media through
targeted education, training, and skills building; change
community-wide incentives and policies to deter opioid misuse;
and implement evidence based substance use prevention programs
and curricula in schools and other venues to reach the target
population.
HEALTH SURVEILLANCE AND PROGRAM SUPPORT
Appropriation, fiscal year 2018....................... $160,258,000
Budget request, fiscal year 2019...................... 147,348,000
Committee Recommendation.............................. 165,258,000
Change from enacted level......................... +5,000,000
Change from budget request........................ +17,910,000
The Committee provides the following amounts for Health
Surveillance and Program Support:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Health Surveillance.................................. $47,258,000
PHS Evaluation Funds............................. 30,428,000
Program Support...................................... 79,000,000
Public Awareness and Support......................... 13,000,000
Performance and Quality Information Systems.......... 10,000,000
Drug Abuse Warning Network........................... 15,000,000
Agency-Wide Initiatives:
Behavioral Health Workforce Data and Development. 1,000,000
PHS Evaluation Funds......................... 1,000,000
------------------------------------------------------------------------
Agency for Healthcare Research and Quality
HEALTHCARE RESEARCH AND QUALITY
Appropriation, fiscal year 2018....................... $334,000,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 334,000,000
Change from enacted level......................... - - -
Change from budget request........................ +334,000,000
The Agency for Healthcare Research and Quality's (AHRQ)
mission is to produce evidence to make health care safer,
higher quality, more accessible, equitable, and affordable, and
to work within HHS and other partners to make sure that the
evidence is understood and used. AHRQ conducts, supports, and
disseminates scientific and policy-relevant research on topics
such as promoting high-quality care, eliminating healthcare
disparities, using information technology, and evaluating the
effectiveness of clinical services.
Within the total for AHRQ, the agreement includes the
following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Prevention/Care Management........................... 11,649,000
Health Information Technology (IT)................... 16,500,000
Health IT to Improve Quality..................... 14,500,000
Patient Safety Research.............................. 70,276,000
Healthcare-Associated Infections (HAI) Prevention 36,000,000
Combating Antibiotic-Resistant Bacteria (non-add 10,000,000
within HAI).....................................
Section 933 Grants............................... 10,000,000
Patient Safety and Medical Errors................ 19,000,000
Patient Safety Organizations..................... 4,866,000
Crosscutting Activities Related to Quality, 94,284,000
Effectiveness and Efficiency Research...............
Health Services Contract/IAA Research............ 14,000,000
Investigator-Initiated Research Grants........... 52,933,000
Medical Expenditure Panel Survey..................... 69,991,000
Program Management................................... 71,300,000
------------------------------------------------------------------------
Sepsis Testing.--AHRQ has been the leader in developing the
tools and resources to help providers improve their antibiotic
stewardship programs. The Committee is concerned that AHRQ has
not updated several publications related to the use of
procalcitonin (PCT) tests in sepsis and antibiotic treatment
programs in more than five years. High sensitive PCT tests are
critical tools for initiating and discontinuing antibiotic
therapies and play a key role in antibiotic stewardship
programs. The Committee urges AHRQ to collaborate with NIH,
HRSA, BARDA, CDC, FDA, and other relevant agencies to review
and update their publications with the latest FDA approved uses
for PCT tests in antibiotic stewardship. The Committee requests
an update on these activities in the fiscal year 2020
Congressional Justification.
Centers for Medicare and Medicaid Services
GRANTS TO STATES FOR MEDICAID
Appropriation, fiscal year 2018................ *$284,798,384,000
Budget request, fiscal year 2019............... 276,236,212,000
Committee Recommendation....................... 276,236,212,000
Change from enacted level.................. -8,562,172,000
Change from budget request................. - - -
Medicaid provides health coverage eligible populations,
including eligible low-income adults, children, pregnant women,
elderly adults, and people with disabilities. Medicaid is
administered by States, according to Federal requirements. The
program is funded jointly by States and the Federal government.
This amount does not include $134,847,759,000, which was
provided as advance funding for the first quarter of fiscal
year 2019. In addition, the Committee recommends an advance
appropriation of $137,931,797,000 for program costs in the
first quarter of fiscal year 2020.
The Committee continues bill language providing indefinite
budget authority for unanticipated costs in fiscal year 2019.
Federal Medicaid grants reimburse States for a portion of their
expenditures in providing health care for individuals whose
income and resources fall below specified levels. Subject to
certain minimum requirements, States are provided certain
limited authority within the law to set eligibility, coverage,
and payment levels.
PAYMENTS TO THE HEALTH CARE TRUST FUNDS
Appropriation, fiscal year 2018........... $323,497,300,000
Budget request, fiscal year 2019.......... 378,343,800,000
Committee Recommendation.................. 378,343,800,000
Change from enacted level............. +54,846,500,000
Change from budget request............ - - -
This account includes the general fund subsidy to the
Federal Supplementary Medical Insurance Trust Fund for Medicare
Part B benefits, and Medicare drug benefits and administration,
as well as other reimbursements to the Federal Hospital
Insurance Trust Fund for benefits and related to administrative
costs, which have not been financed by payroll taxes or premium
contributions. The Committee continues bill language providing
indefinite authority to pay the general revenue portion of the
Medicare Part B premium match and providing resources for the
Medicare Part D drug benefit program in the event that the
annual appropriation is insufficient.
PROGRAM MANAGEMENT
Appropriation, fiscal year 2018....................... $3,669,744,000
Budget request, fiscal year 2019...................... 3,543,879,000
Committee Recommendation.............................. 3,502,024,000
Change from enacted level......................... -167,720,000
Change from budget request........................ -41,855,000
Program Operations
The Committee recommends $2,402,089,000 for Program
Operations to support activities used to administer the
programs under the Centers for Medicare & Medicaid Services
(CMS), fund beneficiary outreach and education, maintain
information technology infrastructure needed to support various
claims processing systems, and continue other programmatic
improvements.
Addressing Regional Disparities in Medicare Access.--The
Committee notes increasingly large regional disparities in the
Medicare Area Wage index and is concerned that such disparities
are negatively impacting the ability of hospitals to provide
necessary, timely, and evidence based care to individuals
entitled to benefits under part A or enrolled under part B of
title XVIII of the Social Security Act. When developing
regulations under section 1886 of the Social Security Act, the
Committee encourages the Secretary to take into account ideas
and suggested reforms for the area wage index stated in the
comments received as part of the request for public comments on
wage index disparities published in the proposed rule entitled
``Medicare Program; Hospital Inpatient Prospective Payment
Systems for Acute Care Hospitals and the Long-Term Care
Hospital Prospective Payment System and Proposed Policy Changes
and Fiscal Year 2019 Rates; Proposed Quality Reporting
Requirements for Specific Providers; Proposed Medicare and
Medicaid Electronic Health Record Incentive Programs (Promoting
Interoperability Programs) Requirements for Eligible Hospitals,
Critical Access Hospitals, and Eligible Professionals; Medicare
Cost Reporting Requirements; and Physician Certification and
Recertification of Claims'' (83 Fed. Reg. 20372). In addition,
CMS is directed to submit a report to the Committees on
Appropriations of the House of Representatives and Senate, and
the authorizing Committees of jurisdiction, with an analysis of
the ideas and suggested reforms received as part of the request
for public comments on the area wage index published in such
rule. The report should also analyze data that may demonstrate
disparities resulting from the current area wage index
calculation under Inpatient Prospective Payment System
payments. Additionally, the report should analyze solutions
presented by commenters and present possible solutions
identified by CMS to rectify such disparities identified
through such information collected under the request for public
comments. Such report shall be provided not later than 180 days
after enactment of this Act.
Adult Immunization Rates.--The Committee recognizes the
importance of vaccines in preventing diseases that can result
in increased morbidity and mortality, particularly among the
Medicare population, and is concerned about the
underutilization of adult vaccinations in this population. The
Committee strongly encourages CMS to work toward achievement of
the Healthy People 2020 goals to increase the percentage of
adults [aged 65 or older] who receive recommended vaccinations.
In particular, CMS is encouraged to: 1) incorporate the
National Vaccine Advisory Committee Standards for Adult
Immunization Practice in provider outreach and educational
materials pertaining to the Initial Preventive Physical
Examination under Medicare and Annual Wellness Visits,
including but not limited to the Medicare Learning Network
Educational Tools, The ABCs of the Initial Preventive Physical
Examination and The ABCs of The Annual Wellness Visit; 2)
support development and implementation of electronic health
records and other technologies, such as reminder recall
programs, that can identify Medicare beneficiaries who have not
received recommended vaccinations and remind those
beneficiaries and their providers to adhere to vaccination
schedules; and 3) to work with CDC and other relevant
stakeholders to develop guidance for electronic health record
systems to provide consistency and ensure greater
interoperability between electronic health records and State
and local immunization information systems and improve the
value and reduce the burden of reporting for Medicare
providers.
Agents Used for Cosmetic Purposes or Hair Growth.--Section
5008 of the 21st Century Cures Act (PL 114-255) eliminated
Federal Medicaid matching funds for prescription drugs used for
cosmetic purposes or hair growth unless they are determined to
be ``medically necessary''. The Committee appreciates the
important role of the physician in deciding medical necessity
for prescription drugs used for hair growth, particularly in
regards to patients within State Medicaid programs. The
Committee encourages CMS to provide further guidance to States
on this issue, including whether medical conditions that cause
hair loss, such as the autoimmune disease alopecia areata and
thyroid disease, are medically necessary and allow Medicaid
coverage for hair loss products for Medicaid patients suffering
from these diseases. The Committee requests an update on this
effort in the fiscal year 2020 Congressional Justification.
Ambulatory Surgical Centers.--CMS is directed to submit a
report to the Committees on Appropriations of the House of
Representatives and Senate, and the authorizing committees of
jurisdiction, on the migration of procedures to ambulatory
surgical centers (ASCs). The report should evaluate volume
changes in hospital outpatient departments and ASCs for
procedures that have been added to the ambulatory surgical
center payable list since 2008. For procedures that have not
shown any significant volume shift, the report will evaluate
factors that may be limiting migration into ASCs as well as
potential incentives for ownership of certain Medicare sites
based on reimbursement disparity.
Breast Prostehtics.--Congress enacted the Women's Health
and Cancer Rights Act in 1998. This law requires health plans
that provide mastectomy converage to also provide coverage for
surgical breast reconstruction. For some women, reconstructive
surgery is not an option. For women who do not receive
reconstructive surgery, CMS provides coverage for a
prefabricated breast prosthetic. However, these prosthetics can
be difficult for regular and normal use. The Committee supports
efforts by CMS to evaluate the coverage determinations
concerning custom fabricatged prosthetics.
Burden Reduction and Improved Coordination of the Medicare
Program.--The Committee is concerned about the lack of
coordination between the Center for Medicare and the Center for
Clinical Standards and Quality (CCSQ) within CMS. CCSQ is
responsible for activities, functions, and duties that create
administrative burden on providers who serve Medicare
beneficiaries. In order to ensure there is sufficient
coordination across components in CMS that impact Medicare, the
Committee urges the Director of Medicare to oversee all
activities, functions, and duties of the Center for Clinical
Standards and Quality of the Centers for Medicare & Medicaid
Services that relate to activities, functions, and duties of
the Center for Medicare and the Medicare program under title
XVIII of the Social Security Act, including but not limited to
activities, functions, and duties relating to Medicare
coverage, conditions of participation, and quality measures
applied under the Medicare program. The Committee requests an
update on these activities in the fiscal year 2020
Congressional Justification.
Cardiac Quality Measures.--The Committee requests CMS
provide an update in the fiscal year 2020 Congressional
Justification on the inclusion of quality measures to assign
accountability of the prevention of conditions and
complications that are commonly associated with cardiac
procedures, such as perioperative hemorrhage.
Center for Medicare and Medicaid Innovation.--The Center
for Medicare and Medicaid Innovation (CMMI) was created in the
Patient Protection and Affordable Care Act (PL 111-148) to test
new payment models. CMMI previously overstepped its authority
by proposing simultaneously to make near nationwide, mandatory
changes, including compulsory participation of providers to the
Medicare program without appropriate debate or input from
Congress or Medicare providers and beneficiaries. CMS recently
released a set of principles for CMMI that would ensure CMMI
serves as an actual testing ground, not a place to insert full-
scale policy changes by circumventing Congress. The Committee
supports these actions, and urges CMS to formalize a process
for testing CMMI models, and provide more transparency on the
impact of CMMI demonstrations on patient access, care quality,
and health care costs in the annual report to Congress. Insofar
as CMMI is utilized for the advancement of alternative payment
models in the implementation of the Medicare Access and CHIP
Reauthorization Act of 2015 (PL 114-10), the Committee expects
that CMMI will work closely with the Physician Technical
Advisory Committee (PTAC) to ensure input from PTAC. The
Committee also believes models recommended by PTAC and approved
by the Secretary should be given priority in testing with the
input of PTAC.
Chief Dental Officer.--The Committee is concerned that the
Chief Dental Officer position at CMS has been vacant since
October 2017. Without a dentist to oversee oral health issues
in Medicare and Medicaid, this vacancy leaves a significant gap
of clinical oral health expertise within CMS. Medicaid provides
oral health services to millions of children, pregnant women,
and adults across the country. The Early Periodic Screening,
Diagnosis and Treatment program requires dental services to be
provided to beneficiaries eligible for the program. The
Children's Health Insurance Program also requires dental
services as part of the benefit package available to children.
A licensed dentist clinician is an invaluable resource to these
programs and CMS' growing oral health strategy to expand access
to care. This position can also be utilized to study the
potential benefits of periodontal care for patients suffering
from chronic renal conditions. The Committee urges CMS to move
forward with filling this vacancy.
Clinical Laboratory Fee Schedule.--Inconsistencies in panel
testing reimbursement in Medicare should be resolved to prevent
wasteful government spending. The Committee encourages the
Administrator of CMS to develop and issue a panel pricing
policy that ensures the agency is not paying more for a single
clinical diagnostic laboratory test, or a group of individual
clinical diagnostic laboratory tests, than it would for a
clinical diagnostic laboratory testing panel that tests for the
same analyte(s). The Committee encourages the Administrator to
apply the policy to all types of test panels.
Colorectal Cancer Screening.--The Committee is encouraged
by the inclusion of the proposal in the President's Budget to
address the inequity in beneficiary cost sharing for screening
colonoscopies. The Committee urges CMS to align its
interpretation of the colorectal cancer screening cost-sharing
requirements for Medicare beneficiaries with the policy of
colorectal cancer cost-sharing requirements for other
Federally-funded health programs. The Committee also urges CMS
to consider coverage of blood tests that could serve to deter
or immediately recommend the need for colonoscopy so as to
increase the number of patients that go in for testing and
decrease the amount of late-stage colon cancer diagnoses.
Community Benefits Provided by Hospitals.--The Committee
requests from GAO an update to the GAO Report entitled
``Nonprofit, For-Profit, and Government Hospitals:
Uncompensated Care and Other Community Benefits'' (GAO-05-
743T).
Community Participatory Health Dashboard.--The Committee
strongly encourages effort by CMS and CDC to devise a strategy
on how to construct a decision-support tool that includes
Geographic Information System epidemiologic data paired with
Medicaid and other health program claims data that can
contribute to community-participatory health prevention
efforts. The effort would serve as a guide for HHS agencies to
collaborate to construct a dashboard for community use to
evaluate rates of disease and the associated costs.
Competitive Bidding Program for Durable Medical Equipment,
Prosthetics, Orthotics, and Supplies.--The Committee notes
concern over CMS' management of the competitive bidding program
for Durable Medical Equipment, Prosthetics, Orthotics, and
Supplies. The Committee strongly supports efforts by CMS to
bring greater transparency and oversight. The Committee
supports efforts in upcoming proposed rulemaking to ensure
continued access for rural areas.
Congressional Justification.--The Committee directs CMS to
include in the fiscal year 2020 Congressional Justification a
table for current law estimates for all CMS administered
programs listed in the table at the back of this report.
Contractor Oversight.--The Committee expects CMS to
increase oversight of contractors who are tasked with audit of
claims, including Zone Program Integrity Contractor, Medicare
Administrative Contractor, and Qualified Independent
Contractor. CMS should have a formal process to review appeals
to ensure CMS guidance is properly followed. The Committee
remains concerned with the degree of independence given to
contractors to determine sample methodology for claim review
and assessing penalties. The Committee believes CMS should have
standard protocols to ensure consistent principles are applied
by contractors in all regions and for all levels of the appeal
process. The Committee expects an update on this effort in the
fiscal year 2020 Congressional Justification.
Critical Access Hospitals.--The Committee supports Critical
Access Hospitals (CAH). Reduced reimbursement could impede the
hospital's ability to properly provide care to local residents.
Prior to implementation of a change in reimbursement policy,
the Committee encourages CMS to engage with stakeholders to
ensure the change would not negatively impact a CAH's ability
to fully operate.
Diabetic Retinal Exams.--According to the CDC, diabetes-
related blindness costs the Nation about $500 million annually.
The Committee recognizes that as more Medicare beneficiaries
are diagnosed with diabetes, diabetic retinopathy remains a
concern, and change is required to eradicate this leading cause
of severe vision loss and blindness. Non-compliance is driving
preventable blindness. Experts recommend that all individuals
diagnosed with diabetes should be examined for eye health, yet
failure to receive annual diabetic retinal exams is common. The
Committee urges CMS to update its policy to make diabetic
retinal exams more accessible to diabetic patients in primary
care settings, through the use of digital retinal imaging with
remote specialist interpretation.
Direct and Indirect Remuneration.--The Committee is aware
that CMS has put forth a Request for Information as part of the
2019 proposed Part D rule. The Committee understands any
specific policy changes must occur through a future notice and
comment rulemaking and urges the Secretary to consider the
impact this proposal will have on seniors' premiums and the
taxpayer, as well as its potential to reveal competitively
sensitive information. The Committee requests an update on this
topic in the fiscal year 2020 Congressional Justification.
Disaster Impacted Areas.--The Committee strongly supports
efforts to increase access to care for local hospitals located
in areas impacted by a National disaster. Storm damage to
facilities and infrastructure can significantly impede a
community's access to primary, emergency, and specialty care.
CMS should take necessary administrative action to ensure the
existing physical infrastructure for health care facilities is
effectively utilized to provide for necessary care in disaster
impacted communities.
Drug Pricing Report.--The Committee directs the Secretary
of Health and Human Services to submit a report to the
Committee on appropriations of the House of Representatives not
later than 120 days after the date of the enactment of the Bill
to which this Committee Report pertains regarding price changes
of prescription drugs since 2008. The report should include
comparative prescription drug prices (net of rebates) paid by
the following programs for the 10 most frequently prescribed
drugs and the 10 highest-cost drugs for each of the following:
(1) The Medicare program under part B of title XVIII
of the Social Security Act.
(2) The Medicare prescription drug program under part
D of title XVIII of the Social Security Act.
(3) The Medicaid program under title XIX of the
Social Security Act.
(4) The Department of Veterans Affairs.
The report should also provide a breakdown of the
comparative prices (net of rebates) for each of the 10 most
frequently prescribed drugs and the 10 highest-cost drugs
between ambulatory settings and retail settings.
Under Medicare Part D, the report should detail gross Part
D drug costs and net Part D drug costs and the Direct and
Indirect Remuneration for the 10 most frequently prescribed
drugs and the 10 highest-cost drugs.
In addition, the report should include total annual costs
due to prescription drugs to the Medicare program under part B
of title XVIII of the Social Security Act, the Medicare
prescription drug program under part D of title XVIII of such
Act, and the Medicaid program under title XIX of such Act.
Finally, the report should list the drugs that have been
registered for sale by the Food and Drug Administration (FDA)
in the past five years that have benefited significantly from
government grants or research subsidies in either the pre-
clinical or clinical stages of development, as well as the
price (net of rebates) and total spending in Medicare and
Medicaid for each of those drugs.
Geographic Practice Cost Index.--The Committee supports
efforts by CMS to create a more transparent process for the
development of a Geographic Practice Cost Index (GPCI). The
Committee believes more transparency is needed to understand
the methodology used to determine input variables. The
Committee supports a process that accounts for variables in a
GPCI that lead to fair reimbursement for rural States.
Health Insurance Information.--The Committee supports
efforts by CMS to utilize private sector solutions for
information on health insurance options.
Hospital Acquired Pressure Ulcers.--The Committee
understands data released in October 2017 by the CMS Office of
Enterprise Data and Analytics identified that hospital
discharges of patients with pressure ulcers have increased by
over 58 percent between the first quarter of 2016 and 2017. In
addition, HHS research shows that hospital-acquired pressure
ulcers and their associated complications have led to roughly
60,000 patient deaths per year. These statistics are deeply
concerning. The Hospital-Acquired Condition (HAC) Reduction
Program requires CMS to reduce payments for hospitals that rank
among the lowest-performing 25 percent of hospitals with regard
to HACs, but it also allows the Administration to adjust the
Domain 1 and Domain 2 formulas used for that calculation. Given
this adjustment ability, the Committee requests CMS provide
information in the fiscal year 2020 Congressional Justification
on steps CMS is taking to review the formulas and any other
actions they are taking to reverse the trend of increased
hospital-acquired pressure ulcers.
Hospital Based Nursing.--The Committee encourages CMS to
address the ability of hospital-based nursing programs to
maintain their pass-through payments in light of conflicting
eligibility requirements established by national and regional
higher education accrediting bodies. The CMS pass-through
payments are essential for hospital-based nursing programs to
continue to produce well-educated nurses and address areas of
national need and underserved populations. The Committee
requests that CMS provide an update in the fiscal year 2020
Congressional Justification on efforts to remedy this policy
discrepancy.
Hospital Surveys.--The Committee commends CMS for ensuring
standards for safety and quality are maintained for the health
of Medicare beneficiaries. The Committee is concerned with
revisions to the State Operation Manual described in S&C Memo:
17-44-All Hospitals. In this Memorandum, CMS mandates a new
standard for a hospital survey, and retroactively applies this
standard to facilities for the prior 12 months. The Committee
believes such a change is rulemaking and subject to a notice
and comment period. The Committee notes CMS had to issue two
additional memorandums to clarify the new policy. Such
revisions serve as evidence that the change in policy warrants
time for stakeholders to prepare. The Committee has concerns
that hospitals did not receive notice and requests that CMS
provide justification for why notice was not provided for
hospitals through notice and comment rulemaking.
Impact of Tobacco Cessation on Medicaid.--The Committee
notes that Medicaid coverage of tobacco cessation
nonprescription drugs may assist individuals in efforts to
limit tobacco usage, which could result in savings to the
Medicaid program. The Committee requests an update in the
fiscal year 2020 Congressional Justification on the possible
impact of such a coverage change, including any assoicated
savings.
Kidney Dialysis Payment and Transplant Services.--The
Committee is aware of an unintended issue within Medicare
coverage of kidney dialysis and kidney transplant services
regarding anti-rejection medication known as immunosuppressive
drugs. Currently the Medicare program pays for a large share of
the medication needed to prevent rejecting a transplanted
kidney but coverage of these drugs for non-aged, non-disabled
beneficiaries is limited to three years from the date of the
transplant. Recipients who cannot afford the high cost of the
drugs sometimes resort to skipping doses and stretching
medication resulting in diminished kidney function and
ultimately rejection, returning the patient to years of
dialysis and another kidney transplant. The Committee
encourages CMS to commission a study to determine the cost of
effectiveness of the current policy of restrictive coverage for
these lifesaving immunosuppressive medications by analyzing the
long-term cost of dialysis for patients who have received a
kidney transplant and subsequent transplants due to the lack of
access to anti-rejection medications. The Committee also
encourages CMS to consider all possible payment models for
dialysis patients considering the immense amount of data
showing the benefits of greater care management for this
population.
KidneyX.--KidneyX stimulates the commercialization of new
therapies while providing a catalyst for investment by the
private market in three specific ways that are not currently
addressed by market forces or Federal efforts: de-risks the
commercialization process by fostering coordination among NIH,
FDA, and CMS to provide a clear, predictable path towards
commercialization, provides non-dilutive funding to seed,
incent, and accelerate breakthroughs to promising innovators,
selected through a competitive process, and offers
participating innovators access to investors and business
experts and repositions the kidney space as an attractive and
untapped market. While the first round of seed funding focuses
on the development and commercialization of an artificial
kidney, the portfolio will expand to include diagnostics, other
devices, medications, and patient-centered tools to more
effectively and efficiently manage kidney diseases. Revenue
generated from breakthrough commercialized developments will be
cycled back to support KidneyX, funding future therapies
without the need for additional public investment beyond the
first five years. Similar public-private accelerators, like the
Combating Antibiotic Resistant Bacteria Biopharmaceutical
Accelerator, have shown great success in catalyzing private
sector investment. KidneyX is a true public-private
partnership: the private sector is committed to providing
matching funds to achieve the total $250 million required for
the first five years. To date, $25 million has been committed
to KidneyX from the private sector. KidneyX will issue its
first round of seed funding using private contributions in
2018.
Lactation Support.--The Committee recognizes the important
health and economic benefits of breastfeeding, which may reduce
the rate of common and costly diseases in infants, acute and
chronic diseases later in life, and provides important health
benefits to mothers. The Committee also recognizes that certain
medical conditions and time restrictions make low-cost
breastfeeding supplies, such as hand pumps, insufficient for
the needs of many mothers. The reimbursement rate offered by
many public and private health insurance providers is less than
the cost of high quality pumps, which include an electric
motor, replaceable parts that meet the anatomical needs of each
mother, and optimal suction and cycling. The Committee
encourages HHS to work with stakeholders to better provide
women up-to-date information on how to access quality
counseling, education, and breastfeeding equipment and
supplies, including a list of in-network lactation consultants
or other trained health care providers. HHS should also include
information in the fiscal year 2020 Congressional Justification
on how health insurers have implemented comprehensive lactation
services, what standards they use to set reimbursement rates
for breastfeeding supplies, and what best practices currently
exist to provide coverage to help women breastfeed.
Lymphedema Compression Garments.--Nearly two million
Medicare beneficiaries lack equal access to Lymphedema
Compression Garments. The Department of Veterans Affairs and
the TRICARE program provide coverage for compression garments
used to treat lymphedema, as do 42 states and the District of
Columbia as part of their Medicaid programs, yet the Medicare
program does not provide access to these garments for Medicare
beneficiaries. The Committee notes CMS decision memorandum
(CAG-00016N) encourages patients to use compression garments to
prevent re-accumulation of fluid. In order to ensure equal
access to care and adherence to CMS' recommendations, the
Committee strongly encourages CMS to take necessary steps to
ensure Medicare beneficiaries have access to Lymphedema
Compression Garments. The Committee requests an update on this
effort in the fiscal year 2020 Congressional Justification.
Medicaid 1115 Waiver.--The Committee continues to note
concern regarding the process for approval for section 1115
Medicaid demonstrations. The Committee expects a collaborative
process between CMS and States. These demonstrations serve as
vital links to care for vulnerable populations. The Committee
strongly encourages CMS to engage with States who have
outstanding requests. Moreover, the Committee encourages CMS to
give priority to requests that seek to ensure access to
physician residency training and education for underserved and
rural populations.
Medicare Star Quality Rating System.--The Committee is
concerned that the CMS Star Ratings system does not accurately
rate plans that serve a larger proportion of dual eligible
beneficiaries. Further, the Committee understands that as
mandated by the Improving Medicare Post-Acute Care
Transformation Act of 2014 (PL 113-185), the Assistant
Secretary for Planning and Evaluation (ASPE) is conducting a
study examining the effect of socioeconomic status on quality
measures and resource use and other measures. CMS should not
remove plans from markets based on three consecutive years of
low star scores until the ASPE study is completed and the
recommendations are implemented.
Medication Diversion.--The Committee understands the
important role of medication-assisted treatment for
beneficiaries with opioid use disorder. At the same time,
several State and Federal authorities report rising rates of
diversion of these FDA-approved medications. The Committee
requests CMS evaluate diversion data from the Drug Enforcement
Administration and State sources to determine the scope of this
problem and submit an update in the fiscal year 2020
Congressional Justification. CMS should discuss specifically
efforts to reduce division of prescriptions.
Muscular Dystrophy.--The Committee is aware of the addition
of the new ICD-10 code for Duchenne/Becker to the CMS FY 2019
Codding Addenda. The Committee requests a report on utilization
for the newly established ICD-10 code, as compared to the
former broader ICD-10 code in the fiscal year 2020
Congressional Justification.
Naloxone.--Naloxone is a community-use overdose reversal
agent that can be ingested through the nose. Some have
recommended co-prescription of naloxone and opioids as a tool
in mitigating the risk of overdose death. Studies within the
Department of Veterans Affairs have determined co-prescriptions
can reduce long-term opioid use by 39 percent. The Committee
requests an update in the fiscal year 2020 Congressional
Justification on efforts by CMS to address access to naloxone
for identified at-risk populations.
National Health Expenditures.--The Committee requests that
CMS include a detailed explanation in its fiscal year 2020
Congressional Justification of CMS' methodology for including
data in the National Health Expenditure (NHE) database, and an
analysis of how CMS-published data compares to other comparable
information on health expenditures. The Committee remains
concerned there are discrepancies between CMS estimates and
industry surveys suggesting that CMS' method may understate the
actual growth of private health insurance and total health
spending at the household level. If private health spending is
underreported in NHE, estimates of total health US spending may
be too low as well.
National Vaccine Advisory Committee.--Historically,
disparities in childhood immunization rates have been reported
in the US, with lower rates among children living in poverty,
among urban children, and among black and Hispanic children.
Children living below the Federal poverty level have lower
coverage with many vaccinations compared to children living at
or above the Federal poverty level since at least 2009. The CDC
estimates that based on 2015 data an estimated 32.9 percent of
US children aged 19-35 months were living below the poverty
level. The Committee requests, as part of the fiscal year 2020
Congressional Justification, the National Vaccine Advisory
Committee, in coordination with CMS, to review data and provide
to the Committee: the number of children under the age of 35
months that received childhood vaccinations and an assessment
on the extent to which individuals under the age of 35 months
received vaccinations according to the vaccine schedule
recommendation put forth by CDC.
Out of Network Emergency Care.--The Committee is concerned
the Center for Consumer Information and Insurance Oversight
(CCIIO) has not provided sufficient clarity on how to determine
the ``Usual, Customary & Reasonable'' (UCR) amount in its final
rule for patient protections (80 Fed. Reg. 72191). Therefore,
the Committee requests CCIIO publish guidance, which may come
in the form of Frequently Asked Questions, clarifying what
constitutes the UCR amount using a transparent and fair
standard, such as an independent unbiased charge database.
Patient Access to Medically Necessary Foods.--The Committee
notes that medical foods are an essential, physician-directed
component of managing a variety of serious medical conditions.
The Committee notes that patients continue to face a variety of
access challenges related to coverage and reimbursement with
many individuals and families being forced to pay for essential
medical foods out-of-pocket. The Committee notes the recent
action taken by TRICARE to advance proper coverage for medical
foods and encourages CMS to work proactively with the
stakeholder community to identify and address improper barriers
to access.
Physician Disclosure.--The Committee encourages the
Secretary to clarify that medical text books and journal
article re-publications are considered as non-reportable
transfers and permissible under the patient education exclusion
as intended by Congress. The Committee believes these
publications serve as direct patient education and should not
be subject to reporting requirements of section 1128G of the
Social Security Act.
Physician-Owned Hospitals.--The Committee notes physician-
owned hospitals provide high quality healthcare to local
communities. The Committee supports efforts by CMS to
demonstrate the additional value these hospitals are able to
provide to beneficiaries.
Pneumococcal Vaccinations.--The Committee is concerned
about the underutilization of pneumococcal vaccinations for
adults and in particular high risk adults where rates do not
exceed 20 percent. The Committee strongly urges CMS to work
toward achievement of the Healthy People 2020 goals to reduce
invasive pneumococcal infections and increase the percentage of
adults, aged 65 or older, who are vaccinated against
pneumococcal disease. CMS is encouraged to support development
and implementation of electronic health records and other
technologies, such as reminder recall programs, to identify
Medicare beneficiaries who have not received the full course of
pneumococcal vaccinations and remind those beneficiaries and
their providers to adhere to the recommendations.
Prescription Drugs.--The Committee supports efforts to
improve patient access to prescription drugs. The Committee is
encouraged by recent proposals to lower costs for
beneficiaries, generate savings for the Federal government, and
increase access to medication for Medicare beneficiaries. As
CMS evaluates options for the Prescription Drug Benefit
Program, the Committee expects adherence to the noninterference
clause, which ensures robust competition and beneficiary value.
Preliminary Determinations.--CMS previously granted
``preliminary determinations'' to hospitals to be designated as
a Critical Access Hospitals (CAH). Following CMS guidance,
these facilities made preparations to receive a final CAH
designation, including paying for expensive upgrades and an on-
site survey. Subsequently, CMS revised its guidance for
attaining CAH designation. Due to the length of time required
to comply with the requirements included in the preliminary
determination, facilities that were deemed in compliance by CMS
proceeded to comply with CMS guidance, but were then
subsequently denied final CAH status due to the change in CMS
policy regarding CAH designation. The Committee requests that
CMS monitor affected facilities and their local communities to
help ensure access to care.
Qualified Clincial Data Registries.--The Committee supports
the development and utilization of Qualified Clincal Data
Registries as part of the Center for Medicare and Medication
Innovation's purpose of testing innovate payment and service
delivery models. The Committee requests and update in the
fiscal year 2020 Congressional Justification regarding
compliance with section 105(b) of the Medicare Access and CHIP
Reauthorization Act of 2015 (PL 114-10) and how CMS will
support data that is real-time.
Quality Payment Program.--The Committee understands
numerous physicians were ineligible to receive reimbursement
from the Quality Payment Program (QPP) due to changes to their
tax identification number (TIN) made between August 31st and
December 31st, 2017. Claims changes to the TIN that took place
in this time frame were ineligible and could not be
retroactively reimbursed due to technological shortcomings. The
Committee encourages CMS to review the QPP's procedures and
report back to the Committee in the fiscal year 2020
Congressional Justification on proposals for necessary
improvements to ensure qualified physicians are not denied
reimbursement regardless of their employment start date.
Readmission Rates.--The Committee is supportive of efforts
within CMS to reduce readmission rates among high-risk seniors
living in communities challenged by poverty, poor health
literacy, health disparities or non-compliance with treatment
regimens. In particular, flexible, community-based multi-payer
arrangements have encouraged health and social service
providers to combine efforts in tailoring services to these at-
risk populations. The Committee encourages CMS to work with
community-based organizations to help identify best practices
and transition them to Medicare's value-based purchasing
initiatives.
Recovery Audit Contractors.--The Committee acknowledges
that the Medicare Trust Funds are at risk of insolvency and
that Recovery Audit Contractors are an industry best practice
that play an important role in preventing wasteful government
spending. CMS should continue to utilize private sector best
practices, such as recovery auditing, to address Medicare
improper payments to the fullest extent.
Renal Replacement Therapy.--The Committee requests CMS
provide an update in the fiscal year 2020 Congressional
Justification on efforts to inform the healthcare community
that new renal replacement therapy codes are available for
reporting and encourage such code use to support additional
research in the acute kidney injury population.
Robotic Stereotactic Radiosurgery.--The Committee remains
concerned that inadequate payment for robotic stereotactic
radiosurgery threatens its viability in both the hospital and
freestanding center setting. The Committee encourages CMS and
contractors administering the Medicare Part B program not to
make further changes to these services (G0339 and G0340) in the
freestanding center as CMS complies with the Patient Access and
Medicare Protection Act (PL 114-115).
Rural Health Clinics.--The Committee continues to encourage
CMS to engage States and other stakeholders on outstanding
issues of payment recoupment, as it relates to CMS-designated
Rural Health Clinics. The Committee strongly supports the Rural
Health Clinic program, which increases access to primary care
services for Medicaid and Medicare patients in rural
communities.
Rural Nursing Homes.--Long-term services and supports are
critical for the care and wellbeing of our senior population.
Skilled nursing facilities play an instrumental role in
providing this care for some of the most vulnerable Americans.
Particularly in rural areas, ensuring continued access to high-
quality nursing facility care in an individual's home community
is an ever-increasing challenge. Similar to Medicaid's
prioritization of funding for Critical Access Hospitals,
adequate reimbursement helps preserve access to skilled nursing
facility care in our country's rural and frontier regions. The
Committee requests an update in the fiscal year 2020
Congressional Justification on CMS' efforts to support rural
nursing facilities.
Sepsis Testing.--In the United States, more than 1.5
million people are diagnosed with sepsis resulting in
approximately 250,000 deaths each year. CMS current SEP-1
guidelines for treating septic patients are controversial and
need to take into account evolving practices including the use
of FDA approved tests for biomarkers like procalcitonin. SEP-1
is highly prescriptive, replaces physician's discretion over
care, and could lead to excessive antibiotic use. The Committee
urges CMS to reevaluate their SEP-1 policy taking into account
expanded FDA approvals for biomarker tests like procalcitonin
in conjunction with its impact on antibiotic stewardship. CMS
is also to identify the direct and indirect cost of treating
sepsis patients on its Medicaid and Medicare programs. The
Committee requests an update on these activities in the fiscal
year 2020 Congressional Justification.
Sexually Transmitted Diseases.--The Committee notes an
increase in sexually transmitted diseases, particularly in
pregnant women and young adults. To address this public health
issue the Committee supports efforts to target at-risk and
vulnerable populations. The Committee supports collaboration
with CDC to address appropriate screening and treatment for
these conditions.
Technology and Ophthalmic Disorders.--The Committee notes
that the specific use of technology, such as web-based
telemedicine software, centralized reading centers, hand-held
fundus cameras, photography training programs, and internet-
based storage and transmission of images can efficiently detect
early signs of diabetic retinopathy and glaucoma in rural and
underserved populations.
Telehealth and the Pediatric Population.--The Committee
recognizes the potential for telehealth to help meet the needs
of patients and families across the country, including in both
rural and urban areas. The Committee encourages CMS to identify
and share with States best practices regarding ways in which
telehealth and remote patient monitoring can be leveraged
through the Medicaid and CHIP programs, particularly for the
pediatric population. This could include identification of
barriers to pediatric telehealth coverage, as well as ways to
address those barriers.
Tribal Governance.--The Secretary, in coordination with the
Indian Health Service, CMS, and CDC, is urged to facilitate and
support partnerships with Tribes and medical colleges and
universities as opportunites arise, in order to foster
leadership development, build organizations to better deliver
and coordinate high-quality care, and to support systems of
care and prevention that can have a positive outcome on the
health of the community and cost of care.
Tribal Sovereignty.--Federally-recognized Indian Tribes are
sovereign nations residing within a State. Moreover, Indian
Tribes are political, sovereign entities to which the Federal
government owes a trust responsibility. As a result of this
responsibility, the Federal government has consistently held
Indian Tribes as a unique group when applying Federal law and
policy. Congress has routinely codified this relationship, most
notably in the provision of health care by establishing a
health system for Tribal populations exclusively. In addition,
the Federal government has enacted exemptions to ensure States
would not bear the burden of additional costs. Specifically,
the Social Security Act provides a 100 percent Federal match
for Medicaid services provided by an Indian or by an Indian
Health Service or Tribally-operated facility. No discretionary
action taken by any Administration can impede the direct
relationship between the Federal government and the provision
of health care for Indian Tribes.
Volume Decrease Payment.--The Committee notes that a change
in the Medicare Administrative Contractor (MAC) should not
negatively impact provider payment. The Committee encourages
CMS to ensure consistent policy and guidance is provided to all
MACs to ensure overpayment notices to providers are processed
promptly. The Committee supports efforts by CMS to encourage
MACs to reduce the interval of time between the identification
of an overpayment and official notice sent to the provider.
Federal Administration
The Committee recommends $702,601,000 for Federal
Administration activities related to the Medicare and Medicaid
programs, which is $29,932,000 below the fiscal year 2018
enacted level and the same as the fiscal year 2019 budget
request. The Federal Administration funding supports CMS staff,
along with operating and administrative expenses for planning,
developing, managing, and evaluating healthcare financing
programs and policies.
Health Insurance Exchange Transparency.--The Committee
continues to include bill language requiring CMS to provide
cost information for the following categories: Federal Payroll
and Other Administrative Costs; Exchange related Information
Technology (IT); Non IT Program Costs, including Health Plan
Bid Review, Management and Oversight; Payment and Financial
Management; Eligibility and Enrollment; Consumer Information
and Outreach, including the Call Center, Navigator Grants, and
Consumer Education and Outreach; Exchange Quality Review; Small
Business Health Options Program and Employer Activities; and
Other Marketplace Activities. Cost information should be
provided for each fiscal year since the enactment of the
Patient Protection and Affordable Care Act (Public Law 111-
148). CMS is also required to include the estimated costs for
fiscal year 2020.
HEALTH CARE FRAUD AND ABUSE CONTROL ACCOUNT
Appropriation, fiscal year 2018....................... $745,000,000
Budget request, fiscal year 2019...................... 770,000,000
Committee Recommendation.............................. 765,000,000
Change from enacted level......................... +20,000,000
Change from budget request........................ -5,000,000
This includes a base amount of $311,000,000 and an
additional $454,000,000 through a discretionary budget cap
adjustment authorized under section 251(b) of the Balanced
Budget and Emergency Deficit Control Act of 1985. The Health
Care Fraud and Abuse Control Account (HCFAC) funds support
activities conducted by CMS, the HHS Office of Inspector
General, and the Department of Justice. This level is
$20,000,000 above the fiscal year 2018 enacted level and
$5,000,000 below the fiscal year 2019 budget request.
This funding is in addition to other mandatory funding
provided through authorizing legislation. The funding will
provide resources to continue efforts for Medicaid program
integrity activities, for safeguarding the Medicare
prescription drug benefit and the Medicare Advantage program,
and for program integrity efforts related to these programs
carried out by the Department of Justice.
The Committee continues to include bill language to ensure
the Secretary funds the Senior Medicare Patrol Program
administered by the Administration for Community Living from
funds provided to this account.
The Committee expects all recipients of funds from the
Health Care Fraud and Abuse Control Account, the Centers for
Medicare & Medicaid Services, the Department of Health and
Human Services Office of Inspector General, and the Department
of Justice, to use funds for efforts to address fraud and abuse
as described in section 1128C of the Social Security Act.
Administration for Children and Families
PAYMENTS TO STATES FOR CHILD SUPPORT ENFORCEMENT AND FAMILY SUPPORT
PROGRAMS
Appropriation, fiscal year 2018....................... $2,995,400,000
Budget request, fiscal year 2019...................... 2,922,247,000
Committee Recommendation.............................. 2,922,247,000
Change from enacted level......................... -73,153,000
Change from budget request........................ - - -
The Committee also recommends $1,400,000,000 in advance
funding, as requested, for the first quarter of fiscal year
2020 to ensure timely payments for Child Support Enforcement
programs. These programs support State-administered programs of
financial assistance and services for low-income families to
promote their economic security and self-sufficiency.
LOW INCOME HOME ENERGY ASSISTANCE
Appropriation, fiscal year 2018....................... $3,640,304,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 3,640,304,000
Change from enacted level......................... - - -
Change from budget request........................ +3,640,304,000
Within the amount available for formula grants, the
Committee recommends up to $2,988,000 for technical assistance,
training, and monitoring of program activities. The Low Income
Home Energy Assistance Program supports eligible families and
households through programs providing assistance with energy
costs.
REFUGEE AND ENTRANT ASSISTANCE
Appropriation, fiscal year 2018....................... $1,864,936,000
Budget request, fiscal year 2019...................... 1,792,311,000
Committee Recommendation.............................. 1,864,936,000
Change from enacted level......................... - - -
Change from budget request........................ +72,625,000
The Office of Refugee Resettlement programs are designed to
help refugees, asylees, Cuban and Haitian entrants, and
trafficking victims become employed and self-sufficient. These
programs also provide for care of unaccompanied immigrant
children in Federal custody and victims of torture.
Within the total, the Committee recommends the following:
------------------------------------------------------------------------
Budget Activity FY 2019 Committee
------------------------------------------------------------------------
Transitional and Medical Services.................... $320,000,000
Victims of Trafficking............................... 23,755,000
Refugee Support Services............................. 207,201,000
Unaccompanied Children............................... 1,303,245,000
Victims of Torture................................... 10,735,000
------------------------------------------------------------------------
National Human Trafficking Training and Assistance
Center.--The Committee directs the Administration for Children
and Families to increase funding for the National Human
Trafficking Hotline.
Facility Oversight.--The Committee expects the Office of
Refugee Resettlement (ORR) to maintain strict oversight of all
ORR-funded care provider facilities and to report and correct
violations of Federal, State, or local codes related to
standards of childcare or the wellbeing of children. The
Committee directs ORR, within 90 days of the enactment of this
Act, to submit a report to the Committee detailing the number
and nature of facility violations, and the steps it is taking
to work with grantees to address and prevent such infractions.
IG Report.--Within 30 days of enactment, the Inspector
General shall report to the Committee on the implementation of
and any interagency coordination associated with the previous
policy of separating migrant families, the Executive Order
issued on June 20, 2018 entitled `Affording Congress an
Opportunity to Address Family Separation,' and efforts made to
reunify families separated under the previous family separation
policy.
Unaccompanied Children.--The Committee supports oversight
efforts relating to forced family separation and efforts to
mitigate the trauma experienced by separated children.
The Committee directs the Office of Refugee Resettlement
(ORR) to comply with its legally mandated duties as outlined in
Section 462 of the Homeland Security Act of 2002, Section 235
of the William Wilberforce Trafficking Victims Protection
Reauthorization Act of 2008, and the 1997 Flores settlement
agreement.
Unaccompanied Children.--The Committee directs that in
cases of separation, within 24 hours, parents, legal guardians,
or other relatives shall be informed of the whereabouts of
their children and children shall be informed of the
whereabouts of their parents, legal guardians, or other
relatives, except in cases of suspected abuse or trafficking.
The Committee also directs the Secretary of HHS to work in
collaboration with the Secretary of DHS to submit a report to
the Committees on Appropriations of the House of
Representatives and of the Senate within 60 days of this bill's
enactment detailing actions it has taken and will take and
policies it has implemented and will implement to facilitate:
(1) the ability of separated children to make contact and
maintain communication with their separated parents, relatives,
legal guardians, or primary caregivers (for tender-age and non-
verbal children, this should include methods to facilitate in-
person visits and video chats); (2) the ability of family
members residing abroad to utilize the hotline to receive
information on the status and location of separated children;
and (3) the coordinated reunification and post-release support
of a separated child and adult family member, when it is in the
best interest of the child.
Protection of DNA.--The Committee understands that DNA
testing is being used for the purpose of reunifying families
that were separated by the Department of Homeland Security. The
Committee directs the Office of Refugee Resettlement (ORR) to
ensure the protection of privacy and genetic material, data, or
information of children, parents, and of all individuals being
tested and their relatives. The Committee prohibits any
governmental agency or private entity from accessing using, or
storing any genetic material, data, or information collected in
this reunification effort, including for the purpose of
criminal or immigration enforcement. Any genetic material,
data, and information obtained should be fully destroyed after
testing and the probability of a genetic relationship is
calculated. The entities conducting the DNA testing shall
obtain the consent of any individual over age 18 prior to
testing, and shall make every effort to obtain the consent of a
guardian prior to testing on anyone under age 18.
PAYMENTS TO STATES FOR THE CHILD CARE AND
DEVELOPMENT BLOCK GRANT
Appropriation, fiscal year 2018....................... $5,226,000,000
Budget request, fiscal year 2019...................... 3,006,000,000
Committee Recommendation.............................. 5,226,000,000
Change from enacted level......................... - - -
Change from budget request........................ +2,220,000,000
The Child Care and Development Block Grant provides funds
according to a formula to States, territories, and Tribes to
provide financial assistance to help low-income working
families and families engaged in training or education
activities access child care and to improve the quality of
child care for all children.
The Committee includes $100,000,000 in bill language for
competitive grants to States, territories, Tribes, local
governments, and public entities to develop, implement, and
evaluate models of providing care for working families in rural
communities, families needing child care on an emergency basis,
and families with non-traditional work hours.
The Committee recognizes that many child care providers are
small business owners and therefore may need support to
strengthen business operations. Accordingly, the committee
recognizes that Child Care and Development Block Grant (CCDBG)
funds could be used to strengthen the business practices of
child care providers to expand the supply and improve the
quality of child care services. Areas of support for child care
providers may include, but are not limited to, such practices
related to fiscal management, budgeting, record-keeping,
hiring, developing, and retaining qualified staff, risk
management, community relationships, marketing and public
relations, and parent-provider communications, including who
delivers the training, education and/or technical assistance.
Accordingly, the Committee supports efforts by the Office of
Child Care to report on its efforts to support States with
strengthening business practices of child care providers,
including available data on the average salaries and retention
of child care staff by State and type of care, in the biennial
Childcare Development Fund Report to Congress required by
Section 658L of the CCDBG.
SOCIAL SERVICES BLOCK GRANT
Appropriation, fiscal year 2018....................... $1,700,000,000
Budget request, fiscal year 2019...................... 1,785,000,000
Committee Recommendation.............................. 1,700,000,000
Change from enacted level......................... - - -
Change from budget request........................ -85,000,000
The Social Services Block Grants provides grants to States
by formula. States have the flexibility to determine what
services and activities are supported, provided they are
targeted at a broad set of goals, including reducing or
eliminating poverty, achieving or maintaining self-sufficiency,
and preventing neglect, abuse, or exploitation of children and
adults.
CHILDREN AND FAMILIES SERVICES PROGRAMS
Appropriation, fiscal year 2018....................... $12,022,225,000
Budget request, fiscal year 2019...................... 10,323,890,000
Committee Recommendation.............................. 12,122,225,000
Change from enacted level......................... +100,000,000
Change from budget request........................ +1,798,335,000
The Children and Families Services programs fund activities
serving children, youth, families, the developmentally
disabled, Native Americans, victims of child abuse and neglect
and domestic violence, and other vulnerable populations.
The Committee recommends the following amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Programs for Children, Youth, and Families:
Head Start....................................... $9,913,095,000
Early Head Start-Child Care Partnerships..... 780,000,000
Preschool Development Grants..................... 250,000,000
Runaway/Homeless Youth........................... 104,280,000
Abuse of Runaway Youth Prevention................ 17,141,000
State Child Abuse Prevention..................... 85,310,000
Discretionary Child Abuse Prevention............. 33,000,000
Community-based Child Abuse Prevention........... 39,764,000
Child Welfare Services........................... 278,735,000
Child Welfare Training........................... 17,984,000
Adoption Opportunities........................... 39,100,000
Adoption Incentives.............................. 80,000,000
Social Services/Income Maintenance Research...... 6,512,000
Native American Programs......................... 55,050,000
Community Services:
Community Services Block Grant................... 750,000,000
Community Economic Development................... 19,883,000
Rural Community Facilities....................... 10,000,000
Domestic Violence Hotline............................ 9,250,000
Family Violence/Battered Women's Shelters............ 160,000,000
Independent Living Training Vouchers................. 43,257,000
Disaster Human Services Case Management.............. 1,864,000
Program Direction.................................... 208,000,000
------------------------------------------------------------------------
Head Start
The Committee recommends $9,913,095,000 for the Head Start
program, which is $50,000,000 above the fiscal year 2018
enacted level and $638,095,000 above the fiscal year 2019
budget request. Within the total for Head Start, the Committee
recommends $25,000,000 for a cost-of-living adjustment and
includes $25,000,000 for the Designation Renewal System. Head
Start promotes school readiness of children under 5 from low-
income families through education, health, social and other
services.
In addition, the Committee recommends $780,000,000 for
Early Head Start-Child Care Partnership grants, which is
$25,000,000 above the fiscal year 2018 enacted level and
$780,000,000 above the fiscal year 2019 budget request. The
Early Head Start-Child Care Partnership program brings together
Early Head Start and child care through layering of funding to
provide comprehensive and continuous services to low-income
infants, toddlers, and their families. The program enhances
developmental services and supports for low-income infants and
toddlers, and their families, by providing strong relationship-
based experiences and preparing them for the transition into
Head Start and preschool.
The Committee notes that HHS is in the process of reviewing
public comments on proposed changes to the Designation Renewal
System (DRS), which is a key tool in ensuring strong standards.
The Committee is also aware of concerns regarding the use of
the CLASS lowest 10 percent provision in appropriately
identifying grantees subject to re-competition. The Committee
encourages HHS to complete this review promptly, and to
maintain high standards, strong accountability, and
transparency to grantees and the public, while ensuring the
integrity of program evaluation measures.
Preschool Development Grants
The Committee recommends $250,000,000 for Preschool
Development Grants, which is the same as the fiscal year 2018
enacted level and $250,000,000 above the fiscal year 2019
budget request. This program provides grants to States to build
State and local capacity to provide preschool for 4-year-olds
from low- and moderate-income families. Research confirms that
high-quality preschool improves school readiness and long-term
academic success of children by supporting their academic and
social-emotional skills. Support for this grant is an important
step to building a globally competitive 21st century workforce.
Child Abuse Discretionary Activities
Child Abuse Hotline.--The Committee notes the lack of
knowledge regarding effective and appropriate text-based
intervention and education services for child abuse victims and
concerned adults as this new communications channel becomes
more prevalent. Therefore, the Committee provides $1,500,000
for an extramural grant to develop and expand text capabilities
and protocols for a national child abuse hotline to determine
best practices in appropriate communication, identity
verification, privacy protection, and resource sharing with
youth seeking assistance.
Native American Programs
The Committee recommends $55,050,000 for Native American
Programs, which is $1,000,000 above fiscal year 2018 enacted
level and $3,000,000 above the fiscal year 2019 budget request.
These programs assist Tribal and village governments and Native
American institutions and organizations in their efforts to
support and develop stable, diversified local economies. Tribes
and non-profit organizations use funds to develop and implement
sustainable community-based social and economic programs and
services to improve the well-being of Native people.
Within the total, the Committee recommendation includes
$12,000,000 for Native American language preservation
activities, including $3,000,000 for Generation Indigenous,
which focuses on improving Native American language instruction
across the educational continuum. The Committee provides not
less than $4,000,000 for language immersion programs as
authorized by section 803C(b)(7)(A)-(C) of the Native American
Programs Act, as amended by the Esther Martinez Native American
Language Preservation Act of 2006. The Committee strongly
encourages the Administration for Children and Families to give
priority to grantees with rigorous immersion programs.
Community Services Programs
Community Services Block Grant.--The Committee recommends
$750,000,000 for the Community Services Block Grant, which is
$35,000,000 more than the fiscal year 2018 enacted level and
$715,000,000 more than the fiscal year 2019 budget request. The
Community Services Block Grant provides funds to alleviate the
causes and conditions of poverty in communities.
Community Economic Development.--The Committee recommends
$19,883,000 for the Community Economic Development Grants,
which is the same as the fiscal year 2018 enacted level and
$19,883,000 more than the fiscal year 2019 budget request.
Community Economic Development is a grant program, which funds
Community Development Corporations. Community Development
Corporations seek to address the economic needs of low-income
individuals and families through the creation of sustainable
business development and employment opportunities.
Rural Community Facilities Development.--The Committee
recommends $10,000,000 for the Rural Community Facilities
program, which is $2,000,000 more than the fiscal year 2018
enacted level, and $10,000,000 more than the fiscal year 2019
budget request. Rural Community Development is a grant program
that works with regional and Tribal organizations to manage
safe water systems in rural communities.
Family Violence Prevention and Battered Women's Shelters
The Committee recommends $160,000,000 for the Family
Violence Prevention and Battered Women's Shelters programs,
which is the same as the fiscal year 2018 enacted level and
$9,000,000 above the fiscal year 2019 budget request. The
Family Violence Prevention and Services Act programs provide
funding to support the prevention of incidents of family
violence, domestic violence, and dating violence, and provide
the immediate shelter and supportive services for adult and
youth victims (and their dependents).
PROMOTING SAFE AND STABLE FAMILIES
Appropriation, fiscal year 2018....................... $444,765,000
Budget request, fiscal year 2019...................... 534,765,000
Committee Recommendation.............................. 404,765,000
Change from enacted level......................... -40,000,000
Change from budget request........................ -130,000,000
The Committee recommends $345,000,000 in mandatory funds
for the Promoting Safe and Stable Families program, which is
the same as the fiscal year 2018 enacted level and $20,000,000
below the fiscal year 2019 budget request. The Committee also
recommends $59,765,000 in discretionary funds for this program,
which is $40,000,000 below the fiscal year 2018 enacted level
and $150,000,000 below the fiscal year 2019 budget request.
This program enables each State to operate a coordinated
program of family preservation services, community-based family
support services, time-limited reunification services, and
adoption promotion and support services. States receive funds
based on their share of children in all States receiving food
stamp benefits.
PAYMENTS FOR FOSTER CARE AND PERMANENCY
Appropriation, fiscal year 2018....................... $6,225,000,000
Budget request, fiscal year 2019...................... 6,035,000,000
Committee Recommendation.............................. 6,035,000,000
Change from enacted level......................... -190,000,000
Change from budget request........................ - - -
The Committee also recommends an advance appropriation of
$2,800,000,000 for the first quarter of fiscal year 2020 to
ensure timely completion of first quarter grant awards.
Within the total, the Committee recommends $5,329,000,000
for the Foster Care program, which is $208,000,000 below the
fiscal year 2018 enacted level and the same as the fiscal year
2019 budget request. This program provides funds to States for
foster care maintenance payments for children living in foster
care. These funds also reimburse States for administrative
costs to manage the program and training for staff and parents.
Within the total, the Committee recommends $3,063,000,000
for Adoption Assistance, which is $196,000,000 more than the
fiscal year 2018 enacted level and the same as the fiscal year
2019 budget request. This program provides funds to States to
subsidize families who adopt children with special needs, such
as older children, a member of a minority or sibling group, or
children with physical, mental, and emotional disabilities. In
addition, the program provides training for adoptive parents
and State administrative staff. This annually appropriated
entitlement provides alternatives to long, inappropriate stays
in foster care by developing permanent placements with
families.
Within the total, the Committee recommends $203,000,000 for
the Kinship Guardianship Assistance program, which is
$22,000,000 more than the fiscal year 2018 enacted level and
the same as the fiscal year 2019 budget request. This program
provides subsidies to a relative taking legal guardianship of a
child for whom being returned home or adoption are not
appropriate permanency options.
Finally, within the total, the Committee recommends
$140,000,000 for the Independent Living program, which is the
same as the fiscal year 2018 enacted level and the fiscal year
2019 budget request. This program assists foster children age
16 or older make successful transitions to independence. Funds
support a variety of services, including educational
assistance, career exploration, vocational training, job
placement, life skills training, home management, health
services, substance abuse prevention, preventive health
activities, and room and board. Each State receives funds based
on the number of children on whose behalf the State receives
Federal Foster Care Payments.
Administration for Community Living
AGING AND DISABILITY SERVICES PROGRAMS
Appropriation, fiscal year 2018....................... $2,144,215,000
Budget request, fiscal year 2019...................... 1,818,681,000
Committee Recommendation.............................. 2,186,732,000
Change from enacted level......................... +42,517,000
Change from budget request........................ +368,051,000
Created in 2012, the Administration for Community Living
(ACL) brings together the efforts and achievements of the
Administration on Aging, the Administration on Intellectual and
Developmental Disabilities, and the HHS Office on Disability to
serve as the Federal agency responsible for increasing access
to community supports, while focusing attention and resources
on the unique needs of older Americans and people with
disabilities across the lifespan.
The Committees recommends funding for the Senior Medicare
Patrol Program, and provides this funding under the Health Care
Fraud and Control Abuse Account.
Home and Community-Based Supportive Services
The Committee recommends $385,074,000 for Home and
Community-Based Supportive Services, which is the same as the
fiscal year 2018 enacted level and $34,850,000 above the fiscal
year 2019 budget request. This program provides formula grants
to States and territories to fund a wide range of social
services that enable seniors to remain independent in their
homes for as long as possible.
Preventive Health Services
The Committee recommends $24,848,000 for Preventive Health
Services, which is the same as the fiscal year 2018 enacted
level and the fiscal year 2019 budget request. This program
funds activities that help seniors remain healthy and avoid
chronic diseases.
Protection of Vulnerable Older Americans
The Committee recommends $21,658,000 for activities to
protect vulnerable older Americans, which is the same as the
fiscal year 2018 enacted level and $1,030,000 above the fiscal
year 2019 budget request. These programs provide grants to
States for protection of vulnerable older Americans through the
Long-Term Care Ombudsman and Prevention of Elder Abuse and
Neglect programs.
Family Caregiver Support Services
The Committee recommends $180,586,000 for the National
Caregiver Support program, which is the same as the fiscal year
2018 enacted level and $30,000,000 above the fiscal year 2019
budget request. This program supports a multifaceted support
system in each State for family caregivers.
Native American Caregiver Support Services
The Committee recommends $10,556,000 for the Native
American Caregiver Support program, which is $1,000,000 above
the fiscal year 2018 enacted level and $3,000,000 above the
fiscal year 2019 budget request. This program provides grants
to Tribes for the support of American Indian, Alaskan Native,
and Native Hawaiian families caring for older relatives with
chronic illness or disabilities.
Congregate and Home-Delivered Nutrition Services
The Committee recommends a total of $896,753,000 for senior
nutrition. The Committee recommends $490,342,000 for Congregate
Nutrition Services, which is the same as the fiscal year 2018
enacted level and $40,000,000 above the fiscal year 2019 budget
request. The Committee recommends $246,342,000 for Home-
Delivered Meal Services, which is the same as the fiscal year
2018 enacted level and $19,000,000 above the fiscal year 2019
budget request. The Committee recommends $160,069,000 for the
Nutrition Services Incentives program, which is the same as the
fiscal year 2018 enacted level and the fiscal year 2019 budget
request. These programs help older Americans remain healthy and
independent in their communities by providing meals and related
services in a variety of settings (including congregate
facilities such as senior centers) and via home-delivery to
older adults who are homebound due to illness, disability, or
geographic isolation.
Native American Nutrition and Supportive Services
The Committee recommends $35,208,000 for Native American
Nutrition and Supportive Services, which is $2,000,000 above
the fiscal year 2018 enacted level and $4,000,000 above the
fiscal year 2019 budget request. This program provides grants
to Tribes to promote the delivery of nutrition and home and
community-based supportive services to Native American, Alaskan
Native, and Native Hawaiian elders.
Aging Network Support Activities
The Committee recommends $17,461,000 for the Aging Network
Support Activities, which is $5,000,000 more than the fiscal
year 2018 enacted level and $8,463,000 more than the fiscal
year 2019 budget request. This program supports activities that
expand public understanding of aging and the aging process.
Care Corps Grants.--The Committee recognizes the growing
demand for services and supports to help seniors and
individuals with disabilities live independently in their
homes, and the need to support family caregivers who facilitate
that independence. In addition to existing aging network
support activities funded under Section 411 of the Older
Americans Act, the Committee includes $5,000,000 for grants to
public agencies or private nonprofit agencies for the purpose
of placing volunteers in communities to assist family
caregivers and/or assist seniors and individuals with
disabilities in maintaining independence by providing non-
medical care. Such grants shall be consistent with the
requirements of the Nationwide Program for National and State
Background checks on direct patient access employees of long-
term care facilities and providers, and the worker displacement
and grievance provisions in the AmeriCorps program.
Holocaust Survivor's Assistance.--The Committee provides
not less than $5,000,000 for the Holocaust Survivor's
Assistance program. This program provides supportive services
for aging Holocaust survivors living in the U.S.
Alzheimer's Disease Program
The Committee recommends $23,500,000 for the Alzheimer's
disease program, which is the same as the 2018 enacted program
level and $4,010,000 above the fiscal year 2019 budget request.
This program provides competitive matching grants to a limited
number of States to encourage program innovation and
coordination of public and private services for people with
Alzheimer's disease and their families.
Technology and Caregiver Health.--In 2017, Medicare and
Medicaid spent an estimated $175 billion caring for those with
Alzheimer's and other dementias, 68 percent of total costs
spent nationally. It is the most expensive disease in America.
While medical breakthroughs to prevent, slow, or stop the
disease are critical, interventions that reduce the cost and
increase the effectiveness of care can be an invaluable method
to bend the cost curve. The Committee supports efforts to
improve caregiver health through a self-management support
system using home-based telehealth technology. Such a system
could reduce the cost of institutional health care and
emergency room visits for individuals with Alzheimer's and
Dementia by providing significant support to both the informal
caregiver and the patient in home-based care. The Committee
supports technology solutions that can monitor, assess, guide,
educate, and provide alerts to enhance both physical and
psychosocial dimensions of caregiver's well-being.
Lifespan Respite Care
The Committee recommends $4,110,000 for Lifespan Respite
Care, which is the same as the fiscal year 2018 enacted level
and $750,000 above the fiscal year 2019 budget request. The
program focuses on easing the burdens of caregiving by
providing grants to eligible State organizations to improve the
quality of, and access to, respite care for family caregivers.
Elder Falls
The Committee recommends $5,000,000 for the Elder Falls
program, which is the same as the fiscal year 2018 enacted
level and $5,000,000 above the fiscal year 2019 budget request.
Fall prevention grants support the promotion and dissemination
of prevention tools delivered in community settings.
Chronic Disease Self-Management Program
The Committee recommends $8,000,000 for the Chronic Disease
Self-Management program, which is the same as the fiscal year
2018 enacted level and $8,000,000 above the fiscal year 2019
budget request. This program supports grants to States for low-
cost, evidence-based prevention models that use state-of-the-
art techniques to help those with chronic conditions address
issues related to the management of their disease.
Elder Rights Support Activities
The Committee recommends $15,874,000 for Elder Rights
Support Activities, which is the same as the fiscal year 2018
enacted level and $4,000,000 above the fiscal year 2019 budget
request. This program supports efforts that provide
information, training, and technical assistance to legal and
aging services organizations towards the end of preventing and
detecting elder abuse and neglect.
Aging and Disability Resource Centers
The Committee recommends $8,119,000 for Aging and
Disability Resource Centers, which is the same as the fiscal
year 2018 enacted level and $2,000,000 above the fiscal year
2019 budget request. These centers provide information,
counseling and access for individuals to learn about the
services and support options available to seniors and the
disabled so they may retain their independence.
State Health Insurance Assistance Program
The Committee recommends $49,115,000 for the State Health
Insurance Assistance Program, which is the same as the fiscal
year 2018 enacted level and $49,115,000 above the fiscal year
2019 budget request. The State Health Insurance Assistance
Program provides Medicare beneficiaries with information,
counseling, and enrollment assistance.
Paralysis Resource Center
The Committee recommends $7,700,000 for the Paralysis
Resource Center, which is the same as the fiscal year 2018
enacted level and $7,700,000 above the fiscal year 2019 budget
request. The Paralysis Resource Center offers activities and
services aimed at increasing independent living for people with
paralysis and related mobility impairments, and supporting
integration into the physical and cultural communities in which
they live.
