On June 21, the Senate Appropriations Committee approved the FY2008 Labor, Health and Human Services, Education, and Related Agencies spending bill (S. 1710) (see The Source, 6/22/07). The committee report accompanying the bill has been printed and details a number of programs of interest to women and their families.
The measure would allocate $149.872 billion in discretionary funds in FY2008, $5.262 billion more than FY2007, $9.158 billion over President Bush’s request, and $1.676 less than the House version of the bill.
The bill includes a provision to expand federal funding for embryonic stem cell research, permitting the Department of Health and Human Services (HHS) to spend federal money to conduct research using stem cells derived on or before June 15, 2007. No federal funds would be used to create stem cell lines, in accordance with the Dickey-Wicker amendment. The amendment, enacted as part of the Balanced Budget Downpayment Act (P.L. 104-99), prohibits the use of federal funds for research in which a human embryo is created or destroyed.
Department of Labor
The Women In Apprenticeship and Nontraditional Occupations (P.L. 102-530) program would receive level funding of $1 million in FY2008. The administration would have eliminated the program.
The Department of Labor Women’s Bureau would receive $10.3 million in FY2008, $634,000 more than FY2007 and $468,000 more than the budget request.
Dislocated worker assistance would be level-funded at $1.19 billion in FY2008, $286.872 million more than the administration’s request.
Job Corps would receive $1.66 billion in FY2008, $81.595 million below FY2007 and $137.5 million less than President Bush’s request.
The committee “has recognized over the years the quality academic and vocational services Job Corps has provided to over two million economically disadvantaged youth. Currently, Job Corps has the capacity to serve one percent of the over six million youth in our country that have been left behind by traditional education programs. The committee has also recognized and responded to this growing service gap by mandating an expansion of the program in new communities in FY2006 and FY2007. The committee rejects the Department of Labor’s proposal to reduce Job Corps student training slots by over 4,300. Rather, the committee includes sufficient funding to maintain student services at the existing 122 Job Corps centers, as well as to operate any new centers. This funding will ensure that determined young people wanting to participate in Job Corps will not be turned away from an opportunity to become successful and self-sufficient members of their communities.”
Youthbuild would receive $65 million in FY2008, $15.5 million above FY2007 and $15 million more than the budget request. The YouthBuild program “provides the opportunity for eligible youth to learn construction trade skills by building or rehabilitating housing for low-income individuals, earn a high school diploma or equivalency degree, and prepare for postsecondary training. Personal counseling and training in life skills and financial management also are provided. The students are a part of a mini-community of adults and youth committed to each other’s success and to improving the conditions in their neighborhoods. The committee notes that 68,000 YouthBuild students have built or rehabilitated 16,000 units of affordable housing since 1994. Construction projects range from constructing new homes to restoring multi-unit buildings to rebuilding entire neighborhoods.”
Responsible Reintegration of Youthful Offenders programs would receive $55 million in FY2008, $5.896 million more than FY2007. The administration would have merged this program into a new program the Reintegration of Ex-Offenders.
The committee “does not include funding for the Prisoner Re-entry initiative. The comparable FY2007 level is $19.642 million, while the budget request proposed eliminating funding for this purpose. The budget proposes to redirect these funds to a new Responsible Reintegration of Ex-Offenders program.”
The new Responsible Reintegration of Ex-Offenders Program would receive $13.642 million in FY2008, $25.958 million below President Bush’s request. According to the committee report, “Funds would be used to connect adult ex-offenders with pre-release, mentoring, housing, case management and employment services, utilizing the best practices learned from the Prisoner Re-entry initiative. The committee urges the department to award grants to organizations that will: (1) implement programs, practices, or strategies shown in well-designed randomized controlled trials to have sizable, sustained effects on important workforce and reintegration outcomes; (2) adhere closely to the specific elements of the proven program, practice, or strategy; and (3) obtain sizeable matching funds for their project from other federal or non-federal sources, such as the Adult Training formula grant program authorized under the Workforce Investment Act of 1998, or state or local programs.”
The bill would fund the Bureau of International Labor Affairs at $82.516 million, $10 million above FY2007 and $68.419 million more than President Bush’s request. Of that amount, $42.61 million would “be used for the United States contribution to expand on the successful efforts of the International Labor Organization’s International Program for the Elimination of Child Labor” and $26.77 million would be directed “to help ensure access to basic education for the growing number of children removed from the worst forms of child labor in impoverished nations where abusive and exploitative child labor is most acute. The committee expects the Department of Labor to work with the governments of host countries to eliminate school fees that create a barrier to education.”
The committee is “disappointed that the Department of Labor has once again proposed a budget that drastically reduces funding for International Labor Affairs Bureau (ILAB), in particular, those initiatives working with the International Labor Organization (ILO) to combat abusive and exploitative child labor. The committee is pleased by findings contained in the ILO report entitled ‘The End of Child Labor: Within Reach,’ which was released in May 2006. The report stated that child labor is in decline worldwide, in large part because of the programs advanced by this committee. Between 2000 and 2004, the number of child laborers worldwide fell by 11 percent, from 246 million to 218 million. Moreover, the number of children and youth aged 5-17 trapped in hazardous work decreased by 26 percent, and for the age group of 5-14 years, the decline in hazardous work was even steeper, at 33 percent.”
