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FY2003 LHHSE Spending Bill Ready for Senate Consideration

Last week, the Senate Appropriations Committee approved, 29-0, the FY2003 Labor, Health and Human Services, and Education appropriations bill (S. 2766) (see The Source, 7/19/02). S. 2766 would provide $136.7 billion in discretionary funding in FY2003, a 7 percent increase over last year. The Senate Appropriations Committee report accompanying the bill includes language detailing a number of programs affecting women and families. Although report language is not binding, federal agencies give careful consideration to such language as it indicates programs or initiatives that are particularly important to appropriators.

Department of Labor
S. 2766 would provide $5.6 billion for the Department of Labor in FY2003, an increase of $148.5 million over FY2002 and $657.6 million over the President’s request.

Dislocated workers assistance would receive $1.54 billion, $177.5 million more than last year.

The Department of Labor’s Women’s Bureau would be provided $10.973 million in FY2003, a $808,000 increase over FY2002 and $2.6 million more than the President’s request. The committee urges the Women’s Bureau to “to provide increased support for effective programs such as Women Work!, to provide technical assistance and training on programming for women in transition, as well as Pay Equity initiatives.”

Additionally, the measure would level-fund the Women in Apprenticeship and Nontraditional Occupations program at $1 million.

Department of Health and Human Services
Safe Motherhood Initiative: The committee has developed a Safe Motherhood initiative to help the Secretary “put key elements of such a safe motherhood initiative in place.” The bill would provide $17 million for this initiative. Of this amount, $7 million would be allocated to the CDC to establish a demonstration program to improve data collection about pregnancy-related complications and maternal mortality. The CDC also would receive $2 million for its National Summit of Safe Motherhood activities and $2 million to provide individual grants to conduct prevention and health promotion research “to focus specifically on improving maternal outcomes in maternal morbidity and mortality.”

Also included in this funding level is $3 million for the Substance Abuse and Mental Health Services Administration to provide residential treatment programs for pregnant women. In addition, the committee urges the National Institutes of Health and the Food and Drug Administration to work together to “improve the quality of information on drugs and biological products for women who are pregnant and lactating…to determine the safety and dosing for marketed drugs and biologics that were not approved or licensed based on studies in pregnant women.” The committee would provide $3 million to the office in FY2003 to establish an Interagency Coordinating Committee on Safe Motherhood. The new committee would include representatives of relevant federal agencies and offices, community healthcare experts, relevant community health professionals, and leaders from the women’s health community.

Health Resources and Services Administration (HRSA): Under S. 2766, the HRSA would receive $6.2 billion, $809 million more than the President’s request and $94.9 million more than FY2002. Community health centers would receive $1.54 billion, a $190 million increase over last year and $75.7 million more than the President’s request. In addition, $755 million would be provided for the Maternal and Child Health Block Grant, a $23.5 million increase over the President’s request but the same funding level provided last year.

In addition, $103 million would be provided for the healthy start infant mortality initiative to reduce high rates of infant mortality. This funding amount is $4 million more than the President’s request and equal to the FY2002 funding level. S. 2766 would provide $13 million for universal newborn hearing screening and early intervention activities, a $13 million increase over the President’s request and $3 million more than FY2002. The measure also would reject the administration’s proposal to consolidate this program into the Maternal and Child Health Block Grant program.

Ryan White: The Ryan White CARE Act would receive a $161.4 million increase to $2.1 billion. This level would be $161.3 more than the President’s request. Of this amount, $75 million would be provided to help children, youth, women, and families infected with, or affected by, HIV/AIDS.

Family Planning:Title X, the nation’s family planning program, would receive $285 million, approximately $20 million more than FY2002 and $19.7 million more than the President’s request.

Abstinence-only Education: Total funding for abstinence-only education programs would be level-funded at $90 million. Of this amount, $40 million would be provided to support “the development and implementation of abstinence education programs for adolescents, ages 12 through 18” through the Maternal and Child Health Bureau. This amount is approximately $33 million less than the President’s request. The other $50 million would be allocated from mandatory funds provided by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.