Limb Loss Resource Center
The Committee recommends $3,500,000 for the Limb Loss
Resource Center, which is the same as the fiscal year 2018
enacted level and $3,500,000 above the fiscal year 2019 budget
request. The Limb Loss Resource Center supports a variety of
programs and services for those living with limb loss,
including a national peer support program, educational events,
training for consumers and healthcare professionals, and
information and referral services.
Traumatic Brain Injury
The Committee recommends $11,321,000 for the Traumatic
Brain Injury program, which is the same as the fiscal year 2018
enacted level and $2,000,000 above the fiscal year 2019 budget
request. The program provides grants to States for the
development of a comprehensive, coordinated family and person-
centered service system at the State and community level for
individuals who sustain a traumatic brain injury.
Developmental Disabilities State Councils
The Committee recommends $76,000,000 for State Councils on
Developmental Disabilities, which is the same as the fiscal
year 2018 enacted level and $20,000,000 above the fiscal year
2019 budget request. The Developmental Disabilities State
Councils work to develop, improve and expand the system of
services and supports for people with developmental
disabilities.
Developmental Disabilities Protection and Advocacy
The Committee recommends $40,734,000 for Developmental
Disabilities Protection and Advocacy, which is the same as the
2018 enacted level and $2,000,000 above the fiscal year 2019
budget request. This formula grant program provides funding to
States to establish and maintain protection and advocacy
systems to protect the legal rights of persons with
developmental disabilities.
The Committee recognizes that the Americans with
Disabilities Act (ADA) encourages States to administer services
for people with Intellectual/Developmental Disabilities (I/DD)
``in the most integrated setting appropriate to the needs of
qualified individuals with disabilities.'' As a result of
enactment of the ADA and the Supreme Court decision in Olmstead
v. L.C. (1999), there has been a national trend towards
deinstitutionalization, whereby individuals have been
encouraged to move out of State-run and other Federally-funded,
certified facilities and into residential settings in their
respective communities. However, the Committee is aware that
many family members and legal guardians of individuals residing
in these facilities have been pressured to move their loved
ones into the community against their wishes. The Committee is
concerned about the adequacy of community-based housing and the
lack of specialized care and support services available in
these settings. In addition, the Committee notes concern
regarding the pace of transfer to community-based settings for
some individuals, higher rates of abuse and mortality in
community settings, and the adequacy of opportunities for
residents to express views and preferences throughout the
transfer process.
The Committee fully supports the ADA's goal of enabling
people with I/DD to receive services ``in the most integrated
setting appropriate to their needs.'' However, the Committee
also notes that Olmstead held that the ADA does not condone or
require removing individuals from institutional settings when
they are unable to handle or benefit from a community-based
setting and that the ADA does not require the imposition of
community-based treatment on patients who do not desire it.
Congress endorsed the same principle in the Developmental
Disabilities (DD) Act of 2000. By continuing to pursue closure
of facilities that are authorized by Federal law to provide
services to people with I/DD under the Intermediate Care
Facilities for Individuals with Intellectual Disabilities
program, DD Act programs are also overriding the decisions of
States on how to best allocate resources.
The Committee remains concerned that the
deinstitutionalization stance taken by both Federally-supported
DD Act programs and the Department of Justice in its related
prosecutorial discretion involve impact individuals who may be
unable to handle or benefit from community integration and do
not desire such care. The Committee strongly urges the
Department to ensure that DD Act programs properly account for
the needs and desires of patients, their families and
caregivers, and the importance of affording patients the proper
setting for their care, into enforcement of the Americans with
Disabilities Act.
Voting Access for Individuals with Disabilities
The Committee recommends $6,963,000 for Voting Access for
Individuals with Disabilities program, which is the same as the
fiscal year 2018 enacted level and $2,000,000 above the fiscal
year 2019 budget request. The Voting Access for Individuals
with Disabilities program authorized by the Help America Vote
Act provides formula grants to ensure full participation in the
electoral process for individuals with disabilities, including
registering to vote, casting a vote, and accessing polling
places.
Developmental Disabilities Projects of National Significance
The Committee recommends $12,000,000 for Developmental
Disabilities Projects of National Significance, which is the
same as the fiscal year 2018 enacted level and $10,950,000
above the fiscal year 2019 budget request. This program funds
grants and contracts that develop new technologies and
demonstrate innovative methods to support the independence,
productivity, and integration of those living with a disability
into the community. The Committee recommends not less than
$1,000,000 for transportation assistance activities for older
adults and persons with disabilities. The transportation
activities should focus on the most cost-effective and
sustainable strategies that can be replicated to other
communities.
University Centers for Excellence in Developmental Disabilities
The Committee recommends $40,619,000 for University Centers
for Excellence in Developmental Disabilities, which is the same
as the fiscal year 2018 enacted level and $8,073,000 above the
fiscal year 2019 budget request. The University Centers for
Excellence in Developmental Disabilities Education, Research,
and Service are a nationwide network of independent but
interlinked centers, representing a national resource for
addressing issues, finding solutions, and advancing research
related to the needs of individuals with developmental
disabilities and their families.
Independent Living
The Committee recommends $120,000,000 for the Independent
Living program, of which $27,000,000 is for the Independent
Living State Grants program and $93,000,000 is for the Centers
for Independent Living program. This funding level is
$6,817,000 above the fiscal year 2018 enacted level and
$24,003,000 above the fiscal year 2019 budget request.
Independent Living programs maximize the leadership,
empowerment, independence, and productivity of individuals with
disabilities.
The Committee expects ACL to distribute funds as soon as
possible. In addition, the Committee strongly supports efforts
by ACL to engage the grantee and stakeholder community to
assist in planning for the grant cycle.
National Institute on Disability, Independent Living, and
Rehabilitation Research
The Committee recommends $104,970,000 for the National
Institute on Disability, Independent Living, and Rehabilitation
Research (NIDILRR), which is the same as the fiscal year 2018
enacted level and $104,970,000 above the fiscal year 2019
budget request. NIDILRR generates knowledge and promote its
effective use to enhance the abilities of people with
disabilities to perform activities of their choice in the
community and to expand society's capacity to provide full
opportunities for its citizens with disabilities.
The Committee does not move NIDILRR to NIH, as proposed in
the fiscal year 2019 budget request. The Committee believes
NIDILRR's unique mission to improve the abilities of
individuals with disabilities is best achieved within ACL.
Assistive Technology
The Committee recommends $36,000,000 for Assistive
Technology, which is the same as the fiscal year 2018 enacted
level and $4,061,000 above the fiscal year 2019 budget request.
Assistive Technology (AT) supports programs providing grants to
States for addressing assistive technology needs of individuals
with disabilities. The goal is to increase awareness of and
access to assistive technology devices and services that may
help with education, employment, daily activities, and
inclusion of people with disabilities in their communities.
Of this amount, the Committee provides $2,000,000 for
competitive grants to support existing and new alternative
financing programs that provide for the purchase of AT devices.
The Committee intends for this funding to support the expansion
of existing programs and the creation of new programs that
allow greater access to affordable financing to help people
with disabilities purchase the specialized technologies
required to live independently, to succeed at school and work
and to live active and productive lives. Programs that have
previously received funding are eligible to compete but must
report on how the prior funding has been used, including the
number of loans extended and individuals served, funding
leveraged, and asset development programs created. The
Committee intends for applicants to incorporate credit-building
activities into their programs, including financial education
and information about other possible funding sources.
Successful applicants must emphasize consumer choice and
control and build programs that will provide financing for the
full array of AT devices and services and ensure that all
people, regardless of type of disability or health condition,
age, level of income, and residence have access to the program.
AT programs maximize the ability of individuals with
disabilities of all ages and their family members, guardians,
advocates, and authorized representatives to obtain AT devices
and AT services.
Program Administration
The Committee recommends $41,063,000 for Program
Administration, which is the same as the fiscal year 2018
enacted level and $3,076,000 above the fiscal year 2019 budget
request. This funding supports Federal administrative costs
associated with administering ACL's programs.
The Achieving a Better Live Experience Act of 2014 or ABLE
Act (PL 113-295) allows individuals and families to save for
the purpose of supporting individuals with disabilities in
maintaining their health, independence, and quality of life.
The Committee strongly encourages the Administration on
Community Living through its programs supporting individuals
living with a disability to raise awareness on the eligibility
and benefits of these accounts. The Committee requests an
update on this effort in the fiscal year 2020 Congressional
Justification.
Office of the Secretary
OFFICE OF MEDICARE HEARINGS AND APPEALS
Appropriation, fiscal year 2018....................... $182,381,000
Budget request, fiscal year 2019...................... 112,381,000
Committee Recommendation.............................. 172,381,000
Change from enacted level......................... -10,000,000
Change from budget request........................ +60,000,000
This Office supports hearings at the administrative law
judge level, the third level of Medicare claims appeals.
Medicare Appeals Backlog.--The Committee is concerned with
the size the Medicare Appeals Backlog. The Committee supports
the Office of Medicare Hearings and Appeals to take
administrative actions that will reduce the number of cases
awaiting a hearing with an Administrative Law Judge.
GENERAL DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2018....................... $535,457,000
Budget request, fiscal year 2019...................... 342,990,000
Committee Recommendation.............................. 433,290,000
Change from enacted level......................... -102,167,000
Change from budget request........................ +90,300,000
Of the funds provided, $53,445,000 shall be derived from
evaluation set-aside funds available under section 241 of the
Public Health Service Act, which is $11,383,000 below the
fiscal year 2018 enacted level and the same as the fiscal year
2019 budget request.
This appropriation supports activities that are associated
with the Secretary's roles as policy officer and general
manager of the Department of Health and Human Services. The
Office of the Secretary also implements administration and
Congressional directives, and provides assistance, direction
and coordination to the headquarters, regions, and field
organizations of the department. In addition, this funding
supports the Office of the Surgeon General and several other
health promotion and disease prevention activities that are
centrally administered.
Black Men in the Medical Profession.--The Committee
supports the efforts of the National Academies of Sciences,
Engineering, and Medicine to explore the factors that
contribute to the low participation of Black men in the medical
profession. The Committee urges the Secretary, in collaboration
with NIH, to review the proceedings of the November 2017 joint
workshop on this topic, titled An American Crisis: The Growing
Absence of Black Men in Medicine and Science: Proceedings of
Joint Workshop. The Committee directs the Secretary to submit
an action plan to address the increasing underrepresentation of
Black men in medical schools and in the medical profession to
the Committee within 180 days of enactment of this Act.
Cybersecurity.--The Committee is concerned about reports
that indicate hospitals and medical practitioners are not
adequately protecting patient records with respect to cyber
threats. While laws exist to provide such protection, these
laws are weakly enforced such that there is little
accountability for inadequate compliance with cybersecurity
protocols. The Committee requests the Secretary assess the
adequacy of current enforcement policy and additional measures
that may be necessary to hold those who are responsible for
compliance with existing regulations accountable.
Early Detection of Brain Aneurysms.--The Committee
recognizes that although one in 50 Americans have a brain
aneurysm, there are typically no warning signs or symptoms.
Unfortunately, 40 percent of patients will not survive a brain
aneurysm hemorrhage. Even when an aneurysm has bled, the
symptoms are not widely known among health care professionals,
including first responders and emergency room physicians. As a
result, individuals who experience a hemorrhage from a brain
aneurysm can be easily misdiagnosed, potentially missing an
opportunity to institute life-saving treatments. The Committee
encourages the Secretary, in consultation with appropriate
stakeholders--including neurosurgeons, neurologists, neuro-
interventional surgeons, emergency physicians, brain aneurysm
patient advocacy foundations, brain aneurysm survivors, and
caregivers--to facilitate the development of best practices on
brain aneurysm detection and diagnosis for first responders,
emergency room physicians, primary care physicians, nurses, and
advanced practice providers. In doing so, the Committee
encourages the Secretary to consider incorporating topics such
as the symptoms of brain aneurysms, evidence-based risk factors
for brain aneurysms, appropriate utilization of medical testing
and diagnostic equipment, and screening recommendations. The
Committee encourages the Secretary to consult appropriate
stakeholders to develop a strategy for disseminating
information about the best practices and begin implementing
this strategy not later than one year after the date of
enactment of this Act.
Faith Based Center.--The Committee includes $1,299,000 for
the Faith Based Center, the same as fiscal year 2018 enacted
level and the fiscal year 2019 budget request.
Global Health Research Strategy.--The Committee requests an
update in the fiscal year 2020 Congressional Justification on
how CDC, FDA, BARDA, and NIH--including the Fogarty
International Center--jointly coordinate global health research
activities. The update should include specific metrics used to
track progress and collaboration toward agreed upon health
goals.
Nonrecurring Expenses Fund.--The Committee directs the
Secretary to prioritize completion of projects for the Indian
Health Service.
Privacy in Mental Health Scenarios.--Section 11004 of the
21st Century Cures Act (PL 114-255) directed the Secretary of
Health and Human Services to identify model programs and
materials for training health care providers regarding the
permitted uses and disclosures of protected health information
of patients seeking or undergoing mental or substance use
disorder treatment, consistent with standards and regulations
governing the privacy and security of individually identifiable
health information under the Social Security Act and the Health
Insurance Portability and Accountability Act of 1996. In
addition, the Secretary was directed to identify a model
program and materials for training patients and their families
regarding their rights to protect and obtain such information.
The Committee urges the Secretary to submit a report to the
Committees on Appropriations of the House of Representatives
and the Senate within 180 days of enactment of this Act
identifying model programs and materials addressed in section
11004 of the 21st Century Cures Act.
Tribal Access.--The Committee is concerned that HHS grant
programs that address public health issues are not sufficiently
accessible to Tribal health departments, and that HHS could do
more to support the needs for those services in Indian Country.
Tribal health departments often do not have the funding
available for public health initiatives such as disease
prevention, injury prevention, education, research and wellness
promotion. The Committee directs the Secretary to report,
within 180 days of enactment of this Act, on the number of
Tribal governments or Tribal consortia receiving direct
funding, and the total percentage of that funding, from public
health block grants--including but not limited to the
Preventive Health and Health Services Block Grant; Community
Mental Health Services Block Grant; Community Service Block
Grant; Maternal and Child Health Block Grant; and the Social
Services Block Grant. In addition, HHS is encouraged to collect
from the States the percentage of Federal funding from such
block grants that each State provides to Tribal health
departments.
Tribal Governance.--The Secretary, in coordination with the
Indian Health Service, CMS, and CDC, is urged to facilitate and
support partnerships with Tribes and medical colleges and
universities as opportunities arise, in order to foster
leadership development, build organizations to better deliver
and coordinate high-quality care, and to support systems of
care and prevention that can have a positive outcome on the
health of the community and cost of care.
Office of the Assistant Secretary for Health
Adverse Childhood Experience.--The Committee is concerned
about the link between adverse childhood experience--such as
physical abuse, substance misuse in the household, sexual
abuse, and parental divorce or separation--and negative long-
term health and behavioral health outcomes, including early
initiation of alcohol and tobacco use, substance misuse, teen
pregnancy, violence, and increased risk of suicide. The
Committee directs the Office of the Surgeon General to submit a
report to the Committees on Appropriations of the House of
Representatives and the Senate within 180 days of enactment of
this Act on the connection between adverse childhood experience
and negative long-term health outcomes, including future
substance misuse. The Committee urges the Office of the Surgeon
General to consult with CDC, NIH, SAMHSA, and ACF, in the
process of developing the report.
Breast Milk.--The Committee recognizes the importance of
breast milk in improving health outcomes for babies and
mothers. The Committee encourages HHS to provide a study within
2 years of the date of the enactment of this Act on the impact
of recommended breastfeeding rates on health outcomes and
healthcare costs. HHS, through CDC or AHRQ, should review the
most recent research (published in the last 5 years) and
develop a report that could be provided to Congress examining
the impact of clinically recommended breastfeeding rates on
associated Medicaid expenditures, urgent care costs, and direct
and indirect medical costs in order to inform health care and
funding decisions. The Committee also encourages the Secretary
to ensure that pregnant women have access to nutritional
guidance, including through the 2020-2025 edition of the
Dietary Guidelines for Americans currently under development,
based on the latest scientific research on the health and cost
benefits of human milk.
Embryo Adoption Awareness Campaign.--The Committee
recommends $1,000,000 for the Embryo Adoption Awareness
Campaign, the same as the fiscal year 2018 enacted level and
the fiscal year 2019 budget request. These funds will be used
to educate Americans about the existence of frozen human
embryos (resulting from in-vitro fertilization), which may be
available for donation/adoption to help other couples build
their families. The Committee includes bill language permitting
these funds also to be used to provide medical and
administrative services to individuals adopting embryos, deemed
necessary for such adoptions, consistent with the Code of
Federal Regulations.
Stillbirth.--The Committee is aware that each year about
24,000 babies are stillborn in the US, approximately 2,000
babies each month. According to the CDC, this is about the same
number of babies that die during the first year of life and it
is more than 10 times as many deaths as the number that occur
from Sudden Infant Death Syndrome (SIDS). Additionally the US
has made some of the slowest progress of any country in
reducing stillbirths, with the US rate declining by 0.4 percent
per year between 2000 and 2015, putting us at 155th out of 159
in the world. In order to elevate the issues surrounding
stillbirth for consumers and providers, the Committee
encourages the Surgeon General's Office to issue a Call to
Action on Stillbirth that will provide a roadmap for future
federal efforts to reduce stillbirth rates and eliminate the
disparities that surround this condition.
Sexual Risk Avoidance.--The Committee provides $30,000,000
in budget authority for sexual risk avoidance programs, which
is $5,000,000 above the fiscal year 2018 enacted level and
$30,000,000 more than the fiscal year 2019 budget request.
In implementing these funds, it is the intent of the
Committee that HHS provide substantive and practical technical
assistance to grantees so they place meaningful emphasis on
Sexual Risk Avoidance (SRA) in all educational messaging to
teens. The Committee notes that such technical assistance
should be provided in the following venues: during National and
regional conferences, webinars and one-on-one conversations
with funded projects. The Committee further intends that SRA-
credentialed experts consult with grantees and HHS staff with
oversight of these programs on methodologies and best practices
in SRA for teens. The Committee also encourages all operating
divisions at HHS that implement or inform youth programs to
implement consistently a public health model that stresses risk
avoidance or works to return individuals to a lifestyle without
risk, particularly as it relates to sexual risk.
Office of Minority Health
The Committee provides $56,670,000 for the Office of
Minority Health (OMH), which is the same as the fiscal year
2018 enacted level and $2,714,000 more than the fiscal year
2019 budget request. The OMH works with US Public Health
Service agencies and other agencies of the Department to
address the health status and quality of life for racial and
ethnic minority populations in the United States. OMH develops
and implements new policies; partners with States, Tribes, and
communities through cooperative agreements; supports research,
demonstration, and evaluation projects; and disseminates
information.
Hepatitis.--The Committee commends OMH for their
advancements in the treatment and management of hepatitis and
requests an update in the fiscal year 2020 Congressional
Justification on the progress of community partnerships that
promote awareness and outreach to improve testing, diagnosis,
and treatment.
Hispanic Serving Institutions.--The Committee supports
OMH's efforts to enter into or continue cooperative agreements
with Hispanic Serving Institution medical schools in addition
to their work with Historically Black Colleges and Universities
medical schools.
HIV/AIDS.--The Committee continues to be concerned about
the HIV/AIDS epidemic in the African American and Hispanic
communities, and is aware of the concurrent high co-infection
rate for Hepatitis C. The Committee urges OMH to address
opportunities to reduce the burden of HIV/AIDS and Hepatitis C
by implementing partnerships for screening and community
engagement programs.
Lupus.--The Committee is encouraged by research conducted
by the OMH National Health Education Lupus Program and
encourages OMH to optimize that research and utilize other
resources currently in development to further support
populations at highest risk--specifically Hispanics, Native
Americans, Asians and African Americans. The Committee is
particularly concerned about the disproportionately high rates
of Lupus among African American women and other women of color.
The Committee recommends collaborating with the lupus community
to expand the development of linguistically and culturally
appropriate tools, resources and materials for these adults and
children with lupus, their caregivers and health care
providers.
Office on Women's Health
The Committee includes $32,140,000 for the Office on
Women's Health, which is the same as the fiscal year 2018
enacted level and $3,686,000 more than the fiscal year 2019
budget request.
OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH
INFORMATION TECHNOLOGY
Appropriation, fiscal year 2018....................... $60,367,000
Budget request, fiscal year 2019...................... 38,381,000
Committee Recommendation.............................. 42,705,000
Change from enacted level......................... -17,662,000
Change from budget request........................ +4,324,000
The Office of the National Coordinator (ONC) is the
principal Federal entity charged with coordinating efforts to
implement and use health information technology and exchange
electronically health information.
Patient Data Matching.--The Committee is aware that one of
the most significant challenges inhibiting the safe and secure
electronic exchange of health information is the lack of a
consistent patient data matching strategy. With the passage of
the Health Information Technology for Economic and Clinical
Health (HITECH) Act, a clear mandate was placed on the Nation's
healthcare community to adopt electronic health records and
health exchange capability. Although the committee continues to
carry a prohibition against HHS using funds to promulgate or
adopt any final standard providing for the assignment of a
unique health identifier for an individual until such activity
is authorized, the Committee notes that this limitation does
not prohibit HHS from examining the issues around patient
matching. Accordingly, the Committee continues to encourage the
Secretary, acting through the ONC and CMS, to provide technical
assistance to private-sector-led initiatives to develop a
coordinated national strategy that will promote patient safety
by accurately identifying patients to their health information.
Prescription Drug Monitoring.--The Committee understands
that the spread of the prescription drug epidemic throughout
the Nation has made the creation, implementation, and use of
State prescription drug monitoring programs (PDMPs) and their
ability to communicate with electronic health record (EHR) and
electronic prescribing (e-prescribing) systems more important
than ever. The Committee encourages ONC to continue its support
for pilot programs to find usability challenges among PDMP,
EHR, and e-prescribing systems; develop and award challenge
awards to private entities for health information technology
innovation; and offer targeted technical assistance to help
medical professionals use PDMP, EHR, and e-prescribing systems.
The Committee further encourages ONC to collaborate and
coordinate its efforts with partner agencies such as CDC and
the Bureau of Justice Assistance in the Department of Justice.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $80,000,000
Budget request, fiscal year 2019...................... 80,000,000
Committee Recommendation.............................. 80,000,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
The Office of Inspector General (OIG) serves as an
independent and objective oversight unit of HHS. OIG carries
out activities intended to prevent fraud and abuse and promote
economy, efficiency and effectiveness of HHS programs and
operations.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2018....................... $38,798,000
Budget request, fiscal year 2019...................... 30,904,000
Committee Recommendation.............................. 38,798,000
Change from enacted level......................... - - -
Change from budget request........................ +7,894,000
The Office for Civil Rights (OCR) is responsible for
enforcing civil rights statutes that prohibit discrimination in
health and human services programs. OCR implements the civil
rights laws through a compliance program designed to generate
voluntary compliance among all HHS recipients.
The Committee strongly supports efforts to investigate
violations of Federal Conscience Rights statutes. The
establishment of a Conscience and Religious Freedom Division is
a necessary step to ensure appropriate application of Federal
law. The Committee also values the vital work done by the Civil
Rights Division and Health Information Privacy Division.
Additional funding through the assessment of civil monetary
penalties ensures the work for the Health Information Privacy
Division will not be reduced. The Committee maintains funding
for OCR and increases the program level for these divisions.
Within the resources available to OCR, the Committee
provides not less than $4,600,000 for the Civil Rights
Division, which is above the fiscal year 2018 enacted level and
the fiscal year 2019 budget request. From budget authority and
offsetting collections, the Committee provides not less than
$7,500,000 for the Health Information Privacy Division, which
is above the fiscal year 2018 enacted level and the fiscal year
2019 budget request. The Committee provides not less than
$3,000,000 for the Conscience and Religious Freedom Division,
which is above the fiscal year 2018 enacted level and the
fiscal year 2019 budget request.
The Committee commends the Secretary for establishing the
Division on Conscience and Religious Liberty within the Office
for Civil Rights and is encouraged by the proposed rule
entitled Protecting Statutory Conscience Rights in Health Care;
Delegations of Authority. The Committee urges the
Administration to finalize the rule at the appropriate time.
The Committee looks forward to the important work the Office
for Civil Rights will do to safeguard Americans' civil rights.
The Committee is concerned that the State of California,
State of New York, State of Oregon, and State of Washington are
requiring insurance providers to cover elective abortions.
Furthermore, the Committee is aware that the State of
California has enacted a law that requires pregnancy centers to
refer patients for free or low-cost state-funded abortions.
These laws, policies, and requirements appear to violate the
Weldon Amendment, which prevents discrimination against health
care entities that choose not provide abortion coverage.
Accordingly, the Committee directs the Secretary to fully
investigate and resolve potential violations of the Weldon
Amendment and report findings back to Congress.
RETIREMENT PAY AND MEDICAL BENEFITS FOR
COMMISSIONED OFFICERS
Appropriation, fiscal year 2018....................... $618,689,000
Budget request, fiscal year 2019...................... 629,209,000
Committee Recommendation.............................. 629,209,000
Change from enacted level......................... +10,520,000
Change from budget request........................ - - -
The Committee provides for retirement pay and medical
benefits of Public Health Service Commissioned Officers, for
payments under the Retired Serviceman's Family Protection Plan,
and for medical care of dependents and retired personnel.
PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND
Appropriation, fiscal year 2018....................... $1,953,458,000
Budget request, fiscal year 2019...................... 2,303,877,000
Committee Recommendation.............................. 2,813,128,000
Change from enacted level......................... +859,670,000
Change from budget request........................ +509,251,000
This account supports the activities of the Assistant
Secretary for Preparedness and Response (ASPR) and other
components within the Office of the Secretary to prevent,
prepare for, and respond to the health consequences of
bioterrorism and other public health emergencies, including
pandemic influenza. It also includes funding for the
Department's cybersecurity efforts.
Office of the Assistant Secretary for Preparedness and Response
The Committee provides $2,489,128,000 for activities
administered by ASPR. ASPR is responsible for coordinating
national policies and plans for medical and public health
preparedness and for administering a variety of public health
preparedness programs.
National Ebola Training and Education Center.--The
Committee supports the continued efforts of the National Ebola
Training and Education Center (NETEC), and recognizes the
importance of NETEC's work in preventing, preparing for, and
responding to Ebola and other special pathogen incidents.
Regional Disaster Medical Response Demonstration Project.--
The Committee commends ASPR for its work to develop and
evaluate regional, coalition-based disaster medical response
systems to handle the health impacts of 21st century health
security threats. The Committee encourages ASPR to leverage the
Hospital Preparedness Program and National Disaster Medical
System to strengthen regional disaster response capabilities by
working with States that have demonstrated success in creating
statewide disaster healthcare systems to coordinate patient
movement, evacuation, and emergency care, particularly in areas
with high incidence of natural disasters or high risk for
deliberate attacks, with the goal of establishing best
practices and maximizing Federal resources.
Operations
The Committee recommends $30,938,000 for Operations. This
account supports activities within the Assistant Secretary's
Immediate Office; the Office of the Chief Operating Officer;
the Office of Acquisitions Management, Contracts, and Grants;
and the Office of Financial Planning and Analysis.
Preparedness and Emergency Operations
The Committee recommends $24,654,000 for Preparedness and
Emergency Operations. The Preparedness and Emergency Operations
account funds the Office of Emergency Management, which support
a full spectrum of emergency management responsibilities,
including planning, coordination, logistics, training, and
responding to planned events and unplanned incidents.
National Disaster Medical System
The Committee recommends $62,404,000 for the National
Disaster Medical System (NDMS). NDMS deploys trained medical
teams to communities impacted by public health and medical
emergencies due to natural and man-made incidents.
Hospital Preparedness Program
The Committee recommends $279,555,000 for the Hospital
Preparedness Program (HPP). HPP supports cooperative agreements
with State, local, and territorial health departments to build
healthcare coalitions that improve regional and local hospital
preparedness and surge capacity in public health emergencies.
Biomedical Advanced Research and Development Authority
The Committee provides $586,700,000 for the Biomedical
Advanced Research and Development Authority (BARDA). BARDA
supports the advanced development of vaccines, drugs, and
therapeutics for potential serious public health threats,
including chemical, biological, radiological, and nuclear
threats, pandemic influenza, and emerging and re-emerging
infectious diseases.
Advanced Blood Pathogen Reduction Technologies.--The
Committee commends BARDA for actions taken during the Zika
virus epidemic to quickly and efficiently accelerate the use of
modern blood pathogen reduction technologies to improve the
safety of the nation's blood supply. The Committee encourages
BARDA to continue to give priority to this effort in fiscal
year 2019, which if successful will complete development of
pathogen reduction technology for all transfused blood
components as a countermeasure to ensure sustainability of the
national blood supply as part of emergency preparedness for
emerging epidemic pathogens.
Antimicrobial-Resistant Tuberculosis.--The National
Strategy for Combating Antibiotic-Resistant Bacteria identified
drug resistant tuberculosis (TB) as a serious threat level
pathogen. New diagnostic, treatment, and prevention tools are
urgently needed to address this global health threat. The
Committee encourages BARDA to support the development of new TB
diagnostic tests, drugs, and vaccines and report on the
agency's efforts in the fiscal year 2020 Congressional
Justification.
Antimicrobial Technologies.--The Committee notes that
efforts to combat microbial resistance to traditional
treatments is advancing faster than current regulatory
frameworks. The Committee encourages BARDA to work with
entities developing antimicrobial technologies that are not
pharmacological in nature. The Committee sees particular
promise in technologies which alter environments to inhibit
microbial growth and spread.
Zika Vaccine Development.--The number of new Zika virus
infections has dropped dramatically because much of the
population in Zika-endemic areas has developed an immunity to
the virus. However, like other similar mosquito-borne
flaviviruses, the virus is likely to reemerge in these areas in
several years, and could emerge unpredictably in isolated areas
in the meantime, including within the US. Given the links
between Zika virus infections and serious birth defects, and
the length of time necessary to develop vaccines, the Committee
believes it is prudent to continue efforts to develop a vaccine
for the Zika virus. Within the total funding provided for
BARDA, the Committee directs BARDA to continue to support
research and development on a vaccine for the Zika virus.
Policy and Planning
The Committee recommends $14,877,000 for Policy and
Planning. The Office of Policy and Planning leads HHS'
emergency preparedness and response strategic direction and
policy coordination.
Project BioShield Special Reserve Fund
The Committee provides $780,000,000 for Project BioShield.
These funds support the acquisition of promising medical
countermeasures developed through BARDA contracts for the most
serious public health threats.
Strategic National Stockpile
The Committee provides $710,000,000 for the Strategic
National Stockpile (SNS) in ASPR. The Committee commends the
Department for its efforts to achieve efficiencies in its
public health preparedness activities and looks forward to
continuing to work with the Department to enhance the nation's
preparedness to respond to public health threats. The Committee
expects that this organizational change will continue to
include a significant role for CDC in providing scientific
expertise in decision-making related to procurement of
countermeasures as well as maintaining strong relationships
with State and local public health departments to facilitate
efficient deployment of countermeasures in public health
emergencies. Within 60 days of enactment of this Act, the
Committee requests an update on ASPR's plans to: 1) maintain
funding for State and local operational readiness to distribute
and dispense medical countermeasures from the Stockpile; 2)
continue technical assistance, support and oversight for State
and local health departments' operational readiness to
distribute and dispense medical countermeasures from the
Stockpile; and 3) incorporate and access CDC expertise
throughout the Public Health Emergency Medical Countermeasures
Enterprise, including decisions related to procurement and
deployment for the Stockpile.
Office of the Assistant Secretary for Administration--Cybersecurity
The Committee provides $60,000,000 for information
technology cybersecurity in the Office of the Assistant
Secretary for Administration. These funds provide for
continuous monitoring and security incident response
coordination for the Department's computer systems and
networks.
Computer Security Incident Response Center.--HHS
established the Computer Security Incident Response Center
(CSIRC) to serve as the primary entity within HHS responsible
for maintaining cybersecurity situational awareness and
determining the Department's overall cybersecurity risk
posture. The Committee directs HHS to submit a report within
180 days of enactment of this Act that includes an analysis and
assessment of the effectiveness of the CSIRC in ensuring the
Department, to include operating and staff divisions, is
appropriately prepared for and protected against cyber threats
and incidents.
Office of Security and Strategic Information
The Committee provides $8,000,000 for the Office of
Security and Strategic Information to maintain the security of
the Department's personnel, systems, and critical
infrastructure.
Office of Public Health and Science--Medical Reserve Corps
The Committee provides $6,000,000 for the Medical Reserve
Corps program, which is a network of local volunteers who work
to strengthen the public health infrastructure and preparedness
capabilities of their communities.
Pandemic Influenza Preparedness
The Committee recommends $250,000,000 for the pandemic
influenza preparedness program. This funding supports research
and development of next-generation influenza medical
countermeasures, preparedness testing and evaluation, and
stockpiling.
Pandemic Influenza Vaccine.--The Committee remains
concerned about our nation's limited ability to rapidly respond
to a pandemic influenza outbreak and meet the Federal
government's desired goal of delivering pandemic vaccines
within 12 weeks of the declaration of a pandemic. Late-stage
pandemic and pre-clinical influenza vaccines are under
development that can enhance current rapid response capacity in
the US. The Committee encourages ASPR and BARDA to support
development of promising pre-clinical as well as development
and acquisition of late-stage vaccine candidates that can meet
the goal of producing a pandemic vaccine within 12 weeks of a
declaration.
General Provisions
Sec. 201. The Committee continues a provision to limit the
amount available for official reception and representation
expenses.
Sec. 202. The Committee continues a provision to limit the
salary of an individual through an HHS grant or other
extramural mechanism to not more than the rate of Executive
Level II.
Sec. 203. The Committee continues a provision to prohibit
the Secretary from using evaluation set-aside funds until the
Committees on Appropriations of the House of Representatives
and the Senate receive a report detailing the planned use of
such funds.
Sec. 204. The Committee continues a provision regarding the
level for the PHS evaluation set-aside.
(TRANSFER OF FUNDS)
Sec. 205. The Committee continues a provision permitting
the Secretary of HHS to transfer up to one percent of any
discretionary funds between appropriations, provided that no
appropriation is increased by more than three percent by any
such transfer to meet emergency needs. Notification must be
provided to the Committees on Appropriations at the program,
project, and activity level in advance of any such transfer.
Sec. 206. The Committee continues the 60 day flexibility
for National Health Service Corps contract terminations.
Sec. 207. The Committee continues a provision to prohibit
the use of Title X funds unless the applicant for the award
certifies to the Secretary that it encourages family
participation in the decision of minors to seek family planning
services and that it provides counseling to minors on how to
resist attempts to coerce minors into engaging in sexual
activities.
Sec. 208. The Committee continues a provision stating that
no provider of services under Title X shall be exempt from any
state law requiring notification or the reporting of child
abuse, child molestation, sexual abuse, rape, or incest.
Sec. 209. The Committee continues a provision related to
the Medicare Advantage program.
Sec. 210. The Committee continues a provision prohibiting
funds from being used to advocate or promote gun control.
Sec. 211. The Committee continues a provision to allow
funding for HHS international HIV/AIDS and other infectious
disease, chronic and environmental disease, and other health
activities abroad to be spent under the State Department Basic
Authorities Act of 1956.
Sec. 212. The Committee continues a provision authorizing
certain international health activities.
(TRANSFER OF FUNDS)
Sec. 213. The Committee continues a provision to provide
the Director of NIH, jointly with the Director of the Office of
AIDS Research, the authority to transfer up to three percent of
human immunodeficiency virus funds.
(TRANSFER OF FUNDS)
Sec. 214. The Committee continues a provision that makes
NIH funds for human immunodeficiency virus research available
to the Office of AIDS Research.
Sec. 215. The Committee continues a provision granting
authority to the Office of the Director of the NIH to enter
directly into transactions in order to implement the NIH Common
Fund for medical research and permitting the Director to
utilize peer review procedures, as appropriate, to obtain
assessments of scientific and technical merit.
Sec. 216. The Committee continues a provision clarifying
that funds appropriated to NIH institutes and centers may be
used for minor repairs or improvements to their buildings, up
to $3,500,000 per project with a total limit for NIH of
$45,000,000.
(TRANSFER OF FUNDS)
Sec. 217. The Committee continues a provision transferring
one percent of the funding made available for National
Institutes of Health National Research Service Awards to the
Health Resources and Services Administration.
Sec. 218. The Committee continues the Biomedical Advanced
Research and Development Authority ten year contract authority.
Sec. 219. The Committee continues language requiring HHS to
include certain information concerning the number of full-time
Federal employees and contractors working on the Affordable
Care Act in the fiscal year 2020 budget request.
Sec. 220. The Committee continues specific report
requirements for CMS's Health Insurance Exchange activities in
the fiscal year 2020 budget request.
Sec. 221. The Committee continues a provision prohibiting
CMS Program Management account from being used to support risk
corridor payments.
(TRANSFER OF FUNDS)
Sec. 222. The Committee continues language directing the
spending of the Prevention and Public Health fund.
PREVENTION AND PUBLIC HEALTH FUND
The Committee continues a provision that directs the
transfer of the Prevention and Public Health Fund. In fiscal
year 2019, the level appropriated for the fund is $848,000,000
after accounting for sequestration. The Committee includes bill
language in section 222 of this Act that requires that funds be
transferred within 45 days of enactment of this Act to the
following accounts, for the following activities, and in the
following amounts:
------------------------------------------------------------------------
FY 2019
Agency Budget Activity Committee
------------------------------------------------------------------------
CDC............................. Breastfeeding 10,000,000
Grants (Hospitals
Promoting
Breastfeeding)..
CDC............................. Diabetes........... 76,675,000
CDC............................. Epidemiology and 40,000,000
Laboratory
Capacity Grants.
CDC............................. Healthcare 12,000,000
Associated
Infections.
CDC............................. Heart Disease and 73,975,000
Stroke Prevention
Program.
CDC............................. Million Hearts 4,000,000
Program.
CDC............................. Preventive Health 160,000,000
and Health
Services Block
Grant.
CDC............................. Tobacco............ 126,000,000
CDC............................. Section 317 324,350,000
Immunization
Grants.
CDC............................. Lead Poisoning 17,000,000
Prevention.
CDC............................. Early Care 4,000,000
Collaboratives.
------------------------------------------------------------------------
Sec. 223. The Committee modifies a provision relating to
breast cancer screening.
Sec. 224. The Committee continues a provision relating to
indirect cost negotiated rates.
(TRANSFER OF FUNDS)
Sec. 225. The Committee continues a provision permitting
transfer of funds within NIH, if such funds are related to
opioid and pain management research.
(TRANSFER OF FUNDS)
Sec. 226. The Committee includes a new provision for
evaluation activities within the Administration for Children
and Families.
Sec. 227. The Committee includes a new provision
prohibiting funds from being used for Title X family planning
activities.
(TRANSFER OF FUNDS)
Sec 228. The Committee includes a new provision
establishing an Infectious Diseases Rapid Response Reserve Fund
in CDC.
Sec. 229. The Committee includes a new provision
prohibiting funds from being used to support the Monograph
Programme of the International Agency for Research on Cancer
unless NIH submits a report to Congress outlining transparency
and conflict-of-interest requirements that are a condition of
these awards.
Sec. 230. The Committee includes a new provision relating
to cervical cancer screening.
Sec. 231. The Committee includes a new provision extending
the authorization of Small Business Innovation Research pilot
programs.
Sec. 232. The Committee includes a new provision relating
to donations for the care of unaccompanied alien children.
Sec. 233. The Committee includes a new provision relating
to reporting of children separated from their parents or legal
guardians.
Sec. 234. The Committee includes a new provision related to
a plan to reunify children separated from their parents or
family units.
Sec. 235. The Committee includes a new provision ensuring
that efforts are taken to place unaccompanied alien children
who are siblings together.
Sec. 236. The Committee includes a new provision requesting
a monthly report on the status of children separated from their
parents or legal guardians.
TITLE III--DEPARTMENT OF EDUCATION
EDUCATION FOR THE DISADVANTAGED
Appropriation, fiscal year 2018....................... $16,443,790,000
Budget request, fiscal year 2019...................... 15,926,790,000
Committee Recommendation.............................. 16,443,790,000
Change from enacted level......................... - - -
Change from budget request........................ +517,000,000
Of the total amount available, $5,525,990,000 is
appropriated for fiscal year 2019 for obligation on or after
July 1, 2019 and $10,841,177,000 is appropriated for fiscal
year 2019 for obligation on or after October 1, 2019. This
appropriation account includes compensatory education programs
authorized under title I and subpart 2 of part B of title II of
the Elementary and Secondary Education Act of 1965 (ESEA) and
section 418A of the Higher Education Act.
Grants to Local Educational Agencies
For fiscal year 2019, the Committee recommends
$15,759,802,000 for Title I grants to Local Educational
Agencies (LEAs or school districts). Title I grants provide
supplemental education funding for activities that offer extra
academic support to help students from low-income families and
in high-poverty schools to meet State academic standards.
Of the amounts provided for Title I programs,
$6,459,401,000 is available for Basic Grants to LEAs, which is
the same as both the fiscal year 2018 enacted level and the
fiscal year 2019 budget request. Basic grants are awarded to
school districts with at least 10 low-income children who make
up more than two percent of the school-age population.
Within the amount for Title I Basic Grants, up to
$5,000,000 is made available to the Secretary of Education on
October 1, 2018, to obtain annually-updated LEA-level poverty
data from the Bureau of the Census.
The Committee recommends $1,362,301,000 for Title I
Concentration Grants, which is the same as both the fiscal year
2018 enacted level and the fiscal year 2019 budget request.
Concentration Grants target funds to school districts in which
the number of low-income children exceeds 6,500 or 15 percent
of the total school-age population.
The Committee recommends $3,969,050,000 for Title I
Targeted Grants, which is the same as the fiscal year 2018
enacted level and $150,000,000 above the fiscal year 2019
budget request. Targeted Grants provide higher payments to
school districts with high numbers or percentages of low-income
students.
The Committee recommends $3,969,050,000 for Title I
Education Finance Incentive Grants (EFIGs), which is the same
as the fiscal year 2018 enacted level and $150,000,000 above
the fiscal year 2019 budget request. EFIGs provide payments to
States and school districts that incorporate equity and effort
factors to improve the equity of State funding systems.
The Committee notes, within the fiscal year 2019 budget
request, the inclusion of legislative proposals as well as
grants to local educational agencies to implement weighted per-
pupil funding systems, including open enrollment systems that
allow students to enroll in a public school selected by their
parents. However, the Committee notes that such a program has
not been authorized. Accordingly, the Committee has not
provided funding for such a program within this bill. Funding
for this approach will be considered should it be authorized in
law.
Comprehensive Literacy Development Grants
The Committee recommends $190,000,000 for Comprehensive
Literacy Development Grants, which is the same as the fiscal
year 2018 enacted level and $190,000,000 above the fiscal year
2019 budget request. This program makes competitive grants to
States to subgrant to school district and/or early education
programs to improve literacy instruction for disadvantaged
students.
Innovative Approaches to Literacy
The Committee recommends $27,000,000 for Innovative
Approaches to Literacy, the same as the 2018 enacted level and
$27,000,000 above the fiscal year 2019 budget request. This
program provides competitive grants to support school
libraries.
State Agency Programs: Migrant
The Committee recommends $374,751,000 for the State Agency
Program for Migrant Education, which is the same as both the
fiscal year 2018 enacted level and the fiscal year 2019 budget
request. This program supports special educational and related
services for children of migrant agricultural workers and
fishermen, including: (1) supplementary academic education; (2)
remedial or compensatory instruction; (3) English for limited
English proficient students; (4) testing; (5)guidance
counseling; and (6) other activities to promote coordination of
services across States for migrant children whose education is
interrupted by frequent moves.
State Agency Programs: Neglected and Delinquent
For the State Agency Program for Neglected and Delinquent
Children, the Committee recommends $47,614,000, which is the
same as both the fiscal year 2018 enacted level and the fiscal
year 2019 budget request. This formula grant program supports
educational services for children and youth under age 21 in
State-run institutions, attending community day programs, and
in correctional facilities. A portion of these funds is
provided for projects that support the successful re-entry of
youth offenders into postsecondary and vocational programs.
Special Programs for Migrant Students
The Committee recommends $44,623,000 for the Special
Programs for Migrant Students, which is the same as both the
fiscal year 2018 enacted level and the fiscal year 2019 budget
request. These programs make grants to colleges, universities,
and nonprofit organizations to support educational programs
designed for students who are engaged in migrant and other
seasonal farm work. The High School Equivalency Program (HEP)
recruits migrant students age 16 and over and provides academic
and support services to help those students obtain a high
school equivalency certificate and subsequently to gain
employment or admission to a postsecondary institution or
training program. The College Assistance Migrant Program (CAMP)
provides tutoring and counseling services to first-year,
undergraduate migrant students and assists those students in
obtaining student financial aid for their remaining
undergraduate years. The Committee recommendation assumes the
allocation of funds between HEP and CAMP as proposed by the
Administration.
IMPACT AID
Appropriation, fiscal year 2018....................... $1,414,112,000
Budget request, fiscal year 2019...................... 1,259,790,000
Committee Recommendation.............................. 1,466,112,000
Change from enacted level......................... +52,000,000
Change from budget request........................ +206,322,000
This account supports payments to school districts affected
by Federal activities, such as those that educate children
whose families are connected with the military or who live on
Indian land.
The Committee notes that documents supporting the
Department's budget proposal references the possibility of a
high-quality evaluation which could be used to better
understand the economic effects of the Federal presence in
participating school districts. The Committee requests to be
kept informed of any steps taken in the planning for or
development of such a study.
Basic Support Payments
The Committee recommends $1,320,242,000 for Basic Support
Payments to LEAs, which is $50,000,000 above the fiscal year
2018 enacted level and $131,009,000 above the fiscal year 2019
budget request. Basic Support Payments compensate school
districts for lost tax revenue and are made on behalf of
Federally-connected children, such as children of members of
the uniformed services who live on Federal property.
Payments for Children with Disabilities
The Committee recommends $48,316,000 for Payments for
Children with Disabilities, which is the same as both the
fiscal year 2018 enacted level and the fiscal year 2019 budget
request. These payments compensate school districts for the
increased costs of serving Federally-connected children with
disabilities.
Facilities Maintenance
The Committee recommends $4,835,000 for Facilities
Maintenance, which is the same as both the fiscal year 2018
enacted level and the fiscal year 2019 budget request. These
capital payments are authorized for maintenance of certain
facilities owned by the Department.
Construction
The Committee recommends $17,406,000 for the Construction
program, which is the same as both the fiscal year 2018 enacted
level and the fiscal year 2019 budget request. This program
provides competitive grants for building and renovating school
facilities to school districts that educate Federally-connected
students or have Federally-owned land.
Payments for Federal Property
The Committee recommends $75,313,000 for Payments for
Federal Property, which $2,000,000 above the fiscal year 2018
enacted level and $75,313,000 above the fiscal year 2019 budget
request. Funds are awarded to school districts to compensate
for lost tax revenue as the result of Federal acquisition of
real property since 1938.
SCHOOL IMPROVEMENT PROGRAMS
Appropriation, fiscal year 2018....................... $5,158,467,000
Budget request, fiscal year 2019...................... 645,214,000
Committee Recommendation.............................. 5,258,467,000
Change from enacted level......................... +100,000,000
Change from budget request........................ +4,613,253,000
The School Improvement account includes programs authorized
under Titles I, II, IV, VI, and VII of the ESEA; the McKinney-
Vento Homeless Assistance Act; Title IV-A of the Civil Rights
Act; section 203 of the Educational Technical Assistance Act of
2002; and section 105 of the Compact of Free Association
Amendments Act of 2003.
Supporting Effective Instruction State Grants
The Committee recommends $2,055,830,000 for Supporting
Effective Instruction State Grants, which is the same as the
fiscal year 2018 enacted level and $2,055,830,000 above the
fiscal year 2019 budget request. These grants provide States
and school districts with a flexible source of funding to
strengthen the skills and knowledge of teachers, principals,
and administrators to enable them to improve student
achievement.
Supplemental Education Grants
The Committee recommends $16,699,000 for Supplemental
Education Grants to the Federated States of Micronesia and the
Republic of the Marshall Islands, which is the same as both the
fiscal year 2018 enacted level the fiscal year 2019 budget
request. The Compact of Free Association Amendments Act of 2003
(PL 108-188) authorizes these entities to receive funding for
general education assistance. The Committee recommendation
includes a consolidated amount for Supplemental Education
Grants because the underlying statute determines the allocation
between Micronesia and the Marshall Islands.
21st Century Community Learning Centers
The Committee recommends $1,211,673,000 for 21st Century
Community Learning Centers, which the same as the fiscal year
2018 enacted level and $1,211,673,000 above the fiscal year
2019 budget request. This program awards formula grants to
States, which in turn distribute funds on a competitive basis
to local school districts, nonprofit organizations, and other
public entities. Funds may be used to provide activities that
complement and reinforce the regular school-day program for
participating students and may also fund local activities that
are included as part of an expanded learning time program.
State Assessments
The Committee recommends $378,000,000 for State
Assessments, which is the same as the fiscal year 2018 enacted
level and $8,900,000 above the fiscal year 2019 budget request.
Funds are available to develop and implement academic standards
and assessments. The program includes a set-aside for audits to
identify and eliminate low-quality or duplicative assessments.
Education for Homeless Children and Youth
The Committee recommends $85,000,000 for the Education for
Homeless Children and Youth program, which is the same as the
fiscal year 2018 enacted level and $8,000,000 above the fiscal
year 2019 budget request. The Committee recognizes that without
an education, these at-risk children and youth are unlikely to
obtain the skills they need to become productive adults
contributing to the economy and their communities. Grants are
allocated to States in proportion to the total each State
receives under the Title I program.
Training and Advisory Services
The Committee recommends $6,575,000 for Training and
Advisory Services authorized by Title IV-A of the Civil Rights
Act, which is the same as both the fiscal year 2018 enacted
level and the fiscal year 2019 budget request. Title IV-A
authorizes technical assistance and training services for
school districts to address problems associated with
desegregation on the basis of race, sex, or national origin.
The Department awards three-year grants to regional Equity
Assistance Centers (EACs) located in each of the 10 Department
of Education regions. The EACs provide services to school
districts upon request. Typical activities include
disseminating information on successful education practices and
legal requirements related to nondiscrimination on the basis of
race, sex, and national origin in educational programs.
Education for Native Hawaiians
The Committee recommends $36,397,000 for the Education for
Native Hawaiian program, which is the same as the fiscal year
2018 level and $36,397,000 above the fiscal year 2019 budget
request. Funds are used to provide competitive awards for
supplemental education services to the Native Hawaiian
population.
Alaska Native Education Equity
The Committee recommends $35,453,000 for the Alaska Native
Education Equity program, which is the same as the fiscal year
2018 level and $35,453,000 above the fiscal year 2019 budget
request. Funds are used to provide competitive awards for
supplemental education services to the Alaska Native
population.
Rural Education
The Committee recommends $180,840,000 for Rural Education
programs, which is the same as the fiscal year 2018 enacted
level and $5,000,000 above the fiscal year 2019 budget request.
There are two programs to assist rural school districts with
improving teaching and learning in their schools: the Small,
Rural Schools Achievement program, which provides funds to
rural districts that serve a small number of students; and the
Rural and Low-Income Schools program, which provides funds to
rural districts that serve concentrations of poor students,
regardless of the number of students served by the district.
Funds appropriated for Rural Education shall be divided equally
between these two programs.
Comprehensive Centers
The Committee recommends $52,000,000 for Comprehensive
Centers, which is the same as the fiscal year 2018 enacted
level and $52,000,000 above the fiscal year 2019 budget
request. This grant program currently supports 22 comprehensive
centers, including 15 regional centers that provide training,
technical assistance, and professional development to build
State capacity to provide high-quality education to all
students. The remaining seven centers specialize in particular
content areas. The Committee includes bill language directing
the Secretary to ensure that the Bureau of Indian Education
(BIE) has access to services provided under this section.
Student Support and Academic Enrichment State Grants
The Committee recommends $1,200,000,000 for Student Support
and Academic Enrichment (SSAE) State Grants, which is
$100,000,000 above the fiscal year 2018 enacted level and
$1,200,000,000 above the fiscal year 2019 budget request. The
Every Student Succeeds Act (ESSA) eliminated several narrowly-
focused competitive grant programs and replaced them with this
new formula grant program. States and school districts have
flexibility to focus these resources on locally-determined
priorities to provide students with access to a well-rounded
education, including rigorous coursework, and to improve school
conditions and the use of technology.
Non-Cognitive Factors.--The Committee notes that programs
designed to support non-cognitive factors such as critical
thinking skills, social skills, work ethic, problem solving,
and community responsibility are an eligible use of funds SSAE
grants supporting a well-rounded education.
School-Based Mental Health Services.--School districts are
encouraged to consider using SSAE grants funds for services
that promote mental wellness for all students while assessing
and addressing students with more complex needs, including
those who may be on the pathway to violence. The Committee is
aware that access to school mental and behavioral health
services contribute to improved student learning, a more
positive school climate, and increased school safety. The
Committee notes that SSAE permits districts to use portions of
their allocations to invest in technology solutions that could
assist school-based mental health professionals in identifying,
assessing and tracking treatment for students with mental
health issues, including monitoring students for signs that
they are a potential danger to themselves or others.
School Climate.--The Committee notes that SSAE funds
provide opportunities to increase students' access to STEM,
computer science, music, physical education, the arts, college
and career counseling, access to Advanced Placement classes,
and other well-rounded education programs, which are critical
to keeping students engaged in school and thriving
academically, ultimately supporting a positive school climate.
School Safety Measures.--Through SSAE grants, school
districts should consider utilizing funds for security
hardening measures. These security measures can include bullet
resistant doors and glass with hinge-locking mechanisms,
immediate notification systems to emergency 911, mechanisms
that provide real time actionable intelligence direct to law
enforcement and first responders, or installation of
distraction devices or other countermeasures administered by
law enforcement and first responders.
INDIAN EDUCATION
Appropriation, fiscal year 2018....................... $180,239,000
Budget request, fiscal year 2019...................... 164,939,000
Committee Recommendation.............................. 180,239,000
Change from enacted level......................... - - -
Change from budget request........................ +15,300,000
This account supports programs authorized by part A of
title VI of the ESEA.
Grants to Local Educational Agencies
The Committee recommends $105,381,000 for Grants to Local
Educational Agencies, which is the same as the fiscal year 2018
enacted level and $5,000,000 above the fiscal year 2019 budget
request. This program provides assistance through formula
grants to school districts and schools supported or operated by
the Bureau of Indian Education. The purpose of this program is
to improve elementary and secondary school programs that serve
American Indian students, including preschool children.
Grantees must develop a comprehensive plan and ensure that the
programs they carry out will help Indian students reach the
same challenging standards that apply to all students. This
program supplements the regular school program to help American
Indian children sharpen their academic skills, bolster their
self-confidence, and participate in enrichment activities that
would otherwise be unavailable.
Special Programs for Indian Children
The Committee recommends $67,993,000 for Special Programs
for Indian Children, which is the same as the fiscal year 2018
enacted level and $10,000,000 above the fiscal year 2019 budget
request. These programs make competitive awards to improve the
quality of education for American Indian students. The program
also funds the American Indian Teacher Corps and the American
Indian Administrator Corps to recruit and support American
Indians as teachers and school administrators.
National Activities
The Committee recommends $6,865,000 for National
Activities, which is the same as the fiscal year 2018 enacted
level and $300,000 above the fiscal year 2019 budget request.
Funds under this authority support (1) research, evaluation and
data collection to provide information about the educational
status of Indian students and the effectiveness of Indian
education programs; (2) grants to support Native language
immersion schools and programs; and (3) grants to Tribes for
education administrative planning, development, and
coordination.
Language Immersion Program.--Within the total for National
Activities, the Committee continues funding for the Native
American and Alaska Native Language Immersion Program at the
same level as the fiscal year 2019 budget request. This
program, which was authorized in ESSA, will make grants to
maintain and promote the use of Native languages, support
Native language education and development, and provide
professional development to teachers.
State-Tribal Education Partnership.--The Committee
recommends continued funding for the State-Tribal Education
Partnership (STEP) program. This program makes grants to Tribes
to build capacity to assume certain State responsibilities for
the administration of ESEA programs. Indian educators have long
called for Tribal-State-Federal partnerships to involve Indian
Tribes in educating their students and to improve American
Indian education outcomes. STEP programs have, and will
continue to, assist State and Tribal governments to continue
delivering the highest quality education for Indian students.
INNOVATION AND IMPROVEMENT
Appropriation, fiscal year 2018....................... $982,256,000
Budget request, fiscal year 2019...................... 1,777,647,000
Committee Recommendation.............................. 1,058,441,000
Change from enacted level......................... +76,185,000
Change from budget request........................ -719,206,000
This appropriation account includes programs authorized
under portions of Titles II and IV of the ESEA.
The Committee is aware of the proposal to include
$1,000,000,000 for grants to local educational agencies and
non-profit organizations to implement a program of awarding
scholarship to students of low-income families to attend a
private or public school selected by their families. The
Committee notes that such a program has not been authorized.
Accordingly, the Committee has not provided funding for such a
program within this bill. Funding for this approach will be
considered should a program be authorized in law.
Education Innovation and Research
The Committee recommends $145,000,000 for the Education
Innovation and Research program. This amount is $25,000,000
above the fiscal year 2018 enacted level and $35,000,000 below
the fiscal year 2019 budget request. This program makes
competitive grants to support the replication and scaling-up of
evidence-based education innovations. The funding will support
a competition to promote innovation and reform in science,
technology, engineering, and mathematics (STEM) education,
including computer science. Coupled with dedicated funding in
the Career, Technical, and Adult Education account, this
increase will help support the Administration's commitment to
STEM education.
Partnerships with Rural Schools.--The Department is
encouraged to work with institutions of higher learning or
other relevant stakeholders who can partner with rural school
districts on STEM education, including efforts to bring
``makerspace'' opportunities to schools.
STEM and Computer Science Education.--The Committee notes
that funds available under this program may be used by States
and school districts to provide or strengthen instruction in
STEM fields, including computer science. The Committee
recognizes the importance of funding Pre K-12 computer science
education that addresses the enrollment and achievement gap for
underrepresented students such as minorities, girls, and youth
from families living at or below the poverty line. Supporting
education in the science, technology, engineering, arts, and
mathematics fields, particularly computer science, is critical
to ensure that our nation continues to lead in innovation. As
computer science is a basic skill in the 21st century global
economy, the Committee encourages the Department to support Pre
K-12 computer science education to schools across the country.
Teacher and School Leader Incentive Grants
The Committee recommends $200,000,000 for the Teacher and
School Leader Incentive Grants program, which is the same as
the fiscal year 2018 enacted level and $200,000,000 above the
fiscal year 2019 budget request. This program provides grants
to States, school districts, and partnerships to develop,
implement, improve, or expand human capital management systems
or performance-based compensation systems in schools.
American History and Civics Academies
The Committee recommends $4,700,000 for American History
and Civics National Activities, which is $3,000,000 above the
fiscal year 2018 enacted level and $4,700,000 above the fiscal
year 2019 budget request. This program reaches a limited number
of teachers and students since an academy may select no more
than 300 teachers or students for participation.
American History and Civics National Activities
The Committee recommends $1,700,000 for American History
and Civics National Activities, the same as the fiscal year
2018 enacted level and $1,700,000 above the fiscal year 2019
budget request. The Committee recognizes the importance of
improving the quality of instruction in American history,
civics, and geography, particularly for schools in underserved
rural and urban communities. In recognition of the fact that no
one size fits all in effective education, and that a variety of
approaches are required to meet the range of student and
community needs, these competitive grants will support multiple
grantees in making available a menu of innovative, effective
approaches to teaching American history, civics and government,
and geography. These validated approaches will be available to
schools and school districts for their consideration and
voluntary use, based on the approach that best meets the needs
of the students and community.
Supporting Effective Educator Development
The Committee recommends $75,000,000 for the Supporting
Effective Educator Development (SEED) grant program, which is
the same as the fiscal year 2018 level and $75,000,000 above
the fiscal year 2019 budget request. SEED provides competitive
grants to Institutions of Higher Education (IHEs), national
nonprofit organizations, BIE, and partnerships to support
alternative certification and other professional development
and enrichment activities for teachers, principals, and other
school leaders. Funds are included to fully support
continuation costs for grants made in prior years.
Charter Schools Grants
The Committee recommends $450,000,000 for Charter Schools
Grants, which is $50,000,000 above the fiscal year 2018 enacted
level and $50,000,000 below the fiscal year 2019 budget
request. The Committee recommends an allocation of funds within
this program that aligns with ESSA.
In exchange for a commitment to increase student
achievement, charter schools are exempt from many statutory and
regulatory requirements. The Charter Schools Grants program
awards grants to State Educational Agencies (SEAs) or, if a
State's SEA chooses not to participate, to charter school
developers to support the development and initial
implementation of public charter schools. State Facilities
Incentive Grants and Credit Enhancement for Charter School
Facilities awards help charter schools obtain adequate school
facilities. These programs work in tandem to support the
development and operation of charter schools.
Maximizing State Grant Competition Impact.--In the
reauthorization of the ESEA, Congress determined that 65
percent of the funding for charter schools should go to State
grants and, in doing so, expanded the use of funds to include
replication and expansion of high quality charter schools.
Funds should be used to support high-quality models along with
promising new charter schools to provide the best education
options for students. The Committee recommends that the
Secretary issue clarifying guidance to ensure States understand
the flexibility they have to use charter school funds to
support the growth of high-quality charter schools with a
demonstrated track record of academic achievement. Guidance
should clarify that States may look at how to meet strong
parent demand for new or replicated or expanded charter school
models when awarding subgrants. The Secretary should also make
every effort to help States improve authorizing by providing
guidance to States on utilizing the technical assistance funds.
Magnet Schools Assistance
The Committee recommends $105,000,000 for the Magnet
Schools Assistance program, which is the same as the fiscal
year 2018 enacted level and $7,353,000 above the fiscal year
2019 budget request. This program makes competitive grants to
support the establishment and operation of magnet schools that
are a part of a court-ordered or Federally-approved voluntary
desegregation plan.
Ready to Learn Programming
The Committee recommends $27,741,000 for Ready to Learn
Programming, which is the same as the fiscal year 2018 enacted
level and $27,741,000 above the fiscal year 2019 budget
request. This program supports the development and distribution
of educational video programming for preschool and elementary
school children and their parents, caregivers, and teachers.
Arts in Education
The Committee recommends $29,000,000 for Arts in Education,
which is the same as the fiscal year 2018 level and $29,000,000
above the fiscal year 2019 budget request. This program
provides competitive grants to support professional development
and the development of instructional materials and programming
that integrate the arts into the curricula.
Javits Gifted and Talented Education
The Committee recommends $12,000,000 for the Javits Gifted
and Talented Education Program, which is the same as the fiscal
year 2018 enacted level and $12,000,000 above the 2019 budget
request. This program makes grants and contracts to States,
schools districts, and other organizations to support a
coordinated program of research, demonstration projects,
innovative strategies, and other activities to help schools
identify gifted and talented students and address their unique
educational needs.
Statewide Family Engagement Centers
The Committee recommends $10,000,000 for Statewide Family
Engagement Center grants, which is the same as fiscal year 2018
and $10,000,000 above the 2019 budget request. This program
makes grants to organizations to provide technical assistance
and training to State and local educational agencies in the
implementation and enhancement of systemic and effective family
engagement policies, programs, and activities that lead to
improvements in student development and academic achievement.
SAFE SCHOOLS AND CITIZENSHIP EDUCATION
Appropriation, fiscal year 2018................ $185,754,000
Budget request, fiscal year 2019............... 43,000,000
Committee Recommendation....................... 185,754,000
Change from enacted level.................. - - -
Change from budget request................. +142,754,000
This appropriation account includes programs authorized
under parts of Title IV of the ESEA.
Promise Neighborhoods
The Committee recommends $78,254,000 for Promise
Neighborhoods, which is the same as the fiscal year 2018
enacted level and $78,254,000 above the fiscal year 2019 budget
request. Promise Neighborhoods supports grants to nonprofit,
community-based organizations for the development of
comprehensive neighborhood programs designed to combat the
effects of poverty and improve educational outcomes for
children and youth, from birth through college.
School Safety National Activities
The Committee recommends $90,000,000 for School Safety
National Activities, which is the same as the fiscal year 2018
enacted level and $47,000,000 above the fiscal year 2019 budget
request. The funding will support a new cohort of School
Climate Transformation Grants which will enable State or local
educational agencies to develop, adopt, or expand to more
schools, and support the implementation of evidence-based
practices to improve behavior and school climates. This cohort
of grants will be used to focus on some of the effects of the
opioid epidemic in schools. Funding could support evidence-
based strategies for prevention of opioid abuse by students, we
all as addressing the mental health needs of students adversely
impacted by opioid use in their family or community. The
Committee urges the Department to prioritize communities that
have experienced high levels of trauma due to the opioid
crisis, as described in the fiscal year 2019 budget request.
The Project School Emergency Response to Violence (Project
SERV) program provides counseling and referral to mental health
services as well as other education-related services to LEAs
and IHEs in which the learning environment has been disrupted
by a violent or traumatic crisis. The Committee directs the
Department to report to the Committee on Appropriations of the
House of Representatives and the Senate within 180 days of
enactment of this Act on how fiscal years 2017 and 2018 grant
recipients used Project SERV funds; recommendations from grant
recipients on how the program could be improved; and,
information on how these funds helped them recover from a
violent or traumatic crisis.
Full-Service Community Schools
The Committee recommends $17,500,000 for Full-Service
Community Schools, which is the same as the fiscal year 2018
level and $17,500,000 above the fiscal year 2019 budget
request. This program makes competitive grants to support
school-based comprehensive services for students, families, and
communities.
ENGLISH LANGUAGE ACQUISITION
Appropriation, fiscal year 2018....................... $737,400,000
Budget request, fiscal year 2019...................... 737,400,000
Committee Recommendation.............................. 737,400,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
Of this amount provided for the 2019-2020 academic year,
funds are appropriated for obligation on or after July 1, 2019
and available through September 30, 2020.
This program provides formula grants to States to serve
English learner (EL) students. Grants are based on each State's
share of the National EL, students and recent immigrant student
population. Funds under this account also support professional
development to increase the pool of teachers prepared to serve
EL students activities and the National Clearinghouse for
English Language Acquisition.
