c
2006
109TH CONGRESS 2D SESSION
Report
HOUSE OF REPRESENTATIVES
Report
[Graphic image not available]
June 20, 2006- Committed to the Committee of the Whole House on the State of the Union and ordered to be printed
c 28-324
2006
109TH CONGRESS 2D SESSION
Report
HOUSE OF REPRESENTATIVES
Report
[Graphic image not available]
June 20, 2006- Committed to the Committee of the Whole House on the State of the Union and ordered to be printed
2d Session
109-515
--DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS BILL, 2007
[To accompany H.R. 5647]
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 and the Indian Health Service), and Education, 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, Medicare Payment Advisory Commission, National Commission on Libraries and Information Science, National Council on Disability, National Labor Relations Board, National Mediation Board, Occupational Safety and Health Review Commission, Railroad Retirement Board, and the Social Security Administration for the fiscal year ending September 30, 2007, and for other purposes.
SUMMARY OF ESTIMATES AND APPROPRIATIONS
The following table compares on a summary basis the appropriations including trust funds for fiscal year 2006, the budget request for fiscal year 2007 and the Committee recommendation for fiscal year 2007 in the accompanying bill.
2007 LABOR, HHS, EDUCATION APPROPRIATIONS BILL
[In millions of dollars]
-------------------------------------------------------------------------------------------------------------------------------
Fiscal year-- 2007 committee compared to--
2006 adjusted 2007 budget 2007 committee 2006 adjusted 2007 budget
-------------------------------------------------------------------------------------------------------------------------------
Department of Labor $14,531 $14,080 $14,605 +$74 +$525
Advances 2,537 2,531 2,481 -56 -50
Department of Health and Human Services 475,252 473,290 475,117 -135 +1,827
Advances 67,103 69,456 69,456 +2,353 0
Department of Education 62,962 57,168 58,536 -4,426 +1,368
Advances 15,034 15,034 15,484 +450 +450
Related Agencies 48,933 48,897 48,685 -248 -212
Advances 11,510 16,810 16,810 +5,300 0
Grand Total, current year 601,678 593,435 596,943 -4,735 +3,508
Advances 96,184 103,831 104,231 +8,047 +400
Current year total using 302(b) scorekeeping 601,398 592,485 596,502 -4,896 +4,017
Mandatory 460,310 454,691 454,572 -5,738 -119
Discretionary 141,088 137,794 141,930 +842 +4,136
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PROGRAM LEVEL DISCRETIONARY
[In millions of dollars]
--------------------------------------------------------------------------------------------------------------------------
Fiscal year-- 2007 committee compared to--
2006 adjusted 2007 budget 2007 committee 2006 adjusted 2007 budget
--------------------------------------------------------------------------------------------------------------------------
Department of Labor $11,534 $10,983 $11,458 -$76 $475
Department of Health and Human Services 62,698 61,793 63,738 +1,040 +1,945
Department of Education 55,953 54,331 56,149 +196 +1,818
Related Agencies 11,346 11,638 11,426 +80 -212
Subtotal Program Level $141,531 $138,745 $142,771 +$1,240 +$4,026
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GENERAL SUMMARY OF THE BILL
Funding levels in the fiscal year 2007 appropriation bill for the Departments of Labor, Health and Human Services, Education and Related Agencies reflect the Committee's attempt to establish priorities within the very stringent limitations. This year the Committee has made a special effort to increase funding for programs that help low and moderate income people and represent a core Federal responsibility. For example, within the allocation, major increases over 2006 or the Budget Request for 2007 are being provided for Pell Grants, vocational education, special education, community health centers and immunization programs.
Bill total.--Total funding, including offsets, for fiscal year 2007 in the Departments of Labor, Health and Human Services, Education and Related Agencies Appropriations Act, 2007 is $596,502,468,000.
Discretionary programs.--For Discretionary accounts for 2007 the bill provides $141,930,000,000, including offsets. This is $842,180,000 above the fiscal year 2006 comparable level.
Mandatory programs.--The bill provides $454,572,468,000 for entitlement programs in fiscal year 2007. This is $5,737,076,000 below the fiscal year 2006 comparable level. Funding requirements for entitlement programs are determined by the basic authorizing statutes. Mandatory programs include general fund support for the Medicare and Medicaid programs, Supplemental Security Income, Trade Adjustment Assistance and Black Lung payments. The following chart indicates the funding levels for the major mandatory programs in fiscal years 2006 and 2007.
MANDATORY
[Dollars in thousands]
------------------------------------------------------------------------------------------------------
Program Fiscal Year 2006 Fiscal Year 2007 Change
------------------------------------------------------------------------------------------------------
Department of Labor:
Federal Unemployment Benefits and Allowances $966,400 $938,600 -$27,800
Advances to the UI and other trust funds 465,000 452,000 -13,000
Special Benefits 237,000 230,000 -7,000
Special Benefits for Disabled Coal Miners 232,250 229,373 -2,877
Energy Employees Occupational Illness Compensation Fund 96,081 102,307 +6,226
Black Lung Disability Trust Fund 1,068,000 1,071,000 +3,000
Department of Health and Human Services:
Vaccine Injury Compensation Trust Fund 60,972 62,802 +1,830
Medicaid current law benefits 204,166,276 189,499,928 -14,666,348
Medicaid State and local administration 9,803,100 9,349,700 -453,400
CMS Vaccines for Children 1,502,333 2,006,445 +504,112
Medicare Payments to Healthcare Trust Funds 178,647,200 197,017,391 +18,370,191
Welfare Payments 39,000 39,300 +300
Child Support Enforcement 4,079,494 4,076,162 -3,332
Social Services Block Grant 1,700,000 1,700,000 0
Promoting Safe and Stable Families 305,000 345,000 +40,000
Payments to States for Foster Care and Adoption 4,940,800 5,211,000 +270,200
Medical Benefits for Commissioned Officers 328,552 341,694 +13,142
Department of Education:
Vocational Rehabilitation 2,720,192 2,837,160 +116,968
Pell Grant Shortfall Payoff 4,300,000 0 -4,300,000
Related Agencies:
Payments to Social Security Trust Funds 20,470 27,756 +7,286
Supplemental Security Income 37,566,174 37,231,000 -335,174
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COMPARISONS
Unless otherwise specified, the descriptions that follow highlight the program content and the significant differences that are occurring in 2007 compared to the 2006 enacted levels (including the across the board reduction enacted subsequent to the enactment of the 2006 appropriations acts.) One time supplementals are not included for purposes of comparison since as one-time appropriations there is no assumption that funds would be included in baseline funding for those programs. Nevertheless, comparisons to other benchmarks can be found in the table at the back of this report as well as in separately issued tables or analyses that the Committee may issue in the future.
OPERATING PLAN
The table at the end of this report also provides further details concerning the distribution of funds among activities and sub-activities that are recommended in this Act.
Unless specified otherwise in the bill or this accompanying report, the amounts included in the budget request shall be the amounts provided for fiscal year 2007. Within 45 days of enactment each Department and related Agency funded by this Act shall submit an operating plan to the Committees on Appropriations in the House and the Senate for approval. The operating plan should detail any reprogramming requests which are based on information obtained since the submission of the Budget in February 2006 or based on the effects of the amounts provided in this Act.
PROGRAM ASSESSMENT RATING TOOLS (PART)
A general provision is included in this Act to increase the role of the Congress in the Administration's PART studies, which have increasingly become the basis for individual budget requests and legislative proposals that consolidate and reduce program levels.
Unless specifically exempted, no funds are provided in this Act to conduct or participate in the conduct of a PART analysis or study unless the Committees on Appropriations of the House and Senate have approved of the study, inclusive of the data on which the analysis will be based, the methodology to be employed and the relative weight of each of the four factors that will be assigned to the study in determining a final score.
E-GOV INITIATIVE (E-GOV)
Language is included as a general provision to this Act precluding the use or transfer of funds provided in this Act to implement the Government-wide `E-Gov Initiative' unless a reprogramming request is included in the initial or an amended operating plan. The Committee has become increasingly concerned over the failure of this initiative to produce meaningful results, the huge reported costs of implementation and the resulting delay or loss of important information technology investments that were requested and approved by the Congress. The Committee is also concerned about the large number of complaints it has received from career program managers who have been forced to transfer funds, shut down innovative and creative web sites and delay the development of critical technology because they have had to conform to inferior Agency-wide Web sites or transfer funds to the Departmental Chief Information Officers (CIO) for subsequent transfer to other Departments or Agencies with lead responsibility for a specific E-Gov initiatives. The amounts being assessed on program offices appear to have no relationship to the benefits that are returned to the assessed programs. Further, claimed savings associated with the `E-Gov Initiative' can not be verified. Previous attempts by the Committee to ensure that the initiative would not impede the development of critical technology and the continuation of valuable, innovative or creative web sites have been ignored. In fact, new initiatives have been introduced which means higher assessments on the programs in the future.
Therefore, concurrent with the submission of any request to reprogram or transfer funds in this Act for any purpose relating directly or indirectly to the `E-Gov Initiative,' the lead career executive in the program or office being assessed must submit a certification that: (1) states and attests to the accuracy of previously estimated savings the Department assumed to be associated with the `E-Gov Initiative' and (2) certifies that the benefits to the program or office that would be derived from the proposed transfer exceed the benefits to the program or office from the use of funds for the purposes for which funds were originally appropriated. Failure to submit this certification will automatically result in a denial of the request.
TITLE I--DEPARTMENT OF LABOR
EMPLOYMENT AND TRAINING ADMINISTRATION
TRAINING AND EMPLOYMENT SERVICES
(INCLUDING RESCISSION)
The Committee recommends $4,966,899,000 for this account, which provides funding authorized primarily by the Workforce Investment Act of 1998 (WIA). This is $150,567,000 below the fiscal year 2006 level ($121,679,000 below the 2006 level adjusted for the change in Job Corps funding) and $554,494,000 above the budget request.
The Training and Employment Services account is comprised of programs that enhance the employment and earnings of those in need of such services, operated through a decentralized system of skill training and related services. The account is mostly forward-funded on a July to June cycle, with funds provided for fiscal year 2007 supporting the effort from July 1, 2007 through June 30, 2008.
The Committee directs that the Department take no action to amend, through regulatory or other administrative action, the definition established in 20 CFR 667.220 for functions and activities under title I of the Workforce Investment Act until April 1, 2007, until such time as legislation reauthorizing the Act is enacted or until the Department reaches agreement with the Workforce and Education and Health, Education, Labor, and Pension Committees, whichever occurs first. Recent reports of significant abuses of administrative costs by local Worker Investment Board has prompted Congress to take immediate action but also highlights the importance of enacting permanent legislation.