Centers for Disease Control and Prevention (CDC): Under the CDC budget, $99.8 million would be provided for the prevention of birth defects, developmental disabilities, and disability and health activities. That would represent a $9.9 million increase over the FY2002 level and a $10.5 million increase over the President’s request.

Chronic disease prevention and health promotion would receive $810.8 million, a $63.6 million increase over last year and $120.6 million over the President’s request. Within that amount, $47.2 million would be provided for heart disease and stroke, $290.5 million would be provided for cancer prevention and control, $62.5 million for safe motherhood/infant health, and $100.6 million for tobacco prevention initiatives.

The WISEWOMAN program, operated through the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP), would receive a $1 million increase. In FY2002, Congress appropriated $11.7 million to fund WISEWOMAN programs in 12 states.

The committee would provide $1.17 billion for HIV/AIDS, sexually transmitted diseases (STDs), and tuberculosis prevention at the CDC, an increase of $33.5 million over last year and $33.5 million more than the President’s request. Of that amount, $168.8 million would be for global HIV/AIDS programs and $170.5 million would be for global STD programs. Committee report language urges the CDC “to continue to expand funding and staff for microbicide research and development within funds provided for global HIV/AIDS. These funds could support clinical trials of microbicides as set forth in the CDC’s HIV Prevention Strategic Plan and its topical microbicide 5-year research agenda.”

National Institutes of Health (NIH): Report language urges the National Heart, Lung, and Blood Institute (NHLBI) at the NIH to “expand cardiovascular disease research in women, including studies to develop safe, efficient and cost-effective diagnostic approaches for women.” The committee also encourages the NHLBI to “create more informational and educational programs for women patients and health care providers on heart disease and stroke risk factors.”

In addition, the committee “continues to place a high priority on research to combat infertility and speed the development of improved contraceptives” and urges the National Institute of Child Health and Human Development to continue “aggressive activities in this area, including individual research grants and those of the infertility and contraceptive research centers.”

The National Institute of Arthritis and Musculoskeletal Diseases at the NIH is encouraged to “work to identify the extent” of underlying gender differences that “contribute to differences in disease incidence and severity between males and females,” and “develop a plan for addressing the questions that require further research.”

The National Center on Minority Health and Health Disparities is encouraged to “capitalize on opportunities provided by recent advances in biomedical, clinical and behavioral research by strengthening its focus on efforts to unravel the genomic analysis of diseases that disproportionately affect minorities.”

The committee report contains language commending the NIH for increasing the funds available for microbicide research development. The committee “remains concerned that microbicide research at the NIH is currently conducted with no single line of administrative accountability or specific funding coordination.” In addition, the report notes that the CDC and U.S. Agency for International Development have expanded their microbicide portfolios and without “federal coordination, costly inefficiencies may result.” The committee requests a report by March 31, 2003, on the status of microbicide programs.

To address the second-leading cause of death among women worldwide, the committee urges the NIH to increase research in stroke among women of all ages, with a focus on stroke prevention, acute stroke management, post-stroke recovery, long-term outcomes, and quality of life. Committee report language states that the Office of Research on Women’s Health at the NIH plays a critical role in the “research on sex and gender factors affecting women’s health,” and the committee encourages the Office to “support the Building Interdisciplinary Research Careers in Women’s Health programs.”

Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA would receive $3.2 billion in FY2003. This allocation is $99.8 million more than the FY2002 level and $44.5 million more than the President’s request.

Center for Mental Health Services: The committee recommends $843 million for mental health services, $11.2 million more than last year’s level and $21 million more than the President’s request. Committee report language states that the committee is “concerned about the prevalence of pregnancy-related mental health conditions suffered by women today” and recommends that, “resources be expended for the treatment of women and their families.”

