This week, the House approved the Department of Defense and Legislative Branch spending bills and was expected to complete the Labor, Health and Human Services and Education spending bill at press time. The House Appropriations Committee approved the Foreign Operations, Export Financing and Related Agencies and Transportation, Treasury, Housing and Urban Development, the Judiciary, and the District of Columbia spending bills. The Senate began its consideration of the Interior and Related Agencies spending bill. In addition, the Senate Appropriations Committee approved the Agriculture, Rural Development and Related Agencies and Commerce, Justice, and Science spending bills.
House Floor Action
Department of Defense
On June 20, the House approved, 398-19, the FY2006 Department of Defense spending bill (H.R. 2863). The House began its debate on the bill last week (see The Source, 6/17/05).
H.R. 2863 would allocate $408 billion for the Department of Defense in FY2006, a $55.6 billion increase over FY2005 and $41.3 billion more than the administration’s request. Of that amount, $45 billion would be included to cover the projected costs of continuing operations in Iraq and Afghanistan.
The measure also would provide $20 million for the Family Advocacy Program, $3 million more than FY2005.
Although most funding for the Defense Health Program is now provided in the annual Military Quality of Life and Veterans Affairs spending bill, H.R. 2863 would include $17 million for military HIV/AIDS research. This amount is $2.86 million above FY2005 and $10 million more than the budget request.
Labor, Health and Human Services, and Education
At press time, the House was debating amendments to the FY2006 Labor, Health and Human Services, and Education spending bill (H.R. 3010) and was expected to approve the bill on June 24. The House Appropriations Committee approved the measure on June 16 (see The Source, 6/17/05).
H.R. 3010 would provide $142.5 billion in FY2006, a $164.1 million decrease below FY2005 and $923.78 million more than the administration’s request.
During consideration of the bill, the House defeated, 161-262, an amendment by Rep. Jeb Bradley (R-NH) that would have provided an additional $50 million for special education, bringing the total to $12.3 billion in FY2006. The increase would have been offset by cutting administrative and program management funds allocated to the Department of Education and the Occupational Safety and Health Administration.
Report Language
The House Appropriations Committee report accompanying the bill includes language detailing a number of programs affecting women and their 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 for appropriators.
Department of Labor
As requested by the administration, the Department of Labor Women’s Bureau would receive $9.76 million in FY2006, $286,000 more than FY2005.
Dislocated workers assistance would be level-funded at $1.19 billion in FY2006, $120 million above the administration’s request.
The measure would provide $1.54 billion for Job Corps, a $9.84 million decrease below FY2005 and $25 million more than the administration’s request. According to the report, “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 economically disadvantaged young people in the 16 to 24 age range who are unemployed and out of school.”
The committee “believes that Job Corps’ partnerships with national non-profit faith founded organizations such as Joint Action in Community Services (JACS), Women in Community Services, and the YWCA are essential to the success of Job Corps…The Committee encourages the Department to expand its Job Corps partnership with such national volunteer programs in order to ensure the continued availability of youth [in] transition services that are national in scope, yet local in focus.”
Under the bill, $125 million would be provided for the administration’s Community College Initiative, $1 million more than FY2005, but $125 million less than the budget request. Of that amount, no less than $10 million would be dedicated to community college partnerships with Job Corps Centers. The committee “requests this portion to be designated to 1) develop strategic partnerships with community colleges, business and industry leaders, and Job Corps centers to train students in high growth, high demand industries and 2) design ‘dual enrollment’ programs based on reciprocal agreements between Job Corps and community colleges.”
The prisoner re-entry initiative would be level-funded at $19.84 million in FY2005, $15.16 million less than the amount requested by President Bush.
H.R. 3010 would include the administration’s request of $12.42 million for the Bureau of International Labor Affairs, an $80.83 million decrease below the FY2005 level.
Department of Health and Human Services (HHS)
Health Resources and Services Administration (HRSA): Under the bill, HRSA would receive $6.87 billion in FY2006, $69.3 million more than FY2005 and $906.2 million above the administration’s request.
Community health centers would receive $1.83 billion in FY2006, an increase of $100 million above FY2005, but $203.6 million less than the administration’s request. Of that total, $26 million would be provided for a new initiative to fund health centers in approximately 40 high poverty counties across the country. According to the report, the committee “encourages community health centers to make ultrasound services available to their patients.”
The measure would provide $700 million for the Maternal and Child Health Block Grant, $23.93 million less than FY2005 and the budget request. Of this amount, $4 million would be provided to continue the sickle cell newborn screening program and its locally based outreach and counseling efforts.
H.R. 3010 would allocate $3 million for newborn and child screening for heritable disorders. The report states, “Newborn screening is used for early identification of infants affected by certain genetic, metabolic, hormonal and/or functional conditions for which there is effective treatment or intervention. Screening detects disorders in newborns that, left untreated, can cause death, disability, mental retardation and other serious illnesses.”
The committee “recognizes the critical role of hemophilia treatment centers…in providing needed comprehensive care for persons with bleeding disorders and the expanded role of these centers in addressing the needs of women with bleeding disorders and persons with clotting disorders such as thrombophilia.”
The Healthy Start infant mortality initiative would receive $97.75 million in FY2006, a $4.8 million decrease below the FY2005 level and equal to the administration’s request.