The report continues, “It is a testament to the importance of the programs administered by the ILAB, which this committee has consistently supported. For over the past decade, the ILAB has built up a staff of professional experts with a knowledge base on the issue of exploitative child labor that is unrivaled in any other U.S. government agency. Clearly, these programs administered by ILAB are having a positive impact and the committee feels strongly that reducing United States efforts to eradicate child labor or substantially changing the structure and leadership of those efforts would, at best, endanger the progress being made. At worse, withdrawing from these efforts could damage the credibility and reputation of the United States in the countries whose governments are real partners to the United States in this effort.”
Department of Health and Human Services
Health Resources and Services Administration (HRSA): HRSA programs would receive $6.869 billion in FY2008, $452.971 million more than FY2007 and $1.048 billion more than the budget request.
Community health centers would receive $2.238 billion in FY2008, $250 million more than FY2007 and $249.572 million more than the budget request.
The committee “supports continued efforts to expand the Health Centers program into those areas of the country with high poverty and no current access to a health center. The committee urges HRSA to implement such an expansion to address the lack of access in the neediest communities of the country, and that eligibility for new funding not be limited to certain geographic areas, such as counties. The committee directs HRSA to expedite awards to new access points by funding sufficiently high-scoring applications from the FY2007 cycle that were left unfunded. Further, the committee urges HRSA to make funding available to increase capacity at existing centers, and for service expansion awards adding mental health services, dental services, and pharmacy services at community health centers. The committee expects HRSA to implement any new expansion initiative using the existing, and statutorily-required, proportionality for urban and rural communities, as well as migrant, homeless, and public housing health centers.”
As requested by the administration, the bill would level-fund the Maternal and Child Health Block Grant at $673 million.
“The Maternal and Child Health (MCH) Block Grant program provides a flexible source of funding that allows states to target their most urgent maternal and child health needs through development of community-based networks of preventive and primary care that coordinate and integrate public and private sector resources and programs for pregnant women, mothers, infants, children, and adolescents. The program supports a broad range of activities, including prenatal care, well child services and immunizations, reducing infant mortality, preventing injury and violence, expanding access to oral health care, addressing racial and ethnic disparities, and providing comprehensive care for children, adolescents, and families through clinics, home visits, and school-based health programs. The MCH block grant funds are provided to states to support health care for mothers and children. According to statute, 85 percent of appropriated funds up to $600 million are distributed to states and 15 percent are set aside for special projects of regional and national significance (SPRANS). Also according to statute, 12.75 percent of funds over $600 million are to be used for community-integrated service systems programs. The remaining funds over $600 million are distributed on the same 85/15 percent split as the basic block grant. The committee does not intend to cut grants to states or the grants for community integrated service systems. Therefore, the committee has included a statutory provision to hold harmless both of these grant programs.”
The committee “has included bill language identifying $95,936,920 for the SPRANS set-aside. Within that total, the committee intends that $1.536 million be used for a first-time motherhood education program; $2.881 million be used for epilepsy demonstration projects; $990,000 be used for a fetal alcohol syndrome demonstration program; $3.841 million be used to continue the sickle cell newborn screening program and its locally based outreach and counseling efforts; $1.921 million be used for newborn and child screening for heritable disorders as authorized in title XXVI of the Children’s Health Act of 2000 [P.L. 106-310]; and $4.802 million be used to continue the oral health demonstration programs and activities in the states.”
As stated above, “the committee also provides $1.536 million for a first-time motherhood demonstration program, equally divided between urban and rural settings. Funding for urban settings should be focused on community-based doula activities. These funds may be used to improve infant health, strengthen families, and provide supports to ensure family success through a community-based doula program. This approach identifies and trains indigenous community leaders to mentor pregnant women during the months of pregnancy, birth, and the immediate post-partum period. Doulas provide pregnancy and childbirth education, early linkage to health care and social services, labor coaching, breastfeeding education and counseling, and parenting skills while fostering parental attachment. Rural areas represent a unique challenge in supporting first-time mothers, particularly around the area of lactation support and services. Funding for the rural portion of the demonstration should be focused on the best ways of delivering supportive services, including delivery outside the hospital setting both before and after the birth of the child. Priority should be given to applications which emphasize breastfeeding initiation and retention.”
The Healthy Start infant mortality initiative would receive level funding of $101.518 million in FY2008, $1.015 million above President Bush’s request.
Universal newborn hearing screening would receive $12 million in FY2008, $2.196 million more than FY2007. The administration would have eliminated the program.
Ryan White: The Ryan White Care Act would receive a total of $2.171 billion, a $33.124 million increase over FY2007 and $13.007 million more than the administration’s request.
Part D of the Ryan White CARE Act, which provides funding for programs for children, youth, women, and families, would be funded at $75 million, $3.206 million more than FY2007 and President Bush’s request.
National Cord Stem Cell Inventory: The National Cord Stem Cell Inventory would be funded at $12 million in FY2008, $8.04 million over FY2007 and $10.034 million above the budget request.
Family Planning: Title X, the nation’s family planning program, would receive $300 million, $16.854 million over FY2007 and $16.897 million more than President Bush’s request.