Additionally, the Mental Health Performance Partnership Block Grant would be level-funded at $433 million. These funds are used by states to fund the development and implementation of “innovative community-based services and maintain continuity of community programs.”

Center for Substance Abuse Treatment: The committee recommends $2.1 billion be provided for substance abuse treatment programs. This allocation is $88.7 million more than last year’s level and $38 million less than the President’s request. Included in the committee report is language that the committee remains “concerned about the incidence of drug addition among pregnant women” and therefore recommends that $3 million be provided for the Residential Treatment Program for Pregnant and Postpartum Women.

In addition, the substance abuse prevention and treatment block grant would receive $1.8 billion, a $70 million increase over last year and $10 million more than the President’s request. Center for Substance Abuse Prevention (CSAP): In FY2003, CSAP would receive $202 million for programs to prevent substance abuse. This level is $4 million more than last year’s allocation and $49 million more than the President’s request.

Agency for Healthcare Research and Quality (AHRQ): The committee recommends $308.6 million for AHRQ in FY2003. This funding would be $9.9 million more than the FY2002 level and $58.6 million more than the President’s request. The committee also urges AHRQ to “identify surgical procedures and treatment protocols” for childhood birth defects and developmental disorders.

Administration for Children and Families

Child Care and Development Block Grant: S. 2766 would provide $2.1 billion for the Child Care and Development Block Grant to provide low-income families with financial assistance for child care. This funding level is $18,000 more than last year’s allocation and the same as the President’s request.

Social Services Block Grant: S. 2766 would level-fund the Social Services Block Grant at $1.7 billion, and the committee report includes language that allows “states to transfer up to 10 percent of their annual allocations under the Temporary Assistance for Needy Families program to the Social Services Block Grant program.” The committee also recognizes that the “block grant is a vital source of support for many vulnerable children and families.”

Child Support Enforcement and Family Support Programs: The Senate measure would allocate $2.48 billion in FY2003 for payments to states for child support enforcement and family support programs to help promote the self-sufficiency and economic security of low-income families. Last year, Congress allocated $2.54 billion for these programs.

International Trafficking: Under the Refugee and Entrant Assistance account, a program to aid victims of trafficking is level-funded at $10 million.

Child and Families Services Programs: Head Start would receive $6.9 billion, an increase of $332.4 million over FY2002 and a $202.4 million increase over the President’s request.

The committee recommendation does not include the $10 million that the President requested for the Maternity Group Homes program. Rather, the committee has deferred action on this program until language authorizing this program has been enacted.

The committee also recommends that $48.4 million be allocated for child abuse and neglect prevention and treatment activities. This amount includes level funding of $22 million for state grants.

Programs to increase abandoned infant assistance would receive $12.2 million, an increase of $3,000 over the FY2002 level and the same amount requested by the President.

Child welfare services would be level-funded at $292 million.

Additionally, the committee recommends that the $20 million, requested by the President to promote responsible fatherhood and responsible marriage, not be included in S. 2766 because legislation has not been enacted to create this new program.

Adoption: The committee recommends $27.4 million for adoption opportunities, an increase of $20,000 more than the FY2002 level and the same amount as the President’s request. Committee report language notes the progress made in “increasing adoptions of children within two years of their placement in the public foster care system, as well as the increase in family reunification within one year of placement.” S. 2766 also would level-fund adoption incentives at $43 million and level-fund the Adoption Awareness program at $12.9 million.

Mentoring Children of Prisoners: Funding for the new Mentoring Children of Prisoners program in FY2003 would be $12.5 million. This program is geared towards helping children while their parents are imprisoned and increasing “the chances that the family will come together successfully when the parent is released.” The President had requested $25 million for this program.

Promoting Safe and Stable Families: The committee recommends that $505 million be provided for the Promoting Safe and Stable Families program in FY2003. This allocation is the same as the President’s request and $140 million more than the FY2002 level. Funding for this program helps to support family preservation services, time-limited family reunification services, community-based family support services, and adoption promotion and support services.