The measure would provide $10 million for universal newborn hearing screening, $208,000 more than FY2005. Under the administration’s budget request, this program would not have been funded. The report states that “currently, 52 states and territories have received competitive grants for the purpose of implementing statewide early hearing detection and intervention (EHDI) programs. Since these grants have only been operational for a few years, the Committee believes that a small amount of continued Federal funding is critical at this time to ensure that state EHDI programs become fully operational and that screening programs are properly linked with diagnosis, early intervention, and the child’s routine medical care.”
Ryan White: The Ryan White Care Act would receive a $10 million increase over the FY2005 funding level to $2.08 billion as requested by the administration. Of this amount, $72.5 million would be provided to help children, youth, women, and families infected with, or affected by, HIV/AIDS. The committee “expects that Ryan White 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 will be supported at no less than the fiscal year 2005 level.”
National Cord Stem Cell Bank: As requested by President Bush, the bill would not provide funding for the National Cord Stem Cell Bank program “pending the HRSA response to the Institute of Medicine report on the structure and administration of such a program.” Last year, Congress allocated $9.86 million for the program.
H.R. 3010 would provide level funding of $25.4 million for the National Marrow Donor Program (NMDP) in FY2006, $2.5 million above the budget request. According to the report, “The Committee strongly urges the NMDP to continue innovative, technological, and scientific advances in non-embryonic cell therapies that have the potential to help some of the hundreds of thousands of Americans with leukemia or other life threatening blood diseases. The Committee also strongly encourages NMDP to continue the expansion of the Registry through its umbilical cord blood program to reduce racial and ethnic disparities and improve access for all Americans for this lifesaving therapy. The Committee encourages the NMDP to implement an education effort on the use of umbilical cord blood to increase donation and awareness of this resource.”
Family Planning: Title X, the nation’s family planning program, would be level-funded at $286 million as requested by President Bush. The report notes that Title X “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 Committee encourages HRSA to work with CDC to implement HIV/AIDS testing and counseling as part of the services provided in family planning centers.” The report also includes language “making it 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.”
Centers for Disease Control and Prevention (CDC): The measure would allocate $5.95 billion for the CDC in FY2006, a $1.44 billion increase over FY2005 and $1.9 billion more than the administration’s request. Of this total, $127.2 million would be provided for the prevention of birth defects, developmental disabilities, and disability and health activities. This would represent a $2.6 million increase over the FY2005 level and a $3.6 million increase over the administration’s request. The total includes $5.3 million for the national spina bifida program and $2.4 million for an educational campaign to increase the number of women taking folic acid daily. According to the report, the committee “is pleased to learn that since fortification of U.S. grain products with folic acid, the rate of neural tube defects has decreased 26% and encourages CDC to enhance the national campaign to increase the number of women taking folic acid daily. The Committee also encourages CDC to continue to support collaboration among the states on issues related to surveillance, research and prevention through support of the National Birth Defects Prevention Network.”
The report states that the committee “is concerned about the prevalence of Fetal Alcohol Syndrome (FAS) in the United States and notes that drinking during pregnancy is the nation’s leading known preventable cause of mental retardation and birth defects. The Committee commends the U.S. Surgeon General for releasing an updated advisory in February 2005, on alcohol use in pregnancy, urging women who are pregnant or who may become pregnant to abstain from alcohol. The Committee urges CDC to work with partner organizations, such as the National Organization on Fetal Alcohol Syndrome, to generate awareness of the Surgeon General’s new FAS prevention advisory, especially among high-risk communities.”
Chronic disease prevention and health promotion would receive $854.7 million in FY2006, $42.5 million below FY2005 and $13.8 million above the budget request. Within that amount, $46.1 million would be provided for heart disease and stroke, $312.6 million for cancer prevention and control, $41.9 million for nutrition and health promotion, and $44.7 million for safe motherhood and infant health.
Within the amount provided for cancer prevention and control, no less than $204.4 million would be allocated for the National Breast and Cervical Cancer Early Detection Program. According to the report, “The Committee commends the CDC for creating partnerships to address the early detection of breast cancer, particularly in historically underserved communities, including the Native American, Hispanic and African American populations. As part of this initiative, the Committee is very interested in the innovative approach of the Men Against Breast Cancer Partners In Survival Program focusing on the role of the male support-giver as an integral component of the early detection, patient care and survivorship of breast cancer. The Committee encourages CDC’s continued support of programs of this type that might also have secondary benefits, such as greater participation of the male support-giver in their own health management, including early detection and health screening activities.”
The report states that the committee “encourages the CDC to maintain a focus on public health issues confronting adolescents, including maintaining support of the National Network of State Adolescent Health Coordinators (NNSAHC) Annual Meeting, which brings together specific expertise on the health issues that face adolescents and on the special programmatic consideration for this population.”
The committee “understands that there are other causes of infertility beyond sexually transmitted diseases, such as delayed child bearing, smoking, low or excessive body weight, exposure to hazardous environmental toxins, drug and alcohol abuse and, particularly for men, exposure to high temperatures. The Committee encourages CDC to consider expanding the scope of the Agency’s efforts regarding the prevention of infertility and to providing greater support to public education on the broader risks to fertility.”