SPECIAL EDUCATION
Appropriation, fiscal year 2018....................... $13,366,184,000
Budget request, fiscal year 2019...................... 13,051,775,000
Committee Recommendation.............................. 13,422,651,000
Change from enacted level......................... +56,467,000
Change from budget request........................ +370,876,000
Of the total amount available, $3,709,465,000 is available
for obligation on July 1, 2019, and $9,483,383,000 is available
for obligation on October 1, 2019. These grants help States and
localities pay for a free appropriate education for 6.7 million
students with disabilities aged 3 through 21.
Grants to States
The Committee recommends $12,327,848,000 for Part B Grants
to States, which is $50,000,000 above the fiscal year 2018
enacted level and $325,000,000 above the fiscal year 2019
budget request. This program provides formula grants to assist
States in meeting the costs of providing special education and
related services to children with disabilities. States
generally transfer most of the funds to LEAs; however, they can
reserve some funds for program monitoring, technical
assistance, and other related activities. In order to be
eligible for funds, States must make free appropriate public
education available to all children with disabilities.
The Committee continues to include bill language excluding
any amount by which a State's allocation is reduced for failure
to meet the maintenance of effort threshold from being used to
calculate the State's allocation under section 611(d) of the
Individuals with Disabilities Education Act (IDEA) in
subsequent years. The Committee also continues to include bill
language directing the Secretary to distribute any reduction in
a State's allocation under said section to all other States
based on the formula established under section 611(d),
excluding those States that are penalized.
Preschool Grants
The Committee recommends $395,000,000 for Preschool Grants,
which is $13,880,000 above the fiscal year 2018 enacted level
and $26,762,000 above the fiscal year 2019 budget request.
These funds provide additional assistance to States to help
them make free, appropriate public education available to
children with disabilities ages 3 through 5.
Grants for Infants and Families
The Committee recommends $470,000,000 for Grants for
Infants and Families, which is the same as the fiscal year 2018
enacted level and $11,444,000 above the fiscal year 2019 budget
request. These funds provide additional assistance to States to
help them make free, appropriate public education available to
children with disabilities from birth through age 2. The
Committee notes the Department's focus on communicating to
States that this funding can be used to help address the needs
of the growing population of infants and toddlers that are
likely to require early intervention services due to substance
use disorders, including opioid use disorder, among parents and
families.
IDEA National Activities
The Committee recommends $229,803,000 for the IDEA National
Activities program, which is $7,413,000 below the fiscal year
2018 enacted level and $7,670,000 above the fiscal year 2019
budget request. The IDEA National Activities programs support
State efforts to improve early intervention and education
results for children with disabilities.
Educational Technology, Media, and Materials.--The
Committee recommends $28,047,000 for Educational Technology,
Media, and Materials, which is the same as both the fiscal year
2018 enacted level and the fiscal year 2019 budget request.
This program makes competitive awards to support the
development, demonstration, and use of technology and
educational media activities of educational value to children
with disabilities. The Committee recognizes the ongoing
progress made with the tools and services provided under this
program that have allowed more than 535,000 students with
disabilities free access to more than 600,000 books in
digitally accessible formats. The Committee strongly encourages
continued effort to expand this program's reach to K-12
students in underserved areas.
Parent Information Centers.--The Committee recommends
$27,411,000 for Parent Information Centers, which is the same
as both the fiscal year 2018 enacted level and the fiscal year
2019 budget request. This program makes awards to parent
organizations to support Parent Training and Information
Centers, including community parent resource centers. These
centers provide training and information to meet the needs of
parents of children with disabilities living in the areas
served by the centers, particularly underserved parents and
parents of children who may be inappropriately identified.
Technical assistance is also provided under this program for
developing, assisting, and coordinating centers receiving
assistance under this program.
Personnel Preparation.--The Committee recommends
$89,000,000 for Personnel Preparation, which is $5,300,000
above both the fiscal year 2018 enacted level and the fiscal
year 2019 budget request. This program supports competitive
awards to help address State-identified needs for qualified
personnel to work with children with disabilities, and to
ensure that those personnel have the necessary skills and
knowledge to serve children with special needs. Awards focus on
addressing the need for leadership and personnel to serve low-
incidence populations. Funds are included to fully support
continuation costs for grants made in prior years. The
Committee is concerned about a shortage of teachers of deaf
students and urges the Department to consider revisiting policy
changes it has made in recent years which may have exacerbated
this problem.
State Personnel Development.--The Committee recommends
$41,000,000 for State Personnel Development, which is
$2,370,000 above both the fiscal year 2018 enacted level and
the fiscal year 2019 budget request. This program supports
grants to States to assist with improving personnel preparation
and professional development related to early intervention and
educational and transition services that improve outcomes for
students with disabilities. Funds are included to fully support
continuation costs for grants made in prior years.
Technical Assistance and Dissemination.--The Committee
recommends $44,345,000 for Technical Assistance and
Dissemination, which is $15,083,000 below the fiscal year 2018
enacted level and the same as the fiscal year 2019 budget
request. This program provides funding for technical
assistance, demonstration projects, and information
dissemination. These funds support efforts by State and local
educational agencies, IHEs, and other entities to build State
and local capacity to make systemic changes and improve results
for children with disabilities. Funds are included to fully
support continuation costs for grants made in prior years.
REHABILITATION SERVICES
Appropriation, fiscal year 2018................ $3,587,130,000
Budget request, fiscal year 2019............... 3,634,977,000
Committee Recommendation....................... 3,657,689,000
Change from enacted level.................. +70,559,000
Change from budget request................. +22,712,000
The programs in this account are authorized by the
Rehabilitation Act of 1973 and the Helen Keller National Center
Act.
The Achieving a Better Live Experience Act of 2014 or ABLE
Act (PL 113-295) allows individuals and families to save for
the purpose of supporting individuals with disabilities in
maintaining their health, independence, and quality of life.
The Committee strongly encourages the Department, through its
programs supporting individuals living with a disability, to
raise awareness on the eligibility and benefits of these
accounts.
Vocational Rehabilitation State Grants
The Committee recommends $3,521,990,000 for Vocational
Rehabilitation (VR) State Grants, which is $69,059,000 above
the fiscal year 2018 enacted level and the same as the fiscal
year 2019 budget request.
This program supports basic vocational rehabilitation
services through formula grants to States. These grants support
a wide range of services designed to help persons with physical
and mental disabilities prepare for and engage in gainful
employment to the extent of their capabilities. Emphasis is
placed on providing vocational rehabilitation services to
persons with the most significant disabilities. The Committee's
recommendation provides the cost-of-living adjustment for
Vocational Rehabilitation Grants to States, as authorized.
The Committee is concerned with inconsistencies that have
resulted from the Department of Education's final rule and
regulations to implement the Workforce Innovation and
Opportunity Act as it relates to State VR programs. The
Committee is aware of reports of inconsistent implementation of
this regulation by State vocational rehabilitation agencies and
their work with non-profits within the AbilityOne Program and
State use programs.
The Committee encourages the Rehabilitation Services
Administration to issue updated guidance to state vocational
rehabilitation agencies that would (1) require them to give
full consideration to all employment opportunities at
AbilityOne and State use providers, and make determinations on
a case-by-case basis with an emphasis on the quality of the job
placement (i.e. more work hours, benefit eligible and overall
compensation), and (2) honor a client's informed choice to work
with AbilityOne and State use providers.
Additionally, the Committee encourages the Rehabilitation
Services Administration to restore the uncompensated outcomes
category (Homemaker Exemption), which would allow individuals
experiencing vision loss to have the opportunity to learn
important life skills and be given the opportunity to regain
personal confidence and achieve independence prior to making
any decisions about reentering the workforce.
Client Assistance State Grants
The Committee recommends $13,000,000 for Client Assistance
State Grants, which is the same as both the fiscal year 2018
enacted level the fiscal year 2019 budget request. Client
Assistance State Grants support services for eligible
individuals and applicants of the VR State Grants program, and
other programs, projects, and services funded under the
Rehabilitation Act. These formula grants are used to help
persons with disabilities overcome problems with the service
delivery system and improve their understanding of services
available to them under the Rehabilitation Act.
Training
The Committee recommends $29,388,000 for the Training
program, which is the same as both the fiscal year 2018 enacted
level and the fiscal year 2019 budget request. The program
supports long-term and short-term training, in-service
personnel training, and training of interpreters for deaf
persons. Projects in a broad array of disciplines are funded to
ensure that skilled personnel are available to serve the
vocational needs of persons with disabilities. Funds are
included to fully support continuation costs for grants made in
prior years.
Demonstration and Training Programs
The Committee recommends $5,796,000 for Demonstration and
Training Programs, which is the same as the fiscal year 2018
enacted level and $3,500,000 below the fiscal year 2019 budget
request. These programs authorize competitive grants to public
and private organizations to support demonstrations, direct
services, and related activities for persons with disabilities.
Protection and Advocacy of Individual Rights
The Committee recommends $17,650,000 for Protection and
Advocacy of Individual Rights, which is the same as both the
fiscal year 2018 enacted level and the fiscal year 2019 budget
request. Grants are awarded to entities that have the authority
to pursue legal, administrative, and other appropriate remedies
to protect and advocate for the rights of persons with
disabilities.
Supported Employment State Grants
The Committee recommends $22,548,000 for Supported
Employment State Grants, which is the same as the fiscal year
2018 enacted level and $22,548,000 above the fiscal year 2019
budget request. These formula grants assist States in
developing collaborative programs with public agencies and
nonprofit agencies for training and post-employment services
leading to supported employment. In supported employment
programs, persons with the most significant disabilities are
given special supervision and assistance to enable them to work
in an integrated setting.
Independent Living Services for Older Individuals Who Are Blind
The Committee recommends $33,317,000 for Independent Living
Services for Older Individuals Who Are Blind, which is the same
as both the fiscal year 2018 enacted level and the fiscal year
2019 budget request. Funds are distributed to States according
to a formula based on the population of individuals who are 55
or older, and provide support for services to persons 55 years
old or over whose severe visual impairment makes gainful
employment extremely difficult to obtain, but for whom
independent living goals are feasible.
Helen Keller National Center
The Committee recommends $14,000,000 for the Helen Keller
National Center for Deaf-Blind Youth and Adults, which is
$1,500,000 above the fiscal year 2018 enacted level and
$3,664,000 above the fiscal year 2019 budget request. These
funds are used for the operation of a national center that
provides intensive services for deaf-blind individuals and
their families at Sands Point, New York, and a network of ten
regional offices that provide referral, counseling, transition
services, and technical assistance to service providers.
SPECIAL INSTITUTIONS FOR PERSONS WITH DISABILITIES
Appropriation, fiscal year 2018....................... $228,431,000
Budget request, fiscal year 2019...................... 216,722,000
Committee Recommendation.............................. 237,792,000
Change from enacted level......................... +9,361,000
Change from budget request........................ +21,070,000
The Committee recommends $237,792,000 for Special
Institutions for Persons with Disabilities, which is $9,361,000
above the fiscal year 2018 enacted level and $21,070,000 above
the fiscal year 2019 budget request.
The Achieving a Better Live Experience Act of 2014 or ABLE
Act (PL 113-295) allows individuals and families to save for
the purpose of supporting individuals with disabilities in
maintaining their health, independence, and quality of life.
The Committee strongly encourages these Special Institutions,
through its programs supporting individuals living with a
disability, to raise awareness on the eligibility and benefits
of these accounts.
AMERICAN PRINTING HOUSE FOR THE BLIND
Appropriation, fiscal year 2018....................... $27,431,000
Budget request, fiscal year 2019...................... 25,431,000
Committee Recommendation.............................. 28,431,000
Change from enacted level......................... +1,000,000
Change from budget request........................ +3,000,000
This funding subsidizes the production of educational
materials for legally blind persons enrolled in pre-college
programs. The American Printing House for the Blind (Printing
House), which is chartered by the Commonwealth of Kentucky,
manufactures and maintains an inventory of educational
materials in accessible formats that are distributed free of
charge to schools and States based on the number of blind
students in each State. The Printing House also conducts
research and field activities to inform educators about the
availability of materials and how to use them.
NATIONAL TECHNICAL INSTITUTE FOR THE DEAF
Appropriation, fiscal year 2018....................... $73,000,000
Budget request, fiscal year 2019...................... 70,016,000
Committee Recommendation.............................. 75,000,000
Change from enacted level......................... +2,000,000
Change from budget request........................ +4,984,000
Congress established the National Technical Institute for
the Deaf (Institute) in 1965 to provide a residential facility
for postsecondary technical training and education for deaf
persons with the purpose of promoting the employment of these
individuals. The Institute also conducts applied research and
provides training related to various aspects of deafness. The
Secretary of Education administers these activities through a
contract with the Rochester Institute of Technology in
Rochester, New York.
GALLAUDET UNIVERSITY
Appropriation, fiscal year 2018....................... $128,000,000
Budget request, fiscal year 2019...................... 121,275,000
Committee Recommendation.............................. 134,361,000
Change from enacted level......................... +6,361,000
Change from budget request........................ +13,086,000
Gallaudet is a private, non-profit educational institution
Federally chartered in 1864 providing elementary, secondary,
undergraduate, and continuing education for deaf persons. In
addition, the University offers graduate programs in fields
related to deafness for deaf and hearing students, conducts
research on deafness, and provides public service programs for
deaf persons.
CAREER, TECHNICAL, AND ADULT EDUCATION
Appropriation, fiscal year 2018....................... $1,830,686,000
Budget request, fiscal year 2019...................... 1,637,159,000
Committee Recommendation.............................. 1,945,265,000
Change from enacted level......................... +114,579,000
Change from budget request........................ +308,106,000
This account includes vocational education programs
authorized by the Carl D. Perkins Career and Technical
Education Act of 2006 and the Adult Education and Family
Literacy Act (AEFLA).
Career and Technical Education: State Grants
The Committee recommends $1,294,598,000 for Career and
Technical Education: State Grants, which is $102,000,000 above
the fiscal year 2018 enacted level and $177,000,000 above the
fiscal year 2019 budget request. Funds are made available for
obligation on October 1, 2019.
State Grants support a variety of career and technical
education programs developed in accordance with the State plan.
This program focuses Federal resources on institutions with
high concentrations of low-income students. The populations
assisted by State Grants range from secondary students in pre-
vocational courses to adults who need retraining to adapt to
changing technological and labor markets. Funding for State
Grants will continue support for state-of-the art career and
technical training to approximately 6 million students in
secondary schools and more than 4 million students in community
and technical colleges.
National Programs
The Committee recommends $20,000,000 for National Programs,
which is $12,579,000 above the fiscal year 2018 enacted level
and the same as the fiscal year 2019 budget request. This
authority supports the conduct and dissemination of research in
career and technical education. It also includes support for
the National Centers for Research and Dissemination in Career
and Technical Education and other discretionary research. The
funding will support a competition to promote innovation and
reform in STEM education, including computer science. Coupled
with dedicated funding in the Education Innovation and Research
account, this increase will help support the Administration's
commitment to STEM education.
Adult Basic and Literacy Education State Grants
The Committee recommends $616,955,000 for Adult Basic and
Literacy Education State Grants, which is the same as the
fiscal year 2018 enacted level and $131,106,000 above the
fiscal year 2019 budget request. State formula grants,
authorized under the AEFLA, support programs to enable all
adults to acquire basic literacy skills, to enable those who so
desire to complete secondary education, and to make available
to adults the means to become more employable, productive, and
responsible citizens.
Adult Education National Leadership Activities
The Committee recommends $13,712,000 for National
Leadership Activities, which is the same as both the fiscal
year 2018 enacted level the fiscal year 2019 budget request.
This program supports applied research, development,
dissemination, evaluation, and program improvement efforts to
strengthen the quality of adult education services.
STUDENT FINANCIAL ASSISTANCE
Appropriation, fiscal year 2018....................... $24,445,352,000
Budget request, fiscal year 2019...................... 22,975,352,000
Committee Recommendation.............................. 24,445,352,000
Change from enacted level......................... - - -
Change from budget request........................ +1,470,000,000
Financial Supports for Students.--The Committee recognizes
that financial pressures are among the reasons why students are
unable to complete postsecondary education programs, especially
for low-income and non-traditional students. The Committee
requests the Department to provide a briefing within 180 days
of enactment of this Act on what financial supports have the
greatest impact on student persistence and completion. The
Department should consider students enrolled in career and
technical education programs, community colleges, and four-year
baccalaureate programs in developing this analysis.
Pell Grants
The Committee recommends $22,475,352,000 for the Pell Grant
program, which is the same as both the fiscal year 2018 enacted
level and the fiscal year 2019 budget request. These funds will
support Pell grants to students for the 2019-2020 academic
year.
The Congressional Budget Office estimates that the budget
authority provided in this bill is sufficient to maintain the
discretionary portion of the maximum Pell Grant award at
$5,035. Combined with mandatory funding streams, the maximum
Pell Grant in 2019-2020 will be maintained at $6,095.
Pell Grants help to ensure access to higher educational
opportunities for low- and middle-income students by providing
need-based financial assistance. Grants are determined
according to a statutory formula, which considers income,
assets, household size, and the number of family members in
college, among other factors. Pell Grants are the foundation of
Federal postsecondary student aid programs.
The Committee recommends that the Department take further
steps to promote year-round Pell, in accordance with the Higher
Education Opportunity Act of 2008 (PL 110-315), to help
students to remain continuously enrolled and stay on track for
graduation.
Federal Supplemental Educational Opportunity Grants
The Committee recommends $840,000,000 for this program,
which is the same as the fiscal year 2018 enacted level and
$840,000,000 above the fiscal year 2019 budget request.
Supplemental Educational Opportunity Grants (SEOG) provide
funds to postsecondary institutions for need-based grants of up
to $4,000 to undergraduate students, with priority given to
students who are Pell-eligible. Approximately 68 percent of
dependent recipients have annual family incomes under $30,000
and nearly 74 percent of independent SEOG recipients have
annual family incomes under $20,000. Institutions must
contribute a 25 percent match toward their SEOG allocation.
Federal Work-Study
The Committee recommends $1,130,000,000 for the Federal
Work-Study program, which is the same as the fiscal year 2018
enacted level and $630,000,000 above the fiscal year 2019
budget request. Federal Work-Study funds are provided through
institutions to students who work part-time. The funds assist
with paying for the cost of education. Approximately 3,200
colleges and universities receive funding, according to a
statutory formula, and may allocate it for job location and job
development centers. Work-study jobs must pay at least the
Federal minimum wage and institutions must provide 25 percent
of student earnings.
Within the total funding level for the Federal Work-Study
program, the Committee recommends $9,625,000 for the Work
Colleges program, which is the same as the fiscal year 2018
enacted level. The Work Colleges program is authorized under
section 448 of the Higher Education Act (HEA) and supports
institutions that require all resident students to participate
in a work-learning program.
STUDENT AID ADMINISTRATION
Appropriation, fiscal year 2018....................... $1,678,943,000
Budget request, fiscal year 2019...................... 1,772,000,000
Committee Recommendation.............................. 1,678,943,000
Change from enacted level......................... - - -
Change from budget request........................ -93,057,000
Programs administered under the Student Aid Administration
(SAA) include Pell Grants, campus-based programs, Teacher
Education Assistance for College and Higher Education grants,
and Federal student loan programs.
Salaries and Expenses.--Within the total provided for SAA,
the Committee recommends $698,943,000 for salaries and
expenses, which is the same as the fiscal year 2018 enacted
level and $63,057,000 below the fiscal year 2019 request.
Loan Servicing Activities.--Within the total provided for
SAA, the Committee recommends $980,000,000 for Loan Servicing
Activities, which is the same as the fiscal year 2018 enacted
level and $30,000,000 below the fiscal year 2019 request.
Small Business Credit.--The Committee directs the Small
Business Administration to provide subcontracting small
business credit under Department of Education Title IV program
contracts where the prime contractors' award subcontracts to
small businesses as well as to qualified State or nonprofit
entities with expertise in assisting students and borrowers in
support of Title IV programs. Under this authority,
subcontracts awarded to such entities may be counted toward the
prime contractor's small business subcontracting goals as
established through subcontracting plans required by 15 U.S.C.
637(d). The Small Business Administration may provide this
small business credit for the duration of the contracts
currently in effect for servicing or collection of student
loans and for any contracts awarded for support of Title IV
programs for a period of five years following publication of
this report. Such State or nonprofit entities must meet the
size standard for the North American Industry Classification
System determined by the Contracting Officer to be appropriate
for the contract.
The Department shall coordinate the identification of all
prime and subcontracts awarded to State and nonprofit entities
under Title IV program contracts to the Small Business
Administration so that subcontract reporting may be
appropriately monitored. Five years after publication of this
report, the Small Business Administration, in coordination with
the Department of Education, shall examine the impact of this
provision to small businesses in Title IV programs.
Defaulted Student Loan Debt Collection.--The Committee
understands the Department is continuing to consider options
for the collection of debt from defaulted student loan
borrowers. In considering any new contract award for debt
collection services, the Committee encourages the Secretary to
allocate new defaulted student loan borrower accounts to
private collection agencies on the basis of their performance
compared to all private collection agencies utilizing common
performance and compliance metrics and the capacity of each
contractor to process new and existing accounts. The Committee
also encourages the Secretary to share the common performance
and compliance metrics with the Committees on Appropriations of
the House of Representatives and the Senate, as well as
authorizing Committees of jurisdiction, and report quarterly to
such Committees on all contractor performance concerning these
metrics.
Free Application for Federal Student Aid.--The Committee
encourages the Secretary of Education to translate the Free
Application for Federal Student Aid into additional foreign
languages and to make the translated forms available to
applicants and their parents in paper and electronic formats.
HIGHER EDUCATION
Appropriation, fiscal year 2018....................... $2,246,551,000
Budget request, fiscal year 2019...................... 1,485,848,000
Committee Recommendation.............................. 2,300,551,000
Change from enacted level......................... +54,000,000
Change from budget request........................ +814,703,000
Strengthening Institutions
The Committee recommends $98,886,000 for the Part A,
Strengthening Institutions program, which is the same as the
fiscal year 2018 enacted level and $98,886,000 above the fiscal
year 2019 budget request. This program provides competitive
grants for general operating subsidies to institutions with low
average educational and general expenditures per student and
significant percentages of low-income students. Funds may be
used for faculty and academic program development, management,
joint use of libraries and laboratories, acquisition of
equipment, and student services.
Strengthening Hispanic-Serving Institutions
The Committee recommends $123,183,000 for the Hispanic-
Serving Institutions program, which is the same as the fiscal
year 2018 enacted level and $123,183,000 above the fiscal year
2019 budget request. The Hispanic-Serving Institutions program
provides operating subsidies to schools that serve at least 25
percent Hispanic students. Funds may be used for faculty and
academic program development, management, joint use of
libraries and laboratories, acquisition of equipment, and
student services.
Promoting Postbaccalaureate Opportunities for Hispanic Americans
The Committee recommends $11,052,000 for the Promoting
Postbaccalaureate Opportunities for Hispanic Americans program,
which is the same as the fiscal year 2018 enacted level and
$11,052,000 above the fiscal year 2019 budget request. This
program provides expanded postbaccalaureate educational
opportunities for the academic attainment of Hispanic and low-
income students. In addition, it expands academic offerings and
enhances program quality at IHEs educating the majority of
Hispanic college students.
Strengthening Historically Black Colleges and Universities
The Committee recommends $279,624,000 for Strengthening
Historically Black Colleges and Universities (HBCUs), which is
the same as the fiscal year 2018 enacted level and $34,930,000
above the fiscal year 2019 budget request. This program
provides operating subsidies to accredited, historically black
colleges and universities that were established prior to 1964,
with the principal mission of educating black Americans. Funds
are distributed through a formula grant based on the enrollment
of Pell Grant recipients, number of graduates, and the number
of graduates entering graduate or professional schools in which
blacks are underrepresented.
Strengthening Historically Black Graduate Institutions
The Committee recommends $72,314,000 for the Strengthening
Historically Black Graduate Institutions program, which is the
same as the fiscal year 2018 enacted level and $9,033,000 above
the fiscal year 2019 budget request. The program provides five-
year grants to 18 postsecondary institutions that are specified
in section 326(e)(1) of the Higher Education Act. Institutions
may use funds to build endowments, provide scholarships and
fellowships, and to assist students with the enrollment and
completion of postbaccalaureate and professional degrees.
Strengthening Predominantly Black Institutions
The Committee recommends $11,361,000 for the Strengthening
Predominantly Black Institutions (PBIs) program, which is the
same as the fiscal year 2018 enacted level and $11,361,000
above the fiscal year 2019 budget request. This program
provides grants to PBIs to increase their capacity to serve the
academic needs of students.
Strengthening Asian American and Native American
Pacific-Islander-Serving Institutions
The Committee recommends $3,826,000 for the Asian American
Pacific Islander program, which is the same as the fiscal year
2018 enacted level and $3,826,000 above the fiscal year 2019
budget request. This program provides grants to undergraduate
institutions that have an undergraduate student enrollment of
at least 10 percent Asian American or Native American Pacific
Islander.
Strengthening Alaska Native and Native Hawaiian-Serving
Institutions
The Committee recommends $15,772,000 for the Strengthening
Alaska Native and Native Hawaiian-Serving Institutions program,
which is the same as the fiscal year 2018 enacted level and
$15,772,000 above the fiscal year 2019 budget request, to
provide competitive grants to improve capacity to serve Alaska
Native and Native Hawaiian students.
Native American Serving Non-Tribal Institutions
The Committee recommends $3,826,000 for the Native American
Serving Non-Tribal Institutions program, which is the same as
the fiscal year 2018 enacted level and $3,826,000 above the
fiscal year 2019 budget request. This program makes grants to
IHEs at which enrollment is at least 10 percent Native American
students and that are not Tribally-Controlled Colleges or
Universities.
Strengthening Tribally Controlled Colleges and Universities
The Committee recommends $31,539,000 for the Strengthening
Tribally Controlled Colleges and Universities (TCCUs) program,
which is the same as the fiscal year 2018 enacted level and
$3,940,000 above the fiscal year 2019 budget request. This
program makes grants to TCCUs to increase their capacity to
serve the academic needs of students.
Strengthening HBCU Masters Programs
The Committee recommends $8,571,000 for the Strengthening
HBCU Masters Programs, which is the same as the fiscal year
2018 enacted level and $1,071,000 above the fiscal year 2019
budget request. This program provides grants to specified
colleges and universities making a substantial contribution to
graduate education opportunities at the masters level in
mathematics, engineering, the physical or natural sciences,
computer science, information technology, nursing, allied
health, or other scientific disciplines.
The Committee does not support the budget proposal to shift
to a Consolidated MSI grant program and does not appropriate
funds for such a program.
International Education and Foreign Language Studies
Domestic Programs.--The Committee recommends $65,103,000
for the Domestic Programs of the International Education and
Foreign Languages Studies program, which is the same as the
fiscal year 2018 enacted level and $65,103,000 above the fiscal
year 2019 budget request. Authorized by title VI of the Higher
Education Act, these programs include National resource
centers, foreign language and area studies fellowships,
undergraduate international studies and foreign language
programs, international research and studies projects, business
and international education projects, international business
education centers, language resource centers, American overseas
research centers, and technological innovation and cooperation
for foreign information access.
Overseas Programs.--The Committee recommends $7,061,000 for
the Overseas Programs, which is the same as the fiscal year
2018 enacted level and $7,061,000 above the fiscal year 2019
budget request. Funding for these programs support group
projects, faculty research, special bilateral research, and
doctoral dissertation research conducted abroad.
Postsecondary Programs for Students with Intellectual Disabilities
The Committee recommends $11,800,000 for Postsecondary
Programs for Students with Intellectual Disabilities, which is
the same as both the fiscal year 2018 level and the fiscal year
2019 budget request. This program supports grants to create
model transition programs into higher education for students
with intellectual disabilities.
Minority Science and Engineering Improvement
The Committee recommends $11,025,000 for the Minority
Science and Engineering Improvement Program, which is the same
as the fiscal year 2018 enacted level and $1,377,000 above the
fiscal year 2019 budget request. This program awards grants to
improve mathematics, science, and engineering programs at
institutions serving primarily minority students and to
increase the number of minority students who pursue advanced
degrees and careers in those fields.
Tribally Controlled Postsecondary Career and Technical
Institutions
The Committee recommends $9,469,000 for this program, which
is the same as the fiscal year 2018 enacted level and
$1,183,000 above the fiscal year 2019 budget request. This
program provides competitive grants to Tribally controlled
postsecondary career and technical institutions to provide
career and technical education to Native American students.
Federal TRIO Programs
The Committee recommends $1,060,000,000 for TRIO programs,
which is $50,000,000 above the fiscal year 2018 enacted level
and $110,000,000 above the fiscal year 2019 budget request. The
TRIO programs provide a variety of outreach and support
services to encourage low-income, often first-generation
college students to enter and complete college. Discretionary
grants of up to four or five years are awarded competitively to
IHEs and other nonprofit organizations. At least two thirds of
the eligible participants in TRIO must be low-income, first-
generation college students.
The Committee rejects the proposal to move from competitive
grant programs to a single State formula program. The
Department was unable to provide any information on the details
of how the formula grant would be implemented or how
accountability for performance would be maintained.
The Committeee is concerned with the Department's planned
allocation of the $60,000,000 increase provided in fiscal year
2018 for TRIO, especially given language in the House report
which specified the funding should be allocated as it was in
fiscal year 2017. The Committee expects funding allocations
such as these to be included in the Department's operating plan
in future fiscal years.
Gaining Early Awareness and Readiness for Undergraduate
Programs
The Committee recommends $360,000,000 for Gaining Early
Awareness and Readiness for Undergraduate Programs (GEAR UP),
which is $10,000,000 above the fiscal year 2018 enacted level
and $360,000,000 above the fiscal year 2019 budget request.
GEAR UP provides grants to States and partnerships of low-
income middle and high schools, IHEs, and community
organizations to target entire grades of students and give them
the skills, encouragement, and scholarships to pursue
successfully postsecondary education.
The Committee rejects the proposal to consolidate GEAR UP
activities into a new formula funded State TRIO program. The
Committee continues bill language allowing the Department to
maintain the GEAR UP evaluation set-aside at 1.5 percent to
work with the GEAR UP community and grantees to standardize
data collection, including through the use of third-party data
systems.
Graduate Assistance in Areas of National Need
The Committee recommends $23,047,000 for the Graduate
Assistance in Areas of National Need (GAANN) program, which is
the same as the fiscal year 2018 enacted level and $23,047,000
above the fiscal year 2019 budget request. GAANN provides
fellowships through grants to degree granting postsecondary
institutions, for students of high financial need studying in
areas of national need. The Department consults with
appropriate other agencies and organizations to designate the
fields of study ``in areas of national need''. Recent examples
include computer and informational sciences, engineering,
nursing, and physics.
Teacher Quality Partnership Grants
The Committee recommends $43,092,000 for the Teacher
Quality Partnerships (TQP) program, which is the same as the
fiscal year 2018 enacted level and $43,092,000 above the fiscal
year 2019 budget request. The TQP program helps improve the
quality of teachers working in high-need schools and early
childhood education programs by creating model teacher
preparation and residency programs.
Child Care Access Means Parents in School
The Committee recommends $50,000,000 for the Child Care
Access Means Parents in School program, which is the same as
the fiscal year 2018 enacted level and $34,866,000 above the
fiscal year 2019 budget request. This program makes competitive
grants to colleges and universities to support or establish a
campus-based childcare program primarily serving the needs of
low-income students enrolled at the institution.
HOWARD UNIVERSITY
Appropriation, fiscal year 2018....................... $232,518,000
Budget request, fiscal year 2019...................... 221,821,000
Committee Recommendation.............................. 232,518,000
Change from enacted level......................... - - -
Change from budget request........................ +10,697,000
Howard University is a ``Research I'' university located in
the District of Columbia. Howard University provides
undergraduate liberal arts, graduate and professional
instruction to over 10,000 students from all 50 States.
Within the amount provided, the Committee recommends
$27,325,000 for the Howard University Hospital, which is the
same as both the fiscal year 2018 enacted level and $10,697,000
above the fiscal year 2019 budget request. The hospital serves
as a major acute and ambulatory care center for the District of
Columbia, and functions as a teaching facility.
COLLEGE HOUSING AND ACADEMIC FACILITIES LOANS PROGRAM
Appropriation, fiscal year 2018....................... $435,000
Budget request, fiscal year 2019...................... 448,000
Committee Recommendation.............................. 448,000
Change from enacted level......................... 13,000
Change from budget request........................ - - -
Previously, these programs helped to ensure that
postsecondary institutions were able to make necessary capital
improvements to maintain and increase their ability to provide
a high-quality education. Since 1994, no new loans have been
made, and the Department's role has been to manage the
outstanding loans.
HISTORICALLY BLACK COLLEGE AND UNIVERSITY CAPITAL FINANCING PROGRAM
ACCOUNT
Appropriation, fiscal year 2018....................... $30,484,000
Budget request, fiscal year 2019...................... 20,489,000
Committee Recommendation.............................. 30,489,000
Change from enacted level......................... +5,000
Change from budget request........................ +10,000,000
The Committee recommends $30,489,000 for the HBCU Capital
Financing program, which is $5,000 above the fiscal year 2018
enacted level and $10,000,000 above the fiscal year 2019 budget
request. Funds are available through September 30, 2019. This
program is authorized under part D of Title III of the HEA and
makes capital available for repair and renovation of facilities
at historically black colleges and universities. In exceptional
circumstances, capital provided under the program can be used
for construction or acquisition of facilities.
Within the total provided for this program, the Committee
recommendation includes $339,000 for the administrative
expenses to carry out the program and $20,150,000 for loan
subsidy costs that will be sufficient to guarantee up to
$580,000,000 in new loans in fiscal year 2019. Funds will also
be used to continue technical assistance services to help HBCUs
improve their financial stability and access to capital
markets.
INSTITUTE OF EDUCATION SCIENCES
Appropriation, fiscal year 2018....................... $613,462,000
Budget request, fiscal year 2019...................... 521,563,000
Committee Recommendation.............................. 613,462,000
Change from enacted level......................... - - -
Change from budget request........................ +91,899,000
This account supports education research, statistics,
dissemination, evaluation, and assessment activities.
The Committee rejects the budget request to eliminate the
Regional Education Laboratories and Statewide Longitudinal Data
Systems.
Research, Development, and Dissemination
The Committee recommends $192,695,000 for Research,
Development, and Dissemination, which is the same as the fiscal
year 2018 enacted level and $5,195,000 above the fiscal year
2019 budget request. This budget account supports research,
development, and National dissemination activities that are
aimed at expanding fundamental knowledge of education and
promoting the use of research and development findings in the
design of efforts to improve education.
Statistics
The Committee recommends $109,500,000 for the activities of
the National Center for Education Statistics (NCES), which is
the same as fiscal year 2018 enacted level and $3,000,000 below
the fiscal year 2019 budget request. Statistics activities are
authorized under title I of the Education Sciences Reform Act
of 2002. The Center collects, analyzes, and reports statistics
on all levels of education in the United States. Activities are
carried out directly and through grants and contracts and
include projections of enrollments, teacher supply and demand,
and educational expenditures. NCES also provides technical
assistance to State and local educational agencies and
postsecondary institutions.
Data for Puerto Rico.--The Committee recommends that NCES
collect and publish data for Puerto Rico in the same manner it
collects and publishes data for States.
Regional Educational Laboratories
The Committee recommends $55,423,000 for Regional
Educational Laboratories, which is the same as the fiscal year
2018 enacted level and $55,423,000 above the fiscal year 2019
budget request. This program supports a network of ten
laboratories that promote the use and development of knowledge
and evidence to increase student learning and further school
improvement efforts. Funds are included to support fully
continuation costs for grants made in prior years.
Research in Special Education
The Committee recommends $56,000,000 for Research in
Special Education, which is the same as the fiscal year 2018
enacted level and $2,000,000 above the fiscal year 2019 budget
request. This program supports competitive awards to produce
and advance the use of knowledge to improve services and
results for children with disabilities. The program focuses on
producing new knowledge, integrating research and practice, and
improving the use of knowledge.
Special Education Studies and Evaluations
The Committee recommends $10,818,000 for Special Education
Studies and Evaluations, which is the same as both the fiscal
year 2018 enacted level and the fiscal year 2019 budget
request. This program awards competitive grants, contracts and
cooperative agreements to assess the implementation of the IDEA
and the effectiveness of State and local efforts to provide
special education and early intervention programs and services
to infants, toddlers, and children with disabilities.
Statewide Data Systems
The Committee recommends $32,281,000 for Statewide Data
Systems, which is the same as the fiscal year 2018 enacted
level and $32,281,000 above the fiscal year 2019 budget
request. Competitive grants under this authority are made to
SEAs to help them manage, analyze, disaggregate and use student
data consistent with the ESEA.
Assessment
The Committee recommends $156,745,000 for Assessment, which
is the same as both the fiscal year 2018 enacted level and the
fiscal year 2019 budget request. This amount includes
$7,745,000 for the National Assessment Governing Board (NAGB),
which is the same as both the fiscal year 2018 enacted level
and the fiscal year 2019 budget request.
The National Assessment of Educational Progress (NAEP) is
the only nationally representative and continuing survey of
educational ability and achievement of American students. The
primary goal of the assessment is to determine and report the
status and trends of the knowledge and skills of students,
subject by subject. Subject areas assessed in the past have
included reading, writing, mathematics, science, history,
citizenship, literature, art, and music. The NAEP is operated
by contractors through competitive awards made by the NCES. The
NAGB formulates the policy guidelines for the program.
DEPARTMENTAL MANAGEMENT
Appropriation, fiscal year 2018....................... $608,143,000
Budget request, fiscal year 2019...................... 630,113,000
Committee Recommendation.............................. 610,649,000
Change from enacted level......................... +2,506,000
Change from budget request........................ -19,464,000
These activities are authorized by the Department of
Education Organization Act (PL 96-88) and include costs
associated with the management and operation of the Department
as well as separate costs associated with the Office for Civil
Rights and the Office of Inspector General.
Program Administration
The Committee recommends $432,506,000 for Program
Administration, which is $2,506,000 above the fiscal year 2018
enacted level and the same as the fiscal year 2019 budget
request. These funds support the staff and other costs of
administering programs and activities at the Department. Items
include personnel compensation, health, retirement, and other
benefits as well as travel, rent, telephones, utilities,
postage fees, data processing, printing, equipment, supplies,
technology training, consultants, and other contractual
services.
Developing Tomorrow's Engineering and Technical
Workforce.--The Committee recognizes the widespread interest in
improving STEM education in elementary and secondary schools.
Among the STEM topics, there is a relative small focus on
engineering education and lack of a critical mass of teachers
qualified to deliver engineering instruction. However,
engineering is important in its application of scientific and
mathematical principles to innovation, analysis, design,
evaluation, and manufacture of machines, processes, and
systems. Therefore, the Committee encourages the expansion of
engineering initiatives to support, develop, and implement
formal and informal engineering education programs in
elementary schools and secondary schools through public-private
partnerships.
Education Costs Related to Illegal Immigration.--The
Committee requests an update to the report submitted to
Congress by the Department of Education on this topic as it
appeared in the explanatory statement accompanying division H
of the Consolidated Appropriations Act, 2016 (PL 114-113).
English Learners.--The Committee requests the Department
include information on the effectiveness of English Learner
(EL) programs in delivering adequate services and
accommodations to qualified students, disaggregated to the
extent possible by EL subgroups, in the fiscal year 2020
Congressional Justification.
Skills Development in Critical Thinking.--The Committee
notes the growing trend of the public receiving information in
digital formats and the subsequent need for students to be able
to develop critical thinking and fact-finding skills. The
Committee directs the Department to provide a briefing within
180 days of enactment of this Act on efforts to support
students' ability to assess media information critically and
develop civic knowledge. This could include developing critical
thinking skills, news literacy, investigative journalism, and
improved digital literacy. In addition, the Department should
be prepared to report on how a rigorous program of evaluation
could assess effectiveness of proposed methods.
Social and Emotional Learning Education.--The Committee
notes interest in Social and Emotional Learning (SEL) programs
and urges more support for evidence-based programs that promote
positive youth development that unites the home, school, and
community to cultivate capable and healthy young people of
strong character through the Department of Education's Office
of Elementary and Secondary Education and the Office of Safe
and Healthy Students as well as other programs that support
school counseling. The Committee notes that high-quality SEL
instruction improves academic performance, increases the
resistance factors that lead to the prevention of drug and
alcohol use, and creates stronger connections to the school and
community.
Transparency on Foreign Source Organizations.--The
Committee is concerned by the potential lack of transparency of
certain foreign source organizations on institutions of higher
education, particularly in circumstances where the laws and
customs of the foreign source do not respect the principles of
free expression and openness that may lead to censorship and
other threats to academic freedom. For that reason, the
Committee encourages institutions of higher learning to
increase the transparency of agreements entered into with
foreign source organizations. To ensure greater transparency
regarding the presence of, and contractual relationship
between, a foreign source organization and a Federally funded
institution of higher education, the Committee encourages the
Secretary to require institutions of higher education to file a
disclosure report with the Department of any contractual
agreements with foreign source organizations that do not
respect the principles of free expression and openness. Such
contracts should be made available to the public.
OFFICE FOR CIVIL RIGHTS
Appropriation, fiscal year 2018....................... $117,000,000
Budget request, fiscal year 2019...................... 107,438,000
Committee Recommendation.............................. 117,000,000
Change from enacted level......................... - - -
Change from budget request........................ +9,562,000
The Office for Civil Rights (OCR) is responsible for
enforcing laws that prohibit discrimination on the basis of
race, color, national origin, sex, disability, and age in all
programs and institutions that receive funds from the
Department. These laws extend to 50 State educational agencies,
18,200 LEAs, and nearly 7,200 IHEs, including proprietary
schools. They also extend to 80 State rehabilitation agencies,
libraries, museums, and other institutions receiving Federal
funds.
Expulsions and Suspensions.--The Committee is concerned
about reports of expulsions and suspensions occurring in
preschool settings and K-12 classrooms, and the potential for
adverse impacts on children's subsequent developmental and
educational outcomes. The Committee is particularly interested
in reports of racial and gender disparity in such expulsions.
The Committee therefore urges OCR to report information on
expulsions and suspensions in preschool and elementary and
secondary school settings, disaggregated to the extent possible
by race/ethnicity, sex, disability status, and English Learner
status, in the fiscal year 2020 Congressional Justification.
OCR is also encouraged to suggest specific recommendations on
evidence-based interventions that can reduced the rates of
expulsions and suspensions and identify opportunities to
improve school climate.
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $61,143,000
Budget request, fiscal year 2019...................... 63,418,000
Committee Recommendation.............................. 61,143,000
Change from enacted level......................... - - -
Change from budget request........................ -2,275,000
This Office has authority to inquire into all program and
administrative activities of the Department as well as into
related activities of grant and contract recipients. It
conducts audits and investigations to determine compliance with
applicable laws and regulations, to check alleged fraud and
abuse, efficiency of operations, and effectiveness of results.
Use of Resources.--The Committee urges the Office of
Inspector General to ensure its focus remains on the primary
missions of the Office. The Committee cautions the Office, when
receiving requests from the Department for investigations, to
consider the most effective and best use of its resources.
General Provisions
Sec. 301. The Committee continues a provision that
prohibits funds in this Act from being used to prevent the
implementation of programs of voluntary prayer and meditation
in public schools.
(TRANSFER OF FUNDS)
Sec. 302. The Committee continues a provision providing the
Secretary of Education with the authority to transfer up to one
percent of discretionary funds between appropriations, provided
that no appropriation is increased by more than three percent
by any such transfer. This transfer authority is available only
to meet emergency needs, and may not be used to create any new
program or fund a project or activity that is not otherwise
funded in this Act. All transfers are subject to notification
to the Committees on Appropriations of the House of
Representatives and the Senate.
Sec. 303. The Committee continues to include a provision
that permits Palau to continue participating in Department of
Education and other programs pending formal ratification of a
new compact agreement.
Sec. 304. The Committee amends a provision allowing ESEA
funds consolidated for evaluation purposes to be available from
July 1, 2019 through September 30, 2020.
Sec. 305. The Committee includes a provision allowing
certain institutions to continue to use endowment income for
student scholarships.
Sec. 306. The Committee continues to include a provision
extending the authorization of the National Advisory Committee
on Institutional Quality and Integrity.
Sec. 307. The Committee continues to include a provision
extending the authority to provide account maintenance fees to
guaranty agencies for Federal student loans.
Sec. 308. The Committee adds a provision which permits the
Department of Education to allow universities to service
Perkins Loan accounts.
Sec. 309. The Committee includes a new provision related to
student loan deferment.
Sec. 310. The Committee includes a new provision related to
performance targets and performance bonuses for Office of
Federal Student Aid employees.
TITLE IV--RELATED AGENCIES
Committee for Purchase From People Who Are
Blind or Severely Disabled
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $8,250,000
Budget request, fiscal year 2019...................... 8,650,000
Committee Recommendation.............................. 8,250,000
Change from enacted level......................... - - -
Change from budget request........................ -400,000
The Committee believes oversight is necessary to ensure the
program is operating in accordance with statutory requirements
that blind or other severely disabled individuals provide at
least 75 percent of hours or direct labor required for the
production or provision of the products or services to Federal
government agencies. To ensure the Committee for Purchase from
People Who Are Blind or Severely Disabled (AbilityOne
Commission) maintains its oversight capacity, the Committee
continues bill language requiring the AbilityOne Commission to
establish written agreements with central nonprofit agencies.
The written agreements ensure the AbilityOne Commission can
conduct appropriate audit, oversight, and reporting functions
in accordance with standard Federal procurement policies.
Committee for Purchase from People Who Are Blind or
Severely Disabled--Requested Reports.--The Committee continues
to request the reports listed under this heading in House
Report 115-244.
Office of Inspector General.--The Committee recommends not
less than $1,250,000 for the Office of Inspector General.
Corporation for National and Community Service
OPERATING EXPENSES
Appropriation, fiscal year 2018....................... $1,063,958,000
Budget request, fiscal year 2019...................... 122,646,000
Committee Recommendation.............................. 1,063,958,000
Change from enacted level......................... - - -
Change from budget request........................ +941,312,000
Volunteers in Service to America
The Committee recommends $92,364,000 for Volunteers in
Service to America (VISTA), which is the same as the fiscal
year 2018 enacted level and $87,454,000 above the fiscal year
2019 budget request. This program provides capacity building
for small, community-based organizations with a mission of
combating poverty. VISTA members raise resources, recruit, and
organize volunteers, and establish and expand programs in
housing, employment, health, and economic development.
National Senior Volunteer Corps
The Committee recommends $202,117,000 for the National
Senior Volunteer Corps programs, which is the same as the
fiscal year 2018 enacted level and $201,766,000 above the
fiscal year 2019 budget request. Senior Corps is a collection
of programs that connect Americans older than the age of 55
with opportunities to contribute their job skills and expertise
to community projects and organizations. The breakout of
funding by program is as follows:
------------------------------------------------------------------------
National Senior Volunteer Corps: FY 2019 Committee
------------------------------------------------------------------------
Foster Grandparents Program.......................... $107,702,000
Senior Companion Program............................. 45,512,000
Retired Senior Volunteer Program..................... 48,903,000
------------------------------------------------------------------------
AmeriCorps State and National Grants
The Committee recommends $473,148,000 for AmeriCorps State
and National Grants, which is the same as the fiscal year 2018
enacted level and $446,720,000 above the fiscal year 2019
budget request. This program provides funds to local and
national organizations and agencies to address community needs
in education, public safety, health, and the environment.
Innovation, Assistance, and Other Activities
The Committee recommends $7,600,000 for Innovation,
Assistance, and Other Activities, which is the same as the
fiscal year 2018 enacted level and $7,600,000 above the fiscal
year 2019 budget request.
Evaluation
The Committee recommends $4,000,000 for evaluation, which
is the same as the fiscal year 2018 enacted level and
$4,000,000 above the fiscal year 2019 budget request. These
funds support research on program effectiveness.
National Civilian Community Corps
The Committee recommends $32,000,000 for National Civilian
Community Corps, which is the same as the fiscal year 2018
enacted level and $7,913,000 above the fiscal year 2019 budget
request. This program supports residential, team-based service
opportunities for individuals aged 18-24.
State Commission Administrative Grants
The Committee recommends $17,538,000 for State Commission
Administrative Grants, which is the same as the fiscal year
2018 enacted level and $17,538,000 above the fiscal year 2019
budget request. Funds are used for formula grants to support
State oversight of service programs.
Payment to the National Service Trust
Appropriation, fiscal year 2018....................... $206,842,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 206,842,000
Change from enacted level......................... - - -
Change from budget request........................ +206,842,000
The National Service Trust makes payments for Segal
education awards, pays interest that accrues on qualified
student loans for AmeriCorps participants during terms of
service in approved national service positions, and makes other
payments entitled to members who serve in the programs of the
Corporation for National and Community Service.
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $83,737,000
Budget request, fiscal year 2019...................... 87,389,000
Committee Recommendation.............................. 83,737,000
Change from enacted level......................... - - -
Change from budget request........................ -3,652,000
OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $5,750,000
Budget request, fiscal year 2019...................... 3,568,000
Committee Recommendation.............................. 5,750,000
Change from enacted level......................... - - -
Change from budget request........................ +2,182,000
ADMINISTRATIVE PROVISIONS
Sec. 401. The Committee continues bill language that
combines separate matching requirements for AmeriCorps grants.
Sec. 402. The Committee continues bill language related to
National Service Trust minimum share requirements.
Sec. 403. The Committee continues bill language related to
donations.
Sec. 404. The Committee continues bill language related to
veterans.
Sec. 405. The Committee continues bill language related to
criminal history background checks.
Sec. 406. The Committee continues bill language related to
1,200 hour service positions.
Corporation for Public Broadcasting
Appropriation, fiscal year 2018....................... $465,000,000
Budget request, fiscal year 2019...................... - - -
Committee Recommendation.............................. 465,000,000
Change from enacted level......................... - - -
Change from budget request........................ +465,000,000
This appropriation will fund content development, community
services, and other local station and system needs for the
Corporation for Public Broadcasting (CPB).
National Minority Consortia.--According to the Public
Broadcasting Act, one of the greatest priorities of public
broadcasting is to address the ``needs of unserved and
underserved audiences, particularly children and minorities.''
Programming that reflects the histories and perspectives of
diverse racial and ethnic communities is a core value and
responsibility of public broadcasting, therefore the Committee
supports continued investment in the National Minority
Consortia to help accomplish this goal.
Federal Mediation and Conciliation Service
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $46,650,000
Budget request, fiscal year 2019...................... 47,200,000
Committee Recommendation.............................. 46,800,000
Change from enacted level......................... +150,000
Change from budget request........................ -400,000
The Federal Mediation and Conciliation Service promotes
labor-management cooperation through mediation and conflict
resolution services to industry, government agencies, and
communities.
Federal Mine Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $17,184,000
Budget request, fiscal year 2019...................... 17,053,000
Committee Recommendation.............................. 17,124,000
Change from enacted level......................... -60,000
Change from budget request........................ +71,000
The Federal Mine Safety and Health Review Commission is an
independent adjudicative agency that provides administrative
trial and appellate review of legal disputes arising under the
Federal Mine Safety and Health Act of 1977.
Institute of Museum and Library Services
OFFICE OF MUSEUM AND LIBRARY SERVICES: GRANTS AND ADMINISTRATION
Appropriation, fiscal year 2018....................... $240,000,000
Budget request, fiscal year 2019...................... 23,000,000
Committee Recommendation.............................. 240,000,000
Change from enacted level......................... - - -
Change from budget request........................ +217,000,000
Within the total for the Institute of Museum and Library
Services (IMLS), the Committee recommends the following
amounts:
------------------------------------------------------------------------
FY 2019
Budget Activity Committee
------------------------------------------------------------------------
Library Services Technology Act:
Grants to States................................. $160,803,000
Native American Library Services................. 5,063,000
National Leadership: Libraries................... 13,406,000
Laura Bush 21st Century Librarian................ 10,000,000
Museum Services Act:
Museums for America.............................. 22,899,000
21st Century Museum Professionals................ 0
Conservation Project Support..................... 0
Native American/Hawaiian Museum Service.......... 1,472,000
National Leadership: Museums..................... 8,113,000
African American History and Culture Act:
Museum Grants for African American History and 2,231,000
Culture.........................................
Museum and Library Services Act General Provisions:
Research, Analysis and Data Collection........... 2,013,000
Program Administration............................... 14,000,000
------------------------------------------------------------------------
Library Services and Technology
The Grants to State Library Agencies program provides funds
to State Library Administrative Agencies using a population-
based formula.
Program Administration
The Committee recommends $14,000,000 for Program
Administration, which is the same as the fiscal year 2018
enacted level. These funds provide administrative and
management support for all programs administered by IMLS. The
Committee also includes $2,013,000 for IMLS' activities in
policy, research, and data collection, including functions
formerly conducted by the National Commission on Libraries and
Information Science.
Medicare Payment Advisory Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $12,545,000
Budget request, fiscal year 2019...................... 12,471,000
Committee Recommendation.............................. 13,045,000
Change from enacted level......................... +500,000
Change from budget request........................ +574,000
The Medicare Payment Advisory Commission (MedPAC) is an
independent agency tasked with advising the Congress on issues
affecting the Medicare program. In addition to advising on
payments to private health plans participating in Medicare and
providers in Medicare's traditional fee-for-service program,
MedPAC is also responsible for providing analysis on access to
care, quality of care, and other issues affecting Medicare.
Evaluating Barriers to Care.--The Committee recognizes
HHS's recent focus on eliminating unnecessary paperwork
burdens, which cause barriers to patient care. The Committee
notes there are non-physician practitioners, such as nurse
practitioners, that provide care for CMS beneficiaries. There
may be way to improve or streamline the process for
certification or authorization of CMS rembursed products or
services. Specifically, the Committee encourages MedPAC, in
consultation with MACPAC, to prepare a report that examines the
relationship between the physician or post-acute care physician
and related burdens associated with each provider involved in
authorizing patients for home health care services, certifying
patient's needs for diabetic shoes, conducting assessments to
admit patients to skilled nursing facilities, and providing the
initial certification of patients for hospice care. The
Committee further encourages MedPAC to analyze the costs to the
Medicare program and burdens for patients associated with the
multiple step process for authorizing and/or certifying for
these services, for the two most recent years of data
available, and to submit a report of its findings to the
Committees on Appropriations of the House of Representatives
and the Senate and the authorizing committees of jurisdiction
with recommendations that can be pursued to improve the
collaboration between physicians and non-physician
practitioners in order to reduce burdens overall and improve
patient care.
Medicaid and Chip Payment and Access Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $8,480,000
Budget request, fiscal year 2019...................... 8,700,000
Committee Recommendation.............................. 8,480,000
Change from enacted level......................... - - -
Change from budget request........................ -220,000
The Medicaid and CHIP Payment and Access Commission
(MACPAC) is an independent agency tasked with advising the
Congress on issues affecting Medicaid and the State Children's
Health Insurance Program (CHIP). MACPAC conducts policy and
data analysis on Medicaid and CHIP to support policymakers and
support program accountability.
Puerto Rico.--Recognizing the unique conditions of Puerto
Rico, the Committee supports efforts by MACPAC to evaluate and
assess viable options for ensuring long-term sustainable access
to care for Medicaid beneficiaries in the territory. The
Committee encourages MACPAC to ensure policy recommendations
that may result in additional outlays be accompanied by policy
recommendations that can result in savings.
Therapeutic Foster Care Services.--The Committee is
concerned about the lack of a uniform definition within the
Medicaid program for therapeutic foster care (TFC) services. A
uniform TFC definition could improve the ability for more
consistent care and treatment. The Committee supports efforts
by MACPAC to conduct a review for the development of an
operational TFC definition for the Medicaid program. Further,
the review should examine advantages of a uniform definition,
and include a list of potential services and interventions to
treat mental illness and trauma that could be considered within
the scope of the uniform definition. It is expected the report
will be completed within 12 months after enactment of this Act.
The Committee encourages MACPAC to ensure policy
recommendations that may result in additional outlays be
accompanied by policy recommendations that can result in
savings.
National Council on Disability
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $3,250,000
Budget request, fiscal year 2019...................... 3,211,000
Committee Recommendation.............................. 3,250,000
Change from enacted level......................... - - -
Change from budget request........................ +39,000
The National Council Disability (NCD) is an independent
Federal agency charged with advising the President, Congress,
and other Federal agencies regarding policies, programs,
practices, and procedures that affect people with disabilities.
NCD is comprised of a team of Presidential and Congressional
appointees, an Executive Director appointed by the Chair, and a
full-time professional staff.
The Achieving a Better Live Experience Act of 2014 or ABLE
Act (PL 113-295) allows individuals and families to save for
the purpose of supporting individuals with disabilities in
maintaining their health, independence, and quality of life.
The Committee is concerned about the inconsistent guidance
provided to ABLE beneficiaries from various Federal agencies
that administer needs-based assistance programs. As a
consequence, participation in State ABLE programs suffers. The
Committee strongly encourages NCD when convening stakeholders
to conduct information sessions on ABLE accounts. In addition,
the Committee directs NCD to serve as an interagency
coordinator to ensure consistency across Federal agencies and
programs. NCD through its work with disability organizations
should raise awareness on the eligibility and benefits of these
accounts.
National Labor Relations Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $274,224,000
Budget request, fiscal year 2019...................... 249,000,000
Committee Recommendation.............................. 261,325,000
Change from enacted level......................... -12,899,000
Change from budget request........................ +12,325,000
The National Labor Relations Board is an independent agency
responsible for enforcing US labor law related to collective
bargaining and unfair labor practices, including the National
Labor Relations Act of 1935.
ADMINISTRATIVE PROVISIONS
Sec. 407. The Committee continues a provision relating to
electronic voting for purposes of collective bargaining.
Sec. 408. The Committee includes a new provision relating
to joint-employer standards.
Sec. 409. The Committee includes a new provision relating
to jurisdiction over Indian Tribes.
National Mediation Board
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $13,800,000
Budget request, fiscal year 2019...................... 13,205,000
Committee Recommendation.............................. 13,510,000
Change from enacted level......................... -290,000
Change from budget request........................ +305,000
The National Mediation Board is an independent agency that
coordinates labor-management relations within the US railroads
and airlines industries.
The Committee is aware of the backlog of Section 3
arbitration cases and requests an update in the 2020
Congressional Justification on the number of pending cases in
each of the past three fiscal years, the number of cases filed
each year, and any efforts to reduce the backlog of cases.
The Committee directs the National Mediation Board to
report to the Committees on Appropriations of the House of
Representatives and the Senate within 60 days of enactment of
this Act on any concurrent postponement of a representation
election under the jurisdiction of the National Mediation Board
and the national for the postponement.
Occupational Safety and Health Review Commission
SALARIES AND EXPENSES
Appropriation, fiscal year 2018....................... $13,225,000
Budget request, fiscal year 2019...................... 12,615,000
Committee Recommendation.............................. 12,975,000
Change from enacted level......................... -250,000
Change from budget request........................ +360,000
The Occupational Safety and Health Review Commission is an
independent Federal agency, providing administrative trial and
appellate review, created to decide contests of citations or
penalties resulting from OSHA inspections of American work
places.
Railroad Retirement Board
DUAL BENEFITS PAYMENTS ACCOUNT
Appropriation, fiscal year 2018....................... $21,000,000
Budget request, fiscal year 2019...................... 18,000,000
Committee Recommendation.............................. 18,000,000
Change from enacted level......................... -3,000,000
Change from budget request........................ - - -
This appropriation is authorized by the Railroad Retirement
Act of 1974 to fund vested dual benefits received by railroad
retirees who, under prior law, would have become covered by
both the railroad retirement system and the Social Security
system because railroad retirement was not fully coordinated
with Social Security from 1937 to 1974. The Committee includes
a provision permitting a portion of these funds to be derived
from income tax receipts on dual benefits as authorized by law.
The Railroad Retirement Board estimates that approximately
$1,000,000 may be derived in this manner.
FEDERAL PAYMENT TO THE RAILROAD RETIREMENT ACCOUNTS
Appropriation, fiscal year 2018....................... $150,000
Budget request, fiscal year 2019...................... 150,000
Committee Recommendation.............................. 150,000
Change from enacted level......................... - - -
Change from budget request........................ - - -
LIMITATION ON ADMINISTRATION
Appropriation, fiscal year 2018....................... $123,500,000
Budget request, fiscal year 2019...................... 115,225,000
Committee Recommendation.............................. 126,000,000
Change from enacted level......................... +2,500,000
Change from budget request........................ +10,775,000
The Committee maintains its position that the financial
statements and audit of the National Railroad Retirement
Investment Trust should remain separate from the financial
statements and audit of the Railroad Retire Board (RRB). The
Committee notes that the Railroad Retirement and Survivors'
Improvement Act of 2001 mandates that the Trust function
independently from the RRB. Further, the Act specifically
requires a separate audit of the Trust by a nongovernmental
auditor and requires that the results of this audit be included
in the Trust's Annual Management Report to Congress. The
Committee expects that the Trust shall be administered and
audited solely in conformance with the Railroad Retirement and
Survivors' Improvement Act of 2001.
The Committee includes $12,500,000 for the implementation
of information technology systems modernization efforts. Within
180 days of enactment of this Act, the Railroad Retirement
Board is directed to submit a comprehensive update to the
Committees on Appropriations of the House of Representatives
and the Senate on project status, timelines to completion, and
total cost of development.
LIMITATION ON THE OFFICE OF INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $11,000,000
Budget request, fiscal year 2019...................... 8,437,000
Committee Recommendation.............................. 8,500,000
Change from enacted level......................... -2,500,000
Change from budget request........................ +63,000
Social Security Administration
PAYMENTS TO SOCIAL SECURITY TRUST FUNDS
Appropriation, fiscal year 2018....................... $11,400,000
Budget request, fiscal year 2019...................... 11,000,000
Committee Recommendation.............................. 11,000,000
Change from enacted level......................... -400,000
Change from budget request........................ - - -
This appropriation provides reimbursement to the Social
Security trust funds for non-trust fund activities.
SUPPLEMENTAL SECURITY INCOME PROGRAM
Appropriation, fiscal year 2018....................... $38,487,277,000
Budget request, fiscal year 2019...................... 41,208,000,000
Committee Recommendation.............................. 41,251,000,000
Change from enacted level......................... +2,763,723,000
Change from budget request........................ +43,000,000
The Committee recommends $19,700,000,000 in advance funding
for the first quarter of fiscal year 2020, as requested.
Research and Demonstration
Section 1110 of the Social Security Act provides authority
to the Social Security Administration (SSA) for conducting
research and demonstration projects related to SSA's programs.
Within the appropriation for Supplemental Security Income
(SSI), the Committee recommends $101,000,000 for research and
demonstration activities, which the same as the fiscal year
2018 enacted level and the fiscal year 2019 budget request.
Administration
Within the appropriation for SSI, the Committee recommends
$4,808,000,000, which is $183,277,000 below the fiscal year
2018 enacted level and $43,000,000 above the fiscal year 2019
budget request level. This funding is for payment to the Social
Security trust funds for SSI's share of the administrative
expenses of SSA.
LIMITATION ON ADMINISTRATIVE EXPENSES
Appropriation, fiscal year 2018....................... $11,018,945,000
Budget request, fiscal year 2019...................... 10,575,000,000
Committee Recommendation.............................. 10,739,045,000
Change from enacted level......................... -279,900,000
Change from budget request........................ +164,045,000
The Limitation on Administrative Expenses (LAE) funds the
administrative and operational costs for administering the Old
Age and Survivors Insurance, Disability Insurance, and
Supplemental Security Income programs, and associated costs for
support to the Centers for Medicare and Medicaid Services in
administering their programs.
Within the total for LAE, the Committee provides not less
than $3,475,000,000 for Field Offices and not more than
$1,750,000,000 for Information Technology.
Achieving a Better Life Experience Act.--The Achieving a
Better Life Experience Act of 2014 or ABLE Act (PL 113-295)
allows individuals and families to save for the purpose of
supporting individuals with disabilities in maintaining their
health, independence, and quality of life. The Committee is
concerned about the inconsistent guidance provided to ABLE
beneficiaries from various Federal agencies that administer
needs-based assistance programs. As a consequence,
participation in State ABLE programs suffers. The Committee
strongly encourages SSA to conduct information sessions on ABLE
accounts. In addition, the Committee supports efforts by SSA to
disseminate information on the eligibility and benefits of
these accounts. The Committee further encourages SSA to build
relationships with other agencies and government entities that
support individuals living with a disability to raise
awareness, understanding, and usage of ABLE accounts.
Administrative Law Judge Hiring.--SSA's National Hearing
Centers (NHCs) provide SSA with invaluable flexibility and
support to address the hearings backlog. Understanding the
value of this flexibility and support, the Committee directs
SSA to ensure that its upcoming administrative law judge (ALJ)
hiring decisions result in allocating additional ALJs to NHCs.
Consultative Exams.--The SSA Inspector General has
recommended that all State Disability Determination Service
(DDSs) periodically assess the feasibility of using a
competitively awarded contract for Consultative Exams (CEs) to
improve program integrity and lower costs (Disability
Determination Services' Use of Volume Consultative Examination
Providers, A-07-02-12409, March, 2003). Similarly, GAO has
recommended the use of competitive contracts finding that DDSs,
and thus SSA, can save millions (Use of Competitive Contracts
for Consultative Exams Can Save Millions, HRD-90-141, August
1990). The Committee supports efforts by SSA to develop a
multi-state pilot program, focused on States with large
disability review backlogs, including high appeals backlog, and
continuing disability reviews, to evaluate the use of
competitively awarded, multiple State contract(s) for CEs. This
contract shall require the vendor to manage the scheduling of
CEs; to oversee provider credentialing, recruitment, and
training; provide timely completion of the CEs and reports; and
offer quality assurance for completed CE reports. This contract
shall also require negotiated fees that are comparable to
Medicare rates with volume discounts and shall assess savings
to SSA, provide fraud prevention and improved provider
monitoring by preventing the use of providers suspended or
debarred from receiving Federal funds, and improved exam
quality with adequate medical evidence that decreases the
number of sustained appeals. The Committee recommends that SSA
consult with the Department of Veterans Affairs on its
successful demonstration of similar multiple State contracts
for disability examinations.
Disability Case Processing System.--The Committee is aware
that SSA is undertaking efforts to modernize the Disability
Case Processing System (DCPS). The Committee notes recent cost
overruns of the project. The Committee continues to encourage
SSA to engage with States to explore all possible options for
modernization of the case processing system, to align with the
needs of each State. The Committee continues to request regular
updates on the effort to upgrade DCPS, the cost and anticipated
timeline of the project, and efforts by SSA to engage
stakeholders, including any barriers to implementation.