Title X grants “support primary health care services at more than 4,400 clinics nationwide. About 85 percent of family planning clients are women at or below 150 percent of the poverty level. Title X of the Public Health Service Act, which established the family planning program, authorizes the provision of a broad range of acceptable and effective family planning methods and preventive health services to individuals, regardless of age or marital status. This includes FDA [Food and Drug Administration]-approved methods of contraception.”
The committee “remains concerned that programs receiving Title X funds ought to have access to these resources as quickly as possible. The committee again instructs the Department to distribute to the regional offices all of the funds available for family planning services no later than 60 days following enactment of this bill. The committee intends that the regional offices should retain the authority for the review, award, and administration of family planning funds, in the same manner and timeframe as in FY2006.”
Centers for Disease Control and Prevention (CDC): The measure would allocate $6.427 billion for the CDC in FY2008, a $224.161 million increase over FY2007 and $444.182 million more than the administration’s request.
The committee “notes that there are multiple causes for infertility, including ovulatory and hormonal disorders, blocked fallopian tubes, endometriosis, and cervical problems among women and poor sperm quality, motility, and count among men. There are also recognized risk factors that contribute to these causes in addition to sexually transmitted diseases, which have been the primary focus of CDC’s education on infertility risks. These factors include delayed child bearing, smoking, low or excessive body weight, and other chronic conditions, exposures to hazardous environmental toxins and contaminants, drug and alcohol abuse, diabetes, cancer, and, particularly for men, exposure to high temperatures. The committee encourages CDC to consider expanding the scope of this program and provide greater support to public education on the risks to fertility.”
The committee would allocate $851.18 million for chronic disease prevention and health promotion in FY2008, $16.182 million above FY2007 and $16.985 million more than President Bush’s request. Included in this amount is “$1 million to expand epilepsy and lupus-related activities…$19.228 million to expand cancer control and prevention activities…[and] $50,000 to expand safe motherhood and infant health activities.”
Within the amount provided for cancer control and prevention, “the following amounts are provided for the specified activities above the comparable amount for FY2007: $10 million to expand breast and cervical cancer activities, including $6.535 million to expand Wisewoman; $9.133 million to expand comprehensive cancer activities, and $100,000 to expand activities related to cancer survivorship. All other cancer activities are funded at the FY2007 level.”
The committee “is aware of new research into the prevalence of cerebral palsy in cases of preterm birth, which may indicate a potential correlation between cerebral palsy rates and neonatal treatments. This type of research highlights the need for epidemiologic data on cerebral palsy. The committee requests a report by July 31, 2008 on what types of data are most needed for a public health response to cerebral palsy and the strengths and weaknesses of the various methods of collecting epidemiologic data in this population. As part of that report, the committee encourages the CDC to consider establishing cerebral palsy surveillance and epidemiology systems that would work in concert with similar disorders.”
Of concern to the committee is the “increasing prevalence of eating disorders affecting 8 to 10 million Americans. Research suggests that for females between 15 and 24 years of age, the mortality rate associated with anorexia nervosa is 12 times higher than for all other causes of death. The committee urges the CDC to implement data collection regarding the morbidity and mortality of anorexia nervosa, bulimia nervosa, and related eating disorders so that prevention and treatment strategies may be most effective.”
The committee “is encouraged by the progress that has been made by CDC, in coordination with the Office of Women’s Health at the Public Health Service, to initiate a national education campaign on gynecologic cancers. The committee strongly urges the rapid completion of the evaluation of past and present activities to increase the awareness and knowledge regarding gynecologic cancers and the creation of a strategy for improving efforts to increase awareness and knowledge of the public and health care providers with respect to gynecological cancers.”
The committee report states, “Given the large, preventable health and economic burden of poor nutrition, physical inactivity, and unhealthy body weight, the committee encourages CDC to continue its leadership role in developing, implementing, and evaluating nutrition and physical activity population-based strategies to prevent and control overweight and obesity. Targeting prevention efforts throughout the lifespan — including children as young as toddlers — as well as promoting fruit and vegetable consumption through CDC’s federal lead role in the national Five-A-Day program, and increasing the proportion of children, adolescents, and adults who meet daily physical activity recommendations should remain priorities for the agency. The committee has provided $1 million above the FY2007 level to sustain and expand CDC’s support of the Five-A-Day Program.”
According to the report, “Preterm birth is a serious and growing public health problem that occurs in 12.5 percent of all births in the United States. The committee encourages the CDC to conduct additional epidemiological studies on preterm birth, including the relationship between prematurity, birth defects, and developmental disabilities. The committee also encourages the establishment of systems for the collection of maternal-infant clinical and biomedical information to link with the Pregnancy Risk Assessment Monitoring System [PRAMS] and other epidemiological studies of prematurity in order to track pregnancy outcomes and prevent preterm birth.”
The committee would provide $261,000 for Sudden Infant Death Syndrome (SIDS) prevention activities.” In addition, the committee encourages CDC to consider supporting a National Campaign for Cribs pilot program. Such a pilot project may be composed of a public health education component for new parents and caregivers and seek to provide a crib for babies whose mothers and caregivers cannot afford a proper sleeping environment for their children.”