The report states, “The multiple factors contributing to the overweight and obesity epidemic took years to develop. Reversing the epidemic will require a long-term, well-coordinated, concerted approach to reach Americans where they live, work, play, and pray. Effective collaboration among the public, voluntary, and private sectors is critical to reshape the social and physical environment of our nation’s communities and provide the necessary support, information, tools, and realistic strategies needed to reverse the current obesity trends nationwide.
“To reduce consumer confusion about the myriad of health messages about obesity, diabetes, and cardiovascular disease, the Committee strongly urges CDC to design and develop mechanisms for fast-tracked translation of research into reasoned guidance for the American public. In addition, the Committee urges CDC to develop evidence-based recommendations on body fat measurement to be used in the evaluation of obesity prevention programs.
“Finally, the Committee supports research into the link between disadvantaged or physically and sexually abused youth, and obesity programs that target the physical health of children who have been abused and are in treatment programs. The CDC is encouraged to partner with organizations that treat or otherwise serve youth who have been abused in efforts to identify links between abuse and obesity and programs to address childhood obesity among this population.”
H.R. 3010 would provide $11.2 million for the VERB campaign, “a national multi-ethnic media campaign that promotes regular physical activity among youth ages 9-13.” According to the report, “The campaign was launched in June 2002. Evaluation results over the first two years show that the VERB campaign has contributed to higher levels of physical activity among targeted youth.”
The report states that the committee “is aware of the report issued by the Surgeon General on Bone Health and Osteoporosis requested in the fiscal year 2002 Appropriations bill. In the report, the Surgeon General calls for a national action plan for bone health. The Committee urges the CDC to consider supporting the development of an action plan and to ensure that all relevant federal agencies and public and private stakeholders, including the National Osteoporosis Foundation, be involved in the development of any such plan.”
The House Appropriations Committee “continues to be interested in pulmonary hypertension (PH), a rare, progressive and fatal disease that predominantly affects women, regardless of age or race. Because early detection of PH is critical to a patient’s survival and quality of life, the Committee continues to encourage CDC to work in partnership with the pulmonary hypertension community to foster greater awareness of the disease.”
The bill would provide $956.1 million for HIV/AIDS, sexually transmitted diseases (STDs), and tuberculosis prevention at the CDC, a decrease of $4.57 million below FY2005 and $145,000 less than the budget request. Of that amount, $123.9 million would be provided for global HIV/AIDS programs, $54,000 more than FY2005. In addition, $159.6 million would be provided for STD activities.
National Institutes of Health (NIH): The NIH would receive $28.52 billion in FY2006, $241.5 million more than FY2005 and $97 million above the administration’s request.
According to the report, “Breast cancer’s toll continues to threaten the lives and the quality of life of thousands of women. In addition to ongoing research activities underway at the [National Cancer] Institute, the Committee hopes that increased attention will also be given to areas of research that focus on helping women to more fully restore and improve their quality of life after treatment, including further research on lymphadema, stress, nutrition, exercise, weight, and environment.
“The Committee remains concerned about missed opportunities in breast cancer screening, detection, prevention, control, early diagnosis, and mammogram detection, reading and analysis. The Committee encourages NCI to further accelerate advances in breast cancer screening technology and to capitalize on existing…technologies that improve early diagnosis, health outcomes, and survival.”
The report also notes that the committee “remains concerned that survival rates associated with ovarian cancer have improved only slightly over the past 20 years. Ovarian cancer is the deadliest of all gynecological cancers. For all women diagnosed with ovarian cancer, the five-year survival rate is 45 percent. More than two-thirds of the women have advanced disease at the time of diagnosis, and for this group, the five-year survival rate is 29 percent. The Committee commends NCI for its recognition of the importance of studying this deadly women’s disease and appreciates the NCI’s recent investment that is helping to increase the understanding of the unique molecular pathways associated with ovarian cancer…The Committee encourages NCI to sustain and strengthen its commitment to and investment in ovarian cancer and maintain the specialized programs of research excellence (SPORE) initiatives directed toward ovarian cancer in fiscal year 2006.”
According to the report, “The Committee recognizes and applauds the significant work of HHS and its agencies in the area of tobacco and health, particularly recent efforts aimed at facilitating smoking cessation. The Committee believes it is important to continue to explore additional methods to reduce smoking-related mortality and morbidity in the 10 to 15 percent of the adult population who cannot or will not quit smoking.”
The committee “is encouraged by [the National Heart, Lung, and Blood Institute] NHLBI’s growing interest in scleroderma, a chronic and progressive disease that predominantly strikes women. Scleroderma is disfiguring and can be life-threatening, affecting multiple systems, including the heart and lungs. The Committee is pleased that NHLBI funded the Scleroderma Lung Study, a large multi-center trial whose focus is to find a therapy that may alter the course of the inflammation of the lungs that occurs in approximately 40 percent of those diagnosed with systemic scleroderma. The Committee also commends NHLBI for its commitment to finding a cause and improved therapies for pulmonary arterial hypertension. Pulmonary arterial hypertension occurs in approximately 50 percent of those diagnosed with systemic scleroderma. More research is needed to identify the causes of the complications of scleroderma that include pulmonary fibrosis, pulmonary hypertension, myocardial fibrosis, cardiac arrhythmias, pericarditis, and Raynaud’s Phenomenon.”