Implementation of New Capability Determination
Instructions.--The Committee recognizes the importance of SSA
accurately assessing whether an individual needs a
representative payee. SSA's regulations specify that the agency
will appoint a representative payee in cases where a
beneficiary is not able to manage or direct the management of
his or her Social Security benefits. However, the Committee
recognizes that generally SSA has only evaluated a
beneficiary's ability to manage his or her benefits and has not
considered a beneficiary's ability to direct someone else to
manage his or her benefits. In 2017, SSA drafted new program
instructions for its front-line employees in assessing whether
an individual is able to direct others to manage his or her
benefits. Despite the complexity of implementing this policy,
and SSA's lack of experience making such evaluations, the
instructions were developed without input from external
stakeholders. The Committee is encouraged by the recent steps
SSA has taken to gather stakeholder feedback and expert advice,
including holding a National Disability Forum on representative
payment which included some discussion of this policy. However,
due to the complexity of this policy and the importance of
correctly evaluating the extent to which an individual can
manage (directly or indirectly) his or her benefits, the
Committee believes more stakeholder engagement and expert
consultation is required. The Committee also notes that SSA
should consider ways to test this new policy to ensure it
achieves its goals and can be implemented effectively by field
office employees before expanding it program-wide. Any test of
this policy should include specific objectives and metrics to
assess the policy's effectiveness. Given the Committee's
continued concerns, the Committee expects that SSA will provide
the Committees on Appropriations of the House of
Representatives and the Senate, the Committee on Ways and Means
of the House of Representatives, and the Committee on Finance
of the Senate regular updates and briefings on the agency's
plans prior to moving forward with this policy.
Information Technology.--The Committee requests an update
of the plan referenced under this heading in House Report 114-
699.
Occupational Information System.--SSA is developing a new
Occupational Information System (OIS) that will replace the
Dictionary of Occupational Titles as the primary source of
occupational information used in SSA's disability adjudication
process. SSA expects to begin a new five year data refresh
cycle in fiscal year 2018 and to start using the OIS in 2020.
To provide the Committee with a better understanding of the
project's costs, the Committee directs SSA to include in its
annual Report on the Occupational Information System Project
the estimated costs for each future fiscal year until the
project is expected to be completed and the estimated cost for
a five-year data refresh cycle.
Pilot Program Metrics.--Pilot programs are valuable
opportunities to test the effects of potential process changes
but require a well thought out design that includes clear
objectives and appropriate measures to evaluate the pilot's
effectiveness. Although sometimes terms are used
interchangeably, the Committee uses the term ``pilots'' as
distinct from ``demonstration programs,'' which relate to
programmatic changes, such as changes in eligibility rules. In
addition, the Committee notes that there is not always a clear
distinction between what constitutes a pilot, compared to an
initiative, or a test. The Committee uses the term ``pilot'' to
encompass all efforts to test the effects of process changes.
The Committee continues to be concerned about pilot programs
that lack clear objectives, evaluation plans, or metrics. The
Committee expects that, prior to undertaking any new pilots,
SSA will ensure that it has developed a research design that
includes clear objectives for the pilot and an evaluation plan,
including adequate metrics to determine the pilot's
effectiveness. Metrics should be specific, quantifiable
measures that can be used to evaluate success. The Committee
directs SSA to submit a report to the Committees on
Appropriations of the House of Representatives and the Senate,
the Committee on Ways and Means of the House of Representatives
and the Committee on Finance of the Senate not later than 90
days after the enactment of this act with a description of any
new pilot, initiative or test of process changes launched in
fiscal year 2018, or proposed for fiscal year 2019; the
objective of the pilot; the plan and timeline for evaluation;
which SSA components are involved in the pilot; and the
measures or metrics the SSA will use to determine the pilot's
effectiveness. In addition to the requested information for new
pilots, the report should include a list of the SSA's ongoing
pilots, along with the start date for each of these pilots.
Similar information should be provided in the fiscal year 2020
Congressional Justification. All SSA pilots should be included
in the requested report and justification, including those
undertaken as part of the Compassionate and Responsive Service
(CARES) plan and in other parts of the agency. The report (and
section in the justification) does not need to include
programmatic demonstrations.
Muscular Dystrophy.--The Committee is aware that SSA is
included in the Muscular Dystrophy Coordinating Committee under
the Muscular Dystrophy CARE Act Amendments enacted in September
2014. The Committee requests SSA to include in the fiscal year
2020 Congressional Justification the rate at which persons with
Duchenne and Becker Muscular Dystrophy utilize SSA programs,
particularly those focused on promoting employment and
community independence such as the Ticket to Work Program.
Report on LAE Expenditures.--The Committee continues to
request the report referenced under this heading in House
Report 114-699 as part of the fiscal year 2020 Congressional
Justification.
Social Security Advisory Board
The Committee recommends not less than $2,400,000 for the
Social Security Advisory Board (SSAB), which is $100,000 above
the fiscal year 2018 enacted level and the fiscal year 2019
budget request.
The Committee continues to support SSAB in the development
of new and innovative ways SSA can achieve its mission and
improve the quality of service to the public.
The Committee does not include bill language providing SSAB
reception and representation authority. The Committee requests
information on SSAB's need for such authority in the fiscal
year 2020 Congressional Justification.
User Fees
In addition to the other amounts provided, the Committee
recommends $135,000,000 for administrative activities funded
from user fees. Of this amount, $134,000,000 is derived from
fees collected from States that request SSA to administer State
SSI supplementary payments. The remaining $1,000,000 is derived
from fees charged to non-attorneys who apply for certification
to represent claimants under titles II and XVI of the Social
Security Act.
Continuing Disability Reviews and Redeterminations
The Committee recommends $1,683,000,000 for program
integrity activities. In the wake of multiple large-scale
disability fraud cases, the Committee believes that successful
program integrity activities are vital to maintaining the
public's support for benefit payments to recipients deserving
of assistance. The Committee includes bill language
transferring $10,000,000 to the Office of the Inspector General
for the cost of jointly operating co-operative disability
investigation units.
OFFICE OF THE INSPECTOR GENERAL
Appropriation, fiscal year 2018....................... $105,500,000
Budget request, fiscal year 2019...................... 105,500,000
Committee Recommendation.............................. 108,500,000
Change from enacted level......................... +3,000,000
Change from budget request........................ +3,000,000
The Office of the Inspector General (OIG) is responsible
for meeting the statutory mission of promoting economy,
efficiency, and effectiveness in the administration of SSA
programs and operations and to prevent and detect fraud, waste,
abuse, and mismanagement in such programs and operations. To
accomplish this mission, the OIG directs, conducts, and
supervises audits, evaluations, and investigations relating to
SSA's programs and operations. In addition, the OIG searches
for and reports on systemic weaknesses in SSA programs and
operations, and makes recommendations for needed improvements
and corrective actions.
TITLE V--GENERAL PROVISIONS
(TRANSFER OF FUNDS)
Sec. 501. The Committee continues a provision allowing the
Secretaries of Labor, Health and Human Services, and Education
to transfer unexpended balances of prior appropriations to
accounts corresponding to current appropriations to be used for
the same purposes and for the same periods of time for which
they were originally appropriated.
Sec. 502. The Committee continues a provision prohibiting
the obligation of funds beyond the current fiscal year unless
expressly so provided.
Sec. 503. The Committee continues a provision prohibiting
funds from being used to support or defeat legislation.
Sec. 504. The Committee continues a provision limiting the
amount available for official reception and representation
expenses for the Secretaries of Labor and Education, the
Director of the Federal Mediation and Conciliation Service, and
the Chairman of the National Mediation Board.
Sec. 505. The Committee continues a provision requiring
grantees receiving Federal funds to clearly state the
percentage of the total cost of the program or project that
will be financed with Federal money.
Sec. 506. The Committee continues a provision prohibiting
the use of funds for any abortion.
Sec. 507. The Committee continues a provision providing
exceptions to section 506 and a provision prohibiting funds
from being made available to a Federal agency or program, or to
a State or local government, if such agency, program or
government discriminates against institutional or individual
health care entities because they do not provide, pay for,
provide coverage of, or refer for abortions.
Sec. 508. The Committee continues a provision prohibiting
use of funds for certain research involving human embryos.
Sec. 509. The Committee continues a provision prohibiting
use of funds for any activity that promotes the legalization of
any drug or substance included in schedule I of the schedules
of controlled substances.
Sec. 510. The Committee continues a provision prohibiting
use of funds to promulgate or adopt any final standard
providing for a unique health identifier until legislation is
enacted specifically approving the standard.
Sec. 511. The Committee continues a provision related to
annual reports to the Secretary of Labor.
Sec. 512. The Committee continues a provision prohibiting
transfer of funds made available in this Act except by
authority provided in this Act or another appropriations Act.
Sec. 513. The Committee continues a provision to limit
funds in the bill for public libraries to those that comply
with the requirements of the Children's Internet Protection
Act.
Sec. 514. The Committee continues a provision regarding
procedures for reprogramming of funds.
Sec. 515. The Committee continues a provision pertaining to
appointments to scientific advisory committees.
Sec. 516. The Committee continues a provision requiring
each department and related agency funded through this Act to
submit an operating plan within 45 days of enactment, detailing
any funding allocations that are different than those specified
in this Act, the accompanying detailed table, or budget
request.
Sec. 517. The Committee continues a provision requiring the
Secretaries of Labor, Health and Human Services, and Education
to submit a quarterly report to the Committees on
Appropriations of the House of Representatives and the Senate
containing certain information on noncompetitive contracts,
grants, and cooperative agreements exceeding $500,000 in value.
Sec. 518. The Committee continues a provision prohibiting
the use of funds to process claims for credit for quarters of
coverage based on work performed under a Social Security number
that was not the claimant's number, where the performance of
such work under such number has formed the basis for a
conviction of the claimant of a violation of section 208(a)(6)
or (7) of the Social Security Act.
Sec. 519. The Committee continues a provision prohibiting
the use of funds to implement a Social Security totalization
agreement with Mexico.
Sec. 520. The Committee modifies a provision related to
needle exchange.
Sec. 521. The Committee continues a provision prohibiting
the use of funds for the downloading or exchanging of
pornography.
Sec. 522. The Committee continues a provision that
prohibits funding from going to the Association of Community
Organizations for Reform Now (ACORN), or any of its affiliates,
subsidiaries, allied organizations, or successors.
Sec. 523. The Committee continues a provision relating to
reporting requirements for conference expenditures.
Sec. 524. The Committee continues a provision relating to
disclosure of U.S. taxpayer funding for programs used in
advertising.
Sec. 525. The Committee continues a provision relating to
performance partnership pilots.
Sec. 526. The Committee continues provision requesting
quarterly reports on the status of balances of appropriations
from the Departments of Labor, Health and Human Services and
Education.
Sec. 527. The Committee includes a new provision
prohibiting use of funds to implement, administer, enforce or
further the provisions of Public Law 111-148 and portions of
public Law 111-152 with certain exceptions.
Sec. 528. The Committee includes a new provision
prohibiting use of funds to implement, administer, enforce or
further advance the Navigators program.
(RESCISSION)
Sec. 529. The Committee rescinds $3,345,000,000 in unused
funds provided under section 2104(a)(22) of the Social Security
Act for the Children's Health Insurance Program.
(RESCISSION)
Sec. 530. The Committee rescinds $400,000,000 from the
Nonrecurring Expenses Fund.
(RESCISSION)
Sec. 531. The Committee permanently rescinds $3,378,613,000
in unused funds provided under section 2104(n)(2) of the Social
Security Act for the Child Enrollment Contingency Fund.
Sec. 532. The Committee includes a new provision
prohibiting use of funds for research on fetal tissue obtained
from an induced abortion.
Sec. 533. The Committee includes a new provision
restricting funding to certain health care entities.
Sec. 534. The Committee includes a new provision relating
to conscience protection with respect to health care entities
that refuse to participate in abortions.
Sec. 535. The Committee includes a new provision ensuring
members of the United States Congress may, for oversight
purposes, enter facilities used to house unaccompanied alien
children.
Sec. 536. The Committee includes a new provision related to
family detention centers.
Sec. 537. The Committee includes a new provision related to
conscience protection with respect to child welfare service
providers.
Sec. 538. The Committee includes a new provision related to
administration of medication to unaccompanied alien children.
Sec. 539. The Committee includes a sense of Congress
regarding family separation.
Sec. 540. The Committee includes a new provision related to
religious practices of a potential sponsor of unaccompanied
alien children.
Sec. 541. The Committee includes a new provision requesting
a report related to the communication needs of young
unaccompanied alien children.
Sec. 542. The Committee includes a new provision requesting
a report related to mental health services for unaccompanied
alien children.
Sec. 543. The Committee includes a Spending Reduction
Account.
House of Representatives Reporting Requirements
The following materials are submitted in accordance with
various requirements of the Rules of the House of
Representatives:
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the following is a statement of
general performance goals and objectives for which this measure
authorizes funding: The Committee on Appropriations considers
program performance, including a program's success in
developing and attaining outcome-related goals and objectives,
in developing funding recommendations.
RESCISSION OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following lists the rescissions
of unexpended balances included in the accompanying bill:
RESCISSIONS RECOMMENDED IN THE BILL
------------------------------------------------------------------------
Account Amount
------------------------------------------------------------------------
Department of Labor:
Dislocated Workers National Reserve.............. $200,000,000
Department of Health and Human Services:
Children's Health Insurance Program.............. 3,345,000,000
Nonrecurring Expenses Fund....................... 400,000,000
Child Enrollment Contingency Fund................ 3,378,613,000
------------------------------------------------------------------------
TRANSFER OF FUNDS
Pursuant to clause 3(f)(2) of rule XIII of the Rules of the
House of Representatives, the following lists the transfers of
unexpended balances included in the accompanying bill:
TITLE I
Language is included under ``Job Corps'' permitting the
transfer of funds for Job Corps Center construction,
rehabilitation and acquisition to meet the operational needs of
Job Corps Centers or to achieve administrative efficiencies.
Language is included under ``Special Benefits'' which
provides for the transfer of such sums as necessary from the
``Postal Service'' account.
Language is included under ``Black Lung Disability Trust
Fund'' which provides for the transfer of funds to the
``Department of Labor, Office of Workers' Compensation Program,
Salaries and Expenses.''
Language is included under ``Black Lung Disability Trust
Fund'' which provides for the transfer of funds to the
``Department of Labor, Departmental Management, Salaries and
Expenses.''
Language is included under ``Black Lung Disability Trust
Fund'' which provides for the transfer of funds to the
``Department of Labor, Departmental Management, Office of
Inspector General.''
Language is included under ``Black Lung Disability Trust
Fund'' which provides for the transfer of funds to the
``Department of the Treasury.''
Language is included under ``Departmental Management,
Salaries and Expenses'' authorizing the transfer of funds
available for program evaluation to any other account within
the Department to carry out evaluation activities.
A general provision is included permitting up to one
percent of any discretionary appropriation to be transferred to
another appropriation of the Department of Labor, provided that
no such appropriation is increased by more than three percent
by any such transfer.
A general provision is included that provides for the
transfer of funds from the ``Employment and Training
Administration'' for technical assistance services to grantees
to ``Program Administration,'' and authorizes the transfer of
up 0.5 percent of each discretionary appropriation for
``Employment and Training Administration'' to carry out program
integrity activities subject to certain limitations related to
``Job Corps.''
A general provision is included that provides for the
transfer of up to 0.75 percent of appropriated funds to carry
out program evaluations of ``Training and Employment
Services'', ``Job Corps'', ``Community Service Employment for
Older Americans,'' ``State Unemployment Insurance and
Employment Service Operations'', ``Employee Benefits Security
Administration'', ``Office of Workers' Compensation Programs'',
``Wage and Hour Division'', ``Office of Federal Contract
Compliance Programs'', ``Office of Labor-Management
Standards'', ``Occupational Safety and Health Administration'',
``Mine Safety and Health Administration'', Office of Disability
Employment Policy, ``Bureau of International Affairs'' and
``Women's Bureau'' within the Departmental Management, Salaries
and Expenses'' account, and ``Veterans Employment and
Training'' for use by the Office of the Chief Evaluation
Officer.
TITLE II
Language is included under ``Centers for Disease Control
and Prevention, Buildings and Facilities'' to allow the
transfer of prior year unobligated Individual Learning Account
funds to be transferred to this account to carry out the
purpose of this account.
Language is included under ``Administration for Children
and Families-Refugee and Entrant Assistance'' permitting
transfers pursuant to a general provision to increase an
appropriation under this heading by ten percent.
Language is included under ``Administration for Community
Living, Aging and Disability Services Programs'' for transfer
to the Secretary of Agriculture to carryout section 311 of the
Older Americans Act of 1965.
A general provision is included that allows not to exceed
one percent of any discretionary funds to be transferred
between appropriation accounts of the ``Department of Health
and Human Services'', provided that no appropriation account is
increased by more than three percent by such transfer.
A general provision is included that allows the transfer of
up to three percent among the institutes and centers of the
``National Institutes of Health'' from amounts identified as
pertaining to the human immunodeficiency virus.
A general provision is included that allows the transfer of
funding determined to be related to the human immunodeficiency
virus to the ``Office of AIDS Research''.
A general provision is included that transfers one percent
of the amount made available for ``National Research Service
Awards'' at the ``National Institutes of Health'' to the
``Health Resources and Services Administration''.
A general provision is included to direct the transfer of
the ``Prevention and Public Health Fund'' as specified in the
committee report accompanying this Act.
Language is included under ``National Institutes of Health,
Innovation Account'' to allow the transfer of funds to other
Institutes and Centers to support activities authorized in the
21st Century Cures Act (PL 114-255).
Language is included permitting transfer authority for
evaluation activities for discretionary appropriations in the
Administration for Children and Families.
Language is included establishing an Infectious Disease
Rapid Respond fund for emergency usage by the Secretary under
certain conditions.
TITLE III
A general provision is included that allows not to exceed
one percent of any discretionary funds to be transferred
between appropriation accounts of the Department of Education,
provided that no appropriation account is increased by more
than three percent by such transfer.
TITLE IV
Language is included under Payment to the National Service
Trust authorizing the transfer of funds from the ``Corporation
for National and Community Service, Operating Expenses'' to
support the activities of national service participants.
Language is included under ``Social Security
Administration'' authorizing the transfer of up to three
percent of the Social Security Administration's ``Limitation on
Administration Expenses'' account to be available for purposes
of the Office of Inspector General.
TITLE V
A general provision is included that allows the Secretaries
of Labor, Health and Human Services, and Education to transfer
balances of prior appropriation to accounts corresponding to
current appropriations.
DISCLOSURE OF EARMARKS AND CONGRESSIONALLY DIRECTED SPENDING ITEMS
Neither the bill nor the report contains any Congressional
earmarks, limited tax benefits, or limited tariff benefits as
defined in clause 9 of rule XXI.
COMPLIANCE WITH RULE XIII, CL. 3(E) (RAMSEYER RULE)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
Compliance With Rule XIII, Cl. 3(e) (Ramseyer Rule)
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, existing law in which no change
is proposed is shown in roman):
DEPARTMENT OF LABOR APPROPRIATIONS ACT, 1958
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, That the
following sums are appropriated, out of any money in the
Treasury not otherwise appropriated, for the Departments of
Labor, and Heath, Education, and Welfare, and related agencies,
for the fiscal year ending June 30, 1958, namely:
TITLE I--DEPARTMENT OF LABOR
OFFICE OF THE SECRETARY
* * * * * * *
Working capital fund: There is hereby established a working
capital fund, to be available without fiscal year limitation,
for expenses necessary for the maintenance and operation of
[(1) a central reproduction service; (2) a central visual
exhibit service; (3) a central supply service for supplies and
equipment for which adequate stocks may be maintained to meet
in whole or in part the requirements of the Department; (4) a
central tabulating service; (5) telephone, mail and messenger
services; (6) a central accounting and payroll service; and (7)
a central laborers' service: Provided, That any stocks of
supplies and equipment on hand or on order shall be used to
capitalize such fund: Provided further, That such fund shall be
reimbursed in advance from funds available to bureaus, offices,
and agencies for which such centralized services are performed
at rates which will return in full all expenses of operation,
including reserves for accrued annual leave and depreciation of
equipment: Provided further, That the Secretary of Labor may
transfer annually an amount not to exceed $3,000,000 from
unobligated balances in the Department's salaries and expenses
accounts, to the unobligated balance of the Working Capital
Fund, to be merged with such Fund and used for the acquisition
of capital equipment and the improvement of financial
management, information technology and other support systems,
and to remain available until expended: Provided further, That
the unobligated balance of the Fund shall not exceed
$20,000,000..] a comprehensive program of centralized services
which the Secretary of Labor may prescribe and deem appropriate
and advantageous to provide on a reimbursable basis: Provided,
That such fund may receive advances and reimbursements from
funds available to bureaus, offices, and agencies for which
such centralized services are performed at rates which will
return in full all expenses of operation, including reserves
for accrued annual leave, worker's compensation, depreciation
of capitalized equipment and amortization of human resources
software and systems (either acquired or donated): Provided
further, That the Secretary of Labor may transfer annually an
amount not to exceed $9,000,000 from unobligated balances in
the Department's salaries and expenses accounts, to the
unobligated balance of the Working Capital Fund, to be merged
with such Fund and used for the acquisition of capital
equipment and the improvement of financial management,
information technology and other support systems, and to remain
available for obligation for an additional five fiscal years:
Provided further, That such fund may receive reimbursements
from entities or persons for use of Departmental facilities,
including associated utilities and security services, and such
reimbursements shall be credited to and merged with this fund:
Provided further, That none of the funds shall be available
unless the Chief Information Officer of the Department of Labor
has submitted a plan, approved by the Office of Management and
Budget, describing the amounts to be transferred by account,
the planned use of funds, including descriptions of projects,
project status, including any scheduled delays and cost
overruns, financial expenditures, planned activities, and
expected benefits, to the Committees on Appropriations of the
House of Representatives and the Senate by July 31 of the
calendar year prior to the fiscal year in which the transfer
will occur: Provided further, That pursuant to section 11319 of
title 40, United States Code, the Secretary shall ensure that
the Department's Chief Information Officer shall, at a minimum,
be a principal advisor to the Secretary and a member on any
board or governance structure of the Department responsible for
advising and setting Department-wide information technology
budgets: Provided further, That none of the funds available for
information technology modernization under this section or
under the heading ``IT Modernization'' shall be used for
information technology modernization projects unless an
experienced project manager, employed by the Department of
Labor, is assigned oversight responsibility, including but not
limited to, ensuring such projects are completed within
established timeframes and budgets
* * * * * * *
----------
DEPARTMENT OF LABOR, AND HEALTH, EDUCATION, AND WELFARE, AND RELATED
AGENCIES APPROPRIATIONS ACT, 1970
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, That the
following sums are appropriated, out of any money in the
Treasury not otherwise appropriated, for the Departments of
Labor, and Health, Education, and Welfare, and related
agencies, for the fiscal year ending June 30, 1970, and for
other purposes, namely:
TITLE I--DEPARTMENT OF LABOR
* * * * * * *
Office of the Secretary
* * * * * * *
[WORKING CAPITAL FUND]
[The Working Capital Fund of the Department of Labor shall
hereafter be available for expenses necessary for personnel
functions in regional administrative offices.]
* * * * * * *
----------
DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND
RELATED AGENCIES APPROPRIATIONS ACT, 19994
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, That the
following sums are appropriated, out of any money in the
Treasury not otherwise appropriated, for the Departments of
Labor, Health and Human Services, and Education, and related
agencies for the fiscal year ending September 30, 1994, and for
other purposes, namely:
TITLE I--DEPARTMENT OF LABOR
* * * * * * *
Departmental Management
* * * * * * *
[WORKING CAPITAL FUND]
[For expenses necessary during the fiscal year ending
September 30, 1994, and each fiscal year thereafter, for the
maintenance and operation of a comprehensive program of
centralized services which the Secretary of Labor may prescribe
and deem appropriate and advantageous to provide on a
reimbursable basis under the provisions of the Economy Act
(subject to prior notice to OMB) in the national office and
field: Provided, That such fund shall be reimbursed in advance
from funds available to agencies, bureaus, and offices for
which such centralized services are performed at rates which
will return in full cost of operations including services
obtained through cooperative administrative services units
under the Economy Act, including reserves for accrued annual
leave, worker's compensation, depreciation of capitalized
equipment, and amortization of ADP software and systems (either
acquired or donated): Provided further, That funds received for
services rendered to any entity or person for use of
Departmental facilities, including associated utilities and
security services, shall be credited to and merged with this
fund.]
* * * * * * *
----------
HIGHER EDUCATION ACT OF 1965
* * * * * * *
TITLE I--GENERAL PROVISIONS
* * * * * * *
PART B--ADDITIONAL GENERAL PROVISIONS
* * * * * * *
SEC. 114. NATIONAL ADVISORY COMMITTEE ON INSTITUTIONAL QUALITY AND
INTEGRITY.
(a) Establishment.--There is established in the Department a
National Advisory Committee on Institutional Quality and
Integrity (in this section referred to as the ``Committee'') to
assess the process of accreditation and the institutional
eligibility and certification of institutions of higher
education (as defined in section 102) under title IV.
(b) Membership.--
(1) In general.--The Committee shall have 18 members,
of which--
(A) six members shall be appointed by the
Secretary;
(B) six members shall be appointed by the
Speaker of the House of Representatives, three
of whom shall be appointed on the
recommendation of the majority leader of the
House of Representatives, and three of whom
shall be appointed on the recommendation of the
minority leader of the House of
Representatives; and
(C) six members shall be appointed by the
President pro tempore of the Senate, three of
whom shall be appointed on the recommendation
of the majority leader of the Senate, and three
of whom shall be appointed on the
recommendation of the minority leader of the
Senate.
(2) Qualifications.--Individuals shall be appointed
as members of the Committee--
(A) on the basis of the individuals'
experience, integrity, impartiality, and good
judgment;
(B) from among individuals who are
representatives of, or knowledgeable
concerning, education and training beyond
secondary education, representing all sectors
and types of institutions of higher education
(as defined in section 102); and
(C) on the basis of the individuals'
technical qualifications, professional
standing, and demonstrated knowledge in the
fields of accreditation and administration in
higher education.
(3) Terms of members.--Except as provided in
paragraph (5), the term of office of each member of the
Committee shall be for six years, except that any
member appointed to fill a vacancy occurring prior to
the expiration of the term for which the member's
predecessor was appointed shall be appointed for the
remainder of such term.
(4) Vacancy.--A vacancy on the Committee shall be
filled in the same manner as the original appointment
was made not later than 90 days after the vacancy
occurs. If a vacancy occurs in a position to be filled
by the Secretary, the Secretary shall publish a Federal
Register notice soliciting nominations for the position
not later than 30 days after being notified of the
vacancy.
(5) Initial terms.--The terms of office for the
initial members of the Committee shall be--
(A) three years for members appointed under
paragraph (1)(A);
(B) four years for members appointed under
paragraph (1)(B); and
(C) six years for members appointed under
paragraph (1)(C).
(6) Chairperson.--The members of the Committee shall
select a chairperson from among the members.
(c) Functions.--The Committee shall--
(1) advise the Secretary with respect to
establishment and enforcement of the standards of
accrediting agencies or associations under subpart 2 of
part H of title IV;
(2) advise the Secretary with respect to the
recognition of a specific accrediting agency or
association;
(3) advise the Secretary with respect to the
preparation and publication of the list of nationally
recognized accrediting agencies and associations;
(4) advise the Secretary with respect to the
eligibility and certification process for institutions
of higher education under title IV, together with
recommendations for improvements in such process;
(5) advise the Secretary with respect to the
relationship between--
(A) accreditation of institutions of higher
education and the certification and eligibility
of such institutions; and
(B) State licensing responsibilities with
respect to such institutions; and
(6) carry out such other advisory functions relating
to accreditation and institutional eligibility as the
Secretary may prescribe by regulation.
(d) Meeting Procedures.--
(1) Schedule.--
(A) Biannual meetings.--The Committee shall
meet not less often than twice each year, at
the call of the Chairperson.
(B) Publication of date.--The Committee shall
submit the date and location of each meeting in
advance to the Secretary, and the Secretary
shall publish such information in the Federal
Register not later than 30 days before the
meeting.
(2) Agenda.--
(A) Establishment.--The agenda for a meeting
of the Committee shall be established by the
Chairperson and shall be submitted to the
members of the Committee upon notification of
the meeting.
(B) Opportunity for public comment.--The
agenda shall include, at a minimum, opportunity
for public comment during the Committee's
deliberations.
(3) Secretary's designee.--The Secretary shall
designate an employee of the Department to serve as the
Secretary's designee to the Committee, and the
Chairperson shall invite the Secretary's designee to
attend all meetings of the Committee.
(4) Federal advisory committee act.--The Federal
Advisory Committee Act (5 U.S.C. App.) shall apply to
the Committee, except that section 14 of such Act shall
not apply.
(e) Report and Notice.--
(1) Notice.--The Secretary shall annually publish in
the Federal Register--
(A) a list containing, for each member of the
Committee--
(i) the member's name;
(ii) the date of the expiration of
the member's term of office; and
(iii) the name of the individual
described in subsection (b)(1) who
appointed the member; and
(B) a solicitation of nominations for each
expiring term of office on the Committee of a
member appointed by the Secretary.
(2) Report.--Not later than the last day of each
fiscal year, the Committee shall make available an
annual report to the Secretary, the authorizing
committees, and the public. The annual report shall
contain--
(A) a detailed summary of the agenda and
activities of, and the findings and
recommendations made by, the Committee during
the fiscal year preceding the fiscal year in
which the report is made;
(B) a list of the date and location of each
meeting during the fiscal year preceding the
fiscal year in which the report is made;
(C) a list of the members of the Committee;
and
(D) a list of the functions of the Committee,
including any additional functions established
by the Secretary through regulation.
(f) Termination.--The Committee shall terminate on September
30, [2018] 2019.
* * * * * * *
TITLE IV--STUDENT ASSISTANCE
* * * * * * *
Part B--Federal Family Education Loan Program
* * * * * * *
SEC. 427. ELIGIBILITY OF STUDENT BORROWERS AND TERMS OF FEDERALLY
INSURED STUDENT LOANS.
(a) List of Requirements.--Except as provided in section
428C, a loan by an eligible lender shall be insurable by the
Secretary under the provisions of this part only if--
(1) made to a student who (A) is an eligible student
under section 484, (B) has agreed to notify promptly
the holder of the loan concerning any change of
address, and (C) is carrying at least one-half the
normal full-time academic workload for the course of
study the student is pursuing (as determined by the
institution); and
(2) evidenced by a note or other written agreement
which--
(A) is made without security and without
endorsement;
(B) provides for repayment (except as
provided in subsection (c)) of the principal
amount of the loan in installments over a
period of not less than 5 years (unless sooner
repaid or unless the student, during the 6
months preceding the start of the repayment
period, specifically requests that repayment be
made over a shorter period) nor more than 10
years beginning 6 months after the month in
which the student ceases to carry at an
eligible institution at least one-half the
normal full-time academic workload as
determined by the institution, except--
(i) as provided in subparagraph (C);
(ii) that the note or other written
instrument may contain such reasonable
provisions relating to repayment in the
event of default in the payment of
interest or in the payment of the cost
of insurance premiums, or other default
by the borrower, as may be authorized
by regulations of the Secretary in
effect at the time the loan is made;
and
(iii) that the lender and the
student, after the student ceases to
carry at an eligible institution at
least one-half the normal full-time
academic workload as determined by the
institution, may agree to a repayment
schedule which begins earlier, or is of
shorter duration, than required by this
subparagraph, but in the event a
borrower has requested and obtained a
repayment period of less than 5 years,
the borrower may at any time prior to
the total repayment of the loan, have
the repayment period extended so that
the total repayment period is not less
than 5 years;
(C) provides that periodic installments of
principal need not be paid, but interest shall
accrue and be paid, during any period--
(i) during which the borrower--
(I) is pursuing at least a
half-time course of study as
determined by an eligible
institution; or
(II) is pursuing a course of
study pursuant to a graduate
fellowship program approved by
the Secretary, or pursuant to a
rehabilitation training program
for individuals with
disabilities approved by the
Secretary,
except that no borrower shall be
eligible for a deferment under this
clause, or a loan made under this part
(other than a loan made under section
428B or 428C), while serving in a
medical internship or residency
program;
(ii) not in excess of 3 years during
which the borrower is seeking and
unable to find full-time employment[;
or];
(iii) not in excess of 3 years for
any reason which the lender determines,
in accordance with regulations
prescribed by the Secretary under
section 435(o), has caused or will
cause the borrower to have an economic
hardship; or
(iv) in which the borrower is
receiving treatment for cancer and the
6 months after such period.
and provides that any such period shall not be
included in determining the 10-year period
described in subparagraph (B);
(D) provides for interest on the unpaid
principal balance of the loan at a yearly rate,
not exceeding the applicable maximum rate
prescribed in section 427A, which interest
shall be payable in installments over the
period of the loan except that, if provided in
the note or other written agreement, any
interest payable by the student may be deferred
until not later than the date upon which
repayment of the first installment of principal
falls due, in which case interest accrued
during that period may be added on that date to
the principal;
(E) provides that the lender will not collect
or attempt to collect from the borrower any
portion of the interest on the note which is
payable by the Secretary under this part, and
that the lender will enter into such agreements
with the Secretary as may be necessary for the
purpose of section 437;
(F) entitles the student borrower to
accelerate without penalty repayment of the
whole or any part of the loan;
(G)(i) contains a notice of the system, of
disclosure of information concerning such loan
to consumer reporting agencies under section
430A, and (ii) provides that the lender on
request of the borrower will provide
information on the repayment status of the note
to such consumer reporting agencies;
(H) provides that, no more than 6 months
prior to the date on which the borrower's first
payment on a loan is due, the lender shall
offer the borrower the option of repaying the
loan in accordance with a graduated or income-
sensitive repayment schedule established by the
lender and in accordance with the regulations
of the Secretary; and
(I) contains such other terms and conditions,
consistent with the provisions of this part and
with the regulations issued by the Secretary
pursuant to this part, as may be agreed upon by
the parties to such loan, including, if agreed
upon, a provision requiring the borrower to pay
the lender, in addition to principal and
interest, amounts equal to the insurance
premiums payable by the lender to the Secretary
with respect to such loan;
(3) the funds borrowed by a student are disbursed to
the institution by check or other means that is payable
to and requires the endorsement or other certification
by such student, except--
(A) that nothing in this title shall be
interpreted--
(i) to allow the Secretary to require
checks to be made copayable to the
institution and the borrower; or
(ii) to prohibit the disbursement of
loan proceeds by means other than by
check; and
(B) in the case of any student who is
studying outside the United States in a program
of study abroad that is approved for credit by
the home institution at which such student is
enrolled, the funds shall, at the request of
the borrower, be delivered directly to the
student and the checks may be endorsed, and
fund transfers authorized, pursuant to an
authorized power-of-attorney; and
(4) the funds borrowed by a student are disbursed in
accordance with section 428G.
(b) Special Rules for Multiple Disbursement.--For the purpose
of subsection (a)(4)--
(1) all loans issued for the same period of
enrollment shall be considered as a single loan; and
(2) the requirements of such subsection shall not
apply in the case of a loan made under section 428B or
428C, or made to a student to cover the cost of
attendance at an eligible institution outside the
United States.
(c) Special Repayment Rules.--Except as provided in
subsection (a)(2)(H), the total of the payments by a borrower
during any year of any repayment period with respect to the
aggregate amount of all loans to that borrower which are
insured under this part shall not, unless the borrower and the
lender otherwise agree, be less than $600 or the balance of all
such loans (together with interest thereon), whichever amount
is less (but in no instance less than the amount of interest
due and payable).
* * * * * * *
SEC. 428. FEDERAL PAYMENTS TO REDUCE STUDENT INTEREST COSTS.
(a) Federal Interest Subsidies.--
(1) Types of loans that qualify.--Each student who
has received a loan for study at an eligible
institution for which the first disbursement is made
before July 1, 2010, and--
(A) which is insured by the Secretary under
this part; or
(B) which is insured under a program of a
State or of a nonprofit private institution or
organization which was contracted for, and paid
to the student, within the period specified in
paragraph (5), and which--
(i) in the case of a loan insured
prior to July 1, 1967, was made by an
eligible lender and is insured under a
program which meets the requirements of
subparagraph (E) of subsection (b)(1)
and provides that repayment of such
loan shall be in installments beginning
not earlier than 60 days after the
student ceases to pursue a course of
study (as described in subparagraph (D)
of subsection (b)(1)) at an eligible
institution, or
(ii) in the case of a loan insured
after June 30, 1967, was made by an
eligible lender and is insured under a
program covered by an agreement made
pursuant to subsection (b),
shall be entitled to have paid on his or her behalf and
for his or her account to the holder of the loan a
portion of the interest on such loan under
circumstances described in paragraph (2).
(2) Additional requirements to receive subsidy.--(A)
Each student qualifying for a portion of an interest
payment under paragraph (1) shall--
(i) have provided to the lender a statement
from the eligible institution, at which the
student has been accepted for enrollment, or at
which the student is in attendance, which--
(I) sets forth the loan amount for
which the student shows financial need;
and
(II) sets forth a schedule for
disbursement of the proceeds of the
loan in installments, consistent with
the requirements of section 428G;
(ii) meet the requirements of subparagraph
(B); and
(iii) have provided to the lender at
the time of application for a loan
made, insured, or guaranteed under this
part, the student's driver's number, if
any.
(B) For the purpose of clause (ii) of subparagraph
(A), a student shall qualify for a portion of an
interest payment under paragraph (1) if the eligible
institution has determined and documented the student's
amount of need for a loan based on the student's
estimated cost of attendance, estimated financial
assistance, and, for the purpose of an interest payment
pursuant to this section, expected family contribution
(as determined under part F), subject to the provisions
of subparagraph (D).
(C) For the purpose of this paragraph--
(i) a student's cost of attendance shall be
determined under section 472;
(ii) a student's estimated financial
assistance means, for the period for which the
loan is sought--
(I) the amount of assistance such
student will receive under subpart 1 of
part A (as determined in accordance
with section 484(b)), subpart 3 of part
A, and parts C and E; plus
(II) other scholarship, grant, or
loan assistance, but excluding--
(aa) any national service
education award or post-service
benefit under title I of the
National and Community Service
Act of 1990; and
(bb) any veterans' education
benefits as defined in section
480(c); and
(iii) the determination of need and of the
amount of a loan by an eligible institution
under subparagraph (B) with respect to a
student shall be calculated in accordance with
part F.
(D) An eligible institution may not, in carrying out
the provisions of subparagraphs (A) and (B) of this
paragraph, provide a statement which certifies the
eligibility of any student to receive any loan under
this part in excess of the maximum amount applicable to
such loan.
(E) For the purpose of subparagraphs (B) and (C) of
this paragraph, any loan obtained by a student under
section 428A or 428H or a parent under section 428B of
this Act or under any State-sponsored or private loan
program for an academic year for which the
determination is made may be used to offset the
expected family contribution of the student for that
year.
(3) Amount of interest subsidy.--(A)(i) Subject to
section 438(c), the portion of the interest on a loan
which a student is entitled to have paid, on behalf of
and for the account of the student, to the holder of
the loan pursuant to paragraph (1) of this subsection
shall be equal to the total amount of the interest on
the unpaid principal amount of the loan--
(I) which accrues prior to
the date the student ceases to
carry at least one-half the
normal full-time academic
workload (as determined by the
institution), or
(II) which accrues during a period in which
principal need not be paid (whether or not such
principal is in fact paid) by reason of a
provision described in subsection (b)(1)(M) of
this section or in section 427(a)(2)(C).
(ii) Such portion of the interest on a loan shall not
exceed, for any period, the amount of the interest on
that loan which is payable by the student after taking
into consideration the amount of any interest on that
loan which the student is entitled to have paid on his
or her behalf for that period under any State or
private loan insurance program.
(iii) The holder of a loan with respect to which
payments are required to be made under this section
shall be deemed to have a contractual right, as against
the United States, to receive from the Secretary the
portion of interest which has been so determined
without administrative delay after the receipt by the
Secretary of an accurate and complete request for
payment pursuant to paragraph (4).
(iv) The Secretary shall pay this portion of the
interest to the holder of the loan on behalf of and for
the account of the borrower at such times as may be
specified in regulations in force when the applicable
agreement entered into pursuant to subsection (b) was
made, or, if the loan was made by a State or is insured
under a program which is not covered by such an
agreement, at such times as may be specified in
regulations in force at the time the loan was paid to
the student.
(v) A lender may not receive interest on a loan for
any period that precedes the date that is--
(I) in the case of a loan disbursed by check,
10 days before the first disbursement of the
loan;
(II) in the case of a loan disbursed by
electronic funds transfer, 3 days before the
first disbursement of the loan; or
(III) in the case of a loan disbursed through
an escrow agent, 3 days before the first
disbursement of the loan.
(B) If--
(i) a State student loan insurance program is
covered by an agreement under subsection (b),
(ii) a statute of such State limits the
interest rate on loans insured by such program
to a rate which is less than the applicable
interest rate under this part, and
(iii) the Secretary determines that
subsection (d) does not make such statutory
limitation inapplicable and that such statutory
limitation threatens to impede the carrying out
of the purpose of this part,
then the Secretary may pay an administrative cost
allowance to the holder of each loan which is insured
under such program and which is made during the period
beginning on the 60th day after the date of enactment
of the Higher Education Amendments of 1968 and ending
120 days after the adjournment of such State's first
regular legislative session which adjourns after
January 1, 1969. Such administrative cost allowance
shall be paid over the term of the loan in an amount
per year (determined by the Secretary) which shall not
exceed 1 percent of the unpaid principal balance of the
loan.
(4) Submission of statements by holders on amount of
payment.--Each holder of a loan with respect to which
payments of interest are required to be made by the
Secretary shall submit to the Secretary, at such time
or times and in such manner as the Secretary may
prescribe, statements containing such information as
may be required by or pursuant to regulation for the
purpose of enabling the Secretary to determine the
amount of the payment which he must make with respect
to that loan.
(5) Duration of authority to make interest subsidized
loans.--The period referred to in subparagraph (B) of
paragraph (1) of this subsection shall begin on the
date of enactment of this Act and end at the close of
June 30, 2010.
(6) Assessment of borrower's financial condition not
prohibited or required.--Nothing in this or any other
Act shall be construed to prohibit or require, unless
otherwise specifically provided by law, a lender to
evaluate the total financial situation of a student
making application for a loan under this part, or to
counsel a student with respect to any such loan, or to
make a decision based on such evaluation and counseling
with respect to the dollar amount of any such loan.
(7) Loans that have not been consummated.--Lenders
may not charge interest or receive interest subsidies
or special allowance payments for loans for which the
disbursement checks have not been cashed or for which
electronic funds transfers have not been completed.
(b) Insurance Program Agreements To Qualify Loans for
Interest Subsidies.--
(1) Requirements of insurance program.--Any State or
any nonprofit private institution or organization may
enter into an agreement with the Secretary for the
purpose of entitling students who receive loans which
are insured under a student loan insurance program of
that State, institution, or organization to have made
on their behalf the payments provided for in subsection
(a) if the Secretary determines that the student loan
insurance program--
(A) authorizes the insurance in any academic
year, as defined in section 481(a)(2), or its
equivalent (as determined under regulations of
the Secretary) for any student who is carrying
at an eligible institution or in a program of
study abroad approved for credit by the
eligible home institution at which such student
is enrolled at least one-half the normal full-
time academic workload (as determined by the
institution) in any amount up to a maximum of--
(i) in the case of a student at an
eligible institution who has not
successfully completed the first year
of a program of undergraduate
education--
(I) $3,500, if such student
is enrolled in a program whose
length is at least one academic
year in length; and
(II) if such student is
enrolled in a program of
undergraduate education which
is less than 1 academic year,
the maximum annual loan amount
that such student may receive
may not exceed the amount that
bears the same ratio to the
amount specified in subclause
(I) as the length of such
program measured in semester,
trimester, quarter, or clock
hours bears to 1 academic year;
(ii) in the case of a student at an
eligible institution who has
successfully completed such first year
but has not successfully completed the
remainder of a program of undergraduate
education--
(I) $4,500; or
(II) if such student is
enrolled in a program of
undergraduate education, the
remainder of which is less than
one academic year, the maximum
annual loan amount that such
student may receive may not
exceed the amount that bears
the same ratio to the amount
specified in subclause (I) as
such remainder measured in
semester, trimester, quarter,
or clock hours bears to one
academic year;
(iii) in the case of a student at an
eligible institution who has
successfully completed the first and
second years of a program of
undergraduate education but has not
successfully completed the remainder of
such program--
(I) $5,500; or
(II) if such student is
enrolled in a program of
undergraduate education, the
remainder of which is less than
one academic year, the maximum
annual loan amount that such
student may receive may not
exceed the amount that bears
the same ratio to the amount
specified in subclause (I) as
such remainder measured in
semester, trimester, quarter,
or clock hours bears to one
academic year;
(iv) in the case of a student who has
received an associate or baccalaureate
degree and is enrolled in an eligible
program for which the institution
requires such degree for admission, the
number of years that a student has
completed in a program of undergraduate
education shall, for the purposes of
clauses (ii) and (iii), include any
prior enrollment in the eligible
program of undergraduate education for
which the student was awarded such
degree;
(v) in the case of a graduate or
professional student (as defined in
regulations of the Secretary) at an
eligible institution, $8,500; and
(vi) in the case of a student
enrolled in coursework specified in
sections 484(b)(3)(B) and
484(b)(4)(B)--
(I) $2,625 for coursework
necessary for enrollment in an
undergraduate degree or
certificate program, and, in
the case of a student who has
obtained a baccalaureate
degree, $5,500 for coursework
necessary for enrollment in a
graduate or professional degree
or certification program; and
(II) in the case of a student
who has obtained a
baccalaureate degree, $5,500
for coursework necessary for a
professional credential or
certification from a State
required for employment as a
teacher in an elementary school
or secondary school;
except in cases where the Secretary determines,
pursuant to regulations, that a higher amount
is warranted in order to carry out the purpose
of this part with respect to students engaged
in specialized training requiring exceptionally
high costs of education, but the annual
insurable limit per student shall not be deemed
to be exceeded by a line of credit under which
actual payments by the lender to the borrower
will not be made in any years in excess of the
annual limit;
(B) provides that the aggregate insured
unpaid principal amount for all such insured
loans made to any student shall be any amount
up to a maximum of--
(i) $23,000, in the case of any
student who has not successfully
completed a program of undergraduate
education, excluding loans made under
section 428A or 428B; and
(ii) $65,500, in the case of any
graduate or professional student (as
defined by regulations of the
Secretary), and (I) including any loans
which are insured by the Secretary
under this section, or by a guaranty
agency, made to such student before the
student became a graduate or
professional student, but (II)
excluding loans made under section 428A
or 428B,
except that the Secretary may increase the
limit applicable to students who are pursuing
programs which the Secretary determines are
exceptionally expensive;
(C) authorizes the insurance of loans to any
individual student for at least 6 academic
years of study or their equivalent (as
determined under regulations of the Secretary);
(D) provides that (i) the student borrower
shall be entitled to accelerate without penalty
the whole or any part of an insured loan, (ii)
the student borrower may annually change the
selection of a repayment plan under this part,
and (iii) the note, or other written evidence
of any loan, may contain such reasonable
provisions relating to repayment in the event
of default by the borrower as may be authorized
by regulations of the Secretary in effect at
the time such note or written evidence was
executed, and shall contain a notice that
repayment may, following a default by the
borrower, be subject to income contingent
repayment in accordance with subsection (m);
(E) subject to subparagraphs (D) and (L), and
except as provided by subparagraph (M),
provides that--
(i) not more than 6 months prior to
the date on which the borrower's first
payment is due, the lender shall offer
the borrower of a loan made, insured,
or guaranteed under this section or
section 428H, the option of repaying
the loan in accordance with a standard,
graduated, income-sensitive, or
extended repayment schedule (as
described in paragraph (9)) established
by the lender in accordance with
regulations of the Secretary; and
(ii) repayment of loans shall be in
installments in accordance with the
repayment plan selected under paragraph
(9) and commencing at the beginning of
the repayment period determined under
paragraph (7);
(F) authorizes interest on the unpaid balance
of the loan at a yearly rate not in excess
(exclusive of any premium for insurance which
may be passed on to the borrower) of the rate
required by section 427A;
(G) insures 98 percent of the unpaid
principal of loans insured under the program,
except that--
(i) such program shall insure 100
percent of the unpaid principal of
loans made with funds advanced pursuant
to section 428(j);
(ii) for any loan for which the first
disbursement of principal is made on or
after July 1, 2006, and before July 1,
2010, the preceding provisions of this
subparagraph shall be applied by
substituting ``97 percent'' for ``98
percent''; and
(iii) notwithstanding the preceding
provisions of this subparagraph, such
program shall insure 100 percent of the
unpaid principal amount of exempt
claims as defined in subsection
(c)(1)(G);
(H) provides--
(i) for loans for which the date of
guarantee of principal is before July
1, 2006, for the collection of a single
insurance premium equal to not more
than 1.0 percent of the principal
amount of the loan, by deduction
proportionately from each installment
payment of the proceeds of the loan to
the borrower, and ensures that the
proceeds of the premium will not be
used for incentive payments to lenders;
or
(ii) for loans for which the date of
guarantee of principal is on or after
July 1, 2006, and that are first
disbursed before July 1, 2010, for the
collection, and the deposit into the
Federal Student Loan Reserve Fund under
section 422A of a Federal default fee
of an amount equal to 1.0 percent of
the principal amount of the loan, which
fee shall be collected either by
deduction from the proceeds of the loan
or by payment from other non-Federal
sources, and ensures that the proceeds
of the Federal default fee will not be
used for incentive payments to lenders;
(I) provides that the benefits of the loan
insurance program will not be denied any
student who is eligible for interest benefits
under subsection (a) (1) and (2);
(J) provides that a student may obtain
insurance under the program for a loan for any
year of study at an eligible institution;
(K) in the case of a State program, provides
that such State program is administered by a
single State agency, or by one or more
nonprofit private institutions or organizations
under supervision of a single State agency;
(L) provides that the total of the payments
by a borrower--
(i) except as otherwise provided by a
repayment plan selected by the borrower
under clause (ii), (iii), or (v) of
paragraph (9)(A), during any year of
any repayment period with respect to
the aggregate amount of all loans to
that borrower which are insured under
this part shall not, unless the
borrower and the lender otherwise
agree, be less than $600 or the balance
of all such loans (together with
interest thereon), whichever amount is
less (but in no instance less than the
amount of interest due and payable,
notwithstanding any payment plan under
paragraph (9)(A)); and
(ii) for a monthly or other similar
payment period with respect to the
aggregate of all loans held by the
lender may, when the amount of a
monthly or other similar payment is not
a multiple of $5, be rounded to the
next highest whole dollar amount that
is a multiple of $5;
(M) provides that periodic installments of
principal need not be paid, but interest shall
accrue and be paid by the Secretary, during any
period--
(i) during which the borrower--
(I) is pursuing at least a
half-time course of study as
determined by an eligible
institution, except that no
borrower, notwithstanding the
provisions of the promissory
note, shall be required to
borrow an additional loan under
this title in order to be
eligible to receive a deferment
under this clause; or
(II) is pursuing a course of
study pursuant to a graduate
fellowship program approved by
the Secretary, or pursuant to a
rehabilitation training program
for disabled individuals
approved by the Secretary,
except that no borrower shall be
eligible for a deferment under this
clause, or loan made under this part
(other than a loan made under section
428B or 428C), while serving in a
medical internship or residency
program;
(ii) not in excess of 3 years during
which the borrower is seeking and
unable to find full-time employment,
except that no borrower who provides
evidence of eligibility for
unemployment benefits shall be required
to provide additional paperwork for a
deferment under this clause;
(iii) during which the borrower--
(I) is serving on active duty
during a war or other military
operation or national
emergency; or
(II) is performing qualifying
National Guard duty during a
war or other military operation
or national emergency,
and for the 180-day period following
the demobilization date for the service
described in subclause (I) [or (II);
or] or (II);
(iv) not in excess of 3 years for any
reason which the lender determines, in
accordance with regulations prescribed
by the Secretary under section 435(o),
has caused or will cause the borrower
to have an economic hardship; or
(v) during which the borrower is
receiving treatment for cancer and the
6 months after such period;
(N) provides that funds borrowed by a
student--
(i) are disbursed to the institution
by check or other means that is payable
to, and requires the endorsement or
other certification by, such student;
(ii) in the case of a student who is
studying outside the United States in a
program of study abroad that is
approved for credit by the home
institution at which such student is
enrolled, and only after verification
of the student's enrollment by the
lender or guaranty agency, are, at the
request of the student, disbursed
directly to the student by the means
described in clause (i), unless such
student requests that the check be
endorsed, or the funds transfer be
authorized, pursuant to an authorized
power-of-attorney; or
(iii) in the case of a student who is
studying outside the United States in a
program of study at an eligible foreign
institution, are, at the request of the
foreign institution, disbursed directly
to the student, only after verification
of the student's enrollment by the
lender or guaranty agency by the means
described in clause (i).
(O) provides that the proceeds of the loans
will be disbursed in accordance with the
requirements of section 428G;
(P) requires the borrower to notify the
institution concerning any change in local
address during enrollment and requires the
borrower and the institution at which the
borrower is in attendance promptly to notify
the holder of the loan, directly or through the
guaranty agency, concerning (i) any change of
permanent address, (ii) when the student ceases
to be enrolled on at least a half-time basis,
and (iii) any other change in status, when such
change in status affects the student's
eligibility for the loan;
(Q) provides for the guarantee of loans made
to students and parents under sections 428A and
428B;
(R) with respect to lenders which are
eligible institutions, provides for the
insurance of loans by only such institutions as
are located within the geographic area served
by such guaranty agency;
(S) provides no restrictions with respect to
the insurance of loans for students who are
otherwise eligible for loans under such program
if such a student is accepted for enrollment in
or is attending an eligible institution within
the State, or if such a student is a legal
resident of the State and is accepted for
enrollment in or is attending an eligible
institution outside that State;
(T) authorizes (i) the limitation of the
total number of loans or volume of loans, made
under this part to students attending a
particular eligible institution during any
academic year; and (ii) the emergency action,
limitation, suspension, or termination of the
eligibility of an eligible institution if--
(I) such institution is ineligible
for the emergency action, limitation,
suspension, or termination of eligible
institutions under regulations issued
by the Secretary or is ineligible
pursuant to criteria, rules, or
regulations issued under the student
loan insurance program which are
substantially the same as regulations
with respect to emergency action,
limitation, suspension, or termination
of such eligibility issued by the
Secretary;
(II) there is a State constitutional
prohibition affecting the eligibility
of such an institution;
(III) such institution fails to make
timely refunds to students as required
by regulations issued by the Secretary
or has not satisfied within 30 days of
issuance a final judgment obtained by a
student seeking such a refund;
(IV) such institution or an owner,
director, or officer of such
institution is found guilty in any
criminal, civil, or administrative
proceeding, or such institution or an
owner, director, or officer of such
institution is found liable in any
civil or administrative proceeding,
regarding the obtaining, maintenance,
or disbursement of State or Federal
grant, loan, or work assistance funds;
or
(V) such institution or an owner,
director, or officer of such
institution has unpaid financial
liabilities involving the improper
acquisition, expenditure, or refund of
State or Federal financial assistance
funds;
except that, if a guaranty agency limits,
suspends, or terminates the participation of an
eligible institution, the Secretary shall apply
that limitation, suspension, or termination to
all locations of such institution, unless the
Secretary finds, within 30 days of notification
of the action by the guaranty agency, that the
guaranty agency's action did not comply with
the requirements of this section;
(U) provides (i) for the eligibility of all
lenders described in section 435(d)(1) under
reasonable criteria, unless (I) that lender is
eliminated as a lender under regulations for
the emergency action, limitation, suspension,
or termination of a lender under the Federal
student loan insurance program or is eliminated
as a lender pursuant to criteria issued under
the student loan insurance program which are
substantially the same as regulations with
respect to such eligibility as a lender issued
under the Federal student loan insurance
program, or (II) there is a State
constitutional prohibition affecting the
eligibility of a lender, (ii) assurances that
the guaranty agency will report to the
Secretary concerning changes in such criteria,
including any procedures in effect under such
program to take emergency action, limit,
suspend, or terminate lenders, and (iii) for
(I) a compliance audit of each lender that
originates or holds more than $5,000,000 in
loans made under this title for any lender
fiscal year (except that each lender described
in section 435(d)(1)(A)(ii)(III) shall annually
submit the results of an audit required by this
clause), at least once a year and covering the
period since the most recent audit, conducted
by a qualified, independent organization or
person in accordance with standards established
by the Comptroller General for the audit of
governmental organizations, programs, and
functions, and as prescribed in regulations of
the Secretary, the results of which shall be
submitted to the Secretary, or (II) with regard
to a lender that is audited under chapter 75 of
title 31, United States Code, such audit shall
be deemed to satisfy the requirements of
subclause (I) for the period covered by such
audit, except that the Secretary may waive the
requirements of this clause (iii) if the lender
submits to the Secretary the results of an
audit conducted for other purposes that the
Secretary determines provides the same
information as the audits required by this
clause;
(V) provides authority for the guaranty
agency to require a participation agreement
between the guaranty agency and each eligible
institution within the State in which it is
designated, as a condition for guaranteeing
loans made on behalf of students attending the
institution;
(W) provides assurances that the agency will
implement all requirements of the Secretary for
uniform claims and procedures pursuant to
section 432(l);
(X) provides information to the Secretary in
accordance with section 428(c)(9) and maintains
reserve funds determined by the Secretary to be
sufficient in relation to such agency's
guarantee obligations; and
(Y) provides that--
(i) the lender shall determine the
eligibility of a borrower for a
deferment described in subparagraph
(M)(i) based on--
(I) receipt of a request for
deferment from the borrower and
documentation of the borrower's
eligibility for the deferment;
(II) receipt of a newly
completed loan application that
documents the borrower's
eligibility for a deferment;
(III) receipt of student
status information documenting
that the borrower is enrolled
on at least a half-time basis;
or
(IV) the lender's
confirmation of the borrower's
half-time enrollment status
through use of the National
Student Loan Data System, if
the confirmation is requested
by the institution of higher
education;
(ii) the lender will notify the
borrower of the granting of any
deferment under clause (i)(II) or (III)
of this subparagraph and of the option
to continue paying on the loan; and
(iii) the lender shall, at the time
the lender grants a deferment to a
borrower who received a loan under
section 428H and is eligible for a
deferment under subparagraph (M) of
this paragraph, provide information to
the borrower to assist the borrower in
understanding the impact of the
capitalization of interest on the
borrower's loan principal and on the
total amount of interest to be paid
during the life of the loan.
(2) Contents of insurance program agreement.--Such an
agreement shall--
(A) provide that the holder of any such loan
will be required to submit to the Secretary, at
such time or times and in such manner as the
Secretary may prescribe, statements containing
such information as may be required by or
pursuant to regulation for the purpose of
enabling the Secretary to determine the amount
of the payment which must be made with respect
to that loan;
(B) include such other provisions as may be
necessary to protect the United States from the
risk of unreasonable loss and promote the
purpose of this part, including such provisions
as may be necessary for the purpose of section
437, and as are agreed to by the Secretary and
the guaranty agency, as the case may be;
(C) provide for making such reports, in such
form and containing such information, including
financial information, as the Secretary may
reasonably require to carry out the Secretary's
functions under this part and protect the
financial interest of the United States, and
for keeping such records and for affording such
access thereto as the Secretary may find
necessary to assure the correctness and
verification of such reports;
(D) provide for--
(i) conducting, except as provided in
clause (ii), financial and compliance
audits of the guaranty agency on at
least an annual basis and covering the
period since the most recent audit,
conducted by a qualified, independent
organization or person in accordance
with standards established by the
Comptroller General for the audit of
governmental organizations, programs,
and functions, and as prescribed in
regulations of the Secretary, the
results of which shall be submitted to
the Secretary; or
(ii) with regard to a guaranty
program of a State which is audited
under chapter 75 of title 31, United
States Code, deeming such audit to
satisfy the requirements of clause (i)
for the period of time covered by such
audit;
(E)(i) provide that any guaranty agency may
transfer loans which are insured under this
part to any other guaranty agency with the
approval of the holder of the loan and such
other guaranty agency; and
(ii) provide that the lender (or the holder
of the loan) shall, not later than 120 days
after the borrower has left the eligible
institution, notify the borrower of the date on
which the repayment period begins; and
(F) provide that, if the sale, other
transfer, or assignment of a loan made under
this part to another holder will result in a
change in the identity of the party to whom the
borrower must send subsequent payments or
direct any communications concerning the loans,
then--
(i) the transferor and the transferee
will be required, not later than 45
days from the date the transferee
acquires a legally enforceable right to
receive payment from the borrower on
such loan, either jointly or separately
to provide a notice to the borrower
of--
(I) the sale or other
transfer;
(II) the identity of the
transferee;
(III) the name and address of
the party to whom subsequent
payments or communications must
be sent;
(IV) the telephone numbers of
both the transferor and the
transferee;
(V) the effective date of the
transfer;
(VI) the date on which the
current servicer (as of the
date of the notice) will stop
accepting payments; and
(VII) the date on which the
new servicer will begin
accepting payments; and
(ii) the transferee will be required
to notify the guaranty agency, and,
upon the request of an institution of
higher education, the guaranty agency
shall notify the last such institution
the student attended prior to the
beginning of the repayment period of
any loan made under this part, of--
(I) any sale or other
transfer of the loan; and
(II) the address and
telephone number by which
contact may be made with the
new holder concerning repayment
of the loan,
except that this subparagraph (F) shall only
apply if the borrower is in the grace period
described in section 427(a)(2)(B) or 428(b)(7)
or is in repayment status.
(3) Restrictions on inducements, payments, mailings,
and advertising.--A guaranty agency shall not--
(A) offer, directly or indirectly, premiums,
payments, stock or other securities, prizes,
travel, entertainment expenses, tuition payment
or reimbursement, or other inducements to--
(i) any institution of higher
education, any employee of an
institution of higher education, or any
individual or entity in order to secure
applicants for loans made under this
part; or
(ii) any lender, or any agent,
employee, or independent contractor of
any lender or guaranty agency, in order
to administer or market loans made
under this part (other than a loan made
as part of the guaranty agency's
lender-of-last-resort program pursuant
to section 428(j)), for the purpose of
securing the designation of the
guaranty agency as the insurer of such
loans;
(B) conduct unsolicited mailings, by postal
or electronic means, of student loan
application forms to students enrolled in
secondary schools or postsecondary educational
institutions, or to the families of such
students, except that applications may be
mailed, by postal or electronic means, to
students or borrowers who have previously
received loans guaranteed under this part by
the guaranty agency;
(C) perform, for an institution of higher
education participating in a program under this
title, any function that such institution is
required to perform under this title, except
that the guaranty agency may perform functions
on behalf of such institution in accordance
with section 485(b) or 485(l);
(D) pay, on behalf of an institution of
higher education, another person to perform any
function that such institution is required to
perform under this title, except that the
guaranty agency may perform functions on behalf
of such institution in accordance with section
485(b) or 485(l); or
(E) conduct fraudulent or misleading
advertising concerning loan availability,
terms, or conditions.
It shall not be a violation of this paragraph for a
guaranty agency to provide technical assistance to
institutions of higher education comparable to the
technical assistance provided to institutions of higher
education by the Department.
(4) Special rule.--With respect to the graduate
fellowship program referred to in paragraph
(1)(M)(i)(II), the Secretary shall approve any course
of study at a foreign university that is accepted for
the completion of a recognized international fellowship
program by the administrator of such a program.
Requests for deferment of repayment of loans under this
part by students engaged in graduate or postgraduate
fellowship-supported study (such as pursuant to a
Fulbright grant) outside the United States shall be
approved until completion of the period of the
fellowship.
(5) Guaranty agency information transfers.--(A) Until
such time as the Secretary has implemented section 485B
and is able to provide to guaranty agencies the
information required by such section, any guaranty
agency may request information regarding loans made
after January 1, 1987, to students who are residents of
the State for which the agency is the designated
guarantor, from any other guaranty agency insuring
loans to such students.
(B) Upon a request pursuant to subparagraph (A), a
guaranty agency shall provide--
(i) the name and the social security number
of the borrower; and
(ii) the amount borrowed and the cumulative
amount borrowed.
(C) Any costs associated with fulfilling the request
of a guaranty agency for information on students shall
be paid by the guaranty agency requesting the
information.
(6) State guaranty agency information request of
state licensing boards.--Each guaranty agency is
authorized to enter into agreements with each
appropriate State licensing board under which the State
licensing board, upon request, will furnish the
guaranty agency with the address of a student borrower
in any case in which the location of the student
borrower is unknown or unavailable to the guaranty
agency.
(7) Repayment period.--(A) In the case of a loan made
under section 427 or 428, the repayment period shall
exclude any period of authorized deferment or
forbearance and shall begin the day after 6 months
after the date the student ceases to carry at least
one-half the normal full-time academic workload (as
determined by the institution).
(B) In the case of a loan made under section 428H,
the repayment period shall exclude any period of
authorized deferment or forbearance, and shall begin as
described in subparagraph (A), but interest shall begin
to accrue or be paid by the borrower on the day the
loan is disbursed.
(C) In the case of a loan made under section 428B or
428C, the repayment period shall begin on the day the
loan is disbursed, or, if the loan is disbursed in
multiple installments, on the day of the last such
disbursement, and shall exclude any period of
authorized deferment or forbearance.
(D) There shall be excluded from the 6-month period
that begins on the date on which a student ceases to
carry at least one-half the normal full-time academic
workload as described in subparagraph (A) any period
not to exceed 3 years during which a borrower who is a
member of a reserve component of the Armed Forces named
in section 10101 of title 10, United States Code, is
called or ordered to active duty for a period of more
than 30 days (as defined in section 101(d)(2) of such
title). Such period of exclusion shall include the
period necessary to resume enrollment at the borrower's
next available regular enrollment period.
(8) Means of disbursement of loan proceeds.--Nothing
in this title shall be interpreted to prohibit the
disbursement of loan proceeds by means other than by
check or to allow the Secretary to require checks to be
made co-payable to the institution and the borrower.