The committee would allocate $128.696 million in FY2008 for birth defects and developmental disabilities, $4.032 million above FY2007 and $4.159 million more than President Bush’s request.
The committee “is encouraged with the progress made in preventing neural tube defects, but is concerned by a recent analysis which found that folate concentrations among non-pregnant women of child bearing age decreased by 16 percent from 1999-2000 through 2003-2004. The committee commends the CDC for its efforts related to educating women about multivitamin usage in order to improve folic acid status and reduce the rate of birth defects. The committee has provided sufficient funding to continue these efforts, particularly those that engage Hispanic women and other at-risk populations.”
The report states that the committee “continues to commend the CDC for its commitment to support the enhanced development of a portable, hand-held lead screening device that holds great promise for increasing childhood [lead exposure] screening rates in underserved communities. Further development of this device will help ensure its application in community health settings.”
The committee would fund injury prevention and control programs at $4.197 million in FY2008. Included in that amount is $1.982 million for youth violence prevention and $1.935 million for rape prevention.
The committee “recognizes that child maltreatment is a serious public health threat with extensive short- and long-term health consequences. New avenues to support child maltreatment prevention would allow CDC to further the identification, enhancement, and dissemination of evidence-based child maltreatment prevention programs, such as positive parenting programs and home visitation programs.”
The committee “urges CDC to increase research on the psychological sequelae of violence against women and expand research on special populations and their risk for violence, including adolescents, older women, ethnic minorities, women with disabilities, and other affected populations.”
The committee would level-fund global health programs at $334.038 million in FY2008, $45.681 million below the budget request.
The committee “recognizes that malaria is a global emergency affecting mostly poor women and children. While malaria is treatable and preventable, it remains one of the leading causes of death and disease worldwide. The committee appreciates the integral and unique role that the CDC Malaria Program plays in national and global efforts. Insecticide resistance and drug resistance have the potential to compromise global malaria efforts and point to the need for the development and testing of new technologies and materials for insecticide treated nets and new anti-malarial therapies. The committee is concerned that failure to support these efforts could seriously impair future control efforts.”
National Institutes of Health (NIH): The NIH would receive $29.608 billion in FY2008, $799 million more than FY2007 and $1.279 billion more than the administration’s request.
The committee recommends $110.9 million “for the second full year of implementing the National Children’s Study.” The FY2007 appropriation was $69 million; under the administration’s budget this program would not have been funded. The committee also fully funds the budget request of $300 million for transfer to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The FY2007 transfer was $99 million.”
The committee “again strongly urges the NCI [National Cancer Institute] to give increased attention to breast cancer, particularly in the areas of lymphedema, stress, nutrition, exercise, weight, the environment, and ways to help women more fully restore and improve their quality of life after treatment. The committee also urges the NCI to further accelerate advances in breast cancer screening technology and to capitalize on existing and create new technologies that improve early diagnosis, health outcomes, and survival.”
The committee “urges the NCI to provide additional resources to fund clinical trials through the Gynecologic Oncology Clinical Trials Cooperative Group. Priority should be given to translational research involving biologic prognosticators and therapeutic effects of chemotherapy to speed the development and delivery of new cancer treatments to women with gynecologic cancers.”
The report states that the committee “urges the NCI to fund research that will allow for the identification of the most cost-effective management strategy for cervical cancer screening in the era of HPV [human papillomavirus] L1 vaccines and to identify the circumstances where Pap test/HPV screening fails in vaccinated women.”
According to the committee report, “Lung cancer is the leading cause of cancer death among women and minority populations. The committee encourages the NCI to work with the thoracic surgical community to initiate new clinical trials that involve patients at an early stage of the disease when surgery is a treatment option.”
The committee also “urges the NCI to support randomized, prospective studies that would lead to the validation and acceptance of biomarkers for the early detection of ovarian cancer.”
The committee “urges the NHLBI [National Heart, Lung, and Blood Institute] to… continue and expand intramural and extramural programs on lymphangioleiomyomatosis [LAM], a lung disorder that primarily affects women. In particular, research should focus on the natural history of LAM in TSC and sporadic LAM, as well as support for clinical trials.”
The committee “urges the NINDS [National Institute of Neurological Disorders and Stroke], in coordination with the NICHD [National Institute for Child Health and Human Development], ORWH [Office of Research on Women’s Health], NIH Pain Consortium, and other ICs [Institutes and Centers], to expand its support of research in vulvodynia, with a focus on etiology and multi-center therapeutic trials. The committee also calls on the NINDS to work with the ORWH and other relevant ICs and government agencies, as well as patient and professional organizations, to implement an educational outreach campaign on vulvodynia.”
The committee would provide $1.282 billion for the National Institute of Child Health and Human Development in FY2008, $27.524 million more than FY2007 and $17.285 million above the budget request. According to the committee report, “The comparable amounts for the budget estimate include funds to be transferred from the Office of AIDS Research.”