The report states that “Mycobacteria are environmental organisms found in both water and soil that can cause significant respiratory damage. The Committee is aware of the increasing incidence of nontuberculous mycobacteria (NTM) pulmonary infections in women, particularly involving rapidly growing mycobacteria, an inherently resistant subspecies. The Committee encourages NHLBI to collaborate with [the National Institute of Allergy and Infectious Diseases] NIAID and other institutes leading to a better understanding of NTM and enhancing diagnostics and treatment and promoting appropriate education of health care providers.”
The committee “remains very interested in efforts to find a cure for [lymphangioleiomyomatosis] LAM, a progressive and often fatal lung disease of women with no effective treatment. The Committee understands that very recent scientific findings have presented new treatment approaches for clinical testing, and that experimental trials with the drug sirolimus have begun. The Committee encourages NHLBI to explore opportunities for funding clinical treatment trials through both intramural and extramural means to use all available mechanisms as appropriate, including support of state-of-the-science symposia, request for applications, and facilitating access to human tissues, to stimulate a broad range of clinical and basic LAM research.”
The report indicates that the committee “is aware that research on saliva has progressed rapidly and holds the potential to be an inexpensive non-invasive diagnostic tool for early detection of breast cancer, osteoporosis, hepatitis, HIV, and Sjogren’s disease. The Committee encourages [the National Institute of Dental and Craniofacial Research] NIDCR to work cooperatively with NCI and other appropriate institutes in pursuing research initiatives on the development of saliva as a diagnostic tool.”
According to the report, “The Committee believes that the 2003 [National Institute of Diabetes and Digestive and Kidney Diseases] NIDDK-sponsored scientific symposium on [interstitial cystitis] IC was very successful and encourages NIDDK to convene a similar symposium on IC in 2006, collaborating with appropriate voluntary organizations. The Committee also encourages NIDDK to hold a separate meeting of leading international researchers involved in IC research to seek clarity on the definition of IC. The absence of a uniform definition which accurately captures the condition and the affected population is negatively affecting patients in terms of diagnosis and treatment as well as researchers in terms of literature review. The Committee was encouraged to learn that NIDDK is launching an IC awareness campaign and hopes that NIDDK will continue to work closely with the IC patient community on both developing the content and executing the campaign.”
The committee “encourages NIDDK to support research targeting new technologies and therapies to increase bone mass and combat osteoporosis through a focus on: 1) genetics, environmental and lifestyle factors, and 2) the effects of disease, in order to address the research questions highlighted in the Surgeon General’s Report on Bone Health and Osteoporosis.”
The report states that the committee “strongly encourages [the National Institute of Neurological Disorders and Stroke] NINDS to enhance research to address issues related to the outcome and recommendations of the 2003 Spina Bifida Research Conference. NINDS is urged to strengthen and prioritize research efforts in the prevention and treatment of spina bifida and associated secondary conditions, with a particular focus on improved treatment of hydrocephalus.”
The report notes that “last year, the National Center for Health Statistics reported the first increase in the U.S. infant mortality rate since 1958, and 61% of this increase was due to an increase in the birth of premature and low birthweight babies. The Committee is pleased that [the National Institute of Child Health and Human Development] NICHD is one of the sponsors of an Institute of Medicine study now underway to define and address the health-related and economic consequences of premature birth and encourages NICHD to develop a plan to implement the study’s recommendations once they are available.”
The committee “applauds NICHD efforts in addressing stillbirth, a major public health issue with morbidity equal to that of all infant deaths. The Committee understands that NICHD has established a cooperative network of clinical centers and a data center to address this issue with a standard protocol. The Committee encourages NICHD to strongly support this effort.”
According to the report, the committee “recognizes the efforts of NICHD, through its maternal fetal medicine units network (MFMU) to achieve a greater understanding of…effective treatments for the prevention of pre-term births, low birthweight infants, and medical complications during pregnancy such as pregnancy-related hypertension and diabetes. The Committee is pleased to learn that NICHD is proceeding with a competitive renewal of the MFMU network in 2006 and encourages a sustained research investment in this program to facilitate resolution of these problems and promote the birth of healthy infants.”
The report states that the committee “notes that infertility is a disease which affects over six million people in the United States and is concerned that the number appears to be growing as age, lifestyle, and environmental factors increasingly impact reproductive health outcomes. The Committee suggests that NICHD conduct additional research to improve reproductive health intervention outcomes.”
The committee “encourages studies on quality of life in patients with osteoporosis before and after treatment, and strategies for optimizing treatment of frail nursing home patients at high risk of osteoporotic fracture. The Committee also encourages [the National Institute on Aging] NIA to expand research on the role of environmental and lifestyle factors associated with osteoporosis and Paget’s disease and to work in conjunction with [the National Institute of Arthritis and Musculoskeletal and Skin Diseases] NIAMS on models for Paget’s disease.”
According to the report, “The Committee is aware that the discovery of lupus susceptibility genes may be a prerequisite to developing exciting new therapies for lupus and ultimately a way to prevent and cure the disease. Advanced new technologies make finding these genes less expensive and more feasible than ever before. The Committee is also aware that new consortia within the lupus community have been formed to facilitate genetic research. The Committee urges the Institute to strengthen its work in support of the collection of DNA, serum, genotyping and subject information from lupus patients, their family members and healthy unrelated controls so that identification of the relevant genes can be explained.”