(9) Repayment plans.--
(A) Design and selection.--In accordance with
regulations promulgated by the Secretary, the
lender shall offer a borrower of a loan made
under this part the plans described in this
subparagraph for repayment of such loan,
including principal and interest thereon. No
plan may require a borrower to repay a loan in
less than 5 years unless the borrower, during
the 6 months immediately preceding the start of
the repayment period, specifically requests
that repayment be made over of a shorter
period. The borrower may choose from--
(i) a standard repayment plan, with a
fixed annual repayment amount paid over
a fixed period of time, not to exceed
10 years;
(ii) a graduated repayment plan paid
over a fixed period of time, not to
exceed 10 years;
(iii) an income-sensitive repayment
plan, with income-sensitive repayment
amounts paid over a fixed period of
time, not to exceed 10 years, except
that the borrower's scheduled payments
shall not be less than the amount of
interest due;
(iv) for new borrowers on or after
the date of enactment of the Higher
Education Amendments of 1998 who
accumulate (after such date)
outstanding loans under this part
totaling more than $30,000, an extended
repayment plan, with a fixed annual or
graduated repayment amount paid over an
extended period of time, not to exceed
25 years, except that the borrower
shall repay annually a minimum amount
determined in accordance with paragraph
(1)(L)(i); and
(v) beginning July 1, 2009, an
income-based repayment plan that
enables a borrower who has a partial
financial hardship to make a lower
monthly payment in accordance with
section 493C, except that the plan
described in this clause shall not be
available to a borrower for a loan
under section 428B made on behalf of a
dependent student or for a
consolidation loan under section 428C,
if the proceeds of such loan were used
to discharge the liability of a loan
under section 428B made on behalf of a
dependent student.
(B) Lender selection of option if borrower
does not select.--If a borrower of a loan made
under this part does not select a repayment
plan described in subparagraph (A), the lender
shall provide the borrower with a repayment
plan described in subparagraph (A)(i).
(c) Guaranty Agreements for Reimbursing Losses.--
(1) Authority to enter into agreements.--(A) The
Secretary may enter into a guaranty agreement with any
guaranty agency, whereby the Secretary shall undertake
to reimburse it, under such terms and conditions as the
Secretary may establish, with respect to losses
(resulting from the default of the student borrower) on
the unpaid balance of the principal and accrued
interest of any insured loan. The guaranty agency
shall, be deemed to have a contractual right against
the United States, during the life of such loan, to
receive reimbursement according to the provisions of
this subsection. Upon receipt of an accurate and
complete request by a guaranty agency for reimbursement
with respect to such losses, the Secretary shall pay
promptly and without administrative delay. Except as
provided in subparagraph (B) of this paragraph and in
paragraph (7), the amount to be paid a guaranty agency
as reimbursement under this subsection shall be equal
to 100 percent of the amount expended by it in
discharge of its insurance obligation incurred under
its loan insurance program. A guaranty agency shall
file a claim for reimbursement with respect to losses
under this subsection within 30 days after the guaranty
agency discharges its insurance obligation on the loan.
(B) Notwithstanding subparagraph (A)--
(i) if, for any fiscal year, the amount of
such reimbursement payments by the Secretary
under this subsection exceeds 5 percent of the
loans which are insured by such guaranty agency
under such program and which were in repayment
at the end of the preceding fiscal year, the
amount to be paid as reimbursement under this
subsection for such excess shall be equal to 85
percent of the amount of such excess; and
(ii) if, for any fiscal year, the amount of
such reimbursement payments exceeds 9 percent
of such loans, the amount to be paid as
reimbursement under this subsection for such
excess shall be equal to 75 percent of the
amount of such excess.
(C) For the purpose of this subsection, the amount of
loans of a guaranty agency which are in repayment shall
be the original principal amount of loans made by a
lender which are insured by such a guaranty agency
reduced by--
(i) the amount the insurer has been required
to pay to discharge its insurance obligations
under this part;
(ii) the original principal amount of loans
insured by it which have been fully repaid; and
(iii) the original principal amount insured
on those loans for which payment of the first
installment of principal has not become due
pursuant to subsection (b)(1)(E) of this
section or such first installment need not be
paid pursuant to subsection (b)(1)(M) of this
section.
(D) Notwithstanding any other provisions of this
section, in the case of a loan made pursuant to a
lender-of-last-resort program, the Secretary shall
apply the provisions of--
(i) the fourth sentence of subparagraph (A)
by substituting ``100 percent'' for ``95
percent'';
(ii) subparagraph (B)(i) by substituting
``100 percent'' for ``85 percent''; and
(iii) subparagraph (B)(ii) by substituting
``100 percent'' for ``75 percent''.
(E) Notwithstanding any other provisions of this
section, in the case of an outstanding loan transferred
to a guaranty agency from another guaranty agency
pursuant to a plan approved by the Secretary in
response to the insolvency of the latter such guarantee
agency, the Secretary shall apply the provision of--
(i) the fourth sentence of subparagraph (A)
by substituting ``100 percent'' for ``95
percent'';
(ii) subparagraph (B)(i) by substituting ``90
percent'' for ``85 percent''; and
(iii) subparagraph (B)(ii) by substituting
``80 percent'' for ``75 percent''.
(F)(i) Notwithstanding any other provisions of this
section, in the case of exempt claims, the Secretary
shall apply the provisions of--
(I) the fourth sentence of subparagraph (A)
by substituting ``100 percent'' for ``95
percent'';
(II) subparagraph (B)(i) by substituting
``100 percent'' for ``85 percent''; and
(III) subparagraph (B)(ii) by substituting
``100 percent'' for ``75 percent''.
(ii) For purposes of clause (i) of this subparagraph,
the term ``exempt claims'' means claims with respect to
loans for which it is determined that the borrower (or
the student on whose behalf a parent has borrowed),
without the lender's or the institution's knowledge at
the time the loan was made, provided false or erroneous
information or took actions that caused the borrower or
the student to be ineligible for all or a portion of
the loan or for interest benefits thereon.
(G) Notwithstanding any other provision of this
section, the Secretary shall exclude a loan made
pursuant to a lender-of-last-resort program when making
reimbursement payment calculations under subparagraphs
(B) and (C).
(2) Contents of guaranty agreements.--The guaranty
agreement--
(A) shall set forth such administrative and
fiscal procedures as may be necessary to
protect the United States from the risk of
unreasonable loss thereunder, to ensure proper
and efficient administration of the loan
insurance program, and to assure that due
diligence will be exercised in the collection
of loans insured under the program, including
(i) a requirement that each beneficiary of
insurance on the loan submit proof that the
institution was contacted and other reasonable
attempts were made to locate the borrower (when
the location of the borrower is unknown) and
proof that contact was made with the borrower
(when the location is known) and (ii)
requirements establishing procedures to
preclude consolidation lending from being an
excessive proportion of guaranty agency
recoveries on defaulted loans under this part;
(B) shall provide for making such reports, in
such form and containing such information, as
the Secretary may reasonably require to carry
out the Secretary's functions under this
subsection, and for keeping such records and
for affording such access thereto as the
Secretary may find necessary to assure the
correctness and verification of such reports;
(C) shall set forth adequate assurances that,
with respect to so much of any loan insured
under the loan insurance program as may be
guaranteed by the Secretary pursuant to this
subsection, the undertaking of the Secretary
under the guaranty agreement is acceptable in
full satisfaction of State law or regulation
requiring the maintenance of a reserve;
(D) shall provide that if, after the
Secretary has made payment under the guaranty
agreement pursuant to paragraph (1) of this
subsection with respect to any loan, any
payments are made in discharge of the
obligation incurred by the borrower with
respect to such loan (including any payments of
interest accruing on such loan after such
payment by the Secretary), there shall be paid
over to the Secretary (for deposit in the fund
established by section 431) such proportion of
the amounts of such payments as is determined
(in accordance with paragraph (6)(A)) to
represent his equitable share thereof, but (i)
shall provide for subrogation of the United
States to the rights of any insurance
beneficiary only to the extent required for the
purpose of paragraph (8); and (ii) except as
the Secretary may otherwise by or pursuant to
regulation provide, amounts so paid by a
borrower on such a loan shall be first applied
in reduction of principal owing on such loan;
(E) shall set forth adequate assurance that
an amount equal to each payment made under
paragraph (1) will be promptly deposited in or
credited to the accounts maintained for the
purpose of section 422(c);
(F) set forth adequate assurances that the
guaranty agency will not engage in any pattern
or practice which results in a denial of a
borrower's access to loans under this part
because of the borrower's race, sex, color,
religion, national origin, age, handicapped
status, income, attendance at a particular
eligible institution within the area served by
the guaranty agency, length of the borrower's
educational program, or the borrower's academic
year in school;
(G) shall prohibit the Secretary from making
any reimbursement under this subsection to a
guaranty agency when a default claim is based
on an inability to locate the borrower, unless
the guaranty agency, at the time of filing for
reimbursement, certifies to the Secretary that
diligent attempts, including contact with the
institution, have been made to locate the
borrower through the use of reasonable skip-
tracing techniques in accordance with
regulations prescribed by the Secretary; and
(H) set forth assurances that--
(i) upon the request of an eligible
institution, the guaranty agency shall,
subject to clauses (ii) and (iii),
furnish to the institution information
with respect to students (including the
names and addresses of such students)
who received loans made, insured, or
guaranteed under this part for
attendance at the eligible institution
and for whom default aversion
assistance activities have been
requested under subsection (l);
(ii) the guaranty agency shall not
require the payment from the
institution of any fee for such
information; and
(iii) the guaranty agency will
require the institution to use such
information only to assist the
institution in reminding students of
their obligation to repay student loans
and shall prohibit the institution from
disseminating the information for any
other purpose.
(I) may include such other provisions as may
be necessary to promote the purpose of this
part.
(3) Forbearance.--A guaranty agreement under this
subsection--
(A) shall contain provisions providing that--
(i) upon request, a lender shall
grant a borrower forbearance, renewable
at 12-month intervals, on terms agreed
to by the parties to the loan with the
approval of the insurer and documented
in accordance with paragraph (10), and
otherwise consistent with the
regulations of the Secretary, if the
borrower--
(I) is serving in a medical
or dental internship or
residency program, the
successful completion of which
is required to begin
professional practice or
service, or is serving in a
medical or dental internship or
residency program leading to a
degree or certificate awarded
by an institution of higher
education, a hospital, or a
health care facility that
offers postgraduate training,
provided that if the borrower
qualifies for a deferment under
section 427(a)(2)(C)(vii) or
subsection (b)(1)(M)(vii) of
this section as in effect prior
to the enactment of the Higher
Education Amendments of 1992,
or section 427(a)(2)(C) or
subsection (b)(1)(M) of this
section as amended by such
amendments, the borrower has
exhausted his or her
eligibility for such deferment;
(II) has a debt burden under
this title that equals or
exceeds 20 percent of income;
(III) is serving in a
national service position for
which the borrower receives a
national service educational
award under the National and
Community Service Trust Act of
1993; or
(IV) is eligible for interest
payments to be made on such
loan for service in the Armed
Forces under section 2174 of
title 10, United States Code,
and, pursuant to that
eligibility, the interest is
being paid on such loan under
subsection (o);
(ii) the length of the forbearance
granted by the lender--
(I) under clause (i)(I) shall
equal the length of time
remaining in the borrower's
medical or dental internship or
residency program, if the
borrower is not eligible to
receive a deferment described
in such clause, or such length
of time remaining in the
program after the borrower has
exhausted the borrower's
eligibility for such deferment;
(II) under clause (i)(II) or
(IV) shall not exceed 3 years;
or
(III) under clause (i)(III)
shall not exceed the period for
which the borrower is serving
in a position described in such
clause; and
(iii) no administrative or other fee
may be charged in connection with the
granting of a forbearance under clause
(i), and no adverse information
regarding a borrower may be reported to
a consumer reporting agency solely
because of the granting of such
forbearance;
(B) may, to the extent provided in
regulations of the Secretary, contain
provisions that permit such forbearance for the
benefit of the student borrower as may be
agreed upon by the parties to an insured loan
and approved by the insurer;
(C) shall contain provisions that specify
that--
(i) the form of forbearance granted
by the lender pursuant to this
paragraph, other than subparagraph
(A)(i)(IV), shall be temporary
cessation of payments, unless the
borrower selects forbearance in the
form of an extension of time for making
payments, or smaller payments than were
previously scheduled;
(ii) the form of forbearance granted
by the lender pursuant to subparagraph
(A)(i)(IV) shall be the temporary
cessation of all payments on the loan
other than payments of interest on the
loan that are made under subsection
(o);
(iii) the lender shall, at the time
of granting a borrower forbearance,
provide information to the borrower to
assist the borrower in understanding
the impact of capitalization of
interest on the borrower's loan
principal and total amount of interest
to be paid during the life of the loan;
and
(iv) the lender shall contact the
borrower not less often than once every
180 days during the period of
forbearance to inform the borrower of--
(I) the amount of unpaid
principal and the amount of
interest that has accrued since
the last statement of such
amounts provided to the
borrower by the lender;
(II) the fact that interest
will accrue on the loan for the
period of forbearance;
(III) the amount of interest
that will be capitalized, and
the date on which
capitalization will occur;
(IV) the option of the
borrower to pay the interest
that has accrued before the
interest is capitalized; and
(V) the borrower's option to
discontinue the forbearance at
any time; and
(D) shall contain provisions that specify
that--
(i) forbearance for a period not to
exceed 60 days may be granted if the
lender reasonably determines that such
a suspension of collection activity is
warranted following a borrower's
request for deferment, forbearance, a
change in repayment plan, or a request
to consolidate loans, in order to
collect or process appropriate
supporting documentation related to the
request, and
(ii) during such period interest
shall accrue but not be capitalized.
Guaranty agencies shall not be precluded from
permitting the parties to such a loan from entering
into a forbearance agreement solely because the loan is
in default. The Secretary shall permit lenders to
exercise administrative forbearances that do not
require the agreement of the borrower, under conditions
authorized by the Secretary. Such forbearances shall
include (i) forbearances for borrowers who are
delinquent at the time of the granting of an authorized
period of deferment under section 428(b)(1)(M) or
427(a)(2)(C), and (ii) if the borrower is less than 60
days delinquent on such loans at the time of sale or
transfer, forbearances for borrowers on loans which are
sold or transferred.
(4) Definitions.--For the purpose of this subsection,
the terms ``insurance beneficiary'' and ``default''
have the meanings assigned to them by section 435.
(5) Applicability to existing loans.--In the case of
any guaranty agreement with a guaranty agency, the
Secretary may, in accordance with the terms of this
subsection, undertake to guarantee loans described in
paragraph (1) which are insured by such guaranty agency
and are outstanding on the date of execution of the
guaranty agreement, but only with respect to defaults
occurring after the execution of such guaranty
agreement or, if later, after its effective date.
(6) Secretary's equitable share.--(A) For the purpose
of paragraph (2)(D), the Secretary's equitable share of
payments made by the borrower shall be that portion of
the payments remaining after the guaranty agency with
which the Secretary has an agreement under this
subsection has deducted from such payments--
(i) a percentage amount equal to the
complement of the reinsurance percentage in
effect when payment under the guaranty
agreement was made with respect to the loan;
and
(ii) an amount equal to 24 percent of
such payments for use in accordance
with section 422B, except that--
(I) beginning October 1, 2003
and ending September 30, 2007,
this clause shall be applied by
substituting ``23 percent'' for
``24 percent''; and
(II) beginning October 1,
2007, this clause shall be
applied by substituting ``16
percent'' for ``24 percent''.
(B) A guaranty agency shall--
(i) on or after October 1, 2006--
(I) not charge the borrower
collection costs in an amount in excess
of 18.5 percent of the outstanding
principal and interest of a defaulted
loan that is paid off through
consolidation by the borrower under
this title; and
(II) remit to the Secretary a portion
of the collection charge under
subclause (I) equal to 8.5 percent of
the outstanding principal and interest
of such defaulted loan; and
(ii) on and after October 1, 2009, remit to
the Secretary the entire amount charged under
clause (i)(I) with respect to each defaulted
loan that is paid off with excess consolidation
proceeds.
(C) For purposes of subparagraph (B), the term
``excess consolidation proceeds'' means, with respect
to any guaranty agency for any Federal fiscal year
beginning on or after October 1, 2009, the proceeds of
consolidation of defaulted loans under this title that
exceed 45 percent of the agency's total collections on
defaulted loans in such Federal fiscal year.
(7) New programs eligible for 100 percent
reinsurance.--(A) Notwithstanding paragraph (1)(C), the
amount to be paid a guaranty agency for any fiscal
year--
(i) which begins on or after October 1, 1977
and ends before October 1, 1991; and
(ii) which is either the fiscal year in which
such guaranty agency begins to actively carry
on a student loan insurance program which is
subject to a guaranty agreement under
subsection (b) of this section, or is one of
the 4 succeeding fiscal years,
shall be 100 percent of the amount expended by such
guaranty agency in discharge of its insurance
obligation insured under such program.
(B) Notwithstanding the provisions of paragraph
(1)(C), the Secretary may pay a guaranty agency 100
percent of the amount expended by such agency in
discharge of such agency's insurance obligation for any
fiscal year which--
(i) begins on or after October 1, 1991; and
(ii) is the fiscal year in which such
guaranty agency begins to actively carry on a
student loan insurance program which is subject
to a guaranty agreement under subsection (b) or
is one of the 4 succeeding fiscal years.
(C) The Secretary shall continuously monitor the
operations of those guaranty agencies to which the
provisions of subparagraph (A) or (B) are applicable
and revoke the application of such subparagraph to any
such guaranty agency which the Secretary determines has
not exercised reasonable prudence in the administration
of such program.
(8) Assignment to protect federal fiscal interest.--
If the Secretary determines that the protection of the
Federal fiscal interest so requires, a guaranty agency
shall assign to the Secretary any loan of which it is
the holder and for which the Secretary has made a
payment pursuant to paragraph (1) of this subsection.
(9) Guaranty agency reserve level.--(A) Each guaranty
agency which has entered into an agreement with the
Secretary pursuant to this subsection shall maintain in
the agency's Federal Student Loan Reserve Fund
established under section 422A a current minimum
reserve level of at least 0.25 percent of the total
attributable amount of all outstanding loans guaranteed
by such agency. For purposes of this paragraph, such
total attributable amount does not include amounts of
outstanding loans transferred to the guaranty agency
from another guaranty agency pursuant to a plan of the
Secretary in response to the insolvency of the latter
such guaranty agency.
(B) The Secretary shall collect, on an annual basis,
information from each guaranty agency having an
agreement under this subsection to enable the Secretary
to evaluate the financial solvency of each such agency.
The information collected shall include the level of
such agency's current reserves, cash disbursements and
accounts receivable.
(C) If (i) any guaranty agency falls below the
required minimum reserve level in any 2 consecutive
years, (ii) any guaranty agency's Federal reimbursement
payments are reduced to 85 percent pursuant to
paragraph (1)(B)(i), or (iii) the Secretary determines
that the administrative or financial condition of a
guaranty agency jeopardizes such agency's continued
ability to perform its responsibilities under its
guaranty agreement, then the Secretary shall require
the guaranty agency to submit and implement a
management plan acceptable to the Secretary within 45
working days of any such event.
(D)(i) If the Secretary is not seeking to terminate
the guaranty agency's agreement under subparagraph (E),
or assuming the guaranty agency's functions under
subparagraph (F), a management plan described in
subparagraph (C) shall include the means by which the
guaranty agency will improve its financial and
administrative condition to the required level within
18 months.
(ii) If the Secretary is seeking to terminate the
guaranty agency's agreement under subparagraph (E), or
assuming the guaranty agency's functions under
subparagraph (F), a management plan described in
subparagraph (C) shall include the means by which the
Secretary and the guaranty agency shall work together
to ensure the orderly termination of the operations,
and liquidation of the assets, of the guaranty agency.
(E) The Secretary may terminate a guaranty agency's
agreement in accordance with subparagraph (F) if--
(i) a guaranty agency required to submit a
management plan under this paragraph fails to
submit a plan that is acceptable to the
Secretary;
(ii) the Secretary determines that a guaranty
agency has failed to improve substantially its
administrative and financial condition;
(iii) the Secretary determines that the
guaranty agency is in danger of financial
collapse;
(iv) the Secretary determines that such
action is necessary to protect the Federal
fiscal interest; or
(v) the Secretary determines that such action
is necessary to ensure the continued
availability of loans to student or parent
borrowers.
(F) If a guaranty agency's agreement under this
subsection is terminated pursuant to subparagraph (E),
then the Secretary shall assume responsibility for all
functions of the guaranty agency under the loan
insurance program of such agency. In performing such
functions the Secretary is authorized to--
(i) permit the transfer of guarantees to
another guaranty agency;
(ii) revoke the reinsurance agreement of the
guaranty agency at a specified date, so as to
require the merger, consolidation, or
termination of the guaranty agency;
(iii) transfer guarantees to the Department
of Education for the purpose of payment of such
claims and process such claims using the claims
standards of the guaranty agency, if such
standards are determined by the Secretary to be
in compliance with this Act;
(iv) design and implement a plan to restore
the guaranty agency's viability;
(v) provide the guaranty agency with
additional advance funds in accordance with
section 422(c)(7), with such restrictions on
the use of such funds as is determined
appropriate by the Secretary, in order to--
(I) meet the immediate cash needs of
the guaranty agency;
(II) ensure the uninterrupted payment
of claims; or
(III) ensure that the guaranty agency
will make loans as the lender-of-last-
resort, in accordance with subsection
(j);
(vi) use all funds and assets of the guaranty
agency to assist in the activities undertaken
in accordance with this subparagraph and take
appropriate action to require the return, to
the guaranty agency or the Secretary, of any
funds or assets provided by the guaranty
agency, under contract or otherwise, to any
person or organization; or
(vii) take any other action the Secretary
determines necessary to ensure the continued
availability of loans made under this part to
residents of the State or States in which the
guaranty agency did business, the full honoring
of all guarantees issued by the guaranty agency
prior to the Secretary's assumption of the
functions of such agency, and the proper
servicing of loans guaranteed by the guaranty
agency prior to the Secretary's assumption of
the functions of such agency, and to avoid
disruption of the student loan program.
(G) Notwithstanding any other provision of Federal or
State law, if the Secretary has terminated or is
seeking to terminate a guaranty agency's agreement
under subparagraph (E), or has assumed a guaranty
agency's functions under subparagraph (F)--
(i) no State court may issue any order
affecting the Secretary's actions with respect
to such guaranty agency;
(ii) any contract with respect to the
administration of a guaranty agency's reserve
funds, or the administration of any assets
purchased or acquired with the reserve funds of
the guaranty agency, that is entered into or
extended by the guaranty agency, or any other
party on behalf of or with the concurrence of
the guaranty agency, after the date of
enactment of this subparagraph shall provide
that the contract is terminable by the
Secretary upon 30 days notice to the
contracting parties if the Secretary determines
that such contract includes an impermissible
transfer of the reserve funds or assets, or is
otherwise inconsistent with the terms or
purposes of this section; and
(iii) no provision of State law shall apply
to the actions of the Secretary in terminating
the operations of a guaranty agency.
(H) Notwithstanding any other provision of law, the
Secretary's liability for any outstanding liabilities
of a guaranty agency (other than outstanding student
loan guarantees under this part), the functions of
which the Secretary has assumed, shall not exceed the
fair market value of the reserves of the guaranty
agency, minus any necessary liquidation or other
administrative costs.
(I) The Secretary shall not take any action under
subparagraph (E) or (F) without giving the guaranty
agency notice and the opportunity for a hearing that,
if commenced after September 24, 1998, shall be on the
record.
(J) Notwithstanding any other provision of law, the
information transmitted to the Secretary pursuant to
this paragraph shall be confidential and exempt from
disclosure under section 552 of title 5, United States
Code, relating to freedom of information, or any other
Federal law.
(K) The Secretary, within 6 months after the end of
each fiscal year, shall submit to the authorizing
committees a report specifying the Secretary's
assessment of the fiscal soundness of the guaranty
agency system.
(10) Documentation of forbearance agreements.--For
the purposes of paragraph (3), the terms of forbearance
agreed to by the parties shall be documented by
confirming the agreement of the borrower by notice to
the borrower from the lender, and by recording the
terms in the borrower's file.
(d) Usury Laws Inapplicable.--No provision of any law of the
United States (other than this Act and section 207 of the
Servicemembers Civil Relief Act (50 U.S.C. App. 527)) or of any
State (other than a statute applicable principally to such
State's student loan insurance program) which limits the rate
or amount of interest payable on loans shall apply to a loan--
(1) which bears interest (exclusive of any premium
for insurance) on the unpaid principal balance at a
rate not in excess of the rate specified in this part;
and
(2) which is insured (i) by the United States under
this part, or (ii) by a guaranty agency under a program
covered by an agreement made pursuant to subsection (b)
of this section.
(f) Payments of Certain Costs.--
(1) Payment for certain activities.--
(A) In general.--The Secretary--
(i) for loans originated during
fiscal years beginning on or after
October 1, 1998, and before October 1,
2003, and in accordance with the
provisions of this paragraph, shall,
except as provided in subparagraph (C),
pay to each guaranty agency, a loan
processing and issuance fee equal to
0.65 percent of the total principal
amount of the loans on which insurance
was issued under this part during such
fiscal year by such agency; and
(ii) for loans originated on or after
October 1, 2003, and first disbursed
before July 1, 2010, and in accordance
with the provisions of this paragraph,
shall, except as provided in
subparagraph (C), pay to each guaranty
agency, a loan processing and issuance
fee equal to 0.40 percent of the total
principal amount of the loans on which
insurance was issued under this part
during such fiscal year by such agency.
(B) Payment.--The payment required by
subparagraph (A) shall be paid on a quarterly
basis. The guaranty agency shall be deemed to
have a contractual right against the United
States to receive payments according to the
provisions of this paragraph. Payments shall be
made promptly and without administrative delay
to any guaranty agency submitting an accurate
and complete application under this
subparagraph.
(C) Requirement for payment.--No payment may
be made under this paragraph for loans for
which the disbursement checks have not been
cashed or for which electronic funds transfers
have not been completed.
(g) Action on Insurance Program and Guaranty Agreements.--If
a nonprofit private institution or organization--
(1) applies to enter into an agreement with the
Secretary under subsections (b) and (c) with respect to
a student loan insurance program to be carried on in a
State with which the Secretary does not have an
agreement under subsection (b), and
(2) as provided in the application, undertakes to
meet the requirements of section 422(c)(6)(B) (i),
(ii), and (iii),
the Secretary shall consider and act upon such application
within 180 days, and shall forthwith notify the authorizing
committees of his actions.
(i) Multiple Disbursement of Loans.--
(1) Escrow accounts administered by escrow agent.--
Any guaranty agency or eligible lender (hereafter in
this subsection referred to as the ``escrow agent'')
may enter into an agreement with any other eligible
lender that is not an eligible institution or an agency
or instrumentality of the State (hereafter in this
subsection referred to as the ``lender'') for the
purpose of authorizing disbursements of the proceeds of
a loan to a student. Such agreement shall provide that
the lender will pay the proceeds of such loans into an
escrow account to be administered by the escrow agent
in accordance with the provisions of paragraph (2) of
this subsection. Such agreement may allow the lender to
make payments into the escrow account in amounts that
do not exceed the sum of the amounts required for
disbursement of initial or subsequent installments to
borrowers and to make such payments not more than 10
days prior to the date of the disbursement of such
installment to such borrowers. Such agreement shall
require the lender to notify promptly the eligible
institution when funds are escrowed under this
subsection for a student at such institution.
(2) Authority of escrow agent.--Each escrow agent
entering into an agreement under paragraph (1) of this
subsection is authorized to--
(A) make the disbursements in accordance with
the note evidencing the loan;
(B) commingle the proceeds of all loans paid
to the escrow agent pursuant to the escrow
agreement entered into under such paragraph
(1);
(C) invest the proceeds of such loans in
obligations of the Federal Government or
obligations which are insured or guaranteed by
the Federal Government;
(D) retain interest or other earnings on such
investment; and
(E) return to the lender undisbursed funds
when the student ceases to carry at an eligible
institution at least one-half of the normal
full-time academic workload as determined by
the institution.
(j) Lenders-of-Last-Resort.--
(1) General requirement.--In each State, the guaranty
agency or an eligible lender in the State described in
section 435(d)(1)(D) of this Act shall, before July 1,
2010, make loans directly, or through an agreement with
an eligible lender or lenders, to eligible students and
parents who are otherwise unable to obtain loans under
this part (except for consolidation loans under section
428C) or who attend an institution of higher education
in the State that is designated under paragraph (4).
Loans made under this subsection shall not exceed the
amount of the need of the borrower, as determined under
subsection (a)(2)(B), nor be less than $200. No loan
under section 428, 428B, or 428H that is made pursuant
to this subsection shall be made with interest rates,
origination or default fees, or other terms and
conditions that are more favorable to the borrower than
the maximum interest rates, origination or default
fees, or other terms and conditions applicable to that
type of loan under this part. The guaranty agency shall
consider the request of any eligible lender, as defined
under section 435(d)(1)(A) of this Act, to serve as the
lender-of-last-resort pursuant to this subsection.
(2) Rules and operating procedures.--The guaranty
agency shall develop rules and operating procedures for
the lender-of-last-resort program designed to ensure
that--
(A) the program establishes operating hours
and methods of application designed to
facilitate application by students and ensure a
response within 60 days after the student's
original complete application is filed under
this subsection;
(B) consistent with standards established by
the Secretary, students applying for loans
under this subsection shall not be subject to
additional eligibility requirements or requests
for additional information beyond what is
required under this title in order to receive a
loan under this part from an eligible lender,
nor, in the case of students and parents
applying for loans under this subsection
because of an inability to otherwise obtain
loans under this part (except for consolidation
loans under section 428C), be required to
receive more than two rejections from eligible
lenders in order to obtain a loan under this
subsection;
(C) information about the availability of
loans under the program is made available to
institutions of higher education in the State;
and
(D) appropriate steps are taken to ensure
that borrowers receiving loans under the
program are appropriately counseled on their
loan obligation.
(3) Advances to guaranty agencies for lender-of-last-
resort services.--(A) In order to ensure the
availability of loan capital, the Secretary is
authorized to provide a guaranty agency designated for
a State with additional advance funds in accordance
with subparagraph (C) and section 422(c)(7), with such
restrictions on the use of such funds as are determined
appropriate by the Secretary, in order to ensure that
the guaranty agency will make loans as the lender-of-
last-resort. Such agency shall make such loans in
accordance with this subsection and the requirements of
the Secretary.
(B) Notwithstanding any other provision in this part,
a guaranty agency serving as a lender-of-last-resort
under this paragraph shall be paid a fee, established
by the Secretary, for making such loans in lieu of
interest and special allowance subsidies, and shall be
required to assign such loans to the Secretary on
demand. Upon such assignment, the portion of the
advance represented by the loans assigned shall be
considered repaid by such guaranty agency.
(C) The Secretary shall exercise the authority
described in subparagraph (A) only if the Secretary
determines that eligible borrowers are seeking and are
unable to obtain loans under this part or designates an
institution of higher education for participation in
the program under this subsection under paragraph (4),
and that the guaranty agency designated for that State
has the capability to provide lender-of-last-resort
loans in a timely manner, in accordance with the
guaranty agency's obligations under paragraph (1), but
cannot do so without advances provided by the Secretary
under this paragraph. If the Secretary makes the
determinations described in the preceding sentence and
determines that it would be cost-effective to do so,
the Secretary may provide advances under this paragraph
to such guaranty agency. If the Secretary determines
that such guaranty agency does not have such
capability, or will not provide such loans in a timely
fashion, the Secretary may provide such advances to
enable another guaranty agency, that the Secretary
determines to have such capability, to make lender-of-
last-resort loans to eligible borrowers in that State
who are experiencing loan access problems or to
eligible borrowers who attend an institution in the
State that is designated under paragraph (4).
(4) Institution-wide student qualification.--Upon the
request of an institution of higher education and
pursuant to standards developed by the Secretary, the
Secretary shall designate such institution for
participation in the lender-of-last-resort program
under this paragraph. If the Secretary designates an
institution under this paragraph, the guaranty agency
designated for the State in which the institution is
located shall make loans, in the same manner as such
loans are made under paragraph (1), to students and
parent borrowers of the designated institution,
regardless of whether the students or parent borrowers
are otherwise unable to obtain loans under this part
(other than a consolidation loan under section 428C).
(5) Standards developed by the secretary.--In
developing standards with respect to paragraph (4), the
Secretary may require--
(A) an institution of higher education to
demonstrate that, despite due diligence on the
part of the institution, the institution has
been unable to secure the commitment of
eligible lenders willing to make loans under
this part to a significant number of students
attending the institution;
(B) that, prior to making a request under
such paragraph for designation for
participation in the lender-of-last-resort
program, an institution of higher education
shall demonstrate that the institution has met
a minimum threshold, as determined by the
Secretary, for the number or percentage of
students at such institution who have received
rejections from eligible lenders for loans
under this part; and
(C) any other standards and guidelines the
Secretary determines to be appropriate.
(6) Expiration of authority.--The Secretary's
authority under paragraph (4) to designate institutions
of higher education for participation in the program
under this subsection shall expire on June 30, 2010.
(7) Expiration of designation.--The eligibility of an
institution of higher education, or borrowers from such
institution, to participate in the program under this
subsection pursuant to a designation of the institution
by the Secretary under paragraph (4) shall expire on
June 30, 2010. After such date, borrowers from an
institution designated under paragraph (4) shall be
eligible to participate in the program under this
subsection as such program existed on the day before
the date of enactment of the Ensuring Continued Access
to Student Loans Act of 2008.
(8) Prohibition on inducements and marketing.--Each
guaranty agency or eligible lender that serves as a
lender-of-last-resort under this subsection--
(A) shall be subject to the prohibitions on
inducements contained in subsection (b)(3) and
the requirements of section 435(d)(5); and
(B) shall not advertise, market, or otherwise
promote loans under this subsection, except
that nothing in this paragraph shall prohibit a
guaranty agency from fulfilling its
responsibilities under paragraph (2)(C).
(9) Dissemination and reporting.--
(A) In general.--The Secretary shall--
(i) broadly disseminate information
regarding the availability of loans
made under this subsection;
(ii) during the period beginning July
1, 2008 and ending June 30, 2011,
provide to the authorizing committees
and make available to the public--
(I) copies of any new or
revised plans or agreements
made by guaranty agencies or
the Department related to the
authorities under this
subsection;
(II) quarterly reports on--
(aa) the number and
amounts of loans
originated or approved
pursuant to this
subsection by each
guaranty agency and
eligible lender; and
(bb) any related
payments by the
Department, a guaranty
agency, or an eligible
lender; and
(III) a budget estimate of
the costs to the Federal
Government (including subsidy
and administrative costs) for
each 100 dollars loaned, of
loans made pursuant to this
subsection between the date of
enactment of the Ensuring
Continued Access to Student
Loans Act of 2008 and June 30,
2010, disaggregated by type of
loan, compared to such costs to
the Federal Government during
such time period of comparable
loans under this part and part
D, disaggregated by part and by
type of loan; and
(iii) beginning July 1, 2011, provide
to the authorizing committees and make
available to the public--
(I) copies of any new or
revised plans or agreements
made by guaranty agencies or
the Department related to the
authorities under this
subsection; and
(II) annual reports on--
(aa) the number and
amounts of loans
originated or approved
pursuant to this
subsection by each
guaranty agency and
eligible lender; and
(bb) any related
payments by the
Department, a guaranty
agency, or an eligible
lender.
(B) Separate reporting.--The information
required to be reported under subparagraph
(A)(ii)(II) shall be reported separately for
loans originated or approved pursuant to
paragraph (4), or payments related to such
loans, for the time period in which the
Secretary is authorized to make designations
under paragraph (4).
(k) Information on Defaults.--
(1) Provision of information to eligible
institutions.--Notwithstanding any other provision of
law, in order to notify eligible institutions of former
students who are in default of their continuing
obligation to repay student loans, each guaranty agency
shall, upon the request of an eligible institution,
furnish information with respect to students who were
enrolled at the eligible institution and who are in
default on the repayment of any loan made, insured, or
guaranteed under this part. The information authorized
to be furnished under this subsection shall include the
names and addresses of such students.
(2) Public dissemination not authorized.--Nothing in
paragraph (1) of this subsection shall be construed to
authorize public dissemination of the information
described in paragraph (1).
(3) Borrower location information.--Any information
provided by the institution relating to borrower
location shall be used by the guaranty agency in
conducting required skip-tracing activities.
(4) Provision of information to borrowers in
default.--Each guaranty agency that has received a
default claim from a lender regarding a borrower, shall
provide the borrower in default, on not less than two
separate occasions, with a notice, in simple and
understandable terms, of not less than the following
information:
(A) The options available to the borrower to
remove the borrower's loan from default.
(B) The relevant fees and conditions
associated with each option.
(l) Default Aversion Assistance.--
(1) Assistance required.--Upon receipt of a complete
request from a lender received not earlier than the
60th day of delinquency, a guaranty agency having an
agreement with the Secretary under subsection (c) shall
engage in default aversion activities designed to
prevent the default by a borrower on a loan covered by
such agreement.
(2) Reimbursement.--
(A) In general.--A guaranty agency, in
accordance with the provisions of this
paragraph, may transfer from the Federal
Student Loan Reserve Fund under section 422A to
the Agency Operating Fund under section 422B a
default aversion fee. Such fee shall be paid
for any loan on which a claim for default has
not been paid as a result of the loan being
brought into current repayment status by the
guaranty agency on or before the 300th day
after the loan becomes 60 days delinquent.
(B) Amount.--The default aversion fee shall
be equal to 1 percent of the total unpaid
principal and accrued interest on the loan at
the time the request is submitted by the
lender. A guaranty agency may transfer such
fees earned under this subsection not more
frequently than monthly. Such a fee shall not
be paid more than once on any loan for which
the guaranty agency averts the default unless--
(i) at least 18 months has elapsed
between the date the borrower entered
current repayment status and the date
the lender filed a subsequent default
aversion assistance request; and
(ii) during the period between such
dates, the borrower was not more than
30 days past due on any payment of
principal and interest on the loan.
(C) Definition.--For the purpose of earning
the default aversion fee, the term ``current
repayment status'' means that the borrower is
not delinquent in the payment of any principal
or interest on the loan.
(m) Income Contingent and Income-Based Repayment.--
(1) Authority of secretary to require.--The Secretary
may require borrowers who have defaulted on loans made
under this part that are assigned to the Secretary
under subsection (c)(8) to repay those loans under an
income contingent repayment plan or income-based
repayment plan, the terms and conditions of which shall
be established by the Secretary and the same as, or
similar to, an income contingent repayment plan
established for purposes of part D of this title or an
income-based repayment plan under section 493C, as the
case may be.
(2) Loans for which income contingent or income-based
repayment may be required.--A loan made under this part
may be required to be repaid under this subsection if
the note or other evidence of the loan has been
assigned to the Secretary pursuant to subsection
(c)(8).
(n) Blanket Certificate of Loan Guaranty.--
(1) In general.--Subject to paragraph (3), any
guaranty agency that has entered into or enters into
any insurance program agreement with the Secretary
under this part may--
(A) offer eligible lenders participating in
the agency's guaranty program a blanket
certificate of loan guaranty that permits the
lender to make loans without receiving prior
approval from the guaranty agency of individual
loans for eligible borrowers enrolled in
eligible programs at eligible institutions; and
(B) provide eligible lenders with the ability
to transmit electronically data to the agency
concerning loans the lender has elected to make
under the agency's insurance program via
standard reporting formats, with such reporting
to occur at reasonable and standard intervals.
(2) Limitations on blanket certificate of guaranty.--
(A) An eligible lender may not make a loan to a
borrower under this section after such lender receives
a notification from the guaranty agency that the
borrower is not an eligible borrower.
(B) A guaranty agency may establish limitations or
restrictions on the number or volume of loans issued by
a lender under the blanket certificate of guaranty.
(3) Participation level.--During fiscal years 1999
and 2000, the Secretary may permit, on a pilot basis, a
limited number of guaranty agencies to offer blanket
certificates of guaranty under this subsection.
Beginning in fiscal year 2001, any guaranty agency that
has an insurance program agreement with the Secretary
may offer blanket certificates of guaranty under this
subsection.
(4) Report required.--The Secretary shall, at the
conclusion of the pilot program under paragraph (3),
provide a report to the authorizing committees on the
impact of the blanket certificates of guaranty on
program efficiency and integrity.
(o) Armed Forces Student Loan Interest Payment Program.--
(1) Authority.--Using funds received by transfer to
the Secretary under section 2174 of title 10, United
States Code, for the payment of interest and any
special allowance on a loan to a member of the Armed
Forces that is made, insured, or guaranteed under this
part, the Secretary shall pay the interest and special
allowance on such loan as due for a period not in
excess of 36 consecutive months. The Secretary may not
pay interest or any special allowance on such a loan
out of any funds other than funds that have been so
transferred.
(2) Forbearance.--During the period in which the
Secretary is making payments on a loan under paragraph
(1), the lender shall grant the borrower forbearance in
accordance with the guaranty agreement under subsection
(c)(3)(A)(i)(IV).
(3) Special allowance defined.--For the purposes of
this subsection, the term ``special allowance'', means
a special allowance that is payable with respect to a
loan under section 438.
* * * * * * *
SEC. 428H. UNSUBSIDIZED STAFFORD LOANS FOR MIDDLE-INCOME BORROWERS.
(a) In General.--It is the purpose of this section to
authorize insured loans under this part that are first
disbursed before July 1, 2010, for borrowers who do not qualify
for Federal interest subsidy payments under section 428 of this
Act. Except as provided in this section, all terms and
conditions for Federal Stafford loans established under section
428 shall apply to loans made pursuant to this section.
(b) Eligible Borrowers.--Prior to July 1, 2010, any student
meeting the requirements for student eligibility under section
484 (including graduate and professional students as defined in
regulations promulgated by the Secretary) shall be entitled to
borrow an unsubsidized Federal Stafford Loan for which the
first disbursement is made before such date if the eligible
institution at which the student has been accepted for
enrollment, or at which the student is in attendance, has--
(1) determined and documented the student's need for
the loan based on the student's estimated cost of
attendance (as determined under section 472) and the
student's estimated financial assistance, including a
loan which qualifies for interest subsidy payments
under section 428; and
(2) provided the lender a statement--
(A) certifying the eligibility of the student
to receive a loan under this section and the
amount of the loan for which such student is
eligible, in accordance with subsection (c);
and
(B) setting forth a schedule for disbursement
of the proceeds of the loan in installments,
consistent with the requirements of section
428G.
(c) Determination of Amount of Loan.--The determination of
the amount of a loan by an eligible institution under
subsection (b) shall be calculated by subtracting from the
estimated cost of attendance at the eligible institution any
estimated financial assistance reasonably available to such
student. An eligible institution may not, in carrying out the
provisions of subsection (b) of this section, provide a
statement which certifies the eligibility of any student to
receive any loan under this section in excess of the amount
calculated under the preceding sentence.
(d) Loan Limits.--
(1) In general.--Except as provided in paragraphs
(2), (3), and (4), the annual and aggregate limits for
loans under this section shall be the same as those
established under section 428(b)(1), less any amount
received by such student pursuant to the subsidized
loan program established under section 428.
(2) Limits for graduate, professional, and
independent postbaccalaureate students.--
(A) Annual limits.--The maximum annual amount
of loans under this section a graduate or
professional student, or a student described in
clause (ii), may borrow in any academic year
(as defined in section 481(a)(2)) or its
equivalent shall be the amount determined under
paragraph (1), plus--
(i) in the case of such a student who
is a graduate or professional student
attending an eligible institution,
$12,000; and
(ii) notwithstanding paragraph (4),
in the case of an independent student,
or a dependent student whose parents
are unable to borrow under section 428B
or the Federal Direct PLUS Loan
Program, who has obtained a
baccalaureate degree and who is
enrolled in coursework specified in
paragraph (3)(B) or (4)(B) of section
484(b)--
(I) $7,000 for coursework
necessary for enrollment in a
graduate or professional
program; and
(II) $7,000 for coursework
necessary for a professional
credential or certification
from a State required for
employment as a teacher in an
elementary or secondary school,
except in cases where the Secretary determines
that a higher amount is warranted in order to
carry out the purpose of this part with respect
to students engaged in specialized training
requiring exceptionally high costs of
education, but the annual insurable limit per
student shall not be deemed to be exceeded by a
line of credit under which actual payments by
the lender to the borrower will not be made in
any years in excess of the annual limit.
(B) Aggregate limit.--The maximum aggregate
amount of loans under this section a student
described in subparagraph (A) may borrow shall
be the amount described in paragraph (1),
adjusted to reflect the increased annual limits
described in subparagraph (A), as prescribed by
the Secretary by regulation.
(3) Limits for undergraduate dependent students.--
(A) Annual limits.--The maximum annual amount
of loans under this section an undergraduate
dependent student (except an undergraduate
dependent student whose parents are unable to
borrow under section 428B or the Federal Direct
PLUS Loan Program) may borrow in any academic
year (as defined in section 481(a)(2)) or its
equivalent shall be the sum of the amount
determined under paragraph (1), plus $2,000.
(B) Aggregate limits.--The maximum aggregate
amount of loans under this section a student
described in subparagraph (A) may borrow shall
be $31,000.
(4) Limits for undergraduate independent students.--
(A) Annual limits.--The maximum annual amount
of loans under this section an undergraduate
independent student, or an undergraduate
dependent student whose parents are unable to
borrow under section 428B or the Federal Direct
PLUS Loan Program, may borrow in any academic
year (as defined in section 481(a)(2)) or its
equivalent shall be the sum of the amount
determined under paragraph (1), plus--
(i) in the case of such a student
attending an eligible institution who
has not completed such student's first
2 years of undergraduate study--
(I) $6,000, if such student
is enrolled in a program whose
length is at least one academic
year in length; or
(II) if such student is
enrolled in a program of
undergraduate education which
is less than one academic year,
the maximum annual loan amount
that such student may receive
may not exceed the amount that
bears the same ratio to the
amount specified in subclause
(I) as the length of such
program measured in semester,
trimester, quarter, or clock
hours bears to one academic
year;
(ii) in the case of such a student at
an eligible institution who has
successfully completed such first and
second years but has not successfully
completed the remainder of a program of
undergraduate education--
(I) $7,000; or
(II) if such student is
enrolled in a program of
undergraduate education, the
remainder of which is less than
one academic year, the maximum
annual loan amount that such
student may receive may not
exceed the amount that bears
the same ratio to the amount
specified in subclause (I) as
such remainder measured in
semester, trimester, quarter,
or clock hours bears to one
academic year; and
(iii) in the case of such a student
enrolled in coursework specified in--
(I) section 484(b)(3)(B),
$6,000; or
(II) section 484(b)(4)(B),
$7,000.
(B) Aggregate limits.--The maximum aggregate
amount of loans under this section a student
described in subparagraph (A) may borrow shall
be $57,500.
(5) Capitalized interest.--Interest capitalized shall
not be deemed to exceed a maximum aggregate amount
determined under subparagraph (B) of paragraph (2),
(3), or (4).
(e) Payment of Principal and Interest.--
(1) Commencement of repayment.--Repayment of
principal on loans made under this section shall begin
at the beginning of the repayment period described in
section 428(b)(7). Not less than 30 days prior to the
anticipated commencement of such repayment period, the
holder of such loan shall provide notice to the
borrower that interest will accrue before repayment
begins and of the borrower's option to begin loan
repayment at an earlier date.
(2) Capitalization of interest.--(A) [Interest]
Except as provided in subparagraph (C), interest on
loans made under this section for which payments of
principal are not required during the in-school and
grace periods or for which payments are deferred under
sections 427(a)(2)(C) and 428(b)(1)(M) shall, if agreed
upon by the borrower and the lender--
(i) be paid monthly or quarterly; or
(ii) be added to the principal amount of the
loan by the lender only--
(I) when the loan enters repayment;
(II) at the expiration of a grace
period, in the case of a loan that
qualifies for a grace period;
(III) at the expiration of a period
of deferment or forbearance; or
(IV) when the borrower defaults.
(B) The capitalization of interest described in
subparagraph (A) shall not be deemed to exceed the
annual insurable limit on account of the student.
(C) Interest shall not accrue on a loan deferred
under section 428(b)(1)(M)(v) or 427(a)(2)(C)(iv).
(3) Subsidies prohibited.--No payments to reduce
interest costs shall be paid pursuant to section 428(a)
of this part on loans made pursuant to this section.
(4) Applicable rates of interest.--Interest on loans
made pursuant to this section shall be at the
applicable rate of interest provided in section 427A.
(5) Amortization.--The amount of the periodic payment
and the repayment schedule for any loan made pursuant
to this section shall be established by assuming an
interest rate equal to the applicable rate of interest
at the time the repayment of the principal amount of
the loan commences. At the option of the lender, the
note or other written evidence of the loan may require
that--
(A) the amount of the periodic payment will
be adjusted annually; or
(B) the period of repayment of principal will
be lengthened or shortened,
in order to reflect adjustments in interest rates
occurring as a consequence of section 427A(c)(4).
(6) Repayment period.--For purposes of calculating
the repayment period under section 428(b)(9), such
period shall commence at the time the first payment of
principal is due from the borrower.
(7) Qualification for forbearance.--A lender may
grant the borrower of a loan under this section a
forbearance for a period not to exceed 60 days if the
lender reasonably determines that such a forbearance
from collection activity is warranted following a
borrower's request for forbearance, deferment, or a
change in repayment plan, or a request to consolidate
loans in order to collect or process appropriate
supporting documentation related to the request. During
any such period, interest on the loan shall accrue but
not be capitalized.
[(f) Repealed]
(g) Single Application Form and Loan Repayment Schedule.--A
guaranty agency shall use a single application form and a
single repayment schedule for subsidized Federal Stafford loans
made pursuant to section 428 and for unsubsidized Federal
Stafford loans made pursuant to this section.
(h) Insurance Premium.--Each State or nonprofit private
institution or organization having an agreement with the
Secretary under section 428(b)(1) may charge a borrower under
this section an insurance premium equal to not more than 1.0
percent of the principal amount of the loan, if such premium
will not be used for incentive payments to lenders. Effective
for loans for which the date of guarantee of principal is on or
after July 1, 2006, and that are first disbursed before July 1,
2010, in lieu of the insurance premium authorized under the
preceding sentence, each State or nonprofit private institution
or organization having an agreement with the Secretary under
section 428(b)(1) shall collect and deposit into the Federal
Student Loan Reserve Fund under section 422A, a Federal default
fee of an amount equal to 1.0 percent of the principal amount
of the loan, which fee shall be collected either by deduction
from the proceeds of the loan or by payment from other non-
Federal sources. The Federal default fee shall not be used for
incentive payments to lenders.
* * * * * * *
PART D--WILLIAM D. FORD FEDERAL DIRECT LOAN PROGRAM
* * * * * * *
SEC. 455. TERMS AND CONDITIONS OF LOANS.
(a) In General.--
(1) Parallel terms, conditions, benefits, and
amounts.--Unless otherwise specified in this part,
loans made to borrowers under this part shall have the
same terms, conditions, and benefits, and be available
in the same amounts, as loans made to borrowers, and
first disbursed on June 30, 2010, under sections 428,
428B, 428C, and 428H of this title.
(2) Designation of loans.--Loans made to borrowers
under this part that, except as otherwise specified in
this part, have the same terms, conditions, and
benefits as loans made to borrowers under--
(A) section 428 shall be known as ``Federal
Direct Stafford Loans'';
(B) section 428B shall be known as ``Federal
Direct PLUS Loans'';
(C) section 428C shall be known as ``Federal
Direct Consolidation Loans''; and
(D) section 428H shall be known as ``Federal
Direct Unsubsidized Stafford Loans''.
(3) Termination of authority to make interest
subsidized loans to graduate and professional
students.--
(A) In general.--Subject to subparagraph (B)
and notwithstanding any provision of this part
or part B, for any period of instruction
beginning on or after July 1, 2012--
(i) a graduate or professional
student shall not be eligible to
receive a Federal Direct Stafford loan
under this part; and
(ii) the maximum annual amount of
Federal Direct Unsubsidized Stafford
loans such a student may borrow in any
academic year (as defined in section
481(a)(2)) or its equivalent shall be
the maximum annual amount for such
student determined under section 428H,
plus an amount equal to the amount of
Federal Direct Stafford loans the
student would have received in the
absence of this subparagraph.
(B) Exception.--Subparagraph (A) shall not
apply to an individual enrolled in course work
specified in paragraph (3)(B) or (4)(B) of
section 484(b).
(b) Interest Rate.--
(1) Rates for fdsl and fdusl.--For Federal Direct
Stafford Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made on or
after July 1, 1994, the applicable rate of interest
shall, during any 12-month period beginning on July 1
and ending on June 30, be determined on the preceding
June 1 and be equal to--
(A) the bond equivalent rate of 91-day
Treasury bills auctioned at the final auction
held prior to such June 1; plus
(B) 3.1 percent,
except that such rate shall not exceed 8.25 percent.
(2) In school and grace period rules.--(A)
Notwithstanding the provisions of paragraph (1), but
subject to paragraph (3), with respect to any Federal
Direct Stafford Loan or Federal Direct Unsubsidized
Stafford Loan for which the first disbursement is made
on or after July 1, 1995, the applicable rate of
interest for interest which accrues--
(i) prior to the beginning of the repayment
period of the loan; or
(ii) during the period in which principal
need not be paid (whether or not such principal
is in fact paid) by reason of a provision
described in section 428(b)(1)(M) or
427(a)(2)(C),
shall not exceed the rate determined under subparagraph
(B).
(B) For the purpose of subparagraph (A), the rate
determined under this subparagraph shall, during any
12-month period beginning on July 1 and ending on June
30, be determined on the preceding June 1 and be equal
to--
(i) the bond equivalent rate of 91-day
Treasury bills auctioned at the final auction
prior to such June 1; plus
(ii) 2.5 percent,
except that such rate shall not exceed 8.25 percent.
(3) Out-year rule.--Notwithstanding paragraphs (1)
and (2), for Federal Direct Stafford Loans and Federal
Direct Unsubsidized Stafford Loans made on or after
July 1, 1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1 and
ending on June 30, be determined on the preceding June
1 and be equal to--
(A) the bond equivalent rate of the security
with a comparable maturity as established by
the Secretary; plus
(B) 1.0 percent,
except that such rate shall not exceed 8.25 percent.
(4) Rates for fdplus.--
(A)(i) For Federal Direct PLUS Loans for
which the first disbursement is made on or
after July 1, 1994, the applicable rate of
interest shall, during any 12-month period
beginning on July 1 and ending on or before
June 30, 2001, be determined on the preceding
June 1 and be equal to--
(I) the bond equivalent rate of 52-
week Treasury bills auctioned at final
auction held prior to such June 1; plus
(II) 3.1 percent,
except that such rate shall not exceed 9
percent.
(ii) For any 12-month period beginning on
July 1 of 2001 or any succeeding year, the
applicable rate of interest determined under
this subparagraph shall be determined on the
preceding June 26 and be equal to--
(I) the weekly average 1-year
constant maturity Treasury yield, as
published by the Board of Governors of
the Federal Reserve System, for the
last calendar week ending on or before
such June 26; plus
(II) 3.1 percent,
except that such rate shall not exceed 9
percent.
(B) For Federal Direct PLUS loans made on or after
July 1, 1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1 and
ending on June 30, be determined on the preceding June
1 and be equal to--
(i) the bond equivalent rate of the security
with a comparable maturity as established by
the Secretary; plus
(ii) 2.1 percent,
except that such rate shall not exceed 9 percent.
(5) Temporary interest rate provision.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after July 1, 1998, and before October 1,
1998, the applicable rate of interest shall,
during any 12-month period beginning on July 1
and ending on June 30, be determined on the
preceding June 1 and be equal to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(B) In school and grace period rules.--
Notwithstanding the preceding paragraphs of
this subsection, with respect to any Federal
Direct Stafford Loan or Federal Direct
Unsubsidized Stafford Loan for which the first
disbursement is made on or after July 1, 1998,
and before October 1, 1998, the applicable rate
of interest for interest which accrues--
(i) prior to the beginning of the
repayment period of the loan; or
(ii) during the period in which
principal need not be paid (whether or
not such principal is in fact paid) by
reason of a provision described in
section 428(b)(1)(M) or 427(a)(2)(C),
shall be determined under subparagraph (A) by
substituting ``1.7 percent'' for ``2.3
percent''.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to Federal Direct PLUS Loan for which
the first disbursement is made on or after July
1, 1998, and before October 1, 1998, the
applicable rate of interest shall be determined
under subparagraph (A)--
(i) by substituting ``3.1 percent''
for ``2.3 percent''; and
(ii) by substituting ``9.0 percent''
for ``8.25 percent''.
(6) Interest rate provision for new loans on or after
october 1, 1998, and before july 1, 2006.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after October 1, 1998, and before July 1,
2006, the applicable rate of interest shall,
during any 12-month period beginning on July 1
and ending on June 30, be determined on the
preceding June 1 and be equal to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(B) In school and grace period rules.--
Notwithstanding the preceding paragraphs of
this subsection, with respect to any Federal
Direct Stafford Loan or Federal Direct
Unsubsidized Stafford Loan for which the first
disbursement is made on or after October 1,
1998, and before July 1, 2006, the applicable
rate of interest for interest which accrues--
(i) prior to the beginning of the
repayment period of the loan; or
(ii) during the period in which
principal need not be paid (whether or
not such principal is in fact paid) by
reason of a provision described in
section 428(b)(1)(M) or 427(a)(2)(C),
shall be determined under subparagraph (A) by
substituting ``1.7 percent'' for ``2.3
percent''.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to Federal Direct PLUS Loan for which
the first disbursement is made on or after
October 1, 1998, and before July 1, 2006, the
applicable rate of interest shall be determined
under subparagraph (A)--
(i) by substituting ``3.1 percent''
for ``2.3 percent''; and
(ii) by substituting ``9.0 percent''
for ``8.25 percent''.
(D) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation loan for which the
application is received on or after February 1,
1999, and before July 1, 2006, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal to
the lesser of--
(i) the weighted average of the
interest rates on the loans
consolidated, rounded to the nearest
higher one-eighth of one percent; or
(ii) 8.25 percent.
(E) Temporary rules for consolidation
loans.--Notwithstanding the preceding
paragraphs of this subsection, any Federal
Direct Consolidation loan for which the
application is received on or after October 1,
1998, and before February 1, 1999, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal
to--
(i) the bond equivalent rate of 91-
day Treasury bills auctioned at the
final auction held prior to such June
1; plus
(ii) 2.3 percent,
except that such rate shall not exceed 8.25
percent.
(7) Interest rate provision for new loans on or after
july 1, 2006 and before july 1, 2013.--
(A) Rates for fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans for which the first disbursement is made
on or after July 1, 2006, and before July 1,
2013, the applicable rate of interest shall be
6.8 percent on the unpaid principal balance of
the loan.
(B) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, with
respect to any Federal Direct PLUS loan for
which the first disbursement is made on or
after July 1, 2006, and before July 1, 2013,
the applicable rate of interest shall be 7.9
percent on the unpaid principal balance of the
loan.
(C) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation loan for which the
application is received on or after July 1,
2006, and before July 1, 2013, shall bear
interest at an annual rate on the unpaid
principal balance of the loan that is equal to
the lesser of--
(i) the weighted average of the
interest rates on the loans
consolidated, rounded to the nearest
higher one-eighth of one percent; or
(ii) 8.25 percent.
(D) Reduced rates for undergraduate fdsl.--
Notwithstanding the preceding paragraphs of
this subsection and subparagraph (A) of this
paragraph, for Federal Direct Stafford Loans
made to undergraduate students for which the
first disbursement is made on or after July 1,
2006, and before July 1, 2013, the applicable
rate of interest shall be as follows:
(i) For a loan for which the first
disbursement is made on or after July
1, 2006, and before July 1, 2008, 6.8
percent on the unpaid principal balance
of the loan.
(ii) For a loan for which the first
disbursement is made on or after July
1, 2008, and before July 1, 2009, 6.0
percent on the unpaid principal balance
of the loan.
(iii) For a loan for which the first
disbursement is made on or after July
1, 2009, and before July 1, 2010, 5.6
percent on the unpaid principal balance
of the loan.
(iv) For a loan for which the first
disbursement is made on or after July
1, 2010, and before July 1, 2011, 4.5
percent on the unpaid principal balance
of the loan.
(v) For a loan for which the first
disbursement is made on or after July
1, 2011, and before July 1, 2013, 3.4
percent on the unpaid principal balance
of the loan.
(8) Interest rate provisions for new loans on or
after july 1, 2013.--
(A) Rates for undergraduate fdsl and fdusl.--
Notwithstanding the preceding paragraphs of
this subsection, for Federal Direct Stafford
Loans and Federal Direct Unsubsidized Stafford
Loans issued to undergraduate students, for
which the first disbursement is made on or
after July 1, 2013, the applicable rate of
interest shall, for loans disbursed during any
12-month period beginning on July 1 and ending
on June 30, be determined on the preceding June
1 and be equal to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 2.05 percent; or
(ii) 8.25 percent.
(B) Rates for graduate and professional
fdusl.--Notwithstanding the preceding
paragraphs of this subsection, for Federal
Direct Unsubsidized Stafford Loans issued to
graduate or professional students, for which
the first disbursement is made on or after July
1, 2013, the applicable rate of interest shall,
for loans disbursed during any 12-month period
beginning on July 1 and ending on June 30, be
determined on the preceding June 1 and be equal
to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 3.6 percent; or
(ii) 9.5 percent.
(C) PLUS loans.--Notwithstanding the
preceding paragraphs of this subsection, for
Federal Direct PLUS Loans, for which the first
disbursement is made on or after July 1, 2013,
the applicable rate of interest shall, for
loans disbursed during any 12-month period
beginning on July 1 and ending on June 30, be
determined on the preceding June 1 and be equal
to the lesser of--
(i) a rate equal to the high yield of
the 10-year Treasury note auctioned at
the final auction held prior to such
June 1 plus 4.6 percent; or
(ii) 10.5 percent.
(D) Consolidation loans.--Notwithstanding the
preceding paragraphs of this subsection, any
Federal Direct Consolidation Loan for which the
application is received on or after July 1,
2013, shall bear interest at an annual rate on
the unpaid principal balance of the loan that
is equal to the weighted average of the
interest rates on the loans consolidated,
rounded to the nearest higher one-eighth of one
percent.
(E) Consultation.--The Secretary shall
determine the applicable rate of interest under
this paragraph after consultation with the
Secretary of the Treasury and shall publish
such rate in the Federal Register as soon as
practicable after the date of determination.
(F) Rate.--The applicable rate of interest
determined under this paragraph for a Federal
Direct Stafford Loan, a Federal Direct
Unsubsidized Stafford Loan, or a Federal Direct
PLUS Loan shall be fixed for the period of the
loan.
(9) Repayment incentives.--
(A)(A) Incentives for loans disbursed before
july 1, 2012.--Notwithstanding any other
provision of this part with respect to loans
for which the first disbursement of principal
is made before July 1, 2012,, the Secretary is
authorized to prescribe by regulation such
reductions in the interest or origination fee
rate paid by a borrower of a loan made under
this part as the Secretary determines
appropriate to encourage on-time repayment of
the loan. Such reductions may be offered only
if the Secretary determines the reductions are
cost neutral and in the best financial interest
of the Federal Government. Any increase in
subsidy costs resulting from such reductions
shall be completely offset by corresponding
savings in funds available for the William D.
Ford Federal Direct Loan Program in that fiscal
year from section 458 and other administrative
accounts.
(B) Accountability.--Prior to publishing
regulations proposing repayment incentives with
respect to loans for which the first
disbursement of principal is made before July
1, 2012, the Secretary shall ensure the cost
neutrality of such reductions. The Secretary
shall not prescribe such regulations in final
form unless an official report from the
Director of the Office of Management and Budget
to the Secretary and a comparable report from
the Director of the Congressional Budget Office
to the Congress each certify that any such
reductions will be completely cost neutral.
Such reports shall be transmitted to the
authorizing committees not less than 60 days
prior to the publication of regulations
proposing such reductions.
(C) No repayment incentives for new loans
disbursed on or after july 1, 2012.--
Notwithstanding any other provision of this
part, the Secretary is prohibited from
authorizing or providing any repayment
incentive not otherwise authorized under this
part to encourage on-time repayment of a loan
under this part for which the first
disbursement of principal is made on or after
July 1, 2012, including any reduction in the
interest or origination fee rate paid by a
borrower of such a loan, except that the
Secretary may provide for an interest rate
reduction for a borrower who agrees to have
payments on such a loan automatically
electronically debited from a bank account.
(10) Publication.--The Secretary shall determine the
applicable rates of interest under this subsection
after consultation with the Secretary of the Treasury
and shall publish such rate in the Federal Register as
soon as practicable after the date of determination.
(c) Loan Fee.--
(1) In general.--The Secretary shall charge the
borrower of a loan made under this part an origination
fee of 4.0 percent of the principal amount of loan.
(2) Subsequent reduction.--Paragraph (1) shall be
applied to loans made under this part, other than
Federal Direct Consolidation loans and Federal Direct
PLUS loans--
(A) by substituting ``3.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after the date of enactment of the Higher
Education Reconciliation Act of 2005, and
before July 1, 2007;
(B) by substituting ``2.5 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2007, and before July 1, 2008;
(C) by substituting ``2.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2008, and before July 1, 2009;
(D) by substituting ``1.5 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2009, and before July 1, 2010;
and
(E) by substituting ``1.0 percent'' for ``4.0
percent'' with respect to loans for which the
first disbursement of principal is made on or
after July 1, 2010.
(d) Repayment Plans.--
(1) Design and selection.--Consistent with criteria
established by the Secretary, the Secretary shall offer
a borrower of a loan made under this part a variety of
plans for repayment of such loan, including principal
and interest on the loan. The borrower shall be
entitled to accelerate, without penalty, repayment on
the borrower's loans under this part. The borrower may
choose--
(A) a standard repayment plan, consistent
with subsection (a)(1) of this section and with
section 428(b)(9)(A)(i);
(B) a graduated repayment plan, consistent
with section 428(b)(9)(A)(ii);
(C) an extended repayment plan, consistent
with section 428(b)(9)(A)(iv), except that the
borrower shall annually repay a minimum amount
determined by the Secretary in accordance with
section 428(b)(1)(L);
(D) an income contingent repayment plan, with
varying annual repayment amounts based on the
income of the borrower, paid over an extended
period of time prescribed by the Secretary, not
to exceed 25 years, except that the plan
described in this subparagraph shall not be
available to the borrower of a Federal Direct
PLUS loan made on behalf of a dependent
student; and
(E) beginning on July 1, 2009, an income-
based repayment plan that enables borrowers who
have a partial financial hardship to make a
lower monthly payment in accordance with
section 493C, except that the plan described in
this subparagraph shall not be available to the
borrower of a Federal Direct PLUS Loan made on
behalf of a dependent student or a Federal
Direct Consolidation Loan, if the proceeds of
such loan were used to discharge the liability
on such Federal Direct PLUS Loan or a loan
under section 428B made on behalf of a
dependent student.