Violence Against Women Act (VAWA): S. 2766 would fund several VAWA programs. The National Domestic Violence Hotline would receive $3 million. Last year, Congress allocated $2.157 million for the hotline. In addition, battered women’s shelters would receive a $5.5 million increase to $130 million.

Public Health Service’s Office on Women’s Health (PHS-OWH): The PHS-OWH would receive $31.8 million in FY2003, an increase of $3 million over the President’s request and $5 million more than the FY2002 allocation.

Committee report language expresses the committee’s concern that “little progress has been made at reducing maternal mortality or morbidity over the past twenty years.” The committee would provide $3 million to the office in FY2003 for the Safe Motherhood Initiative.

Public Health Service’s Office on Minority Health (PHS-OMH): The PHS-OWH would receive $46 million in FY2003. This amount is equivalent to the President’s request and $3.23 million less than last year’s allocation. The Committee encourages the office to support established programs that “have a proven record of increasing the number of under-represented minorities entering the health professions.”

Admnistration on Aging National Family Caregiver Support: The committee recommends that $153.5 million be allocated for the National Family Caregiver Support Program, an increase of $17.5 million over the FY2002 level and the President’s request. According to committee report language, the family caregiver support program should be recognized for “the critical role and essential care that millions of informal and family caregivers provide.”

Department of Education No Child Left Behind: Grants to local educational agencies under the No Child Left Behind Act (P.L. 107-110) would receive an increase of $1.5 billion, for a total of $11.9 billion. The large increase in funding for this program would help all students in high-poverty schools “meet challenging state academic standards.” The program serves more than 15 million students in almost all school districts and more than half of all public schools.

Reading First and Early Reading First: The bill would increase the funding level for the Reading First State Grants from $900 million to $1.0 billion in FY2003. According to the committee report, the additional funding will “help ensure that every child can read by third grade.” The Early Reading First program would be level-funded at $75 million and would target children ages three through five to “enhance their verbal skills, phonological awareness, letter knowledge, pre-reading skills, and early language development.”

William F. Goodling Even Start Family Literacy Program: The committee recommends level funding the Even Start program at $250 million, $50 million more than the President’s request. The program provides grants for family literacy programs that serve disadvantaged families with children under eight years of age. The programs combine early childhood education, adult literacy, and parenting education.

Teacher Quality: State Grants for Improving Teacher Quality would receive a $250 million increase over the President’s request and the FY2002 appropriation, for a total of $3.1 billion. According to the committee report, districts may use these funds “to hire teachers to reduce class sizes” and therefore “have a positive impact on students.”

Loan Forgiveness for Child Care: The bill would level-fund loan forgiveness for child care providers at $1 million. Under the program, individuals who have earned a degree in early childhood education and who work for two years as a child care provider in a low-income community may have a portion of their student loans forgiven.

Individuals with Disabilities Education Act (IDEA): S. 2766 would provide $9.7 billion for special education programs authorized by the IDEA. Of this amount, $437 million would be provided for grants for the Infants and Families program, which provides grants to states to implement programs that make available early intervention services to all children with disabilities, ages two and under, and their families. This funding level is the same as the President’s request and $20 million more than the FY2002 allocation. In addition, $28 million would be provided for parent information centers to help meet the needs of parents with disabled children who may be “inappropriately identified.”

Child Care Access Means Parents in School (CAMPUS): Funding for the CAMPUS program would be reduced by $10 million to $15 million in FY2003. According to report language, this program helps support the “efforts of a growing number of non-traditional students who are struggling to complete their college degrees at the same time that they take care of their children.” The committee report explains that funding for this program was reduced because of “the $8.7 million lapsed in FY2001” and the Department’s expectation that funds will remain unused in FY2002.

Office for Civil Rights: The bill would provide $86.3 million 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 $6.3 million more than the FY2002 appropriation and the same amount requested by the President.