The report states that the Office of Research on Women’s Health (ORWH) “works in collaboration with the Institutes and Centers of NIH to promote and foster efforts to address gaps in knowledge related to women’s health through the enhancement and expansion of funded research and/or the initiation of new investigative studies. The ORWH is responsible for ensuring the inclusion of women in clinical research funded by NIH, including the development of a computerized tracking system and the implementation of guidelines on such inclusion. This Office is also involved in promoting programs to increase the number of women in biomedical science careers, and in the development of women’s health and sex and gender factors in biology as a focus of medical/scientific research.
“The Committee is pleased with the increased focus on irritable bowel syndrome (IBS) at the ORWH. It is estimated that between 25 and 45 million Americans, disproportionately women, suffer from IBS.”
The report notes that “since the late 1960s, bone marrow transplants and bone marrow stem cells have been used to treat cancer and blood diseases. In recent years, basic and clinical research has demonstrated the ability of adult stem cells to treat a broader range of diseases through regenerative medicine, including autoimmune diseases and tissue repair. The Committee urges NIH to place a high priority on investigating the plasticity and expansion of adult stem cells using more recently discovered multipotent adult stem cells from fat, dental pulp, heart, umbilical cord blood, and olfactory neurons. Clinical research, including FDA-approved treatment of Parkinson’s disease, ALS, diabetes, heart disease, and other diseases should be pursued vigorously as well.”
The committee “urges strengthened funding for microbicide research and development at NIH. In addition, the Committee has long advocated that NIAID establish a dedicated microbicide unit with clearly identified leadership to accelerate microbicide research. The Committee understands that NIAID has established the Microbicide Team in the Division of AIDS (DAIDS), which also coordinates a broader NIAID group with representatives from DAIDS and the Division of Microbiology and Infectious Diseases (DMID). The Office of AIDS Research, within the Office of the NIH Director, is continuing to coordinate microbicide research across NIH. Greater leadership and coordination on this issue is especially critical given that consideration is being given to the possibility of a microbicide-specific clinical trial network.
“There is an urgent need to expand the development pipeline with more microbicide candidate products, particularly those that target HIV in new ways. In addition to candidates that may arise from NIH-funded basic research efforts, possibilities may be found within pharmaceutical companies where there are potential compounds already developed as therapeutics that could be tested as potential microbicides. NIH has mechanisms in place to encourage partnerships among researchers in academia, government and the private sector. The Committee strongly urges the leadership at NIH to support the microbicide field by encouraging partnering with the pharmaceutical industry and non-governmental organizations. In the past year, the International Partnership for Microbicides has entered into agreements with leading pharmaceutical companies to jointly test and develop leading AIDS drugs as microbicides. More partnerships like these between the pharmaceutical industry and the non-profit community in collaboration with NIH will be critical, and should receive the active support of NIH leadership.”
According to the report, “Rett syndrome is a neurological disorder resulting from a mutated gene that is seen worldwide in mostly racial and ethnic groups, almost exclusively in females. It is estimated to occur in approximately one in fifteen thousand female births, although recent discoveries may reveal significantly more affected people than previously diagnosed. The Committee applauds NIH’s continued commitment to Rett syndrome research and encourages support for new animal models and genotype/phenotype investigations of Rett syndrome.”
The committee “encourages NIH to strengthen its work on psoriasis, a chronic, immune-mediated disease that affects between 5.8 and 7.5 million Americans. Safe and effective treatments for women of child-bearing age and for children are particularly lacking, and new research indicates mothers with psoriasis have a 50% increased risk of bearing a child with autism. New research also indicates psoriasis is twice as common among African Americans as previously believed. Psoriasis research involves many disciplines, and the Committee encourages NIH to intensify coordination of psoriasis research across its institutes and centers.”
The report states that the Surgeon General’s report on osteoporosis “comes at a critical time when the aging population of the United States faces an increasing burden of musculoskeletal disease and disability. Osteoporosis, which the report recognizes will affect one in two Americans over the age of 50 by 2020, will lead to disability, loss of independence and early mortality. The Surgeon General calls for a national action plan to achieve improved bone health. To this end, the Committee encourages NIH to establish a ‘Bone Health Research Blueprint’ to achieve the Surgeon General’s objectives through enhanced cooperation between NIH institutes. The Blueprint should place particular emphasis on osteoporosis, osteogenesis imperfecta, Paget’s disease, other metabolic bone diseases and rare bone disorders such as osteopetrosis.”
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA would receive $3.35 billion in FY2006, $39.7 million less than FY2005 and $16.02 million more than the budget request.
Center for Mental Health Services: H.R. 3010 would provide $858.5 million in FY2006 for mental health services, a $21 million decrease below FY2005 and $43 million above the administration’s request. The Mental Health Performance Partnership would be level-funded at $410.95 million as requested by President Bush.
According to the report, “The estimated number of AIDS cases from 1999 to 2003 has increased for racial and ethnic minorities, including African Americans, Latino/as, Asian Pacific/Islanders and American Indians/Alaska Natives. The Committee recognizes that many persons with HIV have a psychological disorder and that mental health and substance abuse services can help stabilize the health and well-being of persons with HIV/AIDS. The Committee acknowledges that racial and ethnic minorities have less access and lower utilization of mental health and substance abuse services. The Committee recommends that no less than the level provided in fiscal year 2005 be allocated for the Minority AIDS Initiative to provide competent and accessible mental health and substance abuse services to persons of color living with HIV/AIDS.”