Based on an analysis of funding cycles, the Committee established that there remain unexpended balances in many of the local entities which implement workforce training and employment activities. A summary of this analysis follows:
STATE FORMULA SPENDING--WIA YOUTH, ADULTS AND DISLOCATED WORKERS PROGRAMS TOTAL--PROGRAM YEARS 2000-2007
[dollars in thousands]
--------------------------------------------------------------------------------------------------------
Program Year Period Unexpended carry-in New funding Total available Expenditures Expended(%) Unexpended
--------------------------------------------------------------------------------------------------------
PY 2000 $826,788* $3,194,735 $4,021,524 $2,283,197 56.8 $1,738,327
PY 2001 1,755,277 3,209,861 4,965,138 3,236,579 65.2 1,728,559
PY 2002 1,706,193 3,276,241 4,982,434 3,565,273 71.6 1,417,161
PY 2003 1,405,153 3,013,751 4,418,904 3,221,451 72.9 1,197,453
PY 2004 1,178,102 3,034,746 4,212,848 3,069,784 72.9 1,143,064
PY 2005 1,133,865 3,038,371 4,172,237 3,030,105 72.6 1,142,132
PY 2006 (est) 1,132,428 2,975,891 4,108,319 2,976,106 72.4 1,132,213
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As a result, prior year balances are being partially reduced through a rescission of $325,000,000. This analysis supports the Department's testimony over the past two years concerning unspent balances. However, unexpended balances have dropped some and many states are using unspent funds toward implementing other training programs and initiatives. Therefore, prior year balances are being partially reduced through a one time rescission of $325,000,000 instead of the full amount of anticipated unexpended balances. The Department is instructed to ensure that reductions are assigned to entities that have the greatest excess balances, to the maximum extent possible. Of greatest concern to the Committee is the lapsing of funds in each of the past five years. Funds not expended in the allowable time could have been recaptured and applied to other urgent needs in this or other Titles in this Act.
Therefore, the Department's central Budget Office is further directed to establish a methodology using quarterly reports and end of year audited statements to more intensely monitor the expenditure of obligations by the State and local funding recipients and report those findings for the latest program year, for each formula grant, to the Committees on Appropriations in the House and Senate. This information should be included as part of the 2008 congressional budget submission. In addition, the Department's central budget office shall provide the Committees with a detailed description of the funds that have been reallocated between states by the Secretary and between programs within states for fiscal year 2006.
There is evidence that the `core' funded activities of the Adult, Dislocated and Youth programs overlap with the similar core activities funded by the Employment Services account, with both WIA and ES funds often distributed to the same local entities, and providing the same services. This diminishes the overall effectiveness of the two programs and wastes scarce dollars. The Department is instructed to establish detailed funding criteria for all local entities receiving funds from both the WIA and Employment Services accounts that, to the maximum extent possible, ensures that overlap of core activities is reduced. The Employment Services Account should be the primary sponsor of core activities and the WIA account should be the primary source of more intensive services required by Adult, Dislocated and Youth individuals that are not able to secure employment through core services. The Department should incorporate these criteria into each local entity plan and closely monitor their implementation.
Adult employment and training activities
For adult employment and training activities, the Committee recommends $854,000,000. This is $10,199,000 below the fiscal year 2006 level and $142,000,000 above the budget request. Of the amount recommended $712,000,000 will become available on October 1, 2007. This program is authorized by the Workforce Investment Act of 1998. The funds are allocated by formula to States and further distributed to local workforce investment boards. Services for adults will be provided through the One-Stop Centers system and most customers receiving training use their individual training accounts to determine which programs and providers fit their needs. The Act authorizes core services available to all adults with no eligibility requirements, and intensive services for unemployed individuals who are not able to find jobs through core services alone.
Dislocated worker employment and training activities
For dislocated worker employment and training activities, the Committee recommends $1,476,064,000. This is $4,161,000 above the 2006 level and $361,482,000 above the budget request. Of the amount recommended, $1,060,000,000 will become available on October 1, 2007. Of the total, $1,193,264,000 is designated for State formula grants that support core services, intensive services, training, and supportive services. In addition, States use these funds for rapid response assistance to help workers affected by mass layoffs and plant closures.
The Committee recommendation includes $282,800,000 for the National Reserve, which supports National Emergency Grants to respond to mass layoffs, plant and/or military base closings, and natural disasters across the country, which cannot be otherwise anticipated, as well as technical assistance and training and demonstration projects.
Although the Committee is not in agreement with the separate request for a $150,000,000 Community College Initiative, it is not opposed to the use of community colleges for workforce training per se. However, the Committee remains concerned about the role and use of the One-Stop Centers in the initiative. The Committee does not agree with a shift in approach to worker training at this time but instead directs that the Department may use up to $125,000,000 of funds made available in the National Reserve for competitive grants to community colleges for dislocated worker training. This repeats the Committee's recommendation in fiscal year 2006. Again in 2007, the Committee directs that future solicitations for grant applications for the Community Based Job Training initiative include One-Stop Career Centers as an eligible applicant and that all applicants describe the relationship of One-Stop-Centers in their applications.
Even so, the Committee remains concerned about the use of initiative grant funding for community college capacity building instead of training. This is a departure from traditional Department of Labor grant programs. Therefore, the Department is instructed to give highest priority to grant applications that will train workers with skills needed to operate, maintain, and troubleshoot complex integrated technologies and to monitor the expenditure of funds for capacity building and training and report these findings to the Committees on Appropriations in the House and Senate by March 31, 2007. The Committee further directs the Department to utilize existing curricula developed by previously funded initiatives.
Youth employment and training activities
For youth activities, the Committee recommends $935,500,000. This is $5,000,000 below the fiscal year 2006 level and $95,000,000 above the budget request.
The Workforce Investment Act of 1998 consolidated the Summer Youth Employment and Training Program and Youth Training Grants under the Job Training Partnership Act into a single youth training activity. The funds are allocated by formula to states and further distributed to local workforce investment boards in accordance with the Workforce Investment Act of 1988.
For the second straight year the budget request proposes funding in Labor under proposed legislation. To avoid the possibility that the Youthbuild program will not receive funding for fiscal year 2007, the Committee recommendation requires that within the amount made available for youth activities up to $50,000,000 may be dedicated toward the Youthbuild Program, the specific amount to be determined by the Department, and dependent on when the program is authorized for transfer from HUD to Labor. However, the provision requires that all funds shall revert to the Youth formula grant program if the program is not authorized for transfer by April 1, 2007.
Job Corps
The Job Corps, authorized by the Workforce Investment Act of 1998, is a nationwide network of residential facilities chartered by Federal law to provide a comprehensive and intensive array of training, job placement and support services to at-risk young adults. The mission of Job Corps is to attract eligible young adults, teach them the skills they need to become employable and independent, and place them in meaningful jobs or further education. Participation in the program is open to people in the 16 to 24 age range who are unemployed, have dropped out of school or who are at risk of being involved in the criminal corrections system.
For Job Corps operations the Committee recommends $1,465,000,000. This is $8,740,000 above the `comparable' enacted level for 2006 and $64,000,000 above the President's Budget Request. Funds for Job Corps staff that were included in operations in the fiscal year 2006 are included in `program administration' in the Budget Request and the Committee recommendation as it has been in every other year. Of the amount recommended, $591,000,000 will become available on October 1, 2007.
In addition, the Committee provides $58,000,000 for construction, compared to $100,000,000 in the request and $107,920,000 for fiscal year 2006. The Committee did not include the request to rescind $75,000,000 in construction funds. However, based on the projected level of funds for construction and the timeline of construction activities, the Committee includes $50,000,000 in advanced appropriations rather than $100,000,000 as requested. Further, the Job Corps received a $16,000,000 increase in construction funds for the two facilities impacted by the hurricanes in the most recent supplemental appropriation. Finally, the previously appropriated funds are already available for the construction of two new centers.
The Department is directed to give the highest priority to the maintenance, repairs and rehabilitation of existing facilities, prior to the use of funds for new facilities. Every new facility increases the future demand for funds for operating expenses in an increasing tight budgetary environment. Therefore, emphasis should be placed on rehabilitation and repair of existing facilities.
Furthermore, the Committee supports the effort of the Workforce Investment Act of 1998 to more fully integrate Job Corps centers into their local communities and directs that the Department review the system developed and employed by Youthbuild America as a model for local education and training of at risk youth.
After being elevated to the Office of the Secretary in celebration of its 40th anniversary, in 2007 the Job Corps program is returned to ETA, which oversees all youth training activities.
Native Americans
For Native Americans, the Committee recommends $50,000,000. This is $3,696,000 below the fiscal year 2006 level and $1,458,000 below the budget request. This program, authorized by the Workforce Investment Act of 1998, is designed to improve the economic well being of Native Americans (Indians, Eskimos, Aleuts, and Native Hawaiians) through the provision of training, work experience, and other employment-related services and opportunities that are intended to aid the participants to secure permanent, unsubsidized jobs. The Department of Labor allocates formula grants to Indian tribes and other Native American groups whose eligibility for such grants is established in accordance with Department regulations.
The Committee directs the Department to require that the planned use of these funds by Indian tribes or Designated Tribal Entities be coordinated with and incorporated into the Indian Economic Development Block Grant plans, funded through the Department of Housing and Urban Development. Economic development funds and job training funds should go hand in hand.
Migrant and seasonal farm workers
The migrant and seasonal farmworkers program, authorized by the Workforce Investment Act of 1998, is designed to serve members of economically disadvantaged families whose principal livelihood is derived from migratory and other forms of seasonal farm work, or fishing, or logging activities. Enrollees and their families are provided with employment training and related services intended to prepare them for stable, year-round employment within and outside of the agriculture industry.
For migrant and seasonal farm workers, the Committee recommends $80,053,000. This is $801,000 above the fiscal year 2006 level and $80,053,000 above the president's budget request. For the fourth year in a row the budget request did not include funds for this program, and the program continues to be rated as one of the least effective in the Department. The Committee is concerned that the program is not sufficiently focused on job training. Each year, more than 60% of the program's participants receive no job training. Further, the cost per participant has risen to nearly $3,500.
However, the Committee recommendation is unwilling to terminate the program, as requested, until the Department has demonstrated that mainstream health and welfare programs, as well as mainstream job training programs are in place to provide the combination of services needed to help secure permanent employment for farm and forestry workers. Therefore, the Committee is recommending a status quo budget for 2007. As in prior years, the Act directs that of the amounts made available, $5,000,000 is targeted for migrant and seasonal farmworker housing grants.
The Act further directs that not less than 70 percent of this amount be used for permanent housing grants. Recently the Committee has become aware that some of the remaining funds have been allocated to temporary housing. By March 1, 2007 the Department is to provide a list of temporary housing activities and should include a list of the grantees, states in which grantees are located, the uses of funds and the number of individuals or families served.
NATIONAL COMPETITIVE GRANT PROGRAMS
This activity includes Workforce Investment Act authorized programs in support of the workforce system including technical assistance and incentive grants, evaluations, pilots, demonstrations and research.