According to the committee report, “A recent national study showed that the rate of pre-term births among first pregnancies has increased 50 percent over the past decade; women in their first pregnancy are at highest risk for developing preeclampsia; and black women have a two-fold higher risk of these problems than white women. The committee requests that the NICHD launch an intensive research study of first pregnancy women in order to fill the major gap in the research on the etiology, mechanisms and prevention of these complications. The committee also urges the NICHD to investigate the rates of adverse pregnancy outcomes in pregnancies associated with assisted reproductive technology (ART). The committee urges the NICHD to support a multi-center cohort study on ART that would emphasize pregnancy outcomes, and short-and long-term effects on children, to determine if the adverse outcomes are specifically related to ART procedures versus underlying factors within the couple.”
The committee “encourages the NICHD to continue to fund research on effective ways to promote and sustain healthy family formations, particularly for low-income families and families of color.”
The report states, “POF [Premature Ovarian Failure] is a condition in which the ovaries stop functioning normally in a woman younger than age 40. Studies show that it is often associated with the FMR1 gene, the same gene that causes Fragile X syndrome. The committee acknowledges the importance of furthering research into the FMR1 pre-mutation to inform the research community about the genetic causes of infertility and disorders of altered ovarian function. The committee supports further research efforts focused on collecting genetic information from women who possess a mutation of the FMR1 gene as well as women who have POF. To accomplish this goal, the committee urges the NICHD to include the collection of genetic data on women who are relatives of people living with Fragile X in the development of a National Fragile X Patient Registry in order to facilitate genetic screening and counseling services for family members who may be at risk of Fragile X. Additionally, the NICHD is encouraged to address POF as it relates to the FMR1 gene in the development of a blueprint on Fragile X research opportunities.”
The committee “encourages the NICHD to expand, intensify, and coordinate programs for the conduct and support of research with respect to uterine fibroids. Current research and available data do not provide adequate information on the rates of prevalence and incidents of fibroids in Asian, Hispanic, and other minority women, the costs associated with treating fibroids, and the methods by which fibroids may be prevented in these women.”
According to the committee report, “As a result of efforts funded by the NICHD, the number of highly qualified scientists interested in researching vulvodynia has greatly increased. The committee commends the NICHD for reissuing its program announcement in this area; however, to ensure that experts in vulvodynia, and related chronic pain and female reproductive system conditions, are adequately represented on peer review panels, the committee recommends that future program announcements on vulvodynia be issued with ‘special review.’ The committee commends the NICHD for supporting two new projects on vulvodynia in 2006 and strongly urges the Institute to increase the number of awards for vulvodynia studies in fiscal year 2008, with a particular emphasis on etiology and multi-center therapeutic trials. Finally, the committee commends the NICHD for working with the ORWH to implement an educational outreach campaign on vulvodynia, and calls upon the Institute to continue these efforts.”
According to the committee report, “In the last decade, the NIH has supported three important research conferences on vulvodynia, as well as the first prevalence study and clinical trial on the disorder. These efforts have both clearly demonstrated the need for substantial additional research and served to heighten the research community’s level of interest in studying vulvodynia. The committee calls upon the Director to build upon these initial successes by coordinating through the ORWH an expanded, collaborative extramural and intramural research effort into the causes of, and treatments for, vulvodynia. This effort should involve the NICHD, NINDS, and other relevant ICs, as well as the NIH Pain Consortium. The committee also commends the ORWH for working with patient groups, other relevant ICs, and women’s health offices in other governmental agencies to plan an educational outreach campaign on vulvodynia, as previously requested by the committee. Finally, the committee encourages the Director to work with the Center for Scientific Review and ICs to ensure that experts in vulvodynia, and related chronic pain and female reproductive system conditions, are adequately represented on peer-review panels.”
The committee “notes that the Surgeon General calls for measures to decrease the availability of alcohol to youth. The committee urges the NIAAA [National Institute on Alcohol Abuse and Alcoholism] to conduct further research on the most effective means of reducing youth access to alcohol and increasing the cost of obtaining it.”
The report states, “Lupus is two to three times more common among African American, Hispanic, Asian American, and Native American women than Caucasian women—a health disparity that remains unexplained. Moreover, lupus mortality has increased over the past three decades and is higher among older African-American women. The Committee urges the NCMHD [National Center on Minority Health and Health Disparities] to prioritize lupus research with a particular focus on exploring the associated health disparities and co-morbidities, such as heart disease, depression, and renal disease.”
The committee “urges the NIH to support research into the pathophysiology of bone loss in diverse populations in order to develop targeted therapies to improve bone density and bone quality and to identify racial differences in bone and the origin of racial differences in fracture patterns. Furthermore, the committee urges research to identify patients at risk for fracture who do not meet current criteria for osteoporosis, as well as to study the effects of current and developing osteoporosis treatments on these patients.”
The Committee “commends the Office of Research on Women’s Health for its leadership on CFS [Chronic Fatigue Syndrome] research, particularly the coordination of the request for applications that culminated in the October 2006 announcement of seven new awards in this area. The committee recognizes the opportunity created by the requirement that the investigators funded under this initiative meet annually and encourages the NIH to use this meeting to stimulate new research initiatives and build multi-center collaborations. The committee again urges the NIH to develop an intramural CFS research program and to implement the recommendation made by the CFS Advisory Committee to ‘establish five Centers of Excellence within the United States that would effectively utilize state of the art knowledge concerning the diagnosis, clinical management, treatment, and clinical research of persons with CFS.’ The committee also urges special attention to CFS research as part of the NIH effort to refine its disease/research categories.”