Center for Substance Abuse Treatment: The measure would provide $2.1 billion for substance abuse treatment programs in FY2006. This allocation is $12.9 million less than FY2005 and $37.6 million less than the administration’s request.
The report states that the committee “is concerned about the incidence of drug addiction among pregnant and parenting women. The national treatment infrastructure has not kept pace with the demand or complexity of needs experienced by women and their children. Family-based substance abuse treatment, which addresses the needs of a parent, typically a mother, and her children, represents less than 6 percent of the overall treatment options available. The Committee believes that increased capacity for family-based treatment programs is imperative. Increased family treatment capacity ensures child well-being, family stabilization, and health communities.”
Agency for Healthcare Research and Quality (AHRQ): As requested by the administration, the bill would provide level funding of $318.7 million for AHRQ in FY2006. The report notes that the committee “supports the inter-agency agreement between AHRQ and the National Center on Birth Defects and Development Disabilities at CDC to examine clinical treatment and improve quality of care of patients with spina bifida.”
The report also states, “Despite the Healthy People 2010 recommendation to decrease primary cesarean section rates to 15 percent and repeat cesarean section rates to 63 percent, the Committee is aware that rates of primary elective cesarean section are progressively increasing and that vaginal birth after cesarean rates are steadily decreasing. The Committee encourages AHRQ to conduct a comprehensive meta-analysis of the best available research studies comparing short- and long-term risks for mothers and babies of cesarean versus vaginal birth and requests that AHRQ report back to the Committee with this information next year.”
Administration for Children and Families
Child Care and Development Block Grant (CCDBG): Under the bill, the CCDBG would be level-funded at $2.08 billion in FY2006 as requested by President Bush.
Social Services Block Grant: As requested by the administration, the Social Services Block Grant also would be level-funded at $1.7 billion in FY2006.
Child Support Enforcement: H.R. 3010 would allocate $4.19 billion for payments to states for child support enforcement and family support programs. This amount is $119.35 million less than FY2005 and equal to the administration’s request.
International Trafficking: Under the Refugee and Entrant assistance account, a program to aid victims of trafficking would be level-funded at $9.92 million in FY2006 as requested by the administration.
Unaccompanied Minors: The measure would provide $63.1 million for the unaccompanied minors program, $9.3 million more than FY2005 and equal to the budget request.
Child and Family Services Programs: Head Start would receive a $55.89 million increase over FY2005, bringing the total to $6.9 billion. This amount is $336,000 less than the administration’s request.
Consolidated runaway and homeless youth programs would receive $88.73 million in FY2006, $4 million more than FY2005 and equal to the administration’s request. The bill does not include the administration’s request of $10 million for maternity group homes.
According to the report, “It is the Committee’s continued expectation that current transitional living program grantees will continue to provide transitional living opportunities and supports to pregnant and parenting homeless youth, as is their current practice. To further ensure that pregnant and parenting homeless youth are able to access transitional living opportunities and supports in their communities, the Committee encourages the Secretary, acting through the network of federally funded runaway and homeless youth training and technical assistance providers, to offer guidance to grantees and others on the programmatic modifications required to address the unique needs of pregnant and parenting youth and on the various sources of funding available for residential services to this population.”
As requested by President Bush, H.R. 3010 would provide level funding of $42.9 million in FY2006 for child abuse and neglect treatment and prevention activities.
Programs to increase abandoned infant assistance would be level-funded at $12 million in FY2006 as requested by the administration.
The bill would provide level funding of $289.65 million for child welfare services in FY2006, equal to the administration’s request.
Adoption: The measure would provide level funding of $27.12 million for adoption opportunities, $31.85 million for adoption incentives, and $12.8 million for adoption awareness programs. All funding levels are equal to the administration’s request.
Mentoring Children of Prisoners: As requested by the administration, the Mentoring Children of Prisoners program would receive $50 million in FY2006, $395,000 more than FY2005.
Promoting Safe and Stable Families: H.R. 3010 would provide level funding of $305 million for the Promoting Safe and Stable Families program in FY2006, equal to the administration’s request.
Violence Against Women Act (VAWA): The National Domestic Violence Hotline would receive $3 million in FY2006, $224,000 less than FY2005 and equal to the administration’s request. In addition, battered women’s shelters would receive $126 million as requested by the administration. This amount is $361,000 more than FY2005.
Abstinence-only Education: The bill would provide $110 million for the abstinence education program in FY2006, $10.8 million more than FY2005, but $28.05 million less than the administration’s request.
Administration on Aging: The Administration on Aging’s National Family Caregiver Support program would be level-funded at $162.05 million in FY2006, equal to the administration’s request.
Office of the Secretary
Public Health Service’s Office on Women’s Health: The Office on Women’s Health would receive $28.72 million in FY2006, $103,000 less than FY2005 and equal to the administration’s request.
Public Health Service’s Office of Minority Health: As requested by the administration, the measure would provide $47.24 million for the Office of Minority Health, $3.29 million above the FY2005 level. The report states that the committee “is committed to ensuring the overall improved health of the American people, and encourages the Secretary to intensify HHS efforts to work to implement recommendations developed by the Institute of Medicine’s Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care study. The recommendations offer significant guidelines and opportunities for eliminating health disparities and improving health across all populations.”