Pilots, Demonstrations and Research- The Committee recommends $43,361,000 for grants or contracts to conduct research, pilots or demonstrations that improve techniques or demonstrate the effectiveness of programs. This is $13,661,000 above the fiscal year 2006 level and $25,661,000 above the 2007 budget request. Of the amount made available in this account, a total of $25,661,000 is dedicated to specific projects which are detailed below:
| Agudath Israel of America Community Services, Inc., Brooklyn, NY, for its Fresh Start job training and counseling program | $400,000 |
| Alabama Southern Community College, Thomasville, AL, for its pulp and paper training center | 200,000 |
| Arc of Blackstone Valley, Pawtucket, RI, for a workforce development initiative | 150,000 |
| Ashland County-West Holmes Career Center, Ashland, OH for the Northeast Central Ohio Bioscience Consortium's creation of a customized, tiered training model in the biosciences | 150,000 |
| Asnuntuck Community College, Enfield, CT to develop a multi-cluster Manufacturing Technology Center | 300,000 |
| Automation Alley, Troy, MI to train incumbent and new workers to construct, manage, and evaluate the Digital Manufacturing Network | 750,000 |
| Bellingham Technical College, Bellingham, WA, for a Process Technology Workforce Development Project | 150,000 |
| Bismarck State College, Bismarck, ND, for an instrumentation and control training program | 250,000 |
| Brookdale Community College, Lincroft, NJ, for workforce training programs through its Center for Excellence in Technology, Telecommunications and Economic Development | 250,000 |
| Capital Idea, Austin, TX, for a workforce development project | 185,000 |
| Casper Event Center, Casper, WY for infrastructure improvements | 100,000 |
| Center for Employment Training, San Jose, CA, for its Building Trade Jobs for Out-of-School Youth Project | 200,000 |
| Center for Training and Careers, San Jose, CA, for vocational training services | 75,000 |
| Central Maine Community College, Auburn, ME, for a training program in precision metalworking and machine tool technology | 150,000 |
| Charity Cultural Services Center, San Francisco, CA, for job training and placement services for new or recent immigrants | 400,000 |
| Cincinnati Children's Hospital Medical Center, Cincinnati, OH for the Project SEARCH job training for people with disabilities | 150,000 |
| City College of San Francisco, San Francisco, CA, for a health care workforce training initiative through the Welcome Back Center | 200,000 |
| City of Alexandria, VA, for an automobile industry workforce development and training initiative | 275,000 |
| City of Las Vegas, NV for a walk-in employment center | 366,000 |
| City of Milwaukee, WI, for a project to train youth in construction trades | 200,000 |
| College of Southern Maryland, La Plata, MD, for its Partnership for the Advancement of Construction and Transportation Training Project | 250,000 |
| Community Learning Center, Ft. Worth, TX to provide training for dislocated and incumbent aerospace workers | 500,000 |
| Community Solutions for Clackamas County, OR, for its Working for Independence job training and workforce development program | 250,000 |
| Consortium for Worker Education, New York, NY, for education, job readiness and occupational skills training services | 150,000 |
| Construction Apprenticeship Tech Prep Consortium, North Kansas City, MO | 50,000 |
| County of Fresno, CA to provide vocational training services | 200,000 |
| Des Moines Area Community College, IA, for training for dislocated workers, and for career exploration and preparation for high school and community college students | 250,000 |
| East Los Angeles Community Union, Los Angeles, CA, for a workforce training initiative | 500,000 |
| Economic Growth Connection of Westmoreland County, Greensburg, PA, for workforce development initiatives | 200,000 |
| Enterprise South Industrial Park (ESIP) Workforce Training Center, Chattanooga, TN to establish a state of the art training center | 1,300,000 |
| Essex County Community Organization, Lynn, MA, for its Education Advantage for Manufacturing project | 250,000 |
| FIB Economic Development Corporation, Inc., Atlanta, GA, for a youth pre-apprenticeship program | 400,000 |
| Fifth Avenue Committee, Brooklyn, NY, for workforce development services for unemployed or underemployed individuals | 300,000 |
| Foundation of the Delaware County Chamber Job Readiness Program, Media, PA to provide workforce development services | 75,000 |
| Fresno County, CA, for the West Fresno County Vocational Training Project | 300,000 |
| Frontier Community College, Fairfield, IL to help create a lineman training program | 100,000 |
| Georgia Southern University, Statesboro, GA, for its Southeastern Technology Education Program (STEP) workforce training initiative | 400,000 |
| Guam Community College, Barrigada, Guam, for vocational training programs | 250,000 |
| Home of Life Community Development Corporation, Chicago, IL, for a financial services training and placement program | 150,000 |
| Indochina Sino-American Community Center, New York, NY, for its Immigrant Literacy, Technology and Employment Project | 150,000 |
| Iowa Central Community College, Ft. Dodge, IA for workforce skills assessment | 300,000 |
| Ivy Tech Community College of Indiana Center for Cybersecurity, Columbus, IN to train the existing and developing workforce | 100,000 |
| Ivy Tech Community College of Indiana, Center for Health Information Technology, Lafayette, IN, for program support and student aid | 100,000 |
| Ivy Tech Community College of Indiana, Center for Orthopedic Manufacturing, Warsaw, IN for training curriculum | 200,000 |
| Ivy Tech Community College of Indiana, Warsaw, IN Center for Orthopedic Manufacturing to train workers | 350,000 |
| Ivy Tech Community College, Center for Logistics, Evansville, IN for Distribution and Transportation for a technical workforce | 200,000 |
| Ivy Tech Community College, Terre Haute, IN for a Center for Geographical Information Systems | 500,000 |
| Joint Systems Manufacturing Center, Lima, OH for job training in manufacturing technologies | 200,000 |
| JumpStart, Inc., Cleveland, OH for technical assistance job training | 200,000 |
| Kalamazoo Valley Community College, Kalamazoo, MI for training and certification curriculum development | 270,000 |
| Lancaster County Career and Technology Foundation, Lancaster, PA for the Lancaster County Career and Technology Center's Collision Repair Technology program | 100,000 |
| Long Island Teen Challenge, West Babylon, NY for vocational training program | 100,000 |
| Louisiana National Guard, Carville, LA for Job Challenge Program training and equipment | 150,000 |
| Make the Road by Walking, Brooklyn, NY, to establish an English and Economic Literacy Initiative in the Bushwick neighborhood | 200,000 |
| Marc Center, Mesa, AZ for job training for adults with disabilities | 200,000 |
| Massachusetts College of Liberal Arts, North Adams, MA, for the Northern Tier Healthcare Workforce project | 75,000 |
| Medina County Office of Workforce Development, Medina, OH for the Building Careers in the Building Trades Initiative | 50,000 |
| Medina County Office of Workforce Development, Medina, OH, for the Building Careers in Healthcare Initiative | 50,000 |
| Medina County Schools Educational Service Center, Medina, OH for the Workforce Initiative program | 100,000 |
| Melwood Horticultural Training Center, Upper Marlboro, MD, for workforce analysis and services to place individuals with developmental disabilities into competitive employment | 200,000 |
| Michigan Manufacturing Technology Center, Plymouth, MI for a new market sector training pilot | 100,000 |
| Minot State University, Minot, ND, for the Job Corps Executive Management Program | 100,000 |
| Mission Language and Vocational School, San Francisco, CA, for a training program in health-related occupations | 400,000 |
| Moberly Area Community College in Moberly, MO for its Integrated Systems Technology program | 150,000 |
| Monterey County Workforce Investment Board, CA, for a study and other activities to better align the local workforce development system with high-growth industry sectors | 150,000 |
| National Association of Street Schools Career Pathways Program, Denver, CO for tools and training designed to create positive life change for at-risk youth | 100,000 |
| Northeast Bronx Redevelopment Corporation, Bronx, NY, for its PROJECT SUCCESS job training initiative | 75,000 |
| Northern Tier Industry and Education Consortium, Dimock, PA for regional career awareness and training programs | 90,000 |
| Oakland Community College, Oakland County, MI to lead a consortium on emerging sectors in secondary institutions | 500,000 |
| Oil Region Alliance of Business, Industry and Tourism, Oil City, PA for the Rural Technical Training Initiative | 200,000 |
| Oklahoma State University, Oklahoma City, OK to fund a pilot program for training nurse's aides specializing in long-term care facilities | 500,000 |
| Opportunity, Inc., Highland Park, IL to expand the Secure Document Destruction for Disabled Persons Division | 250,000 |
| Our Piece of the Pie, Hartford, CT, for education and employment services for out-of-school youth | 600,000 |
| Palm Beach Education Commission, West Palm Beach, FL to initiate a Quality Economic Development, Education, and Employment (QE 3 ) demonstration project | 100,000 |
| Patrick County Education Foundation, Stuart, VA, for a workforce development project | 100,000 |
| Philadelphia Workforce Development Corporation, Philadelphia, PA, for establishment of a training institute | 175,000 |
| Piedmont Virginia Community College, Charlottesville, VA for the Residential Construction Academy | 300,000 |
| Precision Manufacturing Institute, Meadville, PA for training in advanced manufacturing initiatives | 200,000 |
| Project One, Louisville, KY for the Summer Earnings and Enrichment program | 100,000 |
| PRONTO of Long Island, Inc., Bayshore, NY, for a vocational training initiative | 100,000 |
| Safer Foundation, Chicago, IL, for training and support services to ex-offenders | 200,000 |
| San Diego Workforce Partnership, Inc., San Diego, CA, for its Adult Special Population Contracted Training Program | 250,000 |
| Schoenbaum Family Enrichment Center, Charleston, WV for the Enterprise Development Initiative | 255,000 |
| SCLC/Women's Organizational Movement for Equality Now, Inc., Atlanta, GA, for education, employment and support services at its Empowerment Training Center | 100,000 |
| Sierra College, Rocklin, CA for Mechatronics workforce training initiative | 200,000 |
| Signature Academy Inc., Chicago, IL, for its Exodus to Excellence After School Youth Program | 75,000 |
| South Bay Workforce Investment Board, Hawthorne, CA, for its Bridge-to-Work program | 335,000 |
| South Valley Worksource Center, Palmdale, CA to increase business recruitment | 380,000 |
| Southeast Missouri State University, Cape Girardeau, MO for equipment and training | 350,000 |
| Southern Queens Park Association, Jamaica, NY, for a workforce skills training program | 300,000 |
| Southside Virginia Community College, Alberta, VA for the Heavy Equipment Training Center project | 300,000 |
| Southwestern Oklahoma State University, Weatherford, OK to develop new manufacturing entrepreneurs through the Western Oklahoma Business Commercialization Center | 300,000 |
| Three Rivers Community College, Norwich, CT for the Collegiate Nurse Preceptor program | 100,000 |
| Union Mission, Inc., Savannah, GA, for its culinary arts training program, in collaboration with Savannah Technical College | 100,000 |
| United Mine Workers of America, Fairfax, VA, for the UMWA Career Center's mine worker training and reemployment programs | 1,000,000 |
| University of Saint Francis, Fort Wayne, IN for the Nursing Workforce Initiative | 200,000 |
| University of the Pacific, Stockton, CA for the Business Forecasting Center | 350,000 |
| Valley Initiative for Development and Advancement, Weslaco, TX, for a workforce development project | 180,000 |
| Veteran Community Initiatives, Inc., Johnstown, PA, for employment services and support programs for veterans | 400,000 |
| Webster University, Old Post Office Campus, St. Louis, MO, for workforce development programs | 250,000 |
| West Los Angeles College, Culver City, CA, for a craft and technician training program | 350,000 |
| Westside Industrial Retention and Expansion Network (WIRE-Net), Cleveland, OH, for a manufacturing workforce development and job placement program | 300,000 |
| Worker Investment Board of Herkimer, Madison and Oneida Counties, NY for an aircraft repair training program | 125,000 |
| Workforce Resource, Inc., WI, for a regional web-based clearinghouse | 250,000 |
| York Technical College, Rock Hill, SC, for its construction trades training program | 150,00 |
Technical Assistance- No funds are provided for the technical assistance program, as requested. This is $1,980,000 below the fiscal year 2006 level. The development of performance measurement systems, the provision of quality services and the promotion of accountability and collaboration should be a quintessential part of every program's activity level.