The committee is “pleased with the focus on IBS [Irritable Bowel Syndrome] at the Office of Research of Women’s Health and urges additional research in this area.”
The report states, “Recognizing that women are the single largest group at risk for death from stroke, the committee believes that special attention should be focused on better understanding the gender-related differences in this condition. The committee supports the funding of new and continuing NIH studies on postmenopausal hormone replacement therapy and understanding the impact of hormones on women’s vascular systems. The committee urges the NIH to increase research in stroke among women of all ages, with specific attention to gender-related differences in stroke risk, prevention interventions, acute stroke management, the use of clot buster drugs, post-stroke recovery, long-term outcomes, and quality of care. The committee further urges NIH to increase research into new therapies for stroke in women including (1) observational research on differences in the way men and women present with stroke symptoms, (2) research addressing how stroke influences the likelihood and severity of cognitive impairment in women, (3) a clinical trial of carotid endarterectomy and angioplasty/stenting in women, (4) studies of differences in how men and women respond to antiplatelet agents for recurrent stroke prevention, and (5) basic science research to address unique brain cell death and repair mechanisms in females. The committee also urges and recommends all of these important initiatives be subsumed under an NIH mandate for a Women’s Agenda for Stroke Prevention, Diagnosis, and Treatment.”
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA would receive $3.405 billion in FY2008, $77.777 million more than FY2007 and $237.209 million more than the budget request.
Center for Mental Health Services: The bill would provide $923.812 million in FY2008 for mental health services, a $39.954 million increase above FY2007 and $116.584 million above the administration’s request.
The committee “remains deeply concerned that each year more than 3,000 Americans between the ages of 15 and 24 die by suicide, making suicide the third leading cause of death among adolescents. Beginning in FY2005, the committee has provided funding each year for grants to states and tribes to develop youth suicide prevention and early intervention programs. The committee recommendation includes $30 million for these grants, $12.18 million above last year’s level and the administration’s request. In addition, the committee has provided $5 million for campus-based programs that address youth suicide prevention. The committee also provides $5 million for the Suicide Prevention Resource Center.”
The report “urges SAMHSA to strengthen its efforts to assist local educational systems and non-profit entities to implement mental health screening and suicide prevention programs and to identify evidence-based practices for facilitating treatment for youth at risk. As evidence-based programs are developed and identified, the committee strongly urges SAMHSA to determine how these practices can be best implemented at the community level.”
The committee “intends that no less than last year’s level of funding be used for preventing youth violence. This initiative includes the Safe Schools/Healthy Students interdepartmental program. The administration proposed cutting this initiative by $17.446 million. The committee believes that enhanced school and community-based services can strengthen healthy child development, thus reducing violent behavior and substance use.”
The committee “reiterates its strong support for the national child traumatic stress network (NCTSN). The recommendation includes $35 million to support grants through the NCTSN that will develop knowledge of best practices, offer trauma training to mental health and other child-serving providers, and provide mental health services to children and families suffering from post-traumatic stress disorder [PTSD] and other trauma-related disorders as a result of having witnessed or experienced a traumatic event. The committee encourages the expansion of the number of network centers, with preference to applicants with prior experience in the NCTSN and extensive experience in the field of trauma-related mental disorders in children, youth, and families.”
The Mental Health Block Grant would be level-funded at $406.843 million as requested by President Bush.
As requested by the administration, children’s mental health services would be level-funded at $104.078 million in FY2008.
Center for Substance Abuse Treatment (CSAT): The measure would provide $2.185 billion for substance abuse treatment programs in FY2008. This allocation is $27.619 million more than FY2007 and $74.478 million more than the administration’s request.
The committee report states, “Within the funds appropriated for CSAT, the Committee recommends $20 million for residential treatment programs for pregnant and postpartum women and their children. This amount is $9.61 million above the comparable level for FY2007 and $16.068 million above the administration request.”
The committee “appreciates the administration’s emphasis on funding substance abuse treatment services through the access to recovery program, screening, brief intervention, referral and treatment, and treatment drug courts, but strongly believes that the reduction or elimination of other treatment capacity efforts and the elimination of most of the science to service activities from the request is not in the nation’s best interest. The administration’s requested increases are offset by decreases in opioid treatment activities, treatment for homeless persons and persons with co-occurring substance use and mental health disorders, children and families programs, pregnant and postpartum women programs, recovery support services, and other programs that are small in costs but that provide critical support to states and communities that are attempting to address their serious substance abuse services needs. The administration also proposes to eliminate science to service activities, such as Addiction Technology Transfer Centers, the minority fellowship program, Recovery Month, and consumer affairs activities that support public education campaigns on prescription drug abuse, drug abuse among the elderly, abuse of inhalants, and youth steroid use.”
As requested by the administration, the substance abuse prevention and treatment block grant would be level-funded at $1.759 billion.
Agency for Healthcare Research and Quality (AHRQ): The bill would fund AHRQ at $329.564 million in FY2008, $10.578 million more than FY2007 and an amount equal to the budget request.