(2) Selection by secretary.--If a borrower of a loan
made under this part does not select a repayment plan
described in paragraph (1), the Secretary may provide
the borrower with a repayment plan described in
subparagraph (A), (B), or (C) of paragraph (1).
(3) Changes in selections.--The borrower of a loan
made under this part may change the borrower's
selection of a repayment plan under paragraph (1), or
the Secretary's selection of a plan for the borrower
under paragraph (2), as the case may be, under such
terms and conditions as may be established by the
Secretary.
(4) Alternative repayment plans.--The Secretary may
provide, on a case by case basis, an alternative
repayment plan to a borrower of a loan made under this
part who demonstrates to the satisfaction of the
Secretary that the terms and conditions of the
repayment plans available under paragraph (1) are not
adequate to accommodate the borrower's exceptional
circumstances. In designing such alternative repayment
plans, the Secretary shall ensure that such plans do
not exceed the cost to the Federal Government, as
determined on the basis of the present value of future
payments by such borrowers, of loans made using the
plans available under paragraph (1).
(5) Repayment after default.--The Secretary may
require any borrower who has defaulted on a loan made
under this part to--
(A) pay all reasonable collection costs
associated with such loan; and
(B) repay the loan pursuant to an income
contingent repayment plan.
(e) Income Contingent Repayment.--
(1) Information and procedures.--The Secretary may
obtain such information as is reasonably necessary
regarding the income of a borrower (and the borrower's
spouse, if applicable) of a loan made under this part
that is, or may be, repaid pursuant to income
contingent repayment, for the purpose of determining
the annual repayment obligation of the borrower.
Returns and return information (as defined in section
6103 of the Internal Revenue Code of 1986) may be
obtained under the preceding sentence only to the
extent authorized by section 6103(l)(13) of such Code.
The Secretary shall establish procedures for
determining the borrower's repayment obligation on that
loan for such year, and such other procedures as are
necessary to implement effectively income contingent
repayment.
(2) Repayment based on adjusted gross income.--A
repayment schedule for a loan made under this part and
repaid pursuant to income contingent repayment shall be
based on the adjusted gross income (as defined in
section 62 of the Internal Revenue Code of 1986) of the
borrower or, if the borrower is married and files a
Federal income tax return jointly with the borrower's
spouse, on the adjusted gross income of the borrower
and the borrower's spouse.
(3) Additional documents.--A borrower who chooses, or
is required, to repay a loan made under this part
pursuant to income contingent repayment, and for whom
adjusted gross income is unavailable or does not
reasonably reflect the borrower's current income, shall
provide to the Secretary other documentation of income
satisfactory to the Secretary, which documentation the
Secretary may use to determine an appropriate repayment
schedule.
(4) Repayment schedules.--Income contingent repayment
schedules shall be established by regulations
promulgated by the Secretary and shall require payments
that vary in relation to the appropriate portion of the
annual income of the borrower (and the borrower's
spouse, if applicable) as determined by the Secretary.
(5) Calculation of balance due.--The balance due on a
loan made under this part that is repaid pursuant to
income contingent repayment shall equal the unpaid
principal amount of the loan, any accrued interest, and
any fees, such as late charges, assessed on such loan.
The Secretary may promulgate regulations limiting the
amount of interest that may be capitalized on such
loan, and the timing of any such capitalization.
(6) Notification to borrowers.--The Secretary shall
establish procedures under which a borrower of a loan
made under this part who chooses or is required to
repay such loan pursuant to income contingent repayment
is notified of the terms and conditions of such plan,
including notification of such borrower--
(A) that the Internal Revenue Service will
disclose to the Secretary tax return
information as authorized under section
6103(l)(13) of the Internal Revenue Code of
1986; and
(B) that if a borrower considers that special
circumstances, such as a loss of employment by
the borrower or the borrower's spouse, warrant
an adjustment in the borrower's loan repayment
as determined using the information described
in subparagraph (A), or the alternative
documentation described in paragraph (3), the
borrower may contact the Secretary, who shall
determine whether such adjustment is
appropriate, in accordance with criteria
established by the Secretary.
(7) Maximum repayment period.--In calculating the
extended period of time for which an income contingent
repayment plan under this subsection may be in effect
for a borrower, the Secretary shall include all time
periods during which a borrower of loans under part B,
part D, or part E--
(A) is not in default on any loan that is
included in the income contingent repayment
plan; and
(B)(i) is in deferment due to an economic
hardship described in section 435(o);
(ii) makes monthly payments under paragraph
(1) or (6) of section 493C(b);
(iii) makes monthly payments of not less than
the monthly amount calculated under section
428(b)(9)(A)(i) or subsection (d)(1)(A), based
on a 10-year repayment period, when the
borrower first made the election described in
section 493C(b)(1);
(iv) makes payments of not less than the
payments required under a standard repayment
plan under section 428(b)(9)(A)(i) or
subsection (d)(1)(A) with a repayment period of
10 years; or
(v) makes payments under an income contingent
repayment plan under subsection (d)(1)(D).
(f) Deferment.--
(1) Effect on principal and interest.--A borrower of
a loan made under this part who meets the requirements
described in paragraph (2) shall be eligible for a
deferment, during which periodic installments of
principal need not be paid, and interest--
(A) shall not accrue, in the case of a--
(i) Federal Direct Stafford Loan; or
(ii) a Federal Direct Consolidation
Loan that consolidated only Federal
Direct Stafford Loans, or a combination
of such loans and Federal Stafford
Loans for which the student borrower
received an interest subsidy under
section 428; or
(B) shall accrue and be capitalized or paid
by the borrower, in the case of a Federal
Direct PLUS Loan, a Federal Direct Unsubsidized
Stafford Loan, or a Federal Direct
Consolidation Loan not described in
subparagraph (A)(ii).
(2) Eligibility.--A borrower of a loan made under
this part shall be eligible for a deferment during any
period--
(A) during which the borrower--
(i) is carrying at least one-half the
normal full-time work load for the
course of study that the borrower is
pursuing, as determined by the eligible
institution (as such term is defined in
section 435(a)) the borrower is
attending; or
(ii) is pursuing a course of study
pursuant to a graduate fellowship
program approved by the Secretary, or
pursuant to a rehabilitation training
program for individuals with
disabilities approved by the Secretary,
except that no borrower shall be eligible for a
deferment under this subparagraph, or a loan
made under this part (other than a Federal
Direct PLUS Loan or a Federal Direct
Consolidation Loan), while serving in a medical
internship or residency program;
(B) not in excess of 3 years during which the
borrower is seeking and unable to find full-
time employment;
(C) during which the borrower--
(i) is serving on active duty during
a war or other military operation or
national emergency; or
(ii) is performing qualifying
National Guard duty during a war or
other military operation or national
emergency,
and for the 180-day period following the
demobilization date for the service described
in clause (i) or (ii); or
(D) not in excess of 3 years during which the
Secretary determines, in accordance with
regulations prescribed under section 435(o),
that the borrower has experienced or will
experience an economic hardship.
(3) Deferment for borrowers receiving cancer
treatment.--
(A) Effect on principal and interest.--A
borrower of a loan made under this part who
meets the requirements of subparagraph (B)
shall be eligible for a deferment, during which
periodic installments of principal need not be
paid, and interest shall not accrue.
(B) Eligibility.--A borrower of a loan made
under this part shall be eligible for a
deferment during--
(i) any period in which such borrower
is receiving treatment for cancer; and
(ii) the 6 months after such period.
(C) Applicability.--This paragraph shall
apply with respect to loans--
(i) made on or after the date of the
enactment of this paragraph; or
(ii) in repayment on the date of the
enactment of this paragraph.
[(3)] (4) Definition of borrower.--For the purpose of
this subsection, the term ``borrower'' means an
individual who is a new borrower on the date such
individual applies for a loan under this part for which
the first disbursement is made on or after July 1,
1993.
[(4)] (5) Deferments for previous part b loan
borrowers.--A borrower of a loan made under this part,
who at the time such individual applies for such loan,
has an outstanding balance of principal or interest
owing on any loan made, insured, or guaranteed under
part B of title IV prior to July 1, 1993, shall be
eligible for a deferment under section 427(a)(2)(C) or
section 428(b)(1)(M) as such sections were in effect on
July 22, 1992.
(g) Federal Direct Consolidation Loans.--A borrower of a loan
made under this part may consolidate such loan with the loans
described in section 428C(a)(4), including any loan made under
part B and first disbursed before July 1, 2010. To be eligible
for a consolidation loan under this part, a borrower shall meet
the eligibility criteria set forth in section 428C(a)(3).
(h) Borrower Defenses.--Notwithstanding any other provision
of State or Federal law, the Secretary shall specify in
regulations which acts or omissions of an institution of higher
education a borrower may assert as a defense to repayment of a
loan made under this part, except that in no event may a
borrower recover from the Secretary, in any action arising from
or relating to a loan made under this part, an amount in excess
of the amount such borrower has repaid on such loan.
(i) Loan Application and Promissory Note.--The common
financial reporting form required in section 483(a)(1) shall
constitute the application for loans made under this part
(other than a Federal Direct PLUS loan). The Secretary shall
develop, print, and distribute to participating institutions a
standard promissory note and loan disclosure form.
(j) Loan Disbursement.--
(1) In general.--Proceeds of loans to students under
this part shall be applied to the student's account for
tuition and fees, and, in the case of institutionally
owned housing, to room and board. Loan proceeds that
remain after the application of the previous sentence
shall be delivered to the borrower by check or other
means that is payable to and requires the endorsement
or other certification by such borrower.
(2) Payment periods.--The Secretary shall establish
periods for the payments described in paragraph (1) in
a manner consistent with payment of Federal Pell Grants
under subpart 1 of part A of this title.
(k) Fiscal Control and Fund Accountability.--
(1) In general.--(A) An institution shall maintain
financial records in a manner consistent with records
maintained for other programs under this title.
(B) Except as otherwise required by regulations of
the Secretary an institution may maintain loan funds
under this part in the same account as other Federal
student financial assistance.
(2) Payments and refunds.--Payments and refunds shall
be reconciled in a manner consistent with the manner
set forth for the submission of a payment summary
report required of institutions participating in the
program under subpart 1 of part A, except that nothing
in this paragraph shall prevent such reconciliations on
a monthly basis.
(3) Transaction histories.--All transaction histories
under this part shall be maintained using the same
system designated by the Secretary for the provision of
Federal Pell Grants under subpart 1 of part A of this
title.
(l) Armed Forces Student Loan Interest Payment Program.--
(1) Authority.--Using funds received by transfer to
the Secretary under section 2174 of title 10, United
States Code, for the payment of interest on a loan made
under this part to a member of the Armed Forces, the
Secretary shall pay the interest on the loan as due for
a period not in excess of 36 consecutive months. The
Secretary may not pay interest on such a loan out of
any funds other than funds that have been so
transferred.
(2) Forbearance.--During the period in which the
Secretary is making payments on a loan under paragraph
(1), the Secretary shall grant the borrower
forbearance, in the form of a temporary cessation of
all payments on the loan other than the payments of
interest on the loan that are made under that
paragraph.
(m) Repayment Plan for Public Service Employees.--
(1) In general.--The Secretary shall cancel the
balance of interest and principal due, in accordance
with paragraph (2), on any eligible Federal Direct Loan
not in default for a borrower who--
(A) has made 120 monthly payments on the
eligible Federal Direct Loan after October 1,
2007, pursuant to any one or a combination of
the following--
(i) payments under an income-based
repayment plan under section 493C;
(ii) payments under a standard
repayment plan under subsection
(d)(1)(A), based on a 10-year repayment
period;
(iii) monthly payments under a
repayment plan under subsection (d)(1)
or (g) of not less than the monthly
amount calculated under subsection
(d)(1)(A), based on a 10-year repayment
period; or
(iv) payments under an income
contingent repayment plan under
subsection (d)(1)(D); and
(B)(i) is employed in a public service job at
the time of such forgiveness; and
(ii) has been employed in a public service
job during the period in which the borrower
makes each of the 120 payments described in
subparagraph (A).
(2) Loan cancellation amount.--After the conclusion
of the employment period described in paragraph (1),
the Secretary shall cancel the obligation to repay the
balance of principal and interest due as of the time of
such cancellation, on the eligible Federal Direct Loans
made to the borrower under this part.
(3) Definitions.--In this subsection:
(A) Eligible federal direct loan.--The term
``eligible Federal Direct Loan'' means a
Federal Direct Stafford Loan, Federal Direct
PLUS Loan, or Federal Direct Unsubsidized
Stafford Loan, or a Federal Direct
Consolidation Loan.
(B) Public service job.--The term ``public
service job'' means--
(i) a full-time job in emergency
management, government (excluding time
served as a member of Congress),
military service, public safety, law
enforcement, public health (including
nurses, nurse practitioners, nurses in
a clinical setting, and full-time
professionals engaged in health care
practitioner occupations and health
care support occupations, as such terms
are defined by the Bureau of Labor
Statistics), public education, social
work in a public child or family
service agency, public interest law
services (including prosecution or
public defense or legal advocacy on
behalf of low-income communities at a
nonprofit organization), early
childhood education (including licensed
or regulated childcare, Head Start, and
State funded prekindergarten), public
service for individuals with
disabilities, public service for the
elderly, public library sciences,
school-based library sciences and other
school-based services, or at an
organization that is described in
section 501(c)(3) of the Internal
Revenue Code of 1986 and exempt from
taxation under section 501(a) of such
Code; or
(ii) teaching as a full-time faculty
member at a Tribal College or
University as defined in section 316(b)
and other faculty teaching in high-
needs subject areas or areas of
shortage (including nurse faculty,
foreign language faculty, and part-time
faculty at community colleges), as
determined by the Secretary.
(4) Ineligibility for double benefits.--No borrower
may, for the same service, receive a reduction of loan
obligations under both this subsection and section
428J, 428K, 428L, or 460.
(n) Identity Fraud Protection.--The Secretary shall take such
steps as may be necessary to ensure that monthly Federal Direct
Loan statements and other publications of the Department do not
contain more than four digits of the Social Security number of
any individual.
(o) No Accrual of Interest for Active Duty Service Members.--
(1) In general.--Notwithstanding any other provision
of this part and in accordance with paragraphs (2) and
(4), interest shall not accrue for an eligible military
borrower on a loan made under this part for which the
first disbursement is made on or after October 1, 2008.
(2) Consolidation loans.--In the case of any
consolidation loan made under this part that is
disbursed on or after October 1, 2008, interest shall
not accrue pursuant to this subsection only on such
portion of such loan as was used to repay a loan made
under this part for which the first disbursement is
made on or after October 1, 2008.
(3) Eligible military borrower.--In this subsection,
the term ``eligible military borrower'' means an
individual who--
(A)(i) is serving on active duty during a war
or other military operation or national
emergency; or
(ii) is performing qualifying National Guard
duty during a war or other military operation
or national emergency; and
(B) is serving in an area of hostilities in
which service qualifies for special pay under
section 310, or paragraph (1) or (3) of section
351(a), of title 37, United States Code.
(4) Limitation.--An individual who qualifies as an
eligible military borrower under this subsection may
receive the benefit of this subsection for not more
than 60 months.
(p) Disclosures.--Each institution of higher education with
which the Secretary has an agreement under section 453, and
each contractor with which the Secretary has a contract under
section 456, shall, with respect to loans under this part and
in accordance with such regulations as the Secretary shall
prescribe, comply with each of the requirements under section
433 that apply to a lender with respect to a loan under part B.
(q) Eligibility For, and Interest Charges On, Federal Direct
Stafford Loans for New Borrowers on or After July 1, 2013.--
(1) In general.--Notwithstanding subsection (a) or
any other provision of this title, any borrower who was
a new borrower on or after July 1, 2013, shall not be
eligible for a Federal Direct Stafford Loan if the
period of time for which the borrower has received
Federal Direct Stafford Loans, in the aggregate,
exceeds the period of enrollment described in paragraph
(3). Such borrower may still receive any Federal Direct
Unsubsidized Stafford Loan for which such borrower is
otherwise eligible.
(2) Accrual of interest on federal direct stafford
loans.--Notwithstanding subsection (f)(1)(A) or any
other provision of this title and beginning on the date
upon which a borrower who is enrolled in a program of
education or training (including a course of study or
program described in paragraph (3)(B) or (4)(B) of
section 484(b)) for which borrowers are otherwise
eligible to receive Federal Direct Stafford Loans,
becomes ineligible for such loan as a result of
paragraph (1), interest on all Federal Direct Stafford
Loans that were disbursed to such borrower on or after
July 1, 2013, shall accrue. Such interest shall be paid
or capitalized in the same manner as interest on a
Federal Direct Unsubsidized Stafford Loan is paid or
capitalized under section 428H(e)(2).
(3) Period of enrollment.--
(A) In general.--The aggregate period of
enrollment referred to in paragraph (1) shall
not exceed the lesser of--
(i) a period equal to 150 percent of
the published length of the educational
program in which the student is
enrolled; or
(ii) in the case of a borrower who
was previously enrolled in one or more
other educational programs that began
on or after July 1, 2013, and subject
to subparagraph (B), a period of time
equal to the difference between--
(I) 150 percent of the
published length of the longest
educational program in which
the borrower was, or is,
enrolled; and
(II) any periods of
enrollment in which the
borrower received a Federal
Direct Stafford Loan.
(B) Regulations.--The Secretary shall specify
in regulation--
(i) how the aggregate period
described in subparagraph (A) shall be
calculated with respect to a borrower
who was or is enrolled on less than a
full-time basis; and
(ii) how such aggregate period shall
be calculated to include a course of
study or program described in paragraph
(3)(B) or (4)(B) of section 484(b),
respectively.
* * * * * * *
SEC. 458. FUNDS FOR ADMINISTRATIVE EXPENSES.
(a) Administrative Expenses.--
(1) Mandatory funds for fiscal year 2006.--For fiscal
year 2006, there shall be available to the Secretary,
from funds not otherwise appropriated, funds to be
obligated for--
(A) administrative costs under this part and
part B, including the costs of the direct
student loan programs under this part; and
(B) account maintenance fees payable to
guaranty agencies under part B and calculated
in accordance with subsections (b) and (c),
not to exceed (from such funds not otherwise
appropriated) $820,000,000 in fiscal year 2006.
(3) Authorization for administrative costs beginning
in fiscal years 2007 through 2014.--For each of the
fiscal years 2007 through 2014, there are authorized to
be appropriated such sums as may be necessary for
administrative costs under this part and part B,
including the costs of the direct student loan programs
under this part.
(4) Continuing mandatory funds for account
maintenance fees.--For each of the fiscal years 2007
through [2018] 2019, there shall be available to the
Secretary, from funds not otherwise appropriated, funds
to be obligated for account maintenance fees payable to
guaranty agencies under part B and calculated in
accordance with subsection (b).
(5) Account maintenance fees.--Account maintenance
fees under paragraph (3) shall be paid quarterly and
deposited in the Agency Operating Fund established
under section 422B.
(6) Technical assistance to institutions of higher
education.--
(A) Provision of assistance.--The Secretary
shall provide institutions of higher education
participating, or seeking to participate, in
the loan programs under this part with
technical assistance in establishing and
administering such programs.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $50,000,000 for
fiscal year 2010.
(C) Definition.--In this paragraph, the term
``assistance'' means the provision of technical
support, training, materials, technical
assistance, and financial assistance.
(7) Additional payments.--
(A) Provision of assistance.--The Secretary
shall provide payments to loan servicers for
retaining jobs at locations in the United
States where such servicers were operating
under part B on January 1, 2010.
(B) Funds.--There are authorized to be
appropriated, and there are appropriated, to
carry out this paragraph (in addition to any
other amounts appropriated to carry out this
paragraph and out of any money in the Treasury
not otherwise appropriated), $25,000,000 for
each of the fiscal years 2010 and 2011.
(8) Carryover.--The Secretary may carry over funds
made available under this section to a subsequent
fiscal year.
(b) Calculation Basis.--Account maintenance fees payable to
guaranty agencies under subsection (a)(4) shall be calculated
on the basis of 0.06 percent of the original principal amount
of outstanding loans on which insurance was issued under part
B.
(c) Budget Justification.--No funds may be expended under
this section unless the Secretary includes in the Department of
Education's annual budget justification to Congress a detailed
description of the specific activities for which the funds made
available by this section have been used in the prior and
current years (if applicable), the activities and costs planned
for the budget year, and the projection of activities and costs
for each remaining year for which administrative expenses under
this section are made available.
* * * * * * *
Part E--Federal Perkins Loans
* * * * * * *
SEC. 464. TERMS OF LOANS.
(a) Terms and Conditions.--(1) Loans from any student loan
fund established pursuant to an agreement under section 463 to
any student by any institution shall, subject to such
conditions, limitations, and requirements as the Secretary
shall prescribe by regulation, be made on such terms and
conditions as the institution may determine.
(2)(A) Except as provided in paragraph (4), the total of
loans made to a student in any academic year or its equivalent
by an institution of higher education from a loan fund
established pursuant to an agreement under this part shall not
exceed--
(i) $5,500, in the case of a student who has not
successfully completed a program of undergraduate
education; or
(ii) $8,000, in the case of a graduate or
professional student (as defined in regulations issued
by the Secretary).
(B) Except as provided in paragraph (4), the aggregate unpaid
principal amount for all loans made to a student by
institutions of higher education from loan funds established
pursuant to agreements under this part may not exceed--
(i) $60,000, in the case of any graduate or
professional student (as defined by regulations issued
by the Secretary, and including any loans from such
funds made to such person before such person became a
graduate or professional student);
(ii) $27,500, in the case of a student who has
successfully completed 2 years of a program of
education leading to a bachelor's degree but who has
not completed the work necessary for such a degree
(determined under regulations issued by the Secretary),
and including any loans from such funds made to such
person before such person became such a student; and
(iii) $11,000, in the case of any other student.
(3) Regulations of the Secretary under paragraph (1) shall be
designed to prevent the impairment of the capital student loan
funds to the maximum extent practicable and with a view toward
the objective of enabling the student to complete his course of
study.
(4) In the case of a program of study abroad that is approved
for credit by the home institution at which a student is
enrolled and that has reasonable costs in excess of the home
institution's budget, the annual and aggregate loan limits for
the student may exceed the amounts described in paragraphs
(2)(A) and (2)(B) by 20 percent.
(b) Demonstration of Need and Eligibility Required.--(1) A
loan from a student loan fund assisted under this part may be
made only to a student who demonstrates financial need in
accordance with part F of this title, who meets the
requirements of section 484, and who provides the institution
with the student's drivers license number, if any, at the time
of application for the loan. A student who is in default on a
loan under this part shall not be eligible for an additional
loan under this part unless such loan meets one of the
conditions for exclusion under section 462(g)(1)(E).
(2) If the institution's capital contribution under section
462 is directly or indirectly based in part on the financial
need demonstrated by students who are (A) attending the
institution less than full time, or (B) independent students,
then a reasonable portion of the loans made from the
institution's student loan fund containing the contribution
shall be made available to such students.
(c) Contents of Loan Agreement.--(1) Any agreement between an
institution and a student for a loan from a student loan fund
assisted under this part--
(A) shall be evidenced by note or other written
instrument which, except as provided in paragraph (2),
provides for repayment of the principal amount of the
loan, together with interest thereon, in equal
installments (or, if the borrower so requests, in
graduated periodic installments determined in
accordance with such schedules as may be approved by
the Secretary) payable quarterly, bimonthly, or
monthly, at the option of the institution, over a
period beginning nine months after the date on which
the student ceases to carry, at an institution of
higher education or a comparable institution outside
the United States approved for this purpose by the
Secretary, at least one-half the normal full-time
academic workload, and ending 10 years and 9 months
after such date except that such period may begin
earlier than 9 months after such date upon the request
of the borrower;
(B) shall include provision for acceleration of
repayment of the whole, or any part, of such loan, at
the option of the borrower;
(C)(i) may provide, at the option of the institution,
in accordance with regulations of the Secretary, that
during the repayment period of the loan, payments of
principal and interest by the borrower with respect to
all outstanding loans made to the student from a
student loan fund assisted under this part shall be at
a rate equal to not less than $40 per month, except
that the institution may, subject to such regulations,
permit a borrower to pay less than $40 per month for a
period of not more than one year where necessary to
avoid hardship to the borrower, but without extending
the 10-year maximum repayment period provided for in
subparagraph (A) of this paragraph; and
(ii) may provide that the total payments by a
borrower for a monthly or similar payment period with
respect to the aggregate of all loans held by the
institution may, when the amount of a monthly or other
similar payment is not a multiple of $5, be rounded to
the next highest whole dollar amount that is a multiple
of $5;
(D) shall provide that the loan shall bear interest,
on the unpaid balance of the loan, at the rate of 5
percent per year in the case of any loan made on or
after October 1, 1981, except that no interest shall
accrue (i) prior to the beginning date of repayment
determined under paragraph (2)(A)(i), or (ii) during
any period in which repayment is suspended by reason of
paragraph (2);
(E) shall provide that the loan shall be made without
security and without endorsement;
(F) shall provide that the liability to repay the
loan shall be cancelled--
(i) upon the death of the borrower;
(ii) if the borrower becomes permanently and
totally disabled as determined in accordance
with regulations of the Secretary;
(iii) if the borrower is unable to engage in
any substantial gainful activity by reason of
any medically determinable physical or mental
impairment that can be expected to result in
death, has lasted for a continuous period of
not less than 60 months, or can be expected to
last for a continuous period of not less than
60 months; or
(iv) if the borrower is determined by the
Secretary of Veterans Affairs to be
unemployable due to a service-connected
disability;
(G) shall provide that no note or evidence of
obligation may be assigned by the lender, except upon
the transfer of the borrower to another institution
participating under this part (or, if not so
participating, is eligible to do so and is approved by
the Secretary for such purpose), to such institution,
and except as necessary to carry out section 463(a)(6);
(H) pursuant to regulations of the Secretary, shall
provide for an assessment of a charge with respect to
the loan for failure of the borrower to pay all or part
of an installment when due, which shall include the
expenses reasonably incurred in attempting collection
of the loan, to the extent permitted by the Secretary,
except that no charge imposed under this subparagraph
shall exceed 20 percent of the amount of the monthly
payment of the borrower; and
(I) shall contain a notice of the system of
disclosure of information concerning default on such
loan to consumer reporting agencies under section
463(c).
(2)(A) No repayment of principal of, or interest on, any loan
from a student loan fund assisted under this part shall be
required during any period--
(i) during which the borrower--
(I) is pursuing at least a half-time course
of study as determined by an eligible
institution; or
(II) is pursuing a course of study pursuant
to a graduate fellowship program approved by
the Secretary, or pursuant to a rehabilitation
training program for disabled individuals
approved by the Secretary,
except that no borrower shall be eligible for a
deferment under this clause, or loan made under this
part while serving in a medical internship or residency
program;
(ii) not in excess of 3 years during which the
borrower is seeking and unable to find full-time
employment;
(iii) during which the borrower--
(I) is serving on active duty during a war or
other military operation or national emergency;
or
(II) is performing qualifying National Guard
duty during a war or other military operation
or national emergency,
and for the 180-day period following the demobilization
date for the service described in subclause (I) or
(II);
(iv) not in excess of 3 years for any reason which
the lender determines, in accordance with regulations
prescribed by the Secretary under section 435(o), has
caused or will cause the borrower to have an economic
hardship[; or];
(v) during which the borrower is engaged in service
described in section 465(a)(2); or
(vi) during which the borrower is receiving
treatment for cancer and the 6 months after
such period;
and provides that any such period shall not be included in
determining the 10-year period described in subparagraph (A) of
paragraph (1).
(B) No repayment of principal of, or interest on, any loan
for any period described in subparagraph (A) shall begin until
6 months after the completion of such period.
(C) An individual with an outstanding loan balance who meets
the eligibility criteria for a deferment described in
subparagraph (A) as in effect on the date of enactment of this
subparagraph shall be eligible for deferment under this
paragraph notwithstanding any contrary provision of the
promissory note under which the loan or loans were made, and
notwithstanding any amendment (or effective date provision
relating to any amendment) to this section made prior to the
date of such deferment.
(3)(A) The Secretary is authorized, when good cause is shown,
to extend, in accordance with regulations, the 10-year maximum
repayment period provided for in subparagraph (A) of paragraph
(1) with respect to individual loans.
(B) Pursuant to uniform criteria established by the
Secretary, the repayment period for any student borrower who
during the repayment period is a low-income individual may be
extended for a period not to exceed 10 years and the repayment
schedule may be adjusted to reflect the income of that
individual.
(4) The repayment period for a loan made under this part
shall begin on the day immediately following the expiration of
the period, specified in paragraph (1)(A), after the student
ceases to carry the required academic workload, unless the
borrower requests and is granted a repayment schedule that
provides for repayment to commence at an earlier point in time,
and shall exclude any period of authorized deferment,
forbearance, or cancellation.
(5) The institution may elect--
(A) to add the amount of any charge imposed under
paragraph (1)(H) to the principal amount of the loan as
of the first day after the day on which the installment
was due and to notify the borrower of the assessment of
the charge; or
(B) to make the amount of the charge payable to the
institution not later than the due date of the next
installment.
(6) Requests for deferment of repayment of loans under this
part by students engaged in graduate or post-graduate
fellowship-supported study (such as pursuant to a Fulbright
grant) outside the United States shall be approved until
completion of the period of the fellowship.
(7) There shall be excluded from the 9-month period that
begins on the date on which a student ceases to carry at least
one-half the normal full-time academic workload (as described
in paragraph (1)(A)) any period not to exceed 3 years during
which a borrower who is a member of a reserve component of the
Armed Forces named in section 10101 of title 10, United States
Code, is called or ordered to active duty for a period of more
than 30 days (as defined in section 101(d)(2) of such title).
Such period of exclusion shall include the period necessary to
resume enrollment at the borrower's next available regular
enrollment period.
(d) Availability of Loan Fund to All Eligible Students.--An
agreement under this part for payment of Federal capital
contributions shall include provisions designed to make loans
from the student loan fund established pursuant to such
agreement reasonably available (to the extent of the available
funds in such fund) to all eligible students in such
institutions in need thereof.
(e) Forbearance.--(1) The Secretary shall ensure that, as
documented in accordance with paragraph (2), an institution of
higher education shall grant a borrower forbearance of
principal and interest or principal only, renewable at 12-month
intervals for a period not to exceed 3 years, on such terms as
are otherwise consistent with the regulations issued by the
Secretary and agreed upon in writing by the parties to the
loan, if--
(A) the borrower's debt burden equals or exceeds 20
percent of such borrower's gross income;
(B) the institution determines that the borrower
should qualify for forbearance for other reasons; or
(C) the borrower is eligible for interest payments to
be made on such loan for service in the Armed Forces
under section 2174 of title 10, United States Code,
and, pursuant to that eligibility, the interest on such
loan is being paid under subsection (j), except that
the form of a forbearance under this paragraph shall be
a temporary cessation of all payments on the loan other
than payments of interest on the loan that are made
under subsection (j).
(2) For the purpose of paragraph (1), the terms of
forbearance agreed to by the parties shall be documented by--
(A) confirming the agreement of the borrower by
notice to the borrower from the institution of higher
education; and
(B) recording the terms in the borrower's file.
(f) Special Repayment Rule Authority.--(1) Subject to such
restrictions as the Secretary may prescribe to protect the
interest of the United States, in order to encourage repayment
of loans made under this part which are in default, the
Secretary may, in the agreement entered into under this part,
authorize an institution of higher education to compromise on
the repayment of such defaulted loans in accordance with
paragraph (2). The Federal share of the compromise repayment
shall bear the same relation to the institution's share of such
compromise repayment as the Federal capital contribution to the
institution's loan fund under this part bears to the
institution's capital contribution to such fund.
(2) No compromise repayment of a defaulted loan as authorized
by paragraph (1) may be made unless the student borrower pays--
(A) 90 percent of the loan under this part;
(B) the interest due on such loan; and
(C) any collection fees due on such loan;
in a lump sum payment.
(g) Discharge.--
(1) In general.--If a student borrower who received a
loan made under this part on or after January 1, 1986,
is unable to complete the program in which such student
is enrolled due to the closure of the institution, then
the Secretary shall discharge the borrower's liability
on the loan (including the interest and collection
fees) and shall subsequently pursue any claim available
to such borrower against the institution and the
institution's affiliates and principals, or settle the
loan obligation pursuant to the financial
responsibility standards described in section 498(c).
(2) Assignment.--A borrower whose loan has been
discharged pursuant to this subsection shall be deemed
to have assigned to the United States the right to a
loan refund in an amount that does not exceed the
amount discharged against the institution and the
institution's affiliates and principals.
(3) Eligibility for additional assistance.--The
period during which a student was unable to complete a
course of study due to the closing of the institution
shall not be considered for purposes of calculating the
student's period of eligibility for additional
assistance under this title.
(4) Special rule.--A borrower whose loan has been
discharged pursuant to this subsection shall not be
precluded, because of that discharge, from receiving
additional grant, loan, or work assistance under this
title for which the borrower would be otherwise
eligible (but for the default on the discharged loan).
The amount discharged under this subsection shall be
treated as an amount canceled under section 465(a).
(5) Reporting.--The Secretary or institution, as the
case may be, shall report to consumer reporting
agencies with respect to loans that have been
discharged pursuant to this subsection.
(h) Rehabilitation of Loans.--
(1) Rehabilitation.--
(A) In general.--If the borrower of a loan
made under this part who has defaulted on the
loan makes 9 on-time, consecutive, monthly
payments of amounts owed on the loan, as
determined by the institution, or by the
Secretary in the case of a loan held by the
Secretary, the loan shall be considered
rehabilitated, and the institution that made
that loan (or the Secretary, in the case of a
loan held by the Secretary) shall request that
any consumer reporting agency to which the
default was reported remove the default from
the borrower's credit history.
(B) Comparable conditions.--As long as the
borrower continues to make scheduled repayments
on a loan rehabilitated under this paragraph,
the rehabilitated loan shall be subject to the
same terms and conditions, and qualify for the
same benefits and privileges, as other loans
made under this part.
(C) Additional assistance.--The borrower of a
rehabilitated loan shall not be precluded by
section 484 from receiving additional grant,
loan, or work assistance under this title (for
which the borrower is otherwise eligible) on
the basis of defaulting on the loan prior to
such rehabilitation.
(D) Limitations.--A borrower only once may
obtain the benefit of this paragraph with
respect to rehabilitating a loan under this
part.
(2) Restoration of eligibility.--If the borrower of a
loan made under this part who has defaulted on that
loan makes 6 ontime, consecutive, monthly payments of
amounts owed on such loan, the borrower's eligibility
for grant, loan, or work assistance under this title
shall be restored to the extent that the borrower is
otherwise eligible. A borrower only once may obtain the
benefit of this paragraph with respect to restored
eligibility.
(i) Incentive Repayment Program.--
(1) In general.--Each institution of higher education
may establish, with the approval of the Secretary, an
incentive repayment program designed to reduce default
and to replenish student loan funds established under
this part. Each such incentive repayment program may--
(A) offer a reduction of the interest rate on
a loan on which the borrower has made 48
consecutive, monthly repayments, but in no
event may the rate be reduced by more than 1
percent;
(B) provide for a discount on the balance
owed on a loan on which the borrower pays the
principal and interest in full prior to the end
of the applicable repayment period, but in no
event may the discount exceed 5 percent of the
unpaid principal balance due on the loan at the
time the early repayment is made; and
(C) include such other incentive repayment
options as the institution determines will
carry out the objectives of this subsection.
(2) Limitation.--No incentive repayment option under
an incentive repayment program authorized by this
subsection may be paid for with Federal funds,
including any Federal funds from the student loan fund,
or with institutional funds from the student loan fund.
(j) Armed Forces Student Loan Interest Payment Program.--
(1) Authority.--Using funds received by transfer to
the Secretary under section 2174 of title 10, United
States Code, for the payment of interest on a loan made
under this part to a member of the Armed Forces, the
Secretary shall pay the interest on the loan as due for
a period not in excess of 36 consecutive months. The
Secretary may not pay interest on such a loan out of
any funds other than funds that have been so
transferred.
(2) Forbearance.--During the period in which the
Secretary is making payments on a loan under paragraph
(1), the institution of higher education shall grant
the borrower forbearance in accordance with subsection
(e)(1)(C).
(k) The Secretary may develop such additional safeguards as
the Secretary determines necessary to prevent fraud and abuse
in the cancellation of liability under subsection (c)(1)(F).
Notwithstanding subsection (c)(1)(F), the Secretary may
promulgate regulations to resume collection on loans cancelled
under subsection (c)(1)(F) in any case in which--
(1) a borrower received a cancellation of liability
under subsection (c)(1)(F) and after the cancellation
the borrower--
(A) receives a loan made, insured, or
guaranteed under this title; or
(B) has earned income in excess of the
poverty line; or
(2) the Secretary determines necessary.
* * * * * * *
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PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE II--ADMINISTRATION AND MISCELLANEOUS PROVISIONS
* * * * * * *
Part B--Miscellaneous Provisions
* * * * * * *
SEC. 245A. PROHIBITING GOVERNMENTAL DISCRIMINATION AGAINST PROVIDERS OF
HEALTH SERVICES THAT ARE NOT INVOLVED IN ABORTION.
(a) In General.--Notwithstanding any other law, the Federal
Government, and any State or local government that receives
Federal financial assistance, may not penalize, retaliate
against, or otherwise discriminate against a health care
provider on the basis that the provider does not--
(1) perform, refer for, pay for, or otherwise
participate in abortion;
(2) provide or sponsor abortion coverage; or
(3) facilitate or make arrangements for any of the
activities specified in this subsection.
(b) Rule of Construction.--Nothing in this section shall be
construed--
(1) to prevent any health care provider from
voluntarily electing to participate in abortions or
abortion referrals;
(2) to prevent any health care provider from
voluntarily electing to provide or sponsor abortion
coverage or health benefits coverage that includes
abortion;
(3) to prevent an accrediting agency, the Federal
Government, or a State or local government from
establishing standards of medical competency applicable
only to those who have knowingly, voluntarily, and
specifically elected to perform abortions, or from
enforcing contractual obligations applicable only to
those who, as part of such contract, knowingly,
voluntarily, and specifically elect to provide
abortions;
(4) to affect, or be affected by, section 1867 of the
Social Security Act (42 U.S.C. 1395dd, commonly
referred to as the ``Emergency Medical Treatment and
Active Labor Act''); or
(5) to supersede any law enacted by any State for the
purpose of regulating insurance, except as specified in
subsection (a).
(c) Administration.--The Secretary shall designate the
Director of the Office for Civil Rights of the Department of
Health and Human Services--
(1) to receive complaints alleging a violation of
this section, section 245 of this Act, or any of
subsections (b) through (e) of section 401 of the
Health Programs Extension Act of 1973; and
(2) to pursue the investigation of such complaints in
coordination with the Attorney General.
(d) Definitions.--For purposes of this section:
(1) Federal financial assistance.--The term ``Federal
financial assistance'' means Federal payments to cover
the cost of health care services or benefits, or other
Federal payments, grants, or loans to promote or
otherwise facilitate health-related activities.
(2) Health care provider.--The term ``health care
provider'' means--
(A) an individual physician, nurse, or other
health care professional;
(B) a hospital, health system, or other
health care facility or organization (including
a party to a proposed merger or other
collaborative arrangement relating to health
services, and an entity resulting therefrom);
(C) a provider-sponsored organization, an
accountable care organization, or a health
maintenance organization;
(D) a social services provider that provides
or authorizes referrals for health care
services;
(E) a program of training in the health
professions or an applicant to or participant
in such a program;
(F) an issuer of health insurance coverage;
or
(G) a group health plan or student health
plan, or a sponsor or administrator thereof.
(3) State or local government that receives Federal
financial assistance.--The term ``State or local
government that receives Federal financial assistance''
includes every agency and other governmental unit and
subdivision of a State or local government, if such
State or local government, or any agency or
governmental unit or subdivision thereof, receives
Federal financial assistance.
SEC. 245B. CIVIL ACTION FOR CERTAIN VIOLATIONS.
(a) In General.--A qualified party may, in a civil action,
obtain appropriate relief with regard to a designated
violation.
(b) Definitions.--For purposes of this section:
(1) Qualified party.--The term ``qualified party''
means--
(A) the Attorney General of the United
States; or
(B) any person or entity adversely affected
by the designated violation.
(2) Designated violation.--The term ``designated
violation'' means an actual or threatened violation
of--
(A) section 245 or 245A of this Act; or
(B) any of subsections (b) through (e) of
section 401 of the Health Programs Extension
Act of 1973 regarding an objection to abortion.
(c) Administrative Remedies Not Required.--An action under
this section may be commenced, and relief may be granted,
without regard to whether the party commencing the action has
sought or exhausted available administrative remedies.
(d) Defendants in Actions Under this Section May Include
Governmental Entities as Well as Others.--
(1) In general.--An action under this section may be
maintained against, among others, a party that is a
Federal or State governmental entity. Relief in an
action under this section may include money damages
even if the defendant is such a governmental entity.
(2) Definition.--For the purposes of this subsection,
the term ``State governmental entity'' means a State, a
local government within a State, and any agency or
other governmental unit or subdivision of a State or of
such a local government.
(e) Nature of Relief.--In an action under this section, the
court shall grant--
(1) all necessary equitable and legal relief,
including, where appropriate, declaratory relief and
compensatory damages, to prevent the occurrence,
continuance, or repetition of the designated violation
and to compensate for losses resulting from the
designated violation; and
(2) to a prevailing plaintiff, reasonable attorneys'
fees and litigation expenses as part of the costs.
* * * * * * *
----------
SECTION 235 OF THE WILLIAM WILBERFORCE TRAFFICKING VICTIMS PROTECTION
REAUTHORIZATION ACT OF 2008
SEC. 235. ENHANCING EFFORTS TO COMBAT THE TRAFFICKING OF CHILDREN.
(a) Combating Child Trafficking at the Border and Ports of
Entry of the United States.--
(1) Policies and procedures.--In order to enhance the
efforts of the United States to prevent trafficking in
persons, the Secretary of Homeland Security, in
conjunction with the Secretary of State, the Attorney
General, and the Secretary of Health and Human
Services, shall develop policies and procedures to
ensure that unaccompanied alien children in the United
States are safely repatriated to their country of
nationality or of last habitual residence.
(2) Special rules for children from contiguous
countries.--
(A) Determinations.--Any unaccompanied alien
child who is a national or habitual resident of
a country that is contiguous with the United
States shall be treated in accordance with
subparagraph (B), if the Secretary of Homeland
Security determines, on a case-by-case basis,
that--
(i) such child has not been a victim
of a severe form of trafficking in
persons, and there is no credible
evidence that such child is at risk of
being trafficked upon return to the
child's country of nationality or of
last habitual residence;
(ii) such child does not have a fear
of returning to the child's country of
nationality or of last habitual
residence owing to a credible fear of
persecution; and
(iii) the child is able to make an
independent decision to withdraw the
child's application for admission to
the United States.
(B) Return.--An immigration officer who finds
an unaccompanied alien child described in
subparagraph (A) at a land border or port of
entry of the United States and determines that
such child is inadmissible under the
Immigration and Nationality Act (8 U.S.C. 1101
et seq.) may--
(i) permit such child to withdraw the
child's application for admission
pursuant to section 235(a)(4) of the
Immigration and Nationality Act (8
U.S.C. 1225(a)(4)); and
(ii) return such child to the child's
country of nationality or country of
last habitual residence.
(C) Contiguous country agreements.--The
Secretary of State shall negotiate agreements
between the United States and countries
contiguous to the United States with respect to
the repatriation of children. Such agreements
shall be designed to protect children from
severe forms of trafficking in persons, and
shall, at a minimum, provide that--
(i) no child shall be returned to the
child's country of nationality or of
last habitual residence unless returned
to appropriate employees or officials,
including child welfare officials where
available, of the accepting country's
government;
(ii) no child shall be returned to
the child's country of nationality or
of last habitual residence outside of
reasonable business hours; and
(iii) border personnel of the
countries that are parties to such
agreements are trained in the terms of
such agreements.
(3) Rule for other children.--The custody of
unaccompanied alien children not described in paragraph
(2)(A) who are apprehended at the border of the United
States or at a United States port of entry shall be
treated in accordance with subsection (b).
(4) Screening.--Within 48 hours of the apprehension
of a child who is believed to be described in paragraph
(2)(A), but in any event prior to returning such child
to the child's country of nationality or of last
habitual residence, the child shall be screened to
determine whether the child meets the criteria listed
in paragraph (2)(A). If the child does not meet such
criteria, or if no determination can be made within 48
hours of apprehension, the child shall immediately be
transferred to the Secretary of Health and Human
Services and treated in accordance with subsection (b).
Nothing in this paragraph may be construed to preclude
an earlier transfer of the child.
(5) Ensuring the safe repatriation of children.--
(A) Repatriation pilot program.--To protect
children from trafficking and exploitation, the
Secretary of State shall create a pilot
program, in conjunction with the Secretary of
Health and Human Services and the Secretary of
Homeland Security, nongovernmental
organizations, and other national and
international agencies and experts, to develop
and implement best practices to ensure the safe
and sustainable repatriation and reintegration
of unaccompanied alien children into their
country of nationality or of last habitual
residence, including placement with their
families, legal guardians, or other sponsoring
agencies.
(B) Assessment of country conditions.--The
Secretary of Homeland Security shall consult
the Department of State's Country Reports on
Human Rights Practices and the Trafficking in
Persons Report in assessing whether to
repatriate an unaccompanied alien child to a
particular country.
(C) Report on repatriation of unaccompanied
alien children.--Not later than 18 months after
the date of the enactment of this Act, and
annually thereafter, the Secretary of State and
the Secretary of Health and Human Services,
with assistance from the Secretary of Homeland
Security, shall submit a report to the
Committee on the Judiciary of the Senate and
the Committee on the Judiciary of the House of
Representatives on efforts to improve
repatriation programs for unaccompanied alien
children. Such report shall include--
(i) the number of unaccompanied alien
children ordered removed and the number
of such children actually removed from
the United States;
(ii) a statement of the
nationalities, ages, and gender of such
children;
(iii) a description of the policies
and procedures used to effect the
removal of such children from the
United States and the steps taken to
ensure that such children were safely
and humanely repatriated to their
country of nationality or of last
habitual residence, including a
description of the repatriation pilot
program created pursuant to
subparagraph (A);
(iv) a description of the type of
immigration relief sought and denied to
such children;
(v) any information gathered in
assessments of country and local
conditions pursuant to paragraph (2);
and
(vi) statistical information and
other data on unaccompanied alien
children as provided for in section
462(b)(1)(J) of the Homeland Security
Act of 2002 (6 U.S.C. 279(b)(1)(J)).
(D) Placement in removal proceedings.--Any
unaccompanied alien child sought to be removed
by the Department of Homeland Security, except
for an unaccompanied alien child from a
contiguous country subject to exceptions under
subsection (a)(2), shall be--
(i) placed in removal proceedings
under section 240 of the Immigration
and Nationality Act (8 U.S.C. 1229a);
(ii) eligible for relief under
section 240B of such Act (8 U.S.C.
1229c) at no cost to the child; and
(iii) provided access to counsel in
accordance with subsection (c)(5).
(b) Combating Child Trafficking and Exploitation in the
United States.--
(1) Care and custody of unaccompanied alien
children.--Consistent with section 462 of the Homeland
Security Act of 2002 (6 U.S.C. 279), and except as
otherwise provided under subsection (a), the care and
custody of all unaccompanied alien children, including
responsibility for their detention, where appropriate,
shall be the responsibility of the Secretary of Health
and Human Services.
(2) Notification.--Each department or agency of the
Federal Government shall notify the Department of
Health and Human services within 48 hours upon--
(A) the apprehension or discovery of an
unaccompanied alien child; or
(B) any claim or suspicion that an alien in
the custody of such department or agency is
under 18 years of age.
(3) Transfers of unaccompanied alien children.--
Except in the case of exceptional circumstances, any
department or agency of the Federal Government that has
an unaccompanied alien child in custody shall transfer
the custody of such child to the Secretary of Health
and Human Services not later than 72 hours after
determining that such child is an unaccompanied alien
child.
(4) Age determinations.--The Secretary of Health and
Human Services, in consultation with the Secretary of
Homeland Security, shall develop procedures to make a
prompt determination of the age of an alien, which
shall be used by the Secretary of Homeland Security and
the Secretary of Health and Human Services for children
in their respective custody. At a minimum, these
procedures shall take into account multiple forms of
evidence, including the non-exclusive use of
radiographs, to determine the age of the unaccompanied
alien.
(c) Providing Safe and Secure Placements for Children.--
(1) Policies and programs.--The Secretary of Health
and Human Services, Secretary of Homeland Security,
Attorney General, and Secretary of State shall
establish policies and programs to ensure that
unaccompanied alien children in the United States are
protected from traffickers and other persons seeking to
victimize or otherwise engage such children in
criminal, harmful, or exploitative activity, including
policies and programs reflecting best practices in
witness security programs.
(2) Safe and secure placements.--
(A) Minors in department of health and human
services custody.--Subject to section 462(b)(2)
of the Homeland Security Act of 2002 (6 U.S.C.
279(b)(2)), an unaccompanied alien child in the
custody of the Secretary of Health and Human
Services shall be promptly placed in the least
restrictive setting that is in the best
interest of the child. In making such
placements, the Secretary may consider danger
to self, danger to the community, and risk of
flight. Placement of child trafficking victims
may include placement in an Unaccompanied
Refugee Minor program, pursuant to section
412(d) of the Immigration and Nationality Act
(8 U.S.C. 1522(d)), if a suitable family member
is not available to provide care. A child shall
not be placed in a secure facility absent a
determination that the child poses a danger to
self or others or has been charged with having
committed a criminal offense. The placement of
a child in a secure facility shall be reviewed,
at a minimum, on a monthly basis, in accordance
with procedures prescribed by the Secretary, to
determine if such placement remains warranted.
(B) Aliens transferred from department of
health and human services to department of
homeland security custody.--If a minor
described in subparagraph (A) reaches 18 years
of age and is transferred to the custody of the
Secretary of Homeland Security, the Secretary
shall consider placement in the least
restrictive setting available after taking into
account the alien's danger to self, danger to
the community, and risk of flight. Such aliens
shall be eligible to participate in alternative
to detention programs, utilizing a continuum of
alternatives based on the alien's need for
supervision, which may include placement of the
alien with an individual or an organizational
sponsor, or in a supervised group home.
(3) Safety and suitability assessments.--
(A) In general.--Subject to the requirements
of subparagraph (B), an unaccompanied alien
child may not be placed with a person or entity
unless the Secretary of Health and Human
Services makes a determination that the
proposed custodian is capable of providing for
the child's physical and mental well-being.
Such determination shall, at a minimum, include
verification of the custodian's identity and
relationship to the child, if any, as well as
an independent finding that the individual has
not engaged in any activity that would indicate
a potential risk to the child.
(B) Home studies.--Before placing the child
with an individual, the Secretary of Health and
Human Services shall determine whether a home
study is first necessary. A home study shall be
conducted for a child who is a victim of a
severe form of trafficking in persons, a
special needs child with a disability (as
defined in section 3 of the Americans with
Disabilities Act of 1990 (42 U.S.C. 12102(2))),
a child who has been a victim of physical or
sexual abuse under circumstances that indicate
that the child's health or welfare has been
significantly harmed or threatened, or a child
whose proposed sponsor clearly presents a risk
of abuse, maltreatment, exploitation, or
trafficking to the child based on all available
objective evidence. The Secretary of Health and
Human Services shall conduct follow-up
services, during the pendency of removal
proceedings, on children for whom a home study
was conducted and is authorized to conduct
follow-up services in cases involving children
with mental health or other needs who could
benefit from ongoing assistance from a social
welfare agency.
(C) Access to information.--Not later than 2
weeks after receiving a request from the
Secretary of Health and Human Services, the
Secretary of Homeland Security shall provide
information necessary to conduct suitability
assessments from appropriate Federal, State,
and local law enforcement and immigration
databases.
(4) Legal orientation presentations.--The Secretary
of Health and Human Services shall cooperate with the
Executive Office for Immigration Review to ensure that
custodians receive legal orientation presentations
provided through the Legal Orientation Program
administered by the Executive Office for Immigration
Review. At a minimum, such presentations shall address
the custodian's responsibility to attempt to ensure the
child's appearance at all immigration proceedings and
to protect the child from mistreatment, exploitation,
and trafficking.
(5) Access to counsel.--The Secretary of Health and
Human Services shall ensure, to the greatest extent
practicable and consistent with section 292 of the
Immigration and Nationality Act (8 U.S.C. 1362), that
all unaccompanied alien children who are or have been
in the custody of the Secretary or the Secretary of
Homeland Security, and who are not described in
subsection (a)(2)(A), have counsel to represent them in
legal proceedings or matters and protect them from
mistreatment, exploitation, and trafficking. To the
greatest extent practicable, the Secretary of Health
and Human Services shall make every effort to utilize
the services of pro bono counsel who agree to provide
representation to such children without charge.
(6) Child advocates.--
(A) In general.--The Secretary of Health and
Human Services is authorized to appoint
independent child advocates for child
trafficking victims and other vulnerable
unaccompanied alien children. A child advocate
shall be provided access to materials necessary
to effectively advocate for the best interest
of the child. The child advocate shall not be
compelled to testify or provide evidence in any
proceeding concerning any information or
opinion received from the child in the course
of serving as a child advocate. The child
advocate shall be presumed to be acting in good
faith and be immune from civil liability for
lawful conduct of duties as described in this
provision.
(B) Appointment of child advocates.--
(i) Initial sites.--Not later than 2
years after the date of the enactment
of the Violence Against Women
Reauthorization Act of 2013, the
Secretary of Health and Human Services
shall appoint child advocates at 3 new
immigration detention sites to provide
independent child advocates for
trafficking victims and vulnerable
unaccompanied alien children.
(ii) Additional sites.--Not later
than 3 years after the date of the
enactment of the Violence Against Women
Reauthorization Act of 2013, the
Secretary shall appoint child advocates
at not more than 3 additional
immigration detention sites.
(iii) Selection of sites.--Sites at
which child advocate programs will be
established under this subparagraph
shall be located at immigration
detention sites at which more than 50
children are held in immigration
custody, and shall be selected
sequentially, with priority given to
locations with--
(I) the largest number of
unaccompanied alien children;
and
(II) the most vulnerable
populations of unaccompanied
children.
(C) Restrictions.--
(i) Administrative expenses.--A child
advocate program may not use more that
10 percent of the Federal funds
received under this section for
administrative expenses.
(ii) Nonexclusivity.--Nothing in this
section may be construed to restrict
the ability of a child advocate program
under this section to apply for or
obtain funding from any other source to
carry out the programs described in
this section.
(iii) Contribution of funds.--A child
advocate program selected under this
section shall contribute non-Federal
funds, either directly or through in-
kind contributions, to the costs of the
child advocate program in an amount
that is not less than 25 percent of the
total amount of Federal funds received
by the child advocate program under
this section. In-kind contributions may
not exceed 40 percent of the matching
requirement under this clause.
(D) Annual report to congress.--Not later
than 1 year after the date of the enactment of
the Violence Against Women Reauthorization Act
of 2013, and annually thereafter, the Secretary
of Health and Human Services shall submit a
report describing the activities undertaken by
the Secretary to authorize the appointment of
independent Child Advocates for trafficking
victims and vulnerable unaccompanied alien
children to the Committee on the Judiciary of
the Senate and the Committee on the Judiciary
of the House of Representatives.
(E) Assessment of child advocate program.--
(i) In general.--As soon as
practicable after the date of the
enactment of the Violence Against Women
Reauthorization Act of 2013, the
Comptroller General of the United
States shall conduct a study regarding
the effectiveness of the Child Advocate
Program operated by the Secretary of
Health and Human Services.
(ii) Matters to be studied.--In the
study required under clause (i), the
Comptroller General shall-- collect
information and analyze the following:
(I) analyze the effectiveness
of existing child advocate
programs in improving outcomes
for trafficking victims and
other vulnerable unaccompanied
alien children;
(II) evaluate the
implementation of child
advocate programs in new sites
pursuant to subparagraph (B);
(III) evaluate the extent to
which eligible trafficking
victims and other vulnerable
unaccompanied children are
receiving child advocate
services and assess the
possible budgetary implications
of increased participation in
the program;
(IV) evaluate the barriers to
improving outcomes for
trafficking victims and other
vulnerable unaccompanied
children; and
(V) make recommendations on
statutory changes to improve
the Child Advocate Program in
relation to the matters
analyzed under subclauses (I)
through (IV).
(iii) GAO report.--Not later than 3
years after the date of the enactment
of this Act, the Comptroller General of
the United States shall submit the
results of the study required under
this subparagraph to--
(I) the Committee on the
Judiciary of the Senate;
(II) the Committee on Health,
Education, Labor, and Pensions
of the Senate;
(III) the Committee on the
Judiciary of the House of
Representatives; and
(IV) the Committee on
Education and the Workforce of
the House of Representatives.
(F) Authorization of appropriations.--There
are authorized to be appropriated to the
Secretary and Human Services to carry out this
subsection--
(i) $1,000,000 for each of the fiscal
years 2014 and 2015; and
(ii) $2,000,000 for each of the
fiscal years 2016 and 2017.
(d) Permanent Protection for Certain At-Risk Children.--
(1) In general.--Section 101(a)(27)(J) of the
Immigration and Nationality Act (8 U.S.C.
1101(a)(27)(J)) is amended--
(A) in clause (i), by striking ``State and
who has been deemed eligible by that court for
long-term foster care due to abuse, neglect, or
abandonment;'' and inserting ``State, or an
individual or entity appointed by a State or
juvenile court located in the United States,
and whose reunification with 1 or both of the
immigrant's parents is not viable due to abuse,
neglect, abandonment, or a similar basis found
under State law;''; and
(B) in clause (iii)--
(i) in the matter preceding subclause
(I), by striking ``the Attorney General
expressly consents to the dependency
order serving as a precondition to the
grant of special immigrant juvenile
status;'' and inserting ``the Secretary
of Homeland Security consents to the
grant of special immigrant juvenile
status,''; and
(ii) in subclause (I), by striking
``in the actual or constructive custody
of the Attorney General unless the
Attorney General specifically consents
to such jurisdiction;'' and inserting
``in the custody of the Secretary of
Health and Human Services unless the
Secretary of Health and Human Services
specifically consents to such
jurisdiction;''.
(2) Expeditious adjudication.--All applications for
special immigrant status under section 101(a)(27)(J) of
the Immigration and Nationality Act (8 U.S.C.
1101(a)(27)(J)) shall be adjudicated by the Secretary
of Homeland Security not later than 180 days after the
date on which the application is filed.
(3) Adjustment of status.--Section 245(h)(2)(A) of
the Immigration and Nationality Act (8 U.S.C.
1255(h)(2)(A)) is amended to read as follows:
``(A) paragraphs (4), (5)(A), (6)(A), (6)(C),
(6)(D), (7)(A), and (9)(B) of section 212(a)
shall not apply; and''.
(4) Eligibility for assistance.--
(A) In general.--A child who has been granted
special immigrant status under section
101(a)(27)(J) of the Immigration and
Nationality Act (8 U.S.C. 1101(a)(27)(J)) and
who was in the custody of the Secretary of
Health and Human Services at the time a
dependency order was granted for such child,
was receiving services pursuant to section
501(a) of the Refugee Education Assistance Act
of 1980 (8 U.S.C. 1522 note) at the time such
dependency order was granted, or has been
granted status under section 101(a)(15)(U) of
the Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(U)),, shall be eligible for
placement and services under section 412(d) of
the Immigration and Nationality Act (8 U.S.C.
1522(d)) until the earlier of--
(i) the date on which the child
reaches the age designated in section
412(d)(2)(B) of the Immigration and
Nationality Act (8 U.S.C.
1522(d)(2)(B)); or
(ii) the date on which the child is
placed in a permanent adoptive home.
(B) State reimbursement.--Subject to the
availability of appropriations, if State foster
care funds are expended on behalf of a child
who is not described in subparagraph (A) and
has been granted special immigrant status under
section 101(a)(27)(J) of the Immigration and
Nationality Act (8 U.S.C. 1101(a)(27)(J)), or
status under section 101(a)(15)(U) of the
Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(U)),,\1\ the Federal Government
shall reimburse the State in which the child
resides for such expenditures by the State.
(5) State courts acting in loco parentis.--A
department or agency of a State, or an individual or
entity appointed by a State court or juvenile court
located in the United States, acting in loco parentis,
shall not be considered a legal guardian for purposes
of this section or section 462 of the Homeland Security
Act of 2002 (6 U.S.C. 279).
(6) Transition rule.--Notwithstanding any other
provision of law, an alien described in section
101(a)(27)(J) of the Immigration and Nationality Act (8
U.S.C. 1101(a)(27)(J)), as amended by paragraph (1),
may not be denied special immigrant status under such
section after the date of the enactment of this Act
based on age if the alien was a child on the date on
which the alien applied for such status.
(7) Access to asylum protections.--Section 208 of the
Immigration and Nationality Act (8 U.S.C. 1158) is
amended--
(A) in subsection (a)(2), by adding at the
end the following:
``(E) Applicability.--Subparagraphs (A) and
(B) shall not apply to an unaccompanied alien
child (as defined in section 462(g) of the
Homeland Security Act of 2002 (6 U.S.C.
279(g))).''; and
(B) in subsection (b)(3), by adding at the
end the following:
``(C) Initial jurisdiction.--An asylum
officer (as defined in section 235(b)(1)(E))
shall have initial jurisdiction over any asylum
application filed by an unaccompanied alien
child (as defined in section 462(g) of the
Homeland Security Act of 2002 (6 U.S.C.
279(g))), regardless of whether filed in
accordance with this section or section
235(b).''.
(8) Specialized needs of unaccompanied alien
children.--Applications for asylum and other forms of
relief from removal in which an unaccompanied alien
child is the principal applicant shall be governed by
regulations which take into account the specialized
needs of unaccompanied alien children and which address
both procedural and substantive aspects of handling
unaccompanied alien children's cases.
(e) Training.--The Secretary of State, the Secretary of
Homeland Security, the Secretary of Health and Human Services,
and the Attorney General shall provide specialized training to
all Federal personnel, and upon request, state and local
personnel, who have substantive contact with unaccompanied
alien children. Such personnel shall be trained to work with
unaccompanied alien children, including identifying children
who are victims of severe forms of trafficking in persons, and
children for whom asylum or special immigrant relief may be
appropriate, including children described in subsection (a)(2).
(f) Amendments to the Homeland Security Act of 2002.--
(1) Additional responsibilities.--Section
462(b)(1)(L) of the Homeland Security Act of 2002 (6
U.S.C. 279(b)(1)(L)) is amended by striking the period
at the end and inserting ``, including regular follow-
up visits to such facilities, placements, and other
entities, to assess the continued suitability of such
placements.''.
(2) Technical corrections.--Section 462(b) of such
Act (6 U.S.C. 279(b)) is further amended--
(A) in paragraph (3), by striking ``paragraph
(1)(G),'' and inserting ``paragraph (1),''; and
(B) by adding at the end the following:
``(4) Rule of construction.--Nothing in paragraph
(2)(B) may be construed to require that a bond be
posted for an unaccompanied alien child who is released
to a qualified sponsor.''.
(g) Definition of Unaccompanied Alien Child.--For purposes of
this section, the term ``unaccompanied alien child'' has the
meaning given such term in section 462(g) of the Homeland
Security Act of 2002 (6 U.S.C. 279(g)).
(h) Effective Date.--This section--
(1) shall take effect on the date that is 90 days
after the date of the enactment of this Act; and
(2) shall also apply to all aliens in the United
States in pending proceedings before the Department of
Homeland Security or the Executive Office for
Immigration Review, or related administrative or
Federal appeals, on the date of the enactment of this
Act.
(i) Grants and Contracts.--The Secretary of Health and Human
Services may award grants to, and enter into contracts with,
voluntary agencies to carry out this section and section 462 of
the Homeland Security Act of 2002 (6 U.S.C. 279).
(j) Construction.--
(1) In general.--Notwithstanding any other provision
of law, judicial determination, consent decree, or
settlement agreement, the detention of any alien child
who is not an unaccompanied alien child shall be
governed by sections 217, 235, 236, and 241 of the
Immigration and Nationality Act (8 U.S.C. 1187, 1225,
1226, and 1231). There exists no presumption that an
alien child who is not an unaccompanied alien child
should not be detained, and all such determinations
shall be in the discretion of the Secretary of Homeland
Security.
(2) Release of minors other than unaccompanied
aliens.--In no circumstances shall an alien minor who
is not an unaccompanied alien child be released by the
Secretary of Homeland Security other than to a parent
or legal guardian.
(3) Family detention.--The Secretary of Homeland
Security shall--
(A) maintain the care and custody of an
alien, during the period during which the
charges described in clause (i) are pending,
who--
(i) is charged only with a
misdemeanor offense under section
275(a) of the Immigration and
Nationality Act (8 U.S.C. 1325(a)); and
(ii) entered the United States with
the alien's child who has not attained
18 years of age; and
(B) detain the alien with the alien's child.
----------
SECTION 9 OF THE SMALL BUSINESS ACT
Sec. 9. (a) Research and development are major factors in the
growth and progress of industry and the national economy. The
expense of carrying on research and development programs is
beyond the means of many small-business concerns, and such
concerns are handicapped in obtaining the benefits of research
and development programs conducted at Government expense. These
small-business concerns are thereby placed at a competitive
disadvantage. This weakens the competitive free enterprise
system and prevents the orderly development of the national
economy. It is the policy of the Congress that assistance be
given to small-business concerns to enable them to undertake
and to obtain the benefits of research and development in order
to maintain and strengthen the competitive free enterprise
system and the national economy.