Evaluation- The Committee recommends $4,921,000 to provide for the continuing evaluation of programs conducted under the Workforce Investment Act of 1998, as well as of Federally funded employment-related activities under other provisions of law. This is $2,936,000 below the fiscal year 2006 level and the same as the budget request.
Responsible Reintegration of Youthful Offenders- The Committee does not include funding for the Responsible Reintegration of Youthful Offenders program. The budget did not request funds for this program. The fiscal year 2006 level is $49,104,000.
Prisoner Re-entry- The Committee recommends no further funding for the Prisoner Re-entry Initiative until Congress has authorized the program and has established the authorized program levels. The Committee has funded the program in the past few years under the authority of a demonstration program. However, the Committee is concerned that continued funding for the program under the guise of a demonstration program is inappropriate, since all of the restrictions normally associated with the demonstration program would have to be waived in order for the program to be eligible for funding. It is now time for the program to be authorized or dropped.
Community Based Job Training Initiative- The Committee does not include separate funds for this initiative but provides that of the amount made available for the Dislocated Worker National Reserve competitive grant program, up to $125,000,000 can be made available for the Initiative. This is the same as provided in 2006.
Rescissions- The Committee has included language rescinding $325,000,000 in prior year WIA funds, or if needed other headings under this title.
The Committee directs the Department of Labor continue to submit quarterly reports to the House and Senate Appropriations Committees on the status of H-1B, National Emergency Grants, and High-Growth Job Training Initiative awards, and awards made for pilot, demonstration, multi-service, research, and multi-state projects as directed in House Report 109-337, except that the Department shall identify all awards made on a sole source basis and provide the justification, purpose and expected outcomes for any such awards.
COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
The Committee recommends $420,000,000 for community service employment for older Americans. This is $12,311,000 below the fiscal year 2006 level and the budget request. The Committee's recommendation directs the Department to find ways to reduce the significant overhead costs of the program pending enactment of the program's reauthorization.
The community service employment for older Americans program provides grants to public and private nonprofit organizations that subsidize part-time work in community service activities for unemployed persons aged 55 and older, whose family's annual income does not exceed 125 percent of the poverty level.
The Committee recommends new language requiring the Secretary of Labor to use a portion of funds to make a grant to the Forest Service for the Senior Community Service Employment Program.
FEDERAL UNEMPLOYMENT BENEFITS AND ALLOWANCES
The Committee recommends $938,600,000. This is $27,800,000 below the fiscal year 2006 level and the same as the budget request.
The Trade Adjustment Assistance Program (TAA) provides assistance to certified workers adversely affected by imports and trade with countries covered by the North America Free Trade Agreement. Funding will continue the implementation of the TAA program with an emphasis on integrating the program into the One-Stop System. The Trade Adjustment Assistance Reform Act of 2002 expanded the eligibility to include secondary workers and workers whose employers shift production overseas.
STATE UNEMPLOYMENT INSURANCE AND EMPLOYMENT SERVICE OPERATIONS
The Committee recommends $3,411,762,000 for this account. This is $53,605,000 above the fiscal year 2006 level and $23,955,000 below the budget request. Included in the total available is $3,349,746,000 authorized to be drawn from the Employment Security Administration Account of the Unemployment Trust Fund and $62,016,000 to be provided from the general fund of the Treasury. The funds in this account are used to provide administrative grants and assistance to State agencies that administer Federal and State unemployment compensation laws and operate the public employment service.
For Unemployment Insurance services, the Committee recommends $2,650,075,000. This is $142,405,000 above the fiscal year 2006 level and $100,000 below the budget request. The total includes $2,640,175,000 for State Operations and $9,900,000 for National Activities. Included in the amount provided for State Operations is $40,000,000 for One-Stop Centers to conduct Unemployment Insurance eligibility interviews and to enable staff to investigate unemployment insurance identity theft as requested. However, the original budget request double counted funds for eligibility reviews.
For the Employment Service, the Committee recommends $688,769,000, which includes $22,016,000 in general funds together with an authorization to spend $666,753,000 from the Employment Security Administration Account of the Unemployment Trust Fund. This is $27,114,000 below the fiscal year 2006 level and the same as the budget request.
The Committee recommends $32,918,000 for ES national activities. This is $510,000 below the fiscal year 2006 level and the same as the budget request.
The Committee recommends $40,000,000 for America's Labor Market Information System. This is $41,662,000 below the fiscal year 2006 level and $23,855,000 below the budget request. This funding supports access for customers in labor market transactions, and measuring and displaying WIA performance information. It is important to note that the private sector continues to increase public, free of charge and universal access to job information and the States continue to implement their own electronic job banks. Therefore, this recommendation agrees with the closing of the America's Jobs Bank. Funds should be focused in three areas: Base Realignment and Closures (BRAC), the Workforce Information in Regional Economic Development (WIRED) and the Workforce One web site.
The Committee concurs with the recommendation to provide no funds for the Work Incentives Grants program. The 2006 budget included $19,514,000 for this program to help persons with disabilities find and retain jobs through the One-Stop Career Center system mandated by the Workforce Investment Act. Several years of WIG funding have successively demonstrated approaches to improve accessibility to One-Stop Center services for new job seekers with disabilities. One-Stop Centers now incorporate these best practices into their normal operations.
ADVANCES TO THE UNEMPLOYMENT TRUST FUND AND OTHER FUNDS
The Committee recommends $452,000,000. This is $13,000,000 below the fiscal year 2006 level and the same as the budget request. The appropriation is available to provide advances to several accounts for purposes authorized under various Federal and State unemployment compensation laws and the Black Lung Disability Trust Fund, whenever balances in such accounts prove insufficient.
PROGRAM ADMINISTRATION
General funds in this account provide the Federal staff to administer employment and training programs under the Workforce Investment Act of 1998, the Older Americans Act, the Trade Act, and the National Apprenticeship Act. Trust funds provide for the Federal administration of employment security functions under title III of the Social Security Act and the Immigration and Nationality Act.
The Committee recommends $211,554,000 for fiscal year 2007. This is $42,131,000 above the fiscal year 2006 level and the same as the budget request. Most of the increase reflects the return of the Job Corps staffing cost to this account. Funds are allocated in accordance with the attached table at the end of the report. This includes $118,760,000 in general funds and authority to expend $92,794,000 from the Employment Security Administration Account of the Unemployment Trust Fund. Of the amount made available $700,000 is targeted to the transition of the Youthbuild program if the program transfer is authorized by April 1, 2007.
WORKERS COMPENSATION PROGRAMS
EMPLOYEE BENEFITS SECURITY ADMINISTRATION
SALARIES AND EXPENSES
The bill provides $143,573,000 for the Employee Benefits Security Administration, $10,023,000 above the fiscal year 2006 level and the same as the budget request.
The Committee recognizes the importance of developing and implementing a new EFAST2 system and has provided funds in accordance with the request. Language is also included requiring that the Pension Benefit Guaranty Corporation share in the costs of the new system since they are also a beneficiary of the system's development. The Department is directed to provide a schedule for completion within 30 days of enactment and to report monthly on progress relative to that schedule to the House and Senate Committees on Appropriations.
The Employee Benefits Security Administration (EBSA) is responsible for the enforcement of Title I of the Employee Retirement Income Security Act of 1974 (ERISA) in both civil and criminal areas. This involves ERISA fiduciary and reporting/disclosure requirements. EBSA is also responsible for enforcement of sections 8477 and 8478 of the Federal Employees' Retirement Security Act of 1986. The agency was also given responsibilities under the Health Insurance Portability and Accountability Act of 1996.
PENSION BENEFIT GUARANTY CORPORATION
The Corporation's budget for fiscal year 2007 is $397,644,000, which is $100,666,000 above the fiscal year 2006 level and the same as the budget request.
The Corporation is a wholly owned government corporation established by the Employee Retirement Income Security Act of 1974 (ERISA). The law places it within the Department of Labor and makes the Secretary of Labor the chairperson of its board of directors. The Corporation receives its income from insurance premiums collected from covered pension plans, collection of employer liabilities imposed by ERISA, and investment earnings. It is also authorized to borrow up to $100,000,000 from the United States Treasury. The primary purpose of the Corporation is to guarantee the payment of pension plan benefits to participants if covered plans fail or go out of existence.
The bill includes language permitting obligations in excess of the amount provided in the bill after approval by the Office of Management and Budget and the Committee on Appropriations in the House and Senate. Language is also included to require that the PBGC share in the costs of the new EFAST2 System being developed in EBSA, by transferring $7,000,000 to the Employee Benefits Security Administration.
The Committee has included language that permits workload driven increases in obligational authority. Although unanticipated workload increases do occur, the use of reapportionments authority should not become an excuse for bypassing the normal budgetary process. The Committee directs the Department to submit a report to the Committees on Appropriations in the House and Senate, if administrative expenses increase by more than 25 percent during fiscal year 2007.
EMPLOYMENT STANDARDS ADMINISTRATION
SALARIES AND EXPENSES
The Committee recommends $418,495,000 for this account. This is $7,431,000 above the fiscal year 2006 level and $18,922,000 below the budget request. The bill includes $416,419,000 in general funds for this account and contains authority to expend $2,076,000 from the Special Fund established by the Longshore and Harbor Workers' Compensation Act. Funds are to be distributed in accordance with the table at the end of this Report.
The Employment Standards Administration (ESA) is involved in the administration of numerous laws, including the Fair Labor Standards Act, the Immigration and Nationality Act, the Migrant and Seasonal Agricultural Workers' Protection Act, the Davis-Bacon Act, the Family and Medical Leave Act, the Federal Employees' Compensation Act, the Longshore and Harbor Workers' Compensation Act, and the Federal Mine Safety and Health Act (black lung). The agency also administers Executive Order 11246 related to affirmative action by Federal contractors and the Labor-Management Reporting and Disclosure Act.
The Committee recognizes the importance of succession planning and appreciates the effort by the ESA to plan and train new staff for the future. However, funds were not provided for the staffing increase in the absence of a Department-wide succession plan.
The Department is directed to work with the U.S. Department of Agriculture's Forest Service to implement a Forest Service data base on H2B forestry workers. The Department of Labor is instructed, through its Wage and Hour Division, to populate the data base with violations of wage disbursements. The Department is further instructed to include as part of its 2008 budget request, a report about its enforcement efforts on those companies that have violated employment standards.
SPECIAL BENEFITS
The bill includes $230,000,000. This is $7,000,000 below the fiscal year 2006 appropriation and the same as the budget request. This appropriation primarily provides benefits under the Federal Employees' Compensation Act (FECA). The payments are required by law. In fiscal year 2007, an estimated 152,000 injured Federal workers or their survivors will file claims; 58,500 will receive long-term wage replacement benefits for job-related injuries, diseases, or death.
SPECIAL BENEFITS FOR DISABLED COAL MINERS
The Committee recommends an appropriation of $229,373,000 for special benefits for disabled coal miners, as requested. This is in addition to the $74,000,000 appropriated last year as an advance for the first quarter of fiscal year 2007. These funds are used to provide monthly benefits to coal miners disabled by black lung disease and to their widows and certain other dependents, as well as to pay related administrative costs.
The Committee recommends an advance appropriation of $68,000,000 for the first quarter of fiscal year 2008, the same as the budget request. These funds will ensure uninterrupted benefit payments to coal miners, their widows, and dependents.