Minority HIV/AIDS: As requested by President Bush, H.R. 3010 would provide level funding of $52.42 million for minority HIV/AIDS prevention and treatment activities.
Adolescent Family Life: The Adolescent Family Life program would receive $30.74 million in FY2006, $158,000 less than FY2005 and equal to the administration’s request.
Afghanistan: Health care assistance for Afghanistan would be level-funded at $5.95 million in FY2006, equal to the budget request. The report states that the funding “will be used for the joint Department of Defense and HHS initiative to improve the largest women’s hospital in Kabul, Afghanistan and to create four satellite teaching clinics.”
Embryo Adoption Awareness Campaign: Under the bill, level funding of $992,000 would be provided for the embryo adoption awareness campaign as requested by the administration.
Office of Population Affairs: According to the report, “The Committee is concerned by reports that the State Attorneys General in several states are requesting records to determine any role family planning providers may have had in failing to report criminal activity such as statutory rape. The [Labor, Health and Human Services, and Education] appropriations bill has had a longstanding provision…making clear that no family planning provider is exempt from any State law requiring notification or reporting of child abuse, child molestation, sexual abuse, rape or incest. The Committee directs the Office of Population Affairs to send Title X grantees a reminder notification of this Federal requirement. In addition, the Committee requests the Secretary to conduct an audit of a sample of Title X recipients to determine compliance with mandatory reporting requirements.”
Obesity: The committee “notes the serious nature of rising obesity rates, especially among girls in underrepresented populations or geographic areas where higher obesity rates prevail. The Committee further recognizes the multi-institutional effort that is needed to attack the obesity problem in America and ensure that children and teens make healthy choices. The Committee understands that the Girls Scouts of the USA has begun a Healthy Living Initiative, which may be able to reach many of its members and their families with a healthy living, balanced lifestyle message to address obesity and other risky behaviors. The Committee encourages HHS to actively partner with organizations such as the Girl Scouts of the USA to promote the Department’s obesity and wellness initiatives.”
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 $12.84 billion in FY2006, $100 million more than FY2005, but $502.74 million less than the administration’s request.
William F. Goodling Even Start Family Literacy Program: H.R. 3010 would provide $200 million for the Even Start program in FY2006, a $25.1 million decrease below the FY2005 level. Under the administration’s budget request, the program would not have been funded.
Reading First and Early Reading First: The measure would level fund the Reading First program at $1.04 billion in FY2006 as requested by the administration. In addition, the Early Reading First program would be level-funded at $104.2 million, also equal to the administration’s request.
High School Intervention: No funding would be provided for a proposed high school intervention initiative. The administration requested $1.24 billion for the program in FY2006. According to the report, “The Committee supports the Administration’s goals in this program, which are to increase the achievement of high school students, particularly students at risk of failing to meet challenging State academic content standards; eliminate gaps in achievement between students from different ethnic and racial groups and between disadvantaged students and their more advantaged peers; and enable all high school students to graduate with the education, skills, and knowledge necessary to succeed in postsecondary education and in a demanding high-technology economy. However, the Committee notes that this program has not been authorized.”
Teacher Quality: Under the bill, level funding of $2.92 billion would be provided for teacher professional development programs in FY2006 as requested by the administration. The bill would provide level funding of $44.93 million for the Transition to Teaching program to assist eligible members of the armed forces and mid-career professionals to obtain certification as teachers. This amount is equal to the administration’s request. In addition, the Math and Science Partnerships would be funded at $190 million in FY2006, an $11.4 million increase over FY2005, but $79 million less than the budget request.
21st Century Community Learning Centers: As requested by the administration, H.R. 3010 would provide level funding of $991.1 million in FY2006 for 21st Century Community Learning Centers.
Individuals with Disabilities Education Act (IDEA): Total spending for special education would be $11.81 billion in FY2006, a $140.2 million increase over FY2005, but $312.35 million less than the administration’s request.
Education for Homeless Children and Youth: Under the bill, level funding of $62.5 million would be provided for education for homeless children and youth, equal to the administration’s request.
Vocational Education: The measure would provide $1.31 billion for vocational education in FY2006, $14.21 million less than FY2005. Under the administration’s budget request, the program would not have been funded.
Adult Education: In FY2006, funding for adult education would be level-funded at $585.41 million, a $369.67 million increase over the administration’s request.
Pell Grants: H.R. 3010 would provide $13.38 billion for Pell Grants in FY2006, $1.02 billion more than FY2005 and $184 million above the budget request. The maximum Pell Grant would be $4,100, $50 more than FY2005, but $50 less than the amount requested by President Bush.
Minority Science and Engineering Improvement: As requested by the administration, the Minority Science and Engineering Improvement Program would be level-funded at $8.82 million in FY2006.
Child Care Access Means Parents in School (CCAMPIS): Funding for the CCAMPIS program would be level-funded at $15.97 million as requested by the administration.
Office for Civil Rights: The measure would provide $91.53 million in FY2006 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 $2.15 million more than FY2005 and equal to the budget request.
House Committee Action
Foreign Operations, Export Financing and Related Agencies
On June 21, the House Appropriations Committee approved, by voice vote, the FY2006 Foreign Operations, Export Financing and Related Agencies spending bill (as-yet-unnumbered). A House Appropriations subcommittee approved the bill on June 16 (see The Source, 6/17/05).