(b) It shall be the duty of the Administration, and it is
hereby empowered--
(1) to assist small-business concerns to obtain
Government contracts for research and development;
(2) to assist small-business concerns to obtain the
benefits of research and development performed under
Government contracts or at Government expense;
(3) to provide technical assistance to small-business
concerns to accomplish the purposes of this section;
and
(4) to develop and maintain a source file and an
information program to assure each qualified and
interested small business concern the opportunity to
participate in Federal agency small business innovation
research programs and small business technology
transfer programs;
(5) to coordinate with participating agencies a
schedule for release of SBIR and STTR solicitations,
and to prepare a master release schedule so as to
maximize small business' opportunities to respond to
solicitations;
(6) to independently survey and monitor the operation
of SBIR and STTR programs within participating Federal
agencies;
(7) to report not less than annually to the Committee
on Small Business of the Senate, and to the Committee
on Science and the Committee on Small Business of the
House of Representatives, on the SBIR and STTR programs
of the Federal agencies and the Administration's
information and monitoring efforts related to the SBIR
and STTR programs, including--
(A) the data on output and outcomes collected
pursuant to subsections (g)(8) and (o)(9);
(B) the number of proposals received from,
and the number and total amount of awards to,
HUBZone small business concerns and firms with
venture capital, hedge fund, or private equity
firm investment (including those majority-owned
by multiple venture capital operating
companies, hedge funds, or private equity
firms) under each of the SBIR and STTR
programs;
(C) a description of the extent to which each
Federal agency is increasing outreach and
awards to firms owned and controlled by women
or by socially or economically disadvantaged
individuals under each of the SBIR and STTR
programs;
(D) general information about the
implementation of, and compliance with the
allocation of funds required under, subsection
(dd) for firms owned in majority part by
venture capital operating companies, hedge
funds, or private equity firms and
participating in the SBIR program;
(E) a detailed description of appeals of
Phase III awards and notices of noncompliance
with the SBIR Policy Directive and the STTR
Policy Directive filed by the Administrator
with Federal agencies;
(F) an accounting of funds, initiatives, and
outcomes under the Commercialization Readiness
Program; and
(G) a description of the extent to which
Federal agencies are providing in a timely
manner information needed to maintain the
database described in subsection (k);
(8) to provide for and fully implement the tenets of
Executive Order No. 13329 (Encouraging Innovation in
Manufacturing); and
(9) to coordinate the implementation of electronic
databases at each of the Federal agencies participating
in the SBIR program or the STTR program, including the
technical ability of the participating agencies to
electronically share data.
(c) The Administration is authorized to consult and cooperate
with all Government agencies and to make studies and
recommendations to such agencies, and such agencies are
authorized and directed to cooperate with the Administration in
order to carry out and to accomplish the purposes of this
section.
(d)(1) The Administrator is authorized to consult with
representatives of small-business concerns with a view to
assisting and encouraging such firms to undertake joint
programs for research and development carried out through such
corporate or other mechanism as may be most appropriate for the
purpose. Such joint programs may, among other things, include
the following purposes:
(A) to construct, acquire, or establish laboratories
and other facilities for the conduct of research;
(B) to undertake and utilize applied research;
(C) to collect research information related to a
particular industry and disseminate it to participating
members;
(D) to conduct applied research on a protected,
proprietary, and contractual basis with member or
nonmember firms, Government agencies, and others;
(E) to prosecute applications for patents and render
patent services for participating members; and
(F) to negotiate and grant licenses under patents
held under the point program, and to establish
corporations designed to exploit particular patents
obtained by it.
(2) The Administrator may, after consultation with the
Attorney General and the Chairman of the Federal Trade
Commission, and with the prior written approval of the Attorney
General, approve any agreement between small-business firms
providing for a joint program of research and development, if
the Administrator finds that the joint program proposed will
maintain and strengthen the free enterprise system and the
economy of the Nation. The Administrator or the Attorney
General may at any time withdraw his approval of the agreement
and the joint program of research and development covered
thereby, if he finds that the agreement or the joint program
carried on under it is no longer in the best interests of the
competitive free enterprise system and the economy of the
Nation. A copy of the statement of any such finding and
approval intended to be within the coverage of this subsection,
and a copy of any modification or withdrawal of approval, shall
be published in the Federal Register. The authority conferred
by this subsection on the Administrator shall not be delegated
by him.
(3) No act or omission to act pursuant to and within the
scope of any joint program for research and development, under
an agreement approved by the Administrator under this
subsection, shall be construed to be within the prohibitions of
the antitrust laws or the Federal Trade Commission Act. Upon
publication in the Federal Register of the notice of withdrawal
of his approval of the agreement granted under this subsection,
either by the Administrator or by the Attorney General, the
provisions of this subsection shall not apply to any subsequent
act or omission to act by reason of such agreement or approval.
(e) For the purpose of this section--
(1) the term ``extramural budget'' means the sum of
the total obligations minus amounts obligated for such
activities by employees of the agency in or through
Government-owned, Government-operated facilities,
except that for the Agency for International
Development it shall not include amounts obligated
solely for general institutional support of
international research centers or for grants to foreign
countries, and except that for the Department of Energy
it shall not include amounts obligated for atomic
energy defense programs for weapons and weapons-related
activities or for naval reactor programs;
(2) the term ``Federal agency'' means an executive
agency as defined in section 105 of title 5, United
States Code, or a military department as defined in
section 102 of such title, except that it does not
include any agency within the Intelligence Community
(as the term is defined in section 3.4(f) of Executive
Order 12333 or its successor orders);
(3) the term ``funding agreement'' means any
contract, grant, or cooperative agreement entered into
between any Federal agency and any small business for
the performance of experimental, developmental, or
research work funded in whole or in part by the Federal
Government;
(4) the term ``Small Business Innovation Research
Program'' or ``SBIR'' means a program under which a
portion of a Federal agency's research or research and
development effort is reserved for award to small
business concerns through a uniform process having--
(A) a first phase for determining, insofar as
possible, the scientific and technical merit
and feasibility of ideas that appear to have
commercial potential, as described in
subparagraph (B), submitted pursuant to SBIR
program solicitations;
(B) a second phase, which shall not include
any invitation, pre-screening, or pre-selection
process for eligibility for Phase II, that will
further develop proposals which meet particular
program needs, in which awards shall be made
based on the scientific and technical merit and
feasibility of the proposals, as evidenced by
the first phase, considering, among other
things, the proposal's commercial potential, as
evidenced by--
(i) the small business concern's
record of successfully commercializing
SBIR or other research;
(ii) the existence of second phase
funding commitments from private sector
or non-SBIR funding sources;
(iii) the existence of third phase,
follow-on commitments for the subject
of the research; and
(iv) the presence of other indicators
of the commercial potential of the
idea; and
(C) where appropriate, a third phase for work
that derives from, extends, or completes
efforts made under prior funding agreements
under the SBIR program--
(i) in which commercial applications
of SBIR-funded research or research and
development are funded by non-Federal
sources of capital or, for products or
services intended for use by the
Federal Government, by follow-on non-
SBIR Federal funding awards; or
(ii) for which awards from non-SBIR
Federal funding sources are used for
the continuation of research or
research and development that has been
competitively selected using peer
review or merit-based selection
procedures;
(5) the term ``research'' or ``research and
development'' means any activity which is (A) a
systematic, intensive study directed toward greater
knowledge or understanding of the subject studied; (B)
a systematic study directed specifically toward
applying new knowledge to meet a recognized need; or
(C) a systematic application of knowledge toward the
production of useful materials, devices, and systems or
methods, including design, development, and improvement
of prototypes and new processes to meet specific
requirements;
(6) the term ``Small Business Technology Transfer
Program'' or ``STTR'' means a program under which a
portion of a Federal agency's extramural research or
research and development effort is reserved for award
to small business concerns for cooperative research and
development through a uniform process having--
(A) a first phase, to determine, to the
extent possible, the scientific, technical, and
commercial merit and feasibility of ideas
submitted pursuant to STTR program
solicitations;
(B) a second phase, which shall not include
any invitation, pre-screening, or pre-selection
process for eligibility for Phase II, that will
further develop proposals that meet particular
program needs, in which awards shall be made
based on the scientific, technical, and
commercial merit and feasibility of the idea,
as evidenced by the first phase and by other
relevant information; and
(C) where appropriate, a third phase for work
that derives from, extends, or completes
efforts made under prior funding agreements
under the STTR program--
(i) in which commercial applications
of STTR-funded research or research and
development are funded by non-Federal
sources of capital or, for products or
services intended for use by the
Federal Government, by follow-on non-
STTR Federal funding awards; and
(ii) for which awards from non-STTR
Federal funding sources are used for
the continuation of research or
research and development that has been
competitively selected using peer
review or scientific review criteria;
(7) the term ``cooperative research and development''
means research or research and development conducted
jointly by a small business concern and a research
institution in which not less than 40 percent of the
work is performed by the small business concern, and
not less than 30 percent of the work is performed by
the research institution;
(8) the term ``research institution'' means a
nonprofit institution, as defined in section 4(5) of
the Stevenson-Wydler Technology Innovation Act of 1980,
and includes federally funded research and development
centers, as identified by the National Scientific
Foundation in accordance with the governmentwide
Federal Acquisition Regulation issued in accordance
with section 35(c)(1) of the Office of Federal
Procurement Policy Act (or any successor regulation
thereto);
(9) the term ``commercial applications'' shall not be
construed to exclude testing and evaluation of
products, services, or technologies for use in
technical or weapons systems, and further, awards for
testing and evaluation of products, services, or
technologies for use in technical or weapons systems
may be made in either Phase II or Phase III of the
Small Business Innovation Research Program and of the
Small Business Technology Transfer Program, as defined
in this subsection;
(10) the term ``commercialization'' means--
(A) the process of developing products,
processes, technologies, or services; and
(B) the production and delivery (whether by
the originating party or by others) of
products, processes, technologies, or services
for sale to or use by the Federal Government or
commercial markets;
(11) the term ``Phase I'' means--
(A) with respect to the SBIR program, the
first phase described in paragraph (4)(A); and
(B) with respect to the STTR program, the
first phase described in paragraph (6)(A);
(12) the term ``Phase II'' means--
(A) with respect to the SBIR program, the
second phase described in paragraph (4)(B); and
(B) with respect to the STTR program, the
second phase described in paragraph (6)(B); and
(13) the term ``Phase III'' means--
(A) with respect to the SBIR program, the
third phase described in paragraph (4)(C); and
(B) with respect to the STTR program, the
third phase described in paragraph (6)(C).
(f) Federal Agency Expenditures for the SBIR Program.--
(1) Required expenditure amounts.--Except as provided
in paragraph (2)(B), each Federal agency which has an
extramural budget for research or research and
development in excess of $100,000,000 for fiscal year
1992, or any fiscal year thereafter, shall expend with
small business concerns--
(A) not less than 1.5 percent of such budget
in each of fiscal years 1993 and 1994;
(B) not less than 2.0 percent of such budget
in each of fiscal years 1995 and 1996;
(C) not less than 2.5 percent of such budget
in each of fiscal years 1997 through 2011;
(D) not less than 2.6 percent of such budget
in fiscal year 2012;
(E) not less than 2.7 percent of such budget
in fiscal year 2013;
(F) not less than 2.8 percent of such budget
in fiscal year 2014;
(G) not less than 2.9 percent of such budget
in fiscal year 2015;
(H) not less than 3.0 percent of such budget
in fiscal year 2016; and
(I) not less than 3.2 percent of such budget
in fiscal year 2017 and each fiscal year
thereafter,
specifically in connection with SBIR programs which
meet the requirements of this section, policy
directives, and regulations issued under this section.
(2) Limitations.--A Federal agency shall not--
(A) use any of its SBIR budget established
pursuant to paragraph (1) for the purpose of
funding administrative costs of the program,
including costs associated with salaries and
expenses; or
(B) make available for the purpose of meeting
the requirements of paragraph (1) an amount of
its extramural budget for basic research which
exceeds the percentages specified in paragraph
(1).
(3) Exclusion of certain funding agreements.--Funding
agreements with small business concerns for research or
research and development which result from competitive
or single source selections other than an SBIR program
shall not be considered to meet any portion of the
percentage requirements of paragraph (1).
(4) Rule of construction.--Nothing in this subsection
may be construed to prohibit a Federal agency from
expending with small business concerns an amount of the
extramural budget for research or research and
development of the agency that exceeds the amount
required under paragraph (1).
(g) Each Federal agency required by subsection (f) to
establish a small business innovation research program shall,
in accordance with this Act and regulations issued hereunder--
(1) unilaterally determine categories of projects to
be in its SBIR program;
(2) issue small business innovation research
solicitations in accordance with a schedule determined
cooperatively with the Small Business Administration;
(3) unilaterally determine research topics within the
agency's SBIR solicitations, giving special
consideration to broad research topics and to topics
that further 1 or more critical technologies, as
identified by--
(A) the National Critical Technologies Panel
(or its successor) in the 1991 report required
under section 603 of the National Science and
Technology Policy, Organization, and Priorities
Act of 1976, and in subsequent reports issued
under that authority; or
(B) the Secretary of Defense, in the 1992
report issued in accordance with section 2522
of title 10, United States Code, and in
subsequent reports issued under that authority;
(4)(A) unilaterally receive and evaluate proposals
resulting from SBIR proposals; and
(B) make a final decision on each proposal submitted
under the SBIR program--
(i) not later than 1 year after the date on
which the applicable solicitation closes, if
with respect to the National Institutes of
Health or the National Science Foundation, or
90 days after the date on which the applicable
solicitation closes, if with respect to any
other participating agency; or
(ii) if the Administrator authorizes an
extension with respect to a solicitation, not
later than 90 days after the date that would
otherwise be applicable to the agency under
clause (i);
(5) subject to subsection (l), unilaterally select
awardees for the SBIR funding agreements and inform
each awardee under such an agreement, to the extent
possible, of the expenses of the awardee that will be
allowable under the funding agreement;
(6) administer its own SBIR funding agreements (or
delegate such administration to another agency);
(7) make payments to recipients of SBIR funding
agreements on the basis of progress toward or
completion of the funding agreement requirements and,
in all cases, make payment to recipients under such
agreements in full, subject to audit, on or before the
last day of the 12-month period beginning on the date
of completion of such requirements;
(8) collect annually, and maintain in a common format
in accordance with the simplified reporting
requirements under subsection (v), such information
from awardees as is necessary to assess the SBIR
program, including information necessary to maintain
the database described in subsection (k), including--
(A) whether an awardee--
(i) has venture capital, hedge fund,
or private equity firm investment or is
majority-owned by multiple venture
capital operating companies, hedge
funds, or private equity firms and, if
so--
(I) the amount of venture
capital, hedge fund, or private
equity firm investment that the
awardee has received as of the
date of the award; and
(II) the amount of additional
capital that the awardee has
invested in the SBIR
technology;
(ii) has an investor that--
(I) is an individual who is
not a citizen of the United
States or a lawful permanent
resident of the United States
and, if so, the name of any
such individual; or
(II) is a person that is not
an individual and is not
organized under the laws of a
State or the United States and,
if so, the name of any such
person;
(iii) is owned by a woman or has a
woman as a principal investigator;
(iv) is owned by a socially or
economically disadvantaged individual
or has a socially or economically
disadvantaged individual as a principal
investigator;
(v) is a faculty member or a student
of an institution of higher education,
as that term is defined in section 101
of the Higher Education Act of 1965 (20
U.S.C. 1001); or
(vi) is located in a State described
in subsection (u)(3);
(B) a justification statement from the
agency, if an awardee receives an award in an
amount that is more than the award guidelines
under this section; and
(C) data with respect to the Federal and
State Technology Partnership Program (FAST
Program);
(9) make an annual report on the SBIR program to the
Small Business Administration and the Office of Science
and Technology Policy;
(10) include, as part of its annual performance plan
as required by subsections (a) and (b) of section 1115
of title 31, United States Code, a section on its SBIR
program, and shall submit such section to the Committee
on Small Business of the Senate, and the Committee on
Science and the Committee on Small Business of the
House of Representatives;
(11) provide for and fully implement the tenets of
Executive Order No. 13329 (Encouraging Innovation in
Manufacturing); and
(12) provide timely notice to the Administrator of
any case or controversy before any Federal judicial or
administrative tribunal concerning the SBIR program of
the Federal agency.
(h) In addition to the requirements of subsection (f), each
Federal agency which has a budget for research or research and
development in excess of $20,000,000 for any fiscal year
beginning with fiscal year 1983 or subsequent fiscal year shall
establish goals specifically for funding agreements for
research or research and development to small business
concerns, and no goal established under this subsection shall
be less than the percentage of the agency's research or
research and development budget expended under funding
agreements with small business concerns in the immediately
preceding fiscal year.
(i) Annual Reporting.--
(1) In general.--Each Federal agency required by this
section to have an SBIR program or to establish goals
shall report annually to the Small Business
Administration the number of awards (including awards
under subsection (y)) pursuant to grants, contracts, or
cooperative agreements over $10,000 in amount and the
dollar value of all such awards, identifying SBIR
awards and comparing the number and amount of such
awards with awards to other than small business
concerns.
(2) Calculation of extramural budget.--
(A) Methodology.--Not later than 4 months
after the date of the enactment of each
appropriations Act for a Federal agency
required by this section to have an SBIR
program, the Federal agency shall submit to the
Administrator a report, which shall include a
description of the methodology used for
calculating the amount of the extramural budget
of that Federal agency.
(B) Administrator's analysis.--The
Administrator shall include an analysis of the
methodology received from each Federal agency
referred to in subparagraph (A) in the report
required by subsection (b)(7).
(j)(1) Policy directives.--The Small Business Administration,
after consultation with the Administrator of the Office of
Federal Procurement Policy, the Director of the Office of
Science and Technology Policy, and the Intergovernmental
Affairs Division of the Office of Management and Budget, shall,
within one hundred and twenty days of the enactment of the
Small Business Innovation Development Act of 1982, issue policy
directives for the general conduct of the SBIR programs within
the Federal Government, including providing for--
(A) simplified, standardized, and timely SBIR
solicitations;
(B) a simplified, standardized funding process which
provides for (i) the timely receipt and review of
proposals; (ii) outside peer review for at least Phase
II proposals, if appropriate; (iii) protection of
proprietary information provided in proposals; (iv)
selection of awardees; (v) retention of rights in data
generated in the performance of the contract by the
small business concern; (vi) transfer of title to
property provided by the agency to the small business
concern if such a transfer would be more cost effective
than recovery of the property by the agency; (vii) cost
sharing; and (viii) cost principles and payment
schedules;
(C) exemptions from the regulations under paragraph
(2) if national security or intelligence functions
clearly would be jeopardized;
(D) minimizing regulatory burden associated with
participation in the SBIR program for the small
business concern which will stimulate the cost-
effective conduct of Federal research and development
and the likelihood of commercialization of the results
of research and development conducted under the SBIR
program;
(E) simplified, standardized, and timely annual
report on the SBIR program to the Small Business
Administration and the Office of Science and Technology
Policy;
(F) standardized and orderly withdrawal from program
participation by an agency having a SBIR program; at
the discretion of the Administration, such directives
may require a phased withdrawal over a period of time
sufficient in duration to minimize any adverse impact
on small business concerns; and
(G) the voluntary participation in a SBIR program by
a Federal agency not required to establish such a
program pursuant to subsection (f).
(2) Modifications.--Not later than 90 days after the
date of enactment of the Small Business Research and
Development Enhancement Act of 1992, the Administrator
shall modify the policy directives issued pursuant to
this subsection to provide for--
(A) retention by a small business concern of
the rights to data generated by the concern in
the performance of an SBIR award for a period
of not less than 4 years;
(B) continued use by a small business concern
participating in Phase III of the SBIR program,
as a directed bailment, of any property
transferred by a Federal agency to the small
business concern in Phase II of an SBIR program
for a period of not less than 2 years,
beginning on the initial date of the concern's
participation in Phase III of such program;
(C) procedures to ensure, to the extent
practicable, that an agency which intends to
pursue research, development, or production of
a technology developed by a small business
concern under an SBIR program enters into
follow-on, non-SBIR funding agreements with the
small business concern for such research,
development, or production;
(D) an increase to $150,000 in the amount of
funds which an agency may award in Phase I of
an SBIR program, and to $1,000,000 in Phase II
of an SBIR program, and an adjustment of such
amounts every year for inflation;
(E) a process for notifying the participating
SBIR agencies and potential SBIR participants
of the 1991, 1992, and the current critical
technologies, as identified--
(i) by the National Critical
Technologies Panel (or its successor),
in accordance with section 603 of the
National Science and Technology Policy,
Organization, and Priorities Act of
1976; or
(ii) by the Secretary of Defense, in
accordance with section 2522 of title
10, United States Code;
(F) enhanced outreach efforts to increase the
participation of socially and economically
disadvantaged small business concerns, as
defined in section 8(a)(4), and the
participation of small businesses that are 51
percent owned and controlled by women in
technological innovation and in SBIR programs,
including Phase III of such programs, and the
collection of data to document such
participation;
(G) technical and programmatic guidance to
encourage agencies to develop gap-funding
programs to address the delay between an award
for Phase I of an SBIR program and the
application for and extension of an award for
Phase II of such program;
(H) procedures to ensure that a small
business concern that submits a proposal for a
funding agreement for Phase I of an SBIR
program and that has received more than 15
Phase II SBIR awards during the preceding 5
fiscal years is able to demonstrate the extent
to which it was able to secure Phase III
funding to develop concepts resulting from
previous Phase II SBIR awards; and
(I) procedures to ensure that agencies
participating in the SBIR program retain the
information submitted under subparagraph (H) at
least until the General Accounting Office
submits the report required under section 105
of the Small Business Research and Development
Enhancement Act of 1992.
(3) Additional modifications.--Not later than 120
days after the date of the enactment of the Small
Business Innovation Research Program Reauthorization
Act of 2000, the Administrator shall modify the policy
directives issued pursuant to this subsection--
(A) to clarify that the rights provided for
under paragraph (2)(A) apply to all Federal
funding awards under this section, including
Phase I, Phase II, and Phase III;
(B) to provide for the requirement of a
succinct commercialization plan with each
application for a Phase II award that is moving
toward commercialization;
(C) to require agencies to report to the
Administration, not less frequently than
annually, all instances in which an agency
pursued research, development, or production of
a technology developed by a small business
concern using an award made under the SBIR
program of that agency, and determined that it
was not practicable to enter into a follow-on
non-SBIR program funding agreement with the
small business concern, which report shall
include, at a minimum--
(i) the reasons why the follow-on
funding agreement with the small
business concern was not practicable;
(ii) the identity of the entity with
which the agency contracted to perform
the research, development, or
production; and
(iii) a description of the type of
funding agreement under which the
research, development, or production
was obtained; and
(D) to implement subsection (v), including
establishing standardized procedures for the
provision of information pursuant to subsection
(k)(3).
(k) Database.--
(1) Public database.--Not later than 180 days after
the date of the enactment of the Small Business
Innovation Research Program Reauthorization Act of
2000, the Administrator shall develop, maintain, and
make available to the public a searchable, up-to-date,
electronic database that includes--
(A) the name, size, location, and an
identifying number assigned by the
Administrator, of each small business concern
that has received a Phase I or Phase II SBIR or
STTR award from a Federal agency;
(B) a description of each Phase I or Phase II
SBIR or STTR award received by that small
business concern, including--
(i) an abstract of the project funded
by the award, excluding any proprietary
information so identified by the small
business concern;
(ii) the Federal agency making the
award; and
(iii) the date and amount of the
award;
(C) an identification of any business concern
or subsidiary established for the commercial
application of a product or service for which
an SBIR or STTR award is made;
(D) information regarding mentors and
Mentoring Networks, as required by section
35(d);
(E) with respect to assistance under the STTR
program only--
(i) whether the small business
concern or the research institution
initiated their collaboration on each
assisted STTR project;
(ii) whether the small business
concern or the research institution
originated any technology relating to
the assisted STTR project;
(iii) the length of time it took to
negotiate any licensing agreement
between the small business concern and
the research institution under each
assisted STTR project; and
(iv) how the proceeds from
commercialization, marketing, or sale
of technology resulting from each
assisted STTR project were allocated
(by percentage) between the small
business concern and the research
institution; and
(F) for each small business concern that has
received a Phase I or Phase II SBIR or STTR
award from a Federal agency, whether the small
business concern--
(i) has venture capital, hedge fund,
or private equity firm investment and,
if so, whether the small business
concern is registered as majority-owned
by multiple venture capital operating
companies, hedge funds, or private
equity firms as required under
subsection (dd)(3);
(ii) is owned by a woman or has a
woman as a principal investigator;
(iii) is owned by a socially or
economically disadvantaged individual
or has a socially or economically
disadvantaged individual as a principal
investigator;
(iv) is owned by a faculty member or
a student of an institution of higher
education, as that term is defined in
section 101 of the Higher Education Act
of 1965 (20 U.S.C. 1001); or
(v) received assistance under the
Federal and State Technology
Partnership Program (FAST Program).
(2) Government database.--Not later than 90 days
after the date of enactment of the SBIR/STTR
Reauthorization Act of 2011, the Administrator, in
consultation with Federal agencies required to have an
SBIR program pursuant to subsection (f)(1) or an STTR
program pursuant to subsection (n)(1), shall develop
and maintain a database to be used exclusively for SBIR
and STTR program evaluation that--
(A) contains for each small business concern
that applies for, submits a proposal for, or
receives an award under Phase I or Phase II of
the SBIR program or the STTR program--
(i) the name, size, and location of,
and the identifying number assigned by
the Administration to, the small
business concern;
(ii) an abstract of the applicable
project;
(iii) the specific aims of the
project;
(iv) the number of employees of the
small business concern;
(v) the names and titles of the key
individuals that will carry out the
project, the position each key
individual holds in the small business
concern, and contact information for
each key individual;
(vi) the percentage of effort each
individual described in clause (v) will
contribute to the project;
(vii) whether the small business
concern is majority-owned by multiple
venture capital operating companies,
hedge funds, or private equity firms;
and
(viii) the Federal agency to which
the application is made and contact
information for the person or office
within the Federal agency that is
responsible for reviewing applications
and making awards under the SBIR
program or the STTR program;
(B) contains for each Phase II award made by
a Federal agency--
(i) information collected in
accordance with paragraph (3) on
revenue from the sale of new products
or services resulting from the research
conducted under the award;
(ii) information collected in
accordance with paragraph (3) on
additional investment from any source,
other than Phase I or Phase II SBIR or
STTR awards, to further the research
and development conducted under the
award; and
(iii) any other information received
in connection with the award that the
Administrator, in conjunction with the
SBIR and STTR program managers of
Federal agencies, considers relevant
and appropriate;
(C) includes any narrative information that a
small business concern receiving a Phase II
award voluntarily submits to further describe
the outputs and outcomes of its awards;
(D) includes, for each awardee--
(i) the name, size, and location of,
and any identifying number assigned by
the Administrator to, the awardee;
(ii) whether the awardee has venture
capital, hedge fund, or private equity
firm investment and, if so--
(I) the amount of venture
capital, hedge fund, or private
equity firm investment as of
the date of the award;
(II) the percentage of
ownership of the awardee held
by a venture capital operating
company, hedge fund, or private
equity firm, including whether
the awardee is majority-owned
by multiple venture capital
operating companies, hedge
funds, or private equity firms;
and
(III) the amount of
additional capital that the
awardee has invested in the
SBIR or STTR technology, which
information shall be collected
on an annual basis;
(iii) the names and locations of any
affiliates of the awardee;
(iv) the number of employees of the
awardee;
(v) the number of employees of the
affiliates of the awardee; and
(vi) the names of, and the percentage
of ownership of the awardee held by--
(I) any individual who is not
a citizen of the United States
or a lawful permanent resident
of the United States; or
(II) any person that is not
an individual and is not
organized under the laws of a
State or the United States;
(E) includes any other data collected by or
available to any Federal agency that such
agency considers may be useful for SBIR or STTR
program evaluation;
(F) is available for use solely for program
evaluation purposes by the Federal Government
or, in accordance with policy directives issued
by the Administration, by other authorized
persons who are subject to a use and
nondisclosure agreement with the Federal
Government covering the use of the database;
and
(G) includes a timely and accurate list of
any individual or small business concern that
has participated in the SBIR program or STTR
program that has been--
(i) convicted of a fraud-related
crime involving funding received under
the SBIR program or STTR program; or
(ii) found civilly liable for a
fraud-related violation involving
funding received under the SBIR program
or STTR program.
(3) Updating information for database.--
(A) In general.--A small business concern
applying for a Phase II award under this
section shall be required to update information
in the database established under this
subsection for any prior Phase II award
received by that small business concern. In
complying with this paragraph, a small business
concern may apportion sales or additional
investment information relating to more than
one Phase II award among those awards, if it
notes the apportionment for each award.
(B) Annual updates upon termination.--A small
business concern receiving a Phase II award
under this section shall--
(i) update information in the
database concerning that award at the
termination of the award period; and
(ii) be requested to voluntarily
update such information annually
thereafter for a period of 5 years.
(C) Government database.--Not later than 60
days after the date established by a Federal
agency for submitting applications or proposals
for a Phase I or Phase II award under the SBIR
program or STTR program, the head of the
Federal agency shall submit to the
Administrator the data required under paragraph
(2) with respect to each small business concern
that applies or submits a proposal for the
Phase I or Phase II award.
(4) Protection of information.--Information provided
under paragraph (2) shall be considered privileged and
confidential and not subject to disclosure pursuant to
section 552 of title 5, United States Code.
(5) Rule of construction.--Inclusion of information
in the database under this subsection shall not be
considered to be publication for purposes of subsection
(a) or (b) of section 102 of title 35, United States
Code.
(l) Reporting of Awards Made From Single Proposal, to
Multiple Award Winners, or to Critical Technology Topics.--
(1) Single proposal.--If a Federal agency required to
establish an SBIR program under subsection (f) makes an
award with respect to an SBIR solicitation topic or
subtopic for which the agency received only 1 proposal,
the agency shall provide written justification for
making the award in its next quarterly report to the
Administration and in the agency's next annual report
required under subsection (g)(8).
(2) Multiple awards.--An agency referred to in
paragraph (1) shall include in its next annual report
required under subsection (g)(8) an accounting of the
awards the agency has made for Phase I of an SBIR
program during the reporting period to entities that
have received more than 15 awards for the Phase II of
an SBIR program during the preceding 5 fiscal years.
(3) Critical technology awards.--An agency referred
to in paragraph (1) shall include in its next annual
report required under subsection (g)(8), an accounting
of the number of awards it has made to critical
technology topics, as defined in subsection (g)(3),
including an identification of the specific critical
technologies topics, and the percentage by number and
dollar amount of the agency's total SBIR awards to such
critical technology topics.
(m) Termination.--The authorization to carry out the Small
Business Innovation Research Program established under this
section shall terminate on September 30, 2022.
(n) Required Expenditures for STTR by Federal Agencies.--
(1) Required expenditure amounts.--
(A) In general.--With respect to each fiscal
year through fiscal year 2022, each Federal
agency that has an extramural budget for
research, or research and development, in
excess of $1,000,000,000 for that fiscal year,
shall expend with small business concerns not
less than the percentage of that extramural
budget specified in subparagraph (B),
specifically in connection with STTR programs
that meet the requirements of this section and
any policy directives and regulations issued
under this section.
(B) Expenditure amounts.--The percentage of
the extramural budget required to be expended
by an agency in accordance with subparagraph
(A) shall be--
(i) 0.15 percent for each fiscal year
through fiscal year 2003;
(ii) 0.3 percent for each of fiscal
years 2004 through 2011;
(iii) 0.35 percent for each of fiscal
years 2012 and 2013;
(iv) 0.40 percent for each of fiscal
years 2014 and 2015; and
(v) 0.45 percent for fiscal year 2016
and each fiscal year thereafter.
(2) Limitations.--A Federal agency shall not--
(A) use any of its STTR budget established
pursuant to paragraph (1) for the purpose of
funding administrative costs of the program,
including costs associated with salaries and
expenses, or, in the case of a small business
concern or a research institution, costs
associated with salaries, expenses, and
administrative overhead (other than those
direct or indirect costs allowable under
guidelines of the Office of Management and
Budget and the governmentwide Federal
Acquisition Regulation issued in accordance
with section 25(c)(1) of the Office of Federal
Procurement Policy Act); or
(B) make available for the purpose of meeting
the requirements of paragraph (1) an amount of
its extramural budget for basic research which
exceeds the percentage specified in paragraph
(1).
(3) Exclusion of certain funding agreements.--Funding
agreements with small business concerns for research or
research and development which result from competitive
or single source selections other than an STTR program
shall not be considered to meet any portion of the
percentage requirements of paragraph (1).
(o) Federal Agency STTR Authority.--Each Federal agency
required to establish an STTR program in accordance with
subsection (n) and regulations issued under this Act, shall--
(1) unilaterally determine categories of projects to
be included in its STTR program;
(2) issue STTR solicitations in accordance with a
schedule determined cooperatively with the
Administration;
(3) unilaterally determine research topics within the
agency's STTR solicitations, giving special
consideration to broad research topics and to topics
that further 1 or more critical technologies, as
identified--
(A) by the National Critical Technologies
Panel (or its successor) in reports required
under section 603 of the National Science and
Technology Policy, Organization, and Priorities
Act of 1976; or
(B) by the Secretary of Defense, in
accordance with section 2522 of title 10,
United States Code;
(4)(A) unilaterally receive and evaluate proposals
resulting from STTR solicitations; and
(B) make a final decision on each proposal submitted
under the STTR program--
(i) not later than 1 year after the date on
which the applicable solicitation closes, if
with respect to the National Institutes of
Health or the National Science Foundation, or
90 days after the date on which the applicable
solicitation closes, if with respect to any
other participating agency; or
(ii) if the Administrator authorizes an
extension for a solicitation, not later than 90
days after the date that would be applicable to
the agency under clause (i);
(5) unilaterally select awardees for its STTR funding
agreements and inform each awardee under such an
agreement, to the extent possible, of the expenses of
the awardee that will be allowable under the funding
agreement;
(6) administer its own STTR funding agreements (or
delegate such administration to another agency);
(7) make payments to recipients of STTR funding
agreements on the basis of progress toward or
completion of the funding agreement requirements and,
in all cases, make payment to recipients under such
agreements in full, subject to audit, on or before the
last day of the 12-month period beginning on the date
of the completion of such requirements;
(8) include, as part of its annual performance plan
as required by subsections (a) and (b) of section 1115
of title 31, United States Code, a section on its STTR
program, and shall submit such section to the Committee
on Small Business of the Senate, and the Committee on
Science and the Committee on Small Business of the
House of Representatives;
(9) collect annually, and maintain in a common format
in accordance with the simplified reporting
requirements under subsection (v), such information
from applicants and awardees as is necessary to assess
the STTR program outputs and outcomes, including
information necessary to maintain the database
described in subsection (k), including--
(A) whether an applicant or awardee--
(i) has venture capital, hedge fund,
or private equity firm investment or is
majority-owned by multiple venture
capital operating companies, hedge
funds, or private equity firms and, if
so--
(I) the amount of venture
capital, hedge fund, or private
equity firm investment that the
applicant or awardee has
received as of the date of the
application or award, as
applicable; and
(II) the amount of additional
capital that the applicant or
awardee has invested in the
STTR technology;
(ii) has an investor that--
(I) is an individual who is
not a citizen of the United
States or a lawful permanent
resident of the United States
and, if so, the name of any
such individual; or
(II) is a person that is not
an individual and is not
organized under the laws of a
State or the United States and,
if so, the name of any such
person;
(iii) is owned by a woman or has a
woman as a principal investigator;
(iv) is owned by a socially or
economically disadvantaged individual
or has a socially or economically
disadvantaged individual as a principal
investigator;
(v) is a faculty member or a student
of an institution of higher education,
as that term is defined in section 101
of the Higher Education Act of 1965 (20
U.S.C. 1001); or
(vi) is located in a State in which
the total value of contracts awarded to
small business concerns under all STTR
programs is less than the total value
of contracts awarded to small business
concerns in a majority of other States,
as determined by the Administrator in
biennial fiscal years, beginning with
fiscal year 2008, based on the most
recent statistics compiled by the
Administrator;
(B) if an awardee receives an award in an
amount that is more than the award guidelines
under this section, a statement from the agency
that justifies the award amount; and
(C) data with respect to the Federal and
State Technology Partnership Program (FAST
Program);
(10) submit an annual report on the STTR program to
the Administration and the Office of Science and
Technology Policy;
(11) adopt the agreement developed by the
Administrator under subsection (w) as the agency's
model agreement for allocating between small business
concerns and research institutions intellectual
property rights and rights, if any, to carry out
follow-on research, development, or commercialization;
(12) develop, in consultation with the Office of
Federal Procurement Policy and the Office of Government
Ethics, procedures to ensure that federally funded
research and development centers (as defined in
subsection (e)(8)) that participate in STTR
agreements--
(A) are free from organizational conflicts of
interests relative to the STTR program;
(B) do not use privileged information gained
through work performed for an STTR agency or
private access to STTR agency personnel in the
development of an STTR proposal; and
(C) use outside peer review, as appropriate;
(13) not later than July 31, 1993, develop procedures
for assessing the commercial merit and feasibility of
STTR proposals, as evidenced by--
(A) the small business concern's record of
successfully commercializing STTR or other
research;
(B) the existence of Phase II funding
commitments from private sector or non-STTR
funding sources;
(C) the existence of Phase III follow-on
commitments for the subject of the research;
and
(D) the presence of other indicators of the
commercial potential of the idea;
(14) implement an outreach program to research
institutions and small business concerns for the
purpose of enhancing its STTR program, in conjunction
with any such outreach done for purposes of the SBIR
program;
(15) provide for and fully implement the tenets of
Executive Order No. 13329 (Encouraging Innovation in
Manufacturing); and
(16) provide timely notice to the Administrator of
any case or controversy before any Federal judicial or
administrative tribunal concerning the STTR program of
the Federal agency.
(p) STTR Policy Directive.--
(1) Issuance.--The Administrator shall issue a policy
directive for the general conduct of the STTR programs
within the Federal Government. Such policy directive
shall be issued after consultation with--
(A) the heads of each of the Federal agencies
required by subsection (n) to establish an STTR
program;
(B) the Under Secretary of Commerce for
Intellectual Property and Director of the
United States Patent and Trademark Office; and
(C) the Director of the Office of Federal
Procurement Policy.
(2) Contents.--The policy directive required by
paragraph (1) shall provide for--
(A) simplified, standardized, and timely STTR
solicitations;
(B) a simplified, standardized funding
process that provides for--
(i) the timely receipt and review of
proposals;
(ii) outside peer review, if
appropriate;
(iii) protection of proprietary
information provided in proposals;
(iv) selection of awardees;
(v) retention by a small business
concern of the rights to data generated
by the concern in the performance of an
STTR award for a period of not less
than 4 years;
(vi) continued use by a small
business concern, as a directed
bailment, of any property transferred
by a Federal agency to the small
business concern in Phase II of the
STTR program for a period of not less
than 2 years, beginning on the initial
date of the concern's participation in
Phase III of such program;
(vii) cost sharing;
(viii) cost principles and payment
schedules; and
(ix) 1-year awards for Phase I of an
STTR program, generally not to exceed
$150,000, and 2-year awards for Phase
II of an STTR program, generally not to
exceed $1,000,000, (each of which the
Administrator shall adjust for
inflation annually) greater or lesser
amounts to be awarded at the discretion
of the awarding agency, and shorter or
longer periods of time to be approved
at the discretion of the awarding
agency where appropriate for a
particular project;
(C) minimizing regulatory burdens associated
with participation in STTR programs;
(D) guidelines for a model agreement, to be
used by all agencies, for allocating between
small business concerns and research
institutions intellectual property rights and
rights, if any, to carry out follow-on
research, development, or commercialization;
(E) procedures to ensure that--
(i) a recipient of an STTR award is a
small business concern, as defined in
section 3 and the regulations
promulgated thereunder; and
(ii) such small business concern
exercises management and control of the
performance of the STTR funding
agreement pursuant to a business plan
providing for the commercialization of
the technology that is the subject
matter of the award; and
(F) procedures to ensure, to the extent
practicable, that an agency which intends to
pursue research, development, or production of
a technology developed by a small business
concern under an STTR program enters into
follow-on, non-STTR funding agreements with the
small business concern for such research,
development, or production.
(3) Modifications.--Not later than 120 days after the
date of enactment of this paragraph, the Administrator
shall modify the policy directive issued pursuant to
this subsection to clarify that the rights provided for
under paragraph (2)(B)(v) apply to all Federal funding
awards under this section, including Phase I, Phase II,
and Phase III.
(q) Discretionary Technical Assistance.--
(1) In general.--Each Federal agency required by this
section to conduct an SBIR program or STTR program may
enter into an agreement with a vendor selected under
paragraph (2) to provide small business concerns
engaged in SBIR or STTR projects with technical
assistance services, such as access to a network of
scientists and engineers engaged in a wide range of
technologies, or access to technical and business
literature available through on-line data bases, for
the purpose of assisting such concerns in--
(A) making better technical decisions
concerning such projects;
(B) solving technical problems which arise
during the conduct of such projects;
(C) minimizing technical risks associated
with such projects; and
(D) developing and commercializing new
commercial products and processes resulting
from such projects.
(2) Vendor selection.--Each agency may select a
vendor to assist small business concerns to meet the
goals listed in paragraph (1) for a term not to exceed
5 years. Such selection shall be competitive and shall
utilize merit-based criteria.
(3) Additional technical assistance.--
(A) Phase i.--A Federal agency described in
paragraph (1) may--
(i) provide to the recipient of a
Phase I SBIR or STTR award, through a
vendor selected under paragraph (2),
the services described in paragraph
(1), in an amount equal to not more
than $5,000 per year; or
(ii) authorize the recipient of a
Phase I SBIR or STTR award to purchase
the services described in paragraph
(1), in an amount equal to not more
than $5,000 per year, which shall be in
addition to the amount of the
recipient's award.
(B) Phase ii.--A Federal agency described in
paragraph (1) may--
(i) provide to the recipient of a
Phase II SBIR or STTR award, through a
vendor selected under paragraph (2),
the services described in paragraph
(1), in an amount equal to not more
than $5,000 per year; or
(ii) authorize the recipient of a
Phase II SBIR or STTR award to purchase
the services described in paragraph
(1), in an amount equal to not more
than $5,000 per year, which shall be in
addition to the amount of the
recipient's award.
(C) Flexibility.--In carrying out
subparagraphs (A) and (B), each Federal agency
shall provide the allowable amounts to a
recipient that meets the eligibility
requirements under the applicable subparagraph,
if the recipient requests to seek technical
assistance from an individual or entity other
than the vendor selected under paragraph (2) by
the Federal agency.
(D) Limitation.--A Federal agency may not--
(i) use the amounts authorized under
subparagraph (A) or (B) unless the
vendor selected under paragraph (2)
provides the technical assistance to
the recipient; or
(ii) enter a contract with a vendor
under paragraph (2) under which the
amount provided for technical
assistance is based on total number of
Phase I or Phase II awards.
(r) Phase III Agreements, Competitive Procedures, and
Justification for Awards.--
(1) In general.--In the case of a small business
concern that is awarded a funding agreement for Phase
II of an SBIR or STTR program, a Federal agency may
enter into a Phase III agreement with that business
concern for additional work to be performed during or
after the Phase II period. The Phase II funding
agreement with the small business concern may, at the
discretion of the agency awarding the agreement, set
out the procedures applicable to Phase III agreements
with that agency or any other agency.
(2) Definition.--In this subsection, the term ``Phase
III agreement'' means a follow-on, non-SBIR or non-STTR
funded contract as described in paragraph (4)(C) or
paragraph (6)(C) of subsection (e).
(3) Intellectual property rights.--Each funding
agreement under an SBIR or STTR program shall include
provisions setting forth the respective rights of the
United States and the small business concern with
respect to intellectual property rights and with
respect to any right to carry out follow-on research.
(4) Competitive procedures and justification for
awards.--To the greatest extent practicable, Federal
agencies and Federal prime contractors shall--
(A) consider an award under the SBIR program
or the STTR program to satisfy the requirements
under section 2304 of title 10, United States
Code, and any other applicable competition
requirements; and
(B) issue, without further justification,
Phase III awards relating to technology,
including sole source awards, to the SBIR and
STTR award recipients that developed the
technology.
(s) Competitive Selection Procedures for SBIR and STTR
Programs.--All funds awarded, appropriated, or otherwise made
available in accordance with subsection (f) or (n) must be
awarded pursuant to competitive and merit-based selection
procedures.
(t) Inclusion in Strategic Plans.--Program information
relating to the SBIR and STTR programs shall be included by
each Federal agency in any update or revision required of the
Federal agency under section 306(b) of title 5, United States
Code.
(u) Coordination of Technology Development Programs.--
(1) Definition of technology development program.--In
this subsection, the term ``technology development
program'' means--
(A) the Experimental Program to Stimulate
Competitive Research of the National Science
Foundation, as established under section 113 of
the National Science Foundation Authorization
Act of 1988 (42 U.S.C. 1862g);
(B) the Defense Experimental Program to
Stimulate Competitive Research of the
Department of Defense;
(C) the Experimental Program to Stimulate
Competitive Research of the Department of
Energy;
(D) the Experimental Program to Stimulate
Competitive Research of the Environmental
Protection Agency;
(E) the Experimental Program to Stimulate
Competitive Research of the National
Aeronautics and Space Administration;
(F) the Institutional Development Award
Program of the National Institutes of Health;
and
(G) the National Research Initiative
Competitive Grants Program of the Department of
Agriculture.
(2) Coordination requirements.--Each Federal agency
that is subject to subsection (f) and that has
established a technology development program may, in
each fiscal year, review for funding under that
technology development program--
(A) any proposal to provide outreach and
assistance to one or more small business
concerns interested in participating in the
SBIR program, including any proposal to make a
grant or loan to a company to pay a portion or
all of the cost of developing an SBIR proposal,
from an entity, organization, or individual
located in--
(i) a State that is eligible to
participate in that program; or
(ii) a State described in paragraph
(3); or
(B) any proposal for Phase I of the SBIR
program, if the proposal, though meritorious,
is not funded through the SBIR program for that
fiscal year due to funding restraints, from a
small business concern located in--
(i) a State that is eligible to
participate in a technology development
program; or
(ii) a State described in paragraph
(3).
(3) Additionally eligible state.--A State referred to
in subparagraph (A)(ii) or (B)(ii) of paragraph (2) is
a State in which the total value of contracts awarded
to small business concerns under all SBIR programs is
less than the total value of contracts awarded to small
business concerns in a majority of other States, as
determined by the Administrator in biennial fiscal
years, beginning with fiscal year 2000, based on the
most recent statistics compiled by the Administrator.
(v) Reducing Paperwork and Compliance Burden.--
(1) Standardization of reporting requirements.--The
Administrator shall work with the Federal agencies
required by this section to have an SBIR or STTR
program to standardize reporting requirements for the
collection of data from SBIR or STTR applicants and
awardees, including data for inclusion in the database
under subsection (k), taking into consideration the
unique needs of each agency, and to the extent
possible, permitting the updating of previously
reported information by electronic means. Such
requirements shall be designed to minimize the burden
on small businesses.
(2) Simplification of application and award
process.--Not later than 1 year after the date of
enactment of this paragraph, and after a period of
public comment, the Administrator shall issue
regulations or guidelines, taking into consideration
the unique needs of each Federal agency, to ensure that
each Federal agency required to carry out an SBIR
program or STTR program simplifies and standardizes the
program proposal, selection, contracting, compliance,
and audit procedures for the SBIR program or STTR
program of the Federal agency (including procedures
relating to overhead rates for applicants and
documentation requirements) to reduce the paperwork and
regulatory compliance burden on small business concerns
applying to and participating in the SBIR program or
STTR program.
(w) STTR Model Agreement for Intellectual Property Rights.--
(1) In general.--The Administrator shall promulgate
regulations establishing a single model agreement for
use in the STTR program that allocates between small
business concerns and research institutions
intellectual property rights and rights, if any, to
carry out follow-on research, development, or
commercialization.
(2) Opportunity for comment.--In promulgating
regulations under paragraph (1), the Administrator
shall provide to affected agencies, small business
concerns, research institutions, and other interested
parties the opportunity to submit written comments.
(x) Research and Development Focus.--
(1) Revision and update of criteria and procedures of
identification.--In carrying out subsection (g), the
Secretary of Defense shall, not less often than once
every 4 years, revise and update the criteria and
procedures utilized to identify areas of the research
and development efforts of the Department of Defense
which are suitable for the provision of funds under the
Small Business Innovation Research Program and the
Small Business Technology Transfer Program.
(2) Utilization of plans.--The criteria and
procedures described in paragraph (1) shall be
developed through the use of the most current versions
of the following plans:
(A) The Joint Warfighting Science and
Technology Plan required under section 270 of
the National Defense Authorization Act for
Fiscal Year 1997 (Public Law 104-201; 10 U.S.C.
2501 note).
(B) The Defense Technology Area Plan of the
Department of Defense.
(C) The Basic Research Plan of the Department
of Defense.
(3) Input in identification of areas of effort.--The
criteria and procedures described in paragraph (1)
shall include input in the identification of areas of
research and development efforts described in that
paragraph from Department of Defense program managers
(PMs) and program executive officers (PEOs).
(y) Commercialization Readiness Program.--
(1) In general.--The Secretary of Defense and the
Secretary of each military department is authorized to
create and administer a ``Commercialization Readiness
Program'' to accelerate the transition of technologies,
products, and services developed under the Small
Business Innovation Research Program or Small Business
Technology Transfer Program to Phase III, including the
acquisition process. The authority to create and
administer a Commercialization Readiness Program under
this subsection may not be construed to eliminate or
replace any other SBIR program or STTR program that
enhances the insertion or transition of SBIR or STTR
technologies, including any such program in effect on
the date of enactment of the National Defense
Authorization Act for Fiscal Year 2006 (Public Law 109-
163; 119 Stat. 3136).
(2) Identification of research programs for
accelerated transition to acquisition process.--In
carrying out the Commercialization Readiness Program,
the Secretary of Defense and the Secretary of each
military department shall identify research programs of
the Small Business Innovation Research Program or Small
Business Technology Transfer Program that have the
potential for rapid transitioning to Phase III and into
the acquisition process.
(3) Limitation.--No research program may be
identified under paragraph (2) unless the Secretary of
the military department concerned certifies in writing
that the successful transition of the program to Phase
III and into the acquisition process is expected to
meet high priority military requirements of such
military department.
(4) Funding.--
(A) In general.--The Secretary of Defense and
each Secretary of a military department may use
not more than an amount equal to 1 percent of
the funds available to the Department of
Defense or the military department pursuant to
the Small Business Innovation Research Program
for payment of expenses incurred to administer
the Commercialization Readiness Program under
this subsection.
(B) Limitations.--The funds described in
subparagraph (A)--
(i) shall not be subject to the
limitations on the use of funds in
subsection (f)(2); and
(ii) shall not be used to make Phase
III awards.
(5) Insertion incentives.--For any contract with a
value of not less than $100,000,000, the Secretary of
Defense is authorized to--
(A) establish goals for the transition of
Phase III technologies in subcontracting plans;
and
(B) require a prime contractor on such a
contract to report the number and dollar amount
of contracts entered into by that prime
contractor for Phase III SBIR or STTR projects.
(6) Goal for sbir and sttr technology insertion.--The
Secretary of Defense shall--
(A) set a goal to increase the number of
Phase II SBIR contracts and the number of Phase
II STTR contracts awarded by the Secretary that
lead to technology transition into programs of
record or fielded systems;
(B) use incentives in effect on the date of
enactment of the SBIR/STTR Reauthorization Act
of 2011, or create new incentives, to encourage
agency program managers and prime contractors
to meet the goal under subparagraph (A); and
(C) submit to the Administrator for inclusion
in the annual report under subsection (b)(7)--
(i) the number and percentage of
Phase II SBIR and STTR contracts
awarded by the Secretary that led to
technology transition into programs of
record or fielded systems;
(ii) information on the status of
each project that received funding
through the Commercialization Readiness
Program and efforts to transition those
projects into programs of record or
fielded systems; and
(iii) a description of each incentive
that has been used by the Secretary
under subparagraph (B) and the
effectiveness of that incentive with
respect to meeting the goal under
subparagraph (A).
(z) Encouraging Innovation in Energy Efficiency.--
(1) Federal agency energy-related priority.--In
carrying out its duties under this section relating to
SBIR and STTR solicitations by Federal departments and
agencies, the Administrator shall--
(A) ensure that such departments and agencies
give high priority to small business concerns
that participate in or conduct energy
efficiency or renewable energy system research
and development projects; and
(B) include in the annual report to Congress
under subsection (b)(7) a determination of
whether the priority described in subparagraph
(A) is being carried out.
(2) Consultation required.--The Administrator shall
consult with the heads of other Federal departments and
agencies in determining whether priority has been given
to small business concerns that participate in or
conduct energy efficiency or renewable energy system
research and development projects, as required by this
subsection.
(3) Guidelines.--The Administrator shall, as soon as
is practicable after the date of enactment of this
subsection, issue guidelines and directives to assist
Federal agencies in meeting the requirements of this
subsection.
(4) Definitions.--In this subsection--
(A) the term ``biomass''--
(i) means any organic material that
is available on a renewable or
recurring basis, including--
(I) agricultural crops;
(II) trees grown for energy
production;
(III) wood waste and wood
residues;
(IV) plants (including
aquatic plants and grasses);
(V) residues;
(VI) fibers;
(VII) animal wastes and other
waste materials; and
(VIII) fats, oils, and
greases (including recycled
fats, oils, and greases); and
(ii) does not include--
(I) paper that is commonly
recycled; or
(II) unsegregated solid
waste;
(B) the term ``energy efficiency project''
means the installation or upgrading of
equipment that results in a significant
reduction in energy usage; and
(C) the term ``renewable energy system''
means a system of energy derived from--
(i) a wind, solar, biomass (including
biodiesel), or geothermal source; or
(ii) hydrogen derived from biomass or
water using an energy source described
in clause (i).
(aa) Limitation on Size of Awards.--
(1) Limitation.--No Federal agency may issue an award
under the SBIR program or the STTR program if the size
of the award exceeds the award guidelines established
under this section by more than 50 percent.
(2) Maintenance of information.--Participating
agencies shall maintain information on awards exceeding
the guidelines established under this section,
including--
(A) the amount of each award;
(B) a justification for exceeding the
guidelines for each award;
(C) the identity and location of each award
recipient; and
(D) whether an award recipient has received
any venture capital, hedge fund, or private
equity firm investment and, if so, whether the
recipient is majority-owned by multiple venture
capital operating companies, hedge funds, or
private equity firms.
(3) Reports.--The Administrator shall include the
information described in paragraph (2) in the annual
report of the Administrator to Congress.
(4) Waiver for specific topic.--Upon the receipt of
an application from a Federal agency, the Administrator
may grant a waiver from the requirement under paragraph
(1) with respect to a specific topic (but not for the
agency as a whole) for a fiscal year if the
Administrator determines, based on the information
contained in the application from the agency, that--
(A) the requirement under paragraph (1) will
interfere with the ability of the agency to
fulfill its research mission through the SBIR
program or the STTR program; and
(B) the agency will minimize, to the maximum
extent possible, the number of awards that do
not satisfy the requirement under paragraph (1)
to preserve the nature and intent of the SBIR
program and the STTR program.
(5) Rule of construction.--Nothing in this subsection
shall be construed to prevent a Federal agency from
supplementing an award under the SBIR program or the
STTR program using funds of the Federal agency that are
not part of the SBIR program or the STTR program of the
Federal agency.
(bb) Subsequent Phase II Awards.--
(1) Agency flexibility.--A small business concern
that received a Phase I award from a Federal agency
under this section shall be eligible to receive a
subsequent Phase II award from another Federal agency,
if the head of each relevant Federal agency or the
relevant component of the Federal agency makes a
written determination that the topics of the relevant
awards are the same and both agencies report the awards
to the Administrator for inclusion in the public
database under subsection (k).
(2) SBIR and sttr program flexibility.--A small
business concern that received a Phase I award under
this section under the SBIR program or the STTR program
may receive a subsequent Phase II award in either the
SBIR program or the STTR program and the participating
agency or agencies shall report the awards to the
Administrator for inclusion in the public database
under subsection (k).
(3) Preventing duplicative awards.--The head of a
Federal agency shall verify that any activity to be
performed with respect to a project with a Phase I or
Phase II SBIR or STTR award has not been funded under
the SBIR program or STTR program of another Federal
agency.
(cc) Phase Flexibility.--During fiscal years 2012 through
2017, the National Institutes of Health, the Department of
Defense, and the Department of Education may each provide to a
small business concern an award under Phase II of the SBIR
program with respect to a project, without regard to whether
the small business concern was provided an award under Phase I
of an SBIR program with respect to such project, if the head of
the applicable agency determines that the small business
concern has completed the determinations described in
subsection (e)(4)(A) with respect to such project despite not
having been provided a Phase I award.
(dd) Participation of Small Business Concerns Majority-Owned
by Venture Capital Operating Companies, Hedge Funds, or Private
Equity Firms in the SBIR Program.--
(1) Authority.--Upon providing a written
determination described in paragraph (2) to the
Administrator, the Committee on Small Business and
Entrepreneurship of the Senate, and the Committee on
Small Business and the Committee on Science, Space, and
Technology of the House of Representatives, not later
than 30 days before the date on which any such award is
made--
(A) the Director of the National Institutes
of Health, the Secretary of Energy, and the
Director of the National Science Foundation may
award not more than 25 percent of the funds
allocated for the SBIR program of the
applicable Federal agency to small business
concerns that are owned in majority part by
multiple venture capital operating companies,
hedge funds, or private equity firms through
competitive, merit-based procedures that are
open to all eligible small business concerns;
and
(B) the head of a Federal agency other than a
Federal agency described in subparagraph (A)
that participates in the SBIR program may award
not more than 15 percent of the funds allocated
for the SBIR program of the Federal agency to
small business concerns that are owned in
majority part by multiple venture capital
operating companies, hedge funds, or private
equity firms through competitive, merit-based
procedures that are open to all eligible small
business concerns.
(2) Determination.--A written determination described
in this paragraph is a written determination by the
head of a Federal agency that explains how the use of
the authority under paragraph (1) will--
(A) induce additional venture capital, hedge
fund, or private equity firm funding of small
business innovations;
(B) substantially contribute to the mission
of the Federal agency;
(C) demonstrate a need for public research;
and
(D) otherwise fulfill the capital needs of
small business concerns for additional
financing for SBIR projects.
(3) Registration.--A small business concern that is
majority-owned by multiple venture capital operating
companies, hedge funds, or private equity firms and
qualified for participation in the program authorized
under paragraph (1) shall--
(A) register with the Administrator on the
date that the small business concern submits an
application for an award under the SBIR
program; and
(B) indicate in any SBIR proposal that the
small business concern is registered under
subparagraph (A) as majority-owned by multiple
venture capital operating companies, hedge
funds, or private equity firms.
(4) Compliance.--
(A) In general.--The head of a Federal agency
that makes an award under this subsection
during a fiscal year shall collect and submit
to the Administrator data relating to the
number and dollar amount of Phase I awards,
Phase II awards, and any other category of
awards by the Federal agency under the SBIR
program during that fiscal year.
(B) Annual reporting.--The Administrator
shall include as part of each annual report by
the Administration under subsection (b)(7) any
data submitted under subparagraph (A) and a
discussion of the compliance of each Federal
agency that makes an award under this
subsection during the fiscal year with the
maximum percentages under paragraph (1).
(5) Enforcement.--If a Federal agency awards more
than the percent of the funds allocated for the SBIR
program of the Federal agency authorized under
paragraph (1) for a purpose described in paragraph (1),
the head of the Federal agency shall transfer an amount
equal to the amount awarded in excess of the amount
authorized under paragraph (1) to the funds for general
SBIR programs from the non-SBIR and non-STTR research
and development funds of the Federal agency not later
than 180 days after the date on which the Federal
agency made the award that caused the total awarded
under paragraph (1) to be more than the amount
authorized under paragraph (1) for a purpose described
in paragraph (1).
(6) Final decisions on applications under the sbir
program.--
(A) Definition.--In this paragraph, the term
``covered small business concern'' means a
small business concern that--
(i) was not majority-owned by
multiple venture capital operating
companies, hedge funds, or private
equity firms on the date on which the
small business concern submitted an
application in response to a
solicitation under the SBIR programs;
and
(ii) on the date of the award under
the SBIR program is majority-owned by
multiple venture capital operating
companies, hedge funds, or private
equity firms.
(B) In general.--If a Federal agency does not
make an award under a solicitation under the
SBIR program before the date that is 9 months
after the date on which the period for
submitting applications under the solicitation
ends--
(i) a covered small business concern
is eligible to receive the award,
without regard to whether the covered
small business concern meets the
requirements for receiving an award
under the SBIR program for a small
business concern that is majority-owned
by multiple venture capital operating
companies, hedge funds, or private
equity firms, if the covered small
business concern meets all other
requirements for such an award; and
(ii) the head of the Federal agency
shall transfer an amount equal to any
amount awarded to a covered small
business concern under the solicitation
to the funds for general SBIR programs
from the non-SBIR and non-STTR research
and development funds of the Federal
agency, not later than 90 days after
the date on which the Federal agency
makes the award.
(7) Evaluation criteria.--A Federal agency may not
use investment of venture capital or investment from
hedge funds or private equity firms as a criterion for
the award of contracts under the SBIR program or STTR
program.
(ee) Collaborating With Federal Laboratories and Research and
Development Centers.--
(1) Authorization.--Subject to the limitations under
this section, the head of each participating Federal
agency may make SBIR and STTR awards to any eligible
small business concern that--
(A) intends to enter into an agreement with a
Federal laboratory or federally funded research
and development center for portions of the
activities to be performed under that award; or
(B) has entered into a cooperative research
and development agreement (as defined in
section 12(d) of the Stevenson-Wydler
Technology Innovation Act of 1980 (15 U.S.C.
3710a(d))) with a Federal laboratory.
(2) Prohibition.--No Federal agency shall--
(A) condition an SBIR or STTR award upon
entering into agreement with any Federal
laboratory or any federally funded laboratory
or research and development center for any
portion of the activities to be performed under
that award;
(B) approve an agreement between a small
business concern receiving an SBIR or STTR
award and a Federal laboratory or federally
funded laboratory or research and development
center, if the small business concern performs
a lesser portion of the activities to be
performed under that award than required by
this section and by the SBIR Policy Directive
and the STTR Policy Directive of the
Administrator; or
(C) approve an agreement that violates any
provision, including any data rights
protections provision, of this section or the
SBIR and the STTR Policy Directives.
(3) Implementation.--Not later than 180 days after
the date of enactment of this subsection, the
Administrator shall modify the SBIR Policy Directive
and the STTR Policy Directive issued under this section
to ensure that small business concerns--
(A) have the flexibility to use the resources
of the Federal laboratories or federally funded
research and development centers; and
(B) are not mandated to enter into agreement
with any Federal laboratory or any federally
funded laboratory or research and development
center as a condition of an award.
(4) Advance payment.--If a small business concern
receiving an award under this section enters into an
agreement with a Federal laboratory or federally funded
research and development center for portions of the
activities to be performed under that award, the
Federal laboratory or federally funded research and
development center may not require advance payment from
the small business concern in an amount greater than
the amount necessary to pay for 30 days of such
activities.
(ff) Additional SBIR and STTR Awards.--
(1) Express authority for awarding a sequential phase
ii award.--A small business concern that receives a
Phase II SBIR award or a Phase II STTR award for a
project remains eligible to receive 1 additional Phase
II SBIR award or Phase II STTR award for continued work
on that project.
(2) Preventing duplicative awards.--The head of a
Federal agency shall verify that any activity to be
performed with respect to a project with a Phase I or
Phase II SBIR or STTR award has not been funded under
the SBIR program or STTR program of another Federal
agency.
(gg) Pilot Program.--
(1) Authorization.--The head of each covered Federal
agency may allocate not more than 10 percent of the
funds allocated to the SBIR program and the STTR
program of the covered Federal agency--
(A) for awards for technology development,
testing, evaluation, and commercialization
assistance for SBIR and STTR Phase II
technologies; or
(B) to support the progress of research,
research and development, and commercialization
conducted under the SBIR or STTR programs to
Phase III.
(2) Application by federal agency.--
(A) In general.--A covered Federal agency may
not establish a pilot program unless the
covered Federal agency makes a written
application to the Administrator, not later
than 90 days before the first day of the fiscal
year in which the pilot program is to be
established, that describes a compelling reason
that additional investment in SBIR or STTR
technologies is necessary, including unusually
high regulatory, systems integration, or other
costs relating to development or manufacturing
of identifiable, highly promising small
business technologies or a class of such
technologies expected to substantially advance
the mission of the agency.
(B) Determination.--The Administrator shall--
(i) make a determination regarding an
application submitted under
subparagraph (A) not later than 30 days
before the first day of the fiscal year
for which the application is submitted;
(ii) publish the determination in the
Federal Register; and
(iii) make a copy of the
determination and any related materials
available to the Committee on Small
Business and Entrepreneurship of the
Senate and the Committee on Small
Business and the Committee on Science,
Space, and Technology of the House of
Representatives.
(3) Maximum amount of award.--The head of a covered
Federal agency may not make an award under a pilot
program in excess of 3 times the dollar amounts
generally established for Phase II awards under
subsection (j)(2)(D) or (p)(2)(B)(ix).
(4) Registration.--Any applicant that receives an
award under a pilot program shall register with the
Administrator in a registry that is available to the
public.
(5) Award criteria or consideration.--When making an
award under this section, the head of a covered Federal
agency shall give consideration to whether the
technology to be supported by the award is likely to be
manufactured in the United States.
(6) Report.--The head of each covered Federal agency
shall include in the annual report of the covered
Federal agency to the Administrator an analysis of the
various activities considered for inclusion in the
pilot program of the covered Federal agency and a
statement of the reasons why each activity considered
was included or not included, as the case may be.
(7) Termination.--The authority to establish a pilot
program under this section expires at the end of fiscal
year 2017.
(8) Definitions.--In this subsection--
(A) the term ``covered Federal agency''--
(i) means a Federal agency
participating in the SBIR program or
the STTR program; and
(ii) does not include the Department
of Defense; and
(B) the term ``pilot program'' means each
program established under paragraph (1).
(hh) Timing of Release of Funding.--Federal agencies
participating in the SBIR program or STTR program shall, to the
extent possible, attempt to shorten the amount of time between
the provision of notice of an award under the SBIR program or
STTR program and the subsequent release of funding with respect
to the award.
(ii) Reporting on Timing.--Federal agencies participating in
the SBIR program or STTR program shall provide to the
Administrator, for the annual report on the SBIR and STTR
program under subsection (b)(7), the average amount of time the
agency takes to make a final decision on proposals submitted
under such programs, the average amount of time the agency
takes to release funding with respect to an award under such
programs, and the goals established to reduce such amounts.
(jj) Phase 0 Proof of Concept Partnership Pilot Program.--
(1) In general.--The Director of the National
Institutes of Health may use $5,000,000 of the funds
allocated under subsection (n)(1) for a Proof of
Concept Partnership pilot program to accelerate the
creation of small businesses and the commercialization
of research innovations from qualifying institutions.
To implement this program, the Director shall award,
through a competitive, merit-based process, grants to
qualifying institutions. These grants shall only be
used to administer Proof of Concept Partnership awards
in conformity with this subsection.
(2) Definitions.--In this subsection--
(A) the term ``Director'' means the Director
of the National Institutes of Health;
(B) the term ``pilot program'' refers to the
Proof of Concept Partnership pilot program; and
(C) the terms ``qualifying institution'' and
``institution'' mean a university or other
research institution that participates in the
National Institutes of Health's STTR program.