The Black Lung Consolidation of Administrative Responsibility Act of 2002 amends the Black Lung Benefits Act to transfer part B black lung benefits responsibility from the Commissioner of Social Security to the Secretary of Labor.
ADMINISTRATIVE EXPENSES, ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION FUND
The Committee recommends $102,307,000 for the Energy Employees Occupational Illness Compensation Program authorized by Title XXXVI of the National Defense Authorization Act of 2001. This is $6,226,000 above the fiscal year 2006 level and the same as the budget request. Funds will be used to administer the program that provides compensation to employees or survivors of employees of the Department of Energy (DOE), its contractors and subcontractors, companies that provided beryllium to DOE, and 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.
The Committee directs the Department to submit a report on the implementation of the Part E program, including the level of coordination between the DOL and CDC-NIOSH on the special Exposure Cohort provisions.
BLACK LUNG DISABILITY TRUST FUND
The Committee recommends such sums as necessary for payment of benefits and interest on advances. The Committee estimates that $1,071,000,000 will be required for this account. This is $3,000,000 above the fiscal year 2006 level and the same as the Administration estimates.
The Trust Fund pays all black lung compensation/medical and survivor benefit expenses when no responsible mine operator can be assigned liability for such benefits, or when coal mine employment ceased prior to 1970, as well as administrative costs which are incurred in administering the benefits program and operating the Trust Fund.
The basic financing for the Trust Fund comes from a coal excise tax for underground and surface-mines coal. Additional funds come from reimbursement payments from mine operators for benefit payments made by the Trust Fund before the mine operator is found liable. The advances to the Fund assure availability of necessary funds when liabilities may exceed other income. The Omnibus Budget Reconciliation Act of 1987 continues the current tax structure until 2014.
The Committee is aware that the fund is more than $9,000,000,000 in debt from prior year borrowing from the Treasury and has no hope of keeping current on its interest payments. The fund is in the impossible position of having to borrow from the Treasury just to pay its interest that it owes to the Treasury. The Administration has submitted legislation to implement a one time restructuring of its debt to the Treasury, which is now before the Authorizing Committees.
OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
The Committee recommends $486,051,000 for the Occupational Safety and Health Administration. This is $13,624,000 above the fiscal year 2006 level and $2,384,000 above the budget request. This agency is responsible for enforcing the Occupational Safety and Health Act of 1970 in the Nation's workplaces. Funds are to be distributed in accordance with the table at the end of this report. Included is an increase to fully fund the development and implementation of the OSHA Information System. However, the Department is directed to provide quarterly reports to the Committees on Appropriations in the House and Senate on the progress of the system's implementation.
The Committee continues last year's direction that OSHA take no further action to implement regulations requiring the annual testing of respiratory protection for occupational exposure to TB. Neither the CDC nor the health industry endorses the requirements in the OSHA rule.
The Committee is once again disappointed with the lack of progress on the agency's regulation concerning Employer Payment for Personal Protective Equipment, the public comment period for which ended over seven years ago. The Committee is especially concerned because the rate of worker deaths and injuries, which has decreased in the last decade for all American workers, has increased by two percent among Hispanic workers during 2003 and 2004 because they take on a disproportionate number of jobs in the nation's most dangerous professions, including the construction industry. The Committee expects the Secretary to report to the Committee, within 30 days of the enactment of this Act, the definitive status of this regulation, the agency's reasons for not issuing the regulation sooner, and a timetable for its issuance.
MINE SAFETY AND HEALTH ADMINISTRATION
SALARIES AND EXPENSES
The Committee recommends $278,869,000 for this agency. This is $1,183,000 above the fiscal year 2006 level and $8,967,000 below the budget request. Funds are to be distributed in accordance with the table at the end of this report. This agency enforces the Federal Mine Safety and Health Act in underground and surface coal and metal and non-metal mines. The requested funding increase was not provided since Congress is taking immediate actions to enhance the MSHA inspection and enforcement programs in the 2006 supplemental. The program received a $25,600,000 increase in the recent emergency supplemental H.R. 4939 and funds are available for two years. Hence the requested increase for 2007 is no longer needed.
The Committee is concerned over several reported incidents where, under the guise of `rebuilding', certain equipment manufacturers have built new machines and removed MSHA Approval Plates (commonly referred to as `2G tags') from scrap machines, reattached these plates to the new machinery that they built, and then sold these machines for use in underground mines. Several of these machines have been involved in accidents that have resulted in serious injuries. The Committee directs MSHA to increase emphasis to ensure that all mining machinery sold by manufacturers and re-builders for use in a mine is in compliance with the MSHA Approval Plate that is on the machine. The Committee directs that MSHA report back to the Committees on Appropriations in the House and Senate surveillance and enforcement of this misuse of `2G' tags by January 1, 2007.
The Committee commends MSHA for actions on the role of equipment technology in mine rescue efforts and directs that the agency work with manufacturers of new oxygen technology to determine the extent to which the new technology can be applied to mine safety.
In addition, and in the meantime, the agency is urged to promote the use of refillable oxygen cylinders and tubing for mineworker safety.
BUREAU OF LABOR STATISTICS
SALARIES AND EXPENSES
The total funding recommended by the Committee for the Bureau of Labor Statistics (BLS) is $565,288,000. This is $28,189,000 above the fiscal year 2006 level and $2,000,000 above the budget request. The Committee recommends $486,262,000 in general funds for this account and authority to spend $79,026,000 from the Employment Security Administration Account of the Unemployment Trust Fund. The BLS is the principal fact-finding agency in the Federal government in the broad field of labor economics. Its principal surveys include the Consumer Price Index and the monthly unemployment series. Funds are to be distributed in accordance with the table at the end of the Report.
The Committee has provided additional funds to expand the American Time Use Survey (ATUS). This has become, for example, one of the most important surveys for determining dietary patterns and food consumption, an important element in the Nation's evolving understanding of obesity trends. An increase of $2,000,000 is provided to conduct a biennial module, improve the response rates and conduct research on non-response bias. BLS should conduct a module every other year, with the food use module conducted every fourth year and other modules on rotating topics conducted in between.
OFFICE OF DISABILITY EMPLOYMENT POLICY
SALARIES AND EXPENSES
The Committee recommends $20,319,000 for the Office of Disability Employment Policy, which is $7,336,000 below the fiscal year 2006 level and the same as the budget request. The Office provides policy guidance and leadership to eliminate employment barriers to people with disabilities.
The Committee is in agreement with the request to suspend the grant program until the results of the three-year research and demonstration grants programs has been fully assessed and resulting policy changes incorporated in new policy directives.
The Committee directs the Secretaries of Labor and HUD and the Interagency Council on Homelessness (ICH) to develop a joint plan to increase the access of homeless and disabled veterans in locations where homeless veterans congregate, including grantees under the homeless provider grant and per diem program and the homeless veterans reintegration program, to facilitate re-employment.
DEPARTMENTAL MANAGEMENT
SALARIES AND EXPENSES
The Committee recommends $236,784,000 for Departmental Management activities. This is $60,796,000 below the fiscal year 2006 level and $5,307,000 below the budget request. Included is $236,462,000 in general funds for this account along with authority to transfer $322,000 from the Employment Security Administration Account of the Unemployment Trust Fund. The Committee has included $28,000,000 for the Information Technology Crosscut which is the requested amount except for funds targeted to the Government-wide `E-Gov Initiative'.
The Departmental Management appropriation finances staff responsible for formulating and overseeing the implementation of Departmental policy and management activities. In addition, this appropriation includes a variety of operating programs and activities that are not involved in Departmental Management functions, but for which other salaries and expenses appropriations are not suitable. The allocation of the funds is provided in the table accompanying this report.
The Committee agrees with the request to significantly reduce the role of the International Labor Affairs cooperation program. Clearly the role of other Agencies, including those at the Department of State and USAID are greatly increased in the areas of international labor negotiations. In addition, recent legislation has refocused the Department's activities on research, and administering the labor agreements.
The Committee recommends that the Department's strategic plan for the Women's Bureau include a future use of the Women's Work program as part of its overall Women's Bureau activities. The Committee notes however, that the Women's Work program has been funded for years without an authorization and appears to have no specific performance measures. It is only fair that funding in the future should be contingent on the submission and enactment of authorizing legislation for this program, as is required for all others.
VETERANS EMPLOYMENT AND TRAINING
The Committee recommends $224,440,000 for veteran employment and training activities. This is $2,349,000 above the fiscal year 2006 level and $447,000 below the budget request. Within this amount, $195,177,000 is to be expended from the Employment Security Administration account of the Unemployment Trust Fund for the traditional State and Federal administration of veterans' employment and training activities.
Individuals leaving the military are at high risk of homelessness due to a lack of job skills transferable to the civilian sector, disrupted or dissolved family and social support networks, and other risk factors that preceded their military service. The Transition Assistance Program (TAP) has been established to ease the transition of separating service members to the civilian sector. The Committee instructs the Secretary of Labor to ensure that a module on homelessness prevention is added to the TAP curriculum. The module should include a presentation on risk factors for homelessness, a self-assessment of risk factors, and contact information for preventative assistance associated with homelessness.
OFFICE OF THE INSPECTOR GENERAL
The Committee recommends $73,761,000 for the Office of the Inspector General (OIG). This is $2,660,000 above the fiscal year 2006 level and the same as the budget request. This includes $68,073,000 in general funds along with the authority to transfer $5,688,000 from the Employment Security Administration Account of the Unemployment Trust Fund.
The OIG was created by law to protect the integrity of Departmental programs as well as the welfare of beneficiaries served by those programs. Through a program of audits, investigations, and program evaluations, the OIG attempts to reduce the incidence of fraud, waste, abuse, and mismanagement, and to promote economy, efficiency, and effectiveness throughout the Department.
WORKING CAPITAL FUND (WCF)
The Committee includes no direct appropriation for the WCF for 2007 postponing further development of the core accounting system, until funds in the pipeline have been expended, the Department has completed its review and assessment of the individual program requirements and an in depth discussion of alternatives to a new core accounting system for the Department of Labor have been vetted with the Committees on Appropriations in the House and the Senate. This is $6,168,000 below the 2006 level and $13,954,000 below the budget request.
ADMINISTRATIVE PROVISIONS
Sec. 101. The Committee continues and amends a provision to prohibit the use of Job Corps funding for compensation of an individual that is not a Federal Employee at a rate in excess of Executive Level II.
Sec. 102. The Committee repeats and amends a provision to permit transfers of up to one percent between appropriation Accounts.
Sec. 103. The Committee continues a prior year prohibition on the purchase of goods that were in any part produced by indentured children.
Sec. 104. Requires the Department to report to the Committees on Appropriations on the projects awarded under the research and demonstration projects.
Sec. 105. The Committee recommends new language requiring the Secretary to issue a monthly transit subsidy of not less than $105 to each of the Department's eligible employees in the National Capital region.
TITLE II--DEPARTMENT OF HEALTH AND HUMAN SERVICES
HEALTH RESOURCES AND SERVICES ADMINISTRATION
HEALTH RESOURCES AND SERVICES
The Committee includes a program level total of $7,075,917,000 for health resources and services programs, which is $487,553,000 above the fiscal year 2006 funding level for these activities and $742,062,000 above the budget request. The Health Resources and Services Administration (HRSA) supports programs which 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.
Community health centers
The Committee provides $1,988,000,000 for community health centers, which is $205,692,000 above the fiscal year 2006 funding level and $25,139,000 above the budget request. These funds support programs which include community health centers, migrant health centers, health care for the homeless and public housing health service grants. In providing this significant increase to the community health centers program, the Committee intends that funding will be used to support the development of over 300 new or expanded medical capacity sites. Within the total, $25,000,000 also is included to provide base grant adjustments for existing centers. In addition, the Committee urges the community health centers program to continue the initiative designed to help reduce chronic conditions of obesity, diabetes and heart diseases in the communities they serve.
The Committee includes bill language similar to previous years limiting the amount of funds available for the payment of claims under the Federal Tort Claims Act to $44,550,000, which is the same as the budget request and the limitation in the fiscal year 2006 bill.
The Committee does not provide additional funds for loan guarantee authority for community health centers under section 330(d) of the Public Health Service Act. The Committee notes that an estimated $72,000,000, of the $160,000,000 appropriated in fiscal years 1997 and 1998, will be available in the program after the end of fiscal year 2006 for loan guarantee authority for guarantees of both loan principal and interest.
The Committee recognizes the importance of increasing the use of health information technology (IT) at health centers. Health centers have demonstrated improved access to services and improved patient outcomes by utilizing electronic patient registries and other IT tools through their participation in integrated service delivery networks, the integrated information and communication technology project, the shared integrated management information system, and health disparities collaboratives. Given this success, the Committee urges HRSA to ensure that health centers have adequate resources to establish and expand health IT systems in order to further enhance the delivery of cost-effective, quality health care services.
The Committee is pleased by the increasing proportion of National Health Service Corps (NHSC) assignees being placed at community, migrant, homeless, and public housing health centers. The Committee encourages HRSA to further expand this effort to ensure that health centers have access to a sufficient level of health professionals through the NHSC, especially given recent efforts to expand the health centers program.
The Committee believes that adequate funding for the technical assistance and networking functions available for health centers, including through the National Association of Community Health Centers, state and regional primary care associations, and planning, developmental, and operational networks, is critical to the successful operation and expansion of the health centers program. Within amounts provided, the Committee encourages HRSA to make funds available to continue technical assistance and networking to existing centers and support the expansion of these activities to new communities.
The Committee is aware that dental disease disproportionately affects our Nation's most vulnerable populations. New ways of bringing oral health care to underserved populations are needed to address geographic and other challenges that exist. The Committee encourages HRSA to explore innovative programs to delivering preventive and restorative oral health services. Specifically, the Committee encourages HRSA to work with the dental provider community, including representatives of the dentists, dental assistants, dental hygienists, and the African-American and Hispanic dental communities to explore state and community proposals and programs that seek to improve access to care in accordance with state licensing laws.
Free clinics medical malpractice
The Committee provides $10,000 for payments of claims under the Federal Tort Claims Act to be made available for volunteer free clinic health care professionals, which is $30,000 less than the fiscal year 2006 funding level. The budget request did not include funding for this program. The program extends Federal Tort Claims Act coverage to health care professional volunteers in free clinics in order to expand access to health care services to low-income individuals in medically underserved areas. According to section 224(o) of the Public Health Service Act, Section 233(o), a free clinic must apply, consistent with the provisions applicable to community health centers, to have each health care professional `deemed' an employee of the Public Health Service, and therefore eligible for coverage under the Federal Tort Claims Act.
Radiation exposure screening and education program
The Committee provides $1,917,000 for the radiation exposure screening and education program, which is the same as the fiscal year 2006 funding level and the budget request. This program provides grants for the education, prevention, and early detection of radiogenic cancers and diseases resulting from exposure to uranium during mining and milling at nuclear test sites.
National Hansen's disease program
The Committee provides $15,905,000 for the National Hansen's disease program, which is the same as the fiscal year 2006 funding level and the budget request. This program offers Hansen's disease treatment to 11 long-term residents who continue to receive care from the National Hansen's Disease Center and to others who receive care from grant-supported outpatient regional clinics. Other former long-term residents have been offered and elected to receive a living allowance from the program and now live independently. These programs provide treatment to about 3,000 of the 6,000 Hansen's disease sufferers in the continental United States.
National Hansen's disease program--buildings and facilities
The Committee provides $220,000 for National Hansen's disease buildings and facilities, which is the same as the fiscal year 2006 funding level and the budget request. These funds are used to finance the repair and upkeep of buildings at the Gillis W. Long Hansen's Disease Center at Carville, Louisiana.
Payment to Hawaii for treatment of Hansen's disease
The Committee provides $1,996,000 for the treatment of persons with Hansen's disease in the State of Hawaii, which is the same as the fiscal year 2006 funding level and the budget request. The program, which provides a partial matching payment to the State of Hawaii, dates to the period of Father Damien's facility for sufferers of Hansen's disease. That facility now has only 40 residents who live there by choice, and the grounds have been converted to a historical site. Most patients diagnosed with Hansen's disease in Hawaii are now treated in the same manner as new patients on the mainland; their care is handled on an out-patient basis, with the program paying for 247 active ambulatory Hansen's disease cases.
Black lung clinics
The Committee provides $5,891,000 for black lung clinics, which is the same as the fiscal year 2006 funding level and the budget request. The program supports fifteen grantees that treat a declining population of coal miners with respiratory and pulmonary impairments. The clinics presently receive just under one-third of their funding from other sources, such as Medicaid and Medicare. Of the fifteen grantees, six receive health center funding as well as black lung grants.
National Health Service Corps: field placements
The Committee provides $42,218,000 for field placements, which is $1,920,000 above the fiscal year 2006 funding level and the budget request. These funds are used to support the activities of National Health Service Corps (NHSC) obligors and volunteers in the field, including travel and transportation costs of assignees, training and education, recruitment of students, residents and clinicians and retention activities. Salary costs of most new assignees are paid by the employing entity.
National Health Service Corps: recruitment
The Committee provides $89,310,000 for recruitment activities, which is $4,080,000 above the fiscal year 2006 funding level and the budget request. The program awards scholarships to health professions students and assists graduates in repaying their student loans. In return for every year of support, these individuals are obligated to provide a year of service in health professional shortage areas of greatest need. The minimum obligation is two years.
Health professions
The Committee provides $309,296,000 for all health professions training programs, which is $14,419,000 above the fiscal year 2006 funding level and $149,884,000 above the budget request. The table at the end of the report identifies how funding is allocated for programs authorized by titles VII and VIII of the Public Health Service Act. The Committee rejects the rescission proposal included in the budget request that would have cancelled unobligated balances available at institutions of higher education with a student loan revolving fund.
Centers of excellence
The Committee provides $11,880,000 for centers of excellence, which is the same as the fiscal year 2006 funding level. The budget request did not include funding for this program. The program is designed to strengthen the national capacity to educate underrepresented minority (URM) students in the health professions by offering special support to those institutions which train a significant number of URM individuals. Funds are used for the recruitment and retention of students and faculty, information resources and curricula, faculty and student research, and the development of plans to achieve institutional improvements.
The Committee is pleased that HRSA has refocused the minority centers of excellence program on providing support to historically minority health professions institutions. The Committee recognizes the important role of this program in supporting faculty and other academic programs at minority institutions.
The Committee recognizes that the intent of the Title VII funding for the centers of excellence (COE) has been to strengthen the national capacity to train students from minority groups that are under-represented in these health professions, thereby building a more diverse health care workforce, and that budgetary cuts in fiscal year 2006 may not have been adequately inclusive of grants to the health professions schools that would reach the Hispanic student population. Therefore this Committee urges, that within the Title VII funds appropriated in fiscal year 2007 for the COE program, one third of the funds should be set aside for regional Hispanic centers of excellence, to be selected from a competitive applicant pool, that are located in geographic areas that have a large medically underserved Hispanic population, and that would use a regional approach to serve that area.
Health careers opportunity program
The Committee concurs with the budget request and does not include funding for the health careers opportunity program. The fiscal year 2006 funding level for this program is $3,960,000.
Faculty loan repayment
The Committee concurs with the budget request and does not include funding for the faculty loan repayment program. The fiscal year 2006 funding level for this program is $1,289,000.
Scholarships for disadvantaged students
The Committee provides $46,657,000 for scholarships for disadvantaged students, which is the same as the fiscal year 2006 funding level and $36,924,000 above the budget request. The program provides grants to eligible health professions and nursing schools to provide scholarships to eligible individuals from disadvantaged backgrounds, including students who are members of racial and ethnic minority groups. By statute, not less than 16 percent of the funds must go to schools of nursing.
Training in primary care and dentistry
The Committee provides $40,851,000 for training in primary care and dentistry, which is the same as the fiscal year 2006 funding level. The budget request did not include funding for this program. The training program is comprised of four elements: (1) family medicine; (2) general internal medicine and general pediatrics; (3) physician assistants; and (4) general and pediatric dentistry.
Area health education centers
The Committee provides $28,681,000 for area health education centers, which is the same as the fiscal year 2006 funding level. The budget request did not include funding for this program. The program provides cooperative agreements to medical and nursing schools to encourage the establishment and maintenance of community-based training programs in off-campus rural and underserved areas. Emphasis is also placed on enhancing the diversity of the health personnel workforce and improving the practice environment and the quality of care available in underserved areas.
Allied health and other disciplines
The Committee provides $3,960,000 for allied health and other disciplines, which is the same as the fiscal year 2006 funding level. The budget request does not include funding for this program. The program assists eligible entities in meeting the costs associated with expanding or establishing an allied health professions program.
The Committee recognizes the importance of the graduate psychology education program, a competitive and peer reviewed grant program. Established five years ago, this program has achieved a 40 percent increase in the rate of students entering into and staying to practice in underserved areas following completion. The need for mental health services is significant and well documented. Through this program, psychology graduate students are trained along with students from over thirty other health professions to provide mental and behavioral health care services to underserved populations, such as older adults, children, chronically ill persons and victims of abuse or trauma including returning military personnel. Within the total for allied health and other disciplines, the Committee includes $2,000,000 for graduate psychology education.
Geriatric programs
The Committee provides $31,548,000 for geriatric programs, which is the same as the fiscal year 2005 funding level. Funding for these programs was not included in either the fiscal year 2006 appropriation or the fiscal year 2007 budget request. The geriatric programs are comprised of three activities: (1) geriatric education centers; (2) the geriatric training program for physicians, dentists, and behavioral and mental health professionals; and (3) Geriatric Academic Career Awards.
Public health, preventive medicine, and dental public health programs
The Committee concurs with the budget request and does not include funding for the public health, preventive medicine, and dental public health programs. The fiscal year 2006 funding level for this program is $7,920,000.
Advanced education nursing
The Committee provides $57,061,000 for advanced education nursing, which is the same as the fiscal year 2006 funding level and the budget request. The program provides grant support to eligible entities to meet the costs of: (1) projects that support the enhancement of advanced nursing education and practice; and (2) traineeships for individuals in advanced nursing education programs. The program prepares registered nurses as nurse faculty, nurse practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, nurse administrators, public health nurses and other nurse specialists for advanced practice roles. Within the allocation, the Committee encourages HRSA to allocate funding at least at the fiscal year 2001 level for nurse anesthetist education.
Nurse education, practice and retention
The Committee provides $37,291,000 for nurse education, practice and retention, which is the same as the fiscal year 2006 funding level and the budget request. The nurse education, practice and retention program is a broad authority with targeted purposes under three priority areas--education, practice and retention--in response to the growing nursing shortage.
Nursing workforce diversity
The Committee provides $16,107,000 for nursing workforce diversity, which is the same as the fiscal year 2006 funding level and the budget request. The program provides grants and contracts to schools of nursing and other eligible entities to meet the costs of special projects to increase nursing education opportunities for individuals who are from disadvantaged backgrounds, including racial and ethnic minorities, by providing student scholarships or stipends, pre-entry preparation, and retention activities. The program also contributes to the basic preparation of disadvantaged and minority nurses for leadership positions within the nursing and health care community.
Loan repayment and scholarship program
The Committee provides $31,055,000 for the nurse loan repayment and scholarship program, which is the same as the fiscal year 2006 funding level and the budget request. This program offers student loan repayment to nurses or scholarships to nursing students in exchange for an agreement to serve not less than two years at a health care facility with a critical shortage of nurses.
The Committee recognizes that registered nurses who participate in the loan repayment and scholarship program repay their loans and scholarships by working in health care facilities with a critical shortage of nurses, serving many of the Nation's underserved populations. The Committee believes that HRSA should consider allowing graduate educated nurses to repay their service commitment by working as a nurse faculty in a school of nursing.
Comprehensive geriatric nurse education
The Committee provides $3,392,000 for comprehensive geriatric nurse education, which is the same as the fiscal year 2006 funding level and the budget request. The comprehensive geriatric education program supports grants for (1) providing training to individuals who will provide geriatric care for the elderly; (2) develop and disseminate curricula relating to the treatment of the health care problems of elderly individuals; (3) train faculty members in geriatrics; or (4) provide continuing education to individuals who provide geriatric care.
Nursing faculty loan program
The Committee provides $4,773,000 for the nursing faculty loan program, which is the same as the fiscal year 2006 funding level and the same as the budget request. The nursing faculty loan program supports the development of a student loan fund in schools of nursing to increase the number of qualified nursing faculty. Students may receive loans up to $30,000 per year for a maximum of 5 years. The program has a cancellation provision for up to 85 percent of the loan for recipients working full-time as nursing faculty for a period of 4 years.
Children's hospitals graduate medical education payment program
The Committee provides $300,000,000 for the children's hospitals graduate medical education payment program, which is $3,000,0000 above the fiscal year 2006 funding level and $201,000,000 above the budget request. The program provides support for graduate medical education training in children's teaching hospitals that have a separate Medicare provider number (`free-standing' children's hospitals). The funding in this program is intended to make the level of Federal Graduate Medical Education support more consistent with other teaching hospitals, including children's hospitals which share provider numbers with other teaching hospitals. Payments are determined by formula, based on a national per-resident amount. Payments support training of resident physicians as defined by Medicare in both ambulatory and inpatient settings. The Committee believes this program is vital to restoring the reimbursement inequity faced by pediatric hospitals, which provide very high quality care to children with difficult and expensive conditions.
National practitioner data bank
The Committee does not provide funding for the national practitioner data bank for fiscal year 2007, which is the same as both the fiscal year 2006 appropriations and the budget request. The Committee recommendation and the budget request assume that the data bank will be self-supporting, with collections of $15,700,000 in user fees. The national data bank receives, stores, and disseminates information on paid medical malpractice judgments and settlements, sanctions taken by Boards of Medical Examiners, losses of membership in professional societies, and certain professional review actions taken by health care entities. Insurance companies, State licensure boards and authorities, and other health care entities and professional societies are required to report information to the data bank within 30 days of each action. The coverage of the data bank includes dentists and physicians, and, with respect to malpractice settlements and judgments, other categories of licensed health professionals. Hospitals are required to search the data bank when a health care provider applies for employment and once every two years thereafter. State licensing boards, other health care entities, licensing authorities, and professional societies also have access to the data bank. Traditional bill language is included to ensure that user fees are collected to cover the full costs of the data bank operations.
Health care integrity and protection data bank
The Committee does not provide funding for the health care integrity and protection data bank (HIPDB) for fiscal year 2007. The Committee recommendation and the budget request assume that the data bank will be self-supporting, with collections of $4,000,000 in user fees. HIPDB receives, stores, and disseminates information on final adverse actions taken against health care providers, suppliers, and practitioners, health care related civil judgments and criminal convictions. This information is collected from and made available to Government agencies and health plans.
Maternal and child health block grant
The Committee provides $700,000,000 for the maternal and child health (MCH) block grant, which is $7,000,000 above both the fiscal year 2006 funding level and the budget request.
The MCH block grant provides funds to States to meet a broad range of basic and enabling health services, including personal health services; general, population-wide health services, such as screening; family support services; and integrated systems of care. The authorizing statute provides that, up to a funding level of $600,000,000, 85 percent of the funds are distributed to the States, with 15 percent of the funds set aside for special projects of regional and national significance (SPRANS). When the appropriation exceeds $600,000,000, 12.75 percent of the amount over $600,000,000 is directed to the Community Integrated Service Systems set-aside program. The remaining 87.25 percent is distributed by the same 85/15 percent allocation as in the basic block grant formula.
The Committee has included bill language identifying $117,428,000 for the SPRANS set-aside. Within the total, the Committee urges HRSA to provide the highest possible funding level to continue and enhance the Leadership Education in Neurodevelopmental and Related Disabilities (LENDs) programs. These programs are designed to improve the health status of infants, children and adolescents with or at risk for neurodevelopmental and related disabilities and their families. This is accomplished through the interdisciplinary training of professionals for leadership roles in the provision of health and related care, continuing education, technical assistance, research and consultation. The programs focus on the special health care needs of children with a wide range of neurodevelopmental, metabolic and genetic disorders. Additional funding would help these programs initiate or expand their work in the area of Down Syndrome, autism, and genetics counseling.
Within the total, $5,000,000 is provided in SPRANS to help states develop well integrated, quality oral health programs through grants, cooperative agreements and contracts. The Committee further encourages HRSA to assist states through partnerships with national associations and foundations to focus on state based early interventions to prevent early childhood caries. As linkages continue to be made between disease transmissibility and maternal behaviors, and poor birth outcomes and poor periodontal health, further program attention is warranted to avoid the need for more costly care.
Within the total, the Committee provides $3,000,000 within the SPRANS set-aside to continue epilepsy demonstration programs. These programs are designed to improve access to health and other services regarding seizures and to encourage early detection and treatment in children and others residing in medically underserved and rural areas. Of the amount provided, the Committee recommends that up to thirty percent be used to continue to fund the development and testing of a national public health awareness campaign to increase seizure recognition and improve access to care among minorities and underserved populations. The Committee is pleased that HRSA has partnered with a national organization whose mission is to improve the lives of children and adults affected by seizure through research, education, advocacy and service.
In addition, the Committee provides $3,000,000 within the SPRANS set-aside to continue the newborn screening for heritable disorders demonstrations begun several years ago. Newborn screening is used for early identification of infants affected by certain genetic, metabolic, hormonal or functional conditions for which there are effective treatment or intervention. Screening detects disorders in newborns that, left untreated, can cause death, disability, mental retardation and other serious illnesses.
The Committee commends HRSA for convening the Secretary's advisory committee on heritable disorders and genetic diseases in newborns and children to make national recommendations to standardize newborn screening programs in the US; and for funding the regional genetic service and newborn screening collaboratives to address the maldistribution of genetic services and resources to bring services closer to local communities. However, the Committee is aware that wide disparities continue to exist in the number of conditions screened for in each state. The Committee believes that parents and healthcare providers responsible for the care of newborns should be able to provide the best chance at a healthy start on life, and therefore, strongly urges HRSA to include as a requirement for funding a provision that parents be informed in writing of the availability of additional tests that may not be required under state law.
The Committee intends that within the total for the SPRANS set-aside, $1,500,000 will be used to develop model demonstration programs to develop a national data source by which States can report State-specific rates and improve the screening, detection, and treatment of vision problems that would otherwise result in delayed learning and education in children. The Committee encourages HRSA to work in partnership with a national voluntary health organization with expertise in children's vision screening and established certified vision screening training programs.
Of the funds appropriated for the SPRANS set-aside, the Committee includes $4,000,000 to support the continuation and enhancement of the locally-based newborn screening follow-up and community-based sickle cell disease outreach and supportive service initiative.
The Committee reiterates its long-standing support for the continuation of funding that the MCH block grant has provided to comprehensive thalassemia treatment centers under the SPRANS program. The Committee strongly encourages HRSA to continue this program and to coordinate with the relevant voluntary organizations.
The Committee urges HRSA to maintain its funding support through the SPRANS set-aside of the network of hemophilia treatment centers, which provide comprehensive disease management services to persons with bleeding and clotting disorders.
The Committee recognizes the contributions of the longstanding Provider's Partnership program and encourages HRSA to continue its funding. The Partnership includes a series of state-level projects initiated to address female psychosocial issues through integration of medical care with psychosocial services. Such partnerships enhance service integration, minimize demands on individual providers, and facilitate movement between providers and agencies to create comprehensive care.
Sickle cell anemia demonstration program
The Committee provides $2,178,000 for the sickle cell anemia demonstration program, which is the same as the budget request and the fiscal year 2006 funding level. This program was created to develop systemic mechanisms for the prevention and treatment of sickle cell disease.
Traumatic brain injury
The Committee provides $8,910,000 for the traumatic brain injury (TBI) program. This is the same as the fiscal year 2006 funding level. The budget request did not include funding for this program. The TBI program funds the development and implementation of statewide systems to ensure access to care including prehospital care, emergency department care, hospital care, rehabilitation, transitional services, rehabilitation, education and employment, and long-term community support. Grants also go to State protection and advocacy systems.
Healthy Start
The Committee provides $101,518,000 for Healthy Start, which is the same as the fiscal year 2006 funding level and the budget request. Healthy Start provides grants to select communities with high rates of infant mortality to help them identify, plan, and implement a diverse range of community-driven strategies that can successfully reduce disparities in perinatal health that contribute to the Nation's high infant mortality rate.
Since 1990, the Maternal and Child Health Bureau has worked in cooperative agreement to run the National Fetal Infant Mortality Review (NFIMR) program. NFIMR provides training and assistance to enhance cooperative partnerships among local community health professionals, public health officers, community advocates and consumers to reduce infant mortality. The goal is to improve local services and resources for women, infants and families, to remove barriers to care, and to ensure culturally appropriate, family friendly services. Such efforts are crucial to understanding and addressing infant health disparities in communities at highest risk. The Committee encourages HRSA to continue to use Healthy Start funds to support the NFIMR project.
Universal newborn hearing screening
The Committee provides $10,000,000 for the universal newborn hearing screening program, which is $199,000 more than the fiscal year 2006 funding level. The budget request did not include funding for this program. The program provides competitive grants to States for universal newborn hearing screening by means of physiologic testing prior to hospital discharge, audiologic evaluation by three months of age, and entry into a program of early intervention by six months of age.
Emergency medical services for children
The Committee provides $19,800,000 for the emergency medical services for children (EMSC) program, which is the same as the fiscal year 2006 funding level. The budget request did not include funding for this program. Grants are provided to States and territories to improve existing emergency medical services systems and to schools of medicine to develop and evaluate improved procedures and protocols for treating children.
Ryan White HIV/AIDS programs
The Committee provides $2,107,713,000 for Ryan White HIV/AIDS programs, which is $70,000,000 above the fiscal year 2006 funding level and $25,000,000 less than the budget request. The bill also makes available $25,000,000 in program evaluation funding under section 241 of the Public Health Service for special projects of national significance. Within the total provided, the Committee provides no less than the funds provided in fiscal year 2006 for Ryan White HIV/AIDS activities that are targeted to address the growing HIV/AIDS epidemic and its disproportionate impact upon communities of color, including African Americans, Latinos, Native Americans, Asian Americans, Native Hawaiians, and Pacific Islanders.
The Committee is aware that over 30 percent of HIV-infected persons in the United States are also chronically infected with the hepatitis C virus (HCV). Chronic hepatitis C infection may lead to cirrhosis of the liver and liver cancer, and is the leading cause of liver transplantation in the U.S. In addition, chronic hepatitis C disease progresses more rapidly in HIV-infected persons, and end stage liver disease resulting from chronic hepatitis C infection is now a leading cause of death for people with HIV/AIDS. The Committee encourages HRSA to provide guidance to CARE Act grantees to encourage them to proactively address HCV care and treatment among their HIV/HCV co-infected patient populations, and encourages State AIDS Assistance Programs to provide coverage of therapies approved by the FDA for the treatment of HCV in HIV/HCV co-infected patients.
Emergency assistance
The Committee provides $603,993,000 for the Part A, emergency assistance program, which is the same as the fiscal year 2006 funding level and the budget request. These funds provide grants to metropolitan areas with very high numbers of HIV/AIDS cases for outpatient and ambulatory health and social support services. Half of the amount appropriated is allocated by formula and half is allocated to eligible areas demonstrating additional need through a competitive grant process.
Comprehensive care programs
The Committee provides $1,190,518,000 for Part B, comprehensive care programs, which is $70,000,000 above the fiscal year 2006 funding level and the same as the budget request. The funds provide formula grants to States for the operation of HIV service delivery consortia in the localities most heavily affected, for the provision of home and community-based care, for continuation of health insurance coverage for infected persons, and for purchase of therapeutic drugs. The Committee includes bill language identifying $789,546,000 specifically to support State AIDS Drug Assistance Programs (ADAP), the same as the fiscal year 2006 funding level and the budget request.
The Committee is aware of the success HIV therapies have had on prolonging and enhancing the quality of life for those infected with HIV/AIDS. As the infected population lives longer and becomes increasingly resistant to current treatment regimens, there is a growing need to focus on access to newer therapies for treatment-experienced or `later stage' patients. The Committee encourages HRSA and state ADAPs to prioritize coverage of treatments for later stage patients so that there is parity of access to effective treatments for patients across the HIV disease spectrum.
Early intervention program
The Committee provides $193,622,000 for Part C, the early intervention services program, which is the same as the fiscal year 2006 funding level and $25,000,000 less than the budget request. Funds are used for discretionary grants to community health centers, family planning agencies, comprehensive hemophilia diagnostic and treatment centers, Federally-qualified health centers, county and municipal health departments and other non-profit community-based programs that provide comprehensive primary care services to populations with or at risk for HIV disease. The grantees provide testing, risk reduction counseling, transmission prevention, oral health, nutritional and mental health services, and clinical care. Optional services include case management, outreach, and eligibility assistance.
Children, youth, women, and families
The Committee provides $71,794,000 for Part D, children, youth, women, and families programs, which is the same as the fiscal year 2006 funding level and the budget request. HIV-infected children, youth and women and affected family members have multiple, complex medical, economic and social service needs which often require more intensive care coordination, intensive case management, child and respite care, and direct service delivery to engage and maintain adolescents and mothers in care. Funds support innovative and unique strategies and models to organize, arrange for, and deliver comprehensive services through integration into ongoing systems of care.
AIDS dental services
The Committee provides $13,086,000 for AIDS dental services, which is the same as the fiscal year 2006 funding level and the budget request. The program includes two components: the dental reimbursement program, which reimburses dental education programs for non-reimbursed costs incurred in providing care, and the community-based dental partnership, which increases access to oral health services and provider training in community settings.
Education and training centers
The Committee provides $34,700,000 for AIDS education and training centers (AETCs), which is the same as the fiscal year 2006 funding level and the budget request. The centers train health care personnel who care for AIDS patients and develop model education programs.
Organ transplantation
The Committee provides $23,049,000 for organ transplantation activities, which is the same as the fiscal year 2006 funding level and the budget request. The program supports the Scientific Registry of Transplant Recipients; the Organ Procurement and Transplantation Network, which matches organ donors with potential recipients; and grants and contracts with public and private organizations to promote and improve organ donation.
The Committee is pleased with the progress of the transplantation collaborative project to implement best practices in the various organ procurement organizations and donor hospitals across the country. This program is credited with increasing the rate of organ donation by 10.8 percent in 2004 and by an additional 6.6 percent in 2005. The Committee urges that funding be provided to the next phase of the transplantation collaborative, which will help increase the number of organs donated per individual donor. The Committee is also pleased that HRSA has awarded a grant to reimburse for travel and subsistence expenses for individuals traveling to transplantation centers for the purpose of organ donation. The Committee urges that a careful evaluation process be encompassed in this effort to learn its impact on the rate of organ donation and organ evaluation resulting in transplantation. The Committee notes that there are now twenty states with first-person consent laws, which when combined with state registries, have proven to be a powerful factor in increasing the rate of donation.
The Committee commends HRSA for its leadership in promoting increased organ and tissue donations across the nation and encourages the Division of Transplantation to expand its partnership with the pulmonary hypertension community in this important area.
National cord blood inventory
The Committee concurs with the budget request and does not provide additional funding for the national cord blood inventory program. The fiscal year 2006 appropriation provided an additional $3,960,000 for this program. The Committee is very supportive of this program, but notes that from the funds provided in fiscal years 2004 through 2006, more than $22,000,000 remains available for obligation. The purpose of this program is to provide funds to cord blood banks to build an inventory of the highest quality cord blood units for transplantation.
Cell transplantation program
The Committee provides $25,162,000 for the cell transplantation program, which is the same as the fiscal year 2006 funding level and $2,475,000 above the budget request. The C.W. Bill Young Cell Transplantation Program, signed into law on December 20, 2005, is the successor to the National Bone Marrow Donor Registry.
Office of pharmacy affairs
The Committee provides $2,970,000 for the office of pharmacy affairs, the same level as the budget request. The funding for this new budget request within HRSA will help resolve identified deficiencies in the 340B drug pricing program and is intended to make major improvements in program operations.
The Committee is concerned about barriers to safety net pharmacies contracting with the Medicare Part D prescription drug plans and the subsequent impact on low income Medicare beneficiaries' participation. The Committee urges the office of pharmacy affairs to work with the Centers for Medicare and Medicaid Services (CMS) to assess safety net participation in Part D networks and expand assistance to assure that safety net pharmacies may participate on fair and relevant terms. The Committee is aware of legislation that would track and analyze the expenditures that safety net pharmacies make on behalf of their low income Medicare patients which do not count towards beneficiaries' true out-of-pocket expenditures, and supports the goal of ensuring low-income Medicare beneficiaries have continued access to prescription drugs through the Medicare program.
Poison control centers
The Committee provides $23,068,000 for poison control centers, which is the same as the fiscal year 2006 funding level and $9,900,000 above the budget request. These funds support a grant program for poison control centers. In addition, funds are used to maintain a national toll-free number and to implement a media campaign to advertise that number, as well as to support the development of uniform patient management guidelines and the improvement of data collection.
Rural outreach grants
The Committee provides $40,000,000 for rural outreach grants, which is $1,115,000 above the fiscal year 2006 funding level and $29,635,000 above the budget request. The program administers grant programs to deliver and improve rural health care services to the approximately 54,000,000 Americans living in rural areas.
Rural health research
The Committee provides $9,000,000 for rural health research, which is $263,000 above the fiscal year 2006 funding level and the budget request. This activity supports several rural health research centers and the Secretary's rural health advisory committee.
Rural hospital flexibility grants
The Committee provides $40,000,000 for rural hospital flexibility grants, which is $23,538,000 less than the fiscal year 2006 funding level. The budget request did not include funding for this program. The program is comprised of two components: (1) flexibility grants to States to assist small, at risk rural hospitals that wish to convert to Critical Access Hospitals and receive cost-based payments from Medicare and (2) small rural hospital improvement grants that provide modest amounts to hospitals to assist them in automation and compliance with confidentiality requirements.
The Committee concurs with the budget request and does not include funding for the Delta health initiative. The $25,000,000 that was provided in fiscal year 2006 was intended to be a one-time project.
Rural and community access to emergency devices
The Committee provides $1,500,000 for the rural access to emergency devices and the public access defibrillation demonstration program, which is $15,000 above the fiscal year 2006 funding level. Funding for this program was not included in the budget request. The program assists both urban and rural communities in increasing survivability from sudden cardiac arrest by providing funding for the purchase, placement, and training in the use of automated external defibrillators (AEDs).
State offices of rural health
The Committee provides $8,400,000 for State offices of rural health, which is $259,000 above the fiscal year 2006 funding level and the budget request. The State office of rural health program creates a focal point for rural health within each of the fifty States. In each State, the office collects and disseminates information on rural health, coordinates rural health resources and activities, provides technical assistance to rural providers and communities, and helps communities recruit and retain health professionals.
Denali Commission
The Committee concurs with the budget request and has not included funding for the Denali Commission. The fiscal year 2006 funding level is $39,283,000.
Family planning
The Committee provides $283,103,000 for the family planning program, which is the same as the fiscal year 2006 funding level and the budget request. The program provides grants to public and private non-profit agencies to support a range of family planning and reproductive services, as well as related preventive health services such as patient education and counseling, breast and cervical cancer examinations, STD and HIV prevention education, counseling and testing and referral, and pregnancy diagnosis and counseling. The program also supports training for providers, an information and education program, and a research program which focuses on family planning service delivery improvements.
The bill continues to include language making clear that these funds shall not be expended for abortions, that all pregnancy counseling shall be nondirective, and that these funds shall not be used to promote public opposition to or support of any legislative proposal or candidate for public office.
Healthcare-related facilities and other programs
The Committee includes bill language specifying $248,146,000 for healthcare-related facilities and other programs. No funding was included in the budget request or in the fiscal year 2006 appropriation for this activity. This program provides funds for construction and renovation, including equipment, of healthcare and other facilities, directed rural health projects, telehealth grants, health professions training, and other health-related activities. These funds are to be used for the following projects and in the following amounts:
| 16th Street Community Health Center, Milwaukee, WI for facilities and equipment | $75,000 |
| Access Community Health Network, Chicago, IL for facilities and equipment | 400,000 |
| Adams County Hospital, West Union, OH for facilities and equipment | 100,000 |
| Adventist HealthCare, Rockville, MD for facilities and equipment | 200,000 |
| Aims Community College, Greeley, CO for equipment for career training in the health professions | 150,000 |
| Akron General Medical Center, Akron, OH for equipment for an ambulatory medical record system | 200,000 |
| Alabama |