Centers for Medicare and Medicaid: The committee “recommends continuing the Healthy Start, Grow Smart program, which disseminates educational brochures to low-income pregnant women and new mothers. The prenatal brochure provides information on prenatal care and highlights the link between maternal behaviors and development of the unborn child. The remaining brochures are distributed at birth and at key developmental points during the first two years of life. The publications offer vital health and safety information for new parents and focuses on infant brain development and skills these children need to be successful in school.”
Administration for Children and Families
Social Services Block Grant (SSBG): As requested by the administration, the SSBG would be level-funded at $1.7 billion in FY2008.
Child Care and Development Block Grant (CCDBG): As requested by the administration, the CCDBG would be level-funded at $2.062 billion in FY2008.
Included in that amount is $267.786 million “for child care quality activities, including $98.208 million specifically for an infant care quality initiative. These funds are recommended in addition to the four percent quality earmark established in the authorizing legislation. The committee has provided these additional quality funds because of the considerable research that demonstrates the importance of serving children in high quality child care settings, which include nurturing providers who are educated in child development and adequately compensated.”
Child and Family Services Programs: Head Start would receive $7.089 billion, including advance funding that will become available on October 1, 2008. This amount is $200 million more than FY2007 and $300 million more than the administration’s request.
Consolidated runaway and homeless youth programs would receive $102.837 million in FY2008, $15 million more than FY2007 and the administration’s request.
Child abuse and neglect prevention and treatment activities would be funded at $107.175 million in FY2008, $11.958 million above FY2007 and $1.6 million more than the budget request.
Programs to increase abandoned infant assistance would be level-funded at $11.835 million in FY2008, as requested by the administration.
As requested by the administration, child welfare training and services would be level-funded at $294.089 million in FY2008.
Adoption: The measure would provide level funding of $26.848 million for adoption opportunities, as requested by the administration. Adoption awareness programs would be level-funded at $12.674 million, identical to the budget request. Adoption incentives would be funded at $9.5 million, $4.5 million above FY2007, and $4 million below President Bush’s request.
Child Support Enforcement: As requested by the administration, the measure would allocate $2.95 billion for payments to states for child support enforcement and family support programs, $313.965 million less than FY2007.
International Trafficking: Under the Refugee and Entrant Assistance Account, a program to aid victims of trafficking would be level-funded at $9.823 million in FY2008, $4.993 million less than the president’s request.
Unaccompanied Minors: Under the Refugee and Entrant Assistance Account, a program to assist minors entering the country without a parent or guardian would $133.162 million in FY2008, $37.844 million more than FY2007 and $1.5 million below the budget request.
The committee “is troubled by reports that HHS has been hampered by the Department of Homeland Security and the Department of Justice in providing emergency benefits and services to child victims of trafficking. Congress clearly intended in the Trafficking Victims Protection Act of 2000 [P.L. 106-386] to allow children to receive assistance regardless of their ability or willingness to participate in an investigation and prosecution of their traffickers. Yet the committee understands that, in practice, children are often coerced into working with law enforcement because they have contacted HHS for access to services. The committee expects HHS to use its authority from the Trafficking Victims Protection Act to expedite the determination of eligibility of child victims without delays from law enforcement authorities.”
Mentoring Children of Prisoners: The Mentoring Children of Prisoners program would be level-funded at $49.493 million in FY2008, $507,000 less than the administration’s request.
Promoting Safe and Stable Families: The Promoting Safe and Stable Families program would be level-funded at $434.1 million in FY2008, an amount equal to the budget request.
Violence Against Women: The Family Violence Prevention and Services Act (FVPSA) (P.L. 98-457) would receive $127 million in FY2008, $2.269 million above FY2007 and the budget request. The FVPSA awards grants to public and private entities to promote domestic violence intervention and prevention activities, including shelter services for victims.
The National Domestic Violence Hotline would receive $3.2 million in FY2008, $230,000 above FY2007 and the budget request.
Abstinence-only Education: The bill would provide $84.916 million for the abstinence education program in FY2008, $28.484 million below FY2007 and $56.248 million less than President Bush’s request.
The committee “notes that the Department’s recent multi-year, experimentally designed evaluation of abstinence-only education programs funded under title V of the Social Security Act found that they had no effect on the sexual abstinence of youth. The committee notes that community based abstinence education programs have been required to share the same eight statutory elements as programs funded under title V. In light of this evaluation, the committee has not provided funding for the administration’s proposed increase or for the national abstinence media campaign. The committee recommendation fully funds current grantee continuation costs.”
The committee “firmly supports the goal of delaying sexual activity and preventing teen pregnancy among youth. However, the committee believes that the Department must encourage further innovation in abstinence education programs in order to develop effective, evidence-based interventions. Until abstinence programs can demonstrate sizeable and lasting impacts, the committee does not believe that new funding is warranted.
The committee “is disturbed by reports that grantee materials in this program may not contain scientifically accurate information. The committee has included bill language clarifying that funds provided under this program must be scientifically accurate as required by federal law.”
Administration on Aging: The Administration on Aging’s Supportive Services and Senior Centers would receive level funding of $350.595 million in FY2008, as requested by the administration. Family caregiver support programs would be level-funded at $156.167 million in FY2008, $2.02 million more than President Bush’s request.