The measure would allocate $20.27 billion in FY2006, a $730 million increase over FY2005, but $2.55 billion less than the administration’s request.
While all of the funding levels for programs of particular interest to women and their families were not available at press time, the following are highlights from the bill:
The measure would provide $2.7 billion in FY2006 for HIV/AIDS prevention activities, $502 million more than FY2005 and $131 million above the budget request. The total would include $400 million for the Global Fund to Fight AIDS, Tuberculosis, and Malaria, $62.2 million above FY2005 and $200 million more than the amount requested by President Bush.
Under the bill, $432 million would be included for international family planning programs in FY2006. This amount is $9 million less than FY2005 and $7 million more than the administration’s request. In FY2006, the UNFPA would receive level funding of $34 million, $9 million above the budget request. The administration has blocked the release of all UNFPA funds in FY2002 through FY2004. At this time, it remains unclear as to whether the FY2005 funds will be released.
The measure would provide $1.75 billion for the Millennium Challenge Corporation, $262 million more than FY2005, but $1.25 billion below the administration’s request.
The Peace Corps would receive $325 million in FY2006, an $8 million increase over FY2005, but $20 million less than the amount requested by President Bush.
Finally, the bill would provide $69 million for the Darfur region of Sudan.
During consideration of the bill, the committee approved, by voice vote, an amendment by Rep. David Obey (D-WI) that would earmark $50 million of the funds provided for economic assistance to Egypt for programs that promote democracy and human rights, and an additional $50 million for basic education and the promotion of academic freedom in higher education in Egypt.
Transportation, Treasury, Housing and Urban Development, the Judiciary, and the District of Columbia
On June 21, the House Appropriations Committee approved, by voice vote, the FY2006 Transportation, Treasury, Housing and Urban Development, the Judiciary, and the District of Columbia spending bill (as-yet-unnumbered). A House Appropriations subcommittee approved the bill on June 15 (see The Source, 6/17/05).
The measure would allocate $66.94 billion in FY2006, a $3.76 billion increase over FY2005 and $6.23 billion more than the administration’s request.
Department of Transportation
The bill includes funding for job access and reverse commute grants, which are used to aid welfare-to-work recipients who live in “urbanized areas with populations greater than 200,000” and have transportation costs associated with their jobs. In addition, the measure provides funding for the Minority Business Resource Center, funding for minority business outreach, and funding for the Occupant Protection Incentive Grants. More details will be made available when the House Appropriations Committee files its report on the measure.
Department of Housing and Urban Development (HUD)
Under the bill, $1.34 billion would be provided for homeless programs, $100 million more than FY2005, but $60 million less than the budget request.
In FY2006, the Housing Opportunities for Persons with AIDS program would receive $285 million. This amount is $3 million above FY2005 and $17 million more than the amount requested by President Bush.
The measure would include $15.53 billion for Section 8 voucher renewals, $765 million more than FY2005, but $314 million below the administration’s request.
The bill would provide no funding for the Youthbuild program. Under the administration’s budget request, the Youthbuild program would be transferred from HUD to the Department of Labor. The program received $62 million in FY2005.
District of Columbia
The measure would allocate $604 million for the District of Columbia in FY2006, a $48 million increase over FY2005 and $30.6 million more than the budget request.
As requested by the administration, the bill would provide $221.7 million in FY2006 for the operation of the D.C. Courts, $32.5 million more than the FY2005 level. The total would include funding for the Family Court, which handles all cases in the District pertaining to child abuse and neglect, domestic violence, adoption, and foster care.
In FY2006, $41.6 million would be included for D.C. schools. This amount is $1.9 million more than FY2005 and equal to the administration’s request.
Included in the bill is a provision that would maintain current law prohibiting the use of federal funds to implement a D.C. law that permits municipal employees to purchase health insurance benefits for their domestic partners, regardless of gender or marital status.
The bill also would maintain current law with respect to the prohibition on the use of local and federal funds for abortion coverage for low-income women on Medicaid. Exceptions for abortion coverage would be made in cases of rape, incest, or life endangerment.
In addition, the measure would maintain current law prohibiting the use of local and federal funds for a needle exchange program.
Office of National Drug Control Policy
The bill would provide level funding of $120 million in FY2006 for the National Youth Anti-Drug Media Campaign.
Finally, the measure would maintain current law requiring health plans participating in the Federal Employees Health Benefits Program (FEHBP) to cover prescription contraceptives if they cover other prescription drugs. Physicians and others who provide contraceptives are exempted from the requirement if they object based on religious beliefs. Religiously affiliated health plans also are exempt. Additionally, the measure would prohibit abortion coverage under FEHBP, except when the life of the mother is endangered or in the case of rape or incest.
During consideration of the bill, Rep. John Olver (D-MA) offered an amendment that would have provided an additional $250 million for Amtrak, $250 million for the Community Development Block Grant, and $62 million for the Youthbuild program. The increased funding would have been offset by a 6.1 percent tax cut reduction for individuals with annual incomes over $1 million. The amendment was defeated, 27-34.
The committee also rejected, 28-30, an amendment by Rep. Olver than would have included report language recommending an appropriation of $50 million for the Youthbuild program in FY2006.