(3) Proof of concept partnerships.--
(A) In general.--A Proof of Concept
Partnership shall be set up by a qualifying
institution to award grants to individual
researchers. These grants should provide
researchers with the initial investment and the
resources to support the proof of concept work
and commercialization mentoring needed to
translate promising research projects and
technologies into a viable company. This work
may include technical validations, market
research, clarifying intellectual property
rights position and strategy, and investigating
commercial or business opportunities.
(B) Award guidelines.--The administrator of a
Proof of Concept Partnership program shall
award grants in accordance with the following
guidelines:
(i) The Proof of Concept Partnership
shall use a market-focused project
management oversight process,
including--
(I) a rigorous, diverse
review board comprised of local
experts in translational and
proof of concept research,
including industry, start-up,
venture capital, technical,
financial, and business experts
and university technology
transfer officials;
(II) technology validation
milestones focused on market
feasibility;
(III) simple reporting
effective at redirecting
projects; and
(IV) the willingness to
reallocate funding from failing
projects to those with more
potential.
(ii) Not more than $100,000 shall be
awarded towards an individual proposal.
(C) Educational resources and guidance.--The
administrator of a Proof of Concept Partnership
program shall make educational resources and
guidance available to researchers attempting to
commercialize their innovations.
(4) Awards.--
(A) Size of award.--The Director may make
awards to a qualifying institution for up to
$1,000,000 per year for up to 3 years.
(B) Award criteria.--In determining which
qualifying institutions receive pilot program
grants, the Director shall consider, in
addition to any other criteria the Director
determines necessary, the extent to which
qualifying institutions--
(i) have an established and proven
technology transfer or
commercialization office and have a
plan for engaging that office in the
program's implementation;
(ii) have demonstrated a commitment
to local and regional economic
development;
(iii) are located in diverse
geographies and are of diverse sizes;
(iv) can assemble project management
boards comprised of industry, start-up,
venture capital, technical, financial,
and business experts;
(v) have an intellectual property
rights strategy or office; and
(vi) demonstrate a plan for
sustainability beyond the duration of
the funding award.
(5) Limitations.--The funds for the pilot program
shall not be used--
(A) for basic research, but to evaluate the
commercial potential of existing discoveries,
including--
(i) proof of concept research or
prototype development; and
(ii) activities that contribute to
determining a project's
commercialization path, to include
technical validations, market research,
clarifying intellectual property
rights, and investigating commercial
and business opportunities; or
(B) to fund the acquisition of research
equipment or supplies unrelated to
commercialization activities.
(6) Evaluative report.--The Director shall submit to
the Committee on Science, Space, and Technology and the
Committee on Small Business of the House of
Representatives and the Committee on Small Business and
Entrepreneurship of the Senate an evaluative report
regarding the activities of the pilot program. The
report shall include--
(A) a detailed description of the
institutional and proposal selection process;
(B) an accounting of the funds used in the
pilot program;
(C) a detailed description of the pilot
program, including incentives and activities
undertaken by review board experts;
(D) a detailed compilation of results
achieved by the pilot program, including the
number of small business concerns included and
the number of business packages developed, and
the number of projects that progressed into
subsequent STTR phases; and
(E) an analysis of the program's
effectiveness with supporting data.
(7) Sunset.--The pilot program under this subsection
shall terminate at the end of fiscal year [2017] 2019.
(kk) Phase III Reporting.--The annual SBIR or STTR report to
Congress by the Administration under subsection (b)(7) shall
include, for each Phase III award--
(1) the name of the agency or component of the agency
or the non-Federal source of capital making the Phase
III award;
(2) the name of the small business concern or
individual receiving the Phase III award; and
(3) the dollar amount of the Phase III award.
(ll) Consent To Release Contact Information to
Organizations.--
(1) Enabling concern to give consent.--Each Federal
agency required by this section to conduct an SBIR
program or an STTR program shall enable a small
business concern that is an SBIR applicant or an STTR
applicant to indicate to the Federal agency whether the
Federal agency has the consent of the concern to--
(A) identify the concern to appropriate local
and State-level economic development
organizations as an SBIR applicant or an STTR
applicant; and
(B) release the contact information of the
concern to such organizations.
(2) Rules.--The Administrator shall establish rules
to implement this subsection. The rules shall include a
requirement that a Federal agency include in the SBIR
and STTR application a provision through which the
applicant can indicate consent for purposes of
paragraph (1).
(mm) Assistance for Administrative, Oversight, and Contract
Processing Costs.--
(1) In general.--Subject to paragraph (3) and until
September 30, 2017, the Administrator shall allow each
Federal agency required to conduct an SBIR program to
use not more than 3 percent of the funds allocated to
the SBIR program of the Federal agency for--
(A) the administration of the SBIR program or
the STTR program of the Federal agency;
(B) the provision of outreach and technical
assistance relating to the SBIR program or STTR
program of the Federal agency, including
technical assistance site visits, personnel
interviews, and national conferences;
(C) the implementation of commercialization
and outreach initiatives that were not in
effect on the date of enactment of this
subsection;
(D) carrying out the program under subsection
(y);
(E) activities relating to oversight and
congressional reporting, including waste,
fraud, and abuse prevention activities;
(F) targeted reviews of recipients of awards
under the SBIR program or STTR program of the
Federal agency that the head of the Federal
agency determines are at high risk for fraud,
waste, or abuse to ensure compliance with
requirements of the SBIR program or STTR
program, respectively;
(G) the implementation of oversight and
quality control measures, including
verification of reports and invoices and cost
reviews;
(H) carrying out subsection (dd);
(I) contract processing costs relating to the
SBIR program or STTR program of the Federal
agency; and
(J) funding for additional personnel and
assistance with application reviews.
(2) Outreach and technical assistance.--
(A) In general.--Except as provided in
subparagraph (B), a Federal agency
participating in the program under this
subsection shall use a portion of the funds
authorized for uses under paragraph (1) to
carry out the policy directive required under
subsection (j)(2)(F) and to increase the
participation of States with respect to which a
low level of SBIR awards have historically been
awarded.
(B) Waiver.--A Federal agency may request the
Administrator to waive the requirement
contained in subparagraph (A). Such request
shall include an explanation of why the waiver
is necessary. The Administrator may grant the
waiver based on a determination that the agency
has demonstrated a sufficient need for the
waiver, that the outreach objectives of the
agency are being met, and that there is
increased participation by States with respect
to which a low level of SBIR awards have
historically been awarded.
(3) Performance criteria.--A Federal agency may not
use funds as authorized under paragraph (1) until after
the effective date of performance criteria, which the
Administrator shall establish, to measure any benefits
of using funds as authorized under paragraph (1) and to
assess continuation of the authority under paragraph
(1).
(4) Rules.--Not later than 180 days after the date of
enactment of this subsection, the Administrator shall
issue rules to carry out this subsection.
(5) Coordination with ig.--Each Federal agency shall
coordinate the activities funded under subparagraph
(E), (F), or (G) of paragraph (1) with their respective
Inspectors General, when appropriate, and each Federal
agency that allocates more than $50,000,000 to the SBIR
program of the Federal agency for a fiscal year may
share such funding with its Inspector General when the
Inspector General performs such activities.
(6) Reporting.--The Administrator shall collect data
and provide to the Committee on Small Business and
Entrepreneurship of the Senate and the Committee on
Small Business, the Committee on Science, Space, and
Technology, and the Committee on Appropriations of the
House of Representatives a report on the use of funds
under this subsection, including funds used to achieve
the objectives of paragraph (2)(A) and any use of the
waiver authority under paragraph (2)(B).
(nn) Annual Report on SBIR and STTR Program Goals.--
(1) Development of metrics.--The head of each Federal
agency required to participate in the SBIR program or
the STTR program shall develop metrics to evaluate the
effectiveness and the benefit to the people of the
United States of the SBIR program and the STTR program
of the Federal agency that--
(A) are science-based and statistically
driven;
(B) reflect the mission of the Federal
agency; and
(C) include factors relating to the economic
impact of the programs.
(2) Evaluation.--The head of each Federal agency
described in paragraph (1) shall conduct an annual
evaluation using the metrics developed under paragraph
(1) of--
(A) the SBIR program and the STTR program of
the Federal agency; and
(B) the benefits to the people of the United
States of the SBIR program and the STTR program
of the Federal agency.
(3) Report.--
(A) In general.--The head of each Federal
agency described in paragraph (1) shall submit
to the appropriate committees of Congress and
the Administrator an annual report describing
in detail the results of an evaluation
conducted under paragraph (2).
(B) Public availability of report.--The head
of each Federal agency described in paragraph
(1) shall make each report submitted under
subparagraph (A) available to the public
online.
(C) Definition.--In this paragraph, the term
``appropriate committees of Congress'' means--
(i) the Committee on Small Business
and Entrepreneurship of the Senate; and
(ii) the Committee on Small Business
and the Committee on Science, Space,
and Technology of the House of
Representatives.
(oo) Competitive Selection Procedures for SBIR and STTR
Programs.--All funds awarded, appropriated, or otherwise made
available in accordance with subsection (f) or (n) must be
awarded pursuant to competitive and merit-based selection
procedures.
(pp) Limitation on Pilot Programs.--
(1) Existing pilot programs.--The Administrator may
only carry out a covered pilot program that is in
operation on the date of enactment of this subsection
during the 3-year period beginning on such date of
enactment.
(2) New pilot programs.--The Administrator may only
carry out a covered pilot program established after the
date of enactment of this subsection--
(A) during the 3-year period beginning on the
date on which such program is established; and
(B) if such program does not continue and is
not based on, in any manner, a previously
established covered pilot program.
(3) Covered pilot program defined.--In this
subsection, the term ``covered pilot program'' means
any initiative, project, innovation, or other
activity--
(A) established by the Administrator;
(B) relating to an SBIR or STTR program; and
(C) not specifically authorized by law.
(qq) Minimum Standards for Participation.--
(1) Progress to phase ii success.--
(A) Establishment of system and minimum
commercialization rate.--Not later than 1 year
after the date of enactment of this subsection,
the head of each Federal agency participating
in the SBIR or STTR program shall--
(i) establish a system to measure,
where appropriate, the success of small
business concerns with respect to the
receipt of Phase II SBIR or STTR awards
for projects that have received Phase I
SBIR or STTR awards;
(ii) establish a minimum performance
standard for small business concerns
with respect to the receipt of Phase II
SBIR or STTR awards for projects that
have received Phase I SBIR or STTR
awards; and
(iii) begin evaluating, each fiscal
year, whether each small business
concern that received a Phase I SBIR or
STTR award from the agency meets the
minimum performance standard
established under clause (ii).
(B) Consequence of failure to meet minimum
commercialization rate.--If the head of a
Federal agency determines that a small business
concern that received a Phase I SBIR or STTR
award from the agency is not meeting the
minimum performance standard established under
subparagraph (A)(ii), such concern may not
participate in Phase I (or Phase II if under
the authority of subsection (cc)) of the SBIR
or STTR program of that agency during the 1-
year period beginning on the date on which such
determination is made.
(2) Progress to phase iii success.--
(A) Establishment of system and minimum
commercialization rate.--Not later than 2 years
after the date of enactment of this subsection,
the head of each Federal agency participating
in the SBIR or STTR program shall--
(i) establish a system to measure,
where appropriate, the success of small
business concerns with respect to the
receipt of Phase III SBIR or STTR
awards for projects that have received
Phase I SBIR or STTR awards;
(ii) establish a minimum performance
standard for small business concerns
with respect to the receipt of Phase
III SBIR or STTR awards for projects
that have received Phase I SBIR or STTR
awards; and
(iii) begin evaluating, each fiscal
year, whether each small business
concern that received a Phase I SBIR or
STTR award from the agency meets the
minimum performance standard
established under clause (ii).
(B) Consequence of failure to meet minimum
commercialization rate.--If the head of a
Federal agency determines that a small business
concern that received a Phase I SBIR or STTR
award from the agency is not meeting the
minimum performance standard established under
subparagraph (A)(ii), such concern may not
participate in Phase I (or Phase II if under
the authority of subsection (cc)) of the SBIR
or STTR program of that agency during the 1-
year period beginning on the date on which such
determination is made.
(3) Administration oversight.--
(A) Approval and publication of systems and
minimum performance standards.--Each system and
minimum performance standard established under
paragraph (1) or paragraph (2) shall be
submitted by the head of the applicable Federal
agency to the Administrator and shall be
subject to the approval of the Administrator.
In making a determination with respect to
approval, the Administrator shall ensure that
the minimum performance standard exceeds a de
minimis level. The Administrator shall publish
on the Internet Web site of the Administration
the systems and minimum performance standards
approved.
(B) Submission of evaluation results by
agency.--The head of each covered Federal
agency shall submit to the Administrator the
results of each evaluation conducted under
paragraph (1) or paragraph (2).
(4) Requirement of notice and comment.--Each system
and minimum performance standard established under
paragraph (1) or paragraph (2) and each approval
provided by the Administrator under paragraph (3)(A),
at least 60 days before becoming effective, shall be
preceded by the provision of notice of and an
opportunity for public comment on such system,
standard, or approval.
(rr) Publication of Certain Information.--In order to
increase the number of small businesses receiving awards under
the SBIR or STTR programs of participating agencies, and to
simplify the application process for such awards, the
Administrator shall establish and maintain a public Internet
Web site on which the Administrator shall publish such
information relating to notice of and application for awards
under the SBIR program and STTR program of each participating
Federal agency as the Administrator determines appropriate.
(ss) Report on Enhancement of Manufacturing Activities.--Not
later than October 1, 2013, and annually thereafter, the head
of each Federal agency that makes more than $50,000,000 in
awards under the SBIR and STTR programs of the agency combined
shall submit to the Administrator, for inclusion in the annual
report required under subsection (b)(7), information that
includes--
(1) a description of efforts undertaken by the head
of the Federal agency to enhance United States
manufacturing activities;
(2) a comprehensive description of the actions
undertaken each year by the head of the Federal agency
in carrying out the SBIR or STTR program of the agency
in support of Executive Order 13329 (69 Fed. Reg. 9181;
relating to encouraging innovation in manufacturing);
(3) an assessment of the effectiveness of the actions
described in paragraph (2) at enhancing the research
and development of United States manufacturing
technologies and processes;
(4) a description of efforts by vendors selected to
provide discretionary technical assistance under
subsection (q)(1) to help SBIR and STTR concerns
manufacture in the United States; and
(5) recommendations that the program managers of the
SBIR or STTR program of the agency consider appropriate
for additional actions to increase the effectiveness of
enhancing manufacturing activities.
CHANGES IN THE APPLICATION OF EXISTING LAW
Pursuant to clause 3(f)(1)(A) of rule XIII of the Rules of
the House of Representatives, the following statements are
submitted describing the effect of provisions in the
accompanying bill that directly or indirectly change the
application of existing law.
TITLE I--DEPARTMENT OF LABOR
Language is included under ``Employment and Training
Administration'' providing that allotments to outlying areas
are not required to be made through the Pacific Region
Educational Laboratory as provided by section 127 of the
Workforce Innovation and Opportunity Act (WIOA).
Language is included under ``Employment and Training
Administration'' providing additional waiver authority to the
Secretary for Wagner-Peyser Act requirements pursuant to
requests from States.
Language is included under ``Employment and Training
Administration'' providing amounts made available for
dislocated workers may be used for State activities or across
multiple local areas where workers remain dislocated.
Language is included under ``Employment and Training
Administration'' providing that technical assistance and
demonstration projects may provide assistance to new entrants
in the workforce and incumbent workers.
Language is included under ``Employment and Training
Administration'' providing that the Department of Labor may
take no action to limit the number or proportion of eligible
applicants receiving related assistance services in the migrant
and seasonal farmworkers programs.
Language is included under ``Job Corps'' providing that
amounts made available for construction and rehabilitation may
include acquisition and maintenance of major items of
equipment.
Language is included under ``Job Corps'' providing
authority to transfer up to 15 percent of construction and
rehabilitation funds for operational needs with prior written
notice to the Committee and that any such transfers are
available for obligation through June 30, 2019.
Language is included under ``Job Corps'' providing that no
funds from any other appropriation may be used for meal
services at Job Corps.
Language is included under ``Job Corps'' providing that the
Secretary may prioritize enrollment of applicants who are at
least 20 years of age.
Language in included under ``Federal Unemployment Benefits
and Allowances'' providing that funding may be available beyond
the current year in accordance with section 245(c) of the Trade
Act of 1974.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing for reemployment
services and referrals to training for claimants of
unemployment insurance for ex-service members, for improper
payment reviews, and for unemployment claimants most likely to
exhaust their benefits.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing additional funds
for reemployment services, eligibility assessments, and
unemployment insurance improper payment reviews pursuant to the
Balanced Budget and Emergency Deficit Control Act of 1985.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that States may
use up to 100 percent of allotted under Section 6 to carry out
activities described in Section 7(a) of the Wagner-Peyser Act
Act.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing for additional
administrative funds from the Unemployment Trust Fund if
unemployment claims exceed certain levels.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing authority for
States to use funds to assist other States to carry out
authorized activities in cases of a major disaster declared by
the President under the Robert T. Stafford Disaster Relief and
Emergency Assistance Act.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments on behalf of States for
the use of the National Directory of New Hires.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the State Information Data Exchange System.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may make payments from funds appropriated
for States' grants on behalf of States to the entity operating
the Unemployment Insurance Integrity Center of Excellence.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that
appropriations for establishing a national one-stop career
system may be obligated in contracts, grants or agreements with
States or non-State entities.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that States
awarded grants to support national activities of the Federal-
State unemployment insurance system may award subgrants to
other States.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that funds
available for integrated Unemployment Insurance and Employment
Service automation may be used by States notwithstanding cost
allocation principles prescribed under the Office of Management
and Budget ``Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards.''
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' providing that the
Department of Labor may reallot funds among States
participating in a consortium.
Language is included under ``State Unemployment Insurance
and Employment Service Operations'' allowing the Secretary to
collect fees for the costs associated with additional data
collection, analyses, and reporting services related to the
National Agricultural Workers Survey.
Language is included under ``Pension Benefit Guarantee
Corporation'' providing for additional administrative funds if
participants with plans terminated during the period exceed a
certain level.
Language is included under ``Pension Benefit Guarantee
Corporation'' providing that obligations may exceed amounts
provided for unforeseen and extraordinary pretermination
expenses or unforeseen and extraordinary multiemployer program
expenses if approved by the Office of Management and Budget.
Language is included under ``Special Benefits'' providing
that the Department of Labor may use authority to reimburse an
employer who is not the employer at the time of injury for
portions of the salary of a re-employed, disabled beneficiary.
Language is included under ``Special Benefits'' providing
that unobligated balances of reimbursements shall remain
available until expended for the payment of compensation,
benefits, and expenses.
Language is included under ``Special Benefits'' providing
that funds shall be transferred to the appropriation from
entities required under 5 U.S.C. 8147(c) as determined by the
Department of Labor.
Language is included under ``Special Benefits'' providing
that funds transferred from entities under 5 U.S.C 8147(c),
specified amounts may be used by the Department of Labor for
maintenance and data and communications systems, workload
processing, roll disability management and medical review, and
program integrity with remaining amounts paid into the
Treasury.
Language is included under ``Special Benefits'' providing
that the Secretary may prescribe regulations requiring
identification for the filing of benefit claims.
Language is included under ``Administrative Expenses,
Energy Employees Occupational Illness Compensation Fund''
providing that the Secretary may prescribe regulations for
requiring identification for the filing of benefit claims.
Language is included under ``Occupational Safety and Health
Administration'' providing that up to a certain amount of fees
collected from the training institute may be retained and used
for related training and education.
Language is included under ``Occupational Safety and Health
Administration'' providing that fees collected from Nationally
Recognized Testing Laboratories may be used to administer
laboratory recognition programs that insure safety of equipment
used in the workplace.
Language is included under ``Occupational Safety and Health
Administration'' that prohibits enforcement on farming
operations of 10 or fewer employees or of an employer with 10
or fewer employees that is below the national average in
specific injury categories except under specific exclusions.
Language is included under ``Mine Safety and Health
Administration'' providing that funds made available for State
assistance grants may be used for the purchase and maintenance
of equipment required by the Lowering Miners' Exposure to
Respirable Coal Mine Dust rule.
Language is included under ``Mine Safety and Health
Administration'' providing that a specific amount may be
collected by the National Mine Health and Safety Academy and
made available for mine safety and health education and
training.
Language is included under ``Mine Safety and Health
Administration'' providing that a specific amount may be
collected from the approval and certification of equipment and
materials and made available for other such activities.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
accept lands, buildings, equipment, and other contributions
from public and private sources for cooperative projects.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
promote health and safety education and training through
cooperative agreements with States, industry and safety
associations.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may
recognize the Joseph A. Holmes Safety Association as the
principal safety association and may provide funds or personnel
as officers in local chapters or the national organization.
Language is included under ``Mine Safety and Health
Administration'' providing that the Department of Labor may use
appropriated funds to provide for costs associated with mine
rescue and survival operations in the event of a major
disaster.
Language is included under ``Departmental Management--
Salaries and Expenses'' providing that the Bureau of
International Labor Affairs may administer international labor
activities through grants, subgrants or other arrangements.
Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available for
program evaluation may be used to administer grants for
evaluation purposes subject to certain conditions.
Language is included under ``Departmental Management--
Salaries and Expenses'' providing that funds available to the
Women's Bureau may be used for grants to service and promote
the interests of women in the workplace.
Language is included under ``Departmental Management--
Salaries and Expenses'' providing that certain amounts made
available to the Women's Bureau shall be used for grants
authorized by the Women in Apprenticeship and Nontraditional
Occupations Act.
Language is included under ``Veterans Employment and
Training'' providing that up to three percent of States' grants
may be used for federal expenditures for data systems and
contract support.
Language is included under ``Veterans Employment and
Training'' providing that funds may be used for support
specialists providing intensive services to wounded service
members.
Language is included under ``Veterans Employment and
Training'' providing for a pilot project to train and place
transitioning service members in apprenticeships.
Language is included under ``Veterans Employment and
Training'' providing that Department of Labor may reallocate up
to three percent of funds provided among appropriated accounts.
Language is included under ``Veterans Employment and
Training'' providing that the Department may award grants under
section 2023 of Title 38, United States Code.
Language is included under ``Veterans Employment and
Training'' providing that services may be provided to certain
homeless or recently incarcerated veterans under section 2021
of Title 38, United States Code.
Language is included under ``Veterans Employment and
Training'' providing that funds made available to assist
homeless veterans may be used for data systems and contract
support track participant and performance information.
Language is included under ``Veterans Employment and
Training'' providing that the fees assessed pursuant to the
HIRE Vets Medallion Award Fund shall be available to the
Secretary for expenses of the HIRE Vets Medallion Award Program
and that the start date prescribed in the Act shall not apply.
Language is included under ``General Provisions''
prohibiting the use of Job Corps funds to pay the salaries and
bonuses at a rate in excess of Executive Level II.
Language is included under ``General Provisions''
authorizing the transfer of up to one percent of discretionary
funds between programs, projects, or activities as long as the
transfer does not increase any program, project, or activity by
more than three percent and no new program, project, or
activity is created by such transfer.
Language is included under ``General Provisions''
prohibiting the use funds for procurement of goods or services
rendered by forced or indentured child labor.
Language is included under ``General Provisions''
prohibiting the use of any funds appropriated for grants under
section 414(c) of the American Competitiveness and Workforce
Improvement Act of 1998, for purposes other than competitive
grants for training individuals over the age of 16 who are not
currently enrolled in school in the occupations and industries
for which employers are using H-1B visa to hire foreign
workers.
Language is included under ``General Provisions''
prohibiting the use of any funds appropriated for Employment
and Training Administration programs to be used to pay the
salaries and bonuses at a rate in excess of Executive Level II
except under specific exclusions.
Language is included under ``General Provisions'' providing
that the Department of Labor may transfer funds from the
Employment and Training Administration to Program
Administration when it is determined that services will be more
efficiently performed and that the Department may transfer
certain amounts to Program Administration to conduct program
integrity activities.
Language is included under ``General Provisions'' providing
that the Department of Labor may transfer funds from specified
accounts to the ``Office of the Chief Evaluation Officer'' for
program evaluations.
Language is included under ``General Provisions'' regarding
the application of certain Fair Labor Standards Act
requirements pertaining to the evaluation of claims following a
major disaster.
Language is included under ``General Provisions''
rescinding advance appropriations for the Dislocated Workers
National Reserve.
Language is included under ``General Provisions'' providing
flexibility of crossing for H-2B nonimmigrant workers in the
seafood industry.
Language is included under ``General Provisions'' providing
certain authorities related to the Secretary's security detail.
Language is included under ``General Provisions'' providing
certain authorities for the Working Capital Fund.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Language is included under ``Health Resources and Services
Administration--Health Workforce'' overriding the proportional
funding requirements in the Public Health Service Act for
sections 751 and 762.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing that fees
collected for the disclosure of information under the
information reporting requirement program authorized by section
1921 of the Social Security Act shall be sufficient to recover
the full costs of the operation program and shall remain
available until expended to carry out that Act.
Language is included under ``Health Resources and Services
Administration--Health Workforce'' providing funding under the
National Health Service Corps Loan Repayment Program for
substance use disorder counselors and placement in Indian
Health Service facilities.
Language is included under ``Center for Disease Control and
Prevention--Public Health Preparedness and Response''
permitting CDC to operate and maintain an aircraft.
Language is included under ``Center for Disease Control and
Prevention--Buildings and Facilities'' providing the use of
funds to support acquisition, renovation, or replacement, of
the National Institute Occupational Safety and Health's
underground and surface coal mining research capacity.
Language is included under ``Center for Disease Control and
Prevention--Buildings and Facilities'' providing funds from
former employees with existing Individual Learning Accounts
unobligated to be available to support acquisition, renovation,
or replacement, of the National Institute for Occupational
Safety and Health's underground and surface coal mining
research capacity.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' requiring
states to spend 10 percent of the Mental Health Block Grant for
programs for individuals with early serious mental illness.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Mental Health'' exempting the
Mental Health Block Grant from the evaluation set-aside in
section 241 of the Public Health Service Act.
Language is included under ``Substance Abuse and Mental
Health Services Administration--Substance Abuse Treatment''
exempting the Substance Abuse Prevention and Treatment Block
Grant from the evaluation set-aside in section 241 of the
Public Health Service Act.
Language is included under ``Centers for Medicare and
Medicaid Services--Program Management'' prohibiting the
collection of fees from qualified health plans offered through
an Exchange established under Public Law 111-148.
Language is included under ``Centers for Medicare and
Medicaid Services--Health Care Fraud and Abuse Control
Account'' providing funds to support the cost of the Senior
Medicare Patrol program.
Language is included under ``Administration for Children
and Families--Low Income Home Energy Assistance'' modifying the
formula distribution of funds provided.
Language is included under ``Administration for Children
and Families--Refugee and Entrant Assistance'' permitting a 10
percent transfer.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' increasing the tribal set-aside to 5
percent.
Language is included under ``Administration for Children
and Families--Payments to States for the Child Care and
Development Block Grant'' establishing a demonstration grant
program for families needing care on an emergency basis,
located in rural areas, or non-traditional work hours.
Language is included under ``Administration for Children
and Families--Children and Families Services Programs''
providing for payments under the Head Start Act for a cost of
living adjustment and the calculation of a base grant.
Language is included under Administration for Community
Living establishing an assistive technology alternative
financing program.
Language is included under Administration for Community
Living prohibiting the use of the funds provided in the bill to
pursue legal action on behalf of a protection and advocacy
system described in section 103 of the Protection and Advocacy
for Individuals with Mental Illness Act unless public notice
has been provided within 90 of instituting action to the named
person or their legal guardian.
Language is included under Administration for Community
Living waiving the public notice requirement for individuals
without a guardian, who are not competent to consent, who are
wards of the State or subject to public guardianship.
Language is included under ``General Departmental
Management'' for competitive grants that implement education in
sexual risk avoidance using medically accurate information,
evidence-based approaches and teach benefits of healthy
relationships, goal setting and resisting sexual coercion and
other youth risk behaviors.
Section 201 limits the amount available for official
reception and representation expenses.
Section 202 limits the salary of an individual through an
HHS grant or other extramural mechanism to not more than the
rate of Executive Level II.
Section 203 prohibits the Secretary from using evaluation
set-aside funds until the Committees on Appropriations of the
House of Representatives and the Senate receive a report
detailing the planned use of such funds.
Section 204 sets the PHS evaluation set-aside to 2.5
percent.
Section 205 permits the Secretary of HHS to transfer up to
one percent of any discretionary funds between appropriations,
provided that no appropriation is increased by more than three
percent by any such transfer to meet emergency needs.
Notification must be provided to the Committees on
Appropriations at the program, project, and activity level in
advance of any transfer.
Section 206 continues the 60 day flexibility for National
Health Service Corps contract terminations.
Section 207 prohibits the use of Title X funds unless the
applicant for the award certifies to the Secretary that it
encourages family participation in the decision of minors to
seek family planning services and that it provides counseling
to minors on how to resist attempts to coerce minors into
engaging in sexual activities.
Section 208 states that no provider of services under Title
X shall be exempt from any state law requiring notification or
the reporting of child abuse, child molestation, sexual abuse,
rape, or incest.
Section 209 provides conscience protections to participants
in the Medicare Advantage program who chose not to provide, pay
for, provide coverage of, or provide referrals for abortions.
Section 210 prohibits funds from being used to advocate or
promote gun control.
Section 211 limits assignments of Public Health Service
staff to assist in child survival activities to not more than
60 days.
Section 212 permits funding for HHS international HIV/AIDS
and other infectious disease, chronic and environmental
disease, and other health activities abroad to be spent under
the State Department Basic Authorities Act of 1956.
Section 213 provides the Director of NIH, jointly with the
Director of the Office of AIDS Research, the authority to
transfer up to three percent of human immunodeficiency virus
funds.
Section 214 makes NIH funds available for human
immunodeficiency virus research available to the Office of AIDS
Research.
Section 215 grants authority to the Office of the Director
of the NIH to enter directly into transactions in order to
implement the NIH Common Fund for medical research and
permitting the Director to utilize peer review procedures, as
appropriate, to obtain assessments of scientific and technical
merit.
Section 216 clarifies that funds appropriated to NIH
institutes and centers may be used for minor repairs or
improvements to their buildings, up to $3,500,000 per project
with a total limit for NIH of $45,000,000.
Section 217 transfers one percent of the funding made
available for National Institutes of Health National Research
Service Awards to the Health Resources and Services
Administration and Agency for Healthcare Research and Quality.
Section 218 continues the Biomedical Advanced Research and
Development Authority ten year contract authority.
Section 219 requires HHS to include certain information
concerning the number of full-time federal employees and
contractors working on the ACA in the fiscal year 2020 budget
request.
Section 220 includes specific report requirements for CMS's
marketplaces activities in the fiscal year 2020 budget request.
Section 221 prohibits CMS Program Account from being used
to support risk corridor payments.
Section 222 directs the spending and transfer of amount in
the Prevention and Public Health fund.
Section 223 modifies a provision relating to breast cancer
screening.
Section 224 requires the NIH to continue to use existing
indirect cost negotiated rates.
Section 225 permits transfer authority within NIH, to the
Director of NIH for activities related to opioid addiction,
opioid alternatives, pain management, and addiction treatment.
Section 226 permits transfer authority for activities
related to evaluation for programs administered by the
Administration for Children and Families.
Section 227 prohibits funds from being used for Title X
family planning activities.
Section 228 establishes the account Infectious Disease
Rapid Response Reserve Fund for emergency use by the Secretary.
Section 230 includes a new provision relating to cervical
cancer screening.
Section 231 extends the authorization of Small Business
Innovation Research pilot programs.
Section 232 provides authority to accept donations for the
care of unaccompanied alien children.
TITLE III--DEPARTMENT OF EDUCATION
Language is included under ``General Provisions'' allowing
ESEA funds consolidated for evaluation purposes to be available
from July 1, 2019 through September 30, 2020.
Language is included under ``General Provisions'' allowing
certain institutions to continue to use endowment income for
student scholarships.
Language is included under ``General Provisions'' extending
the authorization of the National Advisory Committee on
Institutional Quality and Integrity.
Language is included under ``General Provisions'' extending
the authority to provide account maintenance fees to guaranty
agencies for Federal student loans.
Lanuage is included under ``General Provisions'' permitting
the Department of Education to allow universities to service
Perkins Loan accounts.
TITLE IV--RELATED AGENCIES
Language is included under ``General Provisions''
instructing the Department of Education in matters related to
performance targets and performance bonuses for Office of
Federal Student Aid employees.
Language is included under ``Federal Mediation and
Conciliation Service--Salaries and Expenses'' providing that
fees charged for special training and other services and be
retained and used for authorized purposes, that fees for
arbitration services may only be used for training agency
personnel, and that the Director may accept gifts and services
in aid of any projects under the Director's jurisdiction.
Language is included under ``National Labor Relations
Board--Salaries and Expenses'' prohibiting the use of funds for
organizing or assisting in the organization of agricultural
workers or for investigations, hearings, directives, or orders
related to bargaining units of agricultural workers including
employees involved in the maintenance and operations of
ditches, canals, reservoirs and waterways for agricultural
purposes.
Language is included under ``National Labor Relations
Board--Administrative Provisions'' prohibiting the use of
electronic voting in representation elections.
Language is included under ``National Labor Relations
Board--Administrative Provisions'' prohibiting the application
of a new ``joint-employer'' standard.
Language is included under ``National Labor Relations
Board--Administrative Provisions'' prohibiting the exertion of
jurisdiction related to Indian Tribes.
Language is included under ``The Committee for Purchase
from People Who are Blind or Severely Disabled'' requiring that
written agreements, with certain oversight provisions, be in
place in order for authorized fees to be charged by certified
nonprofit agencies.
TITLE V--GENERAL PROVISIONS
Section 501 permits the Secretaries of Labor, Health and
Human Services, and Education to transfer unexpended balances
of prior appropriations to accounts corresponding to current
appropriations to be used for the same purpose and for the same
periods of time for which they were originally appropriated.
Section 502 prohibits the obligation of funds beyond the
current fiscal year unless expressly so provided.
Section 503 prohibits funds from being used to support or
defeat legislation.
Section 504 limits the amount available for official
reception and representation expenses for the Secretaries of
Labor and Education, the Director of the Federal Mediation and
Conciliation Service, and the Chairman of the National
Mediation Board.
Section 505 requires grantees receiving Federal funds to
clearly state the percentage of the total cost of the program
or project that will be financed with Federal money.
Section 506 prohibits the use of funds for any abortion.
Section 507 provides exceptions to section 506 and a
provision prohibiting funds from being made available to a
Federal agency or program, or to a State or local government,
if such agency, program or government discriminates against
institutional or individual health care entities because they
do not provide, pay for, provide coverage of, or refer for
abortions.
Section 508 prohibits use of funds for certain research
involving human embryos.
Section 509 prohibits use of funds for any activity that
promotes the legalization of any drug or substance included in
schedule I of the schedules of controlled substances.
Section 510 prohibits use of funds to promulgate or adopt
any final standard providing for a unique health identifier
until legislation is enacted specifically approving the
standard.
Section 511 prohibits funds to be obligated or expended on
a contract with an entity that has not submitted a report on
qualified veteran employees as required under 38 U.S.C.
4212(d).
Section 512 prohibits any transfer of funds made available
in this Act except by the authority provided in this Act or
another appropriation Act.
Section 513 limits funds in the bill for public libraries
to those that comply with the requirements of the Children's
Internet Protection Act.
Section 514 dictates the procedures for the reprogramming
of any funds provided in the bill.
Section 515 continues a provision pertaining to
appointments to federal scientific advisory committees to
prevent the disclosure of information like political
affiliation of candidates for appointment.
Section 516 requires each department and related agency
funded through this Act to submit an operating plan within 45
days of enactment, detailing any funding allocations that are
different than those specified in this Act, the accompanying
detailed table, or budget request.
Section 517 requires the Secretaries of Labor, Health and
Human Services, and Education to submit a quarterly report to
the Committees on Appropriations of the House of
Representatives and the Senate containing certain information
on noncompetitive contracts, grants, and cooperative agreements
exceeding $500,000 in value.
Section 518 prohibits use of funds to process claims for
credit for quarters of coverage based on work performed under a
Social Security number that was not the claimant's number,
where the performance of such work under such number has formed
the basis for a conviction of the claimant of a violation of
section 208(a)(6) or (7) of the Social Security Act.
Section 519 prohibits use of funds to implement a Social
Security totalization agreement with Mexico.
Section 520 prohibits federal funds for the purchase of
syringes or sterile needles, but allows communities with rapid
increases in cases of HIV and Hepatitis to access federal funds
for other activities, including substance use counseling and
treatment referrals.
Section 521 prohibits the use of funds for the downloading
or exchanging of pornography.
Section 522 prohibits funding from going to the Association
of Community Organizations for Reform Now (ACORN), or any of
its affiliates, subsidiaries, allied organizations, or
successors.
Section 523 directs certain reporting requirements for
conference expenditures.
Section 524 requires disclosure of U.S. taxpayer funding
for programs used in advertising.
Section 525 authorizes performance partnership pilots.
Section 526 requires quarterly reports on the status of
balances of appropriations from the Departments of Labor,
Health and Human Services and Education.
Section 527 prohibits the use of funds to implement,
administer, enforce or further the provisions of Public Law
111-148 and portions of Public Law 111-152 with certain
exceptions.
Section 528 prohibits the use of funds to implement,
administer, enforce or further advance the Navigators program.
Section 532 prohibits funds for research on fetal tissue
obtained from an induced abortion.
Section 533 restricts funding to certain health care
entities.
Section 536 clarifies standards related to family detention
centers.
Section 537 restricts funding to States related to certain
child welfare service providers.
Section 538 restricts the administration of medication to
unaccompanied alien children, unless certain health assessments
have been completed.
APPROPRIATIONS NOT AUTHORIZED BY LAW
Pursuant to clause 3(f)(1)(B) of rule XIII of the Rules of
the House of Representatives, the following table lists the
appropriations in the accompanying bill which are not
authorized by law for the period concerned (dollars in
thousands):
--------------------------------------------------------------------------------------------------------------------------------------------------------
Appropriations in Last Appropriations in this
Agency Program Last Year of Authorization Authorization Level Year of Authorization Bill
--------------------------------------------------------------------------------------------------------------------------------------------------------
DEPARTMENT OF LABOR ETA:
Reintegration of Ex-Offenders FY 2010..................... $20,000,000................ $15,000,000 $82,078,000
(transition activities authorized by
Second Chance Act, 2007).
VETERANS' EMPLOYMENT AND TRAINING SERVICE:
Homeless Veterans Program.............. FY 2018..................... 50,000,000................. 50,000,000 50,000,000
DEPARTMENT OF HEALTH AND HUMAN SERVICES:
HRSA:
Faculty Loan Repayment............. FY 2014..................... 5,000,000.................. 1,187,000 1,190,000
Scholarships for Disadvantaged FY 2014..................... Such Sums.................. 44,857,000 48,970,000
Students.
National Center for Workforce FY 2014..................... 7,500,000.................. 4,651,000 5,663,000
Analysis.
Primary Care Training and FY 2014..................... Such Sums.................. 38,831,000 48,924,000
Enhancement.
Oral Health Training Programs...... FY 2012..................... 25,000,000................. 31,928,000 40,673,000
Area Health Education Centers...... FY 2014..................... 125,000,000................ 30,250,000 38,250,000
Education & Training--Geriatrics:
(Workforce Development)............ FY 2014..................... 10,800,000................. 33,237,000 40,737,000
(Career Incentive Awards).......... FY 2013..................... 10,000,000................. ....................... .......................
Mental & Behavioral Health FY 2013..................... 35,000,000................. 7,896,000 107,416,000
Education.
Graduate Medical Education......... N/A......................... N/A........................ N/A 200,000,000
Nursing Education Loan Repayment... FY 2007..................... Such Sums.................. 31,055,000 87,135,000
Nurse Education, Practice, Quality FY 2012..................... Such Sums.................. 41,913,000 41,913,000
and Retention Program.
Nurse Education, Practice, FY 2014..................... Such Sums.................. 37,913,000 41,913,000
Retention, and Quality Grants.
Nurse Faculty Loan Program......... FY 2014..................... Such Sums.................. 24,500,000 28,500,000
Nursing Workforce Diversity........ ............................ Such Sums.................. ....................... 17,343,000
Sickle Cell........................ FY 2009..................... 10,000,000................. 4,455,000 4,455,000
Healthy Start...................... FY 2013..................... Formula.................... 100,746,000 110,500,000
Emergency Relief--Part A........... FY 2013..................... 789,471,000................ 649,373,000 655,876,000
Comprehensive Care--Part B......... FY 2013..................... 1,562,169,000.............. 1,314,446,000 1,315,005,000
Early Intervention--Part C......... FY 2013..................... 285,766,000................ 205,544,000 201,079,000
Coordinated Services and Access to FY 2013..................... 87,273,000................. 75,088,000 75,088,000
Research for Women, Infants,
Children and Youth--Part D.
Special Projects of National FY 2013..................... 25,000,000................. 25,000,000 25,000,000
Significance--Part F.
AIDS Education and Training FY 2013..................... 42,178,000................. 33,275,000 33,611,000
Centers--Part F.
Dental Reimbursement--Part F....... FY 2013..................... 15,802,000................. 12,991,000 13,122,000
Organ Transplantation.............. FY 1993..................... Such Sums.................. 2,767,000 25,549,000
Rural Health Outreach Grants....... FY 2012..................... 45,000,000................. 55,553,000 71,500,000
Rural Hospital Flexibility Grants.. FY 2012..................... Such Sums.................. 41,040,000 59,609,000
State Offices of Rural Health...... FY 2002..................... Such Sums.................. 4,000,000 11,000,000
Telehealth......................... FY 2006..................... Such Sums.................. 6,814,000 23,500,000
CDC:
Sexually Transmitted Diseases FY 1998..................... Such Sums.................. 113,671,000 157,310,000
Grants.
National Cancer Registries......... FY 2003..................... Such Sums.................. N/A 49,440,000
National Center for Health FY 2003..................... Such Sums.................. 125,899,000 160,397,000
Statistics.
WISEWOMEN.......................... FY 2003..................... Such Sums.................. 12,419,000 21,120,000
Asthma (Environmental)............. FY 2005..................... Such Sums.................. 32,422,000 29,000,000
Folic Acid......................... FY 2005..................... Such Sums.................. 2,188,000 3,150,000
Injury Prevention and Control...... FY 2005..................... Such Sums.................. 138,237,000 690,559,000
Oral Health Promotion.............. FY 2005..................... Such Sums.................. 11,204,000 22,000,000
Safe Motherhood/Infant Health FY 2005..................... Such Sums.................. 44,738,000 44,000,000
Promotion.
Grants to Promote Childhood FY 2005..................... Such Sums.................. 26,835,000 54,920,000
Nutrition and Physical Activity.
Screening, Referrals, and Education FY 2005..................... 40,000,000................. 36,474,000 35,000,000
Regarding Lead Poisoning.
Birth Defects, Developmental FY 2007..................... Such Sums.................. 122,242,000 150,560,000
Disability, Disability and Health.
Breast and Cervical Cancer......... FY 2012..................... 275,000,000................ 204,779,000 218,000,000
Johanna's Law...................... FY 2014..................... 18,000,000................. 4,972,000 7,000,000
Epidemiology Laboratory Capacity FY 2014..................... 190,000,000................ 32,424,000 40,000,000
Grants.
National TB Strategy/Grants........ FY 2013..................... 243,101,000................ 132,997,000 142,256,000
Public Health Workforce and Career FY 2013..................... 39,500,000................. 64,000,000 51,000,000
Development.
National Diabetes Prevention FY 2014..................... Such Sums.................. 10,000,000 26,800,000
Program.
Section 317 Immunization........... FY 2014..................... Such Sums.................. 610,847,000 620,847,000
Congenital Heart Disease Programs.. FY 2015..................... Such Sums.................. 4,000,000 4,000,000
SAMHSA:
State Opioid Response Grants....... N/A......................... N/A........................ N/A $1,000,000,000
AHRQ:
Research on Health Costs, Quality, FY 2005..................... Such Sums.................. 324,000,000 197,156,000
and Outcomes.
ACF:
Low Income Home Energy Assistance FY 2007..................... 5,100,000,000.............. 2,161,170,000 3,640,304,000
Program.
Children and Families Services
Programs:
Adoption and Legal Guardianship FY 2016..................... 43,000,000................. 37,943,000 80,000,000
Incentive Payments.
Native American Programs........... FY 2002..................... Such Sums.................. 45,826,000 55,050,000
Community Services Block Grant..... FY 2003..................... Such Sums.................. 645,762,000 750,000,000
Head Start......................... FY 2012..................... Such Sums.................. 7,968,544,000 9,963,095,000
Runaway and Homeless Youth Programs FY 2013..................... Such Sums.................. 107,852,000 104,280,000
CAPTA programs..................... FY 2015..................... Such Sums.................. 143,981,000 158,074,000
Family Violence Programs........... FY 2015..................... 178,500,000................ 139,500,000 169,250,000
Child Welfare Services............. FY 2016..................... 325,000,000................ 268,735,000 278,735,000
Refugee and Entrant Assistance:
Transitional and Medical Services.. FY 2002..................... Such Sums.................. 227,243,000 320,000,000
Social Services.................... FY 2002..................... Such Sums.................. 158,600,000 155,000,000
Preventive Health.................. FY 2002..................... Such Sums.................. 4,835,000 4,600,000
Targeted Assistance................ FY 2002..................... Such sums.................. 49,477,000 47,601,000
Victims of Torture................. FY 2007..................... 25,000,000................. 9,817,000 10,622,000
ACL:
Alzheimer's Diseases Demonstration. FY 2002..................... Such Sums.................. 11,483,000 23,500,000
Lifespan Respite Care.............. FY 2011..................... 94,810,000................. 2,495,000 4,110,000
State Health Insurance Assistance FY 1996..................... 10,000,000................. N/A 49,115,000
Program.
Developmental Disabilities......... FY 2007..................... Such Sums.................. 155,115,000 176,316,000
Voting Access for People with FY 2005..................... $17,410,000................ $13,879,000 6,963,000
Disabilities.
Elder Justice/ Adult Protective FY 2014..................... 129,000,000................ 0 15,874,000
Services.
Assistive Technology............... FY 2010..................... Such Sums.................. 25,000,000 36,000,000
PHSSEF:
National Disaster Medical System... FY 2018..................... 52,700,000................. 57,404,000 62,404,000
Medical Reserve Corps.............. FY 2018..................... 11,200,000................. 6,000,000 6,000,000
Hospital Preparedness Program...... FY 2018..................... 374,700,000................ 254,555,000 279,555,000
BARDA.............................. FY 2018..................... 415,000,000................ 536,700,000 586,700,000
Project BioShield.................. FY 2018..................... 2,800,000,000.............. 710,000,000 780,000,000
Strategic National Stockpile....... FY 2018..................... 533,800,000................ 610,000,000 710,000,000
DEPARTMENT OF EDUCATION:
National Technical Institute for FY 2014..................... Such Sums.................. 66,291,000 75,000,000
the Deaf.
Gallaudet University............... FY 2014..................... Such Sums.................. 119,000,000 134,361,000
Aid for Institutional Development.. FY 2014..................... Such Sums.................. 521,299,000 316,880,000
International Education And Foreign FY 2014..................... Such Sums.................. 72,164,000 72,164,000
Language.
Teacher Quality Partnerships....... FY 2011..................... Such Sums.................. 40,592,000 43,092,000
Federal TRIO Programs.............. FY 2014..................... Such Sums.................. 838,252,000 1,060,000,000
GEAR UP............................ FY 2014..................... Such Sums.................. 301,639,000 360,000,000
Child Care Access Means Parents in FY2014...................... Such Sums.................. 15,134,000 37,000,000
School.
Federal Work-Study Programs........ FY 2014..................... Such Sums.................. 974,728,000 1,130,000,000
Federal Supplemental Educational FY 2014..................... Such Sums.................. 733,130,000 840,000,000
Opportunity Grants.
Discretionary Federal Pell Grant... FY 2017..................... Such Sums.................. 22,475,352,000 22,475,352,000
IDEA National Activities........... FY 2010..................... Such Sums.................. 260,203,000 229,803,000
RELATED AGENCIES:
Corporation for Public Broadcasting FY 1996..................... 425,000,000................ 275,000,000 465,000,000
Corporation for National and FY 2014..................... Such Sums.................. 1,049,954,000 767,629,000
Community Service.
Institute of Museum and Library FY 2016..................... Such Sums.................. 274,840,000 240,000,000
Services.
--------------------------------------------------------------------------------------------------------------------------------------------------------
PROGRAM DUPLICATION
Pursuant to section 3(j)(2) of H. Res. 5 (115th Congress),
no provision of this bill establishes or reauthorizes a program
of the Federal Government known to be duplicative of another
Federal program, a program that was included in any report from
the Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
DIRECTED RULE MAKING
The bill does not direct any rule making.
COMPARISON WITH THE BUDGET RESOLUTION
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and Section 308(a)(1)(A) of the
Congressional Budget Act of 1974, the following table compares
the levels of new budget authority provided in the bill with
the appropriate allocations under section 302(b) of the Budget
Act:
[In millions of dollars]
----------------------------------------------------------------------------------------------------------------
302(b) Allocation This Bill
---------------------------------------------------
Budget Budget
Authority Outlays Authority Outlays
----------------------------------------------------------------------------------------------------------------
Discretionary............................................... $177,100 $185,655 $177,105 \1\$182,541
Mandatory................................................... 783,118 782,757 783,118 \1\778,222
----------------------------------------------------------------------------------------------------------------
\1\Includes outlays from prior-year budget authority
FIVE-YEAR OUTLAY PROJECTIONS
Pursuant to section 308(a)(1)(B) of the Congressional
Budget Act of 1974, the following table contains five-year
projections prepared by the Congressional Budget Office of
outlays associated with the budget authority provided in the
accompanying bill:
[In millions of dollars]
Projection of outlays associated with the
recommendation:
2019.............................................. \1\$858,012
2020.............................................. 101,295
2021.............................................. 27,721
2022.............................................. 4,507
2023 and future years............................. 1,057
\1\Excludes outlays from prior-year budget authority.
ASSISTANCE TO STATE AND LOCAL GOVERNMENTS
Pursuant to section 308(a)(1)(C) of the Congressional
Budget Act of 1974, the amounts of financial assistance to
State and local governments is as follows:
[In millions of dollars]
New Budget Authority.................................. $481,368
Fiscal year 2019 outlays resulting therefrom.......... \1\434,643
\1\Excludes outlays from prior-year budget authority.
MINORITY VIEWS
We would like to acknowledge the efforts of Chairman
Frelinghuysen and Chairman Cole to hold a full committee markup
of the Labor-HHS-Education bill for the fourth year in a row.
It is important for the full committee to debate this bill in
public every year.
We are disappointed, however, that the Majority introduced
and passed on a party-line vote a partisan bill that fails to
build on last year's investments. In addition to shortchanging
important programs, this bill once again pushes a dangerous and
harmful agenda to sabotage access to affordable health
insurance and eliminate access to critical health care services
for millions of low-income women.
The Labor-HHS-Education bill supports some of the Nation's
most critical programs, which touch individuals and families
throughout their lifespan, from Early Head Start to Social
Security. The bill supports NIH research, CDC public health
infrastructure, Community Health Centers, and Meals on Wheels.
It helps students go to college with Pell Grants and Work
Study. It helps unemployed workers get access to job training
and ensures the American workforce is not exposed to unsafe or
unhealthy working conditions. The Labor-HHS-Education bill
provides every American with a better chance at a better life--
with a good education, a good job, and access to affordable
health care.
That is why we were so proud of what we all accomplished in
March, when we passed a great fiscal year 2018 Labor-HHS-
Education bill. Members on both sides of the aisle were
justifiably proud. We made many good investments--in biomedical
research, opioid treatment, public health, child care and early
education, postsecondary education, and more. Our colleagues on
the Committee--both Democrats and Republicans--took credit for
those investments. And we should. It was a great bill.
So, we must ask: why not do that again?
As we all know, there is an additional $18 billion of non-
defense discretionary funding for fiscal year 2019. Labor-HHS-
Education is nearly one-third of non-defense discretionary
spending. So, proportionally, the Labor-HHS-Education bill
should see an increase of $5.5 billion. Instead, it receives no
increase at all.
If the Labor-HHS-Education bill received a fair allocation,
we could reach more kids through Head Start. We could help make
college more affordable for students and families with
increased financial aid. We could expand job training and
worker protections.
But sadly, this bill does none of those things.
Moreover, this bill takes only modest steps to address the
humanitarian crisis created by the Trump Administration's Zero
Tolerance policy. The Administration's policy rendered
approximately 2,500 children (and as many as 3,000) as
``unaccompanied''--including more than 100 kids younger than
five years old--and placed them in HHS custody. But even now,
they do not have a clear plan for reunification, or even an
understanding of the path forward. There is no plan. There
never was a plan.
Despite sending a letter to Office of Management and Budget
(OMB) Director Mick Mulvaney and HHS Secretary Alex Azar,
requesting information about the rapidly spiraling costs of the
White House's disastrous policy, the Administration has chosen
not to respond. We have also requested that the Committee hold
oversight hearings. Again, no response.
That is why House Democrats introduced nearly 20 amendments
related to addressing the effects of the Trump Administration's
cruel family separation policy and ensuring proper oversight of
the conditions in which children are being held in custody by
HHS's Office of Refugee Resettlement. We are very pleased the
Majority joined us in agreeing to 12 of those amendments--it is
a positive sign that the Committee is willing to rebuke the
White House on a bipartisan basis and begin to exercise some of
its oversight responsibilities.
Despite these successes, however, House Republicans
severely worsened the humanitarian situation for immigrant
children. The Majority voted to authorize the prolonged and
indefinite detention of families with children and override the
Flores settlement agreement that governs the conditions of
detention for children, including that facilities be safe,
sanitary, and appropriate for children. We strongly oppose this
radical policy.
More broadly, the Labor-HHS-Education bill passed by the
majority shortchanges American families and the problems they
face.
This bill fails to address the rising cost of health care.
Instead, it cuts Medicare and Medicaid operations by almost
half a billion dollars, breaking our promise to seniors. This
follows the Majority's corporate tax cut bill, which continues
to be a dream for the wealthiest and a nightmare for the rest.
We should not be cutting from Medicare or Medicaid while
offering trillions in tax giveaways to corporations and wealthy
families.
This bill also furthers the Majority's attempt to
eviscerate the Affordable Care Act. The Majority recently
endorsed a move by the Trump Administration to once again allow
private insurance companies to discriminate against Americans
with pre-existing conditions. We would note that Republicans
are now breaking their promise to protect Americans with pre-
existing conditions from being denied insurance or being
charged exorbitant premiums.
This bill fails to fund research into firearm injury
prevention. In 2016, the most recent year with CDC data, there
were approximately 38,000 firearm-related deaths; more than
81,000 people went to the emergency room to be treated for
firearm injuries. And yet, the Majority continues to block
research that could save thousands of lives every year.
The bill also fails to address stagnant wages or
insufficient worker protections and training. Instead, it cuts
$289 million from the Department of Labor, including a
rescission of $200 million from Dislocated Worker job training.
And it cuts funding for the Wage and Hour Division, the Office
of Federal Contract Compliance, and the Occupational Safety and
Health Administration.
Of course, there are some bright spots in this bill. We
strongly support increases for NIH research, CDC public health
programs, substance abuse prevention and treatment programs,
emergency preparedness, the Community Services Block Grant, the
Student Support and Academic Enrichment program, career and
technical education, as well as TRIO and GEAR UP.
But even those increases show the fundamental insufficiency
of the subcommittee's allocation: more than 20 of NIH's
Institutes and Centers would receive an increase of only 1.2
percent, which is less than inflation, and the increase for
SAMHSA's Substance Abuse Prevention and Treatment Block Grant
merely offsets the loss of $500 million made available in prior
years by the 21st Century Cures Act.
We also note and appreciate the comprehensive nature of the
committee report accompanying the bill, which reflects a
substantial number of requests from both Republicans and
Democrats.
Unfortunately, the positive elements of this bill are
undermined by the Majority's decision to shortchange critical
priorities in health care, education, job training, and worker
protection, as well as sabotage access to affordable health
insurance.
We offered nearly 50 amendments to remedy these shortfalls
and eliminate unnecessary policy riders, but most of our
amendments were rejected.
AFFORDABLE CARE ACT
This bill reduces access to affordable health care by
cutting the Centers for Medicare and Medicaid Services (CMS)
operating budget by nearly half a billion dollars, in a
misguided attempt to sabotage the Affordable Care Act's health
insurance marketplace. It is irresponsible for the Majority to
continue to push its plan to take away health insurance from
more than 30 million Americans and to support the
Administration's efforts to eliminate protections for people
with pre-existing conditions.
We proposed an amendment to restore funds to CMS's
operating budget, which would ensure ongoing support for 12
million people who receive their health insurance coverage
through the ACA marketplace. Unfortunately, the majority
rejected the amendment.
We also proposed amendments to protect access to affordable
health insurance against attacks by the Trump Administration:
first, we proposed an amendment to prevent the Administration
from filing legal motions in federal court against the
Affordable Care Act; and second, we proposed an amendment to
direct the Secretary of Health and Human Services to make
required payments under the Risk Adjustment program, which
shift funds to insurers that cover patients with the highest
medical costs and come at no cost to American taxpayers. Again,
the majority rejected the amendments.
WOMEN'S HEALTH
The bill also hurts women's health by pushing a dangerous
and harmful ideological agenda. It eliminates funding for Title
X Family Planning and the Teen Pregnancy Prevention program--a
combined elimination of about $400 million to reproductive
health services for women--and includes an ideological rider
that would block all federal funding for Planned Parenthood,
which is the preferred health care provider for 2.5 million
patients annually, including many low-income women with few
health care alternatives. At the same time, the bill includes
additional funding for abstinence-only programs, which studies
show do not work.
We proposed amendments to restore funding for Title X
Family Planning and the Teen Pregnancy Prevention program. In
addition, we offered an amendment to strike the rider against
Planned Parenthood. To our disappointment, the majority
rejected our efforts to restore funds for reproductive health
and retained their misguided anti-Planned Parenthood rider that
does not belong in this bill.
CHILDREN FORCIBLY SEPARATED FROM THEIR PARENTS
As we noted above, this bill takes small steps toward
holding the Administration accountable for its unconscionable
and reckless policy of separating children from their families
at the border. The White House has implemented this policy with
callous disregard for the truth, making up its own version of
the law and history to fit its false narrative.
We proposed a series of amendments to expedite
reunification of children with their families, improve the care
of children in HHS custody, and require significant
congressional oversight of the Administration going forward. We
were pleased that the Majority agreed to adopt Democratic
amendments to:
1. Demand the Secretary of HHS report to Congress on a plan
to swiftly reunify separated families and rescind funds from
the Secretary if the plan is not submitted by August 1;
2. Ensure that siblings who have been separated from their
parents are kept together;
3. Prevent the forced medication of separated children
without a medical assessment, including a trauma assessment;
4. Express the sense of Congress that families should not
be separated and that families should be reunited immediately;
5. Require an HHS Inspector General report on the
implementation of the family separation policy, the Executive
Order ending the policy, and ongoing family reunification
efforts;
6. Reaffirm HHS's statutory and court-ordered
responsibilities about the care of unaccompanied children;
7. Fund mental health services for children separated from
their parents;
8. Prohibit the Office of Refugee Resettlement (ORR) and
its contractors from asking questions about religion or
religious practices for purposes of family reunification;
9. Require a report on the number of pre-literate children
in ORR's custody, a list of languages spoken by those children,
the number of translators needed for each language, and any
additional resources needed to ensure that children are able to
communicate with staff;
10. Direct ORR to ensure protection of genetic material and
other personal data and prohibit use for criminal or
immigration enforcement;
11. Require a report on guidance from ORR to shelters about
the mental health needs of children separated from their
parents, treatment resources available to them, and the average
length of stay for separated children; and
12. Require a monthly report on the number of separated
children and additional details, including a plan for children
and parents to remain in contact and be reunified.
Unfortunately, the Majority rejected additional amendments
to:
1. Require the Administration to comply with court orders
mandating reunification of children separated from their
parents;
2. Prohibit HHS from sharing personally identifiable
information of a sponsor or potential sponsor of an
unaccompanied child with the Department of Homeland Security
for immigration enforcement purposes;
3. Provide $30 million to create a Family Case Management
program as a less costly alternative to detention for asylum
seekers; and
4. Prohibit additional large-scale institutional shelter
facilities for unaccompanied children or tent cities, and
prioritize community-based residential placements.
And despite improving the bill significantly by adopting 12
Democratic amendments, we are dismayed that the Majority chose
to countermand those improvements by adopting a partisan
amendment to allow the Department of Homeland Security to hold
immigrant children in unlicensed family detention facilities
for prolonged periods of time. We do not believe that
indefinite detention of children is in the spirit of our
country's values.
WORKERS
This bill hurts workers by rescinding $200 million in
advance funding for Dislocated Worker job training, as well as
cutting $81 million from the Employment Service, which helps
millions of unemployed workers find jobs through the American
Job Center network. It strips language included since fiscal
year 2016 that supports the bipartisan and successful
registered apprenticeship program to help ensure workers have
an industry-recognized credential, which benefits workers and
employers alike.
We proposed an amendment to restore funding for job
training programs and the Employment Service, and an amendment
to ensure that funding for apprenticeships continues to focus
on high-quality registered apprenticeships instead of
potentially low-quality programs that would not be portable or
lead to higher wages. Unfortunately, while one member of the
majority joined our effort to preserve the registered
apprenticeship model, both amendments were defeated.
Moreover, this bill does nothing to boost wages for current
workers. Despite 75 straight months of strong job growth under
President Obama, which has continued under President Trump,
those job gains are not translating into higher wages for most
workers.
We proposed an amendment to gradually increase the federal
minimum wage to $15 per hour by 2025, which would ensure that
broad economic gains also accrue to the benefit of low-wage
workers. And we proposed an amendment to boost funding for the
Department of Labor's Wage and Hour Division to reduce wage
theft from the paychecks of low-wage workers. Once again, the
majority opposed our amendments.
STUDENTS
We are deeply disappointed that the bill fails to make
additional investments in Title I, which reaches 25 million
students in more than 80 percent of our school districts, and
the 21st Century Community Learning Centers program, which
provides before- and after-school and summer school programs to
nearly 2 million students.
Despite the mountain of evidence that early childhood
interventions work to reduce inequality and narrow achievement
gaps, the bill provides level funding for Preschool Development
Grants and Child Care and only a nominal increase for Head
Start, meaning we will continue to fall behind in providing
children and families with high-quality early education
opportunities and care.
In addition, this bill hurts professionals who committed to
public service by eliminating the discretionary relief fund
created on a bipartisan basis in 2018 to help correct a flaw in
the mandatory Public Service Loan Forgiveness program that has
caused teachers and other intended beneficiaries to be
ineligible for loan forgiveness. And the bill once again
eliminates funding for the Special Olympics program, which
helps support activities to increase the participation of
individuals with intellectual disabilities in the youth sports
demonstration and education program.
We proposed an amendment to increase the maximum Pell Grant
by $135 to help keep up with inflation. Our Republican
colleagues rejected our effort to help make college more
affordable by voting against the amendment.
To help protect students and taxpayer dollars, we proposed
an amendment to block funding to recognize a failing for-profit
college accreditor. While the amendment attracted some
bipartisan support, the majority ultimately defeated it. We
also proposed language that would have forced the Secretary of
Education to withdraw her misguided interpretation that seeks
to block States from enforcing their consumer protection laws
that help borrowers repaying their loans. Unfortunately, the
amendment was defeated by the majority.
A bright spot in the bill, however, is the elimination of
two-longstanding riders that have been carried since at least
1974 regarding the use of funds for transportation to overcome
racial imbalance or to carry out a plan of racial
desegregation. We proposed the elimination of these riders
during fiscal year 2018 conference negotiations, in addition to
similar language in the General Education Provisions Act. We
hope to work together to ensure that all education funding can
be used for transportation and transportation-related
activities if authorized by the Elementary and Secondary
Education Act.
SENIORS
This bill hurts seniors who rely on Medicare and Social
Security. In addition to cutting nearly $500 million from CMS
Program Management, which would undermine Medicare services,
this bill also cuts the Social Security Administration's (SSA)
operating budget by $318 million. As millions of seniors retire
every year, we should be investing in SSA's services instead of
cutting them. This bill would force SSA to continue to close
field offices and it would further exacerbate long waiting
times and busy signals on Social Security's toll-free phone
line.
PARTISAN POLICY RIDERS
In addition to riders that would limit a woman's access to
health care, this bill attempts to block all funding for the
Affordable Care Act. It also blocks funding for important fetal
tissue research and adds an entire authorizing bill that would
hurt a patient's ability to receive potentially life-saving
health care services.
It even includes a new rider on behalf of Monsanto, the
former agribusiness company. The Monsanto Rider would block
funding for the World Health Organization's cancer agency the
International Agency for Research on Cancer (IARC). The IARC
released a report which found that the chemical glyphosate in
some of Monsanto's most popular products is a probable
carcinogen. By blocking NIH from funding the IARC's research,
it appears the Majority is putting Monsanto's interests ahead
of public health.
While the Senate is passing bipartisan bills and avoiding
poison pill riders, the House majority continues to include
provisions that have no chance of enactment.
We proposed amendments to eliminate each of these
ideological riders; unfortunately, the majority rejected each
amendment.
To make matters worse, however, the Majority adopted a new
amendment that inserts bigotry and discrimination into our bill
by allowing child welfare organizations, including adoption and
foster care providers, to make child placement determinations
based on their ``religious beliefs or moral convictions,''
regardless of the needs of the child. Simply put, it would
allow adoption and foster care agencies to discriminate against
and turn away qualified LGBTQ couples who are looking to
adopt--based on the couple's sexual orientation.
CONCLUSION
This bill is filled with misplaced priorities and missed
opportunities, and it stands in stark contrast to the
bipartisan Labor-HHS-Education bill included in the fiscal year
2018 Omnibus.
The funding in this bill fails to meet our country's needs
and breaks our promises to students, seniors, women, families,
and workers. It does not reflect our values of putting the
middle class and the vulnerable first; instead, it benefits
those with the most money and the most lobbyists.
We hope our colleagues on the other side of the aisle will
work with Democrats during the conference process to fix the
many inadequacies in this bill. At that point, we look forward
to working with Chairman Frelinghuysen and Chairman Cole to
move forward on a bill we can all support.
Nita M. Lowey.
Rosa L. DeLauro.