Office of the Secretary
Public Health Service’s Office of Minority Health: The Office of Minority Health would receive $49.475 in FY2008, $3.98 million less than FY2007 and $5.7 million more than the administration’s request.
Public Health Service’s Office on Women’s Health: The Office on Women’s Health would be funded at $30.369 million in FY2008, $2.123 million more than FY2007 and $3 million more than the budget request.
According to the committee report, “The Office on Women’s Health [OWH] develops, stimulates, and coordinates women’s health research, health care services, and public and health professional education and training across HHS agencies. It advances important crosscutting initiatives and develops public-private partnerships, providing leadership and policy direction, and initiating and synthesizing program activities to redress the disparities in women’s health.”
The committee “understands that lupus is a serious, complex, debilitating chronic autoimmune disease that can cause inflammation and tissue damage to virtually any organ system in the body and impacts an estimated one to two million individuals. The committee further understands that public and health professional recognition and understanding of lupus is extremely low, contributing to misdiagnoses or late diagnoses that can result in disability or death. The committee has included sufficient funds for the Office on Women’s Health to work with the advocacy community to develop and implement a sustained lupus awareness and education campaign aimed at reaching health care professionals and the general public, with an emphasis on reaching women at greatest risk for developing lupus.
The committee “has included $1 million for a study by the Institute of Medicine which would comprehensively review the status of women’s health research, summarize what we have learned about how diseases specifically affect woman, and report back to Congress suggestions for the direction of future research.”
Minority HIV/AIDS: As requested by President Bush, the measure would provide level funding of $51.891 million for minority HIV/AIDS prevention and treatment activities.
Adolescent Family Life: The Adolescent Family Life program would receive level funding of $30.307 million in FY2008, an amount equal to the administration’s request.
Embryo Adoption Awareness Campaign: The measure would provide $4 million for embryo adoption awareness in FY2008, $2.02 million above FY2007 and the president’s request.
Office for Civil Rights: As requested by the administration, the office would receive $37.062 million in FY2008, $2.153 million more than FY2007.
Department of Education
No Child Left Behind: Title I Grants to local educational agencies under the No Child Left Behind Act (P.L. 107-110) would receive $13.91 billion in FY2008, $1.072 billion above FY2007, as requested by the administration.
William F. Goodling Even Start Family Literacy Program: As requested by President Bush, this program would not receive funding in FY2008. In FY2007, the program received $82.283 million.
Reading First and Early Reading First: The bill would fund the Reading First program at $800 million in FY2008, $229.234 million less than FY2007 and $218.692 million less than President Bush’s request. The Early Reading First program would be level-funded at $117.666 million in FY2008, as requested by the administration.
The committee report states, “Reading First is a comprehensive effort to provide states and LEAs [local education agencies] with funds to implement comprehensive reading instruction for children in grades K3, to help ensure that every child can read by the end of third grade. The funding cut recommended by the committee is in direct response to the Education Department’s egregious mismanagement of the program, as described in six reports by the Inspector General, numerous media accounts, and congressional hearings. The committee notes that Reading First was long touted by the administration as a model education program that awarded grants solely on the basis of solid scientific research and effectiveness.”
Teacher Quality: Under the bill, level funding of $2.887 billion would be provided to states to improve teacher quality in FY2008, $99.951 million more than FY2007.
Math and Science Partnerships:The Math and Science Partnerships program would receive $184 million in FY2008, $1.84 million more than FY2007 and $1.876 million more than President Bush’s request.
Mentoring Programs: Mentoring programs would receive $50 million in FY2008, $1.186 million more than FY2007. Under the administration’s budget request, these programs would not have received funding.
21st Century Community Learning Centers: The learning centers would be funded at $1 billion in FY2008, $18.834 million above FY2007 and $18.82 million more than President Bush’s request.
Individuals with Disabilities Education Act (IDEA): Total spending for state grants for special education would be $12.33 billion in FY2008, a $527.507 million increase over FY2007 and $845.227 million more than the budget request.
Education for Homeless Children and Youth: Under the bill, these programs would receive level funding of $66.878 million in FY2008. This amount is $5 million more than FY2007 and the administration’s request.
Vocational Education:The measure would level-fund vocational education at $1.294 billion in FY2008, $2 million less than FY2007 and $684.306 million more than the budget request.
Adult Education: In FY2008, adult education would be funded at $577.712 million, $1.851 million less than FY2007 and $2.096 million below the administration’s request.
Pell Grants: The bill would provide $14.487 billion in FY2008 for Pell Grants. This amount is $826.289 million more than FY2007 and $1.073 billion more than the president’s request. The maximum Pell Grant award would increase to $4,600 in FY2008, $290 more than FY2007 and equal to President Bush’s request.
Child Care Access Means Parents in School (CCAMPIS): CCAMPIS would be level-funded at $15.81 million in FY2008, as requested by the administration.
Office for Civil Rights: The measure would provide $93.771 million in FY2008 for the Office for Civil Rights to enforce laws that prohibit discrimination on the basis of race, color, national origin, sex, disability, and age in all programs and institutions funded by the Department of Education. This funding level is $2.566 million more than FY2007 and equal to the budget